• Title/Summary/Keyword: Patient Flow

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A basic study on the Qi-diagnosis(氣診) using method of diagnosis and treatment (임상 활용을 위한 기진(氣診)에 대한 기초적인 연구)

  • Cho, Dae Geun;Kim, Gyeong Cheol
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.22 no.1
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    • pp.45-56
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    • 2018
  • The authors are using Qi-diagnosis (integrated diagnosis by bio-energy) that is a method of diagnosis and treatment. We applied Qi-diagnosis to the main study to lay the foundation and framework for research and education about the Korean Medicine. The authors try to describe systemically and specifically the Qi-diagnosis that the authors are using in clinical diagnosis ane treatment so that anyone can use it. The authors have been able to grasp the flow of human bio-energy through years of training. It has had many effects by applying the Qi-diagnosis to patients. The steps of the bio-energy flow have become objective. And the authors have been applied to acupuncture, herbal medicine, moxibustion, bruising treatment and anthrax anesthesia in clinical through the Qi-diagnosis. Also, it is applied to the life management of patients. It is applied to arts such as music therapy and art therapy. The deeper the depth of the Qi-diagnosis, the greater the opportunity to utilize the Qi-diagnosis. The Qi-diagnosis is the origin of the korean medicine. It was able to make diagnosis and treatment correct and to establish clues that the medical problems would be solved through the Qi-diagnosis. In order to do so, the diagnostician must be able to feel the auricular flow of the body accurately and objectively. In addition, he must have a comprehensive understanding of the overall framework of medicine. As a result, diagnosis and treatment of the patient as well as general problems of the patient can be identified and advised, so comprehensive treatment is possible. And it is not only a specific person can do it, but it is a diagnostic method that anyone can take if they take the basic steps step by step.

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Clinical and Angiographic Outcomes of Endovascular Treatment for Acute Intracranial Vertebral Artery Dissecting Aneurysms Using Double-Overlapping Stents : Low-Profile Visualized Intraluminal Support within Enterprise Stents

  • Ja Ho Koo;Eui Hyun Hwang;Ji Hye Song;Yong Cheol Lim
    • Journal of Korean Neurosurgical Society
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    • v.67 no.5
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    • pp.531-540
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    • 2024
  • Objective : The use of reconstructive treatment with a double-overlapping stents has proven to be effective and safe in the current treatment of intracranial vertebral artery dissecting aneurysms (VADAs). We employed a combination of overlapping stents, using low-profile visualized intraluminal support (LVIS) within the Enterprise stent. This combination was chosen to minimize the outward bulging of the inner LVIS by overlapping it with the Enterprise stent while maintaining flow diversion and stability. This study aimed to evaluate the clinical and angiographic outcomes following the use of double-overlapping stents with LVIS within the Enterprise stent for the treatment of VADAs. Methods : From March 2016 to January 2022, total 28 patients with unruptured VADAs were treated with the double-overlapping stent technique using LVIS within an Enterprise stent in our institute. The Enterprise stent was deployed first, followed by the LVIS stent. Patient clinical and angiographic characteristics, procedural complications, and follow-up outcomes were retrospectively reviewed. Results : All 28 patients (18 males and 10 females) were successfully treated with double-overlapping stent deployment. There were no procedural complications or new neurological deficits in any patient. Of the 28 patients, four VADAs had posterior inferior cerebellar artery involvement. Procedure-related parent artery occlusion did not occur during the angiographic follow-up conducted 6 to 12 months after the procedure. Out of 28 patients, 24 showed complete healing, three had focal residual stenosis or dilatation with residual sac and only one had a residual dissecting flap with aneurysm. All patients, including the four patients, did not require any additional procedures. The postoperative modified Rankin scale scores were 0-1 for all patients. Conclusion : A double-overlapping stent, with a flow-diversion effect, is a safe and effective treatment for patients with VADAs. In particular, when using the LVIS stent within an Enterprise stent, it minimizes the bulging of the inner LVIS stent while maintaining flow diversion and stability. Therefore, both can be effectively utilized as overlapping stents.

