• Title/Summary/Keyword: 환자 공간

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Measuring Spatial Accessibility to the Hospitals for Infants, Children, Adolescents, and Elderly Population Using 2SFCA: A Case Study of Chuncheon-si, Gangwon-do (2SFCA를 활용한 노인과 소아청소년에 대한 병원 접근성 분석: 강원도 춘천시를 사례로)

  • Jung, Nan-Ju;Kang, Jeon-Young
    • Journal of Cadastre & Land InformatiX
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    • v.54 no.1
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    • pp.49-61
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    • 2024
  • South Korea faces a declining population and rural areas vanishing due to urbanization. Infrastructure, especially medical facilities, may not be sustainable for a long-term. This may impact vulnerable groups like children, teens, and the elderly, worsened by an aging population and low birth rates. Gangwon-do, notably Chuncheon-si, suffers from rural depopulation and poor healthcare self-sufficiency. In this paper, using 2SFCA(Two-Step Floating Catchment Area), we analyze healthcare access in Chuncheon-si, identifying gaps and vulnerable areas. LISA analysis helps map medical vulnerability, considering patient demand and supply. The Gini coefficient assesses spatial inequality. We propose distributing healthcare services and personnel based on age and region. The aim is to identify locations for additional hospitals catering to the elders, Infants, Children, and Adolescents,considering spatial accessibility.

In Vitro Performance Assessment of a Bioartificial Liver Packed with Polyurethane Foam (다공성 폴리우레탄 충진형 생인공간의 체외 성능 평가)

  • 이두훈;이지현;김성구;박정극
    • KSBB Journal
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    • v.16 no.1
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    • pp.24-29
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    • 2001
  • Recently hepatocyte-based bioartificial liver (BAL) and hepatocyte transplantation have been actively investigated to treat acute hepatic failure. The BAL acts as a bridge to provide patients with more time until a donor organ becomes available for transplantation or until their own liver can be regenerated. In this study, we manufactured a polyurethane foam (PUF) using 15% NCO-prepolymer with a pore opening that allows it to be used as a hepatocyte immobilizing material. Cubes of PUF (3 mm dim.) were seeded with rat primary hepatocytes at a density of 5.5$\pm$1.1$\times$ $10^6$ cells/$cm^3$ PUF by centrifuging them together. The cell laden PUF cubes were packed into a prototype reactor and perfused with a hormonally defined medium for a week. Hepatocytes in the pores of the PUF formed spheroids that showed stable ammonia removal and urea synthesis activities. The albumin production level was comparable to other BAL systems. The PUF packed hepatocyte bioreactor has the potential to be used as a BAL.

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Uniformity Evaluation of Elderly Hospital Outpatients' Waiting Space using Discrete Event Simulation (이산사건 시뮬레이션을 이용한 요양병원 외래부 대기공간 균일성 평가)

  • Yoon, So-Hee;Kim, Suk-Tae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.490-499
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    • 2017
  • In recent years, the introduction of complex systems analysis based on various variables has become more active in order to identify and analyze complex problems of Modern Society. Prediction of patients' spatial perception and usability according to the spatial arrangement of the outpatient department is a very important factor for providing high quality hospital service. For objective analysis, the standard program procedure and analysis index for the diseases of the elderly were prepared and the uniformity of the atmospheric space was evaluated through heat map analysis and quantitative analysis. In this study, 73 cells were installed and simulated to analyze the uniformity of the four alternatives according to the change of the arrangement of the medical care space, receiving space, and consultation space using the complex system analysis method for the nursing hospitals. The resulting density was derived. The results are as follows. 1)The layout of the reception space has the greatest influence on the total spatial density of the waiting space. 2) The uniformity of the waiting space can be increased by separating the examination space and the examination space. 3)The closer the location of the receiving space is from the entrance, the greater the density of the waiting space. Finally, this study applied discrete event simulation to the evaluation of uniformity of atmosphere space, and proved that the actor - based model can be utilized for utilization and evaluation as spatial analysis methodology.

