• Title/Summary/Keyword: Treatment modality

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Spontaneous Resolution of Chronic Subdural Hematoma : Close Observation as a Treatment Strategy

  • Kim, Hyung Chan;Ko, Jung Ho;Yoo, Dong Soo;Lee, Sang-Koo
    • Journal of Korean Neurosurgical Society
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    • v.59 no.6
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    • pp.628-636
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    • 2016
  • Objective : Chronic subdural hematoma (cSDH) is common condition in neurosurgical field. It is difficult to select the treatment modality between the surgical method and the conservative method when patients have no or mild symptoms. The purpose of this study is to provide a suggestion that the patients could be cured with conservative treatment modality. Methods : We enrolled 16 patients who had received conservative treatment for cSDH without special medications which could affect hematoma resolution such as mannitol, steroids, tranexamic acid and angiotensin converting enzyme inhibitors. The patients were classified according to the Markwalder's Grading Scale. Results : Among these 16 patients, 13 (81.3%) patients showed spontaneously resolved cSDH and 3 (18.7%) patients received surgery due to symptom aggravation and growing hematoma. They were categorized into two groups based on whether they were cured with conservative treatment or not. The first group was the spontaneous resolution group. The second group was the progression-surgery group. The mean hematoma volume in the spontaneous resolution group was 43.1 mL. The mean degree of midline shift in the spontaneous resolution group was 5.3 mm. The mean hematoma volume in the progression-surgery group was 62.0 mL. The mean degree of midline shift in the second group was 6 mm. Conclusion : We suggest that the treatment modality should be determined according to the patient's symptoms and clinical condition and close observation could be performed in patients who do not have any symptoms or in patients who have mild to moderate headache without neurological deterioration.

Optimal Treatment Results of Angiocentric T Cell Lymphoma in Head and Neck according to the Subsites and Stage (두경부 혈관중심성 T세포 림프종의 발생주위 및 병기별 치료결과)

  • Choi Jong-Ouck;Kim Jeong-Joon;You Chan-Ki;Paeng Jae-Pil;Kim Hyung-Jin;Jung Kwang-Yoon;Choi Geon
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.33-36
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    • 2000
  • Objectives: Angiocentric T-cell lymphoma of the head and neck is an angiocentric and angiodestructive lymphoreticular proliferative disorder. It has been treated with various treatment modalities, but its prognosis is poor and the treatment modality is controversial. We performed this study to suggest a treatment modality with improved results. Materials and Methods: We studied 40 cases of pathologically confirmed angiocentric T-cell lymphoma from July 1984 to December 1996, 35 cases of which showed complete response after initial treatment. All the patients were divided into two groups according to treatment modality. 15 cases received radiotherapy alone (Group I) and 20 cases received radiotherapy after five cycles of CHOP-Bleo chemotherapy(Group II). We analyzed the subsites of tumor, stage, treatment modality and treatment outcome and causes of failure for each group, and compared the three-year no evidence of disease(NED) between the two groups. Results: The three-year NED of a combined chemoradiotherapy was higher than that of a radiotherapy alone (p=0.0478). The three-year NED according to groups and stage were as follows: Group I=6/15(40.0%), stage IE=5/10(50.0%), stage IIE=1/5(20%), Group II=13/20(65.0%), stage IE=9/13(69.2%), stage IIE=4/7(57.1%). Radiotherapy alone is not well effective for the nasal cavity lymphoma extended to paranasal sinus and the palate. Conclusion: We are unable to provide clear guidelines for treatment, but recommend the initial treatment with oral alkylating agents and steroids followed by radiotherapy for Ann Arbor stage II tumors and stage I of the palate lymphoma and the nasal cavity lymphoma extended to paranasal sinus.

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Surgical versus Vacuum Bell Therapy for the Correction of Pectus Excavatum: A Comparison of 1-Year Treatment Outcomes

  • Jung, Younggi;Yi, Eunjue;Lee, Kwanghyoung;Chung, Jae Ho;Cho, Seonghyun;Lee, Sungho
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.473-479
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    • 2021
  • Background: The purpose of this study was to compare 1-year clinical outcomes between patients who underwent a Nuss operation or vacuum bell therapy and to present vacuum bell therapy as a possible alternative treatment modality for patients who prefer non-surgical correction of pectus excavatum. Methods: We conducted a retrospective review of pectus excavatum patients who had undergone vacuum bell therapy for more than 1 year and examined patients who had undergone Nuss bar removal more than 1 year previously. The treatment outcomes were evaluated by comparing changes in the Haller index before and after treatment in both patient groups. Results: We included 57 patients in this study and divided them into 2 groups according to the type of treatment received. Both groups showed no significant difference in the post-treatment Haller index after 1 year of follow-up, although the Nuss operation group showed a greater change in the Haller index than the vacuum bell group. Conclusion: Although the Nuss operation is a well-established and effective treatment of choice to correct pectus excavatum, vacuum bell therapy showed comparable outcomes and could become an alternative treatment modality for select patients who prefer non-invasive treatment.

