• Title/Summary/Keyword: Literature Therapeutic

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Pharmacokinetics of Tobramycin in Patients with Hematologic Malignancy (혈액암 환자에 있어서의 Tobramycin Pharmacokinetics)

  • Yeom, Mikyong;Shin, Wan-Gyoon;Lee, Min-Hwa
    • Korean Journal of Clinical Pharmacy
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    • v.1 no.1
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    • pp.31-36
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    • 1991
  • Tobramycin is one of the most frequently selected agents for pharmacokinetic drug monitoring because of its narrow therapeutic index and essential role for the management of serious infections, especially gram-negative infections. Its pharmacokinetic parameters are dependent on race, sex, age, ideal body weight. disease states, and etc. Therefore, to schedule the dosing of tobramycin, the individual pharmacokinetic parameters such as half-life and volume of distribution are needed. However, these pharmacokinetic parameters have never been reported in Koreans. The purposes of this study were to evaluate the volume of distribution of tobramycin in cancer patients who had normal renal function, to compare the mean values of Vd reported in the literature, and to compare the measured half-life with the expected half-life based on ABW, LBW, and IBW, respectively. Venous blood samples were collected just before and thirty minutes after dosing during steady state. Serum tobramycin concentrations were determined by $TD_x$ (fluorescence immunoassay). IBW were measured by the method of Devine: and LBW were measured by the method of Hallynck. Creatinine clearances (CLcr) of the patients were estimated using the Cockcroft and Gault equation. Elimination rate constants (kel) were determined using the Welling and Craig equation. Infusion rate (ko), volume of distribution (Vd), and half-life $(t_{1/2})$ were determined using the Saw chuk and Zaske equation. The volume of distribution Was $27\%$ greater than the Schentag's study (0.26 vs 0.33 l/kg), but the half-life was similar to the Levy's study. The predicted half-lives based on IBW were the closest to actual half-lives (1.85 vs 2.01 hr).

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Assessment of foodservice quality and identification of improvement strategies using hospital foodservice quality model

  • Kim, Kyung-Joo;Kim, Min-Young;Lee, Kyung-Eun
    • Nutrition Research and Practice
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    • v.4 no.2
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    • pp.163-172
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    • 2010
  • The purposes of this study were to assess hospital foodservice quality and to identify causes of quality problems and improvement strategies. Based on the review of literature, hospital foodservice quality was defined and the Hospital Foodservice Quality model was presented. The study was conducted in two steps. In Step 1, nutritional standards specified on diet manuals and nutrients of planned menus, served meals, and consumed meals for regular, diabetic, and low-sodium diets were assessed in three general hospitals. Quality problems were found in all three hospitals since patients consumed less than their nutritional requirements. Considering the effects of four gaps in the Hospital Foodservice Quality model, Gaps 3 and 4 were selected as critical control points (CCPs) for hospital foodservice quality management. In Step 2, the causes of the gaps and improvement strategies at CCPs were labeled as "quality hazards" and "corrective actions", respectively and were identified using a case study. At Gap 3, inaccurate forecasting and a lack of control during production were identified as quality hazards and corrective actions proposed were establishing an accurate forecasting system, improving standardized recipes, emphasizing the use of standardized recipes, and conducting employee training. At Gap 4, quality hazards were menus of low preferences, inconsistency of menu quality, a lack of menu variety, improper food temperatures, and patients' lack of understanding of their nutritional requirements. To reduce Gap 4, the dietary departments should conduct patient surveys on menu preferences on a regular basis, develop new menus, especially for therapeutic diets, maintain food temperatures during distribution, provide more choices, conduct meal rounds, and provide nutrition education and counseling. The Hospital Foodservice Quality Model was a useful tool for identifying causes of the foodservice quality problems and improvement strategies from a holistic point of view.

