• Title/Summary/Keyword: Introduction to Medicine

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Utility of Water Intake to Reduce Stomach's Additional Shooting in PET/CT Test (PET/CT 검사에서 Stomach의 추가 촬영을 줄이기 위한 수분 섭취의 유용성)

  • Lee, Seung-Hwan;Bae, Seong-Bok;Jeong, Byeong-Gon;Lee, Gyu-Chan;Lee, Gwang-Cheol;Bae, Won-Gyu
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.81-85
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    • 2011
  • Purpose: With the introduction of PET since 1994, test methods have made rapid progress. Accordingly, the studies on the diagnosis and treatment of cancer as well as treatment response evaluation PET test are useful. However, it is difficult to divide stomach lesions and secretion. The purpose of this study is to reduce additional shooting by dividing lesions and secretion of stomach. Materials and Method: This study aiming at total 228 cancer patients was conducted from Aug 18 to Sep. 10, 2010. Among them, 115 patients had a test without water intake before shooting from Aug. 8 to 31 and 113 had a test after drinking 500 cc water right before shooting from Sep. 1 to 10 The Discovery ST PET/CT (GE Healthcare, USA) was used, and pearson's chi-square test was conducted to analyze significance through SPSS (Ver.18). Results: Among the total 228 cancer patients, there were 115 who had a test without water intake before shooting, 89 who had no double additional shooting, 13 who had stomach additional shooting and 13 who had other additional shooting. In addition, 109 had no additional shooting among 113 who had a test after taking 500 cc water, 1 had stomach additional shooting and 3 had other additional shooting. According to the findings above, the patients who had a test without water intake show reduced additional shooting, but for more exact significance, pearson's Chi-square test was carried out and the significance percentage was 0.001 that is smaller than 0.05, which means two groups have a significant relationship. As the minimum expectation frequency was 6.94 and there was no expectation frequency smaller than 5, so that it doesn't need to carry out pearson's exact verification. Conclusion: The above analysis has found that if one drinks 500cc water before the test, not only stomach additional shooting but also other additional shooting can be dramatically reduced, and test delay can be also reduced.

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Radiation Oncology Digital Image Chart 8nd Digital Radiotherapv Record System at Samsung Medical Center (디지털 화상 병력 시스템과 디지털 방사선치료 기록 시스템의 개발과 사용 경험)

  • Huh Seung Jae;Ahn Yong Chan;Lim Do Hoon;Cho Chung Keun;Kim Dae Yong;Yeo Inhwan;Kim Moon Kyung;Chang Seung Hee;Park Suk Won
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.67-72
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    • 2000
  • Background :The authors have developed a Digital image chart(DIC) and digital Radiotherapy Record System (DRRS). We have evaluated the DIC and DRRS for reliability, usefulness, ease of use, and efficiency. Materials and Methods :The basic design of the DIC and DRRS was to build an digital image database of radiation therapy Patient records for a more efficient and timely flow of critical image information throughout the department. This system is a submit of comprehensive radiation oncology management system (C-ROMS) and composed of a picture archiving and communication system (PACS), a radiotherapy information database, and a radiotherapy imaging database. The DIC and DRRS were programmed using Delphi under a Windows 95 environment and is capable of displaying the digital images of patients identification photos, simulation films, radiotherapy setup, diagnostic radiology images, gross lesion Photos, and radiotherapy Planning isodose charts with beam arrangements. Twenty-three clients in the department are connected by Ethernet (10 Mbps) to the central image server (Sun Ultra-sparc 1 workstation). Results :From the introduction of this system in February 1998 through December 1999, we have accumulated a total of 15,732 individual images for 2,556 patients. We can organize radiation therapy in a 'paperless' environment in 120 patients with breast cancer. Using this system, we have succeeded in the prompt, accurate, and simultaneous access to patient care information from multiple locations throughout the department. This coordination has resulted in improved operational efficiency within the department. Conclusion :The authors believe that the DIC and DRRS has contributed to the improvement of radiation oncology department efficacy as well as to time and resource savings by providing necessary visual information throughout the department conveniently and simultaneously. As a result, we can also achieve the 'paperless' and 'filmless' practice of radiation oncology with this system.

