• 제목/요약/키워드: therapeutic relationship

검색결과 427건 처리시간 0.029초

Hydrocortisone 정주후 기관지수축이 발생한 기관지 천식 1예 (A Case of Bronchospasm after Intravenous Hydrocortisone Succinate injection in an Asthmatics)

  • 이영수;주용진;김광호;한병근;이상철;용석중;신계철
    • Tuberculosis and Respiratory Diseases
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    • 제41권5호
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    • pp.568-573
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    • 1994
  • 저자들은 급성 기관지 천식환자에서 치료제로 사용하는 hydrocortisone을 투여 후 유발된 기관지 수축이 발생한 예를 경험 하였기에 문헌고찰과 함께 보고하는 바이다.

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암환자의 통합의학 치료경험 - 근거이론을 중심으로 - (Integrated medical treatment experience of cancer patients -grounded theory around-)

  • 문준석;신헌태
    • 대한예방한의학회지
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    • 제21권1호
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    • pp.107-119
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    • 2017
  • Purpose : Recently, cancer has become a chronic disease that requires supervision because of early diagnosis and the development of therapeutic technology. As a result, cancer patients are interested in improving the quality of their lives besides the treatment of cancer itself. Therefore, it is necessary to conduct a qualitative research to understand the vivid experiences of cancer patients and structure their treatment experience. Among qualitative researches, grounded theory is developed based on the data collected in the field. The grounded theory research method is easy to analyze for the process and structure of the treatment experience. Therefore, the purpose of this study is to provide basic data on the integrated medical experience of cancer patients Methods : Participants were conveniently selected, and the criteria for selection were for those who had more than 1 month of hospitalization so that they could dictate their situation and experience in a meaningful manner. Data was collected through in-depth interviews and continued until the data were saturated through theoretical sensitivity and continuous comparison methods. The collected data were analyzed through the process of open-coding, axial coding, and selection coding, which are the research methods of grounded theory. Results : Cancer patients differ in their path, purpose, and attitudes depending on their respective situations and the internal and external resources of individuals. There is also a difference in the perception of their situation among the cancer patients and their families. Cancer patients were shown to recognize and cope with problems in the integrated medical treatment process, and have been classified into 6 different types after the results. Cancer patients showed positive changes in terms of physical, emotional, and lifestyle after their integrated medical treatment. Cancer patients perceived the integrated medical treatment process as a horizontal relationship structure and with diversity. Conclusions : The experience of integrated medical treatment of cancer patients is a process of rehabilitation that heals the body and restores life within the interaction of support system, contextual situation, and internal resources of the individual. Despite this, there is a need not only for the efforts of integrated medical service providers but also institutional support in the future with regards to the current weaknesses and points for improvement. In addition, there is a need for an objective criterion to measure the outcome of integrated medicine for the standardization of integrated medical services.

교감신경계가 암의 발전과 진행에 미치는 영향 (The Influence of the Sympathetic Nervous System on the Development and Progression of Cancer)

  • 박신형;지규용;최영현
    • 생명과학회지
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    • 제28권1호
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    • pp.116-129
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    • 2018
  • 생물체는 스트레스에 대처하기 위한 항상성 유지 기작을 가지고 있으나, 만성적이고 반복적인 스트레스는 카테콜아민과 같은 스트레스 호르몬의 과도한 방출로 인해 인체에 해로운 영향을 미친다. 교감신경계와 암과의 관련성을 분석하는 연구는 스트레스가 암을 악화시킬 수 있다는 오랜 가설을 바탕으로 이루어졌다. 다수의 전임상연구와 역학 연구결과는 교감신경계의 주요 신호전달경로인 ${\beta}$-adrenergic signaling을 조절하는 것이 암의 진행을 억제할 수 있음을 보여주고 있다. 교감신경계의 활성화는 암세포의 oncogene과 DNA repair 유전자 조절, 생존과 사멸 조절, EMT 및 전이 조절, 면역계와 혈관신생 조절, 세포외기질과 간엽세포 조절, 지방세포 조절 등을 통해 암세포와 종양미세환경에 광범위하게 영향을 미칠 수 있다. 오늘날 암의 성장과 관련된 분자적 기전을 차단하는 표적항암치료가 각광받고 있으나, 보상경로의 활성화와 항암제 내성 출현 및 여러 부작용으로 말미암아 임상적 실패를 거듭하면서 암의 생병리를 다방면에서 조절하는 전략이 새로운 치료법으로 대두되고 있다. 본 총설에서는 이러한 암의 전신적 조절인자로서 교감신경계가 암의 형성과 발전에 미치는 영향을 요약하고, 향후 새로운 암 치료전략으로서 ${\beta}$-adrenergic signaling을 조절하는 약물의 임상적 활용가능성에 대해 논의하고자 한다.

