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

검색결과 592건 처리시간 0.023초

혈관여포양 임파선 증식증 -1예 보고- (Angiofollicular Lymph Node Hyperplasia (= Castleman's Disease) -Report of A Case -)

  • 길학준;오윤경;윤세철;신경섭;박용휘
    • Radiation Oncology Journal
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    • 제5권1호
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    • pp.37-41
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    • 1987
  • 혈관여포양 임 파선증식 증 (angiofollicular lymph node hyperplasia)은 원인 미상의 드문 양성 질환으로서 대부분 흉곽내에 발생한다. 진단은 임상증상, 이학적 경사 그리고 X-선 촬영을 비롯한 각종 영상술에 의하며 여러 다른 질환과 감별진단이 어렵다. 대개 수술적 적출에 의한 조직학적 검색으로 확진이 된다. 조직학적으로는 두 가지로 분류되며 하나는 초자양혈관형으로서 여포내에 혈관이 증식되고 초자양화(hyalinization)가 일어나는 것이 특징이다. $90\%$가 이에 속하고 다른 하나는 형질세포형으로서 $10\%$를 차지한다. 후자는 여포간 조직내에 형질세포가 미만성으로 증식되고 신증후군, 발열, 빈혈, 적혈구침강속도 증가, 고감마글로블린혈증, 저알부민혈증 등의 변화가 있는 점이 전자와 다른 점이다. 치료는 주로 수술적 제거술에 의하며 수술로서 절제되지 못하는 것은 방사선 치료에 의하게 된다. 저자들은 경도의 흉부불쾌감과 경부 임파절 종대를 보인 61세 남자에서 전상종격동 종괴를 수술적 부분제거 후 외부 방사선 치료를 실시하여 완치된 1예를 경험하였기에 보고하는 바이다.

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비수술적 부분비만 치료 효과에 관한 근거 중심적 연구 (The Review on the Evidence : Effects on Non-surgical Localized Fat Treatments)

  • 송미영;이명종;김호준
    • 한방비만학회지
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    • 제6권1호
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    • pp.1-10
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    • 2006
  • Localized fat and cellulate have not only esthetic but health problem, they are treated by surgical or non-surgical method. There are elecro-acupuncture, ultrasound, radio frequency, endermologie, mesotherapy, and carbon dioxide therapy in prevalent non-surgical treatments. We reviewed the studies on them to analyze their seicntific evidence. The studies are not many. They reported good results of circumference loss or appearance improvement of histologic change but most of them have poor study design. Before marketing or using these modalities, it is ontcal to evaluate to their effectiveness through strict and scientific clinical trials.

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Risk Factor Analysis of Morbidity and 90-Day Mortality of Curative Resection in Patients with Stage IIIA-N2 Non-Small Cell Lung Cancer after Induction Concurrent Chemoradiation Therapy

  • Ga Hee Jeong;Junghee Lee;Yeong Jeong Jeon;Seong Yong Park;Hong Kwan Kim;Yong Soo Choi;Jhingook Kim;Young Mog Shim;Jong Ho Cho
    • Journal of Chest Surgery
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    • 제57권4호
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    • pp.351-359
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    • 2024
  • Background: Major pulmonary resection after neoadjuvant concurrent chemoradiation therapy (nCCRT) is associated with a substantial risk of postoperative complications. This study investigated postoperative complications and associated risk factors to facilitate the selection of suitable surgical candidates following nCCRT in stage IIIA-N2 non-small cell lung cancer (NSCLC). Methods: We conducted a retrospective analysis of patients diagnosed with clinical stage IIIA-N2 NSCLC who underwent surgical resection following nCCRT between 1997 and 2013. Perioperative characteristics and clinical factors associated with morbidity and mortality were analyzed using univariable and multivariable logistic regression. Results: A total of 574 patients underwent major lung resection after induction CCRT. Thirty-day and 90-day postoperative mortality occurred in 8 patients (1.4%) and 41 patients (7.1%), respectively. Acute respiratory distress syndrome (n=6, 4.5%) was the primary cause of in-hospital mortality. Morbidity occurred in 199 patients (34.7%). Multivariable analysis identified significant predictors of morbidity, including patient age exceeding 70 years (odds ratio [OR], 1.8; p=0.04), low body mass index (OR, 2.6; p=0.02), and pneumonectomy (OR, 1.8; p=0.03). Patient age over 70 years (OR, 1.8; p=0.02) and pneumonectomy (OR, 3.26; p<0.01) were independent predictors of mortality in the multivariable analysis. Conclusion: In conclusion, the surgical outcomes following nCCRT are less favorable for individuals aged over 70 years or those undergoing pneumonectomy. Special attention is warranted for these patients due to their heightened risks of respiratory complications. In high-risk patients, such as elderly patients with decreased lung function, alternative treatment options like definitive CCRT should be considered instead of surgical resection.

