• Title/Summary/Keyword: Hospital medical devices

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Report of the 3rd Japan-Korea Workshop on Acupuncture and EBM;Protocol development for the acupuncture trial on the osteoarthritis of the knee

  • Jang, Jun-Hyouk;Kenji, Kawakita;Hahn, Seo-Kyung;Park, Hi-Joon;Lee, Seung-Deok;Kim, Yong-Suk;Norihito, Takahashi;Toshiyuki, Shichidou;Kazunori, Itoh;Eiji, Sumiya;Eiji, Furuya;Hitoshi, Yamashita;Hiroshi, Tsukayama
    • Journal of Acupuncture Research
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    • v.23 no.6
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    • pp.239-254
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    • 2006
  • The 3rd Japan-Korea Workshop on Acupuncture and EBM was held at Kanazawa on June $16^{th}$. From Korea team, 4 papers were presented. Dr. Hahn introduced a new approach of data analysis on series of n-of-1 trials using the Bayesian statistics. It offered important information for the future n-of-1 trials. Dr. Park clearly demonstrated the significance of various sham devices proposed and stressed the importance of research questions when we choose the control intervention in RCT. Dr. Lee reported the results of survey in Korean Medical Doctors (KMD) for their point selection and techniques to the distal and local points. Dr. Kim presented the results of face to face survey on the KMD with 28 items for acupuncture treatment on the knee OA. Finally, a draft of protocol was introduced by Dr. Kim. The title was "multi-center, a randomized, single blinded, two arms, parallel-group study to compare the effectiveness and safety of 'individualized acupuncture' and 'standardized minimal acupuncture' in Korean and Japanese patients with knee osteoarthritis (Phase IV)". From Japan team, 7 speakers presented their comments and proposals on the protocol. Dr. Takahashi introduced several issues regarding n-of-1 trials and pointed out the importance of obtaining generalizability from n-of-1 trials. Dr. Shichidou pointed the importance of research design, selection of outcome measures and reduction of biases. Dr. Itoh presented the results of point selection for the knee OA based on the literature survey. Dr. Sumiya introduced several differences between KMD and Japanese acupuncturists based on the questionnaire used in KMD survey. Dr. Furuya demonstrated a result of press tack needle and its sham device on shoulder stiffness. Dr. Yamashita introduced the results of literature survey regarding adverse events occurred by acupuncture on knee OA. Dr.Tsukayama stressed the importance of responsibility of Institutional Review Board (IRB) for the conduction of clinical trials. After several issues were discussed, the need of continued meeting for final protocol development was agreed, then the workshop was closed.

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Differences in percussion-type measurements of implant stability according to height of healing abutments and measurement angle (임플란트 healing abutment 높이와 타진각도에 따른 타진방식 임플란트 안정성 측정기기의 수치 차이)

  • Park, Yang-Hoon;Leesungbok, Richard;Lee, Suk-Won;Paek, Janghyun;Lee, Jeong-Yol
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.4
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    • pp.278-286
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    • 2018
  • Purpose: The purpose of this study was to evaluate the effect of healing abutment height and measurement angle on implant stability when using Periotest and AnyCheck. Materials and methods: 60 implants were placed into artificial bone blocks. After implant insertion, 2, 3, 4 and 5 mm healing abutments were installed on 15 specimens, respectively. Insertion torque value, implant stability test, Periotest value were measured. Insertion torque value was controlled between 45 - 55 Ncm. AnyCheck was used for measuring implant stability test and Periotest M was used for measuring Periotest value. Implant stability test and Periotest value were measured at the angles of 0 and 30 degrees to the horizontal plane. Measured values were analyzed statistically. Results: Insertion torque value had no significant difference among groups. When healing abutment height was higher, implant stability test and Periotest value showed lower stability. Also when measurement angle was decreased, implant stability test and Periotest value showed lower stability. Conclusion: When measuring stability of implants with percussion type devices, measured values should be evaluated considering height of healing abutments and measurement angle.

