• 제목/요약/키워드: Early medical intervention

검색결과 244건 처리시간 0.024초

Dimethylnitrosamine-Induced Reduction in the Level of Poly-ADP-Ribosylation of Histone Proteins of Blood Lymphocytes - a Sensitive and Reliable Biomarker for Early Detection of Cancer

  • Kma, Lakhan;Sharan, Rajeshwar Nath
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권15호
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    • pp.6429-6436
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    • 2014
  • Poly-ADP-ribosylation (PAR) is a post-translational modification of mainly chromosomal proteins. It is known to be strongly involved in several molecular events, including nucleosome-remodelling and carcinogenesis. In this investigation, it was attempted to evaluate PAR level as a reliable biomarker for early detection of cancer in blood lymphocyte histones. PAR of isolated histone proteins was monitored in normal and dimethylnitrosamine (DMN)-exposed mice tissues using a novel ELISA-based immuno-probe assay developed in our laboratory. An inverse relationship was found between the level of PAR and period of DMN exposure in various histone proteins of blood lymphocytes and spleen cells. With the increase in the DMN exposure period, there was reduction in the PAR level of individual histones in both cases. It was also observed that the decrease in the level of PAR of histones resulted in progressive relaxation of genomic DNA, perhaps triggering activation of genes that are involved in initiation of transformation. The observed effect of carcinogen on the PAR of blood lymphocyte histones provided us with a handy tool for monitoring biochemical or physiological status of individuals exposed to carcinogens without obtaining biopsies of cancerous tissues, which involves several medical and ethical issues. Obtaining blood from any patient and separating blood lymphocytes are routine medical practices involving virtually no medical intervention, post-procedure medical care or trauma to a patient. Moreover, the immuno-probe assay is very simple, sensitive, reliable and cost-effective. Therefore, combined with the ease of preparation of blood lymphocytes and the simplicity of the technique, immuno-probe assay of PAR has the potential to be applied for mass screening of cancer. It appears to be a promising step in the ultimate goal of making cancer detection simple, sensitive and reliable in the near future.

Famine exposure in early life and type 2 diabetes in adulthood: findings from prospective studies in China

  • Feng Ning ;Jing Zhao ;Lei Zhang ;Weijing Wang ;Xiaohui Sun ;Xin Song ;Yanlei Zhang ;Hualei Xin ;Weiguo Gao;Ruqin Gao ;Dongfeng Zhang ;Zengchang Pang
    • Nutrition Research and Practice
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    • 제17권4호
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    • pp.780-788
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    • 2023
  • BACKGROUND/OBJECTIVES: This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959-1961 Chinese Famine. SUBJECTS/METHODS: A total of 3,418 individuals aged 35-74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962-1978), fetal exposed (individuals born in 1959-1961), child exposed (individuals born in 1949-1958), and adolescent/adult exposed (born in 1931-1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates. RESULTS: During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively (P < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29-3.60), 1.53 (0.93-2.51), and 1.65 (0.75-3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82-42.54) and 2.33 (1.17-4.65), respectively. CONCLUSIONS: These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life.

섬망이 중환자실 환자결과에 미치는 영향: 경로 분석 (Path Analysis for Delirium on Patient Prognosis in Intensive Care Units)

  • 이선희;이선미
    • 대한간호학회지
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    • 제49권6호
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    • pp.724-735
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    • 2019
  • Purpose: This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model. Methods: This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24. Results: In the final model, admission via emergency department (Β=.06, p=.019), age over 65 years (Β=.11, p=.001), unconsciousness (Β=.18, p=.001), dependent activities (Β=.12, p=.001), abnormal vital signs (Β=.12, p=.001), pressure ulcer risk (Β=.12, p=.001), enteral nutrition (Β=.12, p=.001), and use of restraint (Β=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (Β=.06, p=.038), hospital length of stay (Β=5.06, p=.010), and discharge to another facility (not home) (Β=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium. Conclusion: The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.

사상체질병증(四象體質病證) 관리(管理)가 중풍(中風) 초기(初期) 환자(患者)에 미치는 효과(效果)에 대한 임상적(臨床的) 연구(硏究) - 태음인(太陰人) 환자(患者)를 대상으로- (The Clinical Study on the Effect of Sasang Constitutional Medical Therapy for Taeumin Patients in acute stroke.)

