• Title/Summary/Keyword: Hospital Guidance

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Comparison of the Usefulness of MDCT (Multidetective Computed Tomogram) in Facial Bone Fractures (안면부 골절 수술 전후 다중검출기 전산화 단층촬영의 효용성 비교)

  • Hong, Yoon Gi;Kim, Hyung Taek
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.28-34
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    • 2006
  • Purpose: In maxillofacial surgery, proper preoperative diagnosis is very important in achieving good postoperative results. Although conventional CT scans are useful for visual representations of fractures, they cannot provide direct guidance for reconstructing facial bone fractures. However, the recent technology of multislice scanning has brought many clinical benefits to CT images. Direct correlations can be made between preoperative imaging data and operative planning. The aim of the current study is to evaluate the differences between conventional CT and multidetective three-dimensional CT(3D MDCT) measurements in craniofacial deformities. Methods: From January 2005 to November 2005, MDCT scans of 41 patients were evaluated by comparing them with conventional CT scans. The 3D MDCT images were assessed and reviewed by using a simple scoring system. Results: The 3D MDCT scans offered easy interpretation, facilitated surgical planning, and clarified postoperative results in malar complex fractures, mandibular fractures, and extensive maxillofacial fractures and cranioplasty. However, 3D MDCT images were not superior to conventional CT scans in the diagnosis of blowout fractures. Conclusion: In spite of its limitations, the 3D MDCT provided additional and more comprehensive information than the conventional CT for preoperative assessment of craniofacial deformities. Therefore, the 3D MDCT can be a useful tool for diagnosis and systematic treatment planning in craniofacial skeletal deformities.

Rapid Detection of Vancomycin-resistant Enterococci (VRE) in Clinical Samples from University Hospital

  • Yang, Byoung-Seon;Park, Jung-Yeon;Choi, Seung-Gu
    • Korean Journal of Clinical Laboratory Science
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    • v.45 no.1
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    • pp.16-20
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    • 2013
  • Outbreaks of vancomycin-resistant enterococci (VRE) are being reported more frequently in many countries. While seven glycopeptide resistance genotypes have been described in Enterococci, vanA and vanB are the most common resistance genotypes. The aim of this study was to detect antibiotic susceptibilities of 23 Enterococcus faecium strains, which caused an outbreak in a University hospital by a disk diffusion test to investigate the presence of the species specific gene, and the resistant genotypes, vanA and vanB by duplex PCR. PCR for vanA and vanB was performed on 23 enterococci. Twenty three were identified as E. faecium and were tested positive for the vanA genotype. This study will report on the validation of a simple and accurate VRE detection method that can be easily incorporated into the daily routine of a clinical laboratory. Early detection of VRE strains, including those with susceptibility to vancomycin, is of paramount clinical importance as it allows rapid initiation of strict infection control practices, as well as the therapeutic guidance for confirmed infections. The PCR method developed in the present study is simple and reliable for the rapid characterization of VRE.

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Primary Glioblastoma of the Cerebellopontine Angle : Case Report and Review of the Literature

  • Lee, Ji-Hye;Kim, Jong Hyun;Kwon, Taek-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.380-384
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    • 2017
  • Glioblastoma multiforme (GBM) is located most frequently in the cerebral hemispheres. Glioblastoma presenting as an extraaxial mass of cerebellopontine angle (CPA) is very rare in adults. We report a rare case of GBM arising in the CPA. The patient was a 71-year-old female, who complained of progressive gait disturbance and poor memory. Initial magnetic resonance imaging (MRI) revealed a $1.4{\times}1.3cm$ mass in the left CPA, with broad base to the petrous bone, showing homogenous enhancement. Follow-up MRI showed a rapid increase in size of mass ($2.7{\times}2.2cm$) with a necrotic portion. A stereotactic biopsy was done under the guidance of navigation system, and the histopathologic diagnosis was GBM, World Heath Organization grade IV. Further surgical resection was not performed considering her general condition, and the patient underwent concurrent chemotherapy with radiation therapy. Although rare, the possibility of glioblastoma should be included in the differential diagnosis of atypical CPA tumor.

