• Title/Summary/Keyword: prescription rate

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Evaluation of response to stereotactic radiosurgery in patients with radioresistant brain metastases

  • Sayan, Mutlay;Mustafayev, Teuta Zoto;Sahin, Bilgehan;Kefelioglu, Erva Seyma Sare;Wang, Shang-Jui;Kurup, Varsha;Balmuk, Aykut;Gungor, Gorkem;Ohri, Nisha;Weiner, Joseph;Ozyar, Enis;Atalar, Banu
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.265-270
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    • 2019
  • Purpose: Renal cell carcinoma (RCC) and melanoma have been considered 'radioresistant' due to the fact that they do not respond to conventionally fractionated radiation therapy. Stereotactic radiosurgery (SRS) provides high-dose radiation to a defined target volume and a limited number of studies have suggested the potential effectiveness of SRS in radioresistant histologies. We sought to determine the effectiveness of SRS for the treatment of patients with radioresistant brain metastases. Materials and Methods: We performed a retrospective review of our institutional database to identify patients with RCC or melanoma brain metastases treated with SRS. Treatment response were determined in accordance with the Response Evaluation Criteria in Solid Tumors. Results: We identified 53 radioresistant brain metastases (28% RCC and 72% melanoma) treated in 18 patients. The mean target volume and coverage was 6.2 ± 9.5 mL and 95.5% ± 2.9%, respectively. The mean prescription dose was 20 ± 4.9 Gy. Forty lesions (75%) demonstrated a complete/partial response and 13 lesions (24%) with progressive/stable disease. Smaller target volume (p < 0.001), larger SRS dose (p < 0.001), and coverage (p = 0.008) were found to be positive predictors of complete response to SRS. Conclusion: SRS is an effective management option with up to 75% response rate for radioresistant brain metastases. Tumor volume and radiation dose are predictors of response and can be used to guide the decision-making for patients with radioresistant brain metastases.

A Survey on Pharmacists' Prescription Behaviors for Topical Steroids in Regions without Separation of Dispensary from Medical Practice in Korea (의약분업 예외지역 약국의 스테로이드 외용제 복약지도 실태조사)

  • Kim, Kwang-Myo;Kim, Bo-Ri;Lee, Jeong-Seon;Han, Ok-Yeon;Park, Mi-Sun;Yim, Hyeon-Woo;La, Hyen-O;Park, Young-Min
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.2
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    • pp.161-169
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    • 2011
  • The purpose of this study is to survey on the pharmacists' medication teaching service for topical steroids in regions without separation of dispensary from medical practice. The questionnaire was sent to 199 pharmacists who work inregions without separation of dispensary from medical practice via mail, e-mail or fax. 112 out of 199 pharmacists requested have answered the survey (response rate 56.28%). The questionnaire was composed of 4 categories with demographic characteristics, generally explained contents, adverse effects and precaution in pregnancy, breastfeeding and children. We analyzed the questionnaire by the 6 items with reference to the practical guidelines for medication teaching service. The medication teaching service for topical steroids in terms of generic name, physical characteristics, efficacy, usage and dosage, warning and precaution has been well provided by pharmacists in regions without separation of dispensary except for means and duration of optimal storage. The majority of pharmacists provided their patients with 4 and more kinds of items (69.64%), but the generally recommended 4 kinds of items such as generic name, efficacy, usage and dosage, warning and precaution were provided in as low as 48.22% of the respondents. These results show that the medication teaching service for topical steroids in terms of means and duration of optimal storage (45.54%) and the generally recommended 4 kinds of items have not been enough provided by pharmacists in regions without separation of dispensary. Taken together pharmacists in these regions should make a proper guideline for medication teaching service that can prevent the adverse effects of topical steroids.

Methods of The Promoting Blood Circulation and Removing Blood Stasis by Wang Cheong-Im (왕청임(王淸任)의 활혈거어법(活血祛瘀法))

