• Title/Summary/Keyword: therapy protocol

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Cryopreservation of Human Embryos for Assisted Reproductive Technology (인간 배아의 동결보존에 관한 연구)

  • Moon, Shin-Yong;Kim, Chung-Hoon;Kim, Seok-Hyun;Choi, Young-Min;Shin, Chang-Jae;Kim, Jung-Gu;Lee, Jin-Yong;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.21 no.2
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    • pp.137-147
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    • 1994
  • Controlled ovarian hyperstimulation(COH) for in vitro fertilization and embryo transfer(IVFET) often results in the production of more embryos than can be efficaciously transferred at one time. However, embryo cryopreservation provides a mechanism by which additional embryos can be stored for later thawing and transfer. From November, 1990 to October, 1992, we completed 42 transfer cycles of cryopreserved pronucleus(PN) l-cell embryos using the fixed protocol of hormonal replacement therapy in a physiological manner regardless of individual ovarian function. Artificial endometrial stimulation was performed with only exogenous estradiol and progesterone(E-P) in 36 transfer cycles (Group I) and with gonadotropin-releasing hormone agonist(GnRHa) and exogenous estradiol and progesterone(GEEP) in 6 transfer cycles(Group II ). The results were as follows. 1. The Survival rate of total cryopreserved-thawed embryos was 64.9%(198/305): 64.9% (172/265) in Group I and 65.0% (26/40) in Group II. 2. Total 168 embryos were transferred with an average of 4.7 per ET in Group I and total 26 embryos were transferred with an average of 4.3 per ET in Group II. 3. The pregnancy rate(PR) per cryopreserved-thawed ET and the implantation rate was 33.3 %(14/42) and 6.7%(13/194), respectively. The PRs per cryopreserved-thawed ET were 30.6% (11/36) in Group I and 50.0% (3/6) in Group II without significant difference. 4. The take home baby rate was 11.1%(4/36) in Group I and 33.3% (2/6) in Group II.

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Thyroid Tumors in Children - Review of Surgically Treated Cases - (소아에서의 갑상선 종양 - 수술적 체험 예들의 임상 고찰 -)

  • Yang Sung-Hwan;Kim Gab-Tae;Oh Sung-Su;Chung Eul-Sam
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.54-60
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    • 1998
  • Objectives: We'd like to give help in diagnosis and treatment of children's thyoid tumor through our clinical experiences and reference consideration. Materials and Methods: The authors report their experiences with 33 cases of thyroid tumor in patients younger than 16 years of age who were treated at Presbyterian Medical Center from 1979 to 1995. Results: 1) Girls were more predominant than boys by a ratio of 5.6:1. The peak incidence was in the 15 years old of age. 2) The final diagnosis in the 33 patients were thyroid carcinoma in 12 cases, nodular goiter in 6 cases, adenoma in 6 cases, Graves disease in 4 cases, Hasimoto's disease in 4 cases and cyst in 1 case. 3) All of 12 patients with thyroid cancer had nodular tumor. 4) In 5 of 6 patients with palpable cervical lymphadenopathy, the final diagnosis was thyroid carcinoma. 5) Delayed diagnosis arose in 6 of 12 thyroid carcinomas which were treated for long periods as benign disease. 6) The surgical procedures were total thyroidectomy in 3 cases, subtotal thyroidectomy in 13 cases and thyroid lobectomy in 17 cases. 7) 11 of 12 patients with thyroid carcinoma had subtotal or total thyroidectomy with lymphnode dissection and only one had lobectomy. 8) The overall rate of postoperative complication was 3%(1 of 33 patient). 9) Postoperative $^{131}I$ therapy was done in 7 case because of recurrence and distant metastasis in six and severe local invasion in one. 10) In thyroid cancer, the metastatic rate of lymph node at initial surgery was 81%(9/11) and rate of recurrence was 50%(6/12). 11) Patients with thyroid carcinoma were followed up for a mean of 12 years but only one died as a result of thyroid carcinoma 3.5 years later. Conclusion: The authors suggest that thyroid tumors in childhood should receive the benifit of joint management by endocrine pediatrician and experianced surgeons with an agreed protocol of diagnosis and management. We, also, recommend aggressive surgical and $^{131}I$ treatment as the most effective regimen for children with thyroid carcinoma.

