• 제목/요약/키워드: patient positioning

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A Simulation System of Total Knee Replacement Surgery for Extracting 3D Surgical Parameters (슬관절 전치환술용 3차원 시술변수 추출 시스템)

  • Jun, Yong-Tae
    • Korean Journal of Computational Design and Engineering
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    • v.16 no.5
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    • pp.315-322
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    • 2011
  • The goal of total knee replacement (TKR) surgery is to replace patient's knee joint with artificial implants in order to restore normal knee joint functions. Since mismatched knee implants often cause a critical balancing problem and short durability, designing a well-fitted implant to a patient's knee joint is essential to improve surgical outcomes. We developed a software system that three-dimensionally (3D) simulates TKR surgery based upon 3D knee models reconstructed from computed tomography (CT) imaging. The main task of the system was to extract precise 3D anatomical parameters of a patient's knee that were directly used to determine a custom fit implant and to virtually perform TKR surgery. The virtual surgery was simulated by amputating a 3D knee model and positioning the determined implant components on the amputated knee. The test result shows that it is applicable to derive surgical parameters, determine individualized implant components, rehearse the whole surgical procedure, and train medical staff or students for actual TKR surgery. The feasibility and verification of the proposed system is described with examples.

Clinical Study of Prosthetic Heart Valve Replacement with CarboMedics. (CarboMEdics 기계판막을 이용한 심장판막 치환술의 임상 연구)

  • 장원기;구자홍;조중구;김공수
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.45-50
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    • 2000
  • Background: The CarboMedics prosthetic heart valve was produced in an attempt to improve the existing valve designs and was especially concerned with easily the implantation and further reduction of turbulence. Precise positioning of the valve in situ was achieved by the abilityof the valve to rotate relative to the sewing ring. Improved monitoring is possible due to increased radiopacity and the dacron sewing ring is coated with carbon to reduce pannus overgrowth. The leaflets have an opening angle of 78 degrees that apparently allows a rapid synchronous closure The aim of this study was to analyze the clinical performance of the CarboMedics valve prostheses(45 mitral 13 aortic and 7 double aortic-mitral valve replacement) were implanted in 65 patients(mean age 48.75$\pm$9.74 years) Result: The operative mortality was 3.1%(2/65) causes of death were low cardiac output syndrome. Total follow up was 1831 patient-months and mean follow up was 29.06$\pm$10.97 months/patient. No structural failure hemorrhage valve thrombosis and late death have been observed. Embolism occurred at a rate of 0.65%/Patient-year. Actuarial survival and thrombo-mbolism free rate at 36 months were 96.9% and 98.4% respectively. Consclusions: The CarboMedics valve stands for low valve related complicatons.

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Implementaion of Home Healthcare System for a Patient using SAW Tag (SAW 태그를 이용한 재택환자 종합관리시스템 구현)

  • Song, Jai-Chul
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.17 no.3
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    • pp.183-188
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    • 2017
  • This paper is for the a study on home healthcare system for a patient using SAW Tag. This system is useful when there's a patient in home. Many patients are wounded in restroom. But restroom is very private place and nobody want to be disturbed here. The place where the patient is most injured in the house is the toilet, and it is the point where the privacy of the individual should be kept and the patient's condition should be checked and cope with in case of emergency. And using saw tag, we can calculate position and ID through reflected rf signal. Therefore we propose a general home healthcare system. The management system utilized a seat bed system to monitor at-home patients. The system mounts a bio-signal measuring unit on a toilet seat, measures a bio-signal from the bio-signal measuring unit, and the measured bio-signal is transmitted to the main server through the user's smart phone. With proposed system, we can expand operation area to silver town where many patients are cared. In this paper we developed sensor system and saw tag positioning system and showed the result.

Comparison of Image Quality and Dose According to the Arm Positioning in the Chest CT (흉부 CT 검사에서 환자 팔의 위치에 따른 영상의 화질과 선량 비교)

  • Yoo, Muyeon;Park, Sam;Jang, Heuijung;Lee, Hyojin;Lee, Jongwoong;Kweon, Daecheol
    • Journal of the Korean Society of Radiology
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    • v.8 no.2
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    • pp.75-79
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    • 2014
  • The aim of this retrospective research was to investigate the influence of the patient's arm position on radiation dose and scanning during CT. Chest CT image created image degradation, artifact and overdose to the patient due to the difference of the chest thickness. Therefore, the patient's arm should up position during the CT chest examination. In 2012, 1,642 patients underwent chest CT examination in Seoul K hospital. 118 chest CT examination performed hands down position. The average DLP value of the CT chest arm up examination was 275 $mGy{\cdot}cm$. The average DLP value of the CT chest arm down examination was 312.46 $mGy{\cdot}cm$. In the retrospective study with same patient, The average DLP value of the CT chest examination arm up vigorously was 267.5 $mGy{\cdot}cm$. The average DLP value of the CT chest arm down examination was 307.5 $mGy{\cdot}cm$. Chest CT scan without raising arm created linear artifact due to the lack of X-ray photons which is the thickest part of the human body of shoulder area. In conclusion, arm positioning patients' arms above the shoulders at CT of the chest increases image quality and substantially reduces effective radiation dose.