Spinal Cord Tumors : An Analysis of 654 Cases(1973-1999) (척수 종양 654예의 임상 분석(1973-1999))

  • Choe, Woo Jin;Chung, Chun-Kee;Cho, Byung-Kyu;Kim, Hyun Jib
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.1004-1012
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    • 2001
  • Objective : The spinal cord tumors(including vertebral tumors) are increasingly diagnosed and operated due to development of refined diagnostic and therapeutic tools. It is necessary to re-evaluate clinical features and surgical results of spinal cord tumors with increasing cases and developing treatment modalities. The authors reviewed the spinal cord tumor cases to evaluate their clinical characteristics. Material and Methods : The retrospective review of 654 cases of spinal cord tumors between 1973 and 1999 was done. The clinical features, pathological analysis and surgical results were analyzed and compared to the literature. The results of the study are analyzed with a more detailed consideration of each of major pathologies : neurogenic tumors, meningeal tumors, neuroepithelial tumors, and metastatic tumors. Results and Conclusion : The spinal cord tumor was most common in the 5th decade of age(145 cases, 22.1%) and 78 cases(11.9%) were found in children under 15 years of age. The ratio of male to female was 1.2 : 1. The pathologic diagnosis was neurogenic tumor in 266 cases(40.7%), neuroepithelial tumor in 131(20.0%), metastatic tumor in 118(18.0%), and meningeal tumor in 94(14.4%) in the order of frequency. The tumor was located most frequently in the thoracic area(36.5%) and in the intradural extramedullary space(38.1%). The most common initial presentation was pain(40.1%) and the mean duration for presentation to operation was 14.8 months. The total or gross total removal was possible in 404 cases(61.7%) and the surgical result on the postoperative one month was recovery or improvement in 424 cases(64.8%), stationary in 188(28.7%), progression in 42(6.4%). As a surgical complication, there was a spinal deformity(12 cases), wound infection(5 cases), aspiration pneumonia(5 cases) etc. Neurogenic tumors and menigiomas showed good surgical results, whereas neuroepithelial tumors(except ependymoma) and metastatic tumors showed relatively poor prognosis.

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Research clinical trends on Gigong(氣功, Qigong) in the Korean Journal (한국(韓國) 저널에 게재(揭載)된 기공관련(氣功關聯) 임상(臨床) 연구(硏究) 동향(動向) 분석(分析) )

  • Han, Chang-Hyun;Lee, Sang-Nam;Kwon, Young-Kyu;Ahn, Sang-Woo;Choi, Sun-Mi
    • Journal of Korean Medical classics
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    • v.21 no.3
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    • pp.297-306
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    • 2008
  • Background : Gigong(氣功, Qigong) is one energy-healing intervention used to prevent and cure ailments and to improve health through regular practice. Although Gigong(氣功, Qigong) - neither itself nor its postulated mechanism of action - are within the paradigm of modern Western medical science, effects on the human body could be possible. Objectives : This study aims to review the bibliography, biological responses and therapeutic effects of Gigong. In the process, this review will grasp trends in this field of studies and will direct further researches into the right direction. Method : The computerized Korean databases were searched from their respective inceptions up to January 2008. The search terms used were 'Gi(氣, Qi)', 'Gigong(氣功, Qigong)', 'Doin(導引)', 'Training', 'Bioenergy', 'life nurturing' and random or Korean language terms related to Gigong. Several specialized journals were also manually searched for relevant articles. Result : Since the 1990's, Gigong papers in the Korean Literature is increased. Clinical research studies are among the most control design study. Research subjects are less patient than the general public. The most common treatment disease was Musculo-skeletal disorder Conclusions : The depth study for the each Gigong(氣功, Qigong) is needed. Specifically, I think it should be a clinical studies and qualitative research methods for evaluation are needed.

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A Study on the Acupuncture Methods of Joseon Dynasty Using Five Viscera Diagnosis (오장변증(五臟辨證)을 활용한 조선(朝鮮) 침법(鍼法) 연구(硏究))

  • Oh, Jun-Ho;Kim, Nam-Il
    • Korean Journal of Oriental Medicine
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    • v.16 no.2
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    • pp.1-31
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    • 2010
  • Objective : The objective of this study is to verify the characteristics of acupuncture methods of Joseon Dynasty by looking into the relationship between five viscera diagnosis and acupuncture methods. Material & Method : In the process, I've reviewed the relationship between meridian/exterior and viscera/bowels, along with a thorough comparison of the academic tendency in acupuncture of Ming-China, Qing-China and Joseon. Result & Conclusion : The two fields of meridian and exterior, and viscera and bowels had been theoretically merged, and based upon that, foundation methods applying the five viscera diagnosis were designed. Joseon acupuncture exceeded the existing concept of viscera which simply related itself to the exterior meridian and exterior by integrating the concepts from the visceral manifestation theory. With this, large proportions of medicine related to the visceral manifestation theory were invited into acupuncture, expanding therapeutic boundaries for acupuncture treatment. A historical review on medical texts starts from the Hyangyakjipseongbang("鄕藥集成方") which familiarized the public with mainstream acupuncture knowledge up until the Song dynasty, followed by Uibangyuchwi("醫方類聚"), which sparked up interest on the acupuncture methods based on viscera and bowels. Donguibogam("東醫寶鑑") organized the medical theories up until then, building a foundation upon which viscera/bowel-based acupuncture was able to develop further. In Chimgugyeongheombang("鍼灸經驗方"), viscera/bowel-based acupuncture methods started to blossom, integrating the meridian and exterior theory with the viscera manifestation theory, which in turn provided various methods through five viscera diagnosis. In the Saamdoin acupuncture method(舍岩道人鍼法), diagnostic criteria moved on to the five viscera diagnosis, and new methods resulting from the inter-complimentary and inter-prohibiting relationships between the five phases were introduced, opening a new world of acupuncture.

