• 제목/요약/키워드: Clinical practice

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A CLINICAL STUDY ON THE MAINTENANCE OF LIGHT INTENSITY OF VISIBLE-LIGHT CURING MACHINES FOR THE POLYMERIZATION OF COMPOSITE RESINS (복합레진 중합용 가시광선 광중합기의 적정 광강도 유지를 위한 임상적 고찰)

  • Lee, Dong-Soo;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.363-368
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    • 2001
  • It is well known that numerous factors influence the light output of curing units, but many dentists are un aware that the output of their curing lights are inadequate. This study was conducted to evaluate the light in tensity of visible-light curing units in some private dental clinics and hospital dental clinics. In order to determine the maximum light intensity of the curing units, lamps, filters and fiber optic bundles, they were replaced with new ones and light intensity was remeasured. Light intensity was measured by employing a digital radiometer (EFOS model #8000, USA). Light intensity ranged in $29\sim866mW/cm^2$ (below $150mW/cm^2$ ; 17.8%, $150\sim300mW/cm^2$ : 46.6%, above $300mW/cm^2$ ; 35.6%). The replacement of the components increased the light intensity, with maximum increases of 94.8% for lamps, 82.3% for filters, 200.8% for fiber optics and 361.5% for all three parts. According to the manufacturer of radiometer, curing light is considered as unsuitable for use with a reading of above $300mW/cm^2$ by the radiometer. Applying these criteria to the present study, 64.4% of the curing units required repair or replacement. The results of this study indicated that the light intensities of the curing units used in dental practice were lower than optimum level.

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Drug Use Evaluation of Letrozole in Breast Cancer Patients at Regional Cancer Hospitals in Thailand

  • Ketkaew, Chaninun;Kiatying-Angsulee, Niyada
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6055-6059
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    • 2015
  • Background: Medication policy development in Thailand is continually promoting rational drug use. Letrozole, an endocrine therapy drug, is usually prescribed for post-menopausal status early and advanced stage breast cancer. After Ministry of Public Health announced Letrozole as compulsory licensed drug in 2009, more breast cancer patients can access to this drug at low cost especially those within universal coverage schemes. To ensure that Letrozole is rationally prescribed, the drug utilization study was conducted. Objectives: The aim of this study was to describe the appropriate use of Letrozole in breast cancer and the relationship between appropriate use and health benefit schemes. Materials and Methods: A retrospective study to evaluate use of Letrozole in breast cancer patients was performed for six months between January - June 2010 in seven regional cancer hospitals, Thailand. All prescriptions of Letrozole were identified from pharmacy dispensing databases and prescription papers. A medical record review was also performed to evaluate appropriate use referring to the drug use evaluation criteria. The approved criterion of this study was referred from the guideline of Thai National Formulary version 2010. Results: There were 681 prescriptions of Letrozole for 254 breast cancer patients with an average age of $58.6{\pm}10.0years$. The patients in universal coverage scheme (UCS), civil servant medication benefit scheme (CSMBS) and social security scheme (SSS) were 77.7%, 18.5% and 8.7% respectively. 10.6% were prescribed Letrozole for the first time. Letrozole were prescribed by oncologists (82.8%). The average number of tablets per prescription was $58{\pm}10$. Calcium supplements were prescribed concomitant with Letrozole for 19.4%. To assess drug use evaluation criteria, 45 prescriptions were excluded because of uncompleted clinical data, 636 prescriptions were evaluated. The study showed 86 prescriptions (13.5%) with inappropriate use including 6 (0.9%) not prescribed for estrogen receptor (ER) and/or progesterone receptor (PR) positive, 31 (4.9%) not prescribed for post-menopausal and 49 (7.7%) not prescribed for an appropriate duration. Appropriate use percentages in different health benefit schemes were similar, 85.7% of CSMBS, 86.4% of SSS and 86.7% of UCS. The relationship between health benefit scheme and appropriate use of Letrozole was not significantly different, ${\chi}^2$ (2, N = 636) = 0.081, p > 0.05. Conclusions: The study showed inappropriate use in breast cancer patients because of non-compliance with duration, menopausal status and hormone receptor requirements. To prescribe appropriate indication did not referred to the appropriate practice along the treatment. Drug use evaluation proved very useful for detecting the sign of inappropriate use and allows immediate feedback to the stakeholder for developing medication policy in the future. Importantly, there was no significantly difference in appropriate use of Letrozole across health benefit schemes.