Rational treatment planning for implant treatment of the edentulous patients (완전무치악환자의 전악 임플란트 치료 계획 수립을 위한 체계적인 접근법)

  • Jeong-In Bae
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.2
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    • pp.54-68
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    • 2023
  • Treatment planning of edentulous patient with digital method is materialized by designing the surgical guide. When designing the surgical guide, we first implement the shape of the final prosthesis in the virtual space and then materialize the implantation plan based on this. However, it is challenging to make surgical guides for edentulous patients as their lack of both the reference for the arrangement of teeth and interocclusal relationship makes it hard to envision the shape of the final prosthesis. If there exists good partial or complete dentures or residual teeth, its teeth arrangement can be used as a reference for the virtual final prosthesis and the subsequent surgical guide. If such a reference is absent or unsatisfactory, a process of manufacturing a complete denture for diagnostic purposes and verifying it on patient's mouth is necessary and use it as a new reference for the virtual final prosthesis. But even if a surgical guide is produced through the reference from the thorough reflection of the virtual final prosthesis, when we use it in the surgical field, the intraoral condition of the patient may make the implants deviated from planned in the surgical guide. In the worst case, if the positioning of the surgical guide on the mouth is incorrect, it can lead to a catastrophic error that displaces all the implant, in which case the guided surgery would be much worse than the non-guided one. In this article, we will discuss how to obtain references of tooth arrangements in a timely manner and align or register them into a unified coordinate system in digital space, and also introduce how to transfer such an implantation plan from the virtual world into the patient's mouth of real world with minimum error. And lastly, I would like to express my opinion on the establishment of a rational and systematic protocol of guided surgery of the edentulous patients.

A Survey on Quality of Radiographs in Frontal Projection of the Chest (흉부(胸部) 정면(正面)X선사진(線寫眞)의 화질(畵質)에 관한 검사(檢討))

  • Choi, Jong-Hak;Jeon, Man-Jin;Lee, Chang-Yup
    • Journal of radiological science and technology
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    • v.8 no.2
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    • pp.11-14
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    • 1985
  • The author came to analize and get the following problems after researched radiographic quality in order to find out the necessary factors to improve in radiographs of frontal projection of the chest selected at random of the adult patients (1545 male, 1520 female) who had been examined in 4 departments of radiology of the general hospitals in Seoul and Kyungki area. 1. Problems of x-ray film or of radiographic cassette appeared in 2.97% radiographs on account of selection of the film size (except costophrenic sinus) (1.79%), poor screen-film contact (0.85%), light leakage of cassette (0,33%). 2. Problems of patients' positioning or breathing appeared in 16.57% radiographs of all because of overlapping of lung apex and clavicle (6.98%), overlapping of scapula and lung field (5.87%), asymmetrical projection of clavicles (1.76%), errors in positioning and breathing of the patient (1.96%). 3. Problems of x-ray exposure factors or film processing appeared in 22.25% radiographs because of over-density (2.64%), under-density (3.95%), fog (0.59%), demonstration density under clavicles or lung marking unsharply (3.82%), not clear of lung marking from breast region (0.94%), not clear the lung marking from the part overlapped of heart and lungs (3.92%), not clear the lung marking from the part overlapped of liver and lung (6.49%).

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Strategies for Rural Hospitals in Korea (농촌지역 병원들의 경영개선을 위한 전략)

  • 박종연;강명근;최귀선;조우현
    • Health Policy and Management
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    • v.10 no.1
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    • pp.148-173
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    • 2000
  • This thesis is a kind of case report on the managerial difficulties and strategies to overcome them for the rural hospitals in Korea. We examined environmental situations and SWOT(Strength, Weakness, Opportunity, Threat) of the hospitals, and suggested some strategies to improve the hospital business through analysing secondary data and brief survey to staffs and patients at 3 case hospitals. Among the strategies were included establishment of their identity as community hospitals, positioning towards high-touch services rather than high-tech services to improve their competence. For this positioning, patient satisfaction should be emphasized to make rapport with the residents in the community, and a few service areas should be selected and strengthened. Emergency care and geriatric health services are recommended to be covered strongly, because rural hospitals are usually the one and only hospital in the region and rural communities have aged population structure. In addition to these, networking is necessary among rural hospitals nationwide and with local clinics and tertiary hospitals near urban areas. And also, complementary role division with community health post should be developed to lessen the competitive relationship between public and private sectors. To support these strategies, fresh organizational culture should be built up to make hospital staff creative and enthusiastic on their job. Finally, inducement of governmental assistance will be necessary to make the environment advantageous to the rural hospitals.

