• 제목/요약/키워드: tailored medicine

검색결과 221건 처리시간 0.02초

고관절 이형성증에서의 초음파의 사용 1부: 기술적 소개 (Ultrasonography in Developmental Dysplasia of Hip Part I: Technical Introduction)

  • 이순혁
    • 대한정형외과 초음파학회지
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    • 제1권1호
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    • pp.31-39
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    • 2008
  • 초음파을 통하여 신생아 고관절의 형태와 안정성 여부를 관찰 할 수 있음이 알려진 이후 2개의 상반된 견해가 형성되었다. 신생아기에 관찰되는 관절 불안정이 치료를 필요로 하는 중요 병리라는 의견은 신생아기 비구이형성이 중요한 역할을 한다는 의견과 상충되어 왔다. Graf방법같이 신생아 비구이형성을 포함하여 치료의 필요성 여부를 판단하면 고관절 불안정성만을 기준으로 한 경우보다 치료와 추시를 하는 빈도가 훨씬 더 높았었다. 현재는 기술적 검사 방법의 발달과 질환의 적절한 이해로 그 차이는 크지 않은 것으로 여겨지고 있어 여러 방법은 유사한 결과를 보이고 있다. 중요한 것은 방법의 선택이 아니라 표준화한 검사를 할 수 있는 충분한 경험과 이해를 가지고 있어야 한다는 것이다. 이를 위하여 고관절 이형성증(DDH)의 진단에서의 여러 초음파 검사 방법과 의의, 치료시의 유용성에 대하여 논의 하였다.

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Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper Extremity

  • Ng, Zhi Yang;Tan, Shaun Shi Yan;Lellouch, Alexandre Gaston;Cetrulo, Curtis Lisante Jr;Chim, Harvey Wei Ming
    • Archives of Plastic Surgery
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    • 제44권2호
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    • pp.117-123
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    • 2017
  • Background Upper extremity soft tissue defects with complete circumferential involvement are not common. Coupled with the unique anatomy of the upper extremity, the underlying etiology of such circumferential soft tissue defects represent additional reconstructive challenges that require treatment to be tailored to both the patient and the wound. The aim of this study is to review the various options for soft tissue reconstruction of complete circumferential defects in the upper extremity. Methods A literature review of PubMed and MEDLINE up to December 2016 was performed. The current study focuses on forearm and arm defects from the level at or proximal to the wrist and were assessed based on Tajima's classification (J Trauma 1974). Data reviewed for analysis included patient demographics, causality, defect size, reconstructive technique(s) employed, and postoperative follow-up and functional outcomes (when available). Results In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 14 unique articles were identified for a total of 50 patients (mean=28.1 years). Underlying etiologies varied from extensive thermal or electrical burns to high impact trauma leading to degloving or avulsion, crush injuries, or even occur iatrogenically after tumor extirpation or extensive debridement. Treatment options ranged from the application of negative pressure wound dressings to the opposite end of the spectrum in hand transplantation. Conclusions With the evolution of reconstructive techniques over time, the extent of functional and aesthetic rehabilitation of these complex upper extremity injuries has also improved. The proposed management algorithm comprehensively addresses the inherent challenges associated with these complex cases.

국내 여성우울 중재연구에 관한 분석-통합적 고찰 (An Integrative Review of Depression Related to Intervention Studies for Women in Korea Journals)

  • 최은영;이은희;현혜진;변미경
    • 여성건강간호학회지
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    • 제21권4호
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    • pp.284-296
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    • 2015
  • Purpose: The aim of this study was to provide basic data on the intervention for depression program development and application by analyzing the depression intervention studies for women that were published in Korea Journal (2000~2014). Methods: The research method used was the integrative review. Nine studies were reviewed from the Nursing Articles and National Assembly Library of which 41 studies were from 126 research papers that met the inclusion criteria and analyzed using MINORS (Methodological Index for Non-Randomized Studies) and according to general characteristics. Results: There were non-equivalent control group pre-post test design (78%) in research design. 44% of articles in sample size were 14~26 participants and measuring tools were used CES-D (29%), BDI (I & II, 22%), GDSSF-K (22%). In quality of research according to MINORS, most of the papers got 2 scores except for the items of sample size calculation standard. Even though the similar intervention program were reported, the results could not compare because of diverse contents, duration, methods, and measuring tool with intervention program. As the results, aroma, massage, and counseling programs seemed to have significant effects of depression alleviation. Conclusion: The standard tailored program and measuring tool for depression alleviation of women was needed to develop.

