• 제목/요약/키워드: Clinical Protocols

검색결과 360건 처리시간 0.03초

인간의 미성숙난자의 동결보존에 관한 연구 (Cryopreservation of Human Immature Follicular Oocyte)

  • 김은경;손원영;지희준;고정재;윤태기;차광열
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제19권2호
    • /
    • pp.163-168
    • /
    • 1992
  • This study was carried out to set up the ovum bank for ovum donation and to determine the best freezing method for human immature oocytes. Human immature follicular oocytes were cryopreserved by slow freezing and rapid thawing method. Immature follicular oocytes were treated by propanediol(PROH) solution by 2 and 4 step method in protocols A & B, respectively. In protocol C, immature oocytes were exposed to sucrose prior to treatment of PROH by 4 step method. We compared survival rate, maturation rate, and fertilization rate of immature oocytes among three protocols. Results were as follows. 1. Oocytes treated by the protocol C showed the highest survival rate( 70.3 %) and maturation rate(34.6%) after thawing. 2. Survival rate of oocytes treated by the protocol C was significantly higher than that of the protocol B after thawing(p<0.05). In conclusion, treatment of oocytes with sucrose prior to expose PROH was the best freezing method. Sucrose may have reduced the toxic effect of cryoprotectant to oocytes. We failed to induce fertilization of oocytes, which were treated by any protocols, by conventional insemination method, but obtained 28.8% fertilization rate by using partial zona dissection(PZD) method. This result suggests that micromanipulation(PZD) of the thawed oocytes before insemination will improve the fertilization rate.

  • PDF

항암화학요법 중 가글링 유형에 따른 급성백혈병 환자의 구강감염 예방효과에 관한 연구 (Efficacy of three oral gargling protocols for Prevention of oral mucositis in acute leukemia during chemotherapy)

  • 전명희;김연희;최진선;채수원
    • 한국간호교육학회지
    • /
    • 제3권2호
    • /
    • pp.193-206
    • /
    • 1997
  • Because the oral mucositis is often inevitable in acute leukemia patients during chemotherapy, the efforts must be made to keep these leukemia patients from oral mucositis. So we tried to develop two oral care protocols for reducing the level of oral mucositis during cytotoxic therapy through literature review and our clinical experience. This quasi-experimental study was performed to compare the prohpylatic value of these oral care protocols. Thirty-nine subjects were assigned to one of three groups. The first group performed bivon-normal saline gargling protocol, the second group performed chlorhexidine gargling protocol, and the last contrast group kept traditonal gargling protocol. The Oral Assessment Guide(OAG), the Beck's perception of oral comfort were used to assess oral status and subject's oral discomfort during chemotherapy. Each subjects were observed daily from the start of the chemotherapy until Absolute Neutrophil Count (ANC) reached $1,000/mm^3$. It continued about 2-4 weeks. The data was analyzed by ANCOVA and Kruskal-Wallis one way ANOVA, chi-sqare, survival analysis. The results were as follows : The contrast group showed significantly highest mean score of the OAG and Beck's perception of oral discomfort among three groups from second week to third week. However chie-test and survial analysis showed that the incidence of severe mucositis were not significantly different among three groups. Conclusively we recommend that nurses who care acute leukmia patients use bivon-normal saline gargling protocol be careful to occur severe mucositis during chemotherapy.

  • PDF

The Changes in Range of Motion after a Lumbar Spinal Arthroplasty with Charite$^{TM}$ in the Human Cadaveric Spine under Physiologic Compressive Follower Preload: A Comparative Study between Load Control Protocol and Hybrid Protocol

