• Title/Summary/Keyword: 관찰 요법

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Clinical Review of Idiopathic Nephrotic Syndrome in Children (소아 특발성 신증후군에 관한 고찰)

  • Sim, Hyun-Seup;Chu, Jeoung-Min;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.37-47
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    • 2002
  • Purpose: We reviewed the clinical manifestations, responsiveness to treatment, and prognosis in children with nephrotic syndrome. Methods: Medical records of 159 children with idiopathic nephrotic syndrome who were admitted to the pediatric department of Chonbuk National University Hospital from January 1979 to December 2000 w ere retrospectively reviewed. Results: There were 32 females and 127 males. The most common age group was between 3 and 5 years of age among the 159 children with nephrotic syndrome. Generalized edema ($75.5\%$), scrotal edema ($20.1\%$), upper respiratory infection ($19.5\%$), and ascites ($28.3\%$) were frequently observed. After the initial steroid therapy, diuresis occurred within tile first two weeks in 138 children, and proteinuria disappeared within the first two weeks in 105 children. Among 159 patients who received initial daily steroid therapy, 110 children were in complete remission, 29 children were in partial remission and 20 children were in poor response state. Hematuria, hypertension and elevated serum creatinine were more frequently observed in the partial and the poor response groups than in the complete remission group. Among 107 children who were followed up for more than one year, 78 children were in complete remission and 55 children were relapsed within the first one year after steroid therapy. Renal biopsy was undertaken in 76 children and 53 children had minimal change nephrotic syndronm. Conclusion: Our study showed that illost children with idiopathic nephrotic syndrome have a good responsiveness to steroid therapy and even most children show frequent relapse during 1st year after remission, long term prognosis is excellent.

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A Case with Abrupt Progression of Renal Scarring or Abrupt Deterioration of Renal Function Associated with Vesicoureteral Reflux (고등급의 방광요관역류가 있는 환아에서 급격히 진행된 신반흔)

  • Kim, Moon-Kyu;Park, Sung-Eun;Lee, Jun-Ho
    • Childhood Kidney Diseases
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    • v.15 no.2
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    • pp.179-183
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    • 2011
  • Abrupt progression of renal scarring associated with vesicoureteral reflux (VUR) is rare in males over 2 years old of age. We report a 5 year old boy with sustained unilateral high grade VUR who experienced abrupt progression of renal scarring; he had a relative renal radionuclide uptake of 38% at 2 years of age that dropped to 8% after three years. Per his parent's wishes, he took prophylactic antibiotics for 25 months after his first febrile urinary tract infection (UTI) at 4 months old without surgical management. One episode of recurrent breakthrough infection occurred at the age of 2 years. This observation reminds us that a recommending surgical management for sustained high grade VUR associated with renal scarring might be needed. Close follow up of DMSA for renal scanning, and long term follow up of patients after the first febrile UTI are important.

MALIGNANT FIBROUS HISTIOCYTOMA OF THE MAXILLA ; REPORT OF A CASE (상악골에 발생한 악성섬유성조직구종)

  • Ryu, Sun-Youl;Park, Suk-In;Lee, Jin-Hwan;Chung, Mu-Gang;Chung, Jong-Chull;Choi, Hong-Ran
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.1_2
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    • pp.117-123
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    • 1992
  • Malignant fibrous histiocytoma rarely occurs in the jaws. A case of malignant fibrous histiocytoma originated from the maxillary sinus is reported with review of literature. A 59-year-old woman visited the Chonnam University Hospital in March, 1990, with chief complaint of swelling and tenderness in the right cheek. Radiographic findings revealed wide destruction of the maxilla. The biopsy taken from the maxilla showed histopatholgic findings of malignant fibrous histiocytoma. Accordingly the patient received preoperative and postoperative anticancer chemotherapy by the modified CY-VA-DIC protocol of the Southwest Oncology Group (SWOG). Preoperative and postoperative radiotherapy were also given to her in total 40Gy of $^{60}Co$ And she underwent radical resection of the maxilla. No evidence of recurrence or metastasis was shown for 2-year period of postoperative follow up.

