• Title/Summary/Keyword: Follow-ups

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Reliability of Colposcopy in Turkey: Correlation with Pap Smear and 1-year Follow Up

  • Mesci-Haftaci, Simender;Ankarali, Handan;Caglar, Mete;Yavuzcan, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7317-7320
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    • 2014
  • Background: A cytologic reading of a Papanicolaou (pap) smear followed, if the result is positive, by a colposcopic search for abnormal cells is the most common screening method for cervical cancer used worldwide. We aimed to present the correlation of smear and colposcopic findings with 6- to 12-month follow-up results and related factors in women who underwent colposcopy in Turkey. Materials and Methods: The study population consisted of women who attended the gynecology department and were referred for colposcopic evaluation in 2011-2012. A total of 232 women between ages 17 and 68 years were included. Colposcopy indications were ASCUS and higher lesions at cervical smear, macroscopic suspicious lesions, post-coital bleeding history with suspicious smear, and repeated cervical inflammation. All patients were recalled for 6- to 12-month follow-ups. Results: The most common colposcopy indication was ASCUS, and the most common biopsy result was inflammation. Nearly half of the patients returned for the control 6-month follow-up, and almost 20% of patients for a 1-year follow up. Conclusions: Colposcopic biopsy is an effective method in indicated patients but is not sufficient in itself if awareness of the subject is not raised in the population. One of the most important aims of cancer screening programs should be enabling patients in developing countries to take responsibility. Patients must be encouraged to apply to the hospital for better disease control.

Healing of Aneurysm after Treatment Using Flow Diverter Stent : Histopathological Study in Experimental Canine Carotid Side Wall Aneurysm

  • Lee, Jong Young;Cho, Young Dae;Kang, Hyun-Seung;Han, Moon Hee
    • Journal of Korean Neurosurgical Society
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    • v.63 no.1
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    • pp.34-44
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    • 2020
  • Objective : Despite widespread use of flow diverters (FDs) to treat aneurysms, the exact healing mechanism associated with FDs remains poorly understood. We aim to describe the healing process of aneurysms treated using FDs by demonstrating the histopathologic progression in a canine aneurysm model. Methods : Twenty-one side wall aneurysms were created in common carotid artery of eight dogs and treated with two different FDs. Angiographic follow-ups were done immediately after placement of the device, 4 weeks and 12 weeks. At last follow-up, the aneurysm and the device-implanted parent artery were harvested. Results : Histopathologic findings of aneurysms at 4 weeks follow-up showed intra-aneurysm thrombus formation in laminating fashion, and neointimal thickening at the mid-segment of aneurysm. However, there are inhomogenous findings in aneurysms treated with the same type of FD showing same angiographic outcomes. At 12 weeks, aneurysms of complete and near-complete occlusion revealed markedly shrunken aneurysm filled with organized connective tissues with thin neointima. Aneurysms of incomplete occlusion at 12 weeks showed small amount of organized thrombus around fringe neck and large empty space with thick neointmal formation. Neointimal thickness and diameter stenosis was not significantly different between the groups of FD specification and follow-up period. Conclusion : Intra-aneurysmal thrombus formation and organization seem to be an important factor for the complete occlusion of aneurysms treated using the FD. Neointimal formation could occur along the struts of the FD independently of intra-aneurysmal thrombus formation. However, neointimal formation could not solely lead to complete aneurysm healing.

