• Title/Summary/Keyword: Department of Internal Medicine

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The Effects of Aroma Hand Massage on Pruritus, Fatigue and Stress of Hemodialysis Patients (아로마 손마사지가 혈액투석 환자의 소양증, 피로 및 스트레스에 미치는 효과)

  • Kang, Seoung-Ja;Kim, Nam-Young
    • Korean Journal of Adult Nursing
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    • v.20 no.6
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    • pp.883-894
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    • 2008
  • Purpose: This study was to examine the effects of aroma hand massage on pruritus, fatigue and stress of the patients undergoing hemodialysis. Methods: This study was a nonequivalent control group pretest-posttest design. Study sample was conveniently recruited from two hospitals(28 for experimental and 30 for control group). The experimental group went through aroma hand massage on hand without AVF for 5 min for 12 times mixed with Lavender, Chamomile and Geranium oils in the ratio of 4 : 4 : 2, which was diluted 3% with sweet almond crrier oil 100 ml. The collected data were analyzed using SPSS/WIN 12.0. Results: The 1st hypothesis, 'Experimental group who has received aroma hand massage will have lower rate of pruritus than the control group' was accepted(t = -5.084, p = .001). The 2nd hypothesis, 'Experimental group who has received aroma hand massage will have lower rate of fatigue than the control group' was accepted(t = -2.557, p = .015). The 3rd hypothesis, 'Experimental group who has received aroma hand massage will have lower rate of stress than the control group' was accepted(t = -5.537, p = .001). Conclusion: The aroma hand massage has shown to be an effective nursing intervention to reduce the pruritus, fatigue and stress among patients undergoing hemodialysis. Therefore, the massage is needed to continuously be applied to hemodialysis patients to improve their quality of life.

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Clinical Observation on Recombinant Human Endostatin Combined with Chemotherapy for Advanced Gastrointestinal Cancer

  • Gao, Shao-Rong;Li, Lu-Ming;Xia, Hai-Ping;Wang, Guang-Ming;Xu, Hong-Yan;Wang, Ai-Rong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.4037-4040
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    • 2015
  • Objective: To explore the clinical efficacy and toxic and side effects of recombinant human endostatin (rhendostatin/endostar) combined with chemotherapy in the treatment of advanced gastric cancer. Materials and Methods: A total of 70 patients with advanced gastrointestinal adenocarcioma confirmed by histopathology and/or cytological examination were divided into group A (37 patients) and group B (33 patients). Patients in group A were given intravenous drip of 15 mg endostar added into 500 mL normal saline, once every other day until the cessation of chemotherapy or patients' maximal tolerance to chemotherapy. Patients in group B received chemotherapy alone. Two groups selected the same chemotherapy regimens. FOLFIRI scheme: 90-min intravenous drip of $180mg/m^2$ irinotecan, intravenous drip of $200mg/m^2$ calcium folinate (CF) and $400mg/m^2$ 5-fluorouracil (5-Fu) on d1, and continuous intravenous pumping of 2 $400mg/m^2$ 5-Fu for 46 h. FOLFOX4 scheme: intravenous injection of $85mg/m^2$ oxaliplatin (L-OHP), $200mg/m^2$ calcium folinate (CF) and $400mg/m^2$ 5-FU on d1 for 2 h, and then continuous intravenous pumping of 2 $400mg/m^2$ 5-Fu for 46 h. XELOX scheme: oral administration of 1 $500mg/m^2$ xeloda (or tegafur 50~60 mg) in twice during d1~14 and intravenous drip of $135mg/m^2$ L-OHP on d1 for 2 h. The modified FOLFOX scheme: intravenous injection of $135mg/m^2$ L-OHP on d1 for 2 h, $200mg/m^2$ CF and 1.0 g tegafur during d1~5. Whereas, control Group B received chemotherapy regimens which were same as Group A, but no addition of endostar. Before chemotherapy, patients were given intravenous injection of 8 mg ondansetron, intramuscular injection of 10 mg metoclopramide and 20 mg diphenhydramine for prevention of vomiting, protection of liver and stomach as well as symptomatic supportive treatment. One cycle was 21 d, 4~6 cycles in total. The efficacy was evaluated every 2 cycles. Results: 32 patients in Group A could be evaluated, and the response rate (RR) and disease control rate (DCR) were 59.38% and 78.13%, respectively. 31 patients in Groups could be evaluated, and the RR and DCR were 32.26% and 54.84%, respectively. The differences between 2 groups were significant. The toxic effects include myelosuppression, gastrointestinal reaction, fatigue, cardiotoxicity and peripheral neurotoxicity. Conclusions: Preliminary observations show that endostar (once every other day) combined with chemotherapy is effective in the treatment of advanced gastrointestinal cancer, with low toxic effects, good tolerance, deserving further study.

