• Journal of the Korean Society of Radiology
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• v.6 no.6
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• pp.455-464
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• 2012

This study suggested evaluation of approximately exposure to low-dose ionization radiation from medical images using a computed radiography (CR) system in standard X-ray examination and experimental model can compare diagnostic reference level (DRL) will suggest on optimization condition of guard about medical radiation of low dose space. Entrance surface dose (ESD) cross-measuring by standard dosimeter and optically stimulated luminescence dosimeters (OSLDs) in experiment condition about tube voltage and current of X-ray generator. Also, Hounsfield unit (HU) scale measured about each experiment condition in CR system and after character relationship table and graph tabulate about ESD and HU scale, approximately radiation dose about head, neck, thoracic, abdomen, and pelvis draw a measurement. In result measuring head, neck, thoracic, abdomen, and pelvis, average of ESD is 2.10, 2.01, 1.13, 2.97, and 1.95 mGy, respectively. HU scale is $3,276{\pm}3.72$, $3,217{\pm}2.93$, $2,768{\pm}3.13$, $3,782{\pm}5.19$, and $2,318{\pm}4.64$, respectively, in CR image. At this moment, using characteristic relationship table and graph, ESD measured approximately 2.16, 2.06, 1.19, 3.05, and 2.07 mGy, respectively. Average error of measuring value and ESD measured approximately smaller than 3%, this have credibility cover all the bases radiology area of measurement 5%. In its final analysis, this study suggest new experimental model approximately can assess radiation dose of patient in standard X-ray examination and can apply to CR examination, digital radiography and even film-cassette system.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.671-689
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• 2008

The economic recession of North Korea has been prolonged, the need for humanitarian assistance for the women and children of DPRK has been raised. In March 2006, South Korean government signed MOU with World Health Organization (WHO) to financially support "Improving Women's and Children's Health in DPRK (IWCH)" project. The assistance projects through UNICEF and the non-government organizations of South Korea were also followed. IWCH project consists of three parts; nutrition, disease management, children and maternity care. The first term (2006-2007) of the project leading by WHO was finished, and the second term (2008-2010) is just begun. The projects driven by NGOs have relatively been delayed due to difficulties in negotiating on project contents and places with North Korea. Recently, however, re-modeling processes of an obstetric/gynecology hospital and a children hospital in Nampo were started. Up to recently, South Korean government has played only a limited role in the humanitarian assistance for North Korea. IWCH project is, however, a full-scale initiative driven by government based on a systematic review of need and priorities. A significant amount of budget and relatively long term (five year) project compare to the previous short term and small size programs were expected to make more meaningful achievement. Despite these positive aspects, the project remains a list of unsolved problems a lack of mutual trust, a different decision making process between South and North Korea, a lack of conflict management process, and unpredictability and complexity of international politics. In spite of such kind of political uncertainty, the health care sector will be a leading area in the process of improving relationship between South and North Korea, particularly, humanitarian assistance for women and children will play a crucial role in the process. The successful implementation of IWCH project, therefore, will contribute to provide the reference model in developing the mutually constructive relationship between South and North

• Journal of agricultural medicine and community health
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• v.49 no.1
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• pp.13-36
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• 2024

Objectives: The purpose of this field case report is 1) to analyze the community's strategy and performance in responding to infectious diseases through the case of COVID-19 infectious disease crisis response of Daegu Metropolitan City, and 2) to interpret this case using governance theory and infectious disease response governance framework. and 3) to propose a strategic model to prepare for future infectious disease outbreaks of the community. Methods: Cases of Daegu Metropolitan City's infectious disease crisis response were analyzed through researchers' participatory observations. And review of OVID-19 White Paper of Daegu Metropolitan City, Daegu Medical Association's COVID-19 White Paper, and literature review of domestic and international governance, and administrative documents. Results: Through the researcher's participatory observation and literature review, 1) establishment of leadership and response system to respond to the infectious disease crisis in Daegu Metropolitan City, 2) citizen's participation and communication strategy through the pan-citizen response committee, 3) cooperation between Daegu Metropolitan City and governance of public-private medical facilities, 4) decision-making and crisis response through participation and communication between the Daegu Metropolitan City Medical Association, Medi-City Daegu Council, and medical experts of private sector, 5) symptom monitoring and patient triage strategies and treatment response for confirmed infectious disease patients by member of Daegu Medical Association, 6) strategies and implications for establishing and utilizing a local infectious disease crisis response information system were derived. Conclusions: The results of the study empirically demonstrate that collaborative governance of the community through the participation of citizens, private sector experts, and community medical facilities is a key element for effective response to infectious disease crises.

