• Asian Pacific Journal of Cancer Prevention
• /
• 제16권7호
• /
• pp.2613-2617
• /
• 2015

Radiation induced lung injury has long been considered a treatment limiting factor for patients requiring thoracic radiation. This radiation induced lung injury happens early as well as late. Radiation induced lung injury can occur in two phases viz. early (< 6 months) when it is called radiation pneumonitis and late (>6 months) when it is called radiation induced lung fibrosis. There are multiple factors that can be patient, disease or treatment related that predict the incidence and severity of radiation pneumonitis. Radiation induced damage to the type I pneumocytes is the triggering factor to initiate such reactions. Over the years, radiation therapy has witnessed a paradigm shift in radiation planning and delivery and successfully reduced the incidence of lung injury. Radiation pneumonitis is usually a diagnosis of exclusion. Steroids, ACE inhibitors and pentoxyphylline constitute the cornerstone of therapy. Radiation induced lung fibrosis is another challenging aspect. The pathophysiology of radiation fibrosis includes continuing inflammation and microvascular changes due to pro-angiogenic and profibrogenic stimuli resembling those in adult bronchiectasis. General supportive management, mobilization of airway secretions, anti-inflammatory therapy and management of acute exacerbations remains the treatment option. Radiation induced lung injury is an inevitable accompaniment of thoracic radiation.

• Journal of Yeungnam Medical Science
• /
• 제7권1호
• /
• pp.197-201
• /
• 1990

저자들은 비인강암의 포괄적인 방사선 치료의 일부로서 외부 방사선 치료에 뒤이은 고선량율 강내조사를 시행하여 부작용이나 합병증 없이 종양의 완전관해를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• Childhood Kidney Diseases
• /
• 제23권1호
• /
• pp.48-52
• /
• 2019

The ketogenic diet (KD) has been used as an effective antiepileptic therapy for intractable childhood epilepsy. However, various adverse effects have been reported with use of the KD. We report a case of a child who developed acute tubular necrosis subsequent to therapy with KD. A 5-year-old girl had myoclonic epilepsy with developmental delay. She was under the treatment with antiepileptic drugs since the age of 3 months and on the KD during the past 18 months. Proteinuria persisted intermittently with the initiation of the KD and subsequently increased in the past 2 months. She was admitted with intermittent mild fever, vomiting, and lethargy for the past 3-4 weeks. At the time of admission, she presented with hypertriglyceridemia, heavy proteinuria, renal Fanconi syndrome, and acute kidney injury. Renal sonography showed a marked increase in the size and parenchymal echogenicity of both kidneys. A renal biopsy revealed acute tubular necrosis accompanied by early interstitial fibrosis. After the withdrawal of the KD and supportive therapy, without changing other anticonvulsants and their dosages, improvement of renal function was observed. Proteinuria had disappeared after 1 month and kidney size returned to normal after 8 months. It is hypothesized that the KD can induce and/or aggravate the renal tubulointerstitial injury in some patients who are under the treatment with anticonvulsants.

• Journal of Chest Surgery
• /
• 제25권3호
• /
• pp.232-239
• /
• 1992

Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.

• Journal of Periodontal and Implant Science
• /
• 제35권4호
• /
• pp.1109-1116
• /
• 2005

The purpose of this study was to observe the effects of periodontal therapy, including nonsurgical periodontal therapy with azithromycin, surgical therapy, and maintenace therapy on the drug-induced gingival enlargement, by means of measuring gingival thickness. The test group of 18 patients with drug-induced gingival enlargement received scaling, root planing with azithromycin for 5 days, with or without surgical periodontal treatment. The control group of 18 patients who had not taken any medication, received scaling and root planing, with or without surgical periodontal treatment. Both groups received supportive periodontal therapy every 3 months for 2 years. The mean period of total treatment is 32 months in the test group and 31 months in the control group. The thickness of the buccal gingiva was measured using an ultrasonic device of $SDM^{(R)}$(Krupp Corp., Essen, Germany). The results revealed that the test $group(1.21{\pm}0.51mm)$ showed statistically thicker buccal gingiva than the control $group(1.01{\pm}0.3mm)$. In the test group, the buccal gingiva was thickest on 2nd molars and was thinnest on canines of both dental arches. In the control group, the buccal gingiva was thickest on central incisors in the maxilla and 2nd molars in the mandible, while the thinnest areas were on canines in the maxilla and 1st premolars in the mandible. It would be concluded that the periodontal treatment with azithromycin aids in decreasing the degree of the gingival enlargement but cannot prevent the recurrence completely.

