• Title/Summary/Keyword: Risk Treatment Method

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Narrative Review of the Association between Cervical Region Treatment and Facial Paralysis

  • Young-Jun Kim;Hye-Ri Jo;So-Rim Kim;Dong-Guk Shin;Da-Won Lee;Yeon-Sun Lee
    • Journal of Acupuncture Research
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    • v.40 no.4
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    • pp.319-328
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    • 2023
  • Facial nerve palsy refers to sudden, unilateral lower motor neuron facial paralysis. This study aimed to determine the importance of neck treatment in the treatment of facial paralysis. A literature search was performed on six online databases and other sources until January 15, 2023. A total of 426 papers were retrieved. After excluding duplicated and inconsistent papers, papers not including cervical treatment, and experimental papers on animals, two papers were finally selected. The type of treatment method, therapeutic effects, assessment of the risk of bias in randomized controlled trials, and non-randomized controlled trials and side effects were evaluated. Chiropractic, manual therapy, facial meridian massage, and acupotomy were applied to the face and cervical spine region. The results showed that each treatment had a significant therapeutic effect through evaluation index measurement methods, such as the visual analog scale and Yanagihara's unweighted regional grading system. This study demonstrated the importance of the cervical spine area in the treatment of facial paralysis. However, this study has many limitations. Thus, high-quality randomized controlled comparative studies on the treatment of the cervical spine area only or studies that include cervical spine area treatment as an interventional treatment while performing oriental or comprehensive treatment are needed.

Ischemic Complications Occurring in the Contralateral Hemisphere after Surgical Treatment of Adults with Moyamoya Disease

  • Jung, Young-Jin;Ahn, Jae-Sung;Kwon, Do-Hoon;Kwun, Byung-Duk
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.492-496
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    • 2011
  • Objective : Direct revascularization surgery is regarded as the most effective method of treatment of adults with moyamoya disease. These patients, however, have a higher risk of perioperative ischemic complications than do patients with atherosclerotic stroke, and are at risk for ischemic complications in the hemisphere contralateral to the one operated on. We investigated the incidence and risk factors for ischemic stroke in the contralateral hemisphere after surgical treatment of adults with moyamoya disease. Methods : We retrospectively reviewed the medical records and results of neuroimaging studies on 79 hemispheres of 73 consecutive patients with adult moyamoya disease ($mean{\pm}SD$ age, $37.96{\pm}11.27$ years; range, 18-62 years) who underwent direct bypass surgery over 6 years. Results : Ischemic complications occurred in 4 of 79 (5.1%) contralateral hemispheres, one with Suzuki stage 3 and three with Suzuki stage 4. Three patients showed posterior cerebral artery (PCA) involvement by moyamoya vessels. Advanced stage of moyamoya disease (Suzuki stages 4/5/6; $p$=0.001), PCA involvement ($p$=0.001) and postoperative hypotension (mean arterial blood pressure <80% of preoperative mean arterial blood pressure) on the first ($p$<0.0001) and second ($p$=0.003) days after surgery were significantly correlated with postoperative contralateral ischemic complications. Conclusion : In patients with advanced moyamoya disease and involvement of the PCA, intentional hypotension can result in ischemic stroke in the hemisphere contralateral to the one operated on. Careful control of perioperative blood pressure is crucial for good surgical results.

Carboplatin and Doxorubicin in Treatment of Pediatric Osteosarcoma: A 9-year Single Institute Experience in the Northern Region of Thailand

