• 제목/요약/키워드: clinical treatment

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Survival Analysis and Prognostic Factors for Colorectal Cancer Patients in Malaysia

  • Hassan, Muhammad Radzi Abu;Suan, Mohd Azri Mohd;Soelar, Shahrul Aiman;Mohammed, Noor Syahireen;Ismail, Ibtisam;Ahmad, Faizah
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3575-3581
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    • 2016
  • Background: Cancer survival analysis is an essential indicator for effective early detection and improvements in cancer treatment. This study was undertaken to document colorectal cancer survival and associated prognostic factors in Malaysians. Materials and Methods: All data were retrieved from the National Cancer Patient Registry-Colorectal Cancer. Only cases with confirmed diagnosis through histology between the year 2008 and 2009 were included. Retrieved data include socio-demographic information, pathological features and treatment received. Survival curves were plotted using the Kaplan-Meier method. Univariate analysis of all variables was then made using the Log-rank test. All significant factors that influenced survival of patients were further analysed in a multivariate analysis using Cox' regression. Results: Total of 1,214 patients were included in the study. The overall 3- and 5-year survival rates were 59.1% and 48.7%, respectively. Patients with localized tumours had better prognosis compared to those with advanced stage cancer. In univariate analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p=0.001) were found to be predictors of survival. None of the socio-demographic characteristics were found to exert any influence. In Cox regression analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p<0.001) were determined as independent prognostic factors of survival after adjusted for age, gender and ethnicity. Conclusions: The overall survival rate for colorectal cancer patients in Malaysia is similar to those in other Asian countries, with staging at diagnosis, primary tumor size, involvement of lymph node and treatment modalities having significant effects. More efforts are needed to improve national survival rates in future.

Clinical Outcomes of Spontaneous Spinal Epidural Hematoma : A Comparative Study between Conservative and Surgical Treatment

  • Kim, Tackeun;Lee, Chang-Hyun;Hyun, Seung-Jae;Yoon, Sang Hoon;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • 제52권6호
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    • pp.523-527
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    • 2012
  • Objective : The incidence of spontaneous spinal epidural hematoma (SSEH) is rare. Patients with SSEH, however, present disabling neurologic deficits. Clinical outcomes are variable among patients. To evaluate the adequate treatment method according to initial patients' neurological status and clinical outcome with comparison of variables affecting the clinical outcome. Methods : We included 15 patients suffered from SSEH. Patients were divided into two groups by treatment method. Initial neurological status and clinical outcomes were assessed by the American Spinal Injury Association (ASIA) impairment scale. Also sagittal hematoma location and length of involved segment was analyzed with magnetic resonance images. Other factors such as age, sex, premorbid medication and duration of hospital stay were reviewed with medical records. Nonparametric statistical analysis and subgroup analysis were performed to overcome small sample size. Results : Among fifteen patients, ten patients underwent decompressive surgery, and remaining five were treated with conservative therapy. Patients showed no different initial neurologic status between treatment groups. Initial neurologic status was strongly associated with neurological recovery (p=0.030). Factors that did not seem to affect clinical outcomes included : age, sex, length of the involved spinal segment, sagittal location of hematoma, premorbid medication of antiplatelets or anticoagulants, and treatment methods. Conclusion : For the management of SSEH, early decompressive surgery is usually recommended. However, conservative management can also be feasible in selective patients who present neurologic status as ASIA scale E or in whom early recovery of function has initiated with ASIA scale C or D.

Differences in Colistin-resistant Acinetobacter baumannii Clinical Isolates Between Patients With and Without Prior Colistin Treatment

