• Title/Summary/Keyword: Less invasive

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Parent Perspectives of Diagnostic and Monitoring Tests Undertaken by Their Child with Inflammatory Bowel Disease

  • Ho, Shaun Siong Chung;Keenan, Jacqueline Ilene;Day, Andrew Stewart
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.1
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    • pp.19-29
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    • 2021
  • Purpose: To assess parent perspectives of the current and potential future tests for their child with inflammatory bowel disease (IBD). Methods: New Zealand parents of a child with IBD were invited to complete an anonymous online survey. Experiences relating to their child's blood or faecal tests, medical imaging (abdominal ultrasound [US], abdominal computerised tomography [CT] and magnetic resonance enterography) and colonoscopy were collected. Perceived attitudes to potential future testing of urine, saliva, and breath, were sought. Results: Twenty-eight parents, 93% female completed the survey, and 86% were aged between 35 and 54 years. Baseline information was provided by parents for 27 of 28 children, 70.3% had Crohn's disease with a mean disease duration of 2.67 years. Blood tests were the most requested and completed tests, while CT was the least ordered and most refused test. Colonoscopy was rated as the least comfortable and generated the most worry. Explanation of test significantly improved parent's levels of understanding when their child had blood, faecal, imaging (US) or colonoscopy tests. Providing an explanation, test invasiveness and the impact of the blood results may have on their child's treatment significantly improved parents' comfort levels. However, explanation of colonoscopy generated a significant parental concerns. Saliva, urine and blood tests were chosen as the most preferred disease monitoring tests. Conclusion: Parents preferred any tests less invasive than colonoscopy for monitoring their child's IBD. Although providing explanation of their child's tests enhanced parents' understanding, it can also affect parents' levels of concern and comfort.

Evaluation of Reduced Port Laparoscopic Distal Gastrectomy Performed by a Novice Surgeon

  • Park, Dong Jin;Lee, Eun Ji;Kim, Gyu Youl
    • Journal of Gastric Cancer
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    • v.21 no.2
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    • pp.179-190
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    • 2021
  • Purpose: Reduced port laparoscopic distal gastrectomy (RPLDG) using 3 ports is less invasive than conventional laparoscopic distal gastrectomy (CLDG) using 5 ports. Although RPLDG performed by expert surgeons is safe and feasible, novice surgeons have difficulty performing this procedure. This study evaluated the surgical outcomes and feasibility of RPLDG performed by a novice surgeon. Materials and Methods: The records of 136 patients who underwent laparoscopic distal gastrectomy for gastric cancer performed by a single novice surgeon between May 2016 and December 2018 were retrospectively reviewed. Among these 136 patients, 52 underwent RPLDG and 84 underwent CLDG. The clinicopathological characteristics, operative outcomes, and short-term postoperative outcomes of the 2 groups were compared. Results: The percentage of women was significantly higher in the RPLDG group than in the CLDG group (48.1% vs. 31%; P=0.045), but other baseline characteristics did not differ significantly between the groups. Billroth II anastomosis was performed significantly more frequent (90.4% vs. 73.8%, P=0.015) and operation time was significantly shorter (207.1±43.3 min vs. 225.5±44.6 min, P=0.020) in the RPLDG group than in the CLDG group. The time to first flatus, postoperative pain score, length of postoperative hospital stay, and incidence and severity of complications did not differ significantly between the groups. Analysis of the learning curve based on the operation time showed that performing RPLDG on 20-30 patients was required to achieve technical proficiency. Conclusions: RPLDG is a safe and feasible surgical procedure for the treatment of gastric cancer, even when performed by a novice surgeon.

