• Title/Summary/Keyword: Combined disorder

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Optimal Treatment Results of Angiocentric T Cell Lymphoma in Head and Neck according to the Subsites and Stage (두경부 혈관중심성 T세포 림프종의 발생주위 및 병기별 치료결과)

  • Choi Jong-Ouck;Kim Jeong-Joon;You Chan-Ki;Paeng Jae-Pil;Kim Hyung-Jin;Jung Kwang-Yoon;Choi Geon
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.33-36
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    • 2000
  • Objectives: Angiocentric T-cell lymphoma of the head and neck is an angiocentric and angiodestructive lymphoreticular proliferative disorder. It has been treated with various treatment modalities, but its prognosis is poor and the treatment modality is controversial. We performed this study to suggest a treatment modality with improved results. Materials and Methods: We studied 40 cases of pathologically confirmed angiocentric T-cell lymphoma from July 1984 to December 1996, 35 cases of which showed complete response after initial treatment. All the patients were divided into two groups according to treatment modality. 15 cases received radiotherapy alone (Group I) and 20 cases received radiotherapy after five cycles of CHOP-Bleo chemotherapy(Group II). We analyzed the subsites of tumor, stage, treatment modality and treatment outcome and causes of failure for each group, and compared the three-year no evidence of disease(NED) between the two groups. Results: The three-year NED of a combined chemoradiotherapy was higher than that of a radiotherapy alone (p=0.0478). The three-year NED according to groups and stage were as follows: Group I=6/15(40.0%), stage IE=5/10(50.0%), stage IIE=1/5(20%), Group II=13/20(65.0%), stage IE=9/13(69.2%), stage IIE=4/7(57.1%). Radiotherapy alone is not well effective for the nasal cavity lymphoma extended to paranasal sinus and the palate. Conclusion: We are unable to provide clear guidelines for treatment, but recommend the initial treatment with oral alkylating agents and steroids followed by radiotherapy for Ann Arbor stage II tumors and stage I of the palate lymphoma and the nasal cavity lymphoma extended to paranasal sinus.

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Multiple Xanthomatosis in Familiar Hypercholesterolemia Patient - A case report - (가족성 고콜레스테롤혈증 환자에서의 다발성 황색종 - 1례 보고 -)

  • Rhee, Seung-Koo;Lee, Hwa-Sung;Moon, Chan-Woong
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.41-46
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    • 2000
  • We experienced the case of familiar hypercholesterolemia with multiple xanthomas which was treated by combined surgical and medical therapy. He was 26-year-old male patient of familiar hypercholesterolemia with multiple xanthomas in 22 sites on whole body, and was treated by 17 surgical excisions of the xanthomas and by medical therapy of the hypercholesterolemia. There was a normal healing process of the surgical wounds. Continual postoperative medical therapy of the hypercholesterolemia was done. There was no recurrence of the symptoms during more than 13 months of follow-up. But the serum level of the cholesterol was not lowered significantly, so we are treating him with drug therapy. Familial hypercholesterolemia is caused by a specific disorder of lipid metabolism, and is characterized by increased LDL cholesterol, tendon xanthomas, coronary disease associated with autosomal dominant transmission. Xanthomas usually appear in the second decade of life with familiar hypercholesterolemia which may have high risk for premature coronary atherosclerosis, which might be prevented with early diagnosis and medical treatment. So, orthopedic surgeons do not only excise the xanthomatosis surgically but also can diagnose the underlying hypercholesterolemia.

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Clinical Findings of Genotypes in Korean Patients with Glycogen Storage Disease Type Ia (한국인 당원병 제 Ia형에서 유전형의 임상 양상)

