• Title/Summary/Keyword: Alternative test method

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A Computed Tomography-Based Anatomic Comparison of Three Different Types of C7 Posterior Fixation Techniques : Pedicle, Intralaminar, and Lateral Mass Screws

  • Jang, Woo-Young;Kim, Il-Sup;Lee, Ho-Jin;Sung, Jae-Hoon;Lee, Sang-Won;Hong, Jae-Taek
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.166-172
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    • 2011
  • Objective : The intralaminar screw (ILS) fixation technique offers an alternative to pedicle screw (PS) and lateral mass screw (LMS) fixation in the C7 spine. Although cadaveric studies have described the anatomy of the pedicles, laminae, and lateral masses at C7, 3-dimensional computed tomography (CT) imaging is the modality of choice for pre-surgical planning. In this study, the goal was to determine the anatomical parameter and optimal screw trajectory for ILS placement at C7, and to compare this information to PS and LMS placement in the C7 spine as determined by CT evaluation. Methods : A total of 120 patients (60 men and 60 women) with an average age of $51.7{\pm}13.6$ years were selected by retrospective review of a trauma registry database over a 2-year period. Patients were included in the study if they were older than 15 years of age, had standardized axial bone-window CT imaging at C7, and had no evidence of spinal trauma. For each lamina and pedicle, width (outer cortical and inner cancellous), maximal screw length, and optimal screw trajectory were measured, and the maximal screw length of the lateral mass were measured using m-view 5.4 software. Statistical analysis was performed using Student's t-test. Results : At C7, the maximal PS length was significantly greater than the ILS and LMS length (PS, $33.9{\pm}3.1$ mm; ILS, $30.8{\pm}3.1$ mm; LMS, $10.6{\pm}1.3$; p<0.01). When the outer cortical and inner cancellous width was compared between the pedicle and lamina, the mean pedicle outer cortical width at C7 was wider than the lamina by an average of 0.6 mm (pedicle, $6.8{\pm}1.2$ mm; lamina, $6.2{\pm}1.2$ mm; p<0.01). At C7, 95.8% of the laminae measured accepted a 4.0-mm screw with a 1.0 mm of clearance, compared with 99.2% of pedicle. Of the laminae measured, 99.2% accepted a 3.5-mm screw with a 1.0 mm clearance, compared with 100% of the pedicle. When the outer cortical and inner cancellous height was compared between pedicle and lamina, the mean lamina outer cortical height at C7 was wider than the pedicle by an average of 9.9 mm (lamina, $18.6{\pm}2.0$ mm; pedicle, $8.7{\pm}1.3$ mm; p<0.01). The ideal screw trajectory at C7 was also measured ($47.8{\pm}4.8^{\circ}$ for ILS and $35.1{\pm}8.1^{\circ}$ for PS). Conclusion : Although pedicle screw fixation is the most ideal instrumentation method for C7 fixation with respect to length and cortical diameter, anatomical aspect of C7 lamina is affordable to place screw. Therefore, the C7 intralaminar screw could be an alternative fixation technique with few anatomic limitations in the cases when C7 pedicle screw fixation is not favorable. However, anatomical variations in the length and width must be considered when placing an intralaminar or pedicle screw at C7.

Recent Progress in Air-Conditioning and Refrigeration Research : A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2013 (설비공학 분야의 최근 연구 동향 : 2013년 학회지 논문에 대한 종합적 고찰)