Effect of ETCO2 monitoring of poisoning patients with decreased mental state in ED (의식 저하로 내원한 중독 환자들에 대한 호기말 이산화탄소분압 관찰의 효과)

  • Kwon, Yong Hee;So, Byung Hak;Jeong, Won Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.19 no.1
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    • pp.44-50
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    • 2021
  • Purpose: This study aimed to analyse the effect of End-Tidal Carbon Dioxide (ETCO2) monitoring on patients who had been poisoned and presented in the emergency department with decreased consciousness. Methods: The data of patients over 18 years old presenting with poisoning from 2016 to 2020 was collected from the emergency department. We retrospectively analyzed their medical records, and defined patients with a Glasgow Coma Scale (GCS) score of 9 or less as having decreased consciousness. We divided the patients into two groups, one with ETCO2 monitoring and the other without, and the difference between the two groups was compared. Results: 168 patients participated in this study and 83 (49.4%) of them belonged to the ETCO2 monitoring group. In this group, the interval between arterial blood tests was statistically significantly longer and the rate of intubation was lower. In addition, in the monitoring group, the incidence of pneumonia and the rate of poor prognosis was not significantly higher. Conclusion: Although ETCO2 monitoring does not directly affect the prognosis of poisoned patients with decreased consciousness, it should be actively done as it can help to adequately treat patients while avoiding invasive techniques or unnecessary intubation.

Analysis of HPV Prevalence in Pairs of Cervical and Urine Samples from the Same Woman

  • Kim, Dong Hyeok;Jin, Hyunwoo;Lee, Kyung Eun
    • Biomedical Science Letters
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    • v.27 no.1
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    • pp.28-34
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    • 2021
  • The main cause of cervical cancer is a persistent infection with high-risk human papillomavirus (HR-HPV). Cervical cancer is reported as a preventable cancer in more than 80% of cases with early diagnosis and appropriate treatment. Papanicolaou test (Pap test) has been a global strategy to prevent cervical cancer, and recently, HPV test has been reported to be effective against cervical cancer and precancerous lesions. However, pelvic examinations give patients anxiety, discomfort, pain, distress, and psychological stress. HPV test via a urine sample caused less physical and psychological stress and more advantage than the Pap test. Therefore, it is necessary to study the usefulness of the HPV test for easy-to-collect urine samples. A total of 220 samples were collected from a pair of cervical and urine samples from 110 women and only 108 pairs of samples out of 110 were used because 2 cases were not amplified by β-globin. Among 108 pairs of cervical and urine samples, the prevalence of HPV was 37.0% (40/108) in cervical samples, 34.3% (37/108) in urine samples and HR-HPV was 22.2% (24/108) in cervical samples, 18.5% (20/108) in urine samples. In this study, urine samples showed a lower positive rate of HPV than cervical samples. There were many variables that could affect the condition of the urine sample. However, the HR-HPV agreement rate of the cervix and urine samples was 94.44% and the Kappa value was 0.823, which was "almost perfect". Through these results showed the significance of cervical cancer screening using a urine sample. Cervical screening is crucial, as cervical cancer can be prevented in more than 90% of cases. Urine samples collected by non-invasive methods may have the potential advantage of increasing acceptance of cervical cancer screening. Therefore, it is necessary to develop a new cervical cancer screening strategy using urine samples through further study based on the results of this study.

Larger Remaining Stomach Volume Is Associated With Better Nutrition and Muscle Preservation in Patients With Gastric Cancer Receiving Distal Gastrectomy With Gastroduodenostomy

  • Kim, Amy;Lee, Jung-Bok;Ko, Yousun;Park, Taeyong;Jo, Hyeonjong;Jang, Jin Kyoo;Lee, Kyoungsuk;Kim, Kyung Won;Lee, In-Seob
    • Journal of Gastric Cancer
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    • v.22 no.2
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    • pp.145-155
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    • 2022
  • Purpose: Weight loss and deterioration in body composition are observed in patients with gastric cancer (GC) following gastrectomy. This study aimed to investigate the impact of residual stomach volume (RSV) on the nutritional status and body composition of patients with GC treated with distal gastrectomy. Materials and Methods: In total, 227 patients who underwent minimally invasive distal gastrectomy with Billroth 1 anastomosis for stage I GC between February 2015 and May 2018 were enrolled. Clinicodemographic and laboratory data were collected from the GC registry. The RSV, abdominal muscle area, and subcutaneous/visceral fat areas were measured using computed tomography data. Results: A larger RSV was associated with a lower decrease in the nutritional risk index (P=0.004) and hemoglobin level (P=0.003) during the first 3 months after surgery, and better recovery at 12 months. A larger RSV demonstrated an advantage in the preservation of abdominal muscle area (P=0.02) and visceral fat (P=0.04) after surgery, as well as less reduction in weight (P=0.02) and body mass index (P=0.03). Conclusions: Larger RSV was associated with improved nutritional status and better preservation of muscle and fat after distal gastrectomy.

