• Title/Summary/Keyword: Patient-specific guide

Search Result 26, Processing Time 0.033 seconds

Anaphylaxis Induced by Surgical Prophylactic Cefotetan and The Application of World Allergy Organization Guide: A Case Report (사례보고: 수술예방적 항생제 Cefotetan에 의한 아나필락시스 보고 및 World Allergy Organization 가이드라인활용)

  • Jung, Kyung Lae;Kyung, Eun Jung;Lee, Hee Young;Kim, Eun Young
    • Korean Journal of Clinical Pharmacy
    • /
    • v.22 no.3
    • /
    • pp.268-273
    • /
    • 2012
  • The definition of anaphylaxis is 'a serious, life-threatening generalized or systemic hypersensitivity reaction' and is considered as the life threatening adverse drug reaction. We experienced a case of cefotetan induced anaphylaxis with negative pre-skin test, used for surgical prophylaxis. A 82-year-old female was scheduled for total knee replacement therapy. She had no previous history of allergy and her skin test results were also negative. On her right knee surgery, she underwent cefotetan therapy as a surgical prophylaxis for a week with no problems identified. Next left knee surgery, she also received the prophylaxis of intravenous cefotetan. However, a few minutes later, anaphylactic reaction developed with vomiting, severe hypotension, bronchospasm, and dyspnea. After immediate intensive care treatment, she recovered without significant complications. Though commonly used laboratory data in case reports, such as the specific IgE, tryptase, histamine, or allergic skin prick test were limited, we successfully confirmed anaphylaxis based on clinical criteria for diagnosing anaphylaxis based on WAO 2011 guideline with through concurrent patient°Øs medical history review and the process of identifying the causes.

Cranioplasty for Multilobular Osteochondrosarcoma Using 3-Dimensional Printing Technology in Dogs: A Report of Two Cases with a Long-Term Follow-Up

  • Heo, Seong-Hyeon;Lee, Hae-Beom;Jeong, Jae-Min;Jeon, Young-Jin;Kim, Dae-Hyun;Jeong, Seong-Mok;Roh, Yoon-Ho
    • Journal of Veterinary Clinics
    • /
    • v.39 no.5
    • /
    • pp.246-252
    • /
    • 2022
  • Multilobular osteochondrosarcoma (MLO) reportedly has a good prognosis after complete resection. This study reports the successful treatment of MLO in two dogs using 3-dimensional (3D) printing technology. A nine-year-old castrated male Maltese (Case 1) and a five-year-old castrated male poodle (Case 2) both presented with a mass in the skull. Diagnostic imaging revealed a cranial mass arising from the cranio-orbital and parieto-occipital bones. The masses were resected using 3D-printed osteotomy guides, and the resulting defects were reconstructed using 3D-printed patient-specific implants. Histopathological results confirmed the resection of MLOs with clean margins. Patients routinely recover from surgery without complications. To date, the two patients remain alive without clinical signs of tumor recurrence at 20 and 12 months postoperatively, respectively. In the management of MLO in dogs, 3D printing technology can allow accurate tumor resection, reduced surgical time, and successful reconstruction of large defects.

The Concept Analysis of Hope : Among Cancer Patients Undergoing Chemotherapy (희망의 개념 분석 -항암화학요법을 받는 암환자를 대상으로-)

