• Title/Summary/Keyword: Hospital Guidance

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Transbronchial Lung Cryobiopsy for Diagnosing Interstitial Lung Disease: A Retrospective Single-Center Experience

  • Park, Jin Han;Jang, Ji Hoon;Kim, Hyun Kuk;Jang, Hang-Jea;Lee, Sunggun;Kim, SeongHo;Kim, Ji Yeon;Choi, Hee Eun;Han, Ji-yeon;Kim, Da Som;Kang, Min Kyun;Kang, Eunsu;Kim, Il Hwan;Lee, Jae Ha
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.341-348
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    • 2022
  • Background: An accurate diagnosis in patients with interstitial lung diseases (ILDs) by multidisciplinary discussion (MDD) based on histopathologic information is essential for optimal treatment. Transbronchial lung cryobiopsy (TBLC) has increasingly been used as a diagnostic alternative to surgical lung biopsy. This study aimed to evaluate the appropriate methods of TBLC in patients with ILD in Korea. Methods: A total of 27 patients who underwent TBLC were included. TBLC procedure details and clinical MDD diagnosis using TBLC histopathologic information were retrospectively analyzed. Results: All procedures were performed under general anesthesia with the fluoroscopic guidance in the operation room using flexible bronchoscopy and endobronchial balloon blocker. The median procedure duration was less than 30 minutes, and the median number of biopsies per participant was 2. Most of the bleeding after TBLC was not severe, and the rate of pneumothorax was 25.9%. The most common histopathologic pattern was alternative (48.2%), followed by indeterminate (33.3%) and usual interstitial pneumonia (UIP)/probable UIP (18.5%). In the MDD after TBLC, the most common diagnosis was idiopathic pulmonary fibrosis (33.3%), followed by smoking-related ILD (25.9%), nonspecific interstitial pneumonia (18.6%), unclassifiable-ILD (14.8%), and others (7.4%). Conclusion: This first single-center experience showed that TBLC using a flexible bronchoscopy and endobronchial balloon blocker with the fluoroscopic guidance under general anesthesia may be a safe and adequate diagnostic method for ILD patients in Korea. The diagnostic yield of MDD was 85.2%. Further studies are needed to evaluate the diagnostic yield and confidence of TBLC.

Ingested Foreign Body Trapped in the Appendix: A Case Report (충수에서 발견된 섭취된 이물질 1예)

  • Ahn, Young-Jae;Park, Yoon-Joon;Kim, Myung-Joon;Han, Seok-Joo;Oh, Jung-Tak
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.217-221
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    • 2007
  • Foreign body ingestion is a frequent event in the pediatric age group, but the incidence of foreign bodies in the appendix is very low. The authors report a case of ingested foreign body trapped in the appendix in a 7-year-old girl. The foreign body was successfully treated by laparoscopic appendectomy under fluoroscopic guidance.

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Patient Dose for Diagnostic Radiological Procedures in Korea (일반 X-선 촬영에서의 환자피폭선량에 관한 조사연구)

  • Kim, You-Hyun;Choi, Jong-Hak;Kim, Sung-Soo;Lee, Chanh-Yeup;Lee, Young-Bae;Kim, Chel-Min
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2004.11a
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    • pp.59-63
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    • 2004
  • IAEA's Guidance Levels have been provided for Western people to the end. Guidance levels lower than the IAEA'S will be necessary in view of korean people's proportions. Therefore, We need to develope the standard doses for korean people. And we conducted a nationwide survey of patient dose from x-ray examinations in korea. 278 institutions were selected from Members Book of Korean Hospital Association. The valid response rate was approximately 57.9%. Doses were calculated from the questionnaires by NDD method. The results were as follows; 1) General radiographic equipments were 43%, fluoroscopic equipments 29%, dental equipments 13%, CT units 8% and mamographic units 7%. 2) According to classification by rectification way, three-phase equipments were 30%, inverter-type generators 29%, single- phase equipments 26%, unknown units 6%. 3) According to classification by receptor system, film-screen types were 46%, CR types 27%, OR types18% and unknown types 9%. 4) The number of examinations were chest 48%, spine 17% and abdomen 13%. 5) Patient doses were head AP 3.1 mGy, abdomen AP 3.5 mGy and chest PA 0.4 mGy.

