• Title/Summary/Keyword: Periodic Therapy

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Long-term radiographic evaluation of GTR treatment in intrabony defect (골연하 결손부에서 조직유도재생술의 장기적 방사선학적 변화 관찰)

  • Choi, Mi-Hye;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.37 no.2
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    • pp.181-192
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    • 2007
  • Periodontal surgery as part of the treatment of periodontal disease is mainly performed 1) to gain access to diseased areas for adequate cleaning; 2) to achieve pocket reduction or elimination; and 3) to restore the periodontal tissues lost through the disease; i.e., a new attachment formation of periodontal regeneration. To accomplish the latter, often referred to as the ultimate goal of periodontal therapy, a number of surgical procedures have been advocated throughout the years. Clinical studies have demonstrated that considerable gain of clinical attachment and bone can be achieved following guided tissue regeneration (GTR) therapy of intrabony defects. The aim of this study was to analyse the radiographic bone changes 2-year after GTR using a bone graft material and nonresorbable membrane. Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of intrabony defect(s), 33 sites of 30 patients aged 32 to 56 (mean age 45.6) were treated by GTR with a bone graft material and nonresorbable membrane. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. We observed $2.86{\pm}1,87mm$ of bone fill, $065{\pm}0.79mm$ of crestal resorption, $3.49{\pm}2.11mm$ of defect resolution, and $44.42{\pm}19.51%$ of percentage of defect resolution. Mandible, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. But no difference was observed between xenograft and allograft. Outcome of GTR as a therapy of intrabony defect was better than other therapy, but herein, good oral hygiene maintenance as a anti-infective treatment and periodic recall check of patients are essential.

The Effects of Neck Irradiation on Thyroid Gland for Tumors of the Head and Neck -A prospective analysis of 75 cases- (두경부종양 환자에서 경부 방사선조사가 갑상선기능에 미치는 영향 -75예의 전향적 분석-)

  • Park In Kyu;Kim Sang Bo;Yun Sang Mo;Park Jun Sik;Jun Su Han;Kim Bo Wan
    • Radiation Oncology Journal
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    • v.12 no.1
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    • pp.59-66
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    • 1994
  • Seventy-five patients with tumors of the head and neck treated with either radiation therapy alone or combined with surgery or chemotherapy were studied prospectively to evaluate the effects of radiation therapy to the neck on thyroid gland between September 1986 and October 1992. All patients were serially monitored for thyroid function tests before and after radiation therapy. Radiation dose to the thyroid gland ranged from 35 to 60 Gy with a median dose of 50 Gy. Median follow-up time was 30 months with a range of 11 to 85 months. The incidence of thyroid dysfunction was 40$ \% $: forty-five patients(60$ \% $) euthyroid, 2 patients(3$ \% $) clinical hypothyroidism, 27 patients(36$ \% $) subclinical hypothyroidism and 1 patient(1$ \% $) hyperthyroidism. No thyroid nodules or thyroid cancer were detected in any patients. Thyroid dysfunction appeared earlier in patients who underwent surgery than in those patients treated with radiation therapy alone or combination of chemotherapy and radiation therapy(P=0.0013). By multivariate analysis, risk factors that significantly influenced a higher incidence of thyroid dysfunction were female sex(p=0.0293) and combination of total laryngectomy and radiation therapy(p : 0.0045). In conclusion, evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests are recommended to detect thyroid dysfunction in time and thyroid hormone replacement therapy is recommended whenever thyroid dysfunction develops.

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Aortic valve replacement in the patient with rheumatic heart disease (류마치스성 심장질환 환자에서 대동맥판막치환)

  • An, Jae-Ho;Lee, Yeong-Gyun
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.346-355
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    • 1984
  • 77 cases of Aortic Valve Replacement, which were composed of 64 rheumatic valvular heart disease and 13 combined congenital heart disease, were operated at Seoul National University Hospital for Aortic valvular disease during the period from June 1968 to December 1983. Among these 64 rheumatic aortic valvular heart disease cases, 8 patients were expired during and immediate after operation and overall mortality rate was 12.5%. For more precise remarks, these patients were divided into two periodic groups, 1st period [from 1968 to 1976] and 2nd [from 1977 to 1983] when annual open heart surgery were over 100 cases, and in 1st period three of four patients were died and in 2nd period five of sixty patients were died and its mortality rate was 8.3%. There were 12 cases of postoperative complication, which were 3 cases of remaining other valvular heart disease required MVR, 2 paravalvular leaks [one of them got Redo AVR], 4 thromboembolism or problem of anticoagulant therapy, 2 late death due to SBE with replaced valve failure and one functional AS with small sized valve. Operative death was affected by pump-time and aortic cross-clamping time, heart size, Ejection Fraction, LVEDP and symptom duration, and other many factors may influence the survival rate. Improved operative technique and myocardial protection and meticulous evaluation of the preoperative patient status will make the AVR safer.

