• Title/Summary/Keyword: Symptomatic approach

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Treatment of retrograde peri-implantitis: seven-year follow-up study (역행성 임플란트 근단병소 주위염(Retrograde Peri-implantitis) 치료의 7년 관찰)

  • Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.3
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    • pp.259-264
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    • 2014
  • Retrograde peri-implantitis (RPI) is defined as a clinically symptomatic periapical lesion. RPI is generally accompanied by symptoms of pain, tenderness, swelling and fistula. Several etiologic factors of RPI were possible, residual bacteria would be the main cause of RPI. Various treatment modalities have been introduced: debridement only or a combination of debridement with the grafting material accompanied by a detoxification of the infected implant surfaces, apicoectomy and so on. Although the definitive management methods remain undefined, many favorable clinical results of a treatment of RPI have been published. This case report introduces the 7-year long-term clinical result of the application the principle: implant surface detoxification using saline and chlorhexidine and guided bone regeneration with bone graft material and barrier membrane. If the implant was not mobile, it would be possible to treat RPI according to surgical approach and good results will be maintained over long term.

The Efficacy of Bioabsorbable Mesh as an Internal Splint in Primary Septoplasty

  • Kim, Jee Nam;Choi, Hyun Gon;Kim, Soon Heum;Park, Hyung Jun;Shin, Dong Hyeok;Jo, Dong In;Kim, Cheol Keun;Uhm, Ki Il
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.561-564
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    • 2012
  • Nasal bone fractures are often accompanied by septal fractures or deformity. Posttraumatic nasal deformity is usually caused by septal fractures. Submucosal resection and septoplasty are commonly used surgical techniques for the correction of septal deviation. However, septal perforation or saddle nose deformity is a known complication of submucosal resection. Hence, we chose to perform septoplasty, which is a less invasive procedure, as the primary treatment for nasal bone fractures accompanied by septal fractures. During septoplasty, we used a bioabsorbable mesh as an internal splint. We used the endonasal approach and inserted the mesh bilaterally between the mucoperichondrial flap and the septal cartilage. The treatment outcomes were evaluated by computed tomography (CT) and the nasal obstruction symptom evaluation (NOSE) scale. The CT scans demonstrated a significant improvement in the septal deviation postoperatively. The symptomatic improvement rated by the NOSE scale was greater at 1 month and 6 months after surgery compared to the preoperative status. There were no cases of extrusion or infection of the implant. In cases of moderate or severe septal deviation without dislocation from the vomerine groove on the CT scan, our technique should be considered one of the treatments of choice.

The Importance of Complete Pericardiectomy and the Role of the Apical Suction Device in Chronic Constrictive Pericarditis

  • Kim, Sang Yoon;Na, Kwon Joong;Kim, Kyung-Hwan
    • Journal of Chest Surgery
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    • v.50 no.1
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    • pp.22-29
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    • 2017
  • Background: The aim of this study was to analyze the preoperative attributes and clinical impacts of complete pericardiectomy in chronic constrictive pericarditis. Methods: A total of 26 patients were treated from January 2001 to December 2013. The pericardium was resected as widely as possible. When excessive bleeding or hemodynamic instability occurred intraoperatively, a cardiopulmonary bypass (CPB; n=3, 11.5%) or an apical suction device (n=8, 30.8%) was used. Patients were divided into 2 groups: those who underwent ${\geq}80%$ resection of the pericardium (group A, n=18) and those who underwent <80% resection of the pericardium (group B, n=8). Results: The frequency of CPB use was not significantly different between groups A and B (n=2, 11.1% vs. n=1, 12.5%; p=1.000). However, the apical suction device was more frequently applied in group A than group B (n=8, 30.8% vs. n=0, 0.0%; p=0.031). The postoperative New York Heart Association functional classification improved more in group A (p=0.030). Long-term follow-up echocardiography also showed a lower frequency of unresolved constriction in group A than in group B (n=1, 5.60% vs. n=5, 62.5%; p=0.008). Conclusion: Patients with chronic constrictive pericarditis demonstrated symptomatic improvement through complete pericardiectomy. Aggressive resection of the pericardium may correct constrictive physiology and an apical suction device can facilitate the approach to the posterolateral aspect of the left ventricle and atrioventricular groove area without the aid of CPB.

