• Title/Summary/Keyword: treatment planning

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Bone Mineral Bensity and Bone Turnover Markers in Patients with Femur Fracture Who Visited the Emergency Department (응급센터를 내원한 대퇴골 골절 환자에서 골밀도와 생화학적 표지자들의 의의)

  • Lee, Kyoung Mi;Han, Seung Baik;Kim, Jun Sig;Baek, Kwang Je;Hong, Seong Bin;Moon, Kyoung Ho;Kang, Joon Soon;Yoon, Seung-Hwan
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.87-93
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    • 2005
  • Background: The most frequent fracture seen at the emergency department (ED) in the elderly is a femur fracture whereas they do not know the degree of osteoporosis. We analyzed the degree of osteoporosis in patients with femur fractures and compared patients with only femur fractures (FX) to patients with femur and vertebral fractures (VX) by examining the clinical features, the bone mineral density (BMD), and biochemical markers. Methods: From January 2004 to December 2004, we enrolled prospectively 30 femur fracture patients who visited the ED. The bone mineral densities of the lumbar spine and the femur were examined. Total calcium, phosphate, alkaline phosphatase, osteocalcin, and serum C-terminal telopeptide (s-CTx) were measured. The patients with femur fractures were divided into two subgroups according to the presence of vertebral fracture. Results: All BMDs of the FX group showed osteoporosis. The s-CTx levels were higher than normal. The patients in the FX with VX were older than those in the FX only group, and had lower BMDs. There were no significant differences in markers between the subgroups, but the incidence of trochanteric fractures was higher in FX with VX group than in the FX only group. Conclusion: Femur fractures in the elderly were associated with osteoporosis. In our study, despite a considerable difference in BMD between patients with femur fractures and those with femur fractures combined with vertebral fractures, there was no difference in biochemical markers on bone formation nor in the those of bone resorption. We will further investigate the biochemical markers and BMD in the population of osteoporotic fractures. So those indicators should be helpful for planning treatment and for prevention of FX in the elderly.

Analysis about Planning Introduction PACS in Hospital Scale and Equipment Operation of Radiology Department (병원규모에서 PACS 도입 계획과 영상의학과 장비 운영에 관한 분석)

  • Seok, Jong-Min;Jung, Hong-Ryang;Lim, Cheong-Hwan;Kim, Jeong-Koo;Park, Jeong-Kyu
    • The Journal of the Korea Contents Association
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    • v.8 no.12
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    • pp.322-333
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    • 2008
  • This research examined use rate and profitability of equipment in hospital scale with about 500 beds to present data including to review before introducing PACS with the checklist included in preparation and proposal based on expected profit suggested by operation department and cost and use rate of the expensive medical equipment were analyzed. It was proved that profit was generated in the research subject hospital if PACS is introduced. Three to five year of lease is proper for the purchase method of medical equipment. Profit after two year of use will surpass investment cost and generate clear profit. Based on the profit generated from operation of radiology department, the purchase amount to introduce PACS at the hospital will be retrieved after about 1.9 years for the investment. The number of reshoot test at radiology department will be decreased and film, development, and fixer will not be necessary to buy so the operation cost will be reduced. Moreover, other than actual profit increased, the hospital can improve its reputation and employees can reduce their works and get better working environment with less stress. Their job satisfaction will be increased so they can improve service quality and it is good for marketing strategy of the hospital. As a result of this research, it was proved that the small and general hospital should have expected profit with introduction of PACS and analyze its contribution to treatment service and profit after the purchase. Then, the hospital should make a proposal for introduction of the medical equipment and establish effective operation plan.

Effectiveness Analysis of Alternatives for Water Resources Management Considering Climate Change and Urbanization (기후변화 및 도시화를 고려한 수자원관리 대안의 효과 분석)

  • Park, Kyung-Shin;Chung, Eun-Sung;Kim, Sang-Ug;Lee, Kil-Seong
    • Journal of Korea Water Resources Association
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    • v.42 no.12
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    • pp.1103-1111
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    • 2009
  • This study derived the analysis results of alternatives for integrated watershed management under urbanization and climate change scenarios. Climate change and urbanization scenarios were obtained by using SDSM (Statistical Downscaling Method) model and ICM (Impervious Cover Model), respectively. Alternatives for the Anyangcheon watershed are reuse of wastewater treatment plant effluent, and redevelopment of existing reservoir. Flow and BOD concentration duration curves were derived by using HSPF (Hydrological Simulation Program - Fortran) model. As a result, low flow ($Q_{99},\;Q_{95},\;Q_{90}$) and BOD concentration ($Q_{10},\;Q_5,\;Q_1$) were very sensitive to the alternatives comparing to high flow($C_{30},\;C_{10},\;C_1$). Although urbanization makes the hydrological cycle distorted, effective alternatives can reduce its damage. The numbers of days to satisfy the instreamflow requirements and target water quality were also sensitive to urbanization. This result showed that the climate change and urbanization should be considered in the water resources/watershed and environmental planning.

