*#高解析度食道壓力檢查 3/1通過健保了!!*
項目代碼( #30526B)
#HRIM high resolution impedance #manometry
我們員生 #胃食道逆流 中心
其實在2018成立時就已經引進該儀器
但當時都為自費檢測, 也因為不敷成本
所以至今台灣只有少數醫院有此設備
現在 在學會專家的努力下
健保終於通過 "有條件性"的給付了!這是好的開始
我相信 會越來越多醫院願意買機器
提供這樣的檢查服務
對台灣醫療的進步 是好事
感謝學會專家的努力爭取這些患者福利
但這裡要提醒醫師們,健保局過往的踢退方式,
我不方便說.........所以還是自己評估是真是假吧!
#閱讀更多細節 請看同名部落格最新文章
https://reurl.cc/dV1oX2
****影片****
#食道壓力檢查 怎麼做? 吳醫師 做給你看!!!
(2018年的第一例示範)
https://youtu.be/nfWvbXNJHZg
健保.適應症:
(1)吞嚥困難,經上消化道內視鏡檢查或食道攝影檢查評估後,疑似食道蠕動功能異常疾病(如食道弛緩不能症者)。
(2)難治性之胃食道逆流症狀(持續的火燒心、胃酸逆流、不明原因胸痛、慢性咳嗽、氣喘、喉嚨異物感或聲音沙啞),經相關專科醫師診查後,經上消化道內視鏡或二十四小時食道酸鹼度測定檢查後,且經藥物(如質子幫浦抑制劑, PPI)治療八週以上反應不佳者。
(3)十八歲以下兒童及嬰兒胃食道逆流症狀(如持續性嘔吐、火燒心或胃酸逆流、不明原因胸痛、慢性咳嗽、難治性兒童氣喘、喉嚨異物感、聲音沙啞、嬰幼兒呼吸中止或心搏過慢),經相關專科醫師診治四週以上反應不佳者。
(4)十八歲以下兒童及嬰兒因吞嚥困難,進行胃造瘻術(gastrostomy)之術前評估。
(5)食道蠕動功能異常疾病(如食道弛緩不能症)接受內視鏡治療或手術治療後之評估。
(6)胃食道逆流症患者接受外科逆流手術治療前之評估,及術後仍有符合前述症狀之追蹤。
2.禁忌症:(1)造成食道管腔狹窄或阻塞之良性食道疾病或惡性食道腫瘤。(2)食道破裂。(3)食道出血。(4)急性上呼吸道感染。
3.支付規範:(1)執行頻率:每人每年限執行一次,如有接受內視鏡或手術治療者
同時也有3部Youtube影片,追蹤數超過2萬的網紅Hi Fi 發燒台,也在其Youtube影片中提到,這對 Focal Kanta No.1 書架喇叭(影片內有價錢資料),採用不同顏色的面板,相當搶眼。今次這對喇叭採用全新的中、低音振膜,在試音室聽過表現相當不錯,相信在一般家居環境會很適合,不過缺點是88dB也不易推動,一定要配合優質的擴音機,今次試聽用這部AVM Audio Ovation CS ...
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high impedance 在 Lee388 Hi Fi 發燒專頁 Facebook 的最佳貼文
GRANDIOSO K1X
"Two revolutions integrated. Two revolutions connecting people to music... The VRDS-ATLAS and Master Sound Discrete DAC - now come to fruition in an integrated player that carries the name… Grandioso ( Grandioso (music): Grand or noble)."
An unprecedented transport mechanism that invites you to the furthest reaches of sound.
VRDS (Vibration-Free Rigid Disc-Clamping System) is Esoteric's unique CD/Super Audio CD transport technology, which has been specially designed to clamp the disc to a same-diameter turntable in order to eliminate the disc's rotational vibration, as well as any extraneous vibration emanating from the mechanism itself. It also corrects any warpage of the disc, dramatically improving the accuracy of both the optical pickup and the disc pit layer's corresponding optical axis, while also minimizing servo current. This all adds up to dramatically reduced disc read error for exceptional audio quality.
The new VRDS-ATLAS platform boasts unprecedented mechanical perfection and superlative audio quality, with heavyweight construction that is fully 127% heavier than previous iterations (6.6kg for the mechanism alone, and 13.5kg including its base). This highest rigidity and weight in the history of VRDS mechanisms has the effect of greatly reducing any and all vibration that could adversely affect audio quality. The transport's larger new side panels and bridge are all formed of SS400 steel, and its turntable is made from duralumin, which is renowned for its excellent sound quality. Also, its spindle features a newly designed thrust bearing system, for a friction-free one-point spindle support system that ensures smooth, noiseless turntable rotation.