The Clinical Results of Conservative Treatment of Frozen Shoulder Using Continuous Passive Motion

  • Chung, Hoe-Jeong;Kim, Doo-Sup;Yoon, Yeo-Seung;Lee, Dong-Woo;Hong, Kyung-Jin
    • Clinics in Shoulder and Elbow
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    • v.18 no.4
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    • pp.217-220
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    • 2015
  • Background: The purpose of this study is to administer conservative treatment in 30 patients diagnosed with idiopathic frozen shoulder, following the suggested frozen shoulder rehabilitation program and to assess the clinical outcome using a prospective study. Methods: Thirty patients diagnosed with idiopathic frozen shoulder, treated with steroid hormone injection on the articular joint with an intra-articular steroid (triamcinolone 40 mg+lidocaine 4 ml) injection and started on stepwise shoulder extension exercise were chosen. The subjects were divided into two groups of 15 people each with one group undergoing rehabilitation with continuous passive motion (CPM) and the other group without it. Follow-ups were done before rehabilitation and at 4-week intervals with the 24th being the final week. At every follow-up, passive range of motion (ROM) was measured and surveys on pain and clinical score were administered. Results: In the last follow-up, both groups showed statistically significant improvements in all evaluation criteria. However, no statistical difference in all values of the ROM and Constant score evaluation criteria was observed between the groups. Only in the last follow-up, group 1 had a visual analog scale (VAS) score of $2.4{\pm}2.1$ points, which was lower, with statistical significance, than the VAS score of group 2, which was $4.4{\pm}3.1$ points (p<0.001). Conclusions: Study using CPM in treatment of frozen shoulder has been inadequate, meaning that there is still room for improvement and need for more study on setting a more specific protocol and guidelines for this procedure.

Short-Term Lung Function Changes and Predictors of Progressive Systemic Sclerosis-Related Interstitial Lung Disease

  • Kaenmuang, Punchalee;Navasakulpong, Asma
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.4
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    • pp.312-320
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    • 2020
  • Background: Systemic sclerosis (SSc) involves multiple organ systems and has the highest mortality among connective tissue diseases. Interstitial lung disease is the most common cause of death among SSc patients and requires closer studies and follow-ups. This study aimed to identify lung function changes and predictors of progressive disease in systemic sclerosis-related interstitial lung disease (SSc-ILD). Methods: A retrospective study extracted SSc patients from an electronic database January 2002-July 2019. Eligible cases were SSc patients >age 15 diagnosed with SSc-ILD. Factors associated with progressive disease were analyzed by univariate and multivariate logistic regression analyses. Results: Seventy-eight SSc-ILD cases were enrolled. Sixty-five patients (83.3%) were female, with mean age of 44.7±14.4, and 50 (64.1%) were diffuse type SSc-ILD. Most SSc-ILD patients had crackles (75.6%) and dyspnea on exertion (71.8%), and 19.2% of the SSc-ILD patients had no abnormal respiratory symptoms but had abnormal chest radiographic findings. The most common diagnosis of SSc-ILD patients was non-specific interstitial pneumonia (43.6%). The lung function values of diffusing capacity of the lung for carbon monoxide (DLCO) and DLCO per unit alveolar volume declined in progressive SSc-ILD during a 12-month follow-up. Male and no previous aspirin treatment were the two significant predictive factors of progressive SSc-ILD with adjusted odds ratios of 5.72 and 4.99, respectively. Conclusion: This present study showed that short-term lung function had declined during the 12-month follow-up in progressive SSc-ILD. The predictive factors in progressive SSc-ILD were male sex and no previous aspirin treatment. Close follow-up of the pulmonary function tests is necessary for early detection of progressive disease.

Arthroscopic release in adhesive capsulitis of the shoulder: a retrospective study with 2 to 6 years of follow-up

