• Title/Summary/Keyword: 치료이행

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ANTERIOR CROSSBITE CORRECTION IN PRIMARY DENTITION USING INTRAORAL APPLIANCE AND CLASS III ELASTIC (구강 내 장치와 III급 고무줄을 이용한 유치열기 전치부 반대 교합 치료)

  • Choi, A-Mi;Choi, Byung-Jai;Choi, Hyung-Jun;Song, Je-Seon;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.3
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    • pp.306-313
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    • 2012
  • Class III malocclusion or anterior crossbite is commonly seen in Asian. This problem is easily recognized by dentists and parents. During the primary dentition period, anterior crossbite with functional shift and deep overbite could develop to skeletal protrusive mandible. So, early and proper diagnosis of anterior crossbite which needs prompt treatment is important. These cases showed the early management of crossbite with functional shift in primary dentition using intraoral removable appliance resulting in improvement of intermaxillary relationship. And I analyzed the positional change and the dimensional change during treatment with lateral cephalometric x-ray analysis. Our patients showed vertical dimensional change of lower anterior facial height and clockwise rotation which results crossbite correction in 1 year of treatment period.

Postoperative Radiotherapy for Intracranial Meningioma (뇌수막종 환자의 수술 후 방사선치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.95-99
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    • 2001
  • Purpose : To evaluate the effectiveness and tolerance of postoperative external radiotherapy for patients with intracranial meningiomas. Materials and Methods : The records of thirty three patients with intracranial meningiomas who were treated with postoperative external irradiation at our institution between Feb, 1988 and Nov, 1999 were retrospectively analyzed. Median age of patients at diagnosis was 53 years with range of 17 to 68 years. Sites of involvement were parasagital, cerebral convexity, sphenoid ridge, parasellar and tentorium cerebelli. Of 33 evaluated patients, 15 transitional, 10 meningotheliomatous, 4 hemangiopericytic, 3 atypical and 1 malignant meningioma were identified. Four patients underwent biopsy alone and remaining 29 patients underwent total tumor resection. A dose of 50 to 60 Gy was delivered in 28-35 daily fractions over a period of 5 to 7 weeks. Follow-up period ranged from 12 months to 8 years. Results : The actuarial survival rates at 5 and 7 years for entire group of patients were 78% and 67%, respectively. The corresponding disease free survival rates were 73% and 61%, respectively. The overall local control rate at 5 years was 83%. One out of 25 patients in benign group developed local failure, while 4 out of 8 patients in malignant group did local failure (p<0.05). Of 4 patients who underwent biopsy alone, 2 developed local failure. There was no significant difference in 5 year actuarial survival between patients who underwent total tumor resection and those who did biopsy alone. Patients whose age is under 60 showed slightly better survival than those whose age is 60 or older, although this was not statistically significant. There was no documented late complications in any patients. Conclusion : Based on our study, we might conclude that postoperative external beam radiotherapy tends to improve survival of patients with intracranial meningiomas comparing with surgery alone.

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A Study on the Effects of Early Surfactant Replacement and Gentle Ventilation in the Treatment of Respiratory Distress Syndrome (미숙아 호흡 곤란 증후군에서 폐 표면 활성제의 조기 투여와 연성 환기 요법의 치료 효과에 관한 연구)

  • Lee, Yong Suk;Lee, Ji Hye;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1096-1101
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    • 2005
  • Purpose : Recently, early surfactant replacement and tidal volume based gentle ventilation has been a fundamental treatment of respiratory distress syndrome(RDS). The aims of this study were to survey the changes in ventilator care duration and rate of complication in RDS groups. Methods : We performed a retrospective study of 255 newborn infants less than 1,500 g admitted to the neonatal intensive care unit(NICU) and discharged from January 1999 to December 2003. 141 of 255 newborn infants were RDS groups that required invasive management, such as endotracheal intubation, surfactant replacement and assisted ventilation. We analyzed epidemiologic data to study the changes in ventilator care duration and outcome of RDS groups. Results : Of 141 RDS groups, 135 were mild to moderate RDS groups and only 6 were severe RDS groups. 24(17.8%) of 135 mild to moderate RDS groups and 3(50%) of 6 severe RDS groups were antenatal no use of maternal dexamethasone. 127(90.1%) of 141 RDS groups underwent replacement of surfactant during 3 hours after birth. 121(85.9%) weaned within 48 hours. Conclusion : Our study shows a decreased frequency of severe RDS by a antenatal use of maternal dexamethasone and decreased duration of ventilator care by early surfactant replacement and gentle ventilation.