• Journal of Service Research and Studies
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• v.14 no.2
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• pp.48-68
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• 2024

Due to the global pandemic aftermath of the coronavirus, the importance of health care is being emphasized more socially. Due to the influence of these changes, domestic pharmaceutical companies have introduced regular drug delivery services, that is, drug and health functional food subscription services. Currently, this market is continuously growing. However, these regular services are causing new environmental problems in which the number of waste drugs increases due to the presence of unused drugs. Therefore, this study proposes a service that not only promotes health management through regular medication adherence to reduce the amount of pharmaceutical waste but also aims to improve awareness and practices regarding proper medication disposal. As a preliminary survey for service design, a preliminary survey was conducted on 51 adults to confirm their perception of drug use habits and waste drug collection. Based on the Honey Comb model, a guideline for service design was created, and a prototype was produced by specifying the service using the preliminary survey results and service design methodology. In order to verify the effectiveness of the prototype, a first user task survey was conducted to identify the problems of the prototype, and after improving this, a second usability test was conducted on 49 adults to confirm the versatility of the service. Usability verification was conducted using SPSS Mac version 29.0. For the evaluation results of the questionnaire, Spearmann Correlation Analysis was conducted to confirm the relationship between frequency analysis and evaluation items. This study presents specific solutions to the problem of waste drugs due to the spread of drug subscription services.

• Journal of the Korean Society of Radiology
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• v.18 no.3
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• pp.257-265
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• 2024

In this study, we applied AEC(Auto Exposure Control), which is used in many chest examinations, to evaluate whether medical devices inserted into the body affect the dose and image quality of chest images. After attaching three HIMD(Human implantable medical devices) to the ion chamber, the Monte Carlo methodology-based program PCXMC(PC Program for X-ray Monte Carlo) 2.0 was applied to measure the effective dose by inputting the DAP(Dose Ares Product) value derived from the Pacemaker and CRT and Chemoport Additionally, to evaluate image quality, we set three regions of interest and one noise region on the chest and measured SNR and CNR. The final study results showed significant differences in DAP and Effective dose. There was a significant difference between Pacemaker and CRT when AEC was applied and not applied. (p<0.05) When applied, the dose increased by 37% for Pacemaekr and 52% for CRT. Chemoport showed a 10% increase in effective dose depending on whether AEC was applied, but there was no significant difference. (p>0.05) In the image quality evaluation, there was no significant difference in image quality between all HIMD insertions and AEC applied or not. (p>0.05) Therefore, when the HIMD was inserted into the chest during a chest x ray and overlapped with the ion chamber sensor, the effective dose increased, and there was no difference in image quality even at a low dose without AEC. Therefore, when performing a chest X-ray examination of a patient with a HIMD inserted, it is considered that performing the examination without applying AEC is a method that can be considered to reduce the patient's radiation exposure.

• Journal of the Korean Society of Radiology
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• v.6 no.2
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• pp.93-98
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• 2012

Micro-computed tomography (microCT) is an important tool for preclinical vascular imaging, with micron-level resolution. This non-destructive means of imaging allows for rapid collection of 2D and 3D reconstructions to visualize specimens prior to destructive analysis such as pathological analysis. Objectives. The aim of this study was to suggest a method for ex vivo, postmortem examination of stented arterial segments with microCT. And ex vivo evaluation of stents such as bare metal or drug eluting stents on in-stent restenosis (ISR) in rabbit model was performed. The bare metal stent (BMS) and drug eluting stent (DES, paclitaxel) were implanted in the left or right iliac arteries alternatively in eight New Zealand white rabbits. After 4 weeks of post-implantation, the part of iliac arteries surrounding the stent were removed carefully and processed for microCT. Prior to microCT analysis, a contrast medium was loaded to lumen of stents. All samples were subjected to an X-ray source operating at 50 kV and 200 ${\mu}A$ by using a 3D isotropic resolution. The region of interest was traced and measured by CTAN analytical software. Objects being exposed to radiation had different Hounsfield unit each other with values of approximately 1.2 at stent area, 0.12 ~ 0.17 at a contrast medium and 0 ~ 0.06 at outer area of stent. Based on above, further analyses were performed. As a result, the difference of lengths and volumes between expanded stents, which may relate to injury score in pathological analysis, was not different significantly. Moreover, ISR area of BMS was 1.6 times higher than that of DES, indicating that paclitaxel has inhibitory effect on cell proliferation and prevent infiltration of restenosis into lumen of stent. And ISR area of BMS was higher ($1.52{\pm}0.48mm^2$) than that of DES ($0.94{\pm}0.42mm^2$), indicating that paclitaxel has inhibitory effect on cell proliferation and prevent infiltration of restenosis into lumen of stent. Though it was not statistically significant, it showed that the extent of neointema of mid-region of stents was relatively higher than that of anterior and posterior region in parts of BMS as showing cross-sectional 2-D image. suggest that microCT can be utilized as an accessorial tool for pathological analysis.