Serial Comparisons of Quality of Life after Distal Subtotal or Total Gastrectomy: What Are the Rational Approaches for Quality of Life Management?

  • Park, Sujin;Chung, Ho Young;Lee, Seung Soo;Kwon, Ohkyoung;Yu, Wansik
    • Journal of Gastric Cancer
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    • v.14 no.1
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    • pp.32-38
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    • 2014
  • Purpose: The aims of this study were to make serial comparisons of the quality of life (QoL) between patients who underwent total gastrectomy and those who underwent distal subtotal gastrectomy for gastric cancer and to identify the affected scales with consistency. Materials and Methods: QoL data of 275 patients who were admitted for surgery between September 2008 and June 2011 and who underwent subtotal gastrectomy or total gastrectomy were obtained preoperatively and postoperatively at 3, 6, 9, 12, 18, and 24 months. The Korean versions of the European Organization for Research and Treatment (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and the gastric cancer specific module, the EORTC QLQ-STO22, were used to assess QoL. Results: QoL, as assessed by the global health status/QoL and physical functioning, revealed a brief divergence with worse QoL in the total gastrectomy group 3 months postoperatively, followed by rapid convergence. QoL related to restrictive symptoms (nausea/vomiting, dysphagia, reflux, and eating restrictions) and dry mouth was consistently worse in the total gastrectomy group during the first 2 postoperative years. Conclusions: The general QoL of patients after gastrectomy is highly congruent with subjective physical functioning, and the differences between patients who undergo total gastrectomy and subtotal gastrectomy are no longer valid several months after surgery. In order to further reduce the differences in QoL between patients who underwent total gastrectomy and subtotal gastrectomy, definitive preoperative informing, followed by postoperative symptomatic management, of restrictive symptoms in total gastrectomy patients is the most rational approach.

Clinical presentation and specific stabilizing exercise management in Lumbar segmental instability (요추분절의 불안정성에 대한 임상적 소개와 안정성 운동관리)

  • Jung Yeon-Woo;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.15 no.1
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    • pp.155-170
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    • 2003
  • Lumbar segmental instability is considered to represent a significant sub-group within the chronic low back pain population. This condition has a unique clinical presentation that displays its symptoms and movement dysfunction within the neutral zone of the motion segment. The loosening of the motion segment secondary to injury and associated dysfunction of the local muscle system renders it biomechanically vulnerable in the neutral zone. There in evidence of muscle dysfunction related to the control of the movement system. There is a clear link between reduced proprioceptive input, altered slow motor unit recruitment and the development of chronic pain states. Dysfunction in the global and local muscle systems in presented to support the development of a system of classification of muscle function and development of dysfunction related to musculoskeletal pain. The global muscles control range of movement and alignment, and evidence of dysfunction is presented in terms of imbalance in recruitment and length between the global stability muscles and the global mobility muscles. The local stability muscles demonstrate evidence of failure of aeequate segmental control in terms of allowing excessive uncontrolled translation or specific loss of cross-sectional area at the site of pathology Motor recruitment deficits present as altered timing and patterns of recruitment. The evidence of local and global dysfunction allows the development of an integrated model of movement dysfunction. The clinical diagnosis of this chronic low back pain condition is based on the report of pain and the observation of movement dysfunction within the neutral zone and the associated finding of excessive intervertebral motion at the symptomatic level. Four different clinical patterns are described based on the directional nature of the injury and the manifestation of the patient's symptoms and motor dysfunction. A specific stabilizing exercise intervention based on a motor learning model in proposed and evidence for the efficacy of the approach provided.