Modified Docetaxel and Cisplatin in Combination with Capecitabine (DCX) as a First-Line Treatment in HER2-Negative Advanced Gastric Cancer

  • Bilici, Ahmet;Selcukbiricik, Fatih;Demir, Nazan;Ustaalioglu, Bala Basak Oven;Dikilitas, Mustafa;Yildiz, Ozcan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8661-8666
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    • 2014
  • Background: Docetaxel and cisplatin in combination with fluorouracil (DCF) regimen is accepted to be one of the standard regimens in the treatment of advanced gastric cancer. However, substantial toxicity has limited its use in daily clinical practice. Therefore, modification of DCF regimens, including introduction of capecitabine has been investigated to improve the safety profiles. In the present study, the efficacy and toxicity of a regimen with a modified dose of docetaxel and cisplatin in combination with oral capecitabine (DCX) was evaluated in untreated patients with HER2-negative advanced gastric cancer. Materials and Methods: Fifty-four patients with HER2-negative locally advanced or metastatic gastric cancer were included in this cohort. Patients received docetaxel $60mg/m^2$ plus cisplatin $60mg/m^2$ (day 1) combined with capecitabine $1650mg/m^2$ (days 1-14) every 3 weeks. Treatment response, survival, and toxicity were retrospectively analyzed. Results: The median age was 54 years (range: 24-76). The majority of patients (70%) had metastatic disease, while 11 patients (21%) had recurrent disease and underwent curative gastrectomy, and 5 patients (9%) had locally advanced disease (LAD). The median number of DCX cycles was 4. There were 28 partial responses and 11 complete responses, with an overall response rate of 72%. Curative surgery could be performed in four patients among five with LAD. At the median follow-up of 10 months, the median progression-free survival (PFS) and overall survival (OS) of the entire cohort of patients were 7.4 and 12.1 months, respectively. Dose modification was done in 12 patients due to toxicity in 8 and noncompliance in 4 patients. The most common hematological toxicity was neutropenia, which occurred at grade 3-4 intensity in 10 of 54 patients (27.7%). Febrile neutropenia was diagnosed only in two cases. Conclusions: DCX regimen offers prominent anti-tumor activity and considered to be effective first-line treatment with manageable toxicity for patients with HER2-negative advanced gastric cancer.

Effects of Scutellaria Radix Extract on the Membranous Nephropathy Induced by Cationic Bovine Serum Albumin in Mouse Model (황금(黃芩)이 Cationic Bovine Serum ALbumin투여로 유발된 Membranous Nephropathy Mouse Model에 미치는 영향)

  • Kim, Man-Ho;Cho, Chung-Sik;Kim, Cheol-Jung
    • The Journal of Korean Medicine
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    • v.30 no.5
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    • pp.61-76
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    • 2009
  • Background: Membranous nephropathy (MN) is the most common cause of adult nephrotic syndrome worldwide and has been defined as granular subepithelial deposition of immune complexes along the glomerular basement membrane (GBM). MN has few known treatments and gives rise to side effects under treatment with steroids and immunosuppressives. Objective: The purpose of this experimental study was to demonstrate the effects of Scutellariae Radix extract (SRE) treatment on MN mouse model induced by cBSA. Methods: We divided mice into 4 groups. The Normal group had no treatment. We induced MN mouse model to the other 3 groups by injecting cBSA into the abdominal cavity. The control group was treated with cBSA (10 mg/kg, i.p.) only. The second group, 'SRE-250', was treated with cBSA (10 mg/kg, i.p.) and SRE (250 mg/kg, p.o.). The third group, 'SRE-500', was treated with cBSA (10 mg/kg, i.p.) and SRE (500 mg/kg, p.o.). After cBSA and SRE treatment for 4 weeks, gain in body weight, 24hrs proteinuria, serum albumin, total cholesterol, triglyceride, BUN and creatinine of all groups were measured. TNF-$\alpha$, IL-6, IL-1$\beta$, IL-10, IFN-$\gamma$, IgA, IgM and IgG levels of all groups were gauged. H&E staining and electron microscopy of the kidney were observed. Results: SRE showed significant decrease in the 24hrs proteinuria, serum triglyceride, BUN, TNF-$\alpha$, IL-6, serum IgA, IgM and IgG levels compared with the control group. SRE showed increase in the serum IL-10 and IFN-$\gamma$ levels compared with control on RT-PCR. SRE considerably decreased in the thickening of the GBM on H&E staining and deposition of electron-density on electron microscopy of the kidney compared with the control. Conclusions: According to the above results, it is suggested that SRE decreases the symptoms of MN induced by cBSA in mouse model. Therefore, SRE seems to be applicable to MN in clinical practice.

