• 대한간호학회지
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• 제30권5호
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• pp.1279-1291
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• 2000

The main objectives of this study were to analyze the concept of hope, so to provide basic data to develop a valid instrument to measure hope, and to develop hope enhancing nursing intervention a program for cancer patients. The hybrid model approach was applied in three phases, the theoretical phase, the empirical phase, and the analytic phase. The study was developed on universal attributes explaining generalized hope and specific hope, which were revealed in a comprehensive review of the literature. In the empirical phase, eight cancer patients undergoing chemotherapy were interviewed to reveal causes, motivation, and their resource of hope according to The Hope Assessment Guide (Farren, Herth, & Popovich, 1995). In the analytical phase, the results of the two previous stages of the study were compared. The results were as follows : In the theoretical phase, six dimensions of hope emerged; affective, cognitive, behavioral, affiliative, temporal and contextual dimension. The antecedent of hope was loss, crisis, uncertainity, and stress. The consequences were renewal, development of new methods, safety, peace and transcendental competence. In the empirical phase, these six dimensions emerged as theoretical phases were verified and specified as these descriptive terms: feeling, intention, expectation, activity, relation, future- orientation, reality and goal-setting. The antecedent factor of hope was occurrence or recurrence of cancer. The consequence of hope was ability to cope with real condition, feeling of safety and comfort, peace, development of new strategy and recovery of disease. The major content of hope in this phase was related to specific hope, but it was also influenced on by general hope. In the analytic phase, general and specific hope was renamed as trait and state hope. All attributes emerged at the empirical phases, and also emerged at the theoretical phase. However, cognitive and contextual dimensions were revised and specified. In conclusion, the concept of hope is divided into trait hope and state hope, and state hope is an anticipatory expectation that occurs at the time of a stressful stimulus, such as being diagnosed with cancer. Hope is a multidimensional dynamic energized mental state which has the dimensions of affective, cognitive, behavioral, affiliative, temporal and contextual. There should be further studies to develope the state and trait hope scale according to definition and attributes of hope investigated in this study. In addition, considering results of the empirical phase, the family is very a important factor as a resource of hope, so it is necessary to consider family in implementing a nursing intervention program to enhance hope.

• Genomics & Informatics
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• 제15권4호
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• pp.156-161
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• 2017

Transcriptome analysis has been widely used to make biomarker panels to diagnose cancers. In breast cancer, the age of the patient has been known to be associated with clinical features. As clinical transcriptome data have accumulated significantly, we classified all human genes based on age-specific differential expression between normal and breast cancer cells using public data. We retrieved the values for gene expression levels in breast cancer and matched normal cells from The Cancer Genome Atlas. We divided genes into two classes by paired t test without considering age in the first classification. We carried out a secondary classification of genes for each class into eight groups, based on the patterns of the p-values, which were calculated for each of the three age groups we defined. Through this two-step classification, gene expression was eventually grouped into 16 classes. We showed that this classification method could be applied to establish a more accurate prediction model to diagnose breast cancer by comparing the performance of prediction models with different combinations of genes. We expect that our scheme of classification could be used for other types of cancer data.

• 한국인터넷방송통신학회논문지
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• 제10권2호
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• pp.167-172
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• 2010

최근 병원에서는 전반적으로 의료정보시스템의 전산화가 진행되고 있으며, 시스템 간에 효율적인 정보 교환을 위하여 HL7, DICOM 등의 의료 표준이 존재한다. 그러나 병원별로 이질적으로 구축된 시스템으로 인해 환자의 의료정보의 데이터 구조가 다르므로 서로 다른 병원 간에 정보를 공유하기 어렵다. 본 논문에서는 XML을 기반으로 하여 다양한 의료정보를 단일 구조로 결합하고, 병원마다 독립적으로 관리되고 있는 의료정보시스템을 일괄적으로 관리하는 통합의료정보 시스템을 제안하였다. 따라서 제안 시스템은 타 병원의 내부 시스템에 따라 별도의 구조를 고려하지 않는 효과적인 정보 공유가 가능하다. 이로 인하여 의료기관들은 환자들에게 시간과 비용의 절감과 함께 정확한 진료를 제공할 수 있게 된다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.305-309
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• 2016