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Association between adherence to the Korean Food Guidance System and the risk of metabolic abnormalities in Koreans

  • Jung, Hyun-Ju;Han, Sung-Nim;Song, Su-Jin;Paik, Hee-Young;Baik, Hyun-Wook;Joung, Hyo-Jee
    • Nutrition Research and Practice
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    • v.5 no.6
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    • pp.560-568
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    • 2011
  • Consumption of a diet consistent with dietary guidelines is believed to have a beneficial effect on the prevention of chronic diseases and the promotion of general health. This study was conducted to explore the relationship between adherence to the Korean Food Guidance System (KFGS), which was based on the 2010 revised KDRIs, and the risk of metabolic abnormalities. Five hundred and ninety-six Korean adults between 30 and 59 years of age were recruited by advertisement to the Bundang Jesaeng General Hospital (BJGH), and those not taking regular medications and without diagnoses of fulminant disease were included. Data were collected on anthropometric measurements, diagnostic parameters for metabolic syndrome (MetS), and 3-day dietary intakes from individuals in the study. The number of servings consumed from each food group was compared to the KFGS recommended servings for each of the 6 food groups. Poor adherence to the recommendations for servings of milk and dairy products (OR: 2.038, 1.128-3.682) was associated with a higher risk of MetS, and poor adherence to the guidelines for fruit consumption (OR: 1.849, 1.027-3.329) was associated with a higher risk for the existence an elevated waist circumference. Conversely, the consumption of meat, fish, eggs, and beans above the recommended number of servings was associated with a lower risk of having an elevated waist circumference (OR: 0.523, 0.288-0.950), and the consumption of vegetables above the recommended number of servings was associated with a reduced risk of having elevated fasting glucose (OR: 0.533, 0.298-0.954). These results suggest that adherence to the KFGS guidelines helps to prevent the development of MetS, but this association needs to be confirmed by prospective studies.

An Alternative Approach to Needle Placement in Cervicothoracic Epidural Injections

  • Park, Seung-Yong;Leem, Jung-Gil;Jung, Sung-Hwan;Kim, Young-Ki;Koh, Won-Uk
    • The Korean Journal of Pain
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    • v.25 no.3
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    • pp.183-187
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    • 2012
  • The use of fluoroscopy guidance together with the loss of resistance technique during epidural injections has been advocated lately; moreover, epidural injections in the absence of fluoroscopic guidance have a high rate of inaccurate needle-tip placement during the injections. However, the approach to the lower cervical and upper thoracic epidural space may be challenging due to its obscure lateral fluoroscopic views from overlying normal tissue structures. In this case, we report an alternative oblique C-arm fluoroscopy guided view approach to supplement the standard anterior-posterior and lateral fluoroscopic views to facilitate successful needle placement and precise anatomical localization of the epidural space.

Free Hand Pedicle Screw Placement in the Thoracic Spine without Any Radiographic Guidance : Technical Note, a Cadaveric Study

  • Hyun, Seung-Jae;Kim, Yong-Jung J.;Cheh, Gene;Yoon, Seung-Hwan;Rhim, Seung-Chul
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.66-70
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    • 2012
  • Thoracic pedicle screw fixation techniques are still controversial for thoracic deformities because of possible complications including neurologic deficit. Methods to aid the surgeon in appropriate screw placement have included the use of intraoperative fluoroscopy and/or radiography as well as image-guided techniques. We describe our technique for free hand pedicle screw placement in the thoracic spine without any radiographic guidance and present the results of pedicle screw placement analyzed by computed tomographic scan in two human cadavers. This free hand technique of thoracic pedicle screw placement performed in a step-wise, consistent, and compulsive manner is an accurate, reliable, and safe method of insertion to treat a variety of spinal disorders, including spinal deformity.

Comparison of clinical efficacy in epidural steroid injections through transforaminal or parasagittal approaches

