• Title/Summary/Keyword: Patient outcome

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Treatment of Primary Malignant Bone Tumors of the Scapula

  • Tomori, Yuji
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2009년도 제17차 학술대회
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    • pp.222-222
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    • 2009
  • Primary malignant bone tumors of the scapula are very rare, and little literature is available regarding their characteristics and outcome. We studied the clinical characteristics, and outcome of patients with primary malignant bone tumors of the scapula. From 1979 to 2008, we treated 7 patients at our institute (4 men and 3 women; chondrosarcoma 3, Ewing's sarcomas 3, Osteosarcoma 1). The mean age was 45 years (range, 5~65 years). The follow-up period was 2 - 180 months. Six patients were performed operations: total scapulectomy 3, partial scapulectomy 1, forequarter resection 1, total resection of the shoulder girdle (Tikhoff-Linberg procedure) 1. No-operative treatment was chosen for one patient with a limited life expectancy. Local recurrence occurred in one patient. Distant metastasis occurred in 3 patients. Of the 7 patients, 4 patients are died because of propagation of the disease. Three patients were alive and apparently disease-free, and these patients were evaluated for functional results with the functional evaluation system of the International Society of Limb Salvage (ISOLAS). Functional result of partial scapulectomy was excellent, however, the function after total scapulectomy or Tikhoff-Linberg procedure is severely impaired. Our study indicates reconstruction procedure needs to be reconsidered following total scapulectomy or Tikhoff-Linberg procedure.

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성대구증에서 KTP Laser를 사용한 수술적 치료 1례 (Surgical Treatment of Sulcus Vocalis Using KTP Laser)

  • 정찬민;김지형;임재열;최홍식
    • 대한후두음성언어의학회지
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    • 제28권2호
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    • pp.131-134
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    • 2017
  • Sulcus vocalis remains a surgical challenge despite many recent advances in laryngomicrosurgeries. We previously reported that 585-nm Pulsed dye laser (PDL) exerts favorable outcome in treatment of sulcus vocalis due to its therapeutic effects of collagen rearrangement and improved wound remodeling. In spite of the usefulness of PDL glottoplasty for treating sulcus vocalis, the device is no more available in the country. It prompted us to focus another angiolytic laser ; 532-nm KTP laser which has similar mechanisms of action and has been used for treatment of other laryngeal lesions elsewhere. Herein, we present a case of sulcus vocalis successfully treated with KTP laser. A patient underwent laryngomicrosurgery with angiolytic KTP laser (KTP glottoplasty) by the same surgical procedure with PDL glottoplasty. After the surgery, the patient presented improved voice outcome in time without complications.

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What are the most important prognostic factors in patients with residual rectal cancer after preoperative chemoradiotherapy?

  • Kim, Sol-Min;Yoon, Ghilsuk;Seo, An Na
    • Journal of Yeungnam Medical Science
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    • 제36권2호
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    • pp.124-135
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    • 2019
  • Background: We aimed to establish robust histoprognostic predictors on residual rectal cancer after preoperative chemoradiotherapy (CRT). Methods: Analyzing known histoprognostic factors in 146 patients with residual disease allows associations with patient outcome to be evaluated. Results: The median follow-up time was 77.8 months, during which 59 patients (40.4%) experienced recurrence and 41 (28.1%) died of rectal cancer. On univariate analysis, residual tumor size, ypT category, ypN category, ypTNM stage, downstage, tumor regression grade, lymphatic invasion, perineural invasion, venous invasion, and circumferential resection margin (CRM) were significantly associated with recurrence free survival (RFS) or/and cancer-specific survival (CSS) (all p<0.005). On multivariate analysis, higher ypTNM stage and CRM positivity were identified as independent prognostic factors for RFS (ypTNM stage, p=0.024; CRM positivity, p<0.001) and CSS (p=0.022, p=0.017, respectively). Furthermore, CRM positivity was an independent predictor of reduced RFS and CSS, irrespective of subgrouping according to downstage (non-downstage, p<0.001 and p<0.001; downstage, p=0.002 and p=0.002) or lymph node metastasis (non-metastasis, p<0.001 and p=0.001; metastasis, p<0.001 and p<0.001). Conclusion: CRM status may be as powerful as ypTNM stage as a prognostic indicator for patient outcome in patients with residual rectal cancer after preoperative CRT.

