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

검색결과 592건 처리시간 0.029초

인두피판성형술 전후의 언어 평가 (SPEECH-LANGUAGE EVALUATION BEFORE AND AFTER PHARYNGOPLASTY)

  • 유양근;한진순;김정록;황순정
    • 대한구순구개열학회지
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    • 제3권2호
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    • pp.61-66
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    • 2000
  • General characteristics of speech in deft palate patients are hypemasality and articulation disorder, which are affected by velopharyngeal inadequacy(VPI). 17 subjects with a chief complaint of 'nasal sounds and inaccurate pronunciation' underwent a speech-language evaluation before and after pharyngoplasty. Hypemasality and obligatory articulation errors were improved but compensatory articulation errors remained after pharyngoplasty. Above mentioned results indicate that resonance may be normal or improved following successful surgical management of VPI but, compensatory articulation errors will still persist. The separate recognition of hypemasality, compensatory and obligatory articulation errors in deft palate patients is important in determining the timing of therapy and selection of appropriate targets in therapy.

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Distal biceps tendon injection

  • van der Vis, Jacqueline;Janssen, Stein J.;Bleys, Ronald L.A.W.;Eygendaal, Denise;van den Bekerom, Michel P.J.
    • Clinics in Shoulder and Elbow
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    • 제24권2호
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    • pp.93-97
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    • 2021
  • Background: Injection therapy around the distal biceps tendon insertion is challenging. This therapy may be indicated in patients with a partial distal biceps tendon tear, bicipitoradial bursitis and tendinopathy. The primary goal of this study was to determine the accuracy of manually performed injections without ultrasound guidance around the biceps tendon. Methods: Seven upper limb specialists, two general orthopedic specialists, and three orthopedic surgical residents manually injected a cadaver elbow with acrylic dye using an anterior and a lateral infiltration approach. After infiltration the cadaveric elbows were dissected to determine the location of the acrylic dye. Results: In total, 79% of the injections were localized near the biceps tendon. Of these injections, 20% were localized on the radius near the bicipitoradial bursa. In total, 53% of the performed infiltrations were injected by anterior and 47% by lateral approaches. Of the injections near the distal biceps (79%), 47% were injected by an anterior and 53% by a lateral approach. Of the injections on the radius (20%), 33% were injected by anterior and 67% by lateral approach. Of the inaccurate injections (21%), 75% were injected anterior and 25% lateral. Conclusions: Manual infiltration without ultrasound guidance for distal biceps pathology lacks accuracy. We therefore recommend ultrasound guidance for more accurate infiltration.

BCG 접종후 발생한 림프선염의 외과적 치료후 Isoniazid 투여의 필요여부 (Is Postoperative Isoniazid Therapy Necessary for Regional Lymphadenitis Following BCG Vaccination?)

  • 신관수;이남혁;김상윤
    • Advances in pediatric surgery
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    • 제3권1호
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    • pp.1-5
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    • 1997
  • Regional lymphadenitis is the most common complication following BCG vaccination in this country. The literature describes controversial results with medical, surgical and combined therpy. The purpose of this study is to clarify the therapeutic effect of isoniazid(INH) after surgical procedures. The early and late postoperative complications of 136 children with lymphadenitis following BCG vaccination at the Taegu Fatima Hospital between March 1985 and February 1996 were reviewed. In 90 children, INH was given for 3-4 days before operation and for 3 months after surgery. In the other 46 cases, INH was not given during the pre- or postoperative period. Surgical procedures were excision or incision and currettage according to the states of lesions. Postoperative complications were fluid accumulation, wound infection, sinus formation and others. Complication rates were 14.4 % in INH-treated group and 13.0% of INH-nontreated group. The difference was not significant. There was no recurrence or other late complication in either groups. The result suggest that surgical excision or incision and currettage are sufficient for the treatment of regional lymphadenitis following BCG vaccination and postoperative INH therapy is not necessary.

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Pulsed Electromagnetic Field Stimulators Efficacy for Noninvasive Bone Growth in Spine Surgery

  • Fiani, Brian;Kondilis, Athanasios;Runnels, Juliana;Rippe, Preston;Davati, Cyrus
    • Journal of Korean Neurosurgical Society
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    • 제64권4호
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    • pp.486-494
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    • 2021
  • The growth of pulsed electromagnetic field (PEMF) therapy and its progress over the years for use in post-operative bone growth has been revolutionary in its effect on bone tissue proliferation and vascular flow. However, further progress in PEMF therapy has been difficult due to lack of more evidence-based understanding of its mechanism of action. Our objective was to review the current understanding of bone growth physiology, the mechanism of PEMF therapy action along with its application in spinal surgery and associated outcomes. The authors of this review examined multiple controlled, comparative, and cohort studies to compare fusion rates of patients undergoing PEMF stimulation. Examining spinal fusion rates, a rounded comparison of post-fusion outcomes with and without bone stimulator was performed. Results showed that postoperative spinal surgery PEMF stimulation had higher rates of fusion than control groups. Though PEMF therapy was proven more effective, multiple factors contributed to difficulty in patient compliance for use. Extended timeframe of treatment and cost of treatment were the main obstacles to full compliance. This review showed that PEMF therapy presented an increased rate of recovery in patients, supporting the use of these devices as an effective post-surgical aid. Given the recent advances in the development of PEMF devices, affordability and access will be much easier suited to the patient population, allowing for more readily available treatment options.

