• Title/Summary/Keyword: 환자대기시간

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Clinical Validation of Nebulized Budesonide and Effect of Nebulized Budesonide on the Hypothalamic-Pituitary-Adrenal Axis in Adult Patients Admitted with Acute Asthmatic Attack (급성 발작으로 내원한 성인 천식 환자에서 Nebulized Budesonide의 임상적인 효과와 시상하부-뇌하수체-부신 축에 대한 작용)

  • Seo, Ki-Hyun;Moon, Seung-Hyug;Kim, Yong-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.529-538
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    • 2002
  • Background : Many clinicians are reluctant to prescribe systemic corticosteroids to manage an asthmatic attack because of many complications such as osteoporosis, cushing's syndrome, diabetes, hypertension and bleeding tendency. The use of nebulized budesonide may be of value in some infants, old men, and in particular adult asthmatic patients who complain of severe dyspnea. A clinical validation and steroid-sparing effect of nebulized budesonide in asthmatic adults and COPD were evaluated, and the short-term effects of budesonide use on the HPA axis were assessed. Materials and Methods : Study A was prospectively done with 41 patients diagnosed with pure asthma and 30 patients diagnosed with COPD (including asthmatic component) in Soonchunhyang Hospital, Chunan from June. 2000 to Sep. 2001. They were treated with nebulized budesonide including systemic steroids (Group 1), a budesonide tubuhaler including a systemic steroid (Group 2), or only the systemic steroid(Group 3). The peak flow rate, arterial blood gas in room air, pulmonary function test, symptom scoring, steroid amount and hospital stay were analyzed. Study B was conducted with 19 patients to evaluate the short-term effects on the HPA axis of treatment with nebulized budesonide 1mg twice daily and a budesonide turbuhaler 5 puffs twice daily. The adrenal function was assessed prior to budesonide inhalation and after 7 days of budesonide inhalation. Results : In the pure asthmatic patients, the mean value of the symptoms (dyspnea, wheezing, cough, night asthma) or the arterial BGAs, total amounts of steroid or hospital stay and the difference in the results of the pulmonary function tests or peak expiratory flow rate were similar in the three groups. In COPD with an asthmatic component, there were no significant differences among the three groups. Although nebulized budesonide suppressed HPA function,(p=0.006) the HPA responses from the nebulized budesonide and turbuhaler budesonide were similar (p=0.288) Conclusion : This result suggests that systemic steroid should only be made available for acute asthmatic patients irrespective of the inhaled budesonides. Nebulized budesonide at the therapeutic dose has similar effects on the HPA axis compared to that of turbuhaler budesonide.

Evaluation of Proper Image Acquisition Time by Change of Infusion dose in PET/CT (PET/CT 검사에서 주입선량의 변화에 따른 적정한 영상획득시간의 평가)