  • Choeyprasert, Worawut;Natesirinilkul, Rungrote;Charoenkwan, Pimlak;Sittipreechacharn, Somjai
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1101-1106
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    • 2013
  • Background: Osteosarcoma is the most common primary bone tumor in childhood and adolescence. Carboplatin, a platinum-derived agent, is used as neoadjuvant chemotherapy for pediatric osteosarcoma because of its anti-tumor activity and had low toxicity as compared to cisplatin. Objective: To determine demographic data, prognostic factors and outcome of childhood osteosarcoma treated with a carboplatin-based chemotherapeutic protocol at Chiang Mai University. Method: A retrospective analysis was conducted on 34 osteosarcoma patients aged less than 18 years and treated between 2003 and 2011. Results: Overall limb-salvage and amputation rates were 23.5% and 70.6%, respectively. With the mean follow-up time of 29.5 months (1.5-108.9), the Kaplan-Meier analysis for 3-year disease-free survival (DFS) and 3-year overall survival (OS) were $20.2{\pm}7.7%$ and $47.1{\pm}9.5%$ respectively. Patients who had initial pulmonary metastasis were at significantly greater risk for developing recurrence (p=0.02, OR=7; 1.2-40.1) and had a tendency to have lower 3-year OS compared to those without initial pulmonary metastasis ($28.1{\pm}13%$, $63.1{\pm}12.3%$, respectively, p=0.202). On univariate analysis, age at diagnosis >14 years and patients who were declined surgery were significantly associated with lower 3-year OS (p=0.008 and <0.05, respectively). However, age at diagnosis, sex, tumor size and histological subtypes were not found to significantly affect recurrence or survival. Conclusions: In our study, the survival rate was far lower than those reported from developed countries. These might indicate the ineffectiveness of carboplatin in combination with doxorubicin as frontline treatment of pediatric osteosarcoma, especially in those with initial pulmonary metastasis. Refinement in risk and treatment stratification and dose intensification for pediatric osteosarcoma constitutes a future challenge to improve outcomes, especially in metastatic patients who may need a more intensive regimen.

The Risk Factors Associated with Nonunion after Surgical Treatment for Distal Fibular Fractures (원위 비골 골절의 수술 후 발생한 불유합의 관련 인자)

  • Lee, Jun Young;Choi, Kwi Youn;Kang, Sinwook;Ko, Kang Yeol
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.95-99
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    • 2018
  • Purpose: The purpose of this study was to evaluate the radiologic outcomes of distal fibular fractures and to analyze the risk factors associated with nonunion. Materials and Methods: Between January 2009 and March 2016, 13 patients who had final nonunion with ankle fracture were included. In the control group, 370 patients who had undergone bony union and removed metal implants were included. All patients underwent the same surgical procedure and had the same treatment method, ultimately achieving satisfactory open reduction results with less than 2 mm fracture gap. Surgical treatment of fracture was considered to have the same effect on nonunion, and factors that might be associated with nonunion were evaluated. SPSS ver. 13.0 (SPSS Inc., USA) was used for all statistical analyses. Pearson's chi-square test and multi-variate regression analysis were performed to determine the factors affecting nonunion of distal fibular fracture. A p-value less than 0.05 was considered statistically significant, and relative risk was assessed. Results: The mean age of 13 patients was 46.9 years (range, 16~57 years); there were 8 men and 5 women. Among the 13 patients with nonunion, atrophic was the most common (12 cases). The association between the injury mechanism and the Lauge-Hansen classification and diabetes mellitus was not statistically significant. Distal fibular fractures with tibia shaft fracture (p=0.015) and Danis-Weber type C fracture (p=0.023), open fracture (p=0.011), and smoking (p=0.023) were significantly associated with nonunion. Conclusion: In this study, the combined injury of the ipsilateral tibia shaft fracture, open fracture, and Danis-Weber type C fracture may increase the possibility of nonunion. Therefore, caution is advised to prevent nonunion.

Chuna Manual Therapy For Simple Obesity: A Systematic Review and Meta-analysis (단순성 비만에 대한 추나요법의 효과: 체계적 문헌고찰과 메타분석)

  • Lee, Yun-Jin;Lee, Eun-Byeol;Kim, Hyeon-Ji;An, Hee-Duk;Yang, Doo-Hwa
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.1
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    • pp.43-52
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    • 2021
  • Objectives The purpose of this study was to investigate the effectiveness of Chuna manual therapy (CMT) in the treatment of simple obesity. Methods We used seven databases to perform a literature search using the keywords "Chuna OR Tuina" AND "Obesity." We selected randomized clinical trials in which Chuna was used as the main method for treating simple obesity. The risk of bias was assessed by three independent researchers using the Cochrane risk of bias. Results A total of 14 RCTs were selected and analyzed. The results of the meta-analysis showed a significantly higher efficacy rate in the patient group treated with CMT as the main treatment than that in the control group. Conclusions The results of this systematic review suggest that CMT is effective in the treatment of simple obesity. However, given the limitations such as the small number of studies and the high risk of bias in the studies, additional research is needed to lend further support to this claim.

