• Title/Summary/Keyword: Post-procedural management

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Indication and Post-Procedural Management of Upper GI Stent Implantation (상부 위장관 스텐트 삽입술의 이해 -적응증 및 추적 관리-)

  • Joo, Moon-Kyung;Park, Jong-Jae
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.49-55
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    • 2009
  • Self expandable metal stent (stent) implantation of upper gastrointestinal (UGI) tract is now widely accepted for the palliation of obstructive symptoms caused by inoperable malignant UGI obstruction. With the technical progress and accumulation of clinical experiences, it became possible to perform the procedure easily, safely and effectively. However, clinicians should pay attention to the post-procedural care, because early or late complications such as ulceration, pain, bleeding, food impaction, perforation, migration or in-stent tumor growth could occur. In this review, several topics about stent placement in the UGI tract are discussed, such as major indications for stenting, kinds of stents, and post-procedural management.

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Mediating Effects of Relationship Fairness Between Franchisor's Support Service and Performance in Food Service Franchise (외식프랜차이즈 가맹본부 지원서비스와 성과간에 관계공정성의 매개효과)

  • LEE, Sang-Suk
    • The Korean Journal of Franchise Management
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    • v.10 no.2
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    • pp.19-32
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    • 2019
  • Purpose - This paper aims to investigate the mediating effects of relationship fairness factors between franchisor's support services and performance(re-contract intention) in food service franchise. More specifically, fairness was measured into distributive, procedure, interaction, and information, franchisor's support service was divided into pre-start support services (initial support services) and post-start support services (continued support services), and performance (re-contract intent) was measured using 3 items such as re-contract, contract extension, and recommendation. Research design, data, and methodology - The population for the survey is the head of franchises in the metropolitan area (Seoul/Gyeonggi), which operates a restaurant franchise, and samples included a wide range of overseas/domestic brands and regions. The survey was conducted from August 1 to September 30, 2018 through the survey agency. The survey was conducted together with a telephone interview and a direct visit by the investigator. A total of 205 questionnaires were collected and retrieved, 4 questionaires containing missing information were excluded and 201 responses were used for analysis. Results - The results shows that franchisor's initial support services have significant positive effects on procedural, interpersonal, and informational relationship fairness, and continuous support services have significant positive effects on distributive, procedural, interpersonal, and informational relationship fairness. This study also shows that informational and procedural fairness have significant positive effects on performance(re-contract intention). Finally, continuous services a significant positive effect on performance(re-contract intention). Conclusions - The results show that franchisor make a manual, and should improve fairness through regular investigation whether support services was executed as promised in the manual after franchisee operation. In addition, information fairness and procedural fairness have been shown to increase performance(re-contract intention). These results mean that the franchisor's headquarters should provide product and service support for the merchant in accordance with the manual and management policy to reduce asymmetry in information and improve procedural fairness to enhance performance(re-contract intention).

Endoscopic retrograde cholangiopancreatography-related complications: risk stratification, prevention, and management

  • Clement Chun Ho Wu;Samuel Jun Ming Lim;Christopher Jen Lock Khor
    • Clinical Endoscopy
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    • v.56 no.4
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    • pp.433-445
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    • 2023
  • Endoscopic retrograde cholangiopancreatography (ERCP) plays a crucial role in the management of pancreaticobiliary disorders. Although the ERCP technique has been refined over the past five decades, it remains one of the endoscopic procedures with the highest rate of complications. Risk factors for ERCP-related complications are broadly classified into patient-, procedure-, and operator-related risk factors. Although non-modifiable, patient-related risk factors allow for the closer monitoring and instatement of preventive measures. Post-ERCP pancreatitis is the most common complication of ERCP. Risk reduction strategies include intravenous hydration, rectal nonsteroidal anti-inflammatory drugs, and pancreatic stent placement in selected patients. Perforation is associated with significant morbidity and mortality, and prompt recognition and treatment of ERCP-related perforations are key to ensuring good clinical outcomes. Endoscopy plays an expanding role in the treatment of perforations. Specific management strategies depend on the location of the perforation and the patient's clinical status. The risk of post-ERCP bleeding can be attenuated by preprocedural optimization and adoption of intra-procedural techniques. Endoscopic measures are the mainstay of management for post-ERCP bleeding. Escalation to angioembolization or surgery may be required for refractory bleeding. Post-ERCP cholangitis can be reduced with antibiotic prophylaxis in high risk patients. Bile culture-directed therapy plays an important role in antimicrobial treatment.