  • Song, Mi-Sun;Lee, Eun-Ok;Park, Yeong-Suk;Ha, Yang-Suk;Sim, Yeong-Suk;Yu, Su-Jeong
    • Journal of Korean Academy of Nursing
    • /
    • v.30 no.5
    • /
    • pp.1279-1291
    • /
    • 2000
  • The main objectives of this study were to analyze the concept of hope, so to provide basic data to develop a valid instrument to measure hope, and to develop hope enhancing nursing intervention a program for cancer patients. The hybrid model approach was applied in three phases, the theoretical phase, the empirical phase, and the analytic phase. The study was developed on universal attributes explaining generalized hope and specific hope, which were revealed in a comprehensive review of the literature. In the empirical phase, eight cancer patients undergoing chemotherapy were interviewed to reveal causes, motivation, and their resource of hope according to The Hope Assessment Guide (Farren, Herth, & Popovich, 1995). In the analytical phase, the results of the two previous stages of the study were compared. The results were as follows : In the theoretical phase, six dimensions of hope emerged; affective, cognitive, behavioral, affiliative, temporal and contextual dimension. The antecedent of hope was loss, crisis, uncertainity, and stress. The consequences were renewal, development of new methods, safety, peace and transcendental competence. In the empirical phase, these six dimensions emerged as theoretical phases were verified and specified as these descriptive terms: feeling, intention, expectation, activity, relation, future- orientation, reality and goal-setting. The antecedent factor of hope was occurrence or recurrence of cancer. The consequence of hope was ability to cope with real condition, feeling of safety and comfort, peace, development of new strategy and recovery of disease. The major content of hope in this phase was related to specific hope, but it was also influenced on by general hope. In the analytic phase, general and specific hope was renamed as trait and state hope. All attributes emerged at the empirical phases, and also emerged at the theoretical phase. However, cognitive and contextual dimensions were revised and specified. In conclusion, the concept of hope is divided into trait hope and state hope, and state hope is an anticipatory expectation that occurs at the time of a stressful stimulus, such as being diagnosed with cancer. Hope is a multidimensional dynamic energized mental state which has the dimensions of affective, cognitive, behavioral, affiliative, temporal and contextual. There should be further studies to develope the state and trait hope scale according to definition and attributes of hope investigated in this study. In addition, considering results of the empirical phase, the family is very a important factor as a resource of hope, so it is necessary to consider family in implementing a nursing intervention program to enhance hope.

  • PDF

Clinical Characteristics of Cervical and Thoracic Radiculopathies: Non-Invasive Interventional Therapy (목 및 가슴신경뿌리병증의 임상적 고찰: 비침습적 중재시술치료)

  • Roh, Hakjae;Lee, Sang-Heon;Kim, Byung-Jo
    • Annals of Clinical Neurophysiology
    • /
    • v.10 no.2
    • /
    • pp.83-97
    • /
    • 2008
  • Cervical and thoracic radiculopathies are among the most common causes of neck pain. The most common causes are cervical disc herniation and cervical spondylosis in patients with cervical radiculopathy, and diabetes mellitus and thoracic disc herniation in thoracic radiculopathy. A thorough history, physical examination, and testing that includes electrodiagnostic examination and imaging studies may distinguish radiculopathy from other pain sources. Although various electrodiagnostic examinations may help evaluate radiculopathy, needle electromyography is the most important, sensitive, and specific method. Outcome studies of conservative treatments have shown varying results and have not been well controlled or systematic. When legitimate incapacitating symptoms continue despite conservative treatment attempts, more invasive spinal procedures and intradiscal treatment may be appropriate. Surgery has been shown to have excellent clinical outcomes in patients with disc extrusion and neurological deficits. However, patients with minimal disc herniation have fair or poor surgical outcomes. In addition, conventional open disc surgery entails various inadvertent surgical related risks. Although there has not yet been a non-surgical interventional procedure developed with the therapeutic efficacy of open surgery, conservative procedures can offer substantial benefits, are less invasive, and avoid surgical complications. While more invasive procedures may be appropriate when conservative treatment fails, prospective studies evaluating cervical and thoracic radiculopathies treatment options would help guide practitioners toward optimally cost-effective patient evaluation and care.

  • PDF

The Development and Evaluation of the Active Gait Training System for the Patients with Gait Disorder (보행 장애인을 위한 능동형 보행훈련 시스템 개발 및 평가)

