• 제목/요약/키워드: Interventional therapy

검색결과 125건 처리시간 0.024초

다낭성 난소 증후군의 침치료 연구에 관한 체계적 문헌고찰 (Recent Acupuncture Therapy for Polycystic Ovary Syndromes : Systematic Review)

  • 김세화;황덕상;이진무;이경섭;이창훈;장준복
    • 대한한방부인과학회지
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    • 제27권2호
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    • pp.71-82
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    • 2014
  • Objectives: The purpose of this systematic review was to overview and evaluate the efficacy of acupuncture treatment for women with polycystic ovary syndrome (PCOS). Methods: Relevant randomized controlled studies (RCTs) were identified by database searches in MEDLINE, EMBASE, and CENTRAL, up to Dec 2013, and by additional hand searches. Data were extracted regarding anovulation, hyperandrogenism, obesity indices. Meta-analyses were separatedly conducted for the symptoms of PCOS. The risk of bias was assessed. Results: Three studies which were included for analysis, but they showed severly heterogeneity therefore meta-analysis could not be performed. Outcomes for evaluating the efficacy of acupuncture treatment for PCOS were anovulation index (menstrual frequency), hyperandrogenism index (free testosterone) and obesity index (body-mass index). For menstrual frequency, acupuncture treatment consistently suggested an interventional benefit. Although other outcomes did not suggest any enough relevant evidence to interventional benefit for acupuncture treatment. Conclusions: Acupuncture treatment appeared to improve menstrual frequency in PCOS patients. Since a limited number of RCTs were available in the current literature and those studies were also clinically heterogeneous, further research is needed to gather evidence to support acupuncture therapy in PCOS.

131I-Labeled-Metuximab Plus Transarterial Chemoembolization in Combination Therapy for Unresectable Hepatocellular Carcinoma: Results from a Multicenter Phase IV Clinical Study

  • Ma, Jun;Wang, Jian-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7441-7447
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    • 2015
  • Objective: This study evaluated the safety and objective response of combining $^{131}I$-labeled-metuximab (Licartin) with transarterial chemoembolization (TACE) in the treatment of unresectable hepatocellular carcinoma (HCC). Materials and Methods: In a multicenter open-label clinical trial, 341 enrolled patients with stage III/IV HCC according to TNM criteria were nonrandomly assigned to a trial group (n=167) and a control group (n=174), undergoing TACE following hepatic intra-arterial injection of licartin or TACE alone from July 2007 to July 2009. Radiopharmaceutical distribution was evaluated. The primary endpoint was overall survival; secondary endpoints included time-to-progression (TTP), toxicity and adverse events (AEs). Results: The radiobiological distribution demonstrated better localization of licartin in liver tumors than other tissues (P<0.01). The organ absorbed doses to liver and red marrow were $3.19{\pm}1.01Gy$ and $0.55{\pm}0.22Gy$, respectively. The 1-year survival rate was significantly higher [79.47% vs. 65.59%, hazard ratio (HR), 0.598, P=0.041] and TTP significantly improved ($6.82{\pm}1.28$ vs. $4.7{\pm}1.14months$, P=0.037) compared with the control group. Patients at stage III achieved more benefit of one year survival than stage IV in the trial group (86.9% vs. 53.8%, P<0.001). There were significant different toxicities in leukocytopenia, thrombocytopenia and increased total bilirubin level [P<0.001, P=0.013, P<0.01, relative risk (RR) 1.63, 1.33, 1.43], but no differences in severe AEs of upper GI hemorrhage and severe liver dysfunction between the groups (5.39% vs. 2.3%, P=0.136). Conclusions: Owing to excellent tumor-targeting, promised efficacy and favourable toxicity profile, the novel combination therapy of licartin and TACE could be applied in patients with unresectable HCC.