  • Kim Hya-Sung;Jung Seung-Woo;Lee Jong-Il;Kwon Dong-Yeul
    • Herbal Formula Science
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    • v.12 no.2
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    • pp.47-55
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    • 2004
  • Wang Cheong-Im(1768-1831) in the Ching dynasty conducted the therapy of blood statis syndrome using the methods for promoting blood circulation and removing blood statis in accordance with the description in the book Uirimgaechak(醫林改錯). Thus, this study examined his methods for promoting blood circulation and removing blood statis, therapy of blood statis syndrome and mechanism of function. Since the blood statis symptoms varied on the parts where the blood statis were occurred, the therapy for promoting blood circulation and removing blood statis applied different treatments and drugs depending on the symptoms. The therapy also valued much of qi and blood. Qi is important to the human body so that the therapy replenished qi and simultaneously promoted the blood circulation as mainly focusing on the regulation of the qi flow. Moreover, the therapy adjusted the level of removing blood circulation and rate of replenishing qi. The degree of prescription and drug was differentiated in treating a variety of blood statis because of the difference in the seriousness and characteristics of blood circulation, amount and application of drug and combination of drugs. The therapy was careful about the regulation of qi for the replenishment of qi and the nurishment of blood for the promotion of blood circulation. If the blood circulation was blocked, the blood statis was formed. Accordingly, the phlegm and the blood statis were closely related. Then, the phlegm and blood statis were simultaneously treated. The therapy divided the properties of blood statis into the stagnant excess syndrome, the stagnant deficiency syndrome, the stagnant cold syndrome and the stagnant heat syndrome and treated the patients suitable for each symptom. The function of mechanism in the treatment using the methods for promoting blood circulation and removing blood statis was divided into the stagnation of blood and interruption in blood circulation. The therapy laid stress on promoting blood circulation and removing blood circulation. With such emphasis, the therapy facilitated the circulation in the bloood vessel, prevented the coagulation of blood, removed the blood statis and promoted the metabolism. Then, the physiological function and pathological change internal organs were improved. Furthermore, the therapy strengtened the heart and promoted the blood circulation by improving the systemic blood circulation. Moreover, the therapy facilitated the micro-circulation by adjusting the balance of body.

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Anti-angiogenic Effects of Shiquandabutang (십전대보탕(十全大補湯)이 혈관신생(血管新生) 억제(抑制)에 미치는 효과(效果))

  • Cui, Xun;Kang, Hee;Shim, Bum-Sang;Kim, Sung-Hoon;Choi, Seung-Hoon;Ahn, Kyoo-Seok
    • Journal of Korean Traditional Oncology
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    • v.11 no.1
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    • pp.119-134
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    • 2006
  • Shiquandabutang is very famous prescription for tonifying vital energy. We examined the anti-metatstastic effect of Shiquandabutang with in vitro invasion assay model. We performed the following experiments and the results are listed below:Cell viability assay was carried to determine the dose of Shiquandabutang. At lower dose under 200 ${\mu}g/m{\ell}$ (89.6%) viability was very high. But, viability downed as dose grows. At the dose of 600 ${\mu}g/m{\ell}$ (54.2%) viability was almost half of that of control. And at high dose of 1000 ${\mu}g/m{\ell}$ (15.8%) viability was very pure. In BrdU incorporation assay, Shiquandabutang treated groups showed the decreased DNA synthesis rate compared with control group.(200 ${\mu}g/m{\ell}$ (64.4%), 400 ${\mu}g/m{\ell}$ (7.3%)) The results of gelatinase assay showed that Shiquandabutang decreases the gelatinolytic activity of MMP-9. We examined tube formation assay and the result was that Shiquandabutang ihhibits the tube formation at the dose of 200 ${\mu}g/m{\ell}$ and 400 ${\mu}g/m{\ell}$. We examined rat aortic ring assay and the result was that Shiquandabutang ihhibits the angiogenesis of the rat aortic ring at the dose of 400 ${\mu}g/m{\ell}$. From our research, part of the mechanism underlying anti-metastastic effect of Shiquandabutang was proven in vitro. Moreover, we knew that Shiquandabutang is more effectively inhibits the angiogenesis at high dose.

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A Relationship between Corneal Type, Corneal Astigmatism and Lens Fitting States and the Stable Centration of Spherical RGP Lens (각막형상, 각막난시 및 렌즈 피팅상태와 구면 RGP렌즈의 중심안정위치와의 상관 관계)

  • Lim, Shin Gyu;Lee, Min Ha;Choi, Sun Mi;Park, Sang Hee;Kim, So Ra;Park, Mijung
    • Journal of Korean Ophthalmic Optics Society
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    • v.17 no.2
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    • pp.143-151
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    • 2012
  • Purpose: The present study was conducted to investigate whether there is any difference in the centration of spherical RGP lens on cornea according to corneal types, corneal astigmatism and lens fitting states. Methods: Spherical RGP lens was fitted on 29 eyes of round-typed cornea and 45 eyes of symmetric bowtie-typed cornea with 0.00~2.75 D of corneal astigmatism in alignment, steep or flat. Their lens centrations on cornea were analyzed by taking photographs. Results: The centration of spherical RGP lens in the vertical direction was decentrated to downward direction in all cases, and the degree of decentration was not consistent. The lens centration in horizontal direction was significantly more-decentrated to the temporal meridian as base curve of lens was increased, and the degree of decentration was different according to the corneal type, corneal astigmatism and fitting states. With the same degree of astigmatism, the lens decentration to the temporal meridian was bigger in round-typed cornea than that in symmetirc bowtie-typed cornea. Conclusions: The centration of spherical RGP lens varies depending on lens fitting states, corneal astigmatism, and corneal types. Thus, the consideration of these factors may improve the success rate in RGP lens prescription.

