• 제목/요약/키워드: therapy protocol

검색결과 408건 처리시간 0.02초

Initial experience with intra-articular 188Re-tin colloid as a "radiation synovectomy" agent in various joints

  • Shinto, Ajit S;Indira, VU;Kamaleshwaran, KK;Banka, Vinay Kumar;Aswathy, KK;Thirumalaisamy, SG;Rajamani, V;Mallia, Madhav;Banerjee, Sharmila
    • 대한방사성의약품학회지
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    • 제1권2호
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    • pp.109-117
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    • 2015
  • Radiation synovectomy has been proposed as a promising palliative therapy for recurrent joint effusions for the last two or three decades. Ionizing radiations emitted by intrarticularly administered radiolabelled colloids. The aim of this study was to assess the effectiveness of radiation synovectomy (RSV) using $^{188}Re$-tin colloid in the treatment of recurrent joint effusions and chronic synovitis of knee joints. Three phase bone scan was acquired for the concerned joint prior to radiosynovectomy. $^{188}Re$-tin colloid was prepared as per the reported protocol. 9 patients, diagnosed with rheumatoid arthritis and suffering from chronic resistant synovitis of the knee, ankle or elbow joints were administered the radiopharmaceuticals, checked for radiochemical purity >95% by intraarticular route. A whole body scan was acquired 2 h post-radiosynovectomy. In all the 9 treatments, no leakage to non-target organs was visible in the whole body scan. Static scans of the joint revealed complete retention of $^{188}Re$-tin colloid in the joints post administration of the agent. Clinically all patients exhibited a complete or partial response. RSV with $^{188}Re$-tin colloid was safe and effective in patients with chronic synovitis of rheumatoid origin.

Management of complex surgical wounds of the back: identifying an evidence-based approach

  • Zolper, Elizabeth G.;Saleem, Meher A.;Kim, Kevin G.;Mishu, Mark D.;Sher, Sarah R.;Attinger, Christopher E.;Fan, Kenneth L.;Evans, Karen K.
    • Archives of Plastic Surgery
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    • 제48권6호
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    • pp.599-606
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    • 2021
  • Background Postoperative dehiscence and surgical site infection after spinal surgery can carry serious morbidity. Multidisciplinary involvement of plastic surgery is essential to minimizing morbidity and achieving definitive closure. However, a standardized approach is lacking. The aim of this study was to identify effective reconstructive interventions for the basis of an evidence-based management protocol. Methods A retrospective review was performed at a single tertiary institution for 45 patients who required 53 reconstruction procedures with plastic surgery for wounds secondary to spinal surgery from 2010 to 2019. Statistical analysis was performed for demographics, comorbidities, and treatment methods. Primary outcomes were postoperative complications, including dehiscence, seroma, and infection. The secondary outcome was time to healing. Results The overall complication rate was 32%, with dehiscence occurring in 17%, seroma in 15% and infection in 11% of cases. Median follow-up was 10 months (interquartile range, 4-23). Use of antibiotic beads did not affect rate of infection occurrence after wound closure (P=0.146). Use of incisional negative pressure wound therapy (iNPWT) was significant for reduced time to healing (P=0.001). Patients treated without iNPWT healed at median of 67.5 days while the patients who received iNPWT healed in 33 days. Demographics and comorbidities between these two groups were similar. Conclusions This data provides groundwork for an evidence-based approach to soft tissue reconstruction and management of dehiscence after spinal surgery. Timely involvement of plastic surgery in high-risk patients and utilization of evidence-based interventions such as iNPWT are essential for improving outcomes in this population.

한양방통합치료로 완치되어 5년 생존에 도달한 3기B 비소세포성폐암 증례 보고 (Case Report on Complete Response and 5 year Survival of Non-Small Cell Lung Cancer IIIB Patient Treated with Integrative Medicine)

  • 방선휘;윤영주;최준용;한창우;김소연;박성하;홍진우;권정남;이인
    • 대한한의학회지
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    • 제42권1호
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    • pp.119-128
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    • 2021
  • 비소세포성폐암 3기B 진단을 받고, 표준치료인 동시항암방사선치료를 시행했으나 별무효과였던 40대 남자에게, 한양방통합치료를 장기간 집중적으로 시행한 결과, 3개월만에 완전 관해에 도달하고, 5년 생존에 성공함으로써 한양방통합치료의 가능성을 보여 주었기에, 이에 증례를 보고한다.