도인술(導引術)과 한방 물리치료 (Toinsul and Oriental Physical Therapy)

  • 배주한;김상수
    • The Journal of Korean Physical Therapy
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    • 제10권2호
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    • pp.195-200
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    • 1998
  • 도인술은 경락과 경혈에 자극에 의한 체조법과 호흡법을 결합하여 기혈의 순환을 활발하게 하고 사기의 배설을 촉진시키므로 근육, 건, 인대의 탄력성과 활력성을 증강하고 관절의 활액 분비와 관절 주위의 순환을 촉진하고 경락을 통해 전신을 조정해 준다.(신준식, 1995). 내$\cdot$외관적 질환, 부인과 질환을 예방하고 치료하는 운동요법 중에 요통과 견괄절 질환에 대해서만 몇 가지 행법만 소개하므로 모든 질병을 치료보다 예방적인 측면으로 건강증진, 치료목적, 근 이완, 피로 회복의 효과를 달성할 수 있다. 도인법은 확고하게 과학적으로 증명된 것은 아니지만 질병 치료와 건강 증진 목적으로 현재까지 시행하고 있으므로 한방 물리치료의 한 분야이므로 좀 더 효과적이고 발전에 많은 활용하기 위하여 제한하는 바이다.

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성대용종 환자의 음성치료 효과 (The Effect of Voice Therapy in Vocal Polyp Patients)

  • 김성태;정고은;김상윤;최승호;임길채;한주희;남순열
    • 말소리와 음성과학
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    • 제1권2호
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    • pp.43-49
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    • 2009
  • Vocal polyps are benign phonotraumatic lesions which are traditionally treated using phonomicrosurgical techniques. In the case of hyperfunctional voice use, voice therapy is effective and results in voice improvement. However, the utility of voice therapy about vocal polyp is in great demand. The purpose of this study was to evaluate the effects of voice therapy in patients with vocal polyps. The authors reviewed the medical records of 193 patients with vocal nodules or vocal polyps, and 64 patients (31 nodules and 33 polyps) were enrolled. All of the subjects had received explanation of problems, vocal hygiene education, and been treated by the $SKMVTT^{(R)}$ (Seong-Tae Kim's multiple voice therapy technique) ranging from 4 to 16 sessions (mean: 8.6 sessions). All subjects were examined by perceptual assessment, acoustic and aerodynamic measures, and VRP (voice range profile). In perceptual assessment, patients with vocal nodules had more breathy and strained voices than the vocal polyp group. Both groups significantly reduced rough, breathy voice after voice therapy. Patients with vocal polyps had worse voice quality than patients with nodules in acoustic measures. Both groups showed reduced jitter and shimmer after voice therapy. In aerodynamic measures, MPT and Psub were increased, and MFR was reduced (p<.05). Participants' frequency range and intensity range were increased after voice therapy, but only frequency range resulted in a significant difference (p<.05). In conclusion, the therapeutic effect of voice therapy in patients with vocal nodules and polyps was demonstrated perceptually and acoustically. We can suggest that voice therapy, including advice, vocal hygiene, and $SKMVTT^{(R)}$ is a useful as an initial choice of treatment for patients with vocal polyps before considering a surgical approach.

