• 한국컴퓨터정보학회논문지
• /
• 제25권2호
• /
• pp.93-103
• /
• 2020

원격 의료 정보 시스템(TMIS; Telecare Medical Information System)은 편리하고 빠른 헬스 케어(health-care) 서비스를 제공한다. 원격 의료 정보 시스템을 위한 안전하고 효율적인 인증 및 키 합의 기법은 전자 환자 기록(EPR; Electronic Patient Record)을 안전하게 보호하고, 헬스케어 종사자와 의료진이 신속하고 정확하게 임상 의사결정(clinical decision)을 할 수 있도록 도와준다. Giri 등은 원격 의료 정보 시스템을 위한 스마트 카드(smart card)를 이용한 RSA기반 원격 사용자 인증 기법을 제안하였으며, 제안한 기법이 다양한 악의적인 공격에 강인하다고 주장하였다. 본 논문에서는 그들의 기법이 여전히 스마트 카드 분실 공격(lost smart card attack)과 재전송 공격(replay attack)에 취약함을 보이고, 그러한 단점을 개선한 기법을 제안한다. 기존의 원격 의료 정보 시스템을 위한 인증 기법들과 안전성을 비교한 결과를 보면, 제안한 기법이 더욱 안전하고 실용적이다.

• 대한전기학회논문지:전기물성ㆍ응용부문C
• /
• 제54권8호
• /
• pp.378-383
• /
• 2005

We report the development of miniature fluorescence detection systems that employ miniature prism, mirrors and low coat CCD camera to detect the fluorescence emitted from 40 fluorescently-labeled protein patterns without scanner. This kind of miniature fluorescence detection system can be used in point of care. We introduce two systems, one uses prism+mirror block and the other uses prism and two mirrors. A large NA microscope eyepiece and low cost CCD camera are used. We fabricated protein chip containing multi-pattern BSA labeled with Cy5, using MEMS technology and modified the surface chemically to clean and to immobilize proteins. The measurements show that the combination of prism and mirrors can homogenize elliptical excitation light over the sample with higher optical efficiency, and increase the separation between excitation and fluorescence light at the CCD to give higher signal intensity and higher signal to noise ratio. The measurements also show that protein concentrations ranging from 10 ng/ml to 1000 ng/ml can be assayed with very small error. We believe that the proposed fluorescence detection system can be refined to build a commercially valuable hand-held or miniature detection device.

• 대한응급의학회지
• /
• 제29권6호
• /
• pp.663-670
• /
• 2018

Objective: Radio-contrast abdomino-pelvic computed tomography (APCT) is considered the gold standard diagnostic tool for an acute abdomen in the emergency department. On the other hand, APCT has a risk of contrast-induced nephropathy. Emergency physicians evaluate the creatinine (Cr) level prior to taking a APCT for the above reason but it takes time to evaluation the serum Cr level. This study hypothesized that Cr measured by a point-of-care test (POCT) can shorten the time to making clinically important decisions for patients with an acute abdomen. Methods: This prospective randomized study was conducted between March 2017 and October 2017. The subjects were divided into two groups (Cr measured by laboratory vs. Cr measured by POCT). To analyze the clinical acceptability for creatinine, agreement was demonstrated graphically by Bland-Altman plots. This study compared the time to make a clinically important decision by physicians and the length of stay at the emergency department in both groups. Results: A total of 76 patients were eligible for the study, 38 patients were assigned to each group. There was no statistically significant difference in the time to the first medical examination (P=0.222) and emergency department stay time (P=0.802). On the other hand, the time to recognition of the Cr level (P<0.001), time to performing APCT (P<0.001), time to decision making (P<0.001), and time to initiation of treatment (P<0.001) were shortened significantly in the point-of-care creatinine group. Conclusion: In this study, the POCT for creatinine can allow rapid decision making by shortening the time to performing the radio-contrast APCT than the laboratory for patients with an acute abdomen.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제18권6호
• /
• pp.367-373
• /
• 2018