Effects of 7~11 cycles adjuvant FOLFOX chemotherapy on the prognosis of patients with stage III colon cancer

  • Rhee, Jiyoung;Jo, Jaemin
    • Journal of Medicine and Life Science
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    • 제16권1호
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    • pp.6-9
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    • 2019
  • Adjuvant fluorouracil, leucovorin, and oxaliplatin (FOLFOX) chemotherapy for 6 months is the standard treatment of stage III colon cancer to improve patient survival. Recent studies have shown that restricting the treatment to 3 months to reduce toxicity negatively affects the outcome. However, the effect of FOLFOX treatment for a duration of between 3 and 6 months(7~11 cycles) on survival is not known. The effect of a reduced duration of FOLFOX chemotherapy on the prognosis of stage III colon cancer was examined. The 5-year disease-free survival in patients receiving 7~11 cycles of FOLFOX was lower than those receiving 12 cycles(72.9% vs. 87%, respectively). Patients receiving 7~11 cycles who had a bowel obstruction at diagnosis had a significantly higher recurrence rate (66.7% vs. 15.0%) and shorter median disease-free survival (24.7 months vs. not reached) than those receiving 12 cycles. Among patients receiving 12 cycles of FOLFOX, there was no difference in the outcome between those with and those without intestinal obstructions at diagnosis. These results suggest that the completion of 12 cycles FOLFOX chemotherapy is important to improve the patient's prognosis, especially for with intestinal obstructions at diagnosis.

Outcome analysis of biplanar mandibular distraction in adults

  • Chattopadhyay, Debarati;Vathulya, Madhubari;Jayaprakash, Praveen Ambadivalappil;Kapoor, Akshay
    • 대한두개안면성형외과학회지
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    • 제22권1호
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    • pp.45-51
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    • 2021
  • Background: Mandibular deficiency leading to facial asymmetry causes cosmetic deformity as well as psychological stigma for the patient. Correction of these mandibular asymmetries is a major challenge. The study investigates the efficacy of bidirectional mandible distraction for the treatment of mandibular deficiency. Methods: This prospective study included six individuals aged between 17 and 24.4 years. Five patients had hemifacial microsomia and one had unilateral temporomandibular joint ankyloses. All patients underwent mandibular distraction osteogenesis. Postoperative skeletal changes in affected mandible, and changes in occlusal plane and oral commissure cant were evaluated using three-dimensional reconstruction. Patient satisfaction and understanding of the procedure were assessed through three questionnaires administered during pre-distraction, distraction and post-distraction phases. Results: In pre-distraction phase, aesthetic appearance seemed to be the primary indication for surgery. In distraction phase, pain while chewing was the primary handicap. In post-distraction phase all patients were satisfied with the aesthetic outcome. The facial deformity was improved through mandibular distraction osteogenesis. On the affected side in all the patients, height and length of the mandible increased. Canting of the occlusal plane and oral commissure was corrected. Conclusion: Bidirectional mandible distraction is an effective treatment for correction of mandible deformities in adult patients.

한양방통합치료를 병행 후 완치된 재발성 소포림프종 증례 보고 (A Case Report on the Complete Response of a Patient with Recurrent Follicular Lymphoma Treated with Integrative Medicine)

  • 박경덕;김지수;오유나;정범진;정유진;방선휘
    • 대한한방내과학회지
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    • 제44권3호
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    • pp.585-593
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    • 2023
  • Objective: The purpose of this study is to report the effect of integrative medicine on recurrent follicular lymphoma, thus providing a clinical basis for integrative medicine. Methods: The medical report of a patient with follicular lymphoma who had undergone several chemotherapies but continuously relapsed before treated with integrative medicine was analyzed. Radiologic outcome was assessed by several imaging tests based on Response Evaluation Criteria in Solid Tumors. Clinical outcome and safety were assessed by laboratory tests. Results: After five years of integrative treatment, there was a complete response in imaging tests such as computed tomography (CT), positron-emission tomography/CT, and endoscopy. There were no toxicity in the laboratory test and no serious side effect of integrative medicine. Conclusion: This study suggested that integrative medicine has few side effects but significant effects on treating recurrent follicular lymphoma. However, the results should be taken cautiously as further clinical studies are needed.

근육뼈대계 환자보고식 결과 측정과 KCF의 연결: 물리치료 중심으로 (Mapping between Musculoskeletal Patient-Reported Outcome Measures and KCF: Physical Therapy Perspective)

  • 송주민
    • 대한물리의학회지
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    • 제19권1호
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    • pp.143-154
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    • 2024
  • PURPOSE: The present study was conducted to improve the understanding of the Korean Standard Functional, Disability, and Health Classification (KCF) and its ease of use in the clinical domain of the musculoskeletal system by comparing, analyzing, and linking the KCF codes with items from patient-reported outcome measures (PROMs), which are currently mainly used to evaluate patients with neck, shoulder, waist, and knee pain. METHODS: The items of the most widely used PROMs, the Neck Disability Index (NDI), Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Oswestry Disability Index (ODI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the codes of the KCF were linked by two experts according to the linking rules. RESULTS: The concordance between the items of each of the PROMs and the KCF code linked by the two experts was NDI,86.4%86.4%, DASH 83.3%, ODI 92.0%, and WOMAC 80.7%. The NDI, DASH, and WOMAC indexes were found to comprise items corresponding to physical function, activity, and participation areas, and were linked to 22, 43, and 31 KCF codes, respectively. In addition to these two areas, the ODI included items related to environmental factors and was linked to 25 codes (duplicated codes are treated as one). CONCLUSION: This research can be used by adding the KCF code to the questions of the currently used evaluation tool. This coding can be easily applied and will contribute to the easy understanding of the KCF.

