• 제목/요약/키워드: Risk Severity

검색결과 778건 처리시간 0.026초

소아 암 환자에서 항암제 치료 후 발생한 구내염에 대한 저출력 레이저의 효과 (Effects of Low Level Laser Therapy on Oral Mucositis Caused by Anticancer Chemotherapy in Pediatric Patients)

  • 김혜자;노시연;신용섭
    • The Korean Journal of Pain
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    • 제14권1호
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    • pp.51-55
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    • 2001
  • Background: Oral mucositis is a common complication of anticancer chemotherapy. The sequelae of this consist of an increased risk of infection, moderate to severe pain, compromised oral function, and bleeding. This study was performed to evaluated the effects of the He-Ne laser and the Ga-Al-As laser on oral mucositis caused by anticancer chemotherapy in pediatric patients. Methods: There were 3 cases of osteosarcoma and 6 cases of leukemia. All patients received He-Ne laser (632.8 nm wavelength, power 60 mW) application on 400-600 Hz scanning for 5-20 minutes and Ga-Al-As laser (904 nm wavelength, power 40 mW) application by fiberoptic hand piece placed in immediate proximity to the tissue without direct contact with it for 30 seconds per point for 5 days per week. During the application patients wore wavelength-specific dark glasses and were instructed to keep their eyes closed. Results: The mean number of treatments with oral intake was $4.89{\pm}0.64$. The mean number of total treatments was $9.44{\pm}2.59$. There were no significant side effects during and after the laser treatments. Conclusions: He-Ne laser and Ga-Al-As (IR) laser treatment were well tolerated and reduced the severity and duration of chemotherapy-induced oral mucositis in pediatric oncologic patients.

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중독연계전공 학생들의 상담실습에 관한 질적 연구 (A Qualitative Study on the Counseling Practice of Students with Majoring in Addiction)

  • 박종환
    • 한국콘텐츠학회논문지
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    • 제17권8호
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    • pp.667-676
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    • 2017
  • 본 연구는 중독기관에서의 상담실습을 마친 중독을 연계 전공하는 학생들을 대상으로 상담실습에 대한 경험과 그 경험의 의미를 알아보고, 이를 통하여 중독연계 학생의 효율적인 상담현장실습의 지도와 방향을 제시하고자 한다. 이를 위하여 두 곳의 중독치료 기관에 상담실습을 의뢰하였고, 그 기관에서 상담실습을 경험한 학생 중 16명의 학생을 대상으로 개인 면담을 실시한 후 그 자료를 질적 분석하였다. 연구결과 상담실습은 중독자들에 대한 두려움과 편견, 중독자들에 대한 편견, 병식의 변화, 중독의 심각성과 위험성, 중독영역에서의 진로기대, 중독 현장의 현실을 경험한 것으로 나타났다. 그리고 상담실습이 남긴 의미는 자신을 성찰하는 계기, 중독전문 상담자로서의 태도를 정립하는데 중요한 실물교훈이 되었다. 논의에서는 도출된 주제를 중심으로 중독현장에서의 상담실습의 체계적 운영 방안이 제시 되었다.

Correlation of Habits and Clinical Findings with Histopathological Diagnosis in Oral Submucosal Fibrosis Patients

  • Ara, Syeda Arshiya;Arora, Vini;Zakaullah, Syed;Raheel, Syed Ahmed;Rampure, Prakash;Ashraf, Sajna
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7075-7080
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    • 2013
  • Background: Oral submucosal fibrosis (OSMF) is one of the most prevalent premalignant conditions in India which is easy to diagnose but difficult to manage. At present it is considered as irreversible and incurable. It has also been referred to as an epidemic in India. Aims and Objectives: To correlate the frequency and duration of habits with clinical staging, functional staging and histopathological grading and to correlate the clinical and functional staging with histopathological grading. Materials and Methods: The study included a total of 90 subjects, 80 with OSMF in the experimental group and 10 patients in the control group. Patient personal history was recorded with chewing habits, including frequency and duration of chewing. The site of keeping the quid, time duration and whether he/she swallows it or spits it were also noted. Clinical staging was done on the presence of palpable fibrous bands. Functional staging was accomplished by measuring mouth opening. Incisional biopsy was done for all the patients for histopathological examination. Histopathological grading was according to Pindborg and Sirsat. Results: The experimental group comprised 71 males and 9 females, the majority of which were in the age group of 21-30 years. Correlation of habits with clinical staging, functional staging and histopathological grading were significant (p<0.05). Clinical and functional staging did not correlate with histopathological grading, but the correlation of clinical and functional staging was highly significant (p<0.01). Conclusions: The widespread habit of chewing gutkha is a major risk factor for OSMF, especially in the younger age group. In this study, it was found that with increase in the duration and frequency of the habit the severity of the disease increased.