Transcranial Doppler and Cerebrospinal Fluid Flow Study in Normal Pressure Hydrocephalus

  • Lee, Hui-Keun;Hu, Chul;Whang, Kum;Kim, Hun-Joo
    • Journal of Korean Neurosurgical Society
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    • v.39 no.1
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    • pp.20-25
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    • 2006
  • Objective : The authors analyze prospectively the result of transcranial doppler[TCD] in normal pressure hydrocephalus and compared its cerebral blood flow parameters to radionuclide cerebrospinal fluid[CSF] flow study, postoperative brain computed tomography[CT] findings and clinical outcome, and studied the relationship between cerebral hemodynamics and clinical performance. Methods : Twenty five patients with hydrocephalus undertook pre- and post-operative TCD but only preoperative CSF flow study was performed. Mean flow velocity[Vm], pulsatility index[PI] and resistance index[RI] were assessed through TCD and changes in ventricle size and cortical gyral atrophy were checked through brain CT. Results : Postoperative hydrocephalus showed an increase in Vm[ACA P=0.037, MCA P=0.034], decrease in PI[ACA P=0.019, MCA P=0.017] and decrease in RI [ACA P=0.017, MCA P=0.021] compared to preoperative TCD parameters in the postoperative improvement group. In the postoperative improvement group, postoperative TCD parameters correlated with CSF flow study grade [Vm : $R^2=-0.75$, PI : $R^2=0.86$, RI : $R^2=0.78$] and ventriculocranial ratio change correlated with PI change [$R^2=0.73$]. The convexity gyral atrophy and initial TCD parameters showed close relationship to outcome. Conclusion : PI and RI can be used as an indicator of post operative prognosis, and with the addition of CSF flow study values, can also be used as a tool to predict pre-op and post-op patient status and successful shunt surgery.

The Change of Blood Flow Velocity of Radial Artery after Linear Polarized Infrared Light Radiation near the Stellate Ganglion: Comparing with the Stellate Ganglion Block (성상신경절 부위의 직선편광 근적외선 조사 후 요골동맥에서의 혈류속도의 변화: 성상신경절 차단술과의 비교)

  • Han, Soung-Moon;Lee, Sang-Chul
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.37-40
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    • 2001
  • Background: It had been reported by authors that linear polarized infrared light radiation (Superizer: SL) near the stellate ganglion had a similar effect on the change of skin temperature of hand compared with the stellate ganglion block (SGB). We hypothesized that this was due to dilatation of vessels and an increased blood flow. The aim of this study was to measure the velocity of blood flow in peripheral vessels after linear polarized infrared light radiation near the stellate ganglion and to compare the effect of SL with that of SGB using local anesthetics. Methods: Forty patients whose clinical criteria were matched for the symptoms of SGB were selected for study. We radiated the stellate ganglion by linear polarized infrared light radiation and measured the blood flow of radial artery using Ultrasound Doppler blood flow meter before and after 10, 20 and 30 minutes post-radiation. After 3 days, SGB was performed using 8 ml of 1% mepivacaine to the same patient, and the radial artery blood flow was measured in the same manner. Results: The blood flow velocity was increased by 40% and 27% at 10 min and 20 min after SL and by 42% and 41% at 10 min and 20 min after SGB. However, there was no statistically significant difference in blood flow velocity between SGL and SGB. Conclusions: We could conclude that linear polarized radiation is a clinically simple and useful noninvasive therapeutic tool in clinical area.

