Background : Theoretically as the waiting-time of patient is estimated in queueing, many men and much money are needed. But being the estimation of patient s waiting-time very important in hospital service, so the continuous monitoring of waiting-time is inevitable. To verify that the estimation of waiting-time using parking time is economical, effective and continuous monitoring method and to develop utilizing the method, this study was done. Method : In parking confirmation office, the personnel of parking office wrote parking confirm time, chart number and whether medical examination and treatment finish or not in parking ticket. The next day the parking tickets were gathered and the above data were input. The input parking data were connected with the hospital outpatient file indexing chart number. Then the patient' s data for department, new patient or not, reservation or not, receipt time and payment time were retrieved. The group for finishing medical treatment were compared with that for not finishing in average time lag between confirmation and out-time for hospital. And In-time for hospital, receipt time, payment and out-time for hospital were also analyzed. Result : Confirming parking ticket, the group for finished medical treatment left hospital after 7 minutes. This result showed that the patient for finished medical treatment left hospital immediately. So parking time was reasonable to estimation of hospital-time was concluded. The time for medical treatment, diagnosis and test was constant for all patients and short for waiting time, Then I concluded that the parking time was reasonable for estimation patient's waiting time. Overall patient's waiting time was 113 minutes and new patient's time was 149 minutes, old patient's times was 109 minutes. Waiting time for reservation patient was 98 minutes and for non reservation patient was 122 minutes. The time from hospital arrival to payment was 50 minutes for the group of reservation patient and 69 minutes for non-reservation group. The time from payment to hospital leaving was 51 minutes and 56 minutes for non reservation group. The short time difference between reserved group and not reserved group from payment to hospital leaving time was due to bottle neck effect. Conclusion : The estimation of patient's waiting time using parking time was reasonable because the possession of car was common and the time for medical treatment was equal and the patient after treatment left hospital immediately. Using this method, timely, fast evaluation and continuous monitoring of the intervention effect were possible.
Purpose: Many companies developed a lot of programs with continuous effort for program upgrading. With this acquire superior image quality for the purpose of quick examination and progress in spatial resolution. This study was to obtained clinical usefulness on a appropriate parameter of FWHM for speed and alpha value for superior image quality. Materials and Methods: Gamma camera by Siemens (e.cam) and spatial resolution phantom and four quadrant bar phantom used. Compared for FWHM by changed scan speed 15, 20, 25, 30, 35, 40 cm/min in scatter and non scatter in Onco Flash of spatial resolution phantom. Visual evaluation of count rate and bar phantom image for increased of alpha value of 10% in 0~100%. Results: FWHM by the scan speed was 9.37, 9.40, 9.28, 9.30, 9.31, 9.53 mm in the scatter. Count rate increased alpha value 10% increased. Visual evaluation was suitable to below 30%, Therefore spatial resolution improved on FWHM at the scan speed 25~35 cm/min applying for alpha value 30% in Onco Flash was average 9.3 mm less than FWHM of below 15 cm/min and above 40 cm/min. Conclusion: We found on appropriate parameter to progress of image quality. And there be a useful guideline for you that appropriate scan speed on vary in parameters of reduction on examination time and advancing image quality.
Journal of the Korea Society of Computer and Information
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v.17
no.12
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pp.241-249
/
2012
The rapid development of the current information and communication brings big changes and progress in the health service delivery system. And it is becoming the worldwide trend increasingly. As the name of medical information, by more rapid, detail and more quickly to the patients and diagnosis of the disease it provides not only a high level of health care services but also hospitals and related institutions are making increase the efficiency of the work. Among them, the Telemedicine, that system has many advantage which can expect the shorten the waiting time and the uniform high level of medical, etc. without visiting medical institutions. Especially, the most advantage is it can increase the accessibility of information about extensive medical, without regard to the time and place. But this is the reality, which compared speed the development of modern science and technology with lack of operational regulations and mindset. Current in our Medical Law, it regulates the Telemedicine, but it has Institutional, facility, and environmental constraints. Because, there is no detailed legal relationship. And it takes that in terms of a special form called by a non-face-to-face contact with medical practice rather than the scene. Therefore, in this paper will find a way out to activate the Telemedicine by presupposes the development potential is infinite and find the legal issues and improvements.
