• Title/Summary/Keyword: 치료적 전기자극

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Hospice-Palliative Care Activities of personnel in a Long-Term Care Hospital; a retrospective chart review (일개요양병원 호스피스·완화의료의 서비스의 직종별 행위 분석; 후향적 의무기록 중심으로)

  • Cho, Hyun;Lim, Heeyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.570-577
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    • 2017
  • The purpose of this study was to provide a basis for the development of a health insurance payment system by exploring inpatient hospice & palliative care activities in a long-term care hospital by occupational personnel. The contents and frequency of inpatient hospice-palliative care activities were obtained retrospectively from the chart review of 12 terminally ill patients who died during the 6 months before their deaths. According to their occupational personnel, doctors were doing blood transfusion, family counseling, and medication guidance. Nurses' main activities were airway suction, oxygen supply, EKG monitoring, observing patient's status, helping medication and tube feeding. Other workers' activities are as follows: social workers were applying individualized programs, physical therapists were doing electrostimulation, nutritionists were giving nutrition evaluation and meal rounding, and careworkers were assisting with meals and nutrition. Although certain nursing activities, like emotional support, were performed by nurses, the hospice-palliative activities from doctors, social workers and physical therapists were largely unavailable for terminally ill patients in a long-term care hospital. And some terminally ill patients were receiving too intensive and invasive medical cares for end end-of-life care. The results highlight the importance of valid measures of hospice-palliative care quality and the need for establishing an adequate reimbursement system for ensuring and improving end-of-life care.

Effects of Neuromuscular Electrical Stimulation on Muscle Wasting with Cancer Patient: A Systematic Review (신경근전기자극치료가 암 환자의 근육 손실에 미치는 영향: 체계적 문헌고찰)

  • Eun Soo Park;Jong Hee Kim;Soo Dam Kim;Dong Hyun Kim;Eun Jung Lee;Min Seok Oh;Hwa Seung Yoo
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.15-29
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    • 2023
  • Objectives The purpose of this study is to systematically review the effects of Neuromuscular Electrical Stimulation treatment on muscle wasting in cancer patients. Methods Randomized controlled trials (RCTs) were searched from seven online databases (PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Oriental Medicine Advanced Searching Integrated System, Korean studies Information Service System, Research Information Sharing Service. The selected RCTs were evaluated for methodological quality through the Cochrane RoB. Results A total of 126 articles were identified, and 4 randomized controlled trials were selected for systematic review. In one study, it was found that there were statistically significant improvements in the Health-Related Quality of Life (FACTH&N total score, p<0.001). Additionally, significant effects were observed in measurements that represented the size of the quadriceps muscle (cross-sectional area of Vastus lateralis and Rectus femoris, p=0.004), maximum muscle strength, the twitch response of resistance muscles, and voluntary activation (p<0.001). However, no significant differences were observed between the intervention and control groups in terms of quadriceps muscle strength in two other studies (p>0.05). Lastly, while one study showed no significant differences in muscle fiber characteristics between the two groups, it did report significant improvements in measurements related to mitochondria within muscle tissue and muscle strength in the intervention group (p<0.05). Conclusions Neuromuscular electrical stimulation can be a method used to improve muscle strength in muscle wasting of cancer patients, but it is difficult to see its effects as significant compared to other treatments.

The Inhibitory Effect of Nicotine on TNF-α Expression in Human Fetal Astrocytes (담배 니코틴에 의한 사람 태아 성상세포에서 종양괴사인자(TNF-α)의 발현 억제작용)