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Efficient Verification of X-ray Target Replacement for the C-series High Energy Linear Accelerator

  • Cho, Jin Dong;Chun, Minsoo;Son, Jaeman;An, Hyun Joon;Yoon, Jeongmin;Choi, Chang Heon;Kim, Jung-in;Park, Jong Min;Kim, Jin Sung
    • Progress in Medical Physics
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    • v.29 no.3
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    • pp.92-100
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    • 2018
  • The manufacturer of a linear accelerator (LINAC) has reported that the target melting phenomenon could be caused by a non-recommended output setting and the excessive use of monitor unit (MU) with intensity-modulated radiation therapy (IMRT). Due to these reasons, we observed an unexpected beam interruption during the treatment of a patient in our institution. The target status was inspected and a replacement of the target was determined. After the target replacement, the beam profile was adjusted to the machine commissioning beam data, and the absolute doses-to-water for 6 MV and 10 MV photon beams were calibrated according to American Association of Physicists in Medicine (AAPM) Task Group (TG)-51 protocol. To verify the beam data after target replacement, the beam flatness, symmetry, output factor, and percent depth dose (PDD) were measured and compared with the commissioning data. The difference between the referenced and measured data for flatness and symmetry exhibited a coincidence within 0.3% for both 6 MV and 10 MV, and the difference of the PDD at 10 cm depth ($PDD_{10}$) was also within 0.3% for both photon energies. Also, patient-specific quality assurances (QAs) were performed with gamma analysis using a 2-D diode and ion chamber array detector for eight patients. The average gamma passing rates for all patients for the relative dose distribution was $99.1%{\pm}1.0%$, and those for absolute dose distribution was $97.2%{\pm}2.7%$, which means the gamma analysis results were all clinically acceptable. In this study, we recommend that the beam characteristics, such as beam profile, depth dose, and output factors, should be examined. Further, patient-specific QAs should be performed to verify the changes in the overall beam delivery system when a target replacement is inevitable; although it is more important to check the beam output in a daily routine.

Free Muscle Transplantation of the Chronic Lower Extremity Osteomyelitis (만성 하지 골수염에 시행한 유리 근 이식술)

  • Lee, Jun-Mo;Huh, Dal-Young
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.176-183
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    • 1999
  • Chronic osteomyelitis have been treated with wound dressing and antibiotics therapy often results in healing but foul odor pus discharges from the fibrotic soft tissues reactivates and requires appropriate control of the infection. Debridement of the wound, curettage and sequestrectomy, bone graft and immediate free flap transplantation is the curative protocol for the chronic osteomyelitis in the lower extremity. Authors have treated 7 cases of chronic osteomyelitis in the lower extremity with microsurgical free tissue transplantation at Department of Orthopedic Surgery, Chonbuk National University Hospital from December 1993 through February 1998. The results are as follows. 1. The chronic osteomyelitis occurred in tibial shaft in 4 cases, in calcaneus 2 cases and in femur 1 case. 2. Duration of the chronic osteomyelitis was at average 31.6 years. 3. Squamous cell carcinoma in the surrounding fibrotic tissue was biopsied in 1 case. 4. 4 cases had no trauma and occurred through hematogenous infection and 3 cases had fracture trauma. 5. Wound debridement and immediate free muscle transplantation had done in 5 cases and wound debridement, sequestrectomy and immediate free muscle transplantation in 2 cases. 6. Rectus abdominis muscle transplantation had peformed in 4 cases(57.1%), latissimus dorsi mucle 1 case(14.3%), latissimus dorsi myocutaneous 1 case(14.3%) and gracilis 1 case (14.3%). 6 cases of 7 were success(85.7%). 7. 1 case of failed latissimus dorsi musculocutaneous flap in thigh had done above knee amputation and 1 case of chronic posttraumatic osteoarthritis of the ankle joint had done below knee amputation at other hospital.

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Acupuncture, an Adjunct Therapy for Asthma: a Pilot Study Protocol of Randomized Controlled Trial (본 임상시험을 대비한 천식 침치료 무작위 대조군 예비 임상시험 프로토콜)

