• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.177-179
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• 2002

We have developed a scheduling system for heavy ion radiotherapy considering the condition of three treatment rooms and treatment planning for each patient. This system consists of a database (patient information, treatment method and machine schedule), a schedule for radiotherapy and WEB server. All operation of this system, such as data input, to change and to view the schedule, are performed by using a WEB browser. In order to protect personal information for the patients, access privilege to each information are limited by according to the occupational category. This system is connected with a hospital central information management system (AMIDAS) and an irradiation-managing computer for the heavy ion radiotherapy. A basic information for the patient is got from AMIDAS and the daily schedule sends to the treatment control computer at each treatment room through the irradiation-managing computer every morning. The daily, weekly, monthly schedules in the treatment room and the treatment condition of each patient are shared on the WEB browser with the all participants of the heavy ion therapy. This system could be useful to save a time to generate a treatment schedule and to inform us the most up-to-date treatment schedule and the related information at the same time.

• 한국의학물리학회지:의학물리
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• 제24권3호
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• pp.191-197
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• 2013

방사선 치료 시 방사선이 조사되는 동안 환자의 움직임을 모니터링하는 것은 치료의 성공을 결정 하는 중요한 요인이다. 따라서 방사선이 조사되는 동안 환자의 움직임을 실시간으로 감시하고 움직인 치료위치를 자동으로 보정 할 수 있는 시스템을 개발 하였다. 원점을 중심으로 직교하게 위치한 2개의 CCD 카메라를 이용하여 3차원적 환자의 위치를 확인 하고, 틀 맞춘 상호교차 비교법(normalized cross-correlation method)을 이용한 영상 본 맞춤(image pattern matching) 방법을 이용한 환자위치 모니터링 시스템을 개발하였다. CCD카메라로부터 촬영된 영상을 컴퓨터로 전달하여 위치 변화를 정량적으로 분석 하여 빔 켜고 끔(beam on and off)를 위한 방아쇠신호(trigger signal)를 발생시키고, 이동치료대(moving couch)의 모터를 제어할 수 있는 시스템을 개발하였다. 이 시스템은 0.5 mm 이하의 분해능으로 환자의 위치를 자동으로 보정할 수 있었다.

• Journal of Trauma and Injury
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• 제33권3호
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• pp.170-174
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• 2020

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.

• 한국의료질향상학회지
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• 제5권2호
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• pp.312-323
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• 1998

Background : Evaluation of patient's satisfaction is one of the most important aspects of quality improvement. If the patient highly satisfies with the medical service provided in the hospital, he/she will be likely to visit the same hospital again. Patient's satisfaction of a particular hospital is directly correlated with hospital profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the patient's satisfaction. This study is to find the effect of hospital QI activities on the patent's satisfaction level. Methods: After questionnares were developed, survey of measuring satisfaction level was performed in August, 1998. On the basis of survey results, QI activities were carried out to attain the target point of 4.0 and subsequent survey was done in November, 1998. Results: With three main principles of "problem solving approach with kindness". "helping patient to participate in medical procedure with sufficient information", and "putting employees into practice of attitude with human respect", the average level of satisfaction was enhanced from 3.45 to 3.55 level. Also kindness level of employees was increased from 3.71 to 3.82. Level of dissatisfaction about insufficient explanation and unkind attitude was dropped from 69% to 48% and from 82% to 46% respectively. Conclusion: With the result of this study overall satisfaction level was enhanced. In order to keep these advantages a operation of Quality Improvement Task Force Team in each subject will be required.

• 전자공학회논문지
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• 제51권10호
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• pp.128-136
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• 2014

온라인에서 공유 및 활용되고 있는 정보들이 기하급수적으로 생성되는 인터넷 정보 시대에서, 개별 의료기관의 환자 정보는 의료기관 고유의 데이터베이스 구성 및 환자 사생활 정보 보호 문제 등의 이유로 인해 병원들 간의 환자 데이터 공유가 원활히 이루어지지 않고 있다. 환자 사생활 정보를 보호하면서 각 의료기관 고유의 환자 정보를 의료기관들 간에 상호 공유하는 것은 의료 정보화를 위해 아직도 해결해야 할 과제로 남아있다. 본 논문에서는 환자 사생활 정보를 보호하면서 환자의 의료정보를 공유하기 위해서, 국내외 의료정보 공유 현황 및 관련 국제 의료정보 표준안을 고찰 및 국내 의료기관의 데모그래픽 데이터를 활용하기 위해 실제 국내 의료기관의 환자 데이터 구조 및 특성을 분석하고 의료 정보 공유 시스템 구조 설계를 제안하고자 한다.

