• 제목/요약/키워드: adverse effect

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비협조적인 아동의 치과 치료를 위한 정주 진정요법 (INTRAVENOUS SEDATION FOR UNCOOPERATIVE DENTAL CHILD PATIENTS)

  • 박용규;김종수;김승오
    • 대한소아치과학회지
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    • 제33권4호
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    • pp.710-716
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    • 2006
  • 소아치과에서 진정요법은 치과 환경에 대하여 공포를 가진 아동, 협조 전 단계의 아동, 장애를 가진 아동 그리고 구토반사 등을 보이는 환자에게 사용될 수 있다. 본 증례에서는 다발성 치아 우식증을 주소로 본원에 내원한 환아에서 1.0mg/kg 케타민과 $0.03{\sim}0.06mg/kg$ 미다졸람 그리고 아트로핀 정주 병용투여 하에 수복치료를 시행하였다. 치료시간의 연장과 적절한 진정 상태 유지를 위하여 케타민(0.33mg/kg)과 미다졸람 $1mg(0.03{\sim}0.05mg/kg)$을 혼합하거나 각각 추가 투여하였다. 지속적으로 환자의 활력징후를 관찰하면서 약물의 추가투여 용량을 결정하였다. 모니터링 장비로 맥박 산소 측정법(pulse oximetry), 전자심전도(electrocardiogram), 비혈관식혈압(NIBP : Noninvasive Blood Pressure)을 사용하여 맥박, 호흡수, 혈압, 산소 포화도 등을 측정하였다. 진료 과정동안 안전을 위해 미국 소아치과 학회(American Academy of Pediatric Dentistry ; AAPD)의 권고 사항을 준수하였다.

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Nasal Breath in the Lateral Position for Sleep Apnea: a Retrospective Case Series

  • Kim, Ho-Sun;Kim, Tae-Hun
    • 대한한의학회지
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    • 제35권2호
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    • pp.12-18
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    • 2014
  • 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.

항암화학요법과 통합의학치료를 병행하여 부분 관해 된 간전이 동반 말기 췌장암 1례 (A Case Report of Partial Remission of End-stage Pancreatic Cancer Patient with Liver Metastasis Treated with Chemotherapy and Integrated Medicine Therapy)

  • 고은비;장권준;장주영;송미화;신광순
    • 대한한방내과학회지
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    • 제41권2호
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    • pp.166-176
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    • 2020
  • 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.

CYP2D6 P34S Polymorphism and Mirtazapine Responses in Koreans with Major Depression

  • Jeon, Si-On;Chang, Hun-Soo;Lee, Hwa-Young;Ham, Byung-Joo;Kang, Rhee-Hun;Jeong, Yoo-Jung;Lee, Min-Soo
    • Molecular & Cellular Toxicology
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    • 제5권4호
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    • pp.346-353
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    • 2009
  • 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.

해바라기씨앗으로 사육된 병아리의 성장 및 산란계로서의 생산능력에 관한 연구 (A Study on the Performances of Pullets and Subsequent Egg Production with the Substitution of Ground Sunflower Seeds)

  • K. H. Nahm
    • 한국가금학회지
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    • 제17권4호
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    • pp.281-283
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    • 1990
  • 10주령 병아리를 이용하여 Cage당 10수로 하여 15반복의 시험구를 배치하였다. 10주령까지는 19%의 단백질사료로 사육되었으며 그 후에는 12%의 단백질사료를 이용하여 사육하였다. 대조구는 옥수수와 대두박구로 하고 시험구는 대조구의 대두박 대신 해바라기 씨앗으로 일부(19%) 또는 전부(38%)를 대치하여 19주령까지 사육하였다. 19주령에서 산란계용 cage로 옮긴 후 13.5%의 단백질 수준을 유지시켰다. 시험결과에 의하면 해바라기씨앗 첨가구는 19% 대치한 구에서는 전 산란기간을 통하여 반 생산 및 능력이 대조구에 비하여 아무 차이가 없었다. 그러나 38% 대치구에서는 약간의 성성숙 지연이 있었지만 전 산란기간을 통하여 얻어진 시험결과에 의하면 오히려 경제적으로 이익이었다.

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Influence of different fatigue loads and coating thicknesses on service performance of RC beam specimens with epoxy-coated reinforcement

  • Wang, Xiao-Hui;Gao, Yang;Gao, Run-Dong;Wang, Jing;Liu, Xi-La
    • Computers and Concrete
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    • 제19권3호
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    • pp.243-256
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    • 2017
  • 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.

골관절염 환자의 한약 양약 투여 현황 및 안전성 연구 (A Study of the Co-Administration of Herbal and Western Medicines to Hospitalized Patients with Osteoarthritis)

  • 김동현;이다은;노지원;안영민;안세영;이병철
    • 대한한방내과학회지
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    • 제39권2호
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    • pp.97-106
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    • 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.

Clinical Research on Albumin-Bound Paclitaxel-Based Chemotherapy for Advanced Esophageal Cancer

  • Yuan, Yuan;Zhang, Yan;Shi, Lin;Mei, Jing-Feng;Feng, Jif-Eng;Shen, Bo
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.4993-4996
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    • 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.

Clinical Observation of Whole Brain Radiotherapy Concomitant with Targeted Therapy for Brain Metastasis in Non-small Cell Lung Cancer Patients with Chemotherapy Failure

  • Cai, Yong;Wang, Ji-Ying;Liu, Hui
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.5699-5703
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    • 2013
  • 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.

Compressive performance of RAC filled GFRP tube-profile steel composite columns under axial loads

  • Ma, Hui;Bai, Hengyu;Zhao, Yanli;Liu, Yunhe;Zhang, Peng
    • Advances in concrete construction
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    • 제8권4호
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    • pp.335-349
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    • 2019
  • 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.