• 제목/요약/키워드: intervention treatment

검색결과 2,363건 처리시간 0.026초

Impact of Surgery on Oligometastatic Pancreatic Cancer: Current Status and Future Perspectives

  • Masayuki Sho;Satoshi Yasuda;Minako Nagai;Kota Nakamura;Taichi Terai;Yuichiro Kohara
    • Journal of Digestive Cancer Research
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    • 제11권1호
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    • pp.1-8
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    • 2023
  • Pancreatic cancer treatment has advanced. In particular, effective chemotherapy regimen development has fundamentally altered the therapeutic concept and strategy for pancreatic cancer treatment. Consequently, the prognosis of patients with pancreatic cancer has gradually improved. Conversion surgery for locally advanced pancreatic cancer may offer long-term survival or even a full recovery in some individuals. In contrast, metastatic pancreatic cancer has long been considered a surgical contraindication because aggressive surgical resection of the metastatic lesions does not prolong patient survival. Unexpectedly positive benefits of anticancer therapy in recent clinical experience were observed even with metastatic pancreatic cancer. To date, little evidence presented the success of surgical resection for metastatic pancreatic cancer treatment in such rare cases. However, hope and concern are growing that surgical intervention, even in patients with metastatic cancer, may result in favorable outcomes. Several studies suggested different surgical intervention effects depending on metastasis sites and patterns. Thus, this review summarizes the current status of surgery in the multidisciplinary treatment of oligometastatic pancreatic cancer and discusses future perspectives.

소아 말초성 안면마비의 중재로 침 치료를 응용한 중의학 임상 연구 고찰 (A Review of Clinical Researches for Applying Acupuncture Treatment as Intervention of Peripheral Facial Paralysis in Children)

  • 류세나;장수비;김기봉;천진홍
    • 대한한방소아과학회지
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    • 제38권2호
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    • pp.41-52
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    • 2024
  • Objectives The objective of this study was to investigate the impact of applying acupuncture as intervention of peripheral facial paralysis in children. Methods We conducted searches on China National Knowledge Infrastructure and Wanfang Data using the keywords "facial paralysis", "children", and "acupuncture". Results Six randomized controlled trials were included in the analysis. The acupoints most frequently utilized were Hapgok (LI4), Jichang (ST4), Yangbaek (GB14), Sabaek (ST2), Hyeopgeo (ST6), Yeonghyang (LI20), Yepung (TE17), and Taeyang (EX-HN5). The Stomach Meridian (ST) was the most targeted. Acupuncture treatment was found to be as effective as or more effective than Western medicine treatment in certain cases. Conclusions Acupuncture therapy shows promise for treating pediatric peripheral facial paralysis. However, further clinical randomized controlled trials are necessary to validate the efficacy and safety of acupuncture treatment.

Garre's osteomyelitis of the mandible managed by nonsurgical re-endodontic treatment

  • Heegyun Kim;Jiyoung Kwon;Hyun-Jung Kim;Soram Oh;Duck-Su Kim;Ji-Hyun Jang
    • Restorative Dentistry and Endodontics
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    • 제49권2호
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    • pp.13.1-13.7
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    • 2024
  • Chronic osteomyelitis with proliferative periostitis, known as Garre's osteomyelitis, is a type of osteomyelitis characterized by a distinctive gross thickening of the periosteum of bones. Peripheral reactive bone formation can be caused by mild irritation or infection. Garre's osteomyelitis is usually diagnosed in children and young adults, and the mandible is more affected than the maxilla. The following is a case report of a 12-year-old female patient with Garre's osteomyelitis of the mandible due to an infection of a root canal-treated tooth. Without surgical intervention, the patient's symptoms were relieved through nonsurgical root canal re-treatment with long-term calcium hydroxide placement. A cone-beam computed tomography image obtained 6 months after treatment completion displayed complete healing of the periapical lesion and resolution of the peripheral reactive buccal bone. Due to the clinical features of Garre's osteomyelitis, which is characterized by thickening of the periosteum, it can be mistaken for other diseases such as fibrous dysplasia. It is important to correctly diagnose Garre's osteomyelitis based on its distinctive clinical features to avoid unnecessary surgical intervention, and it can lead to minimally invasive treatment options.

흔한 질병(疾病)의 진료비분석(診療費分析) (A Study of the Analysis of Treatment Expenses of Selected Common Diseases Covered by Medical Care Inserance System)