급성 범자율신경장해성신경병증 (Acute Pandysautonomic Neuropathy) 2개증례 (Acute Pandysautonomic Neuropathy 2 Cases)

  • 전종은;이용석;남현우;박성호
    • Annals of Clinical Neurophysiology
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    • 제3권1호
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    • pp.43-46
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    • 2001
  • Acute pandysautonomic neuropathy(APN) is an uncommon clinical entitiy involving vasomotor, sudomotor, pupilomotor, secretomotor and other autonomic systems. Both sympathetic or parasympathetic fibers are involved with relative preservation of somatic sensory and motor function. Although APN shares several clinical features with GBS, it is not clear whether APN is a subvariety of GBS. We report two young patients with APN. Patient 1 was a 18-year-old girl with recurrent fainting spells. Patient 2 was a 23-year-old man sufferring from unexplained nausea and vomiting. Both had a history of previous upper respiratory infection. They presented with gastroparesis, anhydrosis and orthostatic hypotension. Mild numbness and tingling sense was present, but motor power was intact. Neurologic examination showed bilateral tonic pupil, decreased pain and vibration sense, and absent tendon reflexes. Nerve conduction study indicated diffuse sensorimotor polyneuropathy. Nerve biopsy in patient 2 revealed axonal degeneration. After conservative management, gastrointestinal symptoms were improved in patient 2, however, patient 1 suffered from the symptoms lasting more than several months. These cases suggest that post-infectious dysautonomic symptoms in young patient may indicate the diagnosis of APN. Although the natural course is generally benign, accurate diagnosis and proper management may be mandatory for the better clinical outcome.

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과민성 방광을 동반한 쇼그렌 증후군 소양인 환자 치험 1례 (A Clinical Case Report of Soyangin Patient Diagnosed as Sjögren's Syndrome with Irritable Bladder)

  • 이민정;박민영;황민우
    • 사상체질의학회지
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    • 제32권3호
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    • pp.46-54
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    • 2020
  • Introduction This study aims to report a significant improvement of Sjögren's syndrome patient with irritable bladder, diagnosed as 'Soyangin chest-binding symptomatology' based on Sasang medicine. Methods The patient had treatment with 'Dojeokganggi-tang' and western medications. We evaluated the treatment outcome of Sjögren's syndrome symptoms by using a numerical score of 0 to 10, based on the patient's subjective discomfort of dry eye and dry mouth, and irritable bladder symptoms by recording the number of night urination every month. Results Sjögren's syndrome symptoms were significantly improved, and the number of night urination was decreased. After 41 weeks of treatment, the patient didn't have dry mouth any more and had only a little dry eye. The number of night urination was decreased from 3-4 times to once a night. Discussion The patient diagnosed with Sjögren's syndrome, treated with Dojeokganggi-tang and western medications for 41 weeks, showed a significant improvement in dry eye, dry mouth, and night urination compared to the first visit.

전신성 접촉피부염과 안면홍조를 호소하는 태음인 환자 치험 1례 (A Clinical Case Report of Taeeumin Patient Diagnosed with Systemic Contact Dermatitis and Facial Flushing)

  • 이민정;이지연;황민우
    • 사상체질의학회지
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    • 제34권4호
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    • pp.68-80
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    • 2022
  • Objectives This study is to report a significant improvement in a Taeeumin patient with systemic contact dermatitis after eating urushiol chicken by herbal medicine treatment. Methods The patient had complaints of erythema, swelling, pruritus, scaly skin, and facial flushing. We treated the patient with an herbal medicine 'Galgeunhaegi-tang' for three months. We evaluated the treatment outcome of systemic contact dermatitis using the Three Item Severity(TIS) score every visit and facial flushing by Image color summarizer at the first and last visit. Results After the treatment, the severity of the patient's skin complaints lessened from moderate to mild. The Image color summarizer showed a minor decrease in the normalized red color level and a significant increase in the brightness level and facial color percentage. Conclusions The patient diagnosed with systemic contact dermatitis, treated with Galgeunhaegi-tang for three months, showed a significant improvement in skin complaints with brighter and even facial color.