• Title/Summary/Keyword: Patient's position

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Measurement of Nursing Service Quality using SERVQUAL Model (SERVQUAL 모델을 이용한 간호 서비스 질 측정)

  • Lim, Ji-Young;Kim, So-In
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.2
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    • pp.259-279
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    • 2000
  • This study is a descriptive analytic research measuring nursing service quality, using SERVQUAL model, to make fundamental data and strategies for nursing service improvement. Data were collected by self-reported questionnaire from 202 patients and 142 nurses, from June 7 to 14, 1999. The reliability of instrument were adequate(Cronbach ${\alpha}=.94$). SAS program was utilized for statistical analysis of collected data. The results were as follows; 1. There was a gab between patient's expectation and perception on nursing service(Gap B). Gap D was indicated an affecting factor to decide nursing service quality. Gap C was indicated an indirect affecting factor of nursing service quality. Because it was not statistically significant in total item analysis, but in individual item analysis, 7 items were appeared statistically significant. Gap A was not a gap occurrence factor of nursing service quality. 2. Focuses of nursing service quality improvement strategies were; (1) to direct qualitative improvement of nursing service in order to correspondence patient's nursing service expectation. (2) to make nurse's service activity modified because nurse's practice were not reached patient's expectation level. (3) to need internal, external factor analysis affecting nurse's service activity. 3. Nursing service quality was decided by rather environmental inappropriateness provided nursing service than itself. Therefore, to make nursing service quality improvement, it is required to improve nursing service environment. For this, followings are required; (1) to strengthen nurse's education on lower part of nursing service satisfaction and QI activities. (2) to balance demand and supply of nursing personnel. 3) to fix computerized system for reducing other duties weight except nursing care through analysis of nursing activity. (4) to construct rational cooperating system among related departments. 4. The important parts for nursing service quality improvement were indicated as follows: (1) Gap B: 'prompt reaction', 'examination symptom before patient's complaint', 'hearted nursing service reducing patient's dissatisfaction', 'explanation goals of nursing activities', 'having special Knowledge enough', 'maintenance position comfortably', 'management of patient's physical hygiene'. (2) Gap C: 'maintenance physical safety', 'explanation about hospital rules and facilities'. (3) Gap D: 'tender, safe injection and wound care'. Because above items are mostly improved through nurse's attitude change and quality improvement, it is required to establish nursing standardization and to strengthen nurse's clinical education. As the based on above results, followings are suggested; 1. SERVQUAL model is very useful to make strategies for nursing service quality improvement because it indicates multiple factors affecting hap occurrence. 2. At individual items analysis of Gap C, statistically significant 7 items appeared higher nurse's perception level than patient's perception level on nursing service were trouble perception level on nursing service quality improvement. So. it need further research to analysis about these difference occurring factors. 3. At analysis of Gap D, it is indicated that in nursing service performance process, multiple factors lowing nursing service quality were intruded. So it needs further research to analysis what these factors are and how each factors affect on nursing performance process. 4. nursing service quality measurement is changeable according to sample select time or sampled subject's characteristics. So to develope strategy for nursing service quality improvement is based on the results of periodical analysis.

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Determination of Proton Beam Position Based on Prompt Gamma Ray Detection (즉발감마선을 이용한 양성자 빔 위치 측정에 관한 연구)

  • Seo, Kyu-Seok;Kim, Jong-Won;Kim, Chan-Hyeong
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2004.11a
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    • pp.69-71
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    • 2004
  • The proton therapy of radiation therapy methods using Bragg Peak which is proton beam's characteristic dose distribution can give a normal tissue lower dose than cancer, comparing with the former existing radiation therapy methods. For exact treatment and patient' safety, we need to know proton beam's position in body, but a proton beam completely stops at treatment region and proton beam's range is uncertainly made by the variety of organs having each different density, so we aren't able to find a proton beam' position by suitable methods yet. With Monte Carlo Computing Method, as a result that we had simulated prompt gamma detection system using correlation of proton beam's absorbed dose distribution about water and prompt gamma distribution by nuclear interaction occurred by collisions of proton and water's hydrogen atoms, we could confirm that a proton beam's position was able to detect by using simulated prompt gamma detection system in body on the real-time

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Esthetic Implant Prostheses for Anterior Teeth (심미적인 상악 전치부 임플란트 보철물 만들기)

  • Kim, Ki-Seong
    • The Journal of the Korean dental association
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    • v.56 no.9
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    • pp.492-502
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    • 2018
  • Anterior maxillary teeth play an important role in determining a person's first impression and facial profile. Implant surgery in esthetic area requires more careful diagnosis, treatment planning, surgery, and prosthetic restoration than in posterior area. To avoid complications in surgery and prosthetic restoration for implants in esthetic area, accurate diagnosis and appropriate case selection become very important. If you have decided to restore the area with implant prosthesis, you have to know exactly where to place an implant. I will discuss the ideal implant position in terms of mesio-distally, apico-coronally, labio-palatally, and implant angulation. And I would like to point out the selection of fixture diameter & length for anterior implant. Finally, a clinical implant prosthesis case in maxillary central incisor will be shown. In conclusion, for superior esthetic outcome in anterior implant prostheses, we must understand the patient's anatomic condition and know our ability.