쇄골 골절 치료의 최근 경향 (Recent Treatment Options for the Clavicle Fracture)

  • 오주한;최혜연
    • Clinics in Shoulder and Elbow
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    • 제15권1호
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    • pp.43-51
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    • 2012
  • 목적: 쇄골 골절의 치료에 관한 광범위한 자료 검토를 통해 현 시점에서의 적절한 쇄골 골절 치료방법을 찾고자 한다. 대상 및 방법: 성인에서 발생한 쇄골 골절과 관련된 전반적인 내용, 즉 쇄골 골절의 역학, 분류, 수술 적응증, 최근 도입된 치료 방법의 현황 및 결과를 문헌 고찰을 통해 정리하였다. 또한, 쇄골 중간 부위 골절의 수술 적응증의 확대와, 새로운 치료법의 하나로 주목받고 있는 anatomically precontoured plate의 도입을 비롯한 최신 지견에 대해 살펴보았다. 결과 및 결론: 지금까지 쇄골 골절은 비수술적 방법으로 대부분 치료되어 왔다. 하지만 최근 들어 기존에 추산되었던 것 보다 많은 수의 불유합, 부정유합 발생이 보고되면서 수술적 치료의 적응증이 점점 확대되는 추세이다. 하지만 아직까지는 쇄골 골절에 대한 이상적인 치료 방침이 확립되지 않았음을 고려할 때, 환자 개개인의 임상 정보와 선호도를 세심히 고려한 맞춤형 치료가 이루어져야 하겠다.

GSTP1, ERCC1 and ERCC2 Polymorphisms, Expression and Clinical Outcome of Oxaliplatin-based Adjuvant Chemotherapy in Colorectal Cancer in Chinese Population

  • Li, Hui-Yan;Ge, Xin;Huang, Guang-Ming;Li, Kai-Yu;Zhao, Jing-Quan;Yu, Xi-Miao;Bi, Wen-Si;Wang, Yu-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3465-3469
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    • 2012
  • Aim: Platinum agents have shown to be effective in the treatment of colorectal cancer. We assessed whether single nucleotide polymorphisms (SNPs) in GSTP1, ERCC1 Asn118Asn and ERCC2 Lys751Gln might predict the overall survival in patients receiving oxaliplatin-based chemotherapy in a Chinese population. Methods: SNPs of GSTP1, ERCC1 Asn118Asn and ERCC2 Lys751Gln in 335 colorectal cancer patients were assessed using TaqMan nuclease assays. Results: At the time of final analysis on Nov. 2011, the median follow-up period was 37.7 months (range from 1 to 60 months). A total of 229 patients died during follow-up. Our study showed GSTP1 Val/Val (HR=0.44, 95% CI=0.18-0.98), ERCC1 C/C (HR=0.20, 95% CI=0.10-0.79) and ERCC2 G/G (HR=0.48, 95% CI=0.19-0.97) to be significantly associated with better survival of colorectal cancer. GSTP1 Val/Val, ERCC1 C/C and ERCC2 G/G were also related to longer survival among patients with colon cancer, with HRs (95% CIs) of 0.41 (0.16-0.91), 0.16 (0.09-0.74) and 0.34 (0.16-0.91), respectively. Conclusion: GSTP1, GSTP1, ERCC1 Asn118Asn and ERCC2 Lys751Gln genotyping might facilitate tailored oxaliplatin-based chemotherapy for colorectal cancer patients.

만성 폐쇄성 폐질환의 중증도에 따른 자가관리, 증상경험 및 건강관련 삶의 질 (Self-Care, Symptom Experience, and Health-Related Quality of Life by COPD Severity)

  • 강귀정;김명희;황선경
    • 성인간호학회지
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    • 제20권1호
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    • pp.163-175
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    • 2008
  • Purpose: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. Methods: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of $FEV_1$/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, $FEV_1%$ predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. Results: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). Conclusion: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.

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협동학습이 일부 초등학생의 성교육에 미치는 효과 (Effects of Cooperative Learning Methods on Sex Education among Primary School Students)

  • 류정은;김윤신;김현숙
    • 한국학교보건학회지
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    • 제25권1호
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    • pp.122-132
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    • 2012
  • Purpose: The purpose of this study is to determine the effectiveness of cooperative learner-centered methods of sex education. Methods: This study was carried out on 5th grade elementary school students in D-district. Nine classes were divided into 3 groups using each different teaching methods: group A (a cooperative learning), group B (a lecture) and group C (a control group for a comparison). The study period was from Oct. 17 to Dec. 2 in 2011. Both groups A and B received sex education lessons for 40 minutes for 4 weeks and were tested their sex knowledge and attitude to compare the differences. Results: The scores of sex knowledge for all three groups were increased and their sex attitude was increased as well. The points of sex knowledge between pre and post test in group A are greater than the group B's. Thus, the cooperative learning approach with Group A was more effective to improve student's sex knowledge. But the difference between the sex attitude scores was not statistically significant. Group A and B showed a positive improvement in both their sex knowledge and attitudes compared with the control group. Conclusion: This experiment shows that an active teaching methods is more effective to improve student sex knowledge than a passive approach. Thus, a cooperative learning method results in increases of both student's sex knowledge and interests in learning sex education. It needs to develop more diverse teaching methods and programs on sex education that are more systematic and tailored.