A Method on the Implementation of Intelligent Security Service Application based on Spatial Information (공간정보기반 지능형 방범서비스 어플리케이션 개발)

  • Choi, Woo Chul;Na, Joon Yeop
    • Spatial Information Research
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    • v.23 no.6
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    • pp.89-98
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    • 2015
  • In this study, The criteria for assessing the security-related functions and services using spatial information is deduced, and orders of priority a priority for the applicable alternatives of functions/services of intelligent security service application based on spatial information are suggested by calculating relative importance. Also this study suggested connection plan about service implementation of national security services by government ministry & local government. And, the intelligent security app service model which has possible substantiation and commercialization is proposed. This study performed the AHP as the final assessment criterions by 3 item in 1st class and 12 item in 2nd class. And, tried to implementation methods of the intelligent security service application(ex. control of emergency and the crime opportunity, real-time location tracking of protector, the device for missing child & dementia patient, user participation & provision of information).

On the Legality of the Telemedicine between the Patient and Doctor Under the Medical Service Act - Focused on the Prescriptions to the Distanced Patients- (의사 환자 간 원격 의료의 의료법상 적법성에 관하여 - 원격 환자에 대한 처방 중심으로 -)

  • Kim, Jang Han
    • The Korean Society of Law and Medicine
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    • v.22 no.1
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    • pp.3-23
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    • 2021
  • Telemedicine is a field of medicine in which medicine doctors who are in remote distance can treat the patients using audio, video devices which can help the diagnosis. In medicine, even the face-to-face diagnosis and treatment is the traditional way, the telemedicine could provide the convenient way for the patients in long distance, disabled or anyone who want to be stay ones' home. But telemedicine has the task to maintain the quality of medical cares compare with the traditional medicine. Among the several types of telemedicine, the specific type telemedicine in which the medicine doctors examine, diagnosis and do the prescription to the remotely distanced patients could be defined tele-prescription. Under The Medical Service act, it is unclear that teleprescription could be allowed. The Medical Service Act has introduced the specific clause for the prescription. That clause includes the duty of patients who have to receive the prescriptions directly from medical doctors. Under this clause, the constitutional court had decided the tele-prescription was illegal, but the supreme court has been decided tele-prescription could be legalized under the certain circumstances. But the other supreme court decided the tele-prescription was illegal under the article 34 of presenting Medical Service Act. So to understand the interpretations of Supreme court and Constitutional court decisions for the cases of prescription via telephone, we need to understand the history and presented reasons for the revision of prescription clause and also need to understand the other related clauses in the same act. In conclusion, To consider the values of telemedicine should be the level with the ordinary treatments, It is reasonable to interpret that the presenting Medical Service Act only legalize the telemedicine between doctor to doctor and which is regulated by the telemedicine clause.

Full-mouth rehabilitation of partial edentulism in a deep bite patient (과개교합을 갖는 부분무치악환자의 전악수복)

  • Kim, Sung-Hoon;Rhee, Ye-Kyu;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Cho, Lee-Ra;Park, Chan-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.2
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    • pp.187-197
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    • 2017
  • Deep overbite patients who do not have proper occlusal relationship may cause problems such as teeth wear and antagonist extrusion. These lead to the collapse of occlusal plane and esthetic problem. Increasing vertical dimension is frequently essential to resolve those problems. This case report demonstrates a full-mouth rehabilitation for a patient with severe deep bite that contacts surface to surface by increasing vertical dimension. Treatment procedures included diagnosis, treatment planning, implant surgery, and prosthodontic rehabilitation. Satisfactory results were obtained in functional and esthetic aspects.

