• Title/Summary/Keyword: Hospital Phase

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Improvement of Pregnancy Rate in Preimplantation Genetic Diagnosis with FISH Procedure by the Laboratory Optimization and Experiences (형광직접보합법을 이용한 착상전 유전진단 기법의 최적화와 경험 축적에 의한 임신율의 향상)

  • Lim, Chun-Kyu;Min, Dong-Mi;Lee, Hyoung-Song;Byun, Hye-Kyung;Park, So-Yeon;Ryu, Hyun-Mee;Kim, Jin-Young;Koong, Mi-Kyoung;Kang, Inn-Soo;Jun, Jin-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.31 no.1
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    • pp.29-39
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    • 2004
  • Objectives: This study was performed to evaluate the laboratory system for successful PGD using fluorescence in situ hybridization (FISH) and the clinical outcome of PGD cycles in five years experiences. Methods: A total of 181 PGD-FISH cycles of 106 couples were performed, and diagnosed chromosome normality in the preimplantation embryos. The laboratory and clinical data were classified by the following optimization steps, and statistically analyzed. Phase I: Blastomere biopsy with two kinds of pipettes, removal of cytoplasmic proteins without treatment of pepsin and culture of biopsied embryos with single medium; Phase II: Blatomere biopsy with single pipette, removal of cytoplasmic proteins with pepsin and culture of biopsied embryos with single medium; Phase III: Blastomere biopsy with single pipette, removal of cytoplasmic proteins with pepsin and culture of biopsied embryos with sequential media. Results: A total of 3, 209 oocytes were collected, and 83.8% (2, 212/2, 640) of fertilization rate was obtained by ICSI procedure. The successful blastomere biopsies were accomplished in 98.6% (2, 043/2, 071) of embryos, and the successful diagnosis rate of FISH was 94.7% (1, 935/ 2, 043) of blastomeres from overall data. Embryo transfers with normal embryos were conducted in 93.9% (170/181) of started cycles. There was no difference in the successful rate of biopsy and diagnosis among Phase I, II and III. However, the pregnancy rate per embryo transfer of Phase III (38.8%, 26/67) was significantly (p<0.05) higher than those of Phase I (13.9%, 5/36) and Phase II (14.9%, 10/67). Conclusions: The laboratory optimization and experience for the PGD with FISH procedure can increase the pregnancy rate to 38.8% in the human IVF-ET program. Our facility of PGD with FISH provides the great possibility to get a normal pregnancy for the concerned couples by chromosomal aberrations.

Development of the Critical Pathway for Cesarean Section Patient (제왕절개술 환자를 위한 Critical Pathway 개발)

  • Chung Kyung-Hee;Jang Keum-Seung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.4 no.1
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    • pp.66-80
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    • 1998
  • With the opening of healthcare market, the health care environment in Korea is anticipating a drastic change. In this Internationally open market environment, it is necessary to introduce a systematic health care plan and DRG system which offer qualitative medical services as well as reduced cost. Purpose of this study is to develop and test the critical pathway for Cesarean section patient in the way to be possible the integrated inpatient management. It was adopted the process of six phases to develop the critical pathway as the theoretical framework implemented by Johns Hopkins Hospital, Maryland, U.S.A. In the first phase, make a selection of diagnosis/procedures to develop. In the second phase, organize a development team consisted of eight expertises working in maternity nursing area. In the third phase, analyze the overall medical service offered to patient through review medical records and decided the service content and the implementation period for the Cesarean section patient. In the forth phase, make out a preliminary critical pathway after verification of expert group on content validity. In the fifth phase, validity operate to ten Cesarean section patients to test implementation in practice by using the preliminary critical pathway, In the sixth phase, defined the final critical pathway. The result of this study was as follows. 1. There were classified 8 categories as monitoring/assesment, treatment, medication, activity, diet, test, consult, education/discharge plan for vertical axis and showed hospital stayed from admission to discharge for horizontal axis of critical pathway through analysis 68 Cesarean section patients medical records. 2. After critical review 68 medical records to make out a preliminary critical pathway, hospital stays for horizontal axis were showed 6 days, mean hospital stays were 7.5 days, 2.1 days were to be taken operation after admission and 4.2 days were stayed until discharge after operation. 3. After making out a questionare in 90 items of a medical service content of eight categories and verifying the content validity of expertises, the 85 items of the preliminary critical pathway were selected by expertises agreement over 88% and modified or deleted 5 items showing agreement below 75%. 4. After verifying a validity to 10 patients for 4 weeks, hospital stays were 5.9 days. There were deleted 1 item and modified or supplemented the 9 items of the 10 items.