A Study on the Lower Body Muscle Strengthening System Using Kinect Sensor (Kinect 센서를 활용하는 노인 하체 근력 강화 시스템 연구)

  • Lee, Won-hee;Kang, Bo-yun;Kim, Yoon-jung;Kim, Hyun-kyung;Park, Jung Kyu;Park, Su E
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.11
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    • pp.2095-2102
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    • 2017
  • In this paper, we implemented the elderly home training contents provide individual exercise prescription according to the user's athletic ability and provide personalized program to the elderly individual. Health promotion is essential for overcoming the low health longevity of senior citizens preparing for aging population. Therefore, the lower body strengthening exercise to prevent falls is crucial to prevent a fall in the number of deaths of senior citizens. In this game model, the elderly are aiming at home training contents that can be found to feel that the elderly are going out of walk and exercising in the natural environment. To achieve this, Kinect extracts a specific bone model provide by the Kinect Sensor to generate the feature vectors and recognizes the movements and motion of the user. The recognition test using the Kinect sensor showed a recognition rate of about 80 to 97%.

Validation of Nursing-sensitive Patient Outcomes;Focused on Knowledge outcomes (지식결과에 대한 타당성 검증;간호결과분류(NOC)에 기초하여)

  • Yom, Young-Hee;Lee, Kyu-Eun
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.357-374
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    • 2000
  • The purpose of this study was to validate knowledge outcomes included Nursing Outcomes Classification(NOC) developed by Johnson and Maas at the University of Iowa. A sample of 71 nurse experts working in university affiliated hospitals participated in this study. They were asked to rate indicators that examplified the outcomes on a scale of 1(indicator is not all characteristic) to 5(indicator is very characteristic). A questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of outcomes. The results were as follow: 1. All indicators were considered to be 'supporting' and no indicators were considered to be 'nonsupporting'. 2. 'Knowledge: Treatment Regimen' attained and OCV score of 0.816 and was the highest OCV score among outcomes. 3. 'Knowledge: Energy Conservation' attained an OCV score of 0.748 and was the lowest OCV score among abuse outcomes. 4. 'Knowledge: Breastfeeding' attained an OCV score of 0.790 and was the highest indicator was 'description of benefits of breastfeeding'. 5. 'Knowledge: Child Safety' attained an OCV score of 0.778 and was the highest indicator was 'demonstration of first aids techniques'. 6. 'Knowledge: Diet' attained an OCV score of 0.779 and was the highest indicator was 'performance of self-monitoring activities'. 7. 'Knowledge: Disease Process' attained an OCV score of 0.815 and was the highest indicator was 'description of signs and symptoms'. 8. 'Knowledge: Health Behaviors' attained an OCV score of 0.800 and was the highest indicator was 'description of safe use of prescription drugs'. 9. 'Knowledge: Health Resources' attained an OCV score of 0.794 and was the highest indicator was 'description of need for follow-up care'. 10. 'Knowledge: Infection Control' attained an OCV score of 0.793 and was the highest indicator was 'description of signs and symptoms'. 11. 'Knowledge: Medication' attained an OCV score of 0.789 and was the highest indicator was 'description of correct administration of medication'. 12. 'Knowledge: Personal Safety' attained an OCV score of 0.804 and was the highest indicator was 'description of measures to reduce risk of accidental injury'. 13. 'Knowledge: Prescribed Activity' attained an OCV score of 0.810 and was the highest indicator was 'proper performance of exercise'. 14. 'Knowledge: Substance Use Control' attained an OCV score of 0.809 and was the highest indicator was 'description of signs of dependence during substance withdrawl'. 15. 'Knowledge: Treatment Procedure(s)' attained an OCV score of 0.795 and was the highest indicator was 'description of appropriate action for complications'. 16. 'Knowledge: Treatment Regimen' attained an OCV score of 0.816 and was the highest indicator was 'description of self-care responsibilities for emergency situations'. More outcomes need to be validated and outcomes sensitive to Korean culture need to be developed.