Lumped Mechanical Model of Electromagnetic Floating Mass Transducer Implanted on Human Middle Ear (이소골에 장착된 전자기 플로팅매스 진동체에 대한 집중 질량-스프링 모델의 제안)

  • Seong, Ki-Woong;Kim, Min-Woo;Lee, Jang-Woo;Lim, Hyung-Gyu;Jung, Eui-Sung;Kim, Dong-Wook;Lee, Myung-Won;Lee, Jung-Hyun;Kim, Myoung-Nam;Lee, Kyu-Yeop;Lee, Sang-Heun;Park, Il-Yong;Cho, Jin-Ho
    • Journal of Biomedical Engineering Research
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    • v.30 no.2
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    • pp.162-168
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    • 2009
  • Implantable middle ear hearing devices (IMEHDs) have been widely studied as an alternative hearing aids to solve the problems of conventional hearing aids. Vibration transducer of middle ear hearing aids is a key component because vibration characteristics of transducer is directly involved performance of hearing aids. So, the study about middle ear hearing aids concentrate on the transducers. A floating mass type transducer is most efficient. In this paper, we suggest a lumped mechanical model of electromagnetic floating mass transducer implanted on human middle ear. The proposed model enables analysis of the vibration characteristics of a floating mass transducer and prediction of the variation after implant on ossicle that offers a simple and easy to analyze. The parameters was drawn based on the components and the structures of transducer. The Lumped mechanical model was converted by the electrical-mechanical equivalent model, and simulated using PSpice. So, we investigated vibration characteristics of transducer influenced it's components. And we predict vibration characteristics of stapes footplate due to implanted transducer's vibration using combining model of transducer and human ear. To prove the feasibility of the suggested model, we fabricated a differential floating mass transducer (DFMT) as one of floating mass transducers and performed experiments using the human temporal bones.

Ultrasound-guided superficial cervical plexus block under dexmedetomidine sedation versus general anesthesia for carotid endarterectomy: a retrospective pilot study

  • Do, Wangseok;Cho, Ah-Reum;Kim, Eun-Jung;Kim, Hyae-Jin;Kim, Eunsoo;Lee, Heon-Jeong
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.45-53
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    • 2018
  • Background: Carotid endarterectomy (CEA) has been performed under regional and general anesthesia (GA). The general anesthesia versus local anesthesia for carotid surgery study compared the two techniques and concluded that there was no difference in perioperative outcomes. However, since this trial, new sedative agents have been introduced and devices that improve the delivery of regional anesthesia (RA) have been developed. The primary purpose of this pilot study was to compare intraoperative hemodynamic stability and postoperative outcomes between GA and ultrasound-guided superficial cervical plexus block (UGSCPB) under dexmedetomidine sedation for CEA. Methods: Medical records from 43 adult patients who underwent CEA were retrospectively reviewed, including 16 in the GA group and 27 in the RA group. GA was induced with propofol and maintained with sevoflurane. The UGSCPB was performed with ropivacaine under dexmedetomidine sedation. We compared the intraoperative requirement for vasoactive drugs, postoperative complications, pain scores using the numerical rating scale, and the duration of hospital stay. Results: There was no difference between groups in the use of intraoperative antihypertensive drugs. However, intraoperative inotropic and vasopressor agents were more frequently required in the GA group (p<0.0001). In the GA group, pain scores were significantly higher during the first 24 h after surgery (p<0.0001 between 0-6 h, p<0.004 between 6-12 h, and p<0.001 between 12-24 h). The duration of hospital stay was significantly more in the GA group ($13.3{\pm}4.6days$ in the GA group vs. $8.5{\pm}2.4days$ in the RA group, p<0.001). Conclusion: In this pilot study, intraoperative hemodynamic stability and postoperative outcomes were better in the RA compared to the GA group.

Development of Porcine Pericardial Heterograft for Clinical Application (Tensile Strength-thickness) (돼지의 심낭을 이용한 이종이식 보철편의 개발 (장력-두께간의 구조적 특성))