• 대한유전성대사질환학회지
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• 제13권2호
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• pp.120-125
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• 2013

Purpose: McCune-Albright syndrome (MAS) is caused by activating mutations in the GNAS gene, resulting in peripheral precocious puberty, caf$\acute{e}$-au-lait spots, and polyostotic fibrous dysplasia (POFD). The aim of the present study was to describe the diverse clinical and endocrine characteristics of patients with MAS. Methods: Seven patients with MAS were included in this study and medical charts were reviewed retrospectively for following parameters: patient's sex and age at diagnosis, POFD, ovarian cysts, and precocious puberty. Results: The mean age at diagnosis was $5.8{\pm}4.2$ years. One patient was male (14%) and the other six patients were female (86%). Peripheral precocious puberty was associated with 6 patients (86%). Five patients manifested premature menarche as early as 2 to 5 years of age. Letrozole was administered to 4 patients, tamoxifen to one patient and GnRH agonist to one patient. Five females developed ovarian cysts. Thyroid function tests were performed in all patients and one patient showed hyperthyroidism (14%) and has been treated with methimazole. One patient presented with pseudohypoparathyroisdism, phosphaturia, calciuria suggesting hypophosphatemic rickets. Six patients (86%) revealed POFD. One patient had symptoms of optic nerve compression and secondary esotropia and 2 patients had bone pain. Conclusion: This study described clinical characteristics and endocrine complications of patients with MAS. Careful physical examinations with history taking and serial endocrine function tests should be needed to detect complications such as endocrinologic hyperfunction and POFD.

• Archives of Plastic Surgery
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• 제48권3호
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• pp.246-253
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• 2021

In order to provide a physiological solution for patients with breast cancer-related lymphedema (BCRL), the surgeon must understand where and how the pathology of lymphedema occurred. Based on each patient's pathology, the treatment plan should be carefully decided and individualized. At the authors' institution, the treatment plan is made individually based on each patient's symptoms and relative factors. Most early-stage patients first undergo decongestive therapy and then, depending on the efficacy of the treatment, a surgical approach is suggested. If the patient is indicated for surgery, all the points of lymphatic flow obstruction are carefully examined. Thus a BCRL patient can be considered for lymphaticovenous anastomosis (LVA), a lymph node flap, scar resection, or a combination thereof. LVA targets ectatic superficial collecting lymphatics, which are located within the deep fat layer, and preoperative mapping using ultrasonography is critical. If there is contracture on the axilla, axillary scar removal is indicated to relieve the vein pressure and allow better drainage. Furthermore, removing the scars and reconstructing the fat layer will allow a better chance for the lymphatics to regenerate. After complete removal of scar tissue, a regional fat flap or a superficial circumflex iliac artery perforator flap with lymph node transfer is performed. By deciding the surgical planning for BCRL based on each patient's pathophysiology, optimal outcomes can be achieved. Depending on each patient's pathophysiology, LVA, scar removal, vascularized lymph node transfer with a sufficient adipocutaneous flap, and simultaneous breast reconstruction should be planned.

• 동의신경정신과학회지
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• 제22권4호
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• pp.143-155
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• 2011

Objectives : The purpose of this study is to suggest that psychotherapy must be considered when treating conversion disorder patient with convulsion. Methods : We treated the patient with counseling and autogenic training in psychotherapies, not only traditional methods. Results : In this study, we found difference between when counselling and autogenic training is combined and when they are not practiced. Conclusions : Counseling and autogenic training is good treatment at patient with convulsion of conversion disorder.

• Journal of Chest Surgery
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• 제51권6호
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• pp.403-405
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• 2018

This case report concerns a young patient with an extremely rare combination of d-transposition of the great arteries (d-TGA) and anomalous origin of the right subclavian artery. In our patient, the right subclavian artery originated from the pulmonary artery, which is why he did not show reversed differential cyanosis. We conclude that the presence of an aortic arch anomaly should be considered in patients with d-TGA who do not present with reversed differential cyanosis. A further imaging work-up, including computed tomography or magnetic resonance imaging, might be helpful.

• Investigative Magnetic Resonance Imaging
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• 제20권3호
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• pp.152-157
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• 2016

Purpose: Operating room management is the serious and complex task for hospital managers and the common approach is to develop relevant standard operational procedures. From patient and staff safety perspective, operating room management should be well-studied and hospital should identify and address any potential risks. Simultaneous usage of different imaging and less-invasive treatment technologies demands strong management control. Materials and Methods: We have formed the multidisciplinary expert panel (surgeons, anesthesiologists, radiologists, healthcare managers etc.) for hybrid theater management standard operational procedure development. On the first stage the general concept of hybrid room design and patient routing was developed. The second stage included the technical details discussion. For patient safety improvement we modified the Surgical Safety Check-list in accordance with potential MRI-related safety challenges and concerns. Results: WHO Surgical Safety Checklist is a simple and easy-to use tool which includes three blocks of question (grouped by the surgery process). We have developed two additional blocks of questions for the intraoperative magnetic resonance investigation. It is very important to have a special detailed routing with a strong control of ferromagnetic devices and anesthesiology care. Conclusion: High-energy MRI (1.5-3.0T) is characterized by potential influence on patient and staff safety in case of hybrid surgery. It is obvious to have a strong managerial control of ferromagnetic devices and anesthesiology care. Surgical Safety Checklist is the validated tool for improving patient safety. Modification and customization of this check-list potentially provides the opportunity for surgery processes improving.