• Title/Summary/Keyword: access to medicine

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A Study on Central Vein Cannulation Using Audible Doppler Guidance in Children and Infants (Audible Doppler Ultrasound(8 MHz)를 이용한 소아와 영아에서 중심정맥 도관 삽입술에 관한 연구)

  • Ahn, Young Joon;Jung, Jin Young;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1120-1125
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    • 2002
  • Purpose : Percutaneous cannulation of the central vein in children and infants may be technically difficult and can cause serious complications. There are many techniques to improve the success rate and to decrease the complications in central vein cannulation. This study was undertaken to determine whether audible Doppler guidance can help operators improve the results of central vein cannultion in pediatric ICU. Methods : A total of 46 central vein cannulations were performed using audible Doppler guidance technique. Using an 8-MHz Doppler ultrasound device(Pocket-Dop II. iMex. USA), the artery and the vein were identified by their characteristic Doppler sounds. Results : There was a total of 46 patients with 20 boys and 26 girls, respectively. The mean age was $3years{\pm}45months$(range : 1-156 months). The number of infants was 18 and the mean age was $6.3{\pm}3.8$ months(range : 1-12 months). The most common site of central vein cannulation was the right internal jugular vein(63%). The cannulation was successful in 44 out of 46 procedures(96%). The success rate at the first attempt was 59% with 48% in the patients who had the history of previous cannulation and 70% in the patients who did not, respectively. The success rate in infants was 94%(17 out of 18). The average access time was $5.2{\pm}8.3$ minutes in children contrary to $7.5{\pm}10.3$ minutes in infants. There were no serious complications, but six patients had complications including four hematoma, one arterial puncture, and one pneumothorax. Conclusion : This central vein cannulation using Doppler guidance may improve the success rate of central vein cannulation and decrease the development of serious complications in infants and children.

A Study on the Preference of Art Media of Cancer Patients: Multidisciplinary Approach of Art Therapy (통원 암 환자의 미술 매체 선호도 연구: 미술 치료요법의 다학제간 접근)

  • Lee, Yun-Hee;Kim, Jee-Eun
    • Journal of the Korea Convergence Society
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    • v.11 no.10
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    • pp.171-179
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    • 2020
  • This study was attempted to identify the media preferences and the reasons of cancer patients. The data collection was conducted on 76 people. and they are 6 men, 70 women with 38 breast cancer patients, and 38 patients with other cancers. For measuring tools, self-written questionnaires and Mandala paintings were used for single-time art therapy. The data analysis compared the results of technical statistics, independence verification and chi verification using the SPSS WIN ver.25.0 with the Mandala painting. There were no significant differences in media preference by age and duration of the disease, and there were significant differences in media preference by disease. In the Mandala painting, the characteristics of the medium and the factors of specific disease showed that there were reasons and effects of preference media choice. This study is meaningful in that it concentrated on the art therapy access and support in terms of the cancer outpatients, which have been concentrated on inpatients so that they shed light to the support and intervention needed by the outpatients, and can be used as basic data for the development of art therapy programs to help stabilize the mind of cancer patients in the future.

Virtual Reality for Dental Implant Surgical Education (가상현실을 이용한 치과 임플란트 수술 교육)

  • Moon, Seong-Yong;Choi, Bong-Du;Moon, Young-Lae
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.169-174
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    • 2016
  • In this study, we evaluated the virtual reality model for dental implant surgery and discussed about the method to make the surgical environment for virtual reality with practical patient data. The anatomical model for patient face was fabricated by facial and oral scan data based on CT data. The simulation scenario was composed step by step fashion with Unity3D. From incision and sinus bone graft procedure which is needed to this patient model to implant installation and bone graft was included in this scenario. We used the HMD and leap motion for immersiveness and feeling of real operation. Twenty training doctor was attended this simulation study, and surveyed their satisfactory results by questionnaire. Implant surgery education program was showed the possibilities of educational tool for dental students and training doctors. Virtual reality for surgical education with HMD and leap motion had advantages, in terms of cheap prcie, easy access.

Isolation of N-Iauroyl Tyrosine Antibiotic in E. coli Carrying N-acyl Amino Acid Synthase Gene from Environmental DNA in Korean Soils (한국 토양 환경유래의 N-acyl amino acid synthase 유전자에 의한 대장균 내 항생제 N-lauroyl tyrosine 생산)