치매환자의 삼킴장애 중재에 관한 체계적 고찰 (Intervention of Swallowing Disorder in Dementia Patient: A Systematic Review)

  • 박치수;함민주;홍덕기;유두한
    • 재활치료과학
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    • 제11권1호
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    • pp.21-33
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    • 2022
  • 목적 : 본 연구는 치매환자의 삼킴장애 중재에 대한 체계적 고찰을 통해 치매환자의 특성에 따른 중재접근법과 효과에 대한 과학적 근거를 마련하고자 하였다. 연구방법 : 주요 검색 데이터베이스로 CINAHL, Cochrane CENTRAL, PsycINFO, PubMed, Science Direct를 사용하였으며 2010년 1월부터 2020년 5월까지 발표된 문헌을 수집하였다. 검색어는'Dementia', 'Alzheimer disease', 'Deglutition disorder', 'Swallowing disorder', 'Dysphagia'를 사용하였으며 최종 5편의 문헌을 선정하였다. 결과 : 중등도-중증 환자를 대상으로 한 연구가 1편, 중증 환자를 대상으로 한 연구가 4편 포함되었다. 중재 유형은 교정적 중재가 1편, 보상적 중재가 3편, 포괄적 중재가 1편이었다. 중등도-중증 환자를 대상으로 행동 및 심리관리를 포함한 보상적 중재가 사용되었다. 중증 환자를 대상으로는 경관식이에 대한 교정적, 보상적 중재 및 다학제적 중재를 포함한 포괄적 중재가 사용되었다. 각각의 연구에서 사용한 모든 중재 방법은 삼킴능력과 관련된 결과변수에 긍정적인 영향을 끼쳤다. 결론 : 본 연구에서는 치매환자의 진행단계에 따라 중재의 목적과 중재 요소가 달라지는 것을 확인하였다. 따라서 치매환자의 삼킴장애 중재는 치매환자의 진행단계를 고려하여 개인화된 중재를 시행했을 때 더욱 효과적임을 확인하였다. 이러한 결과는 치매환자의 삼킴장애를 위한 효과적 중재 설계에 방향을 제시해 줄 수 있을 것으로 사료된다.

Radiation segmentectomy for gastric leiomyosarcoma hepatic metastasis

  • Roh, Simon
    • 대한종양외과학회지
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    • 제14권2호
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    • pp.142-145
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    • 2018
  • Metastases to the liver can be found in various malignancies, most commonly originating from the colon, rectum, pancreas, stomach, esophagus, breast, lung, and melanoma. Surgical resection of liver metastasis is generally considered to be the definitive therapy fore cure. However, many patients are unable to undergo surgical resection due to medical comorbidities or multifocal extent of malignant disease affecting the liver. Among patients not eligible for surgery, other therapies exist for treatment in order to down stage the disease for surgical resection or for palliation. Radioembolization of hepatic metastases has shown to improve outcomes among patients with variety of malignancies including more common malignancies such as colorectal cancer. Yttrium-90 (Y-90) radioembolization has been successfully used in the management of hepatic metastases. A small series of metastatic sarcoma to the liver treated with radioembolization showed a promising response. We report a case of metastatic gastric leiomyosarcoma to the liver treated with Y-90 glass microspheres therapy using the radiation segmentectomy approach, previously described for hepatocellular carcinoma.

37마리 개의 동맥관 개존증의 임상소견과 비외과적 치료의 회고연구 (Retrospective Study of Patent Ductus Arteriosus in 37 Dogs: Clinical Presentations and Interventional Therapy)

  • 박종인;최란;이승곤;현창백
    • 한국임상수의학회지
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    • 제30권2호
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    • pp.87-94
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    • 2013
  • 본 회고 연구에서는 동맥관 개존증에 이환된 개에서 심장중재술을 통한 치료증례의 임상적 특징과 치료예후를 조사하였다. 환축의 구성을 보면, 말티스와 암컷이 차지하는 비중이 컸다. Bounding pulse와 좌심저부의 심잡음이 가장 대표적인 신체검사 소견이며, differential cyanosis은 매우 드물게 관찰되었다. 심전도상 특징은 좌심종대소견과 동성빈맥이였다. 흉부방사선상 좌심실 종대와 대동맥 확장을 동반한 triple bumps가 대표적인 소견이 였다. 심초음파상 특징은 좌심실 종대를 동반한 폐동맥 단축단면상 심각한 와류 소견이였으며, 다수의 환자에서 이첨판 역류 소견도 관찰되었다. 37증례 중 32증례에서 thromboemolic coils (TCE)이나 Amplatz canine ductal occluder (ACDO)를 이용한 심장 중제술적 치료가 실시되었다. 일시적인 혈색소뇨가 관찰되었고 장착된 코일이나 ACDO가 이탈되는 부작용이 확인되었다. 하지만 장기 관찰이 가능했던 29증례에서 특별한 부작용은 관찰되지 않았다.

