• The Korean Journal of Pain
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• 제3권2호
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• pp.160-164
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• 1990

Herpes Zoster Ophthalmicus comprises 7% of all herpes zoster infection, 50% of those involving eyeballs, and is one disease entitiy with a very grave prognosis. We have experienced a 68-year-old man who visited the emergency room complaining of severe pain in his eye and headache with loss of vision. He was seen by neurosurgeons, dermatologists and ophthalmologists, and finally sent to the pain clinic for control of pain under the diagnosis of herpes zoster ophthalmicus. In spite of zealous treatment efforts, loss of vision, pain and infectious condition did not recover; and furthermore, due to severe infection, he had his eyeball extracted 100 days after the onset of diseases. 140 days after onset, contralateral hemiplegia accompanied the disease process. We present an unusual case of herpes zoster ophthalmicus with no treatment effect.

• 한국재난정보학회 논문집
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• 제16권1호
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• pp.70-78
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• 2020

연구목적: 재난이 발생했을 때, 보통 재난안전상황실로 정보들이 무분별하게 수집되고 전달되고 있어 신속하고 올바른 의사결정에 어려움을 겪고 있다. 따라서 본 연구에서는 현장대응팀과 상황실 모두 최적의 재난 상황인지 및 대응이 가능토록 재난관리 필수정보 요소를 도출하고자 하였다. 연구방법: 본 연구에서는 다중밀집시설 대형화재 재난 사례를 바탕으로 실제 재난 대응과정을 확인하고, 다중밀집시설 대형화재 위기관리 표준매뉴얼과 당시 재난발생시 작성된 화재상황보고 서식을 분석함으로써 현장과 상황실에서 필요로 하는 재난관리 필수정보를 도출하였다. 연구결과: 재난관리 필수정보는 상황접수 및 보고·전파, 총력대응·지역긴급구조통제단(지통단)·지역재난안전대책본부(지대본) 단계, 중앙 긴급구조 통제단(중통단)·중앙재난안전대책본부(중대본) 운영단계, 수습복구 단계의 4단계로 구분하였으며, 각 단계별로 수집되어야할 정보와 핵심 업무에 해당하는 정보를 중심으로 제시하였다. 결론: 이렇게 도출된 재난관리 필수정보는 현장에서 정보를 수집하는 담당자는 효율적으로 정보를 수집할 수 있도록 가이드의 역할이 가능하며, 재난대응의 의사결정을 담당하는 상황실에서는 의사결에 필요로 한 핵심정보를 전달받게 됨으로써 신속한 상황판단이 가능해지므로 더욱 효율적인 재난 상황관리가 가능해질 것으로 기대된다.

• 한국병원경영학회지
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• 제spc호
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• pp.1-13
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• 2016

In a situation where competition becomes intense, health care organizations constantly strive to provide more services with given personnel and time. While not only the 'quantity' of the services but also the 'quality' becomes increasingly important, various problems that can occur during the 'process' of service provision can be effectively managed by applying the methods of management science. In this study, we introduce the cases where the methods of management science can be applied for the management of health care organizations in Korea and abroad. There are many cases where various scenarios for improving the patients' accessibility to the services and for maximizing the efficient use of limited resources are established, and simulation or basic statistical analysis methods are used to solve the problems more systematically or to develop improvement plans. In this study, several exemplary cases, such as no-show of patients, crowding in the emergency room, prediction of the number of available beds in the intensive care units, nurse scheduling, delay of arrival of patients, and ordering of the proper amount of therapeutic materials, are introduced and discussed. From the perspective of administrators or clinicians, however, it may not be easy to master the methodology that requires considerable mathematical background or apply the theories to practice directly. Therefore, it is suggested that more practical and relatively simple analytical methods should be applied. Also, having a more positive attitude toward improving the current performance (e.g., a belief that 'we can always be better than now'), and paying attention to improving the job satisfaction by addressing problems, with experimental spirit and data-driven decision management.

