• Title/Summary/Keyword: Medical delivery system

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A Study on the Recent Trend of German Healthcare Delivery System and Types of Medical Facilities for the Aged (최근 독일 노인 의료시설의 공급체계와 시설유형에 관한 조사 연구)

  • Yang, Nae-Won;Yu, Young-Min
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.4 no.7
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    • pp.47-55
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    • 1998
  • The average life span of Koreans has been increased recently. The percentage of the old(over 65), which was 5% in 1990, is expected to be increased to 15% in 2020. Therefore, the social problems of old people occur in various aspects nowadays, and will become more serious in the near future. In Germany, the have developed a comprehensive welfare system which enables the aged to be more independent, such as various welfare facilities for the aged that are built in consideration of the physical conditions.

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A Classification of Conversion Factors of Relative Values in the National Health Insurance (건강보험 환산지수의 유형별 분류방안)

  • Kim, Jin-Hyun;Choi, Byung-Ho
    • Journal of Society of Preventive Korean Medicine
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    • v.10 no.2
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    • pp.147-158
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    • 2006
  • The purpose of this paper is to review the empirical study results of conversion factors(unit prices) for relative values of health care services in the national health insurance system and establish optimal classification of health care institutions for feasible contract of conversion factors between National Health Insurance Corporation(NHIC) and provider groups, based on legal backgrounds and types of health care service delivery system. some empirical research evidences shows the validity of applying multiple conversion factors to annual contract for reimbursement in the national health insurance. Policy recommendations suggest that clinic, hospital, general hospital, tertiary hospital, dental clinic, oriental medical clinic, pharmacy, and public health centers would be a basic category of provider groups for a meaningful price contract between the NHIC and providers.

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Radiation Therapy against Pediatric Malignant Central Nervous System Tumors : Embryonal Tumors and Proton Beam Therapy

  • Lim, Do Hoon
    • Journal of Korean Neurosurgical Society
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    • v.61 no.3
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    • pp.386-392
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    • 2018
  • Radiation therapy is highly effective for the management of pediatric malignant central nervous system (CNS) tumors including embryonal tumors. With the increment of long-term survivors from malignant CNS tumors, the radiation-related toxicities have become a major concern and we need to improve the treatment strategies to reduce the late complications without compromising the treatment outcomes. One of such strategies is to reduce the radiation dose to craniospinal axis or radiation volume and to avoid or defer radiation therapy until after the age of three. Another strategy is using particle beam therapy such as proton beams instead of photon beams. Proton beams have distinct physiologic advantages over photon beams and greater precision in radiation delivery to the tumor while preserving the surrounding healthy tissues. In this review, I provide the treatment principles of pediatric CNS embryonal tumors and the strategic improvements of radiation therapy to reduce treatment-related late toxicities, and finally introduce the increasing availability of proton beam therapy for pediatric CNS embryonal tumors compared with photon beam therapy.

Apoptotic Cell Death Following Traumatic Injury to the Central Nervous System

  • Springer, Joe E.
    • BMB Reports
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    • v.35 no.1
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    • pp.94-105
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    • 2002
  • Apoptotic cell death is a fundamental and highly regulated biological process in which a cell is instructed to actively participate in its own demise. This process of cellular suicide is activated by developmental and environmental cues and normally plays an essential role in eliminating superfluous, damaged, and senescent cells of many tissue types. In recent years, a number of experimental studies have provided evidence of widespread neuronal and glial apoptosis following injury to the central nervous system (CNS). These studies indicate that injury-induced apoptosis can be detected from hours to days following injury and may contribute to neurological dysfunction. Given these findings, understanding the biochemical signaling events controlling apoptosis is a first step towards developing therapeutic agents that target this cell death process. This review will focus on molecular cell death pathways that are responsible for generating the apoptotic phenotype. It will also summarize what is currently known about the apoptotic signals that are activated in the injured CNS, and what potential strategies might be pursued to reduce this cell death process as a means to promote functional recovery.

Nanoparticle Inducing Device for Effective Drug Delivery System (효과적인 약물전달 시스템을 위한 나노입자 유도 장치)

  • Lee, Chongmyeong;Han, Hyeonho;Jang, Byonghan;Oh, Eunseol;Key, Jaehong
    • Journal of Biomedical Engineering Research
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    • v.38 no.3
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    • pp.102-110
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    • 2017
  • Cancer is one of the most challenging human diseases. Current clinical methods have limitations for early-stage cancer diagnosis and effective therapy. Moreover, current surgical methods to remove tumors are not precise enough and chemotherapy destroys normal tissues as well as malignant tumors, resulting in severe side effects such as hair loss, vomiting, diarrhea, and blood disorders. Recently, nanotechnology using nano-sized particles suggests advanced solutions to overcome the limitations. Various nanoparticles have been reported for more accurate diagnosis and minimized side effects. However, current nanoparticles still show limited targeting accuracy for cancer generally below 5% injection dosage. Therefore, herein we report a new nanoparticle inducing device(NID) to guide the nanoparticles externally by using both variable magnetic fields and blood flows. NID can be a promising approach to improve targeting accuracy for drug delivery using iron oxide nanoparticles.