  • Yeo, Yun-Soo;Lim, Yoon-Ho;Kim, Jeong-Bong;Yang, Jung-Mo;Lee, Chang-Muk;Kim, Soo-Jin;Park, Min-Seon;Koo, Bon-Sung;Yoon, Sang-Hong
    • Applied Biological Chemistry
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    • v.50 no.4
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    • pp.262-267
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    • 2007
  • To access the natural product antibiotics produced by uncultured microorganisms, six cosmid libraries of DNA extracted directly from soil samples (environmental DNA, eDNA) were constructed and screened for the production of antibacterial active molecules. Of the approximately 60,000 clones screened, one antibacterial clone (YS92B) was detected. Ethyl acetate extracts of clone YS92B showed antibacterial activity against various pathogenic bacteria (Listeria monocytogenes, Bacillus subtilis, Pseudomonas syringae, Xanthomonas campestris pv. oryzae, Staphylococcus epidemis). Active constituents from cultures of YS92B were isolated and purified using a bioassay-guided fractionation against B. subtilis through a series of procedures (ethyl acetate extraction, Sephadex LH20 column chromatography, High Performance Liquid Chromatography). NMR (Nuclear Magnetic Resonance) spectral analysis of a major antibacterial active YS92B-VII indicated that it is a lauric acid linked to tyrosine. This report describes the characterization of antibacterially active long chain N-acyl derivatives of tyrosine that are produced by eDNA clones hosted in Escherichia coli from Korean soils.

Developing Digital Library Collection Using Citation and Homepage Information (인용정보와 연구자 홈페이지를 이용한 디지털 도서관 장서개발 방안 연구)

  • Lee, Jee-Yeon
    • Journal of the Korean Society for information Management
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    • v.24 no.1 s.63
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    • pp.301-319
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    • 2007
  • Nowadays the information environment enables users to access the traditional library collection as well as various digital information resources. In this rapidly changing environment, the use of digital information resources such as web sites, data, and homepages has increased. In this research, highly-cited authors' research outcomes as well as the research outcomes of the people, who cited the highly-cited authors' works, were extracted then compared with information stored in the medical colleges' digital libraries and the academic information portals in the clinical medicine area by using the citation information provided by Essential Science Indicators from ISI Web of knowledge. Out of 10,000 authors,146 people's homepages, which present research outcomes, were analyzed. The research outcomes listed in the homepages included journal papers, monographs, conference proceedings, and lecture notes. About 15% of the journal papers, 32% of the monographs, 48% of the conference proceedings, and 100% of lecture notes were accessible only through the homepages. The research outcomes accessible from the homepages were almost analogous to the ones available through the medical college's digital libraries and the academic information portals. Therefore, the digital library collection will be improved and expanded quantitatively and qualitatively by collecting and using the information in the homepages of the prestigious researchers.

Anesthetic efficacy of supplemental buccal infiltration versus intraligamentary injection in mandibular first and second molars with irreversible pulpitis: a prospective randomized clinical trial

  • Zargar, Nazanin;Shojaeian, Shiva;Vatankhah, Mohammadreza;Heidaryan, Shirin;Ashraf, Hengameh;Baghban, Alireza Akbarzadeh;Dianat, Omid
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.5
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    • pp.339-348
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    • 2022
  • Background: To compare the anesthetic efficacy of supplemental buccal infiltration (BI) (1.7 ml) versus intraligamentary (IL) injection containing 0.4 ml of 4% articaine with 1:100.000 epinephrine after an inferior alveolar nerve block (IANB) with 1.7 ml 2% lidocaine in the first and second mandibular molars diagnosed with irreversible pulpitis (IP). Methods: One hundred subjects diagnosed with IP of either the mandibular first (n = 50) or second molars (n = 50) and failed profound anesthesia following an IANB were selected. They randomly received either the IL or BI techniques of anesthesia. Pain scores on a 170 mm Heft-Parker visual analog scale were recorded initially, before, and during supplemental injections. Furthermore, pulse rate was measured before and after each supplemental injection. During the access cavity preparation and initial filing, no or mild pain was assumed to indicate anesthetic success. The chi-square test, Mann-Whitney U test, and independent samples t-test were used for the analyses. Results: The overall success rates were 80% in the IL group and 74% in the BI group, with no significant difference (P = 0.63). In the first molars, there was no significant difference between the two techniques (P = 0.088). In the second molars, IL injection resulted in a significantly higher success rate (P = 0.017) than BI. IL injection was statistically more successful (P = 0.034) in the second molars (92%) than in the first molars (68%). However, BI was significantly more successful (P = 0.047) in the first molars (88%) than in the second molars (64%). The mean pulse rate increase was significantly higher in the IL group than in the BI group (P < 0.001). Conclusions: Both the IL and BI techniques were advantageous when used as supplemental injections. However, more favorable outcomes were observed when the second molars received IL injection and the first molars received BI.