  • 김진순
    • 농촌의학ㆍ지역보건
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    • 제14권1호
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    • pp.16-29
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    • 1989
  • The general objective of this study is to grasp the treatment expenses of common diseases by character of medical care institutions. The specific objective is to find out the treatment expenses for selected common diseases by type of medical care institutions and also by level of symptom. A record review method was employed to obtain required information for the analysis of expenses. A total of 40,000 cases treated by 85 medical care institutions were selected by the study team during the period 22 June to 14 July 1988. The 85 medical care institutions were sampled by stratified proportionate random sampling method. The major findings obtained from the information collected by the study team are as follows ; 1) Treatment expenses were composed of physical examination, medication, injection anesthesia, rehabilitation surgical intervention, lab test, X-ray and diagnosis. The highest expenses was for medication, accounted for 36.7% of the total: 13.9%, injection; Lab, tests respectively: 10.5%, physical examination : 8.6% surgical intervention; 7.9% admission : 6.3%, X-ray and diagnosis: 1.5%, rehabilitation. 2) Treatment expenses per case of common diseases were quite different from not only type of medical care institutions, such as university hospital, general hospital, hospital and clinic, but also from level of symptom. 3) Treatment expenses per case for the aged were higher than that of the young. The treatment cases for over 60 years of age accounted for 19.4% of the total, however the proportion of treatment expenses accounted for 23.8% of the total. 4) Duration of treatment and visits for same diseases varied from type of medical cara institutions. Based on these study findings, the following further research should be conducted: (1) Establishment of health care delivery system. (2) Feasibility of the development of health care programme for the aged. (3) Strengthening for primary health care approach.

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App-기반 청자 반응 대화훈련 프로그램이 고기능 자폐스펙트럼 아동의 대화기술 향상에 미치는 효과 (Effect of a Novel App-based Listener Responsiveness Conversation Training Program on Enhancing Conversational Skills in Children with High-Functioning Autism Spectrum Disorder)

  • 조희정;김소연
    • 감성과학
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    • 제26권3호
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    • pp.115-128
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    • 2023
  • 본 연구는 고기능 자폐 스펙트럼 장애아동을 대상으로 App-기반 청자 대화기술 훈련프로그램의 효과를 검증하고자 하였다. 연구대상은 26명의 자폐 스펙트럼 장애, 아스퍼거 증후군, 전반적 발달장애로 진단된 초등학생으로, 연령과 IQ, SCQ, ASSQ 점수를 사용하여 중재 집단과 통제 집단으로 짝지어 분배하였다. 중재 집단은 9주 동안 교사와의 비대면 학습을 주 1회 실시하고, 가정에서도 부모 또는 아동이 앱(App)을 활용하여 대화훈련을 실시하였다. 통제집단은 다른 특별한 프로그램에 참여하지 않았다. 그리고 훈련 전과 후에 평가자와 아동 간의 1:1 대화를 수행하여 대화 자료를 수집하고, 대화차례 주고받기와 주제 운용능력의 변화를 비교하였다. 연구 결과, 중재 집단에서 본 연구에서 개발한 청자 반응 대화훈련 프로그램의 긍정적 효과가 발견되었다. 구체적으로, 중재 집단은 청자 조건에서 적절한 청자 언어 반응이 유지되었고, 통제 집단은 적절한 청자 언어 반응이 감소하였다. 그리고 화자 조건의 대화 차례 주고받기에서는 개시율과 유지율이 증가하고, 주제 운용능력에서는 적절한 주제 개시율이 증가하고, 부적절한 주제 개시율은 감소하였다. 논의에서는 청자 반응 대화훈련 프로그램이 고기능 자폐 스펙트럼 장애아동의 대화 양상변화에 미치는 효과를 중점적으로 논의하였다.

Herpes Zoster and Postherpetic Neuralgia: Practical Consideration for Prevention and Treatment

  • Jeon, Young Hoon
    • The Korean Journal of Pain
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    • 제28권3호
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    • pp.177-184
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    • 2015
  • Herpes zoster (HZ) is a transient disease caused by the reactivation of latent varicella zoster virus (VZV) in spinal or cranial sensory ganglia. It is characterized by a painful rash in the affected dermatome. Postherpetic neuralgia (PHN) is the most troublesome side effect associated with HZ. However, PHN is often resistant to current analgesic treatments such as antidepressants, anticonvulsants, opioids, and topical agents including lidocaine patches and capsaicin cream and can persist for several years. The risk factors for reactivation of HZ include advanced age and compromised cell-mediated immunity (CMI). Early diagnosis and treatment with antiviral agents plus intervention treatments is believed to shorten the duration and severity of acute HZ and reduce the risk of PHN. Prophylactic vaccination against VZV can be the best option to prevent or reduce the incidence of HZ and PHN. This review focuses on the pathophysiology, clinical features, and management of HZ and PHN, as well as the efficacy of the HZ vaccine.

항혈소판제를 투여받는 환자의 치과치료 (Dental treatment of the patient with antiplatelet agent)

  • 박홍주
    • 대한치과의사협회지
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    • 제57권10호
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    • pp.606-612
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    • 2019
  • Antiplatelet agent is administered to the patients who have ischemic heart disease, transient cerebral infarction, as well as hypertension, etc. Antiplatelet agent prevents thromboembolism by inhibition of platelet aggregation by various mechanism. Due to that reason, patient who administered antiplatelet agent has bleeding tendency. Surgeon does not want to make a complication by bleeding during and after operation, and want to stop taking antiplatelet agent. However, It is very dangerous for the patient to stop antiplatelet agent. Local bleeding as a complication after operation is considered minor one, whereas thromboembolism is life threatening serious complication. Most dental intervention can be performed without withdrawal of antiplatelet agent. Dental intervention should be limited area, and surgeon should do active bleeding control.

