• Title/Summary/Keyword: Clinical Integration

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Hyperpolarized Carbon-13 Magnetic Resonance Imaging: Technical Considerations and Clinical Applications

  • Ying-Chieh Lai;Ching-Yi Hsieh;Yu-Hsiang Juan;Kuan-Ying Lu;Hsien-Ju Lee;Shu-Hang Ng;Yung-Liang Wan;Gigin Lin
    • Korean Journal of Radiology
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    • v.25 no.5
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    • pp.459-472
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    • 2024
  • Hyperpolarized (HP) carbon-13 (13C) MRI represents an innovative approach for noninvasive, real-time assessment of dynamic metabolic flux, with potential integration into routine clinical MRI. The use of [1-13C]pyruvate as a probe and its conversion to [1-13C]lactate constitute an extensively explored metabolic pathway. This review comprehensively outlines the establishment of HP 13C-MRI, covering multidisciplinary team collaboration, hardware prerequisites, probe preparation, hyperpolarization techniques, imaging acquisition, and data analysis. This article discusses the clinical applications of HP 13C-MRI across various anatomical domains, including the brain, heart, skeletal muscle, breast, liver, kidney, pancreas, and prostate. Each section highlights the specific applications and findings pertinent to these regions, emphasizing the potential versatility of HP 13C-MRI in diverse clinical contexts. This review serves as a comprehensive update, bridging technical aspects with clinical applications and offering insights into the ongoing advancements in HP 13C-MRI.

Optimizing Heart Failure Management: A Review of the Clinical Pharmacist Integration to the Multidisciplinary Health Care Team

  • Esteban Zavaleta-Monestel;Sebastian Arguedas-Chacon;Alonso Quiros-Romero;Jose Miguel Chaverri-Fernandez;Bruno Serrano-Arias;Jose Pablo Diaz-Madriz;Jonathan Garcia-Montero;Mario Osvaldo Speranza-Sanchez
    • International Journal of Heart Failure
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    • v.6 no.1
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    • pp.1-10
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    • 2024
  • Heart failure (HF) stands as a prevalent chronic ailment, imposing a substantial burden on global healthcare systems due to recurrent hospitalizations, intricate management, persistent symptoms, and polypharmacy challenges. The augmentation of patient safety and treatment efficacy across various care stages, facilitated by a multidisciplinary HF team inclusive of a clinical pharmacist, emerges as paramount. Evidence underscores that the collaborative engagement of a physician and a clinical pharmacist engenders proficient and secure management, forestalling avoidable adversities stemming from drug reactions and prescription inaccuracies. This synergistic approach tailors treatments optimally to individual patients. Post-discharge, the vulnerability of HF patients to re-hospitalization looms large, historically holding sway as the foremost cause of 30-day readmissions. Diverse strategies have been instituted to fortify patient well-being, leading to the formulation of specialized transitional care programs that shepherd patients effectively from hospital to outpatient settings. These initiatives have demonstrably curtailed readmission rates. This review outlines a spectrum of roles assumed by clinical pharmacists within the healthcare cohort, spanning inpatient care, transitional phases, and outpatient services. Moreover, it traverses a compendium of studies spotlighting the affirmative impact instigated by integrating clinical pharmacists into these fields.

The Change of Characteristics in Clinical Decision Making in Novice Critical Care Nurses (중환자실 신규간호사의 임상의사결정 특성의 변화)

  • Kim, Dong-Oak;Kim, Mae-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.301-314
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    • 2001
  • The main purpose of this research is to describe comprehensively the processes of clinical decision making in novice critical care nurses through clinical experience. This research was an exploratory, longitudinal study using a fieldwork approach incorporating "think-aloud" method and in-depth interviews with the study participants. The study participants consisted of 5 novice nurses assigned to critical care units at a tertiary medical center located in Seoul, among a group of 27 novice nurses who started at the same period at this hospital. The data were collected from March 1999 to April 2000. The major findings of the study is that the novice nurses followed the analytic linear model of clinical decision making in the beginning, but were changed increasingly to follow the comprehensive, integrated model of clinical decision making. Through repeated experience that resulted in increasing repertoire of clinical schema and familiarity of task environments of clinical practice the novice nurses expanded their ability to arrive at comprehensive integration of information and to arrive at accurate and time-efficient decisions. Both the analytic, linear model mostly used at the beginning period and the comprehensive, integrated model that seems to be the mode significantly dependent upon experience seem to have strengths and weaknesses as decision making processes in clinical situations. Hence, it is imperative to develop an effective orientation and training program for novice nurses through the use of clinical preceptors. In addition, students should be exposed to the process of clinical decision making early in their nursing education through an appropriate clinical experiences and clinical assignments.

