• 제목/요약/키워드: Therapeutic range

검색결과 629건 처리시간 0.024초

기계판막을 갖고있는 임산부에서 항응고요법 (Anticoagulant Therapy in Pregnant Women with Mechanical Cardiac valve Prostheses)

  • 최순호;고광표;한재오;최종범;김경호
    • Journal of Chest Surgery
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    • 제33권6호
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    • pp.502-506
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    • 2000
  • Background: Anticoagulant therapy can be required during pregnancy with prosthetic heart valves. Warfarin and heparin provide real protection against thromboembolic phenomena, but they also carry serious risks for the fetus and the mother. In an attempt to identify the best treatment for pregnant women with cardiac valve prostheses who are receiving anticoagulant, we studied 19 pregnancies, the warfarin was discontinued and heparin was administered every 12 hours by subcutaneous injection in doses adjusted to keep the midinterval aPTT in the therapeutic range(at least 2-2.5 control) from the conception to the 12th week of gestation and oral antiocagulant was then administered until the middle of the third trimester in the therapeutic range(at least 2 INR), and heparin therapy was restared until delivery. Also in order to avoid an anticoagulant effect during delivery, it has been our practice to instruct women to either discontinue their heparin injections with the onset of labur or to stop heparin injections 12 hours prior to the elective induction of labour. Result: The outcome of 19 pregnancies managed with above protocol was spontaneous abortion in 3 cases, voluntary termination in 2 cases, premature delivery at 35 weeks in 1 case and delivery at full-term in 14 cases. There was no maternal morbidity and moratality and fetopathy. Conclusion: We conclude that in the second and third trimester of pregnancy, warfarin provide effective protection against thromboembolism, Oral antiocagulant therapy should be avoided in 2 weeks before delivery because of the risk of serious perinatal bleeding caused by the trauma of delivery to the anticoagulated fetus. However, the substitution of heparin at first trimester and 2 weeks before delivery reduce the incidence of complications.

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Brachytherapy of Uveal Melanomas with Ruthenium-106 Plaques

  • Belaid, Asma;Nasr, Chiraz;Jmour, Omar;Cherif, Aziz;Kochbati, Lotfi;Bouguila, Hedi;Besbes, Mounir;Benna, Farouk
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권12호
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    • pp.5281-5285
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    • 2016
  • Background: Brachytherapy is the most commonly used conservative treatment for the uveal melanoma. The aim of this study was to evaluate therapeutic results of Ruthenium-106 plaque brachytherapy in the management of localized uveal melanoma cases. Methods: We reviewed retrospectively the clinical records of all patients treated in our department for an uveal melanoma, undergoing Ruthenium-106 plaque brachytherapy, from January 1996 to December 2015. We focused on clinical features, therapeutic characteristics, local and distant tumor control and side effects. Results: Nineteen patients were enrolled in our study. Mean age was 56.2 years (28-79) and the sex ratio was 1.37:1 males to females. Diagnosis was made on the basis of ophthalmological clinical examination, angiography, ultrasound and/or magnetic resonance. Median tumor diameter was 9.7 mm (6-13) and median thickness 4.4 mm (2.5-8). The dose of Ruthenium-106 plaque brachytherapy prescribed to the apex of each tumor was 70 Gy in all cases. The median radiation dose to the sclera surface was 226.4 Gy (range: 179.6-342.3) and the median total application time 115.2 hours (range: 27 to 237). After a median follow-up of 61.5 months, local control was achieved in 17 patients (89%): 16 demonstrated a partial tumor response and 1 tumor stabilization. Two patients suffered local progression leading to enucleation, one dying of hepatic metastasis. Radiation-induced complications were cataracts in 3 cases and vitreal hemorrhage in 2. Conclusion: Ruthenium-106 plaque brachytherapy is an efficient treatment for localized uveal melanoma, offering good local control with low toxicity.

경부근막동통증후군 환자에게 근막이완요법과 초음파치료의 비교 (A Comparison of Myofascial Release and Ultrasound in Patients with Myofascial Pain Syndrome on Neck)

  • 김종우;현상욱;서현규
    • 대한정형도수물리치료학회지
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    • 제15권2호
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    • pp.15-24
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    • 2009
  • Objectives : The purpose of this study is to compare the effectiveness between myofascial release technique and ultrasound in subjects with myofascial pain syndrome. Method : Twenty subjects with myofascial pain syndrome were randomly assigned to a myofascial release technique group(n=10) or an ultrsound group(n=10). The Cervical Range of Motion(C-ROM) instrument was used to measure cervical range of motion. Electromyography(EMG) was used to measure muscle power sternocleidomastoid and upper trapezius. Result : The result of this study shows there were no significant differences in ROM increase and muscle power increase between the myofascial release technique group and the ultrasound group. In the group with Myofascial Release Technique, the average score was $61.40{\pm}11.12$ in SCM flexion of C-ROM and $127.87{\pm}4.24$ in Rt. upper trapezius extension of EMG. In the group with ultra sound, the average score was $68.60{\pm}10.02$ in SCM flexion of C-ROM and $131.50{\pm}5.45$ in Rt. upper trapezius extension of EMG. Conclusion : The results suggest that there was no significant difference between two therapeutic techniques.

