• Journal of Korean Dental Science
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• 제4권1호
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• pp.20-25
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• 2011

Purpose: To describe the newly developed Film image transfer system (FITS) for proper positioning of the orthodontic mini-implant in the narrow interdental space and considerations for better application. Materials and Methods: A patient who was planning to have orthodontic mini-implant treatment on the posterior maxilla was recruited to assess the feasibility of FITS. Dental radiographic film and bite record was taken. And then the film image was transferred on the photographic emulsion coated model using transfer light through film projector (enlarger). After exposing the photo emulsion coating on the model, the image was developed with a working solution for a paper developer and fixed. The surgical guide for the mini-implant was fabricated from the transported FITS data. Results: The completed surgical guide was easily placed intraorally, and allowed a simple and rapid placement of the mini-implant. The site of the implant placement was accurate as planned position. Conclusion: In the reported case, The FITS technique represents an effort to minimize risk to the patient and produce consistently good results based upon accurate information about the anatomy of the implant site.

• 한국컴퓨터정보학회:학술대회논문집
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• 한국컴퓨터정보학회 2014년도 제49차 동계학술대회논문집 22권1호
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• pp.409-412
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• 2014

본 논문에서는 환자가 실내 측위 기술과 스마트폰을 이용하여 대형 병원의 내부에서 진료 동선을 스스로 찾아갈 수 있도록 하는데 도움을 주는 네비게이션 모델을 제안한다. 정보기술의 비약적인 발전과 함께 실내 측위 기술을 결합한 스마트폰의 위치기반 어플리케이션들이 각광 받게 되었다. 또한, 실내 측위와 관련된 응용 서비스도 새로이 창출되어 점차 이에 대한 관심과 그 정확성을 높이기 위한 연구들이 활발하게 이루어지고 있다. 기존의 실내측위 기법들 중 가장 보편적인 것은 Wi-Fi 신호를 이용 하는 삼각측량 기법으로 초기 구축비용이 저렴하며 서비스 제공 가능 범위가 넓어 본 논문에서 다루고자 하는 장소인 병원의 특성에 알맞다. 따라서 본 모델은 Wi-Fi를 이용하여 사용자의 정확한 위치를 추정하고 진료 프로세스에 따라 경로를 안내를 해주는 네비게이션 서비스를 제공한다. 이를 통하여 환자에게는 진료를 위한 효율적인 동선을 제공함과 동시에 대형 병원에서는 인적, 물적 낭비를 줄이는데 도움이 되고자 한다.

• 한국콘텐츠학회논문지
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• 제12권5호
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• pp.303-310
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• 2012

방사선 치료에 있어서 정확한 환자 포지셔닝과 셋업은 치료의 성패를 좌우할 수 있는 중요한 인자이다. 기존의 방사선 치료실내에 장착된 3-laser system을 이용한 셋업에서, 최근에는 체표면 윤곽 스캐닝 시스템(C-Rad system)의 사용이 시도되고 있다. 체표면 윤곽 스캐닝 시스템의 유용성을 평가하기 위하여 C-Rad system과 3-laser system을 이용한 셋업 오차의 정확도를 비교, 평가함으로써 임상에서의 유용성을 확인하고자 하였다. 인체부위는 내부적인 움직임이 없고, 고정용구의 적용이 간편한 두경부로 한정하였으며, Alderson Rando anthropomorphic phantom과 두경부에 병변이 있는 방사선 치료 환자 10명을 대상으로 하였다. Phantom을 대상으로 한 C-RAD system의 셋업 에러 평균과 표준편차는 X축 $0.55{\pm}0.51mm$, Y축 $-0.2{\pm}0.523mm$, Z축 $-0.85{\pm}0.587mm$로 나타났으며, 환자를 대상으로 한 실험에서는 X축 $-0.05{\pm}0.621mm$, Y축 $0.075{\pm}0.755mm$, Z축 $-1.025{\pm}0.617mm$로 산출되어, 전반적으로 3-laser system에 비해 셋업의 정확도가 우수하였으나, Z축의 에러 발생률은 C-RAD system이 약간 높게 나타났다. 체표면 윤곽 스캐닝 시스템은 두경부의 방사선 치료 시에 정확한 포지셔닝을 유도함으로써 셋업오차를 최소화 시키는데 기여할 것으로 사료된다.F

