• Title/Summary/Keyword: 순차치료

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Left Sleeve Pneumonectomy Via Sequential Bilateral Thoracotomy in Carinal Squamous Cell Carcinoma -One case report- (기관분기부 편평상피 세포암에서 순차적 양측 개흉술을 통한 좌측 소매 전폐 절제술 치험 1예)

  • 김도형;강두영;백효채
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.444-447
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    • 2003
  • Sleeve pneumonectomy can be a method of treatment in a selected patient with bronchogenic carcinoma involving carina. A 64 years old male with a history of mitral valve replacement via midsternotomy 13 years ago and resection of papilloma of the vocal cord 2 years ago. The patient was admitted due to blood-tinged sputum. Bronchoscopy and computerized tomogram of the chest revealed 3.5 cm mass at lower margin of the trachea and totally obstructing the left main bronchus. A biopsy revealed squamous cell carcinoma. He underwent left sleeve pneumonectomy through sequential bilateral thoracotomy without cardiopulmonary bypass, and the pathologic stage was T4N0M0 stage IIIB. The patient is being followed through the outpatient clinic in good general condition.

Endovascular Treatment of a Systemic-to-Pulmonary Artery Fistula: A Case Report (체-폐동맥루의 혈관 내 치료: 증례 보고)

  • Eunbyul Lee;Dong Jae Shim;Doyoung Kim;Jung Whee Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.682-687
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    • 2021
  • Systemic-to-pulmonary artery fistulas are rare. This condition may be congenital, post-traumatic, or post-inflammatory and can cause infection, hemorrhage, or pulmonary hypertension. Here, we report a case of an intercostal-to-pulmonary artery fistula, incidentally detected during the evaluation of dyspnea in a 67-year-old female. Retrograde transcatheter coil embolization in a dilated draining pulmonary artery was initially attempted. However, another draining pulmonary artery developed after 5 months. The intercostal arteries or systemic feeders were successfully embolized through a transarterial access. At the 10-month follow-up, the abnormally dilated vessels had regressed, and dyspnea had improved. Sequential or simultaneous retro- and antegrade transcatheter embolization may successfully treat pleural arterio-arterial fistulas.

Experience of Agent Orange and Depression and Quality of Life: Mixed Method (고엽제 노출 경험과 우울 및 삶의 질: 통합방법론)

  • Joo, Eun-Woo;Lee, Jae-Shin;Kim, Soo-Kyoung;Cha, Tae-Hyun
    • Therapeutic Science for Rehabilitation
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    • v.9 no.4
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    • pp.33-43
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    • 2020
  • Objective: This study used a mixed methods analytical approach to analyze the level of depression in and quality of life of patients who had been exposure to Agent Orange. Methods: Data on the general characteristics, depression level, and the quality of life of 29 patients who were hospitalized because of exposure to Agent Orange were collected. Focus group interviews were conducted with 17 of these 29 patients. Regarding mixed methods, the sequential integrated design model proposed by Teddlie and Tashakkori (2003) was employed. The analytical methods were as follows: (1) general characteristics were examined using frequencies and proportional distributions; (2) depression scores and quality of life scores were assessed using descriptive statistical analysis; and (3) content analysis was used to examine the focus group interview data. Results: The average K-GDS depression score was 19.24 points, and the average WHOQOL-BREF quality of life score was 57.66 points. The focus group interview data yielded 3 topics were named "deployment route", "the manner of exposure to Agent Orange", and "life after Agent Orange exposure". Conclusion: There is an urgent need to increase public awareness, develop a public policy response, and conduct additional research on ground occupational therapy programs that include physical therapy.

Prosthetic treatment for patient with upper lip cancer and severe periodontitis: Maxillary complete denture with denture adhesive and mandibular double crown-retained removable partial denture (구순암 환자에서의 의치접착제를 이용한 상악 총의치와 심한 치주 상태에서의 하악 이중관의치를 이용한 수복 증례)

  • Choi, Hyun-Suk;Lee, Cheong-Hee;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.1
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    • pp.74-80
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    • 2015
  • When oral cancer is occured, one may experience problems such as lip defect, necrosis of periodontal tissue and cervical caries caused by radiotherapy. According to ADI (Association of dental implantology), recent radiotherapy on jaw bone could be a relative contraindication of implant treatment. Due to this controversy, in most cases, treatment is done with removable dentures rather than implants. Especially, lip defect caused by an oral cancer operation have a serious repercussion on the retention of the denture. In this case report, patient with upper lip cancer had undergone resection primarily and secondary radiotherapy was done periodically. As a result, upper teeth of patient were extracted gradually and lower teeth showed very poor periodontal status. Therefore, Polident$^{(R)}$ denture adhesive cream (GlaxoSmithKline, London, England) was applied on maxillary complete denture to overcome reduced retention due to the lip defect and double crown RPD with friction pin was applied on the mandible successfully for two years.