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혈액여과투석 환자의 치료이행 지표와 분류기준, 융합형 혈액여과투석 치료이행 측정도구 개발 : 온라인 혈액여과투석을 중심으로 (The Development of Hemodiafiltration Treatment Compliance Indicators and Discriminant Standards, Development of Hemodiafiltration Treatment Compliance Measurement - Convergent Form(HDFTCM-CF) : Focused on On-line Hemodiafiltration)

  • 허정
    • 디지털융복합연구
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    • 제13권7호
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    • pp.269-282
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    • 2015
  • 본 연구는 혈액여과투석 환자의 치료이행을 측정할 수 있는 지표와 분류기준을 개발하고 치료이행 정도를 측정할 수 있는 전문가의 의견이 반영된 융합형 도구를 개발하고자 시도되었다. 총 300명의 혈액여과투석 환자를 대상으로 자료가 수집되었으며, 저유량 혈액투석, 고유량 혈액투석 치료이행과 불이행에 대한 선행연구 결과 및 전문가 그룹, 임상전문가 그룹의 구성타당도, 내용타당도를 거쳐 혈액여과투석 지표와 분류기준을 개발하였다. 개발된 혈액여과투석 치료이행 지표와 분류기준의 판별분석력을 정준상관판별분석으로 검증한 결과 3가지 지표의 혈액여과투석 치료이행 판별분석력은 95.6%(wilks ramda=.256, p=.002)이었다. 또한 임상형 혈액여과투석 치료이행 측정도구는 91.7%의 판별력을 가진 것으로 검증되었다. 혈액여과투석 치료이행은 환자의 건강상태 악화와 합병증 발생 전 단계에서 환자교육과 간호중재가 이루어질 수 있다는 점에서 의미가 있으며 본 연구의 결과는 향후 혈액투석환자의 합병증 예방을 위한 간호중재의 기초자료로 활용될 수 있을 것이다.

세균성 질증의 한방외치요법에 대한 무작위 대조군 비교 임상시험 중심의 고찰 (Analysis for Randomized Controlled Clinical Trials of Korean Medicine External Treatment on Bacterial Vaginosis)

  • 황영식;이진욱;김규태;박승혁;이진무;이창훈;장준복;황덕상
    • 대한한방부인과학회지
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    • 제32권2호
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    • pp.50-70
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    • 2019
  • Objectives: The purpose of this study was to show effectiveness of Korean medicine external treatment on bacterial vaginosis by analyzing randomized controlled clinical trials. Methods: We searched randomized controlled clinical trials related with Korean external treatment on bacterial vaginosis through national and overseas database and analyzed them in detail. Results: 15 articles were included according to our selection criteria and 2,176 women were involved. 1. All treatment groups were treated with intervention including Korean medicine external treatment and their results were statistically more effective than control groups. 2. External washing was the most frequently used method followed by vaginal tablet, fumigation and powder. 3. The most frequently used herbal medicine was Sophorae Radix followed by Phellodendri Cortex, Cindi Fructus, Dictamni Radicix Cortex and Kochiae Fructusa. 4. There were 4 studies reporting side effects of treatment and no significant side effects were observed. Conclusions: There was significant difference in the effectiveness of the intervention including Korean external therapy. Based on the analysis, it could be an effective way for the treatment of bacterial vaginosis in clinical practice.

국내 학술지에 게재된 증례 연구 분석을 통한 산후풍의 한의학적 치료에 대한 고찰 (A Review on Sanhupung Treatment in Korean Medicine by Analyzing Case Studies Published in Korean Journal)

  • 황수인;이희윤;윤영진;박장경
    • 대한한방부인과학회지
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    • 제34권4호
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    • pp.131-150
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    • 2021
  • Objectives: The purpose of this study is to analyze the domestic study trends on Korean medicine treatment of Sanhupung. Methods: Case studies applying Korean medicine treatment on Sanhupung were searched through 5 domestic journal databases. General characteristics, interventions, outcomes, and results of the selected studies were analyzed. Also, the quality of the case studies was reviewed based on the CAse REport (CARE) guideline and Joanna Briggs Institute (JBI) critical appraisal checklist. Results: 11 studies (16 cases) were found to be analyzed according to their general characteristics, symptoms, interventions, treatment period, outcome, and results. The most common complaint of Sanhupung patients was pain, and the most applied intervention for Sanhupung was herbal medicine and acupuncture. The duration of treatment ranged from 9 days to 4 months. All case studies reported that the Korean medicine treatment was effective in treating Sanhupung. According to the quality assessment, 'Timeline of case', 'Diagnostic challenges', 'Intervention adherence and tolerability', 'Adverse and unanticipated events', and 'Informed consent' were showed low reporting rates. Conclusions: Further clinical studies are needed to establish the evidence for Korean medicine treatment for Sanhupung.