• 제목/요약/키워드: therapy protocol

검색결과 396건 처리시간 0.026초

진행성 치성 감염병소에서 부적절한 진정요법과 국소마취 시행하 절개 배농술에 따른 과환기증 (Hyperventilation due to Incision & Drainage under Inadequate Psychosedation & Local Anesthesia in Advanced Odontogenic Infectious Lesion)

  • 오지현;손정석;유재하;김종배
    • 대한치과마취과학회지
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    • 제14권1호
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    • pp.63-71
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    • 2014
  • Extension of advanced odontogenic infection from deep neck fascial spaces into the mediastinum is heralded by chest pain, dyspnea, fever, and radiographic demonstration of mediastinal widening. The critical care should be done in a team approach by multiple medical and dental departments, such as, oral & maxillofacial surgery, otolaryngology, anesthesiology, chest surgery, and infection medicine. Especially, fluid & drug therapy, adequate incision & drainage and systemic supportive psychosedation care are important. But, acute hyperventilation can be produced by several distinct causes: severe anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The orofacial fears about acute pain, trismus, dysphagia, swelling and oral surgical treatment lead to the severe anxiety and increased blood catecholamine level by stress. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the care, hyperventilation was occurred during psychosedation and local anesthesia for incision and drainage of the masticatory fascial space abscess with deep neck infection & mediastinitis. We suggest that the dental patient with advanced odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

The Clinical Results of Conservative Treatment of Frozen Shoulder Using Continuous Passive Motion

  • Chung, Hoe-Jeong;Kim, Doo-Sup;Yoon, Yeo-Seung;Lee, Dong-Woo;Hong, Kyung-Jin
    • Clinics in Shoulder and Elbow
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    • 제18권4호
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    • pp.217-220
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    • 2015
  • Background: The purpose of this study is to administer conservative treatment in 30 patients diagnosed with idiopathic frozen shoulder, following the suggested frozen shoulder rehabilitation program and to assess the clinical outcome using a prospective study. Methods: Thirty patients diagnosed with idiopathic frozen shoulder, treated with steroid hormone injection on the articular joint with an intra-articular steroid (triamcinolone 40 mg+lidocaine 4 ml) injection and started on stepwise shoulder extension exercise were chosen. The subjects were divided into two groups of 15 people each with one group undergoing rehabilitation with continuous passive motion (CPM) and the other group without it. Follow-ups were done before rehabilitation and at 4-week intervals with the 24th being the final week. At every follow-up, passive range of motion (ROM) was measured and surveys on pain and clinical score were administered. Results: In the last follow-up, both groups showed statistically significant improvements in all evaluation criteria. However, no statistical difference in all values of the ROM and Constant score evaluation criteria was observed between the groups. Only in the last follow-up, group 1 had a visual analog scale (VAS) score of $2.4{\pm}2.1$ points, which was lower, with statistical significance, than the VAS score of group 2, which was $4.4{\pm}3.1$ points (p<0.001). Conclusions: Study using CPM in treatment of frozen shoulder has been inadequate, meaning that there is still room for improvement and need for more study on setting a more specific protocol and guidelines for this procedure.

Transforming Growth Factor-$\alpha$ Increases the Yield of Functional Dopaminergic Neurons from in vitro Differentiated Human Embryonic Stem Cells Induced by Basic Fibroblast Growth Factor

  • Lee, Keum-Sil;Shin, Hyun-Ah;Cho, Hwang-Yoon;Kim, Eun-Young;Lee, Young-Jae;Wang, Kyu-Chang;Kim, Yong-Sik;Lee, Hoon-Taek;Chung, Kil-Saeng
    • 한국발생생물학회:학술대회논문집
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    • 한국발생생물학회 2003년도 제3회 국제심포지움 및 학술대회
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    • pp.102-102
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    • 2003
  • Embryonic stem (ES) cells proliferate extensively in the undifferentiated state and have the potential to differentiate into a variety of cell types in response to various environmental cues. The generation of functional dopaminergic neurons from ES cells is promising for cell replacement therapy to treat Parkinson's disease. We compared the in vitro differentiation potential of pluripotent human embryonic stem (hES, MB03) cells induced with basic fibroblast growth factor (bFGF) or retinoic acid (RA). Both types of treatment resulted in similar neural cell differentiation patterns at the terminal differentiation stage, specifically, 75% neurons and 11% glial cells. Additionally, treatment of hES cells with brain derived neurotrophic factor (BDNF) or transforming growth factor (TGF)- $\alpha$ during the terminal differentiation stage led to significantly increased tyrosine hydroxylase (TH) expression, compared to control (P<0.05). In contrast, no effect was observed on the rate of mature or glutamic acid decarboxylase-positive neurons. Immunostaining and HPLC analyses revealed the higher levels of TH (20.3%) and dopamine in bFGF and TGF-$\alpha$ treated hES cells than in RA or BDNF treated hES cells. The results indicate that TGF-$\alpha$ may be successfully used in the bFGF induction protocol to yield higher numbers of functional dopaminergic neurons from hES cells.

