• Title/Summary/Keyword: Medical Examination Result

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Evaluation of Approximate Exposure to Low-dose Ionizing Radiation from Medical Images using a Computed Radiography (CR) System (전산화 방사선촬영(CR) 시스템을 이용한 근사적 의료 피폭 선량 평가)

  • Yu, Minsun;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.6 no.6
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    • pp.455-464
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    • 2012
  • This study suggested evaluation of approximately exposure to low-dose ionization radiation from medical images using a computed radiography (CR) system in standard X-ray examination and experimental model can compare diagnostic reference level (DRL) will suggest on optimization condition of guard about medical radiation of low dose space. Entrance surface dose (ESD) cross-measuring by standard dosimeter and optically stimulated luminescence dosimeters (OSLDs) in experiment condition about tube voltage and current of X-ray generator. Also, Hounsfield unit (HU) scale measured about each experiment condition in CR system and after character relationship table and graph tabulate about ESD and HU scale, approximately radiation dose about head, neck, thoracic, abdomen, and pelvis draw a measurement. In result measuring head, neck, thoracic, abdomen, and pelvis, average of ESD is 2.10, 2.01, 1.13, 2.97, and 1.95 mGy, respectively. HU scale is $3,276{\pm}3.72$, $3,217{\pm}2.93$, $2,768{\pm}3.13$, $3,782{\pm}5.19$, and $2,318{\pm}4.64$, respectively, in CR image. At this moment, using characteristic relationship table and graph, ESD measured approximately 2.16, 2.06, 1.19, 3.05, and 2.07 mGy, respectively. Average error of measuring value and ESD measured approximately smaller than 3%, this have credibility cover all the bases radiology area of measurement 5%. In its final analysis, this study suggest new experimental model approximately can assess radiation dose of patient in standard X-ray examination and can apply to CR examination, digital radiography and even film-cassette system.

A Study on Radiation Dose for General Radiography Examination at First Medical Institution (Around the Radiology Clinic of National Capital Region) (일차 의료기관에서 일반촬영 검사의 피폭선량 연구 (수도권 영상의학과를 중심으로))

  • Hwang, Su-Lyun;Jung, Hong-Ryang;Lim, Cheong-Hwan
    • Journal of the Korean Society of Radiology
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    • v.5 no.5
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    • pp.245-253
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    • 2011
  • The hazard level will be increased with the augmentation of the dose received by patients. Therefore, patients radiation dose have been analyzed by this study for the radiology clinics located at Seoul and Gyeongin area from August 2009 to September 2010. In the case of the front and rear directional inspection of skull, patient radiation dose was turned out to be 1.75mGy for radiology clinic, 3.00mGy for UK, 3.00mGy for Japan, and 5.00mGy for Germany, therefore, radiology clinic was the lowest. In the case of lateral directional inspection of skull, patient radiation dose was turned out to be 1.49mGy for radiology clinic, 1.50mGy for 3rd medical institution, therefore, radiology clinic was measured lower, and it was lower than 3.00mGy which is the recommended dose of IAEA. In order to reduce medical exposure of patient, optimization of efficient protection of radiation and reduction of medical radiation exposure are thought to be required by observing recommendation of international organization based on the result of this study.

Value-Relevance of R&D and Ad expenditures in the Medical Industry : Medical Precision and Medicine Industry Case (의료관련 산업의 연구개발비와 광고선전비 지출이 기업가치에 미치는 영향 (의료정밀과 의약품 산업을 중심으로))

