• 제목/요약/키워드: Risk Treatment Method

검색결과 565건 처리시간 0.027초

국내 종양유전상담 간호사를 위한 단기 교육프로그램 개발 (The First Korean Cancer Genetic Counseling Program for Nurses)

  • 최경숙;구웬앤더슨;전명희
    • 한국간호교육학회지
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    • 제12권1호
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    • pp.104-114
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    • 2006
  • Genetic knowledge for oncology nurses is important in Korea because oncologists are incorporating genetic counseling and genetic testing into their practice. The purpose of this paper is to describe our method of developing the first academic cancer genetic risk assessment and counseling course for Korean nurses. A one-week (non-credit) cancer genetics counseling program was constructed for master's level Korean oncology nurses. The course emphasized basic genetic concepts and principles the genetics of cancer; hereditary cancer syndromes; family history assessments; pedigree construction; risk calculation; surveillance recommendations and treatment options ethical, legal, social, and psychological issues inherent in genetic testing. The goals of this program are to: 1) provide a comprehensive knowledge base for nurses who are currently expanding their scope of practice into the genetic counseling role 2) introduce this knowledge to nurses who want to use it in their practice; and 3) provide cancer genetic knowledge and resources to Korean nursing faculty who plan to incorporate this knowledge into existing master's courses. This academically-based course is recognized as valuable by nurses, nursing faculty, and physicians. With this new knowledge nurses can begin toexpand their role in delivering comprehensive cancer care services.

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환추-축추 불안정성에 있어서 후방 경관절 나사못 고정술에 대한 수술적 경험 (Surgical Experience with Posterior Atlantoaxial Transarticular Screw Fixation in Atlantoaxial Instability)

  • 차승규;유찬종
    • Journal of Korean Neurosurgical Society
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    • 제29권1호
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    • pp.95-100
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    • 2000
  • Objective : Posterior transarticular screw fixation is known to be one of the best surgical method for the atlantoaxial instability. We assessed the complication and operative risk in 15 patients. Patients and Methods : Between January 1997 and April 1998, 15 patients suffering from this condition were admitted to our institution. Atlantoaxial instability was caused by C1 or C2 fractures in 11, rheumatoid arthritis in 2, and os odontoideum in 2. This technique was used in the treatment of 13 patients and 2 patients was used in sublaminar wire fixation only. Bilateral C1-C2 screws were placed in 11 patients ; 2 patients had only one screw placed becauce of an anomalous vertebral artery and axial destruction. Follow-up period ranged from 5 to 20 months. Results : Most screws were positioned satisfactorily. One screw was malpositioned. No patients had neurological complications. Conclusion : Rigidly fixating C1-C2 instability with transarticular screws showed a significantly higher fusion rate than that achieved using wired grafts alone. The risk of screw malpositioning and catastrophic vascular or neural injury is small and can be minimized by assessing the position of the transverse foramen on preoperative computed tomographic scans and by correctly using intraoperative fluoroscopy and surgeon's precaution.

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방사선으로 처리된 항생물질의 수서 생태위해성 평가 (A study on the aquatic eco-risk assessment of antibiotics treated by radiation)

  • 강선홍;장재구;가순규;김현영;김상돈;이면주
    • 상하수도학회지
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    • 제26권3호
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    • pp.373-381
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    • 2012
  • Antibiotics have been issued recently in water environments because of potential impacts on ecosystem and public health. This study was aimed to investigating the degradation of antibiotics such as tetracycline, lincomycin, sulfamethazine and cephradine using gamma ray irradiation. And the toxicity before and after irradiation on antibiotics was tested in order to examine the aquatic eco-risk assessment by aquatic organisms. In addition, comparing tests on toxicity for gamma ray and UV irradiated antibiotics was conducted. Four different antibiotics were prepared by concentration of 30 mg/L with demi-water respectively. The absorption dose of gamma ray was ranged from 0.2 to 2 kGy. The concentration of four antibiotics was gradually decreased corresponding to the increase of the absorption dose. A method for toxicity assessment using Pseudokirchneriella subcapitata was evaluated to the most acceptable compared with methods by Daphnia magna and Microtox$^{(R)}$ in terms of sensibility. It showed that the reduction of toxicity on antibiotics treated by gamma ray was superior comparing to the test results obtained from UV treatment. By-products from antibiotics treated by gamma ray were easily decomposed by microorganism and their toxicity was also evaluated to low.