급성기관지염의 약물중재 임상시험에 대한 체계적 문헌 고찰: 임상시험 가이드라인 개발을 위한 예비연구 (A Systemic Review of Clinical Trials Using Medication for Acute Bronchitis: A Pre-study on the Development of Traditional Korean Medicine Clinical Practice Guideline)

  • 유이란;박소정;이은정;전주현;정인철;박양춘
    • 대한한의학회지
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    • 제38권1호
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    • pp.93-111
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    • 2017
  • Objectives: The aim of this study is to make evidence-based data for developing a traditional Korean medicine clinical practice guideline for acute bronchitis. Methods: We searched 3 international databases(PubMed, EMBASE, CENTRAL) and 7 domestic databases (KoreaMed, Kmbase, NDSL, KISS, KISTI, OASIS, KoreaTK) to identify randomized controlled trials (RCTs) of acute bronchitis using medicine in recent 10 years. The chosen trials were analyzed by their study design, age range, intervention group, control group, primary and second outcome measure, inclusion and exclusion of participants and adverse events. Results: 15 RCTs are finally included in this study and most of their medications are herbal medicine. For diagnosis and outcome measure of acute bronchitis, Bronchitis Severity Score(BSS) was mostly used. Other measurements eligible are coughing fits, quality of life scale, sputum viscosity, change of individual symptoms and patient's satisfaction. Test duration was for average 7days and safety assessment was held by recording adverse events. Except for anti-inflammatory and antibiotic trials, all medications are found to be effective and well-tolerated. General risk of bias of chosen trials is evaluated low. Conclusions: A well designed clinical trials for traditional Korean medicine of acute bronchitis is needed and this study is expected to make it available.

미국 Medicare 투석환자 치료의 질 지표 개발 : 4가지 주요 치료영역을 바탕으로 (Developing a Composite Quality Indicator to Assess The Quality of Care for US Medicare End-stage Renal Disease Patients)

  • 강혜영
    • 한국의료질향상학회지
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    • 제7권2호
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    • pp.204-216
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    • 2000
  • Background : There has been a concern that the quality of care provided to end-stage renal disease (ESRD) patients in the United States may not be as good as recommended. This paper illustrates a composite measure to assess, the quality of care received by ESRD patients undergoing in-center hemodialysis by incorporating outcomes for 4 major treatment areas. The 4 treatment areas are: dialysis treatments, anemia control, nutritional management, and blood pressure control. Methods : The major data source for the study was the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study Wave 1 (DMMS-1) d Sixteen categories of a composite quality indicator were constructed by combining 4 dichotomous variables (16=2*2*2*2). representing the optimal vs. less than optimal level of outcome for each of the 4 treatment outcome measure respectively. Optimal outcome level for each treatment area was defined based on the recommendation from the National Kidney Foundation: (a) delivered dialysis doses (Kt/V) ${\geq}$ 1.2; (b) hematocrit level ${\geq}$ 30%; (c) serum albumin concentration ${\geq}$ 3.8g/dl ; and (d) blood pressure of <140 / <90mmHg. The 16 quality indicator were ranked according to their relative quality weights, which were estimated from its association with the relative risk of survival, adjusting for patient's baseline severity and dialysis facility characteristics. Results : Out of the entire sample of 2,179 patients, only 229 (10%) meet th recommended outcome levels for all 4 treatment areas. Overall, the study patients were distributed evenly over the 16 quality indicators, indicating a great variation in the quality of ESRD care. It appears that the rank of the 16 quality-indicators is driven by serum albumin concentration, suggesting that serum albumin concentration may be the most powerful predictor of ESRD patient survival among the 4 outcome measures. Conclusion : The developed quality indicator has the advantage of describin a range of care for dialysis patients and thus providing a more complete picture of care as compared to previous studies that have focused on only single or few components of the ESRD care.

