Due to the recent advancement in digital imaging technology, development of intervention equipment has become generalize. Video arbitration procedure is a process to insert a tiny catheter and a guide wire in the body, so in order to enhance the effectiveness and safety of this treatment, the high-quality of x-ray of image should be used. However, the increasing of radiation has become the problem. Therefore, the studies to improve the performance of x-ray detectors are being actively processed. Moreover, this intervention is based on the reference of the angiographic imaging and 3D medical image processing. In this paper, we propose a guidance system to support this intervention. Through this intervention, it can solve the problem of the existing 2D medical images based vessel that has a formation of cerebrovascular disease, and guide the real-time tracking and optimal route to the target lesion by intervention catheter and guide wire tool. As a result, the system was completely composed for medical image acquisition unit and image processing unit as well as a display device. The experimental environment, guide services which are provided by the proposed system Brain Phantom (complete intracranial model with aneurysms, ref H+N-S-A-010) was taken with x-ray and testing. To generate a reference image based on the Laplacian algorithm for the image processing which derived from the cerebral blood vessel model was applied to DICOM by Volume ray casting technique. $A^*$ algorithm was used to provide the catheter with a guide wire tracking path. Finally, the result does show the location of the catheter and guide wire providing in the proposed system especially, it is expected to provide a useful guide for future intervention service.
Background : Integrative cancer treatment is a holistic approach embracing body, mind, and spirit incorporating conventional treatments of surgery, chemotherapy, radiation and personalized complementary treatments. Wheel Balance Therapy (WBT) of East-West Cancer Center(EWCC), Dunsan Oriental Hospital of Daejeon University was developed to balance out all factors involved in cancer care based on the traditional theories of oriental medicine. Objective : This work aims to analytically review literatures on WBT and its related components. Methods : Literatures published from January 1st, 1990 to April 30th, 2011 were reviewed focusing on 4 main components of WBT; herbal medicine, immune activation, anti-cancer diet, and breathing/meditation. Data were retrieved from medical search engines and electronic data bases including Pubmed, Research Information sharing Service (RISS), Korean-studies Information Service System (KISS), China National Knowledge Infrastructure (CNKI), and Korea's National Digital Library (KNDL). Results : In this review, EWCC's most commonly prescribed formulas are explored. The composition of the formulas, their use in clinical settings as well as the background studies and other therapeutic efficacies are explained. Information on incorporating anti-cancer dietary support and breathing and meditation techniques, other therapies practiced as part of the center's integrative cancer care are also covered. Conclusion : WBT based on holistic theories of oriental medicine embracing body, mind, and spirit is expected to further contribute in promotion of cancer patients' quality of life and prolonged survival time.
When women are removed with their matrix which is a emotionally significant organ of symbol in psychologically adapting themselves to mother and woman, that is threatened and injured with woman role decisively. The nursing for women with hysterectomy is limited to medical treatment and the nursing related to troubles in psychology, emotion they experience in general situation due to operations is hardly realized. New basis for nursing can be realized when we both have relation with lived human experience related th health and become to be a part of it. We need to catch their experience due to the loss of matrix to understand women with hysterectomy. The subjects of the study were nine patients who were admitted to a gynecological ward of a hospital in Seoul, suffering from vaginal bleeding, back pain, abdominal pain and so on and diagnosing as non-cancer. The data were collected from April to May 1997 by listening to the subjects' expression of their experience and by participant observation of the subjects' reactions. A tape-recorder was used under the permission of the subjects, to prevent the loss of spoken information. The result of the study was as follows : The data on burden content from the interview were categorized as psych-emotional, physical, personal interaction, financial burden and maternal role burden. The factors which have influence on the burden of the subjects are an offer of information, support system, age, occupation, economic situation, family history, character, season, the existence of ovary and religion. In conclusion, since we ascertained that the nursing in the process of recovery decide the quality of life, though women with hysterectomy undergo various burden experience and adapt to it in the end, it is necessary to give them enough information and educate husband, having on important effect on the burden experience, to be a good supporter. And technically skilled nurses of consultant are thought to be able to contrive better qualitative life of women with hysterectomy as an important bridge between the subjects and their required information, since the nurses have their well-formed position of relationship of confidence through continuous contact with patients and their family.