  • Ko, Jae Sung;Yang, Hye Ran;Kim, Jong Won;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.877-880
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    • 2005
  • Purpose : Glycogen storage disease type Ia(GSD Ia) is an autosomal recessive disorder caused by the deficiency of glucose-6-phosphatase(G6Pase). The aim of the study was to investigate the spectrum of G6Pase gene mutations and relationship between genotype and clinical findings in Korean patients with GSD Ia. Methods : Genomic DNA was extracted from peripheral leukocytes of 20 patients with GSD Ia. The five exons of G6Pase gene were amplified and PCR products were directly sequenced. The frequency of short stature, hypoglycemia, hypercholesterolemia, hyperuricemia, hypercalciuria, nephrocalcinosis and hepatic adenoma was compared between 727G>T homozygotes and 727G>T compound heterozygotes. Results : A total of 5 different mutations were identified. The most common mutation was the 727G>T with an allele frequency of 80%. All patients were either homozygous(12/20) or heterozygous(8/20) for the 727G>T mutation. G122D was found in 3 patients, P178A in 1, G222R in 2, and S339R in 2. There was no difference in the frequency of short stature, hypoglycemia, hypercholesterolemia, hyperuricemia, nephrocalcinosis, and hepatic adenoma between 727G>T homozygotes and heterozygotes. Conclusion : Diagnosis of GSD Ia can be based on clinical and biochemical abnormalities combined with mutation analysis instead of enzymatic diagnosis that requires liver biopsy. Homozygosity for the 727G>T does not seem to alter the disease phenotype as compared with the heterozygous state.

CHARACTERISTICS OF UNRULY & DELINQUENT ADOLESCENTS ADMITTED TO A PSYCHIATRIC INPATIENT UNIT (청소년 병동에 입원한 비행 청소년의 특성에 관한 연구)

  • Lee, Young-Sik;Kim, Wun-Jung;Carey, Michael
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.70-82
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    • 1997
  • Objective:This study was performed to identify and understand the characteristics of adolescents who had a history of police arrest and/or were adjudicated unruly/delinquent by the juvenile court. Method:The study employed a retrospective reivew of coumputer-recorded data set on 210 consecutive admissions to an adolescent psychiatric inpatient unit. Three groups(No Police Contact, N=115;Police Contact Only, N=60;Adjudicated, N=35) were compared on the areas of a) cognitive and educational performance b) emotion:anxiety, depression, suicidality c) personality d) family and life experiences. Standardized assessments were administered to all subjects using WISC-Ⅲ, Kaufman Test of Educational Achievement, Millon Adolescent Personality Inventory, Reynolds Adolescent Depression Scale, Revised-Chilren’s Manifest Anxiety Scale, Suicide Ideation Questionnarie, Suicide Behavior Interive, Life Events Checklist, and Family Environmental Scale. A subgroup of the subjects, 60 cases also received a standardized interview by Child Assessment Schedule. Results:The characteristic findings of the delinquent group(the police contact only and adjudicated subjects combined) included (1) a high rate of adoption, sexual promiscuity, out of home placement, and repeated psychiatric hospitalization, (2) low verbal IQ scores and educational achievements, (3) high impulsivity, low social conformity, and high forcefulness in personality inventory, (4) low activityrecreation orientation and low moral religious emphasis in family environment, (5)a high frequency of adverse life experiences, (6) among 3 groups, the Police Contact Only group showed the lowest depression, anxiety and suicidal ideation scores, (7) a high diagnostic frequency of conduct disorder, ODD, and ADHD. Conclusions:The adolescent psychiatric inpatients with a delinquent history presented with a certain clinical, family, psychometric characteristics that warrant specific clinical intervention strategies for their cognitive deficits, an impulsive personality style, family dysfunction with adverse life experiences and disruptive behavioral disorders, different from the rest of adolescent psychiatric inpatients.

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Gastroesophageal Reflux in Peptic Ulcer Patients (소화성 궤양 환자에서 위식도 역류)

  • Suh, Joong-San;Kim, Jong-Hyeok;Chung, Moon-Kwan
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.302-308
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    • 1999
  • Background: It is well known fact to the patients of duodenal ulcer that their condition is frequently accompanied with reflux esophagitis. Therefore this condition is called an "acid-related disorder" because it is commonly associated with increased acidity. But there has been disputes on the effect of Helicobacter pylori eradication in these two conditions and whether H. pylori infection may have a protective role in reflux esophagitis. Only few reports have dealt with the prevalence of reflux esophagitis and gastroesophageal reflux in patients with peptic ulcer The aim of this study is to estimate the prevalence of gastroesophageal reflux and to analyze the pattern of the pathologic reflux in peptic ulcer patients. Materials and Methods: The study population consisted of 57 patients with endoscopically confirmed duodenal and/or gastric ulcer who all underwent 24hr ambulatory esophageal pH monitoring. Results: The prevalance of gastroesophageal reflux in peptic ulcer patients was 54.2% and 54,5% in gastric ulcer, and 62.5% in duodenal ulcer, 50% in combined ulcer, respectively. The prevalence of gastroesophageal reflux in the control group was 22.7% Conclusion: We discovered significantly higher prevalence of gastroesophageal reflux in patients with peptic ulcer disease than in those without it. In conclusion, the presence or absence of gastroesophageal reflux must be considered in the setting of peptic ulcer disease management.