  • Lee, Dae-Young;Kim, Sa Ryang;Kim, Hyun-Jung;Kim, Dong-Seon;Park, Jun-Seok;Ihm, Pyeong Chan
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.26 no.12
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    • pp.605-619
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    • 2014
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2013. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) The research works on the thermal and fluid engineering have been reviewed as groups of fluid machinery, pipes and relative parts including orifices, dampers and ducts, fuel cells and power plants, cooling and air-conditioning, heat and mass transfer, two phase flow, and the flow around buildings and structures. Research issues dealing with home appliances, flows around buildings, nuclear power plant, and manufacturing processes are newly added in thermal and fluid engineering research area. (2) Research works on heat transfer area have been reviewed in the categories of heat transfer characteristics, pool boiling and condensing heat transfer and industrial heat exchangers. Researches on heat transfer characteristics included the results for general analytical model for desiccant wheels, the effects of water absorption on the thermal conductivity of insulation materials, thermal properties of Octadecane/xGnP shape-stabilized phase change materials and $CO_2$ and $CO_2$-Hydrate mixture, effect of ground source heat pump system, the heat flux meter location for the performance test of a refrigerator vacuum insulation panel, a parallel flow evaporator for a heat pump dryer, the condensation risk assessment of vacuum multi-layer glass and triple glass, optimization of a forced convection type PCM refrigeration module, surface temperature sensor using fluorescent nanoporous thin film. In the area of pool boiling and condensing heat transfer, researches on ammonia inside horizontal smooth small tube, R1234yf on various enhanced surfaces, HFC32/HFC152a on a plain surface, spray cooling up to critical heat flux on a low-fin enhanced surface were actively carried out. In the area of industrial heat exchangers, researches on a fin tube type adsorber, the mass-transfer kinetics of a fin-tube-type adsorption bed, fin-and-tube heat exchangers having sine wave fins and oval tubes, louvered fin heat exchanger were performed. (3) In the field of refrigeration, studies are categorized into three groups namely refrigeration cycle, refrigerant and modeling and control. In the category of refrigeration cycle, studies were focused on the enhancement or optimization of experimental or commercial systems including a R410a VRF(Various Refrigerant Flow) heat pump, a R134a 2-stage screw heat pump and a R134a double-heat source automotive air-conditioner system. In the category of refrigerant, studies were carried out for the application of alternative refrigerants or refrigeration technologies including $CO_2$ water heaters, a R1234yf automotive air-conditioner, a R436b water cooler and a thermoelectric refrigerator. In the category of modeling and control, theoretical and experimental studies were carried out to predict the performance of various thermal and control systems including the long-term energy analysis of a geo-thermal heat pump system coupled to cast-in-place energy piles, the dynamic simulation of a water heater-coupled hybrid heat pump and the numerical simulation of an integral optimum regulating controller for a system heat pump. (4) In building mechanical system research fields, twenty one studies were conducted to achieve effective design of the mechanical systems, and also to maximize the energy efficiency of buildings. The topics of the studies included heating and cooling, HVAC system, ventilation, and renewable energies in the buildings. Proposed designs, performance tests using numerical methods and experiments provide useful information and key data which can improve the energy efficiency of the buildings. (5) The field of architectural environment is mostly focused on indoor environment and building energy. The main researches of indoor environment are related to infiltration, ventilation, leak flow and airtightness performance in residential building. The subjects of building energy are worked on energy saving, operation method and optimum operation of building energy systems. The remained studies are related to the special facility such as cleanroom, internet data center and biosafety laboratory. water supply and drain system, defining standard input variables of BIM (Building Information Modeling) for facility management system, estimating capability and providing operation guidelines of subway station as shelter for refuge and evaluation of pollutant emissions from furniture-like products.

Development of Marine Virus-like Particles Live/Dead Determination Method for the Performance Evaluation of Ballast Water Treatment System (선박평형수처리장치 성능 평가를 위한 해양 바이러스 생사판별 방법 개발)