• The Korean Nurse
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• v.20 no.4 s.112
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• pp.39-49
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• 1981

기존 간호 영역 내 간호는 질적으로, 양적으로 급격히 팽창 확대되어 가고 있다. 많은 나라에서 건강관리체계가 부적절하게 분배되어 있으며 따라서 많은 사람들이 적절한 건강관리를 제공받지 못하고 있어 수준 높은 양질의 건강관리를 전체적으로 확대시키는 것이 시급하다. 혹 건강관리의 혜택을 받는다고 해도 이들 역시 보다 더 양질의 인간적인 간호를 요하고 있는 실정이다. 간호는 또한 간호영역 자체 내에서도 급격히 확대되어가고 있다. 예를들면, 미국같은 선진국가의 건강간호사(Nurse practitioner)는 간호전문직의 새로운 직종으로 건강관리체계에서 독자적인 실무자로 그 두각을 나타내고 있다. 의사의 심한 부족난으로 고심하는 발전도상에 있는 나라들에서는 간호원들에게 전통적인 간호기능 뿐 아니라 건강관리체계에서 보다 많은 역할을 수행하도록 기대하며 일선지방의 건강센터(Health center) 직종에 많은 간호원을 투입하고 있다. 가령 우리 한국정부에서 최근에 시도한 무의촌지역에서 졸업간호원들이 건강관리를 제공할 수 있도록 한 법적 조치는 이러한 구체적인 예라고 할 수 있다. 기존 간호영역내외의 이런 급격한 변화는 Melvin Toffler가 말한 대로 ''미래의 충격''을 초래하게 되었다. 따라서 이러한 역동적인 변화는 간호전문직에 대하여 몇가지 질문을 던져준다. 첫째, 미래사회에서 간호영역의 특성은 무엇인가? 둘째, 이러한 새로운 영역에서 요구되는 간호원을 길러내기 위해 간호교육자는 어떤 역할을 수행해야 하는가? 셋째 내일의 간호원을 양성하는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가 등이다. 1. 미래사회에서 간호영역의 특성은 무엇인가? 미래의 간호원은 다음에 열거하는 여러가지 요인으로 인하여 지금까지의 것과는 판이한 환경에서 일하게 될 것이다. 1) 건강관리를 제공하는 과정에서 컴퓨터화되고 자동화된 기계 및 기구 등 새로운 기술을 많이 사용할 것이다. 2) 1차건강관리가 대부분 간호원에 의해 제공될 것이다. 3) 내일의 건강관리는 소비자 주축의 것이 될 것이다. 4) 간호영역내에 많은 새로운 전문분야들이 생길 것이다. 5) 미래의 건강관리체계는 사회적인 변화와 이의 요구에 더 민감한 반응을 하게 될 것이다. 6) 건강관리체계의 강조점이 의료진료에서 건강관리로 바뀔 것이다. 7) 건강관리체계에서의 간호원의 역할은 의료적인 진단과 치료계획의 기능에서 크게 탈피하여 병원내외에서 보다 더 독특한 실무형태로 발전될 것이다. 이러한 변화와 더불어 미래 간호영역에서 보다 효과적인 간호를 수행하기 위해 미래 간호원들은 지금까지의 간호원보다 더 광범위하고 깊은 교육과 훈련을 받아야 한다. 보다 발전된 기술환경에서 전인적인 접근을 하기위해 신체과학이나 의학뿐 아니라 행동과학 $\cdot$ 경영과학 등에 이르기까지 다양한 훈련을 받아야 할 필요가 있다. 또한 행동양상면에서 전문직인 답게 보다 진취적이고 표현적이며 자동적이고 응용과학적인 역할을 수행하도록 훈련을 받아야 한다. 그리하여 간호원은 효과적인 의사결정자$\cdot$문제해결자$\cdot$능숙한 실무자일 뿐 아니라 소비자의 건강요구를 예리하게 관찰하고 이 요구에 효과적인 존재를 발전시켜 나가는 연구자가 되어야 한다. 2. 미래의 간호교육자는 어떤 역할을 수행해야 하는가? 간호교육은 전문직으로서의 실무를 제공하기 위한 기초석이다. 