Meta-Analysis on Effectiveness of Intervention to Improve Patient Compliance in Korean (한국인 치료순응도 향상을 위한 개입 효과에 대한 메타분석)

  • 김춘배;조희숙;현숙정;박애화
    • Health Policy and Management
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    • v.12 no.2
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    • pp.23-42
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    • 2002
  • The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.

산욕기 질병관리(유열)

  • Kim, Hyeong-Jong
    • Feed Journal
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    • v.4 no.10 s.38
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    • pp.132-137
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    • 2006
  • 목장 경영의 성공과 실패에는 여러 가지 요인이 작용하지만 연중 얼마나 적은 소가 도태되는가 하는 것 또한 아주 중요하게 생각해 보아야 할 사항이다. 낙농에 있어 거의 대부분의 질병이 산욕기에 발병하는데 산욕기(産褥期)란 분만으로 인한 상처가 완전히 낫고, 자궁이 평상시 상태가 되며 신체의 각기관이 임신 전의 상태로 회복되기까지의 기간으로 대개 분만 후 6~8주간을 말한다. 산욕기에 주로 발생할 수 있는 다양한 질병(산욕기 부전마비, 난산, 급성유방염, 제4위 전위증 등)들이 조기에 발견되어 적절히 치료되지 못하고 만성화되면서 전해질불균형, 에너지와 단백질의 섭취부족에 의한 영양장애로 허약과 지방간 및 케토시스 등으로 진행되어 결국 도태됨으로서 목장 경영에 있어 막대한 영향을 끼치는 것이다. 이러한 산욕기 질병의 주 원인은 건유기 사양관리에 있다. 건유기간 동안 체점수(BCS)의 변화를 최대한 줄이면서 분만전의 스트레스를 얼마만큼 줄일 수 있도록 관리하는가에 달려있다. 다시말해 분만 전 마지막 한달간에 건유에서 분만으로의 이행과정을 얼마나 매끄럽게 연결 지어주는가에 따라 산욕기 질병의 발생률이 결정되는 것이다. 본 고에서는 건유기 사양관리 소홀로 발생되는 산욕기 부전마비에 관해서 자세히 설명해 보고자 한다.

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제제설계 및 Scale Up

  • Hong, Sun-Eon
    • Journal of Pharmaceutical Investigation
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    • v.13 no.3
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    • pp.115-125
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    • 1983
  • 제제설계란 제형의 설계 및 그에 따른 처방설정(formulation)을 의미하며 경험적인 제제방법 및 그 기술측면에서의 제제화는 주악 및 첨가물의 종류와 배합비율의 설정등 비교적 단순한 내용을 의미하지만 의약품은 실제적으로 인체에 적용되므로 치료설계상의 연구와 생물약제학적 검토에 의한 유효정과 안전성을 발휘할 수 있도록 설계가 되어야 한다. 또한 약물의 효력은 체내 특정부위에 특정농도의 약물분포가 필요하고, 일정시간 지속되는 것이 요구되므로 약용량도 중요하지만 약물투여 후의 흡수, 체내이행, 대사, 배설등의 상태를 파악하고 이에 미치는 부형제의 영향도 검토하여야 한다. 제제물리학적 측면에서 품질보증을 위하여 preformulation단계에서 주약의 물성검토, 첨가제의 사용량, interaction 및 혼합순서 등과 처방설정 단계에서 제제화에 사용되는 기계장치의 특성 및 능력, 제제화 후의 포장용기 및 포장상태에서의 안정성 등도 면밀히 검토하여야한다. 제제설계란 단순한 dosage form의 design만이 아니고 유효성이 높고, 부작용이 적은 제제를 합리적으로 만드는 기술과 정보의 종합관리로 scale up과정에서 원료, 기계장치, 제조방법, 작업자 등에 의한 품질변동 요인을 극소화하고, 공정의 초기단계에서 즉시 조정될 수 있는 종합관리 system이 필요하다.

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A Study on the Relationships between Family Support, Self-efficacy, and Compliance in Chronic Arthritis (만성 관절염 환자의 가족지지, 자기효능감 및 치료지시 이행과의 관계)

  • Oh, Jin-Hwan;Lim, Nan-Young
    • Journal of muscle and joint health
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    • v.12 no.1
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    • pp.28-38
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    • 2005
  • Purpose: This study was to understand the level of family support, self-efficacy and compliance and to examine the relationships of the above three variables in chronic arthritis. Method: The subjects of this study were 116 patients sampled among the limited population of outpatients and inpatients at Rheumatism Center of the H university hospital in S city. The research instruments used in this study were family support, self efficacy and compliance scale. In data analysis, SPSS 8.0 program was used. Result: 1. Family support and self-efficacy level were above the medium. 2. Compliance level was medificant. Conclusion: Rheumatism patients will be able to live satisfactorily if they gium. 3. The relation among the family support, self efficacy and compliance was signot a good education about efficient training program aimed at compliance.

