• 제목/요약/키워드: medical therapy and surgical therapy

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Masticatory muscle tendon-aponeurosis hyperplasia accompanied by limited mouth opening

  • Yoda, Tetsuya
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제45권4호
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    • pp.174-179
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    • 2019
  • Patients with masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) experience limited mouth opening due to restricted muscle extension. Hyperplastic aponeurosis and tendons lead to the restriction of muscle extension. The criteria for the diagnosis of MMTAH are limited mouth opening that progresses very slowly from adolescence, intraoral palpation reveals a hard cord-like structure along the overhang of the anterior border of the masseter muscle on maximum mouth opening, and a square mandible. Conservative treatment, including pharmacotherapy, occlusal splint and physical therapy are ineffective. The standard therapy is surgical treatment, such as anterior partial aponeurectomy of the masseter muscle and coronoidectomy. The long-term results are very satisfying.

구강암 절제를 위한 하악골이단술: 합병증과 기여인자 (MANDIBULOTOMY, A SURGICAL APPROACH FOR ORAL CANCER: ITS COMPLICATIONS AND CONTRIBUTING FACTORS)

  • 변성규;최은창;박원서;이의웅;차인호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권4호
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    • pp.422-426
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    • 2000
  • We reviewed 56 patients who received mandibulotomy at Yonsei medical center between 1989 and 1999. We also analysed the complications associated with mandibulotomy and its contributing factors. The complications occur in 16 patients(28.6%) and are classified into two categories; intraoperative and postperative complications. Nonunion was observed in 5 patients and osteoradionecrosis in 5. The patients who received preoperative radiation therapy were more tend to develop nonunion and osteoradionecrosis. This study suggests the benefits of mandibulotomy as a surgical approach to oral cancer: 1. Paramedian osteotomy was recommended for preservation of neurovascular bundle and ease of surgical access. 2. By using thin saw blade, reapproximation was improved with minimal bone loss. 3. osteotomy on anterior mandible which lies outside the usual portals of radiation therapy decreases the incidence of osteoradionecrosis.

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한국 침구외과 지표기술 및 지표문헌 DB 구축을 위한 범위 설정과 모델링 연구 - 침구기법과 외과적 수기법을 중심으로 - (A Study on Modeling Index Literatures and Index Techniques for Establishing DB of Korean Acupuncture, Moxibustion and Surgical Techniques)

  • 차웅석;김민선;김동율;안상우
    • 한국의사학회지
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    • 제28권2호
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    • pp.73-85
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    • 2015
  • This paper is the result of a research conducted for "Knowledge Resource Development by Excavation and preservation and DB Establishment of Traditional Home Remedy", a part of Korean Medicine knowledge infrastructure establishment and Korean Medicine therapy development project executed by Korea Institute of Oriental Medicine. This paper is a part of the plans to standardize Korean acupuncture and moxibustion and surgical techniques in order to make new techniques derived from Korean traditional medicine patentable, as presented in the Nagoya Protocol. By first reviewing traditional text sources and classifying them into index literature and index techniques, we can see a mutual relationship between these two categories. Based on current research papers, this study has established a total of 121 pieces of index literature as well as extracted 64 types of index techniques in acupuncture and surgery technique. Both index literature and index technique have been concurrently visualized in this paper in the "Korean Acupuncture & Moxibustion Technique and Surgical Manipulation Base Map".

피부흑색종 (Cutaneous melanoma)

  • 이석종;이수정
    • 대한의사협회지
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    • 제61권11호
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    • pp.662-669
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    • 2018
  • The cutaneous melanoma has been regarded as rare disease entity in Korea for long time but it shows a silent growth recently. Furthermore the management of cutaneous melanoma including staging system, surgical principle, sentinel lymph node biopsy and subsequent complete node dissection and, most importantly, immunotherapy and target therapy against cutaneous melanoma recently. The incidence of cutaneous melanoma is steadily increasing in Korea but its increase is rapid recent 2 decades to 4.3 times and should be greater soon according to the steeper increase of life expectancy. New staging system proposed by American Joint Committee on Cancer (2017) includes changes in individual TNM category and stage groups, particularly from a prognostic viewpoint. Dermoscopy has been successfully introduced in the differential diagnosis of pigmented skin lesion focusing on cutaneous melanoma by non-invasive simple diagnostic tool. Sentinel lymph node biopsy was a issue of long debate whether survival benefit is real or not. Temporary conclusion about this question is reached after two large scale studies and immediate complete node dissection should be performed in a certain situations. Most important change is drug therapy focusing on immunotherapy and target therapy. Braf- and MEK-inhibitor, immune checkpoint inhibitor and PD-1 blocker has been proved to be effective as a sole or combination regimen against advanced and/or high-risk adjuvant setting of cutaneous melanoma. In conclusion, these remarkable changes will be reviewed shortly here.

