• 제목/요약/키워드: intervention level for dose

검색결과 19건 처리시간 0.028초

침습성 프로락틴 분비 뇌하수체 선종에서 Bromocriptine의 치료효과 (The Effect of Bromocriptine Treatment for Invasive Prolactinoma)

  • 양문술;김선호;임승길;이승구
    • Journal of Korean Neurosurgical Society
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    • 제37권4호
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    • pp.275-281
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    • 2005
  • Objective: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. Methods: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1 month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. Results: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had $20{\sim}30%$ of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. Conclusion: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.

전산화단층촬영검사실 방사선사의 방사선피폭 방어행위에 영향을 미치는 요인 분석 (Factors Influencing Protective Behavior against Radiation Exposure of Radiological Technologist in Computed Tomography Examination Room)

  • 김기정;정홍량;홍동희
    • 대한방사선기술학회지:방사선기술과학
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    • 제41권6호
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    • pp.581-586
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    • 2018
  • This study was conducted to analyze factors Influencing Protective Behavior against Radiation Exposure using questionnaires for 231 radiological technologists working in Computed Tomography(CT) examination room with high radiation dose in diagnostic radiology field. Statistical analysis of the collected data revealed that the reasons for partially shielding the examination part in the CT scan were the lack of protective equipment, securing of radiation justification, being annoying and maybe not being harm to adults in order. It was also revealed that the variables influencing the protective behavior were protective behavior against radiation harm, self-efficacy, protective environment, organization culture, protective knowledge and protective instrument in order. The higher the radiological protective environment(${\beta}=0.245$) and the lower the radiological protective knowledge(${\beta}=-0.034$), the more influential the protective behavior against radiation harm was. In this study, it was shown that non examination parts were not shielded in the CT scan. Therefore, it is necessary to improve the level of protective environment, to cultivate knowledge to improve the protective behavior against radiation harm and to have an intervention strategy for concrete action.

인터벤션 시술 시 면적선량계를 이용한 환자 방사선 선량 평가 (Evaluation of Patient Radiation Doses Using DAP Meter in Interventional Radiology Procedures)

  • 강병삼;윤용수
    • 대한방사선기술학회지:방사선기술과학
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    • 제40권1호
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    • pp.27-34
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    • 2017
  • 해외 각국에서 발표된 중재적 방사선 영역에서의 환자선량을 조사하였으며, 전국 23개 주요 병원에서 국내에서 많이 시행되는 13개의 주요 중재적 방사선 시술에 대한 환자선량을 DAP meter를 이용하여 측정하였으며, 시술별 피폭선량에 관한 8,415 건의 국내 자료를 확보하고, 각 주요 시술별로 참고 선량치를 제시하였다. 연구결과는 경동맥화학색전술 $237.7Gy{\cdot}cm^2$, 투석용 동정맥루 인터벤션시술 $17.3Gy{\cdot}cm^2$, 하지 혈관질환의 인터벤션시술 $114.1Gy{\cdot}cm^2$, 뇌혈관조영술 $188.5Gy{\cdot}cm^2$, 뇌동맥류 코일색전술 $383.5Gy{\cdot}cm^2$, 경피경간 담즙 배액술 $64.6Gy{\cdot}cm^2$, 담도 스텐트설치술 $64.6Gy{\cdot}cm^2$, 요로 폐색에 대한 신루설치술 $22.4Gy{\cdot}cm^2$, 다목적 중심정맥 카테터 삽입시술 $4.3Gy{\cdot}cm^2$, 항암제 주입 목적의 매몰형 중심정맥 카테터 삽입시술 $2.8Gy{\cdot}cm^2$, 혈액 투석 목적의 중심정맥 카테터 삽입시술 $4.4Gy{\cdot}cm^2$, 카테터를 이용한 배액시술 $17.1Gy{\cdot}cm^2$ 그리고 장기혈관색전술 $357.9Gy{\cdot}cm^2$이다. 본 연구를 통해 얻은 선량참고치는 방사선 인터벤션 시술에서 환자선량을 줄일 수 있는 최소한의 가이드라인으로 활용될 수 있을 것으로 생각되며, 참고선량치에 대한 연구는 장비의 발달과 시술방법, 재료의 발전으로 변화될 수 있음을 감안하고 선진국에서는 5년마다 시행되고 있음을 참고할 때, 향후 면적선량을 유효선량으로 변환할 수 있는 국내시술에 적합한 한국형 변환계수가 연구되어야 할 것으로 사료된다.

