• Title/Summary/Keyword: clinical guidance

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Lasers and Robots: Recent Developments in Transoral Laser and Transoral Robotic Surgery

  • Padalhin, Andrew Reyes
    • Medical Lasers
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    • v.9 no.2
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    • pp.103-109
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    • 2020
  • Transoral microsurgery has come a long way as a go-to surgical intervention technique for head and neck cancers. This minimally invasive procedure had gained acceptance through comparative clinical studies against radical neck surgical procedures, radiotherapy, and chemotherapy. Laser technology has vastly improved the oncological outcomes of this procedure and brought about an appreciation of transoral laser surgery (TLM) as a mainstay for re-sectioning malignant tumors along the throat. As an established procedure, TLM has undergone several upgrades regarding the different energy devices used for cutting, ablation, and hemostasis. Continued advances in automation have eventually led to surgical robotics, resulting in the emergence of transoral robotic surgery (TORS) as a viable advanced alternative for TLM. Similarly, expansions and enhancements (image-based guidance, fluorescence spectroscopy, and advanced robotic system) have also been investigated as potential upgrades for TORS. This paper reviews a selection of publications on the significant technological advancements to TLM and TORS over the past five years.

Magnetic Resonance Imaging Meets Fiber Optics: a Brief Investigation of Multimodal Studies on Fiber Optics-Based Diagnostic / Therapeutic Techniques and Magnetic Resonance Imaging

  • Choi, Jong-ryul;Oh, Sung Suk
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.4
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    • pp.218-228
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    • 2021
  • Due to their high degree of freedom to transfer and acquire light, fiber optics can be used in the presence of strong magnetic fields. Hence, optical sensing and imaging based on fiber optics can be integrated with magnetic resonance imaging (MRI) diagnostic systems to acquire valuable information on biological tissues and organs based on a magnetic field. In this article, we explored the combination of MRI and optical sensing/imaging techniques by classifying them into the following topics: 1) functional near-infrared spectroscopy with functional MRI for brain studies and brain disease diagnoses, 2) integration of fiber-optic molecular imaging and optogenetic stimulation with MRI, and 3) optical therapeutic applications with an MRI guidance system. Through these investigations, we believe that a combination of MRI and optical sensing/imaging techniques can be employed as both research methods for multidisciplinary studies and clinical diagnostic/therapeutic devices.

Radiomics in Breast Imaging from Techniques to Clinical Applications: A Review

  • Seung-Hak Lee;Hyunjin Park;Eun Sook Ko
    • Korean Journal of Radiology
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    • v.21 no.7
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    • pp.779-792
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    • 2020
  • Recent advances in computer technology have generated a new area of research known as radiomics. Radiomics is defined as the high throughput extraction and analysis of quantitative features from imaging data. Radiomic features provide information on the gray-scale patterns, inter-pixel relationships, as well as shape and spectral properties of radiological images. Moreover, these features can be used to develop computational models that may serve as a tool for personalized diagnosis and treatment guidance. Although radiomics is becoming popular and widely used in oncology, many problems such as overfitting and reproducibility issues remain unresolved. In this review, we will outline the steps of radiomics used for oncology, specifically addressing applications for breast cancer patients and focusing on technical issues.

Deletion or Duplication Syndromes of Chromosome 22: Review

  • Kyung Ran Jun
    • Journal of Interdisciplinary Genomics
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    • v.6 no.1
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    • pp.1-5
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    • 2024
  • Chromosome 22 is an acrocentric chromosome containing 500-600 genes, representing 1.5%-2% of the total DNA in cells. It was the first human chromosome to be fully sequenced by the Human Genome Project. Several syndromes involving the partial deletion or duplication of chromosome 22 are well descibed, including 22q11.2 deletion syndrome, 22q11.2 duplication syndrome, 22q11.2 distal deletion syndrome, Phelan-McDermid syndrome caused by a 22q13 deletion or pathogenic variant in SHANK3, and cat-eye syndrome caused by a 22 pter-q11 duplication. This review aims to provide concise information on the clinical characteristics of these syndromes. In particular, the similarities in features among these syndromes, genetic basis, and standard detection techniques are described, providing guidance for diagnosis and genetic counselling.

Intraductal ultrasonography for biliary strictures

  • Young Koog Cheon
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.164-168
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    • 2023
  • When diagnosing the nature of biliary strictures, it is sometimes difficult to perform non-invasive methods such as ultrasound, spiral computed imaging, magnetic resonance imaging, or endoscopic ultrasonography. Thus, treatment decisions are usually based on biopsy results. However, brush cytology or biopsy, which is widely used for biliary stenosis, has limitations owing to its low sensitivity and negative predictive value for malignancy. Currently, the most accurate method is bile duct tissue biopsy under direct cholangioscopy. On the other hand, intraductal ultrasonography administered under the guidance of a guidewire has the advantages of easy administration and being less invasive, allowing for adequate examination of the biliary tract and surrounding organs. This review discusses the usefulness and drawbacks of intraductal ultrasonography for biliary strictures.

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.