Craniofacial Centre of Children's Hospital Boston and Sequential Management for Cleft Lip and Palate (Children's Hospital Boston의 Craniofacial Centre와 구순구개열 환자의 순차적 치료순서)

  • Jung, Young-Soo
    • Korean Journal of Cleft Lip And Palate
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    • v.11 no.2
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    • pp.59-63
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    • 2008
  • Craniofacial Centre at Children's Hospital Boston is a worldwide leader in the care of children and adolescents with craniofacial anomalies especially with cleft lip and/or cleft palate, which provides a team approach to the evaluation, diagnosis and treatment of children and adults with congenital (present at birth) or acquired facial deformities. This is staffed by an experienced team of clinicians, such as in oral and maxillofacial surgery, plastic surgery, neurosurgery, dentistry, audiology, speech and language pathology, genetics, psychiatry, otolaryngology, and social work, all with specialized training in the care of children with craniofacial anomalies. Here, there is a short introduction of history, attending surgeons, works, and sequential treatment for cleft lip/palate patients about this institution.

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The Effect of Socially-Prescribed Perfectionism to Depression: Focusing on Mediating effect of Ambivalence over Emotional Expressiveness and Experiential Avoidance (사회부과적 완벽주의가 우울에 미치는 영향: 정서표현 양가성과 경험회피의 매개효과를 중심으로)

  • Oh, Yeram;Song, Wonyoung
    • Journal of Convergence for Information Technology
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    • v.10 no.10
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    • pp.150-160
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    • 2020
  • The purpose of this study was to test the effect of socially-perfectionism on depression by mediating ambivalence over emotional expressiveness and experiential avoidance. For this purpose, 201 participants across the country conducted the survey, a measure of MPS, AEQ-K, AAQ-II, CES-D. The descriptive statistics, Pearson correlation, path coefficient were conducted using SPSS 23.0. The indirect effect was examined using bootstrap in PROCESS Macro. The results of the study are as follows. First, all the variables had meaningful positive correlations. Secondly, When socially-perfectionism affects depression, ambivalence over emotional expressiveness, and experiential avoidance were mediated. As a result, the implications and limitations of the study were discussed.

The Influence of Self-Compassion on Binge Eating in College Students: Mediating Effects of Negative Affect and Negative Urgency (대학생의 자기자비가 폭식행동에 미치는 영향: 부정정서와 부정 긴급성의 매개효과)

  • Lee, Seul-Gi;Lee, Hee-Kyung
    • The Journal of the Korea Contents Association
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    • v.22 no.9
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    • pp.412-425
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    • 2022
  • The purpose of this study is to examine the relationship between self-compassion and binge eating and to examine the mediating effects of negative affect and negative urgency. To validify this hypothesis, 441 college and graduate students were measured self-compassion, negative affect, negative urgency, and binge eating. For the collected data, SPSS(23.0) and AMOS(23.0) were used for descriptive statistics, correlation analysis, and analyzing the structural equation model. The results of this study are summarized as follows. First, the correlation analysis showed significant correlations among self-compassion, negative affect, negative urgency, and binge eating. Second, in the relationship between self-compassion and binge eating, negative affect and negative urgency showed serial mediating effects. This means that for college and graduate students, the promotion of self-compassion can reduce binge eating behavior by sequentially reducing negative emotions and negative urgency. Finally based on these results, practical applications of self-compassion in the treatment of binge eating behavior were proposed.

Evaluation of the Bioequivalence of Simvastatin 20mg Tablets in Healthy Volunteers (조코 정에 대한 엘바스타 정의 생물학적 동등성 평가)