Evaluation of the Dose According to the Movement of Breath During Field-in-Field Technique Treatment of Breast Cancer Patients (유방암 환자의 Field-in-Field Technique 치료 시 호흡의 움직임에 따른 선량 평가)

  • Kwon, Kyung-Tae
    • Journal of radiological science and technology
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    • v.41 no.6
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    • pp.561-566
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    • 2018
  • Field-in-Field Technique is applied to the radiation therapy of breast cancer patients, and it is possible to compensate the difference in breast thickness and deliver uniform dose in the breast. However, there are several fields in the treatment field that result in a more complex dose delivery than a single field dose delivery. If the patient's respiration is irregular during the delivery of the dose by several fields and the change of respiration occurs, the dose distribution in the breast changes. Therefore, based on the computed tomography images of breast cancer patients, a human model was created by using a 3D printer (Builder Extreme 1000) to describe the volume in the same manner. A computerized tomography (CT) of the human body model was performed and a treatment plan of 260 cGy / fx was established using a 6-MV field-in-field technique using a computerized treatment planning system (Eclipse 13.6, Varian, USA). The distribution of the dose in the breast according to the change of the respiration was measured using a moving phantom at 0.1 cm, 0.3 cm, 0.5 cm amplitude, using a MOSOXIDE Silicon Field Effect Transistor (MOSFET, Best Medical, Canada) Were measured and compared. The distribution of dose in the breast according to the change of respiration showed similar value within ${\pm}2%$ in the movement up to 0.3 cm compared to the treatment plan. In this experiment, we found that the dose distribution in the breast due to the change of respiration when the change of respiration was increased was not much different from the treatment plan.

A Study on the Development of Integrated Logistics System for Hospital Logistics Cooperation (병원물류 공동화를 위한 통합물류 시스템 구축에 관한 연구)

  • Park, Jong Suk;Kim, Han Sung;Lee, Jae Gun;Choi, Hoon Young;Kang, Kyung Sik
    • Journal of the Korea Safety Management & Science
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    • v.16 no.2
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    • pp.139-146
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    • 2014
  • In Korea's distribution and production field establishment of logistics information system and automation of logistics were greatly developed. But there is no characteristic and professionalism about hospital logistics, and distribution center is located in outside warehouse, logistics system is very important. Since hospital has human power to receive product, system is not as much required, but outside warehouse requires system for arrival from medicine and medical supplies wholesale dealer and vender, warehousing, storage, and automation facilities, and system for various works such as peaking instruction, classification, packing, cargo-working, delivery, order of medicine from hospital and non-medicine in hospital is essential. Therefore, This study is about development of automatic identification of slide which cannot be overlooked in efficiency of hospital logistics, establishment of database, and information interlocking between automatic storage system and outside warehouse.

Effects of Rooming-in on Continuation of Breastfeeding and Maternal Identity (모자동실과 모자별실에 따른 모유수유 실천 및 모성정체감 비교 연구)

  • Shin, Gye-Young;Kim, Oh-Jin;Park, Ju-Hyueon;Lee, Jueng-Rim
    • Women's Health Nursing
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    • v.8 no.3
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    • pp.402-411
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    • 2002
  • Purpose: The objective of this study was to identify the effectiveness of continued breast feeding and maternal identity between rooming-in and not rooming-in groups of mothers in post partum care. Method: The subjects were selected by convenient sampling, with 95 women in childbirth completing a questionnaire. The data were collected on the 2nd day after delivery by questionnaire, and after the 4th and 8th weeks by telephone interview. Measures used in this study included general characteristics, breast feeding related characteristics, and the maternal identity scale revised by Koh(1996). The data were analyzed with the SPSS program, and the Chi-test and t-test were used to identify the effect on breast feeding and maternal identity. Results: Continued breast feeding up to 4 weeks after deliverly was not statistically significant between rooming-in and not rooming-in group, but beyond 8 weeks of deliverly, it was significantly different in rooming-in group(p<.01). Maternal identity was significantly higher in rooming-in group than in not rooming-in group(<.01). Conclusion: Mothers preferred rooming-in system because it helped breast feeding and baby care. Rooming-in system provides self confidence in taking care of baby, knowledge about breast feeding and stimulates early phase lactation. We recommend rooming-in system in hospitals to promote breast feeding and maternal identity. Nurses are encouraged to discuss prenatal breast feeding before delivery and rooming-in care should be planned individually for continuation of breast feeding and formation of maternal identity.