The Feasibility Study of photoconductor materials for the use of a dosimeter in Radiotherapy (광도전체 물질의 치료 방사선 선량계 적용을 위한 가능성 연구)

  • Jang, Giwon;Shin, Jungwook;Oh, Kyungmin;Park, Sungkwang;Kim, Jinyoung;Park, Jikoon;Nam, Sanghee
    • Journal of the Korean Society of Radiology
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    • v.7 no.1
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    • pp.81-84
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    • 2013
  • The use of the dosimetry have been increasingly recognized as high radiation energy and radiation treatment planning(RTP) have rapidly developed in radiotherapy. There are many types of detectors for the dosimetry such as ionization chamber, film, TLD, diode, and etc. Among such detectors, the diode detector uses a photoconductor materials that generate electrical signals by the incident radiation energy. Though many research groups are recently interested in such materials, there is few experimental results except for silicon in the radiation therapy field. In this study, the feasibility of photoconductor materials was verified as a dosimeter through the evaluation of response properties at a high radiation energy. For the fabricated detectors based on $HgI_2$ and $PbI_2$, reproducibility, linearity, and pulse-rate response were analyzed. Such evaluations are essential factors for the use of dosimeter. From results, linearity and reproducibility of the fabricated $HgI_2$ detector indicated about 7% error. The fabricated $PbI_2$ detector showed 1.7% error in linearity, and 12.2% error in reproducibility.

Evaluation of the Developmental Age of Permanent Teeth by the Nolla Method (Nolla 방법을 이용한 영구치의 발육 연령 평가)

  • Shin, Minkyung;Song, Jeseon;Lee, Jaeho;Choi, Byungjai;Kim, Seongoh;Lee, Hyoseol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.1
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    • pp.1-7
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    • 2016
  • The developmental age of permanent teeth was evaluated in children and adolescents according to age and gender using the Nolla Method. A retrospective study was performed on panoramic radiographs of 1,200 subjects aged 4-15 years, including 50 children for each age/gender group. Three well-trained examiners estimated the developmental stage of upper and lower permanent teeth using the Nolla Method. The inter-examiner reliability was excellent (intra-class correlation coefficient value = 0.973). The mean developmental age was calculated. In boys, Nolla stage 6, indicated by crown completion, was seen in the central incisor, lateral incisor, canine, first premolar, second premolar, first molar, and second molar at 5.4, 6.4, 6.7, 7.5, 7.8, 4.6, and 8.1 years, respectively, in the maxilla and at 4.8, 5.1, 6.0, 6.5, 7.2, 4.5, and 8.0 years, respectively, in the mandible. In girls, Nolla stage 6 was seen at 5.3, 6.0, 6.3, 7.3, 7.7, 4.8, and 8.1 years, respectively, in the maxilla and at 4.8, 5.1, 5.9, 6.5, 7.2, 5.0, and 7.9 years, respectively, in the mandible. In this study, the developmental age of permanent teeth was evaluated in Korean children and adolescents who visited Yonsei University Dental Hospital. This study may be helpful in diagnosis and treatment planning in the clinic.

Roles of Cancer Registries in Enhancing Oncology Drug Access in the Asia-Pacific Region

  • Soon, Swee-Sung;Lim, Hwee-Yong;Lopes, Gilberto;Ahn, Jeonghoon;Hu, Min;Ibrahim, Hishamshah Mohd;Jha, Anand;Ko, Bor-Sheng;Lee, Pak Wai;MacDonell, Diana;Sirachainan, Ekaphop;Wee, Hwee-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2159-2165
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    • 2013
  • Cancer registries help to establish and maintain cancer incidence reporting system, serve as a resource for investigation of cancer and its causes, and provide information for planning and evaluation of preventive and control programs. However, their wider role in directly enhancing oncology drug access has not been fully explored. We examined the value of cancer registries in oncology drug access in the Asia-Pacific region on three levels: (1) specific registry variable types; (2) macroscopic strategies on the national level; and (3) a regional cancer registry network. Using literature search and proceedings from an expert forum, this paper covers recent cancer registry developments in eight economies in the Asia-Pacific region - Australia, China, Hong Kong, Malaysia, Singapore, South Korea, Taiwan, and Thailand - and the ways they can contribute to oncology drug access. Specific registry variables relating to demographics, tumor characteristics, initial treatment plans, prognostic markers, risk factors, and mortality help to anticipate drug needs, identify high-priority research area and design access programs. On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes. Concurrent efforts should also be channeled into developing and implementing data integrity and stewardship policies, and providing clear avenues to make data available. Less mature registry systems can employ modeling techniques and ad-hoc surveys while increasing coverage. Beyond local settings, a cancer registry network for the Asia-Pacific region would offer cross-learning and research opportunities that can exert leverage through the experiences and capabilities of a highly diverse region.

