• 제목/요약/키워드: Medical accidents

검색결과 596건 처리시간 0.025초

방사선사고시 피폭선량평가를 위한 휴대전화 부품의 전자상자성공명(EPR) 특성에 대한 예비 연구 (Preliminary Study on Electron Paramagnetic Resonance(EPR) Signal Properties of Mobile Phone Components for Dose Estimation in Radiation Accident)

  • 박병룡;하위호;박선후;이진경;이승숙
    • Journal of Radiation Protection and Research
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    • 제40권4호
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    • pp.194-201
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    • 2015
  • 본 연구에서는 전자상자성공명(electron paramagnetic resonance, EPR) 장치를 사용한 휴대전화 부품들의 EPR 특성 측정을 통해 방사선사고시 회구적 선량평가용 선량계로써 활용가능성에 대하여 확인하였다. 화면표시 방식이 다른 두 스마트폰에서 12개의 시료를 선정하여 실험에 사용하였고, 시료의 방사선조사에는 $^{137}Cs$ 감마선 그리고 EPR 측정은 실온에서 Bruker사의 ELEXSYS E500 X-Band EPR spectrometer를 사용하여 수행하였다. 먼저 각 시료에 대하여 비조사시료와 조사시료의 EPR 스펙트럼을 측정하여 방사선에 의한 라디칼 생성 여부를 확인하였고, 그 후 선량반응곡선과 시간에 따른 시그널 크기 변화를 측정하였다. 측정결과 유심 플라스틱과 IC 칩을 제외한 모든 시료에서 방사선에 의한 EPR 시그널 증가를 확인할 수 있었다. 시료 중에서 덮개유리, 카메라렌즈, 도광판, 확산시트는 결정계수 $R^2=0.93$이상의 좋은 선형상관관계를 보였다. 특히 도광판은 선량에 따른 시그널 증가량이 가장 크고 백그라운드 시그널이 없기 때문에 선량평가에 이상적인 특성을 가지고 있었지만, 72 시간 이내에 시그널이 약 50% 감소하는 약점이 있었다. 확산시트 또한 도광판과 유사한 페이딩 특성을 나타내었고, 덮개유리와 카메라렌즈는 단기간 동안에는 시그널이 안정적으로 보존되었다. 휴대전화 부품을 이용한 EPR 선량평가를 실제 대규모 방사선 사고에서 신속하게 적용하기 위해서는 더 많은 휴대전화 기종의 같은 부품에 대한 시그널 차이, 페이딩, 시료 전처리 방법 등에 대한 추가연구가 진행될 필요가 있다. 그러나 현재 결과를 바탕으로 소규모 방사선사고시 피폭환자가 소지하고 있던 휴대전화와 동일한 제품을 구입하여 비교하는 방법 또는 추가조사법을 이용한 선량평가는 가능할 것으로 판단된다.

산모와 간호원이 본 선택된 산욕기 간호활동의 중요도에 관한 탐색적 연구 (An Exploratory Study about the Importance of Selected Nursing Activities during the Puerperal Period, as Viewed by Women in the Puerperal Period and by Nurses Caring for Them)

  • 박주봉
    • 대한간호학회지
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    • 제8권1호
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    • pp.152-162
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    • 1978
  • The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.

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근접방사선치료에 관한 사고유형과 영향분석 연구 (Study of Failure Mode and Effect Analysis in Brachytherapy)

  • 이순성;박동욱;신동오;김동욱;김금배;오윤진;김주혜;권나혜;김경민;최상현
    • 한국방사선학회논문지
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    • 제11권7호
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    • pp.627-635
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    • 2017
  • 근접방사선치료는 일반적으로 외부방사선치료와 병행하여 수행되고 치료단계가 매우 복잡하며 이로 인해 방사선 사고가 발생될 수 있다. 본 연구에서는 이를 해결하기 위해 근접방사선치료에 사고유형과 영향 분석(Failure mode and effects analysis, FMEA) 방법을 적용하여 프로세스 맵을 구성하고 이를 기반으로 각 치료단계에 대한 위해도를 산출하였다. 프로세스 맵은 "외래 및 진료"와 "근접방사선 모의치료", "CT 모의 치료", "근접방사선치료계획", "방사선치료"로 총 5단계로 구성하였으며, 각 치료단계를 세분화하여 세부단계를 작성하였다. 위해도를 산출하기 위해 의사와 의학물리사, 선량설계사, 방사선사, 간호사가 참여하여 세부단계마다 발생빈도와 심각도, 불검출도를 평가하였다. 전반적으로 프로세스 맵은 각 치료단계마다 환자 신원 확인 절차가 우선적으로 수행되며, 이는 다른 환자로 오인하여 서로 다른 치료계획이 수립되어 방사선사고가 발생될 우려가 있다. 프로세스 맵을 기반으로 작성한 세부단계에 대해 위해도를 평가한 결과, 전반적으로 "외래 및 진료"와 "근접방사선치료계획" 과정이 높은 위해도로 평가되었다. 직종마다 평가한 위해도는 서로 다른 경향을 보였으며, 간호사는 방사선치료를 제외한 모든 과정이 55점 이상의 위해도를 보였으며, "근접방사선 모의치료" 과정이 88.8점으로 가장 높았다. 방사선치료를 수행하는 의료기관마다 치료단계가 다소 차이가 있으므로 해당 기관에 대한 프로세스 맵을 작성하고 위해도를 산출하여 중점관리 항목을 집중적으로 리스크 관리가 수행되어야 할 것으로 생각된다.

