• 한국멀티미디어학회논문지
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• 제22권7호
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• pp.804-814
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• 2019

The patient's waiting time and length of stay have been reported as a factor decreasing their satisfaction in the hospital, especially in developing countries. This paper focuses on modeling hospital's outpatient department workflow in a developing country and optimizing the patient waiting time as well as total length of stay. By using discrete-event simulation, many alternative scenarios have raised, such as adding more working time, altering human resources, and adjusting the staff's responsibility, those scenarios will be examined to explore better settings for the hospital. The results show that possible to achieve a 9.6% reduction in patient total length of stay and it could be accomplished without adding more resources to the hospital.

• Journal of Chest Surgery
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• 제12권3호
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• pp.259-262
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• 1979

Alopecia is a minor complication following open heart surgery, but it is a cosmetic and psychotic problem to the patient. Especially the extensive long period of operation, prolonged mechanical ventilation and no change of patient head position during operative and recovery period may serve the localized scalp pressure effect, which causes postoperative alopecia. So, for prevention of the postoperative alopecia, adequate blood flow and pressure must be maintained with alternative change of head position during operative and recovery period. The author experienced one case of occipital alopecia following open heart surgery and reports with literature.

• Journal of Chest Surgery
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• 제21권1호
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• pp.148-151
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• 1988

We experienced 2 years and 5 months old male patient with partial anomalous pulmonary venous return of the left lung into the coronary sinus without atrial septal defect. After incising the atrial septum and the wall between the left atrium and the coronary sinus, we made the roof of the coronary sinus and closed the artificial atrial septal defect, with using patch, then we could change the direction of the blood flow from the coronary sinus into the left atrium. The patient was discharged on the 13th postoperative day after uneventful postoperative course.

• Journal of Communications and Networks
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• 제8권4호
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• pp.410-421
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• 2006

In this work, we propose an analytic framework for dimensioning the link capacity of broadband access networks which provide universal broadband access services to a diverse kind of customers such as patient and impatient customers. The proposed framework takes into account the flow-level quality of service (QoS) of a connection as well as the packet-level QoS, via which a simple and systematic provisioning and operation of the network are provided. To that purpose, we first discuss the necessity of flow-aware network dimensioning by reviewing the networking technologies of the current and future access network. Next, we propose an analytic model for dimensioning the link capacity for an access node of broadband convergence networks which takes into account both the flow and packet level QoS requirements. By carrying out extensive numerical experiment for the proposed model assuming typical parameters that represent real network environment, the validity of the proposed method is assessed.

• 기본간호학회지
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• 제20권3호
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• pp.239-247
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• 2013

Purpose: This study was done to investigate the relationship between metacognition, learning flow, and problem solving ability in simulation learning of nursing students and to identify the factors influencing problem solving ability. Methods: The study sample was 136 nursing students. Data were collected from September to November, 2012 using a structured questionnaire on metacognition, learning flow and problem solving ability. Descriptive statistics, Pearson correlation and stepwise multiple regression analysis were used with the SPSS win 20.0 program to analyze the data. Results: There were significant positive correlations between metacognition, learning flow and problem solving ability. Learning flow was a significant factor affecting problem solving ability. These variables accounted for 33% of variance. Conclusion: These results suggest that simulation learning has a positive effect on nursing students' learning outcomes.

• 대한의용생체공학회:의공학회지
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• 제29권4호
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• pp.323-328
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• 2008

A patient with respiratory disorders such as a sleep apnea is increasing as the obese patient increase on the modern society. Positive Airway Pressure (PAP) devices are used in curing patient with respiratory disorders and turn out to be efficacious for patients of 75%. However, these devices are required for evaluating their performance to improve their performance by the mechanical breathing simulator. Recently, the mechanical breathing simulator was studied by the real time feedback control. However, the mechanical breathing simulator by an open loop control was specially required in order to analyze the effect of flow rate and pressure after operating the breathing auxiliary devices. Therefore the aims of this study were to make the mechanical breathing simulator by a piston motion and a valve function from the characteristic test of valve and motor, and to duplicate the flow rate and pressure profiles of some breathing patterns: normal and three disorder patterns. The mechanical simulator is composed cylinder, valve, ball screw and the motor. Also, the characteristic test of the motor and the valve were accomplished in order to define the relationship between the characteristics of simulator and the breathing profiles. Then, the flow rate and pressure profile of human breathing patterns were duplicated by the control of motor and valve. The result showed that the simulator reasonably duplicated the characteristics of human patterns: normal, obstructive sleep apnea (OSA), mild hypopnea with snore and mouth expiration patterns. However, we need to improve this simulator in detail and to validate this method for other patterns.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권3호
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• pp.181-185
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• 2004

