• Title/Summary/Keyword: Incomplete treatment

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Sacral Nerve Stimulation for Treatment of Intractable Pain Associated with Cauda Equina Syndrome

  • Kim, Jong-Hoon;Hong, Joo-Chul;Kim, Min-Su;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.473-476
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    • 2010
  • Sacral nerve stimulation (SNS) is an effective treatment for bladder and bowel dysfunction, and also has a role in the treatment of chronic pelvic pain. We report two cases of intractable pain associated with cauda equina syndrome (CES) that were treated successfully by SNS. The first patient suffered from intractable pelvic pain with urinary incontinence and fecal incontinence after surgery for a herniated lumbar disc. The second patient underwent surgery for treatment of a burst fracture and developed intractable pelvic area pain, right leg pain, excessive urinary frequency, urinary incontinence, voiding difficulty and constipation one year after surgery. A SNS trial was performed on both patients. Both patients' pain was significantly improved and urinary symptoms were much relieved. Neuromodulation of the sacral nerves is an effective treatment for idiopathic urinary frequency, urgency, and urge incontinence. Sacral neuromodulation has also been used to control various forms of pelvic pain. Although the mechanism of action of neuromodulation remains unexplained, numerous clinical success reports suggest that it is a therapy with efficacy and durability. From the results of our research, we believe that SNS can be a safe and effective option for the treatment of intractable pelvic pain with incomplete CES.

A Case Report of Complex Korean Medical Treatment for Cervical Spinal Cord Injury and Neurogenic Bladder (한의복합치료 후 호전된 경부척수손상 환자의 사지마비 및 신경인성 방광: 증례보고)

  • Song, Min-Yeong;Jo, Hee-Guen;Kim, Tae-Gwang;Choi, Jin-Bong
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.3
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    • pp.143-151
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    • 2016
  • A 57-year-old male patient was diagnosed as Incomplete cervical spinal cord injury and Neurogenic bladder after falling accident and suffered from tetraplegia and urinary retention. The patient was hospitalized and treated with Complex Korean Medical treatment such as acupuncture, electro-acupuncture, bee venom pharmacopuncture and herbal medication for 13 weeks. International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI) was adopted to evaluate the functional recovery and Korean version of Modified Barthel Index (K-MBI) was adopted to evaluate the recovery of activities of daily living (ADL). After treatment, Total scores of ISNCSCI and K-MBI were improved. Also patient's micturition reflex was recovered and symptoms of neurogenic bladder were improved. This result shows that Korean Medical treatment may be an effective treatment option for spinal cord injury and neurogenic bladder patients. Further clinical studies are needed to clarify the effect of Korean Medical treatment on spinal cord injury.

Influencing factors on functional, psychological, and aesthetic satisfaction in dental prosthetic treatment (치과보철치료의 기능적 만족도와 심리·심미적 만족도에 영향을 미치는 요인)

  • Choi, Da-Hye;Lee, Kyeong-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.15 no.2
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    • pp.225-233
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    • 2015
  • Objectives: The purpose of this study was to investigate the quality improvement of dental prosthetic treatment and better dental service for the patients. Methods: A self-reported questionnaire was completed by 320 users of dental prosthesis in Seoul and metropolitan area from April to June, The questionnaire consisted of 4 questions of general characteristics, 5 questions of dental prosthesis treatment, 5 questions of functional satisfaction, and 6 questions of psychological and aesthetic satisfaction by Likert 5 scale. Cronbach's alpha was o.691 in functional satisfaction and 0.716 in psychological and aesthetic satisfaction. Except 18 incomplete answers, 302 data were analyzed. Results: The functional satisfaction mean was $3.70{\pm}0.51$ and that of psychological aesthetic satisfaction was $3.60{\pm}0.48$. Monthly income was the most important influencing factor on full and partial prosthesis use. Conclusions: In order to improve the satisfaction level in dental prosthetic treatment, the insurance coverage for the dental prosthetic treatment is necessary. The palliative supportive measure for the prosthesis is also required.

Temporary Semi-Jailing Technique for Coil Embolization of Wide-Neck Aneurysm with Small Caliber Parent Artery Following Incomplete Clipping

  • Byun, Jun Soo;Kim, Jae Kyun;Lee, Hwa Yeon;Hwang, Sung Nam
    • Journal of Korean Neurosurgical Society
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    • v.53 no.4
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    • pp.241-244
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    • 2013
  • The authors describe the use of a self-expandable stent in a temporary deployment for treatment of a very wide-neck A1 segment of anterior cerebral artery (ACA) aneurysm following incomplete clipping. A 39-year-old hypertensive man presenting with seizure-like movement underwent computed tomography, which showed acute subarachnoid hemorrhage and an A1 segment of ACA aneurysm with superior and inferior projection. He underwent surgical clipping of the aneurysm, but superior and posterior portion of wide-neck aneurysm remained. We decided to treat the remnant aneurysm using an endovascular modality. After selection of the aneurysm, coil packing was performed assisted by the temporary semi-jailing technique. The Enterprise stent (Cordis Neurovascular, Miami, FL, USA) was deployed and recaptured repeatedly for angiography to ensure safety of the small caliber parent artery. Successful semi-deployment and recapture of the stent allowed subtotal coil occlusion of the aneurysm with good anatomic and clinical results. No complications were encountered. The stent could be recaptured up to the point where the proximal end of the stent marker was aligned with distal marker band of the microcatheter, approximately 70% of the stent length. The temporary semi-jailing technique is feasible for wide-neck aneurysm with small caliber parent artery.

