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Effects of Telephone Hotline Counseling Program on Stroke Care (뇌졸중 환자에 적용한 핫라인 전화상담 프로그램의 효과)

  • Baik Kyun Kim;Dong-Wan Kang;Do Yeon Kim;Jung Hyun Park;Ji-Seok Woo;Young-Hee Kim;Hyun-Sook Kim;Min-Joo Moon;Jeong-Yoon Lee;Hyung Seok Guk;Nakhoon Kim;Sang-Won Choi;Hakyeu Ahn;Bosco Seong Kyu Yang;Jun Yup Kim;Jihoon Kang;Moon-Ku Han;Hee-Joon Bae;Beom Joon Kim
    • Health Policy and Management
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    • v.33 no.2
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    • pp.185-193
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    • 2023
  • Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

Research on Radiation Shielding Film for Replacement of Lead(Pb) through Roll-to-Roll Sputtering Deposition (롤투롤 스퍼터링 증착을 통한 납(Pb) 대체용 방사선 차폐필름 개발)

  • Sung-Hun Kim;Jung-Sup Byun;Young-Bin Ji
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.441-447
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    • 2023
  • Lead(Pb), which is currently mainly used for shielding purposes in the medical radiation, has excellent radiation shielding functions, but is continuously exposed to radiation directly or indirectly due to the harmfulness of lead itself to the human body and the inconvenience caused by its heavy weight. Research on shielding materials that are human-friendly, lightweight, and convenient to use that can block risks and replace lead is continuously being conducted. In this study, based on the commonly used polyethylene terephthalate (PET) film and the fabric material used in actual radiation protective clothing, a multi-layer thin film was realized through sputtering and vacuum deposition of bismuth, tungsten, and tin, which are metal materials that can shield radiation. Thus, a shielding film was produced and its applicability as a radiation shielding material was evaluated. The radiation shielding film was manufactured by establishing the optimized conditions for each shielding material while controlling the applied voltage, roll driving speed, and gas supply amount to manufacture the shielding film. The adhesion between the parent material and the shielding metal thin film was confirmed by Cross-cut 100/100, and the stability of the thin film was confirmed through a hot water test for 1 hour to measure the change of the thin film over time. The shielding performance of the finally realized shielding film was measured by the Korea association for radiation application (KARA), and the test conditions (inverse wide beam, tube voltage 50 kV, half layer 1.828 mmAl) were set to obtain an attenuation ratio of 16.4 (initial value 0.300 mGy/s, measured value 0.018 mGy/s) and damping ratio 4.31 (initial value 0.300 mGy/s, measured value 0.069 mGy/s) were obtained. by securing process efficiency for future commercialization, light and shielding films and fabrics were used to lay the foundation for the application of films to radiation protective clothing or construction materials with shielding functions.

Study on the Trend of Aggregate Industry (국내외 골재산업 동향 연구)

  • Kwang-Seok Chea;Namin Koo;Young Geun Lee;Hee Moon Yang;Ki Hyung Park
    • Korean Journal of Mineralogy and Petrology
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    • v.36 no.2
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    • pp.135-145
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    • 2023
  • Aggregate is used to produce stable materials like concrete and asphalt and is fundamental to meet the social needs of housing, industry, road, energy and health. A total of 42.35 billion tons of aggregate were produced in 2021 worldwide, an increase of 0.91% compared to the previous year. Among them, 2 billion tons were produced in China, India, European Union and United States, making up to 71.75% of the share. South Korea has witnessed a constant increase in aggregate production, overtaking Mexico and Japan for seventh place with 390 million tons and 0.85% of the share. The industrial sand and gravel produced globally amounted to 352.66 million tons. The top seven countries with the highest production were China, United States, Netherlands, Italy, India, Turkey and France, and their production exceeded 10 million tons and held a share of 74.69%. Exports of natural rock recorded $21.68 billion in 2021, increased by $2.3 billion compared to the previous year, while exports of artificial rock increased by $2.66 billion to $13.59 billion. Exports of sand reached $1.71 billion with United States, Netherlands, Germany and Belgium being the four countries with the highest exports of sand. The four countries exported more than $100 million in sand and took up 57.70% of the total amount. Exports of gravel totaled $2.75 billion, with China, Norway, Germany, Belgium, France and Austria in the lead, making up to 48.30% of the total share. The aggregate quarry started to surge in the 1950s due to the change in people's lifestyle such as population growth, urbanization and infrastructure delvelopment. Demand for aggregate is also skyrocketing to prevent land reclamation and flood caused by sea-level rise. Demand for aggregate, which was around 24 gigatons in 2011, is expected to double to 55 gigatons in 2060. However, it is likely that aggregate extraction will heavily damage the ecosystem and the world will eventually face a shortage of aggregate followed by tense social conflict.