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Full Mouth Rehabilitation (완전 구강 회복술)

  • Lee, Seung-Kyu;Lee, Sung-Bok;Kwon, Kung-Rock;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.3
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    • pp.171-185
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    • 2000
  • The treatment objectives of the complete oral rehabilitation are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. There may be many roads to achieving these objectives, but they all convey varing degrees of stress and strain on the dentist and patient. There are no "easy" cases of oral rehabilitation. Time must be taken to think, time must be taken to plan, and time must be taken to perform, since time is the critical element in both success and failure. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. Firstly, we must evaluate the mandibular position. The results of a repetitive, unstrained, nondeflective, nonmanipulated mandibular closure into complete maxillomandibular intercuspation is not so much a "centric" occlusion as it is a stable occlusion. Accordingly, we ought to concern ourselves less with mandibular centricity and more with mandibular stability, which actually is the relationship we are trying to establish. The key to this stability is intercuspal precision. Once neuromuscular passivity has been achieved during an appropriate period of occlusal adjustment and provisionalization, subsequent intercuspal precision becomes the controlling factors in maintaining a stable mandibular position. Secondly, we must evaluate the planned vertical dimension of occlusion in relationship to what may now be an altered(generally diminished), and avoid the hazard of using such an abnormal position to indicate ultimate occlusal contacting points. There are no hard and fast rules to follow, no formulas, and no precise ratios between the vertical dimension of occlusion. Like centric relation, it is an area, not a point.

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Development of Video Image-Guided Setup (VIGS) System for Tomotherapy: Preliminary Study (단층치료용 비디오 영상기반 셋업 장치의 개발: 예비연구)

  • Kim, Jin Sung;Ju, Sang Gyu;Hong, Chae Seon;Jeong, Jaewon;Son, Kihong;Shin, Jung Suk;Shin, Eunheak;Ahn, Sung Hwan;Han, Youngyih;Choi, Doo Ho
    • Progress in Medical Physics
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    • v.24 no.2
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    • pp.85-91
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    • 2013
  • At present, megavoltage computed tomography (MVCT) is the only method used to correct the position of tomotherapy patients. MVCT produces extra radiation, in addition to the radiation used for treatment, and repositioning also takes up much of the total treatment time. To address these issues, we suggest the use of a video image-guided setup (VIGS) system for correcting the position of tomotherapy patients. We developed an in-house program to correct the exact position of patients using two orthogonal images obtained from two video cameras installed at $90^{\circ}$ and fastened inside the tomotherapy gantry. The system is programmed to make automatic registration possible with the use of edge detection of the user-defined region of interest (ROI). A head-and-neck patient is then simulated using a humanoid phantom. After taking the computed tomography (CT) image, tomotherapy planning is performed. To mimic a clinical treatment course, we used an immobilization device to position the phantom on the tomotherapy couch and, using MVCT, corrected its position to match the one captured when the treatment was planned. Video images of the corrected position were used as reference images for the VIGS system. First, the position was repeatedly corrected 10 times using MVCT, and based on the saved reference video image, the patient position was then corrected 10 times using the VIGS method. Thereafter, the results of the two correction methods were compared. The results demonstrated that patient positioning using a video-imaging method ($41.7{\pm}11.2$ seconds) significantly reduces the overall time of the MVCT method ($420{\pm}6$ seconds) (p<0.05). However, there was no meaningful difference in accuracy between the two methods (x=0.11 mm, y=0.27 mm, z=0.58 mm, p>0.05). Because VIGS provides a more accurate result and reduces the required time, compared with the MVCT method, it is expected to manage the overall tomotherapy treatment process more efficiently.

CARE OF RECURRENT TEMPOROMANDIBULAR JOINT DISLOCATION IN CEREBROVASCULAR ACCIDENT PATIENT : REPORT OF A CASE (뇌졸중 환자에서 재발성 턱관절 탈구의 관리 : 증례보고)

  • Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.11 no.2
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    • pp.62-66
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    • 2015
  • Temporomandibular joint dislocation causes considerable pain, discomfort, and swelling. The anatomic construction of the articular fossa and the eminentia articularis may predispose to dislocation, and weakness of the connective tissue forming the capsule is believed to be a predisposing factor. The capsule may be stretched and, more rarely, torn. Dislocation may be unilateral or bilateral and may occur spontaneously after stretching of the mouth to its extreme open position, such as during a yawn or during a routine dental operation. Manual reduction with the patient under muscle-relaxing condition or anesthesia is recommended method. After the reduction of an acute dislocation, immobilization of the jaw is recommended to allow the stretched and sometimes torn capsule to heal, thus preventing recurrence. A Barton's bandage may be applied for 2 to 3 weeks to prevent the patient from opening the jaw too wide. But, it results in recurrent dislocation in the neurologically disabled patient, because of loose intermaxillary fixation. This is a case report about management of recurrent temporomandibular joint dislocation by multiple loop wirings and intermaxillary elastics in cerebrovascular accident patient.

