• Title/Summary/Keyword: 치료이행

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Early Pulmonary Irradiation in Paraquat ($Gramoxone^{(R)}$) Poisoning (Paraquat 중독 환자에서 전폐 방사선치료의 효과)

  • Lee, Chang-Geol;Kim, Gwi-Eon;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.321-330
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    • 1995
  • Purpose : To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. Materials and Methods : From Jun. 1987 to Aug. 1993, thirty patients with paraquat poisoning were evaluated. Fourteen of these patients were received pulmonary irradiation(RT). All of the patients were managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents. Ingested amounts of paraquat were estimated into three groups(A : minimal 50cc). Pulmonary irradiation was started within 24 hours after admission(from day 1 to day 11 after ingestion of paraquat). Both whole lungs were irradiated with AP/PA parallel opposing fields using Co-60 teletherapy machine. A total of 10Gy(2Gy/fr. x 5days) was delivered without correction of lung density. Results : In group A, all patients were alive regardless of pulmonary irradiation and in group C, all of the patients were died due to multi-organ failure, especially pulmonary fibrosis regardless of pulmonary irradiation. However, in group B, six of 7 patients($86{\%}$) with no RT were died due to respiratory failure, but 4 of 8 patients with RT were alive and 4 of 5 patients who were received pulmonary irradiation within 4 days after ingestion of paraquat were all alive though radiological pulmonary change. One patient who refused RT after 2Gy died due to pulmonary fibrosis. All 3 patients who were received pulmonary irradiation after 4 days after ingestion were died due to pulmonary fibrosis in spite of recovery from renal and hepatic toxicity Conclusion : It is difficult to find out the effect of pulmonary irradiation on the course of the paraquat lung because the precise plasma and urine paraquat concentration were not available between control and irradiation groups. But early pulmonary irradiation within 4 days after paraquat poisoning with aggresive supportive treatment appears to decrease Pulmonary toxicity and contribute survival in patients with mouthful ingestion of paraquat who are destined to have reversible renal and hepatic damage but irreversible pulmonary toxicity.

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Postintubation Tracheoesophageal Fistu1a (기관삽관후 발생한 기관식도루 -치험 1례-)

  • Jeon, Sang-Hyeop;Park, Seo-Wan;Jeong, Seong-Un;Lee, Haeng-Ryeol
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.235-238
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    • 1996
  • Acquired tracheoesophageal fistula, a life threatening lesion, is rare but occurs most frequently alter prolonged mechanical ven ilation using a cuffed endotracheal tube. The mechanism of injury seems to be ischemia and inflammation of compressed trachea and esophagus by cuffed endotracheal tube. The patient was a 25 years old pregnant woman who was on prolonged mechanical ventilation for bacterial meningitis secondary to untreated otitis media. 40 days after mechanical ventilation, sudden subcutaneous empysema and pneumomediastinum ocurred and these were due to tracheoesophageal fistula. It was diagnosed with bronchoscopy and CT We performed tracheal repair with TA 60mm stapler and esophageal repair by interruted two layer suture with 410 vicryl and 510 prolene. A flap of sternocleidomastoid muscle was inserted between trachea and esophagus. Postoperative course was uneventful and the result of operation was acceptable by esophagography.

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Full-mouth rehabilitation of skeletal anterior open bite with severely decayed dentition: A case report (심한 우식을 동반한 골격성 전치부 개방 교합 환자의 전악 수복 증례)

  • Kim, Seong-A;Noh, Kwantae;Pae, Ahran;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.79-87
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    • 2017
  • The open bite malocclusion is a common clinical entity and has multifactorial causes. Development of effective treatment plan and management is dependent on proper diagnosis. The skeletal open bite patient requires a coordinated orthodontic and orthognathic surgical approach to achieve stable occlusion, acceptable esthetics, and improved function. But in case of open bite with severely decayed dentition, restoration in the entire dentition is necessary. Using the facial analysis and diagnostic wax-up, the most effective treatment was prosthetic rehabilitation. The provisional restorations were fabricated to satisfy esthetic and functional requirements, which result in the uniformly distributed occlusal force, anterior and canine guidance. The inter-arch relationship, labio-dental harmony, and the soft tissue aspect, which is important to estimate the longevity were evaluated. Definitive restorations of monolithic zirconia were made by replicating provisional restorations by using the latest CAD/CAM technology. They were delivered to the patient and clinical follow-up observation was satisfactory.

