• Tuberculosis and Respiratory Diseases
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• 제81권4호
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• pp.330-338
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• 2018

Background: We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. Methods: We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. Results: There were nine false-negative results among the 238 total cases. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of our system for diagnosing malignancy were 94.4% (152/161), 100% (77/77), 100% (152/152), 89.5% (77/86), and 96.2% (229/238), respectively. The results of univariate analysis showed that the risk factors for a false-negative result were male sex (p=0.029), a final diagnosis of malignancy (p=0.033), a lesion in the lower lobe (p=0.035), shorter distance from the skin to the target lesion (p=0.003), and shorter distance from the pleura to the target lesion (p=0.006). The overall complication rate was 30.5% (74/243). Pneumothorax, hemoptysis, and hemothorax occurred in 21.8% (53/243), 9.1% (22/243), and 1.6% (4/243) of cases, respectively. Conclusion: The additional laser guidance system might be a highly economical and efficient method to improve the diagnostic efficacy and safety of conventional CT-guided PTNB even if performed by inexperienced pulmonologists.

• 대한의용생체공학회:의공학회지
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• 제35권3호
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• pp.50-54
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• 2014

It is being tried to control robot arm using brain signal in the field of brain-machine interface (BMI). This study is focused on applying guidance laws for efficient robot arm control using 3D coordinates obtained from Magnetoencephalography (MEG) signal which represents movement of upper limb. The 3D coordinates obtained from brain signal is inappropriate to be used directly because of the spatial difference between human upper limb and robot arm's end-effector. The spatial difference makes the robot arm to be controlled from a third-person point of view with assist of visual feedback. To resolve this inconvenience, guidance laws which are frequently used for tactical ballistic missile are applied. It could be applied for the users to control robot arm from a first-person point of view which is expected to be more comfortable. The algorithm which enables robot arm to trace MEG signal is provided in this study. The algorithm is simulated and applied to 6-DOF robot arm for verification. The result was satisfactory and demonstrated a possibility in decreasing the training period and increasing the rate of success for certain tasks such as gripping object.

• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.826-831
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• 2000

The major indication of endoscope in neurosurgical field is intraventricular procedures. Recently, it can be used selectively in the intraaxial mass lesion associated cavity. For example, cystic mass, with liquefied necrosis, and blood clot can be approached with this technique. The authors present its usage in brain abscess ruptured into lateral ventricle. The neuroendoscope was introduced into abscess cavity through stereotactic guidance, the pus was then removed through continuous irrigation and suction under direct video visualization. The intraventricular pus was also cleaned through gentle, direct endoscopic irrigation and suction. The postoperative clinical course was uneventful. Brief overview is given for this intraaxial neuroendoscopic procedure.

• Journal of Korean Neurosurgical Society
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• 제52권3호
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• pp.204-209
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• 2012

Objective : The authors performed a retrospective study to assess the accuracy and clinical benefits of a navigation coupled with O-arm$^{(R)}$ system guided method in the thoracic and lumbar spines by comparing with a C-arm fluoroscopy-guided method. Methods : Under the navigation guidance, 106 pedicle screws inserted from T7 to S1 in 24 patients, and using the fluoroscopy guidance, 204 pedicle screws from T5 to S1 in 45 patients. The position of screws within the pedicle was classified into four groups, from grade 0 (no violation cortex) to 3 (more than 4 mm violation). The location of violated pedicle cortex was also assessed. Intra-operative parameters including time required for preparation of screwing procedure, times for screwing and the number of X-ray shot were assessed in each group. Results : Grade 0 was observed in 186 (91.2%) screws of the fluoroscopy-guided group, and 99 (93.4%) of the navigation-guided group. Mean time required for inserting a screw was 3.8 minutes in the fluoroscopy-guided group, and 4.5 minutes in the navigation-guided group. Mean time required for preparation of screw placement was 4 minutes in the fluoroscopy-guided group, and 19 minutes in the navigation-guided group. The fluoroscopy-guided group required mean 8.9 times of X-ray shot for each screw placement. Conclusion : The screw placement under the navigation-guidance coupled with O-arm$^{(R)}$ system appears to be more accurate and safer than that under the fluoroscopy guidance, although the preparation and screwing time for the navigation-guided surgery is longer than that for the fluoroscopy-guided surgery.

