• Progress in Medical Physics
• /
• v.32 no.2
• /
• pp.40-49
• /
• 2021

Purpose: This study aimed to develop a surface-guided radiosurgery system customized for a neurosurgery clinic that could be used as an auxiliary system for improving the accuracy, monitoring the movements of patients while performing hypofractionated radiosurgery, and minimizing the geometric misses. Methods: RGB-D cameras were installed in the treatment room and a monitoring system was constructed to perform a three-dimensional (3D) scan of the body surface of the patient and to express it as a point cloud. This could be used to confirm the exact position of the body of the patient and monitor their movements during radiosurgery. The image from the system was matched with the computed tomography (CT) image, and the positional accuracy was compared and analyzed in relation to the existing system to evaluate the accuracy of the setup. Results: The user interface was configured to register the patient and display the setup image to position the setup location by matching the 3D points on the body of the patient with the CT image. The error rate for the position difference was within 1-mm distance (min, -0.21 mm; max, 0.63 mm). Compared with the existing system, the differences were found to be as follows: x=0.08 mm, y=0.13 mm, and z=0.26 mm. Conclusions: We developed a surface-guided repositioning and monitoring system that can be customized and applied in a radiation surgery environment with an existing linear accelerator. It was confirmed that this system could be easily applied for accurate patient repositioning and inter-treatment motion monitoring.

• Health Policy and Management
• /
• v.18 no.3
• /
• pp.1-17
• /
• 2008

The measurement and management of patient satisfaction has become one of the key issues in the last two decades. Hospitals must thoroughly understand the needs of their customers and design products and health services that meet and exceed their expectations. The importance-performance analysis(IPA) is a widely used analytical technique that yields strategies for managing customer satisfaction in a variety of applications. IP A is a two-dimensional grid based on customer-perceived importance of quality attributes and attribute performance. Depending on the interplay of these two dimensions, four strategies can be derived. The aim of this study is to develop the management strategies for improving patient satisfaction in university hospitals using the I-P analysis. The attributes on inpatient service quality in 4 university hospitals was investigated using the Martilla and James(l977)' s a mean adjusted I-P grid where the axes of the grid cross at the average rating point of all items. The patient satisfaction questionnaires were completed by 600 hospital inpatients. The main statistical methods are path analysis and IPA with SPSS 12.0 and AMOS 4.0 statistical softwares. The two attributes, physician and medical service, administrative staff kindness attributes position in first quadrant(Keep Up the Good domain). The nurse and nursing service attributes position in second quadrant(Possible Overkill domain). The two attributes, convenience of check-in service, facilities and physical environment position in third quadrant(Low Priority domain). Finally the quality of inpatient service(food etc.) attributes position in fourth quadrant(Concentrate Here domain). These findings show various implications on the development of strategies in university hospitals in the future. It was determined that quality of inpatient service(food etc.) need to concentrate more on investments. These investments include a taste, price, proper provision of food service and quick response of pain management. A low priority was given to investment in streamlining the check-in process of inpatient and hospital facilities and physical environment in the long run.

• Journal of Korean Academy of Nursing
• /
• v.20 no.2
• /
• pp.249-270
• /
• 1990

The purpose of this study is to identify whether ethical values of korean nurses are deontological or utilitarian. Nurse's ethical value questionnaire was developed from review of literature and interview of nurses in the clinical settings. Content validity was tested from three nursing faculties and staffs. Ethical problems are categorized into four areas : 1) human life area 2) nurse-patient relationship area 3) nurse - nursing task relationship area 4) nurse-collegue relationship area The data were obtained from the 404 nurses in the clinical settings from Feb. to Mar. in 1990 by ethical value questionnaire. The analysis of data was done by Pearson's correlation coefficient, t-test, anova. The results of this study were as follows : 1. The ethical values of human life slightly took up the position of utilitarian. 2. The ethical values of nurse - patient relationships slightly took up deontological position. 3. The ethical values of nurse - nursing task relationships slightly took up deontological position. 4. The ethical values of nurse - colleague relationships greatly took up deontological position. 5. The ethics of nurses related to demographic characteristics of religion, attitude of nursing, ethical standards, education level and post. Those who have religion took up more deontological position than those who have not. Those who have positive attitude of nursing and firm ethical standards took up more deontological position than those who have not. Those who have higher education level and post took up more deontological position than those who have not.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.20 no.2
• /
• pp.219-225
• /
• 1990