Health beliefs of patients and caregivers of stroke rehabilitation in the implementation and impact the ability to perform everyday actions (뇌졸중 환자 및 보호자의 건강신념이 재활치료 이행 및 일상생활동작 수행능력에 미치는 영향)

  • Lee, Yeon-Seop;Mun, Byeong-Mu
    • Journal of Korean Physical Therapy Science
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    • v.18 no.4
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    • pp.11-18
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    • 2011
  • Purpose : This study attempts to assist stroke patients lead independent daily life movements by providing basic data for stroke patients' successful rehabilitation program and understanding the relationship between health beliefs of stroke patients and their guardians, and patients' rehabilitation performance level and daily life movement fulfillment ability. Methods : 23 stroke patients receiving treatments at rehabilitation specializing hospital after getting diagnosed with a stroke, along with 23 guardians were selected as research subjects, and health belief was measured by modifying supplementing Byun Young-Hee(2002)'s health belief measurement tool for leg movement disorder patients. Research findings revealed the following relationship between health beliefs of stroke patients and their guardians, and patients' rehabilitation performance and daily life movement fulfillment ability. Results : The patients group's initial MBI score was $33.13{\pm}3.46$, and measurement after four weeks was $38.43{\pm}3.47$. As health beliefs got stronger, MBI score increased significantly(p<.05). Correlation analyses of factors that affect rehabilitation attendance rate showed that perceived susceptibility, seriousness and usefulness were statistically significant, and perceived disability was not statistically significant(p<.05). Guardians' health belief index(susceptibility, seriousness, usefulness, disability) had no correlation with rehabilitation attendance rate. Conclusion : In order to increase daily life movement fulfillment ability of patients who are being treated with stroke, health beliefs must be raised to increase changes in daily life movement fulfillment ability. Therefore, it is believed that managing programs that can increase health beliefs of stroke patients can allow patients obtain positive health beliefs, further increase rehabilitation performance rate of stroke patients as well as independent daily life ability.

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Congenital Anomaly of Urinary Tract in Children (소아 선천성 요로계 기형에 관한 고찰)

  • Shin Weon Hye;Ko Cheol Woo;Koo Ja Hoon;Chung Sung Kwang
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.88-94
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    • 1999
  • Purpose : Malformation of urinary tract is among the most common of all congenital anomalies and can progress to irreversible renal damage before diagnosis due to difficulty of early diagnosis. Present study was undertaken to determine the clinical characteristics of urinary tract anomaly and to find out the most appropriate diagnostic and therapeutic measures for children with these anomalies. Methods : During the past 10 years from 1987 to 1998, review of medical records revealed 65 children with congenital anomaly of urinary tract and the following results were obtained. Results : The most common anomalies were ureteropelvic junction obstruction occuring in 26 cases ($36\%$), followed by ureteral duplication in 11 cases, renal agenesis in 10 cases and ureterovesical function obstruction in 7 cases. Complex anomaly of urinary tract was found in 8 cases and anomaly of other systems such as congenital heart disease was detected in 11 cases. The most frequent age group at the time of diagnosis was below 1 year of age constituting 39 cases ($60\%$) and male preponderance was noted as male to female ratio being 2.25:1. Presenting symptoms were urinary tract infection in 25 cases, followed by hematuria, abdominal mass, abdominal pain and voiding difficulty, etc, and in 11 cases, the anomaly was picked up by routine prenatal ultrasonography. Azotemia was noted in 9 cases and the underlying anomaly was obstructive uropathy in 4 out of these 9 cases. Surgical correction was undertaken in 38 cases (most frequently in cases of obstructive uropathy) and in 2 out off cases with obstructive uropathy in whom surgical correction was done, azotemia disappeared during follow up period of 1-5years. No new cases of deteriorating renal function appeared during follow-up period. Conclusion : In spite of high incidence of congenital malformation of urinary tract, early diagnosis is still hampered by nonspecific symptoms and signs. Therefore, in patients with symptoms such as urinary tract infection, abdominal pain and voiding problems, etc, it Is advisable to take various diagnostic tests promptly to pick up any urinary tract anomaly and to apply proper therapy in order to avoid progression to irreversible renal damage. In this regard, prenatal ultrasonography should be utilized more widely as a routine procedure to detect any urinary tract anomalies before birth.

