• Title/Summary/Keyword: 의료비 및 의료비 분석

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Analysis of the Spatial Dose Rates during Dental Panoramic Radiography (치과 파노라마 촬영에서 공간선량률 분석)

  • Ko, Jong-Kyung;Park, Myeong-Hwan;Kim, Yongmin
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.509-516
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    • 2016
  • A dental panoramic radiography which usually uses low level X-rays is subject to the Nuclear Safety Act when it is installed for the purpose of education. This paper measures radiation dose and spatial dose rate by usage and thereby aims to verify the effectiveness of radiation safety equipment and provide basic information for radiation safety of radiation workers and students. After glass dosimeter (GD-352M) is attached to direct exposure area, the teeth, and indirect exposure area, the eye lens and the thyroid, on the dental radiography head phantom, these exposure areas are measured. Then, after dividing the horizontal into a $45^{\circ}$, it is separated into seven directions which all includes 30, 60, 90, 120 cm distance. The paper shows that the spatial dose rate is the highest at 30 cm and declines as the distance increases. At 30 cm, the spatial dose rate around the starting area of rotation is $3,840{\mu}Sv/h$, which is four times higher than the lowest level $778{\mu}Sv/h$. Furthermore, the spatial dose rate was $408{\mu}Sv/h$ on average at the distance of 60 cm where radiation workers can be located. From a conservative point of view, It is possible to avoid needless exposure to radiation for the purpose of education. However, in case that an unintended exposure to radiation happens within a radiation controlled area, it is still necessary to educate radiation safety. But according to the current Medical Service Act, in medical institutions, even if they are not installed, the equipment such as interlock are obliged by the Nuclear Safety Law, considering that the spatial dose rate of the educational dental panoramic radiography room is low. It seems to be excessive regulation.

Effect of the Ayres Sensory Integration Intervention on the Motor Skills and Occupation Participation of Preschool Children with Attention-Deficit/Hyperactivity Disorder (Ayres의 감각통합중재가 학령전기 주의력결핍 과잉행동장애(ADHD) 성향 아동의 운동기능 및 작업참여에 미치는 영향)

  • Jung, Yun-Jin;Kang, Je-wook;Chang, Moon-young;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.22 no.1
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    • pp.1-14
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    • 2024
  • Objective : This study aimed to investigate the impact of Ayres' sensory integration (ASI) intervention on motor skills and occupational participation of preschool children with attention-deficit/hyperactivity disorder (ADHD). Method : Children with ADHD aged between 4 and 6 years who met the inclusion and exclusion criteria were randomly recruited through screening tests. The subjects were divided into an experimental group (10 subjects) and a control group (8 subjects). The instruments used were the Bruininks-Oseretsky test of motor proficiency-2 (BOT-2), Pediatric Evaluation of Disability Inventory (PEDI), and Goal Attainment Scale (GAS) to evaluate occupational participation. The subjects in the experimental group underwent individual sensory integration therapy according to the ASI principles for 40 minutes twice a week in a total of 16 sessions over eight weeks. The control group did not receive the ASI intervention. Data analysis was performed using the Mann-Whitney U test, chi-squared test, Wilcoxon signed-rank test, and Cohen's d test in SPSS 20.0. Results : The ASI experimental group had significantly higher scores in total motor composite, manual coordination, body coordination, strength, and agility in motor function than the control group (p<.05). The two groups did not differ significantly in terms of occupational participation (PEDI), but GAS scores for individual target activities were significantly higher in the experimental group than in the control group (p<.05). Conclusion : This study shows that the ASI intervention has positive effects on motor skills and occupation participation among preschool children with ADHD.

Reliability and validity study of a life style questionnaire for elderly people (노인 생활습관 설문서의 신뢰도 및 타당도 평가 연구)

