• 제목/요약/키워드: Medical control

검색결과 9,049건 처리시간 0.04초

T1N0 성문암의 방사선치료관련 예후 인자 분석 (A Retrospective Analysis of Treatment-Related Prognostic Factors for Local Recurrence after Primary Radiation Therapy for Patients with Primary T1N0 Glottic Cancer)

  • 김수산;김상윤;남순열;최승호;조경자;김종훈;안승도;신성수;송시열;최은경;이상욱
    • 대한두경부종양학회지
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    • 제19권1호
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    • pp.34-40
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    • 2003
  • Objective: To analyze the treatment-related parameters after the radiotherapy of T1N0 squamous cell carcinoma of the glottic larynx. Materials and Methods: Between October 1989 and August 2000, 54 patients with histologically proven T1N0 squamous cell carcinoma of the glottic larynx who received definitive radiation therapy in Department of Radiation Oncology, Asan Medical Center were analyzed. They were all males with age ranged from 31 to 80 years (median 61 years). 1997 AJCC stages were 31 T1a, 23 T1b. Patients were treated with 4-MV X-rays with a parallel-opposed two-field technique. Ten patients received 66.0-68.4Gy at 1.2Gy per fraction twice daily, 21 patients received 64.8-66.6Gy at 1.8Gy per fraction once daily, and 23 patients received 66.0Gy at 2.0Gy per fraction once daily. Follow-up period was 16-119 months (median 56 months). Results: 5-year overall survival and local control rates for patients with T1 lesions were 87.0% and 88.5%, respectively. 5-year local control with larynx preservation rate was 90.5%. Host and tumor-related prognostic factors including age, stage, anterior commissure involvement and tumor bulk proved not to be significant. Only shorter overall treatment time among treatment-related factors had correlation with imporved local control. Conclusion: Comparable high local control rate with organ preservation was achieved with primary radiation therapy and salvage surgery. Shortening of overall treatment time is related to improved local control rate. To determine the optimal fractionation scheme, randomized trial is mandatory.

Design of RF coupler for KIRAMS-13;Korea Institute of Radiological & Medical Sciences-13

  • Jung, In-Su;An, Dong-Hyun;Kim, Yu-Seok;Yang, Tae-Gun;Kim, Jea-Hong;Jang, Hong-Seok;Hong, Bong-Hwan;Lee, Min-Yong;Hong, Sung-Seok;Chai, Jong-Seo;Oh, Bong-Hun
    • 제어로봇시스템학회:학술대회논문집
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    • 제어로봇시스템학회 2003년도 ICCAS
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    • pp.2203-2205
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    • 2003
  • KIRAMS-13, the first medical cyclotron developed by domestic technique, is used to produce radio-isotope such as $^{18}F$ whose life time is relatively short through test operation. For high-power operation of charged particle accelerators, the power coupler must withstand enormous stresses due to charging induced by high RF power passing through. High-power RF testing with peak power in excess of 30kW has been performed on prototype power coupler for KIRAMS-13 normal conducting cavities. CST MICROWAVE STUDIO(CST MWS) is used for fundamental RF Design, and power coupler is manufactured according to fundamental power coupler design requisite. The qualification of the couplers has occurred for the time being only in a limited set of conditions as the available RF system and control instrumentation are under improvement.

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의료급여비용 증가에 공급자 유인효과가 미치는 영향 (The Impact of Supplier Induced Demand on Increase in Medical Aid Expenditure)

  • 신현웅;윤장호;노연홍;여지영
    • 보건행정학회지
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    • 제24권1호
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    • pp.13-23
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    • 2014
  • Background: A need arises to efficiently control health expenditure for medical aid due to a sharp increase in medical aid expenditure. This study experimently analyzes the impact of physician behavior on medical use for medical aid beneficiaries using supplier induced demand (SID) theory. Methods: This study looks into analyze SID effect using expenditure factor analysis of medical aid for the years between 2003 and 2010 in comparison with health insurance. Moreover, this study analyzes the existence and scale of SID using econometrics modeling with panel data on 16 cities and provinces's health expenditure data for medical aid from 2003 1/4 to 2010 4/4. Results: This study finds that the growth rate of visit days per capita and treatment amount per visit days for medical aid is higher than health insurance. Furthermore, the result of econometrics modeling analysis shows the existence of SID in general hospital, hospital, clinic, oriental clinic. Conclusion: In order to efficiently control expenditure for medical aid, it is required to reinforce macro polices such as the introduction of 'target management' and micro policies such as the strengthen of management on medical institutes in the perspective of suppliers as well as regulations of demanders.

