• 제목/요약/키워드: patients

검색결과 62,819건 처리시간 0.076초

Organ preservation with neoadjuvant chemoradiation in patients with orbit invasive sinonasal cancer otherwise requiring exenteration

  • Amsbaugh, Mark J.;Yusuf, Mehran;Silverman, Craig;Bumpous, Jeffrey;Perez, Cesar A.;Potts, Keven;Tennant, Paul;Redman, Rebecca;Dunlap, Neal
    • Radiation Oncology Journal
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    • 제34권3호
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    • pp.209-215
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    • 2016
  • Purpose: We sought to determine if organ preservation (OP) with neoadjuvant chemoradiation (CRT) was feasible in patients with sinonasal cancer determined to require exenteration. Materials and Methods: Twenty patients were determined to require exenteration for definitive treatment from 2005 to 2014. Fourteen patients underwent OP and 6 patients received exenteration with adjuvant CRT. Exenteration free survival (EFS), locoregional control (LRC), progression-free survival (PFS), and overall survival (OS) were estimated. Results: Five patients (36%) receiving OP had complete disease response at time of surgery. With a median follow-up of 18.8 months, EFS was 62% at 2 years for patients undergoing OP. At 2 years, there were no significant differences in LRC, PFS or OS (all all p > 0.050) between the groups. Less grade 3 or greater toxicity was seen in patients undergoing OP (p = 0.003). Visual function was preserved in all patients undergoing OP. Conclusion: For patients with sinonasal cancer, OP may avoid exenteration, offering similar disease control and improved toxicity.

만성신부전 환자의 혈관 석회화와 사망률에 미치는 인결합제의 영향 (Effect of Phosphate Binders on Vascular Calcification and Mortality in Korean Patients with Chronic Kidney Disease)

  • 신혜연
    • 한국임상약학회지
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    • 제24권3호
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    • pp.199-205
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    • 2014
  • Objectives: Current studies are debating on the association of vascular calcification and the benefit of treatment to lower serum phosphorus level in patients with chronic kidney disease. The aim of this study was to evaluate the association of mortality and risk of vascular calcification in patients with CKD who were taking phosphate binders. Methods: This study was conducted through retrospective medical chart review for 420 patients aged 18 years and older who were admitted for chronic kidney disease. Results: Vascular calcification was not statistically significantly associated with increased mortality in patients with CKD [16.7% vs. 19.2%; 95% CI; 0.388 to 1.818 (p=0.656)]. Intervention of calcium-based phosphate binders was not significantly associated with vascular calcification in patients with CKD [9.1% vs. 12.5%; 95% CI; 0.364 to 1.358 (p=0.292)]. Ca x P product ${\geq}55mg^2/dL^2$ was not significantly associated with increased 1 year mortality in patients with CKD [25.4% vs. 17.5%; 95% CI; 0.851 to 3.013 (p=0.142)]. Intervention of sevelamer was significantly associated with reduced 1 year mortality in patients with CKD than that of patients who did not take sevelamer [6.3% vs. 25.3%; 95% CI; 0.044 to 0.880 (p=0.020)]. Conclusion: There was not a statistically significant association between vascular calcification and phosphate binder's use. But phosphate binder use was significantly associated with decreased mortality in patients with CKD.

Brain Metastases from Solid Tumors: an Institutional Study from South India

  • Ghosh, Saptarshi;Rao, Pamidimukkala Brahmananda
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권13호
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    • pp.5401-5406
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    • 2015
  • Background: Brain metastases are the most common intra-cranial neoplasms. The incidence is on a rise due to advanced imaging techniques. Aims: The objective of the study was to analyse the clinical and demographic profile of patients with brain metastases from primary solid tumors. Materials and Methods: This is a retrospective single institutional study covering 130 consecutive patients with brain metastases from January 2007 to August 2014. Results: Some 64.6% of the patients were females. The majority were in the sixth decade of life. The site of the primary tumor was the lungs in 50.8% of the cases. The overall median time from the diagnosis of the primary malignancy to detection of brain metastases was 21.4 months. Survival was found to be significantly improved in patients with solitary brain lesions when compared to patients with multiple brain metastases, and in patients undergoing surgical excision with or without cranial irradiation when compared to whole brain irradiation alone. The majority of the cases belonged to the recursive partitioning analysis class II group. Whole brain radiation therapy was delivered to 79% of the patients. Conclusions: Most of the patients with brain metastases in the study belonged to recursive partitioning analysis classes II or III, and hence had poor prognosis. Most of the patients in the Indian context either do not satisfy the indications for surgical excision or are incapable of bearing the high cost associated with stereotactic radiosurgery. Treatment should be tailored on an individual basis to all these patients.