Background: Fear of local anesthesia (LA) is a significant impediment to dental care as many patients delay or avoid treatment to avert pain. Computer-controlled local anesthetic delivery system (CCLAD), with constant and controlled rate of flow, present a painless alternative. The present study aimed to compare anxiety and pain perceived with conventional and computerized systems, for different stages of anesthesia delivery when administering various nerve blocks. Methods: One hundred patients requiring bilateral LA participated in the study. One side was anesthetized using one system and the contralateral side was anesthetized using the other, in two separate appointments. Patients assigned anxiety scores on a 5-point scale and used the visual analogue scale (VAS) for pain determination at needle insertion, during delivery of anesthetic solution, immediately after injection, and at the end of the periodontal procedure. Each patient's preference for the delivery system of future injections was also recorded. Results: Patients reported significantly lower anxiety levels with CCLAD compared to the syringe. Significantly lower mean VAS scores for anesthesia deposition, pain immediately after, and at the end of the periodontal procedure were also noted. However, pain at needle insertion was comparable between the two systems, with no statistical significance. Overall, 64.4% patients preferred CCLAD for future anesthesia. Conclusion: Lower pain perceived with CCLAD and higher preference for the system suggest that CCLAD should replace conventional syringes to allow pain-free dental treatment.

• 한국의료질향상학회지
• /
• 제30권1호
• /
• pp.88-104
• /
• 2024

Purpose: This study explored the suitability of interventions for medication interruption and intervention preferences. Methods: Two rounds of Delphi surveys were conducted with 18 expert panels comprising staff (or charge) nurses, nursing managers, and Quality Improvement (QI) team nurses working in a tertiary general hospital. For 47 situations involving the location of interruption, medication step, and source of interruption, the suitability of three interventions (no-interruption zone, medication safety vest, and education) was evaluated using a 5-point scale. Results: A total of 51 interventions for each situation were found appropriate by satisfying the degree of convergence and consensus. Patients or caregivers, peer nurses, doctors, telephones, and call bells were sources of interruption and were identified as appropriate for the application of interventions. 'Responding to requests and inquiries' by patients or caregivers showed high overall suitability. The nurses' preferred color for the intervention design (no-interruption zone, medication safety vest) is blue text on a yellow background. The priority groups for education related to medication interruptions were patients or caregivers, nurses, and non-nursing staff, in that order. Conclusion: Effective implementation of tailored intervention strategies that consider the specific characteristics of medication interruptions is crucial for mitigating interruptions and enhancing patient safety. Comprehensive educational programs aimed at reducing medication interruptions by improving awareness are necessary. Moreover, future research should evaluate these strategies in clinical settings to ensure their effectiveness in enhancing patient safety.

• 대한의용생체공학회:의공학회지
• /
• 제42권3호
• /
• pp.125-142
• /
• 2021

The POCT (point-of-care test) sensing that has been a fast-developing field is expected to be a next generation technology in health care. The POCT sensors for the detection of proteins, small molecules and especially nucleic acids have lately attracted considerable attention. According to the World Health Organization (WHO), the POCT methods are required to follow the ASSURED guidelines (Affordable, Sensitive, Specific, User- friendly, Robust and rapid, Equipment-free, Deliverable to all people who need the test). Recently, several CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) based diagnostic techniques using the sensitive gene recognition function of CRISPR have been reported. CRISPR/Cas (Cas, CRISPR associated protein) systems based detection technology is the most innovative gene analysis technology that is following the ASSURED guidelines. It is being re-emerged as a powerful diagnostic tool that can detect nucleic acids due to its characteristics that enable rapid, sensitive and specific analyses of nucleic acid. The first CRISPR-based diagnosis begins with the discovery of the additional function of Cas13a. The enzymatic cleavage occurs when the conjugate of Cas protein and CRISPR RNA (crRNA) detect a specific complementary sequence of the target sequence. Enzymatic cleavage occurs on not only the target sequence, but also all surrounding non-target single-stranded RNAs. This discovery was immediately utilized as a biosensor, and numerous sensor studies using CRISPR have been reported since then. In this review, the concept of CRISPR, the characteristics of the Cas protein required for CRISPR diagnosis, the current research trends of CRISPR diagnostic technology, and some aspects to be improved in the future are covered.