PTEN protein is an important tumour suppressor factor detectable by immunohistochemistry. The goal of the present study was to investigate the prognostic role of PTEN gene expression focusing on length of survival in breast cancer patients. This descriptive-analytical study was conducted on 100 breast cancer cases referred to Sabzevar hospitals in the north east of Iran between 2010 and 2011, followed up to 2015. The PTEN gene expression of tumour tissue samples was determined using specific monoclonal antibodies. The data were analyzed using Chi-square test and Fisher's exact test. Patient length of survival was analyzed after 4 years of follow-up using the Cox regression model. The PTEN gene was expressed in 70 of 100 samples, while being found at a high level in all noncancerous samples. There was an inverse significant relationship between expression of PTEN and tumour stage and grade (p<0.001). In addition, expression of PTEN in invasive ductal tumours was less than in non-invasive tumours. There was also an inverse significant relationship between the likelihood of death and PTEN gene expression (p<0.01). These findings indicate that lack of PTEN gene expression can be sign for a worse prognosis and poor survival in breast cancer.

• 대한간호학회지
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• 제29권3호
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• pp.518-529
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• 1999

The purpose of this research was to develop a nursing intervention list for family caregivers. The specific steps were as follows : 1. Analyze the concept, Soobal, based on literature review and case observation. 2. Generate an initial list of defining activities for ‘Caregiver Support : Soobal’. 3. Validate the defining activities. 4. Complete the final list of defining activities. A two-round Delphi questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of intervention, Caregiver Support : Soobal. The definition of ‘Caregiver Support : Soobal’ was provision of the necessary information, advocacy, and support to facilitate primary patient care by someone other than a health care professional in Korean traditional manners. Ten nurse experts participated in Round I and II of this study. They were asked to rate activities that examplified the interventions on a scale of 1 (activity is not at all characteristic) to 5 (activity is very characteristic). Round I contained 15 ‘critical’ activities and 10 ‘supporting’ activities, while round II contained 16 ‘critical’ activities and 6 ‘supporting’ activities. No activities were considered to be ‘nonsupporting’ in both round I and II. Finally, the definition and 25 defining activities were developed. Intervention, Caregiver Support : Soobal, attained an ICV score of .82. This study provides a protocol model to develop Korean nursing interventions.

• 한국전문물리치료학회지
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• 제20권4호
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• pp.22-31
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• 2013

The aim of the present study was to compare measurement precisions of the Oswestry Back Pain Disability Questionnaire (ODQ) and a computer adaptive testing (CAT) method. The ODQ has been regarded as one of the most reliable condition-specific measure for back pain for decades. Cross-sectional study was carried out with two independent convenient samples from two out-patient rehabilitation clinics for back pain ($n_1=42$) and non-back pain group ($n_2=42$). Participants were asked to fill out the ODQ and CAT of International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM). A series of Rasch analyses were performed to calculate person ability measures. The CAT measures had greater relative precision in discriminating the groups than did the ODQ measure in comparisons of the relative precision. The CAT measure appears to be more effective than did the ODQ measure in terms of measurement precision. By administering test items calibrated in a way, CAT measures using item response theory may promise a means with measurement precision as well as efficiency.

• The Korean Journal of Physiology and Pharmacology
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• 제23권5호
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• pp.295-303
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• 2019

A heart simulator, UT-Heart, is a finite element model of the human heart that can reproduce all the fundamental activities of the working heart, including propagation of excitation, contraction, and relaxation and generation of blood pressure and blood flow, based on the molecular aspects of the cardiac electrophysiology and excitation-contraction coupling. In this paper, we present a brief review of the practical use of UT-Heart. As an example, we focus on its application for predicting the effect of cardiac resynchronization therapy (CRT) and evaluating the proarrhythmic risk of drugs. Patient-specific, multiscale heart simulation successfully predicted the response to CRT by reproducing the complex pathophysiology of the heart. A proarrhythmic risk assessment system combining in vitro channel assays and in silico simulation of cardiac electrophysiology using UT-Heart successfully predicted drug-induced arrhythmogenic risk. The assessment system was found to be reliable and efficient. We also developed a comprehensive hazard map on the various combinations of ion channel inhibitors. This in silico electrocardiogram database (now freely available at http://ut-heart.com/) can facilitate proarrhythmic risk assessment without the need to perform computationally expensive heart simulation. Based on these results, we conclude that the heart simulator, UT-Heart, could be a useful tool in clinical medicine and drug discovery.

