• Title/Summary/Keyword: Medical Examination Result

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Spatial Dose Distribution for C-arm Examination within Operation Room Using Monte Carlo Method (몬테카를로 방법을 이용한 이동형 X선 투시검사 시 수술실 내 공간선량평가)

  • Kim, Jung-Hoon;Shin, Eom-Hyeon
    • Journal of radiological science and technology
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    • v.44 no.3
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    • pp.205-210
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    • 2021
  • The purpose of this study was to analyze the spatial dose according to the distance by location of medical workers when using a mobile X-ray fluoroscopy device in the operating room through a simulation experiment. The MCNPX program was used for the simulation, and the location of medical workers was set around the operating table, and the spatial dose distribution according to the distance and changes in imaging conditions was evaluated. As a result, The highest score was 2.74×10-4 mGy, 2.72×10-4 mGy, and 1.18×10-4 mGy based on the 10 cm distance from the operating table. Spatial dose depending on the distance 100cm, A point 5.15×10-5 mGy is decreased 19% of 10cm, D point 5.12×10-5 mGy, 19 % of 10cm, and G pint, 1.73×10-5 mGy is reduced by 15% of 10cm. Based on this study, medical-related workers directly or indirectly participating in surgery carry potential risks of radiation exposure during surgery, but there are difficulties in radiation protection due to the nature of their work. Therefore, efforts to reduce exposure suitable for the operating room environment will be required.

A Study on the Practice Model for Prescription Information Management of EMR Certification standard - Focus on Data management using SQL - (처방정보관리를 위한 EMR 인증기준의 실습 모델 연구 - SQL을 이용한 데이터 관리 중심 -)

  • Joon-Young Choi
    • Journal of the Health Care and Life Science
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    • v.10 no.1
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    • pp.25-38
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    • 2022
  • In this study, a SQL practice model for understanding EMR certification standards and data management practice for healthcare information managers was presented. This study is to practice prescription information management for the functionality of EMR certification standards through the health and medical information management practice program. The data management practice according to the EMR certification criteria consists of medicaiton master management and medicaiton name inquiry, medicaiton prescription inquiry, previous medication prescription inquiry after converting medical care information, examintaion result inquiry when administering medicine, examination prescription records inquiry. Additionally, dietary prescription records, other prescription records, return reason inquiry when administering medicine is stopped are included. Accordingly, using the prescription management database of the MS-ACCESS-based health care information management education system, a SQL statement was written that can inquire the contents of the prescription information management certification standards. In the EMR certification practice, you can understand the certification standards more easily by directly extracting the query items required by the certification standards using SQL and it will be possible to improve the data management and information generation ability to extract data other than the certification standards.

Consideration on Shielding Effect Based on Apron Wearing During Low-dose I-131 Administration (저용량 I-131 투여시 Apron 착용여부에 따른 차폐효과에 대한 고찰)