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Assessment of Cerebral Circulatory Arrest via CT Angiography and CT Perfusion in Brain Death Confirmation

  • Asli Irmak Akdogan;Yeliz Pekcevik;Hilal Sahin;Ridvan Pekcevik
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.395-404
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    • 2021
  • Objective: To compare the utility of computed tomography perfusion (CTP) and three different 4-point scoring systems in computed tomography angiography (CTA) in confirming brain death (BD) in patients with and without skull defects. Materials and Methods: Ninety-two patients clinically diagnosed as BD using CTA and/or CTP for confirmation were retrospectively reviewed. For the final analysis, 86 patients were included in this study. Images were re-evaluated by three radiologists according to the 4-point scoring systems that consider the vessel opacification on 1) the venous phase for both M4 segments of the middle cerebral arteries (MCAs-M4) and internal cerebral veins (ICVs) (A60-V60), 2) the arterial phase for the MCA-M4 and venous phase for the ICVs (A20-V60), 3) the venous phase for the ICVs and superior petrosal veins (ICV-SPV). The CTP images were independently reviewed. The presence of an open skull defect and stasis filling was noted. Results: Sensitivities of the ICV-SPV, A20-V60, A60-V60 scoring systems, and CTP in the diagnosis of BD were 89.5%, 82.6%, 67.4%, and 93.3%, respectively. The sensitivity of A20-V60 scoring was higher than that of A60-V60 in BD patients (p < 0.001). CTP was found to be the most sensitive method (86.5%) in patients with open skull defect (p = 0.019). Interobserver agreement was excellent in the diagnosis of BD, in assessing A20-V60, A60-V60, ICV-SPV, CTP, and good in stasis filling (κ: 0.84, 0.83, 0.83, 0.83, and 0.67, respectively). Conclusion: The sensitivity of CTA confirming brain death differs between various proposed 4-point scoring systems. Although the ICV-SPV is the most sensitive, evaluation of the SPV is challenging. Adding CTP to the routine BD CTA protocol, especially in cases with open skull defect, could increase sensitivity as a useful adjunct.

Effects of Functional Electrical Stimulation on Gait Patterns in Stroke Patient (기능적 전기자극이 뇌졸중 환자의 보행에 미치는 영향)

  • Kim, Yong-Wook;Weon, Jong-Hyuck;Chung, Bo-In
    • Physical Therapy Korea
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    • v.7 no.3
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    • pp.72-80
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    • 2000
  • This study was to investigate the effects of a functional electrical stimulation (FES) on temporal parameters (stride length, step width and cadence) of gait patterns in a patient with right hemiparesis. A single-subject reversal (ABAB) design was used. The subject was a 25-year-old male who had foot drop and circumduction gait pattern. An ink foot-print method was used to assess the temporal parameters of gait between the baseline phase and the intervention phase. FES was applied at 8 m walkway, three times a week for 5 weeks. The results showed that stride length was increased by 4.04 cm and that step width was decreased by 3.93 cm in the intervention phase. There was no difference in cadence between the baseline phase and intervention phase.

