• Title/Summary/Keyword: additional therapy

Search Result 752, Processing Time 0.037 seconds

Botulinum Toxin A Treatment for Cervical Dystonia Resulting in Endoscopic Thyroidectomy: A Case Report (내시경 갑상샘 절제술 후 발생한 경부 근긴장이상증의 보툴리늄 A 독소를 이용한 치료: 증례보고)

  • Oh, Hwa-Young;Choi, Hwan-Jun;Nam, Doo-Hyun;Kim, Jun-Hyuk;Lee, Young-Man
    • Archives of Plastic Surgery
    • /
    • v.38 no.2
    • /
    • pp.207-211
    • /
    • 2011
  • Purpose: Surgery for thyroid gland requires skin incisions that can result in postsurgical neck scar. To overcome this, many surgeons performed a endoscopic thyroidectomy. But, this approach had a some problems. One of postoperative problems, iatrogenic cervical dystonia (CD) may occur. At common, CD is defined as a syndrome characterized by prolonged muscle contraction causing twisting, repetitive movements or abnormal posture. Botulinum toxin A (BTA, Botox$^{(R)}$, Allergan, Irvine, CA, USA) is well known treatment agent in the treatment of CD. So, the authors applied BTA injection in rare case with iatrogenic CD resulting in endoscopic thyroidectomy. Methods: A 43-year-old female had endoscopic subtotal thyroidectomy operation 3 years ago. She had symptoms such as progressive cervical pain, abnormal neck posture, depression, and sleep difficulty. About 1 year later, the patient who had previous myomectomy of the clavicular head of sternocleidomastoid muscle, however, symptoms were not improved. And then the patient received BTA therapy in our department. The 2 units per 0.1 mL solution was administered in a 1 mL tuberculin syringe. Results: The dose of BTA used in the patient was 36 units for vertical platysmal bands, superficially, and 10 units for ipsilateral sternocleidomastoid muscle, intramuscularly. After 2 weeks, additional the dose of BTA used in the patient was 5 points for remained scar bands, superficially. Complications related to injection such as significant swallowing difficulties, neck muscle weakness, or sensory change were not observed. In 9 months follow-up, the patient maintained a good result from the method of BTA injection alone. Conclusion: The basic concept is selective denervation for the hyperactive individual muscles and scar bands. We conclude that BTA is an effective and safe treatment for CD despite the iatrogenic and complex presentation of this complication.

Carcinoma of the Uterine Cervix Treated with External Beam Irradiation Alone (자궁경부암의 외부방사선 치료 성적)

  • Kim, Mi-Sook;Ha, Sung-Whan
    • Radiation Oncology Journal
    • /
    • v.11 no.2
    • /
    • pp.363-367
    • /
    • 1993
  • A retrospective analysis was peformed on 42 patients with carcinoma of the uterine cervix who were treated with external beam (EB) radiation therapy alone at the Department of Therapeutic Radiology, Seoul National University Hospital from March 1979 to December 1988. After whole pelvic field irradiation of 50Gy, all the patients received additional booster dose of 12-22Gy to the primary tumor Thirty one received EB radiotherapy alone because of poor geometry for intracavitary application,5 because of medical problems and 6 because of other reasons. Five year locoregional control rate and five year survival rate were $34.5\%\;and\;35.4\%,$ respectively. Five year survivals were $66.7\%,\;36.4%,\;32.8\%\;and\;25.0\%$ for stage IIA, IIB, IIIB and IVA, respectively. The response one month after treatment well correlated with prognosis. The incidence of grade 2 and 3 complication was $12\%\;and\;10\%,$ respectively. There was tendency of increased complication with advanced stage.

  • PDF

Primary Pericardial Fibrosarcoma Presenting as Cardiac Tamponade - A case report - (심낭압전으로 발견된 원발성 심낭 섬유육종 - 1예 보고 -)