Panoramic radiography is convenient in clinic and visualizes those areas which other technique do not give. But the technique has limitation of image distortion which results from the relationship of the ramus to the focal trough and from the direction of the central ray. This study is, using 7 dry skulls, to determine the effect of rotation of patient's head on reducing those distortion and determine the magnification ratio of images of mandibular condyle in rotated patient head position. The obtained results were as follows: 1. Generally, in panoramic radiography the anterolateral portion of the mandibular condyle was best to be visualized. 2. There are no significant difference between the image readability of anteromedial portion and that of anterocentral portion of the mandibular condyle. 3. Anterolateral portion of the mandibular condyle was better visualized in rotated head position by 20 degree or horizontal condylar inclination than in conventional position or in rotated head position by 10 degree. 4. The magnification ratio of the anteroposterior diameter in the image of mandibular condyle was least in the rotated head position by horizontal inclination of the mandibular condyle and was largest by 20 degree.

• Journal of the Korea Institute of Information and Communication Engineering
• /
• v.21 no.6
• /
• pp.1231-1236
• /
• 2017

In this study, we developed a system that can change position to improve obstructive sleep apnea. Blocking of the breathing airway caused by obstruction of the apnea, lateral position is provided by the airway to improve the apnea. We used a pressure sensor (FSR402) in the form of an array to determine the position of patient. The air cylinder was controlled to raise and lower the bed. As a result of calculating the pressure difference between the supine position and the lateral position, it was $0.41{\pm}0.30$ and $1.09{\pm}0.73$. In other words, when the patient is lateral position, the difference between the sensor values on the right and left side is large. Therefore, it is confirmed that the system can maintain airway to breath for improvement of obstructive sleep.

• Proceedings of the Korean Society of Medical Physics Conference
• /
• 2002.09a
• /
• pp.189-191
• /
• 2002

In the proton therapy using a gantry system, periodical verification of iso-center position is very important to assure precision of patient positioning system at any gantry angles in proton treatment. In the gantry system, there are three different types of iso-center; 1) in a geometrical view, 2) in an X-ray beam's eye view, 3) in a proton beam's eye view. Idealistically, they would be an identical point. They could, however, be different points. It may be a source of errors in patient positioning. At PMRC, we have established a system of verification for iso-center positions using a stainless ball of 2-cm in diameter and an imaging plate. This system provides the relation among a center of a patient target position, a center of proton irradiation field, and/or a center of X-ray field in accuracy of 50$\square$m in the 2) and 3) views, as images of a center of the stainless ball and a center of a 100 mm${\times}$100 mm-aperture brass collimator recorded on the imaging plate, which is setup at 1-cm behind the ball. In addition, it provides simultaneously the images of the ball and the collimator on an imaging intensifier (II), which is setup downstream of the proton or X-ray beam. We present a method of quality assurance (QA) for calibration of iso-center position in a rotation gantry system at PMRC and the performance of this system. A proton beam position on the 1$\^$st/ scatterer in the nozzle of the gantry affects less sensitive (reduced by a factor of 1/5) to the results of the iso-center position. The effect is systematically correctable. The effect of the nozzle (or the collimator) position is less than 0.5 mm at the maximum extraction (390 mm).

