• Title/Summary/Keyword: Follow-up monitoring

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Microsurgical Fenestration of Middle Cranial Fossa Arachnoid Cyst

  • Kim, In-Soo;Kim, Dong-Won
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.69-73
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    • 2006
  • Objective : The optimal surgical treatment for symptomatic middle cranial fossa arachnoid cysts is controversial. Therapeutic options include endoscopic fenestration, excision, cyst shunting, and craniotomy for fenestration of basal cistern. We reviewed the results of surgically treated middle cranial fossa arachnoid cysts. Methods : We performed a retrospective study in 18 cases of middle cranial fossa arachnoid cysts who had been treated with microsurgical fenestration between 1995 to 2003. The analysis was based on the results of the patients' age, sex distribution, developed area, clinical symptoms, treatment method, and complications. Results : Eighteen surgical treated middle cranial fossa arachnoid cysts patients were evaluated. The age range of cyst development was between 2 years and 44 years with the average of 16.4 years. The follow-up periods averaged 31.48 months. There were 15 male and 3 female patients, with significantly more cyst development in males than females. The most common clinical symptom was headache, followed by seizure. In the entire series, 77.8% of patients demonstrated a decrease in cyst size In serial imaging studies. Of them, 67.3% demonstrated a complete cyst effacement. Overall, 100% of patients with Grade I cysts, 81.8% of patients with Grade II cysts, 60% of patients with Grade III cysts exhibited evidence of decrease in cyst size during long-term monitoring. Complications included headache, meningitis, and hydrocephalus. Conclusion : Patients who were treated with microsurgical fenestration showed good outcome with acceptable complications. We concluded that microsurgical fenestration is a safe and effective surgical method for middle cranial fossa arachnoid cysts.

Superimposed Propionibacterium Acnes Subdural Empyema in a Patient with Chronic Subdural Hematoma

  • Kim, Jong-Hun;Lee, Chul-Hee;Hwang, Soo-Hyun;Kang, Dong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.45 no.1
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    • pp.53-56
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    • 2009
  • The authors present a case of subdural empyema in a macrocephalic patient. A 23-year-old male was admitted due to headache and fever. One month ago, he had mild head injury by his coworkers. Physical examination showed a macrocephaly and laboratory findings suggested purulent meningitis. Neuroimaging studies revealed a huge size of epidural space-occupying lesion. Under the impression of epidural abscess, operation was performed. Eventually, the lesion was located at subdural space and was proven to be subdural empyema. Later, histological examination of the specimen obtained by surgery demonstrated finings consistent with the capsule of the chronic subdural hematoma. Two weeks after operation, Propionibacterium acnes was isolated. The intravenous antibiotics were used for total of eight weeks under monitoring of the serum level of the C-reactive protein. Follow-up brain computed tomography (CT) scan showed the presence of significant amount of remaining subdural lesion. However, he has complained of minimal discomfort. It is suggested that the subdural empyema occurred with preexisting chronic subdural hematoma after head injury about one month prior to admission and it took a long time to treat Propionibacterium acnes subdural empyema with systemic antibiotics, at least over eight weeks.

Autonomy Level of Nurse according to Nursing Delivery System (간호 분담체계에 따른 간호사의 자율성 정도)

  • Oh, Eun Sil
    • Korean Journal of Occupational Health Nursing
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    • v.9 no.2
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    • pp.155-165
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    • 2000
  • This study is to grope for a plan to increase nurse's autonomy by grasping autonomy degree according to nursing delivery system. The subject of this study are 265 nurses who work for 4 general hospitals in Seoul, and 73 of them work in primary nursing delivery system, 99 of them in team nursing delivery system and 93 of them in functional nursing delivery system. Data collection was done through questionaires from Sep. 1, 1997 to Sep. 30, 1997, and autonomy was measured by Professional Nursing Autonomy Scale developed by Schutzonhofer. Data analysis as inspected with $X^2$ test, ANOVA, and t-test, using SPSS program. The results are as follows : 1. When it comes to the autonomy of all the nurses, mean score was 161.99. Which is medium level, and autonomy degree according to nursing delivery system had no significant differences. 2. There was a significant difference in autonomy degree according to inservice education among the subject's work-related characteristics, and there was no significant difference in autonomy distribution in each grade according to general characteristics although older group, married group, and junior college graduates group showed rather higher trends. 3. Considering each item, questions related to direct nursing such as "Vital sign monitoring", "Nursing rounding", "Withhold contraindicated drug", showed high score in autonomy scores, and long-term and indirect nursing behaviors such as "Nursing administration", "Nursing research", "Follow-up care" and "Educational planning".