시도의 사망원인별 사망력 (Cause-Specific Mortality at the Provincial Level)

  • 박경애
    • 한국인구학
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    • 제26권2호
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    • pp.1-32
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    • 2003
  • 시도의 사망원인별 사망력 분석은 정책수립에 필수적인 정보를 제공하고, 각종 질병 및 사망 원인에 대한 가설을 설정하게 한다. 사회경제적, 문화적, 의료적, 생태학적 이유 등 다양한 원인이 시도의 사망원인별 사망수준에 복합적으로 영향을 주지만, 이 연구에서는 시도의 사망원인별 사망력에 대한 설명보다는 공통점과 차이점 파악을 주 목적으로 하였다. 이를 위하여 1998년 기준 사망신고 및 주민등록인구 자료를 활용하여, 시도별로 지연신고와 영아사망 신고누락을 보완하고, 연령표준화사망률과 생명표를 작성하였다. 모든 사인에 의한 사망수준 관련 주요 결과는 다음과 같다: (1) 남녀전체를 합하여 서울이 가장 낮은 사망수준을 전남은 가장 높은 사망수준을 보였다: (2) 시도간 사망수준의 차이가 여자보다 남자에게서, 65세 이상보다 604세 이하 연령층에서 더 컸다. 사망원인별 사망력 관련 남녀별 및 남녀 전체를 합하여 연령표준화 사망률이나 출생시 사망확률이라는 지표 모두에서 일관된 유형을 보이는 주요 결과는 다음과 같다: (1) 심장질환에 의한 사망수준은 부산에서 최고, 강원도에서 최저를 나타냈고: (2) 간질환에 의한 사망수준은 전남에서 최고를; (3) 운수사고에 의한 사망수준은 충남에서 최고 인천에서 최저로 나타났다. 시도의 사망수준 차이에는 다양한 요인이 관련되어 있으므로 사회경제적 변수를 포함한 25개의 설명 변수와 총90개의 사망력 변수에 대한 탐색적 통계분석을 실시하였다. 모든 사인에 의한 사망력은 사회경제적 변수와 밀접한 관련이 있으며, 사망원인별로는 간질환 및 운수사고에 의한 사망력이 사회경제적 변수와 관련이 있는 것으로 나타났다. 끝으로 사망신고 자료의 질 개선 필요성을 논의하고 있다.

진주시 도시시설물별 화재발생 위험도 평가 (The Risk Assessment of the Fire Occurrence According to Urban Facilities in Jinju-si)

