• 제목/요약/키워드: clinical stage

검색결과 2,607건 처리시간 0.025초

Short-term outcomes of two-stage reverse total shoulder arthroplasty with antibiotic-loaded cement spacer for shoulder infection

  • Kim, Du-Han;Bek, Chung-Shin;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • 제25권3호
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    • pp.202-209
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    • 2022
  • Background: The purpose of our study was to investigate short-term outcomes of two-stage reverse total shoulder arthroplasty (RTSA) with an antibiotic-loaded cement spacer for shoulder infection. Methods: Eleven patients with shoulder infection were treated by two-stage RTSA following temporary antibiotic-loaded cement spacer. Of the 11 shoulders, nine had pyogenic arthritis combined with complex conditions such as recurrent infection, extensive osteomyelitis, osteoarthritis, or massive rotator cuff tear and two had periprosthetic joint infection (PJI). The mean follow-up period was 29.9 months (range, 12-48 months) after RTSA. Clinical and radiographic outcomes were evaluated using the visual analog scale (VAS) score for pain, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value (SSV), and serial plain radiographs. Results: The mean time from antibiotic-loaded cement spacer to RTSA was 9.2 months (range, 1-35 months). All patients had no clinical and radiographic signs of recurrent infection at final follow-up. The mean final VAS score, ASES score, and SSV were significantly improved from 4.5, 38.6, and 29.1% before RTSA to 1.7, 75.1, and 75.9% at final follow-up, respectively. The mean forward flexion, abduction, external rotation, and internal rotation were improved from 50.0°, 50.9°, 17.7°, and sacrum level before RTSA to 127.3°, 110.0°, 51.8°, and L2 level at final follow-up, respectively. Conclusions: Two-stage RTSA with antibiotic-loaded cement spacer yields satisfactory short-term clinical and radiographic outcomes. In patients with pyogenic arthritis combined with complex conditions or PJI, two-stage RTSA with an antibiotic-loaded cement spacer would be a successful approach to eradicate infection and to improve function with pain relief.

Nursing students' rights in clinical practice in South Korea: a hybrid concept-analysis study

  • Sunghee Park;Mi-Young Choi
    • Child Health Nursing Research
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    • 제29권4호
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    • pp.260-270
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    • 2023
  • Purpose: This study aimed to derive a conceptual definition and attributes for nursing students' rights in clinical practice in South Korea. Methods: This concept-analysis study was conducted at a nursing school in South Korea. The participants were recruited using purposive sampling. The inclusion criteria were being a fourth-year nursing student and having two or more semesters of practical experience. The hybrid model used in this study had three stages. First, 12 studies were reviewed during the theoretical stage. Second, 10 in-depth interviews were conducted during the fieldwork stage. Third, in the analytical stage, the concept of nursing students' rights related to clinical practice was defined and the attributes were derived. Results: The analysis established five attributes of nursing students' rights: the right to learn, the right to be protected from infections and accidents, the right to be cared for and supported, the right to be respected, and the right to be recognized as a member of a nursing team. A key theme that emerged from this study was having the right to learn in a safe and supportive environment. Conclusion: It is necessary to develop a measurement tool based on the above five attributes and to verify its effectiveness.

Stereotactic radiotherapy for early stage non-small cell lung cancer

  • Ricardi, Umberto;Badellino, Serena;Filippi, Andrea Riccardo
    • Radiation Oncology Journal
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    • 제33권2호
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    • pp.57-65
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    • 2015
  • Stereotactic body radiotherapy (SBRT) represents a consolidated treatment option for patients with medically inoperable early stage non-small cell lung cancer (NSCLC). The clinical evidence accumulated in the past decade supports its use as an alternative to surgery with comparable survival outcomes. Due to its limited toxicity, SBRT is also applicable to elderly patients with very poor baseline pulmonary function or other severe comorbidities. Recent comparative studies in operable patients raised the issue of the possible use of SBRT also for this subgroup, with quite promising results that still should be fully confirmed by prospective trials with long-term follow-up. Aim of this review is to summarize and discuss the major studies conducted over the years on SBRT and to provide data on the efficacy and toxicity of this radiotherapy technique for stage I NSCLC. Technical aspects and quality of life related issues are also discussed, with the goal to provide information on the current role and limitations of SBRT in clinical practice.

