• Title/Summary/Keyword: Clinical work-flow

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The Clamshell Incision for the Complete Repair in Pulmonary Atresia with Ventricular Septal Defect, and Major Aortopulmonary Collaterals (주대동맥폐동맥간 부행혈관이 동반된 폐동맥 형성부전 환아에서의 Clamshell 절개를 통한 완전교정술 -1례 보고-)

  • 차대원;박표원;전태국;강이석;이흥재
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.823-826
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    • 1999
  • A 6-month old girl who had pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals underwent one-stage complete repair with unifocalization through a bilateral thoracosternotomy(clamshell incision). There were no serious postoperative compli cations, and the postoperative echocardio-graphy showed no residual ventricular septal defect or significant pulmonary artery stenosis. In this condition, great surgical variability exists regarding the sources of pulmonary blood flow. Recent clinical work has focused on a one-stage complete repair. The potential advantages of the clamshell incision are apparent in terms of mediastinal approach, postoperative results, and safety.

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An empirical study about the precondition of Qi-daignosis (氣診, integrated diagnosis by bio-energy) (기진(氣診)의 선결조건에 대한 체험적 연구)

  • Cho, Dae Geun;Kim, Gyeong Cheol
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.23 no.1
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    • pp.9-18
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    • 2019
  • Objectives The authors feel the Qi(氣) through the training, and diagnose and treat our patients through the feeling. In order to utilize the Qi-daignosis, we try to summarize the authors's training process by examining what and how to use the Qi-daignosis. Methods The authors have gathered empirical parts of the psychological part and the various methods of training, through what they need most and how to train them. And we want to describe them in order of importance. Result First of all, with psychological sense of securit you should practice trainingy. It should be able to maintain the unity of the body through relaxation on the basis of 'no thinking only watching'. You must concentrate your energy through concentration and strengthen your inner work. Then you can feel the flow of energy inside your body and you can feel the interaction between the outside and your body. Conclusion By doing this, you naturally begin to apply the Qi-daignosis to your patients. It is not only possible for some doctors with specific abilities. Anyone can feel the Qi(氣) through clinical training and use the Qi-daignosis.

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Effect of Supratentorial Stroke on Cerebellar Hemodynamic Parameters - Assessment by Dynamic Susceptibility Contrast MR Imaging (천막상부 뇌졸중에서 소뇌의 혈역학 변화 -Dynamic Susceptibility Contrast MR 영상을 이용한-)

  • Han, Si-Ryung;Kim, Bum-Soo;Guak, Tae-Ho;Choi, Young-Bin;Kim, Yeong-In
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.38-43
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    • 2002
  • Background & Purpose : Dynamic susceptibility contrast MR imaging, one method of perfusion MRI, was developed to define cerebral hemodynamic status with good anatomical resolution. The authors investigated hemodynamic parameters using this imaging method, in an effort to identify hemodynamic changes on the remote crossed cerebellum of patients with a supratentorial infarct. Methods : Dynamic susceptibility contrast MR imaging was performed in 15 patients with only unilateral supratentorial infarcts. Imaging was obtained at the anatomic level of the cerebellum. rCBF, rCBV, MTT and TP were determined over both cerebellar hemispheres of interest. Results : The rCBF and rCBV values of the contralateral cerebellar hemisphere were significantly more decreased than those of the ipsilateral cerebellar hemisphere in 12 patients(p=0.028, 0.033). MTT and TP values of the contralateral and ipsilateral cerebellar hemispheres didn't reveal any differences(p=0.130, 0.121). Conclusions : The results of this work suggest that the region which are remote from the ischemic brain lesion shows no changes of MTT or TP but show decrease of rCBF and rCBV, mean to diaschisis, it also demonstrates that perfusion MRI is an easily available method to evaluate the hemodynamic status of the brain.