Variation of Urinary and Serum Trace Elements (Ca, Zn, Cu, Se) in Bladder Carcinoma in China

  • Guo, Kun-Feng;Zhang, Zhe;Wang, Jun-Yong;Gao, Sheng-Lin;Liu, Jiao;Zhan, Bo;Chen, Zhi-Peng;Kong, Chui-Ze
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2057-2061
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    • 2012
  • Backgrounds: Deficiency or excess of trace elements can induce body metabolic disorders and cellular growth disturbance, even mutation and cancerization. Since there are few studies of the effect of trace elements in bladder carcinoma in China, the aim of this study was thus to assess variation using a case control approach. Methods: To determine this, 81 patients with bladder carcinoma chosen as a study group and 130 healthy persons chosen as a control group were all assayed for urinary and serum trace elements (calcium [Ca], zinc [Zn], copper [Cu], selenium [Se]) using an atomic absorption spectrophotometer, and the results were analyzed by independent sample t tests. The correlative factors on questionnaires answered by all persons were analyzed by logistic regression. Results: The results showed urinary Ca, Zn and serum Cu levels of the study group to be significantly higher (P<0.05) than those of he control group. Serum Ca and Se levels of study group were significantly lower (P<0.05) than those of control group. Conclusion: There were higher urinary Zn and serum Cu concentrations in bladder carcinoma cases. Bladder carcinoma may be associated with Ca metabolic disorder, leading to higher urinary Ca and lower serum Ca. Low serum Se and smoking appear to be other risk factors for bladder carcinoma in China.

구강간호가 인공호흡기관련 폐렴 발생률에 미치는 효과 (The Effect of Oral Hygiene for Ventilator-Associated Pneumonia(VAP) Incidence)

  • 서효경;최은희;김진희
    • 중환자간호학회지
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    • 제4권2호
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    • pp.39-46
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    • 2011
  • Purpose: The purpose of this study was to examine the effect of oral hygiene for ventilator-associated pneumonia (VAP) incidence. Methods: This study was used a nonequivalent control group posttest design. This study was performed in two groups, experimental group and control group. The experimental group (36 patients) had performed oral care for 6 times a day. The control group (39 patients) had followed and 3 times oral care a day. Participants were patients of 20 years of age or older on mechanical ventilation more than 48 hours from July 5 to October 31 in 2007 at the medical and surgical ICU of C university hospital. Results: VAP occurred in 5 cases in the control group, while only 1 case occurred in the experimental group. Incidence for 1000 ventilator day was 12.59 in the control group and 2.18 in the experimental group. Conclusion: Nursing intervention of 6 times oral care a day proved to decrease incidence of VAP. A guideline should be made using the above nursing intervention for the critical ill patients receiving mechanical ventilation.

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병원 감염관리를 위한 중환자부 공간계획에 관한 연구 (A Study on the Space Design for Nosocomial Infection Control in Intensive Care Unit)

  • 이현진;김길채;오영훈
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제22권4호
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    • pp.87-95
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    • 2016
  • Purpose: Recently an experience in the MERS crisis focused on the importance of infection control in hospitals. According to Korean National healthcare-associated Infection Surveillance System (KONIS) of the KSICP, a great number of 498 people, 841 people, and 1021 people were infected by pneumonia, urinary tract infection, and bacteremia respectively from 94 hospital ICUs during the year of 2014. Therefore, the purpose of this study is to investigate the configuration and design guidelines for the ICU rooms to minimize the nosocominal infections. Methods: Based on the several infection control guidelines and revised Medical Law, consequent analyses which classified the planning and operational behavior in the ICUs of seven hospitals, were performed to reduce the cross-infection. Results: The results of this study are offering a space, configuration and design guidelines for effective infection control in the intensive care units through the unit-bed area, the bed-to-bed distance, the isolation room, etc. Implications: It is expected that this study propose the direction of architectural planning and guideline for the ICU room in order to realize the intension of revised Medical Law.

전산화단층촬영장비 정도관리의 적정 인지도에 관한 연구 (A Study on the Adequacy Awareness of Computed Tomography Equipment Quality Control)

  • 김규형;임청환;김기정
    • 대한방사선기술학회지:방사선기술과학
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    • 제42권1호
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    • pp.31-37
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    • 2019
  • Investigate the adequacy awareness of accuracy control of CT apparatus Questionnaire survey and statistical analysis in the analysis according to age, there is a difference between familiarity with accuracy management items (F = 14.187, p<0.001) and necessity of accuracy control (F=8.109, p<0.001), depending on academic background and work history, There is a difference only in familiarity (F=5.103, p<0.05, F=13.394, p<0.001), and according to the scale of the medical institution analysis shows that if you are more interested than senior general hospital grade hospital grade or less It was analyzed. In order to advance the accuracy control level, we have introduced our comprehensive and efficient comprehensive and efficient integrated medical image quality management operation system of the whole medical image equipment including CT device, It is thought that it is necessary to develop human resources capable of doing.

