• Title/Summary/Keyword: 순차치료

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Evaluation of Xerostomia Following 3 Dimensional Conformal Radiotherapy for Nasopharyngeal Cancer Patients (3차원 입체조형 방사선치료를 시행받은 코인두암 환자에서의 구강건조증 분석)

  • Park Young-Je;Park Won;Ju Sang-Gyu;Nam Hee-Rim;Oh Dong-Ryul;Park Hee-Chul;Ahn Yong-Chan
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.81-87
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    • 2006
  • Purose: This study is to evaluate the xerostomia following 3-dimensional conformal radiation therapy (3D CRT) in nasopharynx cancer patients using the xerostomia questionnaire score (XQS). Materials and Methods: Questionnaire study was done on 51 patients with nasopharynx cancer who received 3D CRT from Dec. 2000 to Aug. 2005. 3D CRT technique is based on 'serial shrinking field' concept by 3 times of computed tomography (CT) simulation. Total target dose to the primary tumor was 72 Gy with 1.8 Gy daily fractions. Xerostomia was assessed with 4-questions XQS, and the associations between XQS and time elapsed after RT, age, sex, stage, concurrent chemotherapy, and parotid dose were analyzed. Results: Concurrent chemotherapy was given to 40 patients and RT alone was given to 11 patients. The median time elapsed after 3D CRT was 20 ($1{\sim}58$) months and the mean XQS of all 51 patients was $8.4{\pm}1.9\;(6{\sim}14)$. XQS continuously and significantly decreased over time after 3D CRT ($X^2$=-0.484, p<0.05). There was no significant difference in XQS according to sex, age, and stag. However, XQS of concurrent chemotherapy patients was significantly higher than RT alone patients (P=0.001). XQS of patients receiving total mean parotid dose ${\ge}35 Gy$ was significantly higher than <35 Gy (p=0.05). Decreasing tendency of XQS over time after 3D CRT was observed. Concurrent chemotherapy and total mean parotid dose ${\ge}35 Gy$ were suggested to adversely affect radiation-induced xerostomia.

Helen Bonny and the Development of the First Series of Music Programs for the Bonny Method of Guided Imagery and Music (1972-1979) (Helen Bonny와 Bonny 방식 심상음악(BMGIM) 프로그램 첫 시리즈의 개발(1972-1979))

  • Bae, Min-Jeong
    • Journal of Music and Human Behavior
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    • v.11 no.2
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    • pp.59-80
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    • 2014
  • Helen Lindquist Bonny developed the Bonny Method of Guided Imagery and Music (BMGIM), a music oriented self-exploration of consciousness, with the influence of humanistic and client-centered approaches. BMGIM can help people manage pain, anxiety, relationship issues, depression, and other conditions through self-awareness and self-potential. The purpose of this biographical study was to explore Bonny's early life experiences and their contribution to the humanistic and transpersonal approach to music therapy. The study was organized in chronological order: Bonny's childhood and young adulthood; inspirations that led to development of BMGIM; and research and clinical events that helped solidify the development of BMGIM. An interview with Bonny and a review of the literature supported the significance of these periods. The years between 1972 and 1979 mark the development of the first series of BMGIM music programs, which Bonny said served as the base for many later GIM music programs developed. Bonny's contribution to the field of music therapy includes the provision of strong foundation for music therapy based on Maslow's and Rogerian approach, and the introduction of time-valued music to the music therapy field.

NEW ANTIDEPRESSANTS IN CHILD AND ADOLESCENT PSYCHIATRY (소아청소년정신과영역의 새로운 항우울제)

  • Lee, Soo-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.12-25
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    • 2003
  • Objectives:As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods:Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results:1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion:Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.

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Successful Bilateral Lung Retransplantation in a Patient with Primary Graft Failure Following a Single Lung Transplantation (일측 폐 이식 후 발생한 이식편 부전으로 양측 폐 재이식을 시행한 1예 보고)

  • Hwang Jung-Joo;Joung Eun-Kyu;Kim Jae-Ho;Lee Doo-Yun;Paik Hyo-Chae
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.490-494
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    • 2006
  • Lung transplantation is the choice of treatment for selected patients with end-stage pulmonary disease. However, retransplantation of the lung due to primary graft failure carries a high risk of morbidity and mortality. This is a case of a 52 year old male with emphysema who continuously needed a ventilator care and a tracheostomy. He underwent a left single lung transplantation but were not able to wean from the ventilator due to primary graft failure, and therefore we decided to do a retransplantation. Bilateral sequential single lung transplantation was performed under the cardiopulmonary bypass. The patient recovered quite well and was discharged and fully active with his work. Retransplantation although it carries a high risk, is a very effective treatment in patients with primary graft failure.