Congenital Cystic Adenomatoid Malformation(CCAM) (선천성 낭포성 유선종 기형)

  • 김수원
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1084-1094
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    • 1988
  • Conservative management of 3 iatrogenic perforations of intrathoracic esophagus was reviewed. The primary disorders were achalasia in 2 patients and congenital tracheoesophageal fistula in 1 patient. Perforation occurred after treatment of the primary disorders in the distal esophagus in 2 patients and mid-thoracic esophagus in 1 patient. All the perforations appeared late after the previous treatments and the inflammation spread to mediastinum and pleural cavity in all the 3 patients. Conservative management of esophageal perforation was carried out with intraluminal drainage from the perforated site of esophagus[insertion of Levin`s tube and continuous suction], pleural drainage and feeding of liquid diet through gastrostomy tube with Fowler`s position. The patients revealed spontaneous closure of perforated sites about 3 to 4 weeks after this conservative management without open thoracotomy. This result suggests that this conservative management may be accepted as therapeutic method in the thoracic esophageal perforations regardless of cause and time of the perforation.

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Implementation of Patient Supervision System Using USN and Healthcare board (USN과 헬스 케어 보드를 이용한 환자 감시 시스템 구현)

  • Lee, Cheol-Hee;Lee, Sand-Hoi
    • Proceedings of the IEEK Conference
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    • 2008.06a
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    • pp.141-142
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    • 2008
  • According as USN's application field is magnified, various results are appearing. Efforts to apply this results in life are progressing. In car field, is used in control that level of significance is less. In home network, is used in a household electric appli-ance control and electric lamp control, security etc.. In factory, is used in process control, and is used in various application because is involved with RFID leader recently. In this paper, patient's status monitoring, USN use wish to. Because USN can utilize existent network, it is system that can transmit various data as that change passed information.Wish to send information that get in health-care board. Information that can get in health-care board is blood pressure, blood sugar, stroke, SPO2, ECG, the activity amount, position. Also, wish to forecast use possibility to involved various service, silver industry with database.

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Phylogenetic Characteristics of Fasciola hepatica Isolated from a Korean Patient

  • Jeong, Mi Jin;Park, Jae Kyun;Yu, Hak Sun
    • Parasites, Hosts and Diseases
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    • v.60 no.5
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    • pp.367-370
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    • 2022
  • Fascioliasis is a parasitic infection caused by liver flukes. Although several cases have been reported in Korea, phylogenetic analysis of isolates is lacking. In this study, a 66-year-old woman with right upper quadrant (RUQ) abdominal pain was diagnosed as fascioliasis involving abdominal muscle by imaging study. She received praziquantel treatment, but symptoms were not improved. Lateral movement of the abscess lesion was followed. Trematode parasite was surgically removed from the patient's rectus abdominis muscle. The fluke was identified as Fasciola hepatica based on sequence analysis of 18S rDNA. To determine the phylogenetic position of this Fasciola strain (named Korean Fasciola 1; KF1), the cox1 gene (273 bp) was analyzed and compared with the genes of 17 F. hepatica strains isolated from cows, sheep, goats, and humans from various countries. Phylogenetic analysis showed that KF1 was closely related with the isolates from China goat.

Comparison of Image Quality and Dose According to the Arm Positioning in the Chest CT (흉부 CT 검사에서 환자 팔의 위치에 따른 영상의 화질과 선량 비교)

  • Yoo, Muyeon;Park, Sam;Jang, Heuijung;Lee, Hyojin;Lee, Jongwoong;Kweon, Daecheol
    • Journal of the Korean Society of Radiology
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    • v.8 no.2
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    • pp.75-79
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    • 2014
  • The aim of this retrospective research was to investigate the influence of the patient's arm position on radiation dose and scanning during CT. Chest CT image created image degradation, artifact and overdose to the patient due to the difference of the chest thickness. Therefore, the patient's arm should up position during the CT chest examination. In 2012, 1,642 patients underwent chest CT examination in Seoul K hospital. 118 chest CT examination performed hands down position. The average DLP value of the CT chest arm up examination was 275 $mGy{\cdot}cm$. The average DLP value of the CT chest arm down examination was 312.46 $mGy{\cdot}cm$. In the retrospective study with same patient, The average DLP value of the CT chest examination arm up vigorously was 267.5 $mGy{\cdot}cm$. The average DLP value of the CT chest arm down examination was 307.5 $mGy{\cdot}cm$. Chest CT scan without raising arm created linear artifact due to the lack of X-ray photons which is the thickest part of the human body of shoulder area. In conclusion, arm positioning patients' arms above the shoulders at CT of the chest increases image quality and substantially reduces effective radiation dose.