• Title/Summary/Keyword: 치료효율

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A Task Assignment Rule for the Registered Nurses of the Emergency Department of Hospital Using Multiple System Attributes (병원 응급실에서 여러 속성을 고려한 간호사 치료태스크 할당 규칙에 관한 연구)

  • Kim, Dae-Beom
    • Journal of the Korea Society for Simulation
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    • v.18 no.4
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    • pp.107-116
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    • 2009
  • Overcrowding in an Emergency Department (ED) of hospital is a common phenomenon. To improve the service quality and system performance of the ED, a task assignment rule for the Registered Nurses (RNs) is proposed in this paper. At each task assignment point, the rule prioritizes all treatment requests based on the urgency which is determined by the multiple attributes such as accomplishment time of treatment task, elapsed time of treatment request, total remain time to patient discharge, and number of remain treatments. The values of partial urgency with a single criterion are determined and then overall urgency is computed to find the most urgent one among current requests with the importance weights assigned to the criteria. Through computer simulation, the performance of the proposed rule is compared with current rule in terms of the length of stay and system throughput in a simplified ED system of the hospital M.

IMRT 위한 MLC QA Device 제작

  • 심재구;주상규;박영환
    • The Journal of Korean Society for Radiation Therapy
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    • v.13 no.1
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    • pp.47-50
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    • 2001
  • Purpose : 체내에서 optimal한 dose distribution을 얻기 위해 도입된 IMRT를 시행할 때 사용하는 MLC는 기계특성상 장기적인 check와 교정을 요한다. 또한 MLC는 static하지 않고 dynamic하기 때문에 leaf position의 실제 위치가 매우 중요하다. MLC QA를 위해 QA 소요시간 및 노력이 많이 MLC position check 요구되는 불편이 있어, 삼성서울 병원에서 필름을 이용한 MLC position check device를 제작하여 간편하게 사용하고 그 우수성에 대해 결과를 보고하고자 한다. Materials and Method : MLC position을 check하기위해 사각형 의 device(acryl:$40{\times}40{\times}5cm$)를 제작하였다. position check device의 정확도를 위해 표면에 real scale 표시용으로 Pb marker를 2cm 간격으로 부착하였다. MLC QA film은 마주보는 (opposite) MLC leaf의 간격이 4mm로 set up한 상태에서 double exposure하여 marker를 이용하여 오차를 분석하였다. MLC position check device의 효율성을 평가하기위해 6MV photon으로 10번 반복 실험을 실시하여 MLC leaf의 평균오차를 조사하고 조사에 걸린 시간을 비교하여 유용성을 평가하였다. Results : 실험결과 MLC leaf의 평균오차를 조사하고 조사에 걸린 시간을 비교하여 유용성을 평가하였다. 범위는 1.45mm였고, 최소 오차는 0.34mm로 나타났다. 1회 조사에 걸린 시간은 평균적으로 약 30분 정도 소요되었다. MLC position check device의 효율성을 평가한 결과오차의 반복성은 관찰되지 않았다. Conclusion : MLC leaf position의 정기적인 check와 교정을 위해 본원에서는 주1회 정기 position error를 check하고 있으며, 평균 월1회 교정을 한다. 본 실험을 통해 MLC position check device를 사용하여 leaf 오차가 2mm이하의 만족할 만한 결과를 얻었다. 또한 MLC position check device를 사용하면 짧은 시간에 모든 leaf의 position error를 쉽게 측정할 수 있고 한 장의 필름으로 모든 결과를 평가할 수 있어 경제성 및 업무의 효율성도 높일 수 있었다.