Esoteric's impressive VRDS-ATLAS is the quietest and most elegant transport in the history of VRDS. The key to achieving this was a resolute focus on mechanical grounding technology that more effectively reduces vibration.
Adopting a wide & low-profile design for the entire mechanism helped achieve a lower center-of-gravity, and relocating the turntable motor to below the turntable from its previous position above the bridge dramatically shortened the route for grounding vibration and reducing mechanical noise. Tray hollowing has also been minimized for increased rigidity, and special stoppers made from vibration-absorbing elastomer cancel out resonance when the tray is stored.
The Grandioso K1's mighty power supply was the key to its powerful and profound three-dimensional sound. With the introduction of its new X version, this power supply has been dramatically enhanced to add further depth to its exceptional audio tone. Its built-in D/A converter features independent power transformers for left and right channels, and the K1X includes a total of four independent toroidal power supply transformers. Furthermore, technologies cultivated in the development of the Grandioso P1X/D1X have also been adopted, including a new low-feedback DC power supply regulator featuring a discrete circuit configuration which contributes to its powerful open sound. The K1X also contains a total of 76 EDLC* supercapacitors (with a total capacity of 2,050,000µF or 2.05F). This greatly increased power supply capacity provides a tremendously improved sound quality for exceptional resolution in the lower frequency ranges.
*EDLC (Electric Double-Layer Capacitor):A special type of capacitor boasting an astoundingly high capacity compared to the electrolytic capacitors used in conventional audio equipment.
The VRDS-ATLAS transport mechanism is centrally located within the chassis, where it is fixed to a 5mm-thick steel bottom plate and supported by four proprietary pinpoint feet (patent no. 4075477 and 3778108). This effectively isolates the rotational mechanism from vibration. The internal structure of the chassis features a double deck design, with the audio boards on the upper level and power supply circuits and transformers on the lower level to minimize magnetic flux leakage and vibration, while also shortening the power supply wiring.
Semi-Floating Top Panel
The enclosure's top panel utilizes a screwless semi-floating structure that further contributes to an open and expansive sound.
Master Sound Discrete DAC
Bringing out all the dynamics and energy of the original master recordings.
Master Sound Discrete DAC Bringing out all the dynamics and energy of music.
Unattainable by integrated chips, our goal was to assemble carefully selected and tested discrete components into a complete circuit that could perfectly reproduce all the dynamics and energy of music. Our top engineering teams put their pride on the line to design and produce a quality of sound that can only be found in the Master Sound Discrete DAC discrete D/A converter.
The K1X's Master Sound Discrete DAC is the most revolutionary two-channel stereo DAC circuit in Esoteric's history, and is based on the original circuit developed for the Grandioso D1X monaural D/A converter.
As an extension of the D1X's design philosophy, a luxurious volume of materials have been invested in the construction of K1X's Master Sound Discrete DAC. For example, it features 32 separate elements for each channel. Key components such as a clock driver, logic circuit, and capacitors and resistors, are kept independent for each of these 32 elements to ensure the purest output without no loss of musical energy.
The K1X's independently developed Δ∑ modulator supports 64-bit/512Fs and the latest high-end digital formats, including of 22.5MHz DSD and 768kHz PCM signals. The FPGA's* dedicated digital processing algorithm was developed exclusively for the Master Sound Discrete DAC, and has been fully optimized for outstanding playback of both DSD and PCM digital audio data.
Advanced Quality Control
With a discrete DAC, where component tolerances are directly linked to arithmetic precision, highly advanced quality control is also required for the manufacture of electronic circuit boards. Esoteric's own in-house factory boasts some of the world's leading board mounting technologies, such as soldering performed in an oxygen-free furnace, which is located in a clean room featuring the same level of cleanliness found in a hospital operating room. Technologies cultivated in the production of electronic circuit boards for audio, medical, aerospace, and defense industries support the high production quality of the Master Sound Discrete DAC.
The ESOTERIC-HCLD output buffer amplifier boasts an amazingly high-speed slew rate (response speed) of 2,000V/µs. Current transmission and speed—the most important factors for an analog output circuit—have been pushed to the limits to reproduce the reality of music with a dynamic range that is truly breathtaking.
In addition to its XLR and RCA amplifier line connections, the K1X also features the ES-LINK Analog method of current transmission. Taking full advantage of the HCLD buffer circuit's powerful current supply makes the K1X less susceptible to the detrimental effects of impedance on the signal route. It also enables a more powerful signal transmission, fully driving connected compatible devices.