Clinicopathologic Characteristics and Prognostic Factors in Patients with Operable HER-2 Overexpressing Breast Cancer

  • Liu, Ai-Na;Sun, Ping;Liu, Jian-Nan;Ma, Jin-Bo;Qu, Hua-Jun;Zhu, Hua;Yu, Cai-Yan;Zhang, Liang-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권4호
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    • pp.1197-1201
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    • 2012
  • Objective: To study the relationship between clinical pathologic characteristics, treatment modalities and prognostic factors in HER-2 (Human Epidermal growth factor Receptor-2) overexpressed breast carcinoma. Materials and Methods: Major clinico-pathological factors including therapeutic modalities and survival status of 371 breast cancer patients with HER2 over-expression, teated at Yantai Yuhuangding Hospital from March of 2002 to December of 2010 were retrospectively studied, with special attention focused on survival-related factors. Results: The median age of the total 371 patients in this study was 48 years at time of diagnosis, among which, the leading pathological type was infiltrating ductal carcinoma (92.5%); 62.8% presented with a primary tomor larger than 2 cm in diameter at diagnosis, 51.0% had axillary lymph node (ALN) metastases; ER (Estrogen receptor)/PR (Progesterone receptor) double negative occured in 52.8% of cases, and PCNA (proliferation cell nuclear antigen) (+++) was found in 55.1%. HER-2 overexpressed patients were usually in advanced stage when the diagnosis was made (72.8% at stages IIA~IIIC). The prognosis and survival were assessed in 259 patients with complete follow-up data. 5-year DFS (disease-free survival) and OS (overall survival) rate was 68.0% and 78.0% respectively. Univariate analysis revealed that age, tumor size, ALN metastases, LVSI (lymph-vascular space involvement), PCNA status, hormonal therapy, chemotherapy cycles, and HER-2 overexpression, correlated closely with the prognosis. ALN metastases, LVSI, PCNA status and chemotherapy cycles were independent predictors of survival. Conclusions: HER-2 overexpressed breast cancer has special clinical and pathological characteristics, with advanced clinical stages and high rate of ER/PR double negative. Lymph node metastases, LVSI, PCNA and chemotherapy cycles are independent predictors of prognosis.

의사소통 훈련 프로그램이 간호사의 의사소통능력, 감성지능(EQ), 자존감 및 대인관계능력에 미치는 효과에 대한 사례연구 (A case study on the effect of communication training program on nurse's communication ability, emotional intelligence (EQ), self - esteem and interpersonal ability)

  • 유미자
    • 한국산학기술학회논문지
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    • 제19권6호
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    • pp.280-290
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    • 2018
  • 본 연구는 의사소통 훈련을 받은 실험집단과 그렇지 않은 대조집단 사이의 의사소통능력, 감성지능, 자존감과 대인관계능력의 차이를 비교하는 비동등성 유사실험 연구이다. 연구대상은 C시 소재의 D대학병원에 근무하는 21명의 간호사를 실험집단으로, 21명의 간호사를 대조집단으로 구성하여 2017년 4월부터 5월까지, 실험집단에게는 의사소통능력, 감성지능, 자존감 및 대인관계능력 향상을 위한 의사소통 훈련 프로그램을 주 1회 2시간씩 총 4회기를 진행하였고, 연구의 효과성 검정을 위하여 사전, 사후 검사를 실시하였다. 자료 분석은 SPSS for Window 23을 이용하여 사전사후검사의 평균과 표준편차, 독립표본 Mann-Whitney의 U검증, 대응표본 Wilcoxon 부호 순위 검증을 실시하였다. 연구결과 실험집단과 훈련을 받지 않은 대조집단에서 의사소통능력(Z=-3.361, p<.05), 감성지능(Z=-2.209, p<.05), 자존감(Z=-1.633, p<.05), 대인관계능력(Z=-2.577, p<.05)으로 나타나, 의사소통훈련 프로그램 후 실험집단의 의사소통능력, 감성지능(EQ), 자존감 및 대인관계능력 점수가 모두 유의하게 증가하였으며, 모든 가설은 지지되었다. 이러한 결과를 볼 때 임상현장에서 간호업무 수행 시 의사소통 훈련프로그램을 활용한다면 의사소통능력, 감성지능(EQ), 자존감 및 대인관계능력의 향상으로 치료적인 의사소통과 효과적인 간호를 제공하여 환자의 만족감을 높이고 간호의 질 향상에도 기여할 것이다.

