• Journal of Nutrition and Health
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• 제41권2호
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• pp.147-155
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• 2008

우리나라의 경제적 발달과 문화 수준의 향상으로 질병 양상과 사망 원인에 많은 변화가 있는데, 그 중에서도 최근 당뇨병의 유병률의 상승 현상이 두드러지게 나타나고 있으며, 사망 원인의 수위를 차지하고 있다. 그러므로 이를 예방하고 당뇨병 합병증을 예방하기 위한 구체적이고 근거중심인 영양치료 방법의 제시가 절실한 실정이다. 미국영양사협회에서는 지속적으로 증가하는 당뇨병 유병율을 낮추기 위하여 생활습관의 개선을 목표로 임상영양치료의 표준화 지침을 제시하고 이에 따른 치료 효과 연구가 활발히 진행되고 있으나, 아직 국내에서는 많은 연구가 진행되고 있지 않은 현실이다. 따라서 본 연구에서는 이미 국외에서 사용되고 있는 지침에 근거하여 심층영양교육 방법을 실시하여 그 효과를 1회 교육만으로 시행되는 기본교육 방법과 비교하여 다음과 같으나 결과를 얻었다. 심층 및 기본영양교육 즉, 두 가지 교육 방법을 비교하였을 때 심층영양치료 방법을 실시한 경우 기본영양교육을 실시한 경우보다 혈당, 혈압 및 체중 강하 효과 면에서 유의적으로 개선효과가 있는 것으로 나타났다. 비용효과 면에서 장기간의 혈당변화 상태를 알 수 있는 당화혈색소의 경우 1%를 낮추기 위하여 소요되는 비용은 심층영양교육군에서 더 적었으며, 교육의 잠재 효과를 고려하였을 경우, 모든 혈당 검사 지표의 영양치료 비용 대비 효과 면에서 심층영양교육 방법이 기본영양교육 방법보다 앞서는 것으로 나타났다. 저비용 고치료 효과를 보여주고 있는 임상영양치료는 당노병과 같은 만성질환의 중요한 기본치료로 주목되고 있는 현 시점에서 영양치료행위의 의료 보험 급여화는 국민의 건강을 증진시키고, 국가적으로는 의료비 지출을 감소시키며 국민의 건강을 증진시키는데 큰 기여를 하는 합리적인 방안이라 생각된다. 따라서 현 비급여 수가로 되어 있는 교육수가를 급여화하여 많은 환자들에게 의료 혜택을 주는 일이 필요하리라 사료된다.

• 한국엔터테인먼트산업학회논문지
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• 제15권4호
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• pp.337-347
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• 2021

본 연구는 요양병원에 근무하는 치료사의 코로나19 대응 전략 및 치료실 감염관리 시스템 개선을 위한 기초자료를 제공하고 치료사의 감염관리 업무 이해를 돕고자 실시한 질적 연구이다. 연구방법은 Colaizzi의 현상학적 연구 방법을 적용하였다. 요양병원에서 근무 중인 작업치료사와 물리치료사 9명을 대상으로 전화 인터뷰를 실시하였다. 인터뷰 내용은 연구대상자의 동의하에 녹음하였으며, 추가적인 내용 확인은 이메일로 받았다. 녹음된 내용은 전사 뒤 분석하여, 코로나19에 대처한 경험의 의미와 본질을 기술하였다. 인터뷰 내용은 6개의 주제와 17개의 중심의미, 49개의 의미단위로 정리하였다. 코로나19 상황에 따라 요양병원 내 감염관리 교육 강화, 감염관리 실천, 업무시간 외 감염관리 감독으로 감염관리 시스템이 강화되었으며, 치료실 내 거리두기 실천, 업무시간 내 휴식 및 식사시간 조정, 감염관리 강화로 치료활동 제약으로 치료 환경이 변화된 것을 알 수 있었다. 또한 치료사의 역할이 확대되고 언택트 중재방법에 대한 고려하는 등 치료의 패러다임이 변화되었으며, 코호트 격리, 코로나19 사전검사, 백신접종과 부작용 경험으로 코로나19에 따른 새로운 경험을 하였음을 확인하였다. 하지만 감염업무로 인해 치료사의 업무 부담이 가중되고, 코로나19 확산에 따른 두려움과 우울감, 업무 스트레스를 겪고 있으며, 백신접종 후 휴식 보장, 감염관리 도구 및 장비 지원 등 요양병원 치료인력 지원의 필요성도 인식하고 있었다. 본 연구의 결과는 요양병원 치료실 내 감염병 대응 전략 프로그램 개발 및 요양병원 감염관리를 위한 인적, 물적 지원의 기초 자료로 활용되기를 기대한다.

