• Title/Summary/Keyword: Therapeutic range

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Comparison of Two Methods for Heparin Sensitivity; Activated Partial Thromboplastin Time Assay using in vitro Heparin-spiked Sample and Anti-Xa Assay using in vivo Heparin-treated Sample

  • Koo, Bon-Kyung;Kwon, Eui-Hoon;Ryu, Kwang-Hyun;Yun, Jae-Won;Kim, Hee-Jin
    • Korean Journal of Clinical Laboratory Science
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    • v.43 no.4
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    • pp.133-137
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    • 2011
  • The monitoring of heparin therapy is using almost aPTT assay. This study is compare to estimating aPTT therapeutic range using in vitro heparin-spiked sample and aPTT therapeutic range using in vivo heparin-treated sample. Normal pooled plasma was collected from 20 healthy representative individuals. 11 concentration of heparinized plasmas from 0 U/mL to 1.0 U/mL at intervals of 0.1 U/mL made by addition of heparin to normal pooled plasma were measured aPTT. The aPTT therapeutic range was performed through correlation analysis between heparin level 0.2 to 0.4 U/mL and aPTT. 30 plasmas from patients on heparin therapy were measured aPTT and anti-Xa activity. The aPTT therapeutic range was performed through correlation analysis between anti-Xa activity 0.3 to 0.7 U/mL and aPTT. The aPTT therapeutic range corresponded by heparin level-vs-aPTT value regression analysis was 60.7 to 102.4 seconds. The aPTT therapeutic range corresponded by anti-Xa activity-vs-aPTT value regression analysis was 85.3 to 147.5 seconds. The validation of heparin sensitivity using in-vitro heparin sample was not considered. The establishing aPTT therapeutic range is recommended anti-Xa activity using in-vivo sample.

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Effects of Kinesiotape on Range of Motion and Pain in Frozen Shoulder Patients (동결견 환자에 대한 키네시오 테이프 적용이 관절가동범위 및 통증에 미치는 영향)

  • Yu, Byong-Kyu;Oh, Kyung-Hwan;Lee, Jae-Gab
    • Journal of Korean Physical Therapy Science
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    • v.8 no.1
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    • pp.869-877
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    • 2001
  • This study was performed to assess the efficacy of Kinesiotape for the frozen shoulder patients. The subjects of this study were 17 patients with frozen shoulder who visited the out-patient department of the physical therapy, Pyongchon Sacret Heart Hospital, Hallim University, from July. 3, 2000 through August 12, 2000. To find out the effect of kinesiotape therapy, we sampled 8 patients treated with electrotherapy and therapeutic exercise (control group), and 9 patients treated with electrotherapy and therapeutic exercise with kinesiotape(experimental group). All patients were treated 3 days a week for 5 weeks. The results after 5-week treatment, compared with before treatment, were as follows: 1. The increase in range of motion in the electrotherapy and therapeutic exercise with kinesiotape after 5-week treatment was very significant(p<0.01). 2 The increase in range of motion in the electrotherapy and therapeutic exercise after 5-week treatment was significant (p<0.05). 3. The pain of decrease in the electrotherapy and therapeutic exercise with kinesiotape after 5-week treatment was very significant (p<0.01). 4. The pain of decrease in the electrotherapy and therapeutic exercise with kinesiotape 5-week treatment was significant(p<0.05). 5. The electrotherapy and therapeutic exercise with kinesiotape was more effective in increasing the range of motion on shoulder than the electrotherapy and therapeutic exercise after 5-week treatment(p<0.01). 6. The pain of decrease in between electrotherapy. therapeutic exercise with kinesiotape electrotherapy and therapeutic exercise after 5-week treatment was no significant.

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Evaluation of Peri-procedural Warfarin Therapy Undergoing Cardioversion in Patients with Atrial fibrillation (심방세동 환자의 심율동전환 시행 전·후 warfarin 치료의 적절성 평가)

