• 제목/요약/키워드: treatment guideline

검색결과 709건 처리시간 0.029초

역모델링 기법을 이용한 동해항 주변지역 미세먼지 배출량 산출 (Fine dust(PM10) emission calculated of Dong-Hae harbor around area using inverse modeling technique)

  • 김지현;박영구
    • 한국응용과학기술학회지
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    • 제32권4호
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    • pp.649-660
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    • 2015
  • Calpuff 역모델링 기법을 이용해 산출된 자료는 오염물질 발생량을 예측할 수 있으며, 여러 가지 자료 비교를 통해 감축 가능성 및 목표 수립이 가능해졌다. 본 연구에서는 동해항 주변지역을 대상으로 Calpuff 역모델링 기법을 이용하여 대기 중 미세먼지 저감량 설정하기 위한 기초자료 구축에 목적을 두었으며, 모델링을 이용한 동해항을 포함한 5개 지역 배출농도 산출결과는 다음과 같다. 대기환경기준인 $50{\mu}g/m^3$을 적용하여 대상 지역별 허용배출량 산출 결과 site-D에서 가장 많은 $4.95{\mu}g/m^2{\cdot}S$의 배출량 저감이 요구되었으며, $4.95{\mu}g/m^2{\cdot}S$의 배출량을 감소시킬 경우 영향예측지점(동해하수종말처리장)의 PM10 평균 예측농도는 $42.6{\mu}g/m^3$로 감소될 것으로 나타났다. site-A(동해항)에서 배출되는 오염물질만을 적용하여 모델링 진행 결과 동해항 주변 민가의 기여농도는 평균 $40{\sim}50{\mu}g/m^3$으로 나타났으며, 배경농도를 고려하면 대기환경기준인 $50{\mu}g/m^3$을 상회 할 것으로 예상됨에 따라 더 이상의 오염물질 배출량은 허용되지 않을 것으로 판단된다. site-B는 상가와 나대지로 차량 통행과 나대지에서 비산되는 먼지로 인해 $0.11{\mu}g/m^2{\cdot}S$의 배출량 저감이 요구되었으며, site-C와 E는 오염물질 저감량은 발생하지 않았으나 지속적인 관리가 요구된다.

영양 상담이 방사선 치료를 받는 암환자의 식이 섭취와 영양 상태에 미치는 영향 (Effects of Nutrition Counseling on Diet and Nutritional Status of Cancer Patients on Radiotherapy)

  • 백희영
    • Journal of Nutrition and Health
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    • 제33권2호
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    • pp.193-201
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    • 2000
  • This study was conducted to investigate the effectiveness of nutrition counseling on the dietary intake and nutritional status cancer patients undergoing radiotherapy treatment. The study was conducted over 6 week period and included 104 patients : 66 received nutrition counseling as the variable group of 42 male and 24 female and 38 patients received no counseling as the control group of 19 male and 19 female. Nutrition counseling was accompanied with the radiation therapy and adminstered via counseling session and distribution of printed material during radiation therapy for 6 weeks. Nutrition counseling aimed at maintaining a balanced diet and preventing weight loss of subjects, guideline used for energy and protein intake were 35kcal/kg IBW and 1.5-2.0g/kg IBW, respectively. Over the course of the study, the counseling group increased significantly in comparison to the control group's energy intake, evidenced by the counseling group's initial mean daily energy intake of 1932.0kcal, and 4 and 6 week mean energy intake values of 2046.6kcal, 2066kcal, respectively. But mean energy values of control group was 1614.3kcal at 4 week. Th energy intake per weight values and protein intake per weight values for initial, 4 and 6 week intervals for counseling group were 33.2kcal/kg, 33.7kcal/kg, 34.0kcal/kg, and 1.48g/kg, 1.58g/kg, 1.59g/kg, respectively. Based on results, nutrition counseling had positive effects on both the variety of diet and energy intake of the variable group, mostly due to an increase in dairy product and egg consumption. In addition, the percentage of counseling group patients who consumed all 5 food group increased from 48.5% to 54.5%. Sufficient energy intake and protein consumption seem to be important factors in weight loss prevention, evidenced by weight gain by subjects in the counseling group who had 36.1kcal/kg/day mean energy intake and 1.77g/kg/day mean protein intake after 4 weeks. Counseling group subjects experiencing weight loss had lower intake and 1.77g/kg/day mean protein intake after 3 weeks. Counseling group subjects experiencing weight loss had lower intakes of 29.3kcal/kg/day for energy and 1.33g/kg/day for protein during the same period. Another significant factor in weight loss prevention of the counseling group could be the variety of diet. The dietary variety scores(DVS) of both counseling and control groups differed significantly : the counseling group had a mean score of 34 while the control group of patients. At the end of the study, the mean percentage of subjects within each group having a DDS 5 was higher in the counseling group (54.5% v.s. 24.0%). In this study, nutrition counseling for cancer patients undergoing radiation therapy proved to be effective in preventing weight loss, a major complication during radiotherapy. Nutrition counseling not only increased protein and energy intake, but also had desirable effects on variety or diversity of diet.