THE EFFECT OF SCREW TIGHTENING SEQUENCE AND TIGHTENING METHOD ON THE DETORQUE VALUE IN IMPLANT-SUPPORTED SUPERSTRUCTURE (임플랜트 지지 상부구조물에서 나사조임순서와 조임방법이 풀림토크값에 미치는 영향)

  • Choi, Jung-Han;Kim, Chang-Whe;Lim, Young-Jun;Kim, Myung-Joo;Lee, Seok-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.45 no.5
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    • pp.653-664
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    • 2007
  • Statement of problem: The screw detorque value is a measure of the preload remaining in the screw just before detorquing. Purpose: This study evaluated the effect of different screw tightening sequences and tightening methods on detorque values for a well-fitting implant superstructure. Material and method: An implant superstructure that connected directly to four implants (Astra Tech) was fabricated on a fully edentulous mandibular acrylic resin model. Six well-fitting dental stone casts were made with a pickup impression of the superstructure from the acrylic resin model. To evaluate the effect of three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and two tightening methods (2-step and 1-step) on the stability of screw joint, the detorque values for a well-fitting implant superstructure were measured twice after screw tightening using 20 Ncm. Detorque values were analyzed using multi-way analysis of variance and two-way analysis of variance at a .05 level of significance. Results: 1. The mean detorque values for three screw tightening sequences were 12.3 Ncm, 12.6 Ncm, and 12.0 Ncm, respectively. 2. The mean detorque values for two screw tightening methods were 12.0 Ncm, and 12.2 Ncm, respectively. 3. The mean of mimimum detorque values for three screw tightening sequences and for two tightening methods were 10.6 Ncm, 11.1 Ncm, 10.5 Ncm, and 9.8 Ncm, respectively. 4. No statistically significant differences among the variables of screw tightening sequence and tightening method were found (p>.05) for detorque values and for mimimum detorque values. Conclusion: Within the limitations of this study, the screw tightening sequence and tightening method did not have a significant effect on the detorque values for a well-fitting implant superstructure.

Results of Total Body Irradiation in Allogeneic Bone Marrow Transplantation for Acute Non-Lymphocytic Leukemia (급성 골수성 백혈병에서 동종골수이식을 위한 전신 방사선 조사의 치료 결과)

  • Chung Su Mi;Choi Ihl Bohng;Kim In Ah;Kim Sung Hwan;Kang Ki Mun;Shinn Kyung Sub;Kim Choon Choo;Kim Dong Jip
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.247-253
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    • 1992
  • Between August 1987 and July 1991, 22 patients with acute nonlymphocytic leukemia have received allogeneic bone marrow transplantation (BMT) with non-T-lymphocyte-depleted marrow obtained from matched sibling donors. Of these patients, 12 patients were in first complete remission (CR) and 10 patients in second CR or greater or in relapse. All patients were treated with a preparative regimen consisting of cyclophosphamide (CTX, 60 mg/kg) or combined drugs, and 850 cGy single-dose or $150\~200$ cGy fractionated total body irradiation (TBI) administered twice daily for a total dose of $1200\~1320$ cGy. Survivors have been followed from 8 to 64.5 months (median, 24 months). The overall 2 year survival rate, relapse rate and incidence of radiation pneumonitis and graft versus host disease (GVHD) have been evaluated by age, phase of disease, initial WBC count, modality of TBI or conditioning chemotherapy. Overall 2 year survival was $58{\%}$. The median survival was 31 months and mean survival was 23.2 months. Overall survival have significant impact in patients of age >19 years old (p=0.008), patients in first CR (p=0.09). Two year survival rate is significantly correlated with age ( >19 vs $\leqq$19, $79.4\%$ vs $14.3\%$, p=0.0008), regimen of chemotherapy (CTX vs combined drug, $76.9\%\;vs\;33.3\%$, p=0.04), phase of disease (1st CR vs \geqq2nd$ CR or relapse, $83.3\%\;vs\;30\%$, p=0.01) and method of TBI (fractionated vs single dose, $70.7\%\;vs\;37.5\%$, p=0.05). The influence of French-American-British (FAB) subtypes on relapse rate is not significant, but initial WBC count > 20000/$mm^3$ is associated with increased relapse rate. There is difference in the rate of radiation pneumonitis ($14.3\%\;vs\;25\%$), GVHD ($14.3\%\;vs\;50\%$) and relapse ($21.4\%\;vs\;50\%$) according to fractionated versus single-dose TBI. As mentioned above, fractionated TBI is compatible for the preparative regimen combined with chemotherapy En allogeneic BMT of first CR patients under 41 years of age with suitable donor. Those results from a retrospective, non-randomized study clearly need additional clinical data, ideally from a randomized study.