  • Son, Il-Hong;Lee, Sung-Ik;Yang, Hyun-Duk;Han, Sun-Jung;Suk, Seung-Han;Lee, Jai-Kyoo;Kim, Jae-Hyun;Park, Joo-Young;Moon, Hyung-In;Lee, Sung-Soo
    • Journal of the Korean Chemical Society
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    • v.51 no.3
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    • pp.251-257
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    • 2007
  • The Tumor necrosis factor-α, (TNF-α), is involved in the pathogenesis of multiple sclerosis and contributes to the degeneration of oligodendrocytes as well as neurons. Nicotine has been found to have immunosuppressive and inflammation-suppressing effects. Astrocytes, the major glial cells in the CNS, are capable of producing TNF-α at both the mRNA and protein levels in response to interleukin-1 (IL-1) or TNF-α. Nicotine has been shown to influence glial cell functions. To order to explore the role of astrocytes in the production of TNF-α, astrocytes were pretreated with nicotine and are stimulated with IL-1β to determine their effects on TNF-α production. The results are as follows. Cytotoxic effects of nicotine on human fetal astrocytes were noted above 10 μg/ml of nicotine. The effect of IL-1β on TNF-α mRNA expression in primary cultured human fetal astrocytes was maximal at 2 h after IL- 1β(100 pg/ml) treatment. Human fetal astrocytes were pretreated with 0.1, 1, and 10 μg/ml of nicotine and then stimulated with IL-1β (100 pg/ml) for 2 h. The inhibitory effect of nicotine on expressions of TNF-α mRNA in human fetal astrocytes with pretreated 0.1 μg/ml of nicotine is first noted at 8 hr, and the inhibitory effect is maximal at 12 h. The inhibitory effect at 1 μg/ml of nicotine is inhibited maximal at 24 h. Nicotine at 0.1, 1 and 10 μg/ml concentrations significantly inhibits IL-1β-induced NF-κB activation. Collectively, this study indicates that nicotine might inhibit the expression of TNF-α in activated human fetal astrocytes.

Empirical Study of Key Factors in Satisfaction with Subway Services (지하철 이용만족도 결정요인에 관한 실증적 연구 -서울지역을 중심으로-)

  • Shim, Jong-Seop;Jeon, Ki-Heung
    • Korean Business Review
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    • v.13
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    • pp.49-66
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    • 2000
  • Despite the fact that understanding customers satisfaction with transportation services is a subject of great importance, authors, so far, found no systematic researches referred to that issue. From this point, studying the satisfaction with subways services can be extremely useful. Empirical study of key factors in the satisfaction with subway services is the departure point, which holds as objectives, and we believe, will contribute to overall increasing in the number of subways services used and in the amount of public benefits derived from that usage. In order to achieve these goals: First, several items referred to some key factors in the satisfaction of subway usage were systemized. Second, a research of specific weights attached to those key factors by subway passengers was conducted. Knowledge of the satisfaction variables system can provide deep insights into ones perceptual experience when using a subway. The results were as follows: Various interrelated factors compose a passengers satisfaction with subway services. People do not just use subway passively; a number of key factors, like physical and personal services, exact timing, easiness to access etc. determine the passengers satisfaction with subway. In order to find out specific weights of these key factors multiple regression analysis was employed. Results showed that satisfaction with subway is determined by (in order of importance) easiness to access, quality of physical services, friendliness of working stuff and timing exactness. According to the findings, passengers do not use subway as a simple mean of transportation, rather they perceive it as a complex combination of environmental elements and overall satisfaction depends on these various factors. Therefore, to learn passengers satisfaction with subways services, passengers subway experience must be thoroughly studied and analyzed, and this is where papers value resides.

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The Sympathetic Skin Responses after Thoracic Sympathicotomy for Patients with Palmar Hyperhidrosis (수장부 다한증환자의 흉부 교감신경절단술후 교감신경 피부반응)

