• Title/Summary/Keyword: medical training

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One case of combination therapy of acupuncture, herbal medication, counseling and autogenic training on convulsion of conversion disorder (한방정신요법 및 자율훈련법을 사용한 경련을 주증상으로 하는 전환장애 1례)

  • Seo, Deok-Won;Ahn, Hyo-Jin;Ryu, Ho-Sun;Lee, Su-Bin;Ko, In-Sung;Park, Se-Jin
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.4
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    • pp.143-155
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    • 2011
  • Objectives : The purpose of this study is to suggest that psychotherapy must be considered when treating conversion disorder patient with convulsion. Methods : We treated the patient with counseling and autogenic training in psychotherapies, not only traditional methods. Results : In this study, we found difference between when counselling and autogenic training is combined and when they are not practiced. Conclusions : Counseling and autogenic training is good treatment at patient with convulsion of conversion disorder.

Differential effects of type 1 diabetes mellitus and subsequent osteoblastic β-catenin activation on trabecular and cortical bone in a mouse mode

  • Chen, Sixu;Liu, Daocheng;He, Sihao;Yang, Lei;Bao, Quanwei;Qin, Hao;Liu, Huayu;Zhao, Yufeng;Zong, Zhaowen
    • Experimental and Molecular Medicine
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    • v.50 no.12
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    • pp.3.1-3.14
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    • 2018
  • Type 1 diabetes mellitus (T1DM) is a pathological condition associated with osteopenia. $WNT/{\beta}$-catenin signaling is implicated in this process. Trabecular and cortical bone respond differently to $WNT/{\beta}$-catenin signaling in healthy mice. We investigated whether this signaling has different effects on trabecular and cortical bone in T1DM. We first established a streptozotocin-induced T1DM mouse model and then constitutively activated ${\beta}$-catenin in osteoblasts in the setting of T1DM (T1-CA). The extent of bone loss was greater in trabecular bone than that in cortical bone in T1DM mice, and this difference was consistent with the reduction in the expression of ${\beta}$-catenin signaling in the two bone compartments. Further experiments demonstrated that in T1DM mice, trabecular bone showed lower levels of insulin-like growth factor-1 receptor (IGF-1R) than the levels in cortical bone, leading to lower $WNT/{\beta}$-catenin signaling activity through the inhibition of the IGF-1R/Akt/glycogen synthase kinase $3{\beta}$ ($GSK3{\beta}$) pathway. After ${\beta}$-catenin was activated in T1-CA mice, the bone mass and bone strength increased to substantially greater extents in trabecular bone than those in cortical bone. In addition, the cortical bone of the T1-CA mice displayed an unexpected increase in bone porosity, with increased bone resorption. The downregulated expression of WNT16 might be responsible for these cortical bone changes. In conclusion, we found that although the activation of $WNT/{\beta}$-catenin signaling increased the trabecular bone mass and bone strength in T1DM mice, it also increased the cortical bone porosity, impairing the bone strength. These findings should be considered in the future treatment of T1DM-related osteopenia.

Operating conditions and satisfaction in a clinical training program for 119 emergency medical technicians (119구급대원의 병원 임상수련 운영 실태 및 만족도)

  • Oh, Hyeon-Hwan;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.19 no.2
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    • pp.99-115
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    • 2015
  • Purpose: This study aimed to provide basic data for clinical training program development by analyzing the operating conditions and satisfaction in a clinical training program for 119 emergency medical technicians (EMTs) in South Korea. Methods: Data from 84 EMTs were collected on June 19, 2014. We administered a 64-item questionnaire about operating conditions and satisfaction in the clinical training program, and analyzed data (SPSS v 21.0). Results: The degree of performance in the field, importance of the item in the field, and level of difficulty were 3.36, 4.23, and 3.21, respectively. In the number of times that an item was directly performed according to the subjects' general characteristics a statistically difference in sex (p = .000), duty (p =.021), and total working time of trainees (p = .002). The subjects' total satisfaction score was 3.77. The difference in satisfaction according to the subjects' characteristics was a statistically significant in terms of sex (p = .016) and clinical training area (p = .005). Conclusion: A more efficient training system for hospital clinical training courses should be developed. The operation condition analyzed in this research may contribute to the improvement of the performance of EMTs.

