• Title/Summary/Keyword: additional therapy

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Pressure Regulation System for Optimal Operation of the Pneumatic VAD with Bellows-Type Closed Pneumatic Circuit (벨로우즈 방식의 폐회로를 가진 공압식 심실 보조장치의 최적 작동을 위한 압력 조절 시스템)

  • Kim, Bum-Soo;Lee, Jung-Joo;Nam, Kyung-Won;Jeong, Gi-Seok;Ahn, Chi-Bum;Sun, Kyung
    • Journal of Biomedical Engineering Research
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    • v.28 no.4
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    • pp.569-576
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    • 2007
  • Ventricular Assist Device(VAD) has switched its goal from a short-tenn use for bridge-to-transplantation to a long-tenn use for destination therapy, With this goal, the importance of long-tenn reliability gets more interests and importances, H-VAD is an portable extracorporeal biventricular assist device, and adopts an electro-pneumatic driving mechanism. The pneumatic pressure to pump out blood is generated with compression of bellows, and is transmitted in a closed pneumatic circuit through a pneumatic line. The existing pneumatic VAD adopts a air compressor which can generate stable pressures but has defects such as a noise and a size problem. Thus, it is not suitable for being used as a portable device, These problems are covered with adopting a closed pneumatic circuit mechanism with a bellows which has a small size and small noise generation, but it has defects that improper pneumatic setting causes a failure of adequate flow generation. In this study, the pneumatic pressure regulation system is developed to cover these defects of a bellows-type pneumatic VAD. The optimal pneumatic pressure conditions according to various afterload conditions for an optimal flow rate were investigated and the afterload estimation algorithm was developed, The final pneumatic regulation system estimates a current afterload and regulate the pneumatic pressure to the optimal point at a given afterload condition. The afterload estimation algorithm showed a sufficient performance that the standard deviation of error is 8.8 mmHg, The pneumatic pressure regulation system showed a sufficient performance that the flow rate was stably governed to various afterload conditions. In a further study, if a additional sensor such as ultrasonic sensor is developed to monitor the direct movement of diaphragm in a blood pump part, the reliability would be greatly increased. Moreover, if the afterload estimation algorithm gets more accuracy, it would be also helpful to monitor the hemodynamic condition of patients.

Effects of Posttraumatic MgSO4 Injection and Hypothermia an Animal Model of Traumatic Brain Injury(TBI) (실험적 외상성 뇌손상모델에서 외상 후 저체온과 MgSO4의 효과)

  • Han, Seong Rok;Hyun, Dong Keun;Park, Chong Oon;Ha, Young Soo;Kim, Joon Mee
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1296-1302
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    • 2000
  • Objective : Traumatic brain injury including diffuse axonal injury has been shown to result in a decrease in brainfree magnesium concentration, an endogenous inhibitor of calcium entry into neuron, that is associated with the development of neurological motor deficits. The goal of this study is to establish the therapeutic window during which the therapy with $MgSO_4$ and/or hypothermia improve damaged neurons by TUNEL stain. Method : Moderate brain injury was induced in 64 adult Sprague-Dawley rats, weighing 350 to 450gm each, by using a simple weight-drop device(Marmarou model). The animals were randomly assigned to four groups(sixteen rats each, a control group, a group treated with $MgSO_4$, a group treated with hypothermia, and a group treated with $MgSO_4$ and hypothermia) and the rats in each group were sacrificed and studied after 12 hrs, 24 hrs, 1 wk, and 2 wks after insult. In hypothermic group, these rats were subjected to hypothermia after injury, with their rectal temperatures maintained at $32^{\circ}C$ for 1 hour. After 1-hour period of hypothermia, rewarming to normothermic level was accomplished over 30-minute period. In the groups treated $MgSO_4$, hypothermia and $MgSO_4$ were subsequently treated with $MgSO_4$($750{\mu}moles/kg$) infused intra-muscularly at 30 minutes after trauma. Result : In all treated groups, a significant reduction in TUNEL positive cells was found in comparison with the control group each time(p<0.001). Between treatment groups, No differnce was seen 12hrs, 24hrs, and 1wk. However, hypothermic group treated with or without $MgSO_4$ showed more significant reduction in apoptotic cells than group treated with $MgSO_4$ 2 weeks after trauma(p<0.05). However, hypothermic group treated with $MgSO_4$ showed no significant reduction in apoptotic cells compared with hypothermic group(p>0.05). Conclusion : These findings suggest that both hypothermia and $MgSO_4$ significantly improve pathological changes. Otherwise simultaneously $MgSO_4$ and hypothermia treatment groups is failed to provide additional neuroprotection. These results may be relevant to the design of future clinical trials of therapeutic hypothermia and $MgSO_4$ for traumatic brain injury.