  • Lim, Ju-Yong;Sung, Kyu-Wan;Kang, Gil-Hyun;Yoo, Dong-Gon;Kim, Chong-Wook;Park, Chong-Bin
    • Journal of Chest Surgery
    • /
    • v.40 no.8
    • /
    • pp.574-577
    • /
    • 2007
  • Primary malignant neoplasm of the pericardium is very rare, Neoplastic involvement of the pericardium may result in rapidly developing hemorrhagic effusion. A 30-year-old male who occasionally suffered from chest tightness was referred to our hospital under the diagnosis of unstable angina. He presented with acute chest pain and severe dyspnea that had developed one day previously. The diagnostic investigations such as echocardiography, chest CT and magnetic resonance image suggested cardiac tamponade that was caused by rupture of the pericardial teratoma. An operation to remove the tumor and effusion was performed. The pericardial mass was completely excised, and the result of the frozen biopsy favored malignancy. The final pathologic report was malignant fibrosarcoma of the pericardium and no malignant cells were found on the cytology of the pericardial effusion. The patient had a smooth postoperative course and was referred to another hospital for additional radiation therapy. We report here on this case of cardiac tamponade that was caused by primary pericardial fibrosarcoma, and this required urgent diagnosis and surgical management.

LOCALIZED SCLERODERMA IN A CHILD : CASE REPORT (소아 피부 경화증 환자의 치험례)

  • Kim, Eun-Young;You, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.32 no.2
    • /
    • pp.256-261
    • /
    • 2005
  • Scleroderma is a connective tissue disease of unknown etiology, but known as a kind of auto-immune disease. It is most common in women especially in $30{\sim}50$ years, and very rare in childhood. It can be classified into two main classes : localized scleroderma & systemic sclerosis. Localized type has better prognosis, and usually involves skin only, or in some cases, the muscle below, except inner organs. Systemic type involves skin, oral mucosa and major internal organs. Involving facial skin, we can see small and sharp nose, expressionless stare and narrow oral aperture. Usually they have Raynaud's phenomenon, and in progress, show mouth opening limitation and sclerosis of tongue and gingiva. It is called CREST syndrome showing calcinosis cutis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangioectasia. Treatment of scleroderma is systemic and localized steroid therapy, use of collagen-link inhibitor (D-penicillamine), immune depressor and etc. Mouth opening limitation can be improved by mouth stretching exercise. We report a 6 years old boy, diagnosed with localized scleroderma who had mouth opening limitation. We could get additional mouth opening, and have done successful restorative treatment of mandibular and maxillary 1st and 2nd deciduous molar under deep sedation with nitrous oxide and enflurane.

  • PDF

Adjuvant external beam radiation and brachytherapy for vaginal resection margin positive cervical cancer

  • Kim, Donghyun;Ki, Yongkan;Kim, Wontaek;Park, Dahl;Lee, Joohye;Lee, Jayoung;Jeon, Hosang;Nam, Jiho
    • Radiation Oncology Journal
    • /
    • v.36 no.2
    • /
    • pp.147-152
    • /
    • 2018
  • Purpose: To evaluate the treatment outcomes of adjuvant external beam radiation therapy (EBRT) and vaginal brachytherapy (VB) following radical hysterectomy in cervical cancer patients with involved vaginal resection margin (VRM). Materials and Methods: We retrospectively reviewed the medical records of 21 patients treated with postoperative EBRT and VB for positive VRM FIGO stage IB-IIA cervical cancer between 2003 and 2015. Concurrent platinum-based chemotherapy was administered to all patients. Results: The median whole pelvis EBRT dose was 50.4 Gy (range, 45 to 50.4 Gy). In the VB, the median dose per fraction, number of fractions, and total dose delivered were: 4 Gy (range, 3.0 to 4.0 Gy), 4 fractions (range, 3 to 5 fractions), and 16 Gy (range, 12 to 20 Gy), respectively. At a median follow-up of 46 months (range, 9 to 122 months), local recurrence was observed in 2 patients, and distant metastasis was present in 7 patients. All patients with local recurrence subsequently developed distant metastases. The 5-year local control, disease-free survival, and overall survival rates were 89.1%, 65.9%, and 62.9%, respectively. Of the 21 patients, 7 patients (33.3%) reported grade 2 acute toxicity; however, there were no grade 3 or higher acute adverse events. Grade 1-2 late toxicities were observed in 8 patients. Late grade 3 urinary toxicity was reported in 1 patient. Conclusions: Adjuvant EBRT and VB showed excellent local control and low toxicity in cervical cancer patients with positive VRM. Although limited by its retrospective nature, the findings from our study provide evidence supporting the use of additional VB in pathologically involved VRM.

