• Title/Summary/Keyword: 환자역할기대

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New Role and Implications of Japanese Clinical Laboratory Technologists through Team Medical Care (팀 의료에서 일본 임상병리사의 새로운 역할과 시사점)

  • Bon-Kyeong KOO;Min Woo LEE;Sang Hee LEE;Byoung Ho CHOI
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.3
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    • pp.213-218
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    • 2023
  • When it comes to 'Team Medical Care' in Japan, clinical laboratory technologists have actively engaged in various kinds of teams, such as a diabetes team, a nutrition support team, an infection control team and a medical practice support team. Overall, with continual changes in the medical environment, clinical laboratory technologists are recently being required to not only conduct phlebotomy, specimen collection, laboratory testing, and electrocardiography, but also get actively involved in 'medical practice assistance or support' in collaboration with medical doctors and nurses. Therefore, it is anticipated that resident clinical laboratory technologists in wards or emergency rooms in Korea will be better able to contribute to improving medical quality and securing medical safety by functioning as a link to the clinical laboratory, while medical doctors and nurses will have a reduced burden of work and can dedicate themselves to better patient care.

The Adjunctive Role of Resectional Surgery for the Treatment of Multidrug-Resistant Pulmonary Tuberculosis (다제내성 폐결핵의 치료에서 폐절제술의 보조적인 역할)

  • Koh, Won-Jung;Lee, Jae-Ho;Yoo, Chul-Gyu;Kim, Young-Whan;Chung, Hee-Soon;Sung, Sook-Whan;Im, Jung-Gi;Kim, Joo-Hyun;Shim, Young-Soo;Han, Sung-Koo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.975-991
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    • 1997
  • Background : Many patients with isoniazid and rifampin-resistant pulmonary tuberculosis have organisms that are also resistant to other first-line drugs. Despite of aggressive retreatment chemotherapy, the results are often unsuccessful, with a failure rate approaching 40%. Recently, there has been a revival of resectional surgery for the treatment of multidrug-resistant pulmonary tuberculosis. Methods : A retrospective analyses of the case records and radiographic findings were done. Between January 1991 and December 1995, 14 human immunodeficiency virus (HIV)-seronegative patients with multidrug-resistant pulmonary tuberculosis were selected for resection to supplement chemotherapy. All patients had organisms resistant to many of the first-line drugs, including both isoniazid and rifampin. Results : Despite of aggressive therapy for median duration of 9.5 months, 12 of the 14 patients (86%) were still sputum smear and/or culture positive at the time of surgery. The disease was generally extensive. Although main lesions of the disease including thick-walled cavities were localized in one lung, lesser amounts of contralateral disease were demonstrated in 10 of 14 (71%). Types of surgery performed were pneumonectomy including extrapleural pneumonectomy in six patients, lobectomy or lobectomy plus in six patients, and segmentectomy in two patients. The resected lung appeared to have poor function ; preoperative perfusion lung scan showed only 4.8% of the total perfusion to the resected portion of the lung. There were no operative deaths. Two patients had major postoperative complications including empyema with bronchopleural fistula and prolonged air leak, respectively. Of the 14 patients, 13 (93%) remained sputum-culture-negative for M. tuberculosis for a median duration of 23 months and one remained continuously sputum smear and culture positive for M. tuberculosis. Conclusion : On the basis of comparison with historical controls, adjunctive resectional surgery appears to play a significant beneficial role in the management of patients with multidrug-resistant pulmonary tuberculosis if the disease is localized and there are adequate reserve in pulmonary function.