  • Kim, Chang Hyeon;Lee, Hyun Kuk;Song, Chi Ok;Lee, Gi Heun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.22-27
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    • 2014
  • Purpose There is the recent PET/CT scan in tendency that use low dose to reduce patient's exposure along with development of equipments. We diminished $^{18}F$-FDG dose of patient to reduce patient's exposure after setting up GE Discovery 690 PET/CT scanner (GE Healthcare, Milwaukee, USA) establishment at this hospital in 2011. Accordingly, We evaluate acquisition time per proper bed by change of infusion dose to maintain quality of image of PET/CT scanner. Materials and Methods We inserted Air, Teflon, hot cylinder in NEMA NU2-1994 phantom and maintained radioactivity concentration based on the ratio 4:1 of hot cylinder and back ground activity and increased hot cylinder's concentration to 3, 4.3, 5.5, 6.7 MBq/kg, after acquisition image as increase acquisition time per bed to 30 seconds, 1 minute, 1 minute 30 seconds, 2 minute, 2 minutes 30 seconds, 3 minutes, 3 minutes 30 seconds, 4 minutes, 4 minutes 30 seconds, 5 minutes, 5 minutes 30 seconds, 10 minutes, 20 minutes, and 30 minutes, ROI was set up on hot cylinder and back radioactivity region. We computated standard deviation of Signal to Noise Ratio (SNR) and BKG (Background), compared with hot cylinder's concentration and change by acquisition time per bed, after measured Standard Uptake Value maximum ($SUV_{max}$). Also, we compared each standard deviation of $SUV_{max}$, SNR, BKG following in change of inspection waiting time (15minutes and 1 hour) by using 4.3 MBq phantom. Results The radioactive concentration per unit mass was increased to 3, 4.3, 5.5, 6.7 MBqs. And when we increased time/bed of each concentration from 1 minute 30 seconds to 30 minutes, we found that the $SUV_{max}$ of hot cylinder acquisition time per bed changed seriously according to each radioactive concentration in up to 18.3 to at least 7.3 from 30 seconds to 2 minutes. On the other side, that displayed changelessly at least 5.6 in up to 8 from 2 minutes 30 seconds to 30 minutes. SNR by radioactive change per unit mass was fixed to up to 0.49 in at least 0.41 in 3 MBqs and accroding as acquisition time per bed increased, rose to up to 0.59, 0.54 in each at least 0.23, 0.39 in 4.3 MBqs and in 5.5 MBqs. It was high to up to 0.59 from 30 seconds in radioactivity concentration 6.7 MBqs, but kept fixed from 0.43 to 0.53. Standard deviation of BKG (Background) was low from 0.38 to 0.06 in 3 MBqs and from 2 minutes 30 seconds after, low from 0.38 to 0 in 4.3 MBqs and 5.5 MBqs from 1 minute 30 seconds after, low from 0.33 to 0.05 in 6.7 MBqs at all section from 30 seconds to 30 minutes. In result that was changed the inspection waiting time to 15 minutes and 1 hour by 4.3 MBq phantoms, $SUV_{max}$ represented each other fixed values from 2 minutes 30 seconds of acquisition time per bed and SNR shown similar values from 1 minute 30 seconds. Conclusion As shown in the above, when we increased radioactive concentration per unit mass by 3, 4.3, 5.5, 6.7 MBqs, the values of $SUV_{max}$ and SNR was kept changelessly each other more than 2 minutes 30 seconds of acquisition time per bed. In the same way, in the change of inspection waiting time (15 minutes and 1 hour), we could find that the values of $SUV_{max}$ and SNR was kept changelessly each other more than 2 minutes 30 seconds of acquisition time per bed. In the result of this NEMA NU2-1994 phantom experiment, we found that the minimum acquisition time per bed was 2 minutes 30 seconds for evaluating values of fixed $SUV_{max}$ and SNR even in change of inserting radioactive concentration. However, this acquisition time can be different according to features and qualities of equipment.

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Chemical Compositions of the Highway Side Fogwater in Shingal, Kyunggi-Province (경기도 신갈지역 고속도로변 안개의 화학적 조성)

  • 김홍률;주영특;정동준
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.5 no.1
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    • pp.11-17
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    • 2003
  • pH value of sampled fogwater at source regions (above highway and road) in Yongin sites showed the lowest value and was increased after passing the forest stands. Changes of ion concentrations through the forest stands showed a lowering tendency at sampling sites. The fogwater passing the forest stands (Quercus mangolica and Pinus rigida) surrendered acid pollutants to crown and stem from the atmosphere. It was concluded that environmental moisture in the atmosphere is acidified in fogwater. The influence was extended to the pure zone, and the frequency of acid rain has increased. The forests are assumed to remove air pollutants because ion concentrations in fogwater decreased after passing the forests. The fogwater which functions as a local sink for pollutants (H$_2$SO$_4$, HNO$_3$, etc.) falling on plant surfaces is considered to effectively remove acid pollutants. But if the deposition of pollutants exceeds the capacity of purification, it would damage the forest ecosystem. Further investigation is necessary to identify tree species tolerant to acid pollutants.