Use of Cardiac Computed Tomography and Magnetic Resonance Imaging in Case Management of Atrial Fibrillation with Catheter Ablation

  • Hee-Gone Lee;Jaemin Shim;Jong-il Choi;Young-Hoon Kim;Yu-Whan Oh;Sung Ho Hwang
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.695-708
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    • 2019
  • Atrial fibrillation (AF) is the most common arrhythmia associated with the risk of morbidity and mortality in clinical patients. AF is considered as an arrhythmia type that develops and progresses through close connection with cardiac structural arrhythmogenic substrates. Since the introduction of catheter ablation-mediated electrical isolation of arrhythmogenic substrates, cardiac imaging indicates improved treatment outcome and prognosis with appropriate candidate selection, ablation catheter guidance, and post-ablation follow-up. Currently, cardiac computed tomography (CCT) and cardiovascular magnetic resonance (CMR) imaging are essential in the case management of AF at both pre-and post-procedural stages of catheter ablation. In this review, we discuss the roles and technical considerations of CCT and CMR imaging in the management of patients with AF undergoing catheter ablation.

A novel excisional wound pain model for evaluation of analgesics in rats

  • Parra, Sergio;Thanawala, Vaidehi J.;Rege, Ajay;Giles, Heather
    • The Korean Journal of Pain
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    • v.34 no.2
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    • pp.165-175
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    • 2021
  • Background: Management of pain from open wounds is a growing unmet healthcare need. However, the models available to study pain from wounds or to develop analgesics for the patients suffering from them have primarily relied on incisional models. Here, we present the first characterized and validated model of open wound pain. Methods: Unilateral full-skin excisional punch biopsy wounds on rat hind paws were evaluated for evoked pain using withdrawal responses to mechanical and thermal stimulation, and spontaneous pain was measured using hind paw weight distribution and guarding behavior. Evaluations were done before wounding (baseline) and 2-96 hours post-wounding. The model was validated by testing the effects of buprenorphine and carprofen. Results: Pain responses to all tests increased within 2 hours post-wounding and were sustained for at least 4 days. Buprenorphine caused a reversal of all four pain responses at 1 and 4 hours post-treatment compared to 0.9% saline (P < 0.001). Carprofen decreased the pain response to thermal stimulation at 1 (P ≤ 0.049) and 4 hours (P < 0.011) post-treatment compared to 0.9% saline, but not to mechanical stimulation. Conclusions: This is the first well-characterized and validated model of pain from open wounds and will allow study of the pathophysiology of pain in open wounds and the development of wound-specific analgesics.

Guidance of Nerve Stimulator and Ultrasound for Transforaminal Epidural Steroid Injection in Lumbosacral Radicular Pain : A Single Institution Experience in Vietnam

  • Viet-Thang Le;Chi Hue Nguyen;Phuoc Trong Do;Anh Minh Nguyen;Khoi Hong Vo
    • Journal of Korean Neurosurgical Society
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    • v.67 no.2
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    • pp.194-201
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    • 2024
  • Objective : This study aimed to evaluate the clinical feasibility of the combination of ultrasound and nerve stimulator guidance in transforaminal epidural steroid injections (TESIs) to manage lumbosacral chronic radicular pain. Methods : Using the combination of nerve stimulator and ultrasound guidance, TESIs were performed in 125 segments of 78 patients who presented with chronic lumbar radicular pain. Demographic characteristics and surgical outcomes were recorded on admission, pre-procedural and post-procedural for 1-week, 1-month, 3-month, and 6-month follow-ups. The result was measured using the Numeric rating scale (NRS) and Oswestry disability index (ODI). Results : Patients who received TESIs showed significant improvements on two evaluation tools (NRS, ODI), compared to that before procedure (p<0.001). No significant complications were observed for 6 months' follow-up. Conclusion : The result suggests that a combination of ultrasound and nerve stimulator guidance in transforaminal epidural injections is safe, reliable and effective for short-term management of lumbar disc herniation. It is a promising technique and has shown good results in providing intermediate pain relief.

