• Title/Summary/Keyword: regimen

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Prevalence of Hypertension and Risk Factors According to Sasang Constitution (사상체질(四象體質)에 따른 고혈압 유병률 및 위험인자)

  • Kim, Min-Jong;Yoo, Jun-Sang;Koh, Sang-Baek;Park, Jong-Ku
    • Journal of Sasang Constitutional Medicine
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    • v.21 no.1
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    • pp.150-164
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    • 2009
  • 1. Objectives This study was to designed investigate the relationship between hypertension and its risk factors and the prevalence of hypertension according to Sasang Constitution. 2. Methods Five hundred and twenty six people were subjects out of 666 people, over 40 years old, who participated in the community-based cohort in Wonju, South Korea from July 2nd to August 30th in 2006. Hypertensive group was 263 peoples and normal group was 263 people, selected randomly among non hypertensive people who had same age and sex with hypertensive groups. Sasang Constitutional Diagnosis was carried out using PSSC(Phonetic System of Sasang Constitution), face and tongue photos and a checkup list. Risk factors from blood samples, physical measurements and social indices were analyzed using SPSS. 3. Results The prevalence of hypertension in Taeeumin was 63.1%(N=166), that of Soeumin was 22.4%(N=59) and that of Soyangin was 14.4%(N= 38). Considering risk factors of hypertension, there weren't any differences between two groups in social support indices and Framingham type A score. But scores of Soeumin's and Soyangin's were significantly high compared with that of Taeeumin in female normal group. There were significantly high results in Adiponectin of Soeumin's and HDL-cholesterol of female Soyangin's and HOMA-IR of Taeeumin's than any other groups. Crude OR of Taeeumin was 2.18 as compared with that of Soeumin in terms of risk of hypertension, and OR of Taeeumin was 2.02 as compared with that of Soeumin after drinking, smoking, total cholesterol, fasting blood sugar and HOMA-IR were adjusted. But after BMI was adjusted there wasn't a significance between Soeumin and Taeeumin and the OR of more than 25 was 2.42 as compared with that of less than 23 in BMI. 4. Conclusions Sasang Constitution is thought to be the reasonable variable to control hypertension in terms of prevention, treatment and regimen. And constitution is needed as a good variable to make a cohort study concerning chronic diseases, especially hypertension.

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Is higher dose always the right answer in stereotactic body radiation therapy for small hepatocellular carcinoma?

  • Lee, Kyung Hwa;Yu, Jeong Il;Park, Hee Chul;Park, Su Yeon;Shin, Jung Suk;Shin, Eun Hyuk;Cho, Sungkoo;Jung, Sang Hoon;Han, Young Yih;Lim, Do Hoon
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.129-138
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    • 2018
  • Purpose: This study was conducted to compare clinical outcomes and treatment-related toxicities after stereotactic body radiation therapy (SBRT) with two different dose regimens for small hepatocellular carcinomas (HCC) ${\leq}3cm$ in size. Materials and Methods: We retrospectively reviewed 44 patients with liver-confined HCC treated between 2009 and 2014 with SBRT. Total doses of 45 Gy (n = 10) or 60 Gy (n = 34) in 3 fractions were prescribed to the 95% isodose line covering 95% of the planning target volume. Rates of local control (LC), intrahepatic failure-free survival (IHFFS), distant metastasis-free survival (DMFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Results: Median follow-up was 29 months (range, 8 to 64 months). Rates at 1 and 3 years were 97.7% and 95.0% for LC, 97.7% and 80.7% for OS, 76% and 40.5% for IHFFS, and 87.3% and 79.5% for DMFS. Five patients (11.4%) experienced degradation of albumin-bilirubin grade, 2 (4.5%) degradation of Child-Pugh score, and 4 (9.1%) grade 3 or greater laboratory abnormalities within 3 months after SBRT. No significant difference was seen in any oncological outcomes or treatment-related toxicities between the two dose regimens. Conclusions: SBRT was highly effective for local control without severe toxicities in patients with HCC smaller than 3 cm. The regimen of a total dose of 45 Gy in 3 fractions was comparable to 60 Gy in efficacy and safety of SBRT for small HCC.