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Speech and language disorders in children (소아에서 말 언어장애)

  • Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.922-934
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    • 2008
  • Developmental language disorder is the most common developmental disability in childhood, occurring in 5-8% of preschool children. Children learn language in early childhood, and later they use language to learn. Children with language disorders are at increased risk for difficulties with reading and written language when they enter school. These problems often persist through adolescence or adulthood. Early intervention may prevent the more serious consequences of later academic problems, including learning disabilities. A child's performance in specific speech and language areas, such as phonological ability, vocabulary comprehension, and grammatical usage, is measured objectively using the most recently standardized, norm-referenced tests for a particular age group. Observation and qualitative analysis of a child's performance supplement objective test results are essential for making a diagnosis and devising a treatment plan. Emphasis on the team approach system in the evaluation of children with speech and language impairments has been increasing. Evidence-based therapeutic interventions with short-term, long-term, and functional outcome goals should be applied, because there are many examples of controversial practices that have not been validated in large, controlled trials. Following treatment intervention, periodic follow-up monitoring by a doctor is also important. In addition, a systematized national health policy for children with speech and language disorders should be provided.

Magnetic Resonance Imaging Follow-Up Case Study on Changes in a Lumbar Herniated Intervertebral Disc Treated with Korean Conservative Treatment (보존적 한방치료를 진행한 요추 추간판 탈출증 환자의 시간에 따른 영상의학적 추간판 크기 변화 1례)

  • Roh, Ji-ae;Lee, Ji-won;Jang, Jae-won;Jeong, Wu-jin;Noh, Je-heon
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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    • pp.879-885
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    • 2018
  • Background: A herniated intervertebral disc (HIVD) triggers low back pain (LBP). Korean conservative treatment can decrease the herniated disc size without traditional surgery, but detailed prognosis is unclear. Case summary: One patient presented with LBP and bilateral sciatica. She was diagnosed with lumbar HIVD by magnetic resonance imaging (MRI) and treated by Korean medicine (acupuncture, decoction, and physical therapy). For 6 months, MRI follow-up exams showed the aggravation and migration of L5-S1 followed by distinct improvement of the same lumbar vertebra. Conclusion: The disc size in a patient with lumbar HIVD was reduced by Korean conservative treatment, and periodic radiologic examination showed the previously unrecognized process of absorbing the disc.

Reviews on the Hepatotoxicity of Tyrosine Kinase Inhibitors (티로신 키나아제 저해제의 간독성에 대한 고찰)

  • Han, Ji Min;Gwak, Hye Sun
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.4
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    • pp.223-230
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    • 2019
  • Background: Small-molecule tyrosine kinase inhibitors (TKIs) have had major impacts on anticancer therapy by targeting the catalytic activities of dysregulated tyrosine kinases. TKIs have not presented traditional toxicities; however, some serious adverse effects, including hepatotoxicity, have been documented in clinical trials and post-marketing surveillance. Although TKI-induced hepatotoxicity can cause severe clinical complications in patients, the underlying mechanism is still unclear. Methods: Studies on TKI-induced hepatotoxicity were identified by Pubmed search, and relevant articles were reviewed. Results: Immunoallergic reaction, cytochrome P (CYP) 450 polymorphisms, and formation of reactive metabolites are under consideration as mechanisms of TKI-induced hepatotoxicity. Host protein-drug metabolite conjugates are recognized as antigens by class II major histocompatibility complexes and are believed to cause liver injuries. Polymorphisms in CYP, which influences TKI metabolism, can slow TKI metabolism and may induce development of hepatotoxicity. The formation of reactive metabolites during drug metabolism can induce hepatotoxicity by directly causing cytotoxicity, leading to cell dysfunction, and indirect toxicity by mediating secondary immune reactions. Concurrent use of various medications with TKI can also cause hepatotoxicity by affecting drug transporter or enzyme activities. Conclusion: Periodic monitoring of patients taking TKIs and risk/benefit reassessments though post marketing surveillance are necessary to prevent hepatotoxicity.

A CASE OF CORONOID PROCESS MALFORMATION MIMICKING CONDYLAR HEAD (관절과두를 닮은 오훼돌기 변형증의 일 증례)

  • Kim, Jong-Ryoul;Lee, Seong-Geun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.157-161
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    • 1994
  • A 14-year-old male patient was referred to us for evaluation of Right TMJ clicking sound and mandibular deviation during mouth opening. On examinaaation, protrusion and lateral excursion was also restricted. Radiographs showed hook-like curved elongation of Right coronoid process with limitation o right condylar translation. His past medical and dental history was noncontributory. This patient underwent an extraoral coronoidectomy and the specimen revealed coronoid process malformation mimicking condylar head. Microcoically, the specimen discloses mature bony trabeculae. At postoperative 5 days, physical therapy was instituted. At present, this patient could open his mouth well with any clicking sound and mandibular deviation. The asymmetric face of this patient is expectated to be corrected by periodic observation and remained growth porential. If not to be corrected, orthognathic surgery will be done.