Development of Information Architecture for User-centered Hospital Kiosk (사용자 중심의 병원용 키오스크 정보구조 제안)

  • Park, Min-Hee;Song, Dae-Sik;Kim, Hyun-Jeong
    • The Journal of the Korea Contents Association
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    • v.11 no.7
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    • pp.248-258
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    • 2011
  • Hospital Kiosk is a useful means to decrease human resources and to extend service hour to non-working hour for the stance of hospital and to obtain useful services without time loss in waiting in lines for the stance of user. However, various kinds of information kiosks are respectively installed with independent functions, and they have bad usability due to complexity in manipulate and unclear information architecture. In this paper, we tried to analyze usability and respective functions of each kiosk and aimed to suggest alternative information architecture for the integrated hospital kiosk. We categorized users as patient, guardian and visitor and we conducted usability test and in-depth interview with each group of users. based on result analysis from the research, we could suggest proper information architecture for the integrated user centered hospital kiosk. The new information architecture for the integrated hospital kiosk has better accessibility to the menus which reflects users's preemptive needs and it includes more specific information that can support user tasks.

Development of Client/Server Puretone Audiometer supporting Video Chat (영상대화 지원 클라이언트/서버 순음청력검사 시스템 개발)

  • Song, Bok-Deuk;Kang, Deok-Hun;Shin, Bum-Joo;Kim, Jin-Dong;Wang, Soo-Geun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.3
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    • pp.1401-1407
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    • 2011
  • Abstract In this paper, we describe client/server puretone audiometer supporting video chat. Our system makes it possible for one audiometrist to concurrently assess multiple subjects. An audiometrist in remote place can monitor assessment procedure through video and/or result of each assessment step. This system also provides a video chat facility to lead audiometrist without a hitch whenever there occurs any problem during assessment. The one-to-many model of this system makes subjects to reduce not only expense but also waiting time.

A Development of Home Nursing Service System based Service Oriented Architecture (SOA) (SOA 기반의 가정간호서비스 시스템 개발)

  • Hong, Hae-Sook;Park, Chun-Bok;Kim, Hwa-Sun;Cho, Hun
    • Journal of Korea Multimedia Society
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    • v.12 no.11
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    • pp.1680-1691
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    • 2009
  • To improve the quality of healthcare and build up the health delivery system, electronic health record system is important for healthcare institutions providing health services. However, the systems currently operated in domestic healthcare institutions use independent software interface with distributed environment for data search and process. Therefore, it raises an additional expense to buy or develop each interface module when there is a link to new system and the problem of complexity. To solve these problems, this study implemented the service oriented architecture basis for home nursing service and carried out an assessment. The study defined the process modeling and business requirements based on the scenario of service and drew 17 suitable services based on five verification items for service design. To draw the final service, seven services were selected by service litmus test (SLT). The study found that, by the improvement of business process for healthcare service support department, SOA based information system has an effect of time reduction of patient processing time. In conclusion, to enable the hospital information system to cope with various demands of healthcare consumers, it is necessary to consider the application of SOA technology which has excellent interoperability, reusability and maintenance.

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The Study on Health Care Consumer's Medical Information Serching Behavior according to Chronic Disease (의료소비자의 만성질환 유무에 따른 의료정보 탐색 행태에 관한 연구)

  • Jung, Tae-Young;Han, Jae-Hoon
    • Journal of Convergence for Information Technology
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    • v.12 no.4
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    • pp.212-218
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    • 2022
  • This study aims to understand health care consumer's information searching behavior according to their presence of chronic diseases. For this purpose, 240 patients' data of university hospital located in Seoul were collected by surveys from 9 February to 11 February 2016. For statistical analysis, we used SPSS Ver. 26.0. The main results of this study are as follows: First, Chi-square test showed that chronic patients used expert information sources and experiential information sources more than those without chronic diseases. Second, chronic patients were found to search nutrition management, exercise management, and patient case. Lastly, in the case of hospital-related searches, patients with chronic diseases searched more waiting time and medical expenses than those without chronic diseases. The significance of this study is to provide basic data for efficient information provision and establishment of marketing strategies reflecting information needs of health care consumers.

