• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.925-928
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• 2014

Background: Gestational trophoblastic neoplasia (GTN) is a spectrum of disease with abnormal trophoblastic proliferation. Treatment is based on FIGO stage and WHO risk factor scores. Patients whose score is 12 or more are considered as at extremely high risk with a high likelihood of resistance to first line treatment. Optimal therapy is therefore controversial. Objective: This study was conducted in order to summarize the regimen used for extremely high risk or resistant GTN patients in our institution the in past 10 years. Materials and Methods: All the charts of GTN patients classified as extremely high risk, recurrent or resistant during 1 January 2002 to 31 December 2011 were reviewed. Criteria for diagnosis of GTN were also assessed to confirm the diagnosis. FIGO stage and WHO risk prognostic score were also re-calculated to ensure the accuracy of the information. Patient characteristics were reviewed in the aspects of age, weight, height, BMI, presenting symptoms, metastatic area, lesions, FIGO stage, WHO risk factor score, serum hCG level, treatment regimen, adjuvant treatments, side effects and response to treatment, including disease free survival. Results: Eight patients meeting the criteria of extremely high risk or resistant GTN were included in this review. Mean age was 33.6 years (SD=13.5, range 17-53). Of the total, 3 were stage III (37.5%) and 5 were stage IV (62.5%). Mean duration from previous pregnancies to GTN was 17.6 months (SD 9.9). Mean serum hCG level was 864,589 mIU/ml (SD 98,151). Presenting symptoms of the patients were various such as hemoptysis, abdominal pain, headache, heavy vaginal bleeding and stroke. The most commonly used first line chemotherapeutic regimen in our institution was the VAC regimen which was given to 4 of 8 patients in this study. The most common second line chemotherapy was EMACO. Adjuvant radiation was given to most of the patients who had brain metastasis. Most of the patients have to delay chemotherapy for 1-2 weeks due to grade 2-3 leukopenia and require G-CSF to rescue from neutropenia. Five form 8 patients were still survived. Mean of disease free survival was 20.4 months. Two patients died of the disease, while another one patient died from sepsis of pressure sore wound. None of surviving patients developed recurrence of disease after complete treatment. Conclusions: In extremely high risk GTN patients, main treatment is multi-agent chemotherapy. In our institution, we usually use VAC as a first line treatment of high risk GTN, but since resistance is quite common, this may not suitable for extremely high risk GTN patients. The most commonly used second line multi-agent chemotherapy in our institution is EMA-CO. Adjuvant brain radiation was administered to most of the patients with brain metastasis in our institution. The survival rate is comparable to previous reviews. Our treatment demonstrated differences from other institutions but the survival is comparable. The limitation of this review is the number of cases is small due to rarity of the disease. Further trials or multicenter analyses may be considered.

• 재활간호학회지
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• 제1권1호
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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.

• The Journal of Korean Physical Therapy
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• 제16권4호
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• pp.59-79
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• 2004

The purpose of this study was to determined the effects of reciprocal inhibition on spatial-temporal gait parameters in spastic hemiplegic patients through GaitRite system. The subjects were consisted 45 patients who had spastic hemiplegia due to stroke. All subjects randomly assigned to 3 group : manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not recieved any therapeutic intervention. Before and after experiments, spatial-temporal gait parameters and functional ambulatory profile was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. The results of this study were as following : 1. The percentage of change of functional ambulatory profile were markedly increased in manual group but statistically non significant(p>.01). 2. The percentage of change of gait velocity and cadence were markedly increased in manual group but statistically non significant(p>.01). 3. Asymmetry ratio of gait elements were more improved in manual group but statistically non significant(p>.01). 4. There were no statistical difference between pre-test and post-test with functional ambulatory profile, gait velocity, cadence and asymmetry ratios in NMES group(p>.01). 5. There were no statistical difference between pre-test and post-test with unctional ambulatory profile, gait velocity, cadence and asymmetry ratios in control group(p>.01). In conclusion, the present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be improved spatial-temporal gait parameters including functional ambulatory profile in hemiplegic patients. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyze the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.