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Development and Effect of Nursing Process Scenarios for Cerebral Infarction: HPS (뇌경색환자 간호과정 시나리오 개발 및 효과: HPS)

  • Jang, Ae Ri;Oh, Moon Joo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.1
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    • pp.223-231
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    • 2020
  • The aim of this study was to develop and apply a nursing process simulation scenario for cerebral infarction patients using HPS for nursing students. The effects of this simulation were evaluated and compared with the effects of traditional teaching methods. This study was conducted on 3rd grade students at the College of Nursing from December 7 to December 26, 2018. This study examined 38 subjects in the experimental group and 39 in the control group. This research went through the analysis phase, design phase, and development phase for the development and application of the scenario. The confidence, knowledge, and performance before and after the intervention in the experimental and control groups were analyzed using a t-test. This study developed a simulation scenario based on a nursing process for cerebral infarct patients and was designed to infer three nursing diagnoses. Both groups showed significant pre-post scores except for the clinical performance. The experimental group had higher post-score scores and greater difference between the post-test and pre-test. This study is meaningful in that a standardized scenario of nursing process of infarct patients was developed. In addition, the developed scenario shows the possibility of developing teaching and learning methods that can integrate theoretical learning and practice.

The Study on Marginal discrepancy of Manufactured Coping Crown according to Production method and materials by using CAD/CAM System (CAD/CAM System을 활용하여 제작된 Coping Crown의 제작방식 및 재료에 따른 변연 적합도에 관한 연구)

  • Lee, Hee-Sung;Shin, Seong-Hun;Song, Joon-Ki
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.448-453
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    • 2017
  • The purpose of this study was to compare the marginal discrepancy of coping crowns according to manufacturing method and materials by using the CAD/CAM system to compare the optimum manufacturing method and materials. The coping crowns were fabricated by using manufacturing methods and materials, and marginal fit was measured using the replica technique. For comparative analysis of manufacturing methods and materials, analysis of variance was performed. One-way ANOVA was performed to compare and analyze different mean values. For the milling method of the alloy, 114.6 was obtained for the MM group, 111.4 for the MS group, 67.2 for the MSC group, and 50.9 for the MSS group, respectively, using the milling/sintering method. In the milling/sintering method of ceramic, 35.6 and 36.3, respectively, were obtained for the SLME group and SLMR group, respectively. However,there was a significant difference according to the material. The milling/sintering method of the ceramic material gave the lowest value, and it was verified by the optimal method. However, marginal discrepancy of coping crowns fabricated using the CAD/CAM system is applicable to the clinic since it corresponds to acceptable numerical values in clinical practice.

The Influence of Nurse Image and Major Satisfaction on Nursing Professionalism of Male nursing students (간호사 이미지, 전공 만족도가 남자 간호 대학생의 간호전문직관에 미치는 영향)

  • Lim, Kyoung-Min;Kim, Heui-Yeoung;Park, Geum Ja
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.423-431
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    • 2017
  • This study was conducted to identify the influence of nursing image and nursing as a major, on the professionalism of male nursing students. Totally, 180 male nursing students having experience in clinical practice from B and U cities, were enrolled as subjects. Data were collected from 15th November to 15th December, 2016. Analysis by t-test, ANOVA & Scheff's test, Pearson's correlation coefficients, and stepwise multiple regression revealed a mean score of nursing image at 3.95, major satisfaction score of 3.90, and nursing professionalism score of 3.79. The degree of professional awareness amongst the participants was statistically and significantly different, depending on their year of study and the person who had recommended nursing as a career option. Nursing professionalism was highly correlated with the nursing image, and moderately correlated with satisfaction of nursing as a major subject. Results also indicated that 60.6% results indicating nursing professionalism were most significantly influenced by two factors: the image of the nurse, followed by satisfaction of nursing as major. We conclude that to improve the nursing professionalism of male students requires education and strategy to improve their nursing image, and career education and guidance that focuses towards greater satisfaction for their selected major subject.

Financial Hardship Factors affecting the Cancer Patient's Quality of Life (암 환자의 삶의 질에 영향을 미치는 재정 관련 어려움 요인)

  • Rhee, Young-Sun;Kim, Su-Yeon;Park, Jeong-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.10
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    • pp.299-307
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    • 2020
  • Purpose: The purpose of this study was to investigate the financial hardships affecting the quality of life of cancer survivors. Method: Data were collected from five convalescent hospitals using self-administered questionnaires, and 422 questionnaires were used for the final analysis. We used a 5-step hierarchical multiple-regression analysis by entering each sociodemographic variable, medical variable, and three types of financial hardship (a material situation, the psychological response, and coping behavior coming from cancer treatment cost) into each step. Results: The results of statistical analysis indicate that the most influential factor in the quality of life was the financial difficulty, which was the frustration that they could not work as usual or support their family financially. In addition, the performance of physical activity, accompanying diseases, women patients, psychological burden on cancer treatment cost, the satisfaction of communication with medical staff for medical expenses, and the feeling unsuccessful financial coping strategy were predictors for the quality of life of cancer survivors. Conclusion: This study provides a blueprint for the development of intervention programs in practice to improve the quality of life of cancer patients, clinical intervention plans, and health policies.