  • Kim, Se-Hoon;Chang, Ung-Kyu;Chang, Jae-Chil;Chun, Kwon-Soo;Lim, T. Jesse;Kim, Daniel H.
    • Journal of Korean Neurosurgical Society
    • /
    • 제46권2호
    • /
    • pp.144-151
    • /
    • 2009
  • Objective: To compare two testing protocols for evaluating range of motion (ROM) changes in the preloaded cadaveric spines implanted with a mobile core type Charite$^{TM}$ lumbar artificial disc. Methods: Using five human cadaveric lumbosacral spines (L2-S2), baseline ROMs were measured with a bending moment of 8 Nm for all motion modes (flexion/extension, lateral bending, and axial rotation) in intact spine. The ROM was tracked using a video-based motion-capturing system. After the Charite$^{TM}$ disc was implanted at the L4-L5 level, the measurement was repeated using two different methods: 1) loading up to 8 Nm with the compressive follower preload as in testing the intact spine (Load control protocol), 2) loading in displacement control until the total ROM of L2-S2 matches that when the intact spine was loaded under load control (Hybrid protocol). The comparison between the data of each protocol was performed. Results: The ROMs of the L4-L5 arthroplasty level were increased in all test modalities (p < 0.05 in bending and rotation) under both load and hybrid protocols. At the adjacent segments, the ROMs were increased in all modes except flexion under load control protocol. Under hybrid protocol, the adjacent segments demonstrated decreased ROMs in all modalities except extension at the inferior segment. Statistical significance between load and hybrid protocols was observed during bending and rotation at the operative and adjacent levels (p< 0.05). Conclusion: In hybrid protocol, the Charite$^{TM}$ disc provided a relatively better restoration of ROM, than in the load control protocol, reproducing clinical observations in terms of motion following surgery.

Acarbose 제제의 약력학적 평가 및 생물학적동등성 시험법에 대한 연구 (Methods for Pharmacodynamic Analysis and Proposed Protocols for Bioequivalence Study of Acarbose)

  • 배정우;장춘곤;이석용
    • 약학회지
    • /
    • 제51권6호
    • /
    • pp.440-446
    • /
    • 2007
  • Arcabose is a competitive inhibitor of the intestinal ${\alpha}$-glucosidases and reduces the postprandial digestion and absorption of carbohydrate and disaccharides. Due to its negligible oral absorption, measuring drug concentration in the plasma is impractical. Thus, the common pharmacokinetic study is not available to determine the bioequivalence of the generic acarbose preparations. The aim of this study is the establishment of pharmacodynamic assessment method for the bioequivalence test of the generic acarbose preparations. Placebo-controlled cross-over ($3{\times}3$) clinical study was conducted in 23 healthy volunteers. Volunteers received a single oral dose of placebo, reference drug ($Glucoby^{(R)}$ 100 mg, Lot # D043) or test drug ($Glucoby^{(R)}$ 100 mg, Lot # E005) just before breakfast, then blood samples for evaluation of serum glucose and insulin levels were taken during for 4 hours. $C_{max},\;AUC_{0-2},\;AUC_{0-4},\;{\Delta}C_{max},\;{\Delta}AUC_{0-2}\;and\;{\Delta}AUC_{0-4}$ of the postprandial plasma glucose level significantly decreased when a single dose of acarbose 100 mg preparations was administered. However, any significant difference was not detected between the groups taken the reference drug and the test drug. These results proposed that the pharmacodynamic protocols of this study is suitable to use for bioequivalence test of acarbose preparations. On the basis of the results of this study and the data of literature on this subject, the standard protocols of bioequivalence study of acarbose preparation are proposed.

The Crucial Role of the Establishment of Computed Tomography Density Conversion Tables for Treating Brain or Head/Neck Tumors

  • Yang, Shu-Chin;Lo, Su-Hua;Shie, Li-Tsuen;Lee, Sung-Wei;Ho, Sheng-Yow
    • 한국의학물리학회지:의학물리
    • /
    • 제32권3호
    • /
    • pp.59-69
    • /
    • 2021
  • Purpose: The relationship between computed tomography (CT) number and electron density (ED) has been investigated in previous studies. However, the role of these measures for guiding cancer treatment remains unclear. Methods: The CT number was plotted against ED for different imaging protocols. The CT number was imported into ED tables for the Pinnacle treatment planning system (TPS) and was used to determine the effect on dose calculations. Conversion tables for radiation dose calculations were generated and subsequently monitored using a dosimeter to determine the effect of different CT scanning protocols and treatment sites. These tables were used to retrospectively recalculate the radiation therapy plans for 41 patients after an incorrect scanning protocol was inadvertently used. The gamma index was further used to assess the dose distribution, percentage dose difference (DD), and distance-to-agreement (DTA). Results: For densities <1.1 g/cm3, the standard deviation of the CT number was ±0.6% and the greatest variation was noted for brain protocol conditions. For densities >1.1 g/cm3, the standard deviation of the CT number was ±21.2% and the greatest variation occurred for the tube voltage and head and neck (H&N) protocol conditions. These findings suggest that the factors most affecting the CT number are the tube voltage and treatment site (brain and H&N). Gamma index analyses for the 41 retrospective clinical cases, as well as brain metastases and H&N tumors, showed gamma passing rates >90% and <90% for the passing criterion of 2%/2 and 1%/1 mm, respectively. Conclusions: The CT protocol should be carefully decided for TPS. The correct protocol should be used for the corresponding TPS based on the treatment site because this especially affects the dose distribution for brain metastases and H&N tumor recognition. Such steps could help reduce systematic errors.