간세포암종의 재발 위험과 관련된 한 예후인자로서의 종양의 크기의 범주화 (Categorizing tumor size as a prognostic factor for risk of relapse of hepatocellular carcinoma)

  • 김선우;박철근
    • 응용통계연구
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    • 제15권1호
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    • pp.1-8
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    • 2002
  • 예후인자의 범주화는 질병의 진단, 치료법 결정 및 임상시험의 참여기준 설정 등에 매우 유용하다. 예후인자의 범주화 방법으로는 생물학적 이론에 따라 경계값을 정하는 방법, 자료의 그래프를 이용하는 방법, 모든 가능한 경계 값들을 적용해보는 최소 유의확률 방법 등이 있다. 또한 최소 유의확률 방법의 다중검정문제를 보완한 몇 가지 방법들이 있다. 본 연구에서는 우리 나라에서 높은 발생률을 보이는 간세포암종의 절제술을 받은 환자들에 있어서 간 절제술 후 재발위험이 높은 군을 구별하는 한 근거로 종양의 크기를 범주화하기 위한 경계값을 결정하고자 하였다.

정상체중 대사비만 (Metabolically Obese Normal Weight (MONW))

  • 강현주
    • 보건교육건강증진학회지
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    • 제26권2호
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    • pp.149-155
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    • 2009
  • Metabolically obese but normal weight(MONW) syndrome is characterized, with potentially increased risks for development of the insulin resistance or metabolic syndrome despite their normal body mass index(BMI) < 25 kg/m2. Such characteristics could confer upon MONW individuals a type 2 diabetes mellitus and cardiovascular diseases(CVD) risk however, research on MONW is scarce. MONW individuals have metabolic disturbances typical of obese persons and are identified by having a high amount of visceral fat, a low BMI, a high fat mass, a low lean body mass, low insulin sensitivity, and high triglyceride concentrations. The purpose of this study is to review several markers as potential modulators in individuals displaying the "MONW". Body fat appears to be functionally comparable with a dynamic endocrine organ, producing and secreting various adipocy tokines, such as leptin, adiponectin, CRP, tumor necrosis factor(TNF-), interleukin(IL)-6, all of which play an important role in the onset of cardiovascular disease, and insulin resistance. Otherwise, physical activity and a lower inflammation state might be helped to reduce the number of persons at risk of diabetes, CVD complications, or premature mortality. We should provide a method to optimal treatments resolving the emerging public health problem to prevention of MONW by providing guideline for physical activity as an optimal treatment for the MONW Korean. Furthermore we expect to develop a new strategy to manage MONW Korean in this society in terms of reducing medical costs and enhancing public health care for uprising population with MONW.

The Investigation of Risk Factors Impacting Breast Cancer in Guilan Province

  • Joukar, Farahnaz;Ahmadnia, Zahra;Atrkar-Roushan, Zahra;Hasavari, Farideh;Rahimi, Abbas
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권10호
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    • pp.4623-4629
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    • 2016
  • Introduction: Breast cancer is multifactorial therefore more recognition of risk factors is important in its prevention. Objective: This study was conducted in order to determine the factors influencing breast cancer in women referred to health centers in Guilan province in 2015-2016. Method: In a case- control study, 225 women with breast cancer were investigated. The control group consisted of 225 healthy women of the relatives (third-rank) whose phone numbers were obtained from the patients. Data were collected through telephone interviews. Results: The risk of breast cancer raised in women who have a family history of other cancers (OR= 3.5; 95% CI= 1.96-6.6), exposure to X-Ray (OR= 2.5; 95% CI=1.1-5.5), having more than 4 children (OR= 2.695% CI=1.2-4.8), age more than 36 years at first pregnancy(OR=2.3; 95% CI=0.7-5.1),primary levelof education (OR= 5.4;95% CI=2.8-11.2) and inadequate intake of fruit (OR=1.5; 95% CI=1-2.2). Also, presence of the following factors reduced breast cancer risk: regular menstruation (OR= 0.66; CI=0.4-0.9), duration of breastfeeding more than 12 months, less than 6 months and 7-12 months (OR=0.23; 95% CI=0.09-0.59, OR=0.29; 95% CI=0.17-0.49 and OR=0.03; 95% CI=0.01-0.08) and parity (OR=0.4; 95% CI=0.27-0.83) In multiple linear regression analysis of higher education (OR=0.16; 95% CI=0.03-0.77), using contraceptives for more than 16 years (OR=2.3; 95% CI=1.4-3.9), family history of other cancers (OR=6.1; 95% CI=1.9-19.3) and a history of X-Ray exposure (OR=4.4; 95% CI=1.07-18.1) were considered as predictive factors. Conclusion: The results of this study emphasize the importance of informing women about breast cancer risk factors. So, identification of these risk factors is required as important means of prevention and treatment of breast cancer.

