Special Medical Equipment Research Articles

INDEPENDENT WORK AS AN IMPORTANT FACTOR IN THE FORMATION OF NURSES OF NEW GENERATION

The problems of individual out-of-class work maintenance in the process of medical student education are examined in the article. It is proved that the usage of different kinds of individual in-class and out-of-class work are required in educational process. The main principles of the productive individual work maintenance and qualitative control of its results are presented. Some peculiarities of the fulfillment of individual in-class and out-of- class work with the applying of special medical equipment are pointed out.

PMD125 - Influence of Medical–Economic Analysis on the Categorization of Special Medical Equipment

PMD125 - Influence of Medical–Economic Analysis on the Categorization of Special Medical Equipment

전산화단층촬영용장치의 안전관리 개정에 관한 연구

본 연구에서는 해부학적 영상 획득에 중추적인 역할을 담당함에 따라 전 세계적으로 검사빈도가 증가하고 있다. 하지만, 환자가 받는 방사선량이 상대적으로 높아 적절한 관리가 이루어지지 않으면 과도하거나 불필요한 방사선 피폭으로 환자선량을 증가시킬 수 있다. 이를 위해 특수의료장비로 지정하여 안전관리를 시행하고 있는 전산화 단층촬영용장치의 항구성 시험 IEC 60601-2-44의 개정판에 대하여 문헌 조사하였다. 그리고 비교 및 분석을 통하여 새로운 요구 사항에 대하여 알아보고자 하였다. 문헌 조사 결과 개정된 3판(3rd Ed)에서는 명확하고 강화된 기준값을 적용하고 있고, 2판에서(2nd Ed)의 한계점을 해결하기 위하여 합리적으로 개정되었다. 그러므로 현재 국내에서 적용하고 있는 IEC 60601-2-44 2판을 개정된 IEC 60601-2-44 3판으로 적용한다면 부적합한 의료장비로 인한 환자의 위해를 막을 수 있을 것으로 사료된다. Diagnostic imaging systems play a critical role in obtaining anatomical images, which increases the frequency of inspection all over the world. However the likelihood that patients are exposed to relatively high radiation dose increases, which may lead to an increase of patient dose due to unnecessary radiation exposure unless appropriate management is accompanied. Thus the revised edition of IEC 60601-2-44 which is constancy tests for CT equipment which is designated as special medical equipment and is subject to safety management was studied. The results suggested the 3rd has been revised rationally in order to overcome the limitations in the 2nd by adopting clear and enhanced references, which implies the replacement of IEC 60601-2-44 2nd edition with IEC 60601-2-44 3rd will prevent the patients from the harm from improper medical equipment.

Study on the Humanized Design of Medical Furniture

According to the special requests of modern hospital interior space, the medical furniture is defined and classified. By analysis the humanized design principle of medical furniture, as a special medical equipment, it emphasizes that the patients psychological needs should be considered in the design of medical furniture, and proposes new humanized design methods from each design essential factor to make the medical treatment environment better.

A Study on Small Area Variations of Hospital Services Utilization in Some Acute diseases -Focused on Gastric Diseases and Acute Appendicitis

This study aims to provide an important base resource for the effective medical supply system construction by figuring out the characteristics and changes of admission medical use of gastritis in 160 middle treatment areas classified by 2008 patient examination resources, and by figuring out factors affecting on changes. As a result, in terms of admission rate according to sex and age standardization per small area, there were differences as EQ was 15.1 and CV was 0.4. Top 10 variations were mainly in rural areas. It showed significant positive relations between admission and the number of bed, doctor and special medical equipment per 10,000 population. It is recommended that the government set a priority in the management of regional bed supply and the distribution of efficient medical resources.

A Study on Small Area Variations of Hospital Services Utilization in Heart Diseases

The purpose of this study is to provide preliminary data for political measures to minimize the variations by understanding the regional variations and trends of hospital services for heart diseases, and analyzing the factors that could occur any variations. The various data collected from nation-wide inpatient services conducted separately by small region show that there have been some differences in income level, supply of medical resources, standardized rate of hospitalization by sex and age, health level in the residence, and the length of stay per head. Then it indicated that the number of special medical equipment per 10,000 people and the rate of vigorous physical activity have the highest influence over the regional variations in using hospital services. On the other hand, the number of sick-beds per 10,000 people, the number of special medical equipment, and the present smoking rate have significant degree of influence on the length of stay per head. Thus, it is imperative for the authorities to set aside health promoting policies and to distribute the medical resources equitably throughout the country and to enhance the accessibility of local residents to the health care services.

