• Title/Summary/Keyword: 환자의 접근

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Optimal Water Allocation considering Reservoir Operation Rules (저수지 운영률을 고려한 최적용수배분)

  • Kang Jaewon;Rieu Seung-yup;Cha Donghoon;Ko Ick Hwan
    • Proceedings of the Korea Water Resources Association Conference
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    • 2005.05b
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    • pp.1430-1434
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    • 2005
  • 금강 유역과 같이 복잡한 하천유역 시스템의 관리를 위해서는 시스템 요소들을 통합적으로 분석할 수 있는 효과적인 의사결정지원 도구가 필요하다. K-MODSIM 모형은 단기 물관리, 장기 운영계획, 가뭄 대비계획 및 물관련 분쟁 해결을 위해 보다 개선된 유역관리 전략을 수립하기 위한 컴퓨터 기반 도구로 개발되었으며, 본 연구에서는 K-MODSIM 모형에 저수지 운영률을 반영하여 유역의 용수배분을 평가하였다. 유역 저수지군 운영 환경 및 제약조건을 반영한 네트워크를 구성한 후, 두 단계의 모형 검정을 수행하였다. 먼저 물리적 검정을 통해서 전체 대상 수계의 상하류 물수지를 검토하고, 다음 단계인 운영 측면의 검정에서 물리적으로 나타나는 상황이 댐 운영이나 제약 조건 등에 부합하는지의 여부를 검토하였다. 대청댐과 용담댐의 통합 운영을 위한 최적 운영률의 개발은 동적계획법 소프트웨어인 CSUDP를 이용하여 수행하였으며, 여기서 사유한 접근법은 음해 추계학적 동적계획법이다. 이 접근방법은 유입량 시계열을 추계학적으로 모의발생시키고, CSUDP 모형은 모의발생시킨 유입량 시계열에 대한 최적운영률을 찾기 위해 사용하며, CSUDP의 최적화 결과에 대한 통계적인 분석을 통해 월단위 운영률을 도출하였다. K-MODSIM 모형에 저수지 운영률을 반영하여 유역의 용수배분을 평가하였다. 유역 저수지군 운영 환경 및 제약조건을 반영한 네트워크를 구성하고, 대청댐과 용담댐의 통합 운영을 위한 최적연계 운영를을 개발하여 다음과 같은 운영 시나리오들을 개발하고 평가하였다. $\cdot$ 금강수계에 대한 용당댐의 영향 평가 $\cdot$ 댐 연계운영시 수요량 변화에 따른 영향 평가 $\cdot$ 하도추적을 고려한 일별모형의 검증 개발된 운영률과 하도추적방법을 K-MODSIM 모형에서 검증하기 위해서 vb.net 스크립트 파일을 개발하여 적용하였다.L이하로 이를 유등천 상류부에 공급할 경우 유등천의 수질은 BOD 6.7mg/L, TN 9.80mg/L, TP 0.90mg/L를 나타낼 것으로 예측된다. 고도처리시설의 도입 후 금강 합류점에서 갑천의 예측 BOD는 7.4mg/L로 현재 9.0mg/L에 비하여 개선되지만 이는 금강수계 오염총량 관리계획의 시$\cdot$도 경계지점 목표수질인 5.9mg/L를 만족시키지 못하므로, 이를 만족시키기 위해서는 방류수 BOD 7.2mg/L이하로 처리해야 할 것으로 판단된다.which support only concepts or image features.방하는 것이 선계기준에 적합한 것으로 나타났다. 밸브 개폐에 따른 수압 변화를 모의한 결과 밸브 개폐도를 적절히 유지하여 필요수량의 확보 및 누수방지대책에 활용할 수 있을 것으로 판단된다.8R(mm)(r^2=0.84)$로 지수적으로 증가하는 경향을 나타내었다. 유거수량은 토성별로 양토를 1.0으로 기준할 때 사양토가 0.86으로 가장 작았고, 식양토 1.09, 식토 1.15로 평가되어 침투수에 비해 토성별 차이가 크게 나타났다. 이는 토성이 세립질일 수록 유거수의 저항이 작기 때문으로 생각된다. 경사에 따라서는 경사도가 증가할수록 증가하였으며 $10\% 경사일 때를 기준으로 $Ro(mm)=Ro_{10}{\times}0.797{\times}e^{-0.021s(\%)}$로 나타났다.천성 승모판 폐쇄 부전등을 초래하는 심각한 선천성 심질환이다. 그러나 진단 즉시 직접 좌관상동맥-대동맥 이식술로 수술적 교정을 해줌으로써 좋은 성적을 기대할 수 있음을 보여주었다.특히 교사들이 중요하게 인식하는 해방적 행동에 대한 목표를 강조하여 적용할 필요가 있음을 시사하고 있다.교하여 유의한 차이가 관찰되지 않았다. 또한 HSP 환자군에서도 $IL1RN^{*}2$ allele 빈도와