  • Park, Yu Jin;Hong, Duck Jin;Yoon, Eun-Jeong;Kim, Dokyun;Choi, Min Hyuk;Hong, Jun Sung;Lee, Hyukmin;Yong, Dongeun;Jeong, Seok Hoon
    • Annals of Laboratory Medicine
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    • 제38권6호
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    • pp.545-554
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    • 2018
  • Background: The increasing morbidity and mortality rates associated with Acinetobacter baumannii are due to the emergence of drug resistance and the limited treatment options. We compared characteristics of colistin-resistant Acinetobacter baumannii (CR-AB) clinical isolates recovered from patients with and without prior colistin treatment. We assessed whether prior colistin treatment affects the resistance mechanism of CR-AB isolates, mortality rates, and clinical characteristics. Additionally, a proper method for identifying CR-AB was determined. Methods: We collected 36 non-duplicate CR-AB clinical isolates resistant to colistin. Antimicrobial susceptibility testing, Sanger sequencing analysis, molecular typing, lipid A structure analysis, and in vitro synergy testing were performed. Eleven colistin-susceptible AB isolates were used as controls. Results: Despite no differences in clinical characteristics between patients with and without prior colistin treatment, resistance-causing genetic mutations were more frequent in isolates from colistin-treated patients. Distinct mutations were overlooked via the Sanger sequencing method, perhaps because of a masking effect by the colistin-susceptible AB subpopulation of CR-AB isolates lacking genetic mutations. However, modified lipid A analysis revealed colistin resistance peaks, despite the population heterogeneity, and peak levels were significantly different between the groups. Conclusions: Although prior colistin use did not induce clinical or susceptibility differences, we demonstrated that identification of CR-AB by sequencing is insufficient. We propose that population heterogeneity has a masking effect, especially in colistin non-treated patients; therefore, accurate testing methods reflecting physiological alterations of the bacteria, such as phosphoethanolamine-modified lipid A identification by matrix-assisted laser desorption ionization-time of flight, should be employed.

사경증 환자의 한방 치험 1례 (A Case of Torticollis with Korean Medicine)

  • 김정화;이형민;김연진;이보윤;조승연;박정미;고창남;박성욱
    • 대한중풍순환신경학회지
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    • 제17권1호
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    • pp.15-22
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    • 2016
  • ■ Objectives This clinical report is to report the effect of Korean medicine on a patient with torticollis. ■ Methods We used herbal medicine, acupuncture, moxibustion, pharmaco-acupuncture and bee venom acupuncture to treat a torticollis patient during hospitalization and out patient department (OPD) treatment for 3months. We observed the changes of symptoms using Toronto Western Spasmodic torticollis Scale (TWSTRS). ■ Results After treatment, the patient's symptoms including torticollis, pain and the general condition were improved. The TWSTRS scores were also improved after treatment. ■ Conclusion This clinical case study suggests that Korean medicine treatment could be effective in the treatment of torticollis.

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만성 전립선염에 대한 국내 한의학 임상 논문 경향 분석 (A Review of Domestic Research on Traditional Korean Medicine for Chronic Prostatitis in Clinical Research Papers)

  • 이지윤;조온유;박상민;최새롬;신재욱;백지훈;이은지
    • 대한한방내과학회지
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    • 제44권6호
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    • pp.1150-1175
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    • 2023
  • Objectives: This study was conducted to examine the current status of traditional Korean medicine studies on chronic prostatitis in Korea, identify deficiencies, and suggest future medicine research methods to lay the foundation for traditional Korean medicine treatment. Methods: All domestic clinical research papers on the traditional Korean treatment of chronic prostatitis were selected from the literature published until October 2023 in three domestic databases. A total of 13 selected research data were classified into clinical research papers. Results: In clinical research papers, the basis for the diagnosis of cases was clinical symptoms through medical history listening and diagnosis through past visits to hospitals. The average treatment period was 7 weeks, and the duration of treatment was not significantly affected by the duration of the disease. The most widely used Korean medicine treatment intervention was herbal medicine. Conclusions: This study included all domestic clinical research papers on chronic prostatitis to identify research trends in the Korean oriental medicine community. Based on this, it is meaningful to confirm areas that need to be supplemented in future research plans.

성조숙증 소아 대상 중재 임상시험의 등록 현황 보고 -Clinicaltrial.gov, WHO ICTPR, CRIS를 중심으로- (The Current State of Registration of Interventional Clinical Trials for Children and Adolescents with Precocious Puberty)

  • 심수보;서현식;이현희;이혜림
    • 대한한방소아과학회지
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    • 제36권3호
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    • pp.1-18
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    • 2022
  • Objectives The purpose of this study was to investigate the current status of interventional clinical trial registration for children with precocious puberty and to secure basic data for the design of clinical trials for traditional Korean medicine treatment of precocious puberty. Methods The following resources were used to search for data: Clinicaltrial.gov, World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), and Clinical Research Information Service (CRIS), using the search terms, 'Precocious puberty', 'child'. All clinical trials which were registered as of June 2022 were used. Results For the intervention and clinical trial design, gonadotropin releasing hormone (GnRH) analog was reported in 41.7% of trials, and single group assignment was performed in 66.7% of the studies. Prior consent had not been reported in 50% of the studies. Tanner stage and GnRH stimulation tests were reported by multiple trials as inclusion criteria, and prior treatment experiences for trial drugs were reported as exclusion criteria. The peak serum concentration of luteinizing hormone following GnRH stimulation test was used as a primary outcome in 45.8% of clinical trials, and other growth-related indicators such as growth rate, height, and predicted adult height were also reported. Conclusions In consideration of the design, eligibility criteria, and outcome measurement of the existing clinical trials identified in this study, it should be referred to in the design of clinical trials for traditional Korean medicine treatment of precocious puberty.