Vitamin D Effect on Ultrasonography and Laboratory Indices and Biochemical Indicators in the Blood: an Interventional Study on 12 to 18-Year-Old Children with Fatty Liver

  • Namakin, Kokab;Hosseini, Mahya;Zardast, Mahmoud;Mohammadifard, Mahyar
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권2호
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    • pp.187-196
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    • 2021
  • Purpose: The rising prevalence of childhood obesity in the past decades has caused non-alcoholic fatty liver disease (NAFLD) to become the most common cause of pediatric chronic liver disease worldwide. This study was aimed at determining the effect of vitamin D (Vit D) on ultrasonography and laboratory indices of NAFLD and some blood biochemical indicators in children. Methods: In this interventional study liver ultrasonography was performed in 200 children with overweight and obesity. A 108 had fatty liver among which 101 were randomly divided into two groups of study (n=51) and control (n=50). The study group was treated with Vit D, 50000 U once a week whereas the control group received placebo with the same dose and package, both for 12 weeks. At the end of the intervention lab tests and ultrasound study was performed once again to evaluate the response to treatment. Results: It was found out that Vit D supplementation improved the fatty liver grade in the study group. The mean changes in hemoglobin (Hb), uric acid, highdensity lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), insulin, albumin and alanine aminotransferase (ALT) was significantly higher in the study group compared to controls (p<0.05). After the intervention and means adjustment, a significant difference was obtained in HDL-C, insulin, LDL-C and homeostasis model assessment of insulin resistance (HOMA-IR) between the two groups. Conclusion: Vit D supplementation in addition to improving the fatty liver grade in ultrasonography and increasing the blood Vit D level, increases the HDL and Hb level besides decreasing uric acid, LDL, HOMA-IR, insulin and ALT levels.

Safety and Effectiveness of Food Allergen Immunotherapy (Oral): A Systematic Literature Review and Meta-analysis

  • Mo, Jin-A;Joo, Yea-Il
    • International Journal of Contents
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    • 제14권3호
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    • pp.39-45
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    • 2018
  • Purpose: Food Allergen Immunotherapy (Oral) is a form of immunotherapy administered to patients who are allergic to foods such as egg, milk, and peanut. The food allergen is orally administered to the patient in an escalating dose for desensitization or tolerance development. The safety and effectiveness of the therapy were assessed using a systematic literature review and meta-analysis. Methods: For a literature search, 8 national databases and a number of international databases including Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library were used; and 13 articles (all from international databases) were selected. The target of Food Allergen Immunotherapy (Oral) included patients with food allergy, and the intervention was food allergen immunotherapy without limiting the food type. The safety and effectiveness of Food Allergen Immunotherapy (Oral) were assessed by reviewing all the articles reporting on the therapy. The control group received standard therapies including aversion therapy, no treatment, anti-histamine treatment, and placebo. Safety was assessed through the incidence of complication and emergency medication. Effectiveness was assessed based on therapy success rate, symptomatic improvement, and quality of life. Results: Although Food Allergen Immunotherapy (Oral) was shown to have successful desensitization in patients with food allergy, the safety of the technique has not yet reached an acceptable level; the possible reason is due to the high rate of complication and frequency of emergency medication. Also, each study employed varying protocols while relying on a small number of participants and a short monitoring period. Conclusion: The results of assessment suggest that the level of evidence from current literature review is low and further research is necessitated for the verification of the safety and effectiveness of the therapy (Grade of Recommendation: A; Level of Technology: II-b).