  • 이범준;이준희;김상복;박계수;정용재;이희주;고병희;송일병
    • 사상체질의학회지
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    • 제13권3호
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    • pp.23-30
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    • 2001
  • Objective : Stroke is the most frequent cause of death in Korea. Because it remains severe disablities disturbing normal life, it is important to carry out intervention preventing from progression of condition in patients with acute ischemic stroke within therapeutic time window. Thus early western intervention is necessary and beneficial for patients with acute stroke. However its therapeutic efficacy is not known in combination with Sasang Constitutional medical therapy. In this study, we investigated the clinical effect of East(Sasang Constitutional Medicine)-West integrated therapy. Methods : Among 54 patients with acute onset of stroke no later than seven days, 34 patients received East(Sasang Constitutional Medicine)-West integrated therapy and 20 pateints received West medical therapy. We estimated the subjects's status with Sasang Constitutional Symptomatic Scale (SCSS) prior to therapy and at 1 week, 2 weeks, 3 weeks after the starting each therapy. Results : There is no significant difference in SCSS between two group from admission to 1 week. But significant difference was observed after 2 weaks. Conclusion : The results of these investment suggest that East(Sasang Constitutional medicine)-West integrated therapy is more effective in Sasang Constitutional Pathology.

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Muscle Mass Changes After Daily Consumption of Protein Mix Supplemented With Vitamin D in Adults Over 50 Years of Age: Subgroup Analysis According to the Serum 25(OH)D Levels of a Randomized Controlled Trial

  • Yeji Kang;Namhee Kim;Yunhwan Lee;Xiangxue An;Yoon-Sok Chung;Yoo Kyoung Park
    • Clinical Nutrition Research
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    • 제12권3호
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    • pp.184-198
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    • 2023
  • Early prevention of sarcopenia can be an important strategy for muscle maintenance, but most studies target subjects at slightly pre-sarcopenic state. Our previous paper describes the effect of protein supplements rich in leucine and vitamin D on muscle condition, and in this paper, we performed a sub-analysis to evaluate who benefitted the most in terms of improvement in muscle health. A 12-week randomized clinical trial of 120 healthy adults (aged 50 to 80) assigned to an intervention group (n = 60) or control group (n = 60) were analyzed. Subjects in the intervention group received, twice per day, a protein supplement containing (per serving) 800 IU of vitamin D, 20 g of protein (3 g of total leucine), 300 mg of calcium, 1.1 g of fat, and 2.5 g of carbohydrate. The subjects were classified into 'insufficient' and 'sufficient' groups at 25-hydroxyvitamin D (25[OH]D) value of 30 ng/mL. The skeletal muscle mass index normalized to the square of the skeletal muscle mass (SMM) height (kg/m2) increased significantly in the 'insufficient group' difference value of change between weeks 0 and 12 (Δ1.07 ± 2.20; p = 0.037). The SMM normalized by body weight (kg/kg, %) was higher, but not significantly, in the insufficient group (Δ0.38 ± 0.69; p = 0.050). For people with insufficient (serum 25[OH]D), supplemental intake of protein and vitamin D, calcium, and leucine and adequate energy intake increases muscle mass in middle-aged and older adults and would be likely to exert a beneficial effect on muscle health.

애착장애의 치료 (ATTACHMENT-BASED INTERVENTION)

  • 노경선;이소희
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제15권2호
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    • pp.123-131
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    • 2004
  • 주 양육자와 어린자녀사이에 발생한 여러 애착의 문제들을 애착이론에 근거하여 치료한 네가지의 방법을 검토하였다. 첫째, 부모의 민감도를 증진시키는 방안. 둘째, 부모의 내적표상 및 작동모델(Parent's Representation과 Internal Working Model)을 변화시키는 방법. 셋째, 사회적인 지지를 증진시키는 방법. 넷째, 어머니의 정신건강과 Well-being을 도와주는 방법과 Project STEEP(Steps Toward Effective and Enjoyable Parenting)를 기술하였다. 이러한 리뷰를 통하여 주 양육자의 정서적 반응에 민감성과 반응성이 애착의 발달과 치료의 중요한 요인임을 알게 되었다. 향후 애착문제의 치료시 하기 사항을 특별히 고려하여야 할 것으로 사료된다. 첫째, 참가자의 요구를 충분히 고려할 수 있는 유연성. 둘째, 참가자 주위의 중요한 사람들을 참여 시킬 것. 셋째, 각 개인의 장점을 충분히 살릴 것. 넷째, 가능한 어렸을때 빨리 치료할 것. 다섯째, 장시간에 걸쳐 집중적으로 철저히 치료할 것.

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Surgically Treated Anterior Communicating Artery Aneurysm