An Identification of Domestic Habitat and Settlement of the Invasive Exotic Fish Brown Trout, Salmo trutta (침입성 외래어류 브라운송어 Salmo trutta의 국내 서식 및 정착 확인)

  • Cheol Woo Park;Young-Jin Yun;Jong Wook Kim;Dae-Yeul Bae;Jae Goo Kim;Su Hwan Kim
    • Korean Journal of Ichthyology
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    • v.34 no.4
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    • pp.270-276
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    • 2022
  • In 2020 and 2022, the habitat of brown trout (Salmo trutta) was investigated in the Soyanggang River in Chuncheon, Gangwon province. As a result of the fish survey, A total of 43 individuals brown trout were identified. The total length of brown trout was widely confirmed from 60 cm or more to less than 10 cm. In January 2020, sperm release and spawn were observed in male and female confirmed at the St. 1. Brown trout were identified stably settled in the Soyanggang River and continues to live. In addition, benthic macroinvertebrates that can act as food sources of brown trout and abundantly inhabited. The riverbed structure is evenly composed of fine gravel and gravel, which constitutes the conditions necessary for habitat and spawning. However, the spawning grounds, spawned eggs and hatched fry have not yet been clearly identified, so continuous research is needed.

New anterior guidance induction through spontaneous gap closure after an increase in vertical dimension: a case report (교합고경 증가로 발생한 전치부 공간을 자연 폐쇄시켜 새롭게 유도한 전방유도: 증례 보고)

  • Jung Hyun Nam;Jong-Hee Kim;Yang-Jin Yi
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.3
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    • pp.146-157
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    • 2023
  • The bite collapses due to posterior teeth loss or wear results in inadequate space for restoration and esthetic concerns. Increasing the occlusal vertical dimension to improve space deficiency rotates the mandible posteriorly, creating a gap between the maxillary and mandibular anterior teeth, leading to loss of anterior guidance. To solve this problem, the prosthodontics or orthodontics treatments are the commonly used methods for proper anterior guidance. However, it is reasonable to assume that the anterior teeth can naturally relapse to their original position when the occlusal force is eliminated. Therefore, this case report aimed to test whether natural relapse could recover the lost anterior guidance to develop a less invasive and more convenient treatment method. Digital superimposition was used to evaluate the changes in anterior teeth alignment to confirm the change of the recovered anterior guidance. The appropriate indications for this new treatment method were defined and applied clinically.

Study of frontal and ethmoid sinus of sinonasal complex along with olfactory fossa: anatomical considerations for endoscopic sinus surgery

  • Kusum R Gandhi;Sumit Tulshidas Patil;Brijesh Kumar;Manmohan Patel;Prashant Chaware
    • Anatomy and Cell Biology
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    • v.56 no.2
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    • pp.179-184
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    • 2023
  • The Functional endoscopic sinus surgery through transnasal approach is a common modality of treatment for disorders of the nasal cavity, paranasal air sinuses as well as cranial cavity. The olfactory fossa (OF) is located along the superior aspect of cribriform plate which varies in shape and depth. This variable measurement of the depth of OF is mostly responsible for greater risk of intracranial infiltration during endoscopic procedures in and around the nasal cavity. The morphology of frontal and ethmoid sinus (ES) vary from simple to complex. This cadaveric study is planned to improve the ability of the otolaryngologist, radiologist to understand the possible morphological variations and plan steps of less invasive "precision surgery" to have a safe and complication free procedures. A total of 37 human head regions were included in the study. For classification of OF, Modified Kero's classification was used. The size, shape and cells of frontal and ES were noted. We found, type II (60.8%) OF was more common followed by type I (29.7%) than type III (9.5%). The shape of frontal sinus was comma shaped (55.4%) followed by oval (18.9%) than irregular (16.2%). Most common two cells type of ES was seen in 50.0% of both anterior and posterior ES. Out of 74 ES, 8.1% of Onodi cells and 14.9% of agger nasi cells were seen.