  • Mardani-Kivi, Mohsen;Hashemi-Motlagh, Keyvan;Darabipour, Zohre
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.172-177
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    • 2021
  • Background: This study aimed to evaluate the response rate to arthroscopic release treatment in adhesive capsulitis of the shoulder (ACS) for patients with refractory to conservative treatment. Methods: In this retrospective study, 51 patients (age mean, 49.1±5.6 years) with unilateral adherent capsule underwent arthroscopic releasing surgery for the shoulder capsule. Etiologies of the ACS in 30 patients were idiopathic: 10 patients were affected after surgery and 11 patients following trauma. The patients were evaluated in terms of shoulder function, satisfaction rate, pain intensity, and joint range of motion (ROM) based on a Constant score, a Simple Shoulder Test, the visual analog scale, and four movements, respectively. Results: The mean Constant score before surgery was 48.2±3.5 and reached 74.4±6 and 77.0±6.3 at 6 months and the final follow-up, respectively (p<0.001). The mean scores of pain intensity, a Simple Shoulder Test, and ROM showed significant improvement at all follow-ups (p<0.001). Sex, age, and diabetes did not have any significant effect on patient recovery. However, patients who experienced ACS after surgery had poorer results than others at all follow-up points. Conclusions: Arthroscopic releasing surgery of the shoulder in patients with ACS refractory to conservative treatment produces rare complications and an effective injury response. It seems that patients suffering ACS following surgery have a weaker response to the treatment.

Comparative Efficacy and Safety of Radiofrequency Ablation and Microwave Ablation in the Treatment of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis

  • Hendra Zufry;Timotius Ivan Hariyanto
    • Korean Journal of Radiology
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    • v.25 no.3
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    • pp.301-313
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    • 2024
  • Objective: The current body of evidence lacks clarity regarding the comparative efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) as minimally invasive treatments for benign thyroid nodules. The primary objective of this study is to clarify these concerns. Materials and Methods: A comprehensive search was conducted using the Cochrane Library, Scopus, Europe PMC, and Medline databases until October 10th, 2023, using a combination of relevant keywords. This study incorporated literature that compared RFA and MWA for benign thyroid nodules. The primary outcome was the volume reduction ratio (VRR) from baseline to follow-up. Secondary outcomes were symptom score, cosmetic score, ablation time, major complications rate, hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. We used Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool to assess the risk of bias in the included studies. We employed random effects models to analyze the standardized mean difference (SMD) and odds ratio for the presentation of outcomes. Results: Nine studies with 2707 nodules were included. The results of our meta-analysis indicated similar efficacy between RFA and MWA in terms of VRR during the 1 (SMD 0.06; 95% confidence interval [CI]: -0.13 to 0.26; P = 0.52) and 3 (SMD 0.11; 95% CI: -0.03 to 0.25; P = 0.12) months of follow-up. VRR was significantly higher in RFA than in MWA at the 6 (SMD 0.25; 95% CI: 0.06-0.43; P = 0.008) and 12 month of follow-up (SMD 0.38; 95% CI: 0.17 to 0.59; P < 0.001). There were no significant differences between RFA and MWA in symptom scores, cosmetic scores, or the incidence of complications, including hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. Conclusion: RFA showed a higher VRR than MWA at 6 and 12-month follow-ups, with a comparable safety profile.

Comparison of Dental Outcomes after General Anesthesia According to the Follow-up Pattern in Special Health Care Needs Patients (장애인 환자의 전신마취 하 치과 치료 후 정기검진 패턴에 따른 치과치료 결과 비교)

  • Kim, Jihyun;Nam, Okhyung;Kim, Misun;Lee, Hyoseol;Choi, Sungchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.2
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    • pp.145-150
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    • 2016
  • Special Health Care Needs (SHCN) patients need regular follow-up because of high incidence and severity of oral disease. The aim of this study was to evaluate the dental treatment outcomes of SHCN patients according to follow-up patterns. SHCN patients who were treated under general anesthesia (GA) at Kyung Hee University Dental Hospital from 2006 to 2014 were included in this study. The final samples comprised of 53 patients that were divided into regular (33 patients) and irregular (20 patients) follow-up groups according to their follow-up patterns. The type of dental treatment after GA during the follow-up periods were compared. In the irregular group, aggressive treatment including endodontic, prosthetic treatment, and extraction were predominant, compared with the regular group (p < 0.05). In addition, all patients who had dental treatment under GA in follow-up periods were in the irregular group (p < 0.05). In conclusion, the results of this study provide the importance of regular follow-ups with SHCN patients and emphasize responsibilities of dentists for educating patients and their guardians.