인체적용시험을 통한 홍삼기반 'SSR'이 인체 피로도 감소 및 혈액성분 변화에 미치는 영향분석 (Analysis of the Effects of Red Ginseng Ingredient-based 'SSR' in Decreasing Fatigue and Inducing Changes in Blood Composition through a Clinical Trial)

  • 신경섭;이홍기;박선미
    • 한국식품영양학회지
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    • 제34권2호
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    • pp.196-206
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    • 2021
  • The main purpose of this study was to examine the correlation between the consumption of red ginseng-based 'SSR' for 30 days and the reduction in human fatigue, blood component changes, and immune cell activity in 35 human subjects. 'SSR' is composed of zinc oxide, folic acid, and D-α-tocopherol with red ginseng as the main component. According to the protocol criteria of the study, 35 subjects who understood the purpose of the study and signed an informed consent form were selected. The fatigue survey was conducted through a questionnaire, and after taking 'SSR', a decreased tendency of physical, mental, and neurosensory fatigue was observed. In hematological analysis, no significant changes were observed in the levels of WBC, RBC, and hemoglobin; however, AST (SGOT) and ALT (SGPT) levels were statistically significantly decreased. In immunological analysis, it was observed that the proliferative effect of T cells (CD3+CD4+) was greater than that of NK cells (CD16+CD56+). The collected data were subjected to t-test analysis using the SPSS 25.0 statistical program. The result from this study proposes that 'SSR' can be used as a functional food material as it reduces human fatigue and enhances immune function.

노인 암환자의 건강정보 이해능력을 반영한 항암화학요법 자기관리 프로그램 개발 및 평가 (The Development and Evaluation of a Health Literacy-Adapted Self-Management Intervention for Elderly Cancer Patients Undergoing Chemotherapy)

  • 김윤선;태영숙;정귀임
    • 대한간호학회지
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    • 제49권4호
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    • pp.472-485
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    • 2019
  • Purpose: This study aimed to develop and evaluate the effectiveness of an adapted health literacy self-management intervention for elderly cancer patients undergoing chemotherapy. Methods: The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol and was based on Fransen et al's causal pathway model. A quasi-experimental trial was conducted on a total of 52 elderly patients (26 in an experimental group and 26 in a control group) undergoing chemotherapy in Korea. The intervention consisted of seven sessions over 5 weeks. The experimental tool for this study was an adapted health literacy self-management intervention, which was designed to promote a reduction in the symptom experience and distress of elderly cancer patients through the promotion of self-management behavior. To develop efficient educational materials, the participants' health literacy was measured. To educate participants, clear communication and the teach-back method were used. In addition, for the improvement of self-efficacy, four sources were utilized. For the promotion of self-management behavior, five self-management skills were strengthened. Data were collected before and after the intervention from June 4 to September 14, 2018. The data were analyzed with SPSS/WIN 21.0. Results: Following the intervention, self-management knowledge and behavior and, self-efficacy significantly improved in experimental group. Symptom experience and distress decreased in the experimental group compared to the control group. Conclusion: The self-management intervention presented in this study was found to be effective in increasing self-management knowledge and behavior and, self-efficacy, and ultimately in reducing symptom experience and distress for elderly patients undergoing chemotherapy.