  • Yun, Hwi-yeol;Kang, Wonku;Kwon, Kwang-il
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.1
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    • pp.41-45
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    • 2005
  • 심바스타틴은 cholesterol 생합성 과정에서 속도 조절 효소인 HMG-CoA reductase의 강력한 상경적 길항약으로서 고지혈증 치료에 널리 쓰이는 약물이다. 심바스타틴 제제인 MSD 사의 조코 20 mg정을 대조약으로 하여 시험약인 유영 제약의 엘바스타 20mg정의 생물학적 동등성 평가를 하기 위해 22명의 건강한 지원자를 모집하였다. 지원자를 두 군으로 나누어 2정씩 투여하였고 $2{\times}2$ 교차시험을 실시하였다. 심바스타틴의 혈장 중의 농도를 정량하기 위하여 발리데이션된 LC/MS/MS를 사용하였다. 채혈 시간은 투약 전 및 투약 후 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 10, 12 시간에 걸쳐 총 12시점에 걸쳐 시행하였다. 생물학적 동등성을 판정하기 위한 파라미터로 12시간까지의 혈장 중 농도곡선 하 면적 ($AUC_{12hr}$)과 최고 혈중 농도($C_{max}$)를 사용하였다. 12시간 까지의 혈중 농도 곡선 하 면적의 기하 평균은 $17.30ng{\cdot}ml/hr$(시험약)과 $17.35ng{\cdot}ml/hr$(대조약)으로 나타났다. 최고 혈중 농도의 경우 각 각 5.08 ng/ml(시험약)과 5.20 ng/ml(대조약)으로 관찰 되었다. $AUC_{12hr}$의 경우 로그변환한 평균치 차의 $90{\%}$ 신뢰구간이 log0.8510 - log1.1694이었고, $C_{max}$의 경우 log0.8176 - log1.1649로 계산되어 두 항목 모두 log0.8-log1.25이어야 한다는 식품의약품 안전청과 FDA의 기준을 모두 만족시켰다. 이상의 결과를 종합하면 시험약 엘바스타 정 20mg은 대조약 조코정 20 mg에 대하여 생물학적 동등한 것으로 판정되었다.트리머 전기비저항 탐사를 수행하였다. 이를 통해 하저에 케이블을 설치하는 방식에 비해 매우 신속하고 경제적으로 하저에 분포하는 이상대의 분포범위와 발달방향을 규명할 수 있었다.대에 대해 가장 효과적이다. 모델과 현장 적용 결과들을 통해 GRM SSM 방법을 이용하여 불규칙한 굴절면을 가진 지층들에 대해 좀 더 신뢰할 수 있는 정밀한 탄성파 속도를 산출할 수 있음을 보여주고 있다.별한 주의를 기울여야 한다.EX>$\alpha/\beta$=10인 경우 $62.0\~121.9\;Gy_{10}$ (중앙값: $93.0\;Gy_{10}$)의 분포를, ${\alpha/\beta}=3$인 경우 $93.6\~187.3\;Gy_3$ (중앙값=$137.6\;Gy_3$ )의 분포를 보였다. MD-BED $Gy_3$는 직장합병증 발생과의 관계는 통계적으로 유의하였고, 방광합병증과는 유의하지 않았다. 직장합병증과의 연관성은 MD-BED $Gy_3$보다 개별 환자의 직장전벽 총 선량 BED값인 R-BED $Gy_3$가 훨씬 더 높았다. 요도카테터 풍선의 후방지점이 대변하는 방광의 총 선량 BED값인 V-BED $Gy_3$도 방광합병증과 경향성 테스트에서 통계적 유의성을 보였다. 하지만, 어떠한 방사선선량도 골반제어율과 의미 있는 상관관계를 보이지 않았다. 본 기관에서 주치의의 선호도에 따라 강내근접치료가 외부방사선치료의 중간에 시행되는 형태인 샌드위치기법과 외부방사선치료 후반부에 시행되는 순차적 기법으로 구분하였을 때, 두 방식간 치료성적 및 합병증의 차이는 없었다. 총 치료기간에 대한 분석에서는 치료기간이 길어질수록 재발 위험이 커지는 경향을 보였으나, 나이 및 병기, 종양의 크기, MD-BED $Gy_{10}$

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Order selection method for clinical pathway development in acute appendectomy (맹장염 수술에서 임상경로 개발을 위한 처방 선택 방법)

  • Park, Cheol-Yong;Kim, Tae-Yoon
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.1
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    • pp.43-50
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    • 2010
  • In this study, we propose a new order selection method for clinical pathway development in acute appendectomy. This method is based on the lift concept which is popular in association rule discovery and, starting from the orders with more frequencies, sequentially removes the negatively associated orders which have lift values somewhat less than one. The orders in acute appendectomy we consider in this study are test and medical treatment items respectively, and since there are different order patterns before, during, and after operation, three different order selections are made for each. The selection results are somewhat different from those selected only by the order of more frequencies. Specifically, the selection results of two methods are different in 1 or 2 orders for medical treatment items and in maximum 5 orders for test items, respectively.

The effect of computer based cognitive rehabilitation program on the improvement of generative naming in the elderly with mild dementia: preliminary study (한국형 전산화 인지재활프로그램이 초기 치매노인의 생성 이름대기 수행에 미치는 효과에 관한 예비연구)

  • Byeon, Haewon
    • Journal of the Korea Convergence Society
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    • v.10 no.9
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    • pp.167-172
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    • 2019
  • The purpose of this study was to investigate the effect of computer based cognitive rehabilitation program on the generative naming. Twenty - one patients were assigned to the CoTras program and eight were treated with traditional face - to - face language rehabilitation such as paper and table activities. The experimental group and the control group performed sequential language recall memory training, association memory recall training, language categorization memory training, and language integrated memory training for 12 weeks. The Welch's robust ANCOVA showed significant differences in mean fluency and MMSE-K changes (p<0.05). On the other hand, phonemic fluency increased significantly after 12 weeks of treatment compared to baseline in both experimental and control groups, but there was no statistically significant difference between treatment groups. The results of this study suggest that the computer based cognitive rehabilitation program may be more effective in improving the semantic fluency than the conventional cognitive-linguistic rehabilitation.