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The convergence study on the use of dental impression materials (치과용 인상재의 사용 실태에 대한 융합 연구)

  • Jang, Sun-Ok;Choi, Eun-Mi;Kang, Min-Kyung;Shim, Youn-Soo;Cho, Yoon-Jeong;Oh, Sang-Hwan;Choi, Yu-Ri
    • Journal of Digital Convergence
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    • v.16 no.4
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    • pp.195-203
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    • 2018
  • This study was conducted to investigate the types and methods of dental impression materials used in dental clinics in south Korea, the questionnaire was surveyed by a self-administered method for one dentist in a one dental clinic, the collected data were statistically analyzed using SPSS 20. The most frequently used addition silicone impression materials were used in most dental treatment. It was confirmed that the method of taking impression materials having different flow properties(light body and heavy body) was most preferred at one time, also, the implant impression taking method was the most preferred for two rubber impression materials with different flow properties, both direct and indirect. There were statistically significant differences in age and clinical experience between the methods of impression taking of casting restorations and prosthetic according to general characteristics. These results are expected to be helpful for the development of theoretical and practical work based on the basic data for impression material development and research and the preference of impression materials required for dental professional in clinical practice.

Characterization of Bruton's Tyrosine Kinase Genetic Mutations in One Korean X-linked Agammaglobulinemia Family (반성 열성 범저감마글로불린혈증 1가계 3환자의 Bruton's Tyrosine Kinase 유전자 변이 및 임상 양상)

  • Jo, Eun-Kyeong;Song, Chang-Hwa;Park, Jeong-Kyu;Baek, Young-Jong;Rhu, Hye-Young;Lee, Jae-Ho;Hwang, Tai-Ju;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.183-191
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    • 2002
  • Purpose : X-linked agammaglobulinemia(XLA) is an immunodeficiency caused by abnormalities in Bruton's tyrosine kinase(Btk), and is characterized by a deficiency of peripheral blood B cells. We studied the cytoplasmic expression of Btk protein and analyzed the Btk gene in peripheral blood mononuclear cells from two siblings and one cousin with XLA, as well as additional family members. Methods : Btk protein expression was analyzed by flow cytometry. Isolation of the coding sequence of the Btk gene was performed by amplification using the reverse transcription-polymerase chain reaction(RT-PCR) technique. Sequence alterations were screened by the single-stranded conformation polymorphism(SSCP) method and characterized by standard sequencing protocols. Results : Cytoplasmic expression of Btk protein in monocytes was not detected in three patients with XLA. In addition, Btk protein analysis clearly showed cellular mosaicism in monocytes from four obligate carriers, findings further supported by SSCP. A single base pair mutation(T to C) in Btk-exon three, which encodes the PH domain, was identified in four XLA patients. A diagnostic sequencing analysis was established to detect heterozygotic pattern in 4 carrier females. Furthermore, we found significant clinical heterogeneity in individuals with the same gene mutation. Conclusion : The implicating genetic alteration provided valuable clues to the pathogenesis of XLA in Korea and the flow cytometric analysis was suggested as a useful tool for rapid detection of XLA patients and carriers. The present study has identified a genetic mutation in the Btk coding region and demonstrated heterogeneity in clinical manifestations among patients with the same mutation. A flow cytometric analysis was found to be informative in establishing a deficiency of Btk protein in both patients and carriers and is recommended as a frontline procedure in the molecular diagnosis and work-up of XLA.

Human Activated Lymphocyte Treated with Anti-CD3, CD16, CD56 Monoclonal Antibody and IL-2 (Anti-CD3, CD16과 CD56 단일항체와 IL-2를 사용하여 활성화시킨 사람의 림프구)

  • Hong, Seon-Min;Lee, Dong-Wook;Kang, Jin-Gu;Kim, Han-Soo;Cho, Sung-Hoon
    • IMMUNE NETWORK
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    • v.5 no.1
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    • pp.11-15
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    • 2005
  • Background: Throughtout the last three decades, the therapy of leukemias and lymphoma has set the stage for curative cancer therapy in systemic malignant disease. This was the result of an integrated work of basic reaserch and clinical investigators leading to more aggressive albeit tolerable protocol of chemotherapy and radiotherapy. High dose therapy marks the most elaborated strategies in this field today. However, intensification of conventional therapeutic modalities as mentioned has to be based on new approaches and the exploration of new antineoplastic mechanisms. This insight has resulted in immune therapy of cancer. Among the cells of the immune system, natural killer (NK) cells and T cells are of major interest for the development of therapeutic strategies. Methods: Cytotoxicity to target cells was measured by LDH release method, Characterization of activated lymphocyte was measured by Flow cytometry analysis. Anti-CD3, 16, 56 monoclonal antibody and IL-2 were used for the activation of NK and T cell. The analysis of effect of activated lymphocyte, in vivo, were used by Balb/c nude mouse. Results and Conclusion: Cytotoxicity to K562 cells was significantly higher in the mixture group of NK and T cells than that of a group of activating T cells. The survivors and the rate of reduction of size of tumor craft of nude mouse group treatment with activated lymphocyte was higher than that of the group without treatment with activated lymphocyte. Therefore, this results are suggested that the activated lymphocytes by anti-CD3, CD16 and CD56 can reduce the malignancy effect of lymphoma.