  • Hyun, Bonggil;Woo, Joo-Eun;Jang, Pung-Guk;Jang, Min-Chul;Lee, Woo-Jin;Bae, Mi-Kyung;Shin, Kyoungsoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.1
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    • pp.431-438
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    • 2021
  • To prepare more stringent regulations for USCG Phase II ballast water management, this study investigated the staining efficiency of SYBR Green I(SGI) and SYBR Gold(SG) on the virus-like particle (VLP). A dye with high staining efficiency was applied to the treated water that was passed through the ballast water treatment system (BWTS). VLP staining was observed most clearly under the 100-fold and 200-fold dilution of the stock solution when the volume of filtered samples was 0.5 mL to 2 mL. The staining efficiency of SGI and SG did not show a significant difference. On the other hand, the green fluorescence of viruses in the sample stained with SGI was more pronounced than in the samples stained with SG (expressed yellow fluorescence), making it easier to observe. The abundance of VLP in the test water and control water treatments that did not pass through the two types of BWTS (electrolysis type, UV + electrolysis type) was approximately 109 - 1010 VLP 100 mL-1. In contrast, no stained VLP was observed in the treated water treatments. Moreover, SGI was confirmed to be effectively stained under various salinity conditions, including seawater, brackish water, and freshwater. Further verification tests and development of staining methods under various BWTS are required, but the SGI staining method is believed to be a good alternative to the VLP live/dead determination of the USCG Phase II type approval test.

Development of Dermal Transduction Epidermal Growth Factor (EGF) Using A Skin Penetrating Functional Peptide (피부투과 기능성 펩타이드를 이용한 경피투과성 상피세포성장인자의 개발)

  • Kang, Jin Sun;La, Ha Na;Bak, Sun Uk;Eom, Hyo Jung;Lee, Byung Kyu;Shin, Hee Je
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.45 no.2
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    • pp.175-184
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    • 2019
  • The epidermal growth factor (EGF) has a intrinsic function of inducing growth and proliferation of cells through interacting with cell membrane receptors in human epidermis and dermis layer. These functions of EGF are used as a main ingredient for wound healing medicines and anti-aging cosmetics. As a cosmetic ingredient, the EGF has a problem in exhibiting its natural efficacy due to the lack of the ability to penetrate through the stratum corneum, which is known as the skin barrier. In this study, a recombinant human epidermal growth factor ($MTD_{151}-EGF$) fused with the macromolecule transduction domain $(MTD)_{151}$ with the skin penetration ability was developed to improve the skin penetration efficiency of the EGF. Expression of $MTD_{151}-EGF$ was performed in E. coli transformed with a vector encoding the $MTD_{151}-EGF$ gene and then purified. The purified $MTD_{151}-EGF$ was evaluated using cell proliferation assay, cytotoxicity test and skin penetration test by franz diffusion cell assay and artificial skin. Cell proliferation activity of $MTD_{151}-EGF$ purified to high purity of 99% or above was equivalent to the EGF or better, and cytotoxicity was not observed. In addition, the $MTD_{151}-EGF$ showed an excellent penetration efficiency compared to the EGF in the skin penetration test with EGF and $MTD_{151}-EGF$ labeled by FITC in an artificial skin penetration model. Based on the quantitative analysis of the penetrating substance using franz diffusion cell assay, the amount of penetration was about 16 times more than that of EGF. These results can be regarded as an effective alternative to improve the existing physical transdermal penetration method related to the use of various active ingredients for cosmetics.

Viability Test and Bulk Harvest of Marine Phytoplankton Communities to Verify the Efficacy of a Ship's Ballast Water Management System Based on USCG Phase II (USCG Phase II 선박평형수 성능 평가를 위한 해양 식물플랑크톤군집 대량 확보 및 생물사멸시험)