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An Efficient Management by Analyzing Control Level of Hypertension (고혈압 관리수준에 따른 효율적인 관리 방안)

  • Kim, Ji-On
    • Journal of Digital Convergence
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    • v.11 no.1
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    • pp.369-379
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    • 2013
  • The purpose of this study is to contribute basic data toward the efficient management of Hypertension by comprehensive analysis of several factors which make influences on indicators of Hypertension management. To achieve this, using the data of 2007, 2008 Korea National Health and Nutrition Examination Survey, 2,580 adults aged over 19 who suffered from hypertension have been analyzed comprehensively. The major results can be summarized as follows: First, in regard to the influential factors for awareness and treatment of hypertension, the older the patients were, the poorer their self-rated health status were. And when they had experienced a health examination, the more likely the hypertensive patients were aware of their hypertension and took the treatment for it. Second, as for the influential factors for control of hypertension, those who were older and those who had a health examination were significantly more likely to control their hypertension irrespective of gender. However, regular drinkers fell significantly behind in that aspect. The findings of this study show that systematic hypertension management, focusing on health behavior factors that affect the level of hypertension management, in accordance with the patients' sex and age will provide a more efficient way.

Development of Cell Therapeutics against Ischemic Vascular Diseases Using Mesenchymal Stem Cells: From Bench to Bed (중간엽줄기세포(MSC)를 이용한 허혈성 혈관질환 치료를 위한 세포치료제 개발: 기초연구에서 임상연구)

  • Lee, Eun Ji;Park, Shin Hu;Seo, Jeong Ho;An, Hyo Gyung;Nam, Si Hyun;Kwon, Sang-Mo
    • Journal of Life Science
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    • v.32 no.7
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    • pp.567-577
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    • 2022
  • Recently, the prevalence of ischemic diseases, such as ischemic heart disease, cerebral ischemia, and peripheral arterial disease, has been continuously increasing due to the aging population. The current standardized treatment for ischemic diseases is reperfusion therapy through pharmacotherapy and surgical approaches. Although reperfusion therapy may restore the function of damaged arteries, it is not effective at restoring the function of the surrounding tissues that have been damaged due to ischemia. Therefore, it is necessary to develop a new treatment strategy that can safely and effectively treat ischemic damage and restore the function of surrounding tissues. To overcome these limitations, stem cell-based therapy to regenerate the damaged region has been studied as a promising strategy for ischemic vascular diseases. Mesenchymal stem cells (MSCs) can be isolated from diverse tissues and have been shown to be promising for the treatment of ischemic disease by regenerating damaged tissues through immunomodulation, the promotion of angiogenesis, and the secretion of various relevant factors. Moreover, new approaches to enhancing MSC function, such as cell priming or enhancing transplantation efficiency using a 3D culture method, have been studied to increase stem cell therapeutic efficacy. In this review, we provide various strategies by which MSCs are used to treat ischemic diseases, and we discuss the challenges of MSC transplantation, such as the differentiation, proliferation, and engraftment of MSCs at the ischemic site.

First Clinical Experience about RapidArc Treatment with Prostate Cancer in Ajou University Hospital (아주대학교병원에서의 전립선암에 대한 래피드아크 치료)

  • Park, Hae-Jin;Kim, Mi-Hwa;Chun, Mi-Son;Oh, Young-Teak;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.21 no.2
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    • pp.183-191
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    • 2010
  • In this study, the patient with localized prostate cancer who had previously been treated at Ajou University Hospital was randomly selected since March, 2009. we performed IMRT and 2RA plans and the same dose objectives were used for CTVs, PTVs, rectum, bladder, and femoral head of the respective plans. Arc optimizations and dose calculations were performed using Eclipse versions 8.6. In this paper, we evaluated the performance of IMRT and RA plans to investigate the clinical effect of RA for prostate cancer case. In our comparison of treatment techniques, RA was found to be superior to IMRT being better dose conformity of target volume. As for the rectum and bladder, RA was better than IMRT at decreasing the volume irradiated. RA has the ability to avoid critical organs selectively through applied same dose constraints while maximally treating the target dose. Therefore, this result suggests that there should be less rectal toxicity with RA compared with IMRT, with no compromise in tumor margin. These findings, which show more favorable rectal, bladder, and femoral head DVHs with RA, imply that should not result in excess risk of toxicity when this technique is used. Many experiences with RA have shown not only dosimetric advantage, but also improved clinical toxicity when comparing with IMRT. The main drawbacks of RA are the more complex and time-consuming treatment planning process and the need for more exact physics quality assurance (QA).

