• Korean Journal of Ophthalmology
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• 제32권6호
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• pp.497-505
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• 2018

Purpose: To evaluate and compare published methods of calculating intraocular lens (IOL) power following myopic laser refractive surgery. Methods: We performed a retrospective review of the medical records of 69 patients (69 eyes) who had undergone myopic laser refractive surgery previously and subsequently underwent cataract surgery at Samsung Medical Center in Seoul, South Korea from January 2010 to June 2016. None of the patients had pre-refractive surgery biometric data available. The Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug total corneal refractive power (TCRP) 3 and 4 mm (SRK-T and Haigis), Scheimpflug true net power, and Scheimpflug true refractive power (TRP) 3 mm, 4 mm, and 5 mm (SRK-T and Haigis) methods were employed. IOL power required for target refraction was back-calculated using stable post-cataract surgery manifest refraction, and implanted IOL power and formula accuracy were subsequently compared among calculation methods. Results: Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug TCRP 4 mm (Haigis), Scheimpflug true net power 4 mm (Haigis), and Scheimpflug TRP 4 mm (Haigis) formulae showed high predictability, with mean arithmetic prediction errors and standard deviations of $-0.25{\pm}0.59$, $-0.05{\pm}1.19$, $0.00{\pm}0.88$, $-0.26{\pm}1.17$, $0.00{\pm}1.09$, $-0.71{\pm}1.20$, and $0.03{\pm}1.25$ diopters, respectively. Conclusions: Visual outcomes within 1.0 diopter of target refraction were achieved in 85% of eyes using the calculation methods listed above. Haigis-L, Barrett True-K (no history), and Scheimpflug TCRP 4 mm (Haigis) and TRP 4 mm (Haigis) methods showed comparably low prediction errors, despite the absence of historical patient information.

• 한국의학물리학회지:의학물리
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• 제10권2호
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• pp.95-101
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• 1999

원격방사선치료 기록부의 QA 과정에서 관찰된 환자에 대한 부정확한 자료나 방사선치료 기록부에 기록이나 이기의 오류로 인한 선량이나 선량분포의 오류의 종류와 빈도를 분석하는 것이다. 서울대학교병원 치료방사선과에서는 수치 오류을 시정하기 위해 의학물리학자가 치료개시전과 일주일에 일회 이상 방사선치료 기록부의 병록지와 배치도면, MU 계산용지나 치료계획 요약지, 일일 치료기록지를 점검하고 있다. 관찰된 오류를 다음과 같이 분류하였다. 1) 환자신원 확인, 2) 물리적인 요소를 포함하지 않지만 병록지의 누락이나 미기재, 3) 배치도면의 누락이나 setup 에 필요한 자료의 누락과 착오, 4) MU와 점선량 계산용지에서는 MU의 오류의 중요 원인별로 구분 및 점선량의 오류, 5) 치료계획 요약지의 분실여부와 환자자료의 오류, 6) 일일 치료기록지에서는 치료사실의 기재누락, 치료일정 착오, 처방선량 착오, setup 착오, MU 착오, 누적선량착오, 7) 선량이나 선량분포의 부정확성을 초래한 오류와 그런 가능성은 있지만 실제 실현되지 않은 오류, 단순히 기록상의 오류 , 8) 서명의 누락에 대해 검사하였으며, 결과는 환자의 수 대신 오류 건수별로 분석하였다. 1996년 6월 17일부터 1999년 7 월 31 일까지 방사선치료 기록부의 QA 에서 환자신원의 불일치는 한건도 없었으며 ,399명의 환자에 대해 431건의 오류가 관찰되었다. 물리적인 오류는 405건, 병록지의 누락 또는 미기재가 9 건, 서명누락이 17건이었다. 배치도면이 없는 경우 23 건 (5.7%), 자료의 누락 21건 (5.2%), 자료의 오기 73건(18.0%) 이었으며, MU의 계산용지가 없거나 계산 없이 치료가 시행된 경우는 13건 (3.2%), MU 계산의 착오 68 건 (16.3%), 점선량의 계산착오 8 건(2.0%), 방사선치료계획 결과 용지의 분실이 1건 (0.2%), 환자자료의 입력 오류가 11건(2.7%), 치료기록의 누락이나 치료의 누락이 8건(2.0%), 치료일정의 오류 13건 (3.2%), MU 계산이나 치료계획의 처방선량과 일일 치료기록지 처방선량의 불일치 20건(4.9%), 치료 setup 의 착오 33건(8.1%), MU의 설정 착오 52건(12.8%), 누적선량 착오 61건(15.1%) 이었다. 선량이나 선량분포의 부정확성을 초래한 오류는 239건(59.0%) 이었으며, 그런 가능성은 있지만 실제 실현되지 않은 오류 142건(35.1%), 단순히 기록상 오류는 24건 (5.9%) 이었다. 관찰된 수치 오류는 다양한 분야에 걸쳐 있었다. 나타난 대부분의 오류는 선량이나 선량분포의 오류에 직접 기여하거나 기여할 우려가 있기 때문에 방사선치료 기록부에서 물리적인 면의 QA를 철저하게 할 필요가 있다.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2003년도 제27회 추계학술대회
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• pp.67-67
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• 2003

