• 제목/요약/키워드: clinical treatment

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녹내장치료에 있어서 Tafluprost와 Latanoprost의 경제성평가 (Pharmacoeconomic Analysis of Tafluprost compared with Latanoprost on the Treatment of Primary open Angle Glaucoma or Ocular Hypertension in Korea)

  • 강숙현;송현진;허지행;이의경
    • 한국임상약학회지
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    • 제20권3호
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    • pp.278-287
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    • 2010
  • The main objective of this study is to evaluate the cost-effectiveness of tafluprost compared with latanoprost in primry open Angle Glaucoma (POAG) or ocular hypertension OH patients in Korea. A decision analytic model was developed from a societal perspective to estimate clinical outcome, drug cost and glaucoma related cost. The model assumes branch like following: successful treatment, switching to other drug, adding other drug, laser or surgery. Treatment success rate is defined as the percentage of patients with elevated IOP achieving <20% reduction, and discontinuation rate is the percentage of patients who were withdrawn due to severe adverse events. A model that is comprised of 1 month cycle length has 1 year. Treatment success rate and discontinuation rate were obtained from published literatures searched in database. Resource utilizations and costs were calculated with national health insurance data and clinical expert opinions. Sensitivity analyses were performed on crucial parameters. Tafluprost is less costly than latanoprost, $609.0 vs $651.2 expected cost. Thus tafluprost was shown to be dominant compared with latanoprost. The results of sensitivity analysis revealed stable across most of the included parameters. According to this study, tafluprost shows more clinical outcome for 1 year than latanoprost. In addition, first-line treatment of tafluprost is a more cost-minimizing strategy associated with POAG or OH compared with latanoprost.

소아 간 혈관내피종 : 17년간의 치료경험 (Infantile Hepatic Hemangioendothelioma: Seventeen Years of Experience at a Single Center)

  • 권형주;문석배;박귀원;정성은
    • Advances in pediatric surgery
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    • 제14권2호
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    • pp.134-143
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    • 2008
  • Infantile hepatic hemangioendothelioma (IHHE) is the most common benign vascular hepatic tumor in children. We analyzed the 17-year experience of IHHE. The medical records of 16 patients (M:F=8:8) treated at the Department of Pediatric Surgery and the Department of Pediatrics Seoul National University Children's Hospital between January 1991 and January 2008 were reviewed retrospectively. Mean age at presentation was 87 days (1 day - 551 days). Seventy five percent of patients were diagnosed with imaging study and 25 % with biopsy. Major symptoms were hepatomegaly (N=5), palpable abdominal mass (N=4) and congestive heart failure (N=3). Six patients had no symptoms. Kasabach-Merritt syndrome was combined in one patient. Nine patients (56.3 %) underwent operation and 2 patients (12.5 %) underwent only medical treatment. Clinical observation was tried on 5 patients (31.3 %) without any treatment. Operation was performed on the patient with clinical symptoms or on patients where the differentiation between begin and malignant could not be determined. Patients who had clinical symptoms but tumor was unreresectabile were treated medically. Among the 5 patients who had been observed for their clinical course, 2 patients showed complete regression and the tumors of the remaining 3 patients were regressing. Clinical symptoms, the age at presentation, the size of tumor and ${\alpha}$-FP, all had no significant statistical relationship with the time required for complete tumor regression. There was no relationship between the size change of the tumor and the change of ${\alpha}$-FP level. Only the size of tumor was related with clinical symptoms. One patient died of post-operatvie bleeding. Treatment plan was determined by the extent of the tumor and the presence of clinical symptoms. Observation was enough for the patients without clinical symptoms and complete resection was curative for patients with clinical symptoms. Medical treatment is an alternative for the patient whose tumor is unresectable.