  • Park, Byung-Joo;Kim, Dae-Sung;Koo, Hye-Won;Bae, Jong-Myon
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.1 s.60
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    • pp.49-58
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    • 1998
  • The study was done to determine the reliability and validity of a life style questionnaire for the elderly. The questionnaires were sent to 16,524 elderly people who were beneficiaries of Korean Medical Insurance Corporation in Pusan. Among the completed 9,139 questionnaires, 200 were randomly sampled and retested. finally, 110 duplicates were collected. Weighted kappa-value and Pearson correlation coefficients were estimated to measure the reliability. Validity coefficient was estimated by using reliability coefficient. In self-self responses, reliability coefficients of the most of items were over 0.6 except some physical activity related item. Relatively high reliability was observed in smoking, alcohol related items and anthropometric items. In self-proxy responses, most of the physical activity related items were found to be less reliable than self-self responses. Smoking and alcohol related items were consistently reliable. Male showed higher validity in food related item than female. On the other hand, some of the physical activity related items and smoking and alcohol related items were less valid in male than female. With regard to bias of proxy respondents, offsprings tended to underestimate the frequency of house cleaning' and 'kitchen work' and overestimate the height of them. In conclusion, the life style questionnaire was found to be reliable in the most of items. But, some items related with physical activity were found to be somewhat less reliable. Sexual difference on the validity was identified in some items. With regard to bias of proxy respondents, offsprings tended to have bias in part of items of housework and anthropometry.

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A Study on Bismuth tri-iodide for X-ray direct and digital imagers (직접방식 엑스선 검출기를 위한 $BiI_3$ 특성 연구)

  • Lee, S.H.;Kim, Y.S.;Kim, Y.B.;Jung, S.H.;Park, J.K.;Jung, W.B.;Jang, M.Y.;Mun, C.W.;Nam, S.H.
    • Journal of the Korean Society of Radiology
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    • v.3 no.2
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    • pp.27-31
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    • 2009
  • Now a days, the Medical X-ray equipments has become digitalized from analog type such as film, cassette to CR, DR. And many scientists are still researching and developing the Medical X-ray equipment. In this study, we used the Bismuth tri-iodide to conversion material for digital X-ray equipments and we couldn't get the satisfying result than previous study, but it opened new possibility to cover the disadvantage of a-Se is high voltage aplly and difficultness of make. In this paper, we use $BiI_3$ powder(99.99%) as x-ray conversion material and make films that have thickness of 200um and the film size is $3cm{\times}3cm$. Also, we deposited an ITO(Indium Tin Oxide) electrode as top electrode and bottom electrode using a Magnetron Sputtering System. To evaluate a characteristics of the produced films, an electrical and structural properties are performed. Through a SEM analysis, we confirmed a surface and component part. And to analyze the electrical properties, darkcurrent, sensitivity and SNR(Signal to Noise Ratio) are measured. Darkcurrent is $1.6nA/cm^2$ and sensitivity is $0.629nC/cm^2$ and this study shows that the electrical properties of x-ray conversion material that made by screen printing method are similar to PVD method or better than that. This results suggest that $BiI_3$ is suitable for a replacement of a-Se because of the reduced manufacture processing and improved yield.

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The Clinical Significance of Soluble Intercellular Adhesion Molecule-1 sICAM-1) and Soluble Vascular Cell Adhesion Molecule-1(sVCAM-1) in Kawasaki Disease (급성 발열기 및 아급성기 가와사끼병에서 세포부착분자 sICAM-1, sVCAM-1의 임상적 의의)

  • Rhee, Kang Won;Yun, Sin Weon;Lee, Dong Keun;Choi, Eung Sang;Yoo, Byeong Hoon;Lee, Mi Kyung
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.640-648
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    • 2005
  • Purpose : Kawasaki disease(KD) is known as an acute multi-systemic vasculitis with various immunologic abnormalities. Adhesion of leukocyte to endothelial cells is a key event in the sequence of inflammatory response. This study was performed to investigate the clinical significance of serum soluble intercellular adhesion molecule-1(sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in acute and subacute stages of typical KD for diagnostic and prognostic value. Methods : A typical KD group was 32 patients who were hospitalized from Jan. 2002 to Jun. 2004 was enrolled. Control was 16 non-KD patients with febrile illness. sICAM-1 and sVCAM-1 were measured and compared by Echocardiographic and clinical findings and cardiac troponin T and I. Results : sICAM-1 and sVCAM-1 levels of acute KD were significantly elevated over control(P=0.019 vs. P=0.049, respectively) and sICAM-1 was significantly decreased in subacute stage(P=0.0015). sICAM-1 and sVCAM-1 had positive correlation with each other in both stages(P=0.0067, P=0.015, retrospectively). Neither sICAM-1 nor sVCAM-1 correctly reflected the coronary abnormalities and responsiveness to intravenous gammaglobulin(IVGG) in both stages. But sVCAM-1 was significantly increased in the carditis group in both stages(P=0.025, P=0.014, retrospectively) and had a positive correlation with troponin T(r=0.63, P=0.00063). Conclusion : The levels of sICAM-1 and sVCAM-1 were not very useful tools for detecting and predicting subsequent coronary abnormalities and responsiveness to IVGG in KD patients. However, sVCAM-1 appears to play a significant role in carditis of KD. Further studies are needed about various adhesion molecules and cytokines in the pathogenesis of KD.