  • Hyun, Bonggil;Baek, Seung Ho;Lee, Woo Jin;Shin, Kyoungsoon
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.22 no.5
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    • pp.483-489
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    • 2016
  • The type approval test for USCG Phase II must be satisfied such that living natural biota occupy more than 75 % of whole biota in a test tank. Thus, we harvested a community of natural organisms using a net at Masan Bay (eutrophic) and Jangmok Bay (mesotrophic) during winter season to meet this guideline. Furthermore, cell viability was measured to determine the mortality rate. Based on the organism concentration volume (1 ton) at Masan and Jangmok Bay, abundance of ${\geq}10$ and $<50{\mu}m$ sized organisms was observed to be $4.7{\times}10^4cells\;mL^{-1}$and $0.8{\times}10^4cells\;mL^{-1}$, and their survival rates were 90.4 % and 88.0 %, respectively. In particular, chain-forming small diatoms such as Skeletonema costatum-like species were abundant at Jangmok Bay, while small flagellate ($<10{\mu}m$) and non chain-forming large dinoflagellates, such as Akashiwo sanguinea and Heterocapsa triquetra, were abundant at Masan Bay. Due to the size-difference of the dominant species, concentration efficiency was higher at Jangmok Bay than at Masan Bay. The mortality rate in samples treated by Ballast Water Treatment System (BWMS) (Day 0) was a little lower for samples from Jangmok Bay than from Masan Bay, with values of 90.4% and 93%, respectively. After 5 days, the mortality rates in control and treatment group were found to be 6.7% and >99%, respectively. Consequently, the phytoplankton concentration method alone did not easily satisfy the type approval standards of USCG Phase II ($>1.0{\times}10^3cells\;mL^{-1}$ in 500-ton tank) during winter season, and alternative options such as mass culture and/or harvesting system using natural phytoplankton communities may be helpful in meeting USCG Phase II biological criteria.

Video Assisted Thoracoscopic Sympathetic Ramus Clipping in Essential Hyperhidrosis -Cadaver Fitting Test and Clinical Application (다한증 환자에서 클립을 이용한 교감신경 교통가지 차단술 -사체 연구 및 임상적용-)

  • Lee, Sung-Ho;Cho, Seong-Joon;Jung, Jae-Seung;Kim, Tae-Sik;Son, Ho-Sung;Sun, Kyung;Kim, Kwang-Taik;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.595-601
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    • 2003
  • Background: It has been known that the most effective treatment method of hyperhidrosis is video-assisted thoracoscopic sympathetic nerve block. Postoperative compensatory hyperhidrosis and anhidrosis are major factors that decrease the postoperative satisfaction. Although sympathetic rami have been selectively blocked to decrease the complications, technical difficulties and excessive bleeding have prevented the universal application. Material and Method: Three pre-fixative cadavers were dissected before clinical application. Bilateral sympathetic chains were exposed in supine position after the whole anterior chest wall was removed. Second and third sympathetic rami were blocked using clips. After the sympathetic chains including ganglia were removed, we evaluated the extents of rami block. Twenty-five patients were subjected to the clinical application. Surgeries were performed in semi-fowlers position under general anesthesia and bilateral ventilation. 2 mm thoracoscopy and 5 mm trocar were intro-duced through third and fourth intercostal space, respectively. Second and third sympathetic rami were blocked using thoracoscopic clips. The postoperative complications, satisfaction, and compensatory hyperhidrosis rate were evaluated retrospectively. Result: Sympathetic rami were completely blocked in cadaver dissection study Hyper-hidrosis symptom was improved in all patients without operative complication. Operative time was shorter than that of traditional ramicotomy. All patients, except four, were satisfied with postoperative palmar hyperhidrosis. Com-pensatory hyperhidrosis was more severely happened in fifteen patients (60%). The remaining six patients had no complaint. Two patients had a minimal degree of gustatory hyperhidrosis. Conclusion: This operative method had shorter operative time and less complication rate, compared with traditional ramicotomy Operative success rate was similar to the traditional syrnpathicotorny; lower extent and occurrence rate of compensatory hyperhidrosis. The thoracic sympathetic rami clipping was suggested as an alternative method for treatment of palmar hyperhidrosis.