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Development and Evaluation of Anticoagulation Clinical Pharmacy Sevice for Ambulatory Patients in a Community Hospital (병원 외래환자를 대상으로 한 항응고임상약학업무의 개발과 평가에 대한 연구)

  • Choi Soo Im;Shin Hyun Taek;Choi HaeMi;Kim Jung Sun;An JungSoon;Choi Kyoung Eob
    • Korean Journal of Clinical Pharmacy
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    • v.5 no.2
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    • pp.17-31
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    • 1995
  • Pharmacist-managed Anticoagulation Service(ACS) was estabilished and the effectiveness of warfarin monitoring by ACS in maintaining therapeutic INR was evaluated. The primary goal of ACS is to maximize the control of therapy, to maintain therapeutic INR and to decrease morbidity and hospitalization caused by inadequate dosage regimen. Clinical pharmacists performed chartreview, laboratory interpretation, recommendations for warfarin dosage adjustments, physician and patient education, and coordination of follow-up in ACS. Patients receiving warfarin sodium were evaluated via retrospective chart review. Sixty-two patients were referred to ACS by primary physicians were compared with 117 patients in the physician-amtrolled group. The ACS patients maintained $88.6\%$ in the therapeutic range for anticoagulant therapy and the control group maintained $63.7\%$, where the difference was statistically significant.(P<0.001) The ACS improved warfarin dose determination, PT stability, patient compliance and provided improved therapy compared with the control group. ACS offers safe and efficient anticoagulant therapy in the ambulatory setting.

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Challenges in Patient Counseling and Medication Reconciliation for Foreign Inpatients in Korea (외국인 입원환자의 복약상담과 입원약력관리 현황에 관한 탐색적 연구)

  • Jin, Hye Kyung;Rhie, Sandy
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.1
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    • pp.34-41
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    • 2015
  • Objective: This study is to evaluate the awareness, needs, and barriers in patient counseling for hospitalized foreign patients. As the number of foreign population increases in Korea, demands on quality of Korean health services are rapidly increasing. Previously most of the studies have focused on the availability and utilization of healthcare service, and prevalence of disease for foreigners, however, no study has been conducted on quality of direct-patient care such as patient counseling. Method: In the present study, a survey was conducted on a total of 161 participants between March 7 and May 7 in 2014. The study subjects were consisted with 103 foreign patients who had experienced inpatient care within 1 year and 58 hospital pharmacists who work in the hospital with foreign inpatients. Results: Firstly, the hospital pharmacists were highly aware of the necessity of counseling for foreign inpatients. Secondly, the largest portion of barrier to patient counseling service was accounted a lack of foreign language skills. Lastly, the monitoring of efficacy, potential adverse reactions and discharge follow-up were emphasized. Conclusion: Effective communication skills would be essential to improve pharmaceutical care services to foreign inpatients.

Speech and language disorders in children (소아에서 말 언어장애)

  • Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.922-934
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    • 2008
  • Developmental language disorder is the most common developmental disability in childhood, occurring in 5-8% of preschool children. Children learn language in early childhood, and later they use language to learn. Children with language disorders are at increased risk for difficulties with reading and written language when they enter school. These problems often persist through adolescence or adulthood. Early intervention may prevent the more serious consequences of later academic problems, including learning disabilities. A child's performance in specific speech and language areas, such as phonological ability, vocabulary comprehension, and grammatical usage, is measured objectively using the most recently standardized, norm-referenced tests for a particular age group. Observation and qualitative analysis of a child's performance supplement objective test results are essential for making a diagnosis and devising a treatment plan. Emphasis on the team approach system in the evaluation of children with speech and language impairments has been increasing. Evidence-based therapeutic interventions with short-term, long-term, and functional outcome goals should be applied, because there are many examples of controversial practices that have not been validated in large, controlled trials. Following treatment intervention, periodic follow-up monitoring by a doctor is also important. In addition, a systematized national health policy for children with speech and language disorders should be provided.

