• 제목/요약/키워드: Clinical Protocols

검색결과 363건 처리시간 0.022초

Is there any Potential Clinical Impact of Serum Phosphorus and Magnesium in Patients with Lung Cancer at First Diagnosis? A Multi-institutional Study

  • Kouloulias, Vassilis;Tolia, Maria;Tsoukalas, Nikolaos;Papaloucas, Christos;Pistevou-Gombaki, Kyriaki;Zygogianni, Anna;Mystakidou, Kyriaki;Kouvaris, John;Papaloucas, Marios;Psyrri, Amanda;Kyrgias, George;Gennimata, Vasiliki;Leventakos, Konstantinos;Panayiotides, Ioannis;Liakouli, Zoi;Kelekis, Nikolaos;Papaloucas, Aristofanis
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권1호
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    • pp.77-81
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    • 2015
  • Background: The aim of the study was to determine whether the expression of baseline phosphorus (P) and magnesium (Mg) levels were prognostic in terms of stage and overall survival (OS) in newly diagnosed non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) patients. Materials and Methods: Retrospectively, 130 patients were selected at the time of diagnosis oflung cancer (100 with NSCLC and 30 with SCLC), before the initialization of any chemo-radiotherapy. The median age was 67 (range 29-92). IA, IB, IIA, IIB, IIIA, IIIB and IV stages were present in 3, 4, 19, 6, 25, 8, and 65 patients, respectively. After centrifugation, the levels of serum P and Mg were measured using the nephelometric method/ photometry and evaluated before any type of treatment. Results: Higher than normal levels of P were found in 127/130 patients, while only four patients had elevated Mg serum values. In terms of Spearman test, higher P serum values correlated with either stage (rho=- 0.334, p<0.001) or OS (rho=-0.212, p=0.016). Additionally, a significant negative correlation of Mg serum levels was found with stage of disease (rho=-0.135, P=0.042). On multivariate cox-regression survival analysis, only stage (p<0.01), performance status (p<0.01) and P serum (p=0.045) showed a significant prognostic value. Conclusions: Our study indicated that pre-treatment P serum levels in lung cancer patients are higher than the normal range. Moreover, P and Mg serum levels are predictive of stage of disease. Along with stage and performance status, the P serum levels had also a significant impact on survival. This information may be important for stratifying patients to specific treatment protocols or intensifying their therapies. However, larger series are now needed to confirm our results.

간호사 특성에 따른 일혈예방 지식과 간호수행 (Nurses' Knowledge and Performance for Prevention of Extravasation at Peripheral Intravenous Therapy)

  • 정선아;최은희;이경수;정귀애
    • 한국산학기술학회논문지
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    • 제17권8호
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    • pp.183-191
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    • 2016
  • 이 연구는 간호사를 대상으로 일혈 관련 간호사의 지식 및 간호수행 정도를 파악하여 일혈과 관련된 심각한 손상으로부터 환자를 보호하기 위하여 수행하였다. 연구 대상자는 D시의 3개 대학병원과 2개 종합병원 그리고 항암치료가 많이 시행되고 있는 1개 전문병원에 근무하는 간호사 293명을 대상으로 하였다. 본 연구 결과에서 간호사들의 일혈 관련 지식은 $18.50{\pm}2.18$점이었으며 일혈약물은 주입한 때마다 혈액 역류를 확인해야 하는 문항에 대한 지식 점수가 가장 높게 나타났다. 대상자의 일혈예방 지식 점수와 간호수행 점수는 50세 이상, 기혼, 임상경력 10년 이상, 병원 일혈에 대한 관심이 있는 군에서 유의하게 높았다. 또한 일혈예방 지식점수는 병원 안전관리체계가 있었던 경우에서 간호수행 점수는 고학력, 책임간호사 이상, 내과계와 중환자실, 정맥주입 관련 교육경험이 있었던 경우에서 높게 나타났다. 결론적으로 간호사들의 일혈예방 행위를 증가시키기 위해서는 계속 교육을 통해 지식을 향상시킬 필요가 있으나 지식 향상 뿐 만 아니라 행위를 향상시킬 수 있는 프로그램의 개발이 필요하다. 그러므로 환자 안전 관리팀의 운영, 표준화된 프로토콜의 개발과 적극 사용을 위한 의료기관 차원의 지원이 필요하다고 본다.