Decreased Attention in Narcolepsy Patients is not Related with Excessive Daytime Sleepiness (기면병 환자의 주의집중 저하와 주간졸음증 간의 상관관계 부재)

  • Kim, Seog-Ju;Lyoo, In-Kyoon;Lee, Yu-Jin;Lee, Ju-Young;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.2
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    • pp.122-132
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    • 2005
  • Objectives: The objective of this study is to assess cognitive functions and their relationship with sleep symptoms in young narcoleptic patients. Methods: Eighteen young narcolepsy patients and 18 normal controls (age: 17-35 years old) were recruited. All narcolepsy patients had HLA $DQB_1$ *0602 allele and cataplexy. Several important areas of cognition were assessed by a battery of neuropsychological tests consisting of 13 tests: executive functions (e.g. cognitive set shifting, inhibition, and selective attention) through Wisconsin card sorting test, Trail Making A/B, Stroop test, Ruff test, Digit Symbol, Controlled Oral Word Association and Boston Naming Test; alertness and sustained attention through paced auditory serial addition test; verbal/nonverbal short-term memory and working memory through Digit Span and Spatial Span; visuospatial memory through Rey-Osterrieth complex figure test; verbal learning and memory through California verbal learning test; and fine motor activity through grooved pegboard test. Sleep symptoms in narcolepsy patients were assessed with Epworth sleepiness scale, Ullanlinna narcolepsy scale, multiple sleep latency test, and nocturnal polysomnography. Relationship between cognitive functions and sleep symptoms in narcolepsy patients was also explored. Results: Compared with normal controls, narcolepsy patients showed poor performance in paced auditory serial addition (2.0 s and 2.4 s), digit symbol tests, and spatial span (forward)(t=3.86, p<0.01; t=-2.47, p=0.02; t=-3.95, p<0.01; t=-2.22, p=0.03, respectively). There were no significant between-group differences in other neuropsychological tests. In addition, results of neuropsychological test in narcolepsy patients were not correlated with Epworth sleepiness scale score, Ullanlinna narcolepsy scale score and sleep variables in multiple sleep latency test or nocturnal polysomnography. Conclusion: The current findings suggest that young narcolepsy patients have impaired attention. In addition, impairment of attention in narcolepsy might not be solely due to sleep symptoms such as excessive daytime sleepiness.

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Ultrasound-Guided Axillary Brachial Plexus Block, Performed by Orthopedic Surgeons (정형외과 의사가 시행한 초음파 유도 액와 상완 신경총 차단술)

  • Kim, Cheol-U;Lee, Chul-Hyung;Yoon, Ja-Yeong;Rhee, Seung-Koo
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.513-521
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    • 2018
  • Purpose: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. Materials and Methods: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. Results: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5-13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5-40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141-540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. Conclusion: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.

A Modified Protocol for Myocardial Perfusion SPECT Using Natural Plant Extracts for Enhancement of Biliorg Excretion (담즙분비촉진 식물추출물을 이용한 심근관류영상 검사법 개선)

  • Jeong, Hwan-Jeong;Kim, Chang-Guhn
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.6
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    • pp.364-373
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    • 2003
  • Purpose: For good quality of myocardial perfusion images, an approximately 30 min to 1 hour of waiting time after radiopharmaceutical injection and ingestion of fatty meal are asked of the patients. The aim of this study was to investigate the shortening of waiting time after radiopharmaceutical injection and improvement of image quality using natural plant extracts that promote bile excretion. Materials and Methods: Ten volunteers participated in protocol 1 (7 men, 3 women; mean age, $24.1{\pm}2.4$ years) and protocol 2 (8 men, 2 women; mean age, $26.1{\pm}2.9$ years), respectively. For the modified method of both protocols, subjects took natural plant extracts 15 minutes before the first injection of $^{99m}Tc$ MIBI without laking fatty meals. Control (Conventional) methods were peformed with intake of a fatty meal 20 to 30 minutes after $^{99m}Tc$ MIBI injection. Results: As the results of protocol 1 and 2, the ratio of myocardial to lung ratio were not different between modified and conventional method. Liver to lung ratio of modified method showed significantly lower value than that of conventional method. In modified method, myocardial to liver ratio was higher persistently. In protocol 2, natural plant extracts took before the first injection of $^{99m}Tc$ MIBI exerted accelerating effect of excretion of bile juice into Intestine until the end of examination. Conclusion: These results represent that natural plant extracts for facilitation of bile excretion before injection of $^{99m}Tc$ MIBI may provide better quality of myocardial perfusion images without the need for preparations such as ingestion of fatty meal within the 2 hours compared with conventional method.