• KSII Transactions on Internet and Information Systems (TIIS)
• /
• 제5권4호
• /
• pp.856-873
• /
• 2011

Reversible watermarking is an open problem in information hiding field, with embedding the encoded bit '1' or '0' into some sensitive images, such as the law enforcement, medical records and military images. The technique can retrieve the original image without distortion, after the embedded message has been extracted. Histogram-based scheme is a remarkable breakthrough in reversible watermarking schemes, in terms of high embedding capacity and low distortion. This scheme is lack of capacity control due to the requirement for embedding large-scale data, because the largest hidden capacity is decided by the amount of pixels with the peak point. In this paper, we propose a reversible watermarking scheme to enlarge the number of pixels with the peak point as large as possible. This algorithm is based on an adaptive edge-guided interpolation, furthermore, hides messages by interpolation-error, i.e. the difference between the original and interpolated image value. Simulation results compared with other state-of-the-art reversible watermarking schemes in this paper demonstrate the validity of the proposed algorithm.

• 성인간호학회지
• /
• 제27권2호
• /
• pp.170-179
• /
• 2015

Purpose: To examine the relationships between self-care, social support, and biological markers in liver transplant recipients. Methods: The participants included 118 liver transplant recipients who visited outpatient clinic at Y University Hospital in Seoul from April to May, 2013. Questionnaires consisted of self-care and social support scales. The biological markers were collected by reviewing electronic medical records. Data were analyzed with descriptive statistics, t-test, ANOVA with Scheff$\acute{e}$ post-hoc test, and Pearson's correlation. Results: The self-care score was significantly higher in a patient group within 6 months post-transplant when compared to a patient group post-transplant 3 to 5 years (F=3.10, p=.018). The self-care showed positive correlation with social support with statistical significance (r=.36, p<.001). Conclusion: As the self-care in liver transplant recipients had a positive correlation with social support from family and healthcare providers, the development of comprehensive long-term nursing intervention systems including counseling, education, and support in consideration of progress of time period after transplantation is necessary to enhance self-care behaviors among this population.

• 대한임상독성학회지
• /
• 제4권2호
• /
• pp.122-127
• /
• 2006

Purpose: It is not easy to detect carbon monoxide (CO) leakage, and CO-intoxicated patients do not show a specific set of symptoms. The aims of this study are to clinically evaluate patients with CO gas intoxication from a CO leak at an underground shopping center, and to discuss the establishment of a disaster prevention plan. Methods: A total of 51 patients intoxicated by CO gas exposure in a gas disaster at a underground shopping center in Seoul on September 8, 2006 were enrolled in this study, and the patients' medical records were retrospectively reviewed. Results: The mean patient age was $29.4{\pm}6.3$. The initial mean COHb level was $14.98{\pm}6.97%$. The number of patients with COHb greater than 25% was three, and six patients experienced a syncopal attack. Only one patient-was treated with hyperbaric oxygen therapy. However, none of the patients complained of severe neurologic or cardiovascular symptoms. Conclusion: The symptoms of CO intoxication are non-specific and difficult to define, and the detection of CO leak-age is difficult. Thus, workplaces should be equipped with leakage sensors and automatic alarm systems and should have develop disaster prevention plans.

• Journal of Preventive Medicine and Public Health
• /
• 제45권3호
• /
• pp.127-136
• /
• 2012

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

• Perspectives in Nursing Science
• /
• 제5권1호
• /
• pp.1-15
• /
• 2008

Background: Recent changes in the medical environment have increased the need for the home health care nursing in Korea. Even though the number of home health care patients is increasing, the major nursing problems have not been identified due to lack of a standardized nursing diagnosis. Aim: An investigative study was conducted to determine the frequency and appropriateness of nursing problems in hospital-based home health care patients in Korea using two internationally standardized nursing diagnosis classification systems. Methods: Nursing records of 249 hospital-based home health care patients were reviewed and nursing problems were identified using the North American Nursing Diagnosis Association Nursing Diagnosis Taxonomy I (NANDA) and the Clinical Care Classification of Nursing Diagnoses (CCC). Findings: Out of 463 nursing problems. 403 nursing problems were described using the NANDA whereas 427 nursing problems were described using the CCC. Nursing diagnoses not captured by the NANDA classification include nausea/vomiting, anorexia, risk for nutrition deficit, decreased blood pressure, dying process, blood sugar impairment. infection unspecified, and disuse syndrome. Nursing diagnoses not captured by the CCC include nausea/vomiting and anorexia. Conclusions: In describing nursing problems of home health care patients, it was found that the CCC was able to represent more diagnoses than the NANDA.