  • Hong, Ji Hee;Park, Eun Kyul;Park, Ki Bum;Park, Ji Hoon;Jung, Sung Won
    • The Korean Journal of Pain
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    • v.30 no.3
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    • pp.220-228
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    • 2017
  • Background: The transforaminal (TF) epidural steroid injection (ESI) is suggested as more effective than the interlaminar (IL) route due to higher delivery of medication at the anterior epidural space. However, serious complications such as spinal cord injury and permanent neural injury have been reported. The purpose of this study is to evaluate and compare the clinical effectiveness, technical ease, and safety of the TF and parasagittal IL (PIL) ESI. Methods: A total of 72 patients were randomized to either the PIL group (n = 41) or the TF group (n = 31) under fluoroscopic guidance. Patients were evaluated for effective pain relief by the numerical rating scale (NRS) and Oswestry Disability Index (ODI) (%) before and 2 weeks after the ESI. The presence of concordant paresthesia, anterior epidural spread, total procedure time, and exposed radiation dose were also evaluated. Results: Both the PIL and TF approach produced similar clinically significant improvements in pain and level of disability. Among the 72 patients, 27 PIL (66%) and 20 TF (64%) patients showed concordant paresthesia while 14 (34%) and 11 (36%) patients in the same respective order showed disconcordant or no paresthesia. Radiation dose and total procedure time required were compared; the PIL group showed a significantly lower radiation dose ($30.2{\pm}12$ vs. $80.8{\pm}26.8$ [$Cgy/cm^2$]) and shorter procedure time ($96.2{\pm}31$ vs. $141.6{\pm}30$ seconds). Conclusions: ESI under fluoroscopic guidance with PIL or TF approach were effective in reducing the NRS and ODI. PIL ESI was a technically easier and simple method compared to TF ESI.

Lumbar Juxtafacet Cyst Treated with Direct Needle Aspiration Under the Guidance of Image Intensifier (영상증폭기하에서 직접적 바늘 흡인술로 치료한 요추 후관절 주위 낭종)

  • Hong, Sung-Ha;Suh, Seung-Pyo;Hwang, Seok-Ha;Kim, Yun-Seong
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.261-265
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    • 2020
  • A lumbar juxtafacet cyst is a rare disease that causes low back pain, radiculopathy and neurological claudication by compressing the nerve roots. A 34-year-old male complained of severe low back pain and radicular pain in the right lower extremity. Magnetic resonance images revealed a cyst at the lateral recess of the spinal canal between the L3-4 disc and posterior facet joint that extended to the L4 body level. Under the guidance of an image intensifier, needle aspiration of the cyst was performed, which extracted 1.5 ml of serous, yellowish colored fluid. After the aspiration, the symptoms subsided dramatically. The follow-up magnetic resonance images showed no recurrence of the cyst. To the best of the author's knowledge, there are no reports of lumbar juxtafacet cyst treated with needle aspiration in Korea. This case is reported with a review of the relevant literature.

Job Analysis of Health Guide Nurse for Role Identification: Focusing on Annual Health Guidance Membership Service (통합건강관리간호사 역할규명을 위한 직무분석: 연 회원제 건강관리 서비스 중심)

  • Sim, Won Hee;Lee, Joo Yun
    • Journal of Korean Academy of Nursing Administration
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    • v.22 no.2
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    • pp.129-136
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    • 2016
  • Purpose: The aim of this study was to identify nurses' role in the delivery of health guidance service within the annual health guidance membership service. Methods: Dynamic job analysis process was applied with vertical job analysis and horizontal job analysis through a focus group workshop and expert survey. Results: As a result of this study, job description was established with 4 duties, 11 tasks, 60 task elements. Major duties consisted of 'professional nurse practice', 'coordination and cooperation', 'education and consultation', and 'administrative work and improvement'. A job process map was also framed. Conclusion: The results can be used to establish nurses' role in providing health care service. Ongoing research on nurse's role as a health guider will be a fundamental base for health care service development and will contribute to expansion of common health management services.

Posttraumatic bilateral thigh Morel-Lavallée lesions without an underlying bone fracture in the United Kingdom: a case report

  • Sarah Razaq;James Geffner;Asma Khan;Harry Mee;Cynthia Udensi;Fahim Anwar
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.269-275
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    • 2023
  • A Morel-Lavallée lesion results from a degloving injury between the muscle fascia and the subcutaneous layer. It is most commonly found in the trochanteric area but can occur at other sites. The treatment of the condition varies according to the medical circumstances, as well as the size and chronicity of the condition. A case of large (18×6 and 10×5 cm) bilateral posttraumatic Morel-Lavallée lesions with no underlying bone fracture is presented; the case occurred in a 49-year-old male patient 4 weeks posttrauma. Ultrasound scans showed bilateral large collections of anechoic fluid, which were aspirated under ultrasound guidance and further managed by compression bandages. There were no further complications. The objective of this case report is to present this unique and educational case, as well as to provide an overview of the pathophysiology, diagnosis, and management of Morel-Lavallée lesions. We conclude by discussing the importance of having a high index of suspicion to ensure early detection and prompt treatment of such lesions to avoid complications.