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An Evaluation of the Fundamental Nursing Practice in Clinical Settings by Triangulation Method (트라이앵귤레이션 방법에 의한 기본간호 현장실습교육 평가)

  • Kim, Chun-Mi;Kim, Eun-Man
    • The Journal of Korean Academic Society of Nursing Education
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    • v.17 no.2
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    • pp.235-245
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    • 2011
  • Purpose: The purpose of this study was to identify effectiveness of fundamental nursing practices in clinical settings. Method: This study adopted the triangulation method. Using one group pre-post test design, this study identified differences in self efficacy between pre and post clinical practice. The study was also designed to describe the nursing student's experience of clinical practice by using content analysis Results: 1) All students experienced bedmaking, BST check, V/C check, positioning, transferring, assisting with moving and positioning, and ROM. Sixty percent of students experienced giving oral care, and forty percent experienced shampooing patient's hair. 2) While the mean score of self efficacy was 3.88 in the pre-test, it decreased to 3.76 in the post-test. They were statistically different from each other. 3) Seven categories were elicited from the result of content analysis on the nursing student's experience, which were 'ignorant stranger', 'facing the gap between theory and practice', 'resolving the uncertainty of clinical setting', 'getting used to fundamental nursing practice', 'motivated by a desire to study and self-development', 'understanding the nursing profession's job', and 'being helpful for the future career'. Conclusion: Fundamental nursing practice in clinical settings is a useful strategy that improves fundamental nursing skills and motivates student's self-development.

Errors in light-emitting diodes positioning when curing bulk fill and incremental composites: impact on properties after aging

  • Abdulrahman A. Balhaddad;Isadora M. Garcia;Haifa Maktabi;Maria Salem Ibrahim;Qoot Alkhubaizi;Howard Strassler;Fabricio M. Collares;Mary Anne S. Melo
    • Restorative Dentistry and Endodontics
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    • v.46 no.4
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    • pp.51.1-51.13
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    • 2021
  • Objectives: This study aimed to evaluate the effect of improper positioning single-peak and multi-peak lights on color change, microhardness of bottom and top, and surface topography of bulk fill and incremental composites after artificial aging for 1 year. Materials and Methods: Bulk fill and incremental composites were cured using multi-peak and single-peak light-emitting diode (LED) following 4 clinical conditions: (1) optimal condition (no angulation or tip displacement), (2) tip-displacement (2 mm), (3) slight tip angulation (α = 20°) and (4) moderate tip angulation (α = 35°). After 1-year of water aging, the specimens were analyzed for color changes (ΔE), Vickers hardness, surface topography (Ra, Rt, and Rv), and scanning electron microscopy. Results: For samples cured by single-peak LED, the improper positioning significantly increases the color change compared to the optimal position regardless of the type of composite (p < 0.001). For multi-peak LED, the type of resin composite and the curing condition displayed a significant effect on ΔE (p < 0.001). For both LEDs, the Vickers hardness and bottom/top ratio of Vickers hardness were affected by the type of composite and the curing condition (p < 0.01). Conclusions: The bulk fill composite presented greater resistance to wear, higher color stability, and better microhardness than the incremental composite when subjected to improper curing. The multi-peak LED improves curing under improper conditions compared to single-peak LED. Prevention of errors when curing composites requires the attention of all personnel involved in the patient's care once the clinical relevance of the appropriate polymerization reflects on reliable long-term outcomes.

Pathologic conditions associated with impacted third molars: A retrospective study of panoramic radiographs in a Southern Brazilian population

  • Gabriela Brum Cardoso;Gleica Dal' Ongaro Savegnago;Waneza Dias Borges Hirsch;Mariana Boessio Vizzotto;Gabriela Salatino Liedke
    • Imaging Science in Dentistry
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    • v.53 no.4
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    • pp.303-312
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    • 2023
  • Purpose: This study investigated the prevalence of developmental and acquired pathologic conditions associated with impacted third molars (3Ms) in a Southern Brazilian population and evaluated whether demographic and tooth characteristics were correlated with the presence of bone or tooth lesions. Materials and Methods: Panoramic radiographs were assessed for developmental (bone-related) or acquired (tooth-related) pathoses associated with impacted upper or lower 3Ms. Data on tooth positioning, tooth development, and patient demographics were collected. A trained, calibrated postgraduate student evaluated all images. Binary and multivariate logistic regression models were used to assess associations between outcomes and the demographic and radiographic variables. The threshold for statistical significance was set at 5% (P<0.05). Results: The sample comprised panoramic radiographs from 2054 patients, predominantly female (59.2%), with a mean age of 27.2±11.5 years. Overall, 4066 impacted 3Ms were evaluated, revealing 471 (11.6%) developmental and 710 (17.5%) acquired pathoses. Among the developmental pathoses, 460 (95.2%) were indicative of dentigerous cysts. Male sex, lower 3M location, vertical or distoangular positioning, and incomplete root formation were associated with an elevated likelihood of developmental pathology. Lower tooth position, complete root formation, and partial eruption were linked to an increased probability of an acquired pathology in the third or second molar. Conclusion: The prevalence of pathologic conditions associated with impacted 3Ms was low. Male sex, lower 3M placement, horizontal or distoangular positioning, and incomplete root formation were associated with developmental pathoses, while lower tooth position, complete root formation, and partial eruption were related to acquired pathoses.