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Clinical Usefulness of Phase-Contrast Cine MRI Evaluation in Patients with Cervical Myelopathy (경추 척수병증 환자에 있어서 Phase-Contrast Cine MRI 평가의 임상적 유용성)

  • Lim, Jeong-Hwan;Song, Jun-Hyeok;Shin, Kyu-Man;Kim, Sung-Hak
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1634-1641
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    • 2000
  • Objective : The cerebrospinal fluid(CSF) pulsates within the craniospinal axis in response to rhythmic cerebral blood volume variation during the cardiac cycle. The aim of this study is to characterize the normal and abnormal CSF flow and its waveforms in the cervical spinal subarachnoid space. Methods : The magnetic resonance(MR) images were obtained with 1.5 T(GE Signa, GE Medical Systems, Milwaukee, USA) unit using the 2 dimensional cine PC(phase contrast) sequence with cardiac gating and gradient recalled echo imaging. This pulse sequence yielded 16 quantitative flow-encoded images per cardiac cycle. Sagittal and axial images of the cervical spinal CSF space were obtained, and target sites were analyzed for characteristic CSF flow (TR=50ms, TE=12.5-15ms). The region of interest(ROI) was 1mm 3 in volume. Twenty six persons were included in this study : 10 healthy volunteers and 16 patients with cervical myelopathy. The post-operative cine MR study were also done in five patients. Results : The normal CSF pulsation dynamics in the cervical spine showed discrete systolic and diastolic components. The CSF flow revealed a sine wave pattern, in which the systolic phase was shorter than the diastolic phase(ratio=2 : 3). The patient group revealed decreased amplitudes of the CSF flow and irregularly distored flow waves. The systolic phase was elongated in the ROI above the stenotic level, whereas the diastolic phase was lengthened below the level. In the postoperative images, the abnormal pattern and amplitude were found to be corrected. Conclusion : From these results, the authors believe that the CSF flow study provides valuable informations regarding the extent of cervical stenosis and may be useful for the surgical planning and post-operative evaluation.

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Respiratory Air Flow Transducer Applicable to Cardiopulmonary Resuscitation Procedure (인공심폐소생술에 활용 가능한 호흡기류센서)

  • Kim, Kyung-Ah;Lee, In-Kwang;Lee, You-Mi;Yu, Hee;Kim, Young-Il;Han, Sang-Hyun;Cha, Eun-Jong
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.62 no.6
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    • pp.833-839
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    • 2013
  • Cardiopulmonary resuscitation (CPR) is performed by thoracic compression and artificial ventilation for the patient under emergent situation to maintain at least the minimum level of respiration and blood circulation for life survival. Good quality CPR requires monitoring respiration, however, traditional respiratory air flow transducers cannot be used because the transducer elements are facing the whole area perpendicular to the flow axis. The present study developed a new air flow transducer conveniently applicable to CPR. Specially designed "sensing rod" samples the air velocity at 3 different locations of the flow cross-section, then transforms into average dynamic pressure by the Bernoulli's law. The symmetric structure of the sensing holes of the sensing rod enables bi-directional measurement simply by taking the difference in pressure by a commercial differential pressure transducer. Both inspiratory and expiratory flows were obtained with symmetric measurement characteristics. Quadratic curve fitting provided excellent calibration formula with a correlation coefficient>0.999 (P<0.0001) and the mean relative error<1%. The present results can be usefully applied to accurately monitor the air flow rate during CPR.