Comparison of the Effects of Joint Mobilization, Gym Ball Exercises, and Breathing Exercises on Flexion Relaxation Phenomenon and Pain in Patients with Chronic Low Back Pain

  • Lim, Chaegil
    • 국제물리치료학회지
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    • 제11권1호
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    • pp.1981-1991
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    • 2020
  • Background: Although various exercises have been performed for patients with chronic low back pain (CLBP), the effects of these exercises including joint mobilization, gym ball exercises, and breathing exercises on flexion relaxation ratio (FRR) have not been compared. Objective: To compare the effects of joint mobilization, gym ball exercises, and breathing exercises on the flexion relaxation phenomenon (FRP) and pain in patients with chronic low back pain. Design: Randomized pretest-posttest control group design. Methods: Thirty-six patients with chronic low back pain who were undergoing rehabilitation at a rehabilitation center were included. The patients were randomly divided into three groups: joint mobilization group (JMG; n=12), gym ball exercise group (GBG; n=12), and breathing exercise group (BEG; n=12). The exercises were performed for 40 minutes a day, twice a week, for a total of 12 weeks. Results: There were no significant differences in FRR between the three groups (P>.05). Significant decreases in the modified visual analog scale (MVAS) scores after intervention between the groups were found (P<.05). The GBG was significantly decreases from the JMG in the MVAS (P<.05). However, there were significant improvements between the pre- and post-interventional findings on FRR and MVAS in the three groups (P<.05). Conclusion: We demonstrated that intervention using joint mobilization, gym ball exercises, and breathing exercises improve FRP and pain in patients with CLBP.

Emerging Trends in the Treatment of Advanced Hepatocellular Carcinoma: A Radiological Perspective

  • Gun Ha Kim;Jin Hyoung Kim;Pyeong Hwa Kim;Hee Ho Chu;Dong Il Gwon;Heung-Kyu Ko
    • Korean Journal of Radiology
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    • 제22권11호
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    • pp.1822-1833
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    • 2021
  • This is a narrative review of various treatment modalities for advanced hepatocellular carcinoma (HCC), with a focus on recent updates in radiological treatments, as well as novel treatment concepts related to immune checkpoint inhibitors and combination therapies with locoregional treatments. Interventional radiologists have made efforts toward developing alternative and/or combination treatments for first-line systemic treatment of patients with advanced HCC. Locoregional treatments with or without systemic therapy may be considered in the selected patients. Various treatment modalities for advanced HCC are emerging, and several randomized controlled trials, including those of combination treatments with immunotherapy, are ongoing.

Bile acid sequestrants in poor healing after endoscopic therapy of Barrett's esophagus