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대중매체 식품영양정보에 대한 성인 여성의 요구도 조사 (A Survey for Needs and Preference of Food and Nutrition information on Mass Media for Korean Female Adults)

  • 곽정은;이서연;이상훈;고광석
    • 대한지역사회영양학회지
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    • 제19권6호
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    • pp.550-557
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    • 2014
  • Objectives: This study was conducted to examine the preferences and needs of typical Korean females adults for food and nutrition information provided by the mass media. Methods: A total of 343 females (77 in their 20s, 85 in their 30s, 88 in their 40s and 93 in their 50s) residing in the Seoul/Gyeonggido area was surveyed on general characteristics, main sources of food and nutrition information and needs for sources and contents of nutrition information. Results: The survey showed that typical Korean females obtained knowledge of food and nutrition mainly through the Internet (30.4%) and broadcasting (29.0%). Typical Korean females were interested in 'dietary management for weight control' (21.9%), 'the prevention and treatment of disease' (20.0%), 'food safety' (16.8%), 'proper dietary habits' (14.6%), 'cookery' (11.8%), 'functional foods' (9.6%), 'restaurant details' (3.5%) and 'life-cycle-specific dietary guideline' (1.6%). Needs for food and nutrition program forms on TV were 'educational programs' (34.3%), 'documentaries' (20.8), 'expert lecture-style' (13.0%), 'entertainment programs' (11.9%), 'expert conversation' (11.4%), 'news-style' (4.6%) and 'public campaign advertisements' (4.0%). On the Internet, 38.6% of the respondents preferred to get information provided by food and nutrition-related institutions (38.6%) while 26.1% preferred webtoons for nutritional information. The favored forms in mobile applications were 'monitoring their diets' (29.5%), 'data-based texts information' (21.4%), 'experts feedback' (20.6%), 'communities' (15.1%) and 'games' (13.1%). The rates of the preference to obtain information from experts such as nutritionists and dietitians and doctorsor dietitian turned reporters increased markedly with older ages. Conclusions: Since the mass media is a main source of food and nutrition information for the general public, the effectiveness and accuracy of the information provided should be enhanced by taking the needs of the public into account. The quality of information should be improved by involving more nutrition experts.

소아암 환자의 양성자치료 시 DIPS 촬영에 따른 피폭선량 (Exposure Dose of DIPS in Proton Therapy for Pediatric Cancer Patients)

  • 김정수;김정구
    • 대한방사선기술학회지:방사선기술과학
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    • 제34권1호
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    • pp.59-64
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    • 2011
  • 소아암 환자에 대한 양성자치료 시 정밀한 자세재현 확인 및 종양의 위치파악을 위한 DIPS 촬영으로 인하여 발생하는 방사선 피폭에 관하여 확인하여 보았다. 2007년 3월부터 2009년 10월까지 일산의 K 암전문 병원에서 양성자치료를 받은 50명의 소아암 환자를 대상으로 DIPS의 촬영조건을 비교 분석하였으며, 1회 DIPS 촬영 시 피폭선량은 전후 측면촬영에서 0.09~1.57 mGy로 측정 되었으며, 1일 DIPS 촬영이 가장 많은 소아암 환자는 뇌척수조사 환자로 23.55 mGy로 측정되었다. 전뇌조사 환자에서 1일 DIPS 촬영 시 피폭선량이 1.13 mGy로 1일 처방선량을 가장 많이 초과하였으며, 권고선량의 2%를 초과하지 않았다. 치료기간 중 DIPS 피폭선량이 가장 많은 환자는 전뇌조사 환자로 632.71 mGy로 이는 처방선량의 1.13%로 권고선량의 2%를 초과하지 않는 합당한 선량으로 나타났다. 소아암 환자에 대한 DIPS 촬영 시 피폭선량은 처방선량에 대하여 2%를 초과하지 않는 피폭선량으로 나타났지만, 방사선감수성이 높고 평균 잔여 수명이 긴 소아암 환자에게는 유전적 영향 등의 확률적 영향과 관련된 방사선 장해를 초래할 수 있음을 인식하여 소아암 환자의 DIPS 촬영에 대한 가이드라인 제시로 방사선 피폭을 최소화할 수 있는 방안을 마련해야 할 것으로 사료된다.

