• Title/Summary/Keyword: individualized treatment

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CEPHALOMETRIC AND NASOPHARYNGEAL ENDOSCOPIC STUDY IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA (폐쇄성 수면 무호흡증 환자에 있어서 두부방사선 계측 분석 및 인후 내시경적 연구)

  • Choi, Jin-Young;Engelke, W.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.2
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    • pp.149-165
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    • 1999
  • The pathomechanism of obstructive sleep apnea(OSA) is not clearly elucidated. The possible mechanisms are pathologic reduction of pharyngeal muscular tonus during sleep, abnormal anatomical stenosis of nasopharyx or a combination of the above two mechanisms. It is very important to find the cause(anatomical location or pathologic dynamic change) of OSA in order to treat it. Cephalometric analysis in patients with obstructive sleep apnea is a good method for evaluating anatomical morphologic change but it cannot give any information about the dynamic changes occurring during sleep. On the contrary, nasopharyngeal endoscopy offer 3 dimensional image and information about the dynamic changes. Accordingly, these two diagnostic tools can be utilize in the diagnosis and treatment planning of OSA Cephalometric analysis of craniofacial skeletal and soft tissue morphology in 53 patients with OSA and 43 controls was performed and cephalometric analysis and nasopharygeal endoscopy were performed in 9 patients with OSA in order to come up with individualized therapy plans. Following results were obtained ; Patients with OSA showed 1. body weight gain 2. clockwise mandibular rotation 3. increased anterior lower facial height 4. inferiorly positioned hyoid bone 5. increased length of soft palate 6. decreased sagittal dimension of nasopharyx 7. increased vertical length of inferior collapsable nasopharyx 8. increased length of tongue Through cephalometric analysis and nasopharygeal endoscopy(mutually cooperative in diagnosis), 9. one can find the possible origin of OSA and make a adequate individualized therapy plan and predict accurate prognosis. Cephalometric analysis and nasopharygeal endoscopy are highly recommended as a diagnostic aid in OSA patients

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Individualized Acupuncture versus Standardized Acupuncture in Symptomatic Treatment of Osteoarthritis of the Knee-a Randomized Controlled Trial (ISRCTN 40706107) (퇴행성 슬관절염에 대한 맞춤형 침 치료 효과 검증 무작위 대조군 임상연구(RCT) (ISRCTN 40706107))

  • Byun, Hyuk;Kim, Sun-Woong;Ahn, Ji-Hyun;Kim, Yong-Suk;Seo, Jung-Chul;Choi, Sun-Mi;Park, Ji-Eun;K., Kawakita;N., Takahashi;E., Sumiya;Lee, Seung-Deok
    • Journal of Acupuncture Research
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    • v.24 no.4
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    • pp.183-195
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    • 2007
  • Objectives : To determine whether individualized acupuncture (IA) provides greater pain relief and improved function compared with standardized acupuncture (SA) in patients with osteoarthritis of the knee. Methods: Design is a randomized single blind controlled trial with two intervention arms (IA vs SA) of 6 weeks' duration and 3 months follow up. An orthopedist diagnosed 50 patients' symptoms as knee osteoarthritis. Interventions were applied by 2 residents studying the acupuncture and moxibustion specially in Dongguk University International Hospital. Primary outcome measure is pain as measured by visual analogue scale (VAS). Secondary measures of pain and disability include WOMAC, SF-36, LFI and KHAQ. Results : The 50 participants were well matched for age, sex, bad side, VAS, WOMAC, SF-36, LFI and KHAQ scores at the baseline. 3 participants dropped out. There have not been any adverse events in both groups. Participants in both groups experienced great improvement in all measures except SF-36at 3 and 6 weeks. At 18 weeks, the IA group experienced significantly greater improvement than the SA group in VAS but not in WOMAC, SF-36, LFI and KHAQ. Conclusions : Manipulation of IA seems to provide pain relief longer for osteoarthritis of the knee when compared with SA.

