• Title/Summary/Keyword: treatment guideline

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Uterine Arterial Embolization for the Treatment of Leiomyomas Accompanying with Adenomyosis (자궁선종을 동반한 자궁근종에서 자궁동맥 색전술을 이용한 치료의 효과)

  • Jang, Jin-Beum;Bai, Sang-Wook;Lim, Jae-Hak;Lee, Do-Yeon;Kim, Jung-Yeon;Jeong, Kyung-Ah;Kim, Sei-Kwang;Park, Ki-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.28 no.3
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    • pp.215-223
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    • 2001
  • Objective: The purpose of this study was to make a guideline of uterine artery embolization for the treatment of uterine leiomyomas accompanying with adenomyosis in Korea. Materials and Methods : We performed the retrospective study for 37 women who had uterine leiomyomas accompanying with adenomyosis. Bilateral uterine artery embolization was performed in 37 patients (age range 25-65) during 17 months with pain, hypermenorrhea, urinary frequency etc due to leiomyomas. Ultrasound imaging was performed before the procedure and at mean 6.9 months after the procedure. Results: All procedures were technically successful. Mean clinical follow-up was 12.8 months. Minor complication occurred in 82% patients after the procedure. After imaging follow-up (mean, 6.9 months postprocedure), median uterine volume decreased 34.4%, and dominant myoma volume decreased 86%. There was no statistical difference in uterine volume reduction and dominant myoma size reduction whether occluding agents was polyvinyl alcohol, polyvinyl alcohol plus gelfoam, and gelfoam, and whether ultrasound measured Resistance Index value before the procedure was low or high. Conclusion: Primary candidates for uterine artery embolization include those with symptomatic uterine leiomyomas who no longer des ire fertility but wish to avoid surgery or are poor surgical risks. To our study, uterine volume reduction and dominant myoma size reduction in patients who had adenomyosis were similar to previous other studies in patients who had not adenomyosis. Therefore adenomyosis should not be considered as a contraindication for uterine artery embolization. Because there is little data about subsequent reproductive potential after this procedure, it should not be routinely advocated for infertile women. Further investigation is warranted for occluding agents and Resistance Index.

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Dermatofibrosarcoma Protuberans ; Treatment and Prognosis (융기성 피부섬유육종의 치료 및 예후)

  • Lee, Soo-Yong;Park, Jong-Hoon;Jeon, Dae-Geun;Lee, Jong-Seok;Kim, Sug-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.17-21
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    • 2000
  • Purpose : Dermatofibrosarcoma protuberans(DFSP) is a rare tumor of the skin with a strong tendency of infiltration to surrounding tissues. Inadequate surgical intervention brings about frequent recurrence and poor prognosis. We attempted to find a guideline for adequate treatment for DFSP. Materials and Methods : Fourteen cases who had been treated in our department since Mar. 1993 and followed up for more than 12 months postoperatively were reviewed. Including nine cases who were transferred from other hospital after recurrence, thirteen cases underwent wide resection. One case was treated by intralesional resection followed by chemotherapy (CYVADIC) due to neurovascular abutment to the mass in the inguinal area. Results : The nine cases who were transferred due to recurrences experienced recurrence in average 1.3(1-2) times and the average period until first local recurrence from primary operation was 11.8(2-24) months. The thirteen cases with wide surgical margin showed no recurrence at the final follow up. One case treated by intralesional resection and chemotherapy showed multiple recurrence and died of the disease due to lung metastasis. Conclusions : From these data, we could find that primary wide resection can be the way of reducing recurrence and metastasis, and the follow up period for the detection of recurrence should be at least two years.

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Analyzing association between low-density lipoprotein reduction by statin and adherence to medication using national health insurance service-national sample cohort (NHIS-NSC) (표본코호트기반 고지혈증 약제의 저밀도 콜레스테롤 감소량 및 투약순응도 분석)

  • Kim, Kyu-Jin;Jun, Chi-Hyuck;Lee, Hyeseon;Kim, Hun-Sung
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.5
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    • pp.1027-1041
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    • 2017
  • Hyperlipidemia, the status of blood with high level of low-density lipoprotein cholesterol (LDL-C), is known as a main cause of coronary artery diseases such as myocardiac infarction or brain infarct. Statin is the representative prescription to hyperlipidemia and the effects of it depend on the patient's individual conditions such as health-caring habits or adherence to medication. The main effect of statin is reducing LDL-C, which should reach the target range based on National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) guideline. In this research, the reduction of LDL-C and attainment to patient's target range are considered effects of statin. The association between factors - individual conditions and adherence to medication of patients - and the effects of statin is analyzed with National Health Insurance Service-National Sample Cohort (NHIS-NSC).