Malignant tumor have hypoxic cell fraction, which makes radio-resistant and hypoxia in tumor is a result from the blood flow decrease caused by increase in blood flow resistance. Blood viscosity increase is major factor of increased blood flow resistance and it could be attributed to the decrease in blood deformability index. For the evaluation of the change of blood viscosity and blood deformability in oral squamous cell carcinoma, we perform the test of the change of those factors between the normal control group and oral squamous cell carcinoma cell patient group. Relative viscosity measured against distilled water was $5.25{\pm}0.14$ for normal control group, and $5.78{\pm}0.26$ for the SCC patient group and there was statistical significance between the groups. However, there was no significant difference between the groups in blood viscosity between the groups by tumor size (T1+T2 vs T3+T4). Also, there was no significant difference between the normal control group and SCC patient group in blood deformability index and between the groups by tumor size (T1+T2 vs T3+T4). Increase in blood viscosity was confirmed with this study and it can be postulated that modification blood viscosity might contribute to decrease of hypoxia fraction in oral squamous cell carcinoma, thus improve the effect of radiotherapy and it can be assumed that the main factor of blood viscosity increase is not decrease of blood deformability in oral squamous cell carcinoma.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제25권4호
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• pp.452-461
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• 2023

The Anterior Inferior Cerebellar Artery-Posterior Inferior Cerebellar Artery (AICA-PICA) common trunk is a rare variant of cerebral posterior circulation in which a single vessel originating from either the basilar or vertebral arteries supplies both cerebellum and brainstem territories. We present the first case of an unruptured right AICA-PICA aneurysm treated with flow diversion using a Shield-enhanced pipeline endovascular device (PED, VANTAGE Embolization Device with Shield Technology, Medtronic, Canada). We expand on this anatomic variant and review the relevant literature. A 39-year-old man presented to our treatment center with vertigo and right hypoacusis. The initial head CT/CTA was negative, but a 4-month follow-up MRI revealed a 9 mm fusiform dissecting aneurysm of the right AICA. The patient underwent a repeat head CTA and cerebral angiogram, which demonstrated the presence of an aneurysm on the proximal portion of an AICA-PICA anatomical variant. This was treated with an endovascular approach that included flow diversion via a PED equipped with Shield Technology. The patient's post-procedure period was uneventful, and he was discharged home after two days with an intact neurological status. The patient is still asymptomatic after a 7-month follow-up, with MR angiogram evidence of stable aneurysm obliteration and no ischemic lesions. Aneurysms of the AICA-PICA common trunk variants have a high morbidity risk due to the importance and extent of the territory vascularized by a single vessel. Endovascular treatment with flow diversion proved to be both safe and effective in obliterating unruptured cases.

• Clinical and Experimental Pediatrics
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• 제56권11호
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• pp.500-504
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• 2013

Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.

• 대한물리의학회지
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• 제10권1호
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• pp.115-120
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• 2015

PURPOSE: Vertebrobasilar insufficiency (VBI) should be carefully assessed in patient for whom manipulation of the cervical spine is to be undertaken. The purpose of this study was to investigate the changes in posterior cerebral artery blood flow velocity following head and body positioning by transcranial doppler ultrasonography (TCD) in healthy subjects. METHODS: Twenty two healthy female (mean age $20.77{\pm}1.30yrs.$) participants volunteered to participate in the study. None of the participants had a history of neck pain or headache within the last 6 months. To evaluate the cerebral blood flow, we measured the mean flow velocity of the posterior cerebral artery unilaterally (right side). The blood flow velocity was measured under 3 different head positions (in a neutral head position, ipsilateral head rotation and contralateral head rotation position) and 2 different body conditions (supine position and sitting position). RESULTS: The mean blood flow velocity of posterior cerebral artery was decreased in body positioning from supine to sitting (p<.05), but the decreased rate of blood flow velocity in posterior cerebral artery did not change significantly between ipsilateral head rotation and contralateral head rotation (p>.05). CONCLUSION: These result of our study show that body positioning (sitting and supine) affect the blood flow velocity in posterior cerebral artery.