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서울시 지역주민의 알코올장애와 스트레스, 정신건강 및 자살 (Alcohol Use Disorder, Stress, Mental Health and Suicide among Seoul Citizens)

  • 손애리;;홍인옥;김태경;류은정;오경재
    • 보건교육건강증진학회지
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    • 제26권4호
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    • pp.71-81
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    • 2009
  • Objectives: This study furthers the currents understanding of alcohol use disorders, stress, mental health status and suicide among Seoul citizens. This study is to identify differences according to socio-demographic variables and variables which affect stress, mental status and suicide for developing mental health programs. Methods: The study subjects using cluster-stratified sampling method were 1234 adults over 19 years old from 17 dong, S-Ku in Seoul City. A cross-sectional study with face-to-face interview was used to collect data. A questionnaire measuring socio-demographic variables, Symptom Checklist-90-Revised (SCL-90-R) and psychosocial wellbeing index-short form (PWI-SF) was utilized. Results: Three findings in this study were discussed: (1) The prevalence of problem drinking and alcohol dependence and AUDIT score were significantly higher among male, younger age, and high level of education and income; (2) AUDIT score were related with stress, all 9 symptoms of SCL-R and suicide plan; (3) Problem drinkers were more likely to have 2.5 times of anxiety, 3.0 times of hostility, and 2.4 times psychoticism than non alcohol problem drinkers. Alcohol dependence drinkers were more likely to have 1.9 times of high risk group of stress, 4.1 times of obsessive-compulsive, 4.7 times of anxiety, 5.5 times of hostility, and 2.3 times psychoticism than non alcohol dependence drinkers. Conclusion: The findings suggest that the future intervention of Mental Health programs should be carefully designed and tailored by socio-demographic variables.

Correlation of Occupational Stress Index with 24-hour Urine Cortisol and Serum DHEA Sulfate among City Bus Drivers: A Cross-sectional Study

  • Du, Chung-Li;Lin, Mia Chihya;Lu, Luo;Tai, John Jen
    • Safety and Health at Work
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    • 제2권2호
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    • pp.169-175
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    • 2011
  • Objectives: The questionnaire of occupational stress index (OSI) has been popular in the workplace, and it has been tailored for bus drivers in Taiwan. Nevertheless, its outcomes for participants are based on self-evaluations, thus validation by their physiological stress biomarker is warranted and this is the main goal of this study. Methods: A cross-sectional study of sixty-three city bus drivers and fifty-four supporting staffs for comparison was conducted. Questionnaire surveys, 24-hour urine cortisol testing, and blood draws for dehydroepiandrosterone-sulfate (DHEA-S) testing were performed. The measured concentrations of these biological measures were logarithmically transformed before the statistical analysis where various scores of stressor factors, moderators, and stress effects of each OSI domain were analyzed by applying multiple linear regression models. Results: For drivers, the elevated 24-hour urine cortisol level was associated with a worker's relationship with their supervisor and any life change events in the most recent 3 months. The DHEA-S level was higher in drivers of younger age as well as drivers with more concerns relating to their salary and bonuses. Non-drivers showed no association between any stressor or satisfaction and urine cortisol and blood DHEA-S levels. Conclusion: Measurements of biomarkers may offer additional stress evaluations with OSI questionnaires for bus drivers. Increased DHEA-S and cortisol levels may result from stressors like income security. Prevention efforts towards occupational stress and life events and health promotional efforts for aged driver were important anti-stress remedies.

아연결핍된 단핵구 U937 Cell Line에 있어서의 유전자 발현 탐색 : cDNA Microarray 기법 이용 (Gene Expression in Zn-deficient U937 Cell Line : Using cDNA Microarray)

  • Beattie, John H.;Trayhurn, Paul
    • Journal of Nutrition and Health
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    • 제35권10호
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    • pp.1053-1059
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    • 2002
  • In post-genome period, the technique for identifying gene expression has been changed to high throughput screening. In the field of molecular nutrition, the need for this technique to clarify molecular function of the specific nutrient is essential. In this study, we have tested the zinc-regulated gene expression in zinc-deficient U937 cells, using cDNA microarray which is the cutting-edge technique to screen large numbers of gene expression simultaneously. The study result can be used for the preliminary gene screening data for clarifying, using monocyte U937 cell line, molecular Zn aspect in atherosclerosis. U937 cells were cultured in Zn-adequate (control, 12 $\mu$M Zn) or Zn-deficient (experimental, 0 $\mu$M Zn) ESMI media during 2 days, respectively. Cells were harvested and RNA was extracted. Total RNA was reverse-transcriptinized and synthesized cDNA probe labeled with Cy-3. fluorescent labeled cDNA probe was applied to microarray slide for hybridization slide, and after then, the slide was scanned using fluorescence scanner. ‘Highly expressed genes’ in Zn-deficient U937 cells, comparing to Zn-adequate group, are mainly about the genes for motility protein, immune system protein, oncogene and tumor suppressor and ‘Less highly expressed genes’ are about the genes for transcription, apoptosis associated protein, cell cycle, and several basic transcription factors. The results of this preliminary study imply the effectiveness of cDNA microarray for expression profiling of a singly nutrient deficiency, specially Zn. Furthur study, using tailored-cDNA array and capillary endothelial cell lines, would be beneficial to clarify molecular Zn function, more in detail.