• Journal of the Korean Society of Visualization
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• v.18 no.3
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• pp.96-102
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• 2020

Oral cancer surgery changes the morphologic characteristics of the human upper airway. These changes can affect the flow patterns. In this study, computational fluid dynamics (CFD) simulations with transient solver were performed to numerically investigate the air flows in the human upper airways depending oral cancer surgery. 3D reconstructed models were obtained from 2D CT images of one patient. For the boundary condition, the realistic breathing cycle of human was applied. The hydraulic diameters of cross-sections for post-surgical model are changed greatly along streamwise direction, so these variations can cause higher wall shear stress and flow disturbance compared to pre-surgical model. The recirculation flows observed in the protruding region result in the relatively large pressure drop. These results can be helpful to understand the flow variations after resection surgery of oral cancer.

• Journal of The Korea Institute of Healthcare Architecture
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• v.19 no.4
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• pp.47-60
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• 2013

Purpose: This study examines construction core plans for the users of vertical-typed general hospitals to effectivly use the flow line. Methods: The study sampled representative 9 hospitals, calculated the depth value through Convex Map of Space Syntax and Justified Graph according to the determination of form of construction cire, and analyzed its functional connectivity. Results: The analysis of the connectivity between operation core part and emergency part of core space with high importance in the hospitals showed that the types of hospital and hospital have the lowest depth value in the spatial phase diagram, where central treatment part and outpatient part are arranged well vertically. Elevators for patients at these hospitals are close to operation and emergency parts actually separated from the elevators for passengers. For shortening of flow line of patients and private movement environment, however, it is desirable to arrange the elevators for patients to be adjacent to the operation parts and to arrange the emergent patient entrances more effectively to separate them from the flow line of visitors and guardians. Implications: Consideration should be taken into account for the effective flow line design. This study hopefully may serve as a stepping stone for the standard design of horizontal/vertical flow line.

• Health Policy and Management
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• v.15 no.4
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• pp.81-109
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• 2005

According to many recent studies suggesting that cash flow analysis method tends to be more effective than traditional financial index analysis method to predict corporate bankruptcy, this study applies the cash flow analysis method to hospital business to identify the significant variables which can distinguish between superior hospitals and bankruptcy hospitals. The author analyzed recent 3 years, i.e. from the year of 2000 to the year of 2002, financial statements of 31 bankrupt hospitals In 2003, and the same number of superior hospitals through using Multiple Discriminant Analysis and Logit Analysis. The results are belows; First, the study releases that Logit Analysis is more likely to be effective than Multiple Discriminant Analysis. Second, this research also shows that traditional financial index analysis method is more superior compare to cash flow analysis method for hospital bankruptcy predict model. Finally, this study suggest that the significant variables, which can distinguish superior hospitals from bankrupt hospitals, are Operating/Current Liabilities$(Y_2)$, CFO/Equity$(Y_5)$ for cash flow analysis method and Net Worth to Total Assets Ratio$(X_1)$, Quick Ratio $(X_3)$, Return on Assets$(X_6)$, Growth Rate of Patient Revenues$(X_{16})$ for traditional financial index analysis method.

• Journal of the Korean Society of Manufacturing Technology Engineers
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• v.21 no.1
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• pp.161-166
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• 2012

Intravenous (IV) injection is widely used to supply Ringer solution directly into a vein in hospital. Generally, a passive injection method has been used, which causes the inconsistent flow rate of fluid and inappropriate control of injection time by a patient. It leads to an unnecessary nurse's overwork and decrement of IV injection's effect. To solve these problems, flow control infusion pumps have been developed. But because of relatively heavy weight and high price, its usage has been limited. In the present study, a new automatic IV injection system is developed. It is installed with a small pressing mechanism driven by a small electric motor to regulate the flow rate by pressing tube. Proportional integral derivative (PID) feedback control algorithm is applied to control the electric motor. The system is smaller in size and uses lower power than the existing commercial product. The newly developed system is also installed with networking capability, which enables monitoring the status of several automatic IV injection system at the same time.

• Journal of the Korean Society of Visualization
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• v.20 no.1
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• pp.52-63
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• 2022

Direct numerical simulation of blood flow in a stenosed, patient-specific carotid artery was conducted to explore the transient behavior of blood flow with special emphasis on the wall-shear stress distribution over the transition region. We assumed the blood as an incompressible Newtonian fluid, and the vessel was treated as a solid wall. The pulsatile boundary condition was applied at the inlet of the carotid. The Reynolds number is 884 based on the inlet diameter, and the maximum flow rate and the corresponding Womersley number is approximately 5.9. We found the transitional behavior during the acceleration and deceleration phases. In order to quantitatively examine the wall-shear stress distribution over the transition region, the probability density function of the wall-shear stress was computed. It showed that the negative wall-shear stress events frequently occur near peak systole. In addition, the oscillatory shear stress index was used to further analyze the relationship with the negative wall-shear stress appearing in the systolic phase.