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Is Target Oriented Surgery Sufficient with Borderline Ovarian Tumors? - Role of Accompanying Pathologies

  • Gungor, Tayfun;Cetinkaya, Nilufer;Yalcin, Hakan;Ozdal, Bulent;Ozgu, Emre;Baser, Eralp;Yilmaz, Nafiye;Caglar, Mete;Zergeroglu, Sema;Erkaya, Salim
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6749-6754
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    • 2014
  • Background: There are limited data in the literature related to concomitant genital or extra-genital organ pathologies in patients with borderline ovarian tumors (BOTs). The aim of this study was to evaluate our experience with 183 patients to draw attention to the accompanying organ pathologies with BOTs. Materials and Methods: One hundred eighty-three patients with BOTs, diagnosed and/or treated in our center between January of 2000 and March of 2013 were evaluated retrospectively. Data related to age, tumor histology, lesion side, disease stage, accompanying incidental ipsilateral and/or contralateral ovarian pathologies, treatment approaches, and follow-up periods were investigated. Incidental gynecologic and non-gynecologic concomitant organ pathologies were also recorded. Results: The mean age at diagnosis was 40.6 years (range: 17-78). Ninety-five patients (51%) were ${\leq}40$ years. A hundred and forty-seven patients (80%) were at stage IA of the disease. The most common type of BOT was serous in histology. Non-invasive tumor implants were diagnosed in 4% and uterine involvement was found 2% among patients who underwent hysterectomies. There were 12 patients with positive peritoneal washings. Only 17 and 84 patients respectively had concomitant ipsilateral and concomitant contralateral incidental ovarian pathologies. The most common type of uterine, appendicular and omental pathologies were chronic cervicitis, lymphoid hyperplasia and chronic inflammatory reaction. Conclusions: According to our findings most of accompanying pathologies for BOT are benign in nature. Nevertheless, there were additional malignant diseases necessitating further therapy. We emphasize the importance of the evaluation of all abdominal organs during surgery.

Reducing the waiting time of parkinson's patients in outpatient pharmacy by improving EMR and workflow (외래약국에서 파킨슨병 환자 투약대기시간 단축을 위한 전산 및 업무 흐름 개선)

