• Title/Summary/Keyword: intervention treatment

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Nutritional status of patients treated with radiotherapy as determined by subjective global assessment

  • Koom, Woong Sub;Ahn, Seung Do;Song, Si Yeol;Lee, Chang Geol;Moon, Sung Ho;Chie, Eui Kyu;Jang, Hong Seok;Oh, Young-Taek;Lee, Ho Sun;Keum, Ki Chang
    • Radiation Oncology Journal
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    • v.30 no.3
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    • pp.132-139
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    • 2012
  • Purpose: The purpose of this prospective multi-institutional study was to evaluate the nutritional status of patients undergoing radiotherapy (RT) for treatment of head and neck, lung, or gastrointestinal cancer. Materials and Methods: A total of 1,000 patients were enrolled in this study at seven different hospitals in Seoul, Korea between October 2009 and May 2010. The nutritional status of patients after receiving 3 weeks of RT was evaluated using subjective global assessment (SGA). The nutritional status of each patient was rated as well nourished (A), moderately malnourished (B), or severely malnourished (C). Results: The mean age of patients in this study was $59.4{\pm}11.9$ years, and the male to female ratio was 7:3. According to the SGA results, 60.8%, 34.5%, and 4.7% of patients were classified as A, B, or C, respectively. The following criteria were significantly associated with malnutrition (SGA B or C; p < 0.001): loss of subcutaneous fat or muscle wasting (odds ratio [OR], 11.473); increased metabolic demand/stress (OR, 8.688); ankle, sacral edema, or ascites (OR, 3.234); and weight loss ${\geq}5%$ (OR, 2.299). Conclusion: SGA was applied successfully to assess the nutritional status of most patients. The prevalence of malnutrition in a radiation oncology department was 39.2%. The results of this study serve as a basis for implementation of nutrition intervention to patients being treated at radiation oncology departments.

Surgical Options for Malignant Mesothelioma: A Single-Center Experience

  • Kang, Seung Ri;Bok, Jin San;Lee, Geun Dong;Choi, Se Hoon;Kim, Hyeong Ryul;Kim, Dong Kwan;Park, Seung-Il;Kim, Yong-Hee
    • Journal of Chest Surgery
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    • v.51 no.3
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    • pp.195-201
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    • 2018
  • Background: We investigated the surgical outcomes of patients who underwent therapeutic surgery for malignant pleural mesothelioma (MPM) at a single center. Methods: A retrospective review of 21 patients who underwent therapeutic surgery for MPM from January 2001 to June 2015 was conducted to assess their outcomes. The patients' characteristics and postoperative course, including complications, mortality, overall survival, and recurrence-free survival, were analyzed. Results: Of the 21 patients who underwent therapeutic surgery, 1 5 (71.4%) underwent extrapleural pneumonectomy, 2 pleurectomy (9.5%), and 4 excision (1 9.1 %). The median age was 57 years (range, 32-79 years) and 15 were men (71.4%). The mean hospital stay was 1 6 days (range, 1-63 days). Median survival was 14.3 months. The survival rate was 54.2%, 35.6%, and 21.3% at 1, 3, and 5 years, respectively. In patients' postoperative course, heart failure was a major complication, occurring in 3 patients (14.3%). The in-hospital mortality rate was 2 of 21 (9.5%) due to a case of severe pneumonia and a case of acute heart failure. Conclusion: A fair 5-year survival rate of 21.3% was observed after surgical treatment. Heart failure was a major complication in our cohort. Various surgical methods can be utilized with MPM, each with its own benefits, taking into consideration the severity of the disease and the comorbidities of the patient. Patients with local recurrence may be candidates for surgical intervention, with possible satisfying results.

AUTOTRANSPLANTATION OF A MALPOSITIONED MANDIBULAR SECOND PREMOLAR : A CASE REPORT (이소매복된 하악 제2소구치의 자가치아이식을 이용한 치험례)

  • Chung, Youn-Joo;Koong, Hwa-Soo;Choi, Sung-Chul;Kim, Kwang-Chul;Park, Jae-Hong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.591-596
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    • 2009
  • In the case of the impacted teeth, the clinician has to consider development of tooth, site of impaction, eruption path, and cooperation of patient. Treatment options for the management of impacted teeth are separated into four categories: observation, intervention, orthodontic or surgical relocation and extraction. Autotransplantation may be defined as the transplantation of embedded, impacted or erupted teeth, from one site to another in the same individual into extraction site or surgically prepared sockets. Autotransplantation ensures preservation of natural tooth, induction of alveolar bone growth and root development, offers one of the fastest and most economically feasible means in the replacement of young patients' missing teeth. This case presents a malpositioned impacted mandibular premolar of an 11-year-old girl. It was thought that orthodontic traction was difficult because of its unfavorable impacted position. Therefore the tooth was treated by autotransplantation, we can observe good healing pattern during 12 months.

