• Title/Summary/Keyword: subacute stage

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A Study on the Development of a Health Risk Assessment Method for the Management of the Health Environment of Residents Living Around Areas Affected by Chemical Accidents (화학사고 주변 지역 거주자의 보건환경 관리를 위한 건강위해성 평가 방법 개발에 관한 연구)

  • Park, Sihyun;Park, Sejung;Park, Taehyun;Yoon, Danki;Jung, Jonghyeon;Gang, Sungkyu;Lee, Dongsoo;Seo, Youngrok;An, Yeonsoon;Lee, Cheolmin
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.28 no.1
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    • pp.1-17
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    • 2018
  • Objectives: This research is part of a study to be conducted over five years starting from 2017 by the Ministry of Environment on the development of technologies to evaluate the impact of chemical accidents on the human body. Methods: For this research, a five-stage specific study method was developed. Results: In brief, the developed health risk assessment method can be summarized as follows. First, a health risk assessment system was built based on the guidelines set forth by the USA NRC/NAS. Second, based on the disease manifestation theory, the health risk assessment method was divided into 1) a carcinogenic health risk assessment method focused on all carcinogens except non-genotoxic carcinogens and 2) a non-carcinogenic health risk assessment method focused on noncarcinogens including non-genotoxic carcinogens. Third, the detailed contents of the health risk assessment method were developed in four stages(hazard identification, dose-response assessment, exposure assessment, and risk determination) through theoretical consideration of the assessment of the level of health risk related to chemical exposure. Finally, a health risk assessment methodology, classified into stages to address acute, subacute/subchronic, and chronic conditions was developed after considering the physicochemical behavior of hazardous chemicals upon implementation of countermeasures after a chemical accident. Conclusions: A method to evaluate the health risks related to toxic chemicals generated by chemical accidents was developed. This study was performed with the purpose of developing a mathematical health risk assessment method to evaluate the health effects of exposure to hazardous chemicals upon implementation of emergency countermeasures after chemical accidents.

Role of Concomitant Chemoradiation in Locally Advanced Head and Neck Cancers

  • Lasrado, Savita;Moras, Kuldeep;Pinto, George Jawahar Oliver;Bhat, Mahesh;Hegde, Sanath;Sathian, Brijesh;Luis, Neil Aaron
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4147-4152
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    • 2014
  • Standard therapy for advanced head and neck cancer consists of a combination of surgery and radiation. However, survival of this patient population has not improved during the past 20 years. Many different multimodality treatment schedules have been proposed, and chemotherapy is often used with the intent of organ preservation. The present study was intended to establish the efficacy of concomitant chemoradiation with a single agent carboplatin in advanced head and neck cancers.The objectives were to investigate the feasibility of concomitant administration of carboplatin, monitor acute toxicity during radiotherapy, and determine subacute side effects, such as wound healing following surgery after chemoradiotherapy. A prospective study was conducted wherein a total of 40 patients with stage III and IV squamous cell carcinomas of oral cavity, oropharynx, hypopharynx and larynx were enrolled. All patients were treated with external beam radiotherapy and weekly carboplatin area under curve (AUC of 5). Radiotherapy was given in single daily fractions of 1.8-2 grays (Gy) to a total dose of 66-72 Gy. Salvage surgery was performed for any residual or recurrent locoregional disease. Neck dissection was recommended for all patients with neck disease showing less than a complete response after chemoradiation. A total of 40 patients were enrolled of whom 32 were males and 8 were females. Highest incidence of cancer was seen in the 5th-6th decades of life with a median age of 47.7 years. Oropharyngeal tumours constituted a maximum of 21 patients followed by hypopharynx in 10, larynx in 7 and oral cavity in 2. 80% of the patients had a neck node on presentation of which 40% had N2-N3 nodal status. TNM staging revealed that 58% of patients were in stage III and 43% in stage IV. Evaluation of acute toxicity revealed that 50% had grade II mucositis, 25% grade III mucositis, 2.5% grade IV mucositis. 50% of patients had grade I skin reactions, 65% of patients had grade I thrombocytopenia, and 24% of patients had grade I anaemia. After completion of treatment 65% of patients had complete response at the primary and regional sites, and 35% of patients had a partial response of whom 23% underwent neck dissection and 5% of them underwent salvage surgery at the primary site. At the end of one year there were six deaths and four recurrences and 70% were free of disease. Concurrent chemoradiation with carboplatin provided good locoregional control for locally advanced head and neck cancers. This regimen, although toxic, is tolerable with appropriate supportive intervention. Primary site conservation is possible in many patients. Chemoradiotherapy appears to have an emerging role in the primary management of head and neck cancers.