  • Cho, Duk-Young;Choi, Soo-Hyung
    • Korea Journal of Hospital Management
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    • v.11 no.3
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    • pp.1-18
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    • 2006
  • The purpose of this study is to analyze the relationship between intangible asset items and company value by empirical research in the medical industry, which may enhance usefulness of the results of other empirical research on intangible asset and company value. In order to attain the purpose of this study, the stock price is taken as the independent variable and all of intangible asset items reported to a balance sheet except the development expenditures and other development expenditures, and advertisement expenses, ordinary research & development expenditures reported on the income statement are taken as the dependent variables. In the following, I carried out four meaningful results from the analysis. First, research hypothesis 1; Book value of intangible asset reported in balance sheet bears positive relationship with company value shows that development expenditures 1 variable gives positive association in a significant level while a group of \10,000-above-company shows no relationship with company value, the other group of below-\10,000-company supports a consistently significant association. All this considering, we have to keep in mind that lack of prudence may leads to wrong results when we try to analyze. Second, research hypothesis 2; Intangible asset and other intangible asset expenditures reported on the income statement gives positive effect on company value shows that R&D accounts variables give insignificance in a statistical level to all company, including entire group, \10,000-above and below consistently. These results testify that current accounting system is valid. Third, in the case of other intangible asset, it requires further examination of current KAS because statistical results show negatively significant value or insignificant value in a statistical level. That means the more intangible assets, the less company value or nothing. Last, in the case of advertisement expenditure variables of above-\10,000 and entire company shows insignificances in a statistical level consistently while below-\10,000-company shows significant result coherently. We should regard accounting information on the advertisement expenditures of \10,000-below-company with caution. The results of this study provide controversial points whether intangible asset items reported on B/S, excluding development expenditures, should be regarded as asset. To facilitate the utility of accounting information on intangible asset, it seems necessary to regard advertisement expenditures reported on I/S as asset accounts. There are further arguments on the way of dealing with intangible asset under KAS that might be considered.

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Delayed Transfer of Major Trauma Patients Under the Current Emergency Medical System in Korea (현재의 국내 응급의료체계에서 중증외상환자의 이송 지연)

  • Jung, Kyoung-Won;Jang, Jeong-Moon;Kim, Ji-Young;Baek, Suk-Ja;Song, Seo-Young;Gang, Chan-Suk;Lee, Kug-Jong
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.25-30
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    • 2011
  • Purpose: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. Methods: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. Results: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. Conclusion: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.

Analysis of the Nursing Interventions Performed in the Medical & Surgical Units and the Health Insurance Cost Items Based on the NIC (간호중재분류체계(NIC)에 근거한 내${\cdot}$외과계 간호단위의 간호중재 수행 및 건강보험 수가 항목 분석)

  • Park, Ok-Yeob;Jung, Myun-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.4
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    • pp.449-467
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    • 2005
  • Purpose: This study aims to offer the fundamental data in order to cost the nursing service on the basis of the NIC and a close examination of the interventions that are contained in the health insurance cost list under the system of the current health insurance. Methods: The data is handled with the SPSS 10.0 program. The participants' general peculiarity is calculated in terms of the real number and the percentage, and the performing frequency of the nursing interventions is calculated in terms of the mean and the standard deviation. the correlation between the participants' general peculiarity and the performing frequency of the nursing interventions is analysed with t-test or one way ANOVA of SPSS. Results: In the performing frequency of the nursing interventions, the domain of "the physiological: basic" was the highest as 2.69${\pm}$1.21, the domain of "the behavioral" was the lowest as 2.11${\pm}$1.12. There were 50 core interventions in the medical unit, 48 in the surgical unit, 24 in the MICU and 33 in the SICU. The health insurance cost items contained commonly in the core interventions of each unit were 12, and the health insurance cost items except 12 items contained commonly in the core interventions of each unit were appeared 14 items in the medical unit, 6 in the surgical unit, 7 in the MICU and 2 in the SICU. The core interventions contained commonly in four units of the medical unit, the surgical unit, the MICU & the SICU are 18. And among these, the core interventions contained in the health insurance cost items are 10; pain management, hyperglycemia management, analgegic administration, medication administration: intravenous, oxygen therapy, pressure ulcer prevention, fluid management, fluide monitoring, intravenous(IV) insertion, intravenous(IV) therapy. As the result of the comparison & analysis between the core interventions of the NIC and the health insurance cost items, the core interventions contained in the health insurance cost list are 21(29 as the health insurance cost items). Conclusion: In the performing frequency of the nursing interventions, the domain of "the physiological: basic" is being performed most frequently, and in the performing frequency of the core interventions, the interventions of the domain of "the physiological: complex" is being performed most frequently. On the basis of these results, the writer hopes that the attempts to interlink the nursing interventions into the nursing cost by using of standard terms and the efforts to cost the nursing services would also be made in the future constantly.

