• Title/Summary/Keyword: 환자의 접근

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Effects of EAS Systems on Pacemakers and ICDs Malfunction (도난방지 시스템의 전자기장이 인공심장 박동기 등의 오동작에 미치는 영향)

  • Shim, Young-Woo;Kim, Jong-Jeong;Yang, Dong-In;Lee, Moon-Hyung;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.46 no.6
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    • pp.44-49
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    • 2009
  • EAS (electronic article surveillance) systems have increased rapidly for article surveillance. In this paper, the strength of the EMF (electromagnetic fields) of EAS systems were measured. Pacemaker and ICD were investigated for inappropriate response resulting from EM (electromagnetic) EAS systems. The strength of EMF and the response of pacemaker and ICD were measured in the inner left side, outer right sides and the center of gates of the 6.3 kHz and 14.25 kHz EAS systems at a height of 130cm. As the result, EMF of the EAS system using 14.25 kHz was stronger than that of 6.3 kHz. AU interferences were observed only for 14.25 kHz, and the noisy ECG was found in three static positions on the pacemaker. The ICD resulted in noise reversion and VF (ventricular fibrillation) both static and moving positions by the EMP of 14.25 kHz EAS system. Therefore, it is necessary to post a message warning radiation of EMF from every EAS systems and possible risk of pacemakers and ICDs.

Radiation Safety Management Guidelines for PET-CT: Focus on Behavior and Environment (PET-CT의 방사선안전관리 가이드라인 개발: 행위와 환경을 중심으로)

  • Jung, Jin-Wook;Han, Eun-Ok
    • Journal of Radiation Protection and Research
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    • v.36 no.3
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    • pp.140-147
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    • 2011
  • Our purpose is to specify behavior and environmental factors aimed at reducing the exposed dosage caused by PET-CT and to develop radiation safety management guidelines adequate for domestic circumstances. We have used a multistep-multimethod as the methodological approach to design and to carry out the research both in quality and quantity, including an analysis on previous studies, professional consultations and a survey. The survey includes responses from 139 practitioners in charged of 109 PET-CTs installed throughout Korea(reported by the Korean Society of Nuclear Medicine, 2010). The research use 156 questions using Cronbach's ${\alpha}$ (alpha) coefficients which were: 0.818 for "the necessity of setting and installing the radiation protective environment"; 0.916 for "the necessity of radiation protection", "setting and installing the radiation protective environment"; and 0.885 for "radiation protection". The check list, derived from the radiation safety management guidelines focused on behavior and environment, was composed of 20 items for the radiation protective environment: including 5 items for the patient; 4 items for the guardian; 3 items for the radiologist; and 8 items applied to everyone involved; for a total of 26 items for the radiation protective behavior including: 12 items for the patient; 1 item for the guardian, 7 items for the radiologist; and 6 items applied to everyone involved. The specific check list is shown in(Table 5-6). Since our country has no safety management guidelines of its own to reduce the exposed dosage caused by PET-CTs, we believe the guidelines developed through this study means great deal to the field as it is not only appropriate for domestic circumstances, but also contains specific check lists for each target who may be exposed to radiation in regards to behavior and environment.

Morphological Analysis of the Sinus Lateral Wall Using Cone-Beam Computed Tomography (콘빔형 전산화단층영상을 이용한 상악동 측벽의 형태학적 분석)

  • An, Seo-Young;Kim, Yong-Gun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.349-357
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    • 2012
  • The purpose of this study was to measure the thickness of the sinus lateral wall using cone-beam computed tomography (CBCT), and to find the most suitable vertical position for lateral window opening prior to sinus elevation. Fifty three patients requiring sinus elevation had CBCT scans acquired by CB MercuRay (Hitachi, Medico, Tokyo, Japan) from July, 2010 to June, 2012. The thickness of the sinus lateral wall was measured according to its vertical position against the sinus inferior border (SIB), and its mean was calculated through two repeated measurements. The thickness of the sinus lateral wall was more than 2 mm at 2 mm above the sinus inferior border (SIB+2), however, it was less than 2 mm at 3 mm above the sinus inferior border (SIB+3). In conclusion, it is recommended that the inferior border of lateral wall window be made 3 mm above the sinus inferior border during sinus elevation using the lateral approach considering the thickness of the sinus lateral wall.