침치료에 대한 환자진료 평가 프로그램-독일 보험회사들의 침효과에 대한 검증-

  • Melchart, Dieter
    • Journal of Pharmacopuncture
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    • v.6 no.1
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    • pp.33-34
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    • 2003
  • 배경: 독일 의사와 보험회사 위원회 (The German Board of Physicians and Insurance Companies:Bundesausschuss der Arzte und Krankenkassen)가 앞으로 일부 적응증에 대한 침치료에 대해 공적 보험회사가 보험료를 지급해야 할 지에 대한 추가 결정을 하기 위해 침의 효과를 평가하기로 했다. 목적: 1) 침치료가 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염치료에 대조군 침치료보다 효과가 있는지 검증 2) 침치료가 편두통의 예방적 치료에 표준 약물 치료와 비슷하게 효과가 있는지 검증 3) 보건의료 서비스체계 안에서 주어진 조건에 대한 일상적 침치료의 질적인 부분을 서술하고, 안전성을 평가하며, 다른 침술학파간의 임상결과의 차이와 비용의 효용적 활용부분을 평가한다. 4) 위의 적응증에 해당하는 모든 임상실험연구를 찾아내어 기존의 고찰내용을 갱신한다. 방법: 1) 무작위 표본추출 임상 실험, 침치료, 거짓침 치료, 대기자 명단 대조군, 출발시점 4주, 28주 관찰 2) 무작위 표본추출 임상 실험, 침치료, 표준약물치료 대조군, 츨발시점 4주, 28주 관찰 3) 전향적 다중 의료기관 관찰 연구, 두 가지 다른 자료를 활용하여서, 치료 결과를 침 시술자에 의한 모든 환자 평가 자료와, 열 두 명의 환자 가운데 한 명의 환자로부터 직접 받은 평가 자료 (관찰 출발시점, 치료 출발 시점, 치료 시작 후 6 개월) 실험공간: 1) and 2) 높은 수준의 수련을 한 침 시술 의사가 시술하는 병원이나 일차 진료기관의 외래. 3) 보건 의료 서비스내 저급의 침 시술 의사 (140 시간 수강, 학점 이수 필수) 참가자: 1) $4{\times}320$ 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염 환자 2) 480 편두통 환자(긴장성 두통 환자 추가적) 3) 약 500,000 환자, 2년 반 동안: 대략 한 적응증 당 10,000 환자 치료법: 모든 침치료 자리는 체침만 허용함. 1) 진짜 침은 학파의 지침에 따른 심자, 거짓 침은 비특이적 자리의 표피만 찌르는 자침 (12-15회, 8주): 대기자 대조군은 12주 동안에 아무 치료도 받지 않는다. 2) Group 1(N=240): 최대 15회 치료, 12주 동안: Group II (N=240) 투약 Proponolol (80-240mg), Metoprolol (100-200mg) or Flunarizin (5-10mg) 하루, 16주 이상 3) 치료회수와 침자리의 선정은 참가자가 결정 주된 임상 결과 지표: 1) 군 간의 치료 전 및 치료 진행 도중 4주 마다의 두통을 느낀 날 수의 차이 (평균 혹은 이상의 편두통이나 긴장성 두통) 2) 요통환자 군간의 기능을 측정하는 FFbH-R (Funktionsfragebogen Hannover) 비교 3) 관절염 환자의 군간 WOMAC 지표 비교 4) 군 간의 24주 동안 두통을 느낀 날 수의 차이(평균 혹은 이상의 편두통이나 긴장성 두통) 5) 적응증, 부작용, 성공율에 대한 거시적 평가, 사용한 침수, 환자의 만족도, SES(?). ADS(?) 통증 장애 지표(PDI), 삶의 질 지표(SF36). 예비 결과 위의 결과가 큰 관찰 연구에 초점을 맞추면서 소개될 것임.

Full mouth Rehabilitation in a Patient with Occlusal Collapse with Vertical Dimension Increase (교합 붕괴 환자에서 수직 고경을 증가한 보철 수복 : 증례 보고)