Clinicopathological Features and Survival of Young Turkish Patients with Testicular Germ Cell Tumors

  • Ozgun, Alpaslan;Karagoz, Bulent;Tuncel, Tolga;Emirzeoglu, Levent;Celik, Serkan;Bilgi, Oguz
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6889-6892
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    • 2013
  • Background: Testicular germ cell tumors (TGCTs) are a relatively common malignancy in young men. The aim of this study was to investigate the clinicopathological features and survival of young Turkish patients with TGCT. Materials and Methods: In this retrospective study, the clinical and pathological characteristics of young Turkish patients with TGCT who were monitored by the Department of Medical Oncology of a military hospital between 2008 and 2013 were investigated. Overall survival data were analyzed. Results: Ninety-six patients were included in the study. The mean age was 26.4 years. Among the patients, 17.7% had seminoma and 43.8% had mixed non-seminomatous germ cell tumors. Some 46.9% were Stage I, 30.2% were Stage II, and 22.9 were Stage III. Of the patients, 83.3% received chemotherapy, 25% underwent retroperitoneal lymph node dissection (RPLND), 3.1% received radiotherapy, and 12.5% were followed-up without treatment. In addition, 18.8% of the patients were administered salvage chemotherapy due to relapse or progression. The 5-year overall survival rate was 90.2% for all patients. The 2-year overall survival rate was 100% for Stage I patients, 94% for Stage II patients, and 70.2% for Stage III patients. The difference between the survival curves of stages was statistically significant (p=0.029). Conclusions: In young Turkish patients with TGCT, good results were obtained with appropriate treatment, most receiving chemotherapy. The prognosis of the disease was good even in the advanced stage.

The Effect of Simulation-based Training on the Competence of Basic Life Support of the students Emergency Medical Technology (시뮬레이션 교육이 응급구조과 학생의 기본소생술 수행능력에 미치는 영향)

  • Ko, Chong-Hyeon
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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    • pp.31-45
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    • 2007
  • Purpose : The simulation-based training in this research consists of theory and practice. Before the training, target students took a test on the competence of basic life support. Based on the result, they were separated as the subject group and comparison group. The simulation-based training was offered to the subject group and the traditional training was given to the comparison group. As soon as the training was completed, a follow-up study was conducted. Methods : This research aimed to figure out the effect of the simulation-based training on the competence of basic life support of the students Emergency Medical Technology. To this end, the nonequivalent pretest-posttest-quasi-experimental design using a comparison group was conducted. Results : The first hypothesis was that 'The group who took the simulation-based training would show higher points in the knowledge of basic life support than the group who took the traditional training.' Among those who took prior theory education, the subject group showed $69.38{\pm}20.43$ points while the comparison group showed $76.25{\pm}21.33$ points(t = -0.658, p = 0.531). Among those who took prior theory education and training, the subject group showed $82.86{\pm}10.86$ points while the comparison group showed $79.33{\pm}15.45$ points(t = 0.705, p = 0.487). Since there were no significant statistical differences between the two groups, the first hypothesis didn't hold. It showed few differences between the two training methods. The second hypothesis was that 'The group who took the simulation-based training would show higher points in the basic life support skills than the group who took the traditional training.' Among those who took prior theory education, the subject group showed $65.75{\pm}7.66$ points while the comparison group showed $46.88{\pm}13.48$ points(t = -3.442, p = 0.004). Among those who took prior theory education and training, the subject group showed $79.50{\pm}11.40$ points while the comparison group showed $62.13{\pm}11.44$ points(t = 4.091, p = 0.000). Since there were significant statistical differences between the two groups, the second hypothesis held. It showed substantial differences between the two training methods. Conclusion : The group who took the simulation-based training showed more positive effects on the competence of basic life support than those who took the traditional training. Therefore, it is confirmed that the simulation-based training is a useful method to improve clinical work performance of the students Emergency Medical Technology.