• 성인간호학회지
• /
• 제25권6호
• /
• pp.622-632
• /
• 2013

Purpose: This study was conducted to compare the nurse licensure examination system in Korea with that of the United States (US). Methods: Focus interviews with the administrative staff of the National Council of State Boards of Nursing (NCSBN) were held. two areas were explored in the interviews: the item development process and the general administrative operating procedures. Results: NCLEX-RN items are designed for entry-level practice. The items are subjected to a series of 12 steps including a item writing panel, a content and editorial review, a sensitivity panel, a pre-test, a Differential item functioning panel and a committee review. NCSBN is responsible for the test for registered nurses and one for practical nurses. In contrast the Korean National Health Personnel Licensing Board (KNHPLB) is responsible for nursing is and 21 other health related licensure. Another difference is that in Korea there is no consistent and specialized staff to develop question items. Items are developed by educators who are not active nurses (this last statemtne is not a finding but a point of view usually not given in findings.). Conclusion: Korean nurses form the largest group of health related job categories and the most direct to health care consumers. Therefore, the nursing licensure exam should be acknowledged as the most influential licensure exam in health care services. We recommend a nursing specialized licensing institution to be established with active nurse' participation in item development process to reflect clinical practice into licensure exam.

• 한국보육지원학회지
• /
• 제15권6호
• /
• pp.21-40
• /
• 2019

Objective: The purpose of this study is to find the tendencies and differences of mother's child-rearing anxiety before and after their children enter into elementary school, to analyze the factors influencing child-rearing anxiety at each time, and thereby to seek a support plan at the time of transition. Methods: The subjects of this study were 181 mothers who participated in two surveys which were conducted before and after their child entered into elementary school. Results: Firstly, mother's child-rearing anxiety before and after their children's entrance into elementary school was at a middle level, but increased significantly when they experienced their children's transition to elementary school. Secondly, mother's child-rearing anxiety, before their children's entrance into elementary school, was influenced by private education, the collection of educational information, cognitive ability, whether or not to develop a work status change plan, and birth order sequentially. Thirdly, child-rearing anxiety after their children's entrance into elementary school was significantly influenced by child-rearing anxiety before their children's entrance into elementary school and the mother's employment. Conclusion/Implications: This study is meaningful in the point that it suggested the necessity for the cooperation between multiple systems, such as systematic and stepwise parenting education, the importance of offering information to educational institutions and local governments, and for work- family support policy to prioritize children in order to support children's successful transition into elementary school.

• 디지털융복합연구
• /
• 제12권7호
• /
• pp.133-145
• /
• 2014

최근 병원정보시스템은 병원 경영을 위한 다양한 서비스, 진료 활성화와 진료의 질 향상을 위하여 대용량의 데이터베이스를 보유하게 되었다. 하지만, 병원정보시스템에 대한 정보보호대책은 미흡한 편이다. 따라서, 병원정보시스템 구축할 때, 정보보호에 대한 대책을 적절하게 마련하여 정보보호 감리를 수행하여야 하며, 위험관리를 통한 정보보호 수준을 유지할 수 있도록 정보보호 관리체계(ISMS)를 수립하고 관리해야 한다. 본 논문에서는 병원정보시스템, 정보보호관리체계, 병원정보 보호 요구사항 및 위협요소를 근거로 병원정보시스템에 적합한 정보보호 감리모형을 제안하였다. 감리모형에서는 의료기관의 특성이 잘 반영되어 있는 ISO27799와 비교하여 점검항목들을 도출하였다. 보안영역은 물리적, 기술적, 관리적 영역으로 분류하고 각각에 세부적으로 정보보호 항목들을 도출하였다. 또한 ISO27799의 위험관리 절차에 따라 점검항목을 매핑함으로써 보안성과 효율성을 동시에 향상시킬 수 있도록 설계하였다. 제안한 감리모형은 IT 전문가들의 5점 척도 설문 조사 결과 평균 4.91점으로 나타나 적합하다는 결론이 도출되었다.

• 센서학회지
• /
• 제19권6호
• /
• pp.403-420
• /
• 2010

Nano and micro structure-based biosensors are promising tool for label-free detection of biomolecular interactions with great accuracy. This review gives a brief survey on nano and micro platforms to sense a variety of analytes such as DNA, proteins and viruses. Among incredible nano and micro structure for bio-analytical applications, the scope of this paper will be limited to micro and nano resonators and nanowire field-effect transistors. Nanomechanical motion of the resonators transducers biological information to readable signals. They are commonly combined with an optical, capacitive or piezo-resistive detection systems. Binding of target molecule to the modified surface of nanowire modulates the current of the nanowire through electrical field-effect. Both detection methods have advantages of label-free, real-time and high sensitive detection. These structures can be extended to fabricate array-type sensors for multiplexed detection and high-throughput analysis. The biosensors based on these structures will be applied to lab-on-a-chip platforms and point-of-care diagnostics. Basic concepts including detection mechanisms and trends in their fields will be covered in this review.