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The Application of Machine Learning Algorithm In The Analysis of Tissue Microarray; for the Prediction of Clinical Status

  • Cho, Sung-Bum;Kim, Woo-Ho;Kim, Ju-Han
    • Proceedings of the Korean Society for Bioinformatics Conference
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    • 2005.09a
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    • pp.366-370
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    • 2005
  • Tissue microarry is one of the high throughput technologies in the post-genomic era. Using tissue microarray, the researchers are able to investigate large amount of gene expressions at the level of DNA, RNA, and protein The important aspect of tissue microarry is its ability to assess a lot of biomarkers which have been used in clinical practice. To manipulate the categorical data of tissue microarray, we applied Bayesian network classifier algorithm. We identified that Bayesian network classifier algorithm could analyze tissue microarray data and integrating prior knowledge about gastric cancer could achieve better performance result. The results showed that relevant integration of prior knowledge promote the prediction accuracy of survival status of the immunohistochemical tissue microarray data of 18 tumor suppressor genes. In conclusion, the application of Bayesian network classifier seemed appropriate for the analysis of the tissue microarray data with clinical information.

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Cancer Genomics Object Model: An Object Model for Cancer Research Using Microarray

  • Park, Yu-Rang;Lee, Hye-Won;Cho, Sung-Bum;Kim, Ju-Han
    • Proceedings of the Korean Society for Bioinformatics Conference
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    • 2005.09a
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    • pp.29-34
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    • 2005
  • DNA microarray becomes a major tool for the investigation of global gene expression in all aspects of cancer and biomedical research. DNA microarray experiment generates enormous amounts of data and they are meaningful only in the context of a detailed description of microarrays, biomaterials, and conditions under which they were generated. MicroArray Gene Expression Data (MGED) society has established microarray standard for structured management of these diverse and large amount data. MGED MAGE-OM (MicroArray Gene Expression Object Model) is an object oriented data model, which attempts to define standard objects for gene expression. To assess the relevance of DNA microarray analysis of cancer research it is required to combine clinical and genomics data. MAGE-OM, however, does not have an appropriate structure to describe clinical information of cancer. For systematic integration of gene expression and clinical data, we create a new model, Cancer Genomics Object Model.

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Point-of-care Testing Device Interface in Hospital Information System Standard Connectivity - Using of case ASTM protocol of ABGA application POCT1-A2 - (현장형 임상검사장비와 병원정보시스템의 접속표준 - ASTM protocol을 사용하는 ABGA의 POCT1-A2적용사례 중심으로 -)

  • Kim, Seon-Chil
    • Korean Journal of Digital Imaging in Medicine
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    • v.10 no.2
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    • pp.33-37
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    • 2008
  • To keep the online medical records available to anyone without constraint of time and space, introducing EMR (Electronic medical record), which is a clinical support management system. The purpose of this study is to develop interface standard of clinical test device. Integration and sharing of medical information is faced with enormous obstacles because medical organizations and associated companies are separately developing the interface. I hope that multi-function management system with workstation concept is operated to efficiently transmit clinical device result data based on this study. Transfer of precise medical result data available for decision making will improve quality of health care service.

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Volumizing Threads (Jamber) in the Midface and Managing Side Effects: Clinical Cases

  • Kyu-Ho Yi;Soo-Yeon Park
    • Archives of Plastic Surgery
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    • v.51 no.4
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    • pp.350-355
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    • 2024
  • The clinical application of polydioxanone (PDO) threads, traditionally utilized for tissue lifting, is now being explored for its volumizing effects in midface rejuvenation. The novel approach involves employing PDO volumizing threads to achieve physical augmentation akin to a "solid filler." The study introduces a more convenient insertion method for these threads, prioritizing ease and efficacy. Clinical cases demonstrate the efficacy of volumizing threads in addressing midface concerns, such as nasolabial folds and midcheek grooves. Additionally, the integration of volumizing threads to provide support in sagging areas is examined for achieving natural-looking enhancements. While highlighting positive outcomes, potential side effects like thread protrusion are addressed, along with strategies for their mitigation. Volumizing threads are presented as a suitable procedure for patients wary of traditional fillers or seeking subtle enhancements, with the recommendation of combining them with cog threads for those desiring more pronounced changes in facial contour. In summary, volumizing thread offers a minimally invasive alternative with fewer side effects for midface rejuvenation.

