• Title/Summary/Keyword: A protocol for follow-up

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Speech Outcomes in 5-Year-Old Korean Children with Bilateral Cleft Lip and Palate

  • Kyung S. Koh;Seungeun Jung;Bo Ra Park;Tae-Suk Oh;Young Chul Kim;Seunghee Ha
    • Archives of Plastic Surgery
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    • v.51 no.1
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    • pp.80-86
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    • 2024
  • Background Among the cleft types, bilateral cleft lip and palate (BCLP) generally requires multiple surgical procedures and extended speech therapy to achieve normal speech development. This study aimed to describe speech outcomes in 5-year-old Korean children with BCLP and examine whether normal speech could be achieved before starting school. Methods The retrospective study analyzed 52 children with complete BCLP who underwent primary palatal surgery at a tertiary medical center. Three speech-language pathologists made perceptual judgments on recordings from a speech follow-up assessment of 5-year-old children. They assessed the children's speech in terms of articulation, speech intelligibility, resonance, and voice using the Cleft Audit Protocol for Speech-Augmented-Korean Modification. Results The results indicated that at the age of five, 65 to 70% of children with BCLP presented articulation and resonance within normal or acceptable ranges. Further, seven children with BCLP (13.5%) needed both additional speech therapy and palatal surgery for persistent velopharyngeal insufficiency and speech problems even at the age of five. Conclusion This study confirmed that routine follow-up speech assessments are essential as a substantial number of children with BCLP require secondary surgical procedures and extended speech therapy to achieve normal speech development.

The Early Detection of Recurrence of Malignant Peripheral Nerve Sheath Tumor by Frequent Magnetic Resonance Imaging

  • Lee, Chang-Sub;Huh, Ji-Soon;Chang, Jee-Won;Park, Ji-Kang
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.51-54
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    • 2010
  • Surgery has a key role in the treatment of malignant peripheral nerve sheath tumors (MPNSTs), but the resectability of paraspinal MPNSTs is only 20%. Therefore, spinal MPNSTs show frequent recurrence and poor prognosis. Local recurrence is much more common than metastasis for MPNSTs, and surgery still has a key role in the treatment of local recurrence. Therefore, it is important that recurrence must be detected before resectability is lost. However, no evidence-based follow-up protocol has been established for MPNST. The authors performed gross total resection in a 34-year-old woman presented with thoracic MPNST. Adjuvant radiotherapy and chemotherapy were not administered since these adjuvant therapies generally do not improve survival in MPNST and may cause additional neurovascular damage. Instead, the authors monitored the primary site every 3 months using magnetic resonance imaging to detect local recurrence at the earliest opportunity. The tumor recurred locally on two occasions without overt symptoms at 21 and 24 months postoperatively. These recurrences were treated successfully by gross total removal.

Stereotactic Body Radiation Therapy in Canine Nasal Transitional Cell Carcinoma

  • Park, Noh-won;Lee, Dong-han;Huh, Ra-young;Han, Jae-woong;Eom, Ki-dong
    • Journal of Veterinary Clinics
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    • v.34 no.4
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    • pp.299-303
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    • 2017
  • An 11-year-old neutered male Maltese presented for radiation therapy for nasal transitional cell carcinoma. Stereotactic body radiation therapy (SBRT) was provided for the owner's request. Clinical signs improved 6 days after radiation therapy. Adverse effects including alopecia and pigmentation on the facial region were observed at 21 days after radiation therapy. The first follow-up computed tomography (CT) 96 days after SBRT revealed that the nasal tumor had decreased by 60.63% compared with the pre-treatment volume. Clinical signs related with the tumor reassigned 151 days after SBRT, and the second follow-up CT revealed tumor relapse. The patient was died 238 days after SBRT due to tumor relapse. SBRT showed a good tumor control effect with relatively mild radiation toxicity relative to other radiation therapy modalities, in accordance with a previous study. Further studies are needed to establish an effective treatment protocol, such as total dose, fractional dose, and inter-fractional period, in canine malignant nasal tumors.

The effect of acupuncture on hot flushes : A study protocol of multi-center randomized controlled clinical trial (갱년기 여성의 안면홍조에 대한 침치료 다기관 임상시험 : 프로토콜)

  • Park, Ji-Eun;Oh, Dal-Seok;Kang, Kyung-Won;Kim, Dong-Il;Choi, Sun-Mi
    • Korean Journal of Acupuncture
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    • v.24 no.3
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    • pp.33-45
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    • 2007
  • Background : Hot flushes are general postmenopausal symptoms which about 75% of climacteric women undergo. They affect hotness, perspirations, systemic weakness, panic disorders, insomnia. Acupuncture is effective in alleviating hot flushes in practice. Assessment effectiveness and safety of acupuncture in hot flushes would be needed through multi-center trial. Objectives : Purpose of this study is to develope the protocol of effects of acupuncture on hot flushes, a postmenopausal symptom in climacteric women. Methods & Results : It will be a multi-centered, randomized, sham controlled, comparative trial. It will be performed by Good Clinical Practice after approval of Institutional Review Board. Selection criteria will be set according those of FDA above moderate degree. There will be a notice on concomitant medication, other herbs, dietary supplements. Superficial needling on sham points will be used for control group. Treatment period will be 8 weeks with 12 weeks' follow up. Some questionnaire scale will be used as the primary and secondary outcome. Conclusions : The clinical trials based on this protocol will be performed.