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Successful Transition from Pediatric to Adult Care in Inflammatory Bowel Disease: What is the Key?

  • Kim, Jeongseok;Ye, Byong Duk
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.1
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    • pp.28-40
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    • 2019
  • The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.

Usefulness of Gated RapidArc Radiation Therapy Patient evaluation and applied with the Amplitude mode (호흡 동조 체적 세기조절 회전 방사선치료의 유용성 평가와 진폭모드를 이용한 환자적용)

  • Kim, Sung Ki;Lim, Hhyun Sil;Kim, Wan Sun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.29-35
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    • 2014
  • Purpose : This study has already started commercial Gated RapidArc automation equipment which was not previously in the Gated radiation therapy can be performed simultaneously with the VMAT Gated RapidArc radiation therapy to the accuracy of the analysis to evaluate the usability, Amplitude mode applied to the patient. Materials and Methods : The analysis of the distribution of radiation dose equivalent quality solid water phantom and GafChromic film was used Film QA film analysis program using the Gamma factor (3%, 3 mm). Three-dimensional dose distribution in order to check the accuracy of Matrixx dosimetry equipment and Compass was used for dose analysis program. Periodic breathing synchronized with solid phantom signals Phantom 4D Phantom and Varian RPM was created by breathing synchronized system, free breathing and breath holding at each of the dose distribution was analyzed. In order to apply to four patients from February 2013 to August 2013 with liver cancer targets enough to get a picture of 4DCT respiratory cycle and then patients are pratice to meet patient's breathing cycle phase mode using the patient eye goggles to see the pattern of the respiratory cycle to be able to follow exactly in a while 4DCT images were acquired. Gated RapidArc treatment Amplitude mode in order to create the breathing cycle breathing performed three times, and then at intervals of 40% to 60% 5-6 seconds and breathing exercises that can not stand (Fig. 5), 40% While they are treated 60% in the interval Beam On hold your breath when you press the button in a way that was treated with semi-automatic. Results : Non-respiratory and respiratory rotational intensity modulated radiation therapy technique absolute calculation dose of using computerized treatment plan were shown a difference of less than 1%, the difference between treatment technique was also less than 1%. Gamma (3%, 3 mm) and showed 99% agreement, each organ-specific dose difference were generally greater than 95% agreement. The rotational intensity modulated radiation therapy, respiratory synchronized to the respiratory cycle created Amplitude mode and the actual patient's breathing cycle could be seen that a good agreement. Conclusion : When you are treated Non-respiratory and respiratory method between volumetric intensity modulated radiation therapy rotation of the absolute dose and dose distribution showed a very good agreement. This breathing technique tuning volumetric intensity modulated radiation therapy using a rotary moving along the thoracic or abdominal breathing can be applied to the treatment of tumors is considered. The actual treatment of patients through the goggles of the respiratory cycle to create Amplitude mode Gated RapidArc treatment equipment that does not automatically apply to the results about 5-6 seconds stopped breathing in breathing synchronized rotary volumetric intensity modulated radiation therapy facilitate could see complement.

Study of Acute Myelocytic Leukemia Patient Treatment That Used Total Skin Electron Beam (Total Skin Electron Beam을 이용한 급성 골수성 백혈병 환자 치료에 대한 연구)

  • Lee, Sang-Ryul;Kang, Min-Kyu;Kim, Sung-Kyu
    • Progress in Medical Physics
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    • v.20 no.3
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    • pp.152-158
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    • 2009
  • Total Skin Electron Beam Therapy (TSEBT) of linear accelerator has become use so as to be useful, 2~9 MeV of energy territories came to be used with mycosis fungoides and cutaneous lymphomas in the superficial lesion treatment which covers the major portion of the body. I treat a patient to Stanford technique in this study, and it is $60^{\circ}$ around the patients whom Stanford technique irradiated electronic beam to a linear accelerator in horizontal directions and there is a way a standard of TSEBT treat it to six located field (anterior, posterior, and four obliques) becoming. An each field does horizontally it and consist to beam of the two component which fitted the center to a suitable angle. a patient treats it to three dual field a day in order to make short treatment time. when a first day, we treat one dual field at anterior position and two dual field at posterior position. when the second day, treat one dual field at posterior position and two dual field at anterior position. Therefore, six dual field is finished in perfect periodic two days. we made cylindrical acrylic phantom, and I inserted a dosimeter film between phantom. in order to measure a dose distribution calculation before treat a patient, and a patient checked it in six field directions that got from a treatment. It is after that thermoluminescent dosimetry (TLD) as it uses Rando phantom and then measurement dose distribution in six field directions after attaching at chest, the right and left flank, a back after irradiation.

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