• Title/Summary/Keyword: Relapse

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The Lived Experience of Relapse and Treatment Among the Alcoholics (알코올 중독 환자의 재발과 치료 경험)

  • Woo, Ju-Hyun;Kim, Hyun-Lye;Hyun, Myung-Sun
    • Journal of Home Health Care Nursing
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    • v.19 no.2
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    • pp.162-172
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    • 2012
  • Purpose: The purpose of this study is to explore the subjective experiences of relapse and treatment among the alcoholics. Methods: Phenomenological methodology was used for the study. Participants were seven people with inpatient alcoholics at the alcohol treatment center at K hospital in K province. Data were collected via in-depth interviews from March to September, 2012 and analyzed using Colazzi's framework. Results: Six themes and seventeen meanings were formulated for the relapse and treatment experiences of participants with alcoholism. Six themes were 'Lack of true insight', 'Lack of strength to live a life', 'Unable to overcome an urge to drink', 'Being drawn away from others', 'Falling into the powerlessness and despair', and 'Being foothold of self-growth'. Conclusion: The results from this study revealed the relapse experiences among alcoholic patients. Therefore, the findings can provide the framework and direction for developing the relapse prevention program for alcoholic patients. In addition, practitioners in the treatment center or hospital need to consider their relapse and treatment experience.

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A Study of a Relapse Prevention Program for Alcoholics focused on Action Methods (행위기법을 중심으로 한 알코올의존 재발방지 프로그램 개발에 관한 연구)

  • No, In-Suk;Kim, Seong-Jae
    • Journal of East-West Nursing Research
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    • v.10 no.1
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    • pp.27-40
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    • 2004
  • Relapse is one of the most series problems in alcoholics treatment. Previous studies have shown that significant proportions of treated alcoholics show an early relapse and go through a chronic phase. It is necessity to find more effective relapse prevention program. The Purpose of this study was to develop a relapse prevention program that emphasis on group activities using various action methods. Previous studies revealed that there was no effective therapeutic strategy to prevent relapse and proposed that action methods were more practical ways to be able ti cope with high-risk situation than verbal methods such as discussions and lectures. The special attempt of this program was the application of various actions methods and the integration of many psychosocial therapeutic strategies as compared with many relapse prevention programs. The theoretical framework of this relapse prevention program was based on mainly the Marlatt's Relapse Prevention model and Prochescha and DiClemente's Transtheoretical model. This Program consists of eight structure sessions. Every session has three phase: Warm-up phase, action phase, and sharing phase as sociodrama structure. Sociodrama is based on many of the principles of adult learning. And sociodrama looks at how groups work through an understanding of systems and role theory. Therefore, in working with a group a therapist might explore with them the roles that people play, roles that are missing at present such a visionary and how people can develop new roles or new ways of playing existing roles. The researchers explained the purpose of this study to all participants after their agreement to participate. Voluntary informed consent was obtained from all participants. Every session allows participants to recognize personal specific high-risk situation and to examine possible coping behaviors creatively. Multiple solutions can be proposed, tested and evaluated dramatically, giving new insights or breakthroughs in thinking. This is vital for the initiation of change, and if appropriate, expanding new role development. The first two sessions aim at understanding of relapse process and recognize of high-risk situations focused on orientation about action methods. The next four sessions deal with high-risk situations. The last two sessions give participants opportunities to venture new life-styles. The methods and approaches used in this program utilized as a tool to explore and practice possible coping strategies. and this program can contribute to prevent relapse episode if tune with the particular high-risk situation by using active practices in safe environment.