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Effectiveness of a Training Program Based on Stress Management on NEDSA Staff and Line Staff

  • Azad, Esfandiar;Hassanvand, Bagher;Eskandari, Mohsen
    • Safety and Health at Work
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    • v.13 no.2
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    • pp.235-239
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    • 2022
  • Background: The purpose of present study was to determine the effectiveness of training program based on job stress management in NEDSA and line staff. Methods: The study method of this study was quantitative and quasi-experimental research Methods: From the statistical population (all employees of the NEDSA and line staff in 2020-2021), 30 of these people were selected by judgmental sampling method and considering the inclusion and exclusion criteria. The participants were first matched based on age and education and were randomly divided into experimental and control groups. First, pre-test was taken from both groups (Job Stress Questionnaire). The experimental group was presented with a job stress management training package and no protocol was presented in the control group. After the sessions, post-test was received from both groups (experimental and control). After two months, a follow-up test was performed. Results: The results were entered into SPSS-24 software and analyzed. The results of repeated measure showed high effectiveness of the job stress management package (researcher-made). The results showed that the job stress management training package showed 67.5% effectiveness and also the training effect of job stress management training was stable for two months (follow-up). Conclusion: Based on these results, Training program based on stress management can be effective in military staff.

Comparison of Survival in Stage IIB Osteosarcoma According to the Chemotherapeutic Protocols (Stage IIB 골육종환자에서 항암 화학요법의 종류에 따른 생존율 비교)

  • Jeon, Dae-Geun;Lee, Soo-Yong;Lee, Jong-Seok;Kim, Tae-Wan;Chung, Dong-Hwan
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.17-22
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    • 1995
  • From Sept. 1986 to Dec. 1992, seventy three cases of Enneking's stage IIB osteosarcoma of extremities, which were proved histologically, took neoadjuvant chemotherapy and completed our protocol. Their average age was 16.7 years(7 to 57). For neoadjuvant chemotherapy, 37 cases took high dose methotrexate(HDMTX)-adriamycin(ADR)-cisplatin(CDDP) regimen(HDMTX group) and 36 cases took ADR-CDDP(ADR-CDDP group). The average follow up was 17 months(2-63). According to Kaplan-Meier's plot, 5-year continuously disease free survival for whole 73 cases of neoadjuvant group was 45.2%, for HDMTX group 68.4%, for ADR-CDDP group 26.6%. There was significant stastical difference between these two groups(p<0.001), with log-rank test. There can be a different survival according to the chemotherapeutic protocols. Better results can be achieved through refined protocol and effective chemotherapeutic agents.

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Relapse-free Rate with Childhood Acute Lymphoblastic Leukemia Treated under the Thai National Protocol

  • Tharnprisan, Piangjit;Khiewyoo, Jiraporn;Sripraya, Piporn;Wiangnon, Surapon
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1127-1130
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    • 2013
  • Background: The standard national protocol for treatment of acute lymphoblastic leukemia (ALL) in children was implemented in 2006. A systematic evaluation of the treatment outcome is needed. This study examined the relapse-free survival among childhood ALL cases treated with this protocol and related factors. Materials and Methods: A descriptive study was conducted in children aged between 0-15 years, newly diagnosed with ALL between March 2006 and March 2011 at Srinagarind Hospital, Department of Pediatrics, Faculty of Medicine, Khon Kaen University. The patients were treated on the basis of stratified risk as per the Thai national protocol. Data were compiled from the hospital records. The Kaplan-Meier method was used to describe relapse-free survival and the Cox proportional hazard model to investigate the associated factors. Results: Of the 103 children recruited, 86 (83.5%) achieved complete remission. The total follow-up time was 3132.5 person-months. Eighteen (20.9%) relapsed. The incidence density was 0.6 per 100 person-months (95%CI: 0.4, 0.9). The respective relapse-free rates at 1, 3 and 5 years were 93.0% (95%CI: 85.1, 96.8), 84.5% (95%CI: 74.0, 90.9) and 64.1% (95%CI: 45.6, 77.8). A factor associated with the relapse-free rate was age under 1 year (HR=6.0; 95%CI: 1.1, 33.8). Conclusions: The rate of being relapse-free in ALL children treated under the Thai national protocol at Srinagarind Hospital was better than with former protocols; however, it is still not as good as in developed countries. Further review of the treatment approach of ALL is needed.

