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The Effect of Behavior Modification on Enhancing Patient Adherence to Tuberculosis Treatment Regimens (Video프로그램을 통한 환자교육이 결핵환자 치료이행행위에 미치는 영향)

  • 정은리
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.697-708
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    • 1996
  • Most efforts to improve tuberculosis treatment adherence target the patient and his or her behavior. This study examined the effects of behavioral modification training for these patients. Based on Bandura's behavioral principles of modeling, intervention strategies using a video program were devised to elicit specific patient target behaviors considered to improve patients' adherence to tuberculosis treatment regimens. A random assignment, two-group(experimental group and control group) research design including 81 subjects was used. The main outcomes measured were pill taking measured with the Medication Event Monitoring System(MEMS) Medication Cap, patients' self-efficacy, and their knowledge of tuberculosis. The findings are as follows : 1) There was a significant difference between the experimental group and the control group in patients' feelings of self-efficacy. That is, the patients who received the behavior modification program showed greater feeling of self-efficacy to initiate and change their behavior for the tuberculosis treatment regimen than the patients who did not receive the program(t=3.51, p=0.01). 2) There was a significant difference between the experimental group and the control group in patients' knowledge of tuberculosis. That is, the patients who received the behavior modification program showed higher level of knowledge of tuberculosis than the patients who did not receive the program(t=2.15, p=0.03) 3) There was a significant difference between the experimental group and the control group in patients' adherence to tuberculosis treatment regimens. That is, the patients who received the behavior modification program showed greater adherence to the treatment regimens than the patients who did not receive the program(t=5.11, p=0.00). The study findings provided useful insights into nursing practice, particularly in planning intervention strategies aimed at enhancing patients' adherence in tuberculosis that may also be relevant to other chronic diseases with patient adherence problems.

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The effects of closed kinetic chain exercise and open kinetic chain exercise in improving the balance of patients with hemiplegia (닫힌 사슬운동과 열린 사슬운동이 편마비 환자의 균형에 미치는 영향)

  • Kim, Yong-Jeong;Kim, Taek-Yean;Oh, Duck-Won
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.1
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    • pp.22-31
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    • 2009
  • Purpose The purpose of this study was to compare the effects of closed kinetic chain exercise and open kinetic chain exercise in improving the balance of patients with hemiplegia. Methods Ten patients with stroke were randomly allocated to either a closed kinetic chain exercise (CKC) group(n=5) or an open kinetic chain exercise(OKC) group(n=5). The subjects of each group followed the exercise regimen of their respective groups, and each exercise was performed for 50 mins per day, 3 days per week, for 4 weeks. Assessment was made using Berg Balance Scale (BBS), One Leg Standing(OLS) test, and Timed up and go(TUG) test. The 2 groups were assessed twice: before and after the intervention. Results The TUG test score was significantly different in the CKC group between before and after intervention (p<.05); however, there was no such deference in the OKC group (p>.05). Further, the scores of the BBS and OLS tests were not significantly different for the 2 groups between before and after intervention (p>.05). The hanges in these BBS and OLS score were not significantly different(p>.05); however, there was a significant difference in the change in the TUG scores (p<.05). Conclusion On the basis of the results of this study, we found that the closed kinetic chain exercise is more effective in improving the walking ability and dynamic balance in patients with stroke. Future studies are warranted in this regard.

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A Case of Pyrazinamide Induced Fulminant Hepatic Failure (Pyrazinamide에 의한 전격성 간부전 1예)

  • Moon, Dae Sung;Jang, Tae Won;Oak, Chul Ho;Jung, Maan Hong;Yoo, Chan Hui;Song, Jun Young;Kim, Sung Eun;Kim, Ja Kyung;Jang, Lee La;Lee, Eun Young;Jung, Gyu Sik
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.435-439
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    • 2007
  • Standard antituberculous therapy, including isoniazid (INH), rifampin, ethambutol, and pyrazinamide (PZA), is widely used to treat active tuberculosis. The most important side effect is hepatotoxicity. In a standard four-drug regimen, PZA was the most common cause of drug-induced hepatitis and was dose-related. The incidence of drug-induced hepatitis is high at doses of 40~70 mg/kg per day but has fallen significantly since the recommended dose was reduced. Liver toxicity induced by PZA is rare at doses of 25 mg/kg per day or less. PZA-induced fulminant hepatic failure is also rare but fatal. We report a case of fulminant hepatic failure caused by a re-challenge of PZA.