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Modified Direct W-incision with Silicone Sheet to Minimize Operation Scar in Reconstruction of Mild to Moderate Symptomatic Medial Orbital Wall Fracture (경중도 안와 내벽 골절의 수술 시 흉터 최소화를 위한 변형된 직접 W-절개법과 실리콘판을 이용한 재건)

  • Jung, Jae A;Gong, Jung Sik;Kim, Yang Woo;Kang, So Ra
    • Archives of Craniofacial Surgery
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    • v.14 no.1
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    • pp.30-35
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    • 2013
  • Background: For reconstruction of the mild to moderate medial orbital wall fractures, various surgical approaches have been used. Prior existing W-shaped incision was a direct local approach through a 3 cm incision on the superior medial orbital area with a titanium mesh implant. In this study, the authors modified W-shaped incision and reconstructed the defect with silastic sheet to improve the result and the postoperative scar. Methods: This study included 20 patients who had mild to moderate size of medial wall defect and therefore relatively suitable for reconstruction with silastic sheets from July, 2009 to December, 2011. A modified W-shaped skin incision approximately 1.2 to 1.5 cm in length was made along the superior medial orbital rim from approximately 1 cm medial to the medial canthus to the lower border of the medial eyebrow. The angles of the limbs of the W ranged from 150 to 160 degrees. Results: By using soft flexible silastic sheet, the authors reduced the incision from 3 to 1.5 cm, and by widening the angle of the W limbs, scars were more effectively hided in the relaxed skin tension line. Scar assessment was done with modified patient and observer scar assessment scale and mean score from patients was 2.08 and mean score from observers was 2.12. Conclusion: Although this method will not be suitable for every case, it can be a consistent method to obtain the surgical goal in treatment of mild to moderate blowout fractures of the medial orbital wall.

Acupuncture for Symptomatic Rotator Cuff Disease: A Systematic Review and Meta-Analysis

  • Choi, Seoyoung;Lee, Jisun;Lee, Seunghoon;Yang, Gi Young;Kim, Kun Hyung
    • Journal of Acupuncture Research
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    • v.38 no.1
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    • pp.20-31
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    • 2021
  • The objective was to evaluate the effectiveness and safety of acupuncture for patients with rotator cuff diseases. There were 12 electronic databases and 3 trial registries searched up to November 30th, 2019. All randomized trials were eligible, regardless of language, date of publication, or settings. The primary outcomes were pain, shoulder function, and proportion of improved participants assessed within 12 weeks of randomization of the trial. The Cochrane risk of bias for the studies was assessed. Effects sizes were presented as a risk ratio, mean difference, or standardized mean difference with a 95% confidence intervals. Grading of Recommendations Assessment, Development and Evaluation approach was adopted to rate certainty of evidence. Of the 3,686 records screened, 28 randomized trials (2,216 participants) were included in this review. The types of acupuncture included manual acupuncture, dry needling, electroacupuncture, acupotomy, warm needle acupuncture, and fire needle acupuncture. All of the studies had an unclear or high risk of bias related to more than 1 domain. Significant benefits of acupuncture in terms of pain and shoulder function were observed in all comparisons, however, the proportion of improved participants was not described in 2 comparisons. There was substantial heterogeneity among meta-analyzed trials. No serious harm was observed. For primary outcomes, the overall certainty of evidence was very low. There was very low certainty of evidence for the benefits of acupuncture for patients with rotator cuff diseases. The safety of acupuncture remains unclear due to the incompleteness of reporting. Future well-designed randomized trials with transparent reporting are required.

Clinical features of COVID-19 as presented in journal articles : A Korean Medical Approach (COVID-19 임상표현에 대한 한의학적 접근 -국내외 논문을 중심으로-)

  • Kim, Jong-hyun;Ahn, Jinhee;Kim, Sanghyun
    • Journal of Korean Medical classics
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    • v.35 no.1
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    • pp.1-32
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    • 2022
  • Objectives : This paper examines major symptoms representation in COVID-19 patients as groundwork for development of an effective clinical data collection format in Korean Medicine. Methods : Major symptoms representation in COVID-19 related papers published worldwide were collected. Corresponding symptoms in Korean Medicine were then examined, followed by discussion of symptomatic features that require further consideration in regards to a more systematic clinical data collection. Results : Of 256 papers, most papers listed fever and cough while symptoms such as difficulty breathing, diarrhea, muscle pain, headache, nausea, fatigue, chest pain, phlegm, nasal discharge were also mostly listed. Clinical representations could be categorized into general symptoms, throat symptoms, chest symptoms, head and facial symptoms, gastrointestinal symptoms, musculo-skeletal and cutaneous symptoms, psychiatric symptoms and sensory problems. Conclusions : Although each clinical representation could be likened to certain clinical representations of Korean Medicine, the variety of symptoms were too limiting and lacking in detail to be applied in the pattern identification[辨證] of Korean Medicine. For effective clinical data collection and analysis in the future, symptom change according to time, comparison between location, climate and ethnicity, existence of interior symptoms when diagnosing exterior symptoms, deficiency-excessiveness of blood patterns, consciousness levels, etc., need to be considered in establishing criteria for symptom evaluation.

