• The Journal of the Korean bone and joint tumor society
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• v.6 no.1
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• pp.10-16
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• 2000

Object : The aim of the current study is to assess the results of segmental resection and replantation for primary malignant or aggressive tumors of the upper limb. Materials and Methods : From 1986 to 1994, ten patients who had primary malignant or aggressive tumors of the upper limb were managed with segmental resection and replantation method. The average duration of follow-up was 7 years and 7 months. Primary indication of this method is stage II B tumors which, because of their extend, could otherwise be adequately treated only by amputation. Three patients had chondrosarcoma, two had osteosarcoma, two had giant cell tumors with pathologic fracture, one had extensive chondroblastoma, one had Ewings sarcoma, and one had leiomyosarcoma. The location of the tumor was humerus in 6 patients, scapula in 3 patients, and soft tissue of forearm in 1 patient. Wide resection margins were achieved in 7 patients and marginal margin in three. Results : One patient died on 40 months after surgery due to systemic metastasis. Nine patients have remained disease free without local recurrence or metastasis. The average overall functional rating was 65% (43~90%) for ten patients on the last follow-up by the functional rating system of Enneking. The mean grasping power and pinching power of operative hand was 75%(28~95%) and 65%(43~90%) of the opposite hand, respectively. Complications associated with this surgical method included three wound dehiscences and one nerve injury that resolved with proper wound care and time. Conclusion : It was concluded that segmental resection and replantation might be used for partial limb salvage in selected cases for the treatment of primary malignant or aggressive tumors of the upper limb.

• Research in Community and Public Health Nursing
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• v.13 no.1
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• pp.182-196
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• 2002

The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.591-597
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• 2008

Background: Pulmonary endarterectomy is widely accepted as a treatment for chronic thromboembolic pulmonary hypertension. Based on our experiences, we sought to find ways to reduce perioperative complications and to improve surgical outcomes in patients undergoing pulmonary endarterectomy. Material and Method: This study was designed as a retrospective analysis of 20 patients with pulmonary hypertension who underwent pulmonary endarterectomy between January 1998 and March 2008. All patients presented with chronic dyspnea. Deep vein thrombosis (DVT) was the major cause of chronic pulmonary thromboembolism (55%). Seventeen patients (85%) underwent inferior vena cava (IVC) filter placement. Thirteen patients underwent surgery under total circulatory arrest, while the others underwent surgery while on low flow cardiopulmonary bypass. Concomitant tricuspid annuloplasty was done in 6 patients (66%) whose tricuspid regurgitation was as severe as grade IV/IV. The mean follow-up duration was $45{\pm}32$ months. Result: Using of University of California, San Diego (UCSD), thromboembolism classification, 4 patients (20%) were type 1, 8 patients (40%) were type II, and 8 patients (40%) were type III. Right ventricular systolic pressure was reduced significantly from $77{\pm}29$ mmHg to $37{\pm}19$ mmHg after pulmonary endarterectomy (p<0.001). The degree of tricuspid regurgitation and the NYHA functional class were all improved postoperatively. Reperfusion edema occurred in 7 cases (35%). The incidence of reperfusion edema was higher in the UCSD type III group than in the other group (25% vs 50%, p=0.25) and the length of postoperative intensive care unit stay was longer in type III group ($5{\pm}2$ days vs $9{\pm}7$ days, p=0.07). The early mortality rate was 10%, and the late mortality rate was 15% (n=3); one death was due to progression of underlying non-Hodgkin's lymphoma, and the other deaths were related to recurrent thromboembolism and persistent pulmonary hypertension, respectively. Conclusion: Pulmonary endarterectomy, as a curative surgical method for treating chronic thromboernbolic pulmonary hypertension, should be performed aggressively in patients diagnosed with chronic thromboembolic pulmonary hypertension, and an effort should be made to reduce the frequency of perioperative complications and to improve surgical outcomes.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.77-84
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• 2012