미병학(未病學) 체계구축을 위한 질병예측자(疾病豫側子)로서의 형상진단연구 - 담방광체(膽膀胱體)와 남녀형상(男女形象)을 중심으로 - (Study on Diagnosis by Facial Shapes and Signs as a Disease-Prediction Data for a Construction of the Ante-disease Pattern Diagno-Therapeutic System - Focusing on Gallbladder's versus Bladder's Body and Masculine versus Feminine Shape -)

  • 김종원;김경철;이용태;이인선;김규곤;지규용
    • 동의생리병리학회지
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    • 제23권3호
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    • pp.540-547
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    • 2009
  • There needs disease-predictable signs in order to enable preventive diagnosis and therapy. Then traditional Chinese medicine applies various medical diagnostic equipments used in western medicine to diagnosing sub-healthy state. But such data are not originated from inherent oriental medicine, and not obtained easily in ordinary clinical practice. This paper is to provide synopsis of the ante-disease diagno-therapeutics partly and to show predictable data based on the facial shapes and signs, especially of gall bladder's versus bladder's body and masculine versus feminine shape. Ante-disease means not only the complete healthy state, but also the state unseen any symptoms in macrographically in the course of outbreak of disease. It contains two stages, first one is the former state of disease and second one is untransmitted state of disease. The patterns of ante-disease consist of latent disease, pre-disease, transmission type like senescent syndrome, abnormal reactive syndrome(變證), syndrome of transmission and transmutation. The classification with gall bladder and bladder type manifests the differences of shape, color and size of each organ in comparison of the universal and standard figures of the human being. On the other hand, the classification with masculine and feminine shape contrasts the innate sexual difference and the shape, characteristics originated from in itself. These two classification theories have their own pathologic types and syndrome types with each disease so that disease-predictable data can be constructed based on such a relationship. In addition, this diagnostic method by facial shapes and signs is able to be applied to whole stages from prenatal to present state of disease even if the cause and inducement are not clear. Ante-disease diagno-theraputic system by Gall Bladder's versus Bladder's Body and Masculine versus Feminine Shape is getting more important in the chronic and internal disease in comparison of the acute and traumatic disease. So this study is able to make up for the limit of diagnosis on ante-disease in the field of oriental medicine clinic.

반흔형성 과정에서 Sp1 전사인자 조절에 의한 TGF-β1 및 CTGF의 발현 (The Effect of the Transcriptional Regulation of Sp1 for TGF-β1 and CTGF Expression in Scar Formation)

  • 박동만;손대구;한기환;이선영;채영미;장영채;박관규
    • Archives of Plastic Surgery
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    • 제33권1호
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    • pp.39-45
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    • 2006
  • This study is to examine the relationship between TGF-b1 expression and CTGF expression, and to evaluate the effect of Sp1 blockade on the expression of TGF-b1, CTGF and extracellular genes, clones of fibroblasts stably transfected with Sp1 decoy ODN. R-Sp1 decoy ODN was highly resistant to degradation by nucleases or serum, compared to the linear or phosphorothioated-Sp1 decoy ODN. Skin wounds were created on the back of 36 anesthetized rats. They were divided into four groups-the rats with normal skin, with wounded skin without decoy, with wounded skin injected with R-Sp1 decoy, and with wounded skin injected with mismatched R-Sp1 decoy, respectively. Skins were collected at 3rd, 5th, 7th, 14th day after wounding. Cellular RNA was extracted by RT-PCR analysis. TGF-${\beta}1$ and CTGF were deeply related with skin fibrosis during scar formation and it appeared that TGF-${\beta}1$ may cause the induction of CTGF expression. R-Sp1 decoy ODN inhibited TGF-${\beta}1$ and CTGF expression both in cultured fibroblasts and in the skin of rats. These results indicate that targeting Sp1 with R-type decoy efficiently blocks extracellular matrix gene expression, and suggest an important new therapeutic approach to control the scarring in normal wound healing and fibrotic disorders.

치매노인의 목표수립을 위한 인간작업모델 (Model of Human Occupation)의 적용: 사례연구 (Clinical Application of Model of Human Occupation on Goals Setting of Elderly person With Dementia: A Case Study)