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Correction of Malunited Fracture of Zygoma Through Limited Incisions (제한적 접근을 통한 부정유합된 관골골절의 교정)

  • Kim, Yong-Ha;Kim, Sung-Ho;Seul, Jeung-Hyun;Lee, Kyung-Ho
    • Journal of Yeungnam Medical Science
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    • v.13 no.1
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    • pp.22-31
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    • 1996
  • It is difficult to get a satisfactory result for the correction of malunited fracture of zygoma. Triple osteotomy and reposition of malunited zygoma is accepted as the better surgical method than camouflage surgery by means of onlays, if the orbital floor is to be reconstructed. The surgical approach can be divided into bicoronal, periorbital, intraoral and old scar. In 7 patients with malunited fracture of zygoma, the authors used a limited approach through extension of periorbital incision and intraoral incision instead of wide exposure including bicoronal incision. And we performed triple osteotomy and advancement of zygoma complex. The patients were followed for 4.5 months with acceptable result, and this approach was an effective method for the relatively simple tripod type-malunited fracture of zygoma. The authors obtained following conclusions: 1. Preoperative evaluation through thorough measurement of X-rays, investigation of photographs and detail communication with the patients was an important process. 2. Through lateral extension of subciliary incision, lateral eyebrow and intraoral incision, we could obtain adequate exposure for triple osteotomy and advancement of zygoma. 3. The zygoma should be reduced and fixed in an overcorrected superior and medial direction. 4. Return of zygoma to its anatomical position was possible only when it is completely freed from the surrounding soft tissue including masseter. 5. We could not find any different results between autogenous calvareal bone graft and $Medpor^{(R)}$ insertion on the floor of orbit.

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A Qualitative Study of Use of Self-care Training among Occupational Therapists in a Different Clinical Settings (작업치료사가 사용하고 있는 self-care training 치료방법에 관한 질적 연구)

  • Kwak, Ho-Soung;Jung, Bong-Keun
    • The Journal of Korean society of community based occupational therapy
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    • v.3 no.2
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    • pp.47-56
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    • 2013
  • Objective : The objective of this study was understanding the procedure of self-care training in occupational therapy and exploring experienced occupational therapists' perspectives in self-care training Method : A phenomenological study design was used to collect information regarding use of self-care training among occupational therapists working in a different settings. The data collection process was conducted by using a structured interview and survey. Result : The self-care training strategies used by occupational therapists were summarized to four main themes; 1. Different strategies for different age group, 2. Design therapeutic strategy rely on client's natural environment, 3. Use of theoretical background: occupation-based or client-centered, or both. 4. Use of self-awareness stragety; using different method to reflect self-awareness. Conclusion : The self-care training is not just simply conduct ADL training but understanding client's age, environment, theoretical background, and self-awareness of the client. Through eatablishing understandable self-care training strategy according to client's age and environment, the more effective self-care training would be possible.

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Effects of Periodontal Disease on Cardio-Cerebrovascular Disease: A Focus on Personal Income and Social Deprivation (치주질환이 심뇌혈관질환 발생에 미치는 영향: 지역결핍과 개인소득을 중심으로)

  • Kim, Min-Young;Shin, Hosung
    • Journal of dental hygiene science
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    • v.17 no.4
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    • pp.375-381
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    • 2017
  • The study aimed to investigate the effects of differences between personal income and social deprivation on the association between cardio-cerebrovascular disease (hypertension, stroke) and periodontal disease. This study used 12 years of cohort data from the Korea National Health Insurance Service covering the years 2002 to 2013. Among the patients aged more than 40 years who had received treatment for periodontal disease 224,067 and 284,730 who had not received treatment for hypertension and stroke, respectively, were included in the analysis. The Kaplan-Meier analysis revealed differences in the rate of treatment for cardio-cerebrovascular disease (hypertension, stroke) according to regional differences, the rate of treatment increased as the composite deprivation index value increased. The difference in treatment rates for cardio-cerebrovascular disease (hypertension, stroke) according to income was found to be higher in the treatment group with low income. This study empirically proved that the association between systemic disease and periodontal disease varies depending on personal income and the regional socioeconomic deprivation level. This shows that the clinical influence of periodontal illness on systemic disease differs according to the personal socio-demographic characteristic and residential area and that an individual's characteristic (income and the regional) needs to be considered along with the patient's clinical intervention in the disease treatment process.