Effect of maxillary premolar extraction on transverse arch dimension in Class III surgical-orthodontic treatment (III급 부정교합의 수술-교정 치료시 상악 소구치 발치가 치열궁 폭경 변화에 미치는 영향)

  • Lee, Shin-Jae;Hong, Sung-Joon;Kim, Young-Ho;Baek, Seung-Hak;Suhr, Cheong-Hoon
    • The korean journal of orthodontics
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    • v.35 no.1 s.108
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    • pp.23-34
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    • 2005
  • Collective changes caused by orthodontic tooth movement evaluated in a specific treatment modality could give suggestive information on the specific treatment strategy. The aim of this study was to investigate retrospectively the characteristics of the orthodontic tooth movement during surgical-orthodontic treatment in order to provide an effective presurgical orthodontic treatment planning for the maxillary premolar extraction modality In the skeletal Class III malocclusion patient. Pre- and post-treatment dental casts of skeletal Class III malocclusion patients with nonextraction (N=:24) and the maxillary premolar extraction (N=31) were collected. The angulation and inclination measuring gauge(Invisitech Co. Seoul, Korea) was used to evaluate the orthodontic tooth movement. The changes in the maxillary and mandibular dental arch widths were also measured from the canines to the second molars. As a result, more palatal inclination change in the maxillary dentition was found with the premolar extraction modality than with the nonextraction modality. Linear regression analysis showed that the inter-arch width coordination was mainly due to the inclination changes of maxillary posterior teeth We conclude that the indications and proper treatment planning for surgical-orthodontic treatment in skeletal Class III malocclusion with maxillary premolar extraction could depend partly on the magnitude of the transverse inter-arch coordination especially in the maxillary dentition.

Analysis of Approach Modality of Experts for the Research and Treatment on Cancer and Study of Clinical Research Methodology in Korean Medicine (한의학 분야 악성종양 전문가집단의 악성종양 연구 및 치료에 대한 접근방법 분석을 통한 악성종양에 대한 임상연구 접근방법 모색)

  • Jung, Hee;Jung, Seung-Ki;Shin, Yong-Chul;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.1
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    • pp.35-44
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    • 2007
  • Recently, Despite improvements of therapeutic methods on malignancy, the need of modalities on the treatment of cancer have been increasing nowadays and Traditional Oriental Medicine have been considered as alternatives and the uses of it have continued to increase in cancer therapy. The aims of this paper is to analysis of approach modality of experts for the research and treatment on cancer and study of clinical research methodology in Korean Medicine.

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Combined-Modality Treatment of Vocal Cord Atrophy with Thyroplasty Type I and Voice Therapy (제1형 갑상성형술과 음성치료에 의한 성대위축증의 치료)

  • 안철민;김현호
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.8 no.1
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    • pp.33-37
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    • 1997
  • Incomplete glottic closure of vocal cord atrophy is the common cause of dysphonia. Patients with vocal cord atrophy have complaints such as dysphonia, vocal fatigue, abnormal sensation in the throat, laryngeal pain, cough or sputum like functional voice disorders. Many investigators could not confirm the pathologic laryngeal structure because of their minute pathology. But recent advancements of laryngeal examinations made the many clinicians to detect minimal laryngeal pathology and to have mind the treatment for the vocal cord atrophy. But the results were less effective than their thoughts, the reasons of ineffectiveness were not known well. Authors have found the Hyperfunctional movement of the supraglottis during phonation before and after thyroplasty type I for vocal cord atrophy. Then we have applied the combined modality treatment with thyroplaty type I and voice therapy for relieve of hypefunctional movement of the supraglottis. These options have had more imporved results.