  • 김오곤;홍종면;이석재;홍장수;이광래;김상규
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.579-583
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    • 1999
  • Background: Thoracic sympathicotomy has been used safely and successfully to manage palmar hyperhidrosis. The preoperative and postoperative recording of Sympathetic Skin Responses(SSR) was performed for objective evaluation and follow-up of thoracic sympathicotomy in hyperhidrosis patients, and also for ascertaining the clinical usefullness of SSR. Material and Method: The recording of SSR was performed on 15 patients suffering from palmar hyperhidrosis with Medelec Sapphire Plus electromyogragh before and after thoracic sympathicotomy. Eletrical stimuli on the right median nerve was made in patients in supine position and results were recorded on right and left palms with soles at the same time by 4 channels. Skin temperatures were also monitored simultaneously. T2,3 sympathicotomy was performed with VATS in every patients. SSR was done in 2 patients one month later. Result: Clinically, all patients had symptomatic improvement with satisfaction. Postoperative complication was small amount of residual pneumothorax in 5 patients but it was absorbed sponteneously. There was no recurrence during follow-up period and ten patients(66%) complained compensatory hyperhidrosis. After operation, SSR change was shown in every 15 patients. Abolition of SSR on both palms was achieved in 12 patients(80%) and on both soles in 6 patients. In the other 3 patients, the latencies were significantly delayed and the amplitudes were significantly reduced at both palms and soles. In two patients who were examined at one month later after operation, similar results with postoperative SSRs were shown. The skin temperature on preoperative both palm and sole were lower than normal temperature, and those on postoperative both palm and sole were increased. Those had statistical significance(p<0.05), and the temperature on the palm was increased higher that than on the sole. Conclusion: After thoracic sympathicotomy was performed on palmar hyperhidrosis patients, an increment of skin temperatures and SSR changes were achieved at both palms and soles of all patients. Palmar SSRs were completely abolished in 12 patients(80%), and similar results of postoperative SSRs were achieved. The recording of SSR may be useful to easily and objectively assess the completeness of sympathicotomy and the follow-up of recurrence in hyperhidrosis patients.

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Properties of stretch-activated $K^+$ channels in an G292 osteoblast-like cell (G292 세포에서 세포막 신장으로 활성화되는 $K^+$통로의 특성)

  • Lee, Sang-Gook;Jung, Dong-Keun;Suh, Duk-Joon;Park, Soo-Byung
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.197-204
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    • 2000
  • [$K^+$]-selective ion channels were studied in excised inside-out membrane patches from human osteoblast-like cells (G292). Three classes of $K^+$channels were present and could be distinguished on the basis of conductance. Conductances were $270\pm27\;pS,\;113\pm12\;pS,\;48\pm8\;pS$ according to their approximate conductances in symmetrical 140 mM KCl saline at holding potential of -80 mV It was found that the small conductance (48 pS) $K^+$channel activation was dependent on membrane voltage. In current-voltage relationship, small conductance $K^+$channel showed outward rectification, and it was activated by the positive potential inside the membrane. In recordings, single channel currents were activayed by a negative pressure outside the membrane. The membrane pressure increased $P_{open}$ of the $K^+$ channel in a pressure-dependent manner. In the excised-patch clamp recordings, G292 osteoblast-like cells have been shown to contain three types of $K^+$ channels. Only the small conductance (48 pS) $K^+$channel is sensitive to the membrane stretch. These findings suggest that a hyperpolarizing current, mediated in part by this channel, may be associated with early events during the mechanical loading of the osteoblast. In G292 osteoblast-like cells, $K^+$channel is sensitive to membrane tension, and may represent a unique adaptation of the bone cell membrane to mechanical stress.

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The Change of The Effect on The Subcutaneous Fat Area and Visceral Fat Area by The Functional Electrical Stimulation and Aerobic Exercise (기능적 전기 자극과 유산소 운동이 복부비만의 피하지방과 내장지방에 미치는 효과)