• 대한방사선치료학회지
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• 제26권1호
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• pp.51-57
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• 2014

목 적 : 췌장암의 경우 십이지장에 부여되는 선량 분포가 중요하게 다뤄진다. 십이지장의 경우는 호흡에 따라 변화가 발생된다. 이에 본 논문에서는 본원에 설치된 CT-on rail System을 이용하여 환자의 Kilovoltage Cone-Beam CT 촬영하여 십이지장의 위치 변화를 파악하고 체적 당 부여받는 선량의 변화를 파악하고자 한다. 대상 및 방법 : 3 명의 환자를 대상으로 CT-on rail System을 이용하여 KVCBCT를 획득하고 SYNGO Software를 이용하여 최초의 치료계획 영상과 비교 십이지장의 위치 변화를 파악하였다. 획득한 영상을 치료계획장치인 Pinnacle로 전송하여 변화된 위치에서 치료 용적에 포함되는 십이지장의 체적 변화를 파악하고 같은 선량에서 발생되는 체적의 변화를 분석하였다. 결 과 : 위치 변화 분석에서 좌우(Left-Right Direction) 방향에서 1.2cm, 1.0cm 머리 다리(Craniocaudal Direction) 방향에서는 0cm, 0.8cm 전후(Anterior-Posterior Direction) 방향에서는 0.1cm, 1.0cm의 변화를 나타내었다. 체적의 변화는 환자 1의 경우는 최초 치료계획에 비해 체적이 최대 약 460%, 최소 120% 증가하였고 환자 2는 최대 490%, 최소 160% 증가하였다. 반면 환자 3은 최대 150% 증가하였으나 최소 값에서는 약 30% 감소함을 나타내었다. 호흡의 변화에 따라 가장 많은 변화를 나타낸 환자 1의 경우는 최초의 치료계획과 비교하였을 시 초기 선량에서는 변화가 크게 나타나지 않았지만 선량이 증가함에 따라서 $V_{10}$에서는 118%, $V_{20}$ 117%, $V_{30}$ 400%, $V_{40}$ 480%의 체적 변화가 발생됨을 알 수 있었다. 결 론 : 현재 3D-CRT를 이용한 방사선 치료 시 4D-CT를 이용한 모의치료를 통해 환자의 호흡에 따른 십이지장의 위치 변화에 대해 파악하고 정확한 치료계획용적의 설정을 통해 호흡에 따른 십이지장의 체적 변화를 예측하고 이에 맞는 적합한 치료 계획을 세워 십이지장에 부여될 수 있는 선량을 최소화 시켜야 할 필요성이 있다고 사료된다.

• 대한소아치과학회지
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• 제21권2호
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• pp.510-517
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• 1994

It is a relatively common clinical experience to see a impacted maxillary central incisor. This is apparent at the dental age of about eight years and over, when the patient is in the early mixed dentition stage. The adjacent teeth may tilt toward the site of the missing tooth with resulting space closure and midline deviation. Most often, the central incisor is impacted labially. The labial impaction has been indicated as the most difficult to manage. Each of the current articles describing labial impactions shows at least one case with mucogingival recession or a minimal zone of attached gingiva. This report described the surgical uncovering and orthodontic-physiologic positioning methods with labially impacted maxillary central incisors. Through surgical exposure and direct bonding of lingual botton, the central incisors were brought into proper eruption path with elastic traction. The case 1 and 2 were treated with the physiologic erupting forces. The case 3 was applied with continuous orthodontic force. The case 1 and 2 resulted in good positioning, good esthetics and adequate width of keratinised gingiva. The case 3 resulted in local inflammation and inadequate width of keratinised gingiva.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.189-191
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• 2002