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Subjective Symptom of Visual Display Terminal Syndrome and State Anxiety in Adolescent Smartphone Users

  • Park, Soonjoo;Choi, Jung-wha
    • International Journal of Contents
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    • 제11권4호
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    • pp.31-37
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    • 2015
  • The objectives of this study were: 1) to determine smartphone addiction, visual display terminal syndrome (VDTS) related symptoms, and state anxiety among adolescents, and 2) to identify the relationship among these variables. Data were collected via selfadministrated questionnaire survey from May to June, 2013. The survey was carried out with 540 voluntary participants at 13 to 24 years old from middle schools, high schools, and universities in Korea. The presence and severity of smartphone addiction, VDTS symptoms, and state anxiety were measured using Korean Smartphone Addiction Proneness Scale, VDTS Questionnaire, and State Anxiety Inventory, respectively. Data were analyzed by Cohen’s Kappa coefficient, Kruskal-Wallis test, and Mann-Whitney U test. The mean score of smartphone addiction for all students was 2.17 ± 0.51. The mean scores of smartphone addiction depending on school grade were 2.12 ± 0.53, 2.03 ± 0.48, and 2.42 ± 0.43 for middle school, high school, and college students, respectively. Subjects who experienced minor level of VDTS symptoms had a score of 0.49 ± 0.49 for VDTS symptoms. The score was increased when the level of addiction was higher. There were significant differences in VDTS subjective symptoms among smartphone addiction groups (p<.001). High-risk group of smartphone addiction had the highest scores in every subdomain of VDTS symptoms. Differences were also found in state anxiety among the three groups with smartphone addiction. The findings of this study showed that approximately one out of three adolescents might be classified into problematic smartphone users. Therefore, it is important to educate problematic smartphone users about smartphone addiction and VDTS symptoms to prevent further addiction and aggravation of anxiety.

Advanced peri-implantitis cases with radical surgical treatment

  • McCrea, Shane J.J.
    • Journal of Periodontal and Implant Science
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    • 제44권1호
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    • pp.39-47
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    • 2014
  • Purpose: Peri-implantitis, a clinical term describing the inflammatory process that affects the soft and hard tissues around an osseointegrated implant, may lead to peri-implant pocket formation and loss of supporting bone. However, this imprecise definition has resulted in a wide variation of the reported prevalence; ${\geq}10%$ of implants and 20% of patients over a 5- to 10-year period after implantation has been reported. The individual reporting of bone loss, bleeding on probing, pocket probing depth and inconsistent recording of results has led to this variation in the prevalence. Thus, a specific definition of peri-implantitis is needed. This paper describes the vast variation existing in the definition of peri-implantitis and suggests a logical way to record the degree and prevalence of the condition. The evaluation of bone loss must be made within the concept of natural physiological bony remodelling according to the initial peri-implant hard and soft tissue damage and actual definitive load of the implant. Therefore, the reason for bone loss must be determined as either a result of the individual osseous remodelling process or a response to infection. Methods: The most current Papers and Consensus of Opinion describing peri-implantitis are presented to illustrate the dilemma that periodontologists and implant surgeons are faced with when diagnosing the degree of the disease process and the necessary treatment regime that will be required. Results: The treatment of peri-implantitis should be determined by its severity. A case of advanced peri-implantitis is at risk of extreme implant exposure that results in a loss of soft tissue morphology and keratinized gingival tissue. Conclusions: Loss of bone at the implant surface may lead to loss of bone at any adjacent natural teeth or implants. Thus, if early detection of peri-implantitis has not occurred and the disease process progresses to advanced peri-implantitis, the compromised hard and soft tissues will require extensive, skill-sensitive regenerative procedures, including implantotomy, established periodontal regenerative techniques and alternative osteotomy sites.

Rapid Eye Movement-Related Obstructive Sleep Apnea: A Study on the Pathogenesis through Clinical and Polysomnographic Features

