• Title/Summary/Keyword: Patient Management Protocol

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Perioperative Management of the Voice in Thyroid Cancer (갑상선암 수술과 수술 전후 음성관리)

  • Yoon, So Yeon;Hong, Hyun Jun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.2
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    • pp.49-55
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    • 2020
  • Evaluating the patient's voice before thyroidectomy is useful for the purpose of identifying patients with vocal cord paralysis without symptoms, identifying other patient's voice abnormalities, and whether it is related to voice disorders that may occur after surgery. Also voice evaluation after thyroid surgery is helpful in diagnosis, treatment, and rehabilitation and follow-up of voice disorders that occur without clear nerve damage after thyroidectomy. And it is helpful for rapid recovery through active early rehabilitation treatment for patients who complain of speech impairment without paralysis. In particular, neck exercise can improve the adhesion of the surgical site and increase the range of motion of the neck as well as improve subjective neck discomfort. In addition, hearing, voice and breathing functions should be improved, and voice hygiene education and counseling should be provided. Vocal cord injection is the first treatment option for unilateral vocal cord palsy. By establishing a protocol for voice disorders before and after thyroid surgery and providing appropriate treatment, the quality of life of patients can be improved.

Quality assurance for computed-tomography simulator : Report of the AAPM Radiation Therapy Committee Task Group No.66 (Report of the AAPM Radiation Therapy Committee의 Task Group No.66에 의한 전산화 단층촬영 모의치료기의 정도 관리)

  • Lee, Yun-Seok
    • The Journal of Korean Society for Radiation Therapy
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    • v.17 no.1
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    • pp.41-43
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    • 2005
  • Purpose : Wish to present degree management process that is efficient confirm radiation treatment exclusive use CT simulator's Q.A item that become Q.A and Differentiation of diagnosis area that present Report of the AAPM Task Group No.66 using Q.A tool that produce itself and secure safe and correct CT-simulation process and equip convenience. Method and material : Manufacture CT simulator's Q.A tool on source and confirm virtue between isocenter of wall laser system, patient table, CT scanner's imaging plane that present in Report of the AAPM Task Group No.66 by daily publication unit. Result : Confirmed measured value from Report of the AAPM Task Group No.66 to confirmation of presenting degree management item in wall laser's ${\pm}2mm$, table's ${\pm}2mm$, imaging plane's ${\pm}2mm$ tolerance extent. Conclusion : There is unconfirmed item from CT-simulation process for therapy to CT Q.A protocol of existent diagnosis area, premising suitable degree management of radiation treatment exclusive use CT-simulator equipment confirming presenting Q.A item in Report of the AAPM Task Group No.66 safe and correct CT-simulation process guarantee can

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RFID-based Authentication Protocol for Implantable Medical Device (체내삽입장치에 RFID 기술을 적용한 인증 프로토콜)

  • Jeong, Yoon-Su
    • Journal of Digital Convergence
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    • v.10 no.2
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    • pp.141-146
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    • 2012
  • U-healthcare, which grafted advanced IT technology onto medical technology, is in the limelight because it can provide medical services at anytime and anywhere. U-healthcare system applied RFID technology for Implantable Medical Device (IMD), but patient's biometric information can be easily exposed to third parties. In this article, RFID-based U-healthcare authentication protocol is proposed to prevent illegal usage for personal biometric information exposed to the third patty. The proposed protocol guarantees patients' biometric information integrity as compounding random numbers between administrators and hospital/clinic managers, and uses continuous number SEQ and time stamp T to synchronize IMD/administrators and administrators/hospital managers. Also, to protect user's privacy from the third party, patients' biometric information can be safely guarded by managing patients' security identifiers by administrators.

Congenital syngnathia: a case report

  • Kim, Chul-Hwan;Kim, Moon-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.3
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    • pp.171-176
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    • 2012
  • Congenital syngnathia refers to the fusion of bony tissues, a rare disorder with only 41 cases reported in the international literature from 1936 to 2009. The occurrence of syngnathia without any other associated systemic disease or congenital anomaly is extremely rare. This report presents a case of congenital syngnathia with unilateral maxillomandibular bony adhesion without any other oral or maxillofacial anomaly. No recommended protocol for surgery exists due to the rarity of the disorder. There is a very low survival rate for the few patients who have forgone surgical management. This case describes a 74-year-old female patient who was suffering from limitation of mouth opening and was subsequently diagnosed with congenital syngnathia. The surgical staff performed separation surgery and reconstructed the malformed oral vestibule and cheek using the radial forearm free flap operation.