• 한국수정란이식학회지
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• 제33권1호
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• pp.1-11
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• 2018

Cellular cyclic adenosine-3' 5'-monophosphate (cAMP) modulator is known as meiotic inhibitor and can delays spontaneous maturation in IVM experiment. Among many cAMP modulators, the role of Pituitary adenylate cyclase activating polypeptide (PACAP) on IVM isn't known. The purpose of this study is to improve the maturation of oocytes derived from follicles ${\leq}3mm$ in diameter through PACAP as meiotic inhibitor during pre-in vitro maturation (pre-IVM). First, we checked PACAP and its receptors in cumulus cells and, to establish the optimal phase and concentration of PACAP for pre-IVM, we conducted chromatin configuration assessments. As a result, the rate of GV (Germinal Vesicle) according to duration of pre-IVM was significantly decreased 12 h and 18 h after IVM (87.1 and 84.1%, respectively) compared to 0 h (99.4%). When COC was cultured for 18 h, the GV rate in the $1{\mu}M$ of PACAP treatment group (82.1%) was significantly higher than any other PACAP treatment groups (60.5, 64.1, 74.4 and 69.9 %, respectively). So, we divided into four groups as follows; MF (the conventional IVM group, obtained from follicle from 3 to 6 mm in diameter), SF (the conventional IVM group, obtained from follicle ${\leq}3mm$ in diameter), Pre-SF(-)PACAP (IVM group including 18 h pre-IVM without $1{\mu}M$ of PACAP, obtained from follicle ${\leq}3mm$ in diameter) and Pre-SF(+)PACAP (IVM group including 18 h pre-IVM with $1{\mu}M$ of PACAP, obtained from follicle ${\leq}3mm$ in diameter). To examine the effect of PACAP during pre-IVM, we investigated analysis of nuclear maturation, intracellular glutathione (GSH) and reactive oxygen species (ROS) levels. In cumulus cells, PACAP receptors, ADCYAP1R1 and VIPR1 were detected but were not detected in oocytes. After IVM, the Pre-SF(+)PACAP had the highest Metaphase II rate (91.7%) among all groups (P<0.05). The GSH levels in the MF and Pre-SF(+)PACAP were significantly higher than in the other groups (P<0.05) and ROS levels was no significant difference among all groups. In conclusion, these results indicated that even though the oocytes were derived from SF, pre-IVM application of PACAP improved meiotic and cytoplasmic maturation by regulating intracellular oxidative stress.

• 대한정형도수물리치료학회지
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• 제11권1호
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• pp.11-28
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• 2005

Spasticity has been defined as "a motor disorder characterized by a velocity-dependent increased in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one components of the upper motorneuron syndrome". Spasticity is one of the common symptoms of stroke patients and frequently interferes with the motor functions such as gait, posture and activities of daily living. Therefore, its management is becoming a major issue in physical therapy. The purpose of this study was to determined the effects of reciprocal inhibition by isometric contraction of pre-tibia muscle on spasticity in hemiplegic patients through Hoffmann reflex. The subjects were consisted 45 patients who had hemiplegia due to stroke. All subjects randomly assigned to 3 group: manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not received any therapeutic intervention. Before and after experiments, Hoffmann reflex, M-wave and Modified Ashworth scale was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. Modified Ashworth scale were significantly decreased after experiment in manual group(p<.01). The Hmax/Mmax ratios were significantly decreased after experiment in manual group(p<.o1). There were no statistical difference between pre-test and post-test with modified Ashworth scale in NMES group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in NMES group(p>.01). There were no statistical difference between pre-test and post-test with modified Ashworth scale in control group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in control group(p>.01). The present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be reduce spasticity of gastrocnemius. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyse the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.