Arthritis in the Subacute Stage of Kawasaki Disease after Responding to Intravenous Immunoglobulin Treatment (가와사끼병에서 정맥용 면역글로불린에 반응 후 아급성기에 발생한 관절염)

  • Lee, Kyung-Yil;Oh, Jin-Hee;Koh, Dea-Kyun
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1124-1127
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    • 2003
  • We evaluated the clinical and laboratory characteristics of five children with Kawasaki disease who had showed arthritis after responding to intravenous immunoglobulin(IVIG) treatment. Age distribution was between 13 months and six years of age(mean $3.2{\pm}1.6$ years). There were two males and three females. Arthritis occurred when acute symptoms were subsiding, with the average onset on day $5.8{\pm}1.8$ after final IVIG treatment. Arthritis was pauciarticular in three, and polyarticular in two. Regarding laboratory findings, one child was positive in rhematoid factor and changed to negative after two months. Three patients were examined for HLA B27 and all showed negative results. High dose aspirin(two cases), anti-inflammatory drug(ibprofen, three cases), and corticosteroids(methyprednisolon pulse therapy, one case) were used for this type of arthritis. Symptoms and signs of arthritis in all patients were improved by these therapies. There was no relapse or complications within six months. Arthritis after responding to IVIG therapy was rarely observed in children with Kawasaki disease. This type of arthritis responded well to anti-inflammatory drugs including corticosteroids, and showed no relapses.

A Case-Control Study on the Effect of Hyperbaric Oxygen Therapy on Cerebral Infarction Patients (고압 산소 요법의 뇌경색 환자 치료 효과에 대한 연구)

  • Oh, Min-Kyu;Kim, Dong-Jin;Yun, Hye-Yeon;Shin, Hyeon-Su
    • The Journal of Internal Korean Medicine
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    • v.29 no.3
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    • pp.675-683
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    • 2008
  • Objectives : This study was designed to examine the effects of hyperbaric oxygen therapy on cerebral infarction. Methods : Fifty-five patients with acute or subacute cerebral infarction were classified into two groups, the study group and control group. The study group was treated by hyperbaric oxygen therapy(HBOT) for 2 weeks(5 times/week) and the control group wasn't treated by HBOT. We compared the score of National Institutes of Health Scale(NIHSS scale) between two groups. We subdivided the study group by TOAST classification and onset stage, and compared the results. All of this data was analyzed by statistical method. Results : The study group patients who were treated by hyperbaric oxygen therapy saw more improvement than the control group patients in NIHSS score, and there was significant consideration. Among the study group patients, we saw more improvement during the first week period than in the course of the second week, and there was significant consideration. Conclusion : These results suggest that hyperbaric oxygen therapy(HBOT) could be a useful medical treatment to treat cerebral infarction. Further studies are needed on more cases to make sure that hyperbaric oxygen therapy (HBOT) is surely effective for cerebral infarction.

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Changes of Toxicological Factors in Rats Short-Term Treated with Two Feeding Methods at Low Level of Microcystin-LR (저농도의 Microcystin-LR를 단기간 처리한 흰쥐에서 투여방법에 따른 독성 지표의 변화)

  • 함영국;김성완
    • Environmental Analysis Health and Toxicology
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    • v.18 no.3
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    • pp.209-217
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    • 2003
  • To investigate the effects of low dosed microcystin -LR (MCLR) on the initial stage of subacute hepatotoxicity in vivo, male Sprague-Dawley rats after weanling were divided in four groups. The orally treated group (OG) was administered orally by 1 $\mu\textrm{g}$/kg B.W. at an interval of three days. The free group (FG) has taken the drinking water including 1 $\mu\textrm{g}$/L freely and the control group (CC) was only treated with 0.9% saline solution All groups were treated for a period of 3 weeks. There was a significant correlation in body growth rate between OG and FC and especially, a deterioration of the growth of spleen was observed in the FG after 5 days. The protein levels were also decreased in OG and FG after 9 days. Level of total fat was increased to the 9th day but again decreased up to the initial level. High hemolysis of the isolated erythrocytes occurred only in OG. Activities of ${\gamma}$-G7 of 0G and FG were higher twice-fold than CG, but the values of OG were already higher at the first treatment day. No significant change in aspartate aminotransferase (AST) activity was shown in all groups, but the activity of alanine aminotransferase (ALT) was slightly increased at the beginning state. There were much similarities in the results of OG and FG. except the growth inhibition of spleen in FG. It may be concluded that long -term effects of the low doses of mycrocystins in animals including human being can lead to serious health problems, especially to liver and spleen.