  • Hwang, S.J.;Tae, K.S.;Kang, S.J.;Kim, J.Y.;Hwang, S.H.;Kim, H.I.;Park, S.W.;Kim, Y.H.
    • Journal of Biomedical Engineering Research
    • /
    • v.28 no.2
    • /
    • pp.218-228
    • /
    • 2007
  • Modem concepts of gait rehabilitation after stroke favor a task-specific repetitive approach. In practice, the required physical effort of the therapists limits the realization of this approach. Therefore, a mechanized gait trainer enabling nonambulatory patients to have the repetitive practice of a gait-like movement without overstraining therapists was constructed. In this study, we developed an active gait training system for patients with gait disorder. This system provides joint movements to patients who cannot carry out an independent gait. It provides a normal stance-swing ratio of 60:40 using an eccentric configuration of two gears. Joint motions of the knee and the ankle were evaluated with using the 3D motion analysis system and compared with the results from the multi-body dynamics simulation. In addition, clinical investigations were also performed for low stroke patients during the 6-week gait training. Results from the dynamics simulation showed that joint movements of the knee and the ankle were affected by the gear size, the step length and the length of the foot plate, except the radius of curvature of the foot guide plate. Also, the 6-week gait training revealed relevant improvements of the gait ability in all low subjects. Functional ambulation category levels of subjects after training were 2 in three patients and 1 in a patient. The developed active gait trainer seems feasible as an adjunctive tool in gait rehabilitation after stroke.

Planning of Multiple Tooth Implant Placement Using the Standardized Data in Teeth Size and Position (표준 치아 크기 및 배열 정보를 이용한 다중 치아 임플란트 식립계획 방안)

  • Park, Hyung-Wook;Park, Sang-Jin;Park, Hyungjun
    • Korean Journal of Computational Design and Engineering
    • /
    • v.20 no.4
    • /
    • pp.348-356
    • /
    • 2015
  • It is important to devise methods for assisting dentists to consistently determine implant positions and directions and to accurately perform drilling tasks during dental implant surgery. In this paper, we propose a novel approach to tooth implant placement planning which deals with the determination of the positions and directions of multiple implant fixtures for a set of missing mandibular teeth and suggests the selection of the sizes and types of the implant fixtures. We combine Korean standard data in the sizes and positions of human teeth with the patient specific 3D models of mandibular jawbones, nerve curves, and neighboring teeth around the missing teeth in order to determine the positions and directions of the implant fixtures for the missing teeth. Using the geometric and spatial information of the jawbones, the teeth and the implant fixtures, we can construct the 3D models of surgical guide stents which are crucial to perform drilling tasks with ease and accuracy. Adopted in 3D simulation of dental implant placement, the approach can provide surgeon students with good educational contents. We also expect that, with further work, the approach can be used as a useful tool to plan for dental implant surgery.

Study on the Validation of the Gated Cone-Beam Computed Tomography on Radiation Therapeutic Linear Accelerator (방사선치료용 선형가속기를 이용한 Gated Cone-Beam CT의 유용성 연구)

  • Seo, Jeong-Min;Kim, Chan-Hyeong;Park, Byoung-Suk;Park, Cheol-Soo;Jang, Hyon-Chol;Kim, Joung-Dae
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.16 no.10
    • /
    • pp.6932-6939
    • /
    • 2015
  • The respiration is one of important factor in the radiation therapy. The existing commercial method of cone-beam computed tomography on LINAC does not consider respiratory motion of patient hence the images are both distorted and inaccurate. In this study, the cone-beam computed tomography images have been reconstructed from back projection radiography of specific phase on breathing cycle which concerned about respiratory movement in radiation therapy. This study investigated how different between cone-beam CT images with and without gating respiratory movement, and this paper provides that guide and implementation of gated cone-beam CT on radiation therapeutic equipment.

Deep Learning in Radiation Oncology

  • Cheon, Wonjoong;Kim, Haksoo;Kim, Jinsung
    • Progress in Medical Physics
    • /
    • v.31 no.3
    • /
    • pp.111-123
    • /
    • 2020
  • Deep learning (DL) is a subset of machine learning and artificial intelligence that has a deep neural network with a structure similar to the human neural system and has been trained using big data. DL narrows the gap between data acquisition and meaningful interpretation without explicit programming. It has so far outperformed most classification and regression methods and can automatically learn data representations for specific tasks. The application areas of DL in radiation oncology include classification, semantic segmentation, object detection, image translation and generation, and image captioning. This article tries to understand what is the potential role of DL and what can be more achieved by utilizing it in radiation oncology. With the advances in DL, various studies contributing to the development of radiation oncology were investigated comprehensively. In this article, the radiation treatment process was divided into six consecutive stages as follows: patient assessment, simulation, target and organs-at-risk segmentation, treatment planning, quality assurance, and beam delivery in terms of workflow. Studies using DL were classified and organized according to each radiation treatment process. State-of-the-art studies were identified, and the clinical utilities of those researches were examined. The DL model could provide faster and more accurate solutions to problems faced by oncologists. While the effect of a data-driven approach on improving the quality of care for cancer patients is evidently clear, implementing these methods will require cultural changes at both the professional and institutional levels. We believe this paper will serve as a guide for both clinicians and medical physicists on issues that need to be addressed in time.