A Cohort Study on Risk Factors for Chronic Liver Disease: Analytic Strategies Excluding Potentially Incident Subjects (만성간질환 위험요인에 대한 코호트연구: 잠재적 발병자 집단을 감안한 분석전략)

  • Kim, Dae-Sung;Kim, Dong-Hyun;Bae, Jong-Myun;Shin, Myung-Hee;Ahn, Yoon-Ok;Lee, Moo-Song
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.452-458
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    • 1999
  • Objectives: The authors conducted the study to evaluate bias when potentially diseased subjects were included in cohort members while analyzing risk factors of chronic liver diseases. Methods: Total of 14,529 subjects were followed up for the incidence of liver diseases from January 1993 to June 1997. We have used databases of insurance company with medical records, cancer registry, and death certificate data to identify 102 incident cases. The cohort members were classified into potentially diseased group(n=2,217) when they were HBsAg positive, serum GPT levels higher than 40 units, or had or has liver diseases in baseline surveys. Cox's model were used for potentially diseased group, other members, and total subjects, respectively. Results: The risk factors profiles were similar for total and potentially diseased subjects: HBsAg positivity, history of acute liver disease, and recent quittance of smoking or drinking increased the risk. while intake of pork and coffee decreased it. For the potentially diseased, obesity showed marginally significant protective effect. Analysis of subjects excluding the potentially diseased showed distinct profiles: obesity increased the risk, while quitting smoking or drinking had no association. For these intake of raw liver or processed fish or soybean paste stew increased risk; HBsAg positivity, higher levels of liver enzymes and history of acute liver diseases increased the risk. Conclusions: The results suggested the potential bias in risk ratio estimates when potentially diseased subjects were included in cohort study on chronic liver diseases, especially for lifestyles possibly modified after disease onset. The analytic strategy excluding potentially diseased subjects was considered appropriate for identifying risk factors for chronic liver diseases.

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Quality Characteristics of Bread with Dried Persimmons Hot-Water Extracts (곶감 열수추출물을 첨가한 식빵의 품질특성)

  • 문혜경;한진희;김준한;김귀영;강우원;김종국
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.4
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    • pp.723-729
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    • 2004
  • To develop foods using dried persimmon, hot-water extracts of dried persimmons were added into strong wheat flour in the ratio of 10, 20, 30, and 40% and the quality characteristics of baked products were investigated. The proximate compositions of dried persimmons hot-water extracts were 70.37% of moisture, 1.72% of crude protein, 0.18% of crude lipids, 1.99% of crude ash and 4.37% of crude fiber, respectively. With increasing the addition of dried persimmons hot-water extracts, moisture content of the added breads was increased to 47.20% from 41.12% of non-added bread and water activity to 0.576 from 0.495. Water binding capacity of the added dried persimmons hot-water extracts rasied weight of the bread but decreased specific volume. In the hunter's color values the more dried persimmons hot-water extracts was added, the lower L vaules we, and the higher a and b values we. In the texture property, the addition of dried persimmons hot-water extracts increased hardness, gumminess and chewiness, while decreased adhesiveness and fracturability. Judging from texture, taste and overall acceptability of the product, recommended substitution level for hot-water extracts of dried persimmons in bread was 30% or less.