Usefulness of Deep Learning Image Reconstruction in Pediatric Chest CT (소아 흉부 CT 검사 시 딥러닝 영상 재구성의 유용성)

  • Do-Hun Kim;Hyo-Yeong Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.297-303
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    • 2023
  • Pediatric Computed Tomography (CT) examinations can often result in exam failures or the need for frequent retests due to the difficulty of cooperation from young patients. Deep Learning Image Reconstruction (DLIR) methods offer the potential to obtain diagnostically valuable images while reducing the retest rate in CT examinations of pediatric patients with high radiation sensitivity. In this study, we investigated the possibility of applying DLIR to reduce artifacts caused by respiration or motion and obtain clinically useful images in pediatric chest CT examinations. Retrospective analysis was conducted on chest CT examination data of 43 children under the age of 7 from P Hospital in Gyeongsangnam-do. The images reconstructed using Filtered Back Projection (FBP), Adaptive Statistical Iterative Reconstruction (ASIR-50), and the deep learning algorithm TrueFidelity-Middle (TF-M) were compared. Regions of interest (ROI) were drawn on the right ascending aorta (AA) and back muscle (BM) in contrast-enhanced chest images, and noise (standard deviation, SD) was measured using Hounsfield units (HU) in each image. Statistical analysis was performed using SPSS (ver. 22.0), analyzing the mean values of the three measurements with one-way analysis of variance (ANOVA). The results showed that the SD values for AA were FBP=25.65±3.75, ASIR-50=19.08±3.93, and TF-M=17.05±4.45 (F=66.72, p=0.00), while the SD values for BM were FBP=26.64±3.81, ASIR-50=19.19±3.37, and TF-M=19.87±4.25 (F=49.54, p=0.00). Post-hoc tests revealed significant differences among the three groups. DLIR using TF-M demonstrated significantly lower noise values compared to conventional reconstruction methods. Therefore, the application of the deep learning algorithm TrueFidelity-Middle (TF-M) is expected to be clinically valuable in pediatric chest CT examinations by reducing the degradation of image quality caused by respiration or motion.

Analysis of Optimal Locations for Resource-Development Plants in the Arctic Permafrost Considering Surface Displacement: A Case Study of Oil Sands Plants in the Athabasca Region, Canada (지표변위를 고려한 북극 동토 지역의 자원개발 플랜트 건설 최적 입지 분석: 캐나다 Athabasca 지역의 오일샌드 플랜트 사례 연구)