  • Choi, Jun-Yong;Oh, Dal-Seok;Roh, Young-Lae;Jung, Hee-Jae;Jung, Sung-Ki;Choi, Sun-Mi
    • Korean Journal of Acupuncture
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    • v.25 no.3
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    • pp.43-51
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    • 2008
  • 배경 : 최근까지 이루어진 천식의 침치료 무작위 대조군 연구들에 의한 결과는 뚜렷한 효과를 보여주지 못하고 있다. 이러한 요인의 하나로 적절한 피험자 수를 정하기 위한 예비 임상시험의 부재가 거론되고 있다. 따라서 천식에 대한 침치료의 본 임상시험에 앞서 이의 실행 가능성 및 규모를 예측하는 예비임상시험이 필요한 상황이다. 목적 : 예비임상시험을 통해 서양의학적 치료를 받고 있는 천식환자들에 대한 침치료의 부가적 효과를 검증하기 위한 본 임상시험의 실현 가능성을 예측하기 위함. 방법 : 본 시험은 무작위 단일 맹검 대조군 평행 설계 예비 임상시험이다. 1차 평가변수는 최대 호기량 검사기로 집에서 아침, 저녁으로 매일 측정한 수치로 구해진 최대 호기 유속 일중 변동률의 1주간 평균치 변화이며 2차 평가변수는 의료기관에서 시행하는 폐기능 검사, 기준시점 호흡곤란 지수, 호흡곤란 변화에 대한 지수, 천식환자들의 삶의 질 평가를 위한 설문 등이다. 피험자 수는 총 45명으로 선정 및 제외기준을 통해서 참여하게 되며 1주간의 최대 호기 유속 기저치 평가 기간을 거친 후 진짜침 처치 군, 가짜침 처치 군, 대기군 세 군에 각각 무작위로 15명씩 할당된다. 모든 피험자에게 기존의 천식관련 약물의 사용을 허용하며, 진짜침 처치군 및 가짜침 처치군은 주 3회 4주간 해당 처치를 받고 2주 후에 각 평가 항목에 대하여 추적, 관찰하게 된다. 대기군은 기존의 천식관리를 유지하면서 2주마다 방문하여 총 6주간 평가를 받고 진짜침 처치를 4주간 받게 된다. 고찰 : 본 연구는 국내에서 최초로 이루어지는 천식에 대한 침 무작위 대조군 예비 임상시험으로 향후 적절한 피험자 수와 실행가능성을 예측할 수 있으리라 기대된다.

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Clinical Research of Warm Needle Acupuncture for Chronic Low Back Pain: A Protocol for Randomized, Controlled Pilot Study (온침이 만성요통에 미치는 효과에 대한 무작위배정 대조군 예비 임상연구 프로토콜)

  • Seo, Yeonho;Kim, Taeoh;Cho, Whisung;Ko, Junhyuk;Ahn, Jonghyun;Kim, Soo Jeon;Lee, Hansol;Chang, Hokyung;Kim, Hyungsuk;Kim, Koh-Woon;Cho, Jae-Heung;Chung, Wonseok;Song, Mi-Yeon
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.155-164
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    • 2020
  • Objectives This study is aimed to evaluate the feasibility of further clinical research of warm needle acupuncture as an effective and safe treatment for chronic low back pain. Methods Thirty participants will be randomly assigned to the Warm needle acupuncture group (n=15) and Dry needle acupuncture group (n=15). All patients will receive acupuncture therapy twice a week for 6 weeks, but only the experimental group will receive thermal stimulation. The primary outcome will be measured using the visual analogue scale for bothersomeness of low back pain, and the secondary outcome will be measured using the VAS for pain intensity, Oswestry disability index, 36-Item Short Form Health Survey, Beck's depression inventory, and amount of analgesics used. Conclusions The results of this study will be used to determine the feasibility of a future large-scale randomized controlled trial that provides clinical evidence for the efficacy and safety of warm needle acupuncture in the treatment of patients with chronic low back pain.

Intraoperative Radiotherapy (IORT) for Locally Advanced Colorectal Cancer (대장-직장암의 수술중 방사선 치료)

  • Kim, Myung-Se;Kim, Sung-Kyu;Kim, Jae-Hwang;Kwan, Koing-Bo;Kim, Heung-Dae
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.265-270
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    • 1991
  • Colorectal cancer is the second most frequent malignant tumor in the United States and fourth most frequent tumor in Korea. Surgery has been used as a primary treatment modality but reported overall survivals after curative resection were from $20\%\;to\;50\%$. Local recurrence is the most common failure in the treatment of locally advanced colorectal cancer. Once recurrence has developed, surgery has rarely the role and the five year survival of locally advanced rectal cancer is less than $5\%$, in spite of massive combination therapy. Intraoperative radiotherapy (IORT) with or without external beam irradiation has been advocated for reducing local recurrence and improving survival. The recent report of local failure by this modality was only $5\%$, this indicated that significant improvement of local control could be achieved. We performed 6 cases of IORT for locally advanced colorectal cancer which is the first experience in Korea. Patient's eligibility, treatment applicator, electron energy, dose distribution on the surface and depth within the treatment field and detailed skills are discussed. We hope that our IORT protocol can reduce local failure and increase the long term survival significantly.