Biotechnical measurement and software system controlled features for determining the level of psycho-emotional tension on man–machine systems by fuzzy measures

► A new software technique for determining emotional tension on humans is presented. ► For numerous diseases, a significant risk factor is long-term psycho-emotional tension. ► The assessment of tension is demonstrated on the diagnosis of digestive system diseases. ► In practice acceptable diagnosis quality is achieved without special medical equipment. ► The use of fuzzy logic decision-making can take parameter uncertainties into account. A new software technique for determining emotional tension on humans is developed by means of psychological tests connected with the psycho-emotional sphere and on indicators characterizing the state of a subject’s visual attention. Each of these two areas determines several factors for psycho-emotional tension. The level of tension is determined as an aggregate of these two components with the rules of fuzzy logic. The membership functions and solving rules for the psychological tests, and for the state of visual attention, are constructed using fuzzy logic theory. It is shown that the resulting method can be used as an informative feature for prediction of many properties, such as the situational awareness (training and experience) of an operator and the operator’s individual capacity to function (mental–physiological limits). The second group of indicators characterize properties such as switchable attention (the ability to switch attention) (SWA), concentration (ability to concentrate) (CNA), stability of visual attention (STA) and parameters determining the state of memory. One of the most important issues for man–machine systems is to evaluate the performance of operators under abnormal conditions such as stress or tension.

Current State and Role of Private Breast Clinic in Korea

increased and as treatments became variable including chemotherapy, it has become inevitably necessary to manage cancer at national level. Accordingly, our country established a ‘10-yr project for defeating cancer’in 1996 and started a national cancer screening program to detect early cancer since 1999. At the beginning, screening was held only for stomach, cervix and breast but from 2004, it has been extended to screen for 5 leading cancers including liver and colon. For the past 10 yr, in Korea, incidence of breast cancer has increased significantly and since 2002, it has become the first leading cancer in Korean women. However, the quality of facilities in Korean medical institutions diagnosing breast cancer primarily could not keep up with the increasing rate of breast cancer. Especially, there were large gaps in standards between mammography instruments. The purpose of taking mammography is to make high contrast/high resolution images with minimum radiation exposal. Obtaining the best breast image requires a mammography machine with proper positioning, compression, Quality Control (QC) program, and appropriate management. The State has already passed the Mammography Quality Standard Act (MQSA) law in 1992 and management has been carried out legally. Hence, Korea announced amendment pertaining to safety standards for mammography instruments in January 2001 as the first step. Moreover, as special law for national health insurance and financial soundness established in January 2002, regulations for special medical equipments installation and operation have been constructed.(1) In April 2002, extensive evaluation for control concerning related equipments brought shocking results. 27.4% of CT (81/296) and 52.7% (69/131) of mammography machine had defects. Based on these results, enforcement was increased and mammography machines have been managed legally as special medical equipment, along with CT and MRI since January 2003. Regarding installation and management of special medical equipment, regular overhaul of Mammography is compulsory. Documentation on inspection of man power, testing for proper quality, and phantom image testing should be checked once a year and the clinical imaging test should be compared with the previous 3 check-up tests every three years as part of thorough examination. It was those periods when surgeons from private practice specializing in breast cancer started to form an organization. It was not until 2000 for breast cancer screening to be generalized throughout the country in private clinics although it actually started in 1992. Most of doctors performing breast cancer check-ups in private clinics were surgeons. Before that time, people preferred general hospitals for breast cancer examination, as they had more confidence in medical team and machines, even though the process was time consuming and expensive. However, people began to change their perception when the private clinics were equipped with same facilities as general hospitals and surgeon became responsible for breast cancer evaluation. Surgeons specially trained for Journal of Breast Cancer