A high-accuracy clock circuit is the key to achieving superlative sound quality in digital audio playback. A top-quality clock circuit is truly the heart of any high-end digital player. The K1X now features the superb Grandioso Custom VCXO II clock originally developed for the Grandioso P1X/D1X. This clock was developed with carefully considered modifications made to the earlier model's internal circuitry and components to more vividly emphasize the K1X's ultimate audio quality while further boasting remarkably low phase noise and excellent center precision (±0.5ppm).
The K1X can also be connected to the Grandioso G1 Master Clock Generator for playback, with internal circuits synchronized to a 10MHz clock that features the same high precision as an atomic clock, enabling further pursuit of high sound quality.
D/A Converter Functions for External Input, D/D Conversion, MQA Support & USB Input
In addition to its coaxial and optical inputs, the K1X also features a USB type-B port that is compatible with both 22.5MHz DSD and 768kHz/32-bit PCM asynchronous signal transmission, thus enabling it to also be used as a stand-alone D/A converter. Functions are provided for upsampling a PCM digital signal to 2/4/8/16× (max. 768kHz) and converting PCM to DSD. The K1X is also compatible with MQA-CD decode playback and full MQA decoding for playback of various digital inputs including USB.*
*MQA certification is pending as of August, 2019, and support is scheduled to be added via a software update as soon as certification is complete.
(Source: Esoteric Japan)
high impedance 在 ADBIG Facebook 的最佳解答
หวด FAR CRY 5 เกมดีๆ ภาพสวย เนื้อเรื่องแน่น กับหูฟัง Beyerdynamic MMX300 Gaming
ดาวน์โหลดเกมได้เลยที่ https://uplay.ubi.com/
หูฟังซื้อได้ที่ https://www.facebook.com/beyerdynamicth/
สเปค Minimum
OS: Windows 10 (64-bit)
CPU: Intel Core i5-2400 @ 3.1 GHz
Video Card: Nvidia GeForce GTX 670 or AMD R9 270
RAM: 8GB
Resolution: 720p
Video Preset: Low
สเปค Recommended (60 FPS)
OS: Windows 10 (64-bit )
CPU: Intel Core i7-4770 @ 3.4 GHz or AMD Ryzen 5 1600 @ 3.2 GHz
Video Card:: Nvidia GeForce GTX 970 or AMD R9 290X
RAM: 8GB
Resolution: 1080p
Video Preset: High
================
Beyerdynamic MMX 300
ชุดหูฟังสำหรับการเล่นเกมระดับพรีเมี่ยม ด้วยเทคโนโลยีชั้นสูงให้เสียงชัดเจนสามมิติและทรงพลังและมอบความสบายสูงสุด ให้คุณได้เปรียบเหนือคู่แข่ง ไมโครโฟนแคปซูลคุณภาพสูงให้คุณสื่อสารได้อย่างราบรื่น ถ้วยครอบหูทำจากไมโครฟิล์มนุ่มพิเศษเพื่อการสวมใส่ได้นานหลายชั่วโมง
รายละเอียด
TRANSMISSION TYPE : Wired
REMOTE : Universal 1-button remote
NOMINAL IMPEDANCE HEADPHONES : 32 ohms
HEADPHONE FREQUENCY RESPONSE : 5 Hz - 35,000 Hz
NOMINAL SOUND PRESSURE LEVEL : 96 dB
POLAR PATTERN FOR MICROPHONE : Cardioid
TRANSDUCER TYPE FOR MICROPHONE : Condenser - Cardioid
CONSTRUCTION : Circumaural (around the ear)
CABLE & PLUG : Stereo jack plug 3.5 mm (1/8") & ¼“ adapter (6.35 mm)
================
สเปค
: Core i3-8100 - 4050
: MSI H310M PRO-VD DDR4 LGA1151 - 2190
: GTX1050 Ti 4GB - 6990
: WD BLUE 1TB - 1290