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A Study of the Bystander Effect and Its Enhancement in HSV-TK Gene Therapy Using a Murine Neuroblastoma Model (마우스 신경모세포종 모델을 이용한 HSV-TK 유전자 치료에서 Bystander 효과 및 증폭에 관한 연구)

  • Cho, Hyun Sang;Kim, Moon Kyu;Park, Chong Young
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.354-361
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    • 2002
  • Purpose : Selective introduction of genes conferring chemosensitivity into proliferating tumor cells may be used to treat cancer. We first investigated the bystander effect of retrovirus-mediated gene transfer of herpes simplex virus thymidine kinase(HSV-TK) gene to murine neuroblstoma cell line(neuro-2a) in vitro and in vivo. Second, we examined the mechanism and its enhancement of the bystander effect in murine neuroblastoma. Methods : To investigate the bystander effect, we studied tumor growth and survival time after HSV-TK/ganciclovir(GCV) treatment in a syngenic A/J mouse neuroblastoma model by mixing various ratios of HSV-TK-expressing neuro-2a cells with wild type neuro-2a cells followed by GCV treatment. To investigate the mechanism of the bystander effect in murine neuroblastoma, immunohistochemistry using connexin 43, CD4 and CD8-specific monoclonal antibodies was analyzed. We studied whether IL-2-secreting neuro-2a cells(neuro-2a/IL-2) would potentiate the bystander effect. Results : A strong bystander effect was observed in vitro and in vivo. The bystander effect in murine neuroblastoma was dependent on the immune response rather than connexin-mediated gap junction. Neuro-2a/IL-2 treatment enhanced the bystander effect in the HSV-TK/GCV system in murine neuroblastoma model. Conclusion : We conclude that the bystander effect in murine neuroblastoma depends on immune response and is enhanced by neuro-2a/IL-2.

Early Experiences with Ultra-Fast-Track Extubation after Surgery for Congenital Heart Disease at a Single Center

  • Kim, Kang Min;Kwak, Jae Gun;Shin, Beatrice Chia-Hui;Kim, Eung Re;Lee, Ji-Hyun;Kim, Eun Hee;Kim, Jin Tae;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.51 no.4
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    • pp.247-253
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    • 2018
  • Background: Early extubation after cardiovascular surgery has some clinical advantages, including reduced hospitalization costs. Herein, we review the results of ultra-fast-track (UFT) extubation, which refers to extubation performed on the operating table just after the operation, or within 1-2 hours after surgery, in patients with congenital cardiac disease. Methods: We performed UFT extubation in patients (n=72) with a relatively simple congenital cardiac defect or who underwent a simple operation starting in September 2016. To evaluate the feasibility and effectiveness of our recently introduced UFT extubation strategy, we retrospectively reviewed 195 patients who underwent similar operations for similar diseases from September 2015 to September 2017, including the 1-year periods immediately before and after the introduction of the UFT extubation protocol. Propensity scores were used to assess the effects of UFT extubation on length of stay (LOS) in the intensive care unit (ICU), hospital LOS, and medical costs. Results: After propensity-score matching using logistic regression analysis, 47 patients were matched in each group. The mean ICU LOS ($16.3{\pm}28.6$ [UFT] vs. $28.0{\pm}16.8$ [non-UFT] hours, p=0.018) was significantly shorter in the UFT group. The total medical costs ($182.6{\pm}3.5$ [UFT] vs. $187.1{\pm}55.6$ [non-UFT] ${\times}100,000$ Korean won [KRW], p=0.639) and hospital stay expenses ($48.3{\pm}13.6$ [UFT] vs. $54.8{\pm}29.0$ [non-UFT] ${\times}100,000KRW$, p=0.164) did not significantly differ between the groups. Conclusion: UFT extubation decreased the ICU LOS and mechanical ventilation time, but was not associated with postoperative hospital LOS or medical expenses in patients with simple congenital cardiac disease.