BDSS: Blockchain-based Data Sharing Scheme With Fine-grained Access Control And Permission Revocation In Medical Environment

  • Zhang, Lejun;Zou, Yanfei;Yousuf, Muhammad Hassam;Wang, Weizheng;Jin, Zilong;Su, Yansen;Kim, Seokhoon
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제16권5호
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    • pp.1634-1652
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    • 2022
  • Due to the increasing need for data sharing in the age of big data, how to achieve data access control and implement user permission revocation in the blockchain environment becomes an urgent problem. To solve the above problems, we propose a novel blockchain-based data sharing scheme (BDSS) with fine-grained access control and permission revocation in this paper, which regards the medical environment as the application scenario. In this scheme, we separate the public part and private part of the electronic medical record (EMR). Then, we use symmetric searchable encryption (SSE) technology to encrypt these two parts separately, and use attribute-based encryption (ABE) technology to encrypt symmetric keys which used in SSE technology separately. This guarantees better fine-grained access control and makes patients to share data at ease. In addition, we design a mechanism for EMR permission grant and revocation so that hospital can verify attribute set to determine whether to grant and revoke access permission through blockchain, so it is no longer necessary for ciphertext re-encryption and key update. Finally, security analysis, security proof and performance evaluation demonstrate that the proposed scheme is safe and effective in practical applications.

일부 물리치료사와 작업치료사의 환자 의료정보보호 행동 이해 (Understanding the Behavior of Physical Therapists and Occupational Therapists in Protecting Patient’s Medical Information - An Application of the Theory of Planned Behavior -)

  • 이인희;신아미;손창식;박상영;박희준;윤경일;김윤년
    • The Journal of Korean Physical Therapy
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    • 제22권2호
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    • pp.55-60
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    • 2010
  • Purpose: The purpose of this study was to use the theory of planned behavior, past habit and moral obligation to better understand the behavior of physical therapists (PTs) and occupational therapists (OTs) in protecting the medical information of patients. Methods: We conducted a survey using self-writting questionnaires structured within the framework of the theory of planned behavior to understand to analyze information from 103 clinical PTs and OTs in their efforts to protect patient medical information. Results: The PTs and OTs' medical information protecting behavior was 2.85 mean points. That point failed to reach 1.0 points. Behavior intention was 3.83 mean points. That was judged to be improved. Behavioral intention was closely correlated with behavior, behavioral attitude, subjective norms, behavior control, and past habit. Variables related to the theory of planned behavior, attitude, subjective norms, and perceived behavior control all explained 50% of the behavioral intention of PTs and OTs regarding future divulgence of patient information. The past habits of PTs and OTs were also a significant predictor in explaining the behavioral intention to protect a patient's medical information (p<0.01). Conclusion: Revising the behavioral attitudes, subjective norms, perceived behavior control, and past habits of PTs and OTs helped improve their behavior regarding protection of the medical information of patents.

개별교육프로그램이 역할불이행 혈액투석환자의 투석관련 지식, 이행 및 생리적 지표에 미치는 효과 (Effects of an Individualized Educational Program on Knowledge, Compliance and Physiologic Parameters in Non-Compliant Hemodialysis Patients)

  • 이수진;박향숙;한진희;김해진;서민원;최은아;임은영;최미란;최선숙;박광옥;김경옥
    • 임상간호연구
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    • 제15권3호
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    • pp.5-16
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    • 2009
  • Purpose: This study was done to provide effective nursing interventions using an individualized educational program designed to contribute to the knowledge, compliance and physiologic parameters (serum potassium, phosphorus and interdialytic weight gain) of non-compliant hemodialysis patients. Methods: There were 22 participants in the experimental group and 19 in the control group. Nurses with rapport with patients provided education to non-compliant hemodialysis patients for 20 minutes three times a week for six weeks. This education program consisted of individual consulting, telephones conversations regarding hemodialysis, and requests for patient support from patients' families and colleagues. Results: Hypothesis 1; "Knowledge about hemodialysis in the experimental group will be higher than the control. group" was not supported. Hypothesis 2; "Compliance will be higher in the experimental group than in the control group", and Hypothesis 3; "Physiologic parameters of experimental group will improve" were supported as serum potassium and interdialytic weight gain decreased, but results were not consistent for phosphorous. Conclusion: This program for non-compliant patients increased compliance and improved physiologic parameters. Therefore, this educational program should be effective as a nursing intervention.