Pain management in periodontal therapy using local anesthetics and other drugs: an integrative review

  • Eduarda Cristina Santos;Daniela Huller;Sabrina Brigola;Marceli Dias Ferreira;Marcia Thais Pochapski;Fabio Andre dos Santos
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • 제23권5호
    • /
    • pp.245-256
    • /
    • 2023
  • Background: Surgical and non-surgical periodontal procedures often lead to postoperative pain. Clinicians use pharmacological methods such as anesthetics, anti-inflammatory drugs, and analgesics for relief. However, the multitude of options makes it challenging to select the best approach for routine dental care. Objective: This review aimed to describe previous studies regarding the pharmacological management used for pain control during periodontal procedures as well as factors that may interfere with patients' perception of pain. Methods: We included studies (period of 2000-2023, whose approach corresponded to the pharmacological protocols used for preoperative, trans-operative, and postoperative pain control in adult patients undergoing surgical and non-surgical periodontal therapy. Results: A total of 32 studies were included in the analysis, of which 17 (53%) were related to anesthetic methods and 15 (47%) were related to therapeutic protocols (anti-inflammatory/analgesic agents). These studies predominantly involved nonsurgical periodontal procedures. Studies have reported that factors related to age, type of procedure, and anxiety can influence pain perception; however, only seven of these studies evaluated anxiety. Conclusions: Numerous methods for pain control can be applied in periodontal therapy, which are accomplished through anesthetic methods and/or therapeutic protocols. Factors such as anxiety, age, and type of procedure are related to pain perception in patients. Thus, it is the responsibility of dentists to evaluate each clinical situation and define the best protocol to follow based on the literature.

Low Contrast and Low kV CTA Before Transcatheter Aortic Valve Replacement: A Systematic Review

  • Spencer C. Lacy;Mina M. Benjamin;Mohammed Osman;Mushabbar A. Syed;Menhel Kinno
    • Journal of Cardiovascular Imaging
    • /
    • 제31권2호
    • /
    • pp.108-115
    • /
    • 2023
  • BACKGROUND: Minimizing contrast dose and radiation exposure while maintaining image quality during computed tomography angiography (CTA) for transcatheter aortic valve replacement (TAVR) is desirable, but not well established. This systematic review compares image quality for low contrast and low kV CTA versus conventional CTA in patients with aortic stenosis undergoing TAVR planning. METHODS: We performed a systematic literature review to identify clinical studies comparing imaging strategies for patients with aortic stenosis undergoing TAVR planning. The primary outcomes of image quality as assessed by the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were reported as random effects mean difference with 95% confidence interval (CI). RESULTS: We included 6 studies reporting on 353 patients. There was no difference in cardiac SNR (mean difference, -1.42; 95% CI, -5.71 to 2.88; p = 0.52), cardiac CNR (mean difference, -3.83; 95% CI, -9.98 to 2.32; p = 0.22), aortic SNR (mean difference, -0.23; 95% CI, -7.83 to 7.37; p = 0.95), aortic CNR (mean difference, -3.95; 95% CI, -12.03 to 4.13; p = 0.34), and ileofemoral SNR (mean difference, -6.09; 95% CI, -13.80 to 1.62; p = 0.12) between the low dose and conventional protocols. There was a difference in ileofemoral CNR between the low dose and conventional protocols with a mean difference of -9.26 (95% CI, -15.06 to -3.46; p = 0.002). Overall, subjective image quality was similar between the 2 protocols. CONCLUSIONS: This systematic review suggests that low contrast and low kV CTA for TAVR planning provides similar image quality to conventional CTA.

