• Tuberculosis and Respiratory Diseases
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• v.64 no.4
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• pp.293-297
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• 2008

Mycobacterium fortuitum usually causes colonization or transient infection in patients with underlying lung disease, such as prior tuberculosis or bronchiectasis. The majority of these patients may not need to receive antibiotic therapy for M. fortuitum isolates. We report here on a patient with M. fortuitum lung disease and who was successfully treated with combination oral antibiotic therapy. A 53-year-old woman was referred to our institution because of purulent sputum and dyspnea. A chest radiograph and computed tomography scan revealed cavitary consolidation in the left upper lobe and multiple small cavities in the left lower lobe. Numerous acid-fast bacilli (AFB) were seen in multiple sputum specimens and M. fortuitum was identified by culture from the sputum specimens. The patient received antibiotic treatment including clarithromycin, ciprofloxacin and sulfamethoxazole, because her symptoms were worsening despite conservative treatment. Sputum conversion was achieved after one month of antibiotic therapy. Both the patient's symptoms and radiographic findings improved after 10 months of antibiotic therapy.

• Journal of Haehwa Medicine
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• v.5 no.2
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• pp.473-484
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• 1997

This study was performed to survey the specific information about the time of onset, frequency, duration, and severity of the side effect of radiation therapy following breast cancer surgery, and identify the difference of these data according to the type of breast cancer surgery : modified radical mastectomy(MRM) vs. breast consevative operation(BCO). 38 breast cancer patients were interviewed with side effect profile about radiation therapy. Interview was done weekley from the start of radiation therapy through 6 weeks and 3 month follow-up interview was done at 3 month after completion of the treatment. The results are as follow : 1. Total score of side effect experienced by the breast cancer patients was rapidly increased at 2-3 week after intiating treatement and continousely raised maintaing high score until completion of the treatement. Some problems like cough, dyspnea and pain were more experienced after treatment. 2. Patients with modified radical mastectomy showed more total score of side effects than patients with breast conservative operation. And both patients with MRM and BCO experienced similar pattern of side effect to radiation therapy. Through these data we concluded that side effect to radiation therapy was not ended at completion of treatement. Patents will continously experiend various problems and suffer from not only acute side effects like skin problem, sore throat and swollowing difficulty but also late effect of the radiation therapy. Clinically these data can be used for oncologic nurse to provide informational interventions to prepare breast cancer patients for the radiation therapy.

• The Korean Journal of Pain
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• v.30 no.1
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• pp.44-50
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• 2017

Background: Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. Methods: This retrospective cohort was carried out in the neurosurgery departments of hospitals in KahramanmaraŞ city and 23 patients diagnosed with LDH at the levels of L3-L4, L4-L5 or L5-S1 were enrolled. Results: The average age was $38.4{\pm}8.0$ and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. $Las{\grave{e}}gue$ tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3-L4, L4-L5, and L5-S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was $13.6{\pm}5.4$ months (range: 5-22). Conclusions: It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery.

• The Journal of Korea CHUNA Manual Medicine
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• v.3 no.1
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• pp.153-166
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• 2002

Objective : There is no case report on the ossification of the posterior longitudinal ligament(OPLL) treated by CHUNA manual therapy in oriental medicine. We experienced a patient(32-year-old female) with OPLL improved by CHUNA manual therapy in X-ray image and visual analogue scale(VAS), and we report it clinically. Methods : During the patient with OPLL was treated CHUNA manual therapy, acupuncture, and physical therapy, we examined cervical X-ray, CT and Moire topography and evaluated the patient's symptoms by VAS. And we observed whether the changes exist or not in X-ray and VAS. Results : VAS in symptoms was improved significantly(p<0.05), and the radiologic X-ray image in OPLL patient was improved. Conclusion : OPLL was generally treated conservative treatment and operation in severe case. But CHUNA manual therapy may be more effective in conservative treatment of OPLL, if more clinical studies and reaches are accomplished.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2577-2581
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• 2014

Background: Triple negative breast cancer is associated with aggressive behavior and high risk of local and regional failure. Aggressive surgical intervention is considered suitable. This makes role of breast conserving therapy (BCT) debatable in these patients. The objective of this study was to compare outcome of BCT for triple negative versus non-triple negative breast cancer. Materials and Methods: Medical records of patients who underwent breast conserving therapy from 1999 to 2009 at Shaukat Khanum Cancer Hospital and had complete receptor status information were extracted. Patients were divided into triple negative breast cancer (TNBC) and non-TNBC. Patient characteristics, medical treatment modalities and adverse events were compared. Expected five year locoregional recurrence free, disease free and overall survival was calculated. The Cox proportional hazard model was used to identify independent predictors of outcome. Results: A total of 194 patients with TNBC and 443 with non-TNBC were compared. Significant difference was present for age at presentation (p<0.0001), family history (p=0.005), grade (p<0.0001) and use of hormonal therapy (p<0.0001). The number of locoregional failures, distant failures and mortalities were not significantly different. No significant difference was present in 5 year locoregional recurrence free (96% vs 92%, p=0.3), disease free (75% vs 74%, p=0.7) and overall survival (78% vs 83%, p=0.2). On multivariate analysis, tumor size, nodal involvement and hormonal treatment were independent predictors of negative events. Conclusions: Breast conserving therapy has comparable outcomes for triple negative and non-triple negative breast cancers.