재발성 호흡기 유두종증의 병변내 시도포비어 치료 (Intralesional Cidofovir Therapy for Recurrent Repiratory Papillomatosis)

  • 송형용;한명월;최승호;김상윤;남순열
    • 대한후두음성언어의학회지
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    • 제20권2호
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    • pp.136-140
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    • 2009
  • Background and Objectives: Recurrent respiratory papillomatosis (RRP) is difficult to treat because of its tendency to recur and spread throughout the aerodigestive tract. We aimed to estimate the effect of intralesional injections of cidofovir in patients with RRP. Materials and Method: Within the period from January 2003 to July 2007, 13 patients aged 2 to 61 years were treated with intralesional injections of cidofovir combined with surgical excision of RRP. Cidofovir was injected intralesionaly at a concentration of 5 mg/cc after complete removal of the papilloma with $CO_2$ laser or microdebrider. We evaluated the effect of intralesional cidofovir therapy by comparing pre-treatment mean interval of recurrence with post-treatment interval of recurrence. Results: Of 13 patients, two patients showed complete response during follow up period and four patients showed partial response. Seven patients did not respond to cidofovir at all. Mean pre-treatment mean interval of recurrence was 9 months and mean post-treatment interval of recurrence was 13.1 months (p=0.039). There was a statistical significance between the injected dose of cidofovir and post-treatment interval of recurrence (p=0.009). There were no local or systemic side effects caused by cidofovir. Conculsion : Intralesional injection of cidofovir seems to have a potential of a safe and effective adjuvant therapy of RRP. There was a positive correlation between the injected dose of cidofovir and patient clinical outcomes so that administration of higher doses and more frequency of injections should be needed to reduce recurrence. Further study regarding injection therapy regimen for RRP is required.

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The Effect of Perioperative Radiation Therapy on Spinal Bone Fusion Following Spine Tumor Surgery

  • Kim, Tae-Kyum;Cho, Wonik;Youn, Sang Min;Chang, Ung-Kyu
    • Journal of Korean Neurosurgical Society
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    • 제59권6호
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    • pp.597-603
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    • 2016
  • Introduction : Perioperative irradiation is often combined with spine tumor surgery. Radiation is known to be detrimental to healing process of bone fusion. We tried to investigate bone fusion rate in spine tumor surgery cases with perioperative radiation therapy (RT) and to analyze significant factors affecting successful bone fusion. Methods : Study cohort was 33 patients who underwent spinal tumor resection and bone graft surgery combined with perioperative RT. Their medical records and radiological data were analyzed retrospectively. The analyzed factors were surgical approach, location of bone graft (anterior vs. posterior), kind of graft (autologous graft vs. allograft), timing of RT (preoperative vs. postoperative), interval of RT from operation in cases of postoperative RT (within 1 month vs. after 1 month) radiation dose (above 38 Gy vs. below 38 Gy) and type of radiation therapy (conventional RT vs. stereotactic radiosurgery). The bone fusion was determined on computed tomography images. Result : Bone fusion was identified in 19 cases (57%). The only significant factors to affect bony fusion was the kind of graft (75% in autograft vs. 41 in allograft, p=0.049). Other factors proved to be insignificant relating to postoperative bone fusion. Regarding time interval of RT and operation in cases of postoperative RT, the time interval was not significant (p=0.101). Conclusion : Spinal fusion surgery which was combined with perioperative RT showed relatively low bone fusion rate (57%). For successful bone fusion, the selection of bone graft was the most important.