• 치위생과학회지
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• 제12권4호
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• pp.383-391
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• 2012

본 연구는 치과위생사가 경험하는 윤리적 딜레마와 임파워먼트의 정도를 파악하여 치과위생사의 윤리적 딜레마를 감소시켜 임파워먼트를 증진시키고 질적인 치위생과정을 수행하는데 기초자료를 제공하고자 일부지역 치과위생사 232명의 설문조사를 분석한 결과 다음과 같은 결론을 얻었다. 1. 대상자의 윤리적 딜레마 정도는 평균평점 1.58점(최대 4점)이었고, 각 영역별 점수를 살펴보면 치과위생사와 전문직 1.79점, 치과위생사와 대상자 1.53점, 생명존중 및 인간의 권리 존중 1.51점, 치과위생사와 협동자 1.49점 순으로 나타났다. 2. 대상자의 일반적 특성 중 학력이 높을수록, 결혼 전까지 잠정적인 직업으로 생각하는 경우에서 윤리적 딜레마가 높았다. 3. 대상자의 임파워먼트는 평균평점 3.05점(최대 5점)이었고, 각 영역별 점수를 살펴보면 지지구조 3.52점, 기회구조 3.18점, 정보구조 3.08점, 자원구조 3.04점 순으로 나타났다. 4. 대상자의 임파워먼트는 일반적 특성 중 학력과 치과위생사의 전문직에 대한 태도에서 유의성있는 차이를 보였으며 전공심화, 학점은행제를 통한 학위 취득자와 치과위생사라는 직업을 평생직업으로 생각하는 경우에서 임파워먼트가 높게 나타났다. 5. 윤리적 딜레마와 임파워먼트는 유의한 역상관관계를 보였다. 치과위생사와 대상자는 정보구조, 지지구조 및 자원구조에서, 치과위생사와 전문직은 기회구조, 지지구조 및 자원구조에서 유의한 상관관계를 나타냈다. 치과위생사와 협동자는 기회구조, 지지구조 및 자원구조에서, 생명존중 및 인간의 권리존중은 자원구조에서 유의한 상관관계를 나타냈다. 6. 대상자의 윤리적 딜레마에 영향을 미치는 요인은 결혼여부와 임파워먼트에서 유의한 것으로 나타났고 임파워먼트는 나이, 학력 및 윤리적 딜레마에서 유의한 관계가 있는 것으로 나타났다. 윤리적 딜레마가 낮을수록 임파워먼트가 높다는 본 연구결과를 바탕으로 윤리적 딜레마를 효과적으로 해결할 수 있도록 여러 가지 중재프로그램의 개발과 함께 임파워먼트를 높일 수 있는 전략개발 및 적용연구가 필요할 것으로 사료된다.

• 한국응급구조학회지
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• 제9권2호
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• pp.111-128
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• 2005

Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

• 헤리티지:역사와 과학
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• 제48권3호
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• pp.30-45
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• 2015

본 글의 목적은 사회적 수요의 부족 등으로 인한 국내 무형문화유산의 전승 단절 위기 현상을 주목하고, 문제의 해결방안 중 하나로 자생력 측면에서 무형문화유산 체계를 검토하여 그 발전방안을 모색하는 데 있다. 이러한 목적 하에 본 논문의 제2장에서는 연구방법론으로써 생태계적 방식을 고찰하고 생태계적 방식을 통해 무형문화유산 체계를 분석하였다. 생태계적 방식은 시스템의 운영에 생태계의 특징 및 원리를 적용하여 외부의 개입을 전제하거나 동원하지 않고서도 내부의 자생력만으로 시스템을 유지하는 것을 말한다. 그리고 무형문화유산 체계는 무형문화유산을 보호 전승 활용하기 위해 구성된 제도적 시스템을 말하며 크게 문화재보호법에 의한 기본원칙, 활동주체 그리고 절차 및 방법으로 나눠 살펴볼 수 있다. 생태계적 관점에서 검토한 결과 상호관계성, 순환성, 개방성, 다양성, 균형성 등과 관련한 문제점이 지적되며 정부의 개입을 전제하지 않으면 무형문화유산 체계가 제대로 운영될 수 없는 구조적 문제가 고착화되어 있다. 이에 제3장에서 생태계 원리를 적용해 무형문화유산의 체계의 개선 및 자생력 강화 방안을 제시하였다. 우선 유네스코 무형문화유산보호협약을 기초로 하여 상호관계성, 다양성, 균형성 등 생태계적 관점에 입각해 관련 규정의 기본원칙을 제시하였고, 전체론적 관점에서 제도의 구성요소 및 활동주체의 범위를 확대하여 제안하였다. 그리고 기존 활동주체의 역할 및 관계가 기 예능의 원형 보전에 치중했던 점을 개선하여 무형문화유산의 생산 소비 재생산 소멸 등 선순환적 발전의 흐름이 일어나도록 자연생태계의 생산자, 소비자, 분해자 개념에 따라 그 역할과 관계를 재편성하여 제안하였다. 기존의 체계와 비교하여 활동주체로 창작자, 프로슈머, 창업자, 시민 예술가 등을 제시하였는데 이들의 활동은 공급의 다양화에 기여할 수 있을 것이며 장기적으로 생태계가 건강하게 유지될 수 있는데 기여할 수 있을 것이다. 마지막으로 활동주체들 간의 자유로운 상호작용을 통해 사회의 수요와 공급의 조화, 순환적 발전의 흐름이 일어날 수 있도록 제도의 구성 및 운영 방향을 제시하였다.