Purpose: To develop a geometrical quality control real-time analysis program using an electronic portal imaging to replace film evaluation method. Materials and Methods: A geometrical quality control item was established with the Eclipse treatment planning system (Version 8.1, Varian, USA) after the Electronic Portal Imaging Device (EPID) took care of the problems occurring from the fixed substructure of the linear accelerator (CL-iX, Varian, USA). Electronic portal image (single exposure before plan) was created at the treatment room's 4DTC (Version 10.2, Varian, USA) and a beam was irradiated in accordance with each item. The gaining the entire electronic portal imaging at the Off-line review and was evaluated by a self-developed geometrical quality control real-time analysis program. As for evaluation methods, the intra-fraction error was analyzed by executing 5 times in a row under identical conditions and procedures on the same day, and in order to confirm the infer-fraction error, it was executed for 10 days under identical conditions of all procedures and was compared with the film evaluation method using an Iso-align$^{TM}$ quality control device. Measurement and analysis time was measured by sorting the time into from the device setup to data achievement and the time amount after the time until the completion of analysis and the convenience of the users and execution processes were compared. Results: The intra-fraction error values for each average 0.1, 0.2, 0.3, 0.2 mm at light-radiation field coincidence, collimator rotation axis, couch rotation axis and gantry rotation axis. By checking the infer-fraction error through 10 days of continuous quality control, the error values obtained were average 1.7, 1.4, 0.7, 1.1 mm for each item. Also, the measurement times were average 36 minutes, 15 minutes for the film evaluation method and electronic portal imaging system, and the analysis times were average 30 minutes, 22 minutes. Conclusion: When conducting a geometrical quality control using an electronic portal imaging, it was found that it is efficient as a quality control tool. It not only reduces costs through not using films, but also reduces the measurement and analysis time which enhances user convenience and can improve the execution process by leaving out film developing procedures etc. Also, images done with evaluation from the self-developed geometrical quality control real-time analysis program, data processing is capable which supports the storage of information.

• Journal of Intelligence and Information Systems
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• v.26 no.1
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• pp.23-45
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• 2020

Big data is creating in a wide variety of fields such as medical care, manufacturing, logistics, sales site, SNS, and the dataset characteristics are also diverse. In order to secure the competitiveness of companies, it is necessary to improve decision-making capacity using a classification algorithm. However, most of them do not have sufficient knowledge on what kind of classification algorithm is appropriate for a specific problem area. In other words, determining which classification algorithm is appropriate depending on the characteristics of the dataset was has been a task that required expertise and effort. This is because the relationship between the characteristics of datasets (called meta-features) and the performance of classification algorithms has not been fully understood. Moreover, there has been little research on meta-features reflecting the characteristics of multi-class. Therefore, the purpose of this study is to empirically analyze whether meta-features of multi-class datasets have a significant effect on the performance of classification algorithms. In this study, meta-features of multi-class datasets were identified into two factors, (the data structure and the data complexity,) and seven representative meta-features were selected. Among those, we included the Herfindahl-Hirschman Index (HHI), originally a market concentration measurement index, in the meta-features to replace IR(Imbalanced Ratio). Also, we developed a new index called Reverse ReLU Silhouette Score into the meta-feature set. Among the UCI Machine Learning Repository data, six representative datasets (Balance Scale, PageBlocks, Car Evaluation, User Knowledge-Modeling, Wine Quality(red), Contraceptive Method Choice) were selected. The class of each dataset was classified by using the classification algorithms (KNN, Logistic Regression, Nave Bayes, Random Forest, and SVM) selected in the study. For each dataset, we applied 10-fold cross validation method. 10% to 100% oversampling method is applied for each fold and meta-features of the dataset is measured. The meta-features selected are HHI, Number of Classes, Number of Features, Entropy, Reverse ReLU Silhouette Score, Nonlinearity of Linear Classifier, Hub Score. F1-score was selected as the dependent variable. As a result, the results of this study showed that the six meta-features including Reverse ReLU Silhouette Score and HHI proposed in this study have a significant effect on the classification performance. (1) The meta-features HHI proposed in this study was significant in the classification performance. (2) The number of variables has a significant effect on the classification performance, unlike the number of classes, but it has a positive effect. (3) The number of classes has a negative effect on the performance of classification. (4) Entropy has a significant effect on the performance of classification. (5) The Reverse ReLU Silhouette Score also significantly affects the classification performance at a significant level of 0.01. (6) The nonlinearity of linear classifiers has a significant negative effect on classification performance. In addition, the results of the analysis by the classification algorithms were also consistent. In the regression analysis by classification algorithm, Naïve Bayes algorithm does not have a significant effect on the number of variables unlike other classification algorithms. This study has two theoretical contributions: (1) two new meta-features (HHI, Reverse ReLU Silhouette score) was proved to be significant. (2) The effects of data characteristics on the performance of classification were investigated using meta-features. The practical contribution points (1) can be utilized in the development of classification algorithm recommendation system according to the characteristics of datasets. (2) Many data scientists are often testing by adjusting the parameters of the algorithm to find the optimal algorithm for the situation because the characteristics of the data are different. In this process, excessive waste of resources occurs due to hardware, cost, time, and manpower. This study is expected to be useful for machine learning, data mining researchers, practitioners, and machine learning-based system developers. The composition of this study consists of introduction, related research, research model, experiment, conclusion and discussion.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.29 no.4
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• pp.1-13
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• 2011