  • Taewook Kim;YoungSeok Kim;Sewon Kim;Hyangsun Han
    • The Journal of Engineering Geology
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    • v.33 no.2
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    • pp.275-291
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    • 2023
  • Global warming has made the polar regions more accessible, leading to increased demand for the construction of new resource-development plants in oil-rich permafrost regions. The selection of locations of resource-development plants in permafrost regions should consider the surface displacement resulting from thawing and freezing of the active layer of permafrost. However, few studies have considered surface displacement in the selection of optimal locations of resource-development plants in permafrost region. In this study, Analytic Hierarchy Process (AHP) analysis using a range of geospatial information variables was performed to select optimal locations for the construction of oil-sands development plants in the permafrost region of southern Athabasca, Alberta, Canada, including consideration of surface displacement. The surface displacement velocity was estimated by applying the Small BAseline Subset Interferometric Synthetic Aperture Radar technique to time-series Advanced Land Observing Satellite Phased Array L-band Synthetic Aperture Radar images acquired from February 2007 to March 2011. ERA5 reanalysis data were used to generate geospatial data for air temperature, surface temperature, and soil temperature averaged for the period 2000~2010. Geospatial data for roads and railways provided by Statistics Canada and land cover maps distributed by the North American Commission for Environmental Cooperation were also used in the AHP analysis. The suitability of sites analyzed using land cover, surface displacement, and road accessibility as the three most important geospatial factors was validated using the locations of oil-sand plants built since 2010. The sensitivity of surface displacement to the determination of location suitability was found to be very high. We confirm that surface displacement should be considered in the selection of optimal locations for the construction of new resource-development plants in permafrost regions.

An analysis of anchor stones on the west and south coasts (서·남해안 출수 닻돌 분석)

  • PARK Seungmin
    • Korean Journal of Heritage: History & Science
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    • v.55 no.4
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    • pp.6-22
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    • 2022
  • In this paper classifies the types of 228 anchor stones discharged from the west and south coasts, assumes a combined method by type, routes through discharge locations, and It attempted to estimate the burial site. Prior to classification of types, the weight, thickness, width, and length of the anchor stone were measured, and the largest Young in the tomb The scent weight was classified into I~V groups, and the shape of the anchor stone was classified into 1-6 types. All of these weight and shape correlations It was classified into 17 types. The combined method by type is 180kg or less depending on the morphological characteristics of the reference value of the extracted anchor stone, and the type An anchor of type 1 or 2 is used in combination with an anchor, and a anchor of type 3 or 6 weighs more than 180kg and is combined with an anchor The dragon was assumed to be an anchor. Along with this, the route and burial site are identified through past records and testimony of local residents It was checked against the data. The route was largely consistent with past records, but the new route was apparent in waters near the island or inland It was also drawn. In the case of burial sites, small and large in Taean Mado Sea and Jindo Byeokpajin Sea, where anchor stones are concentrated, Considering the pattern of the type anchor stones being discharged, it was consistent with the testimony that ships of various sizes were mysterious in the two seas. Based on this type classification, a study on the spatiality of the anchors was conducted. First, a comparison and analysis was done on whether actual real data, such as anchor stones, old ships, and relics, were identified on the Joun-ro route and international trade routes as recorded in the past literature. Where there was no record, the route was estimated based on real data. To this end, routes estimated based on the testimony of local residents and modern ship workers were analyzed as to whether ships traveled there in the past and whether they could actually sail. Next, the location of each seedling was estimated by ship size according to the weight of the anchor stone. In the case of the Taean Mado Sea and Jindo Byeokpajin Sea, both small and large anchor stones were discharged from the coastline and were far away.

The Diagnostic Accordance between Transcranial Doppler and MR Angiography in the Intracranial Artery Stenosis (두개강내 혈관 협착에 대한 경두개도플러와 자기공명 혈관조영술의 일치도 평가)