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A New Protocol for Effective Cryopreservation of Human Embryonic Stem Cells by a Minimum Volume Cooling Method

  • Kim, Eun-Young;Lee, Keum-Sil;Shin, Hyun-Ah;Park, Sae-Young;Yoon, Ji-Yeon;Kil, Kwang-Soo;Lee, Young-Jae;Kim, Nam-Hyung;Chung, Kil-Saeng
    • 한국발생생물학회:학술대회논문집
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    • 한국발생생물학회 2003년도 제3회 국제심포지움 및 학술대회
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    • pp.98-98
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    • 2003
  • Recently, human embryonic stem (hES) cells have become very important resources for ES cell basic research, cell replacement therapy, and other medical applications; thus, efficient cryopreservation methods for these cells are needed. This study examined whether a newly developed minimum volume cooling (MVC) vitrification method, which was tested through cryopreservation of sensitive bovine oocytes, can be used for freezing hES cells. Feeder-free cultured hES cell (MB03) colonies were mechanically dissected into several small clumps following enzymatic treatment. We compared the freezing efficiency of a slow-cooling method using a cryo-module (0.4-0.6C/min, 20-30 clumps/vial) and MVC vitrification using a modified 0.5-ml French mini-straw designated as a MVC straw (>$20,000{\circ}C$/min, 10 clumps/straw) After thawing, in vitro survival of hES cell clumps was higher for MVC-vitrified cells (80.8%, 97/120) than for slow-cooled cells (38.2%, 39/102). Further, the proliferation rate of surviving MVC-vitrified cells was similar to that of control hES cells from 2 weeks after thawing. In addition, vitrified-thawed hES cells demonstrated a normal karyotype, were positively immunostained for surface marker antibodies (AP, SSEA-4 and TRA-1-60) and the Oct-4 antibody, and could differentiate into all three embryonic germ layer cells in vitro. This result demonstrates that hES cell clumps can be successfully cryopreserved by a newly developed MVC vitrification method without loss of human cell characteristics.

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Mesenchymal Stem Cell Lines Isolated by Different Isolation Methods Show Variations in the Regulation of Graft-versus-host Disease

  • Yoo, Hyun Seung;Yi, TacGhee;Cho, Yun Kyoung;Kim, Woo Cheol;Song, Sun U.;Jeon, Myung-Shin
    • IMMUNE NETWORK
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    • 제13권4호
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    • pp.133-140
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    • 2013
  • Since the discovery of the immunomodulation property of mesenchymal stem cells (MSCs) about a decade ago, it has been extensively investigated whether MSCs can be used for the treatment of immune-related diseases, such as graft versus-host disease (GvHD). However, how to evaluate the efficacy of human MSCs for the clinical trial is still unclear. We used an MHC-mismatched model of GvHD (B6 into BALB/c). Surprisingly, the administration of the human MSCs (hMSCs) could reduce the GvHD-related mortality of the mouse recipients and xenogeneically inhibit mouse T-cell proliferation and $IFN-{\gamma}$ production in vitro. We recently established a new protocol for the isolation of a homogeneous population of MSCs called subfractionation culturing methods (SCM), and established a library of clonal MSC lines. Therefore, we also investigated whether MSCs isolated by the conventional gradient centrifugation method (GCM) and SCM show different efficacy in vivo. Intriguingly, clonal hMSCs (hcMSCs) isolated by SCM showed better efficacy than hMSCs isolated by GCM. Based on these results, the MHC-mismatched model of GvHD may be useful for evaluating the efficacy of human MSCs before the clinical trial. The results of this study suggest that different MSC lines may show different efficacy in vivo and in vitro.