The Spatial Characteristics of Clinic Distribution by Specialty Subject (진료 전문과목별 개원 의원의 공간적 분포 특성)

  • Seo, Wee-Yeun;Lee, Keum-Sook
    • Journal of the Economic Geographical Society of Korea
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    • v.10 no.2
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    • pp.153-166
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    • 2007
  • This study attempts to investigate the spatial characteristics of medical hospital distributions in Korea. For the purpose we examine the inter- and intra regional variations in the distributions of clinics by specialty subject. In particular, we analyze the distribution patterns of Location Quotients of clinics for 12 specialty subjects in Seoul. Medical services tend to be concentrated on the large cities, especially in the Metropolitan Seoul Area. In particular, clinics and medical doctors as well as large scale general hospitals have been strongly concentrated on the Metropolitan Seoul area. These circumstace may be related with the fact that medical hospitals are established and operated by private sector in Korea, and thus they attempt to find their location where they can get maximum profit. The distribution patterns of clinics of 12 specialty subjects can be classified to several characteristic patterns. In particular, clinics of plastic surgeon tend to be strongly concentrated on the Gangnam area in Seoul. Finally, clinics of plastic surgeon tend to be located on the areas near the subway stations along the subway Line 2 and Line 3 in the beginning. The existence of plastic surgeons turns out to have significant role on determining the location for the newly opening plastic surgeons in the later. Therefore, their agglomeration has been getting more strongly.

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Right Thoracotomy for Reoperation of Mitral Valve (우측 개흉을 통한 승모판 재수술)

  • 조창욱;구본일
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1342-1346
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    • 1996
  • A right thoracotomy was used for the reoperation or mitral valve of 15 patients who had previously undergone a cardiac operation through a median sternotomy. In our experience. this approach provided dn excellent exposure of the nlitral valve and easy cannulations of both cavie with minimal dissection, ilvoiding any damage of cardiac and major vessels during re-sternotomy Arterial cannulation was performed in the ascending aorta in 13 patients And in the femoral artery in 2 patients. In earlier cases, venous cannulation was done in the SVC And IVC through the right atrium and snared. In later cases, this could be done without snaginly of both cavae or by placing a silgle light-angled catheter into the right atrium. Crystalloid cardioplegic solution was infused for myocardial protection. Hypothermia was controlled at 20\ulcorner$25^{\circ}C$. For defibrillation, internal paddles were used In one patient while sterilized external paddles were used in 10 patients. In the remaining four patients. however. the heart beat spontaneously The respirator could be weaned within 48 hours alter the operation and no pulmonary complication was observed. One out of the 15 patients expired due to sudden attack of ventricular tarchycardid developed ten days after the operation, but the rest of the patients were discharged with good condition.

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Association-Based Knowledge Model for Supporting Diagnosis of a Capsule Endoscopy (캡슐내시경 검사의 진단 보조를 위한 연관성 기반 지식 모델)

  • Hwang, Gyubon;Park, Ye-Seul;Lee, Jung-Won
    • KIPS Transactions on Software and Data Engineering
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    • v.6 no.10
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    • pp.493-498
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    • 2017
  • Capsule endoscopy is specialized for the observation of small intestine that is difficult to access by general endoscopy. The diagnostic procedure through capsule endoscopy consists of three stages: examination of indicant, endoscopy, and diagnosis. At this time, key information needed for diagnosis includes indicant, lesions, and suspected disease information. In this paper, these information are defined as semantic features and the extracting process is defined as semantic-based analysis. It is performed in whole capsule endoscopy. First, several symptoms of patient are checked before capsule endoscopy to get some information on suspected disease. Next, capsule endoscopy is performed by checking the suspected diseases. Finally, diagnosis is concluded by using supporting information. At this time, some association are used to conclude diagnosis. For example, there are the disease association between the symptom and the disease to identify the expected disease, and the anatomical association between the location of the lesion and supporting information. However, existing knowledge models such as MST and CEST only lists the simple term related to endoscopy and cannot consider such semantic associations. Therefore, in this paper, we propose association-based knowledge model for supporting diagnosis of capsule endoscopy. The proposed model is divided into two; a disease model and anatomical model of small intestine, interesting area(organs) of capsule endoscopy. It can effectively support diagnosis by providing key information for capsule endoscopy.