  • 배규한;원태홍;유환희
    • 대한공간정보학회지
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    • 제24권1호
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    • pp.43-50
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    • 2016
  • 우리나라의 도시화율은 점점 높아지고 있으며 이에 따라 도시인구 증가와 더불어 다양한 도시시설물들이 급속도로 도시에 집중되고 있는 실정이다. 이에 따라 다양한 재해로 인한 피해가 발생되고 있고 사회재난 중 화재는 교통사고와 더불어 도시에서 가장 많은 피해를 입히고 있다. 2015년 우리나라의 화재발생은 44,432건이 발생하여 253명의 사망자와 4,300억원의 재산피해가 발생하여 다양한 피해 저감 노력에도 불구하고 감소되는 추세를 보이고 있지 않다. 이에 본 연구에서는 국가화재정보시스템과 진주소방서를 통하여 2007년부터 2014년까지 발생한 진주시 화재자료를 수집하였으며 행정자치부의 시설물 현황 DB를 통해 진주시의 화재와 시설물의 군집성을 분석하고 화재위험도를 산출하였다. 그 결과 미국소방기술사회(SEPE:Society of Fire Protection Engineers) 기준에 따른 화재발생빈도에 대한 위험 등급을 4단계로 구분한 경우 가장 높은 A등급으로 업무시설, 위락시설, 자동차시설이 분류되었으며, 그 다음으로 U등급은 단독주택, 공동주택, 교육시설, 판매시설, 숙박시설, 집합시설, 의료시설, 산업시설, 생활서비스시설, EU등급은 기타주택이고, 마지막으로 가장 낮은 BEU등급은 위험물제조시설로 나타났다. 또한 인명피해를 기준으로 한 경우 가장 위험도가 높은 시설물은 위험물제조시설이었고 재산피해를 기준으로 한 경우는 집합시설과 산업시설이 가장 위험도가 높게 나타났다. 이상과 같이 도시에서 발생된 화재를 시설물별로 구분하여 발생빈도, 인명피해, 재산피해에 대해 위험등급을 산정하여 제시함으로서 도시공간에 분포한 시설물에 대한 화재저감대책을 수립하는데 효과적으로 활용할 수 있을 것으로 판단된다.

대퇴경부 골절 환자의 입원 생활 (The Hospital Life of the Patient with Femoral Neck Fracture)

  • 김경자;지성애
    • 간호행정학회지
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    • 제2권1호
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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안면부 골절 환자와 두부 손상의 연관성 (Correlation Between Facial Fracture and Cranial Injury)

  • 이승원;조석진;류석용;이상래;김성은;김성준;안지영
    • Journal of Trauma and Injury
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    • 제19권2호
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    • pp.150-158
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    • 2006
  • Purpose: There are two theories about the relationships between facial fractures and cranial injuries. One is that facial bones act as a protective cushion for the brain, and the other is that facial fractures are the marker for increased risk of cranial injury. They have been debated on for many years. The purpose of this study is to identify the relationship between facial fractures and cranial injuries. Methods: A retrospective study was performed on 242 patients with facial fractures. The data were analyzed based on the medical records of the patients: age, gender, cause of injury, Injury Severity Score (ISS), alcohol intake, type of facial fractures, and type of cranial injury. The patients were divided into two groups: facial fractures with cranial injury and facial fractures without cranial injury. We compared the general characteristics between the two groups and evaluated the relationship between each type of facial fracture and each type of cranial injury. Results: Among the 242 patients with facial bone fractures, 96 (39.7%) patients had a combination of facial fractures and cranial injuries. Gender predilection was demonstrated to favor males: the ratio was 3:1. The mean age was $36.51{\pm}19.63$. As to the injury mechanism, traffic accidents (in car, out of car, motorcycle) were statistically significant in the group of facial fractures with cranial injury (p=0.038, p=0.000, p=0.003). The ISS was significant, but alcohol intake was not significant. No significant relationship between facial fractures and skull fractures was found. Only maxilla fractures, zygoma fractures, and cerebral concussion had a significant difference in cranial injury (p=0.039, p=0.025). Conclusion: There is a no correlation between facial fractures and skull fractures, which suggests that the cushion effect is the predominent relationship between facial fractures and cranial injuries.

경제위기에 따른 사망률 불평등의 변화: 지역의 사회경제적 위치 지표의 활용 (Changes in Mortality Inequality in Relation to the South Korean Economic Crisis: Use of Area-based Socioeconomic Position)

  • 윤성철;황인아;이무송;이상일;조민우;이민정;강영호
    • Journal of Preventive Medicine and Public Health
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    • 제38권3호
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    • pp.359-365
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    • 2005
  • Objectives : An abrupt economic decline may widen the socioeconomic differences in health between the advantaged and disadvantaged in a society. The aim of this study was to examine whether the South Korean economic crisis of 1997-98 affected the socioeconomic inequality from all-causes and from cause-specific mortality between 1995 and 2001. Methods : Population denominators were obtained from the registration population data, with the number of death (numerators) calculated from raw death certificate data. The indicator used to assess the geographic socioeconomic position was the per capita regional tax revenue. Administrative districts (Si-Gun-Gu) were ranked according to this socioeconomic measure, and divided into equal population size quintiles on the basis of this ranking. The sex- and 5-year age-specific numbers of the population and deaths were used to compute the sex- and age-adjusted mortality rates (via direct standardization method), standardized mortality ratios (via indirect standardization methods) and relative indices of inequality (RII) (via Poisson regression). Results : Geographic inequalities from all-causes of mortality, as measured by RII, did not increase as a result of the economic crisis (from 1998-2001). This was true for both sexes and all age groups. However, the cause-specific analyses showed that socioeconomic inequalities in mortalities from external causes were affected by South Korean economic crisis. For males, the RIIs for mortalities from transport accidents and intentional self-harm increased between 1995 and 2001. For females, the RII for mortality from intentional self-harm increased during the same period. Conclusions : The South Korean economic crisis widened the geographic inequality in mortalities from major external causes. This increased inequality requires social discourse and counter policies with respect to the rising health inequalities in the South Korean society.