• Journal of Nutrition and Health
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• 제49권2호
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• pp.111-124
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• 2016

본 연구는 라오스의 도시와 농촌 지역에 따른 식행동 및 최근의 식생활의 변화와 이에 따른 건강상태의 차이를 알아보고자 하는 목적으로 수행되었으며 그 결과는 다음과 같다. 1) 연구 대상자는 라오스의 수도 비엔티안과 교외 농촌 지역에 거주하는 성인 40~59세의 979명 (남자 435명, 여자 544명)이었으며, 도시 집단이 농촌 집단에 비해 읽고 쓸 수 있는 비율, 고학력 비율, 가정 내 소유 물품이 많은 비율, 정부기관이나 사 기관에 근무자의 비율이 유의적으로 높게 나타났다. 따라서 경제적 수준은 전반적으로 도시 집단이 농촌 집단에 비해 높은 경향을 보였다. 2) 전반적인 건강의 상태는 도시가 농촌에 비해 몸무게, 허리둘레, 체질량지수, 이완기 고혈압 비율, 알코올 섭취 빈도가 유의적으로 높았으며, 농촌은 도시 집단에 비해 흡연율이 유의적으로 높았다. 주관적 건강의 상태는 안 좋다는 비율이 농촌 집단이 유의적으로 높았으며 매우 좋다는 비율은 도시 집단이 유의적으로 높았다. 3) 거주 지역별 남녀의 건강 상태를 비교 시 도시에 거주하는 여성이 도시에 거주하는 남성에 비해 체질량지수와 비만율이 유의적으로 높았으며, 도시에 거주하는 남성에서 수축기 혈압과 이완기 혈압의 평균이 농촌 지역에 거주하는 남성에 비해 유의적으로 컸다. 4) 농촌에서는 하루 세끼 섭취 비율과 아침식사 섭취 횟수가 도시에 비해 유의적으로 높았으며, 도시 지역에서는 외식 횟수가 농촌 지역에 비해 높았다. 또한 주관적인 식사의 평가와 주관적인 식욕의 정도는 도시가 농촌에 비해 'poor/fair' 비율이 농촌 지역에 비해 유의적으로 높았다. 5) 도시에서는 농촌 지역에 비해 최근 삼 년간 식사가 변화한 비율, 외식의 증가 비율, 서양식 식사가 증가한 비율이 유의적으로 높았다. 6) 도시에서는 우유 및 유제품, 단백질 식품, 과일, 튀기거나 볶은 음식, 지방질 많은 고기의 섭취와 다양하고 균형잡힌 식사의 섭취가 농촌 지역에 비해 유의적으로 높게 나타났으며, 농촌에서는 도시 보다 세끼를 규칙적으로 섭취하고 있었다. 7) 각 식품군별 섭취빈도에서 주간 섭취 횟수는 도시가 과일과 우유의 섭취가 농촌에 비해 유의적으로 높았으나, 채소의 섭취는 낮았다. 하루 섭취량은 도시가 과일, 우유의 섭취 양이 농촌에 비해 유의적으로 높았으며, 채소, 육류, 계란의 섭취 양은 낮았다. 8) 결론적으로 라오스의 도시는 농촌에 비해 식습관에서 서구화의 영향을 더 받으며 전통적인 식사가 건강하지 않은 서구화된 식사로의 변화가 진행되고 있으며, 이는 비전염성질환을 증가 시키는 위험 요소로 작용 할 수 있다. 또한 도시 지역과 농촌 지역 모두에서 높은 만성질환율을 보이므로 건강한 식행동으로의 변화와 라오스의 만성질환율의 감소 및 예방을 위해 지역의 차이에 따른 차별화된 개별적 맞춤형 영양교육이 필요하다고 사료된다.