• Annals of Clinical Neurophysiology
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• v.10 no.2
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• pp.83-97
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• 2008

Cervical and thoracic radiculopathies are among the most common causes of neck pain. The most common causes are cervical disc herniation and cervical spondylosis in patients with cervical radiculopathy, and diabetes mellitus and thoracic disc herniation in thoracic radiculopathy. A thorough history, physical examination, and testing that includes electrodiagnostic examination and imaging studies may distinguish radiculopathy from other pain sources. Although various electrodiagnostic examinations may help evaluate radiculopathy, needle electromyography is the most important, sensitive, and specific method. Outcome studies of conservative treatments have shown varying results and have not been well controlled or systematic. When legitimate incapacitating symptoms continue despite conservative treatment attempts, more invasive spinal procedures and intradiscal treatment may be appropriate. Surgery has been shown to have excellent clinical outcomes in patients with disc extrusion and neurological deficits. However, patients with minimal disc herniation have fair or poor surgical outcomes. In addition, conventional open disc surgery entails various inadvertent surgical related risks. Although there has not yet been a non-surgical interventional procedure developed with the therapeutic efficacy of open surgery, conservative procedures can offer substantial benefits, are less invasive, and avoid surgical complications. While more invasive procedures may be appropriate when conservative treatment fails, prospective studies evaluating cervical and thoracic radiculopathies treatment options would help guide practitioners toward optimally cost-effective patient evaluation and care.

• Electrolytes & blood pressure
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• v.16 no.2
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• pp.23-26
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• 2018

A 22-year-old male patient was diagnosed with autosomal dominant polycystic kidney disease (ADPKD). He received conservative treatment with an angiotensin-converting enzyme inhibitor. Two years later, oral therapy, consisting of 60 mg tolvaptan per day, was initiated. Compared with height-adjusted total kidney volume, the rate of kidney growth reduced significantly from 7.33% to 0.66% annually, since commencement of the tolvaptan therapy. The liver enzyme profile and serum sodium level and osmolality were constantly within normal ranges. In Korea, this is the first reported case of a patient with ADPKD who received tolvaptan treatment for more than 1 year. This case demonstrates that long-term tolvaptan treatment appears to be safe, well tolerated, and effective for ADPKD.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.3
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• pp.73-84
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• 2022

Background : Lymphedema is a progressive disorder characterized by the impairment of lymph flow from tissues to the blood circulation system. This occurs as a result of damage to the lymphatic system. Complex decongestive therapy (CDT) is a multimodal, conservative therapeutic approach that is used for the management of lymphedema. CDT consists of a combination of compression therapy, manual lymphatic drainage, exercise, and skin care. Purpose : This study aimed to provide a review of available physical therapy interventions as well as general care guidelines for patients with lymphedema. Methods : The recommendations and guidelines for physical therapy management, medical management, and general information were reviewed from the following sources: 1) The American Physical Therapy Association, 2) The Norton School of Lymphatic Therapy, and 3) The International Society of Lymphology. This review contains general information, including the medical management and the importance of physical therapy in lymphedema. Physical therapy management should be based on an assessment of the patients' presenting impairments, including based on inclusion or exclusion of physical therapy interventions. This review also outlines a step-by-step approach that starts with disease diagnosis and progression all the way through to rehabilitation as an outpatient. Conclusion : Depending on the patients' journey to recovery and the requirement for rehabilitation, physical therapy interventions should focus on the patients' needs including pain, appearance, physical function and general rehabilitation. We hope that this review will provide information on evidence-based physical therapy and general care to patients with lymphedema.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.4
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• pp.347-354
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• 2022

Backgrounds/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) remains the primary treatment for a subset of patients with pancreatic fistulae. The objective of this study was reporting outcomes of ERCP and predictors of resolution in patients with pancreatic fistulae refractory to conservative therapy. Methods: Retrospective review of patients who underwent ERCP and pancreatic stent placement for pancreatic fistula not responding to medical therapy was performed. Clinical features, laboratory parameters, radiological features and pancreatogram findings were noted. Clinical resolution of fistula was the primary outcome measure. Results: Sixty-eight patients underwent ERCP for high-output pancreatic fistula (Mean age 34.1 years, 91.1% males, 35/68 chronic pancreatitis, 52.9% alcohol etiology). Internal fistulae (pancreatic ascites, pleural effusion, or pericardial effusion) were seen in 55 (80.9%) patients and external fistula in 13 (19.1%) patients. Technical success for ERCP was 92.6% (63/68). Leak was seen in 98.4% (62/63). The most common leak site was body (69.8%). Multiple leak sites were seen in 23.1%. Pancreatic stricture was found in 36.5%. In 44 (69.4%) patients, stent was placed beyond the site of the leak. Resolution at six weeks was achieved in 76.4% (52/68). On univariate and multivariate analyses, placement of stent beyond site of leak was significantly associated with resolution of high-output fistulae (3/41 [7.3%] vs. 5/19 [26.3%], p = 0.03; odds ratio: 6.5, 95% confidence interval: 1.211-34.94). Conclusions: In our experience, ERCP was successful in 76% of patients with pancreatic fistulae refractory to conservative therapy. Stent placement beyond the site of leak was associated with higher resolution of fistulae.

• Advances in pediatric surgery
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• v.9 no.1
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• pp.57-60
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• 2003

A 4 year old female with acute lower abdominal pain was admitted with the diagnosis of periappendiceal abscess made by ultrasonography. At laparotomy, the appendix was normal, but the left ovary was twisted and necrotic. Appendectomy and left salpingo-oophorectomy were performed. The pathology of the appendix was normal, and the left tube and ovary were ischemic and had hemorrhagic necrosis. Pediatric adnexal torsion may be difficult to diagnosis clinically. Sonography is the preferred imaging study. It usually confirms a pelvic mass but may not establish the diagnosis. The correct diagnosis of adnexal torsion is often made at exploration. The most common erroneous diagnosis is acute appendicitis or periappendiceal abscess. Therapy for adnexal torsion remains controversial. While extirpation has been the standard of treatment in the past, there are current proponents of conservative therapy with adnexal sparing. Early diagnosis may lead to more frequent salvage of affected adnexa.