• Title/Summary/Keyword: medical direction methods

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Using Bayesian Approaches to Reduce Truncation Artifact in Magnetic Resonance Imaging

  • Lee, Su-Jin
    • Journal of Biomedical Engineering Research
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    • v.19 no.6
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    • pp.585-593
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    • 1998
  • In Fourier magnetic resonance imaging (MRI), the number of phase encoded signals is often reduced to minimize the duration of the studies and maintain adequate signal-to-noise ratio. However, this results in the well-known truncation artifact, whose effect manifests itself as blurring and ringing in the image domain. In this paper, we propose a new regularization method in the context of a Bayesian framework to reduce truncation artifact. Since the truncation artifact appears in t도 phase direction only, the use of conventional piecewise-smoothness constraints with symmetric neighbors may result in the loss of small details and soft edge structures in the read direction. Here, we propose more elaborate forms of constraints than the conventional piecewise-smoothness constraints, which can capture actual spatial information about the MR images. Our experimental results indicate that the proposed method not only reduces the truncation artifact, but also improves tissue regularity and boundary definition without oversmoothing soft edge regions.

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Effects of Gluteus Medius Strengthening Training Using Pressure Biofeedback Unit for Muscle Function and Balance in Stroke Patients

  • Park, Jeong-Ju;So, Hyun-Jeong;Shin, Won-Seob
    • The Journal of Korean Physical Therapy
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    • v.27 no.4
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    • pp.221-227
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    • 2015
  • Purpose: The purpose of this study was to examine the impact of gluteus medius (GM) strengthening training using the pressure biofeedback unit for lower extremity muscle function and balance ability in stroke patients. Methods: Twenty-seven stroke patients (14 men, 13 women) volunteered to participate in this study. They were randomly assigned to 3 groups: pressure biofeedback unit GM training, general GM training, and control group. Experimental group 1 performed GM strengthening training using PBU in the sidelying position. Experimental group 2 performed GM strengthening training without PBU in the sidelying position. The training program lasted 4 weeks (20-minute sessions, three times a week). Muscle function was assessed by measuring muscle strength and endurance, and Berg balance scale (BBS), Lateral Reach Test (LRT), and limited of stability (LOS) velocity were measured for evaluation of balance ability. Results: Enhancement of muscle strength and endurance was significantly higher in experimental group 1 than in the other two groups (p<0.05). In comparison of the balance function, experimental group 1 showed a significantly enhanced ability to balance (p<0.05). After the intervention, experimental group 1 showed a significant reduction of LOS velocity in the anterior direction and affected direction (p<0.05). There was no significant difference than the other two groups but a large reduction was observed. Conclusion: These findings suggest that selective gluteus medius strengthening training using the pressure biofeedback unit is effective for lower extremity muscle function and balance ability in stroke patients.

The Broad-beam CT Image Reconstruction from Simulator Images (모의치료(Simulation) 영상을 이용한 Broad-beam CT 영상 구현)

  • Yi, Byong-Yong
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.81-86
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    • 1998
  • Purpose : To generate the axial, coronal and sagittal images from conventional simulation images, as a preliminary study of broad-beam simulator CT. Methods and Materials : Volumetric filtered back-projection was performed using 90 sheets of films from conventional simulator for every $4^{\circ}$ gantry angle. Two mAs exposure condition for 120kvp beam qualify at SFD 140cm was given to each film. Outside the silhouette portion was removed and scatter component was deconvolved before back-projection. Results : The axial, the sagittal and the coronal images with same spatial resolutions over all direction could be obtained. But image quality was very poor. Conclusion : CT images could be obtained using broad-beam. Scatter deconvolution technique was effective for this reconstruction. The fact that same spatial resolutions over all direction tells us the possibility of application of this technique to DRR or Simulator-CT. But the quality of image should be improved for clinical application practically.