Local and regional recurrence following mastectomy in breast cancer patients with 1-3 positive nodes: implications for postmastectomy radiotherapy volume

  • Park, Shin-Hyung;Lee, Jeeyeon;Lee, Jeong Eun;Kang, Min Kyu;Kim, Mi Young;Park, Ho Yong;Jung, Jin Hyang;Chae, Yee Soo;Lee, Soo Jung;Kim, Jae-Chul
    • Radiation Oncology Journal
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    • v.36 no.4
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    • pp.285-294
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    • 2018
  • Purpose: To determine the necessity of postmastectomy radiotherapy (PMRT) and which regions would be at risk for recurrence, we evaluated local and regional recurrence in breast cancer patients with 1-3 positive nodes and a tumor size of <5 cm. Materials and Methods: We retrospectively analyzed data of 133 female breast cancer patients with 1-3 positive nodes, and a tumor size of <5 cm who were treated with mastectomy followed by adjuvant systemic therapy between 2007 and 2016. The median follow-up period was 57 months (range, 12 to 115 months). Most patients (82.7%) were treated with axillary lymph node dissection. Adjuvant chemotherapy, endocrine therapy, and trastuzumab therapy were administered to 124 patients (93.2%), 112 (84.2%), and 33 (24.8%), respectively. The most common chemotherapy regimen was anthracycline and cyclophosphamide followed by taxane (71.4%). Results: Three patients (2.3%), 8 (6.0%), and 12 (9.0%) experienced local, regional, and distant failures, respectively. The 5-year cumulative risk of local recurrence, regional recurrence, distant metastasis, and disease-free survival was 3.1%, 8.0%, 11.7%, and 83.4%, respectively. There were no statistically significant clinicopathologic factors associated with local recurrence. Lymphovascular invasion (univariate p = 0.015 and multivariate p = 0.054) was associated with an increased risk of regional recurrence. Conclusion: Our study showed a very low local recurrence in patients with 1-3 positive nodes and tumor size of <5 cm who were treated with mastectomy and modern adjuvant systemic treatment. The PMRT volume need to be tailored for each patient's given risk for local and regional recurrence, and possible radiation-related toxicities.

The Efficacy of Induction Chemotherapy in Stage III Non-Small Cell Lung Cancer (제 3기 비소세포 폐암에서 유도 화학 요법의 효과)

  • Cho Heung Lae;Joo Young Don;Sohn Seung Chang;Sohn Chang Hak
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.283-289
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    • 1998
  • Purpose : This study was performed to analyze the efficacy of induction chemotherapy fellowed by radiation therapy in locally advanced non-small cell lung cancer Materials and Methods : Eighty patients with locally advanced non-small cell lung cancer treated from 1989 to 1995 at Pusan Paik hospital were analyzed retrospectively. Twenty-one patients were treated with induction chemotherapy followed by radiation therapy and Fifty-nine Patients were treated with radiation therapy alone. Chemotherapy regimen consisted of cisplatin-based combination (2 or 3 drugs). All patients were treated by Co-60 or 6 MV linear accelerators. Radiation dose ranged from 50 Gy to 80 Gy (median 64.8 Gy). We evaluated response rate, survival rate, and pattern of failure in both treatment groups. Results : Overall response rate in induction chemotherapy group and radiotherapy alone group were 48% and 45%, respectively. Of the 80 patients, 46 patients were evaluable for pattern of failure. Initial failure pattern in induction chemotherapy group was as follows: 8 (67%) at locoregional, 4 (33) in distant metastasis. Radiation alone group was 21 (71%) and 5 (29%), respectively. Results showed no difference of distant failure between induction chemotherapy group and radiation alone group. The 1 and 2 year survival rate in induction chemotherapy group were 43% and 14%, respectively and in radiotherapy alone group, 31% and 7%, respectively (p=0.135). Conclusion : In stage III non-small cell lung cancer, induction chemotherapy and radiation therapy showed increased tendency in survival with no statistical significance Induction chemotherapy seems to have no effect of decreasing distant failure and no survival advantage compared with radiotherapy alone.

