Journal of the korean academy of Pediatric Dentistry
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v.33
no.4
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pp.710-716
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2006
The purpose of this study is to evaluate the intravenous (IV) sedation technique with midazolam and ketamine for uncooperative dental child patients. Three child patients between the ages of 4.4 years and 5.6 years who required sedation for dental treatment were given midazolam and ketamine. Initial dosage was combined of $0.03{\sim}0.06mg/kg$ midazolam and 1.0mg/kg ketamine. Additional dosages of ketamine (0.33mg/kg) were given as needed to maintain deep sedation. Pulse rate, respiratory rate, blood pressure, oxygen saturation, adverse reactions, postoperative recovery and behavior were monitored with saturation pulse oximetry, ECG, NIBP and Cardiocap. In conclusion, the combination of midazolam and ketamine is efficacious in deep sedation for painful dental treatment. However, a significant drop in oxygen saturation was observed as a common adverse side effect. Therefore advanced airway management proficiency is required in order to achieve a successful IV sedation.
Objectives: This was a retrospective case series about the clinical effect of integrated approach with behavior therapy for obstructive sleep apnea (OSA). Methods: Medical records of twelve patients with OSA who were treated with behavior modification including nasal breathing with oral appliances and sleep in lateral position, oral administration of herbal medicines and acupuncture treatment between January and September of 2013 were reviewed. Apnea-hypopnea index (AHI), day time sleepiness, apneas and hypopneas counts during sleep, risk indicator (RI), oxygen desaturation index, average saturation during sleep, lowest desaturation, lowest saturation, snoring events ratio and number of desaturations (%) were assessed before and after treatments with the ApneaLink device, which is a portable diagnostic apparatus for monitoring airflows of the patient's breath at home. Results: After an average 62.67 (SD 37.16) days of treatment, AHI (from 17.67, 12.79 to 8.75, 8.25, p=0.007), RI (from 22.00, 13.26 to 12.09, 8.03, p=0.004), oxygen desaturation index (from 17.33, 12.17 to 8.17, 7.86, p=0.005), and number of desaturations (from 7.00 times, 9.79 to 0.92 times, 1.39, p=0.044) showed significant improvement. Daytime sleepiness improved from 6.5 (3.2) to 3.8 (1.8) but there was no significant difference after treatment (p=0.17). No adverse events related to treatment were observed during participation in the treatment. Conclusion: From this case series, we found that behavior modification with herbal medication and acupuncture may be effective for improving sleep apnea without serious adverse events. Future randomized controlled trials with larger sample size will be necessary for concrete evidence on the benefit of this integrated treatment for OSA.
Objectives: This study reports on the effect of Integrative Medicine Therapy (IMT) on a patient with pancreatic cancer with liver metastasis. Methods: One pancreatic cancer with liver metastasis patient was treated using IMT in conjunction with Gemcitabine/Abraxane since September 2019. The cycle was repeated every four weeks for a total of 11 times. At the same time, the patient was treated with IMT. Tumor size was measured by scanning with Computed Tomography (CT). Adverse events were evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After treatment with Gemcitabine/Abraxane and IMT for eight months, the size of the body and tail of the cancer tumor and several hepatic metastatic regions decreased (partial response, [PR]), size, and number of multiple nodules in both lungs decreased. No evidence of newly developed metastatic lesions was found. The patient has maintained a good treatment outcome and has shown prolonged overall survival. Conclusions: This case demonstrates that treatment with IMT may have substantial benefits for patients with end-stage pancreatic cancer.
Drug metabolism is a critical determinant of the therapeutic and adverse effects of many psychotropic drugs. The metabolism depends on the pharmacokinetics of a drug, which includes its absorption, distribution, and elimination. Psychotropic drugs are metabolized mainly by cytochrome P450 (CYP) enzymes; about 20 of these enzymes exist and they are often responsible for the rate-limiting step of drug metabolism. CYP2D6 is the best-characterized P450 enzyme that exhibits polymorphism in humans. This study determined the relationship between the CYP2D6*10 (P34S) polymorphism and the response to mirtazapine in 153 Koreans with major depressive disorder (MDD). The genotype frequencies were compared using logistic regression analysis, and between-genotype differences in the decrease in the 21-item Hamilton Depression (HAMD21) score over the 12-week treatment period were analyzed using a linear regression analysis. The proportion of remitters was lower in patients with MDD possessing the S allele than in P allele carriers after 2 weeks of mirtazapine treatment. Similarly, the reductions in the HAMD21 and Clinical Global Impression (CGI) scores in S allele carriers were smaller than those in patients with the P allele after 2 weeks of mirtazapine treatment. In the analysis of depression symptoms, the sleep and delusion scores had smaller reductions in S allele carriers. Based on the Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), the psychic adverse effects of mirtazapine were associated with CYP2D6 P34S, while weight gain was not. These results suggest that CYP2D6 P34S affects the outcome of mirtazapine treatment in patients with MDD, and that this polymorphism may be a good genetic marker for predicting the clinical outcome of mirtazapine treatment.