  • Jang, Ji Hee;Chung, Jin Woo
    • Journal of Oral Medicine and Pain
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    • 제41권4호
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    • pp.180-187
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    • 2016
  • Purpose: The aims of this study were to evaluate the differences of clinical and polysomnographic features between rapid eye movement (REM)-related obstructive sleep apnea (OSA) and not-REM-related OSA, and to suggest the pathogenesis according to the REM dependency of OSA. Methods: One hundred ninety consecutive patients diagnosed with OSA were evaluated clinical features and performed full night polysomnography. The patients were divided into REM-related (REM apnea-hypopnea index [AHI] at least two times higher than their non-REM AHI) and not-REM-related (a REM AHI less than two times higher than their non-REM AHI) OSA groups and evaluated the differences in age, body mass index (BMI), neck circumference, Ep-worth Sleepiness Scale score, and parameters of polysomnography. Results: REM-related patients were younger and showed higher sleep efficacy, low percentage of light sleep stage (stage 1 sleep), and low rate of positional OSA. Age was significantly associated with REM dependency of OSA and REM AHI were significant correlated with BMI, neck circumference, percentage of sleep in supine position, and percentage time of snoring. Conclusions: Our results showed that REM-related OSA patients showed less severe polysomnographic parameters than not-REM-related patients. However, significant risk factors were differed depending on the REM dependency and OSA severity, and the clinical features correlated with REM AHI and non-REM AHI were also showed differently. We suggest that the occurrence of OSA according to the REM dependency can be based on different mechanisms.

섭식장애 환자에서 전도 이상 및 관련 요인 (Conduction Abnormalities and Associated Factors in Korean Patients with Eating Disorders)

  • 배상빈;도준형;김율리
    • 생물정신의학
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    • 제19권1호
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    • pp.38-44
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    • 2012
  • Objectives : QT interval prolongation and dispersion known as indicators of an increased risk for ventricular arrhythmias and sudden death have been reported to be prolonged in patients with anorexia nervosa. The aims of this study were to compare conduction abnormalities in Korean patients with anorexia nervosa and bulimia nervosa, and to examine its relation with clinical and laboratory factors. Methods : We retrospectively examined 45 women with anorexia nervosa and 75 women with bulimia nervosa who were assessed by 12-lead electrocardiogram at baseline. QT interval and corrected QT interval, QT dispersion of the difference between the longest and shortest QT intervals, and abnormal U wave were measured for conduction abnormalities. Results : QT interval was significantly longer in patients with anorexia nervosa compared with those with bulimia nervosa. There were no differences in QTc (Corrected QT), QTd (QT dispersion) and abnormal U wave between patients with anorexia nervosa and those with bulimia nervosa. QTd was significantly correlated with the lowest ever lifetime body mass index ($kg/m^2$) as well as the serum amylase level in patients with anorexia nervosa. Conclusions : These results suggest some conduction abnormalities reported in patients with anorexia nervosa are also found in patients with bulimia nervosa. It appears that severity of weight loss and purging behavior could affect the cardiac arrhythmia in patients with eating disorders. Appropriate attention should be paid to cardiac involvement in patients with eating disorders.

Genetic Diversity of Fusarium proliferatum Populations from Maize, Onion, Rice and Sugarcane in Iran Based on Vegetative Compatibility Grouping

  • Alizadeh, Alireza;Javan-Nikkhah, Mohammad;Fotouhifar, Khalil-Berdi;Motlagh, Elahe Rabiee;Rahjoo, Vahid
    • The Plant Pathology Journal
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    • 제26권3호
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    • pp.216-222
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    • 2010
  • Fusarium proliferatum is the causal agent of stalk and root rot disease of maize, foot rot disease of rice, basal and root rot disease of onion and knife cut disease of sugarcane in Iran. In recent years, incidence and severity of these diseases have been increased in Iran. Fifty seven F. proliferatum single-spore isolates collected from diseased maize, rice, onion and sugarcane plants at different areas were used to study genetic diversity by determination of vegetative compatibility groups (VCGs). Chlorate-resistant nitrate non-utilizing (nit) mutants were recovered from selected isolates of F. proliferatum and used in complementation tests. All isolates in which both nit1 and NitM (or nit3) mutants were recovered, demonstrated self-compatibility. Vegetative compatibility tests by pairing nit mutants identified 30 VCGs among 57 isolates. Twenty-three isolates belonged to singlemember VCGs and the remaining 34 isolates, belonged to other seven multimember VCGs. Segregation of F. proliferatum isolates obtained from various area and host plants into different VCGs in Iran is reported for the first time. In this study, none of isolates obtained from rice complemented with any other isolates from onion and sugarcane and, non complementation occurred between onion and sugarcane isolates. Also, only one complementation occurred between one isolate of maize and one isolate of sugarcane and rice. Thus, a correlation between VCGs grouping and host preferences was founded. It is concluded that natural populations of F. proliferatum in Iran are probably genetically divergent and include isolates representing a potential risk for disease development.