Journal of The Korean Society of Maternal and Child Health
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v.21
no.3
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pp.159-165
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2017
The thalidomide tragedy in the 1960s has resulted in a perpetuation of a certain perception amongst physicians and pregnant women that the use of medication during pregnancy is a potential teratogen. Consequently, physicians hesitate in prescribing medication to pregnant women. In addition, pregnant women often refuse medication despite therapeutic necessity because of this existing perception. Recently there have been frequent adverse pregnancy outcomes related to the recurrence of chronic diseases, such as hypertension and diabetes, following pregnancy in older women. And there are lots of unnecessary termination of pregnancy due to the of information of medication exposed to medication following over 50% of unintended pregnancy. In light of this, better dissemination of information regarding the safe usage of medication for pregnant women is required. This would not only be cost-effective in terms of medical expenditure, but also prove beneficial for the treatment of diseases. In addition, Korea needs to adapt to the increasing changes of the international information system regarding supporting the safe usage of medication during pregnancy. An example of this is shown by the recent changes to the labeling of medication by the United States Food and Drug Administration. The new labeling includes information on the risk of usage, rather than just an arbitrary alphabetic classification of B, C, D, or X. Furthermore, this information is limited in Korea because of the lack of research, which in turn is due to several limitations on ethics and methodology, as well as present regulations on the research of pregnant women. From this, we can learn that government support is critical for the establishment of research so that we can alter the perception that all medication is harmful to pregnant women.
Park, Ji-Woong;Kim, Joung-Joon;Yun, Jae-Kwan;Han, Ki-Joon
Journal of Korea Spatial Information System Society
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v.7
no.1
s.13
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pp.25-37
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2005
Recently, with the development of wireless communications and mobile computing, interest about mobile computing is rising. Mobile computing can be regarded as an environment where a user carries mobile devices, such as a PDA or a notebook, and shares resources with a server computer via wireless communications. A mobile database refers to a database which is used in these mobile devices. The mobile database can be used in the fields of insurance business, banking business, medical treatment, and so on. Especially, LBS(Location Based Service) which utilizes location information of users becomes an essential field of mobile computing. In order to support LBS in the mobile environment, there must be an Embedded Spatial MMDBMS(Main-Memory Database Management System) that can efficiently manage large spatial data in spatial mobile devices. Therefore, in this paper, we designed and implemented the Embedded Spatial MMDBMS, extended from the HSQLDB which is an existing MMDBMS for PC, to manage spatial data efficiently in spatial mobile devices. The Embedded Spatial MMDBMS adopted the spatial data model proposed by ISO(International Organization for Standardization), provided the arithmetic coding method that is suitable for spatial data, and supported the efficient spatial index which uses the MBR compression and hashing method suitable for spatial mobile devices. In addition, the system offered the spatial data display capability in low-performance processors of spatial mobile devices and supported the data caching and synchronization capability for performance improvement of spatial data import/export between the Embedded Spatial MMDBMS and the GIS server.