EMS fund, is it functioning or fumbling? (응급의료기금, 무엇이 문제인가?)

  • Baek, Hong-Seok;Lee, Jun-Ho;Kim, Igic-Sung;Park, Hyun-Suk;Park, Sang-Sub
    • Journal of Korean Clinical Health Science
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    • v.1 no.1
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    • pp.35-45
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    • 2013
  • Purpose. Based on the comparison and analysis with those of United States, the aim of this research is to find the problems in current management, operation and future directions of emergency medical service (EMS) fund in S. Korea and to provide basic resources and appropriate measures to make a right decision in policies for EMS fund. Methods. Data from Ministry of Health and Welfare and other various sources during 1995 to 2012 were collected and analyzed. Results. From our analyses, several problems are identified in EMS fund operation. In brief, problems discerned are as follows. First, whereas the purpose and direction of EMS fund operations in United States are highlighted and focused on pre-hospital EMS system and associated infrastructures which need to be constructed, those of S. Korea are emphasized mainly on the in-hospital EMS system so far. Second, on the contrary to the fact that the EMS funds in United States are tuned to pre-hospital EMS system to provide prompt and efficient emergency care at the emergency scene of pre-hospital stage and to achieve the development, design, planning and demonstration projects for pre-hospital EMS systems, up to date, our investment of EMS funds demonstrated an excess biased inclination toward the construction of in-hospital EMS system, which is far from the realization of constructive and vital pre-hospital infrastructures. Third, while emergency medical technician is important and principal body in the management of emergency medical funds in United States, so far, no EMS funds in S. Korea existed for EMTs including the job condition, improved treatment and working environment for them. Conclusion. In conclusion, we strongly suggest that the problems pointed out must be revised and corrected. Current usage of EMS fund needs to be redirected predominatly to pre-hospital EMS system. Otherwise, unless current management and investment of emergency medical funds in S. Korea are applied and used for the vital necessities and demands of EMTs, public EMS units and private EMS units as well as related units in pre-hospital EMS system as in the cases of United States, in our consideration, they must be suspended or abolished.

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Anticipating the Need for Healthcare Resources Following the Escalation of the COVID-19 Outbreak in the Republic of Kazakhstan

  • Semenova, Yuliya;Pivina, Lyudmila;Khismetova, Zaituna;Auyezova, Ardak;Nurbakyt, Ardak;Kauysheva, Almagul;Ospanova, Dinara;Kuziyeva, Gulmira;Kushkarova, Altynshash;Ivankov, Alexandr;Glushkova, Natalya
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.6
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    • pp.387-396
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    • 2020
  • Objectives: The lack of advance planning in a public health emergency can lead to wasted resources and inadvertent loss of lives. This study is aimed at forecasting the needs for healthcare resources following the expansion of the coronavirus disease 2019 (COVID-19) outbreak in the Republic of Kazakhstan, focusing on hospital beds, equipment, and the professional workforce in light of the developing epidemiological situation and the data on resources currently available. Methods: We constructed a forecast model of the epidemiological scenario via the classic susceptible-exposed-infected-removed (SEIR) approach. The World Health Organization's COVID-19 Essential Supplies Forecasting Tool was used to evaluate the healthcare resources needed for the next 12 weeks. Results: Over the forecast period, there will be 104 713.7 hospital admissions due to severe disease and 34 904.5 hospital admissions due to critical disease. This will require 47 247.7 beds for severe disease and 1929.9 beds for critical disease at the peak of the COVID-19 outbreak. There will also be high needs for all categories of healthcare workers and for both diagnostic and treatment equipment. Thus, Republic of Kazakhstan faces the need for a rapid increase in available healthcare resources and/or for finding ways to redistribute resources effectively. Conclusions: Republic of Kazakhstan will be able to reduce the rates of infections and deaths among its population by developing and following a consistent strategy targeting COVID-19 in a number of inter-related directions.