Upper gastrointestinal series is non-invasive examination, and it is useful for patients or elderly patients who have difficulty in endoscopic examination because of absence of any side effects other than temporary constipation or abdominal pain. The entire image of the gastrointestinal tract can be seen and have been widely used in the diagnosis of upper gastrointestinal diseases. However, there is a possibility that radiation dose increases due to improper movement and breath control, when examination is carried out by lack of understanding the overall inspection process for the upper gastrointestinal series. In upper gastrointestinal series to increase understanding of examination, to induce appropriate cooperation during examination, to reduce the number of retakes and shorten examination time, and to reduce dose of the subject, the procedure and precautions of the gastrointestinal test were made as a movie. We investigated the effectiveness of pre-education using the movie to reduce the inspection time, the number of re-shoots, and the reduction of exposure dose by watching the movie during the waiting time before examination. 120 patients that were selected each 20 patients aged from 30s to 80s were evaluated were evaluated for exposure dose, examination time, and the number of retakes before and after the movie training. The radiation dose, the examination time, and the number of retakes were respectively $3171.83{\mu}Gy{\cdot}m^2$ and $2931.73{\mu}Gy{\cdot}m^2$, 8.05 min, and 6.75 min, and 1.68 times and 1.22 times before and after movie training. It can be concluded that the movie training on the gastrointestinal examination influences the reduction of the examination time, the number of retakes and the reduction of the radiation dose.
Han, Jae Hyun;Suh, Seung Wan;Cho, Gyu Chong;Kim, Jung Mi;Seo, Hong Taek;Jung, Yu Jin;Seong, Su Jeong;Hwang, Jae Yeon;Lee, Won Joon
Korean Journal of Psychosomatic Medicine
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v.28
no.2
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pp.161-167
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2020
Objectives : Although the seasonality of suicide is a well-known phenomenon, little is reported about the seasonality of non-suicidal self-injury. The purpose of this study was to identify the seasonality of wristcutting behavior and to examine its relationship with meteorological factors. Methods : To identify the presence of seasonality, we investigated whether there was a difference in the average number of visits per month to an emergency room (ER) of an urban hospital for 226 patients with wrist-cutting behavior enrolled between December 2014 and May 2019. To ascertain significant meteorological factors, we used the multiple Poisson regression using generalized additive model with time, monthly temperature, monthly sunshine hour, and atmospheric pressure in the prior month as explanatory variables. Results : In males, the average number of monthly visits to the ER for wrist cutting behavior differed by month and was the highest in September (male : p=0.048, female : p=0.21, total : p=0.28). As a result of multiple regression analysis, the average number of patients admitted to the ER for wrist cutting behavior was related to the interaction between atmospheric pressure in the prior month and temperature in males (p=0.010), and showed a positive correlation with sunlight in females [p=0.044, β=4.70×10-3, 95% CI=(1.19×10-4, 9.27×10-3)]. Conclusions : Wrist cutting behavior shows seasonality in male, which is associated with changes in meteorological variables.