• Journal of Korean Academy of Nursing Administration
• /
• v.4 no.1
• /
• pp.19-31
• /
• 1998

The purpose of this study was to identify whether ethical values of nursing students are deontological or utilitarinian. The subjects of this study were consisted of 163 nursing students. The data was collected from September 3 to 30, 1997. Sub-scale of Nursing Ethical Values(Lee, 1990) were used to measure human life area, nurse-patient relationship area, nurse-nursing task relationship area, nurse-colleague relationship area. Data were analyzed by SPSS for Windows program. The results of this study were summarized as follows: 1. The students took the position of utilitarian slightly in human life area. 2. The students took deontological position slightly in nurse-patient relationships area. 3. The students took deontological position slightly in nurse-nursing task relationships area. 4. The students took deontological position greatly in nurse-colleague relationships area. 5. There were significant relationship between nurse-colleague relationship area and both human life area and nurse-patient relationship area(p< .01). 6. The ethical values of human life area related to religion(p< .01) and attitude of nursing(p< .05). The ethical values of nurse-colleague relationships area related to attitude of nursing(p< .01).

• Journal of Korean Physical Therapy Science
• /
• v.27 no.2
• /
• pp.88-95
• /
• 2020

Background: In the present study to investigate the immediate effects of standing position of the trunk stabilization exercise on Guillain-Barre syndrome patient's balance and gait abilities were examined. Design: Case report and conducted as a single-blind. Methods: Standing position of trunk stabilization exercise was conducted for five Guillain-Barre syndrome patient's who met the selection criteria were recruited. The subjects were conducted conservative exercise and trunk stabilization exercise. Conservative exercise was implemented for thirty min, five times for 8 weeks, and trunk stabilization exercise was implemented for 15 min. The participants' balance was measured via force plate (COP), functional reach test (FRT), timed up and go test (TUG), gait was measured using the 10 m walk test, and 6 minute walk test. Results: After training, the change values of the balance and gait ability in the subjects were significantly greater than pre-test. participants showed significant improvements in COP, FRT, TUG, 10 m walk test and 6 minute walk test pre and post the training (p<0.05). Conclusions: standing position of the trunk stabilization exercise was effective on Guillain-Barre syndrome patient's balance (COP, FRT, TUG) and gait (10 m walk test and 6 minute walk test) abilities were examined.

• PNF and Movement
• /
• v.1 no.1
• /
• pp.19-25
• /
• 2003

Objectives: The purpose of this article is to summarize the effect of stretch stimulus on muscle contraction facilitation. Methods : Some studies of the stretch reflex. ${\gamma}-motor$ system, and the effect of stretch stimulus on muscle activation were reviewed. Results : To facilitate muscle contraction, before the movement is started, the prime mover is in stretched position. The patient must be instructed to occur voluntary muscle contraction after quick stretching. It elicits the functional stretch reflex to produce a more powerful and functional contraction. The intensity of muscle contraction depends on two ways. One is firing rate of ${\alpha}-motor$ neuron by sensory information from the periphery induced in stretched position and stretch reflex. The other is excitation level of the cortical motor area and the corresponding motor neurons. Conclusions: To activate central nervous system and to increase firing rate of ${\alpha}-motor$ neuron. the therapist should apply quick stretch for the patient with stretched position and the patient should make voluntary muscle contraction.

• Archives of Plastic Surgery
• /
• v.48 no.5
• /
• pp.543-546
• /
• 2021

Despite the extensive use of lithotomy position in several plastic surgery procedures, most reports regarding the related incidence of complications are presented in the urologic, gynecologic, and anesthesiologic fields. We present the case of a 54-year-old male patient. polytrauma patient who underwent internal iliac artery embolization leading to extensive gluteal necrosis requiring: debridement, abdominoperineal resection and composite anterolateral thigh flap reconstruction with prolonged lithotomy position. The patient presented lower limb ischemia briefly after surgical theater. A computed tomography scan revealed the obstruction of the left superficial femoral artery requiring emergency revascularization. Arterial thrombosis is a potentially devastating complication and plastic surgeons should be aware of the possible dangers when performing surgeries in prolonged lithotomy position. Preoperative detection of patients at high risks for developing complications should be performed in order to implement preventive measures and avoid potentially life-threatening sequelae.