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A Case of Concurrent Chemoradiotherapy After Endoscopic Resection For Early Esophageal Cancer (조기 식도암에서 내시경점막하박리술 시행 후 항암방사선동시요법을 시행한 1예)

  • Kyuhyun Han;Sunyoung Shin;Junil Moon;Gawon Song;Wonjin Koh;Wonhee Kim;Sungpyo Hong;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.3 no.1
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    • pp.35-38
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    • 2015
  • 62-year-old patient who had past history of endoscopic submucosal dissection for early gastric cancer at September 2008, underwent endoscopic submucosal dissection of esophagus for early esophageal cancer at mid esophagus during health screening service. Because there was a high risk of lymph node metastasis at biopsy results, concurrent chemoradiotherapy was added to endoscopic submucosal dissection. There was a metachronous cancer at mid-esophagus at March 2013. He underwent endoscopic mucosal resection and photodynamic therapy. Concurrentchemoradiotherapy after endoscopic submucosal dissection is an effective treatment method.

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Results of Preoperative Chemoradiotherapy in Low Rectal Cancer (하부 직장암의 수술 전 화학방사선요법 결과)

  • Yun Hyong-Geun
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.21-29
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    • 2006
  • Purpose: This study explored the anal sphincter-saving rate and down-staging rate after preoperative chemoradiotherapy for treating lower rectal cancer. We also explored the prognosis of the patients who refused surgery after preoperative chemoradiotherapy. Materials and Methods: Thirty seven patients with histologically proven lower rectal cancer who underwent preoperative chemoradiotherapy were retrospectively analyzed. In each case, the tumor location was 0 to 5 em from the anal verge, and curative resection of the cancer with performing a sphincter-saving procedure was not feasible before chemoradiotherapy. In each case, the staging examinations, including biopsy, were done before starting radiotherapy and this was repeated at 1 month after radiation therapy. Results: After chemoradiotherapy, among the 37 included patients, 56.8% and 32.4% were downstaged to the T stage and N stage, respectively, when comparing the postradiotherapy stage with pre-radiotherapy stage. Twenty five patients underwent complete resection of cancer at 6 weeks after radiotherapy: eleven, eight and six patients underwent abdominoperineal resection, low anterior resection and local excision, respectively. The sphincter-saving rate among the 24 completely resected cases was 54.2%. Twelve patients refused surgery after radiotherapy. Among 6 patients who refused surgery with biopsy-proven complete remission after chemoradiotherapy, 5 patients were alive without disease at a median follow up period of 31 months, and only 1 patient had local failure. Conclusion: For lower rectal cancer, a high sphincter-saving rate was accomplished with preoperative chemoradiotherapy. The prognosis of the patients who refused surgery with biopsy proven complete remission after chemoradiotherapy was good and these patients need to be kept under close surveillance.

Effect of Radiation Therapy on Voice Parameters in Early Layngeal Cancer and Normal Larynx (방사선요법이 초기 후두암 및 정상후두의 음성지표에 미치는 영향)

  • 박한종;이인자;박영학;김민식;조승호
    • Proceedings of the KSLP Conference
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    • 1994.06b
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    • pp.88-88
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    • 1994
  • 초기후두암에 대한 방사선요법은 수술적 치료에 비하여 정상 후두기능 즉 발성 기능을 최대 한 보존할 수 있는 장점이 있다. 그러나 방사선 치료법은 병적 혹은 정상 후두조직에 섬유화, 점막부종 혹은 점액선 간소등의 변영을 초래할 수 있기 때문에 어느 정도의 음성장애를 유발하게 된다. 방사선요법이 후두의 발성기능에 미치는 영향을 알아보기 위하여 초기후두암 환자와 두경부암으로 인하여 정상후두에 방사선 조사를 받았던 환자 및 정상대조군 각 20명에 대하여 음향 및 공기역학적 음성검사를 시행하여 음성장애의 특성을 비교, 검토하였다. 초기 후두암 환자들에게 사는 방사선 치료 후 음성지표들이 관찰되었고, 정상후두에는 큰 영향을 미치지 않았다. (중략)

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A Case Study on Effect of Herbal Diet an Childhood Obese Patient (한방비만치료의 소아비만 증례 1)