Assessment Tools of Cognitive-communicative Ability for Traumatic Brain Injury and Right Hemisphere Damage: A Review (외상성 뇌손상 및 우반구 손상 환자의 인지-의사소통 능력 평가도구에 관한 문헌 고찰)

  • Lee, Mi-Sook;Kim, Hyang-Hee
    • The Journal of the Korea Contents Association
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    • v.11 no.4
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    • pp.253-262
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    • 2011
  • Cognitive-communicative disorders after traumatic brain injury(TBI) and right hemisphere damage(RHD) are different from other neurological disorders in nature. Therefore, it is not desirable to use aphasia tests in evaluating individuals with TBI or RHD. The aim of this study is to review assessment protocols on TBI and RHD, and literature related with them. As a result, it is recommended that individuals with TBI be examined in scope of the cognition including attention, memory, organization, reasoning, as well as the functional communication. Similarly, it is useful to consider high-order language related to various cognitive domains in assessing cognitive-communicative ability after RHD. In conclusion, we need to focus on the overall cognitive-communicative domains in an evaluative process of TBI and RHD. Furthermore, it is necessary to develop multiple items for individuals with cognitivecommunicative disorders for the purpose of differentiating these heterogeneous groups from other neurological disorders such as aphasia, and of making good use of them as a therapeutic manual.

Long-Term Efficacy of Anti-Tumor Necrosis Factor Agents in Pediatric Luminal Crohn's Disease: A Systematic Review of Real-World Evidence Studies

  • Rheenen, Hanna van;Rheenen, Patrick Ferry van
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.2
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    • pp.121-131
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    • 2020
  • Purpose: To determine the long-term efficacy of the anti-tumor necrosis factor (TNF) agents, infliximab (IFX) and adalimumab (ADA), in pediatric luminal Crohn's disease (CD) by performing a systematic literature review. Methods: An electronic search was performed in Medline, Embase, and the Cochrane Library from inception to September 26, 2019. Eligible studies were cohort studies with observation periods that exceeded 1 year. Studies that reported time-to-event analyses were included. Events were defined as discontinuation of anti-TNF therapy for secondary loss of response. We extracted the probabilities of continuing anti-TNF therapy 1, 2, and 3 years after initiation. Results: In total, 2,464 papers were screened, 94 were selected for full text review, and 13 studies (11 on IFX, 2 on ADA) met our eligibility criteria for inclusion. After 1 year, 83-97% of patients were still receiving IFX therapy. After 2 and 3 years the probability of continuing IFX therapy decreased to 67-91% and 61-85%, respectively. In total, 5 of the 11 studies subgrouped by concomitant medication consistently showed that the probabilities of continuing IFX therapy in patients with prolonged immunomodulator use were higher than those in patients on IFX monotherapy. Conclusion: This review of real-world evidence studies confirms the long-term therapeutic benefit of IFX therapy in diverse cohorts of children with luminal CD. Moreover, it supports the view that combination therapy with an immunomodulator prolongs the durability of IFX therapy in patients who previously failed to recover following first-line therapy. The limited number of time-to-event studies in patients on ADA prevented us from drawing definite conclusions about its long-term efficacy.