A network pharmacology and molecular docking approach in the exploratory investigation of the biological mechanisms of lagundi (Vitex negundo L.) compounds against COVID-19

  • Robertson G. Rivera;Patrick Junard S. Regidor;Edwin C. Ruamero Jr;Eric John V. Allanigue;Melanie V. Salinas
    • Genomics & Informatics
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    • v.21 no.1
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    • pp.4.1-4.18
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    • 2023
  • Coronavirus disease 2019 (COVID-19) is an inflammatory and infectious disease caused by severe acute respiratory syndrome coronavirus 2 virus with a complex pathophysiology. While COVID-19 vaccines and boosters are available, treatment of the disease is primarily supportive and symptomatic. Several research have suggested the potential of herbal medicines as an adjunctive treatment for the disease. A popular herbal medicine approved in the Philippines for the treatment of acute respiratory disease is Vitex negundo L. In fact, the Department of Science and Technology of the Philippines has funded a clinical trial to establish its potential as an adjunctive treatment for COVID-19. Here, we utilized network pharmacology and molecular docking in determining pivotal targets of Vitex negundo compounds against COVID-19. The results showed that significant targets of Vitex negundo compounds in COVID-19 are CSB, SERPINE1, and PLG which code for cathepsin B, plasminogen activator inhibitor-1, and plasminogen, respectively. Molecular docking revealed that α-terpinyl acetate and geranyl acetate have good binding affinity in cathepsin B; 6,7,4-trimethoxyflavanone, 5,6,7,8,3',4',5'-heptamethoxyflavone, artemetin, demethylnobiletin, gardenin A, geranyl acetate in plasminogen; and 7,8,4-trimethoxyflavanone in plasminogen activator inhibitor-1. While the results are promising, these are bound to the limitations of computational methods and further experimentation are needed to completely establish the molecular mechanisms of Vitex negundo against COVID-19.

A Review of Anticancer Efficacy Outcome Measures in Clinical Trials of Herbal Medicine for Cancer Patients (한약을 사용한 암환자 대상 임상시험에서의 항암 효능 평가변수 고찰)

  • Chunhoo Cheon;Min Jun Kang;Wonbin Shin;;Hyunsuk Park;Unho Yang;Unseog Yeo
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.1
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    • pp.119-130
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    • 2024
  • Objectives : The objective of this review is to examine the variety of evaluation parameters utilized in clinical trials that assess the anticancer efficacy of herbal medicine, focusing on the importance of including both symptomatic management and direct anticancer effectiveness. Methods : A detailed literature review was conducted across PubMed, Embase, and the Cochrane Library to identify clinical trials investigating the antitumor efficacy of herbal medicine. The search was performed on February 22, 2024. This review specifically examined the employed outcome measures, which were then categorized and analyzed to understand their relevance and application in evaluating the anticancer properties of herbal medicine. Results : From an initial search of 900 records, 15 clinical trials were selected for in-depth analysis after deduplication and screening. These studies evaluated the efficacy of herbal medicine across various cancers, including hepatocellular carcinoma, colorectal cancer, and breast cancer, using outcome measures such as survival rates, disease control rates, and quality of life improvements. The research spanned multiple countries, primarily in East Asia and the United States, reflecting a global interest in herbal medicine as a complementary approach to cancer treatment. The present study demonstrated that herbal medicine, especially when used alongside standard treatments, potentially improved clinical outcomes and patient well-being. Conclusions : The findings of this review highlight the need for a broader focus on the full range of therapeutic capabilities of herbal medicine, including its direct anticancer effects, in the management of cancer patients. Future oncology research involving herbal medicine should integrate a wide spectrum of clinical endpoints to fully ascertain its impact on cancer treatment and patient health.