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Concha bullosa, nasal septal deviation, and their impacts on maxillary sinus volume among Emirati people: A cone-beam computed tomography study

  • Al-Rawi, Natheer H;Uthman, Asmaa T;Abdulhameed, Elaf;Al Nuaimi, Ahmed S;Seraj, Zahra
    • Imaging Science in Dentistry
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    • v.49 no.1
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    • pp.45-51
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    • 2019
  • Purpose: To determine the prevalence of concha bullosa (CB) and nasal septal deviation (NSD) and their impact on maxillary sinus volume (MSV). Materials and Methods: Cone-beam computed tomographic (CBCT) images of 106 Emirati people were used in this study. The direction and angle of septal deviation were calculated. The presence of CB, which could be unilateral, contralateral, or bilateral in relation to the direction of NSD, was also recorded. MSV was measured using reconstructed Digital Imaging and Communication in Medicine images on Dolphin 3D imaging software version 11.8 premium (Dolphin Imaging, Chatsworth, CA, USA). P values<0.05 were considered to indicate statistical significance. Results: CB was detected in 37.7% of the sample; 20.7% of the sample showed single unilateral CB and 16.6% had single bilateral CB. NSD was seen in 74.5% of the sample. In the participants with CB, 45.5% showed mild deviation, 34.4% showed moderate deviation, and only 12.5% showed severe septal deviation. CB, but not NSD, was associated with significantly higher MSV on the affected side (P=0.001). Conclusion: Although NSD was observed in more than two-thirds of the sample and CB was present in more than one-third of the sample, only CB had a significant impact on MSV.

Comparison of postural control between subgroups of persons with nonspecific chronic low back and healthy controls during the modified Star Excursion Balance Test

  • Shallan, Amjad;Lohman, Everett;Alshammari, Faris;Dudley, Robert;Gharisia, Omar;Al-Marzouki, Rana;Hsu, Helen;Daher, Noha
    • Physical Therapy Rehabilitation Science
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    • v.8 no.3
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    • pp.125-133
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    • 2019
  • Objective: To compare the postural control between non-specific chronic low back pain (NSCLBP) subgroups and healthy people during dynamic balance performance using a modified Star Excursion Balance Test (mSEBT). Design: Cross-sectional study. Methods: Eighteen NSCLBP subjects (9 active extension pattern [AEP], 9 flexion pattern [FP]), and 10 healthy controls were enrolled in this study. All subjects performed mSEBT on their dominant leg on a force plate. Normalized reach distance and balance parameters, including the center of pressure (COP) displacement and velocity, were recorded. Results: There were significant differences in mean reach distances in both posterolateral and posteromedial (PM) reach directions between AEP and healthy subjects (p<0.001) and between FP and healthy subjects (p<0.001). However, there were no significant differences among the three groups in the anterior reach direction. Also, the results showed no significant differences in mean COP variables (velocity and displacement) between pooled NSCLBP and healthy subjects. However, the subjects were reclassified into AEP, FP and healthy groups and the results showed a significant difference in mean COP velocity in the PM direction between AEP and FP subjects (p=0.048), and between AEP and healthy subjects (p=0.024). Conclusions: The findings in this study highlight the heterogeneity of the individuals with NSCLBP and the importance of identifying the homogenous subgroups. Individuals with AEP and FP experience deficits in dynamic postural control compared to healthy controls. In addition, the findings of this study support the concept of the Multidimensional Classification System.

Korean Domestic Trends of Clinical Research and Direction of Intervention for Fibromyalgia (섬유근통에 대한 국내 임상 연구 동향 및 중재 방향)

  • Lee, Jung-Han;Geum, Ji-Hye;Woo, Hyeon-Jun;Lee, Chang-Hoon;Chung, Chong-Hyuk;Lee, Myeung-Su
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.15 no.2
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    • pp.43-54
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    • 2020
  • Objectives The purpose of this review was to analyze the trend of clinical research related to fibromyalgia and to suggest the direction of intervention Methods We reviewed the clinical research by searching seven Korean web databases and classified the studies by the year of publication, academic field, and study design. Results A total of 75 clinical studies were selected. Except for 2002, more than one study was annually published; however, the number was below 10. In the academic field, there were 34 in the medical field, 21 in the Korean medicine field, and 15 in the nursing science field. By study design, there were 62 observational studies, mostly case reports and case-control studies. There were 13 experimental studies, including non-random control studies and one group pre and post-test design studies. Conclusions Fibromyalgia-related clinical research requires a greater number of studies, and a study design with a high level of evidence should be conducted along with various observational and intervention studies. Additionally, multidisciplinary and integrated intervention plans and research are needed.