Clinical evaluation of Laser-Assisted New Attachment Procedure® (LANAP®) surgical treatment of chronic periodontitis: a retrospective case series of 1-year results in 22 consecutive patients

  • Raymond A. Yukna
    • Journal of Periodontal and Implant Science
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    • 제53권3호
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    • pp.173-183
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    • 2023
  • Purpose: Treatment for periodontitis has evolved over the years as new technologies have become available. Currently, lasers seem attractive as a treatment modality, but their effectiveness needs to be verified. The purpose of this project was to evaluate Laser Assisted New Attachment Procedure® (LANAP®) surgery as a single treatment modality. Methods: As part of a mandatory training program for periodontists and other dentists, 22 consecutive patients diagnosed with moderate to severe periodontitis (probing depth [PD] up to 11 mm) were treated with the LANAP® surgical approach using a 1064-nm Nd:YAG laser as part of a multi-step protocol. Following single-session active therapy, they were entered into a maintenance program. Their clinical status was re-evaluated at 12-18 months following surgery. Results: All 22 patients completed the 12- to 18-month follow-up. PD, clinical attachment level, and furcation (FURC) showed substantial improvement. Recession was minimal (mean, 0.1 mm), while 93.5% of PD measurements were 3 mm or less at re-evaluation. Furthermore, 40% of grade 2 FURC closed clinically. Conclusions: Within the limits of this case series, LANAP® was found to be an effective, minimally invasive, laser surgical therapy for moderate to advanced periodontitis.

가족성 고콜레스테롤혈증 환자에서의 다발성 황색종 - 1례 보고 - (Multiple Xanthomatosis in Familiar Hypercholesterolemia Patient - A case report -)

  • 이승구;이화성;문찬웅
    • 대한골관절종양학회지
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    • 제6권1호
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    • pp.41-46
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    • 2000
  • 다발성 황색종을 보이는 가족성 고콜레스테롤혈증 환자 1례를 경험하고 수술 및 내과적 치료를 병행하였으며, 계속 추적관찰 중이기에 문헌고찰과 함께 이에 보고하고자 한다. 전신 22 곳에 다발성 황색종을 보이는 26세 남자의 가족성 고콜레스테롤혈증 환자에서 17군데의 황색종을 수술적으로 절제하고, 고콜레스테롤혈증에 대하여는 내과적 약물치료를 병행하였으며, 술 후 13개월 이상 추적 관찰하였다. 환자는 정상적인 수술창의 치유과정을 보였고, 술 후 Simvastatin 약물치료를 병행하고 있으며, 1년 후 최종추시시 종괴의 재발은 없었으나 고콜레스테롤혈증의 치료는 미세한 변화만을 보여 계속 내과적 추적관찰 중이다. 가족성 고콜레스테롤혈증은 저밀도지단백 콜레스테롤의 증가, 건 황색종 및 관상동맥 질환을 특징으로 하며, 상염색체 우성으로 유전되는 지질대사의 장애를 보이는 질환이다. 황색종은 보통 10대에 처음 발견되고 조기 진단에 중요한 단서가 될 수 있으며, 특히 종골건 황색종은 가족성 고콜레스테롤혈증의 첫 번째 임상징후로 나타날 수 있다. 고콜레스테롤혈증은 관상동맥경화증의 위험이 높아 조기 진단과 치료가 중요하며, 이에 정형외과 의사도 황색종의 수술적 제거외에 이러한 숨어 있는 질환을 진단할 수 있어야 하겠다.

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Clinical and anatomic description of patients with arteriovenous malformation treated with endovascular therapy in a Mexican population

  • Mallyolo Eliezer Pelayo-Salazar;Hector Alfredo Montenegro-Rosales;Jorge Luis Balderrama-Banares;Pablo Martinez-Arellano;Omar Andres Campos-Flota;Laura Mestre-Orozco;Julio Cesar Lopez-Valdes
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • 제25권1호
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    • pp.36-49
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    • 2023
  • Objective: Arteriovenous malformations (AVMs) are benign congenital lesions. The estimated prevalence is 10-18 per 100,000 individuals, with an incidence rate of 1.1-1.4 per 100,000 person-year; only 12% of AVMs present symptoms during life. It is important to study different characteristics associated with AVMs because these patients require multidisciplinary treatment. Methods: A descriptive, observational, longitudinal, and retrospective study was carried out from January 15, 2016 to October 19, 2021. Convenience sampling was used on patients diagnosed with arteriovenous malformation. Sociodemographic data was obtained, such as: sex, age, site, predominant symptoms, clinical debut, type of malformation, data associated with post therapy evolution, type of embolizing agent used, associated complications, Rankin scale, and death. Results: Data from 535 procedures was collected, we calculated an incidence of 4.4 cases per million inhabitants. Ninety procedures in 56 patients that used endovascular therapy were obtained with a female-male ratio of 0.75 and an age distribution of 35±14 (SD). A 36.3±11.5 (SD) mm diameter was registered. There was a 33% success rate for endovascular surgery. Conclusions: The multidisciplinary treatment of AVMs is made up of three pillar techniques: microsurgical resection, embolization, and radio-neurosurgery. It is extremely important to make an appropriate decision, with an emphasis on achieving better functional outcomes for the patient. Although neurological endovascular therapy was initially used as an adjuvant treatment for neurosurgery and radio-neurosurgery, it has been used more and more frequently as the first line of treatment.