The Effects of Perceived Justice of Service Recovery Efforts on the Customer Relationship Performance in Mobile Social Commerce (모바일 소셜 커머스에서 서비스 회복 노력의 공정성이 대고객 관계성과에 미치는 영향)

  • Yoon, In-Hwan;Lee, Hee-Sang
    • Journal of Digital Convergence
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    • v.14 no.4
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    • pp.267-276
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    • 2016
  • This paper aims to examine the effects of perceived justice of service recovery efforts on the customer relationship performance in mobile social commerce. To this end, we classified cognitive-affective trusts and post-recovery satisfaction into the customer relationship performance. This research employs a field survey of customers who experienced service failures in mobile social commerce and a covariance structural model analysis in order to test hypotheses of our research model. The findings present that all justices of service recovery efforts positively affect the cognitive trust, whereas the only procedural justice significantly influences the affective trust. In addition, the results show that cognitive-affective trusts have a positive effect on the post-recovery satisfaction. Our results suggest practical implications that are used to help managers maintain and improve relations with the customers who experienced service failures and to increase the post-recovery satisfaction.

Transarterial Chemoembolization for Hepatocellular Carcinoma: 2023 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association

  • Yuri Cho;Jin Woo Choi;Hoon Kwon;Kun Yung Kim;Byung Chan Lee;Hee Ho Chu;Dong Hyeon Lee;Han Ah Lee;Gyoung Min Kim;Jung Suk Oh;Dongho Hyun;In Joon Lee;Hyunchul Rhim;Research Committee of the Korean Liver Cancer Association
    • Korean Journal of Radiology
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    • v.24 no.7
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    • pp.606-625
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    • 2023
  • Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

The Current State of and Barriers to Quality Measurement, and Quality Managers' Reported Evaluation on Quality Indicators in Korea (국내 질 향상부서 중심의 질 지표 측정 현황, 장애요인과 평가)

  • Hwang Jee-In
    • Health Policy and Management
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    • v.15 no.4
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    • pp.26-45
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    • 2005
  • The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

Single Shot Epidural Injection for Cervical and Lumbosaccral Radiculopathies: A Preliminary Study

  • Nawani, Digambar Prasad;Agrawal, Sanjay;Asthana, Veena
    • The Korean Journal of Pain
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    • v.23 no.4
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    • pp.254-257
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    • 2010
  • Background: Epidural steroid injection is an established treatment modality for intervertebral disc prolapse to radiculopathy. In cases where two levels of radiculopathy are present, two separate injections are warranted. Herein, we present our experience of management of such cases with a single epidural injection of local anaesthetic, tramadol and methylprednisolone, and table tilt for management of both radiculopathies. Methods: 50 patients of either sex aged between 35-65 years presenting with features of cervical and lumbar radiculopathic pain were included and were subjected to single lumbar epidural injection of local anaesthetic, tramadol and methylprednisolone, in the lateral position. The table was then tilted in the trendelberg position with a tilt of 25 degrees, and patients were maintained for 10 minuted before being turned supine. All patients were administered 3 such injections with an interval of 2 weeks between subsequent injections, and pain relief was assessed with a visual analogue scale. Immediate complications after the block were assessed. Results: Immediate and post procedural complications observed were nausea and vomiting (20%), painful injection site (4%), hypotension (10%) and high block (4%). Pain relief was assessed after the three injections by three grades: 37 (74%) had complete resolution of symptoms; 18% had partial relief and 8% did not benefit from the procedure. Conclusions: This technique may be used as an alternative technique for pain relief in patients with unilateral cervical and lumbar radiculopathies.