The Effect of Bee Venom Therapy on Skin Aging (봉독이 피부 노화에 미치는 영향)

  • Kim, Jin-Myoung;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.2
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    • pp.27-40
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    • 2010
  • Background and Objective : Increasing interest in anti-aging and anti-wrinkling agents for the skin has triggered the recent outflow of researches and studies in this field. This study was designed to investigate the effects of bee venom on skin wrinkling and skin aging by testing the skin wrinkling, skin elasticity, trans-epidermal water loss (TEWL), free radical level, anti-oxidative agent level, and skin tissue after infusion of bee venom on hairless mouse. Materials and Methods : Fifteen hairless mice aged between 36~40 weeks were divided randomly into 3 Group; the Bee Venom Syringe Group, the Bee Venom Needle Group, and the control group. The Bee Venom Syringe Group were injected subcutaneously with bee venom (0.1cc in total) using an insulin syringe on three spots in the lumbar spine (one spot on the center and two spots 1~2cm to the side bilaterally). The Bee Venom Needle Group were pricked with bee venom-smeared acupuncture needles on three longitudinal spots in the lumbar spine each 1cm apart, after which the needles were removed 10 minutes later. The Control Group did not receive any form of intervention. All procedures took place thrice a week for four weeks, during which the mice were allowed free access to water and fodder. The mice were measured and compared in the weight, skin wrinkling scale, skin elasticity, and TEWL before and after the experiment. After the experiment, blood samples were taken to measure the free radical and anti-oxidative agent level, and the skin tissue was sliced for examination. Data was analyzed using the SPSS program (ver 12.0). The ANOVA analysis was used to compare and contrast the three groups, and t-test for paired samples was used to evaluate skin-wrinkling before and after experiment. The cut-off p-value of significance was set at p<0.05. Results : 1. Administration of bee venom did not cause serious weight loss or gain. 2. Compared to the control group, the Bee Venom Syringe Group and the Bee Venom Needle Group both showed a decrease in skin wrinkling scale after intervention. Especially, the Bee Venom Syringe Group showed a significant decrease (p<0.05). 3. Compared to the control group, the Bee Venom Syringe Group and the Bee Venom Needle Group both showed an increase in skin elasticity. Especially, the Bee Venom Syringe Group showed a significant increase (p<0.05). 4. No significant change in TEWL was found in the mice in all the three groups before and after experiment. 5. Free radical level was normal in all 15 mice in all the three groups, and anti-oxidative agent was not significantly different across the three groups. 6. The Bee Venom Syringe Group, the Bee Venom Needle Group, and the control group did not show any significant difference in the thickness of epidermis and dermis, infiltration of inflammatory cells, and skin wrinkling. The epidermis layer was relatively better preserved in the Bee Venom Syringe Group as compared to the Bee Venom Needle Group and the control group. Conclusion : Direct injection of bee venom on the hairless mouse using a syringe was found to improve wrinkling of the skin and increase skin elasticity but did not show effectiveness on skin dryness due to water loss. The bee venom appears to have suppressive effects on skin wrinkling, one of the symptoms of skin aging, through a process independent of suppression of free radicals or increase of anti-oxidative agent.

The Proteasome Inhibitor MG132 Sensitizes Lung Cancer Cells to TRAIL-induced Apoptosis by Inhibiting NF-κ Activation (폐암세포주에서 NFκ 활성 억제를 통한 Proteasome 억제제 MG132의 TRAIL-유도성 Apoptosis 감작 효과)

  • Seo, Pil Won;Lee, Kye Young
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.476-486
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    • 2008
  • Background: TRAIL (TNF-related apoptosis inducing ligand) is a newly identified member of the TNF gene family which appears to have tumor-selective cytotoxicity due to the distinct decoy receptor system. TRAIL has direct access to caspase machinery and induces apoptosis regardless of p53 phenotype. Therefore, TRAIL has a therapeutic potential in lung cancer which frequently harbors p53 mutation in more than 50% of cases. However, it was shown that TRAIL also could activates $NF-{\kappa}B$ in some cell lines which might inhibit TRAIL-induced apoptosis. This study was designed to investigate whether TRAIL can activate $NF-{\kappa}B$ in lung cancer cell lines relatively resistant to TRAIL-induced apoptosis and inhibition of $NF-{\kappa}B$ activation using proteasome inhibitor MG132 which blocks $I{\kappa}B{\alpha}$ degradation can sensitize lung cancer cells to TRAIL-induced apoptosis. Methods: A549 (wt p53) and NCI-H1299 (null p53) lung cancer cells were used and cell viability test was done by MTT assay. Apoptosis was confirmed with Annexin V assay followed by FACS analysis. To study $NF-{\kappa}B$-dependent transcriptional activation, a luciferase reporter gene assay was used after making A549 and NCI-H1299 cells stably transfected with IgG ${\kappa}-NF-{\kappa}B$ luciferase construct. To investigate DNA binding of $NF-{\kappa}B$ activated by TRAIL, electromobility shift assay was used and supershift assay was done using anti-p65 antibody. Western blot was done for the study of $I{\kappa}B{\alpha}$ degradation. Results: A549 and NCI-H1299 cells were relatively resistant to TRAIL-induced apoptosis showing only 20~30% cell death even at the concentration 100 ng/ml, but MG132 ($3{\mu}M$) pre-treatment 1 hour prior to TRAIL addition greatly increased cell death more than 80%. Luciferase assay showed TRAIL-induced $NF-{\kappa}B$ transcriptional activity in both cell lines. Electromobility shift assay demonstrated DNA binding complex of $NF-{\kappa}B$ activated by TRAIL and supershift with p65 antibody. $I{\kappa}B{\alpha}$ degradation was proven by western blot. MG132 completely blocked both TRAIL-induced $NF-{\kappa}B$ dependent luciferase activity and DNA binding of $NF-{\kappa}B$. Conclusion: This results suggest that inhibition of $NF-{\kappa}B$ can be a potentially useful strategy to enhance TRAIL-induced tumor cell killing in lung cancer.