A Study on Demand and the Supply for Home-based Cancer Patient Management Projects of Public Health Centers (보건소 재기 암환자 관리사업에 대한 환자의 요구도 및 제공정도)

  • Cho, Hyun;Son, Joo-Young;Heo, Jeom-Do;Jin, Eun-Hee
    • Journal of Hospice and Palliative Care
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    • v.10 no.4
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    • pp.195-201
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    • 2007
  • Purpose: As a part of the analysis of home-based cancer patients management of public health renters in cities, counties and districts across the nation, this study is to understand the degree of patient demands for that management and the degree and scope of the supply for the patient's demand. Methods: Developed the questionnaire which was constituted of degree of demand and supply for home-based cancer patient management and analyzed data centering on the frequencies and percentages by utilizing SPSS WIN 12.0. Results: The services provided through the home-based cancer patients management project include physical, emotional, spiritual and education/informative services. A survey was conducted for home-based cancer patients about these services, and its result showed that the degree of demand and supply was highest for emotional service, followed by education/informative service, spiritual service and physical service in the order of the demand-supply degree. When main items for each service were examined, it was found that: in the case of physical service, pain control was provided murk lower than its demand, while excretion disorder control and individual hygiene is provided murk more than its demand. In the case of emotional service, the degree of demand was overall higher than that of supply; spiritual service was provided appropriately to the degree of demand. Conclusion: This study examines the home-based canter patients management project of public health centers and compares and analyzes the degree of demand for patient services and the degree of services that are actually provided. The findings could be used as based data for the development of effective programs in future on the basis of actual demands of home-based cancer patients.

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Symptom Experience in Terminal Cancer Patients during the Last 48 Hours of Life (말기 암환자의 임종 전 48시간 동안의 임상증상)

  • Sim, Yun-Su;Kim, Do-Yeun;Nam, Eun-Mi;Lee, Soon-Nam
    • Journal of Hospice and Palliative Care
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    • v.10 no.4
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    • pp.190-194
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    • 2007
  • Purpose: Individual cancer patients often experience many symptoms that impair their quality of life at the end of life. Identifying symptoms at the terminal stage of cancer patients and possible imminent death prediction by using that assessment can assist physicians and patients in preparing the 'peaceful death'. This study examines symptom experience during the last 48 hours of life of terminal cancer patients, and determines whether symptom experience change with proximal to death. Methods: The medical records of 89 patients who died with terminal cancer at a hospital between July 1, 2003 and March 31, 2006 were reviewed. Symptom prevalence at the last 48 hours was analyzed along with the change of symptom experience at the admission, $48{\sim}24$ hours, and $24{\sim}0$ hours before death. Results: Median age of all patients was 62 years old (range $16{\sim}97$). During the last 48 hours, symptom prevalence was described as follows; unclear consciousness (57%), pain (30%), fever (22%), and dyspnea (19%). According to the primary site, unclear consciousness was notified the most frequent symptom, but fever was relatively high prevalence in patients of biliary origin cancer rather than other site cancer (P=0.012). As death was Impending, the prevalence of poor appetite and general weakness were decreased, while that of unclear consciousness was increased, which were all statistically significant (P < 0.05). Conclusion: The presence of unclear consciousness could be regarded as the symptom indicator as imminent death of terminal canter patients.

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Multimodal Brain Image Registration based on Surface Distance and Surface Curvature Optimization (표면거리 및 표면곡률 최적화 기반 다중모달리티 뇌영상 정합)

  • Park Ji-Young;Choi Yoo-Joo;Kim Min-Jeong;Tae Woo-Suk;Hong Seung-Bong;Kim Myoung-Hee
    • The KIPS Transactions:PartA
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    • v.11A no.5
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    • pp.391-400
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    • 2004
  • Within multimodal medical image registration techniques, which correlate different images and Provide integrated information, surface registration methods generally minimize the surface distance between two modalities. However, the features of two modalities acquired from one subject are similar. So, it can improve the accuracy of registration result to match two images based on optimization of both surface distance and shape feature. This research proposes a registration method which optimizes surface distance and surface curvature of two brain modalities. The registration process has two steps. First, surface information is extracted from the reference images and the test images. Next, the optimization process is performed. In the former step, the surface boundaries of regions of interest are extracted from the two modalities. And for the boundary of reference volume image, distance map and curvature map are generated. In the optimization step, a transformation minimizing both surface distance and surface curvature difference is determined by a cost function referring to the distance map and curvature map. The applying of the result transformation makes test volume be registered to reference volume. The suggested cost function makes possible a more robust and accurate registration result than that of the cost function using the surface distance only. Also, this research provides an efficient means for image analysis through volume visualization of the registration result.