갈락토스혈증의 신생아 선별검사 후 진단 알고리즘 (A Diagnostic Algorithm of Newborn Screening for Galactosemia)

  • 손영배
    • 대한유전성대사질환학회지
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    • 제15권3호
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    • pp.101-109
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    • 2015
  • 신생아 선별검사의 확장으로, 조기에 진단되어 치료하지 않으면 치명적인 경과를 보이는 고전적 갈락토스 혈증 환자를 조기 발견하여 치료할 수 있게 되었다. 신생아 선별검사에서는 원인에 관계없이 갈락토스 대사 산물이 증가한 경우를 양성으로 판정한다. 그러나 신생아 선별검사에서 양성 판정을 받은 경우 실제 GALT 효소의 완전 결핍에 의한 고전적 갈락토스혈증 뿐만 아니라, 다른 원인에 의해 갈락토스가 증가하는 경우도 많으므로 정확한 감별진단을 위한 진단 과정이 필수적이다. 특히 우리나라를 포함한 아시아에서는 서양과 달리 고전적 갈락토스혈증의 발생률이 낮으며, 유전형이 전혀 다른 것으로 보고되고 있어, 신생아 선별검사에서 갈락토스혈증이 있는 경우 정확한 원인을 감별하는 진단 과정이 서양의 것과 차별화 될 필요가 있다. 그러나 아직 우리나라에서는 선천성 대사이상질환 신생아 선별검사에서 갈락토스혈증 양성 판정을 받은 경우 이후 확진을 위한 진단 및 치료 지침이 확립되어 있지 않은 실정이다. 이에 본 종설에서는 국내 현실을 고려하여 신생아 선별검사 양성 판정을 받은 이후 확진을 위한 적절한 진단 및 치료를 위한 지침을 제시하고자 하였다. 갈락토스혈증은 위양성의 경우, 추적검사 결과를 기다리는 적어도 2-3주 동안 모유 수유를 중단해야 한다는 점을 고려해야 한다. 최근 국내에서 다양한 선천성 질환에서 유전자 검사가 매우 활발하게 이용되고 있으므로, 갈락토스혈증의 선별검사나 생화학적 검사결과가 모호하여 추적 검사를 필요로 하는 경우, 유전자 검사를 조기에 시행하면 Duarte 변이형 갈락토스혈증과 같이 철저한 식이 제한을 필요로 하지 않는 형태의 갈락 토스혈증을 감별하는데 도움이 될 것으로 생각된다.

미성년자 대상 임상시험에 관한 법적 문제점 (Legal Issues in Clinical Trial on Minor)

  • 송영민
    • 의료법학
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    • 제17권2호
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    • pp.125-144
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    • 2016
  • 모든 형태의 임상시험은 시험 자체가 불확실하며, 리스크가 다양하므로 피험자를 보호하기 위한 제도가 완비되어 있어야 한다. 그럼에도 불구하고 현행 임상시험에 관한 법률은 약사법과 의료기기법에서 일정한 규정을 두고 있으나 이는 '의약행정'을 원활하게 수행하기 위한 법목적에 비추어 피험자 보호에는 일정한 한계가 있다. 더 나아가 미성년 피험자를 대상으로 하는 임상시험은 약사법 등에서 직접적인 규정을 두지 않고, '소아를 대상으로 하는 임상시험 평가 가이드라인'이나 '의약품임상시험관리기준' 등에서 일정 부분 규율하고 있으나 이는 법적 효력이 없는 권고사항이라는 점에서 일정한 한계가 있다. 미성년자 대상 임상시험에 대한 법흠결 문제는 인체침습의 정도 면에서 통상적인 의료행위의 경우보다 강한 장기이식법상의 미성년자 취급제도와 기타 외국법상의 미성년자 임상시험 제도를 검토함으로서 입법적 해결이 가능하다고 할 것이다. 그러나 근본적으로는 현행법 체계상 약사법, 의료기기법 기타 가이드라인을 중심으로 이루어지고 있는 임상시험 규율체계를 이른바 "피험자보호법"이라는 법률제정을 통해 해결하는 것이 바람직하다고 본다.