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Detection of Circulating Tumor Cells in Breast Cancer Patients: Prognostic Predictive Role

  • Turker, Ibrahim;Uyeturk, Ummugul;Sonmez, Ozlem Uysal;Oksuzoglu, Berna;Helvaci, Kaan;Arslan, Ulku Yalcintas;Budakoglu, Burcin;Alkis, Necati;Aksoy, Sercan;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1601-1607
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    • 2013
  • A determination of circulating tumor cell (CTC) effectiveness for prediction of progression-free survival (PFS) and overall survival (OS) was conducted as an adjunct to standard treatment of care in breast cancer management. Between November 2008 and March 2009, 22 metastatic and 12 early stage breast carcinoma patients, admitted to Ankara Oncology Training and Research Hospital, were included in this prospective trial. Patients' characteristics, treatment schedules and survival data were evaluated. CTC was detected twice by CellSearch method before and 9-12 weeks after the initiation of chemotherapy. A cut-off value equal or greater than 5 cells per 7.5 ml blood sample was considered positive. All patients were female. Median ages were 48.0 (range: 29-65) and 52.5 (range: 35-66) in early stage and metastatic subgroups, respectively. CTC was positive in 3 (13.6%) patients before chemotherapy and 6 (27.3%) patients during chemotherapy in the metastatic subgroup whereas positive in only one patient in the early stage subgroup before and during chemotherapy. The median follow-up was 22.0 (range: 21-23) and 19.0 (range: 5-23) months in the early stage and metastatic groups, respectively. In the metastatic group, both median PFS and OS were significantly shorter in any time CTC positive patients compared to CTC negative patients (PFS: 4.0 vs 14.0 months, Log-Rank p=0.013; and OS: 8.0 months vs. 20.5 months, Log-Rank p<0.001). OS was affected from multiple visceral metastatic sites (p=0.055) and higher grade (p=0.044) besides CTC positivity (log rank p<0.001). Radiological response of chemotherapy was also correlated with better survival (p<0.001). As a result, CTC positivity was confirmed as a prospective marker even in a small patient population, in this single center study. Measurement of CTC by CellSearch method in metastatic breast carcinoma cases may allow indications of early risk of relapse or death with even as few as two measurements during a chemotherapy program, but this finding should be confirmed with prospective trials in larger study populations.

Does Immunohistochemistry Provide Additional Prognostic Data in Gastrointestinal Stromal Tumors?

  • Demir, Lutfiye;Ekinci, Nese;Erten, Cigdem;Kucukzeybek, Yuksel;Alacacioglu, Ahmet;Somali, Isil;Can, Alper;Dirican, Ahmet;Bayoglu, Vedat;Akyol, Murat;Cakalagaoglu, Fulya;Tarhan, Mustafa Oktay
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4751-4758
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    • 2013
  • Background: To investigate the predictive and prognostic effects of clinicopathologic and immunohistochemical (IHC) features in patients with gastrointestinal stromal tumours (GISTs). Materials and Methods: Fifty-six patients who were diagnosed with GIST between 2002 and 2012 were retrospectively evaluated. Relationships between clinicopathologic/immunohistochemical factors and prognosis were investigated. Results: Median overall survival (OS) of the whole study group was 74.9 months (42.8-107.1 months), while it was 95.2 months in resectable and 44.7 months in metastatic patients respectively (p=0.007). Epitheliolid tumor morphology was significantly associated with shortened OS as compared to other histologies (p=0.001). SMA(+) tumours were significantly correlated with low (<10/50HPF) mitotic activity (p=0.034). Moreover, SMA(+) patients tended to survive longer and had significantly longer disease-free survival (DFS) times than SMA (-) patients (37.7 months vs 15.9 months; p=0.002). High Ki-67 level (${\geq}30%$) was significantly associated with shorter OS (34 vs 95.2 months; 95%CI; p=0.001). CD34 (-) tumours were significantly associated with low proliferative tumours (Ki-67<%10) (p=0.026). Median PFS (progression-free survival) of the patients who received imatinib was 36 months (27.7-44.2 months). CD34 (-) patients had significantly longer PFS times than that of negative tumours; (50.8 vs 29.8 months; p=0.045). S100 and desmin expression did not play any role in predicting the prognosis of GISTs. Multivariate analysis demonstrated that ${\geq}10/50HPF$ mitotic activity/HPF was the only independent factor for risk of death in GIST patients. Conclusions: Despite the negative prognostic and predictive effect of high Ki-67 and CD34 expression, mitotic activity remains the strongest prognostic factor in GIST patients. SMA positivity seems to affect GIST prognosis positively. However, large-scale, multicenter studies are required to provide supportive data for these findings.

