• Title/Summary/Keyword: Medical using

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22-gauge Co-Cr versus stainless-steel Franseen needles for endoscopic ultrasound-guided tissue acquisition in patients with solid pancreatic lesions

  • Yuki Tanisaka;Masafumi Mizuide;Akashi Fujita;Ryuhei Jinushi;Rie Shiomi;Takahiro Shin;Kei Sugimoto;Tomoaki Tashima;Yumi Mashimo;Shomei Ryozawa
    • Clinical Endoscopy
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    • v.57 no.2
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    • pp.237-245
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    • 2024
  • Background/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) using Franseen needles is reportedly useful for its high diagnostic yield. This study compared the diagnostic yield and puncturing ability of EUS-TA using 22-gauge cobalt-chromium (CO-Cr) needles with those of stainless-steel Franseen needles in patients with solid pancreatic lesions. Methods: Outcomes were compared between the 22-gauge Co-Cr Franseen needle (December 2019 to November 2020; group C) and stainless-steel needle (November 2020 to May 2022; group S). Results: A total of 155 patients (group C, 75; group S, 80) were eligible. The diagnostic accuracy was 92.0% in group C and 96.3% in group S with no significant intergroup differences (p=0.32). The rate of change in the operator (from training fellows to experts) was 20.0% (15/75) in group C and 7.5% (6/80) in group S. Stainless-steel Franseen needles showed less inter-operator difference than Co-Cr needles (p=0.03). Conclusions: Both Co-Cr and stainless-steel Franseen needles showed high diagnostic ability. Stainless-steel Franseen needles are soft and flexible; therefore, the range of puncture angles can be widely adjusted, making them suitable for training fellows to complete the procedure.

Analytical Consideration of Surface Dose and Kerma for Megavoltage Photon Beams in Clinical Radiation Therapy

  • Birgani, Mohammad Javad Tahmasebi;Behrooz, Mohammad Ali;Razmjoo, Sasan;Zabihzadeh, Mansour;Fatahiasl, Jafar;Maskni, Reza;Abdalvand, Neda;Asgarian, Zeynab;Shamsi, Azin
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.153-157
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    • 2016
  • Background: In radiation therapy, estimation of surface doses is clinically important. This study aimed to obtain an analytical relationship to determine the skin surface dose, kerma and the depth of maximum dose, with energies of 6 and 18 megavoltage (MV). Materials and Methods: To obtain the dose on the surface of skin, using the relationship between dose and kerma and solving differential equations governing the two quantities, a general relationship of dose changes relative to the depth was obtained. By dosimetry all the standard square fields of $5cm{\times}5cm$ to $40cm{\times}40cm$, an equation similar to response to differential equations of the dose and kerma were fitted on the measurements for any field size and energy. Applying two conditions: a) equality of the area under dose distribution and kerma changes in versus depth in 6 and 18 MV, b) equality of the kerma and dose at $x=d_{max}$ and using these results, coefficients of the obtained analytical relationship were determined. By putting the depth of zero in the relation, amount of PDD and kerma on the surface of the skin, could be obtained. Results: Using the MATLAB software, an exponential binomial function with R-Square >0.9953 was determined for any field size and depth in two energy modes 6 and 18MV, the surface PDD and kerma was obtained and both of them increase due to the increase of the field, but they reduce due to increased energy and from the obtained relation, depth of maximum dose can be determined. Conclusions: Using this analytical formula, one can find the skin surface dose, kerma and thickness of the buildup region.

The New Understanding of Korean Medicine Practice in Korean Medicine Doctor's Medical Devices Using and Duty of Care (한의사의 의료기기 사용과 주의의무에 있어서 한방의료행위의 새로운 이해)

  • Park, Yong-Sin
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.2
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    • pp.117-127
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    • 2019
  • Objectives : Korean medicine practice is not specifically described in medical law, and then has always been a quarrel. So far The criteria for judgment in Korean Medicine Doctor's Medical Devices Using should clinically prove it only by Korean medicine theory and academic Traditionally descending from old ancestors. Comprehensively review of Korean Medicine Doctor's Medical Devices Using and Duty of Care, and then present a new understandings to determine future Korean Medicine Practice. Method : An existing court cases of Korean Medicine Doctor's Medical Devices Using and Duty of Care were reviewed. After reviewing various papers published for several years, various opinions were reviewed and suggested. Results : The range of Korean Medicine Doctor's Medical Devices Using has changed since the 1951 National Medical Law stipulated Korean medicine as medical professionals. The issue of the recent ruling that distinguishes medical practice from Korean medicine practice were condensed into what emphasis to interpret amongst 1) The basic principles of learning, 2) Curriculum and professionalism, 3) Risks. The Constitutional Court's ruling was important in order of 'Risk', 'curriculum and expertise', and 'basic principles of learning.' A duty of Care means an obligation to pay attention to something. A duty of Care does not mean a "highest level," but requires a "best care" and does "best under given conditions." Even in the duty of Care, Because Korean medicine has a purpose to protect and promote the health of the people, Some standards of western medicine have to be adapted to the current general medical technology. Korean Medicine doctors can recognize the duty of care in the "some basic range" of knowledge belonging to western medicine. Conclusions : The interpretation of Korean Medicine practice are currently in compatible the argument that should clearly divide Korean medicine from Western medicine, and that should be changed in light of the changing medical environment. Therefore If Korean medicine's standard is applied to the extent to which Korean Medicine doctors are educated, it is necessary to define a new definition to actively interpret Korean Medical practice. The academic basis of Korean medicine and the level of Korean medicine practice based on the books that are traditionally available, and then current textbooks of Korean Medicine College, Korean Medicine Clinical Care Guidelines, and classification of Korean standard medical practices should be standardized. Increasingly, Korean Medicine practice should be interpreted according to reality, focusing on protecting and promoting the health of the people rather than academic differences.