• 인간행동과 음악연구
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• 제4권2호
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• pp.1-17
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• 2007

청소년기는 성장과 발달의 과도기적 단계로 모든 영역에서의 발달과 새로운 역할 수행, 학업수준의 향상으로 인한 부담감 등 커다란 변화를 겪게 된다. 이 시기의 청소년은 발달 과제를 해내지 못하거나 변화로 인한 좌절이나 갈등을 반복하는 경우 스트레스와 우울 같은 심리적 어려움을 토로하게 되고, 성숙한 대처를 못하거나 극복하지 못하는 경우 우울이나 불안 같은 정신장애를 얻기도 한다. 오늘날 현대 사회의 청소년을 위한 실질적인 정신건강이나 정신장애에 대한 대응과 예방은 미비하며, 이에 청소년을 위한 상담이나 심리치료 프로그램의 개발이 절실히 요구되고 있다. 그러므로 본 연구에서는 우울 성향을 가진 여중생에게 블루스 음악형식을 활용한 자기효능감 증진 연주활동을 시행하여 참여자들의 우울과 자기효능감에 대해 미치는 영향과 대상자들이 연주를 통해 어떠한 경험을 했는지에 대해 살펴보고자 하였다. 연구 참여자는 서울시 소재 D중학교 1학년에 재학 중인 여자 중학생 3명으로 연구자가 70여명의 학생들에게 아동우울척도(CDI)와 자기효능감척도 검사를 실시하여 선별한 여학생들이다. 실시된 10회기의 연주활동은 3단계로 나누어지는데, 1단계에서는 자기소개와 라포형성, 블루스 음악소개와 블루스 음악형식 연주를 통한 활동에 대한 흥미 유발을 목표로 진행하였다. 2단계에서는 블루스 음악에서 자주 볼 수 있는 특징적인 부분인 부점, 셋잇단음표, 엇박자를 활용한 블루스 음악형식을 연주해 익히고, 5회기 동안 각 회기에서 수행하는 음악과제의 난이도를 달리하여 음악연주과제(즉흥연주 포함)를 수행하도록 하였다. 3단계에서는 전 단계에서 배워 연주했던 곡들을 정리하고 각 대상자들이 곡을 선택하거나 새로운 곡을 창작하여 연습한 뒤 음악연주 발표시간을 가짐으로써 완수경험의 극대화로 음악연주에 대한 경험을 확장하는 시간으로 활용하고자 하였다. 연구결과는 첫째, 연주활동에 참여한 참가자들의 우울 점수는 유의미한 차이를 보이진 않았으나 우울과 자기효능감이 부적상관관계가 있음을 볼 수 있었다. 둘째, 연주활동에 참여한 참가자들의 자기효능감에 미친 영향으로는 자기효능감의 세 가지 하위영역 중 과제난이도선호에서 유의미한 차이를 보여주었다. 셋째, 연주활동에 참가자들의 음악연주에 대한 자기효능감의 세 가지 하위영역 중 과제난이도 선호에서 유의미한 차이를 보여주었다. 넷째, 사후 인터뷰 질문지의 내용과 대상자들의 각 회기 세션 내용을 질적으로 서술하고 분석해 본 결과 대상자들은 블루스 음악형식 연주활동을 통해 과제난이도를 달리하여 연주활동을 했을 때, 자신감을 경험하고 긍정적인 정서를 경험했으며 대상자들에게 의미 있는 경험이었다는 것을 알 수 있었다. 마지막으로 본 연주활동의 효과와 대상자들의 음악경험의 결과와 의미를 볼 때에 블루스 음악형식을 활용한 연주활동이 치료적인 중재 도구로서의 가능성이 있음을 시사한다.

• 인간행동과 음악연구
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• 제2권2호
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• pp.33-56
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• 2005

본 연구의 목적은 공격성 아동을 대상으로 하여 타악기 중심의 음악활동이 아동의 공격성에 미치는 효과를 사례연구를 통해서 알아보고 그 치료적 프로그램을 제시하는데 있다. 본 연구에서는 공격성 아동 3명을 대상으로 타악기 중심의 음악활동 프로그램을 적용하여 7주에 걸쳐 총 21회 소그룹 세션을 실시하였고 각 세션은 30분으로 구성하였다. 공격성 아동의 선정은 4학년에 재학 중인 학생을 대상으로 곽금주(1992)가 다소 수정하여 만든 교사평정용 공격성 측정도구를 사용하여 공격성 점수가 높은 아동 3명을 선정하였다. 또한 이들에게 조해연(2001)과 이주식(2003)이 사용한 척도를 수정 보완한 16문항의 자기 질문식 충동성 측정 도구를 사용하여 충동성 검사도 함께 사전 실시하였다. 이를 통하여 사례아동의 공격성과 충동성 측정 도구의 사전-사후 검사 결과와 함께 음악활동 개입 후 치료 초기(1~3회기)와 후기(19~21회기)의 공격적 행동발생 변화를 데이터화하여 비교 분석 하는 양적인 연구와 타악기 연주활동이 아동에게 미친 반응을 관찰 기록하는 질적인 연구를 동시에 하였다. 연구 결과는 공격성 측정도구의 사후검사 점수가 사례아동 A는 19점에서 16점으로, 사례아동 B는 23점에서 19점으로, 사례아동 C는 21점에서 18점으로 낮아졌으며 충동성 측정도구의 사후검사 점수도 사례아동 3명 모두 낮아졌음을 보여주었다. 또한 목표행동 발생 빈도수의 변화도 음악치료 초기보다 후기로 갈수록 감소한 결과를 나타내었다. 사례아동의 질적 연구결과는 타악기 연주활동 후 자기표현을 통해 스트레스 해소라는 감정상태의 변화를 나타내었다. 이러한 양적 질적 분석의 결과들은 타악기 중심의 음악치료 프로그램이 사례아동에게 공격성 감소라는 치료적 효과를 보여준 것으로 타악기가 공격성 아동을 위해 유용한 치료적 수단으로 활용될 수 있음을 입증한 것이라 할 수 있다.