  • Choi, Dan-Hee;Yim, Ji-Yoon;Lee, Yong-Hwa
    • Quality Improvement in Health Care
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    • v.20 no.1
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    • pp.28-40
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    • 2014
  • Objectives: Prescriptions for Parkinson's can be dispensed at the outpatient pharmacy. In general, the treatment of Parkinson's disease requires a multitude of drugs, sometimes taken 4 to 6 times a day at specific times as prescribed by the medical practitioner. Said "time-specific therapy" is one of the major reasons of dispensing delay observed at the outpatient pharmacy. Because our establishment lacked a computerized system to support time-specific prescriptions, they were not recognized electronically. They had to be issued and dispensed manually, which required a greater amount of time than the automated process. To solve the problem, a new sig code was developed to handle time-specific prescriptions with a comprehensive automated dispensing system to support it. This study aims to create electronic programs and streamline the process to increase dispensing performance. And thus, ensure greater patient safety and dispensing accuracy within a shorter dispensing time and also increase employee satisfaction through a decreased workload. Methods: After identifying the problems caused by non-electronic prescriptions an automated system that allowed the issuance of time-specific prescriptions was developed. A new sig code was created that could be recognized by the Pharmacy electronic medical program, the label printer to group medications by administration times and the Automatic Tablet Counter(ATC) to count the grouped drugs accordingly. Result: With the new sig code, the practitioner became able to electronically select the times of drug administration while issuing the prescription. This 'time-specific prescription' can now be recognized by the pharmacy electronic medical program, the label printer and the ATC like any other prescription. Conclusion: The developed program started operating on September 2013. Although not all Parkinson's patients have been issued with the new electronic 'time-specific prescription', the overall dispensing process has become more streamlined and accurate. As the medical team continues to integrate the new system in their practice an additional decrease of the dispensing time is predicted. Future program upgrades and other new time-saving approaches are scheduled, which are expected to further increase the service quality of our outpatient pharmacy.

Effects on the Psychosocial Health Status of Job Stress and Job-related Characteristics among Clerical Public Officers using the Structural Equation Model (구조방정식모형을 이용한 사무직 공부원의 직업관련 특성과 직무스트레스가 사회심리적 건강상태에 미치는 영향)

  • Cho, Young-Chae;Kwon, In-Sun;Bae, Nam-Kyou;Park, Jae-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.6
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    • pp.2169-2177
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    • 2010
  • The effects of job related factors on psychosocial health status were examined by taking job stress into account. The self-administered questionnaires were performed, during the period between Oct. 1st, 2009 and Nov. 30th, 2009, to 805 individuals in the service of general administration located in Daejeon City. Causal relationships between job related factors, job stress, and, psychosocial health status were examined by structural equation model. The main finding as follows: For correlations of such indices of psychosocial health status as PWI and MFS with various studied items, all of these two indices were found to be in a negative correlation with the job position, job career, satisfaction in job life, autonomy of job, supervisors support and coworkers support, whereas in positive correlation with the experience of sick absence per year and job demand. With the analysis of structural equation model, the degree of job stress factors was more influential on the level of psychosocial health status than job related factors in such a manner as that the greater the job stress, while the lower the job related factors, the higher the psychosocial health status(PWI and MFS). Moreover, it was found to have the inter-relational effects that the greater the job related factors, the lower the job stress factors. Thus the effective strategy for stress and fatigue symptoms reduction among governmental employees requires additional programs focusing on innovated job specifications.

Development and Evaluation of a Patient-Reported Outcome (PRO) Scale for Breast Cancer

  • Zhang, Jun;Yao, Yu-Feng;Zha, Xiao-Ming;Pan, Li-Qun;Bian, Wei-He;Tang, Jin Hai
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8573-8578
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    • 2016
  • Background: This study was guided by principles of the theoretical system of evidence-based medicine. In particular, when searching for evidence of breast cancer, a measuring scale is an instrument for evaluating curative effects in accordance with the laws and characteristics of medicine and exploring the establishment of a system for medically assessing curative effects. At present, there exist few tools for evaluating curative effects. Patient-reported outcomes (PROs) refer to outcomes directly reported by patients (without input or explanations from doctors or other intermediaries) with respect to all aspects of their health. Data obtained from PROs provide evidence of treatment effects. Materials and Methods: In accordance with the tenets of theoretical medicine and ancient medical theory regarding breast cancer, principles for developing a PRO scale were established, and a theoretical model was developed and a literature review was performed, items from this pool were combined and split, and an initial scale was constructed. After a pilot survey and additional modifications, a pre-questionnaire scale was formed and used in a field investigation. After the application of statistical methods, the item pool was used to create a formal scale. The reliability, validity and feasibility of this formal scale were then assessed. Results: In a clinical investigation, 479 responses were recovered, with an acceptance rate of 95%. a combination of various methods was employed, and the items that were selected by all methods or more than half of the methods were employed in the questionnaire. In these cases, the screening methods were combined with certain features of the item, A total of four domains and 38 items were reserved. The reliability analysis indicated that the PRO scale was relatively reliable. Conclusions: Scientific assessment proved that the proposed scale exhibited good reliability and validity. This scale was readily accepted and could be used to assess the curative effects of medical therapy. However, given the limited scope of this investigation, the capacity for adapting this scale to incorporate other theories could not be determined.