Spread of Bacterial Canker of Kiwifruit by Secondary Infection of Pseudomonas syringae pv. actinidiae Biovar 3 in Gyeongnam in 2016 (2016년 경남지역 Pseudomonas syringae pv. actinidiae Biovar 3의 2차감염에 의한 키위 궤양병의 확산)

  • Kim, Gyoung Hee;Choi, Eu Ddeum;Lee, Young Sun;Jung, Jae Sung;Koh, Young Jin
    • Research in Plant Disease
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    • v.22 no.4
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    • pp.276-283
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    • 2016
  • Bacterial canker caused by Pseudomonas syringae pv. actinidiae (Psa) occurred at 202 kiwifruit orchards for the survey period of 2013-2016, of which Psa biovar 2 (Psa2) and Psa biovar 3 (Psa3) were detected at 73 and 129 kiwifruit orchards, respectively. The number of kiwifruit orchards infected by Psa3 in 2016 increased nearly two times compared to 2015. Psa3 was detected from all the kiwifruit cultivars except some kiwiberry cultivars growing in Korea. Yellow-fleshed cultivars Hort16A and Jecy-gold and red-fleshed cultivar Hongyang were highly susceptible to Psa3. Our epidemiological and random amplification of polymorphic DNA analyses indicated that the first Psa3 incidence on Hongyang orchard in Sacheon, Gyoungnam might result from an introduction of Psa3-contaminated pollens from China for artificial pollination in 2014 and recent outbreaks of Psa3 in Sacheon and Goseong, Gyoungnam in 2016 might be due to rapid spread of bacterial canker by secondary infection of Psa3 from Hongyang orchard to neighboring Jecy-gold and Hayward orchards.

Multimodality and Application Software (다중영상기기의 응용 소프트웨어)

  • Im, Ki-Chun
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.2
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    • pp.153-163
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    • 2008
  • Medical imaging modalities to image either anatomical structure or functional processes have developed along somewhat independent paths. Functional images with single photon emission computed tomography (SPECT) and positron emission tomography (PET) are playing an increasingly important role in the diagnosis and staging of malignant disease, image-guided therapy planning, and treatment monitoring. SPECT and PET complement the more conventional anatomic imaging modalities of computed tomography (CT) and magnetic resonance (MR) imaging. When the functional imaging modality was combined with the anatomic imaging modality, the multimodality can help both identify and localize functional abnormalities. Combining PET with a high-resolution anatomical imaging modality such as CT can resolve the localization issue as long as the images from the two modalities are accurately coregistered. Software-based registration techniques have difficulty accounting for differences in patient positioning and involuntary movement of internal organs, often necessitating labor-intensive nonlinear mapping that may not converge to a satisfactory result. These challenges have recently been addressed by the introduction of the combined PET/CT scanner and SPECT/CT scanner, a hardware-oriented approach to image fusion. Combined PET/CT and SPECT/CT devices are playing an increasingly important role in the diagnosis and staging of human disease. The paper will review the development of multi modality instrumentations for clinical use from conception to present-day technology and the application software.

Treatment of Subclavian Artery Injury in Multiple Trauma Patients by Using an Endovascular Approach: Two Cases (다발성 외상환자에서 혈관계 접근을 통해 치료한 쇄골하동맥 손상 2례)

  • Cho, Jayun;Jung, Heekyung;Kim, Hyung-Kee;Lim, Kyoung Hoon;Park, Jinyoung;Huh, Seung
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.243-247
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    • 2013
  • Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

The study on appropriateness of adapting door-to-door delivery system for the reducong of waiting time at outpatient pharmacy department in Tertiary care hospital (3차 진료기관 외래약국 투약대기시간 단축을 위한 택배 제도 도입 타당성 조사)