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Antifibrotic effects of sulforaphane treatment on gingival elasticity reduces orthodontic relapse after rotational tooth movement in beagle dogs

  • Kim, Kyong-Nim;Kim, Jue-Young;Cha, Jung-Yul;Choi, Sung-Hwan;Kim, Jin;Cho, Sung-Won;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.50 no.6
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    • pp.391-400
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    • 2020
  • Objective: Increased gingival elasticity has been implicated as the cause of relapse following orthodontic rotational tooth movement and approaches to reduce relapse are limited. This study aimed to investigate the effects of sulforaphane (SFN), an inhibitor of osteoclastogenesis, on gene expression in gingival fibroblasts and relapse after rotational tooth movement in beagle dogs. Methods: The lower lateral incisors of five beagle dogs were rotated. SFN or dimethylsulfoxide (DMSO) were injected into the supra-alveolar gingiva of the experimental and control group, respectively, and the effect of SFN on relapse tendency was evaluated. Changes in mRNA expression of extracellular matrix components associated with gingival elasticity in beagles were investigated by real-time polymerase chain reaction. Morphology and arrangement of collagen fibers were observed on Masson's trichrome staining of buccal gingival tissues of experimental and control teeth. Results: SFN reduced the amount and percentage of relapse of orthodontic rotation. It also decreased the gene expression of lysyl oxidase and increased the gene expression of matrix metalloproteinase (MMP) 1 and MMP 12, compared with DMSO control subjects. Histologically, collagen fiber bundles were arranged irregularly and were not well connected in the SFN-treated group, whereas the fibers extended in parallel and perpendicular directions toward the gingiva and alveolar bone in a more regular and well-ordered arrangement in the DMSO-treated group. Conclusions: Our findings demonstrated that SFN treatment may be a promising pharmacologic approach to prevent orthodontic rotational relapse caused by increased gingival elasticity of rotated teeth in beagle dogs.

Efficacy and Safety of Mycophenolate Mofetil in Children with Steroid Dependent Nephrotic Syndrome

  • Lim, Taek Jin;Kim, Seong Heon;Kim, Su Young
    • Childhood Kidney Diseases
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    • v.19 no.2
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    • pp.105-111
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    • 2015
  • Purpose: Steroid dependent nephrotic syndrome (SDNS) is a chronic illness in childhood hard to treat. Steroid sparing drugs are often used, because long-term steroid therapy can cause severe side effects. We studied to compare efficacy between MMF and other drugs including cyclosporine and levamisole. Methods: This study was performed retrospectively on patients with SDNS, who were treated at Pusan National University Children's hospital. MMF group included 11 patients who were treated with MMF for at least six months between June 2012 and July 2014. As control groups, cyclosporine group (n=15) and levamisole group (n=18) included patients treated between January 2008 and July 2014. Number of relapse was analyzed in patients treated more than six months, and relapse free for one year was analyzed in patients treated more than one year. Results: In MMF group, ten were boys and mean age at onset was 5.8 years. Mean age at starting of MMF was 8.6 years. Number of relapse in MMF group was reduced significantly after treatment from 3.4 /year to 0.2 /year (P=0.003). There was no significant difference in number of relapse among groups (MMF: 0.2 /year, cyclosporine: 0.5 /year, levamisole: 0.5 /year). Comparing the early relapse within six months after treatment levamisole group was significantly higher than the other two groups (P=0.04). Conclusions: MMF which is used in SDNS significantly reduced the relapse and side effects were rare. In addition, MMF did not show any significant difference in comparison with the other two groups in number of relapse and relapse free for one year.

Effects of Rituximab Including Long-term Maintenance Therapy in Children with Nephrotic Syndrome in a Single Center of Korea