Accuracy and Satisfaction with IVIC300 (Intravenous infusion controller) (IVIC300(Intravenous infusion controller)의 정확성과 만족도)

  • Park, Jung Hee;Yang, Nam Young;Na, Moon Jun;Go, Young Jin;Kim, Ki Suk;Kim, Young Aue
    • Journal of Korean Public Health Nursing
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    • v.28 no.1
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    • pp.114-126
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    • 2014
  • Purpose: The purpose of this study was to determine the accuracy and satisfaction with IVIC300 (Intravenous infusion controller). Method: The subjects consisted of 90 nurses and 100 patients. Data collected during July 2013 were analyzed using descriptive statistics, t-test, ANOVA, and $X^2$-test (Chi-Square). Result: The error value of IVIC300 was less than that of Dosi-flow. Differences of error values according to variable of fluid infusion (needle's gauge, patient's moving, patient's calls, and nurse's arabitary calls) were not significant. The mean scores for satisfaction with IVIC300 of nurses ($3.67{\pm}.76$), patients ($3.75{\pm}.63$) were above average. Satisfaction with IVIC300 of nurses differed significantly according to age, work unit, and clinical career. Satisfaction with IVIC300 of patients was not significantly different according to general characteristics. Conclusion: These findings indicate that it is proven the accuracy of IVIC300, and is considered individual characteristics in use IVIC300.

Design and Implementation of the Web-based Monitoring System for an Artificial Heart (웹 기반 인공심장 모니터링 시스템의 설계와 구현)

  • 정진한;최재순;이지훈;민병구
    • Journal of Biomedical Engineering Research
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    • v.23 no.2
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    • pp.131-137
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    • 2002
  • The remote monitoring system including hemodynamic information and pump status of the implanted animal could be helpful during the in vivo experiment or clinical trial for an artificial heart Implantation. In order to monitor the course of the in vivo experiment continuously and anywhere, web-based remote monitoring system was developed, which can monitor pressures(AoP, LAP, RAP, PAP) and flow information as well as the pump operating conditions. The system consists of data sending, storing viewer part. The data sending part was constructed using component object model and the viewer part was constructed using the Java applet. In addition, the dialog box was introduced to communicate earth other instantly and the alarming function was also introduced when the hemodynamic values were out of the desired ranges. The developed remote monitoring system was applied during the in vivo experiment of the BVAD (Bi-ventricular Assist Device) implantation for 1 month and showed designed work without failure.

The Evolution of Flow-Diverting Stents for Cerebral Aneurysms; Historical Review, Modern Application, Complications, and Future Direction

  • Shin, Dong-Seong;Carroll, Christopher P.;Elghareeb, Mohammed;Hoh, Brian L.;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.137-152
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    • 2020
  • In spite of the developing endovascular era, large (15-25 mm) and giant (>25 mm) wide-neck cerebral aneurysms remained technically challenging. Intracranial flow-diverting stents (FDS) were developed to address these challenges by targeting aneurysm hemodynamics to promote aneurysm occlusion. In 2011, the first FDS approved for use in the United States market. Shortly thereafter, the Pipeline of Uncoilable or Failed Aneurysms (PUFS) study was published demonstrating high efficacy and a similar complication profile to other intracranial stents. The initial FDA instructions for use (IFU) limited its use to patients 22 years old or older with wide-necked large or giant aneurysms of the internal carotid artery (ICA) from the petrous segment to superior hypophyseal artery/ophthalmic segment. Expanded IFU was tested in the Prospective Study on Embolization of Intracranial Aneurysms with PipelineTM Embolization Device (PREMIER) trial. With further post-approval clinical data, the United States FDA expanded the IFU to include patients with small or medium, wide-necked saccular or fusiform aneurysms from the petrous ICA to the ICA terminus. However, IFU is more restrictive in South Korea than in United States. Several systematic reviews and meta-analyses have sought to evaluate the overall efficacy of FDS for the treatment of cerebral aneurysms and consistently identify FDS as an effective technique for the treatment of aneurysms broadly with complication rates similar to other traditional techniques. A growing body of literature has demonstrated high efficacy of FDS for small aneurysms; distal artery aneurysms; non-saccular aneurysms posterior circulation aneurysms and complication rates similar to traditional techniques. In the short interval since the Pipeline Embolization Device was first introduced, FDS has been firmly entrenched as a powerful tool in the endovascular armamentarium. As new FDS are developed, established FDS are refined, and delivery systems are improved the uses for FDS will only expand further. Researchers continue to work to optimize the mechanical characteristics of the FDS themselves, aiming to optimize deploy ability and efficacy. With expanded use for small to medium aneurysms and posterior circulation aneurysms, FDS technology is firmly entrenched as a powerful tool to treat challenging aneurysms, both primarily and as an adjunct to coil embolization. With the aforementioned advances, the ease of FDS deployment will improve and complication rates will be further minimized. This will only further establish FDS deployment as a key strategy in the treatment of cerebral aneurysms.