옻나무 전탕추출물을 활용한 대장암 4기 환자치험 1례 (Treatment of Rhus vernifciflua STOKES decoction to colorectal cancer patient (stage IV):single case report)

  • 김보근;박상채
    • 대한암한의학회지
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    • 제15권1호
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    • pp.111-117
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    • 2010
  • Background & Objectives: Colorectal Cancer is 10% of all cancer incidence and the motality from colorectal cancer is nearly 450,000 a year. Since chemopreventive agents from Herbal medicine is hot issue recently, to prove antitumor effecicacy of Rhus vernifciflua STOKES decoction (Chijong-dan), clinical study was carried out. Here we report one patient with colorectal cancer of stage IV. The patient had a colorectal cancer (Stage IV, T4N2M1), lymph node metastases and underwent chemotherapy. Methods: The patient visited Hana oriental medicine Clinic in 2009 and was treated using Chijong-dan for 1 year at Hana Oriental Clinic. Results: Chijongdan showed no side effect during its treatment and tumor size was retarded based on CT scanning. Overall, this case report suggests that Rhus vernifciflua STOKES decoction can be a potent cancer preventive agents for colorectal cancer but it is still required to verify the scientific and clinical evidences for Rhus vernifciflua STOKES decoction (Chijong-dan).

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개에서 Tetrachlorethylene에 의해 유발된 간장 병변의 임상 및 초음파학적 연구 (Clinical and Ultrasonographic Studies for the Liver Lesion Induced by Tetrachlorethylene in Dogs)

  • 김영범;김명철
    • 한국임상수의학회지
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    • 제16권2호
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    • pp.321-327
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    • 1999
  • This study was performed to examine the clinical, serological, ultrasonographic and pathological findings in dogs with acute liver disease induced by tetrachlorethylene at 4 times of anthelminthic oral dose. The results obtained through this experiment could be summarized as follows: 1. The dogs administered with tetrachlorethylene, revealed decreased body weight, and showed lethargy and depression. 2. In serological findings, bilirubin values slightly increased, AST and ALT was decreased at 1∼3 days, and after that time increased according to the lapse of days, and revealed the highest at 5 days, and decreased to normal values at 6 days. 3. In ultrasonographic findings, branches of the portal vein were increased, the echodensity of the liver parenchyma was decreased at early stage, and increased at mid stage, and decreased at last stage. 4. In histopathological findings, necrosis of parenchymal cell, and perivascular hemorrhage were observed more severely at 6 days, as compared with 3 days. There results suggest that ultrasonographic examination is considered to be a more simple, rapid, non-invasive and useful diagnostic method for acute liver parenchymal lesion.

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폐에 발생한 선편평상피세포암종;1례 보고 (Adenosquamous Carcinoma of the Lung - One Case Report -)

  • 백효채
    • Journal of Chest Surgery
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    • 제25권10호
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    • pp.1082-1086
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    • 1992
  • Adenosquamous carcinoma of the lung is a rare disease entity and its clinical characteristics, treatment, and prognosis are poorly described. Stage I disease are amenable to operation as in bronchogenic carcinoma of non-small cell type, but stage III adenosquamous carcinoma shows highly aggressive behavior with rapid progression. We have experienced a case of stage III adenosquamous carcinoma of the lung in a 38-year-old male with a large mass in the right upper lobe with multiple metastasis in the mediastinal lymph nodes. Interestingly, all of the metastatic lymph nodes proved to be adenous component histologically. After right pneumonectomy and extensive lymph node dissection, the patient had received one cycle of chemotherapy. However, clinical signs of distant metastasis to bone and brain were discovered within 5 months postoperatively.