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궁형 성대를 보이는 환자들에 있어 음성치료의 효과 (The Efficacy of Voice Therapy for the Treatment of Vocal Fold Bowing)

  • 신혜정;김진경;김은아;고영민;박애경;정성민
    • 대한후두음성언어의학회지
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    • 제14권2호
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    • pp.94-97
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    • 2003
  • Background and Objectives : Bowing of the vocal fold, a bowed edge of the vocal fold results from various disorder causes glottic incompetence resulting in voice disorders. The results of treatment were not satisfactory even though a variety of methods of treatment were applied. The goal of this study is to evaluate of efficacy of the non-surgical, voice therapy in patients with vocal fold bowing. Materials and Method : Twenty two patients of vocal fold bowing not resulting from vocal fold palsy and sulcus vocalis were analyzed. After voice therapy and medical treatment, parameters of perceptual, acoustic, aerodynamic analysis and stroboscopic findings were compared those of pretreatment results. Results and Conclusion : Jitter, shimmer and maximal phonation time were significantly improved and subjective satisfaction was improved in 73% of patients. In the videostroboscopic examination, vocal fold gap was decreased in 27% of patents. The result of this study indicates that voice therapy alone has effect in treatment of vocal fold bowing. Voice therapy is one of the mainstay of treatment of vocal fold bowing.

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환축추 회전 아탈구 환자에 대한 도수치료 효과 (Effect of Manual Therapy on a Patient With Atlantoaxial Rotatory Subluxation)

  • 전재국;양성화;신의주
    • 대한정형도수물리치료학회지
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    • 제25권1호
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    • pp.71-76
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    • 2019
  • Background: An 8-year-old girl had severe neck pain and stiffness after trauma. CT scan showed atlantoaxial rotatory subluxation (AARS). She had conservative treatment because she did not have neurological symptoms and spinal basilar artery dysfunction. Conservative therapy was halter traction twice for 4 weeks. However, pain and stiffness persisted. She had been recommended to have surgery from her physician, but she received manual therapy for non-surgical procedures. Methods: The joint mobilization, muscle energy technique, motor control exercise, and deep neck flexor (DNF) endurance exercise were applied as manual therapy and 10 session for 2weeks. Results: Clinical outcomes were measured at initial baseline, after 2 weeks, and after 6weeks. Active range of motion was completely restored after 6weeks and numeric pain rating scale was completely reduced after 2 weeks. The strength of neck flexor muscle recovered to normal after 2 weeks, and the DNF endurance was improved to 25 seconds after 2 weeks and to 42 seconds after 6weeks. Motor control capacity recovered to 30 ㎜Hg after 2 weeks. Conclusions: This case report describes the immediate and short-term clinical outcomes for a patient presenting with symptoms of neck pain following AARS. Clinical rationale and patient preference aided the decision to incorporate manual therapy as a treatment for this patient. Manual therapy has shown a successful recovery in AARS patients, more research is needed to validate the inference of this case report.

Long-term Surgical Outcomes in Oligometastatic Non-small Cell Lung Cancer: A Single-Center Study