In the proton therapy using a gantry system, periodical verification of iso-center position is very important to assure precision of patient positioning system at any gantry angles in proton treatment. In the gantry system, there are three different types of iso-center; 1) in a geometrical view, 2) in an X-ray beam's eye view, 3) in a proton beam's eye view. Idealistically, they would be an identical point. They could, however, be different points. It may be a source of errors in patient positioning. At PMRC, we have established a system of verification for iso-center positions using a stainless ball of 2-cm in diameter and an imaging plate. This system provides the relation among a center of a patient target position, a center of proton irradiation field, and/or a center of X-ray field in accuracy of 50$\square$m in the 2) and 3) views, as images of a center of the stainless ball and a center of a 100 mm${\times}$100 mm-aperture brass collimator recorded on the imaging plate, which is setup at 1-cm behind the ball. In addition, it provides simultaneously the images of the ball and the collimator on an imaging intensifier (II), which is setup downstream of the proton or X-ray beam. We present a method of quality assurance (QA) for calibration of iso-center position in a rotation gantry system at PMRC and the performance of this system. A proton beam position on the 1$\^$st/ scatterer in the nozzle of the gantry affects less sensitive (reduced by a factor of 1/5) to the results of the iso-center position. The effect is systematically correctable. The effect of the nozzle (or the collimator) position is less than 0.5 mm at the maximum extraction (390 mm).

• The Korean Journal of Pain
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• 제10권1호
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• pp.117-120
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• 1997

Cancer is a devastating disease, and the treatment of related pain is an extremely challenging task. Providing adequate analgesia while avoiding unnecessary drug effects often requires a polypharmacologic approach in cancer pain management. A 36-year old woman with breast cancer metastatic to the axial skeleton and bilateral hip joints was admitted to hemato-oncology service with complaints of intractable abdominal and hip pain. Despite rapidly increasing doses of intravenous morphine up to 350 mg per day; transdermal fentanyl; midazolam; ketorolac; lorazepam; dexamethasone, the patient continued to describe her pain as 10 of 10, refusing all surgical/diagnostic interventions not directly related to pain control. She did, however, consent to lumbar epidural catheter placement. The patient was sedated with titrating doses of propofol to assist with positioning. Even though the procedure was not successful due to significant thoracolumbar scoliosis, the patient admitted feeling better than she has in months during attempted placement. After continuous infusion of propofol was initiated at subhypnotic dose, the patient's analgesic demand was drastically reduced and described her pain as "1 to 3" of "10". Approximately 96 hours after the propofol infusion was started, the patient expired comfortably. There had been no change in her medical regimen during fecal 48 hours. In the case described, propofol was extremely advantageous as an adjuvant in the management of cancer related pain.

• The Journal of Asian Finance, Economics and Business
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• 제9권1호
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• pp.93-103
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• 2022

The main purpose of this study was to gauge the patient satisfaction index and subsequently discuss the Importance-Performance (IP) matrix analysis of the inpatient services in the context of the private hospital setting. The Malaysian Customer Satisfaction Index Model was employed as the theoretical framework for the above purposes. This study involving 242 patients in Malaysian's private healthcare sector used a Web-based survey as the main method of data collection. Partial least square structural equation modeling (PLS-SEM) was utilized for data analysis. Using Fornell et al. (1996)'s formula, the resulting patient satisfaction index was slightly lower than the "very satisfied" category, the target level required for positioning as one of the world's premier medical tourism players. The IP matrix showed that medical quality is the main competitive advantage of the private hospitals that can propel their growth in the global healthcare marketplace. The results also indicate that outcome quality, patient rights, and privacy, and service quality are the three quality domains that need to be prioritized for further improvement. On the other hand, the servicescape quality domain needs to be strategized as the unique selling proposition as the performance of the private hospitals in this regard is already extremely good.

