• 제목/요약/키워드: Hospital Guidance

검색결과 376건 처리시간 0.024초

천미골 접합부를 이용한 외톨이 신경절 차단법 (Modified Approach through the Sacrococcygeal Junction to Block the Ganglion Impar)

  • 송선옥;권오득;김성기
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.254-257
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    • 1997
  • Ganglion impar lies immediately anterior to the sacrococcygeal junction and blockade of the ganglion is used to treat anorectal and perineal pain. Although the technique introduced by Plancarte et at is widely practised, the bent needle is sometimes difficult to position precisely and patients find the procedure painful. We modified this approach of block of ganglion impar by positioning the needle into the sacrococcygeal junction and using the loss of resistance technique. With the patient in the lateral position, a skin wheal was raised at 1-1.5cm below the sacral hiatus. Twenty-three gauge short needle was directly placed into the sacrococcygeal junction with aid of fluoroscopic guidance. From 1 cm behind the anterior margin of the vertebral body in lateral view, we used the loss of resistance technique to confirm the retroperitoneal space. We found this modified approach easier to perform during six blocks for three patients with anorectal or perineal pain. Our modified approach through the sacrococcygeal junction may provide opportunity for wider administration of this procedure because of its simple technique, reduced pain during procedure and decreased risk of infection.

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요추부 초음파 유도하 중재술 (Ultrasound-guided Intervention in Lumbar Spine)

  • 문상호
    • 대한정형외과 초음파학회지
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    • 제6권2호
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    • pp.81-93
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    • 2013
  • 본 종설에서는 요추부 중재술에 있어서 초음파라는 장비가 영상 장치로서 얼마나 유용한가에 대해 기술하였다. 우선 요천추부의 표면 해부학과 초음파 해부학에 대하여 기술하였는데, 이는 초음파 유도하 중재술에서 영상의 판독과 술기의 수행에 있어 해부학의 자세한 이해가 반드시 필요하기 때문이다. 방사선 투시하에 척추 중재술을 하는 것이 보편화 되어 있지만 방사선을 피폭해야 하는 문제가 늘 존재한다. 초음파는 방사선이 없고 간편하며 높은 정확도로 실시간 영상을 제공하는 장점들이 있으며 어떠한 임상 환경적 조건에서도 시행할 수 있다. 초음파 유도하 요추부 중재술은 방사선 투시기나 컴퓨터 단층촬영 유도로 시행하였던 기존의 방식을 대신할 수 있으며 방사선 피폭 없이 안전하게 시행할 수 있는 방법이다.

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스마트 구급 활동 지원 앱 개발 (A Development of Support Smart Application for Emergency Rescue Activities)

  • 엄상희;김기련;김광년
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2017년도 춘계학술대회
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    • pp.238-240
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    • 2017
  • 최근 시간적, 공간적, 의료기술 적용의 한계를 극복하기 위하여 의료 기술과 IT 기술의 융합을 시도하고 있다. 본 연구에서는 응급 의료 서비스에 적용할 수 있는 구급 활동을 지원하기 위한 앱을 개발하였다. 개발된 스마트 구급 활동 지원 앱은 응급 환자의 상황 파악 및 구급 일지 등을 쉽게 작성하고, 이를 원격지 의료 지도 의사에게 전달하여 응급조치 및 병원 대응이 신속하게 이루어질 수 있도록 할 수 있다.

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The effect of insemination methods on in vitro maturation outcomes

  • Pongsuthirak, Pallop
    • Clinical and Experimental Reproductive Medicine
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    • 제47권2호
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    • pp.130-134
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    • 2020
  • Objective: The aim of this study was to compare the effects of conventional insemination (in vitro fertilization [IVF]) and intracytoplasmic sperm injection (ICSI) on the fertilization, developmental competence, implantation potential, and clinical pregnancy rate of embryos derived from in vitro matured oocytes of patients with polycystic ovary syndrome (PCOS). Methods: A prospective study was carried out among 38 PCOS patients who had undergone In vitro maturation (IVM) treatment. In total, 828 immature oocytes were collected from 42 cycles and randomly assigned for insemination by IVF (416 oocytes) or ICSI (412 oocytes). After fertilization, the embryos were cultured until the blastocyst stage and single embryos were transferred after endometrial preparation and under ultrasound guidance. Results: No significant differences were found in the maturation rate (78.1% vs. 72.6% for IVF and ICSI insemination, respectively; p= 0.076), fertilization rate (59.4% vs. 66.9% for IVF and ICSI insemination, respectively; p= 0.063), or the formation of good-quality blastocysts (40.9% vs. 46.5% for IVF and ICSI insemination, respectively; p= 0.314). Implantation and clinical pregnancy also did not show significant differences. Conclusion: There was a comparable yield of in vitro matured oocytes derived from PCOS patients in terms of fertilization, blastocyst formation, implantation rate, and clinical pregnancy between IVF and ICSI insemination. These findings provide valuable insights for choosing assisted reproductive treatment in women with PCOS, as IVM offers promising outcomes and is less invasive and less costly.

