• 제목/요약/키워드: time in therapeutic range

검색결과 115건 처리시간 0.03초

Selective embolization of the internal iliac arteries for the treatment of intractable hemorrhage in children with malignancies

  • Bae, Sul-Hee;Han, Dong-Kyun;Baek, Hee-Jo;Park, Sun-Ju;Chang, Nam-Kyu;Kook, Hoon;Hwang, Tai-Ju
    • Clinical and Experimental Pediatrics
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    • 제54권4호
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    • pp.169-175
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    • 2011
  • Purpose: Acute internal hemorrhage is an occasionally life-threatening complication in pediatric cancer patients. Many therapeutic approaches have been used to control bleeding with various degrees of success. In this study, we evaluated the efficacy of selective internal iliac artery embolization for controlling acute intractable bleeding in children with malignancies. Methods: We retrospectively evaluated the cases of 6 children with various malignancies (acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, T-cell prolymphocytic leukemia, Langerhans cell histiocytosis, and rhabdomyosarcoma), who had undergone selective arterial embolization (SAE) of the internal iliac artery at the Chonnam National University Hwasun Hospital between January 2004 and December 2009. SAE was performed by an interventional radiologist using Gelfoam$^{(R)}$ and/or Tornado$^{(R)}$ coils. Results: The patients were 5 boys and 1 girl with median age of 6.9 years (range, 0.7-14.8 years) at the time of SAE. SAE was performed once in 4 patients and twice in 2, and the procedure was unilateral in 2 and bilateral in 4. The causes of hemorrhage were as follows: hemorrhagic cystitis (HC) in 3 patients, procedure-related internal iliac artery injuries in 2 patients, and tumor rupture in 1 patient. Initial attempt at conservative management was unsuccessful. Of the 6 patients, 5 (83.3%) showed improvement after SAE without complications. Conclusion: SAE may be a safe and effective procedure for controlling acute intractable hemorrhage in pediatric malignancy patients. This procedure may obviate the need for surgery, which carries an attendant risk of morbidity and mortality in cancer patients with critical conditions.

Surgical Excision for Refractory Ischiogluteal Bursitis: A Consecutive Case Series of 21 Patients

  • Sun-Ho Lee;Won-Young Jang;Min-Su Lee;Taek-Rim Yoon;Kyung-Soon Park
    • Hip & pelvis
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    • 제35권1호
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    • pp.24-31
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    • 2023
  • Purpose: A response to conservative treatment is usually obtained in cases of ischiogluteal bursitis. However, the time required to achieve relief of symptoms can vary from days to weeks, and there is a high recurrence rate, thus invasive treatment in addition to conservative treatment can occasionally be effective. Therefore, the aim of this study was to examine surgical excision in cases of refractory ischiogluteal bursitis and to evaluate patients' progression and outcome. Materials and Methods: A review of 21 patients who underwent surgical excision for treatment of ischiogluteal bursitis between February 2009 and July 2020 was conducted. Of these patients, seven patients were male, and 14 patients were female. Injection of steroid and local anesthetic into the ischial bursa was administered at outpatient clinics in all patients, who and they were refractory to conservative treatment, including aspiration and prescription drugs. Therefore, surgery was considered necessary. Excisions were performed by two orthopedic specialists using a direct vertical incision on the ischial area. A review of each patient was performed after excision, and quantification of the outcomes recorded using clinical scoring systems was performed. Results: The results of radiologic evaluation showed that the mean lesion size was 6.2 cm×4.5 cm×3.6 cm. The average disease course after excision was 21.6 days (range, 15-48 days). Measurement of clinical scores, including the visual analog scale and Harris hip scores, was performed during periodic visits, with scores of 0.7 (range, 0-2) and 98.1 (range, 96-100) at one postoperative month, respectively. Conclusion: Surgical excision, with an expectation of favorable results, could be considered for treatment of ischiogluteal bursitis that is refractory to therapeutic injections, aspirations, and medical prescriptions, particularly in moderate-to-severe cases.

