• Title/Summary/Keyword: 침습의 위험성

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OCT를 기반으로 한 FFR지표계산과 임상결과 비교에 대한 연구

  • Sin, Seong-Ung;Lee, Gyeong-Eun;Lee, Seo-Ho;Bang, Hyeon-Gi;Lee, Jong-Ho;Park, Seon-Yeol;Lee, Yeong-Gwon;Sim, Eun-Bo
    • Proceeding of EDISON Challenge
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    • 2017.03a
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    • pp.628-630
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    • 2017
  • 관상동맥의 협착 병변의 위험성을 치료 및 예방하기 위하여 FFR(Fractional flow reserve)이라는 지표를 사용한다. 기존의 임상에서 FFR을 측정하기 위하여 침습적인 방법을 이용하여 진행하였다. 이러한 침습적 방법은 부작용의 위험성을 가지고 있기 때문에 컴퓨터 시뮬레이션을 통해 계산하면 위험성을 해소할 수 있다. 하지만 현재 컴퓨터 시뮬레이션은 CT image를 이용하기 때문에 칼슘을 정확히 구별하거나 지질의 위치 등을 확인하는 것이 어렵기 때문에 FFR 결과에 오류를 발생시킬 수도 있고, 또한 전체 관상동맥을 해석하기 때문에 많은 계산량이 필요하다. 본 연구에서는 최근 높은 해상도를 가진 OCT(Optical Coherence Tomography)를 이용하여 이러한 한계점을 극복하고자 하고, 임상에서 측정한 FFR과 OCT에서 측정된 FFR은 비교하는 것이 목적이다.

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Implementation of Non-Invasive Cerebral Perfusion Platform (비침습적 대뇌관류 장치의 구현)

  • Kwon, Seong-tae;Lee, Jean;Kim, Young-kil
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.5
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    • pp.1016-1026
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    • 2017
  • Shipping Along with the aging of the total population, its importance is greater cause of stroke, which is one of the diseases are listed cerebral perfusion is about 80%,.ie that the flow of blood flowing to the brain is reduced as the cause. One of the most typical prophylaxis and treatment of these stroke is to enhance cerebral perfusion. There are several ways to increase cerebral blood flow are a therapy through drugs, through surgery and invasive NeuroFlo. NeuroFlo is to insert a catheter to which a balloon is attached into a patient's artery. However, since the method of enhancing conventional cerebral perfusion have been conducted mainly in invasive method, giving a burden to the patient, the problem of inducing a number of complications were noted. In this paper, an attempt to supplement the shortcomings of such invasive brain perfusion increase method, to provide a device to enhance the non-invasively brain perfusion.

Long-term Outcome after Minimally Invasive Treatment for Early Gastric Cancer beyond the Indication of Endoscopic Submucosal Dissection (내시경점막하박리술의 적응증을 넘어선 조기위암의 미세침습 치료 후 장기 추적 결과)

  • Weon Jin Ko;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.44-49
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    • 2017
  • Background: Recently, endoscopic submucosal dissection (ESD) with laparoscopic sentinel lymph node dissection, named ESN or endoscopic full-thickness gastric resection with laparoscopic sentinel lymph node dissection, named Hybrid-natural orifice transluminal endoscopic surgery (NOTES) was suggested the possibility of minimally invasive treatment for patients with early gastric cancer (EGC) who were beyond the indication of ESD. This study aimed to evaluate the outcomes of ESN or Hybrid-NOTES. Methods: We retrospectively analyzed patients treated with these therapies from January 2009 to May 2013 in terms of short- and long-term outcomes. Each patient was diagnosed with EGC but was not included in ESD indications and had the high risk of lymph node metastasis (LNM). Results: A total of 42 patients with EGC treated by ESN or Hybrid-NOTES. Of the 21 patients who underwent ESN, a total of 4 patients underwent additional gastrectomy, 1 with LNM, 1 with surgical complication, and 2 with noncurative resection. Of the 21 patients who underwent Hybrid-NOTES, a total of 5 patients underwent additional surgery, 1 with LNM, 2 with surgical complication, and 2 with noncurative resection. Overall survival was 100% over a mean follow-up of 75 months, but 3 patients underwent ESD or gastrectomy with metachronous lesion. And 1 patient who had received ESN was found to have a metastatic lymph node and undergo palliative chemotherapy. Conclusion: ESN or Hybrid-NOTES showed favorable short-and long-term outcomes. These methods may be utilized as a bridge between ESD and gastrectomy in the case of EGC which is more likely to have LNM beyond the ESD indications.