Design and Development of a Medical Education System Using Information Technology: A Case Report from the Pusan National University School of Medicine (정보기술을 활용한 의학교육시스템의 설계와 개발: 부산대학교 의학전문대학원 사례)

  • Im, Sun Ju;Lee, Sang Yeoup;Baek, Sun Yong;Woo, Jae Seok;Kam, Beesung
    • Korean Medical Education Review
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    • v.16 no.1
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    • pp.16-24
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    • 2014
  • The development of information technology (IT) has led to changes in medical education. IT has been used for e-learning and e-teaching, e-assessment, e-logistics, and e-administration. Pusan National University School of Medicine has developed its own educational information system using IT to support students' learning and assessment and to manage curricular activities. Based on our experience, we propose six suggestions for designing new software, specifically regarding simplifying the design for users, communication with the programmer, a rapid cycle from design to implementation, orientation support for users, backup and security support, and obtaining patents. Collaborating with the Department of Medical Informatics within the School of Medicine has advantages, and an alliance among medical schools can simplify the development of software. In any case, curricular innovation should precede the introduction of technology because all technologies should support curricular goals.

A Study on Finding Emergency Conditions for Automatic Authentication Applying Big Data Processing and AI Mechanism on Medical Information Platform

  • Ham, Gyu-Sung;Kang, Mingoo;Joo, Su-Chong
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.16 no.8
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    • pp.2772-2786
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    • 2022
  • We had researched an automatic authentication-supported medical information platform[6]. The proposed automatic authentication consists of user authentication and mobile terminal authentication, and the authentications are performed simultaneously in patients' emergency conditions. In this paper, we studied on finding emergency conditions for the automatic authentication by applying big data processing and AI mechanism on the extended medical information platform with an added edge computing system. We used big data processing, SVM, and 1-Dimension CNN of AI mechanism to find emergency conditions as authentication means considering patients' underlying diseases such as hypertension, diabetes mellitus, and arrhythmia. To quickly determine a patient's emergency conditions, we placed edge computing at the end of the platform. The medical information server derives patients' emergency conditions decision values using big data processing and AI mechanism and transmits the values to an edge node. If the edge node determines the patient emergency conditions, the edge node notifies the emergency conditions to the medical information server. The medical server transmits an emergency message to the patient's charge medical staff. The medical staff performs the automatic authentication using a mobile terminal. After the automatic authentication is completed, the medical staff can access the patient's upper medical information that was not seen in the normal condition.

A Case Study on the Use of Megestrol Acetate and Korean Medical Treatment for the Loss of Appetite and Weight Loss in Patients with Amyotrophic Lateral Sclerosis(ALS)

  • Jeong, Ho Hyun;Lee, Sang Mi;Lee, Jong Chul;Park, Man Yong;Kim, Dong Woung;Song, Bong Keun;Kim, Sung Chul
    • Journal of Acupuncture Research
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    • v.30 no.5
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    • pp.185-192
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    • 2013
  • Objectives : Weight loss and loss of appetite in amyotrophic lateral sclerosis patients are common symptoms, these are associated with survival as well as nutritional condition. The changes in weight and appetite were reported after treatment using Megestrol acetate and Korean medical treatments. Methods : Amyotrophic lateral sclerosis patient with weight loss and loss of appetite were treated by administering megestrol acetate a known anti-malignant tumor agent and Korean medical treatments such as acupuncture, pharmacopuncture and herbal medicine. The changes in weight and appetite were checked using body mass index(BMI) and simplified nutritional appetite questionnaire(SNAQ). Results : There was a more than 17 kg increase in weight. BMI increased from 15.94 $kg/m^2$ to 21.97 $kg/m^2$ and SNAQ score increased from 7 to 16. Owing to several side effects, Megestrol acetate was stopped after which only Korean medical treatments were provided. After which the lasting effects in BMI and appetite could be seen. Conclusion : There are few studies on weight loss and loss of appetite in ALS patients. Using only megestrol acetate can cause several considerable side effects. Which respect to this, the findings in this study could open up new clinical guideline possibilities.