이는 간호교육자야말로 미래사회에서 국민의 건강요구를 충족시키기는 능력있는 간호원을 공급하는 일에 전무해야 함을 시사해준다. 그러면 이러한 일을 달성하기 위해 간호교육자는 무엇을 해야 하는가? 우선 간호교육자는 두가지 측면에서 이 일을 수정해야 된다고 본다. 그 하나는 간호교육기관에서의 측면이고 다른 하나는 간호교육자 개인적인 측면엣서이다. 우선 간호교육기관에서 간호교육자는 1) 미래사회에서 요구되는 간호원을 교육시키기 위한 프로그램을 제공해야 한다. 2) 효과적인 교과과정의 발전과 수정보완을 계속적으로 진행시켜야 한다. 3) 잘된 교과과정에 따라 적절한 훈련을 철저히 시켜야 한다. 4) 간호교육자 자신이 미래의 예측된 현상을 오늘의 교육과정에 포함시킬 수 있는 자신감과 창의력을 가지고 모델이 되어야 한다. 5) 연구 및 학생들의 학습에 영향을 미치는 중요한 의사결정에 학생들을 참여시키도록 해야한다. 간호교육자 개인적인 측면에서는 교육자 자신들이 능력있고 신빙성있으며 간호의 이론$\cdot$실무$\cdot$연구면에 걸친 권위와 자동성$\cdot$독창성, 그리고 인간을 진정으로 이해하려는 자질을 갖추도록 계속 노력해야 한다. 3. 미래의 간호원을 양성하는 능력있는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가? 내일의 도전을 충족시킬 수 있는 능력있는 간호교육자를 준비시키기 위한 실질적이고 현실적인 전략을 논함에 있어 우리나라의 실정을 참조하겠다. 전문직 간호교육자를 준비하는데 세가지 방법을 통해 할 수 있다고 생각한다. 첫째는 간호원 훈련수준을 전문직 실무를 수행할 수 있는 단계로 면허를 높이는 것이고, 둘째는 훈련수준을 더 향상시키기 위하여 학사 및 석사간호교육과정을 발전시키고 확대하는 것이며, 셋째는 현존하는 간호교육 프로그램의 질을 높이는 것이다. 첫째와 둘째방법은 정부의 관할이 직접 개입되는 방법이기 때문에 여기서는 생략하고 현존하는 교과과정을 발전시키고 그 질을 향상시키는 것에 대해서만 언급하고자 한다. 미래의 여러가지 도전에 부응할 수 있는 교육자를 준비시키는 교육과정의 발전을 두가지 면에서 추진시킬 수 있다고 본다. 첫째는 국제간의 교류를 통하여 idea 및 경험을 나눔으로서 교육과정의 질을 높일 수 있다. 서로 다른 나라의 간호교육자들이 정기적으로 모여 생각과 경험을 교환하고 연구하므로서 보다 체계적이고 효과적인 발전체인(chain)이 형성되는 것이다. ICN같은 국제적인 조직에 의해 이러한 모임을 시도하는 것인 가치있는 기회라고 생각한다. 국가간 또는 국제적인 간호교육자 훈련을 위한 교육과정의 교환은 한 나라안에서 그 idea를 확산시키는데 효과적인 영향을 미칠 수 있다. 충분한 간호교육전문가를 갖춘 간호교육기관이 새로운 교육과정을 개발하여 그렇지 못한 기관과의 연차적인 conference를 가지므로 확산시킬 수도 있으며 이런 방법은 경제적인 면에서도 효과적일 뿐만 아니라 그 나라 그 문화상황에 적합한 교과과정 개발에도 효과적일 수 있다. 간호교육자를 준비시키는 둘째전략은 현존간호교육자들이 간호이론과 실무$\cdot$연구를 통합하고 발전시키는데 있어서 당면하는 여러가지 요인-전인적인 간호에 적절한 과목을 이수하지 못하고 임상실무경험의 부족등-을 보충하는 방법이다. 이런 실제적인 문제를 잠정적으로 해결하기 위하여 1) 몇몇 대학에서 방학중에 계속교육 프로그램을 개발하여 현직 간호교육자들에게 필요하고 적절한 과목을 이수하도록 한다. 따라서 임상실무교육도 이때 실시할 수 있다. 2) 대학원과정 간호교육프로그램의 입학자의 자격에 2$\~$3년의 실무경험을 포함시키도록 한다. 결론적으로 교수와 학생간의 진정한 동반자관계는 자격을 구비한 능력있는 교수의 실천적인 모델을 통하여서 가능하게 이루어 질수 있다고 믿는 바이다.