Dosimetry Check™를 이용한 MVCT 선량계산 모델 구축에 관한 연구 (A Study on the Construction of MVCT Dose Calculation Model by Using Dosimetry Check™)

  • 엄기천;김창환;전수동;백금문
    • 대한방사선기술학회지:방사선기술과학
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    • 제43권6호
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    • pp.431-441
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    • 2020
  • The purpose of this study was to construct a model of MVCT(Megavoltage Computed Tomography) dose calculation by using Dosimetry Check™, a program that radiation treatment dose verification, and establish a protocol that can be accumulated to the radiation treatment dose distribution. We acquired sinogram of MVCT after air scan in Fine, Normal, Coarse mode. Dosimetry Check™(DC) program can analyze only DICOM(Digital Imaging Communications in Medicine) format, however acquired sinogram is dat format. Thus, we made MVCT RC-DICOM format by using acquired sinogram. In addition, we made MVCT RP-DICOM by using principle of generating MLC(Multi-leaf Collimator) control points at half location of pitch in treatment RP-DICOM. The MVCT imaging dose in fine mode was measured by using ionization chamber, and normalized to the MVCT dose calculation model, the MVCT imaging dose of Normal, Coarse mode was calculated by using DC program. As a results, 2.08 cGy was measured by using ionization chamber in Fine mode and normalized based on the measured dose in DC program. After normalization, the result of MVCT dose calculation in Normal, Coarse mode, each mode was calculated 0.957, 0.621 cGy. Finally, the dose resulting from the process for acquisition of MVCT can be accumulated to the treatment dose distribution for dose evaluation. It is believed that this could be contribute clinically to a more realistic dose evaluation. From now on, it is considered that it will be able to provide more accurate and realistic dose information in radiation therapy planning evaluation by using Tomotherapy.

재발된 자궁경부암 환자의 한의 기반 통합 암 치료에 대한 증례보고 (A Case Report of Traditional Korean Medicine-Based Integrative Oncology of Recurrent Cervical Cancer)

  • 주한음;박지혜;송시연;조영민;박소정;유화승
    • 대한한방내과학회지
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    • 제43권4호
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    • pp.751-760
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    • 2022
  • Objective: To show a decrease in tumor recurrence and improvement in quality of life in patients with recurrent cervical cancer. Method: A 58-year-old female patient diagnosed with recurrent cervical cancer in February 2021 was treated for 14 months with integrative cancer treatment (ICT) to decrease the tumor size and improve chemotherapy-induced peripheral neuropathy (CIPN) and nausea. The patient underwent chemotherapy or concomitant chemoradiation therapy (CCRT) with ICT. Radiologic outcomes were assessed by abdomen & pelvis computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT) based on the Response Evaluation Criteria in Solid Tumors (RECIST) protocol. Clinical outcomes were assessed by the National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), Eastern Cooperative Oncology Group (ECOG), and a numeric rating scale (NRS). Result: During the 14 months of treatment, the size and metabolic activity of the recurrent tumor decreased and underwent partial remission based on RECIST. The NRS scores for CIPN and nausea were improved, and the ECOG score improved from grade 2 to 1. No serious side effects of grade 3 or higher were noted on the NCI-CTCAE test. Conclusion: This case suggests that ICT may have a synergetic effect with chemotherapy or radiotherapy for recurrent cervical cancer.

Intraovarian platelet-rich plasma administration could improve blastocyst euploidy rates in women undergoing in vitro fertilization

  • Merhi, Zaher;Seckin, Serin;Mouanness, Marco
    • Clinical and Experimental Reproductive Medicine
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    • 제49권3호
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    • pp.210-214
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    • 2022
  • Objective: Platelet-rich plasma (PRP) therapy has received a considerable attention as an adjunct to fertility treatments, especially in women with very low ovarian reserve and premature ovarian insufficiency. Although recent studies have demonstrated that PRP led to improvements in folliculogenesis and biomarkers of ovarian reserve, the effect of intraovarian PRP administration on embryo genetics has not been studied. Methods: We report a pilot study of patients who had preimplantation genetic testing for aneuploidy (PGT-A) before and then within 3 months following PRP administration. Twelve infertile women with at least one prior failed in vitro fertilization (IVF) cycle underwent ovarian stimulation (cycle 1) with a gentle stimulation protocol and PGT-A performed at the blastocyst stage. Following cycle 1, autologous intraovarian PRP administration was performed. Within 3 months following PRP administration, the patients underwent cycle 2 and produced blastocysts for PGT-A. The percentage of euploid embryos between both cycles was compared. Results: The mean age of all participants was 40.08±1.46 years, and their mean body mass index was 26.18±1.18 kg/m2. The number of good-quality embryos formed at the blastocyst stage was similar between cycle 1 and cycle 2 (3.08±0.88 vs. 2.17±0.49, respectively; p=0.11). Among all patients in cycle 1, 3 of 37 embryos were euploid (8.11%) while in cycle 2, 11 out of 28 embryos were euploid (39.28%, p=0.002). Three clinical pregnancies were noted among this patient group. Conclusion: This novel study is the first to present an improvement in the embryo euploidy rate following intraovarian PRP application in infertile women with prior failed IVF cycles. The growth factors present in PRP may exhibit a local paracrine effect that could improve meiotic aberrations in human oocytes and thus improve euploidy rates. Whether PRP improves live birth rates and lowers miscarriage rates remains to be determined in large trials.