A Review of Acupuncture Treatment for Infertility

  • Chun, Hea sun;Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • 제38권4호
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    • pp.257-264
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    • 2021
  • The purpose of this study was to analyze acupuncture treatment methods and acupoint used to treat infertility in the last decade. The data were retrieved from 2010.1 to 2021.8. using national and international electronic databases (PubMed, EMBASE, OASIS, NDSL, and KISS). "Infertility," "sterility," "acupuncture," "electroacupuncture," "bloodletting," "pharmacopuncture," were used as search terms. All studies were mainly concerned with acupuncture treatment of infertility, but the studies which were not related included; (1) infertility or acupuncture treatment; (2) animal studies; (3) review/meta/protocol or clinical study; comparative studies and case reports which were excluded from this review. Only clinical trials for acupuncture treatment of infertility were included in this review (n = 18). For infertility treatment studies using acupuncture, polycystic ovarian syndrome was the main cause of infertility, the most common acupoint used was CV4, CV3, CV6, SP6, BL23, and the treatment effect significantly improved in the group receiving acupuncture treatment compared with the control group, or the group taking Western medicine alone. In some studies, the group using acupuncture treatment did not show side effects. Acupuncture is an effective treatment for infertility.

근위축측삭경화증에 대한 치료약물 임상시험 현황 (Update of Therapeutic Clinical Trials for Amyotrophic Lateral Sclerosis)

  • 김남희;이민오
    • Annals of Clinical Neurophysiology
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    • 제17권1호
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    • pp.1-16
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    • 2015
  • Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that is characterized by progressive death of motor neurons in the cortex, brainstem, and spinal cord. Until now, many treatment strategies have been tested in ALS, but so far only Riluzole has shown efficacy of slightly slowing disease progression. The pathophysiological mechanisms underlying ALS are multifactorial, with a complex interaction between genetic factors and molecular pathways. Other motor neuron disease such as spinal muscular atrophy (SMA) and spinobulbar muscular atrophy (SBMA) are also progressive neurodegenerative disease with loss of motor neuron as ALS. This common thread of motor neuron loss has provided a target for the development of therapies for these motor neuron diseases. A better understanding of these pathogenic mechanisms and the potential pathological relationship between the various cellular processes have suggested novel therapeutic approaches, including stem cell and genetics-based strategies, providing hope for feasible treatment of ALS.

한방요법으로 호전된 수술이 지연된 마미 증후군 환자의 증례보고 (A Clinical Case Study of Operation-delayed Cauda Equina Syndrome Patient Improved by Korean Traditional Treatment)

  • 정해창;정수현
    • 한방재활의학과학회지
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    • 제25권2호
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    • pp.181-187
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    • 2015
  • Objectives The objective of this study is to report clinical effect of korean traditional treatments for Operation-delayed Cauda Equina Syndrome patient. Methods The patient was treated by korean traditional treatments including acupuncture, physical treatment, herbal medication. The improvement of the clinical symptoms was observed by Modified Visual analog scale (Modified VAS), SSCES (Scoring System for Cauda Equina Syndrome), function of urination and function of defecation. Results After treatments, Modified VAS, SSCES, function of urination and function of defecation were improved in this case. Conclusions On the basis of these results, we suggest that korean traditional treatment might be an effective method to improve the clinical symptoms of Operation-delayed Cauda Equina Syndrome patient.

갑상선기능항진증(T3 중독증) 치험 1례에 대한 보고 (A clinical case report of Hyperthyroidism(T3 toxicosis) patient)

  • 이주호;최정식;조충식;김철중
    • 혜화의학회지
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    • 제16권2호
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    • pp.225-228
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    • 2007
  • Objective : This study was designed to evaluate oriental medicine therapy on a hyperthyroidism(T3 toxicosis) patient Methods : The clinical data was analyzed on a patient with hyperthiroidism(T3 toxicosis). This patient was treated with oriental medicine therapy only. After treatment, we analyzed a paient clinical symptom and thyroid function(T3, free T4, TSH) Results : After treatment, improvement was seen in clinical symptom, thyroid function test. conclusion : The study suggests that oriental medicine therapy is effective on the treatment of hyperthyroidism(T3 toxicosis).

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