• 대한간호학회지
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• 제11권1호
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• pp.65-87
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• 1981

The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1％ indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0％ of the respondents view that patient is the client, while only 67.1％ of nursing student and 74.7％ of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6％ satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9％ were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l％ were not have any religion; 52.6% were unmarried； 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p ＜ 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96％ of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

• 대한의용생체공학회:의공학회지
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• 제6권2호
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• pp.1-8
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• 1985

The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70$\pm$1.32mmHg/min)compared to CF dialyzers(4.32$\pm$0.55mmHg/min)(p<0.05). However, there was no observable difference in the UFR between the two dialyzers. Neither APD nor UFR showed any significant increase with an increasing number of reuses for up to more than 20reuses. A substantial number of failures observed in APD(larger than 20mmHe/min)on the reused dialyzers(2 out of 40 CP and S out 26 C-DAK) were attributed to the Possible damage on the fibers. The CF 15-11 HFDs which failed APD test did not show changes in the UFR compared to normal dialyzers indicating that APD is a more sensitive test than UFR test to evaluate the integrity of the fibers. 30527 T00401030527 ^x For quantitative measurement of reflected light from a clinical diagnostic strip, a prototype old reflectance photometer was designed. The strip loader and cassette were made to obtain more accurate reflectance parameters. The strip was illuminated at 45˚c through optical fiber and the intensity of reflected light was determined at rectanguLat angle using a photodiode. The kubelka-munk coefficient and reflection optical density were determined ar four different wavelengths(500, 550, 570 and 610nm) for blood glucose strip. For higher concentration than 300mg/41 about glucose, a saturation state of abforbance was observed at 500, 550 and 570nm. The correlation between glucose concentration and parameters was the best at 610nm. 30535 T00401030535 ^x Radiation-induced fibrosarcoma tumors were grown on the flanks of C3H mice. The mice were divided into two groups. One group was injected with Photofrin II, intravenously (2.5mg/kg body weight). The other group received no Photofrin II. Mice from both groups were irradialed for approximately 15 minutes at 100, 300, or 500 mW/cm2 with the argon (488nm/514.5 nm), dye(628nm) and gold vapor (pulsed 628 nm) laser light. A photosensitizer behaved as an added absorber. Under our experimental conditions, the presence of Photolfrin II increased surface temperature by at least 40% and the temperature rise due to 300 mW/cm2 irradiation exceeded values for hyperthermia. Light and temperature distributions with depth were estimated by a computer model. The model demonstrated the influence of wavelength on the thermal process and proved to be a valuable tool to investigate internal temperature rise. 30536 T00401030536 ^x We investigated the structural geometry of thirty-eight Korean femurs. The purpose of this study is to identify major geometrical differences between Korean femurs 3nd others that we believe belong to Caucasians so that we would be able to get insights into the femoral component design that fits Asians including Koreans. We utilized computerized tomography (CT) images of femurs extracted from cadavers. The CT images were transformed into bitmap data by using a film scanner, and then analyzed by using a commercially available software called Image v.1.0 and a Macintosh IIci computer.The resulting data were compared with already published data. The major results show that the geometry of the Korean femurs is significantly different from that of Caucasians: (1) the anteversion angle and the canal flare index are greater by the amount of approximately 8˚ and 0.5, respectively, (2) the shape of the isthmus cross section is more round, and (3) the distance between the teaser trochanter and the proximal border of the isthmus is shelter by about 15 mm. The results suggested that the femoral component suitable for Asians should be different from the currently-used components designed and manufactured mostly by European or American companies. 30537 T00401030537 ^x It is well known that nonlinear propagation characteristics of the wave in the tissue may give very useful information for the medical diagnoisis. In this paper, a new method to detect nonlinear propagation characteristics of the internal vibration in the tissue for the low frequency mechanical vibration by using bispectral analysis is proposed. In the method, low frequency vibration of f0( = 100Hz) is applied on the surface of the object, and the waveform of the internal vibration x (t) is measured from Doppler frequency modulation of silmultaneously transmitted probing ultrasonic waves. Then, the bispectra of the signal x (t) at the frequencies (f0, f0) and (f0, 2f0) are calculated to estimate the nonlinear propagation characteristics as their magnitude ratio, w here since bispectrum is free from the gaussian additive noise we can get the value with high S/N. Basic experimental system is constructed by using 3.0 MHz probing ultrasonic waves and the several experiments are carried out for some phantoms. Results show the superiority of the proposed method to the conventional method using power spectrum and also its usefulness for the tissue characterization. 