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Development of a standardized mucositis and osteoradionecrosis animal model using external radiation

  • Seo, Mi Hyun;Lee, Min Young;Eo, Mi Young;Lee, Suk Keun;Woo, Kyung Mi;Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권4호
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    • pp.240-249
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    • 2020
  • Objectives: Although the side effects of radiation therapy vary from mucositis to osteomyelitis depending on the dose of radiation therapy, to date, an experimental animal model has not yet been proposed. The aim of this study was to develop an animal model for assessing complications of irradiated bone, especially to quantify the dose of radiation needed to develop a rat model. Materials and Methods: Sixteen Sprague-Dawley rats aged seven weeks with a mean weight of 267.59 g were used. Atraumatic extraction of a right mandibular first molar was performed. At one week after the extraction, the rats were randomized into four groups and received a single dose of external radiation administered to the right lower jaw at a level of 14, 16, 18, or 20 Gy, respectively. Clinical alopecia with body weight changes were compared and bony volumetric analysis with micro-computed tomography (CT), histologic analysis with H&E were performed. Results: The progression of the skin alopecia was different depending on the irradiation dose. Micro-CT parameters including bone volume, bone volume/tissue volume, bone mineral density, and trabecular spaces, showed no significant differences. The progression of osteoradionecrosis (ORN) along with that of inflammation, fibrosis, and bone resorption, was found with increased osteoclast or fibrosis in the radiated group. As the radiation dose increases, osteoclast numbers begin to decrease and osteoclast tends to increase. Osteoclasts respond more sensitively to the radiation dose, and osteoblasts are degraded at doses above 18 Gy. Conclusion: A standardized animal model clinically comparable to ORN of the jaw is a valuable tool that can be used to examine the pathophysiology of the disease and trial any potential treatment modalities. We present a methodology for the use of an experimental rat model that incorporates a guideline regarding radiation dose.

고분자 기반 코팅형 상아질 지각 과민 처치제의 효과에 대한 비교 연구 (Comparison of high molecular coating type dentine hypersensitivity desensitizers)

  • 노영훈;이주연;박현정;최차남;박윤정;구기태;김태일;설양조;이용무;구영;류인철;정종평
    • 대한치과의사협회지
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    • 제46권11호
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    • pp.683-688
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    • 2008
  • Purpose : The aim of this study was to evaluate the clinical efficacy of two commercially available desensitizing agents over 3 weeks on patients with dentin hypersensitivity. Materials and Methods : An oxalate-based solution, Sensblok (NIBEC Inc. Seoul, Korea) & Superseal (Pheonix Inc. Michigan, USA), and a distilled water placebo were compared in a clinical setting. Seven volunteers exhibiting three or more teeth that were sensitive to tactile & air were enrolled in the study (35 teeth total). A visual analog scale (VAS) was used for recording each patient s level of sensitivity to tactile & air stimuli. A Florida probe was rubbed across the exposed dentin three times with a constant pressure 20 grams to measure the tactile stimulus. The air stimulus was generated by dental unit air syringe for 1-second blast from 1/2 inch distance. The desensitizing agents were applied according manufacture s guideline. VAS scores were recorded at baseline, 1 minute after treatment, at 1 week, 2weeks, 3weeks. VAS score were analyzed using a repeated measures ANOVA ( =0.05). Results : The Sensblok, Superseal, and distilled water placebo all decreased dentin sensitivity. A statistically significant difference existed between Sensblok and placebo when tactile stimulus was applied (P<0.05), but no significant difference was found among other desensitizing agents and tactile and air stimuli.