• 정보처리학회논문지D
• /
• 제11D권1호
• /
• pp.229-240
• /
• 2004

초$.$중등학교에서는 교육인적자원부 주관 하에 개발한 ERP시스템인 전국단위 교육행정정보시스템(National Education Information System： NEIS)을 활용하고 있다. 본 논문에서는 NEIS를 교육행정업무뿐만 아니라, 국가인적자원을 평생 관리하는 정보시스템으로도 활용할 수 있음을 보였다. 그동안의 초 중등학교 정보관리시스템은 현장 적합도와 사용자 편이성이 미흡하였다. 이와 같은 문제점을 해결하기 위해서는 시스템의 재구축 또는 개정작업이 필요하다. 개정과 보완의 한 방법으로, 전 국민의 건강정보를 학교와 의원에서 공동으로 활용할 수 있는 구체적인 예를 제시해 보고자 하였다. 이를 위해 NEIS의 학생건강기록부와 의사가 기록하는 전자의무기록부의 건강정보를 통합하여 평생관리 할 수 있는 방안을 모색하였다. 구체적으로는, 학교와 의원에서 공통으로 관리하여야할 건강정보들을 XML로 작성해 보았다. 여기에 수요자의 요구에 적합한 뷰를 제공하기 위하여 각기 다른 XSL 스타일시트를 적용하였다. 이 뷰를 이용하여 건강정보를 효율적으로 관리하고 활용할 수 있음을 알았다. 이에 건강정보관리 비효율성과 유관기관간 연계성 미흡을 해결하고, 국가인적자원을 평생관리 할 수 있는 가능성을 확인하였다.

• 기본간호학회지
• /
• 제21권4호
• /
• pp.392-402
• /
• 2014

Purpose: This study was done to investigate the status of disinfection and sterilization in healthcare facilities. Method: A survey of 193 Korean healthcare facilities was conducted from February 8 to March 7, 2013. Data were analyzed using descriptive statistics, ${\chi}^2$ test, Fisher's exact test, one-way ANOVA, Scheffe with SPSS WIN 18.0. Results: Of the healthcare facilities 93.2% had specific guidelines for disinfection/sterilization, but only 47.9% had a committee on disinfection/sterilization for decision-making, less than half (42.7%) conducted regular monitoring of actual practices, while 83.9% had established procedures for recovery in case of problems with the disinfection process and 89.0% kept records and archives of disinfection practices. Cleaning process, selection of chemical disinfectants and process of disinfection and sterilization were found to be inadequate in some healthcare facilities. Perception score for adequacy of medical instruments was 8.10, environmental disinfection was 7.20, and sterilizer management was 8.45 out of a possible 10. Conclusion: Compared to larger institutions, smaller healthcare facilities had less effective disinfection and sterilization management systems, while some facilities showed inadequate practices for medical equipment and general sterilization. Better academic and state-level support is recommended for smaller facilities in order to establish a better system-wide management system.