• 정신신체의학
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• 제16권2호
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• pp.69-74
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• 2008

섬망은 의식의 장애와 인지 증상이 급성 발병을 하며 변동하는 경과를 보여주는 기질적인 정신과 증후군이다. 임상적 아형을 이상적으로 분류하기 위한 도구는 없지만 Lipowski(1983)가 섬망의 아형을 정신운동의 활동성을 기준으로 과활동성, 저활동성, 혼재성으로 분류한 이래로 연구자들 마다 다양한 도구를 이용하여 섬망의 아형을 임상적으로 구분하여 왔다. 그 연구 결과에 의하면 저활동성 섬망의 유병율이 과활동성 섬망에 비하여 오히려 많거나 적지 않은 것으로 보고되고 있지만 증상의 특성 때문에 저활동성 섬망의 임상적 진단이 적게 이루어지거나 우울증이나 치매 등으로 오인되는 경향을 보였다. 과활동성 섬망은 알코올 또는 벤조디아제핀 금단등에 의해 유발되며 도파민 과잉과 아세틸콜린의 결핍과 관련이 있으며 고역가 항정신병약물에 반응이 좋아 다른 아형에 비하여 예후가 양호한 반면에 저활동성 섬망은 대사성 뇌병증에 의한 경우가 흔하며 고역가 항정신병약물에 의한 반응이 예상보다 좋지 않는 경우가 있으며 임상적으로 정신자극제 치료가 효과적이라는 보고가 되고 있다. 입원 기간도 더 길고 인지 증상도 심하여 전반적으로 예후가 좋지 못한 경향이 있다. 섬망은 아형을 갖는 이질적인 증후군이다. 아형이 존재한다는 것은 아마도 각기 다른 기전에 의할 가능성을 시사하며 따라서 아형에 따라 구별되는 치료 전략이 필요할 것이다.

• 대한인간공학회지
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• 제35권6호
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• pp.551-568
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• 2016

Objective: The objective of this study is to identify the difference in the press behavior characteristics of 3D Touch, which is a new touch interaction of smart phones, and the existing 'Tap and Long Press' touch interaction, and to examine behavior changes upon feedbacks. Background: Since 3D Touch is similar to the existing 'Tap and Long Press' touch interactions in terms of press behavior, which is likely to cause interference, it is necessary to conduct a preliminary study on behavior characteristics of touch interactions. Method: In utilization of smart phones with the 3D Touch function to measure press behavior characteristics of touch interaction, an experiment was conducted where 30 subjects were given a task to press 30 buttons of touch interactions on the screen. During the experiment, two press behavior characteristics-maximum touch pressure and press duration-were analyzed. To grasp changes in behaviors upon feedbacks, the task was carried out in a condition where there was no feedback and in a condition where there were feedbacks of specific critical values. Results: While there was no feedback given, subjects tended to press with much strength (318.98gf, 0.60sec) in the case of 3D Touch, and press the Long Press button for a while (157.12gf, 1.10sec) and press the Tap button with little strength only for a short moment (37.92gf, 0.10sec). 3D Touch and Long Press had an area of intersection in time, but when feedbacks of specific critical values were given, there were behavior calibration effects to adjust the press behavior characteristics of 3D Touch and Long Press. Conclusion: Although interferences are expected between 3D Touch and Long Press due to the similarity of press behaviors, feedbacks induce behavior calibration. Hence, once feedbacks were provided with 3D Touch operated in an appropriate condition of critical pressure, interference between two motions can be minimized. Application: The findings of this study are expected to be utilized as a basis for the values of optimal critical pressure, at which users can easily distinguish 3D Touch from Long Press which is the existing touch interaction.

• 구강회복응용과학지
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• 제29권2호
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• pp.141-151
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• 2013