근관 충전제의 과충전에 의한 하치조 신경손상에 관한 비수술적 치료 증례 (Case Report : Non-surgical Treatment of Inferior Alveolar Nerve Injury as a Result of Overinstrumented Root Canal Treatment)

  • 배국진;안종모;윤창륙;조영곤;유지원
    • Journal of Oral Medicine and Pain
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    • 제36권3호
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    • pp.199-205
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    • 2011
  • 근관치료 중 수동 또는 엔진구동파일을 사용하다 과도한 기구 조작을 하게 되면, 근관충전제, 드레싱제 그리고 근관세척제가 근관에서 나와 하악관으로 확산될 수 있다. 이 때 환자는 통증, 지각과민, 지각감퇴, 무감각, 이상감각 등을 호소하게 될 것이다. 이런 문제들은 근관충전제에 포함되어 있으면서 생체적합성이 떨어지는 물질들에 의한 비가역적인 손상을 피하기 위해 가능한 빨리 해결되어야 한다. 비록 근관치료와 관련하여 발생한 하치조신경의 손상을 치료하는 진료지침이 비교연구 되어 있는 것이 없으나, 이 합병증에 대한 통상의 치료는 통증과 염증을 조절하는 것이고, 가능하다면 수술적인 치료로 근원을 처치하는 것이다. 그러나, 비수술적인 치료로 통증을 완전히 개선하거나 감소시키고 또는 감각이상을 치료하는 것이 보고되어왔다. 가바펜틴(gabapentin) 또는 프리가발린(pregabalin) 같은 항간질제는 신경병증 통증의 치료에 이용되어 왔다. 이번 논문에서는 하악 우측 제 2대구치의 근관치료 후의 하치조신경의 손상과 이에 대해 프레드니솔론과 가바펜틴으로 비외과적 치료를 시행한 것과 임상적으로 신경감각검사와 신경전류인지역치검사(Neurometer)를 통해 경과관찰을 시행하였다.

전치부 영역 임플란트의 식립 시기에 따른 심미적 평가 (Comparative esthetic evaluation of anterior zone with immediate, early, and delay implantation)

  • 김정화;서성용;김나홍;유정현;이동운
    • 대한심미치과학회지
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    • 제26권1호
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    • pp.17-23
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    • 2017
  • 임플란트 식립시기가 심미적인 부분에 영향을 미치는 것에 대한 연관성을 평가하기 위해 전치부 영역에 식립된 34개의 임플란트 (27명 환자)를 후향적으로 조사했다. 즉시, 조기 및 지연식립으로 시기별로 그룹을 나누고 모든 환자를 보철완료 1년후에 연조직 평가를 시행했다. 통계적으로 그룹별 유의한 의미는 없었다. 식립 시기에 상관없이 만족할 만한 최종결과를 위해 다양한 골이식술과 연조직 이식술이 이루어졌다. 즉, 식립시기로 그 결과를 결정지을 수 없다는 점은 다각적인 면에서 고려사항이 요구된다는 점을 시사한다.