• The Korean Journal of Pain
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• 제30권1호
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• pp.66-70
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• 2017

The lumbar sympathetic ganglion block (LSGB) is widely used for diagnosing and treating sympathetically maintained pain disorders. The LSGB has been conventionally carried out under fluoroscopy or computed tomography guidance. However, as ultrasound technology improved, ultrasound-guided interventions have been expanding their territory to deeper structures. Ultrasound guidance provides many benefits including protecting vascular injection, shortening procedure time in some cases, and reducing the emission of radiation. In this report, we describe a successful case of a US-guided LSGB without major complications. We expect that US-guided LSGBs can be implemented and furnished in the daily outpatient clinical setting by highly trained pain physicians.

• 대한기관식도과학회지
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• 제19권1호
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• pp.15-18
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• 2013

Esophageal foreign body is common condition for visit emergency room, and most of them were successfully removed with endoscopy. However, in case of esophageal foreign body impaction, it can be difficult to localize the foreign body. We report a 29-year old man with esophageal foreign body impaction. We successfully localized and removed the esophageal submucosal foreign body using rigid endoscopy under C-arm guidance, avoiding more invasive procedure. The patient was followed up without any complication.

• 보건교육건강증진학회지
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• 제7권2호
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• pp.78-88
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• 1990

The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.

• Clinical and Experimental Reproductive Medicine
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• 제46권2호
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• pp.87-94
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• 2019

Objective: The primary objective of this study was to compare clinical pregnancy rates in intrauterine insemination (IUI) treatment cycles with transabdominal ultrasound guidance during intrauterine catheter insemination (US-IUI) versus the "blind method" IUI without ultrasound guidance (BM-IUI). The secondary objective was to compare whether US-IUI had better patient tolerability and whether US-IUI made the insemination procedure easier for the clinician to perform compared to BM-IUI. Methods: This was a randomized controlled trial done at the Reproductive Medicine Unit of General Hospital Kuala Lumpur, Malaysia. We included women aged between 25 and 40 years who underwent an IUI treatment cycle with follicle-stimulating hormone injections for controlled ovarian stimulation. Results: A total of 130 patients were recruited for our study. The US-IUI group had 70 patients and the BM-IUI group had 60 patients. The clinical pregnancy rate was 10% in both groups (p> 0.995) and there were no significant difference between the groups for patient tolerability assessed by scores on a pain visual analog scale (p= 0.175) or level of difficulty for the clinician (p> 0.995). The multivariate analysis further showed no significant increase in the clinical pregnancy rate (adjusted odds ratio, 1.07; 95% confidence interval, 0.85-1.34; p= 0.558) in the US-IUI group compared to the BM-IUI group even after adjusting for potential covariates. Conclusion: The conventional blind method for intrauterine catheter insemination is recommended for patients undergoing IUI treatment. The use of ultrasound during the insemination procedure increased the need for trained personnel to perform ultrasonography and increased the cost, but added no extra benefits for patients or clinicians.

• The Korean Journal of Pain
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• 제10권1호
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• pp.82-85
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• 1997

Destruction of the gasserian ganglion can be carried out by creating a radiofrequency lesion under biplanar fluoroscopic guidance. This procedure is reserved for patients who have failed various interventions for intractable trigeminal neuralgia including retro-gasserian injection of glycerol and whose physical status otherwise precludes more invasive neuro-surgical treatments such as microvascular decompression. Radiofrequency thermocoagulation of the gasserian ganglion provides a safe method of achieving long-standing relief from trigeminal neuralgia with low risk. This technique is currently emerging worldwide as the surgical treatment of choice for trigeminal neuralgia. Recently we performed a successful radiofrequency gasserian ganglionotomy, without any complication, under fluoroscopic guidance. The procedure was successful and complete pain relief was achieved for a patient who already had treatments of various interventions including microvascular decompression but never experienced pain relief.

• 한국지능시스템학회:학술대회논문집
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• 한국퍼지및지능시스템학회 2001년도 추계학술대회 학술발표 논문집
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• pp.95-98
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• 2001

In this paper, we propose a method how to determine the medical section select that get input the conditions of illness from a dialog-box using a fuzzy logic as a guidance system of the Cyber Hospital. It is to offer an output the most matched section for medical treatment using the Algebraic product fuzzy inference and Max inference after match the membership degree table of symptoms of received input from patient and their information. It will present of the direction for ignored patient which of a medical section select.