• Title/Summary/Keyword: Clinical Setting

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Contemporary treatment with radiosurgery for spine metastasis and spinal cord compression in 2015

  • Ryu, Samuel;Yoon, Hannah;Stessin, Alexander;Gutman, Fred;Rosiello, Arthur;Davis, Raphael
    • Radiation Oncology Journal
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    • v.33 no.1
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    • pp.1-11
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    • 2015
  • With the progress of image-guided localization, body immobilization system, and computerized delivery of intensity-modulated radiation delivery, it became possible to perform spine radiosurgery. The next question is how to translate the high technology treatment to the clinical application. Clinical trials have been performed to demonstrate the feasibility of spine radiosurgery and efficacy of the treatment in the setting of spine metastasis, leading to the randomized trials by a cooperative group. Radiosurgery has also demonstrated its efficacy to decompress the spinal cord compression in selected group of patients. The experience indicates that spine radiosurgery has a potential to change the clinical practice in the management of spine metastasis and spinal cord compression.

CLINICAL CONSIDERATION OF INDIRECT BONDING TECHNIQUE (INDIRECT BONDING TECHNIQUE에 대한 고찰)

  • Lee, Kyung Hwan;Kim, Sang Cheol
    • The korean journal of orthodontics
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    • v.19 no.2
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    • pp.155-163
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    • 1989
  • Indirect bonding is done by placing the brackets on a model in the laboratory and using a template or tray to transfer the laboratory positioning to the teeth. The advantages of this technique are 1. decreased chair time 2. less patient discomfort 3. accuracy of a attachment placement 4. good adaptation of attachment to tooth contour 5. occlusal relationship of brackets and opposing teeth can be checked The disadvantages of the technique are 1. complex laboratory procedure 2. sometimes difficult on very short clinical crowns 3. teeth with crowns, large buccal restoration will not bond 4. may not be fitted close, if poor adaptation 5. likely to be disturbed setting Several indirect bonding techniques have proved reliable in clinical practice. However, they differ in the way the brackets are attached temporarily to the model, the type of transfer tray or other mechanism used, the adhesive or sealant employed, whether segmented or full bonding used, and the way the transfer is removed so as not to exert excessive force on a still maturing bond.

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A Clinical Trial on the Method of Urine Sampling for Urinalysis (소변검사의 검체 채취 방법에 관한 임상실험연구)

  • An Hae-Sung;Lee Sung-Eun;Park Hyun-Ok
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.2
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    • pp.131-137
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    • 1995
  • Improving validity and reliability is the important components of clinical laboratory tests. And the quality control of the test should be started with the accurate collection of specimen. Urinalysis is one of the useful and common tests in diseases diagnosis and determining the process of medical treatment. Since urinalysis is requested routinely in hospital setting, the importance of the quality control for urine specimen is often ignored. To improve the validity of urinalysis, a clinical trial was done on the method of collecting urine specimen. The result was as follows : 1. The rate of presumtive UTI(urinary tract infection) was decreased in 21.6% with experiment method for collecting urine specimen. 2. The rate of presumtive UTI in female patients was decreased in 43.2% with the experiment method. 3. The rate of negative urine culture was decreased in 6.6% with the experiment method.

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Whole genome sequencing based noninvasive prenatal test

  • Cho, Eun-Hae
    • Journal of Genetic Medicine
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    • v.12 no.2
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    • pp.61-65
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    • 2015
  • Whole genome sequencing (WGS)-based noninvasive prenatal test (NIPT) is the first method applied in the clinical setting out of various NIPT techniques. Several companies, such as Sequenom, BGI, and Illumina offer WGS-based NIPT, each with different technical and bioinformatic approaches. Sequenom, BGI, and Illumina utilize z-, t-, and L-scores, as well as normalized chromosome values, respectively, for trisomy detection. Their outstanding performance has been demonstrated in clinical studies of more than 100,000 pregnancies. The sensitivity and specificity for detection of trisomies 13, 18, and 21 were above 98%, as reported by all three companies. Unlike other techniques, WGS-based NIPT can detect other trisomies as well as clinically significant segmental duplications/deletions within a chromosome, which could expand the scope of NIPT. Incorrect results could be due to low fetal fraction, fetoplacental mosaicism, confined placental mosaicism or maternal copy number variation (CNV). Among those, maternal CNV is a significant contributor of false positive results and therefore genome wide scanning plays an important role in preventing the occurrence of false positives. In this article, the bioinformatic techniques and clinical performance of three major companies are comprehensively reviewed.

Multiple Tuberculous Splenic Abscesses in a Child (소아에서 발생한 비장의 다발성 결핵성 미세농양 1예)

  • Park, Chan-Yong;Choi, Soo-Jin-Na;Chung, Sang-Young;Kim, Shin-Kon
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.244-250
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    • 2006
  • Splenic abscess is a rare clinical condition with a reported incidence of 0.14 % to 0.70 % in various autopsy series. Primary tuberculosis of the spleen as a cause of splenic abscess is even rarer, especially in the antitubercular era. Infants and children have a higher predisposition to extra-pulmonary tuberculosis than adults and tend to develop severe extra-pulmonary disease such as miliary tuberculosis and meningitis. The diagnosis of tuberculosis in infants and children can be difficult because of nonspecific symptoms and clinical findings. Computed tomography establishes the diagnosis of splenic abscess and demonstrates the number and location of abscesses. Splenectomy is the standard of care in most clinical setting. We present a 4-year-old girl who had multiple tuberculosis splenic abscesses and was treated successfully with splenectomy.