Comparisons of food intake between breast cancer patients and controls in Korean women

  • Kim, Eun-Young;Hong, Yeong-Seon;Jeon, Hae-Myung;Sung, Mi-Kyung;Sung, Chung-Ja
    • Nutrition Research and Practice
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    • v.1 no.3
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    • pp.237-242
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    • 2007
  • The purpose of this study was to compare food intakes between Korean breast cancer patients and a healthy control group. We compared the intake of nutrients of 117 food items between Korean breast cancer patients (n=97) and age matched healthy controls (n=97). Nutrient intake was estimated using a quantitative food frequency questionnaire. The mean caloric intake of breast cancer patients and healthy controls was not significantly different. Breast cancer patients consumed significantly less fat and antioxidant nutrients such as vitamin A, retinol, ${\beta}-carotene$, vitamin C and vitamin E when compared to the control subjects. Among the food items, the intake of eggs (p<0.01), legumes (p<0.05), vegetables (p<0.05), seasonings (p<0.001), and oils and fats (p<0.01) in breast cancer patients was significantly lower than that in the controls. These results suggest that Korean breast cancer patients consumed less amount of soy and vegetables, which are rich source of antioxidant nutrients and phytosterols. Thus, dietary guidance to increase intake of these foods may be beneficial in the prevention of breast cancer.

United Kingdom pediatric dentistry specialist views on the administration of articaine in children

  • Ezzeldin, Maryam;Hanks, Gemma;Collard, Mechelle
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.5
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    • pp.303-312
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    • 2020
  • Background: Lidocaine is the gold standard local anesthetic (LA) for UK pediatric dental treatment. Recent reports suggest frequent Articaine use in Europe and Canada, with evidence indicating more profound anesthesia. The aim of this study was to examine pediatric dentistry specialist experiences and practices relating to Articaine administration in the UK. Methods: A literature review was followed by a survey using an anonymous 15-item electronic questionnaire, which was sent to 200 registered British Society of Pediatric Dentistry (BSPD) specialists. Descriptive analyses, Z score, chi-squared test, Fisher's exact test, and Spearman's correlation test were performed. Results: Sixty-one (30.5%) participants responded, and 12 (19.7%) indicated Articaine as their first line anesthetic. Articaine was used daily or weekly by 38 (62.3%) respondents, depending on the clinical context. Articaine was commonly used to avoid inferior alveolar nerve blocks and gain more profound anesthesia in abscessed or hypomineralized teeth. Participants reported significantly more adverse effects with lidocaine (Fisher's exact test, P < 0.0001) than with Articaine. Articaine was most often administered in children aged > 4 years via infiltration techniques. Only 15 (24.6%) respondents reported awareness of guidelines for Articaine use in pediatric patients. Conclusions: Articaine use in pediatric dentistry is common; however, evidence supporting its practice is limited. Several specialists follow conventions based on anecdotal evidence. Formulating guidance to aid decision-making when treating pediatric patients under LA would be beneficial.

Establishment an Environment for Smart Emergency Information Service (스마트 구급 정보 서비스를 위한 환경 구축)

  • Eum, Sang-hee;Kim, Gi-Ryon;Kim, Gwang-nyeon;Nam, Jae-hyun
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2017.10a
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    • pp.279-281
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    • 2017
  • In the recent years, An attempts have been made to convergence medical technology and IT technology to overcome the limitations of temporal, spatial, and medical technology applications. In this study, we established an environment for emergency information services. The developed smart application for emergency rescue activities support can easily identify emergency situation and First Aid. Then, it can be transmitted to a remote medical guidance doctor so that emergency treatment and hospital response can be performed quickly.

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Ultrasound-Guided Shoulder Injections (초음파 유도하 견관절 주사요법)

  • Moon, Young Lae;Jun, Yong Cheol;Sun, Jae Myeong
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.393-401
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    • 2019
  • The shoulder pain is one of the most common problems to orthopaedic surgeons in clinic. Among therapeutic modality used to manage this pain, joint and periarticular injection, as well as suprascapular nerve block, show good clinical outcome. Ultrasound guidance is a safe technique, increasing the safety and accuracy of the procedure and reducing complications. An accurate understanding of the surface anatomy is important in performing the ultrasound-guided shoulder injections. This article aims to describe the surface anatomy and sono anatomy of both the shoulder and the surrounding structures and also summarize different infiltration techniques and peripheral nerve blocks.