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Impact of Respiratory Phase during Pleural Puncture on Complications in CT-Guided Percutaneous Lung Biopsy (CT 유도 경피 폐생검에서 흉막 천자 시 호흡 시기가 합병증에 미치는 영향)

  • Ji Young Park;Ji-Yeon Han;Seok Jin Choi;Jin Wook Baek;Su Young Yun;Sung Kwang Lee;Ho Young Lee;SungMin Hong
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.566-578
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    • 2024
  • Purpose This study investigated whether the respiratory phase during pleural puncture in CT-guided percutaneous transthoracic needle biopsy (PTNB) affects complications. Materials and Methods We conducted a retrospective review of 477 lung biopsy CT scans performed during free breathing. The respiratory phases during pleural puncture were determined based on the table position of the targeted nodule using CT scans obtained during free breathing. We compared the rates of complications among the inspiratory, mid-, and expiratory respiratory phases. Logistic regression analysis was performed to control confounding factors associated with pneumothorax. Results Among the 477 procedures, pleural puncture was performed during the expiratory phase in 227 (47.6%), during the mid-phase in 108 (22.6%), and during the inspiratory phase in 142 (29.8%). The incidence of pneumothorax was significantly lower in the expiratory puncture group (40/227, 17.6%; p = 0.035) and significantly higher in the mid-phase puncture group (31/108, 28.7%; p = 0.048). After controlling for confounding factors, expiratory-phase puncture was found to be an independent protective factor against pneumothorax (odds ratio = 0.571; 95% confidence interval = 0.360-0.906; p = 0.017). Conclusion Our findings suggest that pleural puncture during the expiratory phase may reduce the risk of pneumothorax during image guided PTNB.

Efficacy and Safety of an Increased-dose of Dexamethasone in Patients Receiving Fosaprepitant Chemotherapy in Japan

  • Kumagai, Hozumi;Kusaba, Hitoshi;Okumura, Yuta;Komoda, Masato;Nakano, Michitaka;Tamura, Shingo;Uchida, Mayako;Nagata, Kenichiro;Arita, Shuji;Ariyama, Hiroshi;Takaishi, Shigeo;Akashi, Koichi;Baba, Eishi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.461-465
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    • 2014
  • Background: Antiemetic triplet therapy including dexamethasone (DEX) is widely used for patients receiving highly emetogenic chemotherapy (HEC). In Japan, the appropriate dose of DEX has not been established for this combination. Materials and Methods: To assess the efficacy and safety of increased-dose DEX, we retrospectively examined patients receiving HEC with antiemetic triplet therapy. Results: Twenty-four patients (fosaprepitant group) were given an increased-dose of DEX (average total dose: 45.8mg), fosaprepitant, and 5-HT3 antagonist. A lower-dose of DEX (33.6mg), oral aprepitant, and 5-HT3 antagonist were administered to the other 48 patients (aprepitant group). The vomiting control rates in the fosaprepitant and aprepitant groups were 100% and 85.4% in the acute phase, and were 75.0% and 64.6% in the delayed phase. The incidences of toxicity were similar comparing the two groups. Conclusions: Triplet therapy using an increased-dose of DEX is suggested to be safe and effective for patients receiving HEC.

TASKS AND TECHNIQUES IN THE INITIAL PHASE OF PLAYPSYCHOTHERAPY ILLUSTRATED BY GROUP SUPERVISION PROCESSES (집단 지도 ${\cdot}$ 감독 과정을 통해 본 초기 놀이치료의 기법과 과제)

  • Hong, Kang-E;Park, Min-Sook;Nam, Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.142-163
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    • 1993
  • A 8 year old boy with problems of hyperactivity, impulsivity received playpsychotherapy. Through the detailed examination of their contents and group supervision of play therapy session, common mistakes novice therapist make frequently and tasks in the initial phase of play psychotherapy are illustrated. Therapist's personality and anxiety frequently interferes therapeutic processes. Common mistakes therapist makes during initial phase of play therapy are ; therapist's over-enthusiasm, overinvolvement or non-responsiveness, premature or inappropriate interpretation and direct connection of play theme to reality. It is utmost important for the therapist to make positive and trusting relationship with the patient in the initial phase of the therapy. In order to do so therapist must accept the patient as he is, permit the patient takes his leads. And as a result, the Patient can go through corrected developmental experience. In conclusion, it is a therapist's main task to establish relationship.