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Characterization of dental phenotypes and treatment modalities in Korean patients with Parry-Romberg syndrome

  • Yim, Sunjin;Yang, Il-Hyung;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.50 no.6
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    • pp.407-417
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    • 2020
  • Objective: To investigate the dental phenotypes and treatment modalities (Tx-Mod) in Korean patients with Parry-Romberg syndrome (PRS) using longitudinal data. Methods: The samples consisted of 10 PRS patients, who were treated and/or followed-up at Seoul National University Dental Hospital between 1998 and 2019. Using a novel PRS severity index based on the numbers of the atrophy-involved area and asymmetry-involved item, we classified them into mild (n = 3), moderate (n = 2), and severe (n = 5). Dental phenotypes, including congenitally missing tooth (Con-Missing-Tooth), microdontia, tooth with short root (Short-Root), tooth with dilacerated root, and delayed eruption/impacted tooth, were investigated along with Tx-Mod. Results: The side of occurrence of all dental phenotypes showed 100% concordance with the side of PRS involvement. The most two common dental phenotypes were Con-Missing-Tooth and Short-Root (n = 29 and n = 17 in six patients). The sums of the average number of Con-Missing-Tooth and Short-Root increased from mild PRS to moderate PRS and severe PRS cases (1.0, 6.0, and 6.2). In terms of Tx-Mod, growth observation due to mild atrophy, fixed orthodontic treatment, and grafting were used for mild PRS cases. Tx-Mod for moderate PRS cases involved growth observation for surgery due to an early age at the initial visit. For severe PRS cases, diverse Tx-Mod combinations including unilateral functional appliance, fixed orthodontic treatment, growth observation, grafting, and orthognathic surgery were used. Conclusions: The novel PRS severity index may be useful to provide primary data for individualized diagnosis and treatment planning for PRS patients.

Pharmacogenomics of Depressive Disorders (우울증의 약물유전체학)

  • Ham, Byung-Joo;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.8 no.2
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    • pp.226-232
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    • 2001
  • The pharmacotherapy of depression has reduced morbidity and improved outcome for many depressive patients. A wide range of classical and new antidepressants are available for their treatment. However, 30-40% of all patients do not respond sufficiently to the initial treatment and present adverse effects. Pharmacogenetics studies the genetic basis of an individual's ability to respond to pharmacotherapy. Recently, some reports on serotonin transporter gene polymorphisms and their influence on the response to antidepressive therapy provide an interesting diagnostic tool in assessing the chances of response to antidepressants. We also investigated the relationship between serotonin transprter polymorphisms(5-HTTLPR) and the long-term effect of the antidepressant treatment. 128 depressive patients were enrolled into 2nd year study. The therapeutic response of each subset was not different at 8th, 16th week, but the subset with homozygote(l/l) of long variant showed a better therapeutic response to antidepressant than the heterozygote(l/s) of long and short variant, which showed a better therapeutic response than the subset with homozygote (s/s) of short variant at 1st year and 2nd year after the antidepressant treatment. This result shows that the serotonin transporter polymorphisms may be related to the long-term effect of antidepressant treatment. The potential for pharmacogenomics, the use of genetic information to guide pharmacotherapy and improve outcome by providing individualized treatment decisions, has gained increasing attention. pharmacogenomics will contribute to individualize drug choice by using genotype to predict positive clinical outcomes, adverse reactions, and levels of drug metabolism. Personalized medicine, the use of marker-assisted diagnosis and targeted therapies derived from an individual molecular profile, will impact the antidepressant therapy and this approach will replace the traditional trial-and-error practice of medicine.

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Tomographic study of temporomandibular joints before orthodontic treatment (교정치료 전 환자의 측두하악관절에 관한 방사선학적 연구)

  • Kwon Ki-Jeong
    • Imaging Science in Dentistry
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    • v.31 no.4
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    • pp.193-197
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    • 2001
  • Purpose : To determine whether there is a relationship between abnormal temporomandibular joint radiographic findings and age or gender in a sample of preorthodontic patients. Materials and Methods : Individualized corrected sagittal tomographs of 188 temporomandibular joints in 94 preorthodontic patients, aged 11 to 29 years, were taken and viewed by an observer blinded to clinical records. The study population was divided into 2 aged groups (11-15 years and 16-29 years) for comparative purposes. Temporomandibular joint radiographic findings were classified as normal or abnormal. Results: There was no difference in ratio of abnormal to normal findings between the both aged groups. The frequency of osseous abnormalities was similar with that of abnormalities of condylar position. Abnormalities in CP and JS were most frequent in all aged groups. Conclusion : There is no significant difference between ages or genders for temporomandibular joint radiographic abnormalities.