: ADATA DDR4 8GB 2400 - 3090
: CORSAIR VS550 REV.2 - 1750
: AEROCOOL AERO-300 FAW Black - 1250
เสริม
: CORSAIR K63
: CORSAIR HARPOON
: PREDATOR XB272 240Hz
สเปคสตรีม
: Intel Core i7-8700K @ 4.7GHz
: WATERCOOL HEATKILLER CPU Block
: EK CoolStream 360 Radiator
: MSI Z370 TOMAHAWK
: Corsair Dominator Platinum DDR4 3000 16GB
: ZOTAC GeForce GTX 1080Ti 11GB GDDR5X Artic Strom
: Corsair MP500 240GB NVMe
: Corsair HX850i
: Corsair Graphite 760T ADBIG Edition
: HRC Custom kit
: Galaxy PC Cable Full-Modular
เกมมิ่งเกียร์
: Elgato HD 60 Plus
: Elgato Stream Deck
high impedance 在 Hi Fi 發燒台 Youtube 的精選貼文
這對 Focal Kanta No.1 書架喇叭(影片內有價錢資料),採用不同顏色的面板,相當搶眼。今次這對喇叭採用全新的中、低音振膜,在試音室聽過表現相當不錯,相信在一般家居環境會很適合,不過缺點是88dB也不易推動,一定要配合優質的擴音機,今次試聽用這部AVM Audio Ovation CS 8.2 Crystal一體化多功能合併機也不錯,如果大家想找純合併機,我建議採用 GRYPHON Diablo 300也相當合襯。
詳細報告請留音【音響技術】雜誌,現在先來欣賞一下這套前後級精美的外觀。
另設Facebook群組Hi Fi 發燒圈,歡迎加入:
https://www.facebook.com/groups/454356881290493/
#Audiotechnique #Lee388 #發燒圈 #Focal #Kanta #Speaker #音響技術 #試音報告
2-way bass-reflex bookshelf speaker
Drivers 1 x 61/2"(16.5cm) Flax bass-midrange with TMD suspension and NIC motor 11/16" (27mm) ‘IAL3’ pure Beryllium inverted dome tweeter
Sensitivity (2,83V/1m) 88dB
Frequency Response (+/-3dB) 46Hz - 40kHz
Low Frequency Point (- 6dB) 42Hz
Nominal Impedance 8 Ohms Minimum Impedance 3.9 Ohms
Recommended Amplifier Power 25 - 150W
Crossover Frequency 2,400Hz
Dimensions (HxWxD) 1639/64 x 97/32 x 1525/64" (422 x 234 x 391mm)
Net weight (with front grille) 28.1lbs (13kg)
Packaging dimensions (HxWxD) 241/64 x 143/8 x 205/64" (610 x 365 x 510mm)
Total weight (including packaging) 33.1lbs (15kg)
https://www.focal.com/en/home-audio/high-fidelity-speakers/kanta/kanta-ndeg1
high impedance 在 Hi Fi 發燒台 Youtube 的最佳解答
T2 SPECIFICATION:
DSD SUPPORT:
Up to DSD512 22.6MHz, 1-bit
PCM SUPPORT:
Up to 384kHz, 16–32-bit, Stereo
ANALOG OUTPUT STAGE:
Dual ESS SABRE32 ES9028Pro DAC chips
Fully balanced layout with high-quality components
Completely redesigned analogue buffer includes audiograde output capacitor and ultra-low-noise and high dynamic range
Discreet clock system for precision timing
Precision 32-bit internal digital volume
UPSAMPLING RATES & BIT DEPTHS:
DSD128 upsampling option for all files
PCM 384kHz upsampling option for all files
DIGITAL OUTPUT STAGE:
USB:
Native DSD512 support
PCM 44.1–384kHz, 16–32-bit, Stereo
BNC SPDIF:
PCM 44.1kHz–192kHz, 16–24-bit
DSD (DoP, DSD over PCM) 2.8MHz, 1-bit
POWER SUPPLY:
Internal 100–240V AC auto-ranging
Low-noise
Shielded power supply compartment for reduced interference with delicate electronics
PHYSICAL:
FINISH:
Black anodised brushed aluminium
Raw brushed aluminium
LUMIN (SOLID ALUMINIUM CHASSIS):
350mm (W), 345mm (D), 60mm (H), 6kg
LUMIN AMP SPECIFICATION
OPERATING MODE: (selectable)
Stereo, Dual Mono or Bridged mode
INPUT: (selectable)
1 x XLR pair (pin 2 hot), 1 x RCA pair
POWER:
160W per channel into 8Ω
320W per channel into 4Ω
640W into 8Ω (Bridged)
POWER SUPPLY:
Available in 220–240V AC and 110–120V AC versions ~ 50/60Hz