  • Kim, Seong Heon;Lim, Taek Jin;Song, Ji Yeon;Kim, Su Young
    • Childhood Kidney Diseases
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    • v.22 no.1
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    • pp.1-6
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    • 2018
  • Rituximab (RTX) is a chimeric monoclonal antibody that inhibits CD20-mediated B-cell proliferation and differentiation. Several studies have examined its use in intractable nephrotic syndrome (NS) with some positive results. However, those studies examined such effects for a short-term period of 1 year, and some patients continued to relapse after a lapse in RTX treatment. Our use of RTX as a maintenance therapy (RTX injection when the CD19 cell count exceeded $100-200/{\mu}L$ before relapse) showed some noticeable efficacy. We used RTX in 19 patients with steroid-dependent NS (SDNS). In 12 patients treated with RTX maintenance therapy, only one relapse occurred. The mean treatment period was $23.4{\pm}12.7months$, and the mean number of RTX administrations was $3.9{\pm}1.6$. The relapse rates were decreased (from 2.68/year to 0.04/year), and the drug-free period also increased (from 22.5 days/year to 357.1 days/year) during maintenance therapy. The other seven patients were treated with one cycle of RTX or additional cycles in case of relapse (non-maintenance therapy). Relapse rates were significantly decreased after RTX treatment (from 1.76/year to 0.96/year, P=0.017). The relapse-free period was $15.55{\pm}7.38$ (range, 5.3-30.7) months. No severe side effects of RTX were found except for a hypersensitivity reaction such as fever and chills during its infusion. In conclusion, RTX is considered an effective and safe option to reduce the relapse rate by a single- or maintenance-interval therapy in SDNS.

Investigating the effect of age on skeletal stability after sagittal split ramus osteotomy for mandibular setback

  • Lee, Chung-O;Hwang, Hee-Don;Choi, Jin-Wook;Kim, Jin-Wook;Lee, Sang-Han;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.6
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    • pp.354-359
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    • 2012
  • Objectives: The purpose of this study was to investigate whether the age factor would be related with stability of mandibular setback surgery for patients with mandibular prognathism. Materials and Methods: We compared the relapse patterns of 47 patients divided into three age groups (termed younger, adult, and older). The younger group consisted of patients between 15 and 17 years old; the adult group was made up of patients between 21 and 23 years old, and the older group was made up of patients more than 40 years old. The positional change of B point was evaluated at preoperative, postoperative, and follow-up states. Results: The horizontal relapse ratio was 21.7% in the younger group, 15.3% in the adult group, and 15.7% in the older group. Although relatively higher degrees of relapse were found in the younger group, this increase was not statistically significant. Spearman's correlation analysis was performed to explore other factors contributing to relapse. We subsequently found that the amount of relapse was related to horizontal setback. Conclusion: Although the degree of relapse in younger patients is not significant;y higher compared to other groups. The major contributing factor to relapse after sagittal split ramus osteotomy is amount of setback rather than age when the surgery was performed to patients over than 15 years of age.

Analysis of Alcoholism Treatment Programs in North America - Focused on Relapse Prevention - (북미지역 알코올중독 치료 프로그램 분석 - 재발방지를 중심으로 -)

  • Kim Sung-Jae
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.206-218
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    • 1999
  • Relapse is one of the most serious problem in alcoholism treatment area. But there is no proper post-treatment management program for preventing relapse in Korea. The purposes of this study are the analysis of several alcoholism treatment programs and recommendation about consideration for developing our alcoholism treatment program to prevent relapse in our country. Five different alcoholism treatment programs were collected for this study, two programs were collected by participant observation and three were collected by instruction manuals, references, and briefing materials. The followings are the criteria for this analysis of the five treatment programs. 1. the specific characteristics of the treatment program 2. the criterion of the patients, the duration and period (or the treatment, the special activities, and goals of the treatment. 3. the common characteristics of the five treatments. The common characteristics of those treatment programs are; 1 preparation for post-treatment from the beginning of the treatment (hospitalization) 2. assessment of relapse related factors 3. assessment of the relapse-warning signs 4. development and plan of individualized intervention strategy 5. practice of the plan The common characteristics of those treatment programs are 1. groups are classified the recovery training groups and the self-help groups 2 all kind of treatment programs carried out as groups rather than individuals. 3. usefulness which apply to various settings and various types 4. multidisciplinary and interdisciplinary approach As results, those programs were developed as post-detoxication management program, follow up program, and continued care program and their theoretical framework was from social learning theory. Those programs used the principles of cognitive-behavioral therapy for the classes, groups, and social skill training. These finding can be used for developing culturally appropriate alcoholism treatment programs focused on relapse prevention.