Comparative Analysis of 3 Experimental Mouse Model for Blood Hematology and Chemistry

  • Kong, Dae Young;Park, Jung Hwan;Lee, Kyo Won;Park, Ho;Cho, Jung Ah
    • Biomedical Science Letters
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    • v.22 no.3
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    • pp.75-82
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    • 2016
  • The immune system and neuroendocrine systems are the two key components that maintain bodily homeostasis. Peripheral blood specimens can indicate abnormalities in a body, which often cause various threats to human health, including devastating autoimmune or metabolic diseases. To develop a treatment regimen for such diseases, experimental animal models are indispensable to researchers in academic fields. In this study, we examined the peripheral blood of 3 representative mouse strains (ICR, Balb/c, and C57Bl/6), which are widely used, to investigate whether there is a difference in reference range according to animal model. We performed hematological and chemistry analysis on individuals of both genders. The results of hematology analysis showed that the number of most types of blood cells was lower in ICR than in the other two strains. The results of chemical analysis revealed no specific pattern, but different patterns according to the individual indicator. Although the distinction between ICR and B6 was prominent, differences between Balb/c and B6 were also observed for several indicators. For some indicators, totally different patterns existed between females and males. Conclusively, this study provides the information that 3 experimentally representative mouse models have their own basal levels of blood components, suggesting the importance of a careful choice of a proper mouse model in research into immune or metabolic diseases, to exclude any biases.

Preventive and Inhibitory Effect of Korean Red Ginseng on Collagen-Induced Arthritis in Mice (고려홍삼의 콜라겐 유도 관절염의 예방과 억제효과)

  • Cha, Mi-Ran;Wang, Yutie;Jang, Jin-Sun;Kim, Chae-Kyun
    • Journal of Ginseng Research
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    • v.33 no.2
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    • pp.149-154
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    • 2009
  • Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation and progressive cartilage and bone erosion. Korean red ginseng (KRG) has been shown to have an anti-inflammatory effect by inhibiting the secretion of inflammatory cytokines like $TNF-{\alpha}$, IL-1, -6, and -8, and $IPN-{\gamma}$. In this study, whether KRG extract has an inhibitory effect on the collagen-inducible development of arthritis in DBA/1J mice was investigated. To induce arthritis, type II collagen emulsified in Complete Freund's Adjuvant was intradermally injected into the base of the tails of mice. Three weeks after the initial injection, a booster injection of type II collagen emulsified in Incomplete Freund's Adjuvant was administered. The oral administration of KRG extract for 8${\sim}$10 weeks at the dose of 300 mg/kg (three days a week) inhibited the development of arthritis in the experimental group, compared to the control group which was given saline. While the administration of KRG extract three times a week demonstrated both preventive and inhibitory effects, the administration of KRG extract once a week had little inhibitory effect. In other studies, the regimen of KRG administration has been shown to decrease the plasma level of inflammatory cytokines like IL-8 and TNF-${\alpha}$, but the plasma levels of these cytokines were not decreased in the present study. The results of the present study suggest that KRG has preventive and inhibitory effects on collagen-induced arthritis.