자기공명영상장치의 정도관리에 관한 연구

의료장비의 정도관리는 시스템 성능평가와 시스템의 유지.보수를 지속적으로 수행하고 다양한 측정 및 평가하여 의료정보의 정확성을 나타내기 위해 필요하여 한국의료영상품질관리원은 특수의료장비의 품질 관리 교육은 매년 정기적으로 실시하고 있다. 하지만 품질관리교육은 영상의학과 전문의 위주로 행해지고 있으며 의료기관에서도 영상의학과 전문의와 일부 방사선사에게 교육의 기회가 주어지지만 이차적인 내부교육의 실시 또는 내용 전달 등이 미비하여 장비를 직접 다루는 방사선사들은 잘 모르거나 교육을 이수하였더라도 정확히 모르고 있다. 본 연구는 2008년 대한자기공명기술학회에 등록된 전국의 방사선사를 대상으로 설문을 실시하여 2008년 5월부터 9월까지 5개월 동안 자료를 수집하여 분석하였다. 500명을 대상으로 우편 설문조사를 실시하였으며, 설문응답률은 6%(n=180)이었다. 본 연구 결과는 품질관리검사의 필요성은 86.7%가 필요하다고 느끼지만 특수의료장비 관리자 교육이수는 27.8%밖에 되지 않았고, 품질관리검사를 숙지하는 사람도 53.9%로 거의 절반 밖에 되지 않았다. 품질관리교육의 이수는 성별, 나이, 근무지의 규모, 근무지의 방사선사 인원, MR실내의 방사선사 인원, 방사선사 경력 및 MR실내의 경력과 병원에 의공학과의 유무와 상관관계는 없었다. 한국의료영상품질관리원에서 실시하는 품질관리교육 이수자 중 78.0%가 검사숙지를 하고 있는 것(p<0.05)에 비교하여 병원자체의 교육은 43.9%의 병원이 하고 있었지만 검사 숙지자는 54.4%에 이르기 때문에 병원자체교육은 검사숙지에 큰 영향을 미치지 못하였다. 이는 교육의 내용, 교육의 방법, 교육이수에 대한 전반적인 환경요인이 품질관리교육에 얼마나 중요한지를 알 수가 있다. The quality control is needed to ensure the accuracy of medical information and achieved by evaluating the performance of and maintaining the system and practicing various measurements and evaluations. The Korean Institute for Accreditation of Medical Image, therefore, have held educational program for quality control of special medical equipments. The major of programs participants, however, are radiology specialists with only small number of radiological technologists from some hospitals, furthermore, the follow-up education and the share of information between participants and non-participants are insufficient in general, thus, the knowledge level of radiological technologists, regardless of their participation, is relatively low. This study carried out the questionnaire research for the 500 radiological technologists registered in Korean Society of MRI Technology, on the basis of 2008, and performed analysis for five months from May to Oct., 2008. The questionnaires were delivered by post to each radiological technologists and the response rate was 36%(n=180). The results of this revealed that the 86.7% of respondents felt the necessity of inspection on quality management, while only the 27.8% completed the educational program for manager of special medical equipment. and only the half(53.9%) had the knowledge about inspection on quality management. The completion of educational program had no correlations with sex, age, size of occupying hospital, the number of radiological technologists in occupying site and MRI laboratory, career year of general radiologist and in MRI laboratory, and the presence of biomedical engineering department in occupying hospital. The 78.0% of participants at the educational program for quality management held by the Korean Institute for Accreditation of Medical Image had the knowledge about inspection on quality management(p<.05) whereas the 43.9% of the hospitals held such program and the 54.4% of radiological technologists from those hospitals had related knowledge, which indicated that such programs held by hospitals had not effects on the knowledge level of radiological technologists. This indicates also that the contents, methods, and other conditional factors of educational programs are important for the outcome of them.

Piezoelectric-ferroelectric systems in medicine and biology

Abstract The results of a practical use of ferroelectric-piezoactive elements in medicine and biology are presented. The elements may be used in special medical and biological equipment (defibrillator for activation of the functioning of the heart, various kinds of stimulants to act upon the biologically active points—the so called acupuncture, etc.) as well as for the purposes of its miniaturization. In addition, special attention is given to working out the equipment operating without an external power supply (power network, batteries, accumulator, etc.) but at the expense of various kinds of energy converters (say, the conversion of mechanical energy into electric one due to a piezoelectric effect). This has a qualitative significance for the practical utilization.

A Treatment for Hiccups

To the Editor.— Hiccups are a common and annoying symptom for which many remedies have been tried without consistent success. 1,2 Stimulation of the nasopharynx with a plastic or rubber suction catheter was reported as successful in 84 of 85 patients. 2 Although this is an impressive rate, this is a procedure that may be at least mildly unpleasant and would require the availability of such a catheter and a certain degree of medical expertise. In addition, suction of secretions is sometimes required to achieve optimal results. During the past 12 years, I have had occasion to use a simpler procedure that involves oropharyngeal stimulation and that has been almost 100% successful in the dozen or so persons in whom it has been attempted. It involves no special medical equipment and can easily be performed at home by a layperson who is trying to help a friend or relative suffering

MEDICAL PREPAREDNESS

<h3>EMERGENCY MEDICAL SERVICE FOR CIVILIAN DEFENSE</h3> The following letter was mailed to all state and county medical societies and to administrators and chiefs of staff of hospitals: In Bulletin No. 1 of the Medical Division, the U. S. Director of Civilian Defense recommends that all approved general hospitals in states along both seaboards and in industrial areas in the interior proceed without delay with the organization of a field casualty service. Hospitals which have already established emergency medical field units for this purpose should revise their organization so as to conform with the plans outlined in this bulletin. Uniformity in organization is essential if medical field units are to respond promptly and effectively to emergency calls from the local control center. The provision of special medical and surgical equipment for field units should await distribution of Bulletin No. 2 of the Medical Division, which will deal with equipment. Most