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Ascitic Fluid Analysis for the Differentiation of Malignancy-Related and Nonmalignant Ascites (악성 복수와 비악성 복수의 감별을 위한 복수액 분석)

  • Lee, Eun-Young;Kim, Byeoung-Deok;Choi, Jae-Hyuk;Lee, Sang-Yeop;Ryu, Hun-Mo;Lee, Kyung-Hee;Hyun, Myung-Soo
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.76-84
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    • 1999
  • The differentiation between malignancy-related ascites(MRA) and non-malignant ascites (NMA) is important for further diagnostic and therapeutic purposes. Although many parameters were investigated, none has provided a complete distinction between MRA and NMA. We investigated several ascitic fluid parameters to determine the differential power, and to differentiate malignant-related from nonmalignant-related ascites with a sequence of sensitive parameters followed by specific parameters. For the present study, 80 patients with ascites were divided into two groups: MRA and NMA, The MRA group was consisted of 27 patients with proven malignancy by image study, biopsy, and follow up: 21 of these patients had peritoneal carcinomatosis, but the remaining 6 showed no evidence of peritoneal carcinomatosis. The NMA group was consisted of 53 patients with no evidence of malignancy: among these patients, one had SLE, and others had liver cirrhosis, The samples of blood and ascites were obtained simultaneously, and then the levels of ascites cholesterol, CEA. protein and LDH, cytology, albumin gradient, ascites/serum concen-tration ratios of LDH(LDH A/S), and ascites/serum concentration ratios of protein(protein A/S) were measured. Applying cut-off limits for determined parameters, we estimated the diagnostic efficacy of each parameter, Among the eight parameters investigated, ascites fluid cholesterol yielded the best sensitive value of 93%(cut-off value 30mg/dl), and cytologic examination and the protein A/S(cut-off value 0.5) showed the most specific value of 100% and 96%, respectively. Based on the above results, the diagnostic sequence with cholesterol as a sensitive parameter followed by the combination of cytologic examination and protein A/S as specific parameters, was tested in 80 patients. This diagnostic sequence identified 81.5% of patients with malignancy, and all patients with peritoneal carcinomatosis were classified as malignancy-related ascites. In spite of many limitations, this proposed diagnostic sequence may permit a cost-effective and simple differentiation of malignancy-related ascites from nonmalignant ascites.

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A Case Report on the Ossification of the Posterior Longitudinal Ligament Treated by CHUNA Manual Therapy (추나요법으로 치료한 후방 종인대 골화증 1예)

  • Kim, Mi-Young;Park, Sung-Cheul;Kang, Sung-Ho;Song, Yung-Sun;Shin, Byung-Cheul
    • The Journal of Korea CHUNA Manual Medicine
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    • v.3 no.1
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    • pp.153-166
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    • 2002
  • Objective : There is no case report on the ossification of the posterior longitudinal ligament(OPLL) treated by CHUNA manual therapy in oriental medicine. We experienced a patient(32-year-old female) with OPLL improved by CHUNA manual therapy in X-ray image and visual analogue scale(VAS), and we report it clinically. Methods : During the patient with OPLL was treated CHUNA manual therapy, acupuncture, and physical therapy, we examined cervical X-ray, CT and Moire topography and evaluated the patient's symptoms by VAS. And we observed whether the changes exist or not in X-ray and VAS. Results : VAS in symptoms was improved significantly(p<0.05), and the radiologic X-ray image in OPLL patient was improved. Conclusion : OPLL was generally treated conservative treatment and operation in severe case. But CHUNA manual therapy may be more effective in conservative treatment of OPLL, if more clinical studies and reaches are accomplished.

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The Development of Portable Digital X-ray Power Supply Unit for Emergency Medical Services (응급의료에서 이용될 휴대용 디지털 X-ray 전원장치 개발)

  • Cho, Dong-Heon;Koo, Kyung-Wan;Yong, Hae-Sool
    • Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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    • v.20 no.1
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    • pp.125-131
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    • 2006
  • The existing X-ray generators are either ones which are settled at fixed places or ones which are movable to sick rum. Movable generators can be very useful according to the circumstances of patients, but there remains a restraint that AC220[V] in the hospitals must be provided. When examining a first-aid patient who stays distant from the hospital or when grouping patients caused by disaster, the services of doctors at emergency centers should be very restrictive. Hence, this study developed a portable digital X-ray power supply unit that are utilizable at the accident spot or in a moving ambulance. By using the nit, the information of patients can be transmitted to the emergency center on the spot and thereby doctors can make a correct diagnosis. The properties of the unit are as follows: First, portable batteries(DCl2[V]) are utilized as electric source for the wit. Second PIC16F84A is utilized as control circuit in order to guarantee considerable reliance and to provide various functions. This portable digital X-ray power supply unit is expected to contribute to the emergency medical service system to be more advanced.

