• 제목/요약/키워드: Clinical observation

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기관-기관지 협착에서 내시경적 확장술 및 실리콘 스텐트의 유용성 : 예비보고 (Effectiveness of Endoscopic Dilatation & Silicone Stent Insertion for Tracheobronchial stenoses : Preliminary study)

  • 이경수;박동욱;김규훈;김재욱;고윤우;김도진;이승원
    • 대한기관식도과학회지
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    • 제15권1호
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    • pp.50-55
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    • 2009
  • Objectives: Endoscopic airway dilatation and stenting has been developed to treat the airway stenosis without potential morbidities of open surgery. We report the clinical results of endoscopic airway dilatation with silicone stenting in patients with posttuberculous bronchial stenosis(PTBS) and with severe main tracheal stenosis who have poor general conditions Methods : A prospective observation study of five patients, who have undergone endoscopic airway dilatation and silicone stenting between Feb 2007 and Feb 2009. A total of twelve patients were treated with endoscopic airway dilatation, among them 5 patients were included in this study. three patients were treated with newly designed silicone stent (Natural stent: TNO Co., Seoul, South Korea) because of poor surgical conditions and longer stenotic segment Results: 3 patients were grade III PTBS, and the other 2 patients were grade IV post tracheotomy main tracheal stenosis. One patient of PTBS were treated with silicone stent following endoscopic dilatation because of longer stenotic segment. Two patients of main tracheal stenosis patients were treated with silicone stent because of tracheal lumen collapse. There was no severe postoperative complications except mild granulation tissue formations Conclusions : Endoscopic dilatation including silicone stenting could be a useful method for treating patients with PTBS, and for main tracheal stenosis patients with poor general surgical conditions

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평위산가미방(平胃散加味方)이 아토피피부염을 유발한 NC/Nga mouse에 미치는 영향 (The Effects of Pyeongwi-san-gamibang on NC/Nga mice with atopic dermatitis)

  • 정의령;김윤범
    • 한방안이비인후피부과학회지
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    • 제24권2호
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    • pp.16-27
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    • 2011
  • Objective : To investigate the effects of Pyeongwi-san-gamibang on atopic dermatitis, this study measured TEWL(transepidermal water loss), observed scratching behaviors and checked levels of Total IgE, IL-4, IFN-${\gamma}$ and conducted skin biopsy on NC/Nga mice with atopic dermatitis. Methods : NC/Nga mice were challenged with DNCB during 5 weeks to develop atopic dermatitis-like skin lesions. The NC/Nga mice with atopic dermatitis were divided into three groups of control group, PW-d, PW-e group. Once a day for 22 days, Pyeongwi-san-GamiBang extract with water was administered for the PW-d group and the extract with 80% ethanol was administered for PW-e group compared with saline solution for control group. During drug administration, sensitization by DNCB had lasted for three times per week. Results : 1. TEWL had no statistical difference among 3 groups. 2. The scratching behaviors had no statistical difference among 3 groups. 3. The levels of Total IgE in PW-d, PW-e group had a statistically significantly higher than that of the control group although difference between the control group and the PW-d, PW-e group were similar. 4. The level of IL-4 had no statistical difference among 3 groups. 5. The level of IFN-${\gamma}$ had no statistical difference among 3 groups. 6. As the observation of toluidine blue stained lesion, both PW-d and PW-e group had lower level of histamine releasement compared with the control group. Conclusion : Result based on these experiments, Pyeongwi-san-GamiBang on atopic dermatitis-like skin inflammation in NC/Nga mice is not effective. But, as the study showed significantly individual differece, we need to repeat these study after supplementing the object number and modified indicator of clinical severity.