Ten-week-old layer type pullets were used in this study, housed 10 birds per cage(61$\times$41cm) and were replicated 15 times After raising them on a 19% protein diet up to ten weeks of age they were fed a 12% protein corn-soy control diet or one with half or all of the soybean mea replaced with ground full-fat sunflower seeds. At 19 weeks of age, pulltes were transferred to a layer house and their respective diet was gradually changed to a 13.5% layer diet containing 635% oats. The 19% protein SFS diet in treatment 2 did not show my, adverse effect on body weight or subsequent egg productio. The higher level of SES(38%) appeared to delay sexual maturity somewhat as was indicated by body weight and egg production data. However, the higher replacement of soybean with SFS(38%) in the pullet ration may not be critical for sexual maturity, but beneficial in a full laying cycle. There were no adverse effects on later stages of production.
Epoxy-coated reinforcing bars are widely used to protect the corrosion of the reinforcing bars in the RC elements under their in-service environments and external loads. In most field surveys, it was reported that the corrosion resistance of the epoxy-coated reinforcing bars is typically better than the uncoated bars. However, from the experimental tests conducted in the labs, it was reported that, under the same loads, the RC elements with epoxy-coated reinforcing bars had wider cracks than the elements reinforced with the ordinary bars. Although this conclusion may be true considering the bond reduction of the reinforcing bar due to the epoxy coating, the maximum service loads used in the experimental research may be a main reason. To answer these two phenomena, service performance of 15 RC beam specimens with uncoated and epoxy-coated reinforcements under different fatigue loads was experimentally studied. Influences of different coating thicknesses of the reinforcing bars, the fatigue load range and load upper limit as well as fatigue load cycles on the mechanical performance of RC test specimens are discussed. It is concluded that, for the test specimens subjected to the comparatively lower load range and load upper limit, adverse effect on the service performance of test specimens with thicker epoxy-coated reinforcing bars is negligible. With the increments of the coating thickness and the in-service loading level, i.e., fatigue load range, load upper limit and fatigue cycles, the adverse factor resulting from the thicker coating becomes noticeable.
Kim, Dong-hyun;Lee, Da-eun;Noh, Ji-won;Ahn, Young-min;Ahn, Se-young;Lee, Byung-cheol
The Journal of Internal Korean Medicine
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v.39
no.2
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pp.97-106
/
2018
Objectives: The combined use of herbal and Western medicine is increasing. However, herbal medicine is highly likely to interact with Western medicine making it important to understand the effects of co-administration. This study investigates the ratio of patients who take Western medicine with herbal medicine, the types of medicines commonly prescribed together, and the results of hospital examinations. Methods: We investigated patients who were hospitalized at Kyung Hee University Korean Medical Hospital for at least one day from January 1, 2010 to December 31, 2017. There were some inclusion criteria. First, we chose patients aged 19 and over. Second, we chose patients who were diagnosed with osteoarthritis (OA) with diagnosis codes M13, M15, M17 according to KCD-7. Third, patients had liver function tests, renal function tests, and general hematology tests performed at least two times during hospitalization. Results: Among a total of 131 OA patients, 32 (24.4%) patients were treated with herbal-Western medicine combination therapy. The most commonly prescribed herbal medicine was Daegalwhal-tang, and the most commonly prescribed Western medicine was celecoxib. In the laboratory findings, all liver function tests, renal function tests, and general hematology tests showed no difference compared to admission day. There were also no differences between herbal medicine single treatment and herbal-Western medicine combination treatment. Conclusions: From these results, we suggest that herbal medicine single treatment and herbal-Western medicine combination treatment for OA patients does not cause adverse effects.