• 인간행동과 음악연구
• /
• 제2권2호
• /
• pp.15-31
• /
• 2005

아동에게 있어서 말기 질환의 범위는 악성종양을 비롯하여 선천성 대사이상, 염색체 이상, 선천성 기형, 신경근육계 질환, 기타 다른 불치의 상태까지 포함한다. 병원환경에서 이러한 말기 질환 아동은 질병의 치료 과정과 관련하여 공포심, 분노, 좌절감을 경험할 수 있으며 통제된 병원 환경안에서 자율성을 제한받기 때문에 통제감을 상실하고 무기력해질 수 있다. 본 연구에서는 환경적 지지 모델(Contextual Support Model of Music Thterapy)을 중심으로 음악치료가 병원환경에 있는 말기질환자들의 정서 및 기능 변화에 긍정적 변화를 줄 수 있는지를 알아보았다. 환경적지지 모델 음악치료는 음악 환경의 구조적인 특성(structure), 자발성 지지(autonomy support) 그리고 참여(involvement)라는 세 가지 요소로 구성된다. 그리고 이러한 치료적 구성 요소로 이루어진 음악 환경은 아동의 활동을 지지하고 격려하도록 도와준다. 이 세 가지 치료적 요소를 중심으로 하여 본 연구는 말기질환 아동과의 음악치료사례를 분석하여 말기 질환 아동의 행동이 환경적 지지 역할을 하는 음악 안에서 어떠한 유형으로 나타나는지에 대해서 알아보았다. 본 연구의 대상자는 만 10살의 급성 림프성 백혈병 여아로 총 9회의 세션을 통한 음악 치료 활동 내용을 질적 연구방법으로 사용하여 내용분석을 하였다. 내용분석은 환경적 지지모델의 세 가지 치료적 요소 중심으로 본 연구자가 설정한 행동들을 기준으로 이루어졌다. 환아와의 주 음악 치료 활동은 악기 연주하며 노래부르기, CD플레이어로 노래 들으면서 노래 부르기, 노래 만들기, 노래 가사 탐색하기 활동으로 이루어졌다. 본 연구의 결과는 다음과 같다. 환경적인 구조적 특성(Structure) 측면에서는 음악치료는 노래를 부를 수 있는 환경과 악기를 연주할 수 있는 환경을 제공해주고 음악 만들기 활동을 할 수 있는 준비를 해줌으로써 아동이 성공적으로 음악 활동을 할 수 있도록 방향을 제시해주었다. 자발성 지지(Autonomy support) 측면에서 음악치료는 노래를 부르거나 악기를 연주할 때 여러 가지 선택의 기회를 제공함으로써 아동이 자발적으로 참여할 수 있도록 하였다. 참여(Involvement)의 측면에서는 치료사가 아동에게 긍정적인 강화를 제시함으로써 아동이 긍정적으로 경험하고 공유된 활동 안에서 치료사와 상호 협력적으로 음악활동을 진행하는 모습을 볼 수 있었다. 이와 같이 음악치료는 환경적으로 지지 역할을 하며 정서적으로 위축되어있는 아동에게 자발성과 독립성을 개발시켜주고 병원 환경이라는 제약된 환경 안에서 자율성을 촉진시켜줄 수 있음을 보여주었다. 이러한 음악 치료의 효과를 근거로 하여 입원 환경에 있는 아동들을 위한 더 다양한 접근 방법의 음악치료 연구가 이루어지기를 기대한다.

• 대한암한의학회지
• /
• 제22권1호
• /
• pp.1-11
• /
• 2017

Objectives: The purpose of this study is to investigate preliminarily for development of the Korean medicine clinical practice guideline (CPG) for pancreatic cancer through the analysis of existing CPGs. Methods: Through searching the medical database such as Pubmed, SCOPUS, CNKI, Google Scholar, etc. The global CPGs within recent three years were collected and analyzed. In particular, recommendations related to the Korean medicine or Chinese medicine were made primarily in the Guidelines of Diagnosis and Therapy in Oncology with Traditional Chinese Medicine. Results: The six CPGs were mentioned in this study. The academic societies and organizations developing the CPGs were located in China, Japan, Europe and America. The contents of the CPGs were the clinical questions and statements, surgical therapy, adjuvant therapy, radiation therapy, chemotherapy, palliative medicine, risk assessment, palliation and supportive care, follow-up and recurrence, Tumor-Node-Metastasis (TNM) staging. In the Guidelines of Diagnosis and Therapy in Oncology with Traditional Chinese Medicine, the etiology, mechanisms, herbal drugs, Chinese medicine assessment, complication, syndrome differentiation (SD), Chinese medicine treatment were described. Conclusions: In order to develop the proper Korean medicine CPG for pancreatic cancer and to adapt the correct integrative treatment program on the pancreatic cancer, institutional arrangements for cooperation with Korean medical communities and standardization of SD should be performed.

