• 디지털융복합연구
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• 제16권9호
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• pp.319-327
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• 2018

본 연구는 만성 심부전 환자를 대상으로 스마트폰을 활용한 자가관리에 대한 환자의 인식을 파악하고자 스마트폰을 이용하는 만성심부전 환자 11명을 대상으로 질적연구의 한 방법인 포커스 그룹을 이용하였다. 환자는 세 그룹으로 나누어 조사하였고 면담 시 녹취한 자료를 기록하여 내용분석하였다. 그 결과 자가관리에 대한 인식은 자가관리 보조, 일상생활 불편, 혼란스러운 건강정보, 개인정보노출에 대한 두려움이었고, 방해요인은 요금부담, 노화에 따른 사용의 어려움, 사용방법에 대한 이해부족, 부정적 건강신념이었으며, 촉진요인은 이해가 쉬운 건강정보 전달, 의료진과 환자 간 의사소통 채널, 심리사회적지지, 개별화된 건강관리로 범주화 되었다. 그러므로 심부전 환자를 위한 모바일 자가관리 프로그램 개발 시 심부전 환자의 요구도와 선호도에 대한 측면과 스마트폰 활용을 함에 있어 긍정적 혹은 부정적 영향요인을 고려하여 설계하는 데 기초자료를 제공할 것이다.

• Journal of Microbiology and Biotechnology
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• 제27권4호
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• pp.747-758
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• 2017

Chronic wounds, pressure sores, lesions, and infections of microbial origin in bedridden, paralyzed, or malnutrition patients remain the object of study of many researchers. A variety of factors behind the development of these disorders are related to the patient's immune system, making it unable to respond effectively to the treatment of the wound. These factors can be properly controlled, giving particular importance to the ethiology and stage of the wound, as well as the time periods corresponding to the replacement of the dressings. The present research reports a novel foam/soft material, ${{\small}L}$-Cys-g-PCL, with an application for decubitus/pressure ulcers, especially for wounds with a difficult healing process due to infections and constant oxidation of the soft tissues. During this work, the interactions between S. aureus and ${{\small}L}$-Cys-g-PCL foam were studied under conditions that simulate decubitus ulcers; namely, pH and exudate. The effects of duration of grafting (1 or 8 h) and pH (7.0 and 8.9) on wettability, surface energy, swelling, and porosity were also evaluated. Results showed an effective microbicidal activity exhibiting an inhibition ratio of 99.73% against S. aureus. This new ${{\small}L}$-Cys-g-PCL soft material showed saftey to contact skin, ability to be shaped to fill in sunken holes (craters) - pressure ulcers stage III - and to act as a smart material responsive to pH, which can be tailored to develop better swelling properties at alkaline pH where exudates are normally higher, so as to address exudate self-cleaning and prevention of desiccation.

• Archives of Plastic Surgery
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• 제47권5호
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• pp.419-427
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• 2020

Background This study evaluated the Blossom system, an innovative self-filling, rate-controlled, pressure-responsive saline tissue expander (TE) system. We investigated the feasibility of utilizing this technology to facilitate implant-based and combined flap with implant-based breast reconstruction in comparison to conventional tissue expansion. Methods In this prospective, single-center, single-surgeon pilot study, participants underwent either implant-based breast reconstruction or a combination of autologous flap and implantbased breast reconstruction. Outcome measures included time to full expansion, complications, total expansion volume, and pain scores. Results Fourteen patients (TEs; n=22), were included in this study. The mean time to full expansion was 13.4 days (standard error of the mean [SEM], 1.3 days) in the combination group and 11.7 days (SEM, 1.4 days) in the implant group (P=0.78). The overall major complication rate was 4.5% (n=1). No statistically significant differences were found in the complication rate between the combination group and the implant group. The maximum patient-reported pain scores during the expansion process were low, but were significantly higher in the combination group (mean, 2.00±0.09) than in the implant group (mean, 0.29±0.25; P=0.005). Conclusions The reported average duration for conventional subcutaneous TE expansion is 79.4 days, but this pilot study using the Blossom system achieved an average expansion duration of less than 14 days in both groups. The Blossom system may accommodate single-stage breast reconstruction. The overall complication rate of this study was 4.5%, which is promising compared to the reported complication rates of two-stage breast reconstruction with TEs (20%-45%).