Prediction of the Hepatotoxicity Risk Factor Induced by Antituberculosis Agents in Koreans (한국인의 항결핵제에 의한 간독성 위험인자 예측)

  • Lee, Ji-Sun;Kim, Hyun-Ah;Cho, Eun;Lee, Ok-Sang;Lim, Sung-Cil
    • YAKHAK HOEJI
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    • v.55 no.4
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    • pp.352-360
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    • 2011
  • Standard combination chemotherapy including isoniazid, rifampin, pyrazinamide, and ethambutol is very effective against tuberculosis. But, these medicines can cause hepatotoxicity which is the main reason for treatment interruption or change in drug regimen. In order to identify risk factors associated with hepatotoxcity in Koreans and assess elevated baseline LFTs' contributions to hepatotoxicity, a retrospective case control study was performed. The medical records of 277 patients who diagnosed with tuberculosis at a community hospital from January 1st, 2007 to June 30th, 2010 were reviewed. Patients were categorized into 3 groups (non toxic group, patients without increase in LFT levels; mild to moderate hepatotoxic group and severe hepatotoxic group). And the correlation between risk factors and hepatotoxicity was analyzed by using SPSS program. The overall incidence of hepatotoxicity was 18% and 8.7% of patients developed severe toxicity. Patients in the severe toxic group had the longest treatment period among the three groups. In 75% of severe toxic group, hepatotoxicity occurred within 18.3 days after starting medication. Hypoalbuminemia (serum albumin <3 g/dl) was a significant risk factor for development of severe toxicity. Elevated baseline transaminase (except ALT), total bilirubin, and preexisting hepatitis were also risk factors which were more than twice as likely to increase risk of severe hepatotoxicity (p>0.05). In conclusion, hypoalbuminemia (serum albumin level <3 g/dl) was a significant risk factor for anti-tuberculosis druginduced severe toxicity. Therefore, before starting antituberculosis chemotherapy, serum albumin level should be assessed at baseline. In high-risk patients (hypoalbuminemia, elevated LFTs) for hepatotoxicty, liver function should be closely monitored up to at least 21 days after taking medication.

Modulation of Humoral and Cell-Mediated Immunity Against Avian Influenza and Newcastle Disease Vaccines by Oral Administration of Salmonella enterica Serovar Typhimurium Expressing Chicken Interleukin-18

  • Rahman, Md Masudur;Uyangaa, Erdenebileg;Eo, Seong Kug
    • IMMUNE NETWORK
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    • v.13 no.1
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    • pp.34-41
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    • 2013
  • Interleukin-18 (IL-18) has been known to induce interferon-${\gamma}$ (IFN-${\gamma}$) production and promote Th1 immunity. Although mammalian IL-18 has been characterized in great detail, the properties and application of chicken IL-18 remain largely uninvestigated as of yet. In this study, we evaluated the immunomodulatory properties of Salmonella enterica serovar Typhimurium expressing chicken interleukin-18 (chIL-18) on immune responses induced by avian influenza (AI) and Newcastle disease (ND) vaccines. After oral administration of S. enterica serovar Typhimurium expressing chIL-18, chickens were vaccinated intramuscularly with the recommended dose of either inactivated AI H9N2 vaccine or ND (B1 strain) vaccine. Chickens receiving a primary vaccination were boosted using the same protocol 7 days later. Humoral and cell-mediated immune responses were evaluated in terms of HI antibody titers and proliferation and mRNA expression of IFN-${\gamma}$ and IL-4 of peripheral blood mononuclear cells (PBMC) in response to specific antigen stimulation. According to our results, oral administration of S. enterica serovar Typhimurium expressing chIL-18 induced enhanced humoral and Th1-biased cell-mediated immunity against AI and ND vaccines, compared to that of chickens received S. enterica serovar Typhimurium harboring empty vector. Therefore, we conclude that our proposed vaccination regimen using inactivated AI and ND viruses along with oral administration of S. enterica serovar Typhimurium expressing chIL-18 may provide a novel approach in protecting chicken from currently circulating AI and ND virus strains.

