• 제목/요약/키워드: Treatment protocol

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근관치료 실패와 관련된 Enterococcus faecalis 제거를 위한 치료 protocol의 재고찰 (RECONSIDERATION OF TREATMENT PROTOCOL ON THE REDUCTION OF ENTEROCOCCUS FAECALIS ASSOCIATED WITH FAILED ROOT CANAL TREATMENT)

  • 이우철;홍성태;손원준
    • Restorative Dentistry and Endodontics
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    • 제33권6호
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    • pp.560-569
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    • 2008
  • 본 review 논문의 목적은 통상의 근관치료로 해결되지 않는 persistent periapical lesion의 원인이 되는 주요 세균을 제거하고자 시행한 여러가지 실험을 비교분석하여 과연 (1) Enterococcus faecalis가 근관치료 실패의 주요 원인균인지 (2) 그리고 과연 그렇다면 근관치료에 실패한 증례에서 E. faecalis와 biofilm을 제거할 수 있는 치료 protocol이 있는 것인지를 확인하여 보다 나은 근관치료 성공을 위한 치료 protocol의 확립과 앞으로의 연구방향을 재조명하는 것이다. 지금까지 진행되어온 연구 결과에 대한 객관적인 분석이나 적절한 평가가 이루어지지 않은 가운데 어떤 특정한 연구를 통해 E. faecalis를 제거하는데 유의성있는 효과를 보인다고 알려진 세척액이나 약제를 막연한 기대감을 가지고 실제 임상에 사용하고 있는 실정에서 현재 진료실에서 사용하고 있는 치료 protocol에 대한 검증이 절실한 시점에서 review해 본 결과 현재까지 진행되어 왔던 여러 연구 결과를 통해 확신할 수 있는 것은 치료 protocol에 따라 현재 사용하고 있는 근관세척액이나 근관내 약제만으로도 E. faecalis나 그 biofilm을 대부분 제거할 수 있다는 사실이다. 하지만 이 그 protocol에 따라 근관치료 술식을 충실하게 이행한다 해도 근관치료가 100% 성공한다고 보장할 수는 없다. 물론 세균이 아닌 다른 요소에 의해 근관치료의 실패가 일어난다고도 할 수 있지만 그보다는 결국 체내의 면역반응에 저항하는 세균의 능력에 기인하는 것으로 보인다. 따라서 높은 수준의 치료 성공률을 지속적으로 유지하기 위해서는 위에서 언급된 바와 같은 제대로 된 치료 protocol을 따라 근관치료를 진행하면서 좀더 나은 결과를 얻기 위해 새로운 protocol을 개발하고 정립하는 과정이 계속되어야 한다.

상태궤환 적분제어기법을 이용한 HIV 감염 환자에 대한 약물 치료기법 (Drug Treatment Protocol for HIV Infected Patients Using State Feedback Integral Control Technique)

  • 조남훈
    • 전기학회논문지
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    • 제64권10호
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    • pp.1454-1459
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    • 2015
  • In this paper, a drug treatment protocol is proposed for an HIV infection model that explicitly includes the concentration of healthy T cells, infected T cells, and HIV. Since real parameters of HIV infection model differ from patient to patient, most drug treatment protocols are not able to achieve the treatment goal in the presence of modelling errors. Recently, based on the nonlinear robust control theory, a robust treatment protocol has been proposed that deals with parameter uncertainties. Although the developed scheme is inherently complex, it cannot be applied to the case where all parameters are unknown. In this paper, we propose a new drug treatment protocol that is much simpler than the previous one but can achieve the treatment goal even when all model parameters are unknown. The simulation results verify that the substantial improvement in the performance can be achieved by the proposed scheme.

Correction of late adolescent skeletal Class III using the Alt-RAMEC protocol and skeletal anchorage

  • Muhammed Hilmi Buyukcavus;Omer Faruk Sari;Yavuz Findik
    • 대한치과교정학회지
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    • 제53권1호
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    • pp.54-64
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    • 2023
  • This case report describes skeletal anchorage-supported maxillary protraction performed with the Alternate Rapid Maxillary Expansion and Constriction (AltRAMEC) protocol over a treatment duration of 14 months in a 16-year-old female patient who was in the late growth-development period. Miniplates were applied to the patient's aperture piriformis area to apply force from the protraction appliance. After 9 weeks of following the Alt-RAMEC protocol, miniplates were used to transfer a unilateral 500-g protraction force to a Petit-type face mask. A significant improvement was observed in the soft tissue profile in measurements made both cephalometrically and in three dimensional photographs. Subsequently, the second phase of fixed orthodontic treatment was started and the treatment was completed with the retention phase. Following treatment completion, occlusion, smile esthetics, and soft tissue profile improved significantly in response to orthopedic and orthodontic treatment.

패혈증 및 패혈성 쇼크로 진단 받은 소아 중환자에서 vitamin protocol의 효과 비교 (The Effect of the Vitamin Protocol for Treating Sepsis or Septic Shock in Pediatric Intensive Care Unit)