Clinical Evaluation of Risk Factors Affection Postoperative Morbidity and Mortality in the Surgical Treatment of Tuberculous Destroyed Lung (결핵성 파괴폐의 수술적 치료에 대한 술후 이환율과 사망률에 영향을 미치는 위험 인자에 대한 임상고찰)

  • Shin, Sung-Ho;Chung, Won-Sang;Jee, Heng-Ok;Kang, Jung-Ho;Kim, Young-Hak;Kim, Hyuck
    • Journal of Chest Surgery
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    • v.33 no.3
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    • pp.231-239
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    • 2000
  • Background: This retrospective study tries to identify specific risk factors that may increase complication rates after the surgical treatment of tuberculous destroyed lung. Material and method: A retrospective study was performed on forty-seven patients, who received surgical treatment for tuberculous destroyed lung in the Department of Thoracic and Cardiovascular Surgery at Hanyang University Hospital from 1988 to 1998, to identify specific preoperative risk factors related to postoperative complications. Fisher's exact test was used to identify the correlations between the complications and right pneumonectomy, preoperative FEV1, predicted postoperative FEV1, massive hemoptysis, postoperative persistent empyema. Result: Hospital mortality and morbidity rates of the patients who received surgical treatment for tuberculous destroyed lung were 6.4% and 29.7%, respectively. In view of the hospital mortality and morbidity rates as a whole, predicted postoperative FEV1 less than 0.8L(p<0.005), preoperative FEV1 less than 1.8L(p=0.01), massive hemoptysis(p<0.005), postoperative persistent positive sputum cultures(p<0.0005), and the presence of multi drug resistant tuberculosis(p<0.05) presented statistically significant correlations. Among the postoperative complications, bronchopleural fistula, the most common complication, was found to have statistically significant corrleations with the preoperative empyema(p<0.05) and postoperative persistent positive sputum cultures(p<0.05). Conclusion: Although mortality and morbidity rates after surgical treatment of tuberculous destroyed lung were relatively low, when predicted postoperative FEV1 was less than 0.8L, when preoperative FEV1 was less than 1.8L, when massive hemoptysis was present, when postoperative sputum cultures were persistently positive, and when multi drug resistant tuberculosis was present, the rates were significantly higher.

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The Analysis of Type D Personality Research as a Psychosocial Risk Factor in Cardiovascular Disease for Elders with a Chronic Disease (심혈관질환의 심리사회적 위험요인으로써의 D유형 성격에 관한 논문 분석)

  • Song, Eun-Kyeung;Son, Youn-Jung
    • Journal of Korean Academy of Nursing
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    • v.38 no.1
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    • pp.19-28
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    • 2008
  • Purpose: The purpose of this paper was to examine the relationship between type D personality and cardiovascular disease, and to suggest future research directions. Method: A literature search was conducted from the following nine databases: 1) MEDLINE, 2) CINAHL, 3) Pubmed Unrestricted, 4) PsycINFO, 5) KISS, 6) RICHIS, 7) RISS4U, and 8) Nanet. The combinations of the words, "type D personality", "personality", "heart", "cardiovascular", and "coronary" were used for keyword searches to find relevant articles. Twenty eight studies were identified. Result: Type D personality has been associated with increased morbidity and mortality in patients with established cardiovascular disease. Type D patients are also at increased risk for impaired quality of life, and seem to benefit less from medical and invasive treatment. Conclusion: There is substantial evidence for a relationship between type D personality and clinical outcomes related to cardiovascular disease. Randomized clinical trials are needed to further evaluate the value of controlling type D personality to improve survival and reduce morbidity in patients with cardiovascular disease. Accumulating evidence from this analysis indicates the urgent need to adopt a personality approach in order to optimize the identification of patients at risk for stress related cardiac events.