불안정성 골반골 골절 손상에서 동반 복부 고형장기 손상의 임상적 특성 (Clinical Characteristics of Unstable Pelvic Bone Fractures Associated with Intra-abdominal Solid Organ Injury)

  • 이상원;김선휴;홍은석;안력
    • Journal of Trauma and Injury
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    • 제25권1호
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    • pp.1-6
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    • 2012
  • Purpose: This study analyzed the characteristics of unstable pelvic bone fractures associated with intra-abdominal solid organ injury. Methods: Medical records were retrospectively collected from January 2000 to December 2010 for patients with unstable pelvic bone fractures. Unstable pelvic bone fracture was defined as lateral compression types II and III, antero-posterior compression types II and III, vertical shear and combined type by young classification. Subjects were divided into two groups, with (injured group) and without (non-injured group) intra-abdominal solid organ injury, to evaluate whether the characteristics of the fractured depended on the presence of associated solid organ injury. Data included demographics, mechanism of injury, initial hemodynamic status, laboratory results, revised trauma score (RTS), abbreviated injury scale (AIS), injury severity score (ISS), amount of transfusion, admission to the intensive care unit (ICU), and mortality. Results: The subjects were 217 patients with a mean age of 44 years and included 134 male patients(61.8%). The injured group included 38 patients(16.9%). Traffic accidents were the most common mechanism of injury, and lateral compression was the most common type of fracture in all groups. The initial blood pressure was lower in the injured group, and the ISS was greater. The arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. The amount of the transfused packed red blood cells within 24 hours was higher in the injured group than the non-injured group. Invasive treatment, including surgery and angiographic embolization, was more common in the injured group, and the stay in the ICU was longer in the injured group. Conclusion: A need exists to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with unstable pelvic bone fractures and multiple associated injuries.

HRV 분석을 이용한 운전피로도에 관한 연구 (The Study of Driving Fatigue using HRV Analysis)

  • 성홍모;차동익;김선웅;박세진;김철중;윤영로
    • 대한의용생체공학회:의공학회지
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    • 제24권1호
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    • pp.1-8
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    • 2003
  • 장시간 운전을 하는 동안 운전자는 외부상황을 계속해서 주시하고 경계하게 하므로 운전자에게는 정신적 부하로 작용하게 되며 이로 인해 발생하는 운전피로는 자동차 사고의 원인이 될 수 있다. 본 연구에서는 심박변동신호를 분석하여 운전시간의 증가에 따른 발생하는 운전피로도를 알아보았다. 심박변동신호의 분석방법에는 이전 연구들에서 널리 사용되어져 왔던 선형분석방법들과 함께 ApEn, Poincare Plot등을 이용한 비선형 분석방법들을 이용하였다. 3년 이상의 운전경력을 가진 5명의 실험자가 참가하였으며 모든 실험자는 4대의 승용차를 2번씩 운전하여 총 40회의 실험을 실시하였다. 운전구간은 고속도로 300km구간을 왕복해서 주행하도록 하였으며 약 3시간 정도가 소요되었다. 운전하는 동안 30분 간격으로 심전도 데이터를 측정하였다. 측정된 심전도 신호로부터 유도된 심박변동신호(HRV : heart rate variability)로부터 시간영역 변수, 주파수 영역변수, 비선형 특성 등을 구한다음, 안정 상태의 데이터라 비교하여 통계석 유의성을 살펴보았다. 분석결과 시간영역의 변수인 평균심박동수는 운전시간의 증가에 따라 계속적으로 감소하였으며 심박동율의 표준편차와 연속적인 RR간격의 차이는 90분 이후로는 일정 수준을 유지하였다. 주파수 영역에서 구한 L $F_{norm}$, LF/HF는 운전시간에 따라 증가함을 보였다. 비선형 특성을 알아보기 위해서 ApEn, Poincare plot을 이용하였는데 모두 시간에 따라 감소함을 나타내었다. 대부분의 변수에서 통계적 유의성은 1시간 이후부터 나타남을 볼 수 있었다.