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위 등세모근에 적용한 근육 에너지 기법이 목 신경뿌리병증 환자의 통증, 관절가동범위 및 근수행력에 미치는 영향 (The Effects of Muscle Energy Techniques Applied to Upper trapezius on Pain, Range of Motion and Muscle Performance in Patients with Cervical Radiculopathy)

  • 홍진기;김영민
    • 대한정형도수물리치료학회지
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    • 제30권1호
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    • pp.15-27
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    • 2024
  • Background: This study examined the effects of the muscle energy technique and cervical traction after applying conservative physical therapy to patients with cervical radiculopathy. Methods: Twenty-six patients with cervical radiculopathy were randomized into two groups: the experimental group (n=13) and the control group (n=13). The two groups performed the muscle energy technique and for 4 weeks, 3 times a week, in 70-minute sessions. Pain, range of motion, function, and muscle performance were assessed using the visual analogue scale (VAS), cervical range of motion (CROM) goniometer, neck disability index (NDI), and stabilizer pressure biofeedback, before and after training. Results: After four weeks of therapy, the VAS (p<.001), NDI (p<.01), and the maximum strength of the deep neck flexion muscles significantly decreased (p<.01) and CROM significantly increased in both groups (p<.05). Conclusion: The muscle energy technique and therapeutic modalities such as cervical traction are effective in reducing VAS and NDI and increasing CROM and muscle performance in patients with cervical radiculopathy.

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응급실 간호사-환자 상호작용 행위 (Emergency Nurse-Patient Interaction Behavior)

  • 김은정
    • 대한간호학회지
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    • 제35권6호
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    • pp.1004-1013
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    • 2005
  • Purpose: The main purpose of this study was to explore nurse-patient interaction behaviors and patient satisfaction with the interaction in the emergency department. Method: This study used video technology to record complete conversations between the nurse and patient, thus obtaining the interactions naturally occurring in a clinical setting. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data was collected from November, 2002 to April, 2003. The video recordings were observed for 4 hours for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS), which yields frequencies of thirty-six types of interaction behaviors. Result: The information exchange related to therapeutic items including medications, simple orientation, and situational positive talk were characterized in the nurses' interaction behaviors. Giving information about one's own condition, questions about therapeutic regimen, and showing worry were characterized in patient interaction behaviors. The patients' satisfaction with the interaction was 37.75.9 (range 9-45). Conclusion: The emergency nurse-patient interaction behavior was task-related. The results suggest that identification of effective interaction behavior in the Emergency department and an interaction skill training program could increase patient satisfaction.

기무라병의 임상특성과 치료성적 (Kimura's Disease - Clinical Characteristics and Treatment Outcomes -)

  • 홍순기;최진섭;박정수
    • 대한두경부종양학회지
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    • 제10권1호
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    • pp.7-12
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    • 1994
  • The clinical features and treatment outcomes of 20 patients with Kimura's disease treated from 1981 to 1993 were analyzed to determine proper therapeutic modalities. The mean age was 36.3 yrs old (range l4-53yrs) and the male to female ratio was 1.5:1 (male:female=12:8). Among 20 patients, 13 had multiple lesions and the remaining 7 had single lesion. Almost all lesions were found in the head and neck area(41 lesions) and only 7 in the other sites. The initial treatment modalities were excision, excision with immunotherapy, radiotherapy with immunotherapy, or immunotherapy(steroid, azathioprine). Among 17 patients who could be followed up, a recurrent or persistent disease was found in 13 patients. The retreatment modalities for patients with recurrent lesions were excision, excision with immunotherapy, or immunotherapy. The retreatment outcomes were also disappointing. The proper therapeutic modality of the Kimura's disease is not established yet, but the radiotherapy after excision or immunotherapy seems to be more effective than others.