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A Re-discussion on the Characteristics of Medicine (의료행위의 특질 재론)

  • HeeTae Suk
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.3-58
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    • 2024
  • It has become a general idea today that the characteristics of medicine should be considered as a basis when discussing a medical personnel's duty of care and whether or not it has been violated, and when discussing its duty of explanation and whether or not it has been fulfilled in medical practice. However, in the discussion of its characteristics, some shortcomings still exist, so the need for a re-discussion has been raised. Firstly, existing discussions on characteristics have failed to comprehensively grasp and explain the characteristics of medical practice. Secondly, in some researchers' arguments, there are discrepancies between the terms used to express characteristics and their conceptual definitions or content. Thirdly, the lack of exemplified cases that reflect the characteristics of medicine - especially Supreme Court precedents - has led some to think negatively about the recognition and reflection of certain characteristics. In my early writings, I have described five characteristics of medical practice: 'conflict in medical goals', 'initiating appropriate medical actions (progression of illness)', 'dynamics of medical intervention (diversity of symptoms)', 'diversity of medical effects', 'inherent risk of medical treatment (invasiveness)'. In this paper, keeping in mind the reasons for the need for reconsideration, I aim to analyze the characteristics of medicine in detail and cite key parts of representative Korean Supreme Court precedents that reflect each characteristic. The characteristics of medicine extracted from this paper are; There are ten factors, including the legitimacy of the essence of medical practice, timeliness of medical execution, dynamics of medical progress, diversity of medical effects, risk of medical invasion, non-uniformity of medical methods, limitations of medical capabilities, intervention of the medical subject, high degree of medical standards, and maldistribution of medical data.

Non-invasive Blood Glucose Detection Sensor System Based on Near-Infrared Spectroscopy (근적외선 분광법 기반 비침습식 혈당 검출 센서 시스템)

  • Kang, Young-Man;Han, Soon-Hee
    • The Journal of the Korea institute of electronic communication sciences
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    • v.16 no.5
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    • pp.991-1000
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    • 2021
  • Among non-invasive blood glucose detection technologies, the optical technique is a method that uses light reflection, absorption, and scattering characteristics when passing through a biological medium. It reduces pain or discomfort in measurement and has no risk of infection. So it is becoming a major flow of blood glucose detection research. Among them, near-infrared spectroscopy has a disadvantage in that the complexity increases when analyzing signals detected due to interferences between proteins and acids that share a similar absorption function with blood glucose molecules. In this study, a non-invasive sensor system with multiple near-infrared bands was designed and manufactured to alleviate the deterioration of blood glucose detection function that may occur due to skin absorption of near-infrared rays. A blood survey was conducted to verify the system, and the degree of blood glucose response in the blood was collected as spectral data, and the results of this study were quantitatively verified in terms of correlation between the data and blood glucose.

A Retrospective Study of Invasive Bacterial Infections in Children with Asplenia (18세 이하 무비증 환자에서 발생한 침습성 세균 감염증에 대한 후향적 연구)

  • Choe, Yong-Joon;Seo, Euri;Lee, Jina
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.160-167
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    • 2017
  • Purpose: Because children with asplenia have an increased risk of fulminant infection associated with a high fatality, chemoprophylaxis, and vaccinations against encapsulated bacteria are recommended. However, there have been few reports of the burden of severe bacterial infection and the current status of chemoprophylaxis and immunization among children with asplenia in Korea. Methods: We conducted a retrospective study including children with asplenia who were treated at our institute between January 1997 and December 2016. Results: From a total of 213 children with asplenia, 114 (53.5%) had congenital asplenia and 58 (27.2%) had functional asplenia. The remaining 41 (19.3%) had acquired asplenia with the median age at splenectomy being 12.2 years (range, 5.0 to 16.9 years); the most common cause of splenectomy was hereditary spherocytosis (39.0%). The chemoprophylaxis rate was 16.4%. The immunization rates were 44.1% for pneumococcus, 53.0% for Haemophilus influenzae type B, and 10.7% for meningococcus. The incidence of invasive bacterial infection among children with asplenia was 0.28/100 person-year; a total of six episodes (2.8%) were observed in five patients with congenital asplenia and one patient with functional asplenia. The median age for these infections was 15 months (range, 4 to 68 months). Five of the six episodes were bacteremia, and the other was meningitis. The most common pathogen was Streptococcus pneumoniae (n=3), followed by H. influenzae (n=1). Three of the six patients (50.0%) died, all of whom had pneumococcal bacteremia. None of the six had chemoprophylaxis or proper vaccinations. Conclusions: Although there is an increased risk of a severe infection proper vaccinations and chemoprophylaxis are still lacking. Physicians should be encouraged to implement appropriate chemoprophylaxis and immunizations for patients with asplenia.