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레바미피드 100 mg 정제의 새울학적동등성 (Bioequivalence Test of Rebamipide 100 mg Tablets)

  • 김세미;조혜영;강현아;이용복
    • 한국임상약학회지
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    • 제18권1호
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    • pp.38-44
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    • 2008
  • Rebamipide, ($\pm$)-2-(4-chlorobenzoylamino)-3-[2(1H)-quinolinon-4-yl] propionic acid, is used for mucosal protection, healing of gastroduodenal ulcers, and treatment of gastritis. It works by enhancing mucosal defense, scavenging free radicals and temporarily activating genes encoding cyclooxygenase-2. The purpose of the present study was to evaluate the bioequivalence of two rebamipide tablets, $Mucosta^{(R)}$ (Korea Otsuca Pharmaceuticals Co., Ltd.) and Mustar (Korean Drug Co., Ltd.), according to the guidelines of the Korea Food and Drug Administration (KFDA). The release of rebamipide from the two rebamipide formulations in vitro was tested using KP VIII Apparatus II method with pH 6.8 dissolution medium. Twenty six healthy male subjects, $23.46{\pm}2.63$ years in age and $66.62{\pm}8.97\;kg$ in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After a single tablet containing 100 mg as rebamipide was orally administered, blood samples were taken at predetermined time intervals and the concentrations of rebamipide in serum were determined using HPLC with fluorescence detector. The dissolution profiles of two formulations were similar in the tested dissolution medium. The pharmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated, and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, $Mucosta^{(R)}$ were -5.08, 3.52 and -9.71 % for $AUC_t$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., log 0.84$\sim$log 1.07 and log 0.90$\sim$log 1.17 for $AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Mustar tablet was bioequivalent to $Mucosta^{(R)}$ tablet.

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불임시술의 합병증에 관한 역학적 연구 (An Epidemiological Study on the Complications caused by the Sterilization Program)

  • 홍명선
    • 지역사회간호학회지
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    • 제7권1호
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    • pp.138-153
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    • 1996
  • Intending to offer basic information for a prospective health services in Korea, this study is to investigate the complication caused by sterilization in goverment family planning program from 1962 to 1995. The results are as follows: 1. Total number of sterilization performed during the period from 1962 to 1995 were 1.367,772 cases of male sterilization and 2,889,635 cases of female sterilization. 2. Incidence of the complication caused by sterilization operation from 1980 to 1995 were 1,883(0.20%) out of 925,801 cases in vasectomies and 15,866(0.70%) out of 2,256,020 cases in tubal sterilizations. 3. Major complications in vasectomy were epididymities of 658 cases (34.9%), vas recanalization of 326 cases(17.3%), hematoma of 266 cases(14.1%), scrotal abscess of 184 cases(9.8%), sperm granuloma of 76 cases(4.0%),and other of 373 cases(19.8%). On the other hand, in tubal sterilization, ectopic pregnancy was the most significant complication of 15,078 cases (95.0%) among 15,866 total complications, followed by pelvic inflammatory diseases of 155 cases(0.9%), peritonities of 96 cases(0.6%), ovarian & tubal bleeding of 31 cases(0.2%), intestinal perforation of 16 cases (0.1%), uterine bleeding of 14 cases(0.1%), uterine cervix laceration of 1 case (0.1%), and other of 271 cases(1.7%), while 161 pregnancies(0.1%) were terminated and 43 cases(0.3%) with normal delivery. 4. The occurrence rate of the complication for each period showed that most of the complication cases by vasectomy occurred in a year after the operation -the cases were 1,256 (66.7%). 254 cases(13.5%) occurred between the next year and the 2nd year, 138 cases (7.3%) between the 2nd year and the 3rd year, 73 cases(3.9%) between the 3rd year and the 4th year, 52 cases(2.8%) between the 4th year and the 5th year, 31 cases(1.6%) between the 5th year and the 6th year, 79 cases(4.2%) over the 6th year. Tubal sterilization indicated that the occurred complication cases in a year were 2,175 cases(13.7%), 2,113 cases(13.3%) occurred between the next year and the 2nd year, 2,082 cases(13.1%) between the 2nd year and the 3rd year, 2,049 cases (12. 9%) between the 3rd year and the 4th year, 1,819 cases(11.5%) between the 4th year and the 5th year, 621 cases(10.2%) between the 5th year and the 6th year, 4,007 cases(25.3%) over the 6th year. 5. For the cost of complication treatment, total \7,928,229,000 were paid as medical expenditure in which \609,438,000 for vasectomy and \7,318,791,000 for tubal sterilization. Accordingly per capita expenses were \345,000 for vasectomy and \467,000 for tubal sterilization. As the proportion of government sterilization program was decreased after 1988, that of private sterilization program would be increased. So it is recommended to set a guideline for the private sterilization program and to continue government sterilization program for the lower class.

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