Sub-mm variability of a YSO (EC53) in Serpens main region : JCMT Transient survey

  • Yoo, Hyunju;Lee, Jeong-Eun;Johnstone, Doug;Mairs, Steve;Herczeg, Gregory
    • The Bulletin of The Korean Astronomical Society
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    • v.42 no.1
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    • pp.39.2-39.2
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    • 2017
  • Stars form through the gravitational collapse of molecular clouds. However, the rate at which a star gains most of its mass and the physics that drives the main phase of stellar growth is still unclear. The typical luminosity of observed protostars is smaller than what expected from the Shu's inside-out collapse model, which predicts a constant mass accretion rate. The episodic accretion model has been suggested as a solution of this luminosity problem. The JCMT Transient survey is a long term monitoring program using JCMT/SCUBA-2 to detect accretion variability of protostars in the eight nearby star-forming regions. Recently, we found a rise of the 850 micron flux at a clump in the Serpens main region at the rate of ~17% relative to the mean flux over previous observations. The submm clump is associated with a class I protostar, EC53, which has been reported as a binary system with a periodic variability. In this talk, we will provide a brief overview of the JCMT Transient Survey project, present the detection of the variable source, and discuss about follow-up observations.

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Hybrid Imaging in Oncology

  • Fatima, Nosheen;uz Zaman, Maseeh;Gnanasegaran, Gopinath;Zaman, Unaiza;Shahid, Wajeeha;Zaman, Areeba;Tahseen, Rabia
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5599-5605
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    • 2015
  • In oncology various imaging modalities play a crucial role in diagnosis, staging, restaging, treatment monitoring and follow up of various cancers. Stand-alone morphological imaging like computerized tomography (CT) and magnetic resonance imaging (MRI) provide a high magnitude of anatomical details about the tumor but are relatively dumb about tumor physiology. Stand-alone functional imaging like positron emission tomography (PET) and single photon emission tomography (SPECT) are rich in functional information but provide little insight into tumor morphology. Introduction of first hybrid modality PET/CT is the one of the most successful stories of current century which has revolutionized patient care in oncology due to its high diagnostic accuracy. Spurred on by this success, more hybrid imaging modalities like SPECT/CT and PET/MR were introduced. It is the time to explore the potential applications of the existing hybrid modalities, developing and implementing standardized imaging protocols and train users in nuclear medicine and radiology. In this review we discuss three existing hybrid modalities with emphasis on their technical aspects and clinical applications in oncology.

Multiple Primary Malignancies - A Retrospective Analysis at a Single Center in Turkey

  • Arpaci, Erkan;Tokluoglu, Saadet;Yetigyigit, Tarkan;Alkis, Necati
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.769-773
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    • 2013
  • Background: A literature review on 1,104,269 cancer patients concluded that the prevalence of multiple primary malignancies (MPM) is between 0.73% and 11.7%. MPMs seem to have higher incidence than that influenced by hazard only. The purpose of this study was to investigate clinically useful information for effective screening for synchronous and metachronous second primary cancers and to identify a potential surveillance protocol. Materials and Methods: Using statistical and epidemiological indicators we evaluated the patients with MPMs (double locations) admitted to Dr. Abdurrahman Yurtarslan Ankara Oncology Education and Research Hospital between 1981 and 2010. Results: Out of the 130 cases, 24 (18.4%) were synchronous while 106 cases (81.6%) were metachronous tumours. Mean interval time from first to second primary cancers was 4.65 years (0-27 years). The most frequent malignant associations were breast-breast, breast-endometrium and breast-ovary. Both primary and secondary tumors tended to be in an advanced stage explained by the low compliance of the patients to follow-up. Conclusions: The possibility that MPMs exist must always be considered during pretreatment evaluation. Screening procedures are especially useful for the early detection of associated tumors, whereas careful monitoring of patients treated for primary cancer and a good communication between patients and medical care teams should ensure early detection of secondary tumors, and subsequent appropriate management.

A Study on Development of Disaster Prevention Automation System for by using One-chip Type PLC (원칩형 PLC를 이용한 방재용 자동화시스템 개발에 관한 연구)

  • Kwak, Dong-Kurl;Jung, Do-Young;Oh, Sung-Ji;Kim, Soo-Chang;Park, Young-Jik
    • Proceedings of the KIPE Conference
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    • 2010.07a
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    • pp.107-108
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    • 2010
  • Uncertainty and insecurity is a serious issue in all aspects of our society today as the change in environmental and societal conditions became more apparent than ever before through various disasters. Thus, it is now an important point in time for the government and responsible firms to implement an innovative scientific disaster management method that can lead to establishing a more secure and stable future. Therefore, authors have developed ubiquitous- based disaster prevention automation system(DPAS). The system would follow up after sensors detecting fires, thefts, torrents, floods, and infrastructural leaks. It prevents disasters in advance by utilizing a wireless communications net or ethernet to conduct real-time monitoring from a remote place. The system also has an advantage as it is designed in a compact size that applies a precision-focused programmable logic controller(PLC) of one-chip type.

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