흰쥐에서 급성 일산화탄소 중독 후 뇌 흥분성 변화를 규명하기 위한 탈륨 Autometallography의 적용 (Application of Thallium Autometallography for Observation of Changes in Excitability of Rodent Brain following Acute Carbon Monoxide Intoxication)

  • 이민수;양승범;허준호
    • 대한임상독성학회지
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    • 제17권2호
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    • pp.66-78
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    • 2019
  • Purpose: Thallium (TI+) autometallography is often used for the imaging of neuronal metabolic activity in the rodent brain under various pathophysiologic conditions. The purpose of this study was to apply a thallium autometallographic technique to observe changes in neuronal activity in the forebrain of rats following acute carbon monoxide (CO) intoxication. Methods: In order to induce acute CO intoxication, adult Sprague-Dawley rats were exposed to 1100 ppm of CO for 40 minutes, followed by 3000 ppm of CO for 20 minutes. Animals were sacrificed at 30 minutes and 5 days after induction of acute CO intoxication for thallium autometallography. Immunohistochemical staining and toluidine blue staining were performed to observe cellular damage in the forebrain following intoxication. Results: Acute CO intoxication resulted in significant reduction of TI+ uptake in major forebrain structures, including the cortex, hippocampus, thalamus, and striatum. In the cortex and hippocampal CA1 area, marked reduction of TI+ uptake was observed in the cell bodies and dendrites of pyramidal neurons at 30 minutes following acute CO intoxication. There was also strong uptake of TI+ in astrocytes in the hippocampal CA3 area following acute CO intoxication. However, there were no significant histological findings of cell death and no reduction of NeuN (+) neuronal populations in the cortex and hippocampus at 5 days after acute CO intoxication. Conclusion: The results of this study suggest that thallium autometallography can be a new and useful technique for imaging functional changes in neural activity of the forebrain structure following mild to moderate CO intoxication.

기관절개관을 보유하고 있는 가정간호대상자를 위한 기관절개관 자가관리 프로그램 개발 및 평가: Caregiver를 중심으로 (Development and Evaluation of a Self-Management Program for Tracheostomy Tube Management for Homecare Client: Focus on Caregivers)

  • 마초원;이주연
    • 임상간호연구
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    • 제17권3호
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    • pp.329-339
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    • 2011
  • Purpose: The purpose of this research was to develop and train caregivers in tracheostomy tube care using a self-management program to assist patients with an 'at home' tracheostomy procedure. Caregivers' self-efficacy and knowledge of tracheostomy management before and after the training was also identified. Methods: Research participants were the main caregivers for patients with tracheostomies who were affiliated with a 'Home Healthcare Center'. Training and observation were done at 'A Hospital' and 'G Hospital' both affiliated with 'K University' in Seoul. Data were collected from May 3, 2010 to January 25, 2011 and analyzed using Wilcoxon signed rank test with SPSS program version 12.0. Results: Significant differences were found for the pre and post evaluation of the 'self-management program' for the implementation of tracheostomy care. The development and implementation of the 'self-management program' improved the main caregivers' knowledge of tracheostomy tube management (Z=-3.599, p<.001). Conclusion: Results show that this program has identified an effective nursing intervention for promoting the caregivers' knowledge of tracheostomy care and self-efficacy. We recommend that further research should be done to test primary caregivers' maintenance of knowledge and self-efficacy in tracheostomy tube management and identify factors affecting knowledge and self-efficacy in the care of these patients.

Comparison of surface topography and roughness in different yttrium oxide compositions of dental zirconia after grinding and polishing

  • Shin, Hyun-Sub;Lee, Joon-Seok
    • The Journal of Advanced Prosthodontics
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    • 제13권4호
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    • pp.258-267
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    • 2021
  • PURPOSE. The purpose of this study was to compare the surface roughness, phase transformation, and surface topography of dental zirconia with three different yttrium oxide compositions under same grinding and polishing conditions. MATERIALS AND METHODS. Three zirconia disks (IPS e.max ZirCAD LT, MT, MT multi, Ivoclar Vivadent AG, Schaan, Liechtenstein) were selected for experimental materials. Sixty-nine bar-shaped specimens were fabricated as 12.0 × 6.0 × 4.0 mm using a milling machine and glazing was conducted on 12.0 × 6.0 mm surface by same operator. With a custom polishing device, 12.0 × 6.0 mm surfaces were polished under same condition. Surface roughness (Ra[㎛]) was measured before grinding (C), after grinding (G), and at every 3 steps of polishing (P1, P2, P3). X-ray diffraction and FE-SEM observation was conducted before grinding, after grinding, and after fine polishing (P3). Statistical analysis of surface roughness was performed using Kruskal-Wallis test and Mann-Whitney-U test was used as a post hoc test (α = .05). RESULTS. There were no significant differences of surface roughness between LT, MT, and MM groups. In LT, MT, and MM groups, P3 groups showed significantly lower surface roughness than C groups. X-ray diffraction showed grinding and polishing didn't lead to phase transformation on zirconia surface. In FE-SEM images, growths in grain size of zirconia were observed as yttrium oxide composition increases. CONCLUSION. Polished zirconia surface showed clinically acceptable surface roughness, but difference in yttrium oxide composition had no significant influence on the surface roughness. Therefore, in clinical situation, zirconia polishing burs could be used regardless of yttrium oxide composition.

