• 한국컴퓨터정보학회논문지
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• 제10권3호
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• pp.331-337
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• 2005

DICOM(Digital Imaging and Communications on Medicine) 표준은 2004년 4월에 발표된 "Supplement 23:DICOM SR(Structured Reporting)"을 통해 모든 임상정보의 표준화된 교환이 가능하도록 확장함으로써 의사의 판독보고서와 신체의 특정 부위와의 관계를 체계적으로 연결할 수 있게 되었다. DICOM SR은 정보를 정확하게 표현하기 위해 코드체계를 사용하며, 구성 항목들의 계층적인 트리로써 구조화된 정보를 표현할 수 있다. 본 논문에서는 병원정보시스템의 영상 판독결과 보고서를 분석하여 발견(finding), 결론(conclusion) 및 권고(recommendation)로 세분화하고 구조화한 후 실제로 의사가 진료에 활용할 수 있도록 DICOM SR 시스템을 구현하였다. X-ray와 같은 영상 데이터는 판독결과나 환자의 정보와 같은 텍스트 데이터와 별도로 관리되고 있다. DICOM SR로 표현된 판독결과 보고서는 영상에 대한 참조가 가능하므로 텍스트와 영상이 통합된 정보를 제공할 수 있다.

• 대한간호학회지
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• 제40권1호
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• pp.99-109
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• 2010

Purpose: The purpose of this study was to identify effective nurse interaction patterns with patients in the emergency department. Methods: For this study, video technology was used to record complete conversations between the nurse and patient. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data were collected from November, 2002 to April, 2003. The video recordings were observed for 4 hr for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS). The data were analyzed using cluster analysis to identify the patterns of nurse-patient interaction. Results: Cluster analysis revealed 4 distinct nurse interaction patterns; 1) "closed" characterized by orientation and negative talk, 2) "positive" characterized by positive affective talk, 3) "informative and directing" characterized by task-focused behavior including data gathering, and giving information about medical condition and treatment, 4) "facilitative" characterized by balance of psychosocial and biomedical topics. Patient satisfaction was highest in the facilitative interaction pattern. Conclusion: The patient centered interaction pattern, balancing information exchange and psychosocial exchange are the most effective interactions in the emergency department, suggesting that effective interaction skill is a core clinical nursing intervention in acute care.

• Investigative Magnetic Resonance Imaging
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• 제26권2호
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• pp.83-95
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• 2022

The purpose of this study was to establish and provide guidelines for the standardized acquisition and interpretation of diffusion-weighted magnetic resonance imaging (DW-MRI) to improve the image quality and reduce the variability of the results interpretation. The standardized protocol includes the use of high-resolution DW-MRI with advanced techniques and post-processing. The aim of the protocol is to increase the effectiveness of the medical image information exchange involved in the construction, activation, and exchange of clinical information for healthcare use. An organized interpretation form could make DW-MRIs' interpretation easier and more familiar. Herein, the authors briefly review the basic principles, optimized image acquisition, standardized interpretation guidelines, false negative and false positive cases of DW-MRI, and provide a standard interpretation form and examples of various cases to help users become more familiar with the DW-MRI.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제5권10호
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• pp.1830-1840
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• 2011

CDISC (Clinical Data Interchanging Standards Consortium) standards are to support the acquisition, exchange, submission and archival of clinical trial and research data. SDTM (Study Data Tabulation Model) for Case Report Forms (CRFs) was recommended for U.S. Food and Drug Administration (FDA) regulatory submissions since 2004. Although the SDTM Implementation Guide gives a standardized and predefined collection of submission metadata 'domains' containing extensive variable collections, transforming CRFs to SDTM files for FDA submission is still a very hard and time-consuming task. For addressing this issue, we developed metadata based SDTM mapping rules. Using these mapping rules, we also developed a semi-automatic tool, named CDISC Transformer, for transforming clinical trial data to CDISC standard compliant data. The performance of CDISC Transformer with or without MDR support was evaluated using CDISC blank CRF as the 'gold standard'. Both MDR and user inquiry-supported transformation substantially improved the accuracy of our transformation rules. CDISC Transformer will greatly reduce the workloads and enhance standardized data entry and integration for clinical trial and research in various healthcare domains.