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Phospholipase A2 Contributes to Hemorrhage-induced Acute Lung Injury Through Neutrophilic Respiratory Burst (출혈성 쇼크에 의한 급성 폐손상에서 Phospholipase A2의 활성화에 의한 산화성스트레스의 역할)

  • Jang, Yoo-Suck;Kim, Seong-Eun;Jheon, Sang-Hoon;Shin, Tae-Rim;Lee, Young-Man
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.503-516
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    • 2001
  • Background : The present study was carried out in association with neutrophilic respiratory burst in the lung in order to clarify the pathogenesis of acute respiratory distress syndrome(ARDS) following acute severe hemorrhage. Because oxidative stress has been suggested as one of the principal factors causing tissue injury, the role of free radicals from neutrophils was assessed in acute hemorrhage-induced lung injury. Method : In Sprague-Dawley rats, hemorrhagic shock was induced by withdrawing blood(20 ml/kg of B.W) for 5 min and the hypotensive state was sustained for 60 min. To determine the mechanism and role of oxidative stress associated with phospholipase A2(PLA2) by neutrophils, the level of lung leakage, pulmonary myeloperoxidase(MPO), and the pulmonary PLA2 were measured. In addition, the production of free radicals was assessed in isolated neutrophils by cytochemical electron microscopy in the lung. Results : In hypotensive shock-induced acute lung injury, the pulmonary MPO, the level of lung leakage and the production of free radicals were higher. The inhibition of PLA2 with mepacrine decreased the pulmonary MPO, level of lung leakage and the production of free radicals from neutrophils. Conclusion : A. neutrophilic respiratory burst is responsible for the oxidative stress causing acute lung injury followed by acute, severe hemorrhage. PLA2 activation is the principal cause of this oxidative stress.

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Morphological and immunological characterizaiton of the haemocytes of the oyster, Crassostrea gigas (참굴, Crassostrea gigas, haemocytes의 형태 및 면역학적 특징)

  • Kwon, Mun-Gyeong;Cho, Byoung-Youl;Choi, Hye-Seung;Park, Myoung-Ae;Park, Soo-Il
    • Journal of fish pathology
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    • v.19 no.3
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    • pp.243-251
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    • 2006
  • The internal defense system of mollusks consists of circulating haemocytes. In order to understand the morphological characterization of haemocytes, light and electron microscopy were carried out in oyster, Crassostera gigas. Four types of haemocytes were recognized: type Ⅰ small hyalinocytes, type Ⅱ large hyalinocytes, type Ⅲ large granulocytes and type Ⅳ small granulocytes. Additionally, the activities of alkaline phosphatase (ALP), acid phosphatase (ACP), peroxidase (POD), α-naphthyl acetate esterase, β-glucuronidase, PAS, sudan black B and oil red O in haemocytes were analysed by immunocytochemical methods. The results indicate that enzymatic activities were abundant and more active in granulocytes than in hyalinocytes. After incubation with haemoctyes and Vibrio FKC, phagocytic index and percentage of phagocytic cell were and shown to be increased from 15 to 120 min. In addition, the enzymatic activities were higher than those of controls: ALP, ACP, α-naphthyl acetate esterase and β-glcuronidase, indicating that these enzymes can be related with phagocytosis in oyster.

Staffs' Attitudes and Opinions toward Psychiatry in a Psychiatric Hospital (일 정신병원 직원의 정신과에 대한 인식과 태도)

  • Ryu, Seuk-Hwan
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.60-66
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    • 2005
  • Objectives : The aim of this study was to investigate the staffs' attitudes and opinions toward psychiatry in a hospital. The results of the investigation were taken as a basic data of the education programs of persons who worked in a hospital and community residents. Methods : The subjects of this study were persons who worked in a hospital. The tool used in this study was Attitudes and Opinions toward Psychiatry. Sixty-one persons were studied. Statistically one-way ANOVA or t-test were used. Results : Internal consistency was high, measuring 0.80 for the 26 items. Generally, hospital staffs have positive attitude toward psychiatry. Direct patient contact group scored more higher than indirect contact group, except 'overall merits of the field of psychiatry' and 'efficacy' factor. In factor 'overall merits of the field of psychiatry', and factor 'efficacy' female scored more higher than male averagely. In factor 'role definition and functioning of psychiatrists', 'possible abuses and social criticisms', and 'career and personal reward', direct patient contact group scored more higher than indirect contact group averagely. Conclusion This study results support the hypothesis that the direct patient contact group have more positive attitude toward psychiatry than the other group. It will be necessary to educate for a psychiatric hospital staffs and community residents on psychiatry.