• Journal of the Korean Society of Food Science and Nutrition
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• v.40 no.1
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• pp.128-136
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• 2011

This study was carried out to investigate the factors of food service satisfaction of the elderly in Busan. The survey was conducted from September 1 to October 15, 2009 by questionnaires and data analyzed by SPSS program. Fifty point nine percent of the subjects lived alone and the source of living expenses of 70.5% of the subjects was subsidy from government. The most important reason for the elderly to participate in meal service was 'economic difficulty' and 'to meet friend'. The subjects had various chronic degenerative diseases, such as arthritis, hypertension, diabetes, osteoporosis and cardiac disease. Sixty-six point eight percent of the subjects needed diet therapy for their diseases, but 87.1% of them don't want to pay the extra fee. Thirty six point five percent of the subjects attained information about lunch program because it was 'close to home' but 20.7% was 'from public officials'. The reasons for the use of the meal service were 'economic difficulty' (40.0%), 'to meet friends' (22.6%), and 'bother to prepare meal' (16.50%). The services provided by welfare center were health care, physical exam and haircut. The score given by the subjects on the satisfaction of meal service was 3.84 on the 5-point maximum scale. Higher satisfaction on kindness of staff, satisfaction of social support and awareness of support resulted in higher satisfaction of food service. It would be effective to provide food service models that meet specific needs of the elderly according to social welfare service and social community activities.

• Pediatric Infection and Vaccine
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• v.26 no.1
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• pp.1-10
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• 2019

Purpose: We investigated the distribution and antimicrobial resistance of pneumococcal isolates from hospitalized children at Asan Medical Center for recent 4 years, and aimed to recommend proper choice of empirical antibiotics for pneumococcal infection. Methods: From March 2014 to May 2018, children admitted to Asan Medical Center Childrens' Hospital with pneumococcal infection were subjected for evaluation of minimal inhibitory concentration (MIC) for ${\beta}-lactams$ and macrolide antibiotics. Patient's age, underlying disease, gender were retrospectively collected. Using Monte Carlo simulation model and MIC from our study, we predicted the rate of treatment success with amoxicillin treatment. Results: Sixty-three isolates were analyzed including 20.6% (n=13) of invasive isolates, and 79.4% (n=50) of non-invasive isolates; median age were 3.3 years old, and 87.3% of the pneumococcal infections occurred to children with underlying disease. Overall susceptibility rate was 49.2%, 68.2%, and 74.6% for amoxicillin, parenteral penicillin, and cefotaxime respectively. 23.8% and 9.5% of the isolates showed high resistance for amoxicillin, and cefotaxime. Only 4.8% (n=3) were susceptible to erythromycin. Monte Carlo simulation model revealed the likelihood of treatment success was 46.0% at the dosage of 90 mg/kg/day of amoxicillin. Conclusions: Recent pneumococcal isolates from pediatric patients with underlying disease revealed high resistance for amoxicillin and cefotaxime, and high resistance for erythromycin. Prudent choice of antibiotics based on the local data of resistance cannot be emphasized enough, especially in high risk patients with underlying disease, and timely vaccination should be implemented for prevention of the spread of resistant strains.

• Journal of Korea Spatial Information System Society
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• v.7 no.1 s.13
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• pp.25-37
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• 2005

Recently, with the development of wireless communications and mobile computing, interest about mobile computing is rising. Mobile computing can be regarded as an environment where a user carries mobile devices, such as a PDA or a notebook, and shares resources with a server computer via wireless communications. A mobile database refers to a database which is used in these mobile devices. The mobile database can be used in the fields of insurance business, banking business, medical treatment, and so on. Especially, LBS(Location Based Service) which utilizes location information of users becomes an essential field of mobile computing. In order to support LBS in the mobile environment, there must be an Embedded Spatial MMDBMS(Main-Memory Database Management System) that can efficiently manage large spatial data in spatial mobile devices. Therefore, in this paper, we designed and implemented the Embedded Spatial MMDBMS, extended from the HSQLDB which is an existing MMDBMS for PC, to manage spatial data efficiently in spatial mobile devices. The Embedded Spatial MMDBMS adopted the spatial data model proposed by ISO(International Organization for Standardization), provided the arithmetic coding method that is suitable for spatial data, and supported the efficient spatial index which uses the MBR compression and hashing method suitable for spatial mobile devices. In addition, the system offered the spatial data display capability in low-performance processors of spatial mobile devices and supported the data caching and synchronization capability for performance improvement of spatial data import/export between the Embedded Spatial MMDBMS and the GIS server.