30541 T00401030541 ^x This paper describes the implementation of a computerized radial pulse diagnosis by aids of a clinical expert. On this base, we composed of the radial pulse diagnosis system in korean traditional medicine. The system composed of a radial pulse wave detection system and a radial pulse diagnosis system. With a detection system, we detected Inyoung and Cheongu radial pulse wave and processed it. Then, we have got the characteristic parameters of radial pulse wave and also quantified that according to the method of Inyoung-Cheongu Comparison Radial Pulse Diagnosis. We defined the jugement standard of radial pulse diagnosis system and then we confirmed the possibility for realization of automatic radial pulse diagnosis in korean traditional medicine. 30545 T00401030545 ^x Microspheres are expected to be applied to biomedical areas such as solid-phase immunoassays, drug delivery systems, immunomagnetic cell separation. To synthesize microspheres for biomedical application, "two stage shot growth method" was developed. The uniformity ratio of synthesized microspheres was always smaller than 1.05. And the surface charge density (or the number of ionizable functional groups) of the microspheres synthesized by "two stage shot growth method" was 6~13 times higher than that of the microspheres synthesized by conventional seeded batch copolymerization. As a previous step for biomedical application, adsorption experiments of bovine albumin on microspheres were carried out under various conditions. The maximum adsorbed amount was obtained in the neighborhood of pH 4.5. Isoelectric point of bovine albumin is pH 5.0, so experimental result shows that it shifted to acid area. The adsorption isotherm was obtained, the plateau region was always reached at 2.Og/L (bulk concentration of bovine albumin).The effect of the kind and the amount of surface functional group was also examined. 30575 T00401030575 ^x A medical image workstation was developed using multimedia technique. The system based on PC-486DX was designed to acquire medical images produced by medical imaging instruments and related audio information, that is, doctors' reporting results. Input information was processed and analyzed, then the results were presented in the form of graph and animation. All the informations of the system were hierarchically related with the image as the apex. Processing and analysis algorithms were implemented so that the diagnostic accuracy could be improved. The diagnosed information can be transferred for patient diagnosis through LAN(local area network). 30592 T00401030592 ^x In the conventional infrared imaging system, complex infrared lens systems are usually used for directing collimated narrow infrared beams into the high speed 2-dimensional optic scanner. In this paper, a simple reflective infrared optic system with a 2-dimensional optic scanner is proposed for the realization of medical infrared thermography system. It has been experimentally proven that the intfrared thermography system composed of the proposed optic system has the temperature resolution of 0.1˚c under the spatial resolution of lmrad, the image matrix size of 256 X 240, and tile imaging time of 4 seconds. 30593 T00401030593 ^x In this paper, MIIS (Medical Image Information System) has been designed and implemented using INGRES RDBMS, which is based on a client/server architecture. The implemented system allows users to register and retrieve patient information, medical images and diagnostic reports. It also provides the function to display these information on workstation windows simultaneously by using the designed menu-driven graphic user interface. The medical image compression/decompression techniques are implemented and integrated into the medical image database system for the efficient data storage and the fast access through the network. 30594 T00401030594 ^x In this paper, computerized BEAM was implemented for the space domain analysis of EEG. Trans-formation from temporal summation to two-dimensional mappings is formed by 4 nearest point inter-polaton method. Methods of representation of BEAM are two. One is dot density method which classify brain electrical potential 9 levels by dot density of gray levels and the other is colour method which classify brain electrical 12 levels by red-green colours. In this BEAM, instantaneous change and average energy distribution over any arbitrary time interval of brain electrical activity could be observed and analyzed easily. In the frequency domain, the distribution of energy spectrum of a special band can easily be distinguished normality and abnormality. 30608 T00401030608 ^x Laboratory information system (LIS) is a key tool to manage laboratory data in clinical pathology. Our department has developed an information system for routine hematology using down-sized computer system. We have used an IBM 486 compatible PC with 16MB main memory, 210 MB hard disk drive, 9 RS-232C port and 24 pin dot printer. The operating system and database management system were SCO UNIX and SCO foxbase, respectively. For program development, we used Xbase language provided by SCO foxbase. The C language was used for interface purpose. To make the system use friendly, pull-down menu was used. The system connected to our hospital information system via application program interface (API), so the information related to patient and request details is automatically transmitted to our computer. Our system interfaced with fwd complete blood count analyzers(Sysmex NE-8000 and Coulter STKS) for unidirectional data tansmission from analyzer to computer. The authors suggests that this system based on down-sized computer could provide a progressive approach to total LIS based on local area network, and the implemented system could serve as a model for other hospital's LIS for routine hematology. 