• International journal of advanced smart convergence
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• 제5권2호
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• pp.53-58
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• 2016

With the growing use of big data and data mining, it serves to understand how such techniques can be used to understand various relationships in the healthcare field. This study uses hierarchical methods of data analysis to explore similarities in hospitalization across several New York state counties. The study utilized methods of measuring crowding distance of data for age-specific hospitalization period. Crowding distance is defined as the longest distance, or least similarity, between urban cities. It is expected that the city of Clinton have the greatest distance, while Albany the other cities are closer because they are connected by the shortest distance to each step. Similarities were stronger across hospital stays categorized by age. Hierarchical clustering can be applied to predict the similarity of data across the 10 cities of hospitalization with the measurement of crowding distance. In order to enhance the performance of hierarchical clustering, comparison can be made across congestion distance when crowding distance is applied first through the application of converting text to an attribute vector. Measurements of similarity between two objects are dependent on the measurement method used in clustering but is distinguished from the similarity of the distance; where the smaller the distance value the more similar two things are to one other. By applying this specific technique, it is found that the distance between crowding is reduced consistently in relationship to similarity between the data increases to enhance the performance of the experiments through the application of special techniques. Furthermore, through the similarity by city hospitalization period, when the construction of hospital wards in cities, by referring to results of experiments, or predict possible will land to the extent of the size of the hospital facilities hospital stay is expected to be useful in efficiently managing the patient in a similar area.

• 재활복지공학회논문지
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• 제9권2호
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• pp.153-160
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• 2015

최근 IT융합 기술의 발달에 따라 의료기기에 대한 IT융합 기술은 비약적으로 발전하고 있다. 응급 상황시 가장 기본적으로 우선적으로 시행 되어야 하는 것은 환자에 호흡이고 동시에 응급 환자에 기도를 유지하고 응급 처치를 해야 한다. 그러나 기도를 확보하는 술기인 기관 내 삽관을 하려면 응급 처치 사가 능숙한 경력과 경험을 요구하며 그렇지 않으면 술기에 실패 해 환자에서 후유증을 가져다 줄 수도 있는 매우 민감하고 중요한 술기이다. 이러한 이유로 현재 기관 내 삽관 술기의 성공률은 50%정도로 높은 수준이 아니다. 이러한 문제점을 보완하고자 본 논문에서는 기관 내 삽관을 하는 과정에서 인투베이션 튜브에 내시경 카메라를 삽입하여 삽관하고 실시간 모니터링과 무선 영상 전 송 방법인 스트리밍을 이용하여 스마트기기에서도 모니터링을 가능하게 하여 응급 처치 사들의 기관 내 삽관 성공률을 높이는데 목적이 있다.

• International journal of advanced smart convergence
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• 제7권1호
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• pp.33-41
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• 2018

This study was designed to provide basic data for developing exercise program that helps correcting posture by knowing the effect of strengthening and elongation exercises of upper extremity muscle to forward head posture correction. In this study determined subjects whether they had forward head posture or not. On the basis of the New York state posture rating, if a subject's posture is match up with the normal standard posture, gives 5 points and if the posture is slightly get out of the normal standard posture, gives 3 points and if the posture is apparently get out of the standard, gives 1 points. When determining the forward head posture, if talus, humerus and outer ear center are on the same line, it is determined as normal and if outer ear center is off the line less than 1.0cm, it is a slight deformation and if outer ear center is off the line more than 1.0cm, it is a high deformation. In the study selected people who have more than 1 cm gap between two vertical lines start from outer ear center and acromion separately as subjects. Length between the ideal alignment line measured by using goniometer and temporal region showed statistically significant decrease as $2.36{\pm}1.07cm$ before the intervention and $1.06{\pm}0.88cm$ after the intervention. After 4 weeks of neck and chest extensor muscle exercise, the group who exercised both showed increase in range of neck joint motion and neck flexion of the forward head posture. Meanwhile the group who only exercised neck extensor muscle only and the group who only exercised chest extensor muscle didn't showed statistically significant result. That only the group who exercised both muscles showed significant result is the different with studies before. Because this study didn't target patient who had a lesion, couldn't compare effect of the conservative manner and exercise. However, this study provides the fact that the group who exercised both neck and chest muscle had more effect than the control group.

• 융합정보논문지
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• 제7권6호
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• pp.135-141
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• 2017

최근 만성질환을 앓고 있는 고령자가 늘어나고 교통사고와 같은 재난이 증대됨에 따라 이와 같은 응급상황에 응급구조사와 의사들이 효율적으로 대응할 필요성이 대두되고 있다. 특히, 만성질환과 치매를 앓고 있던 고령자에게 뇌경색이나 교통사고와 같은 응급상황이 발생하게 되면, 기본적인 자신의 인적정보과 병력을 전달하지 못하여 구조대의 응급처치가 늦어지고 의료정보의 부족으로 병원에서의 효율적인 응급치료도 어렵게 된다. 본 논문에서는 QR 코드를 이용하여 응급 구조사에게는 응급치료에 필요한 최소한의 개인정보와 병력을 전달하고 병원의 응급실 의사에게는 QR 코드와 지문인식을 통해 그동안의 병력 및 치료데이터를 전달함으로써 효율적인 응급처치 및 응급치료가 가능하도록 하였다. 특히 스마트폰의 QR 코드와 개인의 지문을 동시에 활용함으로써 개인정보는 보호하고 권한을 부여받은 의사들만이 병적기록을 확인할 수 있도록 하여 의료정보의 프라이버시 및 보안을 강화했다.