Effect of Zedoariae rhizoma on Bronchial Inflammation and Allergic Asthma in Mice

  • Ahn, Jong-Chan;Ban, Chang-Gyu;Park, Won-Hwan
    • 동의생리병리학회지
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    • 제20권6호
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    • pp.1636-1648
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    • 2006
  • There are detailed descriptions of the clinical experiences and prescriptions of asthma in traditional Korean medicine. Zedoariae rhizoma is one of the Korean herbal medicines used to treat bronchial asthma and allergic rhinitis for centuries. However, the therapeutic mechanisms of this medication are still far from clear, In this study, a house-dust-mite (Dermatophagoides pteronyssinus [Der p])-sensitized murine model of asthma was used to evaluate the immunomodulatory effect of Zedoariae rhizoma on the allergen-induced airway inflammation in asthma. Three different protocols were designed to evaluate the treatment and/or long-term prophylacitic effect of Zedoariae rhizoma in Der p-sensitized mice. Cellular infiltration and T-cell subsets in the bronchoalveolar lavage fluid (BALF)of allergen-challenged mice were analyzed. Intrapulmonary lymphocytes were also isolated to evaluate their response to allergen stimulation. When Zedoariae rhizoma was administered to the sensitized mice before AC (groups A and C), it suppressed airway inflammation by decreasing the number of total cells and eosinophil infiltration in the BALF, and downregulated the allergen- or mitogen-induced intrapulmonary lymphocyte response of sensitized mice as compared to those of controls. This immunomodulatory effect of Zedoariae rhizoma may be exerted through the regulation of T-cell subsets by elevation or activation of the CD8+ and double-negative T-cell population in the lung. However, the administration of Zedoariae rhizoma to sensitized mice 24 h after AC (group B) did not have the same inhibitory effect on the airway inflammation as Zedoariae rhizoma given before AC. Thus, the administration of Zedoariae rhizoma before AC has the immunomodulatory effect of reducing bronchial inflammation in the allergen-sensitized mice. On the other hand, to determine the potentiality of prophylactic and/or therapeutic approaches using a traditional herbal medicine, Zedoariae rhizoma, for the control of allergic disease, we examined the effects of oral administration of Zedoariae rhizoma on a murine model of asthma allergic responses. When oral administration of Zedoariae rhizoma was begun at the induction phase immediately after OVA sensitization, eosinophilia and Th2-type cytokine production in the airway were reduced in OVA-sensitized mice following OVA inhalation. These results suggest that the oral administration of Zedoariae rhizoma dichotomously modulates allergic inflammation in murine model for asthma, thus offering a different approach for the treatment of allergic disorders.

개원의중심연구망에서 수행된 보완통합의학 관련 연구 현황: 체계적 문헌고찰 (The Current Research Status of Complementary and Integrative Medicine in Practice-Based Research Networks: A Systematic Review)

  • 원지윤;한가진;김예진;박재량;노은영;지유진;아담스 존;이향숙
    • Korean Journal of Acupuncture
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    • 제37권4호
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    • pp.209-230
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    • 2020
  • Objectives : Practice-Based Research Networks (PBRNs), collaborations of practitioners and academic researchers, have provided platforms for conducting research to address clinical questions generated from daily routine care. This review aimed to critically analyse articles from PBRNs that are related to complementary and integrative medicine (CIM) and to suggest future directions for a PBRN which is appropriate for Korean Medicine (KM). Methods : PubMed, PBRN registries in Agency for Healthcare Research and Quality and relevant PBRN websites were searched up to November 2019 for research articles from PBRNs that focused on CIM regardless of study design. Methodological quality of the included studies was assessed. The included studies were read in full, classified and summarised according to their topics. Results : A total of 51 articles published from 1998 through 2020 were included in this review. They were categorised into three principal themes based on research questions and findings: health services research (embracing researches examining characteristics of patients and CIM practitioners/practices, and communication between patients and practitioners); effectiveness and safety of CIM practices/interventions; and feasibility studies of instruments and interventions in PBRN settings. The study designs varied including surveys (n=30), prospective observational studies (n=6), 2ndary analyses of existing studies (n=7), protocols (n=7), retrospective chart review (n=1) and qualitative study (n=1). Quality of the included studies greatly varied. Conclusions : PBRNs can serve as a feasible platform for conducting practice-relevant research on KM and CIM. Considering growing demands on evidence-base for routine practice of KM amid various stakeholders, a PBRN in KM community and further researches nested within PBRN designs are warranted.