경피신경전기자극(TENS)과 삼음교 지압이 원발성 월경통에 미치는 효과 비교 (Comparison of Effects of Transcutaneous Electrical Nerve Stimulation (TENS) and San-Yin-Jiao (SP6) Acupressure on Primary Dysmenorrhea)

  • 오영택
    • 대한물리의학회지
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    • 제9권4호
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    • pp.415-424
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    • 2014
  • PURPOSE: This study examined the effect of high-frequency transcutaneous electrical nerve stimulation (TENS) and San-Yin-Jiao (SP6) acupressure on primary dysmenorrhea. Furthermore, the difference in effectiveness between the two methods were compared. METHODS: Twenty-six students participated in this study, and were randomly assigned to a high-frequency TENS group(experimental 1, n=9), a San-Yin-Jiao (SP6) acupressure group(experimental 2, n=9), and no treatment group(control, n=8). They were assessed and treated on the first day of their menstruation. The TENS protocol included applying 20 minutes of stimulation with a frequency of 100Hz, $100{\mu}sec$ pulse width. Four electrodes were placed on the skin 3 cm from midline at T12-L1 and S2-3 paravertebral muscles. San-Yin-Jiao (SP6) acupressure should be applied with the thumb for 10 minutes(8 seconds pressure and 2 seconds rest) on the SP6 acupoint. This procedure should be repeated for the other foot. Dysmenorrheal pain measured two pain assessment tools (VAS, DPT) pre-treatment; immediate post-treatment; 30minutes, 1, 2hours; and 3, 4, 5, 6, 24 hours after the VAS test were added. RESULTS: The results showed significant differences in pain assessments (VAS, DPT) after treatment for subjects of experimental group1 (p<.05) and experimental group2 (p<.05), whereas the between-group comparison found no statistically significant differences. CONCLUSION: This result supports the idea that using two methods could be effective in pain reduction among students who suffered from primary dysmenorrhea.

The Effect of a Cooperative System of Oriental and Western Medicine in the Treatment of Allergic Rhinitis

  • Jeong, Su-Hyeon;Kim, Sung-Wan;Jeong, Soo-Jin;Lee, Won-Chul
    • 대한한의학회지
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    • 제24권4호
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    • pp.64-70
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    • 2003
  • Background and Purpose : Allergic rhinitis is a well-known, relatively controllable chronic disease. Although a number of methods for treating allergic rhinitis have been tried, many patients have not been satisfied with their treatment. Therefore, this study tried to evaluate the effect of a cooperative system of Oriental and Western medicine and to develop a new diagnosis protocol for treatment of allergic rhinitis. Methods : We measured improvement rate and acoustic rhinometry after the allergeninduction test and performed a filter paper test as a nonspecific hypersensitivity test with 60 patients who are allergic to house dust mite. Patients were divided into two groups, one treated with Western medicine only and one treated with both Western and Oriental herbal medicine. For the group with Western medicine only, antihistamine for one week and local steroid medicine for two weeks were prescribed. For the group with combined medicine, Oriental herbal medicine was prescribed according to the patient s constitution, along with Western medicine. After all treatments, the above tests were re-performed and the improvement rate was compared. Results and Conclusion : We observed better results in the group treated with both Western and Oriental herbal medicines, comparing improvement rate and the alteration of total nasal volume through acoustic rhinometry after the allergen induction test. In the filter paper test, there was no significant difference between the two groups. In conclusion, we showed the additive effect of Oriental herbal medicine without any severe side effects compared with treatment with Western medicine only. In this study, we set only two patient groups, but further study is required to create various experimental groups and compare among them. We suggest that it might enhance understanding of the improved effect of Oriental herbal medicine in the therapy of allergic rhinitis.