Overview for Pattern and Results of Herbal Medicine-derived Atopic Dermatitis Clinical Researches (한약을 이용한 아토피 임상연구의 경향에 관한 연구)

  • Kim, Yun-Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.26 no.2
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    • pp.53-61
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    • 2012
  • Objectives To make comprehensive feature of clinical trials using herbal medicine and their results by today, then help a strategy for herbal medication-derived clinical studies in the future. Methods Through medical website (Pubmed EBSCO Medline), foreign clinical literatures about atopic dermatitis and herbal medicine were searched. And domestic clinical literatures about atopic dermatitis using internet website (OASIS) and hand-searching. Analysis was performed according to distribution mainly by subject, study design, number by year and its efficacy. Results and Conclusions Seventy-nine (Domestic literatures: Fifty, Foreign literatures: Twenty-nine) literatures were selected according to inclusion criteria of clinical study. 80% of domestic clinical literatures were observational studies, 50% of foreign were intervention. There were six adverse effect case studies, two follow-ups, one case report, four translational and four uncontrolled clinical trials in foreign literatures. And nineteen case reports, eighteen case series, two follow-up and five uncontrolled clinical studies in domestic. Six RCTs have established by four external herb therapy and two decoctions in Korea, showed positive effects. Three out of four external applications RCTs, four out of seven decoctions showed positive results in foreign studies. This study revealed the current status of atopic dermatitis clinical research using herbal drugs. To put clinical trials to use of herbal medicine in the treatment atopic dermatitis, scientific and objective-based studies should be needed.

Extent of Disc Degeneration after Single-Level Cervical Anterior Microforaminotomy Analyzed with Long-Term Radiological Data

  • Han, Chul;Kim, Myung-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.200-205
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    • 2014
  • Objective : To prove the extents and details of cervical degeneration after anterior microforaminotomy (AMF) with 6-years follow-up. Methods : A retrospective study of 24 patients, underwent single-level AMF, was performed. Clinical and radiologic data were analyzed with office charts, questionaires, and picture achieving and communication system images. Results : According to Odom's criteria, 91.6% achieved favorable outcome. The mean visual analog scale score was improved from 8.6 to 3, and the mean neck disability index was improved from 27.9 to 7.3 (p<0.01). Eighteen cases (75%) showed disc height (DH) decrease. The disc invasion was correlated with DH decrease (p<0.05). The disc height decrease correlated with static, dynamic changes of shell angle and spur formation (p<0.05). Any radiological parameters did not affect the clinical outcome. Conclusion : AMF is an effective technique for treating unilateral cervical radiculopathy. It showed excellent surgical outcomes even in long-term follow-ups. However, a decrease in DH occurred in a considerable number of patients. Disc invasion during surgery may be the trigger of sequential degeneration.

Conus Medullaris Levels on Ultrasonography in Term Newborns : Normal Levels and Dermatological Findings

  • Asil, Kiyasettin;Yaldiz, Mahizer
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.731-736
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    • 2018
  • Objective : Ultrasonography (US) is the most non-invasive, safe, and, especially in the period of infancy, best method for visualizing and examining the spinal cord. Furthermore, US is the primary work-up for development of the spinal canal, and for follow-up on issues relating to subcutaneous tissues, bone development, and the spinal cord. Conus medullaris terminates at the second lumbar vertebra, according to a consensus in the literature. Methods : Healthy children under the age of 6 months who were admitted to the radiology clinic for routine USG follow-ups between the dates of March 2012 to December 2014 were included in this study. Results : Our study includes data from 1125 lumbosacral ultrasounds. The terminal point of the conus level of the attended infants, superior, middle part, inferior of the vertebrae L1, L2, and L3. Furthermore, the termination of the discal distance ratio did not differ significantly between genders. Conclusion : Therefore, according to our results, gender is not an influencing factor in the termination of the spinal cord. Based on the study we performed, as well as the previous literature, in infants without a recognized spinal pathology, the spinal cord is detected below the vertebra L3.