Children with Cancer: Adjustment to Disease and Body Image (소아·청소년 암환자의 신체상과 질병적응에 관한 연구)

  • Cho, Hae-Rin;Park, So-Young;Han, In-Young
    • Journal of the Korean Society of Child Welfare
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    • no.26
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    • pp.7-30
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    • 2008
  • The survival rate of children with cancer has increased significantly from less than 30% in 1960s to 75% during the recent years with the development of modern medical technologies. As a result, the cancer of children today is no longer classified as incurable diseases. Rather, it is recognized as a chronic illness. However, children with cancer are still suffering from physical and psychosocial ailments caused by long-term hospitalization. In particular, teenagers are more likely to be affected by these problems because of interests on one's appearance and peer relationships This study investigated the relationship of the level of body distortion and disease adjustment of children with cancer, and how demographic factors, disease factors, and the level of body distortion affect disease adjustment. Data were collected between October 22, 2007 and November 16, 2007 and the total respondents consisted of 82 children, ages 10 to 18. SPSS 12.0 with descriptive statistics, t-test, correlation and multiple regression were used for data analysis. The results showed that the factors which influence the disease adjustment of children with cancer were age, school enrollment, and the level of body distortion. The result of this study has major implications for the government to provide support for children with cancer to stay in school. Additionally, programs that assist children to build positive body images need to be developed in accordance with their ages and psychosocial characteristics.

Symptomatic and Clinical Profiles Across Motoric Subtypes in Delirium (섬망의 운동성 아형에 따른 증상과 임상적 특징)

  • Paik, Soo-Hyun;Min, Seongho;Ahn, Joung-Sook;Park, Ki-Chang;Kim, Min-Hyuk
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.2
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    • pp.79-85
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    • 2015
  • Objectives : To investigate clinical and symptomatic differences among motoric subtypes of delirium. Methods : A total of 256 patients referred to psychiatric consultation services for delirium due to general medical condition were assessed retrospectively. Motoric subtypes were determined according to Lipowski's criteria for hyperactive, hypoactive and mixed subtypes. All patients were evaluated according to Delirium Rating Scale-Revised-98(DRS-98-R) by trained psychiatrists to obtain symptomatic profiles of delirium. Results : Hyperactive subtype were 50.8%(n=130), mixed 46.1%(n=118) and hypoactive 3.1%(n=8). Hyperactive patients were younger than mixed subtype($69.62{\pm}13.976$ vs. $73.97{\pm}11.569$, p=0.022) and received antipsychotics to manage symptoms of delirium more frequently(83.8% vs. 57.6%, p<0.001). Hyperactive patients had higher DRS-R-98 scores on both noncognitive($7.14{\pm}3.543$ for hyperactive, $5.62{\pm}3.279$ for mixed subtype) and cognitive subscales($10.00{\pm}3.574$ for hyperactive, $6.38{\pm}2.875$ for hypoactive, $7.43{\pm}3.771$ for mixed subtype, p<0.001). Conclusions : We demonstrated that clinical and symptomatic profiles were different across motoric subtypes in delirium. Diagnostic and therapeutic approach should be made differently according to motoric subtypes of delirium and special attention is needed not to underestimate or delay treatment in specific motoric subtype of delirium.

Fibromyalgia from the Psychiatric Perspective (정신과적 관점에서의 섬유근통)

  • Lee, Yunna;Lee, Sang-Shin;Kim, Hyunseuk;Kim, Hochan
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.99-107
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    • 2020
  • Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fatigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmental factors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacological and non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyalgia than in the general population ; moreover, the association between fibromyalgia and certain psychopathologies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.

Hospice System Improvement Measures to Increase the Accessibility of Voluntary Home Death: A Comparison of the South Korean and American Hospice Systems (자택임종 증가를 위한 호스피스제도 개선 방안: 한국과 미국의 호스피스제도 비교를 중심으로)

  • Han, Da-Jeong;Choi, Young-Soon;Lee, Dong-Hyun
    • The Journal of the Korea Contents Association
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    • v.22 no.6
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    • pp.567-579
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    • 2022
  • The purpose of this study is to find a way to improve the hospice system to increase comfortable home death, which people prefer, by understanding the factors affecting the difference in the rate of home death between South Korea and America within the hospice system. This study employs the Most Similar Systems Design, which is a case study approach. The result of this study is that both countries have public health insurance systems that are identical in terms of the appropriate time for the receipt of hospice services and the application procedure, which requires that two doctors confirm the patient's hospice eligibility. The main difference is that in South Korea, inpatient hospice is prevalent, whereas routine home care is predominant in the United States. Furthermore, in the United States, hospice assistants and housekeepers support at-home daily living care. Additionally, the United States provides inpatient respite care to allow care-giver, such as family to rest and there is no restriction on hospice-eligible diseases. To increase the accessibility of voluntary home death in South Korea, it is necessary to activate and expand the home type hospice service range and provide at-home daily living care, care-giver support services. Furthermore, there should be no restrictions on hospice-eligible diseases.