• Title/Summary/Keyword: Hospital Guidance

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Development Trends and Use Cases of Medical Service Robots: Focused on Logistics, Guidance, and Drug Processing Robots (의료서비스 로봇의 개발 동향 및 활용 사례: 물류, 안내, 약제처리 로봇을 중심으로)

  • Kim, Seon Hee;Cho, Yong Jin
    • Journal of Digital Convergence
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    • v.19 no.2
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    • pp.523-529
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    • 2021
  • Medical service robots are variously defined and classified by researchers and related government departments, but surgical robots and rehabilitation robots are commonly included in medical service robots, and except for these, the robots are classified as other medical service robots. In this study, domestic and foreign development trends and use cases were considered, focusing on logistics, guidance, and drug processing robots among other medical service robots. Logistics and guidance robots were developed quite a lot in Korea and completed a pilot project, or are being commercialized in hospitals, and exported. However, although the drug prcocessing robots was developed in Korea, the robot being use in the hospital was an imported. In order to expand and activate the robot market, systematic follow-up studies such as demand prediction studies are needed.

Successful pregnancy following transmyometrial embryo transfer after robot-assisted radical trachelectomy

  • Hue, Hye Jeong;Choi, Hyun Ji;Park, Jee Yoon;Suh, Dong Hoon;Lee, Jung Ryeol;Jee, Byung Chul;Kim, Seul Ki
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.2
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    • pp.184-187
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    • 2021
  • Radical trachelectomy is a fertility-preserving alternative to radical hysterectomy in carefully selected young women with early-stage cervical cancer. However, in cases with subsequent severe cervical stenosis, assisted reproductive techniques can be difficult. This is a case report of a 34-year-old patient who underwent robot-assisted radical trachelectomy and cerclage for early-stage (IB2) adenosquamous carcinoma. Three months after surgery, the patient underwent ovarian stimulation using a gonadotropin-releasing hormone antagonist protocol. As it was impossible to perform transcervical embryo transfer due to the almost complete absence of the cervical opening, transmyometrial embryo transfer under ultrasound guidance was performed. This resulted in a successful singleton pregnancy. This is the first case of successful pregnancy conceived by in vitro fertilization with transmyometrial embryo transfer in a patient who had previously undergone robot-assisted radical trachelectomy.

No-Touch Radiofrequency Ablation Using Twin Cooled Wet Electrodes for Recurrent Hepatocellular Carcinoma Following Locoregional Treatments

  • Seong Jun Hong;Jae Hyun Kim;Jeong Hee Yoon;Jeong Hoan Park;Jung-Hwan Yoon;Yoon Jun Kim;Su Jong Yu;Eun Ju Cho;Jeong Min Lee
    • Korean Journal of Radiology
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    • v.25 no.5
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    • pp.438-448
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    • 2024
  • Objective: To evaluate the therapeutic outcomes of no-touch radiofrequency ablation (NT-RFA) using twin cooled wet (TCW) electrodes in patients experiencing recurrent hepatocellular carcinoma (HCC) after undergoing locoregional treatments. Materials and Methods: We conducted a prospective, single-arm study of NT-RFA involving 102 patients, with a total of 112 recurrent HCCs (each ≤ 3 cm). NT-RFA with TCW electrodes was implemented under the guidance of ultrasonography (US)-MR/CT fusion imaging. If NT-RFA application proved technically challenging, conversion to conventional tumor puncture RFA was permitted. The primary metric for evaluation was the mid-term cumulative incidence of local tumor progression (LTP) observed post-RFA. Cumulative LTP rates were estimated using the Kaplan-Meier method. Multivariable Cox proportional hazard regression was used to explore factors associated with LTP. Considering conversion cases from NT-RFA to conventional RFA, intention-to-treat (ITT; including all patients) and per-protocol (PP; including patients not requiring conversion to conventional RFA alone) analyses were performed. Results: Conversion from NT-RFA to conventional RFA was necessary for 24 (21.4%) out of 112 tumors. Successful treatment was noted in 111 (99.1%) out of them. No major complications were reported among the patients. According to ITT analysis, the estimated cumulative incidences of LTP were 1.9%, 6.0%, and 6.0% at 1, 2, and 3 years post-RFA, respectively. In PP analysis, the cumulative incidence of LTP was 0.0%, 1.3%, and 1.3% at 1, 2, and 3 years, respectively. The number of previous locoregional HCC treatments (adjusted hazard ratio [aHR], 1.265 per 1 treatment increase; P = 0.004), total bilirubin (aHR, 7.477 per 1 mg/dL increase; P = 0.012), and safety margin ≤ 5 mm (aHR, 9.029; P = 0.016) were independently associated with LTP in ITT analysis. Conclusion: NT-RFA using TCW electrodes is a safe and effective treatment for recurrent HCC, with 6.0% (ITT analysis) and 1.3% (PP analysis) cumulative incidence of LTP at 2 and 3-year follow-ups.