Media Habits of Sensation Seekers (감지추구자적매체습관(感知追求者的媒体习惯))

  • Blakeney, Alisha;Findley, Casey;Self, Donald R.;Ingram, Rhea;Garrett, Tony
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.2
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    • pp.179-187
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    • 2010
  • Understanding consumers' preferences and use of media types is imperative for marketing and advertising managers, especially in today's fragmented market. A clear understanding assists managers in making more effective selections of appropriate media outlets, yet individuals' choices of type and use of media are based on a variety of characteristics. This paper examines one personality trait, sensation seeking, which has not appeared in the literature examining "new" media preferences and use. Sensation seeking is a personality trait defined as "the need for varied, novel, and complex sensations and experiences and the willingness to take physical and social risks for the sake of such experiences" (Zuckerman 1979). Six hypotheses were developed from a review of the literature. Particular attention was given to the Uses and Gratification theory (Katz 1959), which explains various reasons why people choose media types and their motivations for using the different types of media. Current theory suggests that High Sensation Seekers (HSS), due to their needs for novelty, arousal and unconventional content and imagery, would exhibit higher frequency of use of new media. Specifically, we hypothesize that HSS will use the internet more than broadcast (H1a) or print media (H1b) and more than low (LSS) (H2a) or medium sensation seekers (MSS) (H2b). In addition, HSS have been found to be more social and have higher numbers of friends therefore are expected to use social networking websites such as Facebook/MySpace (H3) and chat rooms (H4) more than LSS (a) and MSS (b). Sensation seekers can manifest into a range of behaviors including disinhibition,. It is expected that alternative social networks such as Facebook/MySpace (H5) and chat rooms (H6) will be used more often for those who have higher levels of disinhibition than low (a) or medium (b) levels. Data were collected using an online survey of participants in extreme sports. In order to reach this group, an improved version of a snowball sampling technique, chain-referral method, was used to select respondents for this study. This method was chosen as it is regarded as being effective to reach otherwise hidden population groups (Heckathorn, 1997). A final usable sample of 1108 respondents, which was mainly young (56.36% under 34), male (86.1%) and middle class (58.7% with household incomes over USD 50,000) was consistent with previous studies on sensation seeking. Sensation seeking was captured using an existing measure, the Brief Sensation Seeking Scale (Hoyle et al., 2002). Media usage was captured by measuring the self reported usage of various media types. Results did not support H1a and b. HSS did not show higher levels of usage of alternative media such as the internet showing in fact lower mean levels of usage than all the other types of media. The highest media type used by HSS was print media, suggesting that there is a revolt against the mainstream. Results support H2a and b that HSS are more frequent users of the internet than LSS or MSS. Further analysis revealed that there are significant differences in the use of print media between HSS and LSS, suggesting that HSS may seek out more specialized print publications in their respective extreme sport activity. Hypothesis 3a and b showed that HSS use Facebook/MySpace more frequently than either LSS or MSS. There were no significant differences in the use of chat rooms between LSS and HSS, so as a consequence no support for H4a, although significant for MSS H4b. Respondents with varying levels of disinhibition were expected to have different levels of use of Facebook/MySpace and chat-rooms. There was support for the higher levels of use of Facebook/MySpace for those with high levels of disinhibition than low or medium levels, supporting H5a and b. Similarly there was support for H6b, Those with high levels of disinhibition use chat-rooms significantly more than those with medium levels but not for low levels (H6a). The findings are counterintuitive and give some interesting insights for managers. First, although HSS use online media more frequently than LSS or MSS, this groups use of online media is less than either print or broadcast media. The advertising executive should not place too much emphasis on online media for this important market segment. Second, social media, such as facebook/Myspace and chatrooms should be examined by managers as potential ways to reach this group. Finally, there is some implication for public policy by the higher levels of use of social media by those who are disinhibited. These individuals are more inclined to engage in more socially risky behavior which may have some dire implications, e.g. by internet predators or future employers. There is a limitation in the study in that only those who engage in extreme sports are included. This is by nature a HSS activity. A broader population is therefore needed to test if these results hold.