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Use of the Sundt Clip Graft in a Previously Coiled Internal Carotid Artery Blister-Like Aneurysm

  • Cho, Jae Ik;Cho, Jae Hoon
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.496-499
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    • 2014
  • Owing to the focal wall defect covered with thin fibrous tissues, an aneurysm arising from the dorsal wall of the internal carotid artery (ICA) is difficult to manage either surgically or endovascularly and is often associated with high morbidity and mortality. Unfortunately, the definitive treatment modality of such highly risky aneurysm has not yet been demonstrated. Upon encountering the complex intracranial pathophysiology of such a highly precarious aneurysm, a neurosurgeon would be faced with a challenge to decide on an optimal approach. This is a case of multiple paraclinoid aneurysms including the ICA dorsal wall aneurysm, presented with spontaneous subarachnoid hemorrhage. With respect to treatment, direct clipping with a Sundt graft clip was performed after multiple endovascular interventions had failed. This surgical approach can be a treatment modality for a blood blister-like aneurysm after failed endovascular intervention(s).

A CASE REPORT : AVMS IN LEFT UPPER LIP (좌측 상순에 발생한 동정맥 기형 1증례)

  • Bae, Yang-Il;Byun, Young-Nam;Song, No-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.741-745
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    • 1996
  • AVMs is not a neoplasm, but a congenital developmental anomalies.$^{5)}$ In oral and maxillofacial area, the high recurrence rate and more facial disfigurement give a difficult problem to surgen and patient.$^{8)}$ Conventional treatment modality nowadays is presurgical embolization and surgical resection. In treatment planning, we consider the possibility of complete surgical resection and the esthetics of soft tissue reconstruction. But, two things are very difficult to achieve. We present a patient with AVMs in left upper lip, he had presurgical embolization with Ivalon and Bucrylate, and conservative surgical procedure. So we present this possible treatment modality.

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Symptom Distress and Spiritual Well-Being in Patients with Cancer according to Illness and Treatment (암 환자의 질병.치료관련 요인에 따른 불편감과 영적안녕에 관한 연구)

  • Bae, Su-Hyun;Park, Jeong-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.4
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    • pp.457-465
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    • 2007
  • Purpose: This study was done to analyze symptom distress and spiritual well-being in patients with cancer according cancer diagnosis, metastasis, treatment stage, number of hospitalizations and treatment modality. Method: The participants, 285 patients being treated in one of ten general hospitals either as in- or out-patients, completed the McCorkle and Young(1978) Symptom Distress Scale translated and adapted by Uhm(1986) and the Spiritual Well-Being Scale by Paloutzian and Ellison(1982) translated by Choi(1990). Data collection was done from June 19 to September 30, 2006. Results: For symptom distress, there were significant differences for cancer diagnosis(p=.018), metastasis(p=.000), treatment stage(p=.000), number of hospitalizations(p=.000), and treatment modality(p=.002). For spiritual well-being, the only significant difference was for cancer diagnosis(p=.002). Patients with ovarian/uterine cancer had the lowest spiritual well-being. Conclusion: For patients with cancer, symptom distress was significantly different for illness and treatment factors, in particular, stage of illness, while for spiritual well-being, patients with uterine ovarian cancer had the lowest spiritual level. These results indicate a need to develop nursing interventions to decrease symptom distress in patients according to treatment stage and to promote spiritual well-being, particularly in women with ovarian/uterine cancer.

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Clinical Application of Botulinum Toxin to Contact Granuloma and Vocal Nodule (보툴리눔 독소를 이용한 성대육아종과 성대결절 치료)

  • Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.82-86
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    • 2019
  • In the field of otolaryngology-head and neck surgery, botulinum toxins are widely used for the treatment of spasmodic dysphonia and vocal tremors. Recently, the applications of botulinum toxin have gradually expanded with time, to include vocal fold granuloma, mutational falsetto, bilateral vocal cord paralysis, and chemical reduction for arytenoid dislocation as an adjunctive modality. According to a nation-wide multicenter study conducted by the Korean Society of Laryngology, Phoniatrics and Logopedics for treatment modality of contact granuloma, among the various treatment modalities, botulinum toxin injection showed the highest response rate and lowest recurrence rate in both primary and refractory cases. Therefore, botulinum toxin could be reserved as a second-line treatment for contact granuloma in which the first treatment was not effective, but also could be used as a first-line treatment depending on the patient's and institution's situation. For recalcitrant nodules, injection of botulinum toxin into the bilateral thyroarytenoid muscle will reduce glottal contact force and result in a forceful chemical voice rest. In special situations, botulinum toxin injection could be one of the alternative treatment options for recalcitrant vocal nodules.