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A Study on Nurses한 and Patients한 Perceptions of Psychotropic Medication (향정신성 약물치료에 대한 간호사와 환자의 지각 비교 연구)

  • 이평숙
    • Journal of Korean Academy of Nursing
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    • v.24 no.1
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    • pp.47-57
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    • 1994
  • The purpose of this study was to examine nurses’ perceptions of medication treatment for psychiatric patients and to compare these perceptions with the perceptions held by the patients. The methodology used in this study was a descriptive design with semi-structured and open-ended interviews. This study used a convenience sample of 112 nurses who worked in, and 209 patients who were under psychiatric treatment, in four hospitals attached to a university and one national mental hospital in the city of Seoul. The collected data were analyzed by SAS, using percentages for descriptive purposes, and t-test or x$^2$ for comparing the variables. The results were as follows : 1. There was no significant differences between nurses’ and patients’ perceptions on the extent to which patients complied with their medication treatment. Generally speaking, the mean compliance scores for both nurses and patients was high(nurse : (equation omitted)=3.70, Patient : (equation omitted)=3.76). 2. There was a significant difference in nurses’ and patients’ perceptions on the reasons why patients do not take medication. The nurse group indicated that the patients did not take medication because of the “worry about side effects or habituation(49.53%)”, “boredom from long-term use of medication(26.17%)” and “distrust toward medical staff(12.15% )”, but the patient group indicated that they “did not want to be dependent on medication (25%)”, “forgot to take medication(19.7%) and “worried about side effects or habituation(15.91%). 3. As for the necessity of medication, both groups showed some different responses. Even though both groups were aware of the necessity of taking medication, the patient group(21.53%) showed a more negative response. As (or the effects of medication, both groups (nurses and patients ) showed positive responses. However, the nurse group showed a higher positive response (91.07% ) than the patient group(74.16%), 5. Both the patient and nurse group indicated that the most helpful element for the patient’s life under psychiatric treatment was interviews and conversations with therapists and nurses. However, the nurse group showed a higher response(70.15%) than the patients group(47.15%). According to the patient group, family support for the patient was another important factor for psychiatric treatment and daily struggles. In conclusion, as there were differences between the perception of nurses and patients, the nurse must consider the patients’ subjective perceptions first. They should also revaluate their false belief and prejudice concerning the patients’ perceptions. Such information can provide a base to be applied by the nurses in devloping effective mutual relationships with patients which can in turn help in compliance with medication regimen. As it was confirmed that medication was the most important factor in the patients’ recovery, a thorough education program on the therapeutic effect of medication and the necessity of their continued use after discharge is also needed.

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A Study of the Effects of Health Contracting on Compliance with Health Behaviors in Clients with Hypertension (자가간호증진을 위한 건강계약이 고혈압자의 건강행위 이행에 미치는 영향)