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Live birth in a woman with recurrent implantation failure and adenomyosis following transfer of refrozen-warmed embryos

  • Safari, Somayyeh;Faramarzi, Azita;Agha-Rahimi, Azam;Khalili, Mohammad Ali
    • Clinical and Experimental Reproductive Medicine
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    • 제43권3호
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    • pp.181-184
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    • 2016
  • The aim was to report a healthy live birth using re-vitrified-warmed cleavage-stage embryos derived from supernumerary warmed embryos after frozen embryo transfer (ET) in a patient with recurrent implantation failure (RIF). The case was a 39-year-old female with a history of polycystic ovarian syndrome and adenomyosis, along with RIF. After ovarian hyperstimulation, 33 cumulus-oocyte complexes were retrieved and fertilized with conventional in vitro fertilization and intracytoplasmic sperm injection. Because of the risk of ovarian hyperstimulation syndrome, 16 grade B and C embryos were vitrified. After 3 and 6 months, 3 and 4 B-C warmed embryos were transferred to the uterus, respectively. However, implantation did not take place. Ten months later, four embryos were warmed, two grade B 8-cell embryos were transferred, and two embryos were re-vitrified. One year later, the two re-vitrified cleavage-stage embryos were warmed, which resulted in a successful live birth. This finding showed that following first warming, it is feasible to refreeze supernumerary warmed embryos for subsequent ET in patients with a history of RIF.

혼종모형을 이용한 암묵적 간호지식의 개념분석 (Concept Analysis of Tacit Nursing Knowledge)

  • 김현주;김주현
    • 대한간호학회지
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    • 제48권6호
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    • pp.637-655
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    • 2018
  • Purpose: The purpose of this qualitative study is to investigate the nature of tacit nursing knowledge practiced in the clinical field in Korea using hybrid models, and to clarify the definitions and attributes of the concept. Methods: The definition and nature of tacit nursing knowledge, obtained through a review of the extensive literature at the theoretical stage of the research, and the analysis of the in-depth interview data conducted by the career nurses in the fieldwork stage, are compared and analyzed. Results: The tacit nursing knowledge was found in three dimensions as knowledge related to the person, the clinical situation work context, the self, the others, and the task. The tacit nursing knowledge was defined as personal nursing knowledge and artistic skills that show up as unconscious behavior patterns, learned informally, and internalizedthrough repeated clinical practice experience based on professional nursing knowledge. Conclusion: Tacit nursing knowledge has been widely used in clinical practice and has been shown to have a great impact, directly or indirectly, on clinical nursing. Therefore, individual and organizational efforts are needed for validation and clarification using the generation, sharing, collection, and peer review of sound implicit nursing knowledge to ensure that it is properly applied.

소세포 폐암의 치료성적에 대한 고찰 (A Clinical Therapeutic Results on Small Cell Lung Cancer)