The Effect of a Multidisciplinary Team Approach on the Rehabilitation of Stroke Survivors (뇌졸중 환자를 위한 팀접근 재활프로그램의 효과)

  • Cho, Bok-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.2
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    • pp.137-151
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    • 2003
  • The purpose of this study was to develop a multidisciplinary team approach program for stroke survivors, and to identify its effects on their rehabilitation. The team was composed of 7 members: a rehabilitation nurse, a physician, a physical therapist, an occupational therapist, a therapeutic recreational therapist, a nutritionist, and a researcher. A quasi-experimental study was performed with 36 subjects: 18 in the experimental group and 18 in the control group, using a noneqivalent control group pretest-posttest design. The experimental group participated 4 times in rehabilitation programsfocused on information and emotional support provided by the rehabilation team-and received telephone counseling from the researcher. The control group did not receive any treatment. The selection criteria for the subjects in this study were: (a) patients who were diagnosed as having had an ischemic stroke within the last year, (b) patients free of any communication disorder, (c) and those having a primary caregiver who could assist in filling out the form assessing the level of ADL. The data were collected from patients who had been discharged from a tertiary hospital, between October 1st, 1999 and September 30th, 2000. The data were analysed by $X^2$ test, Fisher's exact test, ANCOVA, Wilcoxon's rank sum test, and Wilcoxon's signed rank test using an SAS program. The results were as follows: 1. In terms of physical variables (blood pressure, grasp power, and ADL) 1) There was a significant difference in blood pressure between the two groups (systolic pressure P= .012, diastolic pressure P= .050). 2) There was also a significant difference in grasp power between the two groups (affected side : P= .012, unaffected side : P= .010). 3) There was no significant change in the level of ADL between the two groups. 2. In terms of psychosocial variables (depression, self-efficacy, self-esteem, and social activities) 1) There were no significant differences between the two groups. However, all four psychosocial variables showed a tendency to improve in the experimental group, while only two variables (depression and self-efficacy) showed a simalar tendency in the control group. 2) The level of social activities in the control group decreased significantly after a month (P= .050). 3. The level of life satisfaction improved in both groups, but no significant difference was found. Stroke has high recurrence rate and requires considerable follow-up care. The program used in this study was developed and designed for stimulting the rehabilitation process of stroke survivors. Through the program period of one month (meetings were held weekly), a positive effect was detected in physical variables, although the psychosocial variables did not improve significantly. In retrospect, a one month period may not be an adequate length of time to improve the psychosocial variables, as the stroke survivors were complicated cases, and most of them were elderly. Further research is therefore recommended by increasing the length of program, so that its effect can be more noticeable.

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Convergence analysis of determinants affecting on geographic variations in the prevalence of arthritis in Korean women using data mining (데이터마이닝을 이용한 여성 관절염 유병률 소지역 간 변이의 융복합 요인분석)

  • Kim, Yoo-Mi;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.13 no.5
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    • pp.277-288
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    • 2015
  • This study aims to identify determinants affecting on geographic variations in the prevalence of arthritis in Korean women using data mining. Data from Korean Community Health Survey 2012 with 249 small districts were analyzed. Socio-demographic, health behavior and status, and morbidity status measures were analyzed using conventional regression model and convergence analysis method such as decision tree for convergence analysis. Rate of workers in agriculture, forestry, and fishing, salaried workers, persons higher than high school graduates, non-treatment of needing care, non-treatment of care because of economic reason, obesity, heavy drunkers, complaining persons of chewing difficulty, persons with experiencing depression, persons with perceiving stress, and persons with diagnosing hypertension and angina pectoris were variation determinants of prevalence of arthritis in 249 small districts and these districts were classified 10 area groups by decision tree model. Our finding suggest that the approach based characteristics by small area groups rather than national wide or individual level would be effective to reduce in variations of prevalence of arthritis.

THERAPEUTIC APPROACHES FOR TREATMENT RESISTANT OBSESSIVE-COMPULSIVE DISORDER IN CHILDREN AND ADOLESCENTS (소아청소년기 치료저항성 강박장애의 치료적 접근)

  • Suh, Hyun-Ju;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.64-80
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    • 2003
  • Although obsessive-compulsive disorder(OCD) affects children, adolescents, and adults whether its juvenile(dhild and adolescent) and adult forms are different subtype of a disorder remains unknown. But there are increasing findings that suggest that juvenile OCD may be unique subtype of the disorder. One proposed subtype is the childhood OCD associated with high comorbidity of tic disorder and increased familial loading for OCD or tic disorder. The other proposed subtype is the childhood OCD and/or tic disorder occuring in association with streptococcal infection(PANDAS). These two subtypes of OCD are unlikely to respond to SSRI due to possible different pathphysiological mechanism. So this paper reviews the characteristics of OCD and therapeutic approaches for treatment resistant OCD in childhood and adolescence. Considering the likely heterogeneity of OCD, the possibility that juvenild OCD may be a variant of the disorder can have important clinical and scientific implications because it may further our understanding of this disorder, its etiology, and perhaps its treatment.