Temporal Changes in the Hepatic Fatty Liver in Mice Receiving Standard Lieber-DeCarli Diet

  • Yin, Hu-Quan;Lee, Byung-Hoon
    • Toxicological Research
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    • 제24권2호
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    • pp.113-117
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    • 2008
  • Chronic exposure to ethanol induces cumulative damage to the liver starting from fatty infiltration to cirrhosis depending on the dose and duration of exposure. The whole process leading to the development of alcoholic liver disease is very complex and the mechanisms involved are not fully understood. Among many experimental animal models, Lieber-DeCarli liquid diet provides moderate to severe pathophysiological outcome depending on the compositional changes. In the present study, we investigated the temporal changes in the early phase hepatic disease in rats fed with standard Lieber-DeCarli diet. Male Wistar rats were fed with Lieber-Decarli ethanol diet for 6 weeks and the liver samples were obtained after 2, 4 and 6 weeks. Mild fatty infiltration was observed in 2 weeks of feeding and it became evident in 4 and 6 week samples. The level of hepatic triglyceride showed a good agreement with the data obtained in the pathological analysis. Feeding mice with ethanol diet resulted in the maturation and translocation of SREBP-1 to nucleus in the liver. Western blot analysis of the pooled liver sample of control and ethanol fed animals showed a clear-cut time-dependent increase in the expression of nSREBP-1. These data provide important information for selecting proper time point in experimental intervention study in the field of drug development for alcoholic liver disease.

에탄올 비강흡입이 수술 후 자가통증조절기 사용 환자의 오심에 미치는 효과 (The Effect of Ethanol Inhalation on Postoperative Nausea in Patients using Patient Controlled Analgesia)

  • 오소영;박경숙;황윤영
    • 성인간호학회지
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    • 제21권4호
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    • pp.379-390
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    • 2009
  • Purpose: The study was done to investigate the effect of ethanol inhalation on postoperative nausea in patients using Patient Controlled Analgesia (PCA). Methods: The data were collected from June 1st 2006 to September 30th, 2007. The subjects were 70 patients who had had orthopedic surgery under general anesthesia. The levels of the Visual Analogue Scale (VAS) was used to measure postoperative nausea. The experimental group was given ethanol inhalation using ethanol pads and the control group received normal saline pads. All participants were instructed to take two deep sniffs with the pad one inch from the nose. This was repeated every five minutes for three doses. The collected data were analyzed using SPSS/WIN 12.0 program. Results: The study supported all hypotheses. "The experimental group given first dose of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -5.900, p = .000). "The experimental group given second doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -7.507, p = .000). "The experimental group given third doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -6.685, p = .000). Conclusion: According to these results, the ethanol inhalation can be considered an effective nursing intervention for relieving the postoperative nausea in patients using PCA.

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이상지질혈증의 국내 및 국외 치료 가이드라인 비교 (Current Guidelines on the Management of Dyslipidemia)

  • 최윤정;이송;김주영;이경은
    • 한국임상약학회지
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    • 제27권4호
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    • pp.276-283
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    • 2017
  • Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

Preventive and Therapeutic Effects of Quercetin on Experimental Radiation Induced Lung Injury in Mice

  • Wang, Juan;Zhang, Yuan-Yuan;Cheng, Jian;Zhang, Jing-Ling;Li, Bao-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권7호
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    • pp.2909-2914
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    • 2015
  • Objective: To investigate the protective effect of quercetin on radiation induced lung injury (RILI) and related mechanisms. Materials and Methods: Mice treated with radiation and/or quercetin were sacrificed at 1-8 weeks after irradiation under anesthesia. Lung tissues were collected for histological examination. Immunohistochemistry (IHC) and Western blotting were performed to detect the protein expression of nuclear factor-${\kappa}B$ ($NF-{\kappa}B$) and Mitogen-activated protein kinases (MAPK) pathway. Results: Hematoxylin and eosin (HE) staining showed that radiation controls displayed more severe lung damage than quercetin groups, either high or low dose. Results of IHC and Western blotting demonstrated the expression level of $NF-{\kappa}B$ to be decreased and that of an inhibitor of $NF-{\kappa}B$ ($I{\kappa}b-{\alpha}$) to be increased by the quercetin intervention compared with the radiation control group. Numbers of JNK/SAPK, p38 and p44/p42 positive inflammatory cells were decreased in the radiation+quercetin injection group (P<0.05). Conclusions: Quercetin may play a radio-protective role in mice lung via suppression of $NF-{\kappa}B$ and MAPK pathways.