Development of Tissue-Tool Interaction Simulation Algorithms for Rotator Cuff Surgery Scenario in Arthroscopic Surgery Training Simulator

  • Jo, Kyungmin;Bae, Eunkyung;You, Hyeonseok;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.41 no.4
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    • pp.154-164
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    • 2020
  • Various simulator systems for surgery training have been developed and recently become more widely utilized with technology advancement and change in medical education adopting actively simulation-based training. The authors have developed tissue-instrument interaction modeling and graphical simulation algorithms for an arthroscopic surgery training simulator system. In this paper, we propose algorithms for basic surgical techniques, such as cutting, shaving, drilling, grasping, suturing and knot tying for rotator cuff surgery. The proposed method constructs a virtual 3-dimensional model from actual patient data and implements a real-time deformation of the surgical object model through interaction between ten types of arthroscopic surgical tools and a surgical object model. The implementation is based on the Simulation Open Framework Architecture (SOFA, Inria Foundation, France) and custom algorithms were implemented as pulg-in codes. Qualitative review of the developed results by physicians showed both feasibility and limitations of the system for actual use in surgery training.

A Case of Relaxation Training and Oriental Medical Treatment On SimDamHeoGup type of ChilJungGuQiJung (이완요법과 한방치료를 병행한 심담허겁형(心膽虛怯型) 칠정구기증(七情九氣證) 환자 1례(例)의 증례(證例)고찰)

  • Lim, Jung-Hwa;Jung, In-Chul;Hong, Sang-Su;Lee, Sang-Ryong
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.2
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    • pp.223-231
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    • 2005
  • The purpose of this study was to investigate the clinical application of relaxation training and oriental medical treatment to the SimDamHeoGup(心膽虛怯) type of ChilJungGuQiJung(七情九氣證) patient. In this case, a male patient, 31 years old, who lost his job two months ago, complained of the tension of body and anxiety. We treated the patient with relaxation training and oriental medical treatment such as herbal medicine, acupuncture treatment and aroma therapy. And we diagnosed his state SimDamHeoGup(心膽虛怯) type of ChilJungGuQiJung(七情九氣證), so we prescribed HaChuBoSimTang(夏朮補心場) for patient. In result, the patient’s tension of body and anxiety was improved, so he could recover his confidence slowly. Conclusionally, relaxation training and oriental medical treatment could be effective method to treat the patient of adjustment disorder with the tension of body and anxiety.

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A Clinical Study on 2 Cases of Depression Patients with Autogenes Training (슐츠의 자율훈련법을 이용한 우울증 환자 치험 2례)

  • Shin, Hyun-Kwon;Kim, Joo-Won;Kong, Hyun-Woo;Kock, Kyung-Nae;Kim, Hyo-Ju;Park, Se-Jin;Kim, Hyun-Ho;Kim, Tae-Hwan
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.3
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    • pp.165-174
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    • 2006
  • This study was designed to asses the effect of Schultz's Autogenes Training on the pateints diagnosed as depression. We measured the patients' BDI by stage treated by Schultz's Autogenes Training on their adaptation to each stage. In result, BDI of both cases were decreased : the case 1 from 28 to 9 ; the case 2 from 19 to 16. We also recognized that patients' will for recovery is very important to be treated more effectively by Schultz's Autogenes Training: the patients' will of the case 1 was more larger than that of the case 2. After our treatments, Depression and some other symptoms were improved.

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