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Some Conditions of Seeking Happiness: How Can We Feel Happy? (행복의 조건: 우리는 '어떻게' 행복을 느끼는가?)

  • Lee, Eul-sang
    • Journal of Korean Philosophical Society
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    • v.139
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    • pp.133-167
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    • 2016
  • Happiness is no more than a pleasant mental state that we can feel everyday. How to seek happiness is the key subject of positive psychology, for which we also need a clear neural system so that our emotional life can be accomplished. This is an issue in people with neural problems (such as psychopathy or hypochondria) as they can not achieve such emotional clarity. In this sense neuroscience is thought of as a new approach that can replace the traditional rational insight which has been aimed at completing a virtual life. But there is also a limit: we can not reach a virtual life with only a confirmation of our transitive state. A practice of virtue which our moral ethos aims at, has been a problem of rational insight. Here is a gap between our emotional life and our rational insight in which an anguish of psychology results. So a task we should combine organically is band between neuroscientific fact and ethical practice; a new addition to psychology. But unfortunately psychology can not solve this problem by itself, for it is a meta-question arising beyond psychology. Thus an explication of this meta-question is, I believe, a new theory of moral philosophy; one that can only be explored using an interdisciplinary approach.

Leision Detection in Chest X-ray Images based on Coreset of Patch Feature (패치 특징 코어세트 기반의 흉부 X-Ray 영상에서의 병변 유무 감지)

  • Kim, Hyun-bin;Chun, Jun-Chul
    • Journal of Internet Computing and Services
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    • v.23 no.3
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    • pp.35-45
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    • 2022
  • Even in recent years, treatment of first-aid patients is still often delayed due to a shortage of medical resources in marginalized areas. Research on automating the analysis of medical data to solve the problems of inaccessibility for medical services and shortage of medical personnel is ongoing. Computer vision-based medical inspection automation requires a lot of cost in data collection and labeling for training purposes. These problems stand out in the works of classifying lesion that are rare, or pathological features and pathogenesis that are difficult to clearly define visually. Anomaly detection is attracting as a method that can significantly reduce the cost of data collection by adopting an unsupervised learning strategy. In this paper, we propose methods for detecting abnormal images on chest X-RAY images as follows based on existing anomaly detection techniques. (1) Normalize the brightness range of medical images resampled as optimal resolution. (2) Some feature vectors with high representative power are selected in set of patch features extracted as intermediate-level from lesion-free images. (3) Measure the difference from the feature vectors of lesion-free data selected based on the nearest neighbor search algorithm. The proposed system can simultaneously perform anomaly classification and localization for each image. In this paper, the anomaly detection performance of the proposed system for chest X-RAY images of PA projection is measured and presented by detailed conditions. We demonstrate effect of anomaly detection for medical images by showing 0.705 classification AUROC for random subset extracted from the PadChest dataset. The proposed system can be usefully used to improve the clinical diagnosis workflow of medical institutions, and can effectively support early diagnosis in medically poor area.

Development of Wireless Ambulatory Measurement System based on Inertial Sensors for Gait Analysis and its Application for Diagnosis on Elderly People with Diabetes Mellitus (관성센서 기반의 무선보행측정시스템 개발 및 노인 당뇨 환자 보행 진단에의 응용)

  • Jung, Ji-Yong;Yang, Yoon-Seok;Won, Yong-Gwan;Kim, Jung-Ja
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.48 no.2
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    • pp.38-46
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    • 2011
  • 3D motion analysis system which is currently widely used for walking analysis has limitations due to both necessity of wide space for many cameras for measurement, high cost, and complicated preparation procedure, which results in low accessability in use and application for clinical diagnosis. To resolve this problem, we developed 3-dimensional wireless ambulatory measurement system based on inertial sensor which can be easily applicable for clinical diagnosis for lower extremity deformity and developed system was evaluated by applying for 10 elderly people with diabetes mellitus. Developed system was composed of wireless ambulatory measurement module that consists of inertial measurement unit (IMU) which measures the gait characteristics, microcontroller which collects and precesses the inertial data, bluetooth device which transfers the measured data to PC and Window's application for storing and processing and analyzing received data. This system will utilize not only to measure lower extremity (foot) problem conveniently in clinical medicine but also to analyze 3D motion of human in other areas as sports science, rehabilitation.