A Case of Intradiscal Oxygen-ozone Injection Therapy for Cervical Herniated Intervertebral Disc in a Dog (개에서 탈출된 경추디스크에 대한 디스크내 오존가스 주입 치료)

  • Jang, Ha-Young;Lee, Jun-Sub;Lee, Bo-Ra;Kim, Kyung-Hee;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
    • /
    • v.26 no.3
    • /
    • pp.273-275
    • /
    • 2009
  • A 6-year-old castrated male Shih-tzu was presented because of a 1-month history of progressive tetraplegia. On the basis of the findings of neurological examination, radiographs and magnetic resonance imaging, herniated intervertebral disc of C4-C5, C5-C6 and C6-C7 compressed spinal cord. The oxygen-ozone was intra-operatively injected into the C4-C5 and C6-C7 intervertebral disc and a ventral decompression performed at C5-C6 intervertebral space. Immediately after the surgery, neck pain was disappeared and three weeks after surgery, there was complete resolution of the neurological deficits with normal gaits. On magnetic resonance images at 2-month after surgery, herniated disc materials of C5-C6 and C6-C7 were completely removed and that of C4-C5 remarkably reduced. Consequently decompression which was performed at all of the three lesions resulted in good clinical outcome without additional internal fixation for minimizing postoperative instability.

Immunogenicity of staphylococcal enterotoxin C mutant antigen in mice and dairy cows (포도상구균 장내 C 형 변이독소 (SEC mutant)의 면역원성에 대한 연구)

  • Chang, Byoung-sun;Joo, Yi-seok;Moon, Jin-san;Seo, Keun-seok;Yang, Soo-jin;Kim, So-hyun;Park, Yong-ho
    • Korean Journal of Veterinary Research
    • /
    • v.41 no.2
    • /
    • pp.177-188
    • /
    • 2001
  • Mastitis is one of the most significant cause of economic loss to the dairy industry. Especially, Staphylococcus aureus is a major contagious mastitis-causing pathogen in dairy cattle. Because of its high transmission rate and resistance to antibiotic therapy, staphylococcal mastitis presents a constant threat to the dairy industry. Staphylococcal enterotoxin C(SEC) produced by S aureus has been known as one of superantigens which are able to stimulate a large proportion of T lymphocytes independently of their antigenic specificity. In this experiment, we have conducted preliminary studies with mice and lactating cows to evaluate the immunogenicity and safety of the experimental vaccine consists of SEC mutant antigen on controlling the bovine mastitis associated with S aureus infections. The average value of somatic cell counts in quarter milk, isolation rate of S aureus were consistently decreased in SEC-SER vaccinated groups, whereas antibody titers were highly increased in SEC-SER vaccinated groups. Peripheral blood were also collected from the lactating cows to determine the proportion of leukocyte subpopulation associated with humoral immunity(HI) and cell mediated immunity(CMI). Proportion of leukocyte subpopulation expressing $BoCD2^+$(total T lymphocyte), $BoCD4^+$(T helper cell), $BoCD8^+$(T cytotoxic/suppressor cell) and NonT/NonB lymphocyte which are involved in CMI in SEC-SER vaccinated groups were decreased for the initial stage after first vaccination and then increased from ten weeks after first vaccination maintaining elevated level till 14 weeks after vaccination. In contrast, proportion of monocyte, MHC class II and B lymphocyte which are associated with the production of primary immune response in SEC-SER vaccinated groups were increased for the initial period and then decreased from ten weeks after first vaccination. We present evidence that vaccination of SEC-SER mutant antigen in lactating cows induced a significant proliferation of bovine T lymphocytes. These results suggest that SEC-SER mutant antigen used in this experiment might be one of potential immunogen in developing innovative vaccine against bovine IMI associated with S aureus. Additional challenge trials should be carried out to evaluate substantial protection against S aureus under the commercial farm conditions.

  • PDF

Effects of Acupuncture at the River Points(LU8, HT4, PC5, SP5, KI7, LR4) on the Changes of Nitric Oxide Synthase and Norepinephrine in Rats (백서(白鼠)의 경혈(經穴)(LU8, SP5, HT4, KI7, PC5, LR4) 침자(針刺)가 Nitric Oxide Synthase 및 Norepinephrine의 변화에 미치는 영향(影響))