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양 하지 불편감을 호소하는 교뇌 경색 환자에 대한 한의 치험 1례 (A Case of a Patient with Pontine Infarction Complaining of Discomfort in Both Legs)

  • 이혜진;황예채;임태빈;김서영;조승연;박정미;고창남;박성욱
    • 대한한방내과학회지
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    • 제42권5호
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    • pp.991-1000
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    • 2021
  • Objective: This study examined the effectiveness of Korean medical treatment for an 81-year-old female patient with pontine infarction complaining of discomfort in both legs. Methods: The patient was hospitalized for 45 days and treated with herbal medicine (mainly Bohyulanshin-tang [補血安神湯], pharmacopuncture, acupuncture, electroacupuncture, and moxibustion). We used the International Restless Legs Scale (IRLS) and Numerical Rating Scale (NRS) and checked the duration of the symptoms to evaluate the clinical effects of the treatment. Results: After 45 days of hospitalization, the IRLS score decreased from 33 to 19, with the lowest score of 8 recorded on the twenty-seventh day after discharge. The NRS score and the duration of symptoms also improved, and the treatment effect continued following discharge. Conclusions: This study suggests that Korean medical treatment may be effective for the treatment of restless legs.

Neuroimaging in Randomized, Multi-Center Clinical Trials of Endovascular Treatment for Acute Ischemic Stroke: A Systematic Review

  • Chong Hyun Suh;Seung Chai Jung;Byungjun Kim;Se Jin Cho;Dong-Cheol Woo;Woo Yong Oh;Jong Gu Lee;Kyung Won Kim
    • Korean Journal of Radiology
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    • 제21권1호
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    • pp.42-57
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    • 2020
  • Appropriate use and analysis of neuroimaging techniques is an inevitable aspect of clinical trials for patients with acute ischemic stroke. Neuroimaging examinations were recently used to define the core eligibility criteria and outcomes in acute ischemic stroke research. Recent clinical trials for endovascular treatment in acute ischemic stroke have also demonstrated the efficacy or safety of endovascular treatment using various imaging modalities as well as clinical indices. Furthermore, independent imaging reviews and imaging core laboratory assessments are essential to manage and analyze imaging data in order to enhance the reliability of the outcomes. Therefore, we systematically reviewed the use of neuroimaging in recent randomized clinical trials for endovascular treatment of acute ischemic stroke in order to provide a thorough summary, which would serve as a resource guiding the use of appropriate imaging protocols and analyses in future clinical trials for acute ischemic stroke. This review will help researchers select appropriate imaging biomarkers among the various imaging protocols available and apply the selected type of imaging examination for each study in accordance with the academic purpose.

양.한방 협진 의료서비스 최적화를 위한 Clinical Pathway 도입과 진료패턴 분석 (Development of Clinical Pathway and Analysis of Clinical Patterns for Optimizing the Integrative Medical Service)

  • 오가은;박원숙;양형인;한상숙;유명철;박상찬;이상철
    • 대한한의진단학회지
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    • 제16권2호
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    • pp.23-32
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    • 2012
  • Objectives : The purpose of this research is to develop the clinical pathway for optimizing the integrative medical service (oriental-western integrated medical service) and to analyze the clinical pattern of the integrative patients who received the oriental-western integrated medical service. Methods : This research developed the clinical pathway by interviewing with doctors, nursing and experts at K Medical Center. To analyze the clinical patterns, this research used 860 integrative patients and 6345 non-integrative patients at K Medical Center since 2007. Results and Conclusions : 1. We developed the clinical pathway for optimizing the integrative medical service. 2. Comparing the clinical pattern of the integrative patients with the non-integrative patients, the results indicated that the interval and frequency of the integrative patients is shorter than that of the non-integrative patients. 3. Comparing the medical treatment type, the integrated patients take much more medical care and more frequently participate in medical treatment. 4. In conclusion, it is different that the clinical pathway of the integrative medical service from the non-integrative medical service and the integrative medical treatment is more effective than the non-integrative medical treatment.