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Development of Self-management Instrument for Pre-dialysis Patients with Chronic Kidney Disease (투석전 만성신장병 환자의 자가관리 도구 개발)

  • Lee, Suk Jeong;Kim, Sisook
    • The Journal of the Korea Contents Association
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    • v.14 no.7
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    • pp.367-375
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    • 2014
  • This study aimed to develop a valid and reliable self-management instrument for pre-dialysis patients with chronic kidney disease (CKD). A total of 143 patients with CKD recruited from a medical center completed the questionnaire. The dimension and items of self-management were composed by literature review. The items of self-management was evaluated using exploratory factor analysis and measures of reliability. Five factors were extracted and labelled adherence to treatment regimen and partnership, diet adherence, problem solving, health behavior, and pursuit of psycho-social health. The five factors accounted for 51.1% of total variance. Each factors showed acceptable internal reliability with Cronbach's alpha from 0.64-0.79. The developed self-management instrument can be useful in self control of their disease for patients with CKD, and both evaluating patients' self-management and developing intervention program for health care professionals.

Long Term Follow-Up of Cyclic Vomiting Syndrome (주기성 구토증(cyclic vomiting syndrome)의 장기 추적 관찰 -이형 편두통(migraine variant)으로의 이행 과정인가?-)

  • Hwang, Jin-Bok;Oh, Hee-Jong;Choi, Kwang-Hae
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.75-83
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    • 2000
  • Cyclic vomiting syndrome(CVS) is a disorder of unknown etiology that is characterized by its clinical pattern of intermittent episodes of severe vomiting, similar in time of onset and duration, with no symptoms during the intervening period. By definition, CVS is an idiopathic disorder that requires exclusionary laboratory testing. Not only can it be mimicked by many specific disorders, eg, surgical, neurologic, endocrine, metabolic, renal, but within idiopathic CVS there may be specific subgroups that have different mechanisms. It has been reported that CVS usually begins in toddlers and resolves during adolescence. Migraine is also self-limiting episodic condition of children and the clinical features of migraine and CVS show considerable similarity. It is proposed that CVS is a condition related to migraine. This paper reports clinical courses of long term follow-up and reversible EEG changes in three patients whose history included CVS. Clinical situations of attack interval, duration and associated symptoms had changed variablely in each patients through long term follow-up period. Cyclic vomiting subsided in two cases. Abnormal delta activity was seen during episodes and resolved at follow-up, when the patient asymptomatic. The brain wave changes support the interpretation of CVS as a migraine variant.

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Effects of the Insulin Therapy Adherence Program for Patients with Type 2 Diabetes: A Randomized Controlled Trial (제2형 당뇨병 환자를 위한 인슐린치료이행증진 프로그램의 효과: 무작위대조군실험설계)

  • Park, Kyung Min;Son, Jung Tae
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.3
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    • pp.277-288
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    • 2022
  • Purpose: This study was conducted to evaluate the effects of the insulin therapy adherence program (INSTA GRAM) for patients with type 2 diabetes mellitus. Methods: This study examined a total of 63 patients with type 2 diabetes for whom the initiation of insulin therapy is being considered or within 6 months of undergoing insulin therapy. INSTAGRAM is a stage-specific intervention consisting of strategies for motivating patients to initiate and maintain insulin therapy using the transtheoretical model on the stages of change, the process of change, and self-efficacy. The participants were randomly assigned to either the INSTAGRAM group (experimental group, n=32) or the standard diabetes education group (control group, n=31). The INSTAGRAM group received 6 sessions over 8 weeks(face-to-face education was conducted in the first and last sessions, and telephone coaching was conducted from the second to fifth sessions). The outcomes were measured by psychological insulin resistance, self-efficacy, and glycosylated hemoglobin (HbA1c). Results: Psychological insulin resistance (p<.001), self-efficacy (p<.001), and HbA1c (p=.024) of the participants in the INSTAGRAM group significantly improved compared to those in the control group. Conclusion: INSTAGRAM is effective in overcoming psychological insulin resistance and improving self-efficacy and HbA1c. Therefore, the INSTAGRAM can be recommended as a nursing intervention for type 2 diabetic patients who delay the initiation of insulin therapy.