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A prospective study to assess the efficacy and safety of oral propranolol as first-line treatment for infantile superficial hemangioma

  • Yun, Yeong Ju;Gyon, Yun Hee;Yang, Sohyoung;Lee, Youn Kyung;Park, Joohyun;Park, Meerim
    • Clinical and Experimental Pediatrics
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    • 제58권12호
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    • pp.484-490
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    • 2015
  • Purpose: To determine the efficacy and safety of oral propranolol as a first-line treatment for superficially located infantile hemangioma (IH) and propose an assessment tool to measure treatment response. Methods: Patients with superficial IH under 1 year of age were prospectively recruited between May 2012 and December 2013 at the Department of Pediatrics of Chungbuk National University Hospital. Propranolol was administered to 12 infants (median age, 3.8 months) while monitoring cardiovascular and adverse metabolic effects. If a patient showed no adverse events, the dosage was gradually increased up to 3 mg/kg/day and maintained for 1 year. We used our own scoring system to assess treatment response using parameters like change in color, and longest diameter, and thickness of the IH. Results: Eleven out of 12 patients completed the protocol with consistent improvement of hemangiomas during therapy. Patients on propranolol showed a more than 50% involution in the first 3 months, with additional steady involution until 1 year. Patients with the highest scores at 1 month maintained their score and showed better responses until treatment termination. The patient with the lowest score at 1 month did not show any further regression and stopped propranolol treatment 4 months after initiation. In two children with recurrences after successful therapeutic regression, propranolol was effective after being reintroduced. Propranolol treatment was not interrupted in any patient due to adverse events. Conclusion: Oral propranolol at 3 mg/kg/day showed a consistent, rapid, and therapeutic effect on superficial IHs without significant adverse events.

Acupuncture for Subacute and Chronic Post-thoracotomy Pain in Patients with Traumatic Multiple Rib Fractures: A Study Protocol for a Randomised-controlled, Two-arm, Parallel Design, Pilot Trial

  • Kim, Kun Hyung;Cho, Hyun Min;Lee, Chan Kyu;Seok, JunePill;Kim, Seon Hee;Kim, Jung-Eun;Shin, Yu Kyung;Kim, Min Kyung
    • Journal of Acupuncture Research
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    • 제35권2호
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    • pp.95-100
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    • 2018
  • Background: The aim of this study is to assess the feasibility of acupuncture treatment for the management of subacute and chronic post-thoracotomy pain in patients with traumatic multiple rib fractures. Methods: A total of 30 participants who have undergone thoracotomy after traumatic multiple rib fractures will be recruited. Participants will be invited and equally randomised into acupuncture plus usual care and usual care alone groups. A computer-generated random number sequence will be used and concealed using opaque, sealed, sequentially numbered envelopes. Twelve sessions of manual and electrical acupuncture performed by Korean medicine doctors will be provided over a span of 3 months to participants allocated to the acupuncture group. Participants in the usual care group will continue pain medication, exercise and physical therapy as required. Study feasibility will be measured based on the proportion of patients who complete the measurement of pain at 12 or 24 weeks after baseline. The clinical outcomes will include; the average pain intensity over the recent week at rest, movement and cough, quality of life, patient's global assessment of recovery, respiratory function measured by the pulmonary function test and use of pain medication at 4, 8, 12 and 24 weeks after enrolment. Adverse events will be recorded for all participants. Written informed consent will be obtained from all participants. The local ethics committee has approved the study. This pilot trial will inform further studies investigating the potential role of acupuncture for subacute and chronic post-thoracotomy pain in patients with traumatic multiple rib fractures.

Adult Non Hodgkin's Lymphoma Patients: Experience from a Tertiary Care Cancer Centre in North East India

  • Hazarika, Munlima;Iqbal, Asif;Krishnatreya, Manigreeva;Sharma, Jagannath Dev;Bhuyan, Chidananda;Saikia, Bhargab Jyoti;Roy, Partha Sarathi;Das, Rashmi;Nandy, Pintu;Kataki, Amal Chandra
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권7호
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    • pp.2879-2881
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    • 2015
  • There is paucity of data on non Hodgkin's lymphoma (NHL) from our population in North-East India. In this retrospective study, patients were consecutively followed-up to see the clinic-pathological pattern of NHL, various responses, and pattern of relapses to first line treatment with chemotherapy. All patients in the present study received standard regimen of cyclophosphamde, doxorubicin, vincristine, prednisolone (CHOP) with or without rituximab (R-CHOP) as per our institutional protocol as first line therapy. Our study has shown that, in our adult population, the majority of NHL cases present with stage II and stage III disease and extra nodal involvement, B-cell lymphomas and diffuse large cell lymphomas being the most common subtypes. International prognostic index was a significant factor for varied responses to treatment. The majority of relapses after complete remission occurred in the first year.