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Validity of Voice Handicap Index and Voice Analysis following Laryngeal Microsurgery for Benign Vocal Cord Lesions (양성 성대 질환 환자의 후두 미세 수술 전후 음성 장애 지수 및 음성 분석의 유용성)

  • Park, Young-Hak;Lee, Jeong-Hak;Joo, Young-Hoon;Park, Sung-Sin;Bang, Choong-Il;Kim, Min-Sik;Cho, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.16 no.1
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    • pp.23-27
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    • 2005
  • Background and Objectives : Voice disorders can cause problems in patients with benign vocal cord lesions emotionally, physically, economically and functionally. Neither subjective nor objective voice examinations can evaluate such factors adequately. The Voice Handicap Index (VHI) subjectively evaluates voice disorders in terms of physical, functional, emotional factors and measures the patient's perception of the impact of voice disorder. The purpose of this study is to evaluate the usefulness of VHI in the patients with benign vocal cord lesions. Materials and Method : The authors evaluated 37 patients who experienced laryngeal microsurgery for benign vocal cord lesions from september 2003 to August 2004. The VHI was used to measure the postoperative changes of the patient's perception and acoustic analysis and aerodynamic tests were also done. Statistical analysis was done using paired t-test and Pearson's correlation. Results : The VHI scores showed statistically significant reductions postoperatively. In acoustic analysis, jitter and shimmer had statistically significant reductions after surgery but noise-to-harmonics ratio did not. A statistically significant change in the average MFR and MPT perioperatively was found. The relationship between VHI and acoustic, aerodynamic analysis attained statistical significance. Conclusion : The VHI is a useful assessment tool to monitor the patient's self-perception of voice change after the surgery of benign vocal cord lesions. The VHI measurement, when combined with acoustic and aerodynamic analyses, will be helpful in comparing functional outcomes after voice surgery.

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A Case Report of Combined Korean Medicine Treatment of Spinal Stenosis with Lipomatosis (지방종을 동반한 척추관협착증 환자의 복합한방치료 치험 1예)

  • Kim, Mihye;Han, Su-Bin;Park, Byunghak;Son, Jaemin;Lee, Nam-Woo;Han, Jeong-Hun;Kang, Do-Hyeon;Min, Tae-Woon;Ahn, Jae-Seo;Lee, Hansol;Lee, Hyun-Jun
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.195-201
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    • 2020
  • Spinal epidural lipomatosis is a rare disorder characterized by overgrowth of fat in the extradural space, causing spinal stenosis with compression of the neural elements. This study reports on the effectiveness of Korean medicine treatment on a patient who was diagnosed on lumbar stenosis with lipomatosis. The patient was treated with Korean traditional medicine including pharmacopucture, acupuncture, Chuna manual treatment, and Korean herbal medicine, cupping. Numerical rating scale (NRS), Oswestry disability index (ODI), Euroqol five dimension (EQ-5D) index, lumbar range of motion were used as objective tools for evaluating the patient's progress. Back NRS decreased from 6 to 3. In the case of lower limbl radiation NRS, 5 was reduced to 3 upon discharge. EQ-5D index also increased from 0.751 to 0.766. For ODI, the score dropped from 26.67 to 24.44 on hospitalization. As a result, clinical improvements were found in a patient. In conclusion, this study shows that Korean medicine treatment can be considered as effective conservative care for spinal stenosis with lipomatosis.