• 한국의학물리학회지:의학물리
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• 제26권4호
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• pp.258-266
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• 2015

현대 방사선치료는 고선명 X선 투사영상을 이용하여 환자 및 종양의 위치를 확인하는 기술이 요구되지만, 3차원 영상 촬영을 위한 피폭량 및 영상정보의 급격한 증가는 환자에게 추가적인 부담이 될 수 있다. 본 연구에서는 영상의 구조 정보를 효과적으로 추출할 수 있는 Structural similarity (SSIM) 인자를 도입하여 매일 촬영하는 환자의 2차원 X선 영상간 차이를 자동 분석하여 환자의 위치 정확성의 검증 가능성을 제시하였다. 먼저 종양을 모사하기 위하여 구형 전산 팬텀의 크기와 위치를 변화시키면서 각각의 투사 영상을 시뮬레이션하고, SSIM 인자를 통해 영상 간 차이를 검출하여 분석하였다. 또한 12일간 매일 촬영한 방사선 치료 환자의 2차원 X선 영상들 간 차이를 동일한 방법으로 검출하였다. 그 결과 산출된 팬텀 변화에 따른 SSIM 값은 0.85~1 범위로, 관심영역(ROI)을 영상 전체가 아닌 팬텀으로 한정하였을 때는 0.006~1 범위로 나타나서 ROI 적용 시 민감도가 크게 상승하는 것을 확인하였다. 또한 임상 영상의 SSIM은 0.799~0.853 범위의 값을 나타냈으며 영상 간 차이가 SSIM 분포 상에 검출되는 것을 확인하였다. 본 연구결과는 소요 시간 및 피폭 등의 우려로 매일 사용하기 어려운 3차원 영상기법 대신 간단한 2차원 영상만을 이용하여 객관적이고 정량적인 환자 위치 정확성의 자동 평가 기법을 제공할 수 있을 것으로 기대된다.

• 대한디지털의료영상학회논문지
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• 제14권1호
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• pp.13-20
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• 2012

In a normal x-ray examination, the cooperation of a patient in positioning greatly influences the improvement of work performance, the quality of the images and the reduction in time spent on the examination. An attempt was made to discover the connection between an examination information printout and the effects of the examination by informing the patient before the examination on the examination positions in order to increase the level of cooperation by the patient and by surveying the degree of satisfaction of the patient during the examination proceedings. An examination information printout was prepared on five positions that patients consider to be difficult while receiving normal x-ray examinations and were shown to 257 male and female patients between the ages of 30 to 79 who had visited this hospital between January 1 to February 29, 2012 or to a person who had accompanied the patients before the examination to research the degree of satisfaction regarding the printout. In addition, the examination explanation printout was given to Radiologic Technologists with over 1 year experience in this hospital to use while taking the x-rays and the degree of satisfaction was surveyed and it was examined if the increase of the degree of satisfaction had an effect on the reduction in the examination time. The patients who utilized the examination information printout revealed results of approximately a 7.8% higher degree of satisfaction among the patients who had previous experience receiving x-ray examinations compared to those were having an x-ray for the first time. In the age groups between 30 to 70 years of age, the age group in the 30's revealed the lowest level of satisfaction at approximately 69% and the group in the 50's showed the highest degree of satisfaction of 87.94%. In the survey of the Radiologic Technologists, 85% responded that they were satisfied. In the question that stated "Will the examination information printouts reduce the time involved in unnecessary conversations with the patients?," the responses showed a 95% degree of satisfaction. The degree of satisfaction was high over the examination information printout by both the patients and the Radiologic Technologists. Although the effects of examination time reduction varied based on the ages of the patients and physical conditions that they were in and could not be given measurement values, it was able to be seen through the survey that reduction of the unnecessary communication between the patient and the Radiologic Technologists contributed to the increase in the degree of satisfaction. As a result, both the patients and the Radiologic Technologists had an increased degree of satisfaction over the examination information printout and it was possible for improvements to be made in the quality of medical service provided as well. Nevertheless, it is considered that a more developed manual in terms of quality and quantity must be produced using a more systematic approach and design.