A STUDY ON THE CLINICAL ANALYSIS AND PERFORMANCE IN COMPREHENSIVE NURSING CARE (전인간호의 임상학적 분석과 실행에 관한 연구)

  • 전산초
    • Journal of Korean Academy of Nursing
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    • v.4 no.1
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    • pp.1-21
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    • 1974
  • A considerable change of the Korean nursing system has been made during the last decade not only in its philosophy but also in its function and structure to meet political and scientific need of the modern society. The main purpose of this study is to develope the new concept of comprehensive nursing care, both its Philosophy and ethics, as the basic of modern clinical nursing theory and practice. Comprehensive nursing care is the concept of human centered nursing care, and it helps a man to meet the basic physical, psychological, environmental, socioeconomic and teaching needs. It also helps him to help himself to meet these needs. This concept starts from the individualized nursing care and its ultimate goal is to improve a man to have a better position in his own community so that he may able to have a meaningful life. To accomplish this goal, an individualized nursing care plan as a nursing diagnosis and problem solving method should be set up for different patients with similar diagnosis to meet their needs, because each patient has a different social background. from this viewpoint, nursing is a science as well as abstruse humanity. The performance of comprehensive nursing care is a goal and issue of modern clinical nursing care. If nursing is a science and a profession for man, it should have ethics which recognize the dignity of man and offers infinite service voluntarily, and should be able to show leadership in carrying out the nursing responsibility. This leadership finds a person's potential and encourages him to utilize it. Such concepts should develop into a nursing ideology and this ideology should become a priority in comprehensive nursing care. The following statements are the conclusion of this study. 1) Modern nursing has been developed from disease centered nursing care to comprehensive nursing care based on humanity. The primary principle of nursing was to assist in the treatment of disease, but it has been changed to the professional nursing system independently. 2) The concept of nursing is one of continuous or endless scope of dispersion. It proves that nursing is grasping the professional responsibility to be able to coordinate scientific principles Patient health problems are according to scientific principles rather than adhering to nursing technical discipline as a daily work. 3) In chapter I and Ⅱ, the philosophy and ideology of nursing have been discussed and the flow of concept of clinical nursing and the rate of progress which emerges from naturalizing performance of the concept of comprehensive nursing in clinical nursing studied. The discussion developed the theory that a nurse should be to embody nursing ideas and objectives by establishing definite conviction of professions and study. 4) In chapter lil, nursing planning based on nursing diagnosis as a method to attain ideal nursing care for humanity with a definite idea of establishing philosophy of nursing was presented. 5) From the result of survey on patient needs about treatment and nursing, it was observed that all patient had emotional stress from unknown factors. Therefore it was concluded that nurses should not only educate the patient but also give them the opportunity to communicate freely their needs and anxieties. Furthermore complaints and doubts of the patient should be carefully noted and must be considered to meet these needs. 6) Patient teaching is the most important part of comprehensive nursing care. In chapter, Ⅲ, the important of patient teaching was emphasized by demonstrating the effect of patient teaching for diabetic patient. 7) In Chapter Ⅳ, from the result of the study on nurses attitudes to comprehensive nursing care, it was pointed that the evolution of nursing education and the establishment of a complete concept and value of comprehensive nursing was necessary.

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