X-band EPR dosimetry using minimum mass of tooth enamel for use in radiological accidents

  • Jae Seok Kim;Byeong Ryong Park;Han Sung Kim;In Mo Eo;Jaeryong Yoo;Won Il Jang;Minsu Cho;HyoJin Kim;Yong Kyun Kim
    • Nuclear Engineering and Technology
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    • v.56 no.1
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    • pp.123-131
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    • 2024
  • Electron paramagnetic resonance (EPR) dosimetry for a tooth from an individual exposed is well known as retrospective dosimetry in radiological accidents. A major constraint of the conventional X-band tooth-EPR dosimetry is the necessity to extract the tooth of the exposed patient for dose assessment. In this study, to conduct the dose assessments of exposed patients through part-extraction of tooth enamel, the minimum detectable dose (MDD) of the tooth enamel was evaluated based on the amount of mass. Further, a field test was conducted via intercomparison using various dose assessment methods to verify the feasibility of X-band tooth-EPR dosimetry using the minimum mass of tooth enamel. The intercomparison results demonstrated that effective dose determination via X-band tooth-EPR dosimetry is reliable. Consequently, it was determined that the minimum mass of tooth enamel required to evaluate an absorbed dose above 0.5 Gy is 15 mg. Thus, EPR dosimetry using 15 mg of tooth enamel can be applied in the triage and initial medical response stages for patients exposed during radiological accidents. This approach represents an advancement in managing radiological accidents by offering a more efficient and less invasive method of dose assessment.

Disease Testing in Pelvic Pain Patients: Comparison between Ultrasound and Computed Tomography Imaging (골반통 환자의 질환 검사: 초음파와 컴퓨터단층촬영 간의 비교)

  • EunHoe Goo
    • Journal of Radiation Industry
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    • v.17 no.4
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    • pp.385-390
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    • 2023
  • The uterus, one of women's reproductive organs, is also closely related to women's health. Among them, hemorrhagic luteal cysts, one of the causes of pelvic pain that women often experience, were observed through CT and ultrasound, and the quality of images was evaluated through quantitative and qualitative evaluations. This study sought to find out whether the test method is more helpful to patients during CT and ultrasound. This study was conducted on 15 adolescent women and 15 adult women(21.31±3.45 average age). The equipment used for filming used EC3-10X (3~10 MHZ) and Philips Mx8000 iCT 256 among Endocavity Probes among Ecube Platinum. After setting a constant ROI on the cyst and the interface as a quantitative analysis method, SNR and CNR values were measured on a 5-point scale based on image quality, lesion clarity, image distortion, clarity of the interface, and motion artifacts (p<0.05). Independent t-test and Mann Whiteny U were performed, and the statistical program used was noted when SPSS (Version 22.0 for windows software package, Chicago, IL, USA) was statistically less than 0.05. Comparing the SNR and CNR values for this experiment, it can be seen that the SNR value was higher in the case of CT images(p<0.05). As a result of the qualitative evaluation, the quality of the image, the clarity of the lesion, the distortion of the image, the clarity of the interface, and the clarity of the boundary were measured on a 5-point scale based on the movement artifact. Comparing each score, CT images scored higher with a finer difference than ultrasound images(p<0.05). In conclusion, both test methods showed excellent results in finding the patient's lesions. However, in quantitative and qualitative evaluations, CT produced higher results in detecting lesions than ultrasound. However, for cyst tests that require continuous observation, ultrasonography, a non-invasive method that is advantageous for patients, will be clinically useful. Therefore, observing the patient's lesions by appropriately distributing these two test methods will provide optimal diagnostic information. These results will be useful for providing clinical basic data and educational materials to CT and US users in the future.