A Study on the Effect of Healthcare-based IPTV Quality on Intention to Use (Healthcare 기반 IPTV 품질이 사용의도에 미치는 영향에 관한 연구)

  • Kim, Dong-Gu;Song, In-Kuk
    • The KIPS Transactions:PartD
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    • v.18D no.3
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    • pp.185-196
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    • 2011
  • As the Korean Ministry for Health and Welfare announced the likelihood to revise the legislative limit for healthcare telemedicine, u-Healthcare service through IPTV emerged among these business models. However, in spite of many advantages such as treatment improvement, service quality enhancement, and treatment usefulness, most medical trials grafted with IT have not accepted yet. This points out not only that law and institutional environment has not prepared, but also that policy maker neglect the preparation of the strategies through the study on user acceptance. The purpose of this study is to verify the relationship for IPTV quality based Healthcare on satisfaction and intention to use. The results identify that IPTV technology quality for its convenience, contents quality for its completeness, and the quality for healthcare services give significant effect to satisfaction. In addition the study indicates that overall qualities of IPTV technology, contents, and healthcare service, significantly impact on satisfaction respectively and that the satisfaction may lead to the intention to use of this service.

Sequential Bronchoscopic Findings of Endobronchial Tuberculosis (기관지 결핵의 기관지 내서경적 경과 관찰에 관한 연구)

  • Choi, Hyung-Seok;Joeng, Ki-Ho;Lee, Kye-Young;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Kim, Keun-Youl;Han, Young-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.5
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    • pp.407-416
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    • 1992
  • Background: Endobronchial tuberculosis is an important complication of pulmonary tuberculosis. It is highly infetious, difficult to diagnose mimicking bronchogenic carcinoma or bronchial asthma and it can leave bronchial stenosis with parenchymal collapse or bronchiectasis as complications. Early diagnosis, adequate treatment and follow-up are crucial in the management of endobronchial tuberculosis. The most important diagnostic tool in its diagnosis is bronchoscopic examination. Authors have tried to elucidate changes in sequential bronchoscopic findings in these patients to help diagnose and manage these patients. Method: We have analysed the sequential bronchoscopic findings and clinical features of 83 endobronchial tuberculosis patients admitted in Seoul National University Hospital from August 1987 to December 1990. Results: We can observe the following results: 1) In the actively caseating type, improvement of the bronchial stenosis was observed in 29 patients (76.3%) up to 5 months of treatment. Caseation disappeared in 31 patients (81.6%) during the same period. 2) In the stenotic without fibrosis type, improvement of the stenosis was observed in 8 patients (66.4%) during the same period. 3) In the tumorous type, improvement of the stenosis was observed in 12 patients (92.3%) during the same period. Conclusion: We can conclude that improvement of the endobronchial lesions may occur up to about 5 months after adequate treatment of endobronchial tuberculosis.

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Concurrent Chemoradiation with Weekly Paclitaxel in Locally Advanced Non-small Cell Lung Cancer (국소진행성 비소세포폐암에서 Paclitaxel 매주투여 및 방사선치료 동시요법)

  • Bae, Kang Woo;Song, Tak Ho;Yang, Joo Yeon;Kim, Yun Seup;Park, Jae Seok;Jee, Young Koo;Lee, Kye Young
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.351-357
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    • 2004
  • Background : Paclitaxel is highly beneficial anticancer drug for the treatment of non-small cell lung cancer and has shown remarkable radiosensitizing effect in vitro. We evaluated whether concurrent chemoradiation therapy with weekly paclitaxel (60 $mg/m^2$) could be tolerated and effective in the treatment of locally advanced non-small cell lung cancer (NSCLC). Methods : Twenty-two stage III (IIIA:6, IIIB:16) NSCLC patients were treated with weekly administration of paclitaxel (60 $mg/m^2$) on days 1, 8, 15, 22, 29, and 36 in addition to concurrent radiation therapy of 54 Gy. After the initial phase of concurrent chemoradiation, patients received additional two cycles of consolidation chemotherapy with paclitaxel (175 $mg/m^2$)/cisplatin (75 $mg/m^2$) or paclitaxel (175 $mg/m^2$)/carboplatin (6AUC) every 3 weeks. Results : Overall response rate was 81.8% (18/22) with 9.1% (2/22) of complete response and 72.7% (16/22) of partial response rate. Two patients (9.1%) died of chemoradiation-induced pneumonitis after completion of therapy. In total, grade 3 toxicities included pneumonitis (22.7%), esophagitis (22.7%), neuropathy (13.6%), and neutropenia (13.6%). The median survival time was 15 months and 2-year overall survival were 31.8%. Conclusion : Concurrent chemoradiation therapy with weekly paclitaxel in locally advanced NSCLC showed good local response, but survival rate was not completely satisfactory due to potentially fatal chemoradiation-induced pneumonitis.

