• Title/Summary/Keyword: difference of medical system

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A Study on the Correlation of Heart Rate Variability and Coldness of Hands (수부 냉증 정도와 Heart Rate Variability(HRV)의 상관성 연구)

  • Nam, Eun-Young;Yoo, Su-Jeoung;Kim, Hyung-Jun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.28 no.4
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    • pp.46-56
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    • 2015
  • Objectives : Cold hypersensitivity has been regarded to be associated with Autonomic Nervous System (ANS). This study aims to investigate the indicator of cold hypersensitivity of hands and evaluate the correlation between indicator of coldness of hands and Heart Rate Variability (HRV). Methods : We studied 55 patients with cold hypersensitivity of hands who visited in SeMyung University Hospital from 17 August 2015 to 21 August 2015. Thermometer and VAS scale were used for the diagnosis of cold hypersensitivity. After careful examination to rule out other disease which may affect thermometer and HRV data, patients were taken thermometer, those with thermal difference between upper arm (L4) and palm(P8), also asked to answer a VAS scale of cold hypersensitivity of hands, VAS more than 4 were enrolled for evaluation. Results : There was significant correlation between L4-P8 temperature difference and VAS score of cold hypersensitivity. In HRV data, normalized high frequency (HF normal) was significantly correlated with L4-P8 temperature difference, which was objective indicator of cold hypersensitivity of hands. Conclusions : L4-P8 temperature difference using thermometer is objective indicator of cold hypersensitivity, based on VAS scale. Cold hypersensitivity is highly related with ANS, regulating body heat and temperature. HRV is considered to be widely used in cold hypersensitivity in hands for evaluation of ANS.

Clinical Implications of High Definition Multileaf Collimator (HDMLC) Dosimetric Leaf Gap (DLG) Variations

  • Chang, Kyung Hwan;Ji, Yunseo;Kwak, Jungwon;Kim, Sung Woo;Jeong, Chiyoung;Cho, Byungchul;Park, Jin-hong;Yoon, Sang Min;Ahn, Seung Do;Lee, Sang-wook
    • Progress in Medical Physics
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    • v.27 no.3
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    • pp.111-116
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    • 2016
  • This study is to evaluate the dosimetric impact of dosimetric leaf gap (DLG) and transmission factor (TF) at different measurement depths and field sizes for high definition multileaf collimator (HD MLC). Consequently, its clinical implication on dose calculation of treatment planning system was also investigated for pancreas stereotactic body radiation therapy (SBRT). The TF and DLG were measured at various depths (5, 8, 10, 12, and 15 cm) and field sizes ($6{\times}6$, $8{\times}8$, and $10{\times}10cm^2$) for various energies (6 MV, 6 MV FFF, 10 MV, 10 MV flattening filter free [FFF], and 15 MV). Fifteen pancreatic SBRT cases were enrolled in the study. For each case, the dose distribution was recomputed using a reconfigured beam model of which TF and DLG was the closest to the patient geometry, and then compared to the original plan using the results of dose-volume histograms (DVH). For 10 MV FFF photon beam, its maximum difference between 2 cm and 15 cm was within 0.9% and it is increased by 0.05% from $6{\times}6cm^2$ to $10{\times}10cm^2$ for depth of 15 cm. For 10 MV FFF photon beam, the difference in DLG between the depth of 5 cm and 15 cm is within 0.005 cm for all field sizes and its maximum difference between field size of $6{\times}6cm^2$ and $10{\times}10cm^2$ is 0.0025 cm at depth of 8 cm. TF and DLG values were dependent on the depth and field size. However, the dosimetric difference between the original and recomputed doses were found to be within an acceptable range (<0.5%). In conclusion, current beam modeling using single TF and DLG values is enough for accurate dose calculation.

The Necessity of Education on Medical Oxygen Respiration First Aid (응급현장에서 산소 인공호흡법 교육의 필요성)

  • Kang, Yong-Su;Jo, Jean-Man;Lee, Tae-Yong
    • The Korean Journal of Emergency Medical Services
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    • v.12 no.1
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    • pp.43-52
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    • 2008
  • I studied and analyzed current status about the necessity of Medical Oxygen Respiration First Aid when we perform first aid at emergency locations. As immediate and efficient first aid methods it is necessary to be able to use medical oxygen respiration equipments. I presented the basic data to develop and standardize education system on medical oxygen respiration first aid. Among those who were working at emergency locations in Korea from September 15th, 2005 to September 30th, 2005, I performed a survey on a professional group of 75 people and a non-professional group of 132 people. The results of the survey are summarized as follows. 1) There was difference between the professional group and the non-professional group on recognition about whether general public can perform medical oxygen respiration first aid(p<0.05). 2) On the necessity of medical oxygen respiration first aid, 93.2% of the total answered it is necessary and 6.8% answered it is unnecessary, so both groups thought it is very necessary(p>0.05). 3) On the importance of medical oxygen respiration first aid, 95.2% of the total answered it is important and 4.8% answered it is unimportant, so both groups thought it is very important(p>0.05). 4) On correspondence on necessity and importance of medical oxygen respiration first aid, there was a difference in thoughts between the professional group and the non-professional group(p<0.05). 5) On the necessity of education on medical oxygen respiration first aid, 98.1% of the total answered it is necessary and 1.9% answered it is unnecessary, so both groups thought it is very necessary(p>0.05).