Ginsenoside Rg1 Attenuates Neuroinflammation Following Systemic Lipopolysaccharide Treatment in Mice

  • Shin, Jung-Won;Ma, Sun-Ho;Lee, Ju-Won;Kim, Dong-Kyu;Do, Kyuho;Sohn, Nak-Won
    • The Korea Journal of Herbology
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    • v.28 no.6
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    • pp.145-153
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    • 2013
  • Objectives : Neuroinflammation is characterized by microglial activation and the expression of major inflammatory mediators. The present study investigated the inhibitory effect of ginsenoside Rg1 ($GRg_1$), a principle active ingredient in Panax ginseng, on pro-inflammatory cytokines and microglial activation induced by systemic lipopolysaccharide (LPS) treatment in the mouse brain tissue. Methods : Varying doses of $GRg_1$ was orally administered (10, 20, and 30 mg/kg) 1 h before the LPS injection (3 mg/kg, intraperitoneally). The mRNA expression of pro-inflammatory cytokines in the brain tissue was measured using the quantitative real-time PCR method at 4 h after the LPS injection, Microglial activation was evaluated using western blotting and immunohistochemistry against ionized calcium binding adaptor molecule 1 (Iba1) in the brain tissue. Cyclooxigenase-2 (COX-2) expressions also observed using western blotting and immunohistochemistry at 4 h after the LPS injection, In addition, double-immunofluorescent labeling of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and COX-2 with microglia and neurons was processed in the brain tissue. Results : $GRg_1$ (30 mg/kg) significantly attenuated the upregulation of TNF-${\alpha}$, interleukin (IL)-$1{\beta}$ and IL-6 mRNA in the brain tissue at 4 h after LPS injection. Morphological activation and Iba1 protein expression of microglia induced by systemic LPS injection were reduced by the $GRg_1$ (30 mg/kg) treatment. Upregulation of COX-2 protein expression in the brain tissue was also attenuated by the $GRg_1$ (30 mg/kg) treatment. Conclusion : The results suggest that $GRg_1$ is effective in the early stage of neuroinflammation which causes neurodegenerative diseases.

Pediatricians' perception of factors concerning the clinical application of blockchain technology to pediatric health care: a questionnaire survey

  • Yong Sauk Hau;Min Cheol Chang;Jae Chan Park;Young Joo Lee;Seong Su Kim;Jae Min Lee
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.156-163
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    • 2023
  • Background: Interest in digital medical information has increased because it allows doctors to easily access a patient's medical records and provide appropriate medical care. Blockchain technology ensures data safety, reliability, integrity, and transparency by distributing medical data to all users over a peer-to-peer network. This study attempted to assess pediatricians' thoughts and attitudes toward introducing blockchain technology into the medical field. Methods: This study used a questionnaire survey to examine the thoughts and attitudes of 30- to 60-year-old pediatricians regarding the introduction of blockchain technology into the medical field. Responses to each item were recorded on a scale ranging from 1 (never agree) to 7 (completely agree). Results: The scores for the intentions and expectations of using blockchain technology were 4.0 to 4.6. Pediatricians from tertiary hospitals responded more positively (4.5-4.9) to the idea of using blockchain technology for hospital work relative to the general population (4.3-4.7). However, pediatricians working in primary and secondary hospitals had a slightly negative view of the application of blockchain technology to hospital work (p=0.018). Conclusion: When introducing the medical records of related pediatric and adolescent patients using blockchain technology in the future, it would be better to conduct a pilot project that prioritizes pediatricians in tertiary hospitals. The cost, policy, and market participants' perceptions are essential factors to consider when introducing technology in the medical field.

Anatomical study of the bone morphology of the anterior talofibular ligament attachment

  • Hitomi Fujishiro;Akimoto Nimura;Mizuki Azumaya;Soichi Hattori;Osamu Hoshi;Keiichi Akita
    • Anatomy and Cell Biology
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    • v.56 no.3
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    • pp.334-341
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    • 2023
  • Anterior talofibular ligament (ATFL) injuries are the most common cause of ankle sprains. To ensure anatomically accurate surgery and ultrasound imaging of the ATFL, anatomical knowledge of the bony landmarks around the ATFL attachment to the distal fibula is required. The purpose of the present study was to anatomically investigate the ATFL attachment to the fibula with respect to bone morphology and attachment structures. First, we analyzed 36 feet using micro-computed tomography. After excluding 9 feet for deformities, the remaining 27 feet were used for chemically debrided bone analysis and macroscopic and histological observations. Ten feet of living specimens were observed using ultrasonography. We found that a bony ridge was present at the boundary between the attachments of the ATFL and calcaneofibular ligament (CFL) to the fibula. These two attachments could be distinguished based on a difference in fiber orientation. Histologically, the ATFL was attached to the anterodistal part of the fibula via fibrocartilage anterior to the bony ridge indicating the border with the CFL attachment. Using ultrasonography in living specimens, the bony ridge and hyperechoic fibrillar pattern of the ATFL could be visualized. We established that the bony ridge corresponded to the posterior margin of the ATFL attachment itself. The ridge was obvious, and the superior fibers of the ATFL have directly attached anteriorly to it. This bony ridge could become a valuable and easy-to-use landmark for ultrasound imaging of the ATFL attachment if combined with the identification of the fibrillar pattern of the ATFL.