  • Koo, Sang-Keun;Song, Yeung-Jin;Huh, Jae-Taeck
    • Journal of Korean Neurosurgical Society
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    • 제37권6호
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    • pp.405-409
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    • 2005
  • Objective: The purpose of this study is to assess the factors related to the outcome of 84 patients who underwent surgery for anterior communicating Artery(ACoA) aneurysms. Methods: The authors review 84 patients who were undertaken from January 1998 to May 2004. In the management of ACoA aneurysms, the outcome was based on several factors: Clinical condition, Distribution of hemorrhage, Time between aneurysmal rupture and surgery, Direction and shape of the aneurysm. Results: The incidence rate of the ACoA aneurysm was 35%. Seventy four patients were classified as those having a good recovery, but 5 patients suffered from some morbidity and 5 patients died. The rate of good outcome for the patients with Hunt and Hess grade was as follows 100% in grade I, 95% in grade II, 80% in grade III, IV and V. The rate of good outcome for the patients with Fisher grade was as follows 98% in grade I, II and 81% in grade III, IV. Nineteen of 22 patients who underwent early surgery were rated as good, while twenty six of 30 patients for whom surgery was delayed showed a favorable result. The unfavorable outcomes were also attributed by vasospasm or other medical problems. Conclusion: For further improvement of the overall surgical outcome: First, early surgical intervention is recommended for good grade patients. Second, active management of poor grade patients should be scrutinized with early surgery. Third, it is also important to step up the effort to minimize the risk of medical complications to enhance surgical results on top of the mainstay of prevention efforts for vasospasm and rebleeding.

심장수술후 복부장기의 합병증 (Intraabdominal Complications after Cardiac Surgery)

  • 김양원;조용길
    • Journal of Chest Surgery
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    • 제29권1호
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    • pp.38-42
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    • 1996
  • 심장수술후 복부장기의 합병증은 드물게 발생하나 발병시에는 높은 사망률을 야기할 수 있다. 1985년부터 1993년까지 인제의대 부속 부산백병 원에서 인공심폐기를 이용하여 수술한심혈관수술 1241례를 대상으로 하였으며 그중 16명이 복부장기의 합병증이 발생하였고 발병률은 1.3 %였다. 대장염이 6례, 간염이 3례, 위장출혈이 2례, 미란성위염이 1례, 담낭염이 1례, 비장파열이 1례, 부고환염이 1례, 서혜부 탈장이 1례 였다. 16례중 2례가 사망하여 전체적인 사망률은 12.5%였다. 16명의 환자중 3명은 복부장기의 합병증 치료를 위해 수술을 시행하였으며 이중 1명이 사망하였다. 심장수술후 복부장기의 합병증은 높은 사망률을 야기하므로 급성복증이 관찰되거나 내과적인 치료를 통해 증상호전이 없으면 적절한 시기에 적극적인 수술적 치료를 필요로 한다.

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Treatment, Education, and Prognosis of Slow Learners (Borderline Intelligence)

  • So Hee Lee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제35권3호
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    • pp.192-196
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    • 2024
  • Objectives: Borderline intelligence has been excluded from formal diagnostic systems and not included in disability diagnoses, leaving gaps in treatment, education, and social welfare despite various functional impairments. Therefore, we aimed to shed light on ways to enhance the intelligence and functioning of individuals with borderline intelligence by reviewing research on its progression, education, and treatment. Methods: Ten studies that met the inclusion and exclusion criteria were included in the final literature review and analyzed according to detailed topics (participant characteristics, design, and results). Results: Borderline intelligence is associated with various comorbid conditions, such as anxiety, depression, attention deficit/hyperactivity disorder, and addictive disorders, which negatively impact its course and prognosis. Individuals with borderline intelligence often face challenges in academics, employment, interpersonal relationships, and health owing to lifelong cognitive impairments. The treatment of borderline intelligence necessitates addressing environmental factors, such as neglect and abuse, as well as treating comorbid mental disorders, which are crucial for prognosis. Tailoring treatment programs for cognitive profile characteristics have been proposed, and studies have reported the effectiveness of pharmacotherapy, working memory training, and intensive rehabilitation training. Therefore, early intervention during childhood brain development is necessary. Risk factors, such as lack of parental education, and their impact on treatment outcomes have also been reported. Conclusion: Extensive research is needed on education, treatment, and prognosis related to borderline intelligence. Active intervention for children with borderline intelligence is essential to improve their functioning and quality of life.

피판 부전증의 구제를 위한 약용거머리 치료법 (Medicinal Leech Therapy for Salvage of the Failing Flap)

  • 백정환;신준호;박주현
    • 대한두경부종양학회지
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    • 제16권1호
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    • pp.20-25
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    • 2000
  • The medicinal leech, Hirudo medicinalis, has been used for salvage of the venous-congested flap following reconstructive surgery, with increasing frequency during the last two decades. Medicinal leech therapy is a safe, efficacious, economical, and well-tolerated intervention. The flap salvage with leeching occurs in approximately 70% of cases, and leeches need to be used as early as possible. At the time of the bite, evacuation of blood and injection of the leech saliva products, including anticoagulants and inhibitors of platelet aggregation, maintain capillary circulation of the flap, and then venous capillary return is established across the wound by angiogenesis. One of the salivary products, hirudin, represents the first parenteral anticoagulant introduced since the discovery of heparin. We analyzed two cases in which flap salvage with leeching was attempted, and reviewed medicinal leech therapy on the basis of our experiences and literature review. This has not been documented in the head and neck surgery literature in our country.

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