Occupation-based Occupational Therapy for an Youth With Sensory Integrative Dysfunction - A Single Case Study (감각통합기능장애를 가진 청소년의 작업수행에 초점을 맞춘 작업치료 사례)

  • Ji, Seok-Yeon;Lee, Kyoung-Min;Kim, Mi-Sun
    • The Journal of Korean Academy of Sensory Integration
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    • v.6 no.1
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    • pp.47-62
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    • 2008
  • Introduction : Sensory Integration(SI) theory, science it is developed by an occupational therapist A. Jean Ayres, is the one of the most popular frames of reference used in occupational therapy(OT) intervention. It has been proved as a scientific theory especially in neuroscience discipline through abundant research and practice. Occupational therapists apply the SI therapy with strong clinical reasoning to improve adaptive behaviors of their clients and try to link the adaptive behaviors with occupational performance in the clients' everyday life. One of the manners regarding clinical reasoning is Top-down approach. In occupational therapy discipline, Top-down approach is well-reflected within two evaluation tools; Canadian Occupational Performance Measure(COPM) and Assessment of Motor and Process Skills(AMPS) and two models of practice; Canadian Model of Occupational Performance(CMOP) and Occupational therapy intervention process model(OTIPM). Objective : The purpose of this paper demonstrates how SI therapy can be employed within OTIPM and how the OT process (evaluation-intervention-outcome) can be structuralized based on the Top-down approach. This single-case study recognizes the impact of a SI therapy for a male adolescent on his occupational performance. Intervention Examined : "P" was 16 years old male adolescent with no diagnosis and junior of the high school when he was referred. P was always with mouth opened, showed difficulties in gathering things need to be prepared and managing and paying money for shopping, and his colleges dislike getting close to him because he can't was his body well. AMPS was administrated in initial evaluation and reevaluation of P's occupation performance, Bruininks-Oserestky Test of Motor Proficiency-2(BOT-2) was carried out to assess motor functions and perception skills related in sensory integration, and occupational therapist performed clinical observation in order to complement the evaluation quantitatively and quantitatively. Based on the evaluation, it is concluded that the SI therapy is primary means to improve P's occupational performance, and three therapeutic approaches were constructed; restorative, acquired and compensatory approach. P showed improved motor and process skills in occupational performance after undergone the occupational therapy. Conclusions : The sensory integration therapy was practical enough to build the bridge between the occupational performance(Top) and the underlying component problems (Bottom). The OTIPM was helpful to identify meaningful occupation for P and P's family within P's contexts, and the AMPS was valuable to analyze and clarify the cause of difficulties in the chosen occupational performance.

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A Virtual Reality System for the Cognitive and Behavioral Assessment of Schizophrenia (정신분열병 환자의 인지적/행동적 특성평가를 위한 가상현실시스템 구현)

  • Cho, Won-Geun;Kim, Ho-Sung;Ku, Jung-Hun;Kim, Jae-Hun;Kim, Byoung-Nyun;Lee, Jang-Han;Kim, Sun I.
    • Proceedings of the Korean Society for Emotion and Sensibility Conference
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    • 2003.05a
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    • pp.94-100
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    • 2003
  • Patients with schizophrenia have thinking disorders such as delusion or hallucination, because they have a deficit in the ability which to systematize and integrate information. Therefore, they cannot integrate or systemize visual, auditory and tactile stimuli. In this study we suggest a virtual reality system for the assessment of cognitive ability of schizophrenia patients, based on the brain multimodal integration model. The virtual reality system provides multimodal stimuli, such as visual and auditory stimuli, to the patient, and can evaluate the patient's multimodal integration and working memory integration abilities by making the patient interpret and react to multimodal stimuli, which must be remembered for a given period of time. The clinical study showed that the virtual reality program developed is comparable to those of the WCST and the SPM.

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An Implementation of Intefrated Database for Electronic Medical Record System in East-West Medical Collabration (${\cdot}$양방 협진 전자의무기록 시스템 구축을 위한 통합 데이터베이스 구축)

  • Ahn, Yo-Chan;Oh, Sang-Bong
    • Journal of Information Technology Applications and Management
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    • v.12 no.2
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    • pp.129-143
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    • 2005
  • In recent years, two major streams in medical information systems are:1) system integration among OCS(Order Communication System), EMR(Electronic Medical Record), PACS(Picture Archiving and Communication System), and ERP(Enterprise Resource Planning) and 2) system integration through medical collaboration between East and West medical service providers. One of the characteristics which differentiate the Korean medical industry from the western medical industry is the East-West medical collaboration. In many respects there are many differences between East and West medical treatment. Although East and West medical treatment have developed from different medical philosophies and standards, we assume that the better medical care can be provided by integrating their medical procedures effectively. The two possible approaches to the integration of East and West medical information systems are suggested in this paper:One is loosely coupled model and the other is tightly coupled model. EMR improves the quality of medical record which reflects the quality of clinical practice. It provides more efficient and convenient way of input, retrieval, storage, communication and management of medical data. We abstracted the standard medical procedures from the two medical procedures performed in Daejeon Oriental Hospital and Hehwa Clinic at Daejeon University and also abstracted database schema by analyzing the characteristics of information needed in East-West medical collaboration. Our EMR is composed of two types of data:one is structured data and the other is unstructured data, which are formalized by SOAP(Subjective, Objective, Assessment, Plan) format. Currently the integrated system is implemented and operated successfully for six months.

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