  • 고현정;정민재;김재송;손은선;유윤미
    • 한국임상약학회지
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    • 제30권3호
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    • pp.161-168
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    • 2020
  • Background: Recently, a study comprising adult patients with sepsis admitted in the intensive care unit (ICU) was conducted. The patients were treated with high doses of intravenous ascorbic acid, thiamine, and hydrocortisone; the clinical outcomes demonstrated significant therapeutic benefits. The mortality rate in children with sepsis is approximately 25%. However, the effects of additional treatment with ascorbic acid and thiamine ("vitamin protocol") in children are rarely investigated. Methods: A retrospective analysis was performed using medical records of patients diagnosed with sepsis and admitted to the pediatric ICU (PICU) between September 2016 and June 2019. The control group received treatment only as per sepsis protocol, whereas the treated group received both sepsis protocol and the vitamin protocol. The primary endpoint was change in Vasoactive-Inotropic Score (VIS) for 5 days. The secondary endpoints included the length of stay in the PICU, duration of using mechanical ventilators and vasopressors, and mortality rate. Results: The number of patients in the treated and control groups was 33 and 24, respectively. The treated group showed greater decrease in their VIS for 5 days than the control group (44.4 vs 18.6); however, the difference was not statistically significant. The length of stay in the PICU was significantly longer for the treated group than for the control group [10.0 days (Interquartile range (IQR), 6-18) vs 4.5 days (IQR, 4-10.3); p=0.004]. Conclusions: No significant treatment benefits were observed following vitamin protocol administration to the pediatric patients with sepsis. Further studies are necessary for improving the efficacy and safety of the vitamin protocol.

Protocol for management of odontogenic keratocysts considering recurrence according to treatment methods

  • Titinchi, Fadi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권5호
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    • pp.358-360
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    • 2020
  • The management of odontogenic keratocysts (OKC) remains a hotly debated topic in oral and maxillofacial surgery. Despite numerous studies and systematic reviews on treatment options, there is a lack of consensus and no accepted protocol on the management of OKC. Hence, the aim of this study was to briefly summarize all large systematic reviews in the literature on the management of OKC and formulate an evidence-based management protocol. Data from five large systematic reviews were combined to calculate the mean recurrence rate for each technique. Decompression followed by enucleation along with adjuvant methods such as application of Carnoy's solution and peripheral ostectomy can result in very low recurrence and is an acceptable first line treatment. The surgical approach should be determined by lesion size, patient age, proximity to vital structures, accessibility, soft tissue/cortical perforation, and if the lesion is recurrent.

재난트라우마에 대한 이침의 활용 - NADA 프로토콜의 소개 (Ear Acupuncture Treatment for Disaster-Related Trauma: Introduction of the National Acupuncture Detoxification Association (NADA) Protocol)

  • 김다운;김상호
    • 동의신경정신과학회지
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    • 제31권3호
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    • pp.157-168
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    • 2020
  • The number of disasters caused by natural or human-made events such as earthquakes, tsunamis, floods, typhoons, industrial disasters, and the recent outbreak of COVID-19 has increased and the damage caused by such disasters is increasing every year. Disasters can cause physical destruction and also have unexpected psychological impacts, such as post-traumatic stress disorder (PTSD). Ear acupuncture is a treatment modality that can be helpful for both physical and mental health problems. Since ear acupuncture is a cost-effective, flexible, and safe treatment tool, it has the potential to provide medical assistance in disasters. The National Acupuncture Detoxification Association (NADA) auricular acupuncture protocol, originally developed for addiction treatment, has been used for mental illness and behavioral symptoms in both community health settings and in a variety of disaster, terror, and refugee settings. In this review, we introduced the NADA protocol, including its history, features, training, clinical evidence, and cases in disaster settings, suggesting that the NADA protocol could be utilized as a disaster medical support model in Korean medicine.

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
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    • 제32권3호
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    • pp.59-69
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    • 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.

Efficiency of Exponential Deperm Protocol

  • Kim, Yongmin;Kim, Young-Hak;Shin, Kwang-Ho
    • Journal of Magnetics
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    • 제18권3호
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    • pp.326-330
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    • 2013
  • Magnetic treatment of surface vessels and submarines (Deperm) is required to camouflage them against magnetic detection from enemy marine force. So far, deperm has been accomplished by applying an alternating magnetic field of which amplitude decreases linearly. However, the reduction of the residual flux density in the direction of magnetic field is not linear in the case of the linear protocol, since the ferromagnetic material used to construct a surface vessel, mainly Fe-C, shows a nonlinear behavior in an alternating magnetic field. This is one of main reasons to make an ordinary deperm protocol inefficient. In this paper, we propose the exponential deperming protocol and compare the exponential protocol to conventional linear protocol within the framework of deperm performance. We found out that step number could be reduced in the exponential protocol compare with in the linear protocol, because the larger numbers of deperm steps are dedicated in the irreversible domain process region on the magnetic hysteresis.

소아암 환자의 초기 진단단계의 간호중재 프로토콜 개발 (Development of Nursing Intervention Protocol for Childhood Cancer at Early Diagnosis Stage)

  • 최자윤;유일영
    • Child Health Nursing Research
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    • 제8권1호
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    • pp.44-54
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    • 2002
  • The main purpose of this methodological study was to develop an assessment tool and intervention protocol for child and family with childhood cancer at early diagnosis stage. The assessment tool and intervention protocol was developed by extensive literature review and consultation with experts. Review of nine domestic and sixty-six international journal articles were done to identify stress, interventions, coping strategies and adjustment of children with cancer and their family. Results were as follows; First, assessment at the early diagnosis stage need to include information on patient, family, and patient/family attitude toward diagnosis and treatment. Second, intervention protocol for children with cancer includes control physical symptoms, manage the side effects of chemotherapy and diagnostic or therapeutic procedures, control emotional responses, provide support and information, assist decision-making and adjust to environment. Third, intervention protocol for family includes controlling emotional responses, provision of informations, inducing family support to patient, improving family cohesion, supporting siblings and supporting spiritual growth. In conclusion, the early diagnosis stage in cancer treatment is important for child and family since this stage greatly affects the overall adjustment of child and family to live with cancer. Therefore, pediatric nurses need to be sensitive to the need of patient/family and systematically manage their needs at this stage.

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