This study, the value of dental hygiene process and business performance among the dental clinics located in Gyeonggi province by comparing and analyzing the financial and non-financial results specifically in the department that provides and did not provide dental hygiene process (ADPIE). The collected data treated with percentage and t-test in utilization of IBM SPSS Statistics ver. 20.0. In terms of the medical cost per patient, the Department A (DA) that applied the dental hygiene process were 216,664 Korean Won (KRW) in 2013 and 324,810 KRW in 2014 whereas Department B (DB) which did not apply the dental hygiene process resulted in 184,655 KRW in 2013 and 225,698 KRW in 2014 (p<0.01). Regarding the number of daily patients, the DA showed increase of 8.08 (p=0.01) while DB showed increase of 2.42 patients (p>0.05). The medical consent rate was 89.17% in DA and 60.09% in DB in 2013 while showing 89.68% and 66.98% respectively in 2014 (p<0.001). The patients' revisit rate was 87.48% in DA and 44.92% in DB in 2013 and that of the DA and DB was 85.89% and 45.55% respectively in 2014 (p<0.001). The rate of regular check-up was 16.01% in DA and 2.53% in DB in 2013 and the same rate in 2014 showed 19.03% and 6.84% respectively in 2014 (p <0.001). The rate of referred patients was 38.46% and 29.98% respectively in DA and DB in 2013 whereas DA showed 47.59% and DB showed 30.77% in 2014 (p<0.05). According to the results, the medical system with dental hygiene process is verified to be a premium medical program that can improve satisfaction as well as management effectiveness in dental service.
Studies on target motion in 4-dimensional radiotherapy are being world-widely conducted to enhance treatment record and protection of normal organs. Prediction of tumor motion might be very useful and/or essential for especially free-breathing system during radiation delivery such as respiratory gating system and tumor tracking system. Neural network is powerful to express a time series with nonlinearity because its prediction algorithm is not governed by statistic formula but finds a rule of data expression. This study intended to assess applicability of neural network method to predict tumor motion in 4-dimensional radiotherapy. Scaled Conjugate Gradient algorithm was employed as a learning algorithm. Considering reparation data for 10 patients, prediction by the neural network algorithms was compared with the measurement by the real-time position management (RPM) system. The results showed that the neural network algorithm has the excellent accuracy of maximum absolute error smaller than 3 mm, except for the cases in which the maximum amplitude of respiration is over the range of respiration used in the learning process of neural network. It indicates the insufficient learning of the neural network for extrapolation. The problem could be solved by acquiring a full range of respiration before learning procedure. Further works are programmed to verify a feasibility of practical application for 4-dimensional treatment system, including prediction performance according to various system latency and irregular patterns of respiration.
Hee Choon Lee;Jinkyu Hong;Chun-Ho Cho;Byoung-Cheol Choi;Sung-Nam Oh;Joon Kim
Korean Journal of Agricultural and Forest Meteorology
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v.5
no.2
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pp.61-69
/
2003
Surface energy and $CO_2$ fluxes have been measured over a farmland in Haenam, Korea since July 2002. Eddy covariance technique, which is the only direct flux measurement method, was employed to quantitatively understand the interaction between the farmland ecosystem and the atmospheric boundary layer. Maintenance of eddy covariance system was the main concern during the early stage of measurement to minimize gaps and uncertainties in the dataset. Half-hourly averaged $CO_2$ concentration showed distinct diurnal and seasonal variations, which were closely related to changes in net ecosystem exchange (NEE) of $CO_2$. Daytime maximum $CO_2$ uptake was about -1.0 mg $CO_2$ m$^{-2}$ s$^{-1}$ in August whereas nighttime $CO_2$ release was up to 0.3 mg $CO_2$ m$^{-2}$ s$^{-1}$ during the summer. Both daytime $CO_2$ uptake and nighttime release decreased gradually with season. During the winter season, NEE was from near zero to 0.05 mg $CO_2$ m$^{-2}$ s$^{-1}$ . FK site was a moderate sink of atmospheric $CO_2$ until September with daily NEE of 22 g $CO_2$ m$^{-2}$ d$^{-1}$ . In October, it became a weak source of $CO_2$ with an emission rate of 2 g $CO_2$ m$^{-2}$ d$^{-1}$ . Long-term flux measurements will continue at FK site to further investigate inter-annual variability in NEE. to better understand these exchange mechanism and in-depth analysis, process-level field experiments and intensive short-term intercomparisons are also expected to be followed.