  • Choi, Jung-Eun;Kim, Kil-Soo;Ju, Jae-Yong
    • Journal of Korean Medicine for Obesity Research
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    • v.3 no.1
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    • pp.69-74
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    • 2003
  • Childhood obesity is harmful to health and growth. We had experienced a childhood obese patient. From Feb. 28. 2003 to July. 14. 2003. We applied Chegameuiyin-tang(體感意苡仁湯), electrolipolysis and VLCD(very low calorie diet), behavioral therapy, aerobic exercise, infra-red therapy, auricular acupuncture, and aqua-massage. Through this obesity treatment during 5 months, total weight loss was 12.2kg, reduction of percent body fat was 13.4% (from 38.5 to 25.1), her condition and hepatic index(AST, ALT) was improved.

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Effect of Selaginella tamariscina on U937 Cytoxicity (권백이 U937의 세포독성에 미치는 영향)

  • 박성희;이인자
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.23 no.5
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    • pp.799-804
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    • 1994
  • In order to study the antitumoral effect of Selaginella tamariscina extract, the cytotoxicities to human histiocytic lymphoma (U937) and lymphocyte were measured by MTT method. The water extract of Selaginella tamariscina showed the effective cytoxicity and increased the cytotoxicity of doxorubicine, cyclophosphamide on U937, but it has no effect on the cytotoxicity of lymphocyte. The cytotoxicity increased with the addition of other antineplastic agents but decreased with the combination of antineoplastic agent and Selaginella tamariscina in the lymphocyte. The results indicted that the side actions of retinoic acid, doxorubicine and cyclophosphamide decreased by addition of Selaginella tamariscina water extracts.

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Effect of Oriental Anti-Stress Agent(Bohyulanshintang) on the Salivary Gland of Rats under Restraint Stress (보혈안신탕(補血安神湯)이 스트레스에 의한 백서 타액선 조직 변화에 미치는 영향에 관한 연구)

  • Ryu, Ho-Kyung;Chun, Yang-Hyun;Lee, Jin-Yong;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.24 no.3
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    • pp.245-257
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    • 1999
  • 일상 생활에서 우리는 스트레스에 항상 노출되어 있으며, 스트레스는 생체의 신경계, 내분비계 및 면역계의 변화를 수반한 항상성의 파괴로 수많은 정신적, 육체적 질병을 야기시킨다. 특히 구강안면영역에서도 다양한 구강점막질환과 구강건조증 등을 발생시킨다. 스트레스를 제거하는 방법으로는 약물요법 및 상담, 명상요법, 종교요법 등 다양한 방법이 제시되고 있는데, 다소의 부작용이 나타나거나 꾸준히 시행하기가 쉽지 않으며 스트레스의 원인을 근본적으로 제거하기가 현실적으로 용이하지 않은 경우가 많아 스트레스에 대한 해결책에 대하여 많은 관심이 집중되고 있다. 이에 본인은 스트레스가 가해졌을 때 백서 악하선에서 관철되며 apoptosis에 대하여 세포보호작용을 하는 clusterin(SGP-2)을 이용하여 구속스트레스를 가하기에 앞서 오랫동안 경험적으로 사용되어 왔고 부작용이 적은 전통약물인 보혈안신탕을 투여하고 스트레스에 의한 타액선의 조직변화를 관찰하여 그 효과를 확인해 보고자하였다. Sprague-Dawley계 응성 백서(200-230g/bw) 33마리를 정상 대조군(3마리), 구속스트레스군(15마리) 및 보혈안신탕 투여 후 구속스트레스군(15마리)으로 나누고 이틀을 각각 구속장치에 구속한 후 0, 1, 3, 5, 7일에 회생시켜 악하선을 적출하였으며, 면역조직화학법 및 Northern Blot을 이용하여 clusterin의 변화를 관찰하였다. 그 결과는 다음과 같다. 1. 구속스트레스군의 악하선 조직에서 clusterin 단백질과 mRNA는 실험 즉일군에서만 미약하게 관찰되었으며 실험 3일과 5일 후에 핵붕괴 및 핵농축 등의 핵변화를 동반한 apoptosis가 관찰 되었다. 2. 보혈안신탕 투여 후 구속스트레스군의 악하선 조직에서 실험 5일군까지 clusterin 이 증가한 후 실험 7일군에서는 감소하였다. 3. 보혈안신탕 투여 후 구속스트레스군의 악하선 조직에서는 apoptosis가 관찰되지 않았다. 4. 보혈안신탕 투여 후 구속스트레스군의 악하선 조직에서 clusterin mRNA가 실험 전군에 걸쳐 미약하게 관찰되었다. 이상의 결과로 타액선 조직은 스트레스 단백질인 clusterin을 생산하여 세포를 보호함으로써 스트레스 상황에 적응하지만, 생리적 적용한계를 넘는 스트레스에 노출될 때는 apoptosis됨이 확인되었다. 그리고 보혈안신탕은 스트레스 상황에서 세포의 생리적 적응력을 높여 세포의 apoptosis를 억제하는 효과를 나타냄이 확인되었다. 따라서 본 연구결과는 구강건조증등의 스트레스성 타액선 질환의 병리기전을 규명하는데 도움이되리라 생각되며, 향후 항스트레스 효과를 가진 보혈안신탕등의 한약재를 임상에 적용함으로써 스트레스로 인한 신체의 병리적 변화를 다소나마 차단할 수 있을 것으로 사료된다.