근치적 방사선치료 후 재발한 자궁경부암의 재 방사선치료 (Reirradiation in Rcurrent Cervical Cancer Following Definite Radiation Therapy)

  • 김진희;최태진;김옥배
    • Radiation Oncology Journal
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    • 제19권3호
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    • pp.230-236
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    • 2001
  • 목적 : 저자들은 근치적 방사선치료를 시행받고 골반 내에 재발하여 재 방사선치료를 받은 자궁경부암 환자를 대상으로 생존률, 부작용 등 결과를 분석하고자 하였다. 대상 및 방법 : 1987년 11월부터 1998년 3월까지 계명대학교 동산의료원 치료방사선과에서 근치적 방사선치료를 받고 추적 관찰 중 골반내에 재발하여 재 방사선치료를 받은 환자 18명을 대상으로 하였다. 처음 진단당시 병기로는 Ia 1명, Ib 5명, IIa 5명, IIb 3명, IIIb 2명, IVa 2명으로 평균연령은 57세($37\~79$세)이었다. 재발기간은 6개월에서 122개월로 평균 58개월이었다. 재발부위는 7명에서 자궁경부, 10명에서 질부, 1명에서 골반내 림프절에 재발하였다. 12명은 외부방사선치료와 강내 방사선치료를, 4명은 외부방사선치료와 자입방사선치료를, 2명은 외부방사선치료단독를 시행하였다. 재 방사선치료의 외부방사선량은 $2,100\~5,400\;cGy$이었고 방사선총량은 $3,780\~8,550\;cGy$이었다. 재발 후 추적기간은 8개월에서 80개월로 평균 25개월이었다. 결과 : 재 방사선치료 직후 전체 18명 중 14명$(78\%)$에서 국소 제어가 되었으며 재 방사선치료를 시행한 후 2년 무병생존률은 $53.6\%$이었다. 재발부위에 따라 2년 무병생존률이 질에 재발한 환자 10명에서는 $71.4\%$, 자궁에 재발한 환자 7명에서는 $28.5\%$ (p=0.03)를 나타내어 통계적으로 유의한 차이를 보였다. 재 방사선총량에 따라 2년 무병생존률이 통계적으로 유의하게 차이를 보였다$(>6,000\;cGy\;71.8\%,\;{\leq}6,000\;cGy\;25\%\;p=0.007)$. 재 방사선치료 후 20개월 이상 추적 관찰된 환자 10명중 7명에서 무병생존 중이다(7/18, $39\%$). 외부방사선치료와 강내방사선치료를 시행한 환자에서 가장 좋은 생존률을 보였다. 재 방사선치료 후 실패양상은 국소 재발이 국소 제어 안된 4명을 포함한 7명 $(39\%)$에서 자궁 및 질에 재발하였고 2명에서 원격 전이되어 사망하였다. 부작용으로는 장출혈이 3명에서 있었으며 수술을 요하는 장폐쇄가 2명, 방광손상에 의한 혈뇨가 1명, 2도 방광염이 2명, 연부 부종이 2명, 질부조직괴사가 1명에서 있었으나 자연 치유되었다. 재 방사선치료총량이나 재발기간에 따른 부작용의 차이는 없었다. 결론 : 근치적 방사선치료 후 재발한 경우, 재 방사선치료는 도움이 될 것으로 사료되나 심각한 부작용을 줄이는 노력이 더 요구된다.

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비소세포성 폐암에 의한 뇌전이 환자의 예후인자 (Prognostic Factors in Patients with Brain Metastases from Non-Small Cell Lung Carcinoma)

  • 홍성언
    • Radiation Oncology Journal
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    • 제9권2호
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    • pp.197-204
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    • 1991
  • 비소세포성 폐암의 뇌전이 환자에서 방사선 치료후 예후인자를 분석하기 위하여 경희대학부속병원 치료방사선과에서 치료받은 53예의 방사선치료 결과를 분석하였다. 전체 53예중 남자가 37명 여자가 16예이고, 연령분포는 39세부터 85세까지로 평균 59세 였다. 조직학적 소견은 선암이 27예($50.9\%$)로 가장 많았으며 편평세포암(21예), 대세포암(5예) 순이었다. 모든 환자에서 스테로이드투여와 함께 전뇌조사를 시행하였다. 전체 환자의 중간생존 기간은 5개월이었고, 나이, 성별, 조직형태, 초기 수행상태는 예후에 영향을 미치지 않았다. 가장 중요한 예후인자는 방사선치료후 반응여부와 뇌이외 부위의 다발성 전이 유무 였다. 따라서 뇌전이 단독소견을 가진 비소세포성 폐암 환자에서 적정한 방사선 치료선량으로 적극적인 치료로써 생존기간을 연장시키고 quality of life를 향상시킬 수 있을 것으로 기대한다.