30609 T00401030609 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed a composite that is consisted of calcium phosphate and collagen. To use as the structural matrix of the composite, collagen was purified from human umbilical cord. The obtained collagen was treated by pepsin to remove telopeptides, and finally, the immune-free atelocollagen was produced: The cross linked atelocollagen was highly resistant to the collagenase induced collagenolysis. The cross linked collagen demonstrated an improved tensile strength. 30618 T00401030618 ^x This paper is a study on the design of adptive filter for QRS complex detection. We propose a simple adaptive algorithm to increase capability of noise cancelation in QRS complex detection with two stage adaptive filter. At the first stage, background noise is removed and at the next stage, only spectrum of QRS complex components is passed. Two adaptive filters can afford to keep track of the changes of both noise and QRS complex. Each adaptive filter consists of prediction error filter and FIR filter The impulse response of FIR filter uses coefficients of prediction error filter. The detection rates for 105 and 108 of MIT/BIH data base were 99.3% and 97.4% respectively. 30619 T00401030619 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed and produced a composite that is consisted of calcium phosphate and collagen. Human umbilical cord origin pepsin treated type I atelocollagen was used as the structural matrix, by which sintered or non-sintered carbonate apatite was encapsulated to form an inorganic-organic composite. With cross linking atelocollagen by UV ray irradiation, the resistance to both compressive and tensile strength was increased. Collagen degradation by the collagenase induced collagenolysis was also decreased. 30620 T00401030620 ^x We have developed a monoleaflet polymer valve as an inexpensive and viable alternative, especially for short-term use in the ventricular assist device or total artificial heart. The frame and leaflet of the polymer valve were made from polyurethane, To evaluate the hemodynamic performance of the polymer valve a comparative study of flow dynamics past a polymer valve and a St. Jude Medical prosthetic valve under physiological pulsatile flow conditions in vitro was made. Comparisons between the valves were made on the transvalvular pressure drop, regurgitation volume and maximum valve opening area. The polymer valve showed smaller regurgitation volume and transvalvular pressure drop compared to the mechanical valve at higher heart rate. The results showed that the functional characteristics of the polymer valve compared favorably with those of the mechanical valve at higher heart rate. 30621 T00401030621 ^x Explosive evaporative removal process of biological tissue by absorption of a CW laser has been simulated by using gelatin and a multimode Nd:YAG laser. Because the point of maximun temperature of laser-irradiated gelatin exists below the surface due to surface cooling, evaporation at the boiling temperature is made explosively from below the surface. The important parameters of this process are the conduction loss to laser power absorption (defined as the conduction-to-laser power parameter, Nk), the convection heat transfer at the surface to conduction loss (defined as Bi), dimensionless extinction coefficient (defined as Br.), and dimensionless irradiation time (defined as Fo). Dependence of Fo on Nk and Bi has been observed by experiment, and the results have been compared with the numerical results obtained by solving a 2-dimensional conduction equation. Fo and explosion depth (from the surface to the point of maximun temperature) are increased when Nk and Bi are increased.To find out the minimum laser power for explosive evaporative removal process, steady state analysis has been also made. The limit of Nk to induce evaporative removal, which is proportional to the inverse of the laser power, has been obtained. 30622 T00401030622 ^x N1 and N2 gross neural action potentials were measured from the round window of the guinea pig cochlea at the onset of the acoustic stimuli. N1-N2 audiograms were made by means of regulating stimulant intensities in order to produce constant N1-N2 potentials as criteria for different input tone pip frequencies. The lowest threshold was measured with an input tone pip I5 dB SPL in intensity and 12 KHz in frequency when the animal was in normal physiological condition. The procedure of experimental measurements is explained in detail. This experimental approach is very useful for the investigation of the Cochlear function. Both noN1inear and active functions of the Cochlea can be monitored by N1-N2 audiograms. 30623 T00401030623 ^x In electrical impedance tomography(EIT), we use boundary current and voltage measurements toprovide the information about the cross-sectional distribution of electrical impedance or resistivity. One of the major problems in EIT has been the inaccessibility of internal voltage or current data in finding the internal impedance values. We propose a new image reconstruction method using internal current density data measured by NMR. We obtained a two-dimensional current density distribution within a phantom by processing the real and imaginary MR images from a 4.77 NMR machine. We implemented a resistivity mage reconstruction algorithm using the finite element method and sensitivity matrix. We presented computer simulation results of the mage reconstruction algorithm and furture direction of the research. 30624 T00401030624 ^x A new method of digital image analysis technique for discrimination of cancer cell was presented in this paper. The object image was the Thyroid eland cells image that was diagnosed as normal and abnormal (two types of abnormal: follicular neoplastic cell, and papillary neoplastic cell), respectively. By using the proposed region segmentation algorithm, the cells were segmented into nucleus. The 16 feature parameters were used to calculate the features of each nucleus. A9 a consequence of using dominant feature parameters method proposed in this paper, discrimination rate of 91.11% was obtained for Thyroid Gland cells. 