  • Moon, Sang-kwan;Jung, Woo-sang;Park, Sung-uk;Park, Jung-mee;Ko, Chang-nam;Cho, Ki-ho;Bae, Hyung-sup;Kim, Young-suk;Cho, Seong-il
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.7 no.1
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    • pp.11-16
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    • 2006
  • Objectives : Transcranial Doppler (TCD) has been reported to be established as useful in detecting spasm after subarachnoid hemorrhage and to be probably useful in diagnosing stenosis or occlusion in intracranial arteries. In the detection of intracranial stenosis using TCD there have been reported some kinds of diagnostic criteria. This study was aimed to evaluate the accordance between TCD and magnetic resonance angiography (MRA) in detection of intracranial stenosis and to find out more accurate criteria for intracranial stenosis using TCD. Methods : Seventy-six stroke patients were evaluated by TCD and MRA. TCD criteria for middle cerebral artery (MCA) stenosis were used by 3 methods; ≥ 80cm/sec of mean velocity(Vm), ≥ 140 cm/sec of systolic velocity(Vs), and both. For stenosis of vertebral(VA) and basilar arteries(BA), the TCD criteria followed by 2 methods; ≥ 70 cm/sec of Vm and ≥ 100 cm/sec of Vs. The stenosis of intracranial artery in MRA followed by the interpretation of specialist in the department of radiology. The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and kappa agreement were calculated in each criteria of TCD compared with the result of MRA. Results : The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and kappa agreement using ≥ 80cm/sec of Vm for MCA stenosis were 55.6%, 81%, 34.5%, 91.0%, 77.1%, and 0.293, respectively. Using 140 cm/sec of Vs, those were 44.4%, 92.0%, 50.5%, 90.2%, 84.7%, 0.380, and using both criteria those were 44.4%, 95.0%, 61.5%, 90.5%, 87.3%, 0.445, respectively. Those using ≥ 70 cm/sec of Vm for VA and BA stenosis were 71.4%, 93.7%, 26.3%, 99.0%, 93.0%, 0.186 and using ≥ 100 cm/sec of Vs those were 71.4%, 97.3%, 45.5%, 99.1%, 96.5%, 0.539, respectively. Conclusion : These results suggested that for the diagnosis of MCA stenosis using TCD we should use the criteria of both ≥ 80cm/sec of Vm and 140 cm/sec of Vs, and for the VA and BA stenosis we adapt the criteria of ≥ 70 cm/sec of Vm.

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The Comparison on the General Characteristics of Acute Stroke Patient between Heat pattern group and Cold pattern group (한열변증에 따른 중풍 환자의 제반특성 비교)

  • Kim, Min-kyung;Lee, ln-whan;Shin, Ae-sook;Kim, Na-hee;Kim, Hye-mi;Shim, So-ra;Na, Byung-Jo;Cho, Seung-yeon;Park, Seong-uk;Jung, Woo Sang;Moon, Sang Kwan;Park, Jung-mi;Ko, Chang-nam;Cho, Ki Ho;Kim, Young Suk;Bae, Hyung-sup
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.11 no.1
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    • pp.18-25
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    • 2010
  • Object : This study was conducted as part of the national project to standardize stroke diagnosis in Korean medicine. In this study, we aimed to evaluate the characteristics of acute stroke between heat pattern group and cold pattern group. Methods : We recruited stroke patients from 5 universities(Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo medical center, Kyungwon university lncheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university llsan oriental medical center) from April, 2007 until February, 2010. We diagnosed them and selected 463 heat pattern patients and 182 cold pattern patients. Results : We find that the risk factor of smoking, alcohol, diet(prefer to meat) are more associated with the heat pattern group. On the other hand, inflammation history in recent 3 months and diet(prefer to sea food) are more associated with the cold pattern group. RBC, Hg, Hct, TG, CK and Cl are more related to the heat pattern group. CPT, total cholesterol and HDL are more related to the cold pattern group. Tae-eum type takes high distribution of the heat pattern group, and So-eum type takes high distribution of the cold pattern group. Conclusions : This study provides evidence that the heat pattern group have more risk factor than the cold pattern group.