Comparison of concurrent chemoradiotherapy versus sequential radiochemotherapy in patients with completely resected non-small cell lung cancer

  • Kim, Hwan-Ik;Noh, O Kyu;Oh, Young-Taek;Chun, Mison;Kim, Sang-Won;Cho, Oyeon;Heo, Jaesung
    • Radiation Oncology Journal
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    • v.34 no.3
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    • pp.202-208
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    • 2016
  • Purpose: Our institution has implemented two different adjuvant protocols in treating patients with non-small cell lung cancer (NSCLC): chemotherapy followed by concurrent chemoradiotherapy (CT-CCRT) and sequential postoperative radiotherapy (PORT) followed by postoperative chemotherapy (POCT). We aimed to compare the clinical outcomes between the two adjuvant protocols. Materials and Methods: From March 1997 to October 2012, 68 patients were treated with CT-CCRT (n = 25) and sequential PORT followed by POCT (RT-CT; n = 43). The CT-CCRT protocol consisted of 2 cycles of cisplatin-based POCT followed by PORT concurrently with 2 cycles of POCT. The RT-CT protocol consisted of PORT followed by 4 cycles of cisplatin-based POCT. PORT was administered using conventional fractionation with a dose of 50.4-60 Gy. We compared the outcomes between the two adjuvant protocols and analyzed the clinical factors affecting survivals. Results: Median follow-up time was 43.9 months (range, 3.2 to 74.0 months), and the 5-year overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 53.9%, 68.2%, and 51.0%, respectively. There were no significant differences in OS (p = 0.074), LRFS (p = 0.094), and DMFS (p = 0.490) between the two protocols. In multivariable analyses, adjuvant protocol remained as a significant prognostic factor for LRFS, favouring CT-CCRT (hazard ratio [HR] = 3.506, p = 0.046) over RT-CT, not for OS (HR = 0.647, p = 0.229). Conclusion: CT-CCRT protocol increased LRFS more than RT-CT protocol in patients with completely resected NSCLC, but not in OS. Further studies are warranted to evaluate the benefit of CCRT strategy compared with sequential strategy.

Indentifying Metaphor and Analogy Strategies for The Creative Design using Protocol Analysis (프로토콜 분석을 통한 창의적 디자인 전략으로서의 은유와 유추)

  • Choi, Han-Hee;Ju, Seo Ryeung;Kim, Mi Jeong
    • Korean Institute of Interior Design Journal
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    • v.22 no.1
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    • pp.64-74
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    • 2013
  • The aim of this research is to explore the potential of analogy and metaphor as design strategies for supporting the creative design thinking. For the empirical research on analogical and metaphoric process in designing, we conducted design experiments that consist of three different conditions of given items as stimulation for design inspiration: baseline, surrealist paintings, and housing design collections. The results were analyzed using a protocol analysis in order to obtain more systmatic interpretation of the design processes and strategies. As a result, it was noted that students are more apt to read visual information rather than semantic information in the given items. Instead of the representation of their senses or feelings from the paintings, they visualized the analogical images of the paintings for the design representation. However, analogical and metaphoric thinking derived from the given items seem change a designer's perspective, thus bring a novel interpretation on design problems, and eventually more creative and meaningful design ideas. An extended research using one-semester training and observation of the design studio process is introduced as a follow-up study for this paper. This research will investigate the long-term effect of the analogy and metaphor on the design thinking.

Guideline in the Management of Antenatally Diagnosed Unilateral Hydronephrosis (산전 초음파로 발견된 수신증의 치료 방침)

  • Hahn Hye-Won;Jun Nu-Lee;Kim Kun-Seok;Moon Dae-Hyuk;Yoon Chong-Hyun;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.60-66
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    • 2003
  • Purpose : Neonatal hydronephrosis has been detected with increasing frequency with the widespread use of prenatal ultrasonography, but the consensus about its postnatal management has not yet been reached, especially about surgical intervention. We attempted to determine the guideline of follow-up study and surgical intervention of hydronephrosis by analyzing clinical outcomes of neonates with hydronephrosis. Materials and Methods : Between 1994 and 2000, 128 hydronephrotic kidneys were postnatally confirmed. Cases associated with other urologic anomalies were excluded and 90 unilateral hydronephrotic kidneys with a minimum follow-up of 12 months were enrolled in this study. We classified the patients into 6 groups according to the anterior posterior pelvic diameter(APPD) at initial ultrasonography(USG) within 1 month after birth. Renal USG and $Tc^{99m}-mercaptoacetyl$ triglycerine(MAG3) scan were done according to a set protocol, and pyeloplasty was performed when indicated according to our protocol. Results : Most cases whose APPD were below 10 mm improved or resolved. Only few cases with APPD above 20 mm showed spontaneous improvement and most(88%) had undergone operation. Those with initial APPD within 10-19 mm showed variable outcomes. When the risk factors for irreversible renal functional deterioration were analyzed, the age at pyeloplasty and pre-operative functional deficit were significant. Conclusion : We concluded that in infants with initial APPD below 10 mm, consideration of surgery is not needed, and in those with initial APPD above 20 mm, early operation is recommended. Our set protocol based on initial USG is useful, but the cut-off value of relative renal function(RRF) for operation might be increased to 40% to improve post operative RRF.

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