• 인터넷정보학회논문지
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• 제15권3호
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• pp.21-30
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• 2014

고혈압은 전 세계의 심혈관 및 뇌혈관 질환의 중요한 사망 원인으로서 지속적인 혈압관리가 필요하다. 본 연구에서는 급성장하고 있는 모바일 헬스케어 환경에서 지속적으로 혈압 관리를 받을 수 있는 생체정보 교환 서비스 모델로서 HL7 FHIR을 선택하였다. 개발한 HL7 FHIR 프레임워크는 매니저(스마트폰)과 에이전트(혈압계) 간에 블루투스 헬스기기 프로파일과 통하여 IEEE 11073-10407 PHD 프로토콜로 통신하여 혈압정보를 획득한다. 테스트 결과 고혈압 환자의 혈압 모니터링, 측정기록관리, 문서 생성, 측정정보전송을 성공적으로 수행하였다. 실제 임상환경에서는 TCP/IP 프로토콜을 통해 측정정보를 전송할 수 있으므로 모바일 헬스케어에서 지속적인 연구와 활성화가 기대된다.

• 한국정보통신학회논문지
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• 제13권3호
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• pp.498-504
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• 2009

현재 PACS시스템에서 의료영상과 그 판독결과를 기록한 텍스트는 분리되어 저장되고 있다. 이 시스템에 구축된 의료기관간 영상정보 교환은 DICOM 표준화 적용에 따라 쉽게 이루어지고 있다. 하지만 그 영상에 대한 판독결과는 PACS 솔루션에 의존적이므로 개발업 체간에 구현 방식이 다를 경우 추가적인 작업이 필요하다. 판독문서를 기관간 효율적으로 공유하기 위해서는 용어 및 코드체계가 통일되어야 하고, 판독의 정확성을 위해 의료영상과 텍스트 정보가 통합되어야 한다. 본 연구에서는 각 PACS시스템에 종속적으로 작성된 판독문서를 분석하여 템플릿을 정의하고 구조화된 문서로 변환함으로써 정보의 공유가 가능한 의료정보공유시스템을 제안한다. 이를 위해 판독문서를 분석하여 각 항목에 대한 XML스키마를 정의하였으며, DICOM파일을 이 스키마에 맞도록 변환하였다. XML형태로 구현된 HL7-CDA문서는 웹브라우저에 쉽게 표현될 수 있으며, 의료영상을 삽입함으로써 정보교환 시 진단에 대한 의사결정에 도움을 줄 수 있다.

• 대한의용생체공학회:의공학회지
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• 제18권4호
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• pp.381-388
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• 1997

본 논문은 환자 모니터링 시스템에서 환자 모니터, 중앙 환자 모니터, DB서버 그리고 임상 의사용 워커스테이션을 연결하기 위한 인터베드 통신망의 통신방식의 설계와 구현에 대해 기술하였다. 실시간 생체신호 모니터링을 위해 필요한 조건들을 바탕으로 각종 메시지 형식과 교환방식을 결정하였으며, 객체지향 설계기법을 적용하여 구현하였다. 현재, 인터베드 통신방식을 사용하여 구현된 서비스는 모니터링 중인 환자들에 대한 정보를 제공하기 위한 환자 위치 결정 서비스와 실시간으로 환자의 생체 신호 정보를 전달하기 위한 원격 환자 모니터링 서비스이다. 임상 현장에서 실험한 결과 이들 서비스들이 실시간 생체신호 모니터링에 필요한 조건들을 모두 만족하고 있음을 확인하였다.