정량적 게이트 심근관류 SPECT (Quantitative gated myocardial perfusion SPECT)

  • 안병철
    • 대한핵의학회지
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    • 제37권4호
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    • pp.207-218
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    • 2003
  • Myocardial perfusion imaging has been increasingly used to provide prognostic data and guidance on the choice of appropriate management of patients with known or suspected coronary artery disease. The electrocardiogram gated myocardial SPECT program is corning into wide use with an advent of $^{99m}Tc-labeled$ tracers and an improvement of SPECT machines. The gated technique permits measurement of important cardiac prognostic indicators without any further discomforts or radiation burden in patients underwent standard myocardial perfusion SPECT. In addition, gated study significantly improves diagnostic yield by reducing the number of borderline interpretations and could find myocardial stunning and viable myocardium. Gated single photon emission computed tomography (SPECT) imaging allows the automated calculation of end-diastolic volume, end-systolic volume, ejection fraction, myocardial mass and the assessment of regional wall motion and thickening, and it have dramatically improved assessment of coronary artery disease in routine nuclear practice. This allows the simultaneous assessment of both perfusion and function within the same acquisition, and serves as a cost-effective technique for providing more diagnostic data with fewer diagnostic tests. Because the diagnostic and prognostic power derived from knowledge of left ventricular function can be added to that provided by assessing myocardial perfusion, gated SPECT imaging has rapidly gained widespread acceptance and is now used on a routine clinical basis in a growing number of laboratories, including South Korea. The gated SPECT technique for measurement of left ventricular parameters has been validated against a variety of well established techniques. In this work, overview of gated myocardial perfusion SPECT focus on functional parameters is presented.

The Optimal Pyloric Procedure: A Collective Review

  • Kim, Dohun
    • Journal of Chest Surgery
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    • 제53권4호
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    • pp.233-241
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    • 2020
  • Vagal damage and subsequent pyloric denervation inevitably occur during esophagectomy, potentially leading to delayed gastric emptying (DGE). The choice of an optimal pyloric procedure to overcome DGE is important, as such procedures can lead to prolonged surgery, shortening of the conduit, disruption of the blood supply, and gastric dumping/bile reflux. This study investigated various pyloric methods and analyzed comparative studies in order to determine the optimal pyloric procedure. Surgical procedures for the pylorus include pyloromyotomy, pyloroplasty, or digital fracture. Botulinum toxin injection, endoscopic balloon dilatation, and erythromycin are non-surgical procedures. The scope, technique, and effects of these procedures are changing due to advances in minimally invasive surgery and postoperative interventions. Some comparative studies have shown that pyloric procedures are helpful for DGE, while others have argued that it is difficult to reach an objective conclusion because of the variety of definitions of DGE and evaluation methods. In conclusion, recent advances in interventional technology and minimally invasive surgery have led to questions regarding the practice of pyloric procedures. However, many clinicians still perform them and they are at least somewhat effective. To provide guidance on the optimal pyloric procedure, DGE should first be defined clearly, and a large-scale study with an objective evaluation method will then be required.

PNF를 이용한 경부 운동이 뇌졸중 환자의 연하기능과 경부 통증에 미치는 영향 (Effect of Neck Exercise with PNF for Dysphagia and Pain of Neck in Patients with Stroke)

  • 김창헌
    • PNF and Movement
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    • 제13권4호
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    • pp.169-174
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    • 2015
  • Purpose: This study aimed to investigate the effect of neck exercises using proprioceptive neuromuscular facilitation (PNF) on dysphagia and neck pain in stroke patients. Methods: This study included 20 patients with stroke who performed the following neck exercises using PNF: flexion, lateral flexion, and rotation. The PNF technique was repeated under the guidance of verbal commands from a physical therapist. The exercise program consisted of 5 times, 30-minute sessions each week for four weeks. The Mann Assessment of Swallowing Ability (MASA) and the visual analogue scale (VAS) were used to evaluate the patients before and after the training. Swallowing ability was evaluated using MASA, and the patients' pain was evaluated using VAS. All data were analyzed using SPSS 21.0. Results: Significant differences were observed for the MASA and VAS in the subjects: MASA was significantly improved (p<0.00) and VAS was significantlyincreased (p<0.00). Conclusion: The neck is a very important part of the body in stroke patients. Neck exercises using PNF are effective for improving dysphagia and decreasing neck pain in patients with stroke. Thus, neck exercises using PNF are very effective for stroke patients, and this approach would be effective in clinical practice.