EFFECTS OF LASER AND FLUORIDE TREATMENT ON THE RESISTANCE TO MICROORGANISM AND ACID IN ARTIFICIAL CARIOUS LESION (레이저와 불소가 인공우식병소의 항균성 및 내산성에 미치는 영향에 관한 연구)

  • Yoo, Jeong-Min;Kim, Yong-Kee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.2
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    • pp.405-421
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    • 1997
  • The main purpose of this study was to evaluate the acid resistance and antimicrobial effect of fluoride-laser combined application. Recently extracted third molars were used. $5{\times}3mm$ of the buccal and lingual specimens were exposed and incipient artificial carious lesions were formed by keeping them in the artificial cariogenic solution for 5 days. They were divided into five groups and treated with fluoride and laser according to the predetermined regimen. The acid resistance was compared between groups by chemical quantitative analysis of the calcium and phosphorous released into the test solution after single or combined application of fluoride and laser. The antimicrobial effect of each group was analyzed by counting the number of colony forming units after microbial incubation. The results from the present study can be summarized as follows; 1. Experimental groups showed lower values in calcium and phosphorous contents as well as in $CFU/m{\ell}$(colony forming units) than control group. Combined application groups showed lower values than single application groups. 2. Acid resistance and antimicrobial effect by fluoride and laser treatment were confirmed in this study. 3. Based upon the above-mentioned results of this study, it can be assumed that the use of laser-fluoride combined application may provide the child and adolescent patient population with antimicrobial effect as well as acid resistance. Further studies using various materials and experimental conditions are being encouraged.

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Outcomes of Second-Line Chemotherapy for Advanced Non-Small Cell Lung Cancer in One Institution

  • Lee, Seok Jeong;Kang, Hyun Ju;Kim, Seo Woo;Ryu, Yon Ju;Lee, Jin Hwa;Kim, Yookyung;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.1
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    • pp.13-17
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    • 2014
  • Background: This study analyzed the negative prognostic factors in patients who received second-line chemotherapy for advanced inoperable non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed the records of 137 patients with inoperable stage III-IV NSCLC who received second-line chemotherapy. The effects of clinical parameters on survival were analyzed and the hazard ratios (HR) for mortality were identified by a Cox regression analysis. Results: Sex, age older than 65 years, smoking history, cell type, T-stage, best response to first-line chemotherapy and first-line chemotherapy regimen were significant negative predictors in univariate analysis. The multivariate analysis showed that patients older than 65 years (HR, 1.530; 95% confidence interval [CI], 1.020-2.297), advanced T stage (T4 vs. T1; HR, 2.273; 95% CI, 1.010-5.114) and non-responders who showed progression with first-line chemotherapy (HR, 1.530; 95% CI, 1.063-2.203) had higher HR for death. Conclusion: The age factor, T stage and responsiveness to first-line chemotherapy were important factors in predicting the outcome of patients with advanced NSCLC who received second-line chemotherapy. The results may help to predict outcomes for these patients in the future.

Spontaneous Splenic Rupture as a Paradoxical Reaction during Treatment for Splenic Tuberculosis

  • Yeo, Hye Ju;Lee, Soo Yong;Ahn, Eunyoung;Kim, Eun Jung;Rhu, Dae Gon;Choi, Kyoung Un;Lee, Seung Eun;Cho, Woo Hyun;Jeon, Doosoo;Kim, Yun Seong
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.5
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    • pp.218-221
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    • 2013
  • This report describes a rare case of a patient with splenic tuberculosis (TB) who developed spontaneous splenic rupture after 10 weeks of antituberculous chemotherapy. The patient responded well to the antituberculous regimen prior to the spontaneous splenic rupture. We considered a paradoxical reaction as a cause of the splenic rupture. The patient underwent splenectomy and continuously received initial antituberculous drugs without change. To the best of our knowledge, this is the first report of spontaneous splenic rupture as a paradoxical reaction to antituberculous chemotherapy in an immunocompetent host with splenic TB.