후두전적출술후 기관공재발의 위험요소 분석 (An Analysis of Risk Factors in Stomal Recurrence after Total Layngectomy)

  • 박지훈;김형진;오병훈;최건;정광윤;최종욱
    • 대한기관식도과학회지
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    • 제6권1호
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    • pp.80-86
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    • 2000
  • Background : Stomal recurrence that occasionally follows total laryngectomy is associated with very poor prognosis regardless of treatment modality, so it is very important to identify high risk patients to prevent stomal recurrence. Objectives : We attempted to select an optimal management method to prevent stomal recurrence by analyzing risk factors in each patient who was found to have stomal recurrence following total laryngectomy. Materials and Methods : Risk factors in each of eleven patients who had stomal recurrence out of 159 patients who underwent total laryngectomy in the last ten years were analyzed retrospectively. Data were gathered on risk factors such as the presence of subglottic extension, extralaryngeal extension, thyroid gland invasion, lymph node metastasis, timing of tracheotomy, tumor stage, postoperative radiotherapy, and inclusion of the stoma in the radiotherapy field. Results : There were eight cases of subglottic extension, six cases of extralaryngeal invasion, one case of pharyngocutaneous fistula that occurred as a postoperative complication, and one case who was taken completion laryngectomy following conservation surgery. With the exception of one case who was taken tracheotomy prior to total laryngectomy, all tracheotomies were performed intra-operatively after endotracheal intubation. There was no evidence of paratracheal lymph node or prelaryngeal lymph node metastasis on preoperative neck CT scan. There were six cases of T4 tumors, four cases of T3 tumors, and one case of T2 tumor. Salvage surgery was performed following radiotherapy in three cases, and aside from one case who was not taken post-operative radiotherapy, postoperative radiotherapy including the stoma was performed in the remaining seven cases within one month after surgery. Conclusion : Total laryngectomy with wide paratracheal lymph node dissection, thyroidectomy, and tracheotomy should be performed for patients who have high risk factors such as subglottic extension and advanced stage. We believe that tracheotomy should be precede endotracheal intubation. Efforts should be made to prevent stomal recurrence by utilizing postoperative radiotherapy and by minimizing postoperative complications such as infection and fistula.

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코로나19 백신접종이 사회적 거리두기 효과에 미치는 영향분석 (The Effect Analysis of COVID-19 vaccination on social distancing)

  • 문수찬
    • 한국융합학회논문지
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    • 제13권2호
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    • pp.67-75
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    • 2022
  • 이 연구의 목적은 현재 운영되고 있는 코로나19 예방을 위한 거리두기 체계의 과학적 근거 보완으로 적절한 관리방안을 제시하고자 함이다. 현재의 수리 모델들은 연립 상미분방정식으로 표현되어 소상공인이나 영세업자들의 출입자 관리에 사용하기는 어려운 문제가 있다. 본 고에서는 이러한 점을 보완하기 위하여 집합 공간에 주어지는 허용위험도와 기초감염재생산지수, 백신접종에 의한 위험도 감소율을 고려하여 집합하는 사람들에 의한 감염위험도를 정량적으로 표현하는 방법을 제시하였다. 백신접종 상황(미접종, 1차 접종, 완전 접종)에 따른 감염 위험성 정도와 바이러스의 유행상황을 함께 고려하여 방문자의 집합에 따른 감염자 발생 가능성을 확률론적인 차원에서 관리하는 간단한 정량적 모델을 개발하였다. 모델을 사용하여 주어진 예에서 20%의 미접종자가 완전 접종으로 전환될 경우 위험도는 55% 수준으로 감소되는 것을 보였고, 기초 감염재생산지수와 백신접종에 의한 감염위험도 감소 개선 효과를 비교하여 의학적인 관리보다 방역 측면에서의 관리가 더 큰 효과를 얻을 수 있다는 점을 제시하였다. 이를 바탕으로 백신의 종류와 확진자 발생 정도를 고려한 다양한 상황에서 적용할 수 있는 일반화 모델도 제시하였다. 이 모델을 적용하면 백신의 종류, 접종 정도, 접종 후 시간 경과에 따른 실시간 개인별 위험도를 산출할 수 있고, 이를 통해 주어진 공간의 집합 인원에 따른 위험도 관리에 이용할 수 있다.