  • Moon, Jung-Yeon;Kim, Bo-Ram;Jo, Eun-Jung;Cho, Yoon-Sook;Han, Hyun-Joo;Choi, Eue-Keun
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.201-206
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    • 2016
  • Objective: Direct current cardioversion for atrial fibrillation could be associated with the risk of thromboembolic events. Anticoagulation therapy with warfarin (INR 2.0-3.0) is recommended 3 weeks before and 4 weeks after cardioversion to reduce the risk of thromboembolism. This study evaluated warfarin therapy in pharmacist-managed anticoagulant services (ACS). Methods: This retrospective study was performed in 106 patients with atrial fibrillation from 2012 to 2013. The primary efficacy endpoint was the composite of stroke, transient ischemic attack, myocardial infarction, and cardiovascular death. The primary safety measure was major bleeding. To evaluate the peri-procedural effects of warfarin treatment, we studied whether target INR was maintained, as well as the maintenance period of the therapeutic range. Quality of treatment was measured by time in therapeutic range (TTR) by using the Rosendaal method. Results: There were no thromboembolic events, but TEE examination at time of cardioversion showed a left atrial thrombus in three patients (2.8%). Bleeding complications after cardioversion occurred in 2 patients (1.9%). The average INR value at the time of cardioversion was $2.59{\pm}0.8$, and was within the therapeutic range in 83 patients (78%). Analysis of the patients in whom the value was within the therapeutic range twice consecutively showed that the ratio of TTR was 80% and the therapeutic range was maintained in 67 patients (63%) for an average of 4.90 weeks prior to cardioversion. Similarly, 76 patients (72%) had a stable INR within the therapeutic range for an average of 5.70 weeks and a mean TTR of 83%. Conclusion: Pharmacists significantly contributed to appropriate warfarin treatment with close monitoring during cardioversion. Likewise, active pharmacist monitoring and systemic management should be considered to reduce thromboembolism and bleeding complications in the peri-cardioversion period.

The Effect of Therapeutic Massage and Mckenzie Exercise on Pain and Range of Motion in Chronic Neck Pain Patient: a Case Study (치료적 마사지와 맥켄지 운동이 만성 경부통 환자의 통증과 관절가동범위에 미치는 영향: 단일사례연구)

  • Lee, Seong-Jin;Oh, Hwan-Hee;Chae, Ji-Su;Kwon, Nam-Il;Park, Do-Yeon;Kwon, Hyo-Joo;Chung, Eun-Jung
    • Journal of Korean Physical Therapy Science
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    • v.24 no.2
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    • pp.61-70
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    • 2017
  • Purpose : The purpose of this study was to examine the effect of therapeutic massage and Mckenzie exercise on pain and range of motion in chronic neck pain patient: a case study. Method : A Twenty-year old female subject with chronic neck pain was selected, she received therapeutic massage and Mckenzie exercise for 30 minutes a day, three days a week for five weeks. Pain was measured visual analog scale(VAS), neck disability index(NDI) and the Copenhagen neck functional disability scale (CNFDS). Range of motion was measured using a goniometer(shoulder joint) and the CROM Deluxe(cervical range of motion instrument). Result : VAS, NDI and CNFDS were decreased 3 score, 4 score and 6 score(respectively) than before the training. The range of motion was increased in shoulder joint and neck movement than before the training. Conclusion : The massage and Mckenzie exercise increased range of motion in shoulder joint and neck movement, and decreased neck pain in chronic neck pain patient. Additional research on therapeutic massage and Mckenzie exercise for improving pain and range of motion is need.

Effects of Therapeutic Exercise on Pain, Range of Motion, Strength and Balance Ability in a Patient with Anterior Ankle Impingement: A Case Study (치료적 운동이 앞 발목 충돌 증후군 환자의 통증, 관절가동범위, 근력 및 균형능력에 미치는 영향: 증례보고)

  • Park, Sang-Ho;Kim, Ah-Ram;Yoo, Kyung-Tae;Lee, Ho-Seong
    • Journal of the Korean Society of Physical Medicine
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    • v.11 no.4
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    • pp.93-103
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    • 2016
  • PURPOSE: The purpose of this study is to determine the effect of therapeutic exercise on pain, range of motion and strength, and balance ability in a patient with an anterior ankle impingement (AAI). METHODS: A-32-year-old male presented limited ankle motion and pain with forced dorsiflexion at both ankle joints. In response, a therapeutic exercise program consisted of ankle joint mobilization, strength exercises using an elastic band, and proprioceptive exercises including semi-squats and a one-legged standing exercise with open and closed eyes. The program was performed for 40 min/day, twice per week, for 8 weeks. Pain, range of motion (ROM), and muscle strength (ankle dorsiflexion, plantarflexion, inversion, and eversion), as well as a one-legged standing test of both ankles, were measured before and after 4 and 8 weeks of therapeutic exercise. RESULTS: VAS decreased in both ankles after 8 weeks of exercise, respectively, compared to baseline levels. Range of motion and strength increased in both ankles for dorsiflexion, plantarflexion, inversion, and eversion after 8 weeks of exercise compared to baseline levels. In addition, the ability to perform a one-legged standing test with eyes opened and closed improved in both legs after 8 week of exercise compared to baseline levels. CONCLUSION: These results suggest that therapeutic exercise improves pain, ROM, muscle strength, and balancing ability in patients with AAI.