Radiofrequency Thermal Ablation in Painful Myeloma of the Clavicle

  • Gharaei, Helen;Imani, Farnad;Vakily, Masoud
    • The Korean Journal of Pain
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    • v.27 no.1
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    • pp.72-76
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    • 2014
  • A 57-year-old male patient had myeloma. He had severe pain in the left clavicle that did not respond to radiotherapy; therefore, it was treated with radiofrequency thermal ablation (RFTA). Under fluoroscopic guidance, two RF needles at a distance of 1.5 cm from each other were inserted into the mass and conventional radiofrequency ($90^{\circ}C$ and 60 seconds) at two different depths (1 cm apart) was applied. Then, 2 ml of 0.5% ropivacaine along with triamcinolone 40 mg was injected in each needle. The visual analogue pain score (VAS from 0 to 10) was decreased from 8 to 0. In the next 3 months of follow-up, the patient was very satisfied with the procedure and the mass gradually became smaller. There were no complications. This study shows that RFTA could be a useful method for pain management in painful osteolytic myeloma lesions in the clavicle

Interaction effect of Chemical Mixtures (혼합물에서 화학물질간의 상호작용 효과)

  • Leem Jong Han;Shin Joo-Youn;Kim Yong-Kyu
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.11-16
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    • 2005
  • Chemical mixtures of components, each of which are present at less than guidance concentrations, may be hazardous due to additivity, interactions, or both. Toxicological interactions may increase the health hazard above what would be expected from an assessment of each component singly, or all components additively. So chemical mixture are a particular issue in public health. There are several approach to assess whether there are additivity or interaction in assessing toxicological effects, such as, components-based approach, physiologically-based pharmacokinetic /pharmacodynamic(PBPK/PD) models, hazard index method, and weight-of evidence method. If we consider interaction or additivity effects in assessing the health effects of chemcial mixtures, we can get more accurate information about toxicological effects and dose-response relationship in chemical mixtures.

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Accuracy of Pedicle Screw Insertion Using Fluoroscopy-Based Navigation-Assisted Surgery : Computed Tomography Postoperative Assessment in 96 Consecutive Patients

  • Lee, Keong Duk;Lyo, In Uk;Kang, Byeong Seong;Sim, Hong Bo;Kwon, Soon Chan;Park, Eun Suk
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.16-20
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    • 2014
  • Objective : Two-dimensional fluoroscopy-based computerized navigation for the placement of pedicle screws offers the advantage of using stored patient-specific imaging data in providing real-time guidance during screw placement. The study aimed to describe the accuracy and reliability of a fluoroscopy-based navigation system for pedicle screw insertion. Methods : A total of 477 pedicle screws were inserted in the lower back of 96 consecutive patients between October 2007 and June 2012 using fluoroscopy-based computer-assisted surgery. The accuracy of screw placement was evaluated using a sophisticated computed tomography protocol. Results : Of the 477 pedicle screws, 461 (96.7%) were judged to be inserted correctly. Frank screw misplacement [16 screws (3.3%)] was observed in 15 patients. Of these, 8 were classified as minimally misplaced (${\leq}2mm$); 3, as moderately misplaced (2.1-4 mm); and 5, as severely misplaced (>4 mm). No complications, including nerve root injury, cerebrospinal fluid leakage, or internal organ injury, were observed in any of the patients. Conclusion : The accuracy of pedicle screw placement using a fluoroscopy-based computer navigation system was observed to be superior to that obtained with conventional techniques.