Selection and optimization of nutritional risk screening tools for esophageal cancer patients in China

  • Dong, Wen;Liu, Xiguang;Zhu, Shunfang;Lu, Di;Cai, Kaican;Cai, Ruijun;Li, Qing;Zeng, Jingjing;Li, Mei
    • Nutrition Research and Practice
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    • v.14 no.1
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    • pp.20-24
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    • 2020
  • BACKGROUND/OBJECTIVES: Malnutrition has multiple impacts on surgical success, postoperative complications, duration of hospital stay, and costs, particularly for cancer patients. There are various nutrition risk screening tools available for clinical use. Herein, we aim to determine the most appropriate nutritional risk screening system for esophageal cancer (EC) patients in China. SUBJECTS/METHODS: In total, 138 EC patients were enrolled in this study and evaluated by experienced nurses using three different nutritional screening tools, the Nutrition Risk Screening 2002 tool (NRS2002), the Patient-generated Subjective Globe Assessment (PG-SGA), and the Nutrition Risk Index (NRI).We compared sensitivity, specificity, positive and negative likelihood ratios, and Youden index generated by each of the three screening tools. Finally, cut-off points for all three tools were re-defined to optimize and validate the best nutritional risk screening tool for assessing EC patients. RESULTS: Our data suggested that all three screening tools were 100% sensitive for EC patients, while the specificities were 44.4%, 2.96%, and 59.26% for NRS 2002, PG-SGA, and NRI, respectively. NRI had a higher positive likelihood ratio as well as a higher area under the receiver operating characteristic curve compared to those of NRS 2002 and PG-SGA; although, all three tools had null negative likelihood ratios. After adjusting the cut-off points, the specificity and accuracy for all tools were significantly improved, however, the NRI remained the most appropriate nutritional risk screening system for EC patients. CONCLUSIONS: The NRI is the most suitable (highest sensitivity and accuracy) nutritional risk screening tool for EC patients. The performance of the NRI can be significantly improved if the cut-off point is modified according to the results obtained using MedCalc software.

Effect of Hominis Placenta on cutaneous wound healing in normal and diabetic mice

  • Park, Ji-Yeun;Lee, Jiyoung;Jeong, Minsu;Min, Seorim;Kim, Song-Yi;Lee, Hyejung;Lim, Yunsook;Park, Hi-Joon
    • Nutrition Research and Practice
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    • v.8 no.4
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    • pp.404-409
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    • 2014
  • BACKGROUND/OBJECTIVES: The number of diabetic patients has recently shown a rapid increase, and delayed wound healing is a major clinical complication in diabetes. In this study, the wound healing effect of Hominis placenta (HP) treatment was investigated in normal and streptozotocin-induced diabetic mice. MATERIALS/METHODS: Four full thickness wounds were created using a 4 mm biopsy punch on the dorsum. HP was injected subcutaneously at the middle region of the upper and lower wounds. Wounds were digitally photographed and wound size was measured every other day until the 14th day. Wound closure rate was analyzed using CANVAS 7SE software. Wound tissues were collected on days 2, 6, and 14 after wounding for H/E, immunohistochemistry for FGF2, and Masson's trichrome staining for collagen study. RESULTS: Significantly faster wound closure rates were observed in the HP treated group than in normal and diabetes control mice on days 6 and 8. Treatment with HP resulted in reduced localization of inflammatory cells in wounded skin at day 6 in normal mice and at day 14 in diabetic mice (P < 0.01). Expression of fibroblast growth factor (FGF) 2 showed a significant increase in the HP treated group on day 14 in both normal (P < 0.01) and diabetic mice (P < 0.05). In addition, HP treated groups showed a thicker collagen layer than no treatment groups, which was remarkable on the last day, day 14, in both normal and diabetic mice. CONCLUSIONS: Taken together, HP treatment has a beneficial effect on acceleration of cutaneous wound healing via regulation of the entire wound healing process, including inflammation, proliferation, and remodeling.