Open Clinical Trial of Morning Light Therapy in Sleep Disturbance of Alcohol Dependent Patients (알코올의존 환자에서의 수면장애에 대한 아침 광치료의 임상시도)

  • Ko, Young-Hoon;Joe, Sook-Haeng;Jeon, Seung-Kyu;Kim, Byoung-Kyu;Kwon, Sung-Min
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.196-204
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    • 2003
  • Objectives: It is known that sedative hypnotics would make cross tolerance with alcohol and deteriorate quality of sleep in alcoholics. Light therapy is effective non-pharmacological intervention for sleep disturbance in circadian phase disorders, jet-lag, shift-work and age-related sleep disorders. Authors would investigate the effects of morning light therapy on sleep of patients with alcohol dependence during recovery state without withdrawal symptoms. Methods: 13 patients with alcohol dependence who have not any alcohol withdrawal symptom were recruited. Light therapy during 1 hour in the morning had been administered by 2500 Lux light box through serial 3 days. Sleep state of subjects were assessed by sleep log and the subjective satisfaction at sleep was by 100 mm visual analogue scale. Sleepiness, depressive mood, anxiety were evaluated by 100mm visual analogue scale at 8 AM, 2 PM and 8 PM. For assessment of performance ability that would be associated with sleepiness and vigilance, trail making test A, B and digit symbol substitution test were performed by two times on base line and 4th day. Univariate repeated-measures ANOVAs were performed for each measures except performance tests which were analysed by paired t-test. Results: Sleep latency and sleep efficiency were significantly improved with light therapy and satisfaction at sleep was. There was no significant difference in sleepiness at 2 PM with light therapy but sleepiness at 8 AM significantly decreased and at 8 PM increased. The time to complete Trail making test and digit symbol substitution test were significantly shortened at 4th day compared with baseline. Fatigue at 8 AM were not significantly changed with light therapy but at 2 PM and 8 PM significantly decreased. Depressive mood and anxiety were not significantly changed with light therapy. Conclusion: Although this study had some limitations, it showed that light therapy would be effective modality on sleep disturbance of patients with alcohol dependence who have recovered from alcohol withdrawal symptoms. It is proposed that short term light therapy could be used clinically for alcoholics with insomnia. In the future, long term controlled studies using more objective tools for sleep are required to further investigate the effect of light therapy in alcoholics.

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DENTAL CARE AND THE STATE OF EDUCATION AND TRAINING OF DENTISTS FOR THE HANDICAPPED (장애인의 치과진료 현황과 치과의사의 교육 및 훈련 정도에 대한 조사연구)

  • Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.1
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    • pp.87-94
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    • 2001
  • A survey was undertaken among a group of dentists working at private dental clinics to investigate the state of dental care and the level of education and training in the dental care to people with handicaps. Forty four percents of dental clinics take care of one more patients per month. The types of handicaps were physical, mental, sensory handicap and autism. The common problems are difficulty in communication and delay of treatment. Forty nine percents of dentists got education and nineteen percents had clinical experience for dental care of handicapped patients. Most of dentists felt necessity of training program and establishment of specialized dental hospital supported by government for the handicapped. This study indicated the necessity of undergraduate and postgraduate education and clinical training for dental care of handicapped patients.

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Effect of ${\alpha}$-Interferon 2b on Chronic Hepatitis B Patients with High Serum ALT (급상승된 혈청 ALT치를 나타낸 만성 B형 간염 환자에 대한 ${\alpha}$-Interferon 2b의 치료 효과)