  • Kim, Ilsu;Kim, Hosin;Ryu, Hyeonggi;Kang, Yeongjik;Park, Suyoung;Kim, Seungchan;Lee, Guiwon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.32-36
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    • 2016
  • Purpose In nuclear medicine examination, $^{131}I$ is widely used in nuclear medicine examination such as diagnosis, treatment, and others of thyroid cancer and other diseases. $^{131}I$ conducts examination and treatment through emission of ${\gamma}$ ray and ${\beta}^-$ ray. Since $^{131}I$ (364 keV) contains more energy compared to $^{99m}Tc$ (140 keV) although it displays high integrated rate and enables quick discharge through kidney, the objective of this study lies in comparing the difference in exposure dose of $^{131}I$ before and after wearing apron when handling $^{131}I$ with focus on 3 elements of external exposure protection that are distance, time, and shield in order to reduce the exposure to technicians in comparison with $^{99m}Tc$ during the handling and administration process. When wearing apron (in general, Pb 0.5 mm), $^{99m}Tc$ presents shield of over 90% but shielding effect of $^{131}I$ is relatively low as it is of high energy and there may be even more exposure due to influence of scattered ray (secondary) and bremsstrahlung in case of high dose. However, there is no special report or guideline for low dose (74 MBq) high energy thus quantitative analysis on exposure dose of technicians will be conducted based on apron wearing during the handling of $^{131}I$. Materials and Methods With patients who visited Department of Nuclear Medicine of our hospital for low dose $^{131}I$ administration for thyroid cancer and diagnosis for 7 months from Jun 2014 to Dec 2014 as its subject, total 6 pieces of TLD was attached to interior and exterior of apron placed on thyroid, chest, and testicle from preparation to administration. Then, radiation exposure dose from $^{131}I$ examination to administration was measured. Total procedure time was set as within 5 min per person including 3 min of explanation, 1 min of distribution, and 1 min of administration. In regards to TLD location selection, chest at which exposure dose is generally measured and thyroid and testicle with high sensitivity were selected. For preparation, 74 MBq of $^{131}I$ shall be distributed with the use of $2m{\ell}$ syringe and then it shall be distributed after making it into dose of $2m{\ell}$ though dilution with normal saline. When distributing $^{131}I$ and administering it to the patient, $100m{\ell}$ of water shall be put into a cup, distributed $^{131}I$ shall be diluted, and then oral administration to patients shall be conducted with the distance of 1m from the patient. The process of withdrawing $2m{\ell}$ syringe and cup used for oral administration was conducted while wearing apron and TLD. Apron and TLD were stored at storage room without influence of radiation exposure and the exposure dose was measured with request to Seoul Radiology Services. Results With the result of monthly accumulated exposure dose of TLD worn inside and outside of apron placed on thyroid, chest, and testicle during low dose $^{131}I$ examination during the research period divided by number of people, statistics processing was conducted with Wilcoxon Signed Rank Test using SPSS Version. 12.0K. As a result, it was revealed that there was no significant difference since all of thyroid (p = 0.345), chest (p = 0.686), and testicle (p = 0.715) were presented to be p > 0.05. Also, when converting the change in total exposure dose during research period into percentage, it was revealed to be -23.5%, -8.3%, and 19.0% for thyroid, chest, and testicle respectively. Conclusion As a result of conducting Wilcoxon Signed Rank Test, it was revealed that there is no statistically significant difference (p > 0.05). Also, in case of calculating shielding rate with accumulate exposure dose during 7 months, it was revealed that there is irregular change in exposure dose for inside and outside of apron. Although the degree of change seems to be high when it is expressed in percentage, it cannot be considered a big change since the unit of accumulated exposure dose is in decimal points. Therefore, regardless of wearing apron during high energy low dose $^{131}I$ administration, placing certain distance and terminating the administration as soon as possible would be of great assistance in reducing the exposure dose. Although this study restricted $^{131}I$ administration time to be within 5 min per person and distance for oral administration to be 1m, there was a shortcoming to acquire accurate result as there was insufficient number of N for statistics and it could be processed only through non-parametric method. Also, exposure dose per person during lose dose $^{131}I$ administration was measured with accumulated exposure dose using TLD rather than through direct-reading exposure dose thus more accurate result could be acquired when measurement is conducted using electronic dosimeter and pocket dosimeter.

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Clinical study on the improving period of the bell's palsy patients with D.I.T,I (적외선 체열진단을 이용한 구안와사 환자(Bell's palsy)의 호전기간에 대한 임상연구)

  • Park, Yong-Ho;Yu, Mi-Kyung;Park, Youn-Hee;Park, Soo-Yeon;Choi, Jeong-Hwa;Kim, Jong-Han;Kim, Dae-Su
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.19 no.2
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    • pp.202-211
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    • 2006
  • Objectives : This study is designed to evaluate correlation between the data of D.I.T,I examination in Bell's palsy and the improving period. Methods : This study researched into the clinical statistics for 50 patients who are in Bell's palsy and they are treated with oriental medical care of Dongshin university during 18months from January 1, 2005 to June 1, 2006. The data which examinated by D.I.T.I, are the thermal difference of normal and abnormal site of acupuncture int Gl4 BL2 GB3 S3 S4 S6 TE17 in Bell's palsy. Result : There was statistic significance between thermal difference of normal, abnormal site and the improving period. The period was shorter in normal thermal pattern than hypothermal pattern, hyperthermal pattern. Conclusion : According to the result, there was a statistic significance that more thermal difference and more difficult to recover in Bell's palsy.

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A Study on the Noise Level and Patients' Perception of the Noise in Emergency Department (응급실의 소음도와 환자의 인지정도에 관한 연구)

  • Chung Seung-Eun;Choi Chang-Ha
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.5 no.2
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    • pp.341-352
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    • 1998
  • The purpose of this study was to provide a bases for comfort of patient through of measuring the noise level in emergency room and grasping the perception to noise of inpatient. Data on noise level through sound level meter in ER and patients' perception of the noise through a structured questionnaire and were collected from August 21 to September 5 in 1998. And collected data were analyzed with SAS statistics progeam, descriptive statistic, t-test and ANOVA. The result of examination is as follows : 1. Among a noise level of measured highest was 64.6dB(A) in 'rounding of medical teams', the lowest was 54.8dB(A) in 'traffic noise from outside'. 2. The mean score of noise perception was 0.93. Among a kind of noise reported by the subjects, that which ranked highest was 'conversation of patients' caregiver and visitors'(1.75). The ranked lowest was 'noise of airconditioner'(0.59). 3. The relationship between perception of noise and subjects' characteristics was not significient. Therefore, based on this result, ways require to decrease the noise level in emergency department.