Ultrasound-guided Lateral Femoral Cutaneous Nerve Block in Meralgia Paresthetica

  • Kim, Jeong-Eun;Lee, Sang-Gon;Kim, Eun-Ju;Min, Byung-Woo;Ban, Jong-Suk;Lee, Ji-Hyang
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.115-118
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    • 2011
  • Meralgia paresthetica is a rarely encountered sensory mononeuropathy characterized by paresthesia, pain or sensory impairment along the distribution of the lateral femoral cutaneous nerve (LFCN) caused by entrapment or compression of the nerve as it crossed the anterior superior iliac spine and runs beneath the inguinal ligament. There is great variability regarding the area where the nerve pierces the inguinal ligament, which makes it difficult to perform blind anesthetic blocks. Ultrasound has developed into a powerful tool for the visualization of peripheral nerves including very small nerves such as accessory and sural nerves. The LFCN can be located successfully, and local anesthetic solution distribution around the nerve can be observed with ultrasound guidance. Our successfully performed ultrasound-guided blockade of the LFCN in meralgia paresthetica suggests that this technique is a safe way to increase the success rate.

Successful Schooling Rate and Satisfaction of the Inpatient Hospital School Participants among the Child and Adolescent Psychiatric Inpatients in the Closed Ward (정신건강의학과 안정병동 내 병원학교교실 참여자의 학교복귀율과 만족도)

  • Lee, Mi-Kyeong;Bhang, Soo-Young;Ahn, Joon-Ho;Park, Jang-Ho;Choi, Hyun-Kyoung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.24 no.3
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    • pp.141-150
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    • 2013
  • Objectives : The objective of this report is to identify the utilization of hospital school service during hospitalization among patients in their childhood and adolescence with psychiatric disorders. Methods : We retrospectively reviewed the medical record of child and adolescent psychiatric who were hospitalized during March 2009 through October 2012. We compared the one-year successful schooling and outpatient follow up rate between users and nonusers of the inpatient hospital school service. The hospital schooling experiences of the users were investigated upon follow-up visits to the outpatient clinic. Results : Sixty-three students received hospital school service during hospitalization among total 122 child and adolescent inpatients. Hospital school participants showed a significantly higher school reentry rate (61.9%) than non-participants (40.7%). However, there was no difference on follow up rate between the two groups. More than 60% of the 22 interviewed participants expressed an above-average level of satisfaction about hospital school service. Conclusion : Many patients with mental illness experience difficulty in receiving school education during treatment. That induces deterioration in disease, academic failure, poor social skills, low self-esteem, economic difficulties, and future job opportunities. The results of this study emphasize the importance of hospital school service and offer useful guidance for hospital school operation.

Difficult intubation using intubating laryngeal mask airway in conjunction with a fiber optic bronchoscope

  • Kim, Jin-Sun;Seo, Dong-Kyun;Lee, Chang-Joon;Jung, Hwa-Sung;Kim, Seong-Su
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.3
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    • pp.167-171
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    • 2015
  • When anesthesiologists encounter conditions in which intubation is not possible using a conventional direct laryngoscope, they can consider using other available techniques and devices such as fiber optic bronchoscope (FOB)-guided intubation, a laryngeal mask airway (LMA), intubating LMA (ILMA), a light wand, and the Combitube. FOB-guided intubation is frequently utilized in predicted difficult airway cases and is generally performed when the patient is awake to enable easier access to the trachea. An LMA can be introduced to ventilate the patient with relative ease, while an ILMA can be used for definite endotracheal intubation. However, occasionally, an endotracheal tube (ETT) cannot pass through the larynx, despite successful introduction of a FOB into the trachea and placement of an ILMA by the anesthesiologist. Therefore, we initially introduced an ILMA for emergent ventilation, followed by successful insertion of an ETT under FOB guidance. In this report, we describe three cases of difficult intubation using a FOB and ILMA combination approach.

Successful Treatment of Tracheal Invasion Caused by Thyroid Cancer Using Endotracheal Tube Balloon Inflation under Flexible Bronchoscopic Guidance

  • Han, Yang-Hee;Jung, Bock-Hyun;Kwon, Jun Sung;Lim, Jaemin
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.215-218
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    • 2014
  • Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.