뇌졸중으로 인한 편마비 환자의 상지기능 향상을 위한 거울치료의 임상적 효과에 대한 체계적 고찰 (Clinical Effectiveness of Upper Extremity Performances on Mirror Therapy for Adult with Post Stroke Hemiplegia: A Systematic Review)

  • 백선웅;김종배
    • 재활치료과학
    • /
    • 제5권2호
    • /
    • pp.71-80
    • /
    • 2016
  • 목적: 본 연구는 뇌졸중으로 인한 편마비 환자를 대상으로 거울치료의 임상적용 가능성 및 효과를 제시하는 데에 목적이 있다. 연구방법: 2005년 1월부터 2016년 1월까지 국외 학술지에 게재된 논문을 PubMed를 통하여 검색하였다. 포함기준과 배재기준을 고려하여 최종적으로 9개의 논문을 대상으로 분석하였다. 결과: 거울치료의 효과를 알아보기 위한 중재방법으로는 손목과 손의 단순한 움직임과 과제기반 거울치료가 사용되었다. 중재효과를 알아보기 위해 상지기능, 일상생활동작, 신체적 상태, 삶의 질 평가도구가 사용되었다. 상지의 기능은 근위부보다 원위부에서 더욱 효과가 있고, 일상생활동작에서도 유의한 효과가 있는 것으로 나타났으나, 삶의 질에서는 실험군과 대조군 사이에 유의한 차이가 없는 것으로 나타났다. 결론: 연구를 통해 임상 치료사들은 대상자의 특성에 따라 거울치료를 적절하게 사용할 근거를 찾을 수 있을 것이라 생각된다. 하지만 다양한 거울치료의 프로토콜로 인해 효율적인 적용방법을 확인하는 데 어려움이 있었다. 앞으로는 거울치료의 효과를 극대화 할 수 있는 체계화된 치료 프로토콜이 개발되어야 할 것이다.

무릎뼈 골절 후 한방 재활치료의 임상적 효과: 증례 보고 (Clinical Effectiveness of Korean Medical Rehabilitation Treatment after Patellar Fracture: A Report of 4 Cases)

  • 금지혜;우현준;김종규;이정한
    • 한방재활의학과학회지
    • /
    • 제30권4호
    • /
    • pp.203-217
    • /
    • 2020
  • The aim of this study was to propose our rehabilitation protocol involving Korean medicine for patients with patellar fracture and report its effectiveness. Further, for the same patellar fracture patients, we created different protocols for those who underwent surgical treatment and those who required conservative treatment. Among patients who received inpatient treatment at our hospital for three years from August 2017 to August 2020, we included three patients who underwent surgical treatment for patellar fracture and one patient who required conservative treatment for patellar fracture. The degree of improvement of the patients was evaluated using physical examination findings of the knee joint, numeric rating scale, pain disability index, Lysholm knee score, and walking state. After each treatments, we observed that the range of motion of the knee joint, numeric rating scale, pain disability index, Lysholm knee score, and walking state improved in the patient groups. Even with the same patellar fracture, we observed that different rehabilitation treatments involving Korean medicine should be applied to patients who underwent surgical treatment and those who required conservative treatment. However, further studies are needed to design a rehabilitation protocol involving Korean medicine.

Preimplantation genetic diagnosis for Charcot-Marie-Tooth disease

  • Lee, Hyoung-Song;Kim, Min Jee;Ko, Duck Sung;Jeon, Eun Jin;Kim, Jin Young;Kang, Inn Soo
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제40권4호
    • /
    • pp.163-168
    • /
    • 2013
  • Objective: Preimplantation genetic diagnosis (PGD) is an assisted reproductive technique for couples carrying genetic risks. Charcot-Marie-Tooth (CMT) disease is the most common hereditary neuropathy, with a prevalence rate of 1/2,500. In this study, we report on our experience with PGD cycles performed for CMT types 1A and 2F. Methods: Before clinical PGD, we assessed the amplification rate and allele drop-out (ADO) rate of multiplex fluorescent polymerase chain reaction (PCR) followed by fragment analysis or sequencing using single lymphocytes. We performed six cycles of PGD for CMT1A and one cycle for CMT2F. Results: Two duplex and two triplex protocols were developed according to the available markers for each CMT1A couple. Depending on the PCR protocols, the amplification rates and ADO rates ranged from 90.0% to 98.3% and 0.0% to 11.1%, respectively. For CMT2F, the amplification rates and ADO rates were 93.3% and 4.8%, respectively. In case of CMT1A, 60 out of 63 embryos (95.2%) were diagnosed and 13 out of 21 unaffected embryos were transferred in five cycles. Two pregnancies were achieved and three babies were delivered without any complications. In the case of CMT2F, a total of eight embryos were analyzed and diagnosed. Seven embryos were diagnosed as unaffected and four embryos were transferred, resulting in a twin pregnancy. Two healthy babies were delivered. Conclusion: This is the first report of successful pregnancy and delivery after specific PGD for CMT disease in Korea. Our PGD procedure could provide healthy babies to couples with a high risk of transmitting genetic diseases.