티타늄 산화막을 나노단위에서 변형시키는 방법은 다공성 표면을 강화하는 내부적 접근과 나노입자를 피복하는 외부적 접근으로 나눌 수 있다. 나노표면은 나노튜브, 나노피트, 나노노듈 및 다형구조 등 다양한 형태를 지닌다. 형성방법 및 형성재료에 따라 다른 표면이 생성되지만, 현재까지 표준화된 형성방법은 없다. 나노표면을 분석해 보면 마이크론 단위의 표면구조에는 영향을 미치지 않으며 전기화학적으로 안정적이다. 나노표면은 세포독성이 거의 없으며 조골세포의 증식과 분화를 모두 촉진하고, 섬유모세포의 증식을 저해하여 연조직 개재를 감소시키는 효과를 가진다. 또한 세포 및 단백질과 유사한 크기 및 형태를 가지기 때문에 조직과의 친화성이 우수하여 골유착을 증진시킨다. 하지만 그 작용이 미치는 범위는 극히 제한되어 있기 때문에 골조직과의 거리가 있는 경우에는 효과가 미미하다. 마이크론 단위의 표면과는 달리 나노표면은 광촉매효과로 인한 항균작용을 가지지만 지속시간이 짧아 실제 임상에서의 적용효과는 의문시 된다. 하지만 마이크론 단위의 표면거칠기가 가지는 단점을 배제할 수 있어 다양한 가능성을 가지기 때문에 더 많은 연구가 필요하다.

• 한국응용곤충학회지
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• 제56권4호
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• pp.351-356
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• 2017

관주처리에 의한 벼멸구 흡즙 섭식 독성, 잎 침지처리에 의한 접촉독성과 식물체내 침투에 의한 섭식독성, 미량국소처리에 의한 표피 접촉 독성 등, 처리 방법에 따른 카보퓨란의 벼멸구에 대한 살충 작용 특성을 분석하였다. 카보퓨란 관주처리는 시간에 따른 벼멸구의 살충력 변화가 2가지 패턴으로 나타났다. 상대적으로 높은 농도(8~30 ppm)의 처리에서는 급격히 사충율이 올라가다가 시간이 지남에 따라 증가율이 낮아지는 로그곡선의 형태와 낮은 농도(1~4 ppm)의 처리에서는 사충율 증가 패턴이 S 자 모양의 곡선 형태를 보였다. 관주처리 시 높은 농도에서는 처리효과가 즉시 나타나 하루 만에 치사율이 40% 이상 도달하였으나 상대적으로 낮은 1~2 ppm의 농도에서는 처리 5일 후에야 80~100%에 달하는 사충율을 얻을 수 있었다. 침지처리는 사충율이 처리 1일 후 약효가 급격히 증가하고 이 후 증가율이 낮아졌다. 국소처리도 침지처리와 비슷한 경향을 보이나 침지처리와는 달리 처리 후 3일 이후에는 사충율이 거의 증가하지 않았다. 약효 최적 조사 시간은 관주처리에서 처리 후 2일 (42시간)이었으며 침지처리와 국소처리에서는 처리 후 1~2일이 약효 조사 적기였다.

• Clinical and Experimental Reproductive Medicine
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• 제38권1호
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• pp.47-52
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• 2011

Objective: To determine whether characteristics of sperm motility obtained by computer-assisted sperm analysis (CASA) could predict pregnancy after intrauterine insemination (IUI) in couples with unexplained infertility. Methods: Three hundred eighty-three cycles of intrauterine insemination with superovulation were retrospectively analyzed. Semen analysis was performed with CASA before and after swim-up and the parameters were compared between pregnant and non-pregnant women. Results: The pregnancy rate per cycle was 14.1%. Pregnant and non-pregnant women were comparable in terms of age, infertility duration, the number of dominant follicles. While sperm concentration, motility, and parameters such as average path velocity (VAP) and percentage rapid (RAPID) before semen preparation were significantly different between the pregnancy and non-pregnancy groups, there were no differences in sperm parameters when comparing the two groups after preparation. Using a receiver operating characteristic curve to measure sensitivity and specificity, the optimal threshold value for the predictors of pregnancy was revealed to be a concentration of ${\geq}111{\times}10^6/mL$, a motility of ${\geq}$ 51.4%, and RAPID ${\geq}$ 30.1% before preparation for IUI. Conclusion: Sperm parameters including concentration, motility, and RAPID before sperm preparation could have predictive value for pregnancy outcome after intrauterine insemination with superovulation in couples with unexplained infertility, and would be helpful when counseling patients before they make the decision to proceed with IVF/ICSI-ET.