신경근전기자극치료가 암환자의 근육 손실에 미치는 영향: 체계적 문헌고찰을 위한 프로토콜 (Effects of Neuromuscular Electrical Stimulation on Muscle Wasting with Cancer Patient: Study Protocol for a Systematic Review)

  • 박은수;김종희;김수담;김동현;오민석;이은정;유화승
    • 한방재활의학과학회지
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    • 제33권2호
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    • pp.49-55
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    • 2023
  • Objectives The purpose of this study is to analyze randomized controlled trials about neuromuscular electrical stimulation for muscle wasting with cancer patient and evaluate it's motor functionality effect. Methods Studies will be searched from 7 online databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure [CNKI], Korean studies Information Service System [KISS], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS]). Participants will be cancer patients with muscle loss, regardless of cause, gender, race or age, interventions will be neuromuscular electrical stimulation. Other treatments than interventions will be the control group and the main outcome will be reviewed by motor functionality effect. Results Randomized controlled trials about neuromuscular electrical stimulation for muscle wasting should be included in the study. Primary outcomes include motor functionality effect. Secondary outcomes evaluate adverse event. The data uses Review Manager Software 5.4. Conclusions The conclusion of this study will provide a basis for determining whether neuromuscular electrical stimulation treatment for muscle wasting with cancer patient treatment is an effective and safe treatment method in clinical practice.

경두개 직류 전기 자극과 병행한 배 드로우인 방법이 만성 뇌졸중 환자의 균형 능력과 몸통 기능에 미치는 영향 (Effects of Abdominal Draw-In Maneuver Combined with Transcranial Direct Current Stimulation on Balance Ability and Trunk Function in Chronic Stroke Patients)

  • 이양진
    • 대한통합의학회지
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    • 제11권2호
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    • pp.101-108
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    • 2023
  • Purpose : To investigate effects of transcranial directed current stimulus (tDCS) combined with abdominal draw-in maneuver (ADIM) on balance ability and trunk impairment scale of chronic stroke patients. Methods : Twenty-six chronic stroke patients were recruited and twenty-four participated after excluding two patients who met the exclusion criteria. After screening tests, they were randomized through excel program into an experimental group (n = 12) to apply a tDCS combined with ADIM and a control group (n = 12) to apply a sham tDCS with ADIM. The intervention lasted three times a week for six weeks. To compare tDCS intervention effects, trunk impairment scale and balance ability were measured. Comparisons between experimental and control groups were statistically processed using an independent t-test and comparisons within groups were statistically processed using a paired t-test. Results : The experimental group showed significant increases of pre- and post-intervention medial lateral velocity, anterior posterior velocity and area of balance ability, and trunk impairment scale (p<.05). The control group showed significant increases in pre- and post-intervention medial lateral velocity of balance ability and trunk impairment scale (p< .05). The experimental group showed significant increases of medial lateral velocity of balance ability and trunk impairment scale compared to the control group (p<.05). Conclusion : Results of this study suggest that tDCS combined with ADIM for chronic stroke patients can be effective in improving medial lateral velocity of balance ability and trunk impairment scale. Thus, tDCS can be used as an effective treatment protocol for trunk rehabilitation of chronic stroke patients.