뇌졸중 환자의 웰니스를 위한 호흡기능, 하지근활성도 및 균형에 미치는 효과 - 호흡운동을 결합한 전신진동운동을 중심으로 - (Effects on the Respiratory Function, Lower Extremity Muscle Activity and Balance for the Wellness of Stroke Patients - Focused on Whole Body Vibration Exercise Combined with Breathing Exercise -)

  • 강정일;양상훈;정대근
    • 한국엔터테인먼트산업학회논문지
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    • 제14권8호
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    • pp.397-405
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    • 2020
  • 본 연구의 목적은 전신진동이 결합된 들숨근 훈련을 적용하여 뇌졸중 환자의 호흡기능 개선 및 다리근육의 기능향상을 위한 운동방법을 제시하는 것이다. 뇌졸중 환자 21명을 임상 표본추출하여 호흡운동을 결합한 전신진동운동을 적용한 집단 11명을 실험군I로, 호흡운동을 결합한 위약운동을 적용한 집단 10명을 실험군II로 각각 무작위 배치하여 5주 간, 4일/주, 1회/일, 4세트/1회 중재 프로그램을 시행하였다. 중재 전 최대들숨압 측정기로로 호흡기능을 측정하였고, 표면 근전도로 하지 근활성도를 측정하였으며, 버그발란스 검사를 사용하여 균형능력을 측정한 후, 5주 후에 사후검사를 사전검사와 동일하게 재 측정하여 분석하였다. 실험군I의 집단 내 변화 비교에서는 호흡근력, 넙다리두갈래근, 앞정강근의 활성도 및 균형에서 유의한 차이가 있었다(p<.05). 실험군II의 집단 내 변화 비교에서는 호흡근력과 균형에서 유의한 차이가 있었다(p<.05). 집단 간 변화 비교에서는 넙다리두갈래근, 앞정강근의 활성도에서 유의한 차이가 있었다(p<.01). 향후에도 신경근 기능을 향상시키기 위한 호흡운동과 전신진동에 대한 프로토콜에 대한 연구가 지속적으로 필요할 것으로 여겨진다.

족관절 인대 손상 치료 동향: 대한족부족관절학회 회원 설문조사 분석 (Current Trends in the Treatment of Ankle Ligament Injuries: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey)

  • 조병기;조재호;이명진;이준영;배서영;2021 대한족부족관절학회 학술위원회
    • 대한족부족관절학회지
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    • 제26권1호
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    • pp.22-29
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    • 2022
  • Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.

경추근막통증증후군에 대한 초음파 유도하 약침 치료 3례 증례보고 (Case Report on Three Patients with Cervical Myofascial Pain Syndrome Showing Improvement with Ultrasound-Guided Pharmacopuncture: Proposal of the 'SLS Triangle' Treatment Protocol)