한약 치료를 시행한 재발성 아프타성 구내염 환자의 임상소견에 관한 추적 관찰 연구 (A Follow-up Study of Clinical Characteristics of Recurrent Aphthous Stomatitis Patients Treated with Herbal Medicine)

  • 하나연;이재형;이정은;남성욱;고휘형;황미니;김진성
    • 대한한방내과학회지
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    • 제38권5호
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    • pp.812-819
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    • 2017
  • Objectives: The purpose of this study was to report the long-term efficacy of herbal medicine for treatment of patients with recurrent aphthous stomatitis (RAS). Methods: We reviewed the clinical records of 17 patients with RAS who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from September 1st, 2014 to August 29th, 2017. The patients were treated with herbal medicine for more than 3 consecutive weeks, followed by a telephone survey. We evaluated the clinical characteristics of RAS, and compared the short-term and long-term efficacy of herbal medicine treatment. Results: After treatment with herbal medicine, the clinical characteristics improved in the 17 patients with RAS, especially in terms of the duration and interval of recurrence. Prolonged effects were reported upon the follow-up telephone survey. Conclusion: Herbal medicine treatment may have a long-term effect in patients with RAS.

침구 임상시험에서의 중도탈락 관련요인 (Factors Related to Dropout in Clinical Trials of Acupuncture and Moxibustion)

  • 김애란;이무식;홍지영
    • 대한한의학회지
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    • 제32권4호
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    • pp.128-138
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    • 2011
  • Objective: This study aimed at providing preliminary data useful in reducing participant dropout and improving the quality of clinical trials, by analyzing the factors related to dropout. Methods: The data came from 15 acupuncture and/or moxibustion clinical trials (n=638; August 2005 to December 2009). Logistic regression analysis was used to reveal factors influencing participant dropout. Results: Gender, age, treatment method (intervention), treatment frequency, availability of follow-up, and presence of compensation treatment for the control group were factors influencing participant dropout. Conclusion: Subsequent studies of large-scale acupuncture and moxibustion clinical trials should address dropout factors that consider the character of each clinical trial, or general characters like participants' gender, age, occupation, and diverse diseases.

폐경기 이후 여성의 슬통 양상과 뜸시술에 관한 설문 (Clinical Features of Knee Pain of Female after Menopausal and Survey Method for Moxibustion Treatment)

  • 강미숙
    • Journal of Acupuncture Research
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    • 제30권5호
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    • pp.169-174
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    • 2013
  • Objectives : This study was accomplished to find out clinical features of knee pain of female after menopausal and their recognition of moxibustion treatment. Methods : Before and after 8 times moxibustion treatment(mostly 2 times a weak), survey was done. Moxibustion treatment was done on painful location, 3 times per each point. Results & Conclusions : Other symptom with Knee pain was Click 30.8 %, stiffness 25.6 %, press pain 16.7 %, swelling 14.1 %, fever 5.1 %, none 7.7 %. VAS of moxibustion treatment is significantly increased after treatment. Expectation of moxibustion treatmen is not. "Bad smell" is the first cause of evasion of moxibustion therapy. It should have been considered to reduce bad smell in development of moxibustion.

뫼비우스 증후군 - 발병기전, 임상양상, 진단 및 치료 - (Moebius syndrome - About Pathogenesis, Clinical manifestations, Diagnosis, and Treatment of Moebius -)

  • 유승호
    • 대한융합한의학회지
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    • 제1권1호
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    • pp.5-15
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    • 2021
  • Objectives: To review the concept of Moebius syndrome. Methods: Literature search was done to study definition, epidemiology, pathophysiology, clinical feature, and treatment of Moebius syndrome. Pubmed, RISS, Google scholarship and uptodate scholastic were used in the research. Search words were 'Moebius syndrome', 'treatment of Moebius syndrome'. Only English and Korean studies were assessed. Results: Moebius syndrome is rare disease characterized by nonprogressive congenital uni- or bi-lateral facial (VII cranial nerve) and abducens (VI cranial nerve) palsy. This facial palsy is found across the world, and its incidence is approximately 1 per 250,000. Moebius is diagnosed by clinical features. Facial palsy, eye abduction problem, limb deformities, global cerebral nerve impairment can be shown. Rehabilitation, smile surgery, and acupuncture can be used to treat this. Conclusion: Moebius syndrome's epidemiology, pathogenesis, treatment is still not fully revealed. It is known to be a congenital disease which didn't have exact treatment except surgery. But, it needs further study about exact treatment, diagnosis, and pathogenesis.