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Clinical Study on Idiopathic Scoliosis with Massotherapy (추나요법을 시행한 특발성 척추측만증 환자 30례에 관한 임상적 고찰)

  • Yang Ki-Young;Hong Kwon-Eui;Lee Hyun;Lee Byung-Ryul;Shin Young-Il
    • Journal of Acupuncture Research
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    • v.18 no.6
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    • pp.27-34
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    • 2001
  • Objective : The purpose of this study was to inspect the effect of Massotherapy on idiopathic scoliosis patients, utilizing Cobb's angle to determine the degree of curvature progression in the thoracic and lumbar regions. Methods : To obtain this result, we examinated 30 case of parents who visit Dept. of Acupuncture and Moxibustion Oriental Medical Hospital. Taejon University. with idiopathic scoliosis. We observe their age, sex, symptoms and Cobb's angle. Results : As a result of this examination, we detected the fact that it's difficult to treat isiopathic scoliosis fundamentally. But, Their symptoms are improved. So it is necessary to treat scoliosis actively with massotherapy . Conclusion : We want to be put this knowledge to practical use on treating Scoliosis and think the study like this must be go on continuously.

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Correlation Analysis of Cardiac Diastolic Function and Intima-Media Thickness in the Common Carotid Artery of Ultrasonography (초음파검사의 경동맥내중막두께와 심장이완기능의 상관관계 분석)

  • Oh, Song-Mi;Lee, Sang-Hun;Ji, Tae-Jeong
    • Journal of radiological science and technology
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    • v.45 no.5
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    • pp.413-422
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    • 2022
  • In this study, 230 subjects of medical examination were investigated to figure out the relationship with common carotid artery intima-media thickness and cardiac diastolic function. In addition, the change in the carotid artery intima-media thickness according to the presence or absence of metabolic syndrome was examined. As a result of the study the carotid artery intima-media thickness was thick as the age increased and there was a large difference in those in their 60s and over. There was no gender difference. As for metabolic syndrome the carotid artery intima-media thickness was thicker in the study subjects with high blood pressure diabetes and dyslipidemia. The correlation between the carotid artery intima-media thickness and diastolic function indexes was significant. As a result of hierarchical regression analysis the thicker the intima-media thickness in the carotid artery the lower cardiac diastolic function.

A clinical study on patients with Cold Hypersensitivity on hands and feet and their autonomic nervous system function using of Heart Rate Variability(HRV) (수족냉증 환자의 실태 및 HRV(Heart Rate Variability)를 이용한 자율신경계 기능 평가 연구)

  • Kim, Eun-Sook;Hwang, Jae-Ho;Lee, Jin-Moo;Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub;Choi, Jae-Ho
    • Journal of Oriental Medical Thermology
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    • v.5 no.1
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    • pp.1-13
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    • 2006
  • Objectives : This study was designed to analyze basic data for cold hypersensitivity patients with a questionnaire and investigate correlation between cold hypersensitivity and Heart Rate Variability(HRV). Methods : 49 patients who complain of cold hypersensitivity on hands and feet in ambulatory care were investigated in Oriental Gynecology, Kyunghee Oriental Medical Center and Women medical center, Kangnam Koreana hospital from May 1, 2006 to October 20, 2006. All patients were asked to answer a questionnaire. After careful I examination to rule out other disease which may affect Digital Infrared Thermal Imaging(DITI) and HRV data, patients were taken thermography for the diagnosis of cold hypersensitivity Based on the result of thermography, the patients were divided into two groups(Objective cold hypersensitivity and Subjective cold hypersensitivity). Then, these two groups were compared using HRV data which was measured in the supine position for 5 minutes. Results: 1. For most patients, cold hypersensitivity first developed during puberty. 2. The parts of the body that felt cold first time were hands and feet. 3. The cold sensation was increased in winter or at bedtime Showing that the sensation can be changed according to the level of coldness. 4. Among women who sufferfrom cold hypersensitivity, very few of them were treated. 5. More than half of cold hypersensitivity patients's family member also had a cold hypersensitivity. 6. The decrease in mean values of LF/HF ratio was observed in objective cold hypersensitivity group than subjective cold hypersensitivity group and the decrease was significant(P=0.014) when examined by Student t-test. Conclusions : It is necessary that the cold hypersensitivity patients should be treated carefully considering the facts mentioned above. And it can be suggested that dysautinomia be related with cold hypersensitivity and be evaluated by HRV.