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Clinical Evaluation of Patients with Unilateral Non-functioning Kidney on $^{99m}Tc-DMSA$ scan ($^{99m}Tc-DMSA$ 스캔에서 일측성으로 동위원소 섭취가 안되는 환아들에 대한 임상적 고찰)

  • Bae Hyun-Chul;Kim Hyun-Young;Kim Pyung-Kil;Han Sang-Won
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.31-37
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    • 1997
  • The DMSA scan is a useful radiologic study in diagnosis of morphologic and functional diseases of kidney. We evaluated the distribution of sex and age, clinical manifestations, diagnosis, combined diseases, treatment and prognosis of the 61 patients with non-functioning kidney(no isotope uptake or uptake below 5% in DMSA scan) who admitted in our hospital from 1980 to 1995. The proportion of patients under 1 year old age was 46%. Sex ratio was 1.4:1 with male predominance. Most diagnosis of non-functioning kidneys were congenital such as multicystic dysplastic kidney, hydronephrosis due to ureteropelvic junction obstruction, renal agenesis and renal hypoplasia. In order of frequency thirty one percent of them were previously detected on antenatal ultrasonogram. Treatment consisted of operation in 47.5%, mostly nephrectomy and 32.8% of patients were followed up at OPD base without definite treatment. The most common combined diseases was hydronephrosis, in 4patients who had both kidneys inveloved progressed to chronic renal failure, but the prognosis in most cases were good. It is important to evaluate renal diseases in perinatal periods, and we believe that highly sensitive diagnostic study contribute to early treatment plan and thus to good prognosis.

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Radioaerosol Scan Manifestations of Diffuse Panbronchiolitis (미만성 세기관지염의 연무흡입 폐환기스캔 소견)

  • Kim, Hak-Hee;Choi, Byung-Gil;Bahk, Yong-Whee;Chung, Soo-Kyo;Park, Seog-Hee;Shin, Kyung-Sub;Park, Sung-Hak
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.2
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    • pp.192-199
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    • 1994
  • Diffuse pahbronchiolitis(DPB) is a relatively new, chronic, nonspecific, inflammatory disease of the lung that typically involves the airways in the "transitional" zone of the lung. Clinically, DPB strongly resembles chronic obstructive pulmonary disease (COPD) and the distinction between the two is crucial because the former is often fatal, requiring different therapeutic strategies. This study was prospectively carried out to assess diagnostic usefulness of radioaerosol scan(RAS) in DPB. RAS findings were analyzed with respect to the location and extent of abnormal aerosol deposition in the lung divided into the central, intermediary, and transitional airways and the peripheral airspaces. RAS showed mottled aerosol deposits characteristically in the transitional and intermediary airways with peripheral airspace defects. Such a deposition pattern contrasted sharply with central aerosol deposition of COPD. In conclusion, RAS appears to be a convenient, noninvasive, and useful diagnostic method of DPB.

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Biological properties of $\beta$-ketoacetoanilide chlorides against late blight of tomato (베타-케토아세트아닐라이드 염화물 유도체의 토마토 역병에 대한 작용 특성)

  • Choi, Gyung-Ja;Jang, Kyoung-Soo;Kim, Jin-Cheol;Lee, Seon-Woo;Cho, Kwang-Yun;Nam, Kee-Dal;Hahn, Hoh-Gyu
    • The Korean Journal of Pesticide Science
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    • v.8 no.2
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    • pp.137-144
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    • 2004
  • [ $\beta$ ]-Ketoacetoanilide chloride derivatives containing a substituent at 4 in phenyl group (para) reduced specifically the development of tomato late blight caused by Phytophthora infestans. Among $\beta$ketoacetoanilide chloride derivatives, five (KIST163, KIST170, KIST260, KIST263, and KIST267) were selected and tested for their protective, curative, systemic, persistent activities, and disease control efficacy against tomato late blight on adult plants. They exhibited a strong l-day protective activity and $EC_{50}$ of KIST163 and KIST170 were 21.9 and $14.5{\mu}g/mL$, respectively. However, they had little curative and systemic activities. Good persistence of KIST163 and KIST170 on tomato plants were observed against P. infestans; both KIST163 and KIST170 at $100{\mu}g/mL$ showed control values more than 75% in a 7-day protective applications. In addition, the two chemicals effectively controlled the occurrence of P. infestans on adult tomato plants. These results indicate that five $\beta$-ketoacetoanilide chloride derivatives are foliar fungicides with a preventive action and KIST163 and KIST170 have a potential for the control of tomato late blight in the fields.