In vivo Evaluation of Flow Estimation Methods for 3D Color Doppler Imaging

  • Yoo, Yang-Mo
    • Journal of Biomedical Engineering Research
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    • v.31 no.3
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    • pp.177-186
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    • 2010
  • In 3D ultrasound color Doppler imaging (CDI), 8-16 pulse transmissions (ensembles) per each scanline are used for effective clutter rejection and flow estimation, but it yields a low volume acquisition rate. In this paper, we have evaluated three flow estimation methods: autoregression (AR), eigendecomposition (ED), and autocorrelation combined with adaptive clutter rejection (AC-ACR) for a small ensemble size (E=4). The performance of AR, ED and AC-ACR methods was compared using 2D and 3D in vivo data acquired under different clutter conditions (common carotid artery, kidney and liver). To evaluate the effectiveness of three methods, receiver operating characteristic (ROC) curves were generated. For 2D kidney in vivo data, the AC-ACR method outperforms the AR and ED methods in terms of the area under the ROC curve (AUC) (0.852 vs. 0.793 and 0.813, respectively). Similarly, the AC-ACR method shows higher AUC values for 2D liver in vivo data compared to the AR and ED methods (0.855 vs. 0.807 and 0.823, respectively). For the common carotid artery data, the AR provides higher AUC values, but it suffers from biased estimates. For 3D in vivo data acquired from a kidney transplant patient, the AC-ACR with E=4 provides an AUC value of 0.799. These in vivo experiment results indicate that the AC-ACR method can provide more robust flow estimates compared to the AR and ED methods with a small ensemble size.

In vitro experimental study on flow characteristics of abdominal aorta aneurysm (복부대동맥 동맥류의 유동특성에 관한 in vitro 실험적 연구)

  • Lee, J.P.;Kim, D.S.;Lee, S.J.
    • 한국전산유체공학회:학술대회논문집
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    • 2008.03b
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    • pp.10-12
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    • 2008
  • Hemodynamic features of blood flow in the abdominal aorta aneurysm (AAA) are very important, because they are closely related with the rupture of aneurysm to death. It has been considered that the wall shear stress of blood flows influences the formation, growth, and rupture of AAA. On this account, it is important to understand the flow structure of blood in the aneurysm. In this study, the whole velocity field information inside a typical AAA was measured using an in vitro AAA model under the pulsatile flow condition. The vessel geometry was reconstructed based on the computerized tomography (CT) data of a patient. The AAA model was made by using a rapid prototyping (RP) method, based on the reconstructed vessel geometry. Velocity fields in the AAA model were measured at different pulsatile phases using a PIV (particle image velocimetry) system. As experimental results, a large-scale vortex is formed inside the AAA model and the vortices located near the AAA wall are supposed to increase the local pressure and wall shear stress. In this study, the AAA wall stress found to be was one of the most important governing parameters giving rise to the ruptured aneurysm.

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Surgical Treatment of Facial Vascular Malformations (안면부 혈관기형 환자의 수술적 처치)

  • Kim, Soung-Min;Park, Jung-Min;Eo, Mi-Young;Myoung, Hoon;Lee, Jong-Ho;Choi, Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.13 no.2
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    • pp.85-92
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    • 2010
  • Vascular malformations (VMs) in the head and neck region are present at birth and grow commensurately with the child, they can result in significant cosmetic problems for the patient, and some may lead to even serious life threatening hemorrhage. Although the molecular mechanisms underlying the formation of these VMs remain unclear, lesions are known to result from abnormal development and morphogenesis. Histologically, there are no evidence of cellular proliferation, but rather progressive dilatation of abnormal channels, which VMs are designated to their prominent channel types such as capillary, venous, lymphatic, arterial, and combined malformations. VMs with an arterial component are rheologically fast-flow, whereas capillary, lymphatic, and venous components are slow-flow. In this article, we review the clinical presentations, diagnosis, and management of VMs of facial regions with author's embolization and surgical treatment cases.

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Design of a hospital assignment scheme for ambulances based on minimum cost maximum flow algorithm (최소비용 최대유량 알고리즘에 기반한 구급차의 환자이송 병원 배정 기법의 설계)

  • Junghoon Lee
    • Smart Media Journal
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    • v.12 no.9
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    • pp.72-80
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    • 2023
  • This paper presents a design and analyzes the performance of a hospital assignment and reassignment scheme for emergency rescue services based on minimum cost maximum flow algorithm. It consists of flow graph building, link capacity updating, and allocation discovering steps. The efficiency of the algorithm makes it possible to reallocate hospitals even in case of dynamic changes in the number of patients or hospitals. The performance measurement result obtained from a prototype implementation shows that the proposed scheme can reduce the transport time requirement miss by up to 24%.