  • Song, Jung-Hup
    • Quality Improvement in Health Care
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    • v.3 no.1
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    • pp.144-152
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    • 1996
  • Background : Because of introduction of nationwide health care system in 1989 and the improvement of socioeconomic status of population the number of outpatient visiting university hospital has good facilities and manpower has increased. So the waiting time for medical service at university hospital are lengthened. Particularly outpatients complain that waiting for prescribed drugs at pharmacy depart are long. Reducing waiting time at pharmacy depart door-to-door delivery system that the patients applying for door-to-door delivery receive prescribed drug at home without waiting at pharmacy depart were studied. The objective of this study is to analysis the opinion of outpatients for door-to-door delivery system, to study the appropriateness of adopting the system and to produce ideal model for the system. Method : Outpatients waiting drug at pharmacy depart were questioned about door-to-door delivery system. to find the factors affect utilizing the system the logistic regression was used. Result : 83.3% of the patients want to utilize the system without charging, and 72.9% of the patients want to utilized system with charging. 68.3% of patients with charging want to use this system because of long waiting time at pharmacy depart. 50% of patients who do not want to use door-to-door do not use this system because of incorrect delivery. The affecting factors to utilize the system were sex, waiting time, fee. Conclusion : The model for door to door delivery system. 1. door-to-door personnel reside in hospital and the patient want to utilize the system apply for the delivery with charging. 2. The applied drugs dispense at spare time. 3. Delivery company gathers drug at appointed time and delivers. 4. The delivery fee is 2,000-3,000 won. 5. To prevent from loss and changing the drug the name of patient on packet are printed and drug packet are sealed. 6. The company submit the confirm sheet which are written that the patient received drug correctly to hospital. 7. The delivery time of drug is reserved for the convenience of receiving.

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Status and Perspectives of Preplacement Health Examination (PHE) at Certain Workplaces (일부 사업장에서 나타난 배치전건강진단 제도 현황과 향후과제)

  • Park, Hyesook;Kang, Seong-Kyu;Lee, Wanhyung;Choi, Won-Jun;Ham, Seunghon
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.31 no.4
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    • pp.540-548
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    • 2021
  • Introduction: Preplacement health examination (PHE) is performed when a worker starts a certain work task which is designated as having occupational risks by the Ministry of Employment and Labor (MOEL). All data related to health examination except PHE are reported to the MOEL by the law. This study has been performed to understand the status of PHE at certain workplaces. Methods: PHE data gathered in a university hospital were analyzed and they were followed with results of the special health examination (SHE) in 2019 and 2020. Those who were evaluated as unfit to work as it was, were interviewed directly or indirectly through an occupational health manager to follow up the management status of their recognized health problems. Results: The unfit to work (unFTW) rate of PHE was 2.8%, and was not different according to the size of workplace or having occupational health service. The major cause of unfit to work was the uncontrolled life-style diseases such as hypertension and diabetes. The rate of SHE followed by PHE was 31.1%. It was not different by the unFTW rates, however, they were different according to having a full time in-house occupational health manager. Thirty-one among 71 examinees who were evaluated as unFTW underwent SHE after controlling their health condition and were finally evaluated as fit to work. Nineteen among 31 started to take medicine and eight have been placed in the work without designated risks. Conclusion: PHE can be used for new workers, who may have unknown or uncontrolled life-style diseases, to be asked to manage life-style diseases as well as work-related risks such as shift work. In order to have a better tracking system for work-related risks, the information of PHE should be analyzed together with other data from health examination.

Pediatricians' perception of factors concerning the clinical application of blockchain technology to pediatric health care: a questionnaire survey

  • Yong Sauk Hau;Min Cheol Chang;Jae Chan Park;Young Joo Lee;Seong Su Kim;Jae Min Lee
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.156-163
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    • 2023
  • Background: Interest in digital medical information has increased because it allows doctors to easily access a patient's medical records and provide appropriate medical care. Blockchain technology ensures data safety, reliability, integrity, and transparency by distributing medical data to all users over a peer-to-peer network. This study attempted to assess pediatricians' thoughts and attitudes toward introducing blockchain technology into the medical field. Methods: This study used a questionnaire survey to examine the thoughts and attitudes of 30- to 60-year-old pediatricians regarding the introduction of blockchain technology into the medical field. Responses to each item were recorded on a scale ranging from 1 (never agree) to 7 (completely agree). Results: The scores for the intentions and expectations of using blockchain technology were 4.0 to 4.6. Pediatricians from tertiary hospitals responded more positively (4.5-4.9) to the idea of using blockchain technology for hospital work relative to the general population (4.3-4.7). However, pediatricians working in primary and secondary hospitals had a slightly negative view of the application of blockchain technology to hospital work (p=0.018). Conclusion: When introducing the medical records of related pediatric and adolescent patients using blockchain technology in the future, it would be better to conduct a pilot project that prioritizes pediatricians in tertiary hospitals. The cost, policy, and market participants' perceptions are essential factors to consider when introducing technology in the medical field.