Estimating Gastrointestinal Transition Location Using CNN-based Gastrointestinal Landmark Classifier (CNN 기반 위장관 랜드마크 분류기를 이용한 위장관 교차점 추정)

  • Jang, Hyeon Woong;Lim, Chang Nam;Park, Ye-Suel;Lee, Gwang Jae;Lee, Jung-Won
    • KIPS Transactions on Software and Data Engineering
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    • v.9 no.3
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    • pp.101-108
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    • 2020
  • Since the performance of deep learning techniques has recently been proven in the field of image processing, there are many attempts to perform classification, analysis, and detection of images using such techniques in various fields. Among them, the expectation of medical image analysis software, which can serve as a medical diagnostic assistant, is increasing. In this study, we are attention to the capsule endoscope image, which has a large data set and takes a long time to judge. The purpose of this paper is to distinguish the gastrointestinal landmarks and to estimate the gastrointestinal transition location that are common to all patients in the judging of capsule endoscopy and take a lot of time. To do this, we designed CNN-based Classifier that can identify gastrointestinal landmarks, and used it to estimate the gastrointestinal transition location by filtering the results. Then, we estimate gastrointestinal transition location about seven of eight patients entered the suspected gastrointestinal transition area. In the case of change from the stomach to the small intestine(pylorus), and change from the small intestine to the large intestine(ileocecal valve), we can check all eight patients were found to be in the suspected gastrointestinal transition area. we can found suspected gastrointestinal transition area in the range of 100 frames, and if the reader plays images at 10 frames per second, the gastrointestinal transition could be found in 10 seconds.

The Significance of Lymphatic, Venous, and Neural Invasion as Prognostic Factors in Patients with Gastric Cancer (위암 환자의 예후인자로서 림프관 정맥 및 신경 침범의 의의)

  • Kim Chi-Ho;Jang Seok-Won;Kang Su-Hwan;Kim Sang-Woon;Song Sun-Kyo
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.113-119
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    • 2005
  • Purpose: Some controversies exist over the prognostic values of lymphatic, venous, and neural invasion in patients with gastric cancer. This study was conducted to confirm the prognostic values of these histopathologic factors in gastric cancer patients who received a gastrectomy. Materials and Methods: Data for clinicopathologic factors and clinical outcomes were collected retrospectively from the medical records of 1,018 gastric cancer patients who received a gastrectomy at Yeungnam University Medical Center between January 1995 and December 1999. A statistical analysis was done using the SPSS program for Windows (Version 10.0, SPSS Inc., USA). The Kaplan-Meier method was used for the survival analysis. Prognostic factors were analyzed by using a multivariate analysis with Cox proportional hazard regression model. Results: Ages ranged from 21 to 79 (median age, 56). A univariate analysis revealed that age, tumor size, location, gross type, depth of invasion, extent of gastrectomy or lymph node dissection, lymph node metastasis, distant metastasis, lymphatic invasion, venous invasion, neural invasion, pathologic stage, histologic type, and curability of surgery had statistical significance. Among these factors, lymph node metastasis, curability of surgery, neural invasion, lymphatic invasion, and depth of invasion were found to be independent prognostic factors by using a multivariate analysis. Venous invasion showed no prognostic value in the multivariate analysis. Conclusion: Neural invasion and lymphatic invasion are useful parameters in determining a prognosis for gastric cancer patients.