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A Prospective Randomized Trial Comparing the Seciuence of Adiuvant Chemotherapy and Radiotherapy following Curative Resection of Stage II, III Rectal Cancer (직장암의 근치적 수술 루 방사선치료와 화학요법의 순서에 대한 고찰 -전향적 무작위 3상 임상연구 중간 결과 보고-)

  • Kim Kyoung Ju;Kim Jong Hoon;Choi Eun Kyung;Chang Hyesook;Ahn Seung Do;Lee Je Hwan;Kim Jin Cheon;Yu Chang Sik
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.17-25
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    • 2000
  • Purpose : To evaluate the side effects, pattern of failure, and survival rate according to the sequence of postoperative adjuvant radiotherapy and chemotherapy, patients with stages II and III rectal cancer who had undergone curative resection were randomized to 'early radiotherapy group (arm I)' or' late radiotherapy group (arm II)', then we intend to determine the most effective sequence of the radiotherapy and chemotherapy. Materials and Methods . From January 1996 to March 1999, 313 patients with curatively resected stages II and III rectal cancer have been randomized to' early' or' late' radiation therapy group and received combined chemotherapy (5-FU 375 mg/m$^{2}$/day, ieucovorin 20 mg/m$^{2}$, IV bolus daily Dl-5, 8 cycles) and radiation therapy (whole pelvis with 45 Gy/25 fractions/s weeks). Arm I received radiation therapy from day 1 with first cycle of chemotherapy and arm II received radiation therapy from day 57 with third cycle of chemotherapy after completion of first two cycles. Preliminary analysis was peformed with 228 patients registered up to Jun 1998. Two out of the 228 patients were excluded because of double primary cancer. Median follow-up period was 23 months. Results :Local recurrence occurred in 11 patients (9.7$\%$) for arm I and 9 patients (8$\%$) for arm 11. There was no significant difference between both groups ( p=0.64). However, distant metastasis was found in 22 patients (19.5$\%$) for arm I and 35 patients (31.0$\%$) for arm II and which showed statistically significant difference between the two groups ( p=0.046). And neither 3-year disease-free survival (70.2$\%$ vs 59.2$\%$, p=0.2) nor overall survival (89.4$\%$ vs 88.0$\%$, p=0.47) showed significant differences. The incidence of leukopenia during radiation therapy and chemotherapy was 78.3$\%$ and 79.9$\%$ respectively but leukopenia more than RTOG grade 3 was only 2.1$\%$ and 6.0$\%$ respectively. The incidence of diarrhea more than 10 times per day was significantly higher in the patients for arm I than for arm II (71.2$\%$ vs 41.6$\%$, p=0.02) but this complication was controlled with supportive cares. Conclusion : Regardless of the sequence of postoperative adjuvant radiation therapy and chemotherapy after curative resection for rectal cancer, local recurrence rate was low with combined chemoradlotherapy. But distant metastasis rate was lower in early radiation therapy group than in late radiation therapy group and the reason is unclear. Most patients completed these treatments without severe complication, so these were thought to be safe treatments but the treatment compliance should be improved.

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