• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.1
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• pp.90-97
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• 2018

Purpose The lung segment ratio which is obtained through quantitative analyses of lung perfusion scan images is calculated to evaluate the lung function pre and post surgery. In this Study, the planar image production methods by using Q-Metrix (GE Healthcare, USA) program capable of not only quantitative analysis but also computation of the segment ratio after having performed SPECT/CT are comparatively evaluated. Materials and Methods Lung perfusion scan and SPECT/CT were performed on 50 lung cancer patients prior to surgery who visited our hospital from May 1, 2015 to September 13, 2016 by using Discovery 670(GE Healthcare, USA) equipment. AP(Anterior Posterior)method that uses planar image divided the frontal and rear images into three rectangular portions by means of ROI tool while PO(Posterior Oblique)method computed the segment ratio by dividing the right lobe into three parts and the left lobe into two parts on the oblique image. Segment ratio was computed by setting the ROI and VOI in the CT image by using Q-Metrix program and statistically analysis was performed with SPSS Ver. 23. Results Regarding the correlation concordance rate of Q-Metrix and AP methods, RUL(Right upper lobe), RML(Right middle lobe) and RLL(Right lower lobe) were 0.224, 0.035 and 0.447. LUL(Left upper lobe) and LLL(Left lower lobe) were found to be 0.643 and 0.456, respectively. In the PO method, the right lobe were 0.663, 0.623 and 0.702, respectively, while the left lobe were 0.754 and 0.823. When comparison was made by using the Paired sample T-test, Right lobe were $11.6{\pm}4.5$, $26.9{\pm}6.2$ and $17.8{\pm}4.2$, respectively in the AP method. Left lobe were $28.4{\pm}4.8$ and $15.4{\pm}5.6$. The right lobe of PO had values of $17.4{\pm}5.0$, $10.5{\pm}3.6$ and $27.3{\pm}6.0$, while the left lobe had values of $21.6{\pm}4.8$ and $23.1{\pm}6.6$, thereby having statistically significant difference in comparison to the Q-Metrix method for each of the lobes (P<0.05). However, there was no statistically significant difference in Right middle lobe (P>0.05). Conclusion The AP method showed low concordance rate in correlation with the Q-Metrix method. However, PO method displayed high concordance rate overall. although AP method had significant differences in all lobes, there was no significant difference in Right middle lobe of PO method. Therefore, at the time of production of lung perfusion scan results, utilization of Q-Metrix method of SPECT/CT would be useful in computation of accurate resultant values. Moreover, it is deemed possible to expect obtain more practical sectional computation result values by using PO method at the time of planar image acquisition.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

• Korean Journal of Poultry Science
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• v.41 no.3
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• pp.165-171
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• 2014

The objective of this experiment was to investigate the effect of dietary supplementation of copper-soy proteinate (Cu-SP) and herbal mixture (HBM) on growth performance, intestinal microflora, and immune response in broiler. A total 1,000 1-d old ROSS 308 (initial $BW=41{\pm}0.38g$) were randomly allotted to 1 of 5 dietary treatments with 4 replicates during d 35 of the feeding trial. Dietary included: (1) Control : control diet, (2) Antibiotics : control diet + Avilamycin 6 ppm, (3) Cu-SP : control diet + 100 ppm Cu-soy proteinate, (4) HBM : control diet + 0.15% herbal mixture, (5) Cu-SP+HBM : control diet + 100 ppm Cu-soy proteinate + 0.2% herbal mixture. Two-phase feeding program with a starter diet from d 0 to 21, and a finisher diet from d 22 to 35 was used in the experiment. Within each phase, a diet was formulated to meet or exceed NRC requirements of broilers for macro- and micronutrients. The diet and water were available ad libitum. Result indicated that during d 22 to 35 and over all periods of the experiment, feed intake and feed conversion ratio were greater (P<0.05) for other treatment than control. Significant differences were found in lymphocyte (LY), and stress indicator (HE:LY ratio). Lymphocyte was greater (P<0.05) for Cu-SP + HBM treatment than control. However, stress indicator (HE:LY ratio) were greater (P<0.05) for control than Cu-SP + HBM treatment. The plasma IgG was higher (P<0.05) in the antibiotics, HBM, and Cu-SP+HBM treatments groups compared with control. The population of Clostridium perfringens in the antibiotics, Cu-SP, HBM, Cu-SP + HBM treatment groups were lower (P<0.05) than those control. These result suggested that dietary copper-soy proteinate or herbal mixture may be used as an alternative to antibiotics to improve growth performance, and intestinal health of birds.

• Korean Journal of Poultry Science
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• v.41 no.4
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• pp.227-233
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• 2014

This study investigated the effects of dietary supplementation with the effective microorganism (EM) on the growth performance, blood parameter, small intestinal microflora, and noxious gas emission of broilers. A total 720 1-d old ROSS 308 was randomly assigned to 6 dietary treatment groups: control, virginiamycin (6 mg/kg), 0.1% PB 0.1% EM, 0.5% EM, and 1.0% EM. Each treatment was fed to 4 replicates of 30 birds per diet for d 35. Two-phase feeding program with a starter diet from 0 to 3 wk, and a finisher diet from 4 to 5 wk was used in the experiment. Within each phase, a diet was formulated to meet or exceed NRC requirements of broilers for macro- and micronutrients. The diet and water were available ad libitum. Result indicated that during overall periods of the experiment, final weight, body weight gain, and feed intake were not different among dietary treatments. Feed conversion ratio was less (P<0.05) for EM treatments than control, antibiotics, and PB. Total cholesterol (TC), triglyceride (TRG), glucose (GLU), total protein (TP), calcium (CA), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were not different among dietary treatments. White blood cell (WBC), hemoglobin (Hb), heterophils (HE), lymphocyte (LY), monocytes (MO), and eosinophils (EO) were not different among dietary treatments. HE:LY was less (P<0.05) for EM0.5 treatments than control, antibiotics, and PB. Lactobacillus was greater (P<0.05) for EM treatments than control and antibiotics. E. coli and Salmonella were not different among dietary treatments. $NH_3$ and $CO_2$ wereless (P<0.05) for EM treatments than control. These results indicated that EM treatments were effective feed conversion ratio, noxious gas emission and micro flora population on the cecum in broilers.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.7 no.1
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.