A Study on the Mitigation of the Exposure Dose Applying Bolus Tracking in Brain Perfusion CT Scan (뇌 관류 CT검사에서 BolusTracking기법을 적용한 피폭선량 저감화에 관한 연구)

  • Kim, Ki-Jeong;Jung, Hong-Ryang;Lim, Cheong-Hwan;Hong, Dong-Hee;Shim, Jae-Goo;You, In-Gyu
    • Journal of Digital Convergence
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    • v.12 no.3
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    • pp.353-358
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    • 2014
  • This study was conducted to analyze the patient's exposed dose targeting the patients who had acute ischemic stroke symptoms and CT brain perfusion scan, by comparing fixed time technique and bolus tracking technique which was provided by the manufacturer and to identify the Time graph to implement the usability of contrast medium's tracking technique the best contrast enhancement intervals. $CTDI_{VOL}$ of PCT in patient appeared to be 431.72mGy in fixed scan delay protocol, whereas 323.61mGy in Bolus tracking technique. The value of DLP appeared to be $1243.47mGy{\cdot}cm$ in fixed scan delay protocol, whereas $932mGy{\cdot}cm$ in Bolus tracking technique. Time graph appeared to be various in fixed scan delay protocol, whereas the optimal time graph could be obtained in Bolus tracking. The exposure dose could be reduced by 25% applying Bolus tracking technique when taking brain perfusion CT scan.

Home Health Care Service Using Routine Vital Sign Checkup and Electronic Health Questionnaires (주기적인 생리변수 측정과 전자건강설문을 이용한 재택건강관리서비스)

  • 박승훈;우응제;이광호;김종철
    • Journal of Biomedical Engineering Research
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    • v.22 no.5
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    • pp.469-477
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    • 2001
  • In this Paper. we describe a home health care service using electronic health questionnaires and routine checkup of vital signs Including ECG (Electrocardiography) , blood pressure. and SpO$_2$ (Oxygen Saturation) . This system is for patients at home with chronic diseases, discharged Patients, or any normal people for the Prevention of disease The service requires a home health care terminal and a PC with Interned connection installed at Patient home. The distance health care management center is equipped with a vital-sign and questionnaire interpreter as well as database, Web, and notification servers with UMS (Unified Messaging System). Participating Physician can access the servers at the center using a Web browser running on a PC available to them at any time. These components are linked together through various kinds of data and voice communication channels including PSTN (Public Switched Telephone Network) . CATV(Community Antenna TV) . Interned. and mobile communication network. Following the Physician's direction given to a Patient. he or she uses the home health care terminal to collect vital signs and fill out the questionnaire. When the terminal automatically transmits these data to the management center. the data interpreter and servers at the center process the information fo1lowing the Protocol implemented on the system. Physicians can retrieve and review data corresponding to their Patients and send back their diagnostic reports to the center. UMS at the center delivers the physician 's recommendation to the corresponding patient through the notification server. Patients can also reprieve and review their own records as well as diagnostic reports from physicians. The system Provides a new way of collecting diagnostic information and delivering doctor's recommendation to patients at home for their health management. Future works are needed in the development of new technology for measurements and interpretations of various vital signs .

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Prognostic Factor Analysis for Management of Chronic Neck Pain : Can We Predict the Severity of Neck Pain with Lateral Cervical Curvature?

  • Seong, Han Yu;Lee, Moon Kyu;Jeon, Sang Ryong;Roh, Sung Woo;Rhim, Seung Chul;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • v.60 no.4
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    • pp.456-464
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    • 2017
  • Objective : Although little is known about its origins, neck pain may be related to several associated anatomical pathologies. We aimed to characterize the incidence and features of chronic neck pain and analyze the relationship between neck pain severity and its affecting factors. Methods : Between March 2012 and July 2013, we studied 216 patients with chronic neck pain. Initially, combined tramadol (37.5 mg) plus acetaminophen (325 mg) was administered orally twice daily (b.i.d.) to all patients over a 2-week period. After two weeks, patients were evaluated for neck pain during an outpatient clinic visit. If the numeric rating scale of the patient had not decreased to 5 or lower, a cervical medial branch block (MBB) was recommended after double-dosed previous medication trial. We classified all patients into two groups (mild vs. severe neck pain group), based on medication efficacy. Logistic regression tests were used to evaluate the factors associated with neck pain severity. Results : A total of 198 patients were included in the analyses, due to follow-up loss in 18 patients. While medication was successful in reducing pain in 68.2% patients with chronic neck pain, the remaining patients required cervical MBB. Lateral cervical curvature, such as a straight or sigmoid type curve, was found to be significantly associated with the severity of neck pain. Conclusion : We managed chronic neck pain with a simple pharmacological management protocol followed by MBB. We should keep in mind that it may be difficult to manage the patient with straight or sigmoid lateral curvature only with oral medication.