  • Oh Sung-tae;Lee Mun-hwan;Park Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.16 no.1
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    • pp.85-123
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    • 2004
  • Back ground : Subcutaneous fat area is the main factor involved in replacement disease and arteriosclerosis. Simple weight control is the appropriate medical treatment. It's understood that weight reduction does not only reduce the fat concentrations in blood but also reduces blood pressure, improves glucose levels in diabetes patients and reduces incidents of heart disease. there are several methods for reducing fat in the abdominal region but their effectiveness is not folly understood. one method is electrical stimulation of the problem areas. Method : From May 1st 2002 to October 31st. The 15 subjects who received medical examination were aged between 25 and 53 and were of mixed gender. The subjects were divided into two groups one to received functional electrical stimulation and the other a control group. Using Broca's criterion for judging fat grades. I analysed the differences between the two groups before and after the treatment. Subjects received functional electrical stimulation on the abdominal muscle intensity 50Hz. They received this treatment 4 days a week for 40 minutes a day. In the case of aerobic exercise, at the Treadmill, we used it with the intensity of $75\%$ maximum heart rate (220-age). Result 1)After functional electrical stimulation in the case of male subjects, the weight was reduced 1.93kg, obesity $2.60\%$, fat mass 2.73kg, Percent body fat $4.40\%$, waist circumference 6.53cm, circumference of hips 5.53cm. On the other side, the quality of muscle was increased at the rate of 1.03kg, but it's not attentional level. The subcutaneous fat area was reduced by $26.63cm^2$, the visceral fat area was reduced by $43.00cm^2$, In the female subjects, we can see the reduction of fat grade by $26.63cm^2$, the quantity of body fat by 1.5kg, percent body fat by $1.77\%$, circumference of waist by 4.02cm, circumference of hips by 3.67cm, weight by 1.40kg but was increased 0.72kg at the quantity of muscles. We can see the reduction also in the subcutaneous fat area $24.03cm^2$, the visceral fat area by $25.36cm^2$. 2)After aerobic exercise, on the male subjects, we can see reduction of weight by 3.36kg, obesity by $4.00\%$, fat mass by 2.83kg and we can see increase at the soft lean mass by 2.96kg, but we can see reduction, the percent body fat by $3.03\%$, fat distribution by $0.023\%$, circumference of waist by 3.10cm, circumference of hips by 2.23cm. The female subjects show a reduction in the weight by 2.48kg, percent body fat by $2.20\%$, show an increase in the soft lean mass by 1.54kg. We can see a reduction in the quantity of fat mass by 2.32kg, the percent body fat by $2.80\%$, the circumference of waist by 2.16cm, the circumference of hips by 2.68cm, the fat distribution by $0.016\%$, the subcutaneous fat area by $15.25cm^2$ the visceral fat area by $11.52cm^2$. After aerobic exercise, we can't see the attentional change at the total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol. 3)After the application of functional electrical stimulation and aerobic exercise, in result of measurement on the body ingredient, we could see the weight reduction and increase the quantity of muscle with the male group who exercised aerobic. We can see the attentional rate on the electrical stimulation about abdominal fat rate, circumference of waist, circumference of hips. The other hand, I couldn't see the attentional differences between the two groups in the rate of fatness and quantity of body fat and the rate of body fat. There isn't any attentional difference in the area of fat under skin, on the contrary, There is attentional difference in the fat in the internal organs area at the electrical stimulation site. We can't see the attentional change of total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol between electrical stimulation and aerobic exercise. 4)After execution of functional electrical stimulation and aerobic exercise, in result of measurement on change of body ingredient among female objects, We could see weight reduction, increase at muscle quantity in the aerobic exercise group. We could see the attentional differences in the rate of fatness, the rate of abdominal region, the circumference which received electrical stimulation. But, we couldn't see the attentional differences between two groups in the quantity of body fatness, the circumference of hips. The subcutaneous fat area doesn't show the attentional differences. On the Contrary, we could see lots of differences in the visceral fat area of the electrical stimulation group. Conclusion The results show that functional electrical stimulation and aerobic exercise have insignificant differences when if comes to total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol. Though there is affirmative change in body ingredient after both electrical stimulation and aerobic exercise. Functional electrical stimulation is more effective on the subcutaneous fat area and in changing visceral fat area. There fore. It is concluded that the physical therapy is more effective in the treatment of abdominal fatness.

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