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Diagnosis and Treatment of Papillary Thyroid Microcarcinoma(PMC) (유두 미세 갑상선암의 진단 및 치료에 대한 고찰)

  • Yoon Kyung-Seok;Oh Sung-Soo;Park Sung-Gil;Chung Eul-Sam
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.228-235
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    • 1998
  • Objectives: Papillary microcarcinoma of the thyroid was evaluated as to the effectiveness of diagnostic modalities, lymphatic spread pattern, and therapeutic decision according to tumor size. Material and Methods: We retrospectively analyzed a clinicopathologic findings of 72 papillary microcarcinoma patients who were treated at the over 11 years between 1985 and 1995. The authors divided papillary microcarcinoma of the thyroid into two subgroups according to tumor size: $0{\leqq}5mm$ and $5<0{\leqq}10mm$. An analysis including age and gender distribution, diagnostic tools(thyroid sonogram, thyroid scan, thyroid function test, fine needle aspiration cytology, frozen section), pathological examination of lymphnode, and surgical procedures was carried out in each subgroups. Results: The carcinoma of smaller than 5mm were found in 32 patients, and of 6 -10mm were in 40 patients. The average age of patients was 45years and all of them were female. Cold nodules on thyroid scan were noticed in 53 patientss and normal findings were in 15 patients. Suspicious malignant lesions(fine calcification, solid mass, irregular margin) on thyroid sonography were detected in 23 patients and the sonography was more useful in detecting $0{\leqq}5mm$ small sized lesions than other diagnostic methods. FNAC were performed in 17 patients, and 7 patients were diagnosed as having thyroid papillary cancer. But diagnotic rate in $0{\leqq}5mm$ small sized lesions was very low(one of eights).Frozen section were performed in all patients, among these 15 patients were diagnosed as being benign diseases and false negative rates were higher in $0{\leqq}5mm$ small sized lesions than in $5<0{\leqq}10mm$ sized lesions(p-value<0.006). Only thyroidectomies were performed in 24 patients and thyroidectomy with node dissections in 48 patients. The lymphnode metastatic rates were much higher in multifocal lesions(61.5%) than in single lesion. The incidence of cervical lymphnode metastasis was 19.4% in $0{\leqq}5mm$ sized lesions and 47.9% in $5<0{\leqq}10mm$ sized lesions. Postoperative management were performed with TSH suppression therapy(T4, synthroid) in all patients and RI therapy in 29 patients. Conclusion: On the basis of our study, improved preoperative diagnostic tools for papillary microcarcinoma of the thyroid was helpful in the choice of surgical treatment. As a result of techninological progress(ultrasonography, FNAC), the pencentage of the discovery of papillary microcarcinoma has been increased. The thyroid ultrasonography was useful in detecting small sized lesions($0{\leqq}5mm$), but FNAC may not be beneficial in detecting small sized lesions($0{\leqq}5mm$). In the surgical procedure, thyroid lobectomy alone should be avoided because of the high rate of bilaterality and multifocality.

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Combined utilization with herbal products and prescribed drugs: A result from health examinee-based national survey (일부 종합병원의 건강검진 수검자들의 한약·양약 복합투여)