The Evaluation of Teicoplanin Usage in a University Hospital (대학병원에서의 Teicoplanin의 사용 현황 조사 및 실태 평가)

  • Kim, Eun A;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.11 no.1
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    • pp.19-29
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    • 2001
  • Teicoplanin, a glycopeptide antibiotic, has potential for use as an alternative to vancomycin in the treatment of gram-positive bacterial infections. However, unlike vancomycin, there is a lack of study on teicoplanin's efficacy and safety and the guideline for its use is not available, yet. The objective of this study was to investigate and evaluate the pattern of teicoplanin usage in a university hospital. A retrospective study was performed on 72 adult patients, who took teicoplanin for 3 continuous days at D. University hospital from 1 January 1999 to 30 June 2000. The microorganisms treated with teicoplanin were methicillin-resistant Staphylocorcus aureus $(69\%)$, coagulase-negative Staphylococci $(12\%)$, Enterococcus $(4\%)$, vancomycin-resistant Enterococci $(2\%)$, Streptococci $(2\%)$, and Bacillus $(1\%)$. The types of infection treated with teicoplanin were surgical wound infection $(58\%)$, lower respiratory infection $(11\%)$, bactremia $(7\%)$, urinary tract infection $(5\%)$, pleural fluid infection $(4\%)$, and peritoneal fluid infection $(2\%)$. The mean duration of teicoplanin usage was 16.5 days and teicoplanin was used with 1.4 other antibiotics, which were aminoglycosides (isepamicin, amikacin, netilmicin, astromicin) or quinolones (ciprofloxacin, tosufloxacin) or the third generation cephalosporin (ceftazidime). Only 24 cases $(28.6\%)$ met with the criteria for the justification of use, and the rest of 60 cases $(71.4\%)$ did not meet the criteria. In 84 cases $(100\%)$, blood culture tests were performed prior to the initial dose of teicoplanin. In 83 cases $(99\%)$, serum creatinine were conducted before the initial doses. In 45 cases $(53.6\%)$, serum creatinine was monitored at least twice weekly. In 55 cases $(65.5\%)$, WBC was tested at least twice weekly. In 84 cases $(100\%)$, body temperature was monitored at least once per nursing shift. In 15 cases out of 56 cases, maximum temperature decreased at least 1 degree within 3 days of teicoplanin use. In 15 case out of 35 cases, WBC values were within the normal range after treatment. In 23 cases $(27.4\%)$, dosage regimen was appropriate. Drug-related adverse effects were reported in 13 cases. Nephrotoxicity (progressively increasing SCr. or sustained SCr increase of $\geq$0.5 mg/dl from baseline) was noted in five cases. Neutropenia (absolute neutrophil count <1,500 $cells/mm^3$) was noted in one case and eosinophilia (total eosinophil count >350 $cells/mm^3$) was noted in seven cases. A more strict control on use of teicoplanin is required, considering that teicoplanin is categorized as one of restricted antibiotics.

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Single Dose Toxicity Test of Mahwangyounpae-tang Extract in Male SD Rats (마황윤폐탕(麻黃潤肺湯) 추출물의 수컷 SD Rats에서 경구 단회투여 독성 평가)

  • Cho, Dong-Hee;Park, Mee-Yeon;Choi, Hae-Yun;Kim, Jong-Dae;Jeon, Kwi-Ok
    • The Journal of Internal Korean Medicine
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    • v.27 no.1
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    • pp.102-113
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    • 2006
  • Objectives & Methods : To obtain the 50% lethal dose(LD50), approximated lethal dose(ALD) and approximated target organs of 'Mahwangyounpae-tang' for further study into such things as repeated dose toxicity, genotoxicity and reproductive toxicity, single dose toxicity was tested in male SD rats according to KFDA Guideline 1999-61[KFDA, 1999] at dosage levels of 2,000, 1,000, 500, 250 and 125 mg/kg/$10m{\ell}$. In this study, mortalities, clinical signs, body weight changes and body weight gains, gross findings and weight of principal organs were detected during and/or after 14 days of single dosing. Results & Conclusions : After 2 or 3 days of dosing, 1 or 2 animals in 2,000 mg/kg-dosing groups died. Excitation and leaping response were observed as test article-treatment related clinical signs. These abnormal signs were restricted to 2,000 and 1,000 mg/kg-dosing groups and survivors recovered to normal within 3 or 4 days after dosing. Significant decrease in body weight were observed in some periods of observation in 2,000 and 1,000 mg/kg-dosing group, from 1 days after dosing compared to those of vehicle control group. Significantly diminished body weight gains were observed in observation periods in 2,000 and 1,000 mg/kg-dosing group compared to those of vehicle control group. Hypertrophy and hemorrhage of heart and decoloration of kidney were observed as test article-treatment related gross findings. These abnormal findings were restricted to 2,000 and 1,000 mg/kg-dosing groups. A significant increase of absolute and relative heart and kidney weight were demonstrated in 2,000 mg/kg-dosing groups. The value for LD50 found in this study was 2,218.57 mg/kg. ALD in this study was 2,000 mg/kg, and the target organs are considered to be the heart and the kidney.