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수구(水溝; GV26) 위치와 주치증의 관련성 및 해부학적 상관성 고찰 (Review of GV26 Point Locations and Indications and Anatomical Correlation of the Point)

  • 김민지;손지오;구성태
    • Korean Journal of Acupuncture
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    • 제41권3호
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    • pp.90-100
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    • 2024
  • Objectives : This study examined the historical evolution of the GV26 acupuncture point, focusing on its location, therapeutic indications, and anatomical relevance to the philtrum region. Methods : We reviewed 18 historical acupuncture texts, analyzing the descriptions of GV26's location and associated indications. Results : The location of GV26 has varied over time. Early texts like the A-B Classics of Acupuncture and Moxibustion described it at the center of the philtrum groove, while some 16th-century texts shifted it closer to the nasal cavity. However, many sources continued to emphasize the central philtrum groove as the correct location. GV26 was historically indicated for conditions such as cold-type headache, epilepsy, edema, nasal and eye symptoms, respiratory issues, post-stroke symptoms, jaundice, pestilence, mouth-related symptoms, and low back pain. Epilepsy, edema, and post-stroke facial symptoms were consistently cited across texts, while other indications varied. Cadaveric studies show that the superficial orbicularis oris muscle divides into the upper nasalis and lower labialis portions. Needling the upper third of the philtrum stimulates the thinner, closer-to-maxilla upper nasalis portion, potentially providing stronger stimulation, while needling the center targets the lower labialis portion. Conclusions : Historical variations in GV26's location reflect an evolving understanding of its anatomical and therapeutic significance. The upper third of the philtrum groove may be more effective for acute conditions requiring strong stimulation, whereas the central groove may better address a broader range of conditions. These findings highlight the importance of historical and anatomical context in optimizing GV26's clinical use.

국내산(國內産) 명일엽(明日葉)의 부위별 게르마늄 함량(含量) (Germanium(IV) Content in the Korean Angelica keiskei Koidz)

  • 정승일;한완수
    • 한국약용작물학회지
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    • 제7권1호
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    • pp.11-15
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    • 1999
  • 국내에서 재배 수확되는 명일엽에 지역별, 부위별로 게르마늄 함량을 네모파 산화전극 벗김전압 전류법을 이용하여 조사한 결과 재배된 지역에 따라 게르마늄의 함량이 공시재료간 잎은 3.8배 정도, 줄기는 5배 정도였다. 명일옆(明日葉)의 채취부위별 게르마늄 함량은 잎부분에서 386ppm로 가장 높았으며 줄기에서 29ppm으로 13.3배 잎에서 더 높았다.

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Facile analysis of protein-protein interactions in living cells by enriched visualization of the p-body

  • Choi, Miri;Baek, Jiyeon;Han, Sang-Bae;Cho, Sungchan
    • BMB Reports
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    • 제51권10호
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    • pp.526-531
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    • 2018
  • Protein-Protein Interactions (PPIs) play essential roles in diverse biological processes and their misregulations are associated with a wide range of diseases. Especially, the growing attention to PPIs as a new class of therapeutic target is increasing the need for an efficient method of cell-based PPI analysis. Thus, we newly developed a robust PPI assay (SeePPI) based on the co-translocation of interacting proteins to the discrete subcellular compartment 'processing body' (p-body) inside living cells, enabling a facile analysis of PPI by the enriched fluorescent signal. The feasibility and strength of SeePPI (${\underline{S}}ignal$ ${\underline{e}}nhancement$ ${\underline{e}}xclusively$ on ${\underline{P}}-body$ for ${\underline{P}}rotein-protein$ ${\underline{I}}nteraction$) assay was firmly demonstrated with FKBP12/FRB interaction induced by rapamycin within seconds in real-time analysis of living cells, indicating its recapitulation of physiological PPI dynamics. In addition, we applied p53/MDM2 interaction and its dissociation by Nutlin-3 to SeePPI assay and further confirmed that SeePPI was quantitative and well reflected the endogenous PPI. Our SeePPI assay will provide another useful tool to achieve an efficient analysis of PPIs and their modulators in cells.