  • Seungmo Yoo;Won Chul Cho;Geun Dong Lee;Sehoon Choi;Hyeong Ryul Kim;Yong-Hee Kim;Dong Kwan Kim;Seung-Il Park;Jae Kwang Yun
    • Journal of Chest Surgery
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    • 제56권1호
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    • pp.25-32
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    • 2023
  • Background: We reviewed the clinical outcomes of patients with oligometastatic (OM) non-small cell lung cancer (NSCLC) who received multimodal therapy including lung surgery. Methods: We retrospectively analyzed 117 patients with OM NSCLC who underwent complete resection of the primary tumor from 2014 to 2017. Results: The median follow-up duration was 2.91 years (95% confidence interval, 1.48-5.84 years). The patients included 73 men (62.4%), and 76 patients (64.9%) were under the age of 65 years. Based on histology, 97 adenocarcinomas and 14 squamous cell carcinomas were included. Biomarker analysis revealed that 53 patients tested positive for epidermal growth factor receptor, anaplastic lymphoma kinase, or ROS1 mutations, while 36 patients tested negative. Metastases were detected in the brain in 74 patients, the adrenal glands in 12 patients, bone in 5 patients, vertebrae in 4 patients, and other locations in 12 patients. Radiation therapy for organ metastasis was performed in 81 patients and surgical resection in 27 patients. The 1-year overall survival (OS) rate in these patients was 82.8%, and the 3- and 5-year OS rates were 52.6% and 37.2%, respectively. Patients with positive biomarker test results had 1-, 3-, and 5-year OS rates of 98%, 64%, and 42.7%, respectively. These patients had better OS than those with negative biomarker test results (p=0.031). Patients aged ≤65 years and those with pT1-2 cancers also showed better survival (both p=0.008). Conclusion: Surgical resection of primary lung cancer is a viable treatment option for selected patients with OM NSCLC in the context of multimodal therapy.

조기 성문암에서 레이저 수술과 방사선 치료 후 음성기능 비교 (Comparison of Functional Voice Outcomes in Patients Treated with Laser Surgery and Radiation Therapy for Early Glottic Cancer)

  • 이종철;이윤세;남순열
    • 대한후두음성언어의학회지
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    • 제19권1호
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    • pp.7-10
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    • 2008
  • The early glottic cancers are traditionally treated by radiotherapy or endoscopic surgery. The excellent effectiveness of both treatment modalities for local control, larynx preservation, and disease specific death is similar. Therefore, functional voice outcome after treatment is one of the most important factors in the choice of treatment for early glottic cancer. To assess the functional outcomes and compare the voice quality in patients with early glottic cancer treated with curative intent with radiotherapy or laser cordectomy, we performed literature review. Most studies showed that the voice quality after radiation therapy is slightly better than that after laser cordectomy. Subanalysis according to types of laser cordectomy, however, indicates that voice quality depends on type of laser cordectomy. Especially, type I or type II laser cordectomy might be superior to other types of laser cordectomy and radiation therapy. We conclude that the laser cordectomy is a good surgical alternative for properly selected early glottic cancer including professional voice users.

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Successful Outcome of Breast Cancer Patient Refusing Conventional Treatments: A Case Report

  • Lee, Sanghun;Sohn, Kicheul;Chon, Songha
    • 대한한의학회지
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    • 제39권4호
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    • pp.177-182
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    • 2018
  • Background: Breast cancer is a treatable disease, but some women reject conventional treatment in favor of unproven "alternative therapies," which may have serious implications for their survival. Therefore, a process is needed to lead them to more appropriate treatment choices. Case presentation: Here, we present the case of a 51-year-old Korean female diagnosed with early-stage breast cancer (stage IIB, T2N1M0) in Nov. 2015. She refused a standard surgical resection together with chemotherapy and opted instead for moxibustion by nonmedical personnel. Consequently, her preference for alternative therapy without conventional treatment exacerbated her disease. Just a little over a year later, integrative cancer treatment, including chemotherapy based on histological founding, and complementary treatment, comprised of acupuncture, moxibustion, and herbal medicine, were administered for 5 months. Finally, she successfully underwent modified radical mastectomy showing a pathological complete response. She received only adjuvant chemotherapy without any alternative medicine afterwards, and she maintained a good status without recurrence. Conclusion: In the case of breast cancer patients who are resistant to surgery and chemotherapy, integrative therapy considering adverse effects from conventional treatment should be preferred to bitter opposition to alternative medicine.