The purpose of this study is to consider practical examples of the method of utilizing plant material 'lotus' used by the ancients, and the value and meaning they wanted to get from it. The method of this study to do this is descriptive study to consider and interpret poem and painting reflecting impression and concept world of lotus. Summary of this study is as follows. First, ornamental value of lotus could be divided in effect of group plant and detail value held by the flower, the leaves and the stem. Especially, group plant lotus in large site provides unique landscape differentiated form other flowering plants. As well, another feature of lotus is its high ornamental value spread in detail elements including the flower, the leaves, the stem and the lotus seed. Second, fragrance expressed 'Hyang-won-ik-cheong(香遠益淸)' is an important charm of lotus. Lotus was utilized as olfactory element providing fragrance. The ancients considered lotus fragrance not only for enjoy but as symbolic object comparing noble man's dignity so that they expressed it in poem and painting. Third, lotus was utilized as acoustical element. That is, the sound of raindrops harmonizing the surface of water and wide lotus leaves was called 'hearing lotus fond and rain', enjoying it as classic grace. Fourth, summer play lotus sightseeing was called mind wash up meaning 'washing the mind polluted by the mundane world'. Such poetic taste was widely enjoyed by various classes from general public to royal family. Besides, poetic taste related with lotus is the method of drinking alcohol using the feature of big lotus leave and vacant stem, called 'Beog-tong-ju(碧筒酒)'. And in the Joseon dynasty period, when the distinction between the man and the woman influenced by Confucian, lotus seed and 'lotus collecting song' was important sign to express romance between man and woman. Lotus has been enamored by wide classes transcending cultural background as thought and religion since ancient times. Due to such reasons, various symbolic meaning of lotus and planting examples related to religious facilities as temples could not be considered in various manner is limitation of this study, and which is research project for the future.

• The Korean Journal of Nuclear Medicine
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• v.1 no.1
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• pp.55-66
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• 1967