Study in Relation to Social Support, Compliance and Psychosocial Adjustment of Rheumatoid Arthritic Patient (류마티스 관절염환자의 사회적 지지, 치료지시 이행 및 사회심리적 적응과의 관계 연구)

  • Soh, In-Ae;Kwon, Young-Sook;Park, Chung-Ja
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.211-225
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    • 1999
  • This descriptive correlational study was carried to identify the relationship among social support, compliance, and psychosocial adjustment of patients with rheumatoid arthritis. The study was done with 100 rheumatoid arthritic patients who were visited in Outpatient clinic of university hospital in Taegu, Korea from the 23rd of February to the 20th of March in 1998. The Data were collected through person to person interviews which were performed by five researchers. The instruments used for this study were Yu's social support scale(1996), Cho's compliance scale(1987), and Kim's psychosocial adjustment scale(1997). The data was analyzed by using a t-test, Pearson correlation coefficient, ANOVA, and Tukey test with the SAS Program. The results of this study were as follows ; 1. The mean score of social support was 2.76 for 4 full marks, compliance was 3.20 for 5 full marks, and psychosocial adjustment was 2.26 for 4 full marks. 2. Hypothesis 1 : "The higher the social support degree, the higher the compliance degree of the rheumatoid arthritis patient". It was supported(r=0.54, p<0.001). Hypothesis 2 : "The higher the compliance degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.34, p<0.001). Hypothesis 3 : "The higher the social support degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.24, p<0.05). 3. In general, the spouse group compared to other groups was demonstrated as the most dependable group for patients to trust and expect support. And the sons and daughters group was shown higher than other groups in terms of social support(F=4.19, p=0.01). There was no difference in terms of compliance in degree. In the degree of psychosocial adjustment the highly educated group(more than high school) is a little higher than the lowly educated group(F=3.08, p=0.03). In the costs of medical care, the group that could afford was significant higher than the group which could not afford results in terms of the psychosocial adjustment degree(F=3.99, p=0.01). The outcome of this study is that the social support that related rheumatoid arthritic patients had an effect on the following compliance, and the following compliance helps psychosocial adjustment of patients. It also shows that social support related psychosocial adjustment. Therefore, to increase the level of psychosocial adjustment of rheumatoid arthritic patients, it will be effective in supportive nursing intervention to improve social support and compliance.

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In vivo Evaluation of a Novel ${\beta}-Lactam$ Antibiotics, YH-487 (새로운 ${\beta}-Lactam$계 항생물질 YH-487의 in vivo 항균활성)

  • Won, Yu-Jung;Kang, Heui-Il;Lee, Jong-Wook;Chung, Dong-Hyo
    • Applied Biological Chemistry
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    • v.40 no.2
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    • pp.157-162
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    • 1997
  • A novel compound, named YH-487, was synthesized by attaching the thiol and aminothiazole residue to $C_3$ and $C_7$ position of 7-aminocephalosporanic acid (7-ACA). The therapeutic efficacy on infected animals, pharmacokinetics in vivo and the effect on intestinal microflora of YH-487 were examined. The pharmacokinetics of YH-487 were similar to that of cefotaxime, a third generation ${\beta}-lactam$ antibiotics, in rat. Upon in vivo administration, YH-487 was predominantly delivered to kidney, and mostly excreted through kidney without making any metabolites. The therapeutic efficacy of YH-487 to animal infected with E. coli was three times and twenty times higher than that of cefotaxime and cefotiam, respectively, In vivo administration of YH-487 to Sprague-Dawley rats significantly decreased the population of intestinal gram negative species such as Enterobacteria and Barteroides. However, no significant changes were obseved in gram positive species such as Lactobacillus, Bifidobacteria and Staphylococcus. In addition, continuous administration of YH-487 did not increase the possibility to induce resistant strains in intestinal microflora.

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