Assessment of the Prognostic Value of Methylation Status and Expression Levels of FHIT, GSTP1 and p16 in Non-Small Cell Lung Cancer in Egyptian Patients

  • Haroun, Riham Abdel-Hamid;Zakhary, Nadia Iskandar;Mohamed, Mohamed Ragaa;Abdelrahman, Abdelrahman Mohamed;Kandil, Eman Ibrahim;Shalaby, Kamal Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4281-4287
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    • 2014
  • Background: Methylation of tumor suppressor genes has been investigated in all kinds of cancer. Tumor specific epigenetic alterations can be used as a molecular markers of malignancy, which can lead to better diagnosis, prognosis and therapy. Therefore, the aim of this study was to evaluate the association between gene hypermethylation and expression of fragile histidine triad (FHIT), glutathione S-transferase P1 (GSTP1) and p16 genes and various clinicopathologic characteristics in primary non-small cell lung carcinomas (NSCLC). Materials and Methods: The study included 28 primary non-small cell lung carcinomas, where an additional 28 tissue samples taken from apparently normal safety margin surrounding the tumors served as controls. Methylation-specific polymerase chain reaction (MSP) was performed to analyze the methylation status of FHIT, GSTP1 and p16 while their mRNA expression levels were measured using a real-time PCR assay with SYBR Green I. Results: The methylation frequencies of the genes tested in NSCLC specimens were 53.6% for FHIT, 25% for GSTP1, and 0% for p16, and the risk of FHIT hypermethylation increased among patients with NSCLC by 2.88, while the risk of GSTP1 hypermethylation increased by 2.33. Hypermethylation of FHIT gene showed a highly significant correlation with pathologic stage (p<0.01) and a significant correlation with smoking habit and FHIT mRNA expression level (p<0.05). In contrast, no correlation was observed between the methylation of GSTP1 or p16 and smoking habit or any other parameter investigated (p>0.05). Conclusions: Results of the present study suggest that methylation of FHIT is a useful biomarker of biologically aggressive disease in patients with NSCLC. FHIT methylation may play a role in lung cancer later metastatic stages while GSTP1 methylation may rather play a role in the early pathogenesis.

Effects of host modulation by nonsteroidal anti-inflammatory drugs on periodontal disease: a systematic review and meta-analysis (비스테로이드성 항염증제를 이용한 숙주조절이 치주질환에 미치는 영향: 체계적 고찰 및 메타 분석)

  • Kang, Dae-Young;Cho, In-Woo;Shin, Hyun-Seung;Ahn, Hyeong-Sik;Kim, Hyun-Jung;Park, Jung-Chul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.7-18
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    • 2017
  • Purpose: Nonsteroidal anti-inflammatory drugs that prohibit biosynthesis of arachidonic acid metabolites have been considered potent host modulation agents. The aim of this review was to determine the effect of nonsteroidal anti-inflammatory drugs adjunctive with nonsurgical periodontal treatment in patients with periodontal disease. Materials and Methods: Three electronic databases were searched to identify relevant studies. The methodological quality and mean differences of the change in clinical attachment level and probing depth were analyzed according to Cochrane review methods. Results: Twelve studies were included in the methodological assessment and nine studies were suitable for inclusion in the meta-analysis. The mean difference in the clinical attachment level gain did not differ significantly between the nonsteroidal anti-inflammatory drugs and control groups at any observation time. The highest mean difference in clinical attachment level gain was 0.30 mm at 4 weeks (95% confidence interval = -0.37 to 0.97). There was a significant mean difference in the probing depth reduction, of 0.34 mm (95% confidence interval = 0.29 to 0.40) at 6 weeks. Conclusion: Therefore, nonsteroidal anti-inflammatory drugs have additional therapeutic effect when administrated with nonsurgical periodontal treatment.