A Daylighting Design Indicator for Korean Dementia Nursing Homes Based on the Therapeutic Effects of Light - Focusing on maximizing daylight availability, optimizing therapeutic views, and minimizing glare (빛에 의한 치료적 효과 기반의 한국형 치매요양시설의 자연채광 계획지표 개발 - 주광 가용성 최대화, 치료적 조망 최적화 및 현휘 최소화 지표 중심으로)

  • Jee, Soo In
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.29 no.1
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    • pp.29-42
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    • 2023
  • Purpose: This study aimed to develop a daylighting design indicator for Korean dementia nursing homes based on the therapeutic effects of light, focusing on the serious aging index facing Korea and the importance of natural light that occupies the most important position in the therapeutic environments for the elderly with dementia. Methods: A wide range of literature-oriented research methods were mobilized to develop the daylighting design indicator of Korean dementia nursing homes. Results: The daylighting design indicator of Korean dementia nursing homes was derived from three perspectives: maximizing daylight availability, optimizing therapeutic view, and minimizing glare. In addition, eighteen basic indicators were derived within seven indicator items in the range of building layout, windows, glazing, shading devices, spaces, interior finishings, and daylight factor. Implications: The daylighting design indicator of Korean dementia nursing homes revealed in this study will contribute to realizing Korean dementia nursing homes as a therapeutic environment for the elderly with dementia.

Studies on Therapeutic range, Symptom, Pathology, and composition of Polygala tenuifolia-main blended Prescriptions from Donguibogam (동의보감(東醫寶鑑)에 수록된 원지(遠志)가 주약(主藥)으로 배오(配伍)된 처방(處方)의 방제학적(方劑學的) 고찰(考察))

  • Kim Young-Bok;Yun Young-Gab
    • Herbal Formula Science
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    • v.10 no.1
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    • pp.33-39
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    • 2002
  • There are total 33 prescriptions containing Polygala tenuifolia as a principal medicine in Donguibogam. This report describes the studies on therapeutic range, symptom, pathology and composition of 33 Polygala tenuifolia-main blended Prescriptions from Donguibogam. The percentage of Polygala tenuifolia-main blended prescriptions for the therapeutic range are as follows: psychopathy is the most frequent(54.4%) and eczema, purulent inflammation is second(21%) and feebleness is third(15%). The main pathologies of Polygala tenuifolia-main blended prescriptions are associated with heart, kidney and stomach. The main combinations of Polygala tenuifolia-main blended prescriptions in psychopathy are Jeongji-hwan and Chongmyung-tang.

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Clinical and Economic Benefit Evaluation of Therapeutic Drug Monitoring Service on Vancomycin (반코마이신의 임상약동학 모니터링 서비스에 대한 임상적 및 경제적 손익의 평가)

  • Bae, S. M.;Ann, H. L.;Hong, K. J.;La, H. O.;Cho, H. K.
    • Korean Journal of Clinical Pharmacy
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    • v.11 no.1
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    • pp.1-6
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    • 2001
  • This research is conducted to evaluate the clinical and economic benefits from therapeutic drug monitoring(TDM) service on vancomycin in a tertiary general hospital. Total 99 pairs of steady state peak and trough concentrations of vancomycin were obtained from 73 patients. To see the clinical benefits, the appropriateness of vancomycin dosing before TDM was evaluated. In 72 pairs of vancomycin blood concentrations obtained prior to TDM consultation, $47.2\%$ of the cases had reached within therapeutic range. Serum vancomycin levels in patients with $40{\leq}CLcr<60$ (ml/min) were higher and than the levels in patients with 40>CLcr and $60{\leq}CLcr$ (ml/min). Dose reduction rate in patients with creatinine clearance $40{\leq}CLcr<60$ (ml/min) were also significantly higher than those of compared groups ($61.5\%$, p=0.0138). Serum vancomycin concentrations were re-obtained from 21 patients who received modified dose through TDM service. Ninety percent (19/21cases) of them were within the target therapeutic range. For the evaluation of economic benefits from TDM consultation, estimated cost savings were calculated in those patients. The total drug saving were 586 vials in 21 patients. The calculated mean cost saving from the drugs was 314,570 won (range: $11,273\sim473,466)$ per patient. The study revealed that TDM service for vancomycin is necessary because empirical dosing is not effective for obtaining therapeutic drug level, especially patients with mild renal insufficiencies. The cost saving from TDM is also beneficial for the patients.