• Journal of Chest Surgery
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• 제55권4호
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• pp.325-331
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• 2022

Postoperative critical care management for lung transplant recipients in the intensive care unit (ICU) has expanded in recent years due to its complexity and impact on clinical outcomes. The practical aspects of post-transplant critical care management, especially regarding ventilation and hemodynamic management during the early postoperative period in the ICU, are discussed in this brief review. Monitoring in the ICU provides information on the patient's clinical status, diagnostic assessment of complications, and future management plans since lung transplantation involves unique pathophysiological conditions and risk factors for complications. After lung transplantation, the grafts should be appropriately ventilated with lung protective strategies to prevent ventilator-induced lung injury, as well as to promote graft function and maintain adequate gas exchange. Hypotension and varying degrees of pulmonary edema are common in the immediate postoperative lung transplantation setting. Ventricular dysfunction in lung transplant recipients should also be considered. Therefore, adequate volume and hemodynamic management with vasoactive agents based on their physiological effects and patient response are critical in the early postoperative lung transplantation period. Integrated management provided by a professional multidisciplinary team is essential for the critical care management of lung transplant recipients in the ICU.

• 한국경영과학회지
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• 제26권1호
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• pp.109-116
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• 2001

The detection of corporate failures is a subject that has been particularly amenable to cross-sectional financial ratio analysis. In most of firms, however, the financial data are available over past years. Because of this, a model utilizing these longitudinal data could provide useful information on the prediction of bankruptcy. To correctly reflect the longitudinal and firm-specific data, the generalized linear model with assuming the first order AR(autoregressive) process is proposed. The method is motivated by the clinical research that several characteristics are measured repeatedly from individual over the time. The model is compared with several other predictive models to evaluate the performance. By using the financial data from manufacturing corporations in the Korea Stock Exchange (KSE) list, we will discuss some experiences learned from the procedure of sampling scheme, variable transformation, imputation, variable selection, and model evaluation. Finally, implications of the model with repeated measurement and future direction of research will be discussed.

• 대한간호
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• 제30권1호
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• pp.51-62
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• 1991

The Study was carried out for the purpose of investigating the degree of perception in nursing activities. This study reports perceptions of nurses on the choices they make among competing activities, contrasts this perception with their opinion of what tasks they would like to spend time on. A sample of 231 clinical nurses was selected to participate in this study at two genernal hospitals in Seoul. The data was collected from July 10th to 25th, 1990. Subjects were instructed to rate one of five points likert type scale on the 43 items of nursing activities. Analysis of data was done by means of the SPSS-X Program using frequency, t-test and ANOVA. The results of this study were as follows; 1. The characteristics of the subjects were as follows: The age group of 25-29 yeares was 45.9%. For religion, Christians had the highest score, 68.4 % and singles in subjects were 81.4%. For academic background, 64.5% were graduated from nursing junior colleges. In the subjects, staff nurses were 86.6%. 22.5% of them had worked for less than 1 year and 20.8% had 37 months to 5 years experience at the time of the survey. 62.8% were satisfied with the job. 2. The perception level of nursing activities: 1) The mean score for perception of professional nursing functions was 4.157 point, with a maximum score set. at 5 points. The mean score for perception of priorities was 3.781. Perception of spending time was 3.932. 2) In perception of professional nursing functions, more important items were Aseptic technique (4.866), Shift and exchange of information concerning patients(4.654), Observing patients (4.799). Less important items were Transporting patients(3.411), Changing linens(3.442), Giving a bed shampoo (3.506). In priorities, more important ones. were Aseptic technique(4, 706), Shift and exchange of information concerning patients (4.524.), Observing patients(4.390), Taking vital signs (4.355). And less important ones were Changing linens (3.100), Giving bed baths(3.113), Giving back rubs(3.121). In spending time, more important ones were Aseptic technique(1.706), Observing patients (4.532), Shift and exchange of information concerning patients(4.532). And less important ones were Changing lines(3.368), Transporting patients(3.394), Giving bed baths(3.450). 3) In the role perception level, the mean distribution of perception was 3.511- 4.335; the role was perceived to be in order of frequency as a facilitator, coordinator, change agent and advocator role. The most important scale of factors by nursing activities was indirect nursing activities.