• 대한임상독성학회지
• /
• 제9권2호
• /
• pp.95-100
• /
• 2011

Purpose: Ingestion of puffer fish can be poisonous due to the presence of potent neurotoxins such as tetrodotoxin (TTX) found in its tissues. There are few clinical reports related to TTX. We performed this study to evaluate the clinical characteristics of TTX poisoning. Methods: We conducted a retrospective study of the 41 patients diagnosed with TTX poisoning who visited the Seoul Asan medical center from July 2004 and December 2010. A review of patients' electronic medical records and patient telephone interviews were conducted. Diagnosis of TTX poisoning was confirmed by observing the casual link between puffer fish consumption and the development of typical TTX intoxication symptoms. Results: The mean age of the patients included in the study was 46.6 years. The highest incidence of intoxication was observed in patients in their 50s (10 patients). Seasonal distribution of intoxication events included 10 in spring, 7 in summer, 10 in fall, and 14 in winter. In most cases, symptoms occurred within 1 hour of ingestion. A wide range of symptoms were associated with puffer fish ingestion affecting multiple body systems including neuromuscular (27 patients), gastrointestinal (19 patients), and cardiopulmonary/vascular (19 patients). All patients were treated with symptomatic and supportive therapy and recovered completely, without sequelae, within 48 hours. In three cases, ventilator support was required. Conclusion: TTX poisoning is not seasonally related, and patients admitted to the emergency room were observed with a wide range of symptoms. Where TTX poisoning is diagnosed, supportive therapy should be performed. Early intubation and ventilation is important, especially is cases of respiratory failure.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권21호
• /
• pp.9529-9534
• /
• 2014

Background: Cancer staging enables planning for the best treatments, evaluation of prognosis, and predictions for survival. The Collaborative Stage (CS) system makes it possible to significantly reduce the proportion of patients labeled at an "unknown" stage as well as discrepancies among different staging systems. This study aims to analyze the factors that influence the accuracy and validity of CS data. Materials and Methods: Data were randomly selected (233 cases) from stomach cancer cases enrolled for CS survey at the Korea Central Cancer Registry. Two questionnaires were used to assess CS values for each case and to review the cancer registration environment for each hospital. Data were analyzed in terms of the relationships between the time spent for acquisition and registration of CS information, environments relating to cancer registration in the hospitals, and document sources of CS information for each item. Results: The time for extracting and registering data was found to be shorter when the hospitals had prior experience gained from participating in a CS pilot study and when they were equipped with full-time cancer registrars. Evaluation of the CS information according to medical record sources found that the percentage of items missing for Site Specific Factor (SSF) was 30% higher than for other CS variables. Errors in CS coding were found in variables such as "CS Extension," "CS Lymph Nodes," "CS Metastasis at Diagnosis," and "SSF25 Involvement of Cardia and Distance from Esophagogastric Junction (EGJ)." Conclusions: To build CS system data that are reliable for cancer registration and clinical research, the following components are required: 1) training programs for medical records administrators; 2) supporting materials to promote active participation; and 3) format development to improve registration validity.

• Journal of Korean Neurosurgical Society
• /
• 제57권6호
• /
• pp.455-459
• /
• 2015

Objective : A cost comparison of the surgical clipping and endovascular coiling of unruptured intracranial aneurysms (UIAs), and the identification of the principal cost determinants of these treatments. Methods : This study conducted a retrospective review of data from a series of patients who underwent surgical clipping or endovascular coiling of UIAs between January 2011 and May 2014. The medical records, radiological data, and hospital cost data were all examined. Results : When comparing the total hospital costs for surgical clipping of a single UIA (n=188) and endovascular coiling of a single UIA (n=188), surgical treatment [$mean{\pm}$standard deviation (SD) : \$8,280,000{\pm}1,490,000$] resulted in significantly lower total hospital costs than endovascular treatment ($mean{\pm}SD$ : \$11,700,000{\pm}3,050,000$, p<0.001). In a multi regression analysis, the factors significantly associated with the total hospital costs for endovascular treatment were the aneurysm diameter (p<0.001) and patient age (p=0.014). For the endovascular group, a Pearson correlation analysis revealed a strong positive correlation (r=0.77) between the aneurysm diameter and the total hospital costs, while a simple linear regression provided the equation, y (\)=6,658,630+855,250x (mm), where y represents the total hospital costs and x is the aneurysm diameter. Conclusion : In South Korea, the total hospital costs for the surgical clipping of UIAs were found to be lower than those for endovascular coiling when the surgical results were favorable without significant complications. Plus, a strong positive correlation was noted between an increase in the aneurysm diameter and a dramatic increase in the costs of endovascular coiling.