Estimating the Attribute Values of 4 Major River Estuaries in Korea -Focusing on Testing for the IIA Assumption in MNL Model and the Alternative Models- (4대강 하구의 속성 가치 추정 -다항로짓모형에서 IIA가정의 검토와 대안 모형을 중심으로-)

  • Shin, Youngchul
    • Environmental and Resource Economics Review
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    • v.22 no.3
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    • pp.521-545
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    • 2013
  • This study applied choice experiment(CE) method(which is included in the stated preference method) to estimate values of some important attributes(i.e. type of estuary, water quality of river in estuary, water quality of sea in estuary, biodiversity level of estuary) of 4 major river(Hangang, Guemgang, Yeongsangang, Nakdonggang) estuaries in Korea. Although the multinomial logit model(MNL) is generally applied to analyse the CE data, testing for IIA assumption with the Hausman and McFadden test in MNL model shows that the IIA assumption in our data is rejected. Therefore, the heteroscedastic extreme value model(HEV) and the multinomial probit model(MNP) which are not based on the IIA assumption are used to analyse our CE data. As results, the coefficients and the elicited economic values of MNL model are seriously distorted if the IIA assumption is not satisfied in MNL model. The estimation results of MNP model show that the economic values are elicited as 352.3 billion won(95% C.I. 261.1 - 477.8 billion won) for natural estuary, 411.5 billion won(95% C.I. 338.5 - 525.5 billion won) for one grade improvement of river water quality in estuary, 358.9 billion won(95% C.I. 292.5 - 457.0 billion won) for one grade improvement of sea water quality in estuary, and 151.9 billion won(95% C.I. 99.0 - 218.6 billion won) for one grade improvement of biodiversity level of estuary. Therefore, the value of estuary is reached to 2,197.0 billion won(95% C.I. 1,721.0 - 2,879.9 billion won) if any natural estuary in 4 major rivers has good water quality of river in estuary(i.e. 2nd grade), good water quality of sea in estuary(i.e. 1st grade), and good biodiversity level of estuary.

Critical Pathway Development for the Hysterectomy Patients and its applied Effect (자궁적출술 환자를 위한 critical pathway 개발과 적용효과)

  • Noh, Gi-Ok;Park, Kyung-Sook
    • Women's Health Nursing
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    • v.6 no.2
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    • pp.234-257
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    • 2000
  • At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

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Functional MRI of Visual cortex in the Patients with Occipital Lobe Ischemia (후두엽의 허혈성 뇌졸중 환자에서 시각피질의 기능적 자기공명영상)

  • 이영준;정태섭;윤영수;한승한;조영재;배준호
    • Investigative Magnetic Resonance Imaging
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    • v.3 no.2
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    • pp.173-178
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    • 1999
  • Purpose : To evaluate the usefulness of functional MRI (fMRI) of visual cortex in patients with ischemic infarction in the occipital lobe. Materials and Methods : Four patients with the symptoms and signs of visual cortical ischemia were included. Functional MRI was performed by 2D-FLASH technique with the parameter of 90/56msec TR/TE, $40^{\circ}$ flip angle, $240{\times}240{\;}FOV,{\;}64{\times}128$ matrix number, 8.32 seconds acquisition time, 8mm slice thickness. An axial slice including both visual cortices was selected and alternative activation and resting of the visual cortex was performed using red color photostimulator. all patients undertook visual field test, and vascular abnormality was examined by MRA (n=4) and DSA (n=2). fMRI results were compared with the results of a visual field test, conventional MRI and cerebral angiography. Results : On fMRI, decreased activity of the visual cortex was found in the occipital lobe corresponding to stenosis of the posterior cerebral artery or its branch noted on angiogram. However, 2 of 4 patients showed no abnormal findings on conventional MRI. Visual field defect was noted in 3 patients, one and of whom showed no abnormality on conventional MRI and diffusion-weighted image, but revealed decreased activity in the corresponding visual cortex on fMRI. Conclusion : fMRI may be a sensitive method for detection of the status of decreased blood flow or vascular reserve which other methods can not.

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