• 한국지능시스템학회논문지
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• 제20권1호
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• pp.66-75
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• 2010

유비쿼터스 서비스 인프라의 확충에 따라 헬스케어 분야가 중요한 서비스 영역으로 주목받고 있다. 유비쿼터스 헬스케어는 서비스의 실현에 있어서 의료종사자뿐만 아니라 환자 및 환자보호자의 역할이 요구되고, 또한 정보 인프라에서의 지원도 필수적이다. 의료서비스의 정형화 및 품질보증을 위해서 의료분야에서는 임상 프로토콜을 정의하고 이를 임상에 적용하고 있다. 유비쿼터스 환경에서의 의료 서비스 품질을 보증하기 위해서는 마찬가지로 임상 프로토콜을 활용하는 것이 필요하다. 유비쿼터스 헬스케어 서비스에는 의료종사자 뿐만아니라 환자 및 환자보호자, 정보 시스템이 각자의 고유 역할을 하는 것이 요구된다. 이러한 유비쿼터스 헬스케어 서비스에서의 요구사항을 만족하면서 임상프로토콜을 효과적으로 개발할 수 있도록 하는 유비쿼터스 헬스케어 임상 프로토콜을 개발하는 방법을 소개한다. 제안된 방법은 헬스케어 참여자별 태스크들을 명확히 식별하도록 하면서, 태스크간의 관계를 명확히 하도록 하여 가시화가 가능하도록 한다. 개발된 방법론은 유비쿼터스 환경에서 과민성방광 환자관리를 위한 임상 프로토콜을 개발하는데 적용하여 적용가능성을 확인했다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.21.1-21.8
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• 2015

Computer Assisted Simulation Surgery (CASS) is a reliable method that permits oral and maxillofacial surgeons to visualize the position of the maxilla and the mandible as observed in the patient. The purpose of this report was to introduce a newly developed strategy for proximal segment management according to Balanced Orthognathic Surgery (BOS) protocol which is a type of CASS, and to establish the clinical feasibility of the BOS protocol in the treatment of complex maxillo-facial deformities. The BOS protocol consists of the following 4 phases: 1) Planning and simulation phase, 2) Modeling phase, 3) Surgical phase, and 4) Evaluation phase. The surgical interventions in 80 consecutive patients were planned and executed by the BOS protocol. The BOS protocol ensures accuracy during surgery, thereby facilitating the completion of procedures without any complications. The BOS protocol may be a complete solution that enables an orthognatic surgeon to perform accurate surgery based on a surgical plan, making real outcomes as close to pre-planned outcomes as possible.

• Clinical and Experimental Reproductive Medicine
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• 제48권2호
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• pp.163-173
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• 2021

Objective: This study aimed to characterize a validated model for predicting oocyte retrieval in controlled ovarian stimulation (COS) and to construct model-based nomograms for assistance in clinical decision-making regarding the gonadotropin protocol and dose. Methods: This observational, retrospective, cohort study included 636 women with primary unexplained infertility and a normal menstrual cycle who were attempting assisted reproductive therapy for the first time. The enrolled women were split into an index group (n=497) for model building and a validation group (n=139). The primary outcome was absolute oocyte count. The dose-response relationship was tested using modified Poisson, negative binomial, hybrid Poisson-E_max, and linear models. The validation group was similarly analyzed, and its results were compared to that of the index group. Results: The Poisson model with the log-link function demonstrated superior predictive performance and precision (Akaike information criterion, 2,704; λ=8.27; relative standard error (λ)=2.02%). The covariate analysis included women's age (p<0.001), antral follicle count (p<0.001), basal follicle-stimulating hormone level (p<0.001), gonadotropin dose (p=0.042), and protocol type (p=0.002 and p<0.001 for short and antagonist protocols, respectively). The estimates from 500 bootstrap samples were close to those of the original model. The validation group showed model assessment metrics comparable to the index model. Based on the fitted model, a static nomogram was built to improve visualization. In addition, a dynamic electronic tool was created for convenience of use. Conclusion: Based on our validated model, nomograms were constructed to help clinicians individualize the stimulation protocol and gonadotropin doses in COS cycles.

• 한국정밀공학회지
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• 제25권2호
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• pp.148-155
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• 2008

The aim of the study is to interpret the distribution of occlusal force by 3-dimensional finite element analysis of ISP(Implant Supported Prosthesis) supported by minimum number of implant to restore the edentulous patients. For this study, the Astra Tech implant system is used. Geometric modeling for 6 and 4 fixture ISP group is performed with respect to the bone, implant and one piece superstructure, respectively. Implants are arbitrarily placed according to the anatomical limit of lower jaw and for the favorable distribution of occlusal force, which is applied at the end of cantilever extension of ISP with 30mm. Element type is tetrahedral for finite element model and the typical mechanical properties, Young's modulus and Poisson's ratio of each material, cortical, cancellous bone and implant material are utilized for the finite element analysis. From this study, we can see the distribution of equivalent stress equal to real situation and speculate the difference in the stress distribution in the whole model and at each implant fixture, From the analysis, the area of maximum stress is distributed on distal contact area between bone and fixture in the crestal bone. The maximum stress is 53MPa at the 0.2mm area from the bone-implant interface in the maximum side for 300N load condition for 4 fixture case, which is slightly less than the stress calculated from allowable strain. This stress has not been deduced to directly cause the loss of crestal bone around implant fixture, but the stress can be much reduced as the old peoples may have lower chewing force. Thus, clinical trial may be performed with this treatment protocol to use 4 fixtured ISP for old patients.