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Effects of Therapeutic Exercise on Hip Joint Range of Motion, Manual Muscle Test, Functional Movement Screen and Radiological Evaluation in a Youth Football Player with Football-specific Anterior Pelvic Tilt: A Case Report (치료적 운동이 축구 특이적 골반 앞 기울임을 가진 유소년 축구선수 엉덩관절의 관절가동범위, 도수근력, 기능적 움직임 및 방사선학적 평가에 미치는 영향: 증례보고)

  • Yu, Dong-Hun;Seo, Sang-Won;Lee, Ho-Seong
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.4
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    • pp.85-94
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    • 2018
  • PURPOSE: This study was conducted to determine the effects of therapeutic exercise on range of motion (ROM), the manual muscle test (MMT), functional movement screen (FMS) and radiological evaluation in a youth football player with football-specific anterior pelvic tilt (APT). METHODS: The subject of this case report was a 12-year-old youth football player, who presented with football-specific APT. Therapeutic exercise consisted of hamstring stretch, prone hip extension, abdominal crunch, bridging with isometric hip abduction, plank exercise with posterior tilt and posterior pelvic tilting exercise using a swiss-ball for 40 min/day, twice a week for 8-weeks. ROM, MMT, FMS (deep squat, hurdle step, inline lunge, shoulder mobility, active straight-leg raise, rotary stability and trunk stability push-up) and radiographs (lumbar lordotic and sacral horizontal angle) were analyzed before and after week 8 of therapeutic exercise. RESULTS: The ROM, MMT, and FMS increased and the lumbar lordotic angle and sacral horizontal angle improved after 8-weeks of therapeutic exercise. CONCLUSION: The results of this case report suggest that therapeutic exercise improves ROM, MMT and radiography associated parameters in youth football players with football-specific APT. These findings have clinical implications for therapeutic exercise in youth football players with football-specific APT.

A Study on the Therapeutic Shoes for Diabetic Patients (당뇨병 환자의 치료용 신발에 대한 연구)

  • Lee, Woo-Chun;Park, Sung-Sik
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.16-21
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    • 2004
  • Purpose: To investigate the characteristics of the patients and therapeutic shoes for diabetic patients. Materials and Methods: Forty two diabetic patients who had their own therapeutic shoes which were prescribed somewhere else were studied from March 2003 to December 2003. There were 27 males and 15 females, and the mean age was 62.1 years (range, 49-72 years). Duration of diabetes was average 14 years (range, $6{\sim}30$ years), all had type 2 diabetes. Sensation was examined with 5.07 nylon monofilament. The route of purchasing the shoes, compliance to the prescribed shoes were investigated by interview. The shape of shoe, stiffness of upper, conformity of insole to the shape of the foot were recorded. In-shoe plantar pressure was measured in 15 patients. Results: Eighteen patients were insensate to the monofilament. Seven patients did not wear the therapeutic shoes, and only 18 of 35 patients were wearing the therapeutic shoes more than 6 hours a day. The shoes of 17 patients were prescribed by medical doctor and the rest were purchased by the recommendation of acquaintances or advertisement. Ulcer recurred in four of five patients to whom the shoe was prescribed by medical doctor and the cause of three recurrences were evident by just observing the foot and shoe. The therapeutic shoes were made from 11 different makers. Eight shoes were adequate for diabetic patients with respect to the material, shape of insole, type of shoe. In-shoe plantar pressure was examined in 15 patients and was less than 300 kPa in all patients. Conclusion: The therapeutic shoes for the diabetic patients need to be prescribed by medical doctor for selective patients with neuropathy or previous history of ulcer and follow-up examination is important to monitor the compliance of the patients and adequacy of the shoes.

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