• Archives of Reconstructive Microsurgery
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• v.15 no.1
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• pp.17-25
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• 2006

Twelve cases in eleven patients with segmental bone defects were treated with contralateral fibula free flap and ipsilateral island fibula flap in an antegrade, retrograde or bidirectional flow fashion. Five cases were managed with free flaps and seven were with ipsilateral fibula island transfer. Among seven cases, antegrade fashion was three, retrograde was three, and bidirectional was one. All patients were related with open tibial fractures and its sequelae except one who had open foot bone fracture. According to Gustilo's classification, ten patients were type IIIb and one was type IIIc. Basically, antegrade-flow flaps based on the peroneal vessels as in the conventional free flap were used for the proximal or middle one-third tibial defects. On the contrary, retrograde-flow flaps based on the communicating branch between the peroneal and posterior tibial vessels were used for the middle or distal one-third of the tibia. Bidirection-flow flap based on intact peroneal vessels were used for the middle portion of the tibia. The patients who have undergone ipsilateral fibula island flap had one of the following problems: a previously failed free flap, below-knee amputation of the opposite leg because of open tibial fracture, refusal to use the contralateral sound leg, or poor general condition to stand a lengthy operation. Six of the patients who have got ipsilateral fibula island flap also had an associated fibula fracture on the same leg, which was ultimately used as one of the osteotomy sites. The follow-up period was from 1 to 10 years. Two cases of free flap were failed: one patient had below-knee amputation and the other patient had ipsilateral fibula transfer. Other cases were successful and excellent hypertophy of the transferred fibula was achieved. Time to bone union ranged from 4 to 11 months. Time to full weight bearing was from 5 to 13 months after surgery. All of the transferred fibulas showed hypertrophy after weight bearing. In one case, stress fracture was developed during ambulation, which was healed conservatively. Nonunion occurred in two cases, which were treated with a long leg cast and cancellous bone graft, respectively. Length discrepancy of the legs was noted. The limb was shorter by an average 0.5 cm in three cases, longer by 1.1 cm in one case. In the case of island fibula transfer, limited arc of rotation was not a problem. Other disabling complications were not seen. We believe that these diverse modalities using a vascularized fibula will make us more comfortable to handle major bone defects.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.6
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• pp.1513-1520
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• 2009

The purpose of this study was to compare cerebral blood flow between hyperlipidemic patient group and normal healthy aldult group using transcranial doppler ultrasonography(TCD). I investigated cerebral blood flow of 63 hyperlipidemic patients and 42 healthy adults. To evaluate the cerebral blood flow, I measured the systolic peak velocity(Vs) and mean flow velocity(Vm) of the milddle cerebral artery(MCA), anterior cerebral artery(ACA), posterior cerebral artery(PCA), basilar artery(BA), internal carotid artery(ICA) in the two groups using TCD. In normal healthy adults, subjects showed a decerease in Vs and Vm with advancing in age. There was a significant difference in the Vm of ICA. There was no significant differences in the Vm of ACA and ICA. In normal healthy adults, females showed high velocities of all examined vessel. There was a significant difference in the Vs of ICA. There was a significant differences in the Vm of MCA and ICA. Normal healthy adults higher than hyperlipidemic patients in the Vs of MCA, ACA, PCA. There was no significant difference in the Vs of all exmined vessels. Hyperlipidemic patientsincrease higher than normal healthy adults in the Vm of ACA. There was a significant difference in the Vs of BA. In the patients aged under 50's, normal healthy adults higher than hyperlipidemic patients in the Vs and Vm except BA. But there was no significant difference in all exmined vessels. In the patients aged over 50's, hyperlipidemic patients higher than normal healthy adults in all examined vessel expect PCA. There was a significant difference in the Vs of BA and ICA. And hyperlipidemic patients higher than that normal healthy adults in all exmined vessels. There was a significant difference in BA and ICA. In this study, visible differences in blood flow between hyperlipidemic patient group and normal healthy aldult group were shown. However, these results do not come up to the previous values that were reported and known worldwide.

• Proceedings of the KIEE Conference
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• 2008.07a
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• pp.1971-1972
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• 2008

Cardiopulmonary resuscitation(CPR) is an important clinical technique performing artificial ventilation and chest compression on a patient under emergent situation before arriving in hospital. Since the quality of CPR significantly affects the survival rate, it would be of great advantage to monitor respiration in real time during CPR. However, currently applied respiratory air flow transducers are difficult to apply with sensing elements in the middle of the flow axis. The present study developed a new turbulent air flow transducer conveniently applicable to CPR. Abrupt changes in diameter of the flow tube generated turbulence in air flow, thereby pressure difference was obtained to estimate the air flow rate, with no physical object on the flow plane. Expiration and inspiration were separated by the direction of the pressure difference, resulting in good symmetry. Pressure-flow relationship was tested on a quadratic model, which provided accurate enough estimation results. Therefore, the present turbulent air flow transducer seemed appropriate to monitor respiration during CPR.

• Journal of Medicine and Life Science
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• v.20 no.3
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• pp.115-125
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• 2023

Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.

• Journal of Digital Convergence
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• v.12 no.2
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• pp.379-389
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• 2014

The purpose of this study is to optimize the patient(examinee) flow in a health examination center via a simulation model and to improve operational efficiency. Two experimentation scenarios were implemented into the simulation model to determine which proposed scenario provides better improvement in terms of the following performance measures: LOS(Length of Stay), staff utilization, and occupancy level. The simulation results demonstrated that there was no significant difference in response results of two scenarios. Although the original motivation of this study was suggest optimal policy for a patient(examinee) flow, the insight into applying simulation in efficiently managing hospital operations is of more value. Simulation approach is a powerful technique that supports efficient decision-making compared to traditional healthcare management approach based on past experience, feelings, and intuition. Therefore, the proposed experimentation model has wide applicability in healthcare systems.