  • Kim, Kwan-Chang;Lee, Cheul;Choi, Chang-Hue;Lee, Chang-Ha;Oh, Sam-Sae;Park, Seong-Sik;Kim, Kyung-Hwan;Kim, Woong-Han;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.170-176
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    • 2008
  • Background: Bioprosthetic devices for treating cardiovascular diseases and defects may provide alternatives to autologous and homograft tissue. We evaluated the mechanical and physical conditions of a porcine pericardial bioprosthesis treated with Glutaraldehyde (GA), Ethanol, or Sodium dodecylsulfate (SDS) before implantation. Material and Method: 1) Thirty square-shaped pieces of porcine pericardium were fixed in 0.625%, 1.5% or 3% GA solution. 2) The tensile strength and thickness of these and other bioprosthesis, including fresh porcine pericardium, fresh human pericardium, and commercially produced heterografts, were measured. 3) The tensile strength and thickness of the six treated groups (GA-Ethanol, Ethanol-GA, SDS only, SDS-GA, Ethanol-SDS-GA and SDS-Ethanol-GA) were measured. Result: 1) Porcine pericardium fixed in 0.625% GA the thinnest and had the lowest tensile strength, with thickness and tensile strength increasing with the concentration of GA solution. The relationship between tensile strength and thickness of porcine pericardium increased at thicknesses greater than 0.1mm (correlation-coefficient 0.514, 0<0.001). 2) There were no differences in tensile strength or thickness between commercially-produced heterografts. 3) Treatment of GA, ethanol, or SDS minimally influenced thickness and tensile strength of porcine pericardium, except for SDS alone. Conclusion: Porcine pericardial bioprosthesis greater than 0.1 mm thick provide better handling and advantageous tensile strength. GA fixation did not cause physical or mechanical damage during anticalcification or decellularization treatment, but combining SDS-ethanol pre-treatment and GA fixation provided the best tensile strength and thickness.

Effect of Coverage Expansion Policy for an Ultrasonography in the Upper Abdomen on Its Utilization: A Difference-in-Difference Mixed-Effects Model Analysis (상복부초음파검사 급여확대에 따른 의료이용의 변화: 이중차이 혼합효과모형 추정방법을 이용하여)

  • Son, Yena;Lee, Yongjae;Nam, Chung-Mo;Kim, Gyu Ri;Chung, Woojin
    • Health Policy and Management
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    • v.30 no.3
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    • pp.326-334
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    • 2020
  • Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

Comparison of Survival Prediction of Rats with Hemorrhagic Shocks Using Artificial Neural Network and Support Vector Machine (출혈성 쇼크를 일으킨 흰쥐에서 인공신경망과 지원벡터기계를 이용한 생존율 비교)

  • Jang, Kyung-Hwan;Yoo, Tae-Keun;Nam, Ki-Chang;Choi, Jae-Rim;Kwon, Min-Kyung;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.48 no.2
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    • pp.47-55
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    • 2011
  • Hemorrhagic shock is a cause of one third of death resulting from injury in the world. Early diagnosis of hemorrhagic shock makes it possible for physician to treat successfully. The objective of this paper was to select an optimal classifier model using physiological signals from rats measured during hemorrhagic experiment. This data set was used to train and predict survival rate using artificial neural network (ANN) and support vector machine (SVM). To avoid over-fitting, we chose the best classifier according to performance measured by a 10-fold cross validation method. As a result, we selected ANN having three hidden nodes with one hidden layer and SVM with Gaussian kernel function as trained prediction model, and the ANN showed 88.9 % of sensitivity, 96.7 % of specificity, 92.0 % of accuracy and the SVM provided 97.8 % of sensitivity, 95.0 % of specificity, 96.7 % of accuracy. Therefore, SVM was better than ANN for survival prediction.

A New Shock Index for Predicting Survival of Rats with Hemorrhagic Shock Using Perfusion and Lactate Concentration Ratio (흰쥐의 출혈성 쇼크에서 관류와 젖산 농도 비를 이용한 새로운 생존 예측 지표 개발)

  • Choi, Jae-Lim;Nam, Ki-Chang;Kwon, Min-Kyung;Jang, Kyung-Hwan;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.48 no.4
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    • pp.1-9
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    • 2011
  • Hemorrhagic shock is a clinically widespread syndrome characterized by inadequate oxygenation and supply. It is important to diagnose hemorrhagic shock in its early stage for improving treatment effects and survival rate. However, an accurate diagnosis and treatment could be delayed in the early stage of hemorrhagic shock by evaluating only vital signs such as heart rate and blood pressure. There have been many studies for the early diagnosis of hemorrhagic shock, reporting that lactate concentration and perfusion were useful variables for tissue hypoxia and metabolic acidosis. In this study, we measured both perfusion using a laser Doppler flowmeter and lactate concentration from the volume controlled hemorrhagic shock using rats. We also proposed a new shock index which was calculated by dividing lactate concentration by perfusion for early diagnosis. As a result of the survival prediction by the proposed index with the receiver operating characteristic curve method, the sensitivity, specificity, and accuracy of survival were 90.0, 96.7 and 94.0%, respectively. The proposed index showed the fastest significant difference among the other parameters such as blood pressure and heart rate. It could offer early diagnosis and effective treatment for human hemorrhagic shock if it is applicable to humans.