  • Park, Jong-Ku;Choi, Seo-Young;Koh, Kwang-Wook;Yu, Jun-Sang;Kim, Tae-Hun;Sohn, Dong-Kook;Hong, Ju-Hee;Song, Sung-Eun;Kim, Chun-Bae
    • Health Policy and Management
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    • v.16 no.1
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    • pp.1-16
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    • 2006
  • Recently, there has been prevailing of the combined utilization (CU) with herbs and prescribed drugs in medical therapies in the world. But the information about frequency, efficacy and safety of this CU has not well known in Korea, yet. This study aimed to identify the status of CU by Koreans, and to inquire which side effects of CU represent to those people. A self-completed questionnaire survey was performed through each health examination center in twenty general hospitals and one oriental hospital. Of the initial 2,100 health examinees, 1,851 were participated in this survey, resulting in a response rate of 88.1%. The proportion of CD was 26.3%. The most commonly mentioned reason of CD was 'to promote general health and well-being' (17l persons, 35.5%). The main route of taking CD was self-purchase at drugstore or at herbs market, followed by the prescription of (oriental)physicians. 33.0% (151 persons) of those who took the CD rated it as effective. 93 respondents (19.8%) were experienced several adverse effects including nausea, fatigue, and dizziness. The growing simultaneous use of herbal products and pharmaceutical drugs by Korean consumers may be continuously increased the risk of herb-drug interactions. The medical professionals should be provided with comprehensive and up-to-date information about potential benefits and risks of herbs and prescribed drugs. In the future studies it may be recommended to deal common cold, health promotion, indigestion, headache, and hypertension for the effect and safety of the CD by well-organized prospective study design.

Personnel's Perception toward Conducting an Autopsy in General Hospital (대학병원 직원들의 부검에 대한 인식도)

  • Lee, Ho-Beom;Kwak, Jyung-Sik
    • Journal of forensic and investigative science
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    • v.2 no.2
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    • pp.30-49
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    • 2007
  • An autopsy is a postmortem assessment or examination of a body to determine cause of death or manner of death. The author had surveyed Personnel's perception toward conducting an autopsy in general hospital with autopsy at YeungNam University Medical Center, Daegu, Korea from April, to May, 2007. The total number of 286 personnel consisted of 121 men(42.3%), 165 women(57.7%). There were 57 doctors(19.9%), 71 nurses(24.8%), 83 medical technicians (29.0%), 58 office workers(20.3%), and 17 others(5.9%). 61.4% of doctors had an experience of education for autopsy more than 2 times, but nurses(1.4%), medical technicians(15.7%), office workers(1.7%), and others(5.9%) had little experience. Response of conducting an autopsy for sudden death of respondent or respondent's family member was 59.6% of doctors, 22.5% of nurses, 39.8% of medical technicians, 41.4% of office workers, and 35.3% of others. Response of conducting an autopsy for sudden death of respondent's companion was 66.7% of doctors, 33.8% of nurses, 39.8% of medical technicians, 43.1% of office workers, and 17.6% of others. Response of conducting an autopsy for sudden death of patients in general hospital was 50.9% of doctors, 8.5% of nurses, 19.3% of medical technicians, 24.1% of office workers, and 17.6% of others. Survey about a proper institution for autopsy showed 73.7% of doctors for department of forensic medicine in medical school, and 62.0% of nurses, 59.0% of medical technicians, 46.6% of office workers, and 58.8% of others for National Institute of Scientific Investigation. Most of the respondents agreed with the forensic pathologist as the director of autopsy:98.2% of doctors, 94.4% of nurses, 96.4% of medical technicians, 89.7% of office workers, and 88.2% of others. Survey for necessity for autopsy showed responsiveness of doctors, 23.9% of nurses, 47.0% of medical technicians, 34.5% of office workers, and 23.5% of others. Survey for donation of him- or herself after death to the medical school or institution for the death investigation revealed responsiveness of 22.8% of doctors, 11.3% of nurses, 24.1% of medical technicians, 22.4% of office workers, and 23.5% of others. The result of the survey questionnaire showed more negative awareness for autopsy in nurses, medical technicians, office workers, others and than doctors. To improve the negative awareness for autopsy and settle proper postmortem inspection system, education of professional manpower for forensic medicine and inaction of law which is adequate for the actual circumstance of Korea should be considered.