• 한국의료질향상학회지
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• 제30권1호
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• pp.15-32
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• 2024

Purpose: The number of severely ill patients requiring post-acute care has been increasing. Careful discharge planning minimizes unplanned emergency room visits and readmissions. This study aimed to survey the knowledge, experience, confidence, and obstacles faced by medical residents and fellows regarding the discharge process of severely ill patients. Methods: A survey consisting of 27 questions was sent electronically to residents and fellows who had experience in discharging severely ill patients from a tertiary hospital in Korea. The survey was conducted over a two-week period from September 29, 2022. Results: A total of 98 residents and fellows responded to the survey. Of these, 94% experienced difficulties related to the discharge process. The main obstacle was changes in the patient's condition during discharge planning (92.3%). Although 95% of the respondents acknowledged the need for providing discharge information, only 53.1% of the residents and fellows practiced this. Only 42.9% of the respondents and 20.4% of residents and fellows explained local community healthcare and welfare resources to patients because of a lack of relevant knowledge (69.7%) and feeling no responsibility to explain (40.4%). Conclusion: This study revealed that residents and fellows experienced difficulties in devising discharge plans and providing post-acute care related information, despite recognizing the importance of these. These gaps result from the lack of a discharge planning curriculum regarding critically ill patients and appropriate training in the discharge process. This suggests that an integrated discharge planning curriculum should be developed and adopted in residents' training programs for the differentiated treatment of critically ill patients.

• 한국실내디자인학회논문집
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• 제26권3호
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• pp.13-24
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• 2017

Promoting barrier-free living environments is necessary in residential facilities on which senior citizens rely most of their lives. Safety of elder people can be reassured by a certification system based on the existing barrier-free certification program in public facilities. The range of certification does not cover all living area, but is limited to the bathroom, which is a sanitary space. Given the nature of BIM modeling, an existing multi-family building was selected and modeled, as the certification process requires all the necessary information and various viewport. BIM modeling of the bathroom was conducted in accordance with the requirements of the certification for barrier-free living environment. The results suggested that there is a need for a removal of thresholds, larger doors, better selection of finishing materials, sufficient room for a wheelchair, larger space next to the toilet, and the availability of an emergency bell and grab bars. Such information supports the potentials of BIM modeling, and it is expected that an automated certification system would be established in the foreseeable future.

• Journal of Chest Surgery
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• 제28권3호
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• pp.228-232
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• 1995

Computed tomography[CT is an effective technique for the evaluation of the thorax following blunt trauma. To evaluate multiply injured 30 patients who were diagnosed as hemothorax in emergency room, computed tomography of thorax was done. The thickness of slice was one centimeter and the entire pleural cavity from the apex to the costophrenic angle was included in the evaluation. Integration and addition of the hemothorax area for each CT slice was made and amount of blood in the pleural cavity was estimated. The slice which showed largest area of hemothorax was selected and the height and width of the hemothorax area were measured. The number of slices which showed radiographic evidence of hemothorax was counted. Regression analysis was done and measured amount of hemothorax, the height and width of the hemothorax area for each slice and number of slices were put as variables. And following equation was derived. V=108.3A-0.8B-7.4C+84.7 [R2=0.74 [ V: amount of hemothorax, A: height, B: width, C: number of slices Total amount of blood from thoracic drainage was compared to the measured amount by computed tomography and the relation between the two values was statistically significant.[p=0.001 In conclusion, quantitative estimation of size of hemothorax was possible by the above equation and the process was very helpful for determination policy of treatment of individual patient.

• 지역사회간호학회지
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• 제23권4호
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• pp.438-445
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• 2012

Purpose: Medical Aid Beneficiaries were surveyed to identify differences in health behaviors, adherence to drug regimen, and quality of life between those people in the Designated Doctor System and those who are not. Methods: A total of 1,327 study subjects were separated into three groups: those in the Designated Doctor System for 2 years, those in for 1 year, and those not in the system. Results: After the introduction of the Designated Doctor System, 55.8% and 67.9%, respectively, of the subjects in the Designated Doctor System complained of inconvenience in relation to hospital use and the patient referral process. Also, the rate of emergency room use or hospitalization guided by the Designated Doctor System was only 8.7% and 6.5%, respectively. There were no significant differences in health behaviors and adherence to drug regimens between those in the Designated Doctor System and those who are not. Conclusion: This study was carried out early in the introduction of the system. Therefore, it is necessary to monitor the positive and negative effects of the Designated Doctor System for a full reflection of its impact.