상급종합병원과 여성전문병원 간호사의 산후 간호중재 조사 (Tertiary Hospitals' and Women's Special Hospitals' Postpartum Nursing Intervention Survey)

  • 박현순;김하운;김희정;김순익;박은혜;강남미
    • 임상간호연구
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    • 제25권1호
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    • pp.55-66
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    • 2019
  • Purpose: This study was done to assess development and postnatal care interventions in postnatal care intervention records for maternity ward nurses in tertiary hospitals and women's hospitals in South Korea. Methods: This mixed-method research was a Time-Motion (TM) study. Data were collected through external observation of 12 nurses in 4 wards over 24 hours. Mann-Whitney U test and independent t-test were employed for the analysis of frequency and provision time of direct/indirect care activity. $x^2$ (Fisher's exact test) was utilized to determine the difference in frequency between two groups. IBM SPSS 22.0 statistical program was employed for calculation. All statistical significance levels were at ${\alpha}=.05$. Results: According to the KPCS-1 (Korean Patient Classification System-1), women's hospitals are group 3 and tertiary hospitals, group 4. With respect to time difference in direct care, tertiary hospitals showed 791 minutes and women's hospitals, 399 a difference of 392 minutes. For time difference in indirect care, women's hospitals had 2,415 minutes while tertiary hospitals, 2,080, a difference of 335 minutes for women's hospitals. No difference was found in the average total care workload between the two institutions. Individual time also showed no difference (p>.05). Conclusion: High-risk maternal care strength in tertiary hospitals and breast-feeding strength in women's hospitals need to be benchmarked with each other.

Surgical Treatment for a Huge Maxillary Ameloblastoma via Le Fort I Osteotomy: A Case Report

  • Jung, Sang-pil;Jee, Yu-jin;Lee, Deok won;Kim, Hyung Kyung;Kang, Miju;Kim, Se-won;Yang, Sunin;Ryu, Dong-mok
    • Journal of Korean Dental Science
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    • 제11권2호
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    • pp.86-91
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    • 2018
  • Ameloblastomaa are odontogenic benign tumors with epithelial origin, which are characterized by slow, aggressive, and invasive growth. Most ameloblastomas occur in the mandible, and their prevalence in the maxilla is low. A 27-year-old male visited our clinic with a chief complaint of the left side nasal airway obstruction. Three-dimensional computed tomography showed left maxillary sinus filled with a mass. Except for the perforated maxillary left edentulous area, no invaded or destructed bone was noted. The tumor was excised via Le Fort I osteotomy. The main mass was then sent for biopsy and it revealed acanthomatous ameloblastoma. The lesion in the left maxillary sinus reached the ethmoidal sinus through the nasal cavity but did not invade the orbit and skull base. The tumor was accessed through a Le Fort I downfracture in consideration of the growth pattern and range of invasion. The operation site healed without aesthetic appearances and functional impairments. However, further long-term clinical observation is necessary in the future for the recurrence of ameloblastoma. Conservative surgical treatment could be the first choice considering fast recovery after surgery and the patient's life quality.

An Exploration on physiology of Vasa, Meda, Majja in Ayurveda w.s.r. to adipose tissue.