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Usefulness of PCR Test for M. tuberculosis for the Differentiation of Pulmonary Tuberculosis and Nontuberculous Mycobacterial Lung Disease in Patients with Smear-Positive Sputum (객담 도말 양성 환자에서 폐결핵과 비결핵 항산균 폐질환의 구별을 위한 결핵균 PCR 검사의 유용성)

  • Yu, Chang-Min;Koh, Won-Jung;Ryu, Yon Ju;Jeon, Kyeongman;Choi, Jae Chol;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Lee, Jang Ho;Ki, Chang-Seok;Lee, Nam Yong
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.528-534
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    • 2004
  • Background : Microscopic examination of sputum smears for acid-fast bacilli (AFB) is the most important and rapid diagnostic test for pulmonary tuberculosis. However, the AFB observed on the smear may represent either M. tuberculosis or nontuberculous mycobacteria (NTM). This study examined the clinical usefulness of a polymerase chain reaction test for M. tuberculosis (TB-PCR) for the differentiation of pulmonary tuberculosis and NTM lung disease in patients with smear-positive sputums in a tertiary hospital in Korea. Material and Methods : From January, 2003 to December, 2003, 826 AFB smear-positive and culture-positive sputum specimens were collected from 299 patients. Results : NTM were recovered from 26.6% (220/826) of the smear-positive sputum specimens and 23.4% (70/299) of the patients with smear-positive sputum. All the patients with isolated NTM had clinically significant NTM lung disease; 38 patients (54.3%) had M. avium and 26 patients (37.1%). had M. abscessus. In the patients with pulmonary tuberculosis, 78.7% of the patients (74/94) showed TB-PCR positivity, and all the patients with NTM lung disease showed negative results on the TB-PCR test (p<0.001). A positive result of the TB-PCR test on the sputum or bronchial washing fluid specimens was able to predict pulmonary tuberculosis with 88.4% sensitivity, 100% specificity, a 100% positive predictive value and a 79.7% negative predictive value for the patients with smear-positive sputum. Conclusion : The TB-PCR test for sputum specimens or bronchial washing fluid specimens could be useful for differentiating pulmonary tuberculosis and NTM lung disease for the patients with smear-positive sputum in Korea.

Functional MR Imaging Using BOLD Technique in Patients with Brain Tumors (뇌종양 환자에서 BOLD 기법을 이용한 기능적 자기공명영상)

  • Kim Jeong;Yim Nam-Yeol;Shin Sang-Soo;Lim Hyo-Soon;Yoon Woong;Chung Tae-Woong;Jeong Yong-Yeon;Jeong Gwang-Woo;Park Jin-Gyoon;Kang Heoung-Keun;Jung Shin;Kang Sam-Suk;Seo Jeong-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.7 no.2
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    • pp.124-131
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    • 2003
  • Purpose : To reveal clinical usefulness of functional MRI (fMRI) using sensorymotor and language stimuli for demonstrating anatomic relationship between sensorimotor or language cortices and lesions in the planning of brain tumor surgery. Materials and Methods : This study included 12 right-handed patients with brain tumors in or around sensorimotor or language cortices. Eleven patients were evaluated with primary motor and sensory stimuli. Of these patients, six patients were also evaluated with language stimuli. One patient was evaluated with language stimuli only. For fMR imaging, a 1.5T scanner was used and the EPI BOLD technique was employed. For postprocessing image, the SPM99 program and a program made by our department was utilized. We evaluated whether sensorimotor and language stimuli activate sensorimotor and language cortices. And also, clinical efficacy of revealing anatomic relationship between cerebral cortices and lesions for planning neurosurgical operation were evaluated. Finally, we compared post-operative neurologic function with pre-operative neurologic function in same patients. Results : The fMRI examination was successful in identifying the functional cortices and depicting anatomic relationship between functional cortices and lesions in all patients. In nine patients of 11 patients with identified sensorimotor cortices, postoperative grade of manual motor test was not changed, compared with preoperative grade. Whereas postoperative improved than preoperative grade in one patient of remaining two patients, postoperative aggravated than preoperative grade in the other. This result was due to atherosclerotic lacunar infarction, regardless of tumor resection. Postoperative deficit of language function was not found in seven patients with identified language cortices. Conclusion : fMRI could be a helpful method for determining the best approach to neurosurgical treatment in patients with brain tumors in or around sensorimotor or language cortices.

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