POWER CONSUMPTION:
Standby 0.5W
Idle 40W
Max 700W
FREQUENCY RESPONSE:
20hz - 40000hz ± 0.1db
SIGNAL TO NOISE RATIO:
103db, unweighted
INPUT IMPEDANCE:
200kΩ Balanced (XLR)
100kΩ Unbalanced (RCA)
OUTPUT IMPEDANCE:
0.1Ω
INPUT SENSITIVITY:
1.16Vrms
GAIN:
+26dB (Stereo, Dual Mono)
+32dB (Bridged)
PROTECTION:
DC, overload and overheating protection
FINISHES:
Black anodized brushed aluminium or Raw brushed aluminium
CONSTRUCTION:
CNC-machined from a single billet for front, top and sides. Thick 8mm walls, rear panel and base plate
DIMENSIONS:
350mm (W), 374mm (D), 104mm (H)
WEIGHT:
19kg
Hi Fi 發燒台另設Facebook群組Hi Fi 發燒圈,歡迎加入:
https://www.facebook.com/groups/454356881290493/
#音響技術 #發燒圈 #Lee388 #音響 #LUMIN #T2 #AMP #Audio
high impedance 在 ADBIG Youtube 的最佳貼文
หวด FAR CRY 5 เกมดีๆ ภาพสวย เนื้อเรื่องแน่น กับหูฟัง Beyerdynamic MMX300 Gaming
ดาวน์โหลดเกมได้เลยที่ https://uplay.ubi.com/
หูฟังซื้อได้ที่ https://www.facebook.com/beyerdynamicth/
สเปค Minimum
OS: Windows 10 (64-bit)
CPU: Intel Core i5-2400 @ 3.1 GHz
Video Card: Nvidia GeForce GTX 670 or AMD R9 270
RAM: 8GB
Resolution: 720p
Video Preset: Low
สเปค Recommended (60 FPS)
OS: Windows 10 (64-bit )
CPU: Intel Core i7-4770 @ 3.4 GHz or AMD Ryzen 5 1600 @ 3.2 GHz
Video Card:: Nvidia GeForce GTX 970 or AMD R9 290X
RAM: 8GB
Resolution: 1080p
Video Preset: High
================
Beyerdynamic MMX 300
ชุดหูฟังสำหรับการเล่นเกมระดับพรีเมี่ยม ด้วยเทคโนโลยีชั้นสูงให้เสียงชัดเจนสามมิติและทรงพลังและมอบความสบายสูงสุด ให้คุณได้เปรียบเหนือคู่แข่ง ไมโครโฟนแคปซูลคุณภาพสูงให้คุณสื่อสารได้อย่างราบรื่น ถ้วยครอบหูทำจากไมโครฟิล์มนุ่มพิเศษเพื่อการสวมใส่ได้นานหลายชั่วโมง
รายละเอียด
TRANSMISSION TYPE : Wired
REMOTE : Universal 1-button remote
NOMINAL IMPEDANCE HEADPHONES : 32 ohms
HEADPHONE FREQUENCY RESPONSE : 5 Hz - 35,000 Hz
NOMINAL SOUND PRESSURE LEVEL : 96 dB
POLAR PATTERN FOR MICROPHONE : Cardioid
TRANSDUCER TYPE FOR MICROPHONE : Condenser - Cardioid
CONSTRUCTION : Circumaural (around the ear)
CABLE & PLUG : Stereo jack plug 3.5 mm (1/8") & ¼“ adapter (6.35 mm)
================
สเปค
: Core i3-8100 - 4050
: MSI H310M PRO-VD DDR4 LGA1151 - 2190
: GTX1050 Ti 4GB - 6990
: WD BLUE 1TB - 1290
: ADATA DDR4 8GB 2400 - 3090
: CORSAIR VS550 REV.2 - 1750
: AEROCOOL AERO-300 FAW Black - 1250
เสริม
: CORSAIR K63
: CORSAIR HARPOON
: PREDATOR XB272 240Hz
สเปคสตรีม
: Intel Core i7-8700K @ 4.7GHz
: WATERCOOL HEATKILLER CPU Block
: EK CoolStream 360 Radiator
: MSI Z370 TOMAHAWK
: Corsair Dominator Platinum DDR4 3000 16GB
: ZOTAC GeForce GTX 1080Ti 11GB GDDR5X Artic Strom
: Corsair MP500 240GB NVMe
: Corsair HX850i
: Corsair Graphite 760T ADBIG Edition
: HRC Custom kit
: Galaxy PC Cable Full-Modular
เกมมิ่งเกียร์
: Elgato HD 60 Plus
: Elgato Stream Deck
high impedance 在 What's the difference between 0 and high impedance (or ... 的推薦與評價
They are used to control the direction of the flow of data. For example, if an IO line is programmed to switch from an output to an input, the output driver ... ... <看更多>
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