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The Study about the Changes of the Fire and Heat Related Symptoms and Signs On the Acute Cerebral Infarction Patients. (급성기 뇌경색 환자에서 화열 관련 증상과 증후의 변화에 관한 연구)

  • Kwak, Seung-hyuk;Park, Su-kyung;Woo, Su-kyung;Lee, Eun-chan;Park, Joo-young;Jung, Woo-sang;Moon, Sang-kwan;Cho, Ki-ho;Cho, Seung-yeon;Park, Sung-wook;Ko, Chang-nam
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.12 no.1
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    • pp.24-31
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    • 2011
  • Objective : Fire and heat related symptoms and signs are considered common in acute stage of diseases. The purpose of this study is to evaluate the occurrences and changes of fire and heat related symptoms and signs in acute cerebral infarction patients. Method & subjects : 40 acute cerebral infarction patients hospitalized in Oriental medicine hospital, Kyung-Hee University, who had examined and diagnosed 2 or 3 times based on oriental medical diagnosis were selected. We chose 23 as fire and heat related symptoms and signs from 94 diagnostic articles, and we added all those scores together of each patient. We analysed the scores of fire and heat related symptoms and signs as the time passed, and depending on oriental medical diagnosis. Result : In acute cerebral infarction patients of this study, 4 of fire and heat related symptoms and signs were took 1st, 2nd, 4th and 8th places in most changeable 10 articles of total 94 articles. The mean score of fire and heat related symptoms and signs of all patients were decreased significantly over the 3 times of measurements. The 8 patients diagnosed as fire and heat diagnosis at visit1 were samely diagnosed as fire and heat diagnosis at visit2, and at visit3 5 patients of them except for 3 patients excluded between visit2 and visit3, were still diagnosed as fire and heat diagnosis. At all of 3 measuring times, the scores of fire and heat related symptoms and signs of fire and heat diagnosis group were higher than non-fire and heat diagnosis group. Conclusion : This study indicated that fire and heat related symptoms and signs were very changeable phenomenon in acute cerebral infarction patients. And they decreased as time goes on.

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Relation between Ablation Execution Time and Radiation Exposure Effect in the Treatment of Atrial-fibrillation using Cryo-balloon and 3D Radio-frequency Ablation (냉각 풍선 절제술과 3D 고주파 절제술을 이용한 심방세동 치료 시 절제술 시행 시간과 방사선 피폭 영향과의 연관성)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.4
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    • pp.427-434
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    • 2022
  • Atrial fibrillation treatment includes 3D RFCA and Cryo-balloon ablation. Both procedures have in common that they enter after understanding the structure of the heart using angiography equipment. Therefore, there is a disadvantage that the effect of exposure according to the procedure time can be a threat to both the patient and the operator, so this study aims to confirm the relationship between the total ablation time and the effect of radiation exposure. We used follow-up data (retrospective) from 41 patients who underwent coronary angiography and arrhythmia at the same time from March 2019 to July 2022. The range for total ablation time was based on the recorded data from the start to the end of the total ablation. The end point of 3D RFCA was when the ablation was completed for 4 pulmonary veins, and in the case of Cryo-balloon ablation, the data that succeeded in electrical insulation were included. As a result of analyzing the total ablation time, the time taken for Cryo-balloon ablation was 1037.29±103.66 s, which was 2448.61 s faster than 3D RFCA using 3485.9±405.71 s, and was statistically significant. (p<0.05) As a result of analyzing the total fluoroscopy time, the exposure time for 3D RFCA was 2573.75±239.08 s, which was less by 1717.15 s than the exposure time for Cryo-balloon ablation, 4290.9±420.42 s, and was statistically significant. In the case of total area dose product, 3D RFCA was 59.04±13.1 uGy/m2, which was lower than Cryo-balloon ablation 980.6±658.07 uGy/m2 by 921.56 uGy/m2, which was statistically significant. As the insulation time of the Cryo-balloon ablation is shorter than that of the 3D RFCA, the method using the Cryo-balloon ablation is considered to be effective when the patient's condition is not good and a quick procedure is required. However, in patients with permanent Atrial fibrillation, there is a high probability of structural changes in the heart, so it is considered that 3D RFCA is better than Cryo-balloon ablation, which is difficult to manipulate.