Profiling Total Viable Bacteria in a Hemodialysis Water Treatment System

  • Chen, Lihua;Zhu, Xuan;Zhang, Menglu;Wang, Yuxin;Lv, Tianyu;Zhang, Shenghua;Yu, Xin
    • Journal of Microbiology and Biotechnology
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    • 제27권5호
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    • pp.995-1004
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    • 2017
  • Culture-dependent methods, such as heterotrophic plate counting (HPC), are usually applied to evaluate the bacteriological quality of hemodialysis water. However, these methods cannot detect the uncultured or viable but non-culturable (VBNC) bacteria, both of which may be quantitatively predominant throughout the hemodialysis water treatment system. Therefore, propidium monoazide (PMA)-qPCR associated with HPC was used together to profile the distribution of the total viable bacteria in such a system. Moreover, high-throughput sequencing of 16S rRNA gene amplicons was utilized to analyze the microbial community structure and diversity. The HPC results indicated that the total bacterial counts conformed to the standards, yet the bacteria amounts were abruptly enhanced after carbon filter treatment. Nevertheless, the bacterial counts detected by PMA-qPCR, with the highest levels of $2.14{\times}10^7copies/100ml$ in softener water, were much higher than the corresponding HPC results, which demonstrated the occurrence of numerous uncultured or VBNC bacteria among the entire system before reverse osmosis (RO). In addition, the microbial community structure was very different and the diversity was enhanced after the carbon filter. Although the diversity was minimized after RO treatment, pathogens such as Escherichia could still be detected in the RO effluent. In general, both the amounts of bacteria and the complexity of microbial community in the hemodialysis water treatment system revealed by molecular approaches were much higher than by traditional method. These results suggested the higher health risk potential for hemodialysis patients from the up-to-standard water. The treatment process could also be optimized, based on the results of this study.

The Variable Ellipsoid Modeling Technique as a Verification Method for the Treatment Planning System of Gamma Knife Radiosurgery

  • Hur, Beong-Ik;Choi, Byung-Kwan;Sung, Soon-Ki;Cho, Won-Ho;Cha, Seung-Heon;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • 제47권2호
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    • pp.128-133
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    • 2010
  • Objective : The secondary verification of Leksell Gamma Knife treatment planning system (LGP) (which is the primary verification system) is extremely important in order to minimize the risk of treatment errors. Although prior methods have been developed to verify maximum dose and treatment time, none have studied maximum dose coordinates and treatment volume. Methods : We simulated the skull shape as an ellipsoid with its center at the junction between the mammillary bodies and the brain stem. The radiation depths of the beamlets emitted from 201 collimators were calculated based on the relationship between this ellipsoid and a single beamlet expressed as a straight line. A computer program was coded to execute the algorithm. A database system was adopted to log the doses for $31{\times}31{\times}31$ or 29,791 matrix points allowing for future queries to be made of the matrix of interest. Results : When we compared the parameters in seven patients, all parameters showed good correlation. The number of matrix points with a dose higher than 30% of the maximal dose was within ${\pm}\;2%$ of LGP. The 50% dose volume, which is generally the target volume, differs maximally by 4.2%. The difference of the maximal dose ranges from 0.7% to 7%. Conclusion : Based on the results, the variable ellipsoid modeling technique or variable ellipsoid modeling technique (VEMT) can be a useful and independent tool to verify the important parameters of LGP and make up for LGP.