  • 이향련
    • Journal of Korean Academy of Nursing
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    • v.17 no.3
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    • pp.204-217
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    • 1987
  • It is generally accepted that the delivery of health care is undergoing many changes specially those related to acute, contagious disease care and to the increase of chronic illnesses which can not be cured but are controlable. The health care practitioner can not be soley responsible for the control of their clients' care. Because the clients will play a vital role in controlling their illnesses, long term participation by both the health care provider and the client is necessary. Since most individuals with hypertension do not experience signs or symptoms, the disease is difficult to detect and even when diagnosed, clients do not comply well with their hypertension regimens. The noncompliant client is at increased risk for compliants involving the heart, brain, kidney and other organs. In an effort to explore methods of increasing patient participation in and adherence to treatment programs for hypertension, the researcher used health contracting to promote self care. The research questions are; 1) Will the health contracting increase compliance in health behavior and reduce the blood pressure\ulcorner 2) If clients comply with their regimens will this reduce their blood pressure\ulcorner The research design utilized in this study was a quasi-experimental design. A purposive sample, was abtained from two churches in the 1. area, consisting of 64 clients with hypertension. The data was collected from the middle of January to the 1st of September 1985. Randomization was only of the two church groups into experimental and control groups. Compliance with health behavior related to the hypertensive regimen, blood pressure and body weight were measured, compared and analyzed. In the experimental group measurements were made 6 times; one month before the education program after education program when health contracting was done and 4 more times once a month for 4 months. In the control group measurements were made 3 times; one month before the education program after the education program, and once 4 months later. There was no health contracting. The data were analyzed by t-test, Pearson correlation and ANOVA according to purpose of the study. The result of this study may be summarized as follows: The result related to the hypothesis on the effect of health contracting are as follows: H$_1$; “The hypothesis that the experimental group, with a health contractual agreement will demonstrate increased compliance levels for health behavior than the control group” was supported(t=-5.29, df=62, p=.000). H$_2$; “The hypothesis that the experimental group, with a health contractual agreement, will demonstrate a greater reduction in blood pressure than the control group” was supported (for systolic blood pressure t=2.72, df=62, p=.009, for diastolic blood pressure t=1.95, df=62, p=.050). H$_3$; The hypothesis that the greater the compliance of the client with health behavior the lower the client's blood pressure will be was partially supported (for systolic pressure r=-.2981, p=.008, for diastolic pressure r=-.1720, p=.087). From the examination of the results of this study it can be concluded that the interaction between the nurse and the client, contracting to define goals and reinforcing compliant behavior, leads to improved compliance with health care behaviors and thus to an increase in the effectiveness of nursing care. Further consideration need to be given to the inclusion of the concept of health contracting in primary nursing and to further research in this area.

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THE COMPARATIVE STUDY ON THE SEDATIVE EFFECT OF ORAL MIDAZOLAM AND INTRAMUSCULAR MIDAZOLAM IN SEDATING YOUNG PEDIATRIC DENIAL PATIENTS (소아 환자에서 미다졸람의 경구 투여와 근육 투여에 의한 진정 효과의 비교 연구)

  • Min, Yu-Jin;Yu, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.1
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    • pp.53-61
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    • 2006
  • When routine behavior control is impossible, midazolam is often used for sedation, because it has wide margin of safety, relatively few side-effects and multiple route of administration. Although intramuscular administration of all administration route is frequently used, it is a major source of anxiety, discomfort, and trauma in children. To the contrary, oral administration of midazolam is easily administered and accepted by children. But, it's therapeutic drug concentration has not been established. The purpose of this study was to compare sedation effect and physiologic parameter of oral midazolam which palliate demerits of intramuscular administration in sedating young pediatric patients with intramuscular midazolam Twelve negative children, mean age 62.5 months, who needed at least two separate restorative visits, requiring local anesthesia participated in this study On every visit, one of the following 2 different sedative regimen was given : (1) 0.30mg/kg midazolam by intramuscular administration (2) 0.75mg/kg by oral administration. Physiologic parameter(oxygen saturation, heart rate) was recorded by ten procedure and behavior was videotaped and rated using Ohio State University Behavior Rating Scale and Automated Counting System by one investigator, blind to administration route The analyzed sedative effect of oral midazolam resulted in good sedative effect, comparing to intramuscular route, And there is no statistically difference between oral and intramuscular administration of midazolam (p>0.05).

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Clinical Manifestations of Persistent Smear Positive and Culture Negative Sputum Tests 5 Months after First-Line Anti-Tuberculous Chemotherapy (일차 항결핵제 치료 5개월 후 도말 양성 및 배양 음성을 보이는 폐결핵 환자의 임상 양상)

  • Kim, Do Hyung;Hwang, Su Hee;Cheon, Du Su;Min, Jin Hong;Kang, Hyung Seok;Park, Seung Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.417-422
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    • 2007
  • Background: It is not known with certainty whether patients with persistently positive sputum smear results who have also had negative sputum culture results require prolongation of treatment for tuberculosis in order to avoid an increased risk of eventual relapse. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the appropriate duration of treatment in these patients. Methods: Sixty of 69 patients with sputum smear positive and culture negative tests at 5 months after first line anti-tuberculous chemotherapy from 2002 to 2003 were retrospectively analyzed. Exclusion criteria included incomplete treatment or resistance to rifampicin or two additional antibiotics, as determined by a drug susceptibility test (DST). Results: Smear conversion of the study subjects was observed after $8.3{\pm}2.3$ months treatment, and the patients were culture negative after $2.0{\pm}0.8$ months. The relapse rates of the study subjects were 3.8, 10.0, and 25.8% after 1, 2, and 5 years of anti-tuberculosis chemotherapy, respectively. The relapse rates were not significantly affected by a series of risk factors such as age, sex, presence of diabetes, a sputum culture examination after 2 months treatment, previous treatment history, chest radiograph, and duration of the treatment (P>0.05). Conclusion: Regimen change is not required for patients with persistent smear positive but culture negative tests in the fifth month for first line antituberculous treatment. However, a further study will be needed to clarify the high relapse rate in this specific group of patients.