• Journal of Periodontal and Implant Science
• /
• 제51권1호
• /
• pp.53-62
• /
• 2021

Purpose: This study aimed to evaluate the clinical and microbiological efficacy of adjunctive local delivery of minocycline (Periocline^®) in patients receiving supportive periodontal therapy (SPT) after initial treatment. Methods: The participants were 16 men and 8 women (age, 20-65 years) who had at least 15 natural teeth, underwent SPT for more than 1 year due to chronic periodontitis, had 4 or more periodontal pocket sites deeper than 5 mm, and showed >25% gingival bleeding on probing (BoP). They were randomly assigned to the test and control groups. In the test group, mechanical debridement and local antibiotic delivery were performed for all periodontal sulci/pockets; in the control group, mechanical debridement and saline irrigation were performed. In patients who underwent SPT for more than 1 year, clinical and microbiological examinations were performed at baseline and 1 and 3 months after SPT. The clinical examination included an assessment of the periodontal pocket depth, clinical attachment level, plaque index, and BoP. Microbial tests were performed using real-time polymerase chain reaction; the relative ratios of Porphyromonas gingivalis and Fusobacterium nucleatum were determined. Results: Both groups showed significant improvements in clinical parameters at 1 and 3 months from baseline; there were no significant changes between months 1 and 3. Intergroup differences were insignificant. The microbiological analysis revealed no significant differences in P. gingivalis and F. nucleatum ratios across time points. While intergroup differences were insignificant, there was a tendency for the P. gingivalis and F. nucleatum ratios to decrease in the test group. Conclusions: Mechanical debridement in patients receiving maintenance therapy resulted in clinically significant improvement; the effectiveness of additional local delivery of antibiotics was not significant. The ratios of P. gingivalis and F. nucleatum showed a tendency to decrease in the test group, although it was not significant.

• 대한간호학회지
• /
• 제39권6호
• /
• pp.868-877
• /
• 2009

Purpose: The purpose of this study was to examine the effects of Koryo Hand Therapy (KHT) on menopausal symptoms and hormone levels (Follicle Stimulating Hormone [FSH], Luteinizing Hormone [LH], and estradiol [$E_2$]) in climacteric women. Methods: The research design was a nonequivalent control group pretest-posttest design. Data were collected from November 28, 2005 to February 28, 2006. The 45 participants were assigned to either the experimental group (23) or control group (22). KHT was applied three times a week, for a total of 8 weeks to the women in the experimental group. Results: There was a statistically significant decrease in menopausal symptoms (F=42.49, p=.000), FSH level (F=26.98, p=.000) and LH level (F=5.31, p=.026) between the experimental and control groups. There was an increase of the estradiol level in the experimental group but the difference between the two groups was not statistically significant. Conclusion: KHT can be applied as a supportive nursing intervention to climacteric women. KHT is expected to be a complementary alternative intervention for health management of the climacteric women.

• 사상체질의학회지
• /
• 제26권1호
• /
• pp.122-132
• /
• 2014

Objectives The purpose of this case study is to report the effect of Sasang constitutional therapy about chill and fever pattern of malaria by acute urticaria. Methods This Soyangin patient is treated by herbal prescriptions, venesection, and acupuncture therapy according to the change of symptoms. When fever is severe, adequate medical supportive treatments such as normal saline intravenous injection, sedative or anti-histamine are provided for the patient. Results & Conclusions The patient's symptoms of acute urticaria and general conditions were improved after using Yangdokbaekho-tang and Hwagam. However, chill and fever pattern of malaria was continued so that Hyungbangpaedok-san and Dokhwaljihwang-tang for Soyangin's lasting malaria symptom were medicated to the patient. Accordingly, chill and fever pattern lasting about one month was successfully eliminated after herbal treatment.