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Clinical Outcomes of Multidisciplinary Team Care on the Regulation of Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) in Patients Undergoing Dialysis (미네랄 골질환 합병증을 가진 투석환자에서 다학제 팀 서비스의 임상적 성과)

  • Han, Nayoung;Lee, Sang-Min;Hong, Jin Yi;Noh, Hye Jin;Ji, Eunhee;Song, Yun-Kyoung;Song, Jeeyoun;Kim, In-Wha;Kim, Yon Su;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.318-323
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    • 2016
  • Background: Multidisciplinary team care (MTC) is a collaborative approach to treatment plan and ongoing care. We aimed to evaluate the clinical effect of MTC on the regulation of chronic kidney disease-mineral and bone disorder (CKD-MBD) complications in dialysis patients. Methods: This retrospective observational study was approved by the institutional review board. Among patients who have undergone dialysis at admission, the patients admitted to the nephrology ward were allocated to MTC group, and the others to usual care (UC) group. The MTC group had collaborative care by nephrologists, nurses, pharmacists, and nutritionists. The endpoints were the regulation of corrected calcium (cCa) and phosphate (P), the percent of patients in target level of cCa-P product ($cCa{\times}P$), and the prescription rate of non-calcium based P-binders. Results: A total of 163 patients were included from January to December 2009. A significant difference was shown in the percentage of patients in target $cCa{\times}P$ level at admission (MTC vs. UC, 81.40% vs. 91.67%; P = 0.038), but there was no significant difference at discharge. During admission, the cCa and P levels of patients in only UC group were significantly changed. In addition, compared with UC group, patients in MTC group were more likely prescribed appropriate P-binders, when they had higher $cCa{\times}P$ levels than $55mg^2/dL^2$ (P <0.001). Conclusion: It was found that MTC had beneficial effect on improving the regulation of CKD-MBD and the appropriate phosphate binder uses. Therefore, application of the MTC is anticipated to enhance quality of clinical care in chronic diseases.

Comparison of Noncycloplegic Autorefraction, Manifest Refraction and Cycloplegic Autorefraction in School-aged Children (학령기 근시아동에서 비조절마비 자동굴절검사, 검영법, 조절마비 자동굴절검사에 의한 굴절검사값의 비교)

  • Kim, Dae-Young;Lee, Koon-Ja;Baarg, Saang-Bai;Kim, Hyojin
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.2
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    • pp.123-130
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    • 2010
  • Purpose: The study was conducted to compare the values of auto-refraction, manifest refraction and cycloplegic refraction in school-aged children. Methods: One hundred five myopic school children ranged from 6 to 14 years old (210 eyes, $10.28{\pm}1.59$ years old) were recruited and noncycloplegic auto-refraction (AR) and manifest refraction (MR) were conducted and then underwent cycloplegia and refractive status (CR) again with the auto-refractometer. Results: Refractive powers measured by AR, MR, and CR were highly correlated. However, spherical and cylindrical powers of the subjects measured by AR were measured higher negative power than in CR (p<0.001). From 210 eyes, the discrepancy rate in the spherical and cylindrical powers were 40 eyes (19%) and 19 eyes (9%) of the total subjects, respectively and the differences between noncycloplegic and cycloplegic refractions were higher with the spherical and cylindrical powers increasing. Conclusions: The use of the autorefractometer in children with negative spherical power without cycloplegia may overestimate the actual myopia that subjective refraction is the most important in prescription for the eyeglasses and regression equations would be used to prognose the cycloplegic refraction from the auto-refraction as the basic data for the subjective refraction.

Comparison with ABCHES and Abdomen Compression Device in Respirational Radiation Therapy on Patients in Hepatocellular Carcinoma (간세포암 환자에서 ABCHES와 복부압박장비의 적용한 호흡동조방사선 치료의 유용성 비교)

  • Cho, Yoon-Jin;Byun, Sang-Joon;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.6 no.5
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    • pp.395-402
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    • 2012
  • 4D-Radiation Therapy is the optimal treatment to track moving organs(tumor) and give the appropriate prescription dose to tumor and low radiation dose to normal tissue surrounding tumor volume. The ABCHES is a 4DRT devices maintaining shallow breathing to patients. It allows the tumor's movement was minimize. Meanwhile, Abdominal compression device is limited the breath compressing abdomen on patients. In this paper we will quantitative analysis the movement of tumor on only ABCHES versus ABCHES with Abdomal compression device and Analysis tumor dose and normal tissue's dose by Dose Volume Histogram on two parts. The result of Comparision ABCHES and ABCHES with Abdominal compression device, SI(Superior-Inferior) direction, AP(Anterior-Posterior) direction and LR(Left-Right) direction was limited 1.0 mm, 0.2 mm, 0.2 mm(average). and also reduction rate of voluume in HPTV was $16{\pm}2%$, and LPTV was $15.8{\pm}0.8%$ under only using ABCHES and ABCHES with compression. The analysis dose volume histogram was more radiation dose in ABCHES and abdominal compression device than only using ABCHES, and less normal tissue-ipsilateral lung, whole lung, kidney-dose in ABCHES and abdominal compression device than only using ABCHES. The overall analysis was ABCHES with abdominal compression better than only using ABCHES method. In hereafter it will be studies that limitation of ABCHES and abdomonal compression device. In other words, patient's discomfort on compression intensity, method of application on patient with inaccurate respiration cycle.