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Retrospective Clinical Analysis of Treatment for Primary Warm Autoimmune Hemolytic Anemia (원발성 온난자가면역용혈빈혈의 치료에 대한 후향적 분석)

  • Moon, Hong Seop;Park, Chiyoung
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.166-170
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    • 2015
  • Background: Primary warm autoimmune hemolytic anemia (AIHA) is a relatively rare hematologic disorder resulting from autoantibody production against red blood cells. There has been very few studies about primary warm AIHA in South Korea because of its low incidence. We retrospectively analyzed the treatment outcome of primary warm AIHA. Method: We reviewed retrospectively the medical records of 9 primary warm AIHA patients from December 2002 to January 2015. We analyzed the causes and clinical characteristics of primary warm AIHA patients. We retrospectively analyzed the clinical data in electronic medical records for 9 Korean patients with AIHA patients who were diagnosed during the period from December 2002 to January 2015 at the Regional University Hospital in Korea. The study protocol was approved by the Institutional Review Board (IRB #2015-08-007, Chosun University Hospital IRB). Results: The mean age was 52 years (range 27~78), the mean hemoglobin level was 5.0 g/dL (range 2.5~6.4 g/dL). All patients received steroids at therapeutic dosages (corticosteroid 1 mg/Kg) as first line treatment. Eight of them showed complete response (5/8, 62.5%) and partial response (3/8, 37.5%), one patient required second-line treatment with rituximab. Two patients who responded first line treatment were relapsed at 86 weeks and 24 weeks after response, respectively. Only one patient of them was retreated with corticosteroid because of anemic symptoms. Conclusion: This study indicates that oral corticosteroid is an effective therapy for primary warm AIHA.

The Development of Automated Personalized Self-Care (APSC) Program for Patients with Type 2 Diabetes Mellitus (제2형 당뇨병 환자를 위한 자동 맞춤형 셀프케어 프로그램 개발)

  • Park, Gaeun;Lee, Haejung;Khang, Ah Reum
    • Journal of Korean Academy of Nursing
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    • v.52 no.5
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    • pp.535-549
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    • 2022
  • Purpose: The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects. Methods: The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus. Results: The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences. Conclusion: The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients' self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.

First-pass Stress Perfusion MR Imaging Findings of Apical Hypertrophic Cardiomyopathy: with Relation to LV Wall Thickness and Late Gadolinium-enhancement (심첨형 비후성 심근병증에서의 스트레스 부하 관류 자기공명영상 소견: 좌심실 벽 비후 정도와 지연 조영 증강 간의 관련성)

  • Yoo, Jin Young;Chun, Eun Ju;Kim, Yeo-Koon;Choi, Sang Il;Choi, Dong-Ju
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.1
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    • pp.7-16
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    • 2014
  • Purpose : To evaluate the prevalence and pattern of perfusion defect (PD) on first-pass stress perfusion MR imaging in relation with the degree of left ventricular hypertrophy (LVH) and late gadolinium-enhancement (LGE) in patients with apical hypertrophic cardiomyopathy (APH). Materials and Methods: Cardiac MR imaging with first-pass stress perfusion, cine, and LGE sequence was performed in 26 patients with APH from January 2008 to December 2012. We analyzed a total of 416 segments for LV wall thickness on end-diastolic phase of cine images, and evaluated the number of hypertrophied segment and number of consecutive hypertrophied segment (NCH). We assessed the presence or absence of PD and LGE from all patients. If there was PD, we subdivided the pattern into sporadic (sporadic-PD) or ring (ring-PD). Using univariate logistic method, we obtained the independent predictor for presence of overall PD and ring-PD. Results: PD on stress perfusion MRI was observed in 20 patients (76.9%), 12 of them (60%) showed ring-PD. Maximal LV wall thickness and number of hypertrophied segment were independent predictors for overall PD (all, p < 0.05). NCH with more than 3 segments was an additional independent factor for ring-PD. However, LGE was not statistically related with PD in patients with APH. Conclusion: About three quarters of the patients with APH showed PD, most of them represented as ring-PD. LVH degree or distribution was related with pattern of PD, however, LGE was not related with PD. Therefore, the clinical significance of PD in the patients with APH seems to be different from those with non-APH, and further comparison study between the two groups should be carried out.