• 한국산학기술학회논문지
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• 제20권6호
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• pp.402-409
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• 2019

치매 환자나 혼자 힘으로 전혀 움직이지 못하는 노인 환자는 간병 인력 부족으로 낙상 사고 및 욕창 발생 가능성이 매우 크다. 본 논문에서는 이러한 문제를 해결하기 위해 일정 주기마다 감지한 압력 세기를 기준으로 머리, 어깨, 엉덩이 등 주요 신체 부위를 판별하여 환자의 누운 자세를 판별할 수 있는 알고리즘을 제안한다. 신체적 특성에 무관하게 신체 부위 판별이 가능하도록 격자 구조로 압력 센서를 배치한 스마트 매트를 제작하였다. 스마트 매트는 $7{\times}7$ 배열 크기의 2개 모듈을 조합하여 구성하였다. 각 모듈은 모두 49개의 FSR-406 센서로 구성되며 독립적으로 압력을 감지한다. 각 모듈에 대해 필터를 사용한 누적 압력 합 등 압력 분포를 이용해 상체 또는 하체에 해당하는 신체 부위를 순차적으로 판별한다. 제안한 알고리즘은 머리, 어깨, 엉덩이 부위 등 계층-1에 속한 신체 부위간 포함 관계를 조사해 5가지 누운 자세를 판별할 수 있다.

• International journal of advanced smart convergence
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• 제8권1호
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• pp.24-34
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• 2019

In this research, a practical deep learning framework to differentiate the lesions and nodules in breast acquired with ultrasound imaging has been proposed. 7408 ultrasound breast images of 5151 patient cases were collected. All cases were biopsy proven and lesions were semi-automatically segmented. To compensate for the shift caused in the segmentation, the boundaries of each lesion were drawn using Fully Convolutional Networks(FCN) segmentation method based on the radiologist's specified point. The data set consists of 4254 benign and 3154 malignant lesions. In 7408 ultrasound breast images, the number of training images is 6579, and the number of test images is 829. The margin between the boundary of each lesion and the boundary of the image itself varied for training image augmentation. The training images were augmented by varying the margin between the boundary of each lesion and the boundary of the image itself. The images were processed through histogram equalization, image cropping, and margin augmentation. The networks trained on the data with augmentation and the data without augmentation all had AUC over 0.95. The network exhibited about 90% accuracy, 0.86 sensitivity and 0.95 specificity. Although the proposed framework still requires to point to the location of the target ROI with the help of radiologists, the result of the suggested framework showed promising results. It supports human radiologist to give successful performance and helps to create a fluent diagnostic workflow that meets the fundamental purpose of CADx.

• 대한예방한의학회지
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• 제23권2호
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• pp.1-10
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• 2019

Backgrounds : In 2017, National Health Insurance implemented the pilot coverage program for Chuna manual therapy(CMT). 65 Korean Medicine(KM) hospitals and clinics were selected in the program to monitor the effectiveness and patients' satisfaction of insured CMT. Objectives : This study aimed to evaluate patients' satisfaction of CMT in the pilot coverage program of National Health Insurance. Methods : Survey participants were recruited among the patients who used CMT at the designated organizations. On-line questionnaire link was sent to the smart phones of patients who agreed to participate in the survey and provide personal contact information. The questionnaire consisted of the basic charactersitics of respondents, imformation on using CMT satisfaction with CMT and willingness to recommend CMT to others. The answers that were automatically coded and saved were statistically analyzed. Results : Of 386 participants who completed the questionnaire, 92.8% satisfied or strongly satisfied with the CMT. Most frequent reason of satisfaction was 'Good effectiveness', and there was no difference in satisfaction between patients of hospital and those of clinics. Patients with the highest and the lowest level of pain satisfied more than those with other pain levels(p=0.003), but the level of copayment and reasons of CMT use did not affect the satisfaction results(p=0.405). The proportions of respondents who had willingness to recommend CMT to others and to revisit for CMT use were 97.8% and 98.8%, respectively. Conclusions : Most patients were satisfied with CMT in the pilot coverage program, and it can provide the rationale for expanding the insurance coverage of CMT to all KM hospitals and clinics.