Rapid Detection and Monitoring Therapeutic Efficacy of Mycobacterium tuberculosis Complex Using a Novel Real-Time Assay

  • Jiang, Li Juan;Wu, Wen Juan;Wu, Hai;Ryang, Son Sik;Zhou, Jian;Wu, Wei;Li, Tao;Guo, Jian;Wang, Hong Hai;Lu, Shui Hua;Li, Yao
    • Journal of Microbiology and Biotechnology
    • /
    • v.22 no.9
    • /
    • pp.1301-1306
    • /
    • 2012
  • We combined real-time RT-PCR and real-time PCR (R/P) assays using a hydrolysis probe to detect Mycobacterium tuberculosis complex (MTBC)-specific 16S rRNA and its rRNA gene (rDNA). The assay was applied to 28 non-respiratory and 207 respiratory specimens from 218 patients. Total nucleic acids (including RNA and DNA) were extracted from samples, and results were considered positive if the repeat RT-PCR threshold cycle was ${\leq}35$ and the ratio of real-time RT-PCR and real-time PCR load was ${\geq}1.51$. The results were compared with those from existing methods, including smear, culture, and real-time PCR. Following resolution of the discrepant results between R/P assay and culture, the overall sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of all samples (including non-respiratory and respiratory specimens) were 98.2%, 97.2%, 91.7%, and 99.4%, respectively, for R/P assay, and 83.9%, 89.9%, 72.3%, and 94.7%, respectively, for real-time PCR. Furthermore, the R/P assay of four patient samples showed a higher ratio before treatment than after several days of treatment. We conclude that the R/P assay is a rapid and accurate method for direct detection of MTBC, which can distinguish viable and nonviable MTBC, and thus may guide patient therapy and public health decisions.

Sharing Experiences in Selecting Clinical Outcome and Approving Validated Questionnaires : Insights from an Elderly Registry Study (노인등록연구 사례를 통한 임상평가지표 선정 과정 및 검증된 설문도구 승인 경험의 공유)

  • Nahyun Cho;Hyungsun Jun;Won-Bae Ha;Junghan Lee;Mi Mi Ko;Young-Eun Kim;Jeeyoun Jung;Jungtae Leem
    • The Journal of Korean Medicine
    • /
    • v.45 no.1
    • /
    • pp.17-43
    • /
    • 2024
  • Objectives: Underpinned by the context of a Korean traditional medicine cohort study on healthy aging, this research primarily aims to guide the selection of Clinical Outcome Assessments (COAs) for elderly healthy aging patient registry research, offering insights into the selection process; and secondly, to streamline the resource-intensive process of obtaining permissions for validated COAs, benefiting future traditional Korean medicine clinical researchers. Methods : In this study, we identified outcomes through a review of previous studies, followed by a process involving expert consultations to select the final outcomes. Subsequently, for the selected outcomes that were Clinical Outcome Assessments (COAs) developed tools, we searched in commercial databases to confirm the availability of Korean versions and the necessity of obtaining permissions. Finally, we obtained permissions for their utilization and, when needed, acquired the original instrument questionnaire through payment. Results: Through a literature review of existing observational studies, a total of 57 outcomes were selected, with 19 of them identified as COA instruments. Upon verifying usage permissions for these 19 instruments, it was found that 17 required author-specific permissions, and among these, 2 needed a purchase as they were commercially available. Conclusion: This study provides a detailed overview of outcome selection and permission acquisition for elderly patient registry research. It underscores the importance of Clinical Outcome Assessment (COA) tools and the rigorous approval process, aiming to enhance research reliability. Continuous verification of COA information is essential, and future research should explore Core Outcome Set (COS) development through consensus-building approaches like Delphi studies.