In view of its prevalence in the Far East area, a more detailed knowledge on the hookworm infection is one of the very important medical problems. The present study was aimed to; determine the infectivity of the artificially hatched ancylostoma duodenale larvae in man after its oral administration, evaluate the clinical symptomatology of such infection, determine the date of first appearance of the ova in the stool, calculate the blood loss per worm per day, assess the relation-ships between the ova count, infectivity(worm load), blood loss and severity of anemia. An erythrokinetic study was also done to analyse the characteristics of hookworm anemia by means of $^{59}Fe\;and\;^{51}Cr$. Materials and Methods Ten healthy male volunteers(doctors, medical students and laboratory technicians) with the ages ranging from 21 to 40 years were selected as the experimental materials. They had no history of hookworm infection for preceding several years, and care was taken not to be exposed to reinfection. A baseline study including a through physical examinations and laboratory investigations such as complete blood counts, stool examination and estimation of the serum iron levels was done, and a vermifuge, bephenium hydroxynaphoate, was given 10 days prior to the main experiment. The ancylostoma duodenale filariform larvae were obtained in the following manner; The pure ancylostoma duodenale ova were obtained from the hookworm anemia patients and a modified filter paper method was adopted to harvest larger number of infective larvae, which were washed several times with saline. The actively moving mature larvae were put into the gelatine capsules, 150 in each, and were given to the volunteers in the fasting state with 300ml. of water. The volunteers were previously treated with intramuscular injection of 15mg. of chlorpromazine in order to prevent the eventual nausea and vomiting after the larvae intake. The clinical symptoms and signs mainly of the respiratory and gastrointestinal tracts, appearance of the ova and occult blood in the stool etc. were checked every day for the first 20 days and then twice weekly until the end of the experiment, which usually lasted for about 3 months. Roentgenological survey of the lungs was also done. The hematological changes such as the red blood cell, white blood cell and eosinophil cell counts, hemoglobin content and serum iron levels were studied. The appearance of the ova in the stool was examined by the formalin ether method and the ova were counted in triplicate on two successive days using the Stoll's dilution method. The ferrokinetic data were calculated by the modified Huff's method and the apparent half survival time of the red blood cells by the modified Gray's method. The isotopes were simultaneously tagged and injected intravenously, and then the stool and blood samples were collected as was described by Roche et al., namely, three separate 4-day stool samples with the blood sample drawing before each 4-day stool collection. The radio-activities of the stools ashfied and the blood were separately measured by the pulse-height analyser. The daily blood loss was calculated with the following formula; daily blood loss in $ml.=\frac{cpm/g\;stool{\times}weight\;in\;g\;of\;4-day\;stool}{cpm/ml\;blood{\times}4}$ The average of these three 4-day periods was given as the daily blood loss in each patient. The blood loss per day per worm was calculated by simply dividing the daily blood loss by the number of the hookworm recovered after the vermifuge given twice a week at the termination of the experiment. The iron loss in mg. through the gastrointestinal tract was estimated with the daily iron loss in $mg=\frac{g\;Hgb/100ml{\times}ml\;daily\;blood\;loss{\times}3.40}{100}$ 3.40=mg of iron per g Hgb following formula; Results 1. The respiratory symptoms such as cough and sputum were noted in almost all cases within a week after the infection, which lasted about 2 weeks. The roentgenological findings of the chest were essentially normal. A moderate degree of febril reaction appeared within 2 weeks with a duration of 3 or 4 days. 2. The gastrointestinal symptoms such as nausea, epigastric fullness, abdominal pain and loose bowel appeared in all cases immediately after the larvae intake. 3. The reduction of the red blood cell count was not remarkable, however, the hemoglobin content and especially the serum iron level showed the steady decreases until the end of the experiment. 4. The white blood cells and eosinophil cells, on the contrary, showed increases in parallel and reached peaks in 20 to 30 days after the infection. A small secondary rise was noted in 2 months. 5. The ova first appeared in the stool in 40. 1 days after the infection, ranging from 29 to 51 days, during which the occult blood reaction of the stool became also positive in almost cases. 6. The number of ova recovered per day was 164, 320 on the average, ranging from 89,500 to 253,800. The number of the worm evacuated by vermifuge was in rough correlation with the number of ova recovered. 7. The infectivity of ancylostoma duodenale was 14% on the average, ranging from 7.3 to 20.0%, which is relatively lower than those reported by other workers. 8. The mean fecal blood loss was 5.78ml. per day, with a range of from 2.6 to 11.7ml., and the mean blood loss per worm per day was 0.30ml., with a range of from 0.13 to 0.73ml., which is in rough coincidence with those reported by other authors. There appeared to exist, however, no correlation between the blood loss and the number of ova recovered. 9. The mean fecal iron loss was 2.02mg. per day, with a range of from 1.20 to 3.89mg., which is less than those appeared in the literature. 10. The mean plasma iron disappearance rate was 0.80hr., with a range of from 0.62 to 0.95hr., namely, a slight accerelation. 11. The hookworm anemia appeared to be iron deficiency in origin caused by continuous intestinal blood loss.