The pros and cons of ultrasound-guided procedures in pain medicine

  • Jee Youn Moon
    • The Korean Journal of Pain
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    • v.37 no.3
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    • pp.201-210
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    • 2024
  • The application of ultrasound (US) in pain medicine has been a rapidly growing field since the 2000s. Musculoskeletal injections, peripheral nerve blocks, and neuraxial injections under US guidance have been acknowledged for managing chronic pain. Although many studies on US-guided pain procedures have been published, there needs to be a classification system to evaluate which image device, the US or fluoroscopy, is clinically and technically better in various pain interventions. Therefore, this narrative review introduces the classification system for the US-guided pain procedures according to their clinical and technical outcomes and designates US-guided pain procedures into one of the four categories by reviewing previous prospective randomized comparative trials.

The Problems for Application of Nursing Process in Clinical Experience of Nursing Students (임상실습에서 학생들이 경험하는 간호과정 적용문제)

  • Yang Young-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.1
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    • pp.58-71
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    • 1999
  • Nursing process is an essential part for nursing practice. Nursing faculty members must focus on the clinical application for students and try to identify the possible problems that students might face in the fields. The purpose of this study is to examine the actual condition of nursing process education in curricula and to investigate the response of students in clinical experience of nursing process. From 462 students in the 6 associate programs(ADN) and the 6 baccalaureate programs (BSN) data was collected by questionnaire. The results were as followed. 1. Seven programs (58.3%) opened the nursing process in mainly sophomore (BSN) or freshman(ADN). If not opened, the nursing process was taught at the major subjects(espcially fundamental nursing or adult nursing). 2. All Students responded they we supposed to use nursing process in preparing the case report. The majority(94.6%) used NANDA lists for nursing diagnosis and 55.7% of subjects consulted the Korean terms by KNA when translating. The tutors for nursing process in clinical settings were the professor in charge of the subject (68.6) or clinical instructors (48.1%) , assistants(34%). 3. The problems in clinical application that students experienced consisted of 17 items and the mean was 2.27. The biggest problem was 'the lack of the model for RN of applying the nursing process in clinical settings'(2.97). Next the big problem was 'the lack of the competency for implementing the established nursing plans'(2.69). All items were significantly different according to the level of educational programs(ADN or BSN). ADN students had more problems in applying the each step of nursing process and BSN students perceived the NANDA as a guidance of nursing diagnosis and the inconsistency of advices from several instructors or practicum to be mere problematic. 4. The mean of merits after application of nursing process was relatively fair (2.82). The best merit was 'they can identify nursing problems more exactly'(3.07). The second high merit was 'they can study the rational of nursing action' (3.03). BSN than ADN and the subjects of second year than of one year in clinical experience perceived the use of nursing process to be better. Based on this results we need to enforce the application of nursing diagnosis in the class. The use of sample cases can be the efficient method. Students can identify the possible health problems for patient from the cases in imaginary world and discuss them each other. Also we can use the discussion session after practice every other day or as needed. All this is on the good interaction between tutor and student. We must consider to have enough time for student to seize the essence of the nursing process.

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Tracheal Stenosis by Extraluminal Compression (외인성 기관협착)

  • Choi, Jong-Ouck;Kim, Yong-Whoan;Park, Jung-Soo;Jung, Kwang-Yoon;Min, Hun-Ki;Choi, Geon
    • Korean Journal of Bronchoesophagology
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    • v.2 no.1
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    • pp.57-62
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    • 1996
  • Tracheal stenosis can be classified into intrinsic stenosis secondary to tracheal inflammatory lesion or mass effect and extrinsic stenosis secondary tumors of thyroid, esophagus and mediastinum. Extrinsic stenosis which is frequently encountered in clinical setting could be often overlooked due to mild symptom. Recently, even with the increasing interest in extrinsic tracheal stenosis there are limitation in it's diagnosis and treatment. The purpose of this study is to provide guidance in the diagnosis and treaonent of extrinsic tracheal stenosis. Here, we report the etiology, symptoms, radiologic findings, pulmonary fuction finding, treatment and its results in 26 cases of extrinsic tracheal stenosis. Causes of extrinsic tracheal stenosis included compression of aiway by thyroid benign tumor in 13 cases to be the most common, next by thyroid malignancy in 9 cases, metastatic mediastinal turner in 2 cases, 1 case each for esophageal cancer and parathyroid cancer. In 3 cases simple tracheal resection and end to end anastomosis were done, 1 cases underwent total laryngectomy, and 8 cases were treated by conservative management, where all cases failed in treatment. The remaining 14 cases were successfully treated by removing the causes and maintaining tracheal tube insertion for amount of time. Extrinsic tracheal stenosis due to benign conditions were treated satisfactorily by removing mass, however with the malignant causes there was considerable amount of difficulty in treatment.

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ERUPTION GUIDANCE OF DISPLACED PERMANENT SUCCESSOR CAUSED BY PERIAPICAL LESION OF MANDIBULAR PRIMARY MOLAR (하악 유구치 치근단 병소에 의해 변위된 계승 영구치의 맹출유도)

  • Lim, Su-Min;Baik, Byeoug-Ju;Yang, Yeon-Mi;Han, Ji-Hye;Kim, Jae-Gon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.2
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    • pp.335-340
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    • 2007
  • Primary teeth and the permanent successor must be understood as interdependent units, where each one of them interacts with and depends upon the other. The spread of pulpal inflammation in primary teeth to the periradicular tissues can lead to early eruption, enamel hypoplasia or hypocalcification, developmental arrest of permanent successor. Also the periapical inflammation cause permanent tooth displacement in various direction. We describe here two clinical cases of displaced permanent successor caused by periapical lesion of mandibular primary molar in children.

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