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Effects of fungicide tebuconazole on the embryonic development of Korean domestic frogs (Bufo gargarizans, Hyla japonica, and Pelophylax nigromaculatus) (살균제 Tebuconazole이 한국산 개구리류(두꺼비, 청개구리, 참개구리) 배아 발달에 미치는 영향)

  • Lee, Hae-Bum;Ko, Sun-Kun
    • Korean Journal of Environmental Biology
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    • v.39 no.3
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    • pp.311-318
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    • 2021
  • In this experiment, we investigated the toxicity of tebuconazole (fungicide) using domestic frog embryos, along the FETAX (Frog Embryo Teratogenesis Assay-Xenopus) protocol. Bufo gargarizans, Hyla japonica, and Pelophylax nigromaculatus embryos were incubated, and investigation of the tebuconazole effect was performed by the probit analysis. As a result, depending on the concentrations of tebuconazole, the mortality and malformation rates were increased and larval body length was decreased. The teratogenic concentrations (EC50) of tebuconazole were 34.4mg L-1, 10.6mg L-1, and 14.9mg L-1, respectively, and the embryo lethal concentrations(LC50) of tebuconazole were 74.7 mg L-1, 38.5 mg L-1, and 39.1 mg L-1, respectively. The teratogenic index (TI) valuesof tebuconazole were 2.19, 3.58, and 2.65; thus, it showed teratogenicity in embryonic development of these three frogs. These results revealed that in this experiment, tebuconazole suppressed the development of embryos at a relatively low concentration. In addition, mortality, malformation ratios, malformation patterns, and growth rates were similar to the results from the other assay systems. Therefore, tebuconazole was thought to have an effect on the embryo development of domestic frogs. In future, it will be necessary to identify species specificity in order to the clarify the causes of differences in mortality, malformation rate, and malformation patterns depending on the species.

Transient Middle Cerebral Artery Occlusion Model in Mouse using Nylon Thread (Nylon Thread를 이용한 mouse 에서의 Transient middle cerebral artery occlusion (MCAO) model 확립)

  • Lim, Byung-Chul;Sung, Ji-Hee;Kim, Ha-Na;Park, Seoung-Woo
    • The Journal of the Korea Contents Association
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    • v.19 no.7
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    • pp.186-191
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    • 2019
  • Introduction: In aged people, stroke incidence is increased. But standardized experimental animal protocol study for the research of stroke therapy is rare. There is little report on the success rate of cerebral artery occlusion model using standardized Nylon thread length of precise thread end-size controlled. Method: In this study, the operator intended the occlusion of middle cerebral artery (MCA) using $0.18{\pm}0.02mm$ end 5-0 Nylon thread. Middle cerebral artery occlusion was induced for 60min under isoflurane anesthesia. After 60min, the operator removed the Nylon thread and reperfusion was induced for 23hrs. The mice was killed 23hrs after reperfusion and infarction area of brain was confirmed by 1.5% TTC (2,3,5-tryphenyl tetrazolium chloride) staining. Results: According to end size and insert length of Nylon thread, Middle cerebral artery occlusion (n=50), internal carotid artery occlusion (n= 14), distal middle cerebral artery occlusion (n= 36), anterior cerebral artery (n= 1) were induced. And no infarction (n= 50) was observed. Conclusion: According to weight of mice, the operator induced reversible cerebral artery occlusion model by different insert length (30.0~36.9g : 9.0mm, 37.0~40.0g : 9.5mm) of Nylon thread. Success of cerebral artery occlusion model was confirmed by checking infarction area using TTC staining. The success rate (66.9%, 101/151) of reversible cerebral artery occlusion model in the mouse and the operational conditions are shown.

Effect of resistance training on joint flexibility and muscle strength of upper extremities of elderly with impaired cognition (탄력저항성운동 프로그램이 인지기능저하 노인의 상지유연성 및 근력에 미치는 효과)

  • Kim, Shinmi;Lee, Yunjung;Kim, Hwanjoong
    • 한국노년학
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    • v.29 no.3
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    • pp.987-1000
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    • 2009
  • The purpose of the study was to examine the effect of resistance training on joint flexibility and muscle strength of upper extremities of institutionalized elderly with impaired cognition. The study design was pretest-posttest control group study and inclusion criteria were elderly aged 65-year older, MMSE score 23 or less, ones who had no serious physical and/or mental problem except impaired cognition, and were capable to carry out resistance training. After consents were obtained participants were randomly assigned. Pre-post evaluation was performed by staff nurses trained beforehand. Among those 4-week study period, experiment was carried out during 5 consecutive days a week for 3 weeks. ROM and extension range of shoulder joints and muscle strength of shoulders and hands for both sides were measured. Flexion, extension, abduction range of right shoulder joint was significantly improved. Flexion and extension muscle strength of left side shoulder and abduction muscle strength of both sides of shoulder were significantly improved. With the study result, it could be concluded that resistance training has therapeutic effects on joint flexibility and muscle strength. More studies adopted longer experimental period to evaluate timing of effect and extinction to refine the protocol are called for.