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Development of the Dripping Speed Measurement System of Medical Liquid using Heuristic (휴리스틱을 이용한 의료 수액 낙하 속도 측정 시스템 개발)

  • Kim, Jung-Sook;Jeong, Junho
    • Journal of the Korean Institute of Intelligent Systems
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    • v.24 no.5
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    • pp.542-547
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    • 2014
  • This paper describes the medical and IT convergence system using a smart phone and a heuristic method for the measurement of the dripping speed of the liquid in a drip chamber, which can estimate the remaining time using pattern recognition and difference image from video frame information based on Android technology. The video frames were first made using a smartphone camera and we calculated the difference image between the n image and the (n-1) image and then changed into binary images using the threshold value. At this point, it is very important to find an optimal threshold value using heuristic method to recognize the dripping of the liquids. In addition, the user can adjust the dripping speed according to the doctor's prescription, exactly like watching the progress bar of a mobile application. The experiment results show that our method using video processing technique accurately measures the dripping speed for a wide range of speeds that are sufficient for ordinary practice.

Impact of the Liver Imaging Reporting and Data System on Research Studies of Diagnosing Hepatocellular Carcinoma Using MRI

  • Yura Ahn;Sang Hyun Choi;Jong Keon Jang;So Yeon Kim;Ju Hyun Shim;Seung Soo Lee;Jae Ho Byun
    • Korean Journal of Radiology
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    • v.23 no.5
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    • pp.529-538
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    • 2022
  • Objective: Since its introduction in 2011, the CT/MRI diagnostic Liver Imaging Reporting and Data System (LI-RADS) has been updated in 2014, 2017, and 2018. We evaluated the impact of CT/MRI diagnostic LI-RADS on liver MRI research methodology for the diagnosis of hepatocellular carcinoma (HCC). Materials and Methods: The MEDLINE, EMBASE, and Cochrane databases were searched for original articles reporting the diagnostic performance of liver MRI for HCC between 2011 and 2019. The MRI techniques, image analysis methods, and diagnostic criteria for HCC used in each study were investigated. The studies were classified into three groups according to the year of publication (2011-2013, 2014-2016, and 2017-2019). We compared the percentage of studies adopting MRI techniques recommended by LI-RADS, image analysis methods in accordance with the lexicon defined in LI-RADS, and diagnostic criteria endorsed by LI-RADS. We compared the pooled sensitivity and specificity between studies that used the LI-RADS and those that did not. Results: This systematic review included 179 studies. The percentages of studies using imaging techniques recommended by LI-RADS were 77.8% for 2011-2013, 85.7% for 2014-2016, and 84.2% for 2017-2019, with no significant difference (p = 0.951). After the introduction of LI-RADS, the percentages of studies following the LI-RADS lexicon were 0.0%, 18.4%, and 56.6% in the respective periods (p < 0.001), while the percentages of studies using the LI-RADS diagnostic imaging criteria were 0.0%, 22.9%, and 60.7%, respectively (p < 0.001). Studies that did not use the LI-RADS and those that used the LIRADS version 2018 showed no significant difference in sensitivity and specificity (86.3% vs. 77.7%, p = 0.102 and 91.4% vs. 89.9%, p = 0.770, respectively), with some difference in heterogeneity (I2 = 94.3% vs. 86.7% in sensitivity and I2 = 86.6% vs. 53.2% in specificity). Conclusion: LI-RADS imparted significant changes in the image analysis methods and diagnostic criteria used in liver MRI research for the diagnosis of HCC.

The effectiveness of oriental medical therapy compared to oriental-western medical therapy on acute bell's palsy (급성기 말초성 안면신경마비에 대한 한방치료와 한양방 병용치료의 효과비교)

  • Cho, Ki-Ho;Jung, Woo-Sang;Hong, Jin-Woo;Hwang, Jae-Woong;Na, Byung-Jo;Park, Seong-Uk;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Korean Medicine
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    • v.29 no.1
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    • pp.146-155
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    • 2008
  • Objectives : This study was to assess the effectiveness of oriental medical therapy (OM) on acute Bell's palsy, comparing its outcome with that of oriental-western medical therapy (OWM). Methods : Subjects were enrolled atKyung Hee Medical Center from March 2007 to December 2007. We prescribed Igigeopung-san and acupuncture therapy to both the OM and OWM groups, and prednisolone only to the OWM group. Effectiveness was assessed by the House-Brackmann facial nerve grading system (HBGS) and Yanagihara's unweighted grading system (YUGS) every week. Results : There were 31 patients in the OM group and 34 in the OWM group. About grading system scores and weekly score gaps, no significant differences were revealed between the two groups, but statistical significant difference was detected at recovery time. After 2 weeks of treatment, the OM group's HBGS score showed significant difference from baseline score, but the OWM group showed it after 1 week. After 3 weeks of medication, pain was reduced in 22% of OM group patients, but 50% in the OWM group (p=0.028). We made the same comparison study for patients treated within 4 days from onset, but there was no significant difference between the two groups. 3 cases of adverse effect of hyperglycemia were found in the OWM group, which could be due to hyperglycemic side-effect of prednisolone. Conclusion : This work could help us to understand the effectiveness of OM compared to OWM on acute Bell's palsy.