Correction of Bilateral Cleft Lip Using Modified Noordhoff Technique (개선된 Noordhoff 방법을 이용한 양측성 구순열의 교정)

  • Cho, Byung Chae;Lee, Yong Jig
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.399-406
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    • 2006
  • Purpose: The authors accessed the anthropometric measurements of fourty non-cleft normal a three-month-old infant and using this obtained data as a basic guideline, authors applied the modified Noordhoff technique for the treatment of bilateral cleft lip. Methods: Over a period of 10 years, a total of 21 bilateral cleft lips were operated. 13 cases of complete and 8 cases of incomplete bilateral cleft lip and palate. In the complete type of bilateral cleft palate, elastic head cap and passive intraoral appliance were applied at 1 to 2 week of age for 2 months duration. The definitive cheiloplasty was performed at 3 months of age using the modified Noordhoff technique. Results: After a follow-up period ranging one to nine years, most patients presented with cosmetically and functionally satisfying results, with an exception of two cases where an undesired peaking effect of the vermilion and dimpling of the vermilion mucosa was encountered. Conclusion: Accessing the anthropometric measurements of fourty non-cleft normal three-month-old infant and using this obtained dara as a guideline, the modified Noordhoff technique can be applied to either complete or incomplete bilaterally cleft lip providing more naturally pleasing and cosmetically satisfying scars that lie in harmony with the philtral ridges, lip tubercle positioned just below the vermilion and a distinct white line and Cupid's bow.

USING THE SPEECH AID FOR TREATMENT OF VELOPHARYNGEAL INCOMPETENCY IN INCOMPLETE CLEFT PALATE - A CASE REPORT - (음성 폐쇄상을 이용한 구개열 환자의 언어치료의 증례 보고 - 장착 후 제거까지의 경과 -)

  • Leem, Dae-Ho;Yoon, Bo-Keun;Baik, Jin-A;Shin, Hyo-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.5
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    • pp.483-488
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    • 2006
  • Velopharyngeal function refers to the combined activity of the soft palate and pharynx in closing and opening the velopharyngeal port to the required degree. In normal speech, various muscles of palate & pharynx function as sphincter and occlude the oropharynx from the nasopharynx during the production of oral consonant sounds. Inadequate velopharyngeal function caused by neurologic disorder - cerebral apoplexy, regressive diseases - disseminated sclerosis, Parkinson's disease, congenital deformity - cleft palate, cerebral palsy and etc. may result in abnormal speech characterized by hypernasality, nasal emission and decreased intelligibility of speech due to weak consonant production. In our study, we constructed speech aids prosthesis - Speech bulb in the incomplete cleft palate VPI patient with hypernasality and assessed velopharyngeal function with nasometer which can evaluate the speech characteristics objectively.

Radiation Treatment and Survival of Maxillary Sinus Carcinoma (상악동암의 방사선치료와 생존율)

  • Oh W.Y.;Kim G.E.;Suh C.O.;Loh J.K.;Hong W.P.;Kim K.M.;Lee W.S.
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.25-35
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    • 1987
  • Irradiated 88 patients of Maxillary Sinus Carcinoma at Yonsei Cancer Center for 10years between 1971 and 1980 were retrospectively analysed. The majority of patients had very advanced disease(87.5% of $T_3\;and\;T_4$) and 17% of cervical lymph node involvement. 80.6% of all patients were epidermoid type. In 44 cases(50%), irradiation alone was performed. 28 cases(32%) of postoperative radiation after incomplete surgery and the remaining 16 cases(18%) of postoperative radiation after radical surgery were done. The majority of patients except 6 cases had irradiation a dose between 60Gy and 80Gy in 30-40 fractions over 6-8 weeks. The actuarial overall 3 and 5 year survival rate were 362% and 26%, respectively. The actuarial 5 year survival rate for 44 cases of radiation alone group was 14.1%, The actuarial 5 year survival rate for 28 cases of incomplete surgery and postoperative radiation group and 16 cases of radical surgery and postoperative radiation group were 312% and 67.4% respectively. In the actuarial 5 year survival rate according to the stage, stage II, III and IV were 79.5%, 20.9% and 0%. In recent, for the improvement of survival rate of advanced Maxillary Sinus Carcinoma at Yonsei Cancer Center, combined multidisplinary or trimodal treatment modality have been applied and in near time the more excellent results expect to be analyse.