현장실습 중 간호사와의 관계에서 간호대학생이 경험한 무례함 (Incivility experienced by nursing students in relations with nurses during clinical practice)

  • 황윤영;주민선
    • 한국간호교육학회지
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    • 제27권1호
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    • pp.29-38
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    • 2021
  • Purpose: The purpose of this study was to describe the meaning of incivility experienced by nursing students in relations with nurses during clinical practice. Methods: This is a descriptive qualitative study that included thirty participants using convenience sampling in universities in S, J, Ch, and C provinces. Data saturation was achieved and methodological rigor was established. Qualitative content analysis was used to inductively determine categories. Results: The four categories derived from analysis were 'left alone at clinical field', 'treated as an assistant', 'not respected as a person' and 'ignored future dreams'. Conclusions: Nursing students continue to carry out repetitive, low-risk tasks, for which they are not properly trained due to the lack of practical guidance in clinical practice. During clinical practice, they are not respected as persons by nurses and are negatively influenced by nurse professionals. A solution to this requires organic cooperation and policy preparation at universities and hospital sites to improve practical training of nursing students.

The Effects of Coordinative Locomotor Training using Elastic Band on Dynamic Balance and Grip Strength in Elementary School Baseball Player

  • Lee, Han-Gyeol
    • Physical Therapy Rehabilitation Science
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    • 제10권4호
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    • pp.414-420
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    • 2021
  • Objective: The purpose of this study was to investigate the effects of coordinative locomotor training(CLT) using elastic bands on dynamic balance and grip strength for Elementary school baseball players and to provide correct posture guidance and reference on the prevention and rehabilitation program of sports damage and injury in the future. Design: Two groups pre-post randomized controlled design. Methods: Forty-six subjects were randomly divided in two groups;1) CLT using Elastic Band group(Experimental group, n=23), 2) Routine baseball training group(Control group, n=23). The intervention was conducted total 16 times for sixty minutes a day, 2 times a week, for 8 weeks. Evaluations of dynamic balance ability and grip strength were performed with all subjects before the commencement of training and 8 weeks after training. Results: Compared to the control group after training, the dynamic balance ability and dominant handgrip strength of the experimental group were significantly more improved(p<0.05). Conclusions: We confirmed that the effects of CLT using elastic bands on dynamic balance ability and grip strength in Elementary school baseball player. This study should be used for improving the quality of the Elementary school baseball player's training and would be contributed prevention and rehabilitation program of sports damage and injury.

Septic arthritis of the hip joint caused by Klebsiella pneumoniae: a case report

  • Jeong-Bo Moon;Jun-Hwan Lee;Byung-Ju Ryu
    • Journal of Yeungnam Medical Science
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    • 제40권2호
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    • pp.193-197
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    • 2023
  • Klebsiella pneumoniae is an uncommon cause of septic arthritis in adults. However, late detection can cause serious complications, including joint destruction and immobility. The purpose of this study was to report a case of successfully treated septic arthritis of the hip joint (SAHJ) caused by K. pneumoniae. A 49-year-old female patient presented to our hospital with fever and progressive severe pain in the right hip area. Although there was no abnormality on plain radiographs, ultrasonography revealed diffuse swelling of the right hip joint. Under ultrasonography guidance, the hip joint fluid was aspirated, and Gram staining and culturing were performed. The patient's pain was significantly reduced after the joint aspiration. The Gram staining and culturing revealed gram-negative bacilli, which were subsequently identified as K. pneumoniae. According to the results, systemic intravenous antibiotic (ceftriaxone) was administered without complications, and the patient was discharged on oral antibiotic (ciprofloxacin). Clinical cases of septic arthritis of the knee or sacroiliac joint have been occasionally reported in adults, but cases of SAHJ are rare. Moreover, K. pneumonia-induced SAHJ has not been reported to date. Therefore, we report this very rare case and its successful treatment.