A Study on the Strategy of Sustainable Hospital Architecture Masterplan (지속가능한 병원건축 마스터플랜 전략에 관한 연구)

  • Park, Cheolkyun;Yang, Naewon
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.26 no.4
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    • pp.15-26
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    • 2020
  • Purpose: The purpose of this study is to derive a plan to establish a more sophisticated master plan so that the direction of master plan study can be sustained in the mid to long term. Methods:: Compare and analyze the differences between the master plan and the design to identify causes and problems. First, after establishing the master plan, compare the expansion area, net area per bed, and service area with the design drawing of the first project to determine the degree of recovery to the level required by the recent medical environment. Second, the possibility of responding to future internal changes is reviewed by comparing and analyzing the arrangement and connection method of extension buildings. Third, comparing the difference between the project following the first project and the phased of masterplan. Results: The first one is that continuous participation of person or group with high understanding of the master plan. Second, establishing a master plan and proceeding with the project through the determination of the correct business budget. Third, a specific area of the mechanical and electrical room suitable for the size and purpose of the hospital should be presented, and research on the arrangement method should be conducted. Finally, the feasibility of the hospital's own plan for securing parking facilities should be accurately investigated. Implications: It is important for the hospital to recover from the past to the present and respond to the future that the direction of the master plan continues after the establishment.

The Institutionalization Process of the Visiting Rehabilitation System in Japan and the Challenges Faced in the Process

  • Lee, Minyoung
    • The Journal of Korean Physical Therapy
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    • v.34 no.2
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    • pp.80-89
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    • 2022
  • Purpose: In Japan, the long-term care insurance and health insurance acts have stipulated the visiting rehabilitation system to provide support at the national level. The prior case of Japan would provide guidelines for seeking a suitable policy direction in South Korea. This study aims to examine the historical transition process of the visiting rehabilitation system in Japan, and the issues that emerged in the process of the institutionalization of this system. Methods: To examine the historical transition process of the system, the regulations announced by the government and their reports were reviewed. The relevant issues were qualitatively analyzed based on the opinions of scholars, therapists, and interested organizations that were reported in published papers on the topic. Result: The visiting rehabilitation system has been implemented in the following chronological order: The Health and Medical Service Act for the aged (1982-2006), the Health Insurance Act (1988-), and the Long-term Care Insurance Act (2000-). Currently, visiting rehabilitation is provided through hospitals, clinics, visiting nursing stations, etc. The following issues came to the fore in the process of the institutionalization of the system: (1) the complexity of the system, (2) the necessity of changing perceptions into a life model approach, (3) insufficient service provision by therapists, (4) the lack of human resources and an education system, (5) the lack of awareness of care managers and doctors about visiting rehabilitation, and (6) the necessity of quality enhancement through a team approach. Conclusion: It is deemed worthwhile to refer to the visiting rehabilitation system in Japan and the issues that emerged in the process of institutionalizing the system while seeking a policy direction for a similar system in South Korea.

Trends and Future Direction of the Clinical Decision Support System in Traditional Korean Medicine

  • Sung, Hyung-Kyung;Jung, Boyung;Kim, Kyeong Han;Sung, Soo-Hyun;Sung, Angela-Dong-Min;Park, Jang-Kyung
    • Journal of Pharmacopuncture
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    • v.22 no.4
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    • pp.260-268
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    • 2019
  • Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.

The Level of Awareness and Practice in Prehospital Emergency Patient Assessment and Emergency Care of Paramedic in Fire Station (1급 응급구조사의 병원 전 응급환자평가와 응급처치시행에 대한 인식과 실천정도)

  • Kang, Yong-Ju;Choi, En-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.2
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    • pp.67-84
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    • 2011
  • Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.