• Title/Summary/Keyword: Patient Selection

Search Result 539, Processing Time 0.033 seconds

Surgical Treatment of Vascular Injuries (혈관손상에 관한 임상적 고찰)

  • 홍종완
    • Journal of Chest Surgery
    • /
    • v.21 no.6
    • /
    • pp.984-989
    • /
    • 1988
  • 2-D echocardiographic examination of the aortic root diameter was known to be useful in the selection of the size of the prosthetic valve. Valve-patient mismatch was occasionally a serious problem after valve replacement, especially in aortic valve disease. Preoperative knowledge of the patient`s valve annulus size is therefore of great importance in the surgical management of these patients. So the relationship between preoperative 2-D echocardiographic diameter of the annulus size and replaced prosthetic valve were evaluated. 13 patients were analyzed in this study. 2-D echocardiographic measurements of aortic annulus diameter, as determined from the parasternal long axis view and apical four chamber view, demonstrated a high correlation with actual prosthetic valve size implanted at surgery[r=0.86, p< 0.001, SEE=1.08].

  • PDF

Current Opinions on the Radioiodine Treatment of Graves' Hyperthyroidism (Graves병 갑상선 기능항진증에서 방사성 옥소 치료의 지견)

  • Lee, Sang-Woo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
    • /
    • v.37 no.6
    • /
    • pp.341-354
    • /
    • 2003
  • Radioactive iodine therapy using I-131 for hyperthyroidism has been used for more than 50 years, and generally considered safe and devoid of major side effects. Appropriate patient selection criteria and clinical judgement concerning patient preparation should be employed for its optimal use. It has not been possible to resolve the trade-off between efficient definite cure of hyperthyroidism and the high incidence of post-therapy hypothyroidism. The dose of the I-131 needed to maintain euthyroid state remains an area of uncertainity and debate. Early side effects are uncommon and readily managable. Other than the need for long-term monitoring and, in most cases, lifelong thyroid hormone treatment for late adverse consequences of this treatment remains only conjectural. We have reviewed general principles and recent advances in radioiodine treatment for Graves' hyperthyroidism, specially regarding to several controversies.

Aspiration Pneumonia after General Anesthesia Using Laryngeal Mask Airway -A case report- (후두 마스크를 이용한 전신 마취 후 발생된 흡인성 폐렴)

  • Lee, Deok-Hee;Park, Ki-Ho
    • Journal of Yeungnam Medical Science
    • /
    • v.21 no.1
    • /
    • pp.127-131
    • /
    • 2004
  • A laryngeal mask airway (LMA) has many advantages in the management of airway emergencies or the treatment of patients in whom intubation is difficult, but the use of LMA during positive ventilation may seem inappropriate to protect the airway because of the risk of pulmonary aspiration of regurgitated gastric contents. We experienced aspiration pneumonia after general anesthesia using LMA in patient who suffered from panperitonitis. It is considered that the main reason for aspiration pneumonia was a leakage of gastric content through the space surrounding the nasogastric tube while under high airway inflation pressure. We concluded that when LMA or the Proseal laryngeal mask airway (PLMA) is chosen for the use in difficult intubations, careful patient-suitability selection and the correct knowledge of LMA and PLMA are needed to protect the airway against aspiration.

  • PDF

Diagnosis and Management of Patients with Mucopolysaccharidoses in Malaysia

  • Ngu, Lock-Hock
    • Journal of mucopolysaccharidosis and rare diseases
    • /
    • v.4 no.1
    • /
    • pp.11-13
    • /
    • 2018
  • In Malaysia, diagnosis and treatment of patients with mucopolysaccharidoses (MPS) is mainly localized at Hospital Kuala Lumpur, which is the national referral center for rare diseases. To date there are 83 patients diagnosed with MPS in our center, with MPS II being the commonest. The Malaysian National Medicines Policy second edition has a specific section on the orphan drugs which includes recombinant human enzyme for enzyme replacement therapy (ERT) in MPS. So far, National Pharmaceutical Regulatory Agency Malaysia has approved recombinant human enzyme for MPS types I (Loranidase), II (idursulfase), IVA (elosulfase alfa), and VI (Galsufase). Access to Idursulfase beta (another recombinant human enzyme for MPS II) and vestronidase alfa-vjbk (MPS VII) required special authorization on named patient basic. Currently there are 25 patients receiving ERT, 70% of the funding are from Ministry of Health (MOH), the remaining 30% are from various charitable funds and humanitarian programs. Thirteen newly diagnosed patients have to queue for an additional fund. Four patients have been treated with Hematopoietic stem cell transplant. MOH has also published guidelines regarding the patient selection criteria for ERT and treatment monitoring schedule.