  • 추홍민;박성준;남태광;김광호;권준휘;홍현준;송주환;권상혁;김재효;정혜인;김경한;권오빈
    • Korean Journal of Acupuncture
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    • 제41권3호
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    • pp.101-109
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    • 2024
  • Objectives : Cervical myofascial pain syndrome (C-MPS), a key aspect of Visual Display Terminals (VDT) Syndrome, leads to acute and chronic pain due to muscle shortening, potentially causing headaches and movement disorders. This study examines the effectiveness of Pharmacoacupuncture at the intersection of the Splenius Capitis (SC), Levator Scapulae (LS), and Serratus Posterior Superior(SPS) muscles under ultrasound guidance, known as the "SLS triangle" in treating C-MPS. Methods : Three patients (aged 30 to 37) with acute C-MPS presented at two Korean medicine clinics with severe neck pain and restricted cervical rotation. The evaluation of symptoms before treatment, immediately after treatment, and one day after treatment was conducted using the cervical rotation Range of motion (ROM) and the Numeric Rating Scale (NRS) for cervical pain. Treatments included Acupuncture, Cupping therapy, Chuna manipulation, Physical Therapy, and Pharmacopuncture (Jaha-geo extract, 2cc at the SLS triangle). Results : All three patients showed significant improvement post-treatment. Immediately after treatment, Patient 1's NRS improved from 7 to 2, Patient 2's NRS improved from 4 to 1, and Patient 3's NRS improved from 6 to 2. Directly after the procedure, there were no significant adverse reactions except for one patient experiencing temporary dizziness. When the patients were followed up by phone 24 hours later, no adverse reactions were reported. Conclusions : This study demonstrates that ultrasound-guided pharmacopuncture can significantly reduce pain and improve cervical rotation in patients with cervical myofascial pain syndrome. The findings suggest this non-invasive treatment is both safe and effective, warranting further research through larger-scale clinical trials to validate its efficacy and establish standardized protocols.

Henoch-$Sch{\ddot{o}}nlein$(HS) 신염에서 장기 스테로이드와 Azathioprine의 병합치료 효과 (The Effect of Long-term Steroid Therapy Combined with Azathioprine in Henoch-$Sch{\ddot{o}}nlein$ Nephritis)

  • 문경상;진소영;김은미
    • Childhood Kidney Diseases
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    • 제2권2호
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    • pp.118-124
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    • 1998
  • 목 적 : HS 신염은 확정된 특별한 치료지침이 없으며, 신염의 정도가 심한 경우 단일 스테로이드 요법으로 치료 효과가 좋지 않으므로 장기간 스테로이드 투여 및 azathioprine의 병합에 의한 치료 효과를 관찰하기 위해 본 연구를 시행하였다. 대상 및 방법 : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP)로 진단 받은 후 심한 단백뇨(40 mg/hr/$m^2$ 이상)를 보인 HS 신염 환아 5례(남자 2례, 여자 3례)를 대상으로 신장 생검을 실시하여 ISKDC grade III 이상을 보인 환아를 대상으로 하였고 치료방법은 1)스테로이드 pulse치료를 격일로 6회 정주한 다음, 2) 경구로 스테로이드를 2mg/kg/day(최대 80mg/day) 1개월 투여한 후 1 mg/kg/day으로 1 개월 투여하고 2년간 격일로 1mg/kg/day경구 투여하였다. 3)스테로이드 pulse치료 시행 뒤 azathioprine(2 mg/kg/day)을 2년간 병합하여 경구 투여하였다. 단백뇨 및 미세 혈뇨를 추적 검사하여 임상적 관해 여부를 조사하였고 추적 신장조직 검사를 시행하였다. 결 과 :발병 평균 연령은 $10.5{\pm}3.4$년이었으며 HSP에서 신염으로의 발병 기간은 2주에서 5개월로 평균 $7.4{\pm}7.4$주이었다. 24시간 뇨단백은 평균 $4857.8{\pm}2046.1$ mg/day이었다. 임상적 관해는 5례 중 4례($80\%$)로 단백뇨 소실의 평균기간은 $5{\pm}2.4$개월, 미세혈뇨의 소실 기간은 평균 $13.3{\pm}2.9$개월이었다. 병리학적 소견은 ISKDC 분류로 Crade IIIb가 3례, Grade VI가 2례로 추적 신장 조직 검사를 시행한 4례 중 3례에서 조직학적으로 호전된 양상을 보였다. 결 론 : 아직까지 HS 신염에 대한 확정된 치료 지침이 없는 상황에서 본 연구의 장기간 스테로이드 경구 투여 및 azathioprine의 병합 요법이 임상적, 조직학적으로 효과가 있는 것으로 생각되며 앞으로 더 많은 환아에서 추적 관찰이 필요하다.

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