  • Agrawal, Sonam;Verma, Vandana;Gehlot, Sangeeta
    • 셀메드
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    • 제9권3호
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    • pp.3.1-3.7
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    • 2019
  • Recent researches on adipocytes in human and mice model have reported that the adipocytes are not only the fat depots but having role in maintenance of physiology and metabolism through adipokines released by them in accordance to their anatomical location. Ayurveda scholars too have mentioned different tissues like Vasa (inter muscular fat), Meda (visceral fat) and Majja (bone marrow) which are predominantly rich in adipocytes similar to adipose tissues, with a different sites, functions, compositions and pathological outcomes. The metabolic effect of Meda and Majja Dhatu on other tissues like muscle (Mamsa Dhatu), bone (Asthi Dhatu) and reproductive tissue (Shukra Dhatu) shows their functional interdependence. The detailed description of therapeutic indications of Vasa and Majja under Snehakarma (oleation therapy) illustrates that clinical physiology of these tissues have been elaborated rather than general physiology. This article is an attempt to comprehend the physiological aspect of Vasa, Meda and Majja retrospectively on the basis of their therapeutic indication for the management of variety of disorders, in the form of Sneha through different therapeutic procedures. An effort has been also taken to distinguish Vasa, Meda, Majja based on the functional peculiarities of adipocytes present in different sites of body like omentum, muscle and bone marrow. Critical observation of explanations of Vasa, Meda and Majja in Ayurveda compendia and advanced research in field of adipocytes reflected that Ayurveda scholars had deep insights regarding the various dimensions of adipocytes, most of which are in consistent with the advanced physiology and biomolecular studies of adipocytes.

의료인의 의료 행위 경험을 위한 정맥 수액 요법용 의료 소모품 키트 디자인 (The Medical Supplies KIT Design based on the Intravenous Fluid Therapy for Experience of Medical Staff)

  • 이혜민;반영환
    • 한국융합학회논문지
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    • 제10권8호
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    • pp.121-128
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    • 2019
  • 의료 서비스는 환자 뿐 만 아니라 의료 행위의 주체인 의료진에게도 제공되어야 한다. 이 연구는 에스노그라피를 통해, 의료 행위를 수행하는 의료인들의 행태를 살펴보고 처치를 위한 물리적인 의료 행위 중 가장 많은 빈도로 수행하는 행위를 도출하였다. 특히, 심층 인터뷰를 통해 의료인의 침습 의료 행위 시, 인지하는 행위의 중요성과 수행과정의 니즈를 도출하였다. 이를 바탕으로 의료진의 신속한 물리적 의료 행위와 환자와의 관계를 위한 심리적 의료 행위를 포함하는 4가지의 경험적 가치 요소를 정의하였다. 정맥 수액 요법용 의료 소모품 키트 디자인 제안과 함께 디자인 프로토타입을 제작하여, 디자인 요소를 검증하였다. 의료 소모품의 키트화는 처치 전체 과정에 있어 준비 및 폐기 과정을 간소화함으로 업무의 효율성을 높힐 수 있다.

Effects of mechanical intervention on cutaneous sensory change and pressure pain threshold in the same spinal segment of myofascial pain

  • Kim, Do Hyung;Lee, Su-Hyun;Lee, Byoung Hee
    • Physical Therapy Rehabilitation Science
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    • 제8권1호
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    • pp.15-21
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    • 2019
  • Objective: The purpose of this study was to identify whether cutaneous sensory (CS) changes induced by mechanical intervention (MI) increases the trigger point threshold of the same spinal segment as well as to investigate the relationship between the amounts of change in CS pressure pain thresholds (PPT). Design: Randomized controlled trial. Methods: Thirty-nine persons with myofacial pain (MFP) were recruited in this experiment. The subjects consisted of 20 men and 19 women (age 20-39). MI was applied on the subjects using the Graston technique for 5 minutes to induce CS changes. The CS changes were measured with sensory tests by using the Von Frey Filament, and PPT changes were estimated by using the pressure threshold meter. For the observation of sensory and PPT changes with time, the test was conducted for 15 minutes including a pre, post, and after intervention session. Results: CS threshold increased significantly when MI was applied (p<0.001). On the same spinal segment, changes in the right infraspinatus PPT was observed (p<0.001) but the PPT changes in other muscles were not significantly different. Furthermore, the control group CS and PPT were not significantly different. In addition, regression analysis showed that the CS changes have a larger impact on PPT in the same spinal segment (p<0.001). Conclusions: CS changes induced by MI make to change PPT on the same spinal segment. In other words, it is possible to identify PPT changes following CS changes except for the muscle which belongs to a different spinal segment. Therefore, application of MI is necessary for the CS changes in the same spinal segment. Furthermore, it can be useful in the clinical fields as a method of providing pain control and increasing the PPT.