• 한국소음진동공학회논문집
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• 제19권8호
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• pp.843-849
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• 2009

The reliable operation of a swing check valve in the main feed water system of a power plant is most essential for successful shout-down process. A failure to close the valve at proper time often leads to the instability of the main feed water system, or even to an emergency stop of the power plant. In reality it is a very difficult task to monitor the behavior of a swing check valve. Furthermore it is impossible to see the motion of the valve. In this work two measurements were carried out simultaneously to determine the precise valve closure time. The dynamic pressure measurements were made at the inlet and outlet regions of the swing check valve. The transient vibration of the valve housing in the direction of water flow was also measured, which enabled the measurement of the transient vibration of the valve housing near valve closure. By comparing the results produced from these measurements the precise valve closure time could be determined. By carrying out order tracking technique using the dynamic pressure signals and pump rpm signal, the complicated dynamic problems inside the main feed water system can be more easily dealt with. This measurement scheme might be implemented in a power plant on a real-time basis without much difficulty. If this could be implemented, valuable information essential for shut-down operations can readily be passed on to the main control room. The feasibility of this implementation was demonstrated by this experimental work.

• Archives of Reconstructive Microsurgery
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• 제26권1호
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• pp.9-13
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• 2017

Purpose: Fingertip amputations are the most common type of upper limb amputations. Composite grafting is a simple and cost-effective technique. Although many factors have investigated the success of composite grafting, the success rate is not high. Therefore, this study was conducted to investigate whether the microscopic procedure process during composite grafts improves the success rate. Materials and Methods: Thirteen cases of unreplantable fingertip amputation underwent a microscopic resection procedure for composite graft in the operating room. The principle of the procedure was to remove the least devitalized tissue, maximize the clean tissue preservation and exact trimming of the acral vessel and to remove as many foreign bodies as possible. Results: All fingertips in the thirteen patients survived completely without additional procedures. Conclusion: Composite grafting allows for the preservation of length while avoiding the donor site morbidity of locoregional flaps. Most composite grafts are performed as quickly as possible in a gross environment. However, we take noticed the microscopic resection. This process is thought to increase the survival rate for the following reasons. First, the minimal resection will maximize the junction surface area and increase serum imbibition. Second, sophisticated trimming of injured distal vessels will increase the likelihood of inosculation. Third, accurate foreign body removal will reduce the probability of infection and make it possible to increase the concentration and efficiency in a microscopic environment. Although there is a need for more research into the mechanisms, we recommend using a composite graft under the microscopic environment.

• 문화기술의 융합
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• 제8권6호
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• pp.317-326
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• 2022

이 연구에서는 신규 보건교사들의 코로나-19 시기에 교직적응 과정에서 경험한 어려움, 해결과정, 그리고 그것이 시사하는 바를 알아보기 위해 J도에 발령받은 3명의 신규 보건교사들을 대상으로 FGI 연구방법을 통해 분석하였다. 연구결과, 첫째, 코로나-19 업무처리 과정에서 수많은 전화와 매일의 학교 현황보고 과정에서 특히 학부모들과 관계의 어려움이 있었다. 코로나-19 업무가 어느 정도 익숙해진 이후에는 보건실 업무를 혼자서 고민해야 한다는 부담감, 다양한 학생을 대상으로 한 보건 수업의 어려움, 응급상황에서 유일한 의료인으로서 전문성을 발휘해야 한다는 부담감을 느끼고 있었다. 둘째, 신규 보건교사들은 교직 적응과정에서 느낀 어려움을 해결하기 위해 온라인을 통한 보건교사 소모임, 유튜브 등을 통해 계속해서 관련 정보를 공유하며 소통하고 있었다. 셋째, 이러한 교직 적응 과정이 시사하는 바는 교육청 차원에서 신규 보건교사에게 실질적인 도움을 주는 구체적인 연수가 필요하고, 보건수업과 관련한 수업 콘텐츠 등의 인프라를 지원하는 것이 필요하다는 것이다.