• 대한의용생체공학회:의공학회지
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• 제44권1호
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• pp.19-24
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• 2023

Due to the spread of COVID-19, many patients with severe respiratory diseases have occurred worldwide, and accordingly, the use of mechanical ventilators has exploded. However, hospitals do not have systematic risk management, and the Medical Device Regulation also provides medical device risk management standards for manufacturers, but does not apply to devices in use. In this paper, we applied the Failure Mode Effects Analysis (FMEA) risk analysis technique based on the International Standard ISO 14971 (Medical Devices-Application of risk management to medical devices) for 85 mechanical ventilators of a specific model in use in hospitals. Failure modes and effects of each parts were investigated, and risk priority was derived through multiplication of each score by preparing criteria for severity, occurrence, and detection for each failure mode. As a result, it was confirmed that the microprocessor-based Patient Unit/Monitoring board in charge of monitoring scored the highest score with 36 points, and that reliability management is possible through systematic risk management according to priority.

• 대한방사선기술학회지:방사선기술과학
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• 제38권4호
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• pp.437-442
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• 2015

전립선의 정확한 볼륨측정은 전립선암과 전립선비대의 진단, 치료 결정 및 예후 판정에 있어서 중요한 역할을 한다. 또한, 전립선암 선별검사에 사용하고 있는 혈청전립선특이항원(serum prostate-specific antigen)은 전립선의 볼륨과 서로 높은 상관관계를 보이기 때문에 이를 평가하기 위해서는 정확한 볼륨을 아는 것이 중요하다. 기존의 전립선 측정법이 다양하게 제시되고 있으나 전립선 모형 별 측정법에 대한 연구는 없었다. 본 연구에서는 다양한 모형의 팬텀을 제작하고 초음파를 이용하여 볼륨을 알아본 후 모형 별 측정위치를 찾아 새로운 측정방법을 제시하고자 한다. 초음파 검사를 통해 특징적인 전립선 모양 6개를 선정하였다. 이를 횡단과 종단영상을 참고하여 전립선 모형 6개를 제작하였다. 최적의 측정위치에서 각각 3회씩 반복측정 후 실제볼륨과 측정볼륨간의 유의성을 알아보기 위하여 Wilcoxon 부호순위 검정을 실시하였다. p값은 0.05이하일 때 유의한 것으로 정하였다. Axial 영상에서 돌출부위를 제외하고 안쪽으로 두고, Longitudinal 영상에서는 base와 apex의 오목한 부분에 측정 점을 놓았을 때 실제 전립선 크기와 일치도가 높았다. 실제볼륨과 측정볼륨간의 유의성은 p값 0.156으로 통계적으로 유의한 차이가 없었다. 전립선 axial 영상에서 전립선 이행대의 돌출이 심할 경우 돌출부위를 배제하고 측정하는 것이 실제 볼륨에 가까웠다. 또한 longitudinal영상에서는 apex부분이 가늘고 길어질 경우에 끝부분이 아닌 안쪽으로 측정 점을 잡아 그 점을 기준으로 타원을 그려 볼륨을 측정하는 것이 실제 볼륨에 가장 가까웠다.

• Journal of Preventive Medicine and Public Health
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• 제34권3호
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• pp.244-252
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• 2001

Objective : Health insurers and policy makers are increasingly examining the hospital mortality rate as an indicator of hospital quality and performance. To be meaningful, a risk-adjustment of the death rates must be implemented. This study reviewed 5 severity measurement methods and applied them to the same data set to determine whether judgments regarding the severity-adjusted hospital mortality rates were sensitive to the specific severity measure. Methods : The medical records of 584 patients who underwent coronary artery bypass graft surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups, Disease Staging, Computerized Severity Index, APACHE III and KDRG were used to quantify severity of the patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex to evaluate the hospitals' performance, the ratio of the observed number of deaths to the expected number for each hospital was calculated. Results : The overall in-hospital mortality rate was 7.0%, ranging from 2.7% to 15.7% depending on the particular hospital. After the severity adjustment, the mortality rates for each hospital showed little difference according to the severity measure. The 5 severity measurement methods varied in their statistical performance. All had a higher c statistic and $R^2$ than the model containing only age and sex. There was a little difference in the relative hospital performance evaluation by the severity measure. Conclusion : These results suggest that judgments regarding a hospital's performance based on severity adjusted mortality can be sensitive to the severity measurement method. Although the 5 severity measures regarding hospital performance concurred, more often than would be expected by chance, the assessment of an individual hospital mortality rates varied by the different severity measurement method used.