A Measurement of Exposure Dose for Patient Transporter (환자 이송원의 피폭선량 측정)

  • Song, Chaerim;Lee, Wanghui;Ahn, Sungmin
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.433-438
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    • 2019
  • The medical institutions use radiation generating devices and radioactive isotopes to diagnose and treat patients. The patient transporter performs work in an environment that is more likely to be exposed to radiation when compared with the general public, such as inevitably entering the radiation management area for patient transfer, or transferring the isotope-administered patient at a short distance. For this reason, we conducted a study to determine the degree of exposure of the patient transporter. The 12 patient transporters working at Incheon A General Hospital are eligible. From April 1, 2019 to April 30, 2019, the dosimeter was used in the chest for one month and the accumulated dose was measured. The dosimeter used was a Optically Stimulated Luminescence Dosimetry (OSLD) and the dose reading was OSLD Microstar Reading System. As a result of cumulative dose measurement for one month, the average of the deep dose was 0.13 mSv and the surface dose was 0.13 mSv, and the cumulative dose for one month was multiplied by 12 to estimate the cumulative dose expectation As a result, the average of the deep dose and the surface dose were 1.52 mSv and 1.51 mSv, respectively. It is necessary to classify the patient transporter as a frequent visitor in order to measure and manage the exposure dose, increase the knowledge of protection against radiation through education and training, and prevent radiation trouble through medical examination.

Investigation on the Perception of Mandatory Clinical Practice in the Department of Radiology Following the Amendment of the Medical Technologists Act (의료기사 등에 관한 법률 개정으로 방사선(학)과 현장실습 의무화에 따른 인식 조사)

  • Jeong-Mu Lee;Yong-Ki Lee;Sung-Min Ahn
    • Journal of the Korean Society of Radiology
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    • v.18 no.3
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    • pp.293-300
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    • 2024
  • On October 31, 2023, the revision of the Medical Technologist Act made it mandatory to complete field training courses in order to obtain a license as a radiologic technologist. Therefore, we would like to survey the actual situation of field training in medical institutions to inform the revised Medical Technologist Act and propose improvement measures to increase the effectiveness of field training. A survey was conducted from March to April, 2023, among radiologic technologists working in medical institutions. The questionnaire was sent through a form on a domestic portal site, Company N, and 120 respondents completed it. Eighty-two respondents, or 68.3 percent, had experience in educating on-the-job training students. 58% of the respondents were aware of the fact that the amendment to the Act on Medical Technologist etc. made field training mandatory to obtain a radiologic technologist license. In accordance with Article 9 of the Medical Technologist Act, which prohibits unlicensed persons from practicing, 50% of the respondents were aware that those who are in training to complete an education course equivalent to the license they are seeking to obtain at a university or other institution are allowed to practice as medical Technologists. When asked what is currently taught during fieldwork, 6% of respondents said that they are required to perform radiation-generating activities in addition to observing, guiding patients, and positioning and moving patients. When asked about the future direction of education as fieldwork becomes mandatory for licensure, 77% of respondents said that they will teach more than they currently do. When asked about the appropriate total length of fieldwork, 35% said 12 weeks and 480 hours, 33% said 8 weeks and 320 hours, and 27% said 16 weeks and 640 hours. It can be seen that the current on-the-job training is inadequate according to various regulations, and students' satisfaction is low. However, with the revision of the Act on Medical Technologists, field training has become mandatory to obtain a license as a radiologist, and it is necessary to improve the educational conditions of field training. Therefore, it is necessary to comply with the Nuclear Safety Act and the Rules on the Safety Management of Diagnostic Radiation Generating Devices, introduce standardized training objectives and evaluation systems, designate training hospitals and radiologists in charge of training, and introduce extended training periods and simulation exercises to internalize field training.