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Pharmacological Action of Radix Scutellariae on Nicotine-Induced Locomotor Activity and C-Fos Expression in Rats. (황금의 니코틴 약물투여에 의한 유전자 발현과 행동적 변동에 미치는 약리작용)

  • Lee Bom-Bi;Chae Youn-Byoung;Kwon Young-Kyu;Yang Chae-Ha;Kim Mi-Ryeo;Kim Kwang-Jung;Seo Yong-Min;Kim Jang-Hyun;Hahm Dae-Hyun;Lee Hye-Jung;Pyun Kwang-Ho;Shim In-Sop
    • The Journal of Korean Medicine
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    • v.26 no.3 s.63
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    • pp.1-12
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    • 2005
  • Objectives : Substantial evidence suggests that reinforcing effects of nicotine can be mediated by the mesolimbic dopaminergic system. It has been shown that repeated injections of nicotine produce an increase in locomotor activity and expression of the immediate-early gene, c-fos, in the dopaminergic target areas. Herbal medicine as a therapeutic intervention has been widely used for the treatment of mental dysfunction. Many studies have shown that Radix Scutellariae (RS) can affect the biochemical balance in the central nervous system. Tn order to investigate whether RS has an influence on nicotine-induced behavioral sensitization, we examined the effect of RS on nicotine-induced locomotor activity and c-fos expression in the striatum and nucleus accumbens utilizing the fos-tike immunohistochemistry (FLI). Methods : Male SD rats received RS (200mg/kg, i.p.) 30min before repeated daily injections of nicotine (0.4mg/kg, s.c.) for 7 days. This was followed by withdrawal for 3 days and one challenge for 1 day. Results : System challenge with nicotine produced a much larger increase in locomotor activity and accumbal FLI. Pretreatment with RS significantly inhibited nicotine-induced locomotor activity and FLI in the striatum and nucleus accumbens. Conclusions : These results demonstrate that reduction in locomotor activity by RS may be reflected by reduction of dopamine release and postsynaptic neuronal activity in the striatum and nucleus accumbens. Our results suggest that RS may have therapeutic effect on nicotine addiction.

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A Study of the Lived Experiences of Clients Receiving Long-Term Hemodialysis (장기 혈액투석 수혜자들의 생활경험에 관한 연구)

  • 신미자
    • Journal of Korean Academy of Nursing
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    • v.27 no.2
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    • pp.444-453
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    • 1997
  • The purpose of this study was to construct a grounded theory as the basis for nursing intervention by describing and analysing the holistic lived experiences of clients receiving long-term hemodialysis. The subjects of this study were fifteen persons receiving regular hemodialysis regimen at artificial kindey treatment centers in two different university hospitals, and who were able to participate in conversation and were available for long and dup interviews. Eight of the subjects were male and seven were female and their ages ranged from 30's to 60's. The length of the hemodialysis experience ranged from two months to six years. The collection and analysis of data were done in accordance with the grounded theory methodology of Strauss & Corbin. The method to collect the data mainly depended. on long and deep interviews, participant observation and focused group interviews and the equipment used to collect data were a portable tape recorder and field notes. The study is summarized as follows : 1. The meaning of holistic lived experiences of clients receiving long -term hemodialysis was found to be uncertainty. which was identified as the core category. 2. The main categories following the core category were found to be shock, ambiguity, social support and quality of life. 3. Through the main category the type of behavior newly formed by clients receiving long-term hemodialysis was found to be as follows. That is to say, in the circumstances of shock caused by the identified fact and the ambiguity of hemodilysis they formed a quality of life based on social support, which was found to be a kind of chaotic phenomenon. 4. The lived experiences of clients receiving long-tern hemodialysis was found to include nine categories : emotional shock, feelings of isolation, burden, unclearness, dependency, help from others, coping strategies, maintenance of self-esteem and transitional life. 5. The intervening factors influencing each category are as follows : 1) The factors influencing 'emetional shock' were found to be set age, the level of knowledge received in advance, locus of control, the period of struggle against the disease before hemodialysis and whether any serious illness existed. 2) The factors influencing 'feelings of isolation' were found to be religion and the length of the hemodialysis experience. 3) The factors influencing 'burden' were found to be sex, economic situation, employment status and the length of the hemodialysis experience. 4) The factors influencing 'unclearness' were found to be sex, age, religion. economic situation, the length of the hemodiaysis experience, whether they had had a transfusion and whether there were any complications. 5) The factors influencing 'help from others' were found to be religion. economic situation, past experiences and whether family members lived together. 6) The factors influencing 'coping strategies' were foung to be age, level of education, experiences of illness and locus of control. 7) The factors influeruing 'maintenance of self-esteem' were found to be the length of the hemodialysis experience and self-actualization. 8) The factors influencing 'transitional life' were found to be age, religion, economic situation, employment status. locus of control. past experiences and whether there was a plan for a kidney transplant.