Clinical Effect of Arthrocentesis for Patients with Disc Displacement without Reduction of Temporomandibular Joint : Report of Cases (측두하악관절의 비정복성 관절원판변위 환자에 대한 관절강 세정술의 임상효과 : 증례보고)

  • Kim, Cheul;Kim, Young-Jun
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.177-183
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    • 2006
  • The management of refractory pain and limitation of mouth opening in the temporomandibular joint (TMJ) is both challenging and controversial. Arthrocentesis is a simple technique and it can be used instead of more invasive surgical procedures for patients who failed to conventional conservative treatments. The patients in this case report had complained persistent severe pain and restricted mandibular movement of TMJ, although they had been treated with conservative therapy, e.g., stabilization splint therapy, behavioral therapy, physical therapy, pharmacological therapy. Therefore we employed arthrocentesis for these patients, and they showed significant reduction of pain and improvement of mandibular movement after repetitive arthrocentesis. We recommend arthrocentesis as an effective, minimally invasive technique for patients with continuing severe pain and restricted mobility in the TMJ that is unresponsive to conservative management.

Analysis of Risk and Benefit of Open Lung Biopsy in Severe Immunocompromised Patients with Pulmonary Complications (폐합병증을 동반한 심한 면역저하 환자에서 폐생검술의 유효성 및 위험성에 대한 분석)

  • 이호석;이성호;김관민;심영목;한정호
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.539-546
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    • 2001
  • Background: Pulmonary complications in immunocompromised patients are often fatal. Empirical treatment is usually applied based on the clinical and radiological findings because of the risk of the aggressive diagnostic procedures such as open lung biopsy. However, recent advancements in operative procedures and perioperative management has decreased the procedure-related risks. We have prospectively analyzed the risks and benefits of the early application of open lung biopsy in such patients. Material and Method: Forty-two consecutive immunocompromised patients with critical pulmonary complications were included from June, 1996 to December, 1999. The definition of the immunocompromised is as those with chemotherapy and/or other modality for hematologic disorders, with usage of immunosuppressive drug after transplantation, with usage of steroid for more than 1 month, and with primary immunodeficiency disorders. The indication of open lung biopsy was those with no significant improvement after a week of aggressive application of empirical treatment or with rapidly aggressive process. The underlying disease included hematologic disorder(31 patients), post-transplantation(3 patients), chemotherapy for solid tumor(2 patients), and others(6 patients). Operations were done through thoracotomy(conventional or mini-) or VATS.

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Implementation of Noninvasive Blood Pressure Measuring System for Home Health Care Using Oscillometric Method (오실로메트릭법을 적용한 홈헬스케어용 비침습적 혈압측정법의 구현)

  • Kang Seong-Chul;Jeon Gye-Rock;Jeong Do-Un
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2006.05a
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    • pp.689-692
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    • 2006
  • In this study, an implementation of a system for measuring more accurate blood pressure by non-invasive methods of oscillometric was performed to reduce errors and weaknesses of the existing invasive blood pressure measurement methods. The system is composed of pressure control, signal measurement and blood pressure signal processing units. To verify the validity of the system, tests of characteristics evaluations for pressure measurement unit, extraction of characteristic ratios for blood pressure estimation, blood pressure tracking by oscillometric method were performed. A group of five adult male was selected for the clinical test of the implemented system. The results of the oscillometric method in comparison with auscultatory method are that the maximum ratios of PAD of average, systolic and diastolic arterial pressure are 1.38%, 1.63% and 2.97% with SEP of 5.00, 3.72 and 4.34.

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Endovascular Revascularization for Aortoiliac Occlusive Disease (대동맥-장골동맥 폐쇄성 질환의 혈관 내 재개통술)

  • Myungsu Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.512-526
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    • 2021
  • Peripheral arterial disease is an occlusive condition commonly involving the lower extremity vessels. When the aortoiliac region is affected by this disease, conventional management involves surgical bypass and endovascular treatment has been mainly recommended for patients with focal and simple lesions. It has been common strategy to perform endovascular treatment for selected patients with high surgical risk due to its minimally invasive nature. However, recent advances in the devices and techniques for endovascular treatment have resulted in its utilization for treating patients with various disease status and its clinical outcomes are comparable to those of conventional surgery. This review discusses the current diagnostic strategies for peripheral artery disease in the aortoiliac region, followed by the introduction of techniques and devices, and the role of endovascular treatment.