Yuan, Yuan;Zhang, Yan;Shi, Lin;Mei, Jing-Feng;Feng, Jif-Eng;Shen, Bo
Asian Pacific Journal of Cancer Prevention
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v.16
no.12
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pp.4993-4996
/
2015
Background: To evaluate the efficacy and safety of albumin-bound paclitaxel-based chemotherapy in treatment for patients with advanced esophageal cancer who failed in first-line chemotherapy. Materials and Methods: We collected29 advanced esophageal cancer patients who received albumin-bound paclitaxel-based chemotherapy fromJune 2009 to September 2013, and the efficacy and safety of the compound were evaluated. These patients were treated with $100-150mg/m^2$ nab-paclitaxel on days 1,8. The cycle was repeated every 3 weeks. Clinical efficacy was evaluated every two cycles. Results: Of the 29 patients, two persons interrupted treatment because of adverse reactions, failed to evaluate efficacy effect. The rest of 27 patients who could be evaluated for short-term response, 10 patients (37%) achieved partial response, 2 (7.4%) remained stable disease, and 15 (55.6%) had progressivedisease. The objective response rate was 37%, and the disease control rate was 44.4%.The median time to progression was 6.6 months.The major adverse reactions includedalopecia (62.07%), neutropenia (65.5%), gastrointestinalreaction (10.3%) andsensory neuropathy(6.8%). Conclusions: The albumin-bound paclitaxel-based chemotherapy is efficacy and safety in treatment for patients with advanced esophageal cancer who failed in first-line chemotherapy.
Objective: To investigate the clinical effects of whole brain radiotherapy concomitant with targeted therapy for brain metastasis in non-small cell lung cancer (NSCLC) patients with chemotherapy failure. Materials and Methods: Of the 157 NSCLC patients with chemotherapy failure followed by brain metastasis admitted in our hospital from January 2009 to August 2012, the combination group (65 cases) were treated with EGFR-TKI combined with whole brain radiotherapy while the radiotherapy group (92 cases) were given whole brain radiotherapy only. Short-term effects were evaluated based on the increased MRI in brain 1 month after whole brain radiotherapy. Intracranial hypertension responses, hematological toxicity reactions and clinical effects of both groups were observed. Results: There were more adverse reactions in the combination group than in radiotherapy group, but no significant differences were observed between the two groups in response rate (RR) and disease control rate (DCR) (P>0.05). Medium progression free survival (PFS), medium overall survival (OS) and 1-year survival rate in combination group were 6.0 months, 10.6 months and 42.3%, while in the radiotherapy group they were 3.4 months, 7.7 months and 28.0%, respectively, which indicated that there were significant differences in PFS and OS between the two groups (P<0.05). Additionally, RPA grading of each factor in the combination group was a risk factor closely related with survival, with medium PFS in EGFR and KRAS mutation patients being 8.2 months and 11.2 months, and OS being 3.6 months and 6.3 months, respectively. Conclusions: Whole brain radiotherapy concomitant with target therapy is favorable for adverse reaction tolerance and clinical effects, being superior in treating brain metastasis in NSCLC patients with chemotherapy failure and thus deserves to be widely applied in the clinic.
To investigate the axial compressive performance of the recycled aggregate concrete (RAC) filled glass fiber reinforced polymer (GFRP) tube and profile steel composite columns, static loading tests were carried out on 18 specimens under axial loads in this study, including 7 RAC filled GFRP tube columns and 11 RAC filled GFRP tube-profile steel composite columns. The design parameters include recycled coarse aggregate (RCA) replacement percentage, profile steel ratio, slenderness ratio and RAC strength. The failure process, failure modes, axial stress-strain curves, strain development and axial bearing capacity of all specimens were mainly analyzed in detail. The experimental results show that the GFRP tube had strong restraint ability to RAC material and the profile steel could improve the axial compressive performance of the columns. The failure modes of the columns can be summarized as follow: the profile steel in the composite columns yielded first, then the internal RAC material was crushed, and finally the fiberglass of the external GFRP tube was seriously torn, resulting in the final failure of columns. The axial bearing capacity of the columns decreased with the increase of RCA replacement percentage and the maximum decreasing amplitude was 11.10%. In addition, the slenderness ratio had an adverse effect on the axial bearing capacity of the columns. However, the strength of the RAC material could effectively improve the axial bearing capacity of the columns, but their deformability decreased. In addition, the increasing profile steel ratio contributed to the axial compressive capacity of the composite columns. Based on the above analysis, a formula for calculating the bearing capacity of composite columns under axial compression load is proposed, and the adverse effects of slenderness ratio and RCA replacement percentage are considered.
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