A Case of Mucoepidermoid Carcinoma in Pulmonary Tuberculosis Patient (폐결핵 환자에서 발생한 점액표피양 암종 1예)

  • Jeong, Jae-Man;Song, Ju-Young;Hong, Jae-Rack;Kim, Young-Jun;Kim, Moon-Shik
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.429-434
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    • 1994
  • Mucoepidermoid carcinoma of lung are rare carcinoma arising from the submucosal glands tissue of the proximal tracheobronchial tree. The carcinoma can be divided into low grade and high grade varienties. The most important factors in the prognosis include histological grading and the ability to achieve a complete surgical resection. We experienced a case of high grade mucoepidermoid carcinoma in pulmonary tuberculosis patient of 67 years old male who has been suffered from left chest pain for several weeks. He was not treated and died seventeen months later.

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Analysis of Chemical Constituents of Saccharides and Triterpenoids in the Korean Native Mistletoes - II. Screening the Extractives of Korean Camellia Mistletoe (Pseudixus japonicus) for Cytotoxicity - (한국산(韓國産) 겨우살이류(類)의 당류(糖類)와 triterpenoids의 화학적(化學的) 조성(組成) 분석(分析) - II. 동백나무겨우살이 추출물의 항암활성 성분 검색 -)

  • Kim, Pyoung-Su;Ahn, Won-Yung
    • Journal of the Korean Wood Science and Technology
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    • v.24 no.1
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    • pp.87-94
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    • 1996
  • 한국산 동백나무겨우살이(Pseudixus japonicus) 추출물의 암치료를 위한 생약으로서 활성 유효성을 검증하기 위하여 메탄올, 석유에테르, 클로로포름, 초산 에틸 용매로 순차적으로 추출하여 겨우살이 추출물의 다섯 가지 분획을 얻어, 이에 대하여 in vitro로 1차와 2차 검색 시스템을 사용해 항암활성 성분을 체계적으로 검색하였다. 다섯 가지 분획 중 클로로포름 가용성 분획이 1차 검색 세포인 $P388D_1$에 대해 가장 높은 항암활성을 나타내어 MSB1, NIH/3T3, SNU-1, SNU-C2A 등 2차 검색 시스템에 대해 클로로포름 가용성 분획의 항암활성을 다양한 농도하에서 비교 검색하였다. 혈액암 세포중 특히 $P388D_1$의 생장이 클로로포름 추출물에 의해 강하게 저해되었으며, 형질전환된 생쥐의 태아 섬유아세포와 사람의 대장암, 위암세포들도 어느 정도의 생육저해를 나타내었다. 이 클로로포름 가용성 분획의 주성분은 원소분석, 발색시약과의 반응, IR, GC-MS, $^{13}C$-NMR의 스펙트럼의 결과로 세 종류의 알칼로이드 화합물로 확인되었고, 부성분으로는 지방산 메틸 에스테르와 프탈라이드 화합물이 MS 스펙트럼을 통해 동정되었다.

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A Case of End-Stage Renal Disease with Joubert Syndrome due to CEP290 Mutation (CEP290 돌연변이로 인해 발생한 Joubert 증후군 말기 신부전 1례)

  • Kim, Sung Hoon;Lee, Sang Taek;Seong, Moon-Woo;Kim, Man Jin;Lee, Jun Hwa
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.20 no.1
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    • pp.29-35
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    • 2020
  • Joubert syndrome (JS) is a rare genetic disorder that is characterized by ataxia, hypotonia, developmental delay, respiratory abnormalities such as apnea-hyperpnea, and abnormal eye movements. The pathognomonic diagnostic finding is the "molar tooth sign" (MTS) on brain magnetic resonance imaging (MRI), described as cerebellar vermis hypoplasia or dysplasia, thick and horizontally oriented superior cerebellar peduncles, and an abnormally deep interpeduncular fossa. JS is characterized by genetic heterogeneity: pathogenic variants in over 30 genes have been identified to date. The CEP290 protein, which is on chromosome 12q21.3, is most frequently mutated in patients with JS, especially with renal involvement. Here, we report a case of JS in a 14-year-old male patient with end-stage renal disease. To the best of our knowledge, this is the first Korean report of a patient with JS due to CEP290 mutation (c.6012-12T> A) whose diagnosis was confirmed after repetitive MRI. We suggest consultation with an experienced neuro-radiologist and follow-up MRI studies to detect a "hidden" MTS if clinical findings suggest a diagnosis of JS. Furthermore, even in the absence of an MTS, whole exome sequencing should be considered.