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Effect of Microsurgical Varicocelectomy on Human Sperm Nucleus DNA Integrity (미세술기를 이용한 정계정맥류절제술이 정자 핵 내 DNA Integrity에 미치는 효과)

  • Kim, Gi-Young;Lee, Jae-Seok;Chi, Hee-Jun;Kim, Jong-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.3
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    • pp.245-251
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    • 2010
  • Objective: Human sperm nucleus DNA damage may negatively affect pregnancy outcome, and the spermatozoa of infertile men have more DNA damage than that of fertile men. The aim of this study was to evaluate the effect of microsurgical varicocelectomy on human sperm nucleus DNA integrity. Methods: We reviewed the medical records of 18 subfertile male patients who underwent microsurgical varicocelectomy at our hospital from April 2006 to April 2007. Varicocele was diagnosed by physical examination and Doppler ultrasound. Standard semen analysis was performed in 18 patients before and 4 months after microsurgical varicoceletcomy using a computer assisted semen analyzer. Sperm nucleus DNA integrity was assessed by a single-cell gel electrophoresis (comet assay). Results: No recurrence of varicocele was observed after 4 months later. The DNA fragmentation index improved after varicocelectomy compared with pre-operatively (19.3 versus 13.7%, respectively, p<0.05). Semen analysis parameters (total count, concentration, motile sperm, viability, strict morphology) increased after varicocelectomy, but the difference did not reach statistical significance. Conclusion: Our data suggest that microsurgical varicocelectomy can improve semen analysis parameters and human sperm nucleus DNA integrity in infertile men with varicocele.

Restoration of IARPD in partially edentulous patients with bone defects due to osteomyelitis treatment (골수염 치료로 인해 골결함이 있는 부분무치악 환자에서 IARPD 수복)

  • Park, Se-Hyun;Sung, Han-Gyul;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.359-369
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    • 2021
  • Implant prostheses and removable partial dentures are mainly used as treatment methods for partial edentulous patients who have lost a number of teeth. The implant-assisted removable partial denture (IARPD) is strategically selected. The defect in maxillofacial structure due to osteomyelitis, a type of facial bone infection, causes dysfunction such as mastication, swallowing, and pronunciation, as well as social and psychological effects, so a removable restoration is required to restore the supporting tissue. Design of abutment and partial dentures is an essential factor in the success of treatment. In this case, IARPD, which has superior retention and stability compared to traditional removable partial dentures, can have a good prognosis. In a partial edentulous patient with bone defects due to osteomyelitis treatment, the stability of the denture was secured with IARPD restoration. Moreover, maintenance problem that may occur in the future was minimized by providing an appropriate denture design and occlusal scheme through several provisional restorations. This case can be expected to have a favorable prognosis in the long term.

Potential Role of Hedgehog Signaling in Radiation-induced Liver Fibrosis (방사선에 의한 간섬유증에서 헤지호그의 잠재적 역할)

  • Wang, Sihyung;Jung, Youngmi
    • Journal of Life Science
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    • v.23 no.5
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    • pp.710-720
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    • 2013
  • Radiotherapy is commonly used in treating many kinds of cancers which cannot be cured by other therapeutic strategies. However, radiotherapy also induces the damages on the normal tissues. Radiation-induced fibrosis is frequently observed in the patients undergoing radiotherapy, and becomes a major obstacle in the treatment of intrahepatic cancer. Hedgehog (Hh) that is an essential in the liver formation during embryogenesis is not detected in the healthy liver, but activated and modulates the repair process in damaged livers in adult. The expression of Hh increases with the degree of liver damage, regulating the proliferation of hepatic progenitors and hepatic stellate cells (HSC). In addition, Hh induces epithelial-to-mesencymal transition (EMT) and activation of myofibroblasts. In the irradiated livers, up-regulated expression of Hh signaling was associated with proliferation of progenitors, EMT induction, and increased fibrosis. Female-specific expression of Hh leaded to the expansion of progenitors and the accumulation of collagen in the irradiated livers of female mice, indicating that gender disparity in Hh expression may be related with radiation-susceptibility in female. Hence, Hh signaling becomes a novel object of studies for fibrogenesis induced by radiation. However, the absence of the established experimental animal models showing the similar physiopathology with human liver diseases and fibrosis-favorable microenvironment hamper the studies for the radiation-induced fibrosis, providing a few descriptive results. Therefore, further research on the association of Hh with radiation-induced fibrosis can identify the cell and tissue-specific effects of Hh and provides the basic knowledge for underlying mechanisms, contributing to developing therapies for preventing the radiation-induced fibrosis.