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Analysis of Dose Delivery Error in Conformal Arc Therapy Depending on Target Positions and Arc Trajectories (동적조형회전조사 시 표적종양의 위치변위와 조사반경의 변화에 따른 선량전달 오류분석)

  • Kang, Min-Young;Lee, Bo-Ram;Kim, You-Hyun;Lee, Jeong-Woo
    • Journal of radiological science and technology
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    • v.34 no.1
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    • pp.51-58
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    • 2011
  • The aim of the study is to analyze the dose delivery error depending on the depth variation according to target positions and arc trajectories by comparing the simulated treatment planning with the actual dose delivery in conformal arc therapy. We simulated the conformal arc treatment planning with the three target positions (center, 2.5 cm, and 5 cm in the phantom). For the experiments, IMRT body phantom (I’mRT Phantom, Wellhofer Dosimetry, Germany) was used for treatment planning with CT (Computed Tomography, Light speed 16, GE, USA). The simulated treatment plans were established by three different target positions using treatment planning system (Eclipse, ver. 6.5, VMS, Palo Alto, USA). The radiochromic film (Gafchromic EBT2, ISP, Wayne, USA) and dose analysis software (OmniPro-IMRT, ver. 1.4, Wellhofer Dosimetry, Germany) were used for the measurement of the planned arc delivery using 6 MV photon beam from linear accelerator (CL21EX, VMS, Palo Alto, USA). Gamma index (DD: 3%, DTA: 2 mm) histogram and dose profile were evaluated for a quantitative analysis. The dose distributions surrounded by targets were also compared with each plans and measurements by conformity index (CI), and homogeneity index (HI). The area covered by 100% isodose line was compared to the whole target area. The results for the 5 cm-shifted target plan show that 23.8%, 35.6%, and 37% for multiple conformal arc therapy (MCAT), single conformal arc therapy (SCAT), and multiple static beam therapy, respectively. In the 2.5 cm-shifted target plan, it was shown that 61%, 21.5%, and 14.2%, while in case of center-located target, 70.5%, 14.1%, and 36.3% for MCAT, SCAT, and multiple static beam therapy, respectively. The values were resulted by most superior in the MCAT, except the case of the 5 cm-shifted target. In the analysis of gamma index histogram, it was resulted of 37.1, 27.3, 29.2 in the SCAT, while 9.2, 8.4, 10.3 in the MCAT, for the target positions of center, shifted 2.5 cm and 5 cm, respectively. The fail proportions of the SCAT were 2.8 to 4 times as compared to those of the MCAT. In conclusion, dose delivery error could be occurred depending on the target positions and arc trajectories. Hence, if the target were located in the biased position, the accurate dose delivery could be performed through the optimization of depth according to arc trajectory.

Development of an Offline Based Internal Organ Motion Verification System during Treatment Using Sequential Cine EPID Images (연속촬영 전자조사 문 영상을 이용한 오프라인 기반 치료 중 내부 장기 움직임 확인 시스템의 개발)

  • Ju, Sang-Gyu;Hong, Chae-Seon;Huh, Woong;Kim, Min-Kyu;Han, Young-Yih;Shin, Eun-Hyuk;Shin, Jung-Suk;Kim, Jing-Sung;Park, Hee-Chul;Ahn, Sung-Hwan;Lim, Do-Hoon;Choi, Doo-Ho
    • Progress in Medical Physics
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    • v.23 no.2
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    • pp.91-98
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    • 2012
  • Verification of internal organ motion during treatment and its feedback is essential to accurate dose delivery to the moving target. We developed an offline based internal organ motion verification system (IMVS) using cine EPID images and evaluated its accuracy and availability through phantom study. For verification of organ motion using live cine EPID images, a pattern matching algorithm using an internal surrogate, which is very distinguishable and represents organ motion in the treatment field, like diaphragm, was employed in the self-developed analysis software. For the system performance test, we developed a linear motion phantom, which consists of a human body shaped phantom with a fake tumor in the lung, linear motion cart, and control software. The phantom was operated with a motion of 2 cm at 4 sec per cycle and cine EPID images were obtained at a rate of 3.3 and 6.6 frames per sec (2 MU/frame) with $1,024{\times}768$ pixel counts in a linear accelerator (10 MVX). Organ motion of the target was tracked using self-developed analysis software. Results were compared with planned data of the motion phantom and data from the video image based tracking system (RPM, Varian, USA) using an external surrogate in order to evaluate its accuracy. For quantitative analysis, we analyzed correlation between two data sets in terms of average cycle (peak to peak), amplitude, and pattern (RMS, root mean square) of motion. Averages for the cycle of motion from IMVS and RPM system were $3.98{\pm}0.11$ (IMVS 3.3 fps), $4.005{\pm}0.001$ (IMVS 6.6 fps), and $3.95{\pm}0.02$ (RPM), respectively, and showed good agreement on real value (4 sec/cycle). Average of the amplitude of motion tracked by our system showed $1.85{\pm}0.02$ cm (3.3 fps) and $1.94{\pm}0.02$ cm (6.6 fps) as showed a slightly different value, 0.15 (7.5% error) and 0.06 (3% error) cm, respectively, compared with the actual value (2 cm), due to time resolution for image acquisition. In analysis of pattern of motion, the value of the RMS from the cine EPID image in 3.3 fps (0.1044) grew slightly compared with data from 6.6 fps (0.0480). The organ motion verification system using sequential cine EPID images with an internal surrogate showed good representation of its motion within 3% error in a preliminary phantom study. The system can be implemented for clinical purposes, which include organ motion verification during treatment, compared with 4D treatment planning data, and its feedback for accurate dose delivery to the moving target.