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The Effect of the Vestibular Stimulation Training on the Balance of Patient with Chronic Stroke (전정자극 훈련이 만성 뇌졸중 환자의 균형에 미치는 영향)

  • Nam, Ki-Won;Oh, Chae-Eun;Seo, Dong-Yel
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.597-604
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    • 2017
  • This study examined the effects of vestibular stimulation training on the static and dynamic balance of patients with chronic stroke. This study was conducted from July 15th to September 6th, 2014 and 20 subjects diagnosed with stroke participated in this study. The subjects were divided randomly into Group I (general therapeutic exercise, n=10) and Group II (vestibular stimulation training, n=10). Both groups were trained for 40 minutes, 3 times a week, for 6 weeks. The balance ability, static balance and dynamic balance, were evaluated using a Good Balance System and compared before-and-after intervention. In the vestibular training group, there were statistically significant differences in the left-right and anterior-posterior balance with the eyes closed and standing posture, in the left-right and anterior-posterior balance with the eyes open and standing posture, and moving time and distance. In the general therapeutic exercise group, there was no significant difference except in the left-right balance with the eyes open and standing posture. In conclusion, vestibular stimulation training had positive effects on the static and dynamic balance of chronic stroke patients, and this training can be effective in a treatment program to improve the balance ability of stroke patients.

Clinical Features Affecting Antipsychotic Prescription for Delirium Patients (섬망 환자에서 항정신병약물 처방에 영향을 주는 임상적 특징)

  • Kim, Jongwon;Kim, Min-Hyuk;Paik, Soo-Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.111-118
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    • 2019
  • Objectives : The purpose of this study was to investigate the clinical characteristics of antipsychotic medication prescription for the symptom control in patients with delirium. Methods : One hundred and eighty-five patients referred to consultation-liaison psychiatric services for delirium due to general medical condition were included in this study. All subjects were divided into two groups (antipsychotics users vs. antipsychotics nonusers), and comparison analyses on their clinical characteristics were performed. Results : One hundred and twenty nine patients (66.5%) used antipsychotics for their delirium, and 56 patients (30.3%) did not use antipsychotics. The history of psychotropic medication was more frequently observed in antipsychotic users (5.4% vs. 18.6%, χ2=5.498, p=0.022). Especially, the history of benzodiazepine use was significantly high in antipsychotics users. The total score and sub-items of delirium rating scale-severity items except for the psychomotor retardation item showed higher scores in antipsychotic users than in nonusers (all p<0.05). The total score of the delirium rating scale-diagnosis items was higher in antipsychotic users than in the nonusers (p=0.010). Conclusions : Delirium patients with more severe delirium symptoms and with more history of benzodiazepine use were treated with antipsychotics more frequently than those without. These findings imply that benzodiazepine may not only exacerbate delirium but be associated with aggression or psychomotor agitation that need immediate intervention. Clinicians may need to pay attention not only these external symptoms but also to hypoactive symptoms that may lead to misdiagnosis and undertreatment.

The Relationship between Pain Level and Perceived Family Support and Quality of Life in Musculoskeletal Patients with Chronic Pain (근골격계 만성통증 환자가 지각한 통증, 가족지지 및 삶의 질과의 관계)