Verification of X-sight Lung Tracking System in the CyberKnife (사이버나이프에서 폐종양 추적 시스템의 정확도 분석)

  • Huh, Hyun-Do;Choi, Sang-Hyoun;Kim, Woo-Chul;Kim, Hun-Jeong;Kim, Seong-Hoon;Cho, Sam-Ju;Min, Chul-Ki;Cho, Kwang-Hwan;Lee, Sang-Hoon;Choi, Jin-Ho;Lim, Sang-Wook;Shin, Dong-Oh
    • Progress in Medical Physics
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    • v.20 no.3
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    • pp.174-179
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    • 2009
  • To track moving tumor in real time, CyberKnife system imports a technique of the synchrony respiratory tracking system. The fiducial marker which are detectable in X-ray images were demand in CyberKnife Robotic radiosurgery system. It issued as reference markers to locate and track tumor location during patient alignment and treatment delivery. Fiducial marker implantation is an invasive surgical operation that carries a relatively high risk of pneumothorax. Most recently, it was developed a direct lung tumor registration method that does not require the use of fiducials. The purpose of this study is to measure the accuracy of target applying X-sight lung tracking using the Gafchromic film in dynamic moving thorax phantom. The X-sight Lung Tracking quality assurance motion phantom simulates simple respiratory motion of a lung tumor and provides Gafchromic dosimetry film-based test capability at locations inside the phantom corresponding to a typical lung tumor. The total average error for the X-sight Lung Tracking System with a moving target was $0.85{\pm}0.22$ mm. The results were considered reliable and applicable for lung tumor treatment in CyberKnife radiosurgery system. Clinically, breathing patterns of patients may vary during radiation therapy. Therefore, additional studies with a set real patient data are necessary to evaluate the target accuracy for the X-sight Lung Tracking system.

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Cryopreservation of Human Embryos for Assisted Reproductive Technology (인간 배아의 동결보존에 관한 연구)

  • Moon, Shin-Yong;Kim, Chung-Hoon;Kim, Seok-Hyun;Choi, Young-Min;Shin, Chang-Jae;Kim, Jung-Gu;Lee, Jin-Yong;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.21 no.2
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    • pp.137-147
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    • 1994
  • Controlled ovarian hyperstimulation(COH) for in vitro fertilization and embryo transfer(IVFET) often results in the production of more embryos than can be efficaciously transferred at one time. However, embryo cryopreservation provides a mechanism by which additional embryos can be stored for later thawing and transfer. From November, 1990 to October, 1992, we completed 42 transfer cycles of cryopreserved pronucleus(PN) l-cell embryos using the fixed protocol of hormonal replacement therapy in a physiological manner regardless of individual ovarian function. Artificial endometrial stimulation was performed with only exogenous estradiol and progesterone(E-P) in 36 transfer cycles (Group I) and with gonadotropin-releasing hormone agonist(GnRHa) and exogenous estradiol and progesterone(GEEP) in 6 transfer cycles(Group II ). The results were as follows. 1. The Survival rate of total cryopreserved-thawed embryos was 64.9%(198/305): 64.9% (172/265) in Group I and 65.0% (26/40) in Group II. 2. Total 168 embryos were transferred with an average of 4.7 per ET in Group I and total 26 embryos were transferred with an average of 4.3 per ET in Group II. 3. The pregnancy rate(PR) per cryopreserved-thawed ET and the implantation rate was 33.3 %(14/42) and 6.7%(13/194), respectively. The PRs per cryopreserved-thawed ET were 30.6% (11/36) in Group I and 50.0% (3/6) in Group II without significant difference. 4. The take home baby rate was 11.1%(4/36) in Group I and 33.3% (2/6) in Group II.

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