• Journal of Intelligence and Information Systems
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• v.21 no.3
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• pp.1-17
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• 2015

In this paper, we report what we have observed with regards to a prediction model for the military based on enlisted men's internal(cumulative records) and external data(SNS data). This work is significant in the military's efforts to supervise them. In spite of their effort, many commanders have failed to prevent accidents by their subordinates. One of the important duties of officers' work is to take care of their subordinates in prevention unexpected accidents. However, it is hard to prevent accidents so we must attempt to determine a proper method. Our motivation for presenting this paper is to mate it possible to predict accidents using enlisted men's internal and external data. The biggest issue facing the military is the occurrence of accidents by enlisted men related to maladjustment and the relaxation of military discipline. The core method of preventing accidents by soldiers is to identify problems and manage them quickly. Commanders predict accidents by interviewing their soldiers and observing their surroundings. It requires considerable time and effort and results in a significant difference depending on the capabilities of the commanders. In this paper, we seek to predict accidents with objective data which can easily be obtained. Recently, records of enlisted men as well as SNS communication between commanders and soldiers, make it possible to predict and prevent accidents. This paper concerns the application of data mining to identify their interests, predict accidents and make use of internal and external data (SNS). We propose both a topic analysis and decision tree method. The study is conducted in two steps. First, topic analysis is conducted through the SNS of enlisted men. Second, the decision tree method is used to analyze the internal data with the results of the first analysis. The dependent variable for these analysis is the presence of any accidents. In order to analyze their SNS, we require tools such as text mining and topic analysis. We used SAS Enterprise Miner 12.1, which provides a text miner module. Our approach for finding their interests is composed of three main phases; collecting, topic analysis, and converting topic analysis results into points for using independent variables. In the first phase, we collect enlisted men's SNS data by commender's ID. After gathering unstructured SNS data, the topic analysis phase extracts issues from them. For simplicity, 5 topics(vacation, friends, stress, training, and sports) are extracted from 20,000 articles. In the third phase, using these 5 topics, we quantify them as personal points. After quantifying their topic, we include these results in independent variables which are composed of 15 internal data sets. Then, we make two decision trees. The first tree is composed of their internal data only. The second tree is composed of their external data(SNS) as well as their internal data. After that, we compare the results of misclassification from SAS E-miner. The first model's misclassification is 12.1%. On the other hand, second model's misclassification is 7.8%. This method predicts accidents with an accuracy of approximately 92%. The gap of the two models is 4.3%. Finally, we test if the difference between them is meaningful or not, using the McNemar test. The result of test is considered relevant.(p-value : 0.0003) This study has two limitations. First, the results of the experiments cannot be generalized, mainly because the experiment is limited to a small number of enlisted men's data. Additionally, various independent variables used in the decision tree model are used as categorical variables instead of continuous variables. So it suffers a loss of information. In spite of extensive efforts to provide prediction models for the military, commanders' predictions are accurate only when they have sufficient data about their subordinates. Our proposed methodology can provide support to decision-making in the military. This study is expected to contribute to the prevention of accidents in the military based on scientific analysis of enlisted men and proper management of them.

• Radiation Oncology Journal
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• v.22 no.3
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• pp.192-199
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• 2004