The Utilization of Aromatherapy in Clinical Physical Therapy (임상물리치료에 있어서 아로마테라피의 활용)

  • Chang Chung-Hoon;Jeong Dong-Hyuk;Park Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.15 no.1
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    • pp.82-95
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    • 2003
  • Our health is intimately connected to the health of our environment. The contemporary world view which sees a radical distinction between humans as subjects and world as object can obscure our recognition of how much we rely on nature for health and survival. Indigenous traditions and contemporary scholars remind us that we live in a universe in which all things are connected, and in which nature continues to offer its gifts in co-creative partnership for the health and wellbeing of all. Living in awareness of our relationship with nature enables us to open more to the experience of nature's nurturing. Many complementary therapies derive from ancient practices that involve nature in healing partnership. Essential oils have been used for thousands of years. Hippocrates claimed that the way to health was through aromatic baths and massages. Much anecdotal evidence exists regarding aromatherapeutic positive effects on recipients. Aromatherapy is a branch of complementary or alternative therapy which is increasing in popularity, yet has scant scientific credibility. Aromatherapy should be defined as treatment using odors and practised as such. However, essential oils are usually used in conjunction with therapeutic massage and often combined with counselling of some kind. Aromatherapy complements and enhances the therapeutic powers of massage. Massage is one of the most wonderful ways to relax and is throughly beneficial to health. Massage can help unknot tense and aching muscles and other minor symptoms of stress, leaving patients fresh and energized. As the use of aromatherapy within a health care setting has grown so rapidly in recent years, and will continue to do so, the need for suitable training has become apparent. No health service can afford the risk of having staff who are inadequately trained in the practice of aromatherapy using essential oils incorrectly on those in a state of ill-health, especially if the essential oils used are not to a standard suitable for therapeutic use. Training to an acceptable level in aromatic therapy is essential for safety and effectiveness. Knowledge of the nature and make-up of essential oils, their effect on the body and the emotions, and how, when, and where to apply them is imperative in order for them to be beneficial to a patient's health. In order to achieve best practice, further research is necessary to explore the use of aromatherapy in the management of multiple disorder.

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The Effect of Education on Motor Skill Assessment Tool for Occupational Therapists (작업치료사를 위한 운동성 평가도구의 교육효과)

  • Choi, Jeong-sil;Kim, Min-Joo
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.2
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    • pp.63-72
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    • 2020
  • Objective : The purpose of this study is to investigate the effect of intensive one-day training on Movement Assessment Battery for Children-2 screening developmental coordination disorder. Methods : We provided intensive one-day training which combined lecture and practice on MABC-2 assessment tools for 33 trainees. Interrater reliability was calculated by using Intraclass correlation coefficient (ICC) with the raw score of results scored simultaneously by experts and trainees of MABC-2. Results : The 33 female trainees with an average of five years and three months of experience and less experience using motor skill assessment tools scored raw score while watching the performance scenes of normal children. The results of the ICC between experts and training participants in MABC-2 obtained a high confidence 0.95 and above (p<.001). Conclusion : Clinicians who participated in one-day training seems to use MABC-2 effectively. Through this, one-day training seems to be effective in acquiring new motor skill assessment tools.

Clinical Study on 1 Case of Cervical Dystonia Treated by Korean Medicine and Transfer Energy Capacitive and Resistive (TECAR) Therapy (Transfer Energy Capacitive and Resistive (TECAR) Therapy와 한방치료를 병행한 경부 근 긴장성 사경 환자 증례 보고 1예)

  • Lee, Won-Jun;Yoon, Young-Suk;Kim, Jong-Ho;Lee, Keun-Jae;Kim, Mi-Hye;Ryu, Ho-Sun;Han, Su-Bin;Park, Byung-Hak;Son, Jae-Min;Lee, Nam-Woo;Han, Jeong-Hun;Seo, Hye-Jin;Kim, Ji-Hoon
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.4
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    • pp.109-115
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    • 2019
  • Cervical dystonia (CD) is a disorder characterized by sustained or intermittent, involuntary muscle contractions which cause twisting, repetitive movements and abnormal postures. In this case report, a CD patients was treated with transfer energy capacitive and resistive (TECAR) therapy and conventional Korean medicine, which consists of acupuncture, Chuna manual medicine, pharmacopuncture and herbal medicine. For outcome measures, this study evaluated Cobb's angle, EuroQol five dimension scale (EQ-5D), numerical rating scale (NRS), neck disabillity index (NDI) and cervical range of motion. As a result, improvements were found in Cobb's angle ($18.65^{\circ}$ to $15.90^{\circ}$), EQ-5D score (0.808 to 0.862), NRS (5 to 3), NDI (16 to 8) and angle of cervical lateral bending ($15^{\circ}$ to $25^{\circ}$). In conclusion, this study shows that combined therapy of conventional Korean medicine treatment and TECAR therapy can be effective for CD patients.