The Clinical Studies for Non Surgical Spinal Decompression Treatment on Cervical Disc Herniation (경추추간판 탈출증환자의 감압치료 병행효과에 대한 임상적 연구)

  • Seo, Sang-Kyoung;Kim, Byoung-Jung;Park, Kuk-Ji;Kang, Jun-Hyuk;Kim, Seong-Ki;Seo, Deok-Won
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.4
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    • pp.131-143
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    • 2011
  • Objectives: The purpose of this study is to make a survey of the effectiveness of the non surgical spinal decompression treatment in patients with cervical disc herniation documented on magnetic resonance imaging(MRI). Methods: We studied about 27 cases of cervical disc herniation which were treated with non surgical spinal decompression and other medical treatment (acupuncture, interferential current therapy and ice poultice). Each patient has been treated with spine decompression and other medical treatment. And degree of improvement has been evaluated by short form-McGill pain questionnaire(SF-MPQ), visual analogue scale(VAS) and neck disability index(NDI) before treatment and 5th, 10th times after treatments. Results: 1. The VAS SF-MPQ and NDI scores showed statistically significant improvement after 5th and 10th treatment. 2. The VAS, SF-MPQ and NDI scores after 5th treatment showed better improvement than those of after 10th treatment. 3. The VAS, SF-MPQ and NDI scores in Subacute stage showed more statistically significant improvement among the other stages. Conclusions: As a result, non surgical spinal decompression treatment has clinical effects of pain reduction on patient with cervical disc herniation.

Immediate Effect of Pressure Pain Threshold and Flexibility in Tensor Fascia Latae and Iliotibial Band According to Various Foam Roller Exercise Methods

  • Kim, Ho;Shin, Wonseob
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.4
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    • pp.1879-1888
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    • 2019
  • Background: The treatment of pain in the iliotibial band friction syndrome has been difficult to determine, according to studies to date. However, recent studies have suggested that flexibility in the subacute stage of pain in the iliotibial band friction syndrome may help reduce pain. Objective: To investigate the immediate effect on pressure pain threshold and flexibility of the tensor fascia latae and iliotibial band by applying static and dynamic myofascial release foam rolling and self-stretching to adults with shortening iliotibial band. Design: Randomized controlled trial Methods: In this study, 50 subjects who were selected in advance as a randomized controlled trial were randomly allocated using a R Studio program. The included subjects were randomly allocated to three intervention groups. The static self-myofascial release 18 people, dynamic self-myofascial release group 16 people separated the self-stretching group 16 people and conducted a homogeneity check in advance. Before the start of the experiment, after of the experiment, 5 minutes after the end of the experiment, the pressure pain threshold and flexibility change for each part were measured. Results: The results of this study showed that the static self-myofascial release showed a significant difference in the pressure pain threshold in the tensor fascia latae and middle, lower part of the iliotibial band, compared with the other intervention groups (p<.05). In change of flexibility, the static self-myofascial release was significantly different than the other intervention groups (p<.05). Conclusion: The result of this study suggest that static self-myofascial release using foam roller may help to improve the pain and flexibility of the iliotibial band and to apply it as a more discerning intervention.

Changes of Lipid and Lipoprotein Compositions in Kawasaki Disease and its Impact on Cardiac Complications (가와사끼병에서 혈중 지질과 지단백의 변화와 심장 합병증에 미치는 영향에 관한 연구)

  • Yun, Sin Weon;Lee, Ho Seok;Kim, Dong Woon;Rhee, Kang Won;Jung, Young Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1370-1377
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    • 2005
  • Purpose : Delineation of serum lipid and lipoprotein values in children after Kawasaki disease(KD) is important because of the predilection of this disease for the coronary arteries. Methods : The KD group was composed of 51 patients who were hospitalized from Jan. 2002 to Dec. 2003. Control was 25 patients with non-KD febrile illness. The levels of total lipid, phospholipid, triglyceride, HDL-cholesterol(HDL-C), LDL-cholesterol, total cholesterol, apolipoprotein A1(apo A1), apolipoprotein B, and Lipoprotein(a) were measured and compared with Echocardiographic findings. Measurements were obtained in four time periods: acute febrile, subacute, convalescent phase and 1 year after KD. Results : HDL-C($33.64{\pm}7.49mg/dL$ vs $50.43{\pm}14.41mg/dL$, P<0.01) and apo A1($99.75{\pm}6.39mg/dL$ vs $113.34{\pm}11.35mg/dL$, P<0.05) were decreased more in the acute febrile period of KD than in the control, but these changes were not correlated with cardiac complications. All lipid profiles were markedly elevated in the subacute stage and normalized in the convalescent stage; there were no changes until 1-year follow up. There were no significant differences in the changes of lipid profiles, including Lp(a) and coronary dilatation, in any time periods. Conclusion : KD is associated with important abnormalities in lipid metabolism, but these changes were transient and appear to be due to the disease itself. These data lead us to infer that KD dose not cause such permanent changes in lipid abnormalities as to be considered a risk factor for atherosclerosis, beyond that caused by the disease itself.