  • Kim, Youngsun;Choi, Donghee;Jang, Hosun;Na, Changsu;Shin, Heontae;Cho, Joohyun;Lee, Kyoungin;Kim, Sunmin;Pyo, Byoungsik;Youn, Daehwan
    • Korean Journal of Acupuncture
    • /
    • v.30 no.1
    • /
    • pp.37-46
    • /
    • 2013
  • Objectives : The Meridians and acupuncture points are the fundamental theories for acupuncture therapy. They have been associated with nervous system, but It is not well defined. We investigated that the effects of acupuncture at the river points(LU8, HT4, PC5, SP5, KI7, LR4) on the changes in the expression of nNOS, iNOS, eNOS, and NE in rats. Methods : The Male Sprague-Dawley rats were divided into 6 groups each non-acupuncture and acupuncture group. We inserted needle and retained for 5 minutes on both left and right sides of LU8, HT4, PC5, SP5, KI7, LR4 which were the river points of five transport points for 6 yin meridian vessels. After that, blood was drawn via cardiac puncture, and tissues for each point near meridian vessels were extracted to examine the changes in the changes of nNOS, eNOS, iNOS and NE. Results : The LU8 and HT4 group showed a significant decrease on nNOS. In terms of eNOS and iNOS, the LU8 group decreased significantly while the KI7 group increased significantly. However, the experimental groups didn't show any significant changes on the plasma and tissue norepinephrine without plama NE in SP5 group. Conclusions : The effect on the nNOS, iNOS, eNOS of acupuncture at LU8 and KI7 could be observed, and it is considered that the effect of acupuncture related with on nervous system could be studied by additional researches based on this one.

Regulation of Pipernonaline on Biological Functions of Human Prostate Cancer Cells Based on Microarray Analysis (Microarray를 이용한 pipernonaline의 인간 전립선 암세포에 대한 기능 조절 분석)

  • Kim, Sang-Hun;Kim, Kwang-Youn;Yu, Sun-Nyoung;Park, Seul-Ki;Kwak, In-Seok;Rhee, Moon-Soo;Bang, Byung-Ho;Chun, Sung-Sik;Ahn, Soon-Cheol
    • Journal of Life Science
    • /
    • v.22 no.11
    • /
    • pp.1552-1557
    • /
    • 2012
  • It has been reported that pipernonaline isolated from Piper longum Linn. has a wide biochemical and pharmacological effect, including antitumor activity in prostate cancer PC-3 cells. However, its mechanism and expression pattern of many genes involved in biological functions are not clearly understood. To perform the gene expression study in PC-3 cells treated with pipernonaline, a cDNA microarray chip composed of 44,000 human cDNA probes was used. As a result, cell cycle-related genes, apoptosis-related genes, and cell proliferation/growth-related genes have been identified in gene ontology of the DAVID database. These results suggest that pipernonaline has antitumor activity by regulating the expression pattern of genes involved in biological signaling pathway in prostate cancer PC-3 cells. Further, additional analysis of these microarray data can be a useful tool to identify the mechanism and discovery of novel genes in cancer therapy.

Effects of Regional Hyperthermia with Moderate Temperature on Cancer Treatment (국부 중등도 온열요법의 암치료 효과)

  • Kang, Chi-Dug;Kim, Sun-Hee
    • Journal of Life Science
    • /
    • v.26 no.9
    • /
    • pp.1088-1096
    • /
    • 2016
  • Despite that moderate hyperthermia can exert various antitumor activities such as direct cytotoxic effects on tumor cells, effects on tumor vasculatures and immunological effects, hyperthermia has been usually combined with radiotherapy or chemotherapy due to its limited efficacy in cancer treatment, showing some positive clinical benefits with generally well-tolerated side effects. Since heat shock responses itself can interfere with the anti-tumor effects of hyperthermia, not all of these studies might have demonstrated positive clinical outcomes in cancer patients. Therefore, the negative anti-tumor effect of hyperthermia should be reduced to enhance the effectiveness of hyperthermia. Although the responses to heat stress of tumor tissues containing vessels, immune cells, connective tissues as well as cancer cells, are very complicated, it is needed to study in the near future if some clinically available drugs, which can modulate heat stress responses, can improve the efficacy of hyperthermia in patients with cancer. In this review, the effect of clinical hyperthermia centered on non-invasive external hyperthermia using radiofrequency at moderate temperature will be discussed, since it is the state-of-the-art technology in the current clinical practice of hyperthermia, and a moderate operational temperature is used to increase the therapeutic effectiveness of conventional therapy without additional toxicity to normal tissues.