  • Jo, Si-Hoon;Jeong, Su-Yang;Nam, Hyun-Seok;Song, Kwang-Yeob;Park, Ju-Mi;Ahn, Seung-Geun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.4
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    • pp.477-482
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    • 2010
  • In a case of multiple posterior teeth loss, antagonistic teeth extrude to the edentulous space and compensatory occlusion on the remained anterior teeth leads to occlusal trauma. Extrusion of antagonistic teeth breaks down occlusion plane and loss of posterior support bring about severe wear of remained teeth. In this situation, it is needed to restore remained teeth and edentulous space by increasing vertical dimension to obtain prosthodontic rehabilitation space and to correct occlusion plane. In this case report, the patient had a masticatory problem with loss of posterior teeth support and an esthetic problem of shortened anterior teeth. Before the tooth preparation for the prosthodontic restoration, the patient used removable device for 2 months to increase vertical dimension reversibly. After that, he got provisional fixed restoration with irreversible tooth reduction and used it for 3 months. It had spent 5 month to evaluate the adaptation state on final restoration with incresed vertical dimension. The increasing amount was 3 mm, which was relatively in less degree and masticatory system adapted to the increased vertical dimension without any pathologic changes. Final restoration was made to have equal-intensity contacts on all teeth in a verifiable centric relations and immediate disclusion of all posterior contacts the moment the mandible moves in any direction from centric relation. In addition, metal occlusion surface on posterior teeth was applied to prevent excessive muscle activation, occlusal trauma and the porcelain fracture.

Full-mouth rehabilitation with increasing minimum vertical dimension in the patient with severely worn dentition and deep bite (과도한 치아 마모와 과개교합을 보이는 환자에서 최소한의 수직 고경 증가를 동반한 전악 구강 회복 증례)

  • Lee, Kang-Shin;Park, Ju-Mi;Ahn, Seung-Geun;Seo, Jae-Min;Han, Chang-Hee;Lee, Jung-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.431-441
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    • 2021
  • Full-mouth rehabilitation with increasing vertical dimension can be used for patients with severely worn teeth. In severely worn teeth also, the alveolar process can be elongated to compensate for the reduced vertical dimension, and the patient's vertical dimension of occlusion can be kept constant. However, full-mouth rehabilitation with increasing vertical dimension must be carefully chosen, because the vertical dimension can be reduced by tooth wear. It is important to establish a treatment plan with the systematic diagnosis of the change in the vertical dimension and gain space for the prosthesis. It is necessary to change the vertical dimension to secure the restoration space and select the minimum vertical dimension elevation for the esthetic and functional goal. In this case report, the patient complained of difficulty during chewing due to a worn dentition and wanted esthetic improvement of the short mandibular anterior teeth. After systematic evaluation and diagnosis, we performed full-mouth rehabilitation with minimum vertical dimension elevation to obtain the space for restoration. This resulted in a stable and harmonious occlusion, and the functional and esthetic problems of the patient were solved after treatment. The patient was satisfied with the results of the treatment and maintained stable occlusion during the follow-up period.

Surface Dose Evaluation According to the Environment Around the Patient after Nuclear Medicine Examination (핵의학 검사 후 환자의 주위 환경에 따른 표면 선량 평가)

  • Lee, Young-Hee;Park, Jae-Yoon
    • Journal of the Korean Society of Radiology
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    • v.15 no.7
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    • pp.943-948
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    • 2021
  • The purpose of this study was to investigate changes in surface dose due to increased scattering of gamma rays from patients injected with 99mTc and 18F, which are radioactive isotopes, in close contact with materials with high atomic number such as the walls of the stable room. Prepare 99mTc and 18F by injecting 20 and 10 mCi respectively into the NEMA phantom, and then measuring the surface dose for 60 minutes by positioning the phantom at a height of 1 m above the surface, at a distance of 0, 5 and 10 cm from the wall, and at the same location as the phantom facing the wall. Each experiment was repeated five times for reproducibility of the experiment and one way analysis of variability (ANOVA) was performed for significance testing and Tukey was used as a post-test. The study found that surface doses of 220.268, 287.121, 243.957, and 226.272 mGy were measured at 99mTc, respectively, in the case of empty space and in the case of 0, 5 and 10 cm, while those of 18F were measured at 637.111, 724.469, 657.107, and 640.365 mGy, respectively. In order to reduce changes in surface dose depending on the patient's location while waiting, it is necessary to keep the distance from the ground or the wall where the patient is closely adhered to, or install an air mattress, etc., to prevent the scattered lines as much as possible, considering the scattered lines due to the wall etc. in future setup of the patient waiting room and safety room, and in addition to the examination, the external skin width may be reduced.