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Study on the Development of Sensors for Distance Measure Using Ultrasonic (초음파 이용 거리측정을 위한 센서 개발에 관한 연구)

  • Park, Geun Chul;Lee, Seung Hee;Park, Chang Soo;Kim, Dong Won;Kim, Won Taek;Jeon, Gye Rok
    • Journal of Sensor Science and Technology
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    • v.23 no.1
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    • pp.46-50
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    • 2014
  • In this paper, we report a novel algorithm based on phase displacement, which supplements conventional TOF methods for distance measurement using an ultrasonic wave. The proposed algorithm roughly measures the distance between the transmission part and the receiving part by using the initial TOF. Thereafter, the precise distance is determined by measuring the phase displacement value between the synchronizing transmission signal and the signal obtained at the receiving end. A distance measurement experiment using a micrometer was performed to verify the accuracy of the ultrasonic wave sensor system. We found that the mean errors from the one adopting the distance measurement algorithm based on phase displacement varied from a minimum of 0.03 mm to a maximum of 0.09 mm. In addition, the standard deviation varied from a minimum of 0.04 mm to a maximum of 0.07 mm, thus giving a precision of ${\pm}0.1$ mm.

Percutaneous screw fixation and external stabilization as definitive surgical intervention for a pelvic ring injury combined with an acetabular fracture in the acute phase of polytrauma in Korea: a case report

  • Hohyoung Lee;Myung-Rae Cho;Suk-Kyoon Song;Euisun Yoon;Sungho Lee
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.298-303
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    • 2023
  • Unstable pelvic ring injuries are potentially life-threatening and associated with high mortality and complication rates in polytrauma patients. The most common cause of death in patients with pelvic ring injuries is massive bleeding. With resuscitation, external fixation can be performed as a temporary stabilization procedure for hemostasis in unstable pelvic fractures. Internal fixation following temporary external fixation of the pelvic ring yields superior and more reliable stabilization. However, a time-consuming extended approach to open reduction and internal fixation of the pelvic ring is frequently precluded by an unacceptable physiologic condition and/or concomitant injuries in patients with multiple injuries. Conservative treatment may lead to pelvic ring deformity, which is associated with various functional disabilities such as limb length discrepancy, gait disturbance, and sitting intolerance. Therefore, if the patient is not expected to be suitable for additional surgery due to a poor expected physiologic condition, definitive external fixation in combination with various percutaneous screw fixations to restore the pelvic ring should be considered in the acute phase. Herein, we report a case of unstable pelvic ring injury successfully treated with definitive external fixation and percutaneous screw fixation in the acute phase in a severely injured polytrauma patient.

A Study on Formation of Single-phase Film in the Bi-2212 Superconducting Thin Films Substrate Temperature and Oxide Gas Pressures (기판온도와 산화가스압에 따른 Bi-2212 초전도 박막의 단상막 형성에 관한 연구)

  • Yang, Seung-Ho;Lee, Hee-Kab;Park, Yong-Pil
    • Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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    • 2007.06a
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    • pp.484-485
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    • 2007
  • BiSrCaCuO superconducting thin films have been fabricated by co-deposition using the faraday cup. Despite setting the composition of thin film Bi2212, Bi(2201, 2212, 2223) phase were appeared. It was confirmed the obtained field of stabilizing phase was represented in the diagonal direction of the right below end in the Arrhenius plot of temperature of the substrate and $PO_3$, and it was distributed in the rezone.

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