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Correlationship of skeletodental factors to a relapse in class II correctionn (II급 부정교합 치료 후 재발과 골격치성요소의 상관성)

  • Chung, Ae-Jin;Lee, Doe-Hoon;Kang, Kyung-Wha;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.34 no.2 s.103
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    • pp.153-163
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    • 2004
  • The purpose of this study was to evaluate the postretention change of class II malocclusion treatment and to examine which factors were related to the relapse. Seventy-eight treated cases were divided into two groups according to the stability of treatment results. Various measurements in pre-treatment and post-treatment lateral cephalograms were evaluated and comparisons were drawn between the stable and relapse group by t-test and correlation analysis. 1. There were only a row differences in the skeletodental relationship in the pre-treatment phase between the stable and the relapse group. 2. Mandibles in the stable group were repositioned mote anteriorly than those in the relapse group. 3. Mandibular incisors were more uprighted to the basal bone and maxillary incisors were less lingualized in the stable group than in the relapse group. 4. Occlusal plane was inclined forward and downward in the relapse group.

Identification of Cell Type-Specific Effects of DNMT3A Mutations on Relapse in Acute Myeloid Leukemia

  • Seo-Gyeong Bae;Hyeoung-Joon Kim;Mi Yeon Kim;Dennis Dong Hwan Kim;So-I Shin;Jae-Sook Ahn;Jihwan Park
    • Molecules and Cells
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    • v.46 no.10
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    • pp.611-626
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    • 2023
  • Acute myeloid leukemia (AML) is a heterogeneous disease caused by distinctive mutations in individual patients; therefore, each patient may display different cell-type compositions. Although most patients with AML achieve complete remission (CR) through intensive chemotherapy, the likelihood of relapse remains high. Several studies have attempted to characterize the genetic and cellular heterogeneity of AML; however, our understanding of the cellular heterogeneity of AML remains limited. In this study, we performed single-cell RNA sequencing (scRNAseq) of bone marrow-derived mononuclear cells obtained from same patients at different AML stages (diagnosis, CR, and relapse). We found that hematopoietic stem cells (HSCs) at diagnosis were abnormal compared to normal HSCs. By improving the detection of the DNMT3A R882 mutation with targeted scRNAseq, we identified that DNMT3A-mutant cells that mainly remained were granulocyte-monocyte progenitors (GMPs) or lymphoid-primed multipotential progenitors (LMPPs) from CR to relapse and that DNMT3A-mutant cells have gene signatures related to AML and leukemic cells. Copy number variation analysis at the single-cell level indicated that the cell type that possesses DNMT3A mutations is an important factor in AML relapse and that GMP and LMPP cells can affect relapse in patients with AML. This study advances our understanding of the role of DNMT3A in AML relapse and our approach can be applied to predict treatment outcomes.

Testing the Transtheoretical Model in Predicting Smoking Relapse among Malaysian Adult Smokers Receiving Assistance in Quitting

  • Yasin, Siti Munira;Retneswari, Masilamani;Moy, Foong Ming;Taib, Khairul Mizan;Isahak, Marzuki;Koh, David
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2317-2323
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    • 2013
  • The role of The Transtheoretical Model (TTM) in predicting relapse is limited. We aimed to assess whether this model can be utilised to predict relapse during the action stage. The participants included 120 smokers who had abstained from smoking for at least 24 hours following two Malaysian universities' smoking cessation programme. The smokers who relapsed perceived significantly greater advantages related to smoking and increasing doubt in their ability to quit. In contrast, former smokers with greater self-liberation and determination to abstain were less likely to relapse. The findings suggest that TTM can be used to predict relapse among quitting smokers.