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Concept Analysis of Health Inequalities using Hybrid Model (혼종 모형을 이용한 건강 불평등 개념분석)

  • Lee, Ha-na
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.3
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    • pp.520-534
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    • 2018
  • This study was conducted to understand the conceptual definition and characteristics of health inequality. To accomplish this, we analyzed data collected from 14 participants as well as from available literature regarding health inequality using the hybrid model introduced by Schwartz-Barcott and Kim. We categorized health inequality into nine attributes in three dimensions. These dimensions included "target", "precede", and "result," corresponding to the target, cause and consequence of health inequality, respectively. Specifically, we define health inequality as individuals, families, communities, socio-economic, or geographically distinct demographic groups that are treated unfairly and result in several problems such as loss of quality of life, reduction of survival rate, or aggravation of a disease due to (i) poor treatment by a hospital (ii) irregular meals, (iii) desperate need for work (for money), (iv) expensive medical care costs, (v) qualitative differences in medical care by regional groups (vi) the lack of knowledge regarding disease (vii) and inadequate health care because of lack of time. As a result of this unfair treatment, human rights violation occurs. The major contribution from this paper is that we provide a guideline for establishing strategies to reduce health inequality by identifying the concept of health inequality. Based on this study, we recommend development of an educational program to reduce health inequalities.

Acute Toxicity Study on Gumiganghwal-tang(Jiuweiqianghuo-tang) in Sprague-Dawley Rats (Spargue-Dawley 랫드를 이용한 구미강활탕의 급성독성 연구)

  • Shin, In-Sik;Kim, Jung-Hoon;Ha, Hye-Kyung;Seo, Chang-Seob;Lee, Mi-Young;Lee, Ho-Young;Lee, Jun-Kyoung;Lee, Nam-Hun;Lee, Jin-Ah;Lee, Sul-Lim;Huh, Jung-Im;Shin, Hyeun-Kyoo
    • Herbal Formula Science
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    • v.18 no.1
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    • pp.79-85
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    • 2010
  • Objectives : This study was conducted to evaluate the acute toxicity and safety of Gumiganghwal-tang (Jiuweiqianghou-tang) in Sprague-Dawley rats though the current regulatory guideline. Methods : The preliminary study showed that the single oral administration of Gumiganghwal-tang(Jiuweiqianghou-tang) did not induce any toxic effect at a dose level of 2000 mg/kg. Based on the results, 2000 mg/kg was selected as the limited dose. In this study, 10 rats of each sex were randomly assigned to two groups of 5 rats each and were administrated singly by gavage at dose levels of 0 and 2000 mg/kg. Mortalities, clinical signs, and body weight changes were monitored for the 15-day period following administration. At the end of observation period, all animals were sacrificed and complete gross postmortem examinations were performed. Results : Throughout the study period, no treatment-related deaths were observed. There were no adverse effects on clinical signs, body weight, and gross findings at all treatment groups. Conclusions : These results showed that the single oral adminstration of Gumiganghwal-tang(Jiuweiqianghou-tang) did not cause any toxic effect at the dose levels of 2000 mg/kg in rats. In conclusion, the $LD_{50}$ of Gumiganghwal-tang (Jiuweiqianghou-tang) was considered to be over 2000 mg/kg body for both sexes.