사례보고: 수술예방적 항생제 Cefotetan에 의한 아나필락시스 보고 및 World Allergy Organization 가이드라인활용 (Anaphylaxis Induced by Surgical Prophylactic Cefotetan and The Application of World Allergy Organization Guide: A Case Report)

  • 정경래;경은정;이희영;김은영
    • 한국임상약학회지
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    • 제22권3호
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    • pp.268-273
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    • 2012
  • The definition of anaphylaxis is 'a serious, life-threatening generalized or systemic hypersensitivity reaction' and is considered as the life threatening adverse drug reaction. We experienced a case of cefotetan induced anaphylaxis with negative pre-skin test, used for surgical prophylaxis. A 82-year-old female was scheduled for total knee replacement therapy. She had no previous history of allergy and her skin test results were also negative. On her right knee surgery, she underwent cefotetan therapy as a surgical prophylaxis for a week with no problems identified. Next left knee surgery, she also received the prophylaxis of intravenous cefotetan. However, a few minutes later, anaphylactic reaction developed with vomiting, severe hypotension, bronchospasm, and dyspnea. After immediate intensive care treatment, she recovered without significant complications. Though commonly used laboratory data in case reports, such as the specific IgE, tryptase, histamine, or allergic skin prick test were limited, we successfully confirmed anaphylaxis based on clinical criteria for diagnosing anaphylaxis based on WAO 2011 guideline with through concurrent patient°Øs medical history review and the process of identifying the causes.

Decision-Making in Transcatheter Edge-to-Edge Repair: Insights into Atrial Functional Mitral Regurgitation

  • Kim, Joon Bum
    • Journal of Chest Surgery
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    • 제54권6호
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    • pp.449-453
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    • 2021
  • The 2020 American College of Cardiology focused update on the mitral regurgitation (MR) pathway provides an excellent summary of the decision-making trees in the treatment of severe MR, in which 2 main branches of the flowchart are suggested depending on whether MR is primary or secondary. Surgery is suggested as preferable over transcatheter edge-to-edge repair (TEER) in primary MR that needs intervention. The decision-making for secondary MR generally prioritizes TEER over surgery according to the guidelines, but further stratification is necessary based on the pathophysiologic mechanisms of MR. TEER is probably the more suitable option in secondary MR caused by left ventricular dysfunction or dilatation, given the high perceived surgical risks, despite the lack of sufficient evidence in support of overt clinical benefits from surgical therapy in these patients. In atrial functional MR associated with atrial fibrillation (AF), however, concomitant ablation of AF seems to be a desirable option, as it has been demonstrated to be a key factor leading to improved survival, reduced stroke risk, and more durable mitral and tricuspid function in patients undergoing mitral surgery. Therefore, atrial functional MR requiring intervention may be best treated by surgical therapy that combines mitral repair and AF ablation in the majority of patients. This particular issue, however, needs further research to obtain scientific evidence to guide optimal management strategies.

진행성 치성감염 병소들을 가진 두경부 악성종양 환자에서 조기 방사선치료를 위한 치성감염 조절법 : 증례보고 (THE INFECTION CONTROL METHOD FOR EARLY RADIATION THERAPY IN THE HEAD & NECK CANCER PATIENTS WITH ADVANCED ODONTOGENIC INFECTIOUS LESIONS : REPORT OF CASES)

  • 유재하;이종영;정원균;김영남;장선옥;전현선;김종배;남기영
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권2호
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    • pp.168-173
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    • 2006
  • The side effects of head and neck radiation therapy include mucositis, xerostomia, loss of taste, radiation caries, oral infection, osteoradionecrosis and trismus. When a patient is arranged to begin head & neck radiotherapy, oral pathologic lesions are examined and managed for the prevention of oral complications. The advanced odontogenic infection should be especially controlled before the radiotherapy and the patient must be instructed for proper oral prophylaxis. Generally the more conservative treatments, such as, scaling, restoration, endodontic treatment, are the care of choice and dental extraction is performed in advanced periapical and periodontal pathologic conditions. If the dental extraction should be done, the radiotherapy consequently will be delayed until there is epithelium covering the extraction socket, leaving no exposed bone. The cancer patient with severe emotional stress pray for the early radiation therapy, in spite of possibility of the recurrent odontogenic infectious lesions. So, the authors attempted to do the early radiation therapy by the conservative endodontic drainage and surgical incision & drainage without extraction of the infected teeth, and resulted in relatively good prognosis without the severe side effects of head and neck radiotherapy.