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Implantable Functional Electrical Stimulation with Inductive Power and Data Transmission System (유도전력전송방식의 이식형 기능적 전기자극)

  • Lee, Joon-Ha
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.97-106
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    • 2007
  • Functional electrical stimulation (FES) has developed over the last 35 years to become a scientifically, technologically and clinically recognized field of interest in clinical medicine. FES has been applied to locomotion, grasping, ventilation, incontinence, and decubitus healing. However, all of these achievements illustrate the initial applications of FES; its true potential has not yet been realized. Recently, FES systems, which are miniaturized stimulation devices, have been utilized in the clinical setting. However, because the stimulating electrodes of the current FES devices are percutaneous electrodes, which are susceptible to wire breakage, and skin infection an implantable FES stimulating electrode has been introduced in the U.S. and Japan. In the present study, an external power supply method using radio frequency (RF) coupling and data transmission was developed for the control of the implantable FES device. In addition, we review the current understanding of FES devices and their application in clinical medicine.

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Effects of Board Game Therapy on Executive Function in Hospitalized Patients with Chronic Schizophrenia (보드게임요법이 만성 정신분열병 환자의 실행능력에 미치는 효과)

  • Jeong, An-Soon
    • Journal of Home Health Care Nursing
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    • v.18 no.1
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    • pp.40-47
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    • 2011
  • Purpose: This study investigated changes in neurocognitive function over a 2-month period of board game therapy in patients with schizophrenia. Method: Twenty-one schizophrenic patients treated with board game therapy and nineteen control schizophrenic patients were evaluated with neuropsychological and clinical tests, such as the Wisconsin Card Shorting Test (WCST). The same tests were re-administered after 2 months of board game therapy. Results: At the first series of neuropsychological tests, no difference was seen in performance, demographical aspects, or clinical severity among both patient groups. After 2 months, the group receiving board game therapy showed significant improvement of WCST performances compared to the controls. However, no difference was observed in clinical symptoms between the groups. Conclusion: The results of cognitive enhancement in patients playing board games indicates that board game play, easily used in an inpatient setting, is a promising tool for executive function improvement in chronic schizophrenic patients.

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Community Pharmacists' Perception of Barriers to Pharmacy Work (약국업무시 고충에 관한 개국약국 약사의 인식에 관한 연구)

  • Kim, Hyun-Ah
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.1
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    • pp.37-42
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    • 2009
  • The purpose of this study was to evaluate barriers to pharmacists' routine work in community setting. A survey was given to 281 pharmacists who enrolled in 16-week clinical pharmacy educating program in continuous education center for advanced pharmacy at Seoul National University. Three main questions that pharmacists were asked to answer were: (1) difficulties on dispensing prescription, (2) difficulties on communicating with doctors, (3) most difficult disease on patients counseling. The response rates for the survey were more than 60 % for each three questions (62.63 %, 63.7 %, and 64.41 %, respectively). The top three barriers to dispensing prescription were lack of professional knowledge about medications, prescription error and its solving ability and patient counseling. The top three barriers to communicating with doctors were lacking of opportunity to discuss about patients' medication due to unavailability of doctors, doctors' attitude using authoritative manner, and a pharmacist's lack of knowledge. The top 4 most difficult diseases on patients counseling were cardiovascular disorders, dermatologic disorders, endocrinologic disorders, and psychiatric disorders.

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Increased Biceps Translation: A Clinical Sign of Complete Distal Biceps Tendon Rupture

  • Malhotra, Karan;Waheed, Abdul
    • Clinics in Shoulder and Elbow
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    • v.19 no.1
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    • pp.48-50
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    • 2016
  • Various tests to help in the clinical diagnosis of distal biceps tendon ruptures have been described. In our experience these tests are painful in the acute setting. We suggest a simple alternative test wherein the biceps muscle belly is held by the examiner and translated medially and laterally. This is done with the forearm flexed to 90 degrees. It is first performed with the biceps relaxed and subsequently performed with the forearm flexed against resistance. In the relaxed forearm the biceps easily translates over 50% of its width. When placed under tension (by flexing against resistance) this translation is significantly reduced. In cases of complete distal biceps tendon rupture, the biceps still translates, even under resisted flexion of the forearm. This simple test is less painful than other described tests, is easy to perform, and aids in clinical diagnosis of distal biceps tendon ruptures.

Critical Illness Polyneuropathy (위험질병 다발신경병증)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.3 no.2
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    • pp.115-121
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    • 2001
  • The occurrence of muscle weakness in patients with sepsis or multiple organ failure managed in the intensive care unit has been recognized with increasing frequency in the last two decades. The difficulty in examining critically ill patients may explain why this complication has been only recently recognized. This weakness is due to an axonal polyneuropathy which is called critical illness polyneuropathy(CIP). It must be differentiated from myopathy or neuromuscular junction disturbance that can also occur in the intensive care setting. Neither the cause nor the exact mechanism of CIP has been elucidated. Electrophysiological studies demonstrated an acute axonal damage of the peripheral nerves. Before the recognition of CIP, these cases were usually misdiagnosed as Guillain-$Barr{\acute{e}}$ syndrome. Clinical recovery from the neuropathy is rapid and nearly complete in those patients who survive. Thus, neuropathy acquired during critical illness, although causing a delayed in weaning from ventilatory support and hospital discharge, does not worsen long-term prognosis.

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