Evaluation of Stability in the Purified Wood Vinegar and Its Hair Growth Effect (목초액의 안정성 및 모발 성장 촉진 효과)

  • Cho, Young-Ho;Lee, Ju-Yeon;Lee, Jong-Hwa;Cho, Jae-Su;Lee, Gye-Won
    • Journal of Life Science
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    • v.19 no.10
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    • pp.1389-1395
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    • 2009
  • Generally, it takes a long time to purify wood vinegar, and it contains toxic compounds such as tar, methanol, phenol and benzopyrene. To reduce the toxicity of wood vinegar itself, we have developed a new purification method of wood vinegar using an oxidation-cohesion reaction and distillation with an active carbon. We have investigated the physico-chemical change (pH, specific gravity, refractive index and dissolved tar), the change of amount of toxic compounds (carbonyl group, phenol, benzopyrene and residual solvents) and organic acids (formic acid (FA), acetic acid (AA), propionic acid (PA)) of the purified wood vinegar under the long term and accelerated storage conditions. Also, we have evaluated the effect of the purified wood vinegar on hair growth using an alopecia model of C57BL/6 mice. As a result, we could find out that the purified wood vinegar was stable and remained without decay under the storage conditions and benzopyrene, a carcinogenic agent, was not detected in the purified wood vinegar. After topical treatment of the purified wood vinegar solution or minoxidil (MXD) for 2 weeks to dorsal skin, the hair regrowth of the mice accelerated faster than that of the control, with no clinical signs. In conclusion, we could suggest a guideline for quality control of process to reduce the toxic compounds in wood vinegar and it might be a useful hair growth promoter in the treatment of baldness or alopecia.

The Study on Organization, Infection Controller, Patient Infection Control of Dental Clinic in Certain Areas (일부지역 치과의 기관, 감염관리자, 환자의 감염관리에 관한 연구)

  • Choi, Du-Ri;Kim, Seol-Hee
    • Journal of dental hygiene science
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    • v.15 no.4
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    • pp.399-406
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    • 2015
  • The purpose of this study was to investigate the performance of dental infection control. This survey was performed on 158 of the dental hygienist in certain areas. The research was performed using a self-reported questionnaire and interview method from June to July, 2014. The collected data was analyzed by PASW Statistics ver. 18.0. Guideline of infection management, infection controller, regular infection control training, Sterilization of the handpiece/per head resulted 57~74% for dental hospital. It was higher than 13~20% for dental clinics (p<0.05). Infection control guidelines and vaccination recognition of dental were more performed in dental hospital. Patient's hand hygiene performed, tooth brushing before treatment, cross infection educational experience was less than 20%, research cooperation of medical history was over 90% (p<0.05). Performing rate of the dental hospital workers were investigated higher in protective personal devices, infection control of treatment room. A correlation analysis about institutional support, infection control of dental hygienists, patients with infection control cooperation showed a positive correlation statistically significant. Infection control can be enhanced when the medical staff, the patient, the organization combined cognitive and practice. Dental hygienist is required to recognize and practice the infection control guidelines through continuing education.

Effect of continuing dental care program by elementary school dental clinic in Gimcheon (김천시 초등학교 구강보건실 운영을 통한 계속구강건강관리사업 효과)

  • Choi, Ok-Sun;Kim, Hye-Jin;Jang, Sun-ju
    • Journal of Korean society of Dental Hygiene
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    • v.15 no.4
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    • pp.705-711
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    • 2015
  • Objectives: The purpose of the study is to evaluate the effect of continuing dental care program by elementary school dental clinic in Gimcheon from 2008 to 2013. Methods: The subjects were experimental group of 152 students from three elementary schools having dental clinics and control group of 136 students from three elementary schools of no dental clinics. The six dentists in Gimcheon community health center carried out the regular dental checkups in the elementary schools and four dental hygienists recorded the dental examination results. After receiving WHO dental survey guideline education, the examiners used dental mirror and dental probe under the natural light. The contents of the survey included dental caries in the deciduous and permanent teeth, malocclusion, remaining ratio of sealant, treatment, and follow up. Results: DFT index by grade showed that 3.71 in experimental group and 4.56 in control group and it was remarkable in the 3rd grade. Thus. DFT index in the experimental group was lower than that of control group (p<0.05). DT index by grade was 0.63 in experimental group and 1.28 in control group marked in the 6th grade. DT index in the control group was higher than that of the experimental group (p<0,001). DFT index and DMFT Index by grade showed no significant difference between the control group and the experimental group. DFT and DMFT Index of the control group in the 3rd and 6th grade were lower score than those of experimental group. DFT and DMFT index in the third and 6th grade showed no significant difference between the control group and the experimental group. The remaining ratio of the sealant was 4.89 experimental group in the 6th grade. The remaining ratio of the sealant in the experimental group was higher than that in the control group. Conclusions: The continuing dental care program in the elementary school is very effective method in the treatment of oral disease in the elementary school children. The oral health care and prevention for the elementary school children should be implemented and carried out continuously.