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Management of the Sequelae of Severe Congenital Abdominal Wall Defects

  • Fuentes, Sara;Marti, Eunate;Delgado, Maria-Dolores;Gomez, Andres
    • Archives of Plastic Surgery
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    • v.43 no.3
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    • pp.258-264
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    • 2016
  • Background The survival rate of newborns with severe congenital abdominal wall defects has increased. After successfully addressing life-threatening complications, it is necessary to focus on the cosmetic and functional outcomes of the abdominal wall. Methods We performed a chart review of five cases treated in our institution. Results Five patients, ranging from seven to 18 years of age, underwent the following surgical approaches: simple approximation of the rectus abdominis fascia, the rectus abdominis sheath turnover flap, the placement of submuscular tissue expanders, mesh repair, or a combination of these techniques depending on the characteristics of each individual case. Conclusions Patients with severe congenital abdominal wall defects require individualized surgical treatment to address both the aesthetic and functional issues related to the sequelae of their defects.

Cause of Metatarsalgia (중족통의 원인)

  • Gwak, Heui Chul;Ha, Dong Jun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.3
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    • pp.79-82
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    • 2017
  • Metatarsalgia is one of the most common causes of patients complaining of pain in their feet. This pain is the plantar forefoot, including the second to fourth metatarsal heads and arises from either mechanical or iatrogenic causes. On the other hand, it is frequently accompanied by a deformity of the toes as well as of the first and fifth rays. The pain has a variety of causes, and sometimes the cause is difficult to distinguish. The variability of possible causative factors necessitates an individualized approach to treatment. To determine these causes, this paper presents an overview of the gait mechanics, plantar pressure, and the classification according to the etiology.

Fertility preservation for patients with gynecologic malignancies: The Korean Society for Fertility Preservation clinical guidelines

  • Lee, Sanghoon;Kim, Seul Ki;Hwang, Kyung Joo;Kim, Tak;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.4
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    • pp.175-180
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    • 2017
  • Fertility preservation plays a central role in cancer care since an increasingly large number of cancer patients are surviving as a result of improvements in diagnostic and therapeutic strategies. Physicians who take part in the initial diagnosis and management of gynecologic cancer should understand the importance of fertility preservation. Since indications for fertility preservation are limited to early-stage gynecologic cancer, a surgeon must carefully consider each indication. Before performing fertility-sparing surgery, health professionals should compare its oncologic and pregnancy outcomes with those of other standard treatments. Individualized treatment strategies should be delivered depending on the patient's situation, and physicians should provide timely information and appropriate counseling.

Practice Guideline of Use of Benzodiazepines in Psychiatric Field (정신과 영역에서 벤조다이아제핀계 약물의 사용과 문제점)

  • Oh Kang-Seob
    • Anxiety and mood
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    • v.1 no.1
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    • pp.37-42
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    • 2005
  • Benzodiazepines are widely used for a variety of conditions in psychiatric field. In this article, the author reviewed the indications, the effects on anxiety and sleep disorders, the side effects, the drug-drug interactions, and the tapering strategies. Benzodiazepines were relatively safe and useful for the treatment of anxiety and sleep disorders. However, used clinically, benzodiazepines can induce many adverse effects (e. g. over-sedation, cognitive impairments, paradoxical effects, dependence and withdrawal symptoms, and so on). Currently available informations about their effects on the developing fetus is controversial. For this reason, pregnant women and nursing mother should be cautioned against the use of benzodiazepines. Drug-drug interactions have to be considered in combination treatments. For the tapering issues, gradual tapering was important to prevent the withdrawal symptoms. Especially, the tapering schedules have to be individualized for the each long-term benzodiapzepine users.

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Conservative Management of Tracheal Injury After Endotracheal Intubation in a Neonate with Subglottic Stenosis and Esophageal Atresia with Tracheoesophageal Fistula (식도 폐쇄 및 기관식도루와 성대문밑협착을 동반한 신생아에서 기관 삽관후 발생한 기관 손상의 보존적치료 경험 1예)

  • Jung, Eun-Young;Choi, Soon-Ok;Park, Woo-Hyun
    • Advances in pediatric surgery
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    • v.16 no.1
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    • pp.37-42
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    • 2010
  • Tracheal injury is a rare complication of endo-tracheal intubation. However in neonates, the rates of morbidity and mortality are high. Recommendations for treatment are based on the several reports of this injury and are individualized. Conservative management can be effective in some cases. We describe the case of a neonate who presented with subcutaneous emphysema after intubation in a neonatal intensive care unit. This patient suffered full VACTERL syndrome and had 1.7 mm diameter subglottic stenosis. Conservative management resulted in no further increase in subcutaneous emphysema and after 10 days the patient was stable.

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