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Development of the DRG Adjust Index for Nursing Care Quality Assurance (간호의 질 보장을 위한 DRG 보정지수 개발)

  • Kim, Sea-Wha;Kim, Yun-Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.10 no.1
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    • pp.1-9
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    • 2004
  • Korean health insurance has adopted preliminary DRG payment system through 8 DRGs from 1997. But present DRG payment system gives economic incentives for hospitals to hire less nurse. This study was attempted to develope DRG adjust index to differentiate DRG price by nurse staffing level for nursing care quality. Method: We analyzed inpatient care cost by medical institute and developed DRG adjust index to differentiate DRG price by nurse staffing level. Results: Among same medical institute, inpatient care cost are very different according to hospital's nurse staffing level. In the case of casarean section, inpatient care cost of the 1st grade general hospital are more expensive 85,732won than the 6th grade hospital. The cost difference are 8.24% of total casarean section DRG price and 16.48% of DTG variable price. We developed DRG adjust index-a to apply DRG variable price and index-b to apply DRG total price for compensation cost difference of hospitals. Conclusions: DRG price adjust index will give economic incentive for hospitals to hire more nurse and improve nursing care quality.

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The Influence of Unstable Modified Wall Squat Exercises on the Gait Variables of Healthy Adults (정상 성인에서 불안정 지지면의 수정된 월-스쿼트 운동이 보행변수에 미치는 영향)

  • Gong, Won-tae;Lee, Jae-nam;Park, Jae-myoung
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.22 no.1
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    • pp.9-15
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    • 2016
  • Background: This study was conducted to investigate the effects of unstable modified wall squat exercises accompanied by abdominal drawing-in on the gait variables of healthy adults. Methods: The total number of subjects was 30, and 15 were randomly placed in the training group (TG) and 15 in the control group (CG). To determine the gait variables of TG and CG, step length difference (SLD) stance phase difference (STPD), swing phase difference (SWPD), single support difference (SSD), and step time difference (STD) were measured using OptoGait, a gait analysis system. Results: When the pre-intervention and post-intervention results of TG and CG were compared, statistically significant differences in SLD, STPD, SWPD, SSD and STD of TG were seen. Conclusion: Unstable modified wall squat exercises accompanied by abdominal drawing-in might help reduce the deviation between left and right gait variables during walking.

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General Health Status and Physical Care Burdens of Patients Groups in Long-Term Care Hospitals (요양병원 환자분류군별 전반적 건강수준 및 육체적 수발부담 차이)

  • Chin, Young-Ran;Lee, Hyo-Young
    • The Korean Journal of Health Service Management
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    • v.12 no.1
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    • pp.81-93
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    • 2018
  • Objectives : This cross-sectional study aims to investigate the differences in general health status (GHS) and physical care burdens (PCB) of inpatient groups in long-term care hospitals (LTCH). Methods : The data of 228 patients were analyzed by integrating the electronic medical record (EMR) data of 2016, recorded by the nurses of hospitalized patients in the hospital. Results : There was a statistically significant difference in the GHS between the high-medical demand group and the other groups, but there was no difference in the GHS among other groups. The overall PCB was higher in the high-medical demand group than in the middle-medical demand, and cognitive impairment groups, but not in the problem behavioral group. Conclusions : The current classification of patient groups has shown limitations in terms of the basis of differential benefits of the groups. In particular, the PCB of the problem behavior group was not different from that of any group; hence, it should be adjusted through further study. To control the surge of medical care costs, it is necessary to improve the irrationality of the LTCH pay system in terms of the integration and continuity for elderly care.

Operating conditions and satisfaction in a clinical training program for 119 emergency medical technicians (119구급대원의 병원 임상수련 운영 실태 및 만족도)

  • Oh, Hyeon-Hwan;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.19 no.2
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    • pp.99-115
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    • 2015
  • Purpose: This study aimed to provide basic data for clinical training program development by analyzing the operating conditions and satisfaction in a clinical training program for 119 emergency medical technicians (EMTs) in South Korea. Methods: Data from 84 EMTs were collected on June 19, 2014. We administered a 64-item questionnaire about operating conditions and satisfaction in the clinical training program, and analyzed data (SPSS v 21.0). Results: The degree of performance in the field, importance of the item in the field, and level of difficulty were 3.36, 4.23, and 3.21, respectively. In the number of times that an item was directly performed according to the subjects' general characteristics a statistically difference in sex (p = .000), duty (p =.021), and total working time of trainees (p = .002). The subjects' total satisfaction score was 3.77. The difference in satisfaction according to the subjects' characteristics was a statistically significant in terms of sex (p = .016) and clinical training area (p = .005). Conclusion: A more efficient training system for hospital clinical training courses should be developed. The operation condition analyzed in this research may contribute to the improvement of the performance of EMTs.