The Analysis of Risk Factors Influencing Adolescent Depression in a Atopic Dermatitis - Based on the 2014 Korean Youth Health Risk Behavior On-line Survey - (아토피피부염 청소년의 우울감에 영향을 미치는 요인분석 - 2014 청소년건강행태온라인조사를 바탕으로 -)

  • Lee, Su-Jung;Chong, Hyun-Chong;Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.25 no.4
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    • pp.103-111
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    • 2020
  • Objectives: The study recognizes the seriousness of depression in youth with atopic dermatitis, and tries to identify factors that affect depression. Methods: Data were obtained from the 2014 Korean Youth Health Behavior Risk Behavior On-line Survey. In this study, 17,232 people who were Atopic dermatitis without missing variables were included in the final analysis. It conducted frequency, chi-square and logistic regression analysis by SPSS 20.0. Results: An analysis of factors affecting depression showed that subjective health level, subjective happiness satisfaction, subjective sleep satisfaction, subjective stress level, smoking, and drinking had an effect. Conclusions: The factors affecting youth depression with atopic dermatitis revealed health status, life behavior. These results are thought to require attention and research on youth with atopic dermatitis, along with the development of practical treatment programs and systematic management by applying them to teenagers in an appropriate time and method.

Research Trends in Acupuncture Treatment of Internet Addiction Disorder (인터넷 중독에 대한 침 치료 연구동향)

  • Lee, Seung Hwan;Cho, Young Hun;Jeong, Bo Eun;Seong, Woo Yong;Lim, Jung Hwa
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.1
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    • pp.1-13
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    • 2017
  • Objectives: The purpose of this study is to investigate the trends in acupuncture research on Internet addiction disorder. Methods: Clinical research papers on acupuncture treatment were searched and selected. Seven databases, including English, Chinese, Japanese, and Korean databases, were searched systematically. Non-clinical, non-acupuncture, and unpublished studies were excluded. The characteristics of the included articles were described, and these articles were assessed by the Risk of Bias (RoB) tool or the Risk of Bias Assessment for Non-randomized Studies (RoBANS) tool. Results: Ten clinical studies on Internet addiction disorder were finally selected, and all of these studies were published in China. The electroacupuncture (EA) method was used in most of the acupuncture treatment studies. Most of the psychotherapy studies used cognitive behavioral therapy (CBT) in the control group. Most of the studies showed effective results. The results of this study suggest that the combination of acupuncture and psychotherapy is more effective than either treatment modality alone. However, the quality of these clinical studies was low. Conclusions: According to this study, acupuncture treatment seems to have excellent effects in Internet addiction disorder. However, the quality of most studies was low. Therefore, higher quality research on Internet addiction disorder is required.

Analysis for Risk Factors and Effect of Vocal Hygiene Education in Patients of Vocal Polyp (성대 용종의 예후 인자와 음성 위생법 치료 효과 분석)

  • Choi, Nayeon;Kim, Dong Gyu;Lee, GilJoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.1
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    • pp.24-28
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    • 2021
  • Background and Objectives Vocal polyp is one of the most common benign diseases of vocal fold caused by overuse of voice. Laryngeal microsurgery is the first treatment of choice for vocal polyp. However, surgery has many risks such as side effects of general anesthesia, injury of tooth and psychological burden. And we often experience reduction of vocal polyps without surgical procedure. The purpose of study is to evaluate the effect of non-surgical treatment such as vocal hygiene education and proton pump inhibitor (PPI) in patients with vocal polyp. Materials and Method We performed retrospective study for seventy-three patients of vocal polyp who treated with non-surgical modalities such as vocal hygiene education and PPI over three months. Treatment outcomes and risk factors such as age, sex, polyp size, position, symptom duration, presence of laryngopharyngeal reflux (LPR) symptoms, smoking history, voice abuse history and vocal hygiene education were evaluated by comparison between polyp size improved group and non-improved group. Results 5.5% of enrolled patients showed complete response and 23.3% showed partial response without surgery. Polyp size improved group significantly carried out more practice of vocal hygiene education treatment than the non-improved group (p=0.040). And the presence of LPR symptoms [hazard ratio (HR) 3.368, confidence interval (CI) 1.055-10.754, p=0.040] and not performing of vocal hygiene education (HR 3.664, 95% CI 1.078-12.468, p=0.038). Conclusion Vocal hygiene education can be a useful treatment option when making a decision to treat with vocal polyp.