Clinical Study of the Treatments for Abdominal Aortic Aneurysm; Comparison between the Retroperitoneal and Transperitoneal Approaches (복부대동맥류 치료의 임상적 고찰; 후복막 접근법과 경복막 접근법의 비교)

  • Son, Bong Soo;Chung, Sung Woon;Lee, Sang Kwon
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.34-40
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    • 2009
  • Background: The principal surgical technique for treating an abdominal aortic aneurysm since the 1960s has been the transperitoneal approach, yet there have been some recent studies that have reported improved surgical results with using the retroperitoneal approach. However, there are only limited clinical Korean studies that have, compared between the transperitoneal and retroperitoneal approaches. Material and Method: This study included 36 patients who had been diagnosed as having an aneurysm of the abdominal aorta and they were surgically treated between January 2001 and July 2007. The patients were subdivided into the retroperitoneal approach group (n=17) and the transperitoneal approach group (n=19), and they were compared in terms of the preoperative risk factors, the postoperative complications and the operative mortality. The risk factors of operative mortality risk and long-term survival for the 36 patients were assessed by the Kaplan-Meier method. Result: There were no significant differences between the groups in terms of gender, age, the underlying disease, a history of smoking, rupture of aneurysm, the preoperative symptoms, the operation time and the incidence of postoperative complications. However, the duration of postoperative fasting, the number of days of having an indwelling nasogastric tube and the length of the stay in the intensive care unit were significantly short for the retroperitoneal approach group (p<0.05). There was a 16.7% rate of operative mortality (6/36) and five of the deaths were attributed to preoperative ruptured aneurysm. On univariate analysis, a higher preoperative serum creatinine level (SCr ${\geq}$1.8 mg/dL, p=0.016) and ruptured aneurysm (p<0.001) were the significant risk factors of operative mortality. As assessed by the Kaplan-Meier method, the long-term survival was comparable between the groups and the five-year survival rate of all the patients was 57.5%. Conclusion: In the present study, a retroperitoneal approach has several advantages such as a shorter intensive care unit stay, a shorter duration of postoperative fasting and a shorter duration of an indwelling nasogastric tube. Therefore, unless there is any contraindication for a retroperitoneal approach, it could be considered as a primary surgical access for repairing an abdominal aortic aneurysm.

A study on Establishment and Management of the CCTV in Operating Room (수술실 CCTV 설치 및 운영에 대한 고찰)

  • Kim, Minji
    • The Korean Society of Law and Medicine
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    • v.20 no.1
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    • pp.109-132
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    • 2019
  • Recently, medical accidents related to surgical procedures have increased. In addition, the media reported that some of these accidents were involved in health crimes. Patient-advocate groups have called for mandatory establishment and management of CCTV in operating rooms. There is a lot of discussion among the interested parties, so it is necessary to review the relevant laws and regulations. The purpose of this study is to identify the characteristics of CCTV in operating rooms and to review legislations related to establishment and management of the CCTV in operating rooms. Medical institutions use CCTV for management of facilities and patient safety and install it in operating rooms optionally. The Constitution guarantees the privacy and the privacy of correspondence of every citizen, but it can be limited by the law for public welfare. Currently, however, there is no existing law about establishment and management of the CCTV in operating rooms and it can be defect of legal system. Under the current legislations, it is likely that the Self-determination can be violated due to the characteristic of healthcare provider when CCTV is mandatorily installed in operating room. In addition, the regulations on access and leakage of confidential information known by operator are insufficient. So that, the safety of the visual data might be threatened. Furthermore, unless the period and the place of storage of the visual data are clearly defined, it is highly unlikely to meet the original purpose of patient safety and prevention of medical accidents. This study is meaningful as there is few previous study on this topic although the need for legal review about this is growing and several bills are being proposed. It is expected that the results of this study can be utilized as basic data for enactment or amendment of the laws and regulations about establishment and management of CCTV in operating rooms.