파킨슨병 환자 부양자의 부양부담에 영향을 미치는 요인 (Factors Affecting Caregiver Burden in Caregivers of Patients with Parkinson's Disease)

  • 김동원;배은숙
    • 성인간호학회지
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    • 제27권3호
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    • pp.283-293
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    • 2015
  • Purpose: Depression is a common sign of suffering among the patients with Parkinson's disease (PD). Frequent and severe neuropsychiatric symptoms lead to high levels of distress in patients and their caregivers, which results in the high levels of caregiver burden. The aim of this study was to determine the predictors of caregiver burden in caregivers of the patients with Parkinson's disease (PD). Methods: The study included 183 consecutive PD patients and their caregivers. Patients were assessed using the Hoehn and Yahr scale, Mini Mental State Examination (MMSE), Beck Depression Inventory (BDI), and Schwab and England Activities of Daily Living Scale. Caregivers' depressive symptoms were evaluated using the Caregiver Burden Inventor (CBI), BDI, and World Health Organization Quality of Life Scale. Results: All of the patients reported one or more neuropsychiatric symptoms. Patients' and caregivers' depressive symptoms, caregivers' age and education, time for caregiving, and quality of life were significantly associated with the increased caregiver burden. After controlling the level of education as a potential confounding variable, depression in both patients and caregivers, time for caregiving, and quality of life explained 45.6% of the variance in caregiver burden. Conclusion: Substantial attention needs to be given to the early identification of depression in PD patients and their caregivers to improve caregivers' quality of life and burden.

측두하악장애(Temporomandibular Disorder, TMD) 환자의 불안에 대한 연구 (The Study on Anxiety of Patients with Temporomandibular Disorder(TMD))

  • 김광호;김재중;이종진
    • 척추신경추나의학회지
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    • 제1권2호
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    • pp.21-29
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    • 2006
  • Objective: The aim of this study is to investigate whether patients with temporomandibular disorder have more anxiety than normal people. Methods: Patients group(n=50) with TMD and normal group(n=30) without TMD and other disease completed STAl(State-Trait Anxiety Inventory), and there was comparison of mean scores between patients and normal groups. Results: The mean of total STAl scores of patients group was $91.32{\pm}20.32$, whereas that of normal group was $81.27{\pm}12.97(p<0.01)$. The mean of state-anxiety scores of patients group was $45.68{\pm}11.30$, whereas that of normal group was $40.70{\pm}7.28(p<0.05)$. The mean of trait-anxiety scores of patients group was $45.64{\pm}10.02$, whereas that of normal group was $40.57{\pm}7.22(p<0.05)$. There was a tendency that patients with TMD had more anxiety. So, doctors had better give attention to patients' anxiety when they treat the patients with TMD.

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Can pursuit eye movements reflect the efficacy of antiepileptic drugs?

  • Kim, Si Eun;Park, Kang Min
    • Annals of Clinical Neurophysiology
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    • 제19권1호
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    • pp.20-27
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    • 2017
  • Background: We evaluated whether eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy. Methods: Thirty patients with epilepsy of unknown cause as well as age- and sex-matched normal controls were enrolled in this study. We divided the patients into drug-controlled epilepsy (n = 22) and drug-resistant epilepsy (n = 8) groups according to their seizure controls. We analyzed the differences in the parameters of the eye movements in these two groups compared with normal controls using video-based electro-oculography. In addition, we investigated the differences in the cerebellar volumes of these two groups using whole-brain T1-weighted images. Results: The latency and accuracy of saccade in patients with epilepsy were significantly different from normal controls, but they were not different between patients with drug-controlled epilepsy and drug-resistant epilepsy. However, the gain of pursuit was significantly decreased in patients with drug-resistant epilepsy compared with normal controls (p = 0.0010), whereas it was not different between patients with drug-controlled epilepsy and normal controls (p = 0.9646). In addition, the patients with drug-resistant epilepsy had lower cerebellar volumes than normal controls (p = 0.0052), whereas the cerebellar volumes in patients with drug-controlled epilepsy were not different from normal controls (p = 0.5050). Conclusions: We demonstrated that pursuit eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy, a finding that may be related to cerebellar dysfunction.

일 호스피스실 이용 환자와 가족의 상담내용 분석 (Content Analysis with Counseling Cancer Patients and Their Relatives in Outpatient Hospice Office)

  • 최은숙;김금순
    • 재활간호학회지
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    • 제8권1호
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    • pp.50-58
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    • 2005
  • Purpose: The purpose of this study was to increase our understanding of the terminal cancer patients and their families concerns. I analyzed the counseling contents of terminal cancer patients and their relatives who referred to hospice office. Method: Data was collected from January 2004 to November 2004. During the counseling, I took notes the key points and contents. 109 patients and/or their families's counseling records were analyzed with the descriptive statistics and content analysis. Result: 73.4% of patients knew their current terminally ill status. The mobility of 86.2% of the patients was worse than ECOG 3 level. Patients have uncontrolled pain(28.4%), emotional distress(55.0%), and physical distress(49.5%). Caregivers of the patients were spouse(46.8%), sons and daughters(24.8%). Family members had problems to tell the bad news to their family cancer patient. 95.4% of the patient and family members was informed about the hospice and palliative care services, and 35.8% of them was referred to the hospice and palliative organizations. Frequently asked questions were 'what is hospice?', 'how much is the cost of hospice services?' etc. Conclusion: Care planning for terminal cancer patients must include patient. Also, professionals should consider and offer accessible, effective and empathetic counseling services to patients and families.

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당뇨족 