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Surgical Treatment of Anastomotic Recurrence after Gastrectomy for Gastric Cancer

  • Jung, Jae Jun;Cho, Jong Ho;Shin, Sumin;Shim, Young Mog
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.269-274
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    • 2014
  • Background: The purpose of this study was to evaluate the outcome of reoperation with curative intent for the treatment of anastomotic recurrent gastric cancer. Methods: Ten patients with anastomotic recurrence of gastric cancer who underwent reoperation from November 1995 to February 2011 were analyzed retrospectively. The time interval between the first operation and reoperation, recurrence pattern, type of surgery, survival, and postoperative outcome were analyzed. Results: The average time to recurrence after initial surgery was 48.8 months (median, 23.5 months). Of the ten patients, eight (80.0%) had recurrence at the esophagojejunostomy, one (10.0 %) at the esophagogastrostomy, and two (20.0%) at the esophagus. Among these patients, five had combined metastasis or invasion to major organs in addition to anastomotic recurrence. Complete resection was achieved in five patients (50.0%), and incomplete resection or bypass surgery was performed in the remaining five patients (50.0%). The overall median survival time was 7.0 months (range, 2.2 to 105.5 months). The median survival time following complete resection and palliative surgery (incomplete resection or bypass surgery) was 28.1 months (range, 4.2 to 105.5 months) and 5.5 months (range, 2.2 to 7.5 months), respectively. Conclusion: Surgical resection of anastomotic recurrent gastric cancer should be implemented only in selected patients in whom complete resection is possible.

The Importance of Early Surgical Decompression for Acute Traumatic Spinal Cord Injury

  • Lee, Dong-Yeong;Park, Young-Jin;Song, Sang-Youn;Hwang, Sun-Chul;Kim, Kun-Tae;Kim, Dong-Hee
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.448-454
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    • 2018
  • Background: Traumatic spinal cord injury (SCI) is a tragic event that has a major impact on individuals and society as well as the healthcare system. The purpose of this study was to investigate the strength of association between surgical treatment timing and neurological improvement. Methods: Fifty-six patients with neurological impairment due to traumatic SCI were included in this study. From January 2013 to June 2017, all their medical records were reviewed. Initially, to identify the factors affecting the recovery of neurological deficit after an acute SCI, we performed univariate logistic regression analyses for various variables. Then, we performed a multivariate logistic regression analysis for variables that showed a p-value of < 0.2 in the univariate analyses. The Hosmer-Lemeshow test was used to determine the goodness of fit for the multivariate logistic regression model. Results: In the univariate analysis on the strength of associations between various factors and neurological improvement, the following factors had a p-value of < 0.2: surgical timing (early, < 8 hours; late, 8-24 hours; p = 0.033), completeness of SCI (complete/incomplete; p = 0.033), and smoking (p = 0.095). In the multivariate analysis, only two variables were significant: surgical timing (odds ratio [OR], 0.128; p = 0.004) and completeness of SCI (OR, 9.611; p = 0.009). Conclusions: Early surgical decompression within 8 hours after traumatic SCI appeared to improve neurological recovery. Furthermore, incomplete SCI was more closely related to favorable neurological improvement than complete SCI. Therefore, we recommend early decompression as an effective treatment for traumatic SCI.

The Assessment of Risk of Bias on Clinical Studies of Herbal Treatment for Acne (여드름의 한약 치료 임상연구에 대한 비뚤림 위험 평가)

  • Park, Hye-ryun;Roh, Seok-sun
    • Journal of Haehwa Medicine
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    • v.24 no.1
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    • pp.15-24
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    • 2015
  • Objectives : This study was carried out to assess the risk of bias of clinical trials on acne treatment with herbal medicine that have been published in Korea. Methods : 7 electronic databases in Korea were searched for clinical trials on acne treatment. Two independent reviewers selected clinical trials on herbal medicine treatment for acne. Selected studies are categorized according to DAMI(Study Design Algorithm for Medical literature of Intervention). RCTs are assessed according to Cochrane RoB(Risk of Bias), non-randomized studies(Before-after studies) are assessed according to RoBANS(Risk of Bias Assessment tool for Non-randomized Study). Results : After selection process, 25 articles are left. Among 25 articles, 3 RCTs and 4 before-after studies are finally included. In RCTs, the proportion of 'unclear' is high in criteria of 'random sequence generation', 'allocation concealment', and 'blinding'. In before-after studies, 'high' is high in criteria of 'blinding for outcome assessment' and 'incomplete outcome data'. Conclusions : Considering the above results of the assessment, it is necessary to conduct more well designed clinical trials on acne treatment with herbal medicine.

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