Effects of Traditional Korean Medicine Treatment On Lumbar Spinal Stenosis and Assessing Improvement by Radiological Criteria: An Observational Study

  • Kim, Hyun-Joong;Lee, Sun-Ho;Choi, Ji-Hoon;Noh, Je-Heon;Kim, Min-Young;Jang, Jae-Won;Ha, Do-Hyung
    • Journal of Acupuncture Research
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    • v.34 no.4
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    • pp.172-179
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    • 2017
  • Background: This study was designed to evaluate the clinical effectiveness of traditional Korean medicine treatment for lumbar spinal stenosis as assessed by radiological criteria. Methods: This was an observational study of 122 patients who were diagnosed with lumbar spinal stenosis and admitted to Jaseng Hospital between January 2016 and June 2017. They were analyzed according to sex, age, cause of disease, disease stage, length of admission, type of stenosis, morphological grade, and dural sac cross-sectional area. All patients were treated with traditional Korean medicine. Patients were assessed with the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) and EQ-5D before and after treatment. Results: Regarding the distribution of the factors analyzed, these were of note: more females than males (1:3.52); and highest proportions were age more than 70 years (37.70%), cause of lumbar spinal stenosis unknown (67.21%), and subacute stage (42.62%). Comparing before and after treatment, the NRS score for low back and pelvic pain decreased from $6.14{\pm}1.71$ to $4.28{\pm}1.91$ (p < 0.001), and the NRS score for radiating pain and numbness decreased from $6.27{\pm}1.61$ to $2.02{\pm}1.54$ (p < 0.001). ODI decreased from $46.86{\pm}19.40$ to $33.63{\pm}18.66$ (p < 0.001), and gait-related ODI decreased from $3.34{\pm}1.23$ to $2.80{\pm}1.11$ (p < 0.001). There were no statistically significant differences in improvement of the NRS, ODI, gait-related ODI, and EQ-5D for morphological grade and dural sac cross-sectional area. Conclusion: Traditional Korean medicine is effective treatment for patients with lumbar spinal stenosis. Even in patients with severe radiological findings, it is possible to reduce pain and improve quality of life.

Comparative Study between MRI and pain, duration, physical examination in 20 patients with knee joint pain (20례 슬통환자의 통증, 이환기간, 물리적 검사법과 MRI소견과의 비교 고찰)

  • Yang, Myung-bok;Jang, Byung-sun;Lee, Dae-yong;Lee, Seung-hoon;Hwang, Byung-chun;Park, Jung-un;Guk, Ui-suk;Lee, Geon-mok
    • Journal of Acupuncture Research
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    • v.19 no.6
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    • pp.221-233
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    • 2002
  • Background and Purpose : MRI(Magnetic Resonance Imaging) has become one of the most sensitive diagnostic tool no evaluate problems of the knee, because it enables us to identify not only osseous tissue but also soft tissues including muscle, fascia, tendon, ligament, meniscus and fat around the knee joint. Objective : To compare between MRI reading and pain, duration, physical examination in patients with pain of knee joint. Methods : 20 patients with pain of knee joint included in this study. This study researched pain-degree, duration, physical examination with pain of knee joint. Using MRI(Horizon Lx 1.0T-GE), we obtained the results. Results : 1. In the distribution of sex; Female rate was 80.0% and male rate was 20.0%. In the distribution of age, above sixty group was the largest group by each 55.0%. 2. In the distribution of MRI reading; 'Meniscus horm tear' was 70.0%, 'Osteoarthritis' was 55.5%, 'ACL partial tear' was 15.0%, 'Bone bruise at tibia, femur' was 15.0%. 3. Correlation between duration of pain and MRI reading showed that acute and subacute stage related various MRI reading, that chronic stage related 'Osteoarthritis' and 'Meniscus horn tear' by each 69.2%, 92.3%. 4. Correlation between pain and MRI reading showed that severe pain(GVI) related 'ACL partial tear, PCL partial tear' by each 100%, that mild pain(GII) related 'Osteoarthritis, Meniscus horn tear' by each 70.0%, 80.0%. 5. Correlation between physical examination and MRI reading showed that Drawer test related ACL partial tear by each 60.0%, that McMurray test related 'Meniscus horn tear' by each 75.0%. 6. Correlation between effect of treatment and MRI reading showed that 'Osteoarthritis, Meniscus horn tear' related good effect, that ACL partial tear related poor effect. Conclusions : These results suggest that acute and sever pain relate 'ACL partial tear, PCL partial tear', that chronic and mild pain related 'Osteoarthritis, Meniscus horn tear'. So it is responsibility to use MRI as a sensitive diagnostic tool in the knee problems.

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