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비인강암의 수술적 치료 (Surgical Treatment of the Nasopharyngeal Carcinoma)

  • 이원상;전영명;최흥식
    • 대한두경부종양학회지
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    • 제12권1호
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    • pp.92-99
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    • 1996
  • The primary treatment of the nasopharyngeal carcinoma is at this time, mainly based on radiotherapy. In most studies for patient treated with radiotherapy, overall 5-year survival rate is in the range of 35 to 55%. Obviously, these therapeutic results may be influenced by various factors such as clinical stages, histopathological types and radiation techniques, etc. Though the radiotherapy had a good therapeutic result, there is a limitation to apply the radiotherapy only in cases of the advanced nasopharyngeal carcinoma. Anatomical complexity of the skull base and difficulties in complete surgical intervention were the trouble of the surgery but in the case of radiation failure, there is no adequate choice of other curative modalities. So it is appropriate to investigate whether surgical resection may improve the outcome of treatment of nasopharyngeal carcinoma. The purpose of this papaer is to report our surgical experience of the nasopharyngeal carcinoma, then to take into consideration of the new model of treatment strategy of nasopharyngeal carcinoma.

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요통 치료를 위한 경막외강내 스테로이드 투여의 장기 효과 (Therapeutic Duration of Epidural Steroid for Low Back Pain)

  • 최훈;황정한;이준례;김윤희;한영진
    • The Korean Journal of Pain
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    • 제11권2호
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    • pp.210-213
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    • 1998
  • Background: Epidural steroid therapy has been well-established for the treatment of sciatica and low back pain. Disappointing results following surgical decompression or discectomy have led to wide trials of corticosteroids injected either systemically or into the intraspinally. Although epidural steroid is known to be very effective in the treatment of the patients with low back pain, few data showed the therapeutic duration of epidural steroid. Methods: We studied 120 patients who were treated with epidural steroid for the treatment of low back pain or sciatica or both. We retrospectively analysed the duration of analgesia, number of injections per each session, and complications. Results: The duration of analgesia ranged from 17 days to 300 days, and the mean duration was $73.7{\pm}70.5$ (SD) days. The mean number of injections per each session was $1.8{\pm}1.3$ (range: 1 to 12). There were no significant complications with epidural steroid injections. Conclusions: One to three epidural steroid injections at one week interval leads more than two months of pain relief without significant complications.

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비인강암의 수술 치험 (Surgical Treatment of the Nasopharyngeal Carcinoma)

  • 이원상;전영명;윤정선
    • 대한두경부종양학회지
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    • 제9권2호
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    • pp.200-209
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    • 1993
  • The primary treatment of the nasopharyngeal carcinoma is, at this time, mainly based on radiotherapy. In most studies for patient treated with radiotherapy, overall 5-year survival rate is in the range of 35 to 55%. Obviously, these therapeutic results may be influenced by various factors such as clinical stages, histopathological types and radiation techniques, etc. Though the radiotherapy had a good therapeutic result, there is a limitation to apply the radiotherapy only in cases of the advanced nasopharyngeal carcinoma. Anatomical complexity of the skull base and difficulties in complete surgical intervention were the trouble of the surgery but in the case of radiation failure, there is no adequate cholice of other curative modalities. So it is appropriate to investigate whether surgical resection may improve the results of treatment of nasopharyngeal carcinoma. The purpose of this paper is to report the surgical experience with nasopharyngeal carcinoma, then to take into consideration of the new model of treatment strategy of nasopharyngeal carcinoma.

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Acid-sensing ion channels (ASICs): therapeutic targets for neurological diseases and their regulation

  • Kweon, Hae-Jin;Suh, Byung-Chang
    • BMB Reports
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    • 제46권6호
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    • pp.295-304
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    • 2013
  • Extracellular acidification occurs not only in pathological conditions such as inflammation and brain ischemia, but also in normal physiological conditions such as synaptic transmission. Acid-sensing ion channels (ASICs) can detect a broad range of physiological pH changes during pathological and synaptic cellular activities. ASICs are voltage-independent, proton-gated cation channels widely expressed throughout the central and peripheral nervous system. Activation of ASICs is involved in pain perception, synaptic plasticity, learning and memory, fear, ischemic neuronal injury, seizure termination, neuronal degeneration, and mechanosensation. Therefore, ASICs emerge as potential therapeutic targets for manipulating pain and neurological diseases. The activity of these channels can be regulated by many factors such as lactate, $Zn^{2+}$, and Phe-Met-Arg-Phe amide (FMRFamide)-like neuropeptides by interacting with the channel's large extracellular loop. ASICs are also modulated by G protein-coupled receptors such as CB1 cannabinoid receptors and 5-$HT_2$. This review focuses on the physiological roles of ASICs and the molecular mechanisms by which these channels are regulated.