Total Ankle Replacement Arthroplasty (족관절의 인공관절 치환술)

  • Sung, Il Hoon;Kim, Hyun Uk
    • Journal of Korean Foot and Ankle Society
    • /
    • v.19 no.1
    • /
    • pp.1-6
    • /
    • 2015
  • Total ankle replacement has been performed for treatment of end stage arthritis of the ankle, hopefully being an alternative to ankle arthrodesis. However, due to its high failure rates, earlier versions of ankle replacements were not regarded as successful procedures. The latest design has shown increasingly positive results. Total joint replacement of the ankle itself is still regarded as a demanding procedure and much more challenging than that of the hip and knee in many aspects. Several studies, however, have pointed out that it is becoming the viable, accepted alternative for arthrodesis with advanced implants, appropriate patient selection, and proper training experience of procedures. Compared with arthrodesis, it shows equal or better outcomes in pain relief, range of motion, and patient's satisfaction. We are attempting to review its biomechanical characteristics, implant design, indications, complications, clinical outcomes, and survival rate.

Hypofractionated whole breast irradiation: new standard in early breast cancer after breast-conserving surgery

  • Kim, Kyung Su;Shin, Kyung Hwan;Choi, Noorie;Lee, Sea-Won
    • Radiation Oncology Journal
    • /
    • v.34 no.2
    • /
    • pp.81-87
    • /
    • 2016
  • Hypofractionated whole breast irradiation (HF-WBI) has been proved effective and safe and even better for late or acute radiation toxicity for early breast cancer. Moreover, it improves patient convenience, quality of life and is expected to be advantageous in the medical care system by reducing overall cost. In this review, we examined key randomized trials of HF-WBI, focusing on adequate patient selection as suggested by the American Society of Therapeutic Radiology and Oncology (ASTRO) guideline and the radiobiologic aspects of HF-WBI in relation to its adoption into clinical settings. Further investigation to identify the current practice pattern or cost effectiveness is warranted under the national health insurance service system in Korea.

A Concept Analysis of Therapeutic Intervention in Nursing (간호학에서 치료적 중재(therapeutic intervention)에 대한 개념분석)

  • Jin, Hye Kyung;Kim, Moon Ja;Lee, Eun Nam
    • Journal of muscle and joint health
    • /
    • v.26 no.1
    • /
    • pp.1-14
    • /
    • 2019
  • Purpose: This concept analysis was done to clarify therapeutic intervention in nursing. Methods: For this study the process of Walker & Avant's concept analysis was used. Twenty-nine studies from electronic data bases met criteria for selection. Results: Therapeutic intervention can be defined by the following attributes: 1) goal-oriented, 2) forming a therapeutic relationship, 3) reinforcement of coping ability, 4) patient-centered, 5) a holistic integrated approach. The consequences of therapeutic intervention were improvement of quality of life, coping skills, self-care. Conclusion: Attributes of therapeutic intervention identified in this study can be applied to develop tools for measuring therapeutic nursing behaviors or to develop therapeutic nursing intervention programs for patient or family.

Indications for Lung Transplantation and Patient Selection

  • Son, Joohyung;Shin, Changwon
    • Journal of Chest Surgery
    • /
    • v.55 no.4
    • /
    • pp.255-264
    • /
    • 2022
  • Globally, thousands of patients undergo lung transplantation owing to end-stage lung disease each year. As lung transplantation evolves, recommendations and indications are constantly being updated. In 2021, the International Society for Heart and Lung Transplantation published a new consensus document for selecting candidates for lung transplantation. However, it is still difficult to determine appropriate candidates for lung transplantation among patients with complex medical conditions and various diseases. Therefore, it is necessary to analyze each patient's overall situation and medical condition from various perspectives, and ongoing efforts to optimize the analysis will be necessary. The purpose of this study is to review the extant literature and discuss recent updates.

Ultrasound-Guided Injection Therapy for Elbow, Wrist, and Hand Pain (팔꿈치, 팔목, 손 통증의 초음파 유도하 주사치료)

  • Ahn, Jaeki
    • Clinical Pain
    • /
    • v.20 no.2
    • /
    • pp.59-69
    • /
    • 2021
  • Patients with pain, numbness, and weakness in their elbows, wrists, and hands often need proper rehabilitation treatments. Among them, musculoskeletal injection therapy should be performed after a full evaluation of the patient, taking into account history and physical examination leading to clinical diagnosis. General rules such as accurate diagnosis and injection materials selection are used to achieve maximum benefit with minimal side effects. During injection, patient location, aseptic care, penetration techniques, follow-up and follow-up care must be maintained. Specific techniques may vary depending on the type, lesion, and location of the injection therapy. For optimal effectiveness, physician should inject directly into the lesion and avoid the injection of surroundings as much as possible. Therefore, ultrasound-guided injections are needed to accurately inject. These conditions and other conditions of the hands, wrists, and elbows can be effectively diagnosed and treated with diagnostic ultrasound and ultrasound-guided injections.

Surgical treatment of velopharyngeal insufficiency

  • Nam, Seung Min
    • Archives of Craniofacial Surgery
    • /
    • v.19 no.3
    • /
    • pp.163-167
    • /
    • 2018
  • Velopharyngeal insufficiency (VPI) is a common complication after primary palatoplasty. Although the several surgical treatments of VPI have been introduced, there is no consensus guide to select the optimal surgical treatment for VPI patients. The selection of surgical treatment for VPI depends on a multimodal patient evaluation, such as perceptual speech evaluation, nasometery and nasoendoscopy. We can provide more adequate treatment for VPI through the deeper understanding of anatomy and physiology in VPI.