It is crucial to minimize setup errors of a cancer treatment machine using a high energy and to perform precise radiation therapy. Usually, port film has been used for verifying errors. The Korea Cancer Center Hospital (KCCH) has manufactured digital electronic portal imaging device (EPID) system to verify treatment machine errors as a Quality Assurance (Q.A) tool. This EPID was consisted of a metal/fluorescent screen, 45$^{\circ}$ mirror, a camera and an image grabber and could display the portal image with near real time KIRAMS has also made the acrylic phantom that has lead line of 1mm width for ligh/radiation field congruence verification and reference points phantom for using as an isocenter on portal image. We acquired portal images of 10$\times$10cm field size with this phantom by EPID and portal film rotating treatment head by 0.3$^{\circ}$, 0.6$^{\circ}$ and 0.9$^{\circ}$. To check field size, we acquired portal images with 18$\times$18cm, 19$\times$19cm and 20$\times$20cm field size with collimator angle 0$^{\circ}$ and 0.5$^{\circ}$ individually. We have performed Flatness comparison by displaying the line intensity from EPID and film images. The 0.6$^{\circ}$ shift of collimator angle was easily observed by edge detection of irradiated field size on EPID image. To the extent of one pixel (0.76mm) difference could be detected. We also have measured field size by finding optimal threshold value, finding isocenter, finding field edge and gauging distance between isocenter and edge. This EPID system could be used as a Q.A tool for checking field size, light/radiation congruence and flatness with a developed video based EPID.

• 한국의사학회지
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• 제28권2호
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• pp.59-72
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• 2015

Simyak (審藥) was a government officer to lowest, but it was appointed and dispatched directly by officials from the central government. Simyak played a role in mediating between the provincial and central health care. Therefore, understanding Simyak is necessarily required in the researches on the local health care in Joseon dynasty. Preceding researches of Simyak only have contained superficial information causing many errors. The purpose of this paper is to understand Simyak correctly through the historical literature review. The author found the following facts in this study. First, Simyak was succeeded to the government officer of Uihakgyoyou (醫學敎諭) in the previous period. Second, through the change of the name of Simyak, it can be presumed that the main task of Simyak was changed from the role in local medical education to the officer sending the herbs to the central government. Third, in the later Joseon dynasty Simyak was monopolized by some families just like any other medical officials. Fourth, Yangdowollyengui (兩都月令醫) and Tongyeongguryogwan (統營救療官) can also be put in the category of Simyak.

• 성인간호학회지
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• 제17권5호
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• pp.697-708
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• 2005

Purpose: This study was to develop, implement, and evaluate an e-learning education program for improving practical knowledge and preventing nursing errors and adverse events of nurses working in the operating room (OR). Method: The e-learning program was developed and evaluated according to the following processes: 1) preparation phase 2) implementation phase 3) evaluation phase. In evaluation phase, the effectiveness was analyzed based on the Kirkpatrick's model. Results: The e-learning program consisted of OR basic nursing skills and techniques and nursing activities' manual based on the categories of nursing errors: surgical operation preparation, nursing skills and techniques, environment management, patient safety and comfort, and patient monitoring. The program was provided through on-line, http://cafe.daum.net/pnuhorn, for 4 weeks. The mean score(percent) of participants' satisfaction was $21.24{\pm}1.71$(68.2%). Their total knowledge level was significantly improved(Z=-3.00, p=.003) and specifically in the category of environment management(Z=-3.77, p<.001) and patient monitoring(Z=-2.46, p=.014). The occurrence of nursing errors or adverse events was a little decreased, but not statistically significant(Z=-3.10, p=.756). Conclusion: E-learning for nurses is one way of effective and efficient teaching-learning strategies. For better e-learning, it is important to develop the vital content of the education and objective measures for detecting nursing errors and adverse events.