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The Estimation of Patient's Waiting-Time Using Parking Time (주차시간을 이용한 외래환자 대기시간 추정)

  • Song, Jung-Hup
    • Quality Improvement in Health Care
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    • v.2 no.2
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    • pp.20-30
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    • 1996
  • Background : Theoretically as the waiting-time of patient is estimated in queueing, many men and much money are needed. But being the estimation of patient s waiting-time very important in hospital service, so the continuous monitoring of waiting-time is inevitable. To verify that the estimation of waiting-time using parking time is economical, effective and continuous monitoring method and to develop utilizing the method, this study was done. Method : In parking confirmation office, the personnel of parking office wrote parking confirm time, chart number and whether medical examination and treatment finish or not in parking ticket. The next day the parking tickets were gathered and the above data were input. The input parking data were connected with the hospital outpatient file indexing chart number. Then the patient' s data for department, new patient or not, reservation or not, receipt time and payment time were retrieved. The group for finishing medical treatment were compared with that for not finishing in average time lag between confirmation and out-time for hospital. And In-time for hospital, receipt time, payment and out-time for hospital were also analyzed. Result : Confirming parking ticket, the group for finished medical treatment left hospital after 7 minutes. This result showed that the patient for finished medical treatment left hospital immediately. So parking time was reasonable to estimation of hospital-time was concluded. The time for medical treatment, diagnosis and test was constant for all patients and short for waiting time, Then I concluded that the parking time was reasonable for estimation patient's waiting time. Overall patient's waiting time was 113 minutes and new patient's time was 149 minutes, old patient's times was 109 minutes. Waiting time for reservation patient was 98 minutes and for non reservation patient was 122 minutes. The time from hospital arrival to payment was 50 minutes for the group of reservation patient and 69 minutes for non-reservation group. The time from payment to hospital leaving was 51 minutes and 56 minutes for non reservation group. The short time difference between reserved group and not reserved group from payment to hospital leaving time was due to bottle neck effect. Conclusion : The estimation of patient's waiting time using parking time was reasonable because the possession of car was common and the time for medical treatment was equal and the patient after treatment left hospital immediately. Using this method, timely, fast evaluation and continuous monitoring of the intervention effect were possible.

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Establishment and Application of the Guideline for Hypertension by Delphi Method in the Field of Primary Medical Care (Delphi방법을 이용한 일차의료 고혈압 진료지침 개발 및 적용)

  • Yang, Yun-Jun;Hong, Myung-Ho
    • Quality Improvement in Health Care
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    • v.2 no.1
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    • pp.68-84
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    • 1995
  • Background: Guideline for practice is useful because it can be the standard for assessment and way to improve quality. We need to take account of expert opinion and consensus as well as scientific evidences to develope practice guideline because it should be practical. Delphi method has been developed to gather opinions from experts fairly. This study was designed to develop practice guideline and apply it to practices as a method to improve quality in primary medical care. Methods: Hypertension(in adults over 18 years old) was selected as a target problem. Self questionnaires about management of hypertensive patients were developed by a researcher with advice of 11 experts. The questionnaires were designed to response as a 5 pont scale. The results of previous questionary were given to respondents in second and third questionnaires. If needed, the questionnaires were changed on the previous responses. The items with medium greater than or equal to 4 point in 1st and 2nd responses were accepted in guideline. The items with medium lesser than or equal to 3 point were questioned again about whether they can be excluded or not. The criteria for assessment was made with reference to guideline and applied to 85 hypertensive patients of 9 family practitioners. At 3 months after practice guideline had been given to family practitioners, performance of same practitioners was assessed with 36 new hypertensive patients. Results: 23 professors in family medicine, 22 family practitioners and 6 cardiologists, responded among 50, 50, 15 respectively. Practice guideline with 33 items was developed as a result of 3 times questionaires. The difference of responses between professors in family medicine, family practitioners and cardiologists was not significant. Performance of practice was improved in diagnosis, history taking about 6 fields, laboratory examination and decision making about time of pharmaceutical prescription. It was not improved in physical examination, life style modification, method of pharmaceutical prescription, choice of initial antihypertensives and history taking about duration of disease and diet habit. It was decreased in history taking about psychosocial factors. The assessment scores were low in history taking, physical examination and life style modification before and after use of practice guideline. Conclusion: Practice guideline for hypertension could be developed by Delphi method. Performance of practice improved partially after use of guideline.

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