Artificial Rearing of Red-striped Golden Stink Bug, Poecilocoris lewisi(Hemiptera : Scutelleridae) on Peanut : Developmental Characteristics, Host Plant and Oviposition Preference (땅콩 급여에 의한 광대노린재(Poecilocoris lewisi)의 인공 사육 : 발육 특성, 기주 및 산란선호성)

  • 김남정;설광열
    • Korean journal of applied entomology
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    • v.42 no.2
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    • pp.133-138
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    • 2003
  • To establish the successive rearing of red-striped golden stink bug, Poecilocoris lewisi Distant, developmental characteristics, host plant and oviposition preference were investigated. Raw peanuts were supplied to the insect as a substitute food at 25$\pm$$1^{\circ}C$, 60$\pm$5% R.H. and under 16Lㆍ8D photo regimen. Total developmental period was 48 days: 8.2$\pm$0.4, 5.4$\pm$0.2, 8. $\pm$0.5, 6.4$\pm$0.4, 7.4$\pm$0.3 and 12.6$\pm$0.8 days for egg, first though fifth instar, respectively. The instar survival rate was 57.1% and the sex ratio was estimated to be 53 : 47 (male : female). Adult longevity was on the average 30.8 in male and 35.4 days in female, respectively. Egg of P. lewisi was globular ($\phi$1.8-1.9mm) with milky white in color The number of eggs oviposited per clutch was mostly 14. Pre-oviposition period was 25.8 days and mean frequencies of oviposition were 4.4. Female preferred to oviposit on the host plant when available, but oviposited on the artificial leaf successively when the host is not around. On the other hand P. lewisi preferred to suck the nectar of stem or fruit of Phellodendron amurense Ruprecht, Zanthoxylum schinifolium Siebold et zuccarini, Cornus officinalis Siebold et zuccarini and Cornus controversa Hemsley among the 18 plant species tested.

A Study on the Fatigue Analysis of Glass Fiber Reinforced Plastics with Linear and Nonlinear Multi-Scale Material Modeling (선형과 비선형 다중 스케일 재료 모델링을 활용한 유리섬유 강화 플라스틱의 피로해석 연구)

  • Kim, Young-Man;Kim, Yong-Hwan
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.33 no.2
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    • pp.81-93
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    • 2020
  • The fatigue characteristics of glass fiber reinforced plastic (GFRP) composites were studied under repeated loads using the finite element method (FEM). To realize the material characteristics of GFRP composites, Digimat, a mean-field homogenization tool, was employed. Additionally, the micro-structures and material models of GFRP composites were defined with it to predict the fatigue behavior of composites more realistically. Specifically, the fatigue characteristics of polybutylene terephthalate with short fiber fractions of 30wt% were investigated with respect to fiber orientation, stress ratio, and thickness. The injection analysis was conducted using Moldflow software to obtain the information on fiber orientations. It was mapped over FEM concerned with fatigue specimens. LS-DYNA, a typical finite element commercial software, was used in the coupled analysis of Digimat to calculate the stress amplitude of composites. FEMFAT software consisting of various numerical material models was used to predict the fatigue life. The results of coupled analysis of linear and nonlinear material models of Digimat were analyzed to identify the fatigue characteristics of GFRP composites using FEMFAT. Neuber's rule was applied to the linear material model to analyze the fatigue behavior in LCF regimen. Additionally, to evaluate the morphological and mechanical structure of GFRP composites, the coupled and fatigue analysis were conducted in terms of thickness.