Relationship of Amplification and Expression of the C-MYC Gene with Survival among Gastric Cancer Patients

  • Khaleghian, Malihea;Shakoori, Abbas;Razavi, Amirnader Emami;Azimi, Cyrus
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7061-7069
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    • 2015
  • Background: During the past decades, the incidence and mortality rate of stomach cancer has demonstrated a great decrease in the world, but it is still one of the most common and fatal cancers especially among men worldwide, including Iran. The MYC proto-oncogene, which is located at 8q24.1, regulates 15% of genes and is activated in 20% of all human tumors. MYC amplification and overexpression of its protein product has been reported in 15-30% of gastric neoplasias. The aim of this investigation was to find the relative efficacy of CISH (chromogenic in situ hybridization) or IHC (immunohistochemistry) in diagnosis and prognosis of gastric cancer, as well as the relationship of amplification and expression of C-MYC gene with patient survival. Materials and Methods: In this cross-sectional study, 102 samples of gastric cancer were collected from patients who had undergone primary surgical resection at the Cancer Institute Hospital, Tehran University of Medical Sciences, from July 2009 to March 2014. All samples were randomly selected from those who were diagnosed with gastric adenocarcinomas. CISH and IHC methods were performed on all of them. Results: Patients were classified into two groups. The first consisted of stage I and II cases, and the second of stage III and IV. Survival tests for both groups was carried out with referrnce to CISH test reults. Group II (stage III & IV) with CISH+ featured lower survival than those with CISH- (p=0.233), but group I (stage I & II) patients demonstrated no significant variation with CISH+ or CISH- (p=0.630). Kaplan-Meier for both groups was carried out with IHC test findings and showed similar results. This data revealed that both diffuse and intestinal types of gastric cancer occurred significantly more in men than women. Our data also showed that CISH+ patients (43%) were more frequent in comparison with IHC+ patients (14.7%). Conclusions: For planning treatment of gastric cancer patients, by focusing on expanding tumors, which is the greatest concern of the surgeons and patients, CISH is a better and more feasible test than IHC, in regard to sensitivity and specificity. Therefore, CISH can be used as a feasible test for tumor growth and prognosis in stage III and IV lesions. This study also indicated that C-MYC amplification in gastric cancer is correlated with survival in advanced stages.

Study on the Correlation between Digital Infrared Thermal Imaging-induced Severity of Cold Hypersensitivity of Hands and Feet and Heart Rate Variability (Digital Infrared Thermal Imaging에 따른 수족냉증 중증도와 Heart Rate Variability의 상관관계 연구)

  • Woo, Hye-Lin;Pak, Yeon-Kyeong;Kim, Joon-Ho;Park, Kyoung-Sun;Hwang, Deok-Sang;Lee, Jin-Moo;Jang, Jun-Bock;Lee, Chang-Hoon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.3
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    • pp.1-9
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    • 2016
  • Objectives: Cold Hypersensitivity of Hands and Feet (CHHF) has been diagnosed objectively by Digital Infrared Thermal Imaging (DITI) and has been known to be associated with autonomic nervous system (ANS), which can be assessed by Heart Rate Variability (HRV). This study evaluated the correlation between severity of CHHF and HRV variables.Methods: We studied 155 non-menopausal women with CHHF who visited Kyung Hee University Hospital at Gangdong from 01 October 2013 to 30 April 2016. We measured DITI and HRV of each patient. We used DITI to calculate the severity of CHHF with thermal difference between upper arm (L4, 俠白穴) and palm (P8, 勞宮穴) of both hands and anterior thigh (ST32, 伏兎穴) and dorsum of foot (LI3, 太衝穴) of both feet. The correlation between severity of CHHF and HRV variables were analyzed.Results: In time domain analysis, there was significantly positive correlation between the severity of CHHF and both SDNN and RMSSD. In frequency domain analysis, there was significantly positive correlation between the severity of CHHF and TP, HF and HF Norm while there was significantly negative correlation between the severity of CHHF and LF Norm as well as between the severity of cold hypersensitivity of both hands and LF/HF ratio.Conclusions: The more severe CHHF is, the more increased the function of parasympathetic nerve system (PNS) and relatively decreased the function of sympathetic nerve system (SNS) is. Also, it has known that cold hypersensitivity could be caused by deficiency syndrome and qi deficiency has the same ANS tendency as CHHF. Therefore, in practical fields, this result can be helpful in planning treatment and deciding prognosis in respect of deficiency syndrome.