  • 이유나;정민예
    • 재활치료과학
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    • 제2권1호
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    • pp.66-76
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    • 2013
  • 목적 : 본 연구는 주간보호시설을 이용하는 치매노인의 욕구 및 제한점을 파악하고 목표 설정을 하고자 함이다. 연구방법 : 주간보호시설 이용 치매노인 1명을 대상으로 2012년 5월 1일부터 5주에 걸쳐 주 2회 정기적으로 30여 분간 심층 면담 및 평가를 실시하였다. 인간작업모델을 기반으로 한 작업질문지(Occupational Questionnaire; OQ)와 여가활동평가(Interest checklist; IC), 의욕조사표(Volitional Questionnaire; VQ), 의사소통과 상호작용기술평가(The Assessment of Communication and Interaction Skills ACIS), 작업수행 일생 면담II(Occupational Performance History Interview-II OPHI-II), 자가작업평가(Occupational Self Assessment OSA), 작업환경 평가면담과 등급화(The Occupational Circumstances Assessment Interview and Rating; OCAIR)를 대상자에게 실시하였다. 또한 대상자의 사례관리자와 보호자 각 1명씩을 대상으로 직 간접적인 면담을 시행하였다. 결과 : 인간작업모델을 적용하여 면담 및 평가를 실시한 결과 사회와 가족관계형성과 재 정 문제, 전반적인 행복에 제한이 있는 것으로 파악되었다. 결론 : 본 연구의 결과를 통해 치매노인을 대상으로 인간작업모델을 적용하여 전인적으로 판단 할 수 있었으며 대상자를 바라보는 새로운 관점과 해결방안을 제시가능 하였다. 이를 통해 작업치료의 질 향상과 서비스의 영역을 확대하는데 기여할 것이다.

성인둔상환자에서 평균동맥압과 위해사건발생의 관련성:단면 조사 연구 (Relationship of Mean Arterial Pressure with the Adverse Outcomes in Adult Blunt Trauma Patients: Cross-sectional Study)

  • 차승용;김용환;홍종근;이준호;조광원;황성연;이경렬;이영환;최성희
    • Journal of Trauma and Injury
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    • 제26권2호
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    • pp.39-46
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    • 2013
  • Purpose: Non-invasive blood pressure measurement is widely used as a pre-hospital triage tool for blunt trauma patients. However, scant data exits for using the mean arterial pressure (MAP), compared to the systolic blood pressure, as a guiding index. The aim of this study was to determine the association between adverse outcomes and mean arterial pressure (MAP) and to exhibit the therapeutic range of the MAP in adult blunt trauma patients. Methods: The electronic medical records for all trauma patients in a single hospital from January 2010 to September 2012 were retrospectively reviewed. Patients below 17 years of age, patients with penetrating injuries, and patients with serious head trauma (injuries containing any skull fractures or any intracranial hemorrhages) were excluded. Adverse outcomes were defined as one of the following: death in the Emergency Department (ED), admission via operating theater, admission to the intensive care unit, transfer to another hospital for emergency surgery, or discharge as hopeless. Results: There were 14,537 patients who met entry criteria. Adverse outcomes occurred for MAPs in range from 90 to 120 mmHg. Adverse outcomes were found, after adjusting for confounding variables, to occur increasingly as the MAP declined below 90 mmHg or rose above 120 mmHg. Conclusion: Not only lower but also higher mean arterial pressure is associated with increased adverse outcomes in adult blunt trauma patients. Thus, patients with a MAP above 120 mmHg should be considered as a special group requiring higher medical attention, just as those with a MAP below 90 mmHg are.

상산의 $NF-{\kappa}B$ 활성억제작용과 $IKK{\gamma}$의 연관성 연구 (Relationship of Inhibitory Effects of Dichroa febrifuga and $IKK{\gamma}$ on the Activation of $NF-{\kappa}B$)

  • 최병태;이용태;황장선;문혜인;이경수;안원근;김동완
    • 동의생리병리학회지
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    • 제20권3호
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    • pp.651-656
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    • 2006
  • Activation of $NF-{\kappa}B$ is known to be a trigger of various cellular disorders including inflammatory and autoimmune diseases such as rheumatoid arthritis. Numerous approaches are ongoing within laboratories to identify potential therapeutic agents which inhibit the $NF-{\kappa}B$ activation. In this study, we have tested the inhibitory effects of five traditional medicines on the activation of $NF-{\kappa}B$ by NIK. Among three medicines which exhibited inhibitory effect on the expression of $NF-{\kappa}B$ repoter plasmid, we investigated further the inhibitory mechanism of Dichroa febrifuga in connection with IKKY activity. Wild type $IKK{\gamma}$ inhibited the $NF-{\kappa}B$ activation by NIK but the C-terminal deletion mutant of IKKY did not show the inhibitory effect, indicating that the C-terminal leucine zipper domain of $NF-{\kappa}B$ is important for the inhibition of $NF-{\kappa}B$ activation. The water extract of Dichroa febrifuga(DFE) also strongly inhibited the $NF-{\kappa}B$ activation by NIK. The inhibitory activity of DFE appeared to be independent of the expression of $IKK{\gamma}$, suggesting that the pathways of inhibition by Dichroa febrifuga and $IKK{\gamma}$ are different. Our results suggest that Dichroa febrifuga can be used as a medicine for inhibition of the $NF-{\kappa}B$ activation in a wide range of cells without relation to the expression of $IKK{\gamma}$.