A working paradigm for managing mandibular fractures under regional anesthesia

  • Chellappa, Natarajan;Meshram, Vikas;Kende, Prajwalit;Landge, Jayant;Aggarwal, Neha;Tiwari, Manish
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.6
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    • pp.275-281
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    • 2018
  • Objectives: Isolated mandibular fractures contribute to approximately 45% of maxillofacial traumas. Improper management of mandibular fractures can cause myriad potential complications and can lead to serious functional and aesthetic sequelae. The objective of the study is to design a stepwise approach for managing isolated mandibular fractures using open reduction and internal fixation (ORIF) with regional anesthesia on outpatient basis. Materials and Methods: Patients with isolated mandibular fractures presenting to the department of maxillofacial surgery were selected for ORIF under regional anesthesia based on occlusion, age, socioeconomic status, general condition, habits, and allied medical ailments. Standard preoperative, intraoperative, and postoperative protocols were followed. All patients were followed up for a minimum of 4 weeks up to a maximum of 1 year. Results: Of 23 patients who received regional anesthesia, all but one had good postoperative functional occlusion. One patient was hypersensitive and had difficulty tolerating the procedure. Two patients developed an extraoral draining sinus, one of whom was managed with local curettage, while the other required hardware removal. One patient, who was a chronic alcoholic, returned 1 week after treatment with deranged fracture segments after he fell while intoxicated. Conclusion: With proper case selection following a stepwise protocol, the majority of mandibular fractures requiring ORIF can be managed with regional anesthesia and yield minimal to no complications.

Pericardial Tamponade following Perihepatic Gauze Packing for Blunt Hepatic Injury (둔상성 간손상 환자의 손상 통제술 후 발생한 심낭압전)

  • Ye, Jin Bong;Sul, Young Hoon;Go, Seung Je;Kwon, Oh Sang;Kim, Joong Suck;Park, ang Soon;Ku, Gwan Woo;Lee, Min Koo;Kim, Yeong Cheol
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.211-214
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    • 2015
  • The primary and secondary survey was designed to identify all of a patient's injuries and prioritize their management. However 15 to 22.3% of patient with missed injuries had clinically significant missed injuries. To reduce missed injury, special attention should be focused on patients with severe anatomical injury or obtunded. Victims of blunt trauma commonly had multiple system involvement. Some reports indicate that inexperience, breakdown of estalished protocol, clinical error, and restriction of imaging studies may be responsible for presence of missed injury. The best way of reducing clinical significant of missed injuries was repeated clinical assessment. Here we report a case of severe blunt hepatic injury patient and pericardial injury that was missed in primary and secondary survey. After damage control surgery of hepatic injury, she remained hemodynamically unstable. Further investigation found cardiac tamponade during intensive care. This was managed by pericardial window operation through previous abdominal incision and abdominal wound closure was performed.

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Development of a Prototype Patient Monitoring System with Module-Based Bedside Units and Central Stations: Overall Architecture and Specifications (모듈형 환자감시기와 중앙 환자감시기로 구성되는 환자감시시스템 시제품의 개발: 전체구조 및 사양)

  • Woo, E.J.;Park, S.H.;Jun, B.M.;Moon, C.W.;Lee, H.C.;Kim, S.T.;Kim, H.J.;Seo, J.J.;Chae, K.M.;Park, J.C.;Choi, K.H.;Lee, W.J.;Kim, K.S.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.05
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    • pp.315-319
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    • 1996
  • We have developed a prototype patient monitoring system including module-based bedside units, interbed network, and central stations. A bedside unit consists of a color monitor and a main CPU unit with peripherals including a module controller. It can also include up to 3 module cases and 21 different modules. In addition to the 3-channel recorder module, six different physiological parameters of ECG, respiration, invasive blood pressure, noninvasive blood pressure, body temperature, and arterial pulse oximetry with plethysmogaph are provided as parameter modules. Modules and a module controller communicate with up to 1Mbps data rate through an intrabed network based on RS-485 and HDLC protocol. Bedside units can display up to 12 channels of waveforms with any related numeric informations simultaneously. At the same time, it communicates with other bedside units and central stations through interbed network based on 10Mbps Ethernet and TCP/IP protocol. Software far bedside units and central stations fully utilizes gaphical user interface techniques and all functions are controlled by a rotate/push button on bedside unit and a mouse on central station. The entire system satisfies the requirements of AAMI and ANSI standards in terms of electrical safety and performances. In order to accommodate more advanced data management capabilities such as 24-hour full disclosure, we are developing a relational database server dedicated to the patient monitoring system. We are also developing a clinical workstation with which physicians can review and examine the data from patients through various kinds of computer networks far diagnosis and report generation. Portable bedside units with LCD display and wired or wireless data communication capability will be developed in the near future. New parameter modules including cardiac output, capnograph, and other gas analysis functions will be added.

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