PTV considered for the energy, dose distribution exposed to lung and spinal cord, and the characteristic of DVH(Dose Volume Histogram) were compared and investigated by planning the intensity modulated radiation therapy (IMRT) using the photon energies of 6 MV and 10 MV according to tumor location like as the anterior, middle, and posterior regions of lung, and the mediastinum region in lung cancer patients. Our institution installed the linear accelerator (Varian 21 EX-s, USA) equipped with 120 multileaf collimator for lung cancer patients, which is producing the photon energies of 6 MV and 10 MV, and radiation therapy planning was performed with ECLIPSE system (Varian, SomaVision 6.5, USA), which support inverse treatment planning. The tomographic images of 3 mm slice thickness for lung cancer patients were acquired using planning CT, and acquired tomographic images were sent to the Varis system, and then treatment planning was performed in the ECLIPSE system. The radiation treatment planning of the IMRT was processed from various angles according to the regions of the tumor, and using various beam lines according to the size and location of the tumor. The investigation of the characteristic of dose distributions for the energy of 6 MV and 10 MV according to tumor locations in lung cancer patients resulted that the maximum dose of 10 MV energy was 1.2% less than that of 6 MV energy without depending on the tumor location of lung cancer, and the reduction effects of MU were occurred from 10 to 25 MU. Radiation dose exposed to the lung satisfied the less 30% of V20, however radiation dose in 6 MV energy was from 0.1% to 0.5% less than that in 10 MV energy. Radiation dose exposed to the spinal cord for 6 MV energy was from 0.6% to 2.1% less than that for 6 MV energy.
Purpose: Attention deficit hyperactivity disorder (ADHD) has been known as psychiatric disorder in childhood associated with dopamine dysregulation. In present study, we investigated changes in dopamine transporter (DAT) density of the basal ganglias using I-123 N-(3-iodopropen-2-yl) -2-carbomethoxy-3beta-(4-chlorophenyl) tropane [I-123 IPT] SPECT in children with ADHD before and after methylphenidate treatment. Materials and Method: Nine drug-naive children with ADHD and seven normal children were included in the study. We peformed brain SPECT two hours after the intravenous administration of I-123 IPT and made both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of soecific/nonspecific DAT binding ratios in the basal ganglia. All children with ADHD reperformed [123I]IPT SPECT after treatment with methylphenidate(0.7mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ratio of the basal ganglia were compared between before and after treatment methylphenidate. We investigated correlation between the change of ADHD symptom severity assessed with ADHD rating scale-IV and specific/nonspecific DAT binding ratio of basal ganglia. Results: Children with ADHD had a significantly greater specificinonspecific DAT binding ratio of the basal ganglia comparing to normal children(Right : z = 2.057, p = 0.041 : Left : z : 2.096, p = 0.032). Under treatment with methylphenidate in all children with ADHD, specificinonspecific DAT binding ratio of both basal ganglia decreased significantly greater than before treatment with methylphenidate (Right : t = 3.239, p = 0.018 ; Left : t = 3.133, p = 0.020). However, no significant correlation between the change of ADHD symptom severity scores and specific/nonspecific DAT binding ratio of the basal ganglia were found. Conclusions: These findings support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.
Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.
Purpose: This study was conducted to identify subjective attitudes towards terminal patients in nursing students who had clinical practice. The types of subjective attitude were classified by applying Q methodology. According to those types, basic reference data for the development of educational programs were provided. Methods: Thirty-four final Q samples were selected, and Q classification with a nine-point scale was performed with P samples of 43 nursing students. A key factor analysis was conducted with the collected data using the PC QUANAL program. Results: Nursing students' attitudes towards terminal patients were grouped into three types. The total variable was 49.96%. Students with Type 1 ("wish for life-sustaining medical treatment") thought that terminal patients accurately understood their medical condition and wanted to prolong their lives. Others with Type 2 ("need for service and support") believed that a multidisciplinary nursing system needs to be established to help terminal patients prepare for death. Students with Type 3 ("awareness and acceptance of death") thought that terminal patients wanted to die with dignity at a hospice unit. Conclusion: This study analyzed various types of attitude towards terminal patients, as perceived by nursing students with clinical training experience. Development of educational programs for each attitude type analyzed in this study could contribute to systematic training programs for nursing students caring for terminal patients.
Um, Mi Hyang;Park, Yoo Kyung;Lee, Song Mi;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Lyu, Eun Soon
Journal of the Korean Dietetic Association
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v.20
no.3
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pp.183-198
/
2014
The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.
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