  • Lukas Welsch;Andrea May;Tobias Blasberg;Jens Wetzka;Elisa Muller;Myriam Heilani;Mireen Friedrich-Rust;Mate Knabe
    • Clinical Endoscopy
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    • 제56권2호
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    • pp.194-202
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    • 2023
  • Background/Aims: Endoscopic therapy for neoplastic Barrett's esophagus (BE) has become the standard of care over the past two decades. In clinical practice, we regularly encounter patients who fail to achieve complete squamous epithelialization of the esophagus. Although the therapeutic strategies in the individual stages of BE, dysplasia, and esophageal adenocarcinoma are well studied and largely standardized, the problem of inadequate healing after endoscopic therapy is only marginally considered. This study aimed to shed light on the variables influencing inadequate wound healing after endoscopic therapy and the effect of bile acid sequestrants (BAS) on healing. Methods: Retrospective analysis of endoscopically treated neoplastic BE in a single referral center. Results: In 12.1% out of 627 patients, insufficient healing was present 8 to 12 weeks after previous endoscopic therapy. The average follow-up duration was 38.8±18.4 months. Complete healing was achieved in 13 patients already after intensifying proton pump inhibitor therapy. Out of 48 patients under BAS, 29 patients (60.4%) showed complete healing. An additional eight patients (16.7%) improved, but only partial healing was achieved. Eleven (22.9%) patients showed no response to BAS augmented therapy. Conclusions: In cases of insufficient healing even under exhaustion of proton pump inhibitors, treatment with BAS can be an option as an ultimate healing attempt.

근육이완요법이 항암화학요법을 받는 아동의 오심, 구토 및 불안에 미치는 효과 (The Effect of Muscle Relaxation Therapy on Nausea, Vomiting and Anxiety of Children with Chemotherapy)

  • 정경희
    • Child Health Nursing Research
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    • 제6권1호
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    • pp.60-68
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    • 2000
  • The purpose of this study is to assess the effect of progressive muscle relaxation therapy on nausea, vomiting and anxiety experienced by children who were histologically diagnosed as malignancy and have received cancer chemotherapy. Twenty subjects with 10 in experimental group and 10 in control group, between the age of 7 to 12 years participated in this study. All subjects were admitted for inpatients chemotherapy at the S hospital between April to August 1998. The methods used for interventional muscle relaxation were both the 16 items of the progressive muscle relaxation therapy developed by Jacobson and the 4 items of the muscle relaxation therapy by Wolpe. The method for assessing nausea, vomiting was the Index of Nausea and Vomiting by Rhodes et al and that for anxiety was State-Trait Anxiety Inventory for Children by Spielberger. The data was analysed by repeated measures ANOVA and Scheffe test using SAS program. The results were as follows : 1. On measurement of nausea, vomiting, in the experimental group, the mean values of the second and the third measurements showed tendency to slightly decrease compared with the first measurement, but there was no statistically significance. And in the control group, there were no significant differences among first measurement, second measurement and third measurement. Also there was no significant difference in the mean values assessing nausea, vomiting between experimental and control group (F=1.33, p=0.2645). 2. The results assessing state anxiety showed, in the experimental group, progressive decrease in mean values at each measurement, while the control group showed no significant differences between the mean values of each measurement. Also there was statistically significant difference in state anxiety measurements between experimental and control group(F=4.36, p=0.05). In conclusion, muscle relaxation therapy for school-aged children with chemotherapy could not be effective to decrease nausea, vomiting, but it could be effective to decrease anxiety.

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상담 시 거울 환경이 내담자 태도에 미치는 영향 (The Effect of Mirroring Environment on the Attitude of Client in Counselling)

  • 김미소;서선영;이은솔;전나현;조아해;김은주
    • 디지털융복합연구
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    • 제17권6호
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    • pp.427-431
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    • 2019
  • 본 연구의 목적은 상담 시 거울 환경이 내담자의 태도에 영향을 미치는지 확인하고자 하였다. 20대 남녀 32명을 대상으로 실험군 16명, 대조군 16명을 거울 환경의 유무에 따라 상담을 진행하고 진실성 척도와 의미변별척도를 사용하여 거울 환경이 중재된 실험군과 중재하지 않은 대조군 사이에 차이가 있는지를 확인하였다. 거울 환경을 제공한 실험군에서 진실성 척도의 '자기-소외' 요소가 통계학적으로 유의한 차이가 있었다. 실험군과 대조군에서 상담 환경을 어떻게 느끼는지를 알아보기 위한 의미변별척도는 유의한 차이가 없었다. 본 연구는 거울 환경의 유무가 내담자의 진실성에 영향을 미치는지를 알아보기 위한 연구로 진실성 척도의 요인 중 일부에서 유의미한 차이가 있었다.