  • Lee, Heon-Ju;Song, Young-Doo
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.237-245
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    • 1998
  • 만성 B형 간염 환자에서 Interferon (IFN) 치료 후 혈청 HBeAg 소실 및 anti-HBe의 양전율을 높이고 효율적인 치료의 근거를 알기 위하여 치료 전 간기능검사상 갑자기 상승한 혈청 ALT치를 나타낸 환자군과 그렇지 않은 대조군을 대상으로 하여 IFN을 투여한 군과 IFN 치료없이 정상 HBeAg의 자연 소실을 보인 환자군을 임상적으로 장기간 관찰하고 조사하였다. ALT치가 정상 상한치의 4배 이상 높이 증가되어 3개월 이상 왕복을 보인 40명의 환자(A군)와 ALT치가 정상 상한치의 3배 이하로 증가된 10명(B군)에게 ${\alpha}$-IFN 2b를 매일 300만 단위 피하주사로 3~12개월 주사하였다. 대조군으로는 ALT치가 A군처럼 장승한 45명 (C군)이었으며, IFN 치료없이 평균 2.9년을 관찰하였다. HBeAg/anti-HBe 혈청 양전율은 A군 68%, B군 20%, C군 13%이었으며 IFN 치료 중단 후 1년까지의 HBeAg 재양성율은 A군에서 29%였고 HBeAg이 소실된 A와 B군의 38명중에서 6명에서 HBV DNA가 양성이었다. 6명중 4명은 HBeAg/anti-HBe 양전을 보였으나 HBV DNA 양성이었고 나머지 2명은 HBeAg, anti-HBe 및 HBV DNA (hybridization) 모두 음성이었으나 중합효소연쇄반응검사상 HBV DNA 양성이었다. 이상의 결과를 보면 비록 IFN 치료 후에 HBeAg이 소실되었다가 다시 양성화되더라도 IFN은 단기간내에 혈중 HBeAg이나 DNA가 자연적으로 감소가 될 환자나 그렇지 않은 환자에게도 HBV의 비증식화를 유발하여 도움이 될 것으로 사료된다. 그러나 IFN 투여 후에도 혈중 HBeAg과 DNA 소실에 전혀 도움이 되지 않을 환자 및 HBV 증식 억제효과가 기대되는 HBV 간질환 환자의 조건, IFN 투여량, 기간 등에 대한 계획적이고 체계적인 연구로 더 나은 치료효과를 기대할 수 있으리라 생각된다.

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A Study on QA for Radiation Therapy Machine by Using Implemented Electronic Portal Imaging Device (전자포탈영상장치의 제작과 방사선치료장치의 QA 적용에 관한 연구)

  • Lee, Dong-Hoon
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.43 no.6 s.312
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    • pp.68-75
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    • 2006
  • During cancer therapy by using high energy radiation, it is possible to improve the radiation therapy efficiency by performing a precise radiation therapy after verification of generated setup errors. In this paper, the video based electronic portal imaging device (EPID) which could display the portal image with near real time was developed to verify treatment position errors in radiation therapy instead of an analog typed portal film. This EPID system for applying QA tool of radiation therapy machine was consisted of a metal/fluorescent screen, $45^{\circ}$mirror, camera and image grabber. Radiation field verification has been performed to check quality assurance of the treatment machine itself by using this EPID system. The radiation field error was easily observed by edge detection of irradiated field size on EPID image when $0.6^{\circ}$ shift of collimator angle was generated. So, this implemented EPID system could be used as a radiation QA tool.

The Effect of Group Validation Therapy(V/T) in the Elderly with Dementia (집단인정치료(Group validation therapy)가 치매노인에게 미치는 영향에 관한 연구)

  • Chang, Woo-Shim
    • 한국노년학
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    • v.28 no.4
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    • pp.1023-1039
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    • 2008
  • The purpose of this study was to develop a group validation therapy(V/T) which could be implemented for the elderly with dementia in nursing home, and to evaluate the effectiveness of the program on cognition, ADL(Activity of Daily Living), depression, problematic behavior and QOL(Quality of Life). Subjects were recruited from 4 nursing homes in D city. The sample comprised forty elderly with dementia, capable of verbal communication. Each twenty were in an experimental and control groups. However, four elders with dementia dropped out in experimental and control groups due to personal affairs. Experimental group completed twelve consecutive group validation therapy sessions that combined centering, asking factual questions, rephrasing, identifying and using the preferred sense, asking the extreme, imagining the opposite, reminiscing, touching, maintaining eye contact and a caring tone of voice, observing, matching and expressing the emotion with emotion, using ambiguity, linking behavior with a basic human need, using music and mirroring techniques. Following the intervention, experimental group experienced a significant improvement in cognition, ADL, depression, and QOL. But it is a nonsignificant in problematic behavior on statistically. As a result, a group validation therapy should be applied as an effective and practical psychosocial intervention for the elderly with dementia.