송아지에 warfarin 투여 시에 혈액 생화학치의 변화 (The Changes of Blood Biochemical Values during Warfarin Therapy in Calves)

  • 임건태;윤영민;이경갑
    • 한국임상수의학회지
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    • 제20권1호
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    • pp.74-78
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    • 2003
  • We executed this experiment to observe side effects of warfarin, the anticoagulant that is used for preventing thrombus in cardiovascular surgery for calves. The 6 calves(70-130 kg) were used in this experiment regardless of sexes. We administered warfarin at 0.07 mg/kg daily for 25 days. Blood was collected before warfarin administration, every five days for 30 days. PCV, RBC, WBC, fibrinogen, total protein and platelet as blood test, prothrombin time (PT) as blood coagulation test, and AST, SDH, total bilirubin, BUN and creatinine as serum biochemical tests were measured. As the result of the experiment, PT has been gradually increased after warfarin administration. It has been gradually increased and remains within the therapeutic range from the third day to the 28th day. PCV and RBC were decreased significantly from the value before the administration (p < 0.05). In the serum biochemical test, SDH shows significant increase comparing the value before the administration (p < 0.05). AST and total bilirubin were increased gradually from the value before the administration. Considering the result of the experiment, to give wafarin to prevent thrombus in cardiovascular surgery, we can get anticoagulation effect with minimal administration(0.07 mg/kg, PO) from the third day of the administration. However because of the decreased PCV and RBC, it may cause anemia. It may cause damage to liver based on the result of serum biochemical test.

New metabolites from the biotransformation of ginsenoside Rb1 by Paecilomyces bainier sp.229 and activities in inducing osteogenic differentiation by Wnt/β-catenin signaling activation

  • Zhou, Wei;Huang, Hai;Zhu, Haiyan;Zhou, Pei;Shi, Xunlong
    • Journal of Ginseng Research
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    • 제42권2호
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    • pp.199-207
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    • 2018
  • Background: Ginseng is a well-known traditional Chinese medicine that has been widely used in a range of therapeutic and healthcare applications in East Asian countries. Microbial transformation is regarded as an effective and useful technology in modification of nature products for finding new chemical derivatives with potent bioactivities. In this study, three minor derivatives of ginsenoside compound K were isolated and the inducing effects in the Wingless-type MMTV integration site (Wnt) signaling pathway were also investigated. Methods: New compounds were purified from scale-up fermentation of ginsenoside Rb1 by Paecilomyces bainier sp. 229 through repeated silica gel column chromatography and high pressure liquid chromatography. Their structures were determined based on spectral data and X-ray diffraction. The inductive activities of these compounds on the Wnt signaling pathway were conducted on MC3T3-E1 cells by quantitative real-time polymerase chain reaction analysis. Results: The structures of a known 3-keto derivative and two new dehydrogenated metabolites were elucidated. The crystal structure of the 3-keto derivative was reported for the first time and its conformation was compared with that of ginsenoside compound K. The inductive effects of these compounds on osteogenic differentiation by activating the Wnt/b-catenin signaling pathway were explained for the first time. Conclusion: This study may provide a new insight into the metabolic pathway of ginsenoside by microbial transformation. In addition, the results might provide a reasonable explanation for the activity of ginseng in treating osteoporosis and supply good monomer ginsenoside resources for nutraceutical or pharmaceutical development.

치매와 치매노인 간호중재에 대한 연구 분석 (A Review of the Trends of Journal Research on Dementia and Nursing Interventions for Demented Elders)

  • 노국희
    • 지역사회간호학회지
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    • 제19권2호
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    • pp.300-309
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    • 2008
  • Purpose: The purpose of this study was to review research trends and show the developmental direction of studies on dementia and nursing interventions for demented elders. Methods: This study analyzed 104 articles on dementia and 23 on nursing interventions for demented elders published until 2007. Results: These dementia studies increased in quantity after 1996, mainly in studies on demented elders and their families and in quantitative studies, Nursing intervention methods were music, light, horticultural therapy, reminiscence and complex therapeutic program, etc. There were experimental studies after 1996, but non-equivalent control group pretest-posttest design was 8(34.8%) of 23(100,0%). The medium sample size was 16.6 for experimental groups, 13 for control groups. The experimental time range was 10-120 minutes a day, frequency was 1-18 a week, and the total frequency was 4-72. The result variables were cognitive function, dementia behavior, emotion, depression, ADL, social behavior, etc. Conclusion: The findings of this review suggest that studies on dementia have been improved in quantity since 1996, but various and effective research methods should be developed as a way to further improve the quality of studies.

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