췌장암 한의 임상진료지침 개발 예비 연구 (Preliminary Study for Development of Korean Medicine Clinical Practice Guideline for Pancreatic Cancer)

  • 박수정;유화승;유준상
    • 대한암한의학회지
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    • 제22권1호
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    • pp.1-11
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    • 2017
  • Objectives: The purpose of this study is to investigate preliminarily for development of the Korean medicine clinical practice guideline (CPG) for pancreatic cancer through the analysis of existing CPGs. Methods: Through searching the medical database such as Pubmed, SCOPUS, CNKI, Google Scholar, etc. The global CPGs within recent three years were collected and analyzed. In particular, recommendations related to the Korean medicine or Chinese medicine were made primarily in the Guidelines of Diagnosis and Therapy in Oncology with Traditional Chinese Medicine. Results: The six CPGs were mentioned in this study. The academic societies and organizations developing the CPGs were located in China, Japan, Europe and America. The contents of the CPGs were the clinical questions and statements, surgical therapy, adjuvant therapy, radiation therapy, chemotherapy, palliative medicine, risk assessment, palliation and supportive care, follow-up and recurrence, Tumor-Node-Metastasis (TNM) staging. In the Guidelines of Diagnosis and Therapy in Oncology with Traditional Chinese Medicine, the etiology, mechanisms, herbal drugs, Chinese medicine assessment, complication, syndrome differentiation (SD), Chinese medicine treatment were described. Conclusions: In order to develop the proper Korean medicine CPG for pancreatic cancer and to adapt the correct integrative treatment program on the pancreatic cancer, institutional arrangements for cooperation with Korean medical communities and standardization of SD should be performed.

"외대비요(外臺秘要)"의 약욕요법(藥浴療法) 활용에 관한 연구 (A Study of bathing therapy on the ${\ulcorner}$Wai-Tai-Mi-Yao(外臺秘要)${\lrcorner}$)

  • 허경자;이병욱;김은하
    • 한국한의학연구원논문집
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    • 제11권1호
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    • pp.43-60
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    • 2005
  • Objective : ${\ulcorner}$Wai-Tai-Mi-Yao${\lrcorner}$ had been made by Wang-Dao(王燾) in Tang Dynasty(唐朝). It included not only in those days medical knowledge, but also before medical knowledge. So it is regarded as important classic in the oriental medicine. And there are various bathing therapy methods. Therefore we would like to bring out use sphere and detailed method of bathing therapy in Tang Dynasty and before period. Methodologies :We have researched bathing therapy of ${\ulcorner}$Wai-Tai-Mi-Yao${\lrcorner}$ according to below the procedure. (1) Making a related words list: We have used existing external treatments technical books to make a list. The list is consist of 23 words and includes not only technical terms, but also general terms. (2) Searching sentence: We have searched sentence that contain terms that related with bathing therapies. (3) Analysis of related sentence: We have searched and classified sentence by disease. Conclusions :(1) ${\ulcorner}$Wai-Tai-Mi-Yao${\lrcorner}$ has described 15,180 records. Bathing therapies of ${\ulcorner}$Wai-Tai-Mi-Yao${\lrcorner}$ had been used to cure 726 records from the whole volume. The contents account for 4.8% of the whole volume. (2) ${\ulcorner}$Wai-Tai-Mi-Yao${\lrcorner}$ has described 1,104 diseases. Bathing therapies of ${\ulcorner}$Wai-Tai-Mi-Yao${\lrcorner}$ had been used to cure 293 diseases from the whole diseases. The contents account for 26.5% of the whole volume. (3) These diseases belong to dermatologic, internal, ophthalmic, otolaryngologic, obstetrics, gynecologic, pediatric, surgical and veterinary diseases.

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Adjunctive recombinant human parathyroid hormone agents for the treatment of medication-related osteonecrosis of the jaw: a report of three cases

  • Soo Young Choi;Dami Yoon;Kang-Min Kim;Sun-Jong Kim;Heon-Young Kim;Jin-Woo Kim;Jung-Hyun Park
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제50권2호
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    • pp.103-109
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    • 2024
  • Teriparatide has been effective in treating people diagnosed with medication-related osteonecrosis of the jaw (MRONJ). However, its efficacy is not well established to be accepted as a standard of care. The objective of this paper was to investigate the efficacy of recombinant human parathyroid hormone for the treatment of MRONJ. We report three cases of MRONJ patients with osteoporosis as the primary disease who were treated with a teriparatide agent along with other adjunctive measures. Each patient was administered a teriparatide injection subcutaneously for 16 weeks, 36 weeks, or 60 weeks. Surgical intervention including partial resection, sequestrectomy, decortication, and saucerization took place during the teriparatide administration. Complete lesion resolution was identified clinically and radiographically in all three patients. In patients diagnosed with MRONJ, teriparatide therapy is an efficacious and safe therapeutic option to improve healing of bone lesions. These findings demonstrate that teriparatide in combination with another therapy, especially bone morphogenetic protein, platelet-rich fibrin, or antibiotic therapy, can be an effective protocol for MRONJ.