• Journal of Preventive Medicine and Public Health
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• 제53권6호
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• pp.447-454
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• 2020

Objectives: The aim of the present study was to investigate the relationships among hospital safety climate, patient safety climate, and safety outcomes among nurses. Methods: In the current cross-sectional study, the occupational safety climate, patient safety climate, and safety performance of nurses were measured using several questionnaires. Structural equation modeling was applied to test the relationships among occupational safety climate, patient safety climate, and safety performance. Results: A total of 211 nurses participated in this study. Over half of them were female (57.0%). The age of the participants tended to be between 20 years and 30 years old (55.5%), and slightly more than half had less than 5 years of work experience (51.5%). The maximum and minimum scores of occupational safety climate dimensions were found for reporting of errors and cumulative fatigue, respectively. Among the dimensions of patient safety climate, non-punitive response to errors had the highest mean score, and manager expectations and actions promoting patient safety had the lowest mean score. The correlation coefficient for the relationship between occupational safety climate and patient safety climate was 0.63 (p<0.05). Occupational safety climate and patient safety climate also showed significant correlations with safety performance. Conclusions: Close correlations were found among occupational safety climate, patient safety climate, and nurses' safety performance. Therefore, improving both the occupational and patient safety climate can improve nurses' safety performance, consequently decreasing occupational and patient-related adverse outcomes in healthcare units.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2006년도 제33회 추계학술대회 발표논문집
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• pp.93-93
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• 2006

• 대한의용생체공학회:의공학회지
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• 제26권2호
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• pp.87-93
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• 2005

A new method for real-time estimating left ventricular relaxation time constant (T) from the left ventricular (LV) pressure waveform, based on the isovolumic relaxation model, is proposed. The presented method uses a recursive least squares (RLS) algorithm to accomplish real-time estimation. A new criterion to detect the end-point of the isovolumic relaxation period (IRP) for the estimation of T is also introduced, which is based on the pattern analysis of mean square errors between the original and reconstructed pressure waveforms. We have verified the performance of the new method in over 4,600 beats obtained from 70 patients. The results demonstrate that the proposed method provides more stable and reliable estimation of τ than the conventional 'off-line' methods.

• 대한후두음성언어의학회지
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• 제21권1호
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• pp.42-47
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• 2010

Backgrounds and Objects: Carcinoma of the tongue is the most common cancer of the oral cavity. A primary treatment strategy includes surgery and/or radiotherapy. Resection of the tongue often results in speech dysfunction, which depends on the site and extent of resection, type of reconstruction, and the mobility of remaining tongue. This study aimed to evaluate the characteristics of articulation errors that were resulted from the partial glossectomy without free flap reconstruction. Materials & Method : Articulation evaluations including speech intelligibility and percent of correct consonants (PCC) were performed for 24 patients who underwent partial glossectomy for their T1 or T2 tongue cancer. Mobility of the tongue, size of the resected tongue, and the history of adjuvant radiotherapy were analyzed for their relationship with the results of articulation evaluation. Results: Speech intelligibility score was $6.4{\pm}0.9$ (on 7-point scale) and overall PCC was 96.9%. There were close relationships between the size of resection and limitations in the tongue mobility, especially in "protrusion and elevation (r=-0.687)" and "retroflexion (r=-0.775)". Errors in "alveolar fricatives" and "palatal affricates" were also closely related with the size of resection (r=-0.537 and -0.538, respectively). PCC for "liquid sound" /r/ was 83.2%, which was closely related with the history of radiation therapy. Conclusion : Overall articulatory function was satisfactory in cases of early tongue cancer after partial glossectomy of a limited volume without flap reconstruction. However, the size of resection and the history of radiation therapy were closely related to the limitations in some types of tongue mobility and the resultant articulation errors.

• 대한의용생체공학회:의공학회지
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• 제8권2호
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• pp.245-254
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• 1987

A tuning method for the conventional PID controller in a two-input two-output multivariable system presented. The system is assumed to be no disturbances and modelling errors. Simulation studies show that controller can provide excellent tuning for highly interacting or unfavorable processes.