Purpose: To determine the patterns on evaluation and treatment in the patient with early breast cancer treated with conservative surgery and radiotherapy and to improve the radiotherapy techiniques, nationwide survey was peformed. Materials and Methods: A web-based database system for korean Patterns of Care Study (PCS) for 6 common cancers was developed. Two hundreds sixty-one randomly selected records of eligible patients treated between 1998$\~$1999 from 15 hospitals were reviewed. Results: The patients ages ranged from 24 to 85 years(median 45 years). Infiltrating ductal carcinoma was most common histologic type (88.9$\%$) followed by medullary carcinoma (4.2$\%$) and infiltrating lobular carcinoma (1.5$\%$). Pathologic T stage by AJCC was T1 in 59.7$\%$ of the casses, T2 in 29.5$\%$ of the cases, Tis in 8.8$\%$ of the cases. Axillary lymph node dissection was peformed I\in 91.2$\%$ of the cases and 69.7$\%$ were node negative. AJCC stage was 0 in 8.8$\%$ of the cases, stage I in 44.9$\%$ of the cases, stage IIa in 33.3$\%$ of the cases, and stage IIb in 8.4$\%$ of the cases. Estrogen and progesteron receptors were evaluated in 71.6$\%$, and 70.9$\%$ of the patients, respectively. Surgical methods of breast-conserving surgery was excision/lumpectomy in 37.2$\%$, wide excision in 11.5$\%$, quadrantectomy in 23$\%$ and partial mastectomy in 27.5$\%$ of the cases. A pathologically confirmed negative margin was obtained in 90.8$\%$ of the cases. Pathological margin was involved with tumor in 10 patients and margin was close (less than 2 mm) in 10 patients. All the patients except one recieved more than 90$\%$ of the planned radiotherapy dose. Radiotherapy volume was breast only In 88$\%$ of the cases, breast+supraclavicular fossa (SCL) in 5$\%$ of the cases, and breast+ SCL+ posterior axillary boost in 4.2%$\%$of the cases. Only one patient received isolated internal mammary lymph node irradiation. Used radiation beam was Co-60 in 8 cases, 4 MV X-ray in 115 cases, 6 MV X-ray in 125 cases, and 10 MV X-ray in 11 cases. The radiation dose to the whole breast was 45$\~$59.4 Gy (median 50.4) and boost dose was 8$\~$20 Gy (median 10 Gy). The total radiation dose delivered was 50.4$\~$70.4 Gy (median 60.4 Gy). Conclusion: There was no major deviation from current standard in the patterns of evaluation and treatment for the patients with early breast cancer treated with breast conservation method. Some varieties were identified in boost irradiation dose. Separate analysis for the datails of radiotherapy planning will be followed and the outcome of treatment is needed to evaluate the process.

• Journal of Internet Computing and Services
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• v.16 no.1
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• pp.47-55
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• 2015

Recently, the environment of a hospital information system is a trend to combine various SMART technologies. Accordingly, various smart devices, such as a smart phone, Tablet PC is utilized in the medical information system. Also, these environments consist of various applications executing on heterogeneous sensors, devices, systems and networks. In these hospital information system environment, applying a security service by traditional access control method cause a problems. Most of the existing security system uses the access control list structure. It is only permitted access defined by an access control matrix such as client name, service object method name. The major problem with the static approach cannot quickly adapt to changed situations. Hence, we needs to new security mechanisms which provides more flexible and can be easily adapted to various environments with very different security requirements. In addition, for addressing the changing of service medical treatment of the patient, the researching is needed. In this paper, we suggest a dynamic approach to medical information systems in smart mobile environments. We focus on how to access medical information systems according to dynamic access control methods based on the existence of the hospital's information system environments. The physical environments consist of a mobile x-ray imaging devices, dedicated mobile/general smart devices, PACS, EMR server and authorization server. The software environment was developed based on the .Net Framework for synchronization and monitoring services based on mobile X-ray imaging equipment Windows7 OS. And dedicated a smart device application, we implemented a dynamic access services through JSP and Java SDK is based on the Android OS. PACS and mobile X-ray image devices in hospital, medical information between the dedicated smart devices are based on the DICOM medical image standard information. In addition, EMR information is based on H7. In order to providing dynamic access control service, we classify the context of the patients according to conditions of bio-information such as oxygen saturation, heart rate, BP and body temperature etc. It shows event trace diagrams which divided into two parts like general situation, emergency situation. And, we designed the dynamic approach of the medical care information by authentication method. The authentication Information are contained ID/PWD, the roles, position and working hours, emergency certification codes for emergency patients. General situations of dynamic access control method may have access to medical information by the value of the authentication information. In the case of an emergency, was to have access to medical information by an emergency code, without the authentication information. And, we constructed the medical information integration database scheme that is consist medical information, patient, medical staff and medical image information according to medical information standards.y Finally, we show the usefulness of the dynamic access application service based on the smart devices for execution results of the proposed system according to patient contexts such as general and emergency situation. Especially, the proposed systems are providing effective medical information services with smart devices in emergency situation by dynamic access control methods. As results, we expect the proposed systems to be useful for u-hospital information systems and services.