  • Oh, Hyun-Ja
    • The Korean Journal of Rehabilitation Nursing
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    • v.1 no.1
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    • pp.93-109
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    • 1998
  • The purpose of study is to identify the relation between pain level and perceived family support and quality of life in musculoskeletal patient with chronic pain. The subjects for the study consist of 155 patients with musculoskeletal pain that received medical treatment in hospital or by attending hospital in Chonju. The data were collected during the period from August 5 to August 14, 1998 by means of interviews with structured questionnaire. Data analysis was done by descriptive statistics. t-test, ANOVA, Pearson's correlation, Regression. Cronbach alpha using the SAS program. The result of this study were as follows : 1. The mean score of pain was 8.02, family support was 3.88 and quality of life was 3.07. 2. Hypothesis : The first hypothesis that 'The lower pain level is, the higher quality of life is' was accepted (r=-.2178, p= .0065). In addition, pain level of musculoskeletal patient with chronic pain provided predicted 4.7%(F=7.619, P= .0065) of quality of life. The second hypothesis that 'The higher perceived family support is, the lower pain level is' was rejected (r=-.0376, p= .6425). The third hypothesis that 'The higher perceived family support is, is higher quality of life is' was accepted (r= .3212, p= .0001). In addition, perceived family support of musculoskeletal patient with chronic pain provided predicted 10.31% (F=17.597, p= .0001) of quality of life. 3. General characteristics related pain were age(F=6.85, p= .0001),educational-level(F=9.29, p= .0001), occupation(F=5.81, p= .0037), marriage status(F=8.09, p= .0005), family numbers(F=5.73, p= .001), benefits of medical care(F=4.09, p= .0019), pain period(F=9.52, p= .0001), part of pain(F=2.33, p= .0352), pain period(F=3.08, p= .0181). 4. General characteristics related pain were sex(t=3.20, p= .0017), support sources(t=3.26, p= .0014), pain period(F-4.52, p= .0018). 5. General characteristics related pain were religion(t=3.11. p= .0022), benefits of medical care(F=3.61, p= .0293), pain duration(F=3.03, p= .0195). In conclusion, perceived family support in musculoskeletal patient with chronic pain is an important factor that can improve their quality of life. Therefore, nurses must establish nursing plan included patient's family when nurses carry out nursing intervention and education for patient so that a patient promote quality of life by maintaining optimal wellbeing.

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Investigating Organ Toxicity Profile of Tenofovir and Tenofovir Nanoparticle on the Liver and Kidney: Experimental Animal Study

  • Peter, Aniekan Imo;Naidu, Edwin CS;Akang, Edidiong;Ogedengbe, Oluwatosin O;Offor, Ugochukwu;Rambharose, Sanjeev;Kalhapure, Rahul;Chuturgoon, Anil;Govender, Thirumala;Azu, Onyemaechi O
    • Toxicological Research
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    • v.34 no.3
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    • pp.221-229
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    • 2018
  • Tenofovir nanoparticles are novel therapeutic intervention in human immunodeficiency virus (HIV) infection reaching the virus in their sanctuary sites. However, there has been no systemic toxicity testing of this formulation despite global concerns on the safety of nano drugs. Therefore, this study was designed to investigate the toxicity of Tenofovir nanoparticle (NTDF) on the liver and kidney using an animal model. Fifteen adult male Sprague-Dawley (SD) rats maintained at the animal house of the biomedical resources unit of the University of KwaZulu-Natal were weighed and divided into three groups. Control animals (A) were administered with normal saline (NS). The therapeutic doses of Tenofovir (TDF) and nanoparticles of Tenofovir (NTDF) were administered to group B and C and observed for signs of stress for four weeks after which animals were weighed and sacrificed. Liver and kidney were removed and fixed in formal saline, processed and stained using H/E, PAS and MT stains for light microscopy. Serum was obtained for renal function test (RFT) and liver function test (LFT). Cellular measurements and capturing were done using ImageJ and Leica software 2.0. Data were analysed using graph pad 6, p values < 0.05 were significant. We observed no signs of behavioural toxicity and no mortality during this study, however, in the kidneys, we reported mild morphological perturbations widening of Bowman's space, and vacuolations in glomerulus and tubules of TDF and NTDF animals. Also, there was a significant elevation of glycogen deposition in NTDF and TDF animals when compared with control. In the liver, there were mild histological changes with widening of sinusoidal spaces, vacuolations in hepatocytes and elevation of glycogen deposition in TDF and NTDF administered animals. In addition to this, there were no significant differences in stereological measurements and cell count, LFT, RFT, weight changes and organo-somatic index between treatment groups and control. In conclusion, NTDF and TDF in therapeutic doses can lead to mild hepatic and renal histological damage. Further studies are needed to understand the precise genetic mechanism.

Necessity for a Whole-body CT Scan in Alert Blunt Multiple Trauma Patients. (의식이 명료한 다발성 외상환자에게 전신 전산화단층촬영이 반드시 필요한가?)

  • Mun, You-Ho;Kim, Yun-Jeong;Shin, Soo-Jeong;Park, Dong-Chan;Park, Sin-Ryul;Ryu, Hyun-Wook;Seo, Kang-Suk;Park, Jung-Bae;Chung, Jae-Myung;Bae, Ji-Hye
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.89-95
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    • 2010
  • Purpose: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. Methods: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients' mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients' evidence of injury (present illness, physical examination, neurological examination) with the CT findings. Results: One hundred forty six(146) patients underwent whole-body CT. The mean age was $44.6{\pm}18.9$ years. One hundred four (104, 71.2%) were men, and the injury severity score was $14.0{\pm}10.38$. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. Conclusion: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.