Studies on the advanced model for quality control system of oriental medicine (한약재 품질관리체계 선진화 모형에 관한 연구)

  • Choi Sun-Mi;Yoon Yoo-Sik;Choi Hwan-Soo;Lee Mi-Young;Shin Soon-Shik;Lee Key-Nam;Chung Hee-Jin;Kim Hee-Soo;Sung Hyun-Jea
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.2
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    • pp.193-204
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    • 2000
  • In this study, advanced model for quality control of oriental medicine and methods for practice was suggested through literature inspection, analysis of foreign system such as China and Japan, survey analysis on the current system, quality analysis of randomly selected oriental medicine samples, and intensive discussions among oriental medicine specialists 1. The quality of oriental medicine should be consistently controlled by Ministry of Health and Welfare form its cultivation or import to its circulation process to final consumer 2. All oriental medicines should be circulated as standardized goods which should be marked by lot numbers. The packing material and Packing size should be liberalized. The qualify should be differentialized though free competition among makers. 3. Realistic standards for pesticide, heavy metal and decolorant should be established though long-term monitoring process according to each oriental medicine's origin, therapeutic part, cultivation area, harvesting time, and cultivation method. 4. Ministry of Health and Welfare should educate oriental medicine's quality control personnel regularly or on demand, and establish specialist pool. Ministry of Health and Welfare should also establish oriental medicine information system to provide informations about quality of domestic or foreign oriental medicinal raw materials. 5. The government should provide information about foreign of oriental medicine market to importers. Quality of imported oriental medicine should be inspected before its customs clearance, and all imported oriental medicine should be circulated by standardized oriental medicine makers. 6. Oriental medicine's pharmacopoeia should be Published to provide quality standard of oriental medicine and improve it.

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Efficacy and Safety of Trastuzumab Added to Standard Treatments for HER2-positive Metastatic Breast Cancer Patients

  • Zhu, Zhen-Li;Zhang, Jun;Chen, Mei-Lan;Li, Ke
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7111-7116
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    • 2013
  • Introduction: Trastuzumab, an HER2-targeting agents, has shown efficacy in metastatic HER2-positive breast cancer patients. Single-agent clinical trials have evaluated therapeutic regimens using trastuzumab for metastatic breast cancer patients. The aim of our study is to evaluate the efficacy and safety of trastuzumab in combination with chemotherapy or hormone therapy in HER2-positive metastatic breast cancer patients. Methods: A literature research was conducted in PubMed and to identify appropriate studies from relevant reviews. Randomized controlled trials comparing chemotherapy or hormone therapy regimens in combination with trastuzumab were eligible. Dadta on clinical outcomes, including safety, efficacy, and patient characteristics were collected. Results: Seven articles describing five trials were included in our systematic review and meta-analysis. Partners of trastuzumab included in trials were anthracycline, paclitaxel, docetaxel, anastrozole and letrozole. The addition of trastuzumab to chemotherapy improved the overall survival (HR=0.79, 95%CI 0.65-0.96), while to hormone therapy did not (HR=0.85 95%CI 0.56-1.30). All trastuzumab-containing regimens increased cardiac toxicity (RR=3.37, 95%CI 1.26-9.02) and grade III-IV adverse events. Conclusions: Our study supports the addition of trastuzumab to chemotherapy which is effective and tolerated for metastatic breast cancer with HER2+ patients. Of note, more adverse events will occur followed the use of trastuzumab, especially cardiac toxicity, with two treatment regimens.

Biofeedback Treatment for Tension-Type Headache and Migraine (긴장성두통과 편두통의 바이오피드백 치료)

  • Park, Joo-Eon;Lee, Kye-Seong;Shin, Sang-Eun
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.1
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    • pp.25-32
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    • 2006
  • Objectives : Headache is a clinical symptom that more than 90% of all individuals experience during their life time. This article provides a current concept of tension-type and migraine headaches and summarizes the effects of biofeedback treatment and/or relaxation techniques. Methods : The following terms were used for Pubmed/Medline search : biofeedback, relaxation, physiological, behavioral, nonpharmacological, headache, tension-type headache, and migraine. A review of references from relevant literature was also conducted to collect reports not identified in the Pubmed/Medline search. Interviews with experts on biofeedback were also included in this review. Results : Headache is a psychophysiological symptom that can be treated by some behavioral interventions including biofeedback and relaxation. Literatures on biofeedback and/or relaxation have consistently reported significant therapeutic effects on headaches. Important factors that we have to consider, when we apply to headache patients with biofeedback and relaxation techniques, were also presented. Conclusion : The available evidence suggests that biofeedback and relaxation techniques are effective treatments for the patients with headaches and can be provided to the patients as monotherapy or combination therapy with medication.

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