Breslau's report on the two stillbirths induced by illuminating gas poisoning made many investigators explore the hazards. of carbon monoxide(CO) poisoning to pregnancy. The pregnant woman, her fetus, and the newborn infant have been identified to be particularly vulnerable to CO even in low concentration. Several factors, such as placental barrier, membrane resistance of maternal and fetal red blood cells etc., were considered to be related to the delayed elimination of CO from fetus. Slower elimination of CO from fetus than from mother was confirmed in several in vivo studies. But there are few studies which have confirmed the difference of carboxyhemoglobin (HbCO) dissociation in adult and fetal bloods. Author investigated the effects of hemoglobin itself on the elimination of CO from mother and fetus. By observing the difference of CO dissociation from adult and fetal hemoglobin at the various partial pressures of oxygen, the author tries to suggest the base of the proper treatment measure for the CO poisoning of pregnant woman and newborn infant. The results were as follows: 1. The total hemoglobin amounts of adults and fetal bloods were $16.1{\pm}0.50gm%\;and\;15.7{\pm}0.32gm%$, respectively. The fetal hemoglobin proportions in adult and fetal bloods were $1.2{\pm}0.15%\;and\;72.7{\pm}3.01%$, respectively. 2. Adult and fetal bloods saturated by CO to 100% HbCO were exposed to ambient air$(21%\;O_2),\;100%\;O_2\;and\;3\;ATAO_2$. After 30 minutes exposure, the HbCO saturations of adult blood were 96.7%, 70.9%, and 52.8%, respectively, and those of fetal blood were 98.5%, 76.1%, and 62.2%, respectively. HbCO dissociation was proportional to the partial pressure of oxygen and the most marked dissociation was shown under 3 ATA $O_2$, HbCO dissociation of fetal blood was slower than that of adult blood in all conditions. According to the above results, it is possible that CO poisoning make more serious damage to the fetus and newborn infant than to the adult due to the delayed dissociation of HbCO. Thus in the treatment of CO poisoning of pregnant woman and newborn infant, hyperbaric oxygen therapy seems to be the most eflective treatment measure, but the duration of hyperbaric oxygenation should be lengthened accordingly.
Background: Making the histologic diagnosis of small pulmonary nodules and ground glass opacity (GGO) lesions is difficult. CT-guided percutaneous needle biopsies often fail to provide enough specimen for making the diagnosis. Video-assisted thoracoscopic surgery (VATS) can be inefficient for treating non-palpable lesions. Preoperative localization of small intrapulmonary lesions provides a more obvious target to facilitate performing intraoperative. resection. We evaluated the efficacy of CT-guided localization with using a hook wire and this was followed by VATS for making the histologic diagnosis of small intrapulmonary nodules and GGO lesions. Material and Method: Eighteen patients (13 males) were included in this study from August 2005 to March 2008. 18 intrapulmonary lesions underwent preoperative localization by using a CT-guided a hook wire system prior to performing VATS resection for intrapulmonary lesions and GGO lesions. The clinical data such as the accuracy of localization, the rate of conversion-to-thoracotomy, the operation time, the postoperative complications and the histology of the pulmonary lesion were retrospectively collected. Result: Eighteen VATS resections were performed in 18 patients. Preoperative CT-guided localization with a hook-wire was successful in all the patients. Dislodgement of a hook wire was observed in one case. There was no conversion to thoracotomy, The median diameter of lesions was 8 mm (range: $3{\sim}15\;mm$). The median depth of the lesions from the pleural surfaces was 5.5 mm (range: $1{\sim}30\;mm$). The median interval between preoperative CT-guided with a hook-wire and VATS was 34.5 min (range: ($10{\sim}226$ min). The median operative time was 43.5.min (range: $26{\sim}83$ min). In two patients, clinically insignificant pneumothorax developed after CT-guided localization with a hook-wire and there were no other complications. Histological examinations confirmed 8 primary lung cancers, 3 cases of metastases, 3 cases of inflammation, 2 intrapulmonary lymph nodes and 2 other benign lesions. Conclusion: CT-guided localization with a hook-wire followed by VATS for treating small intrapulmonary nodules and GGO lesions provided a low conversion thoracotomy rate, a short operation time and few localization-related or postoperative complications. This procedure was efficient to confirm intrapulmonary lesions and GGO lesions.
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