30625 T00401030625 ^x An electrical stimulator was designed to induce locomotion for paraplegic patients caused by central nervous system injury. Optimal stimulus parameters, which can minimize muscle fatigue and can achieve effective muscle contraction were determined in slow and fast muscles in Sprague-Dawley rats. Stimulus patterns of our stimulator were designed to simulate electromyographic activity monitored during locomotion of normal subjects. Muscle types of the lower extremity were classified according to their mechanical property of contraction, which are slow muscle (msoleus m.) and fast muscle (medial gastrocneminus m., rectus femoris m., vastus lateralis m.). Optimal parameters of electrical stimulation for slow muscles were 20 Hz, 0.2 ms square pulse. For fast muscle, 40 Hz, 0.3 ms square pulse was optimal to produce repeated contraction. Higher stimulus intensity was required when synergistic muscles were stimulated simultaneously than when they were stimulated individually. Electrical stimulation for each muscle was designed to generate bipedal locomotion, so that individual muscles alternate contraction and relaxation to simulate stance and swing phases. Portable electrical stimulator with 16 channels built in microprocessor was constructed and applied to paraplegic patients due to lumbar cord injury. The electrical stimulator restored partially gait function in paraplegic patients. 30626 T00401030626 ^x Two-Dimensional modelling of the Cochlear biomechanics is presented in this paper. The Laplace partial differential equation which represents the fluid mechanics of the Cochlea has been transformed into two-dimensional electrical transmission line. The procedure of this transformation is explained in detail. The comparison between one and two dimensional models is also presented. This electrical modelling of the basilar membrane (BM) is clearly useful for the next approach to the further. Development of active elements which are essential in the producing of the sharp tuning of the BM. This paper shows that two-dimension model is qualitatively better than one-dimensional model both in amplitude and phase responses of the BM displacement. The present model is only for frequency response. However because the model is electrical, the two-dimensional transmission line model can be extended to time response without any difficult. 30627 T00401030627 ^x A method has been proposed for the fully automatic detection of left ventricular endocardial boundary in 2D short axis echocardiogram using geometric model. The procedure has the following three distinct stages. First, the initial center is estimated by the initial center estimation algorithm which is applied to decimated image. Second, the center estimation algorithm is applied to original image and then best-fit elliptic model estimation is processed. Third, best-fit boundary is detected by the cost function which is based on the best-fit elliptic model. The proposed method shows effective result without manual intervention by a human operator. 30628 T00401030628 ^x The intelligent trajectory control method that controls moving direction and average velocity for a prosthetic arm is proposed by pattern recognition and force estimations using EMG signals. Also, we propose the real time trajectory planning method which generates continuous accelleration paths using 3 stage linear filters to minimize the impact to human body induced by arm motions and to reduce the muscle fatigue. We use combination of MLP and fuzzy filter for pattern recognition to estimate the direction of a muscle and Hogan's method for the force estimation. EMG signals are acquired by using a amputation simulator and 2 dimensional joystick motion. The simulation results of proposed prosthetic arm control system using the EMf signals show that the arm is effectively followed the desired trajectory depended on estimated force and direction of muscle movements. 30638 T00401030638 ^x A new neural network architecture for the recognition of patterns from images is proposed, which is partially based on the results of physiological studies. The proposed network is composed of multi-layers and the nerve cells in each layer are connected by spatial filters which approximate receptive fields in optic nerve fields. In the proposed method, patterns recognition for complicated images is carried out using global features as well as local features such as lines and end-points. A new generating method of matched filers representing global features is proposed in this network. 30659 T00401030659 ^x An implementation scheme of the magnetic nerve stimulator using a switching mode power supply is proposed. By using a switching mode power supply rather than a conventional linear power supply for charging high voltage capacitors, the weight and size of the magnetic nerve stimulator can be considerably reduced. Maximum output voltage of the developed magnetic nerve stimulator using the switching mode power supply is 3, 000 volts and switching time is about 100 msec. Experimental results or human nerve stimulations using the developed stimulator are presented. 30768 T00401030768 ^x In this paper, we describe the design methodology and specifications of the developed module-based bedside monitors for patient monitoring. The bedside monitor consists of a main unit and module cases with various parameter modules. The main unit includes a 12.1" TFT color LCD, a main CPU board, and peripherals such as a module controller, Ethernet LAN card, video card, rotate/push button controller, etc. The main unit can connect at maximum three module cases each of which can accommodate up to 7 parameter modules. They include the modules for electrocardiograph, respiration, invasive blood pressure, noninvasive blood pressure, temperature, and SpO2 with Plethysmograph.SpO2 with Plethysmograph.