  • 김은화;이순형;허원영;김한식;조진웅;김미애;김상균;김귀완;정원규;김수곤
    • Tuberculosis and Respiratory Diseases
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    • 제41권3호
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    • pp.262-269
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    • 1994
  • 연구배경: 소세포 폐암은 비소세포 폐암에 비해 병의 진행경과 및 치료에 대한 반응이 상이하게 나타나는데 저자들은 지난 7년간(1986~1992) 본원에서 진단된 소세포 폐암환자들을 대상으로, 그 치료성적에 대해 고찰해 보고자 하였다. 방법: 조직학적 및 세포진 검사상 폐암으로 진단받은 806명 중 소세포 폐암으로 밝혀진 153명의 환자들을 대상으로 하였으며, 병력일지 및 우편물 또는 전화를 통하여 102명의 환자에 대한 생사확인과 사망일지 등을 확인하였고 임상기록을 중심으로 후향적인 방법으로 분석하였다. 결과: 1) 전체 암환자 수는 8,050명 이었으며, 그 중 폐암환자는 806명(10.0%) 이었고 소세포 폐암환자는 153명으로 전체 폐암환자의 19.0%를 차지했으며, 남녀의 비는 129명: 24명(84.3% : 15.7%) 이었다. 2) 소세포 폐암환자의 연령분포는 60대가 60명(39.2%), 50대가 53명(34.6%)으로 3/4 정도의 환자가 50~60대 사이에 발생했다. 3) 다양한 증상 및 증세를 나타냈으며, 반 수 이상의 환자에서 기침, 객담, 호흡곤란 및 흉통이 있었고 진단방법으로는 128명(83.5%)이 기관지 내시경 및 생검으로 진단 되었으며 ECOG에 의한 수행상태는 $H_2$가 59.5%를 차지하였고, 그 다음은 $H_1$이 30.7%를 차지하였다. 병기 및 위치의 분류는 대개가 limited stage(105명, 68.7%)와 central type(134명, 87.6%) 이었다. 4) 화학요법과 병합요법(항암 및 방사선 치료)을 시행한 군의 치료에 대한 반응을 비교해 본 바 병합요법을 시행한 군이 완전관해 및 부분관해율이 63.4%을 보였으며 평균 생존기간은 3주기 이상의 화학요법으로 시행한 환자중 limited stage의 경우 5.3개월 extensive stage는 4.6개월을 보여 양군간에 유이한 차이가 없었으나, limited stage 에서 시행한 병합요법 환자의 경우 15개월 1일의 평균 생존기간을 나타내어 limited stage시의 화학요법과 유이한 차이를 보였다. 5) 치료의 유무와 상관없이 시행한 각 병기간 환자의 중앙 생존기간은 limited stage가 10.9개월 extensive stage가 4.8개월을 보여 양군간의 유이한 차이를 보였다. 결론: 폐암은 현재 국내에서도 점차 증가하는 추세에 있는 악성 종양중의 하나로 본원에서의 최근 7년간 전체 암환자 순위 중 특히 남자의 경우 위암 다음으로 많았으며, 그 중 소세포 폐암의 치료성적에 대해 후향적인 방법으로 고찰하여 보고하는 바이며, 특히 limited stage 시 항암 및 방사선치료가 항암단일요법보다 더 생존율이 높은것으로 나타났는데, 향후 더 정확한 임상고찰을 위해서는 전향적인 연구가 필요하리라 생각된다.

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Roles of Ki67 in Breast Cancer - Important for Management?

  • Yip, CH;Bhoo-Pathy, N;Daniel, JM;Foo, YC;Mohamed, AK;Abdullah, MM;Ng, YS;Yap, BK;Pathmanathan, R
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.1077-1082
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    • 2016
  • Background: The three standard biomarkers used in breast cancer are the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). The Ki-67 index, a proliferative marker, has been shown to be associated with a poorer outcome, and despite absence of standardization of pathological assessment, is widely used for therapy decision making. We aim to study the role of the Ki-67 index in a group of Asian women with breast cancer. Materials and Methods: A total of 450 women newly diagnosed with Stage 1 to 3 invasive breast cancer in a single centre from July 2013 to Dec 2014 were included in this study. Univariable and multivariable logistic regression was used to determine the association between Ki-67 (positive defined as 14% and above) and age, ethnicity, grade, mitotic index, ER, PR, HER2, lymph node status and size. All analyses were performed using SPSS Version 22. Results: In univariable analysis, Ki -67 index was associated with younger age, higher grade, ER and PR negativity, HER2 positivity, high mitotic index and positive lymph nodes. However on multivariable analysis only tumour size, grade, PR and HER2 remained significant. Out of 102 stage 1 patients who had ER positive/PR positive/HER2 negative tumours and non-grade 3, only 5 (4.9%) had a positive Ki-67 index and may have been offered chemotherapy. However, it is interesting to note that none of these patients received chemotherapy. Conclusions: Information on Ki67 would have potentially changed management in an insignificant proportion of patients with stage 1 breast cancer.