Design and implementation of a smart glass-based emeraency tele-medical direction system (스마트 글래스 기반 응급원격의료지도 시스템 설계 및 구현)

  • Youngho Lee;Incheol Hwang;Hyunmo Yang;Gunwoo Park;Sungmin Lee
    • Smart Media Journal
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    • v.13 no.5
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    • pp.26-32
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    • 2024
  • This paper proposes a smart glass-based emergency tele-medical direction system. This system is designed for hospital specialists to provide remote medical guidance to on-site coast guards or emergency responders. To identify the requirements necessary for system development, relevant technological trends and case studies were analyzed. Based on this analysis, three system requirements were defined: 1) The system must be able to determine the necessity of patient transport, 2) It should assist in providing emergency medical care during transport to the hospital, and 3) It must be capable of transmitting patient information to medical facilities. A prototype that meets these requirements was developed and its usability was evaluated.

Role of biomarkers in antimicrobial stewardship: physicians' perspectives

  • Hyeri Seok;Dae Won Park
    • The Korean journal of internal medicine
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    • v.39 no.3
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    • pp.413-429
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    • 2024
  • Biomarkers are playing an increasingly important role in antimicrobial stewardship. Their applications have included use in algorithms that evaluate suspected bacterial infections or provide guidance on when to start or stop antibiotic therapy, or when therapy should be repeated over a short period (6-12 h). Diseases in which biomarkers are used as complementary tools to determine the initiation of antibiotics include sepsis, lower respiratory tract infection (LRTI), COVID-19, acute heart failure, infectious endocarditis, acute coronary syndrome, and acute pancreatitis. In addition, cut-off values of biomarkers have been used to inform the decision to discontinue antibiotics for diseases such as sepsis, LRTI, and febrile neutropenia. The biomarkers used in antimicrobial stewardship include procalcitonin (PCT), C-reactive protein (CRP), presepsin, and interleukin (IL)-1β/IL-8. The cut-off values vary depending on the disease and study, with a range of 0.25-1.0 ng/mL for PCT and 8-50 mg/L for CRP. Biomarkers can complement clinical diagnosis, but further studies of microbiological biomarkers are needed to ensure appropriate antibiotic selection.

Balloon Bronchoplasty for the Treatment of Bronchial Stenosis After Lung Transplantation: A Single-Center 10-Year Experience

  • Dong Kyu Kim;Joon Ho Kwon;Kichang Han;Man-Deuk Kim;Gyoung Min Kim;Sungmo Moon;Juil Park;Jong Yun Won;Hyung Cheol Kim;Sei Hyun Chun;Seung Myeon Choi
    • Korean Journal of Radiology
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    • v.24 no.5
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    • pp.424-433
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    • 2023
  • Objective: To assess the safety and efficacy of balloon dilatation under dual guidance using fluoroscopy and bronchoscopy for treating bronchial stenosis following lung transplantation (LT), and to elucidate the factors associated with patency after the procedure. Materials and Methods: From September, 2012, to April, 2021, 50 patients (mean age ± standard deviation, 54.4 ± 12.2 years) with bronchial stenosis among 361 recipients of LT were retrospectively analyzed. The safety of balloon dilatation was assessed by evaluating procedure-related complications. Efficacy was assessed by evaluating the technical success, primary patency, and secondary patency. Primary and secondary cumulative patency rates were calculated using the Kaplan-Meier method. The factors associated with patency after the procedure were evaluated using multivariable Cox hazard proportional regression analysis. Results: In total, 65 bronchi were treated with balloon dilatation in 50 patients. The total number of treatment sessions was 277 and the technical success rate was 99.3% (275/277 sessions). No major procedure-related complications were noted. During the mean follow-up period of 34.6 ± 30.8 months, primary patency was achieved in 12 of 65 bronchi (18.5%). However, the patency rate improved to 76.9% (50 of 65 bronchi) after repeated balloon dilatation (secondary patency). The 6-month, 1-year, 3-year, and 5-year secondary patency rates were 95.4%, 90.8%, 83.1%, and 78.5%, respectively. The presence of clinical symptoms was a significant prognostic factor associated with reduced primary patency (adjusted hazard ratio [HR], 0.465; 95% confidence interval [CI], 0.220-0.987). Early-stage treatment ≤ 6 months (adjusted HR, 3.588; 95% CI, 1.093-11.780) and prolonged balloon dilatation > 5 min (adjusted HR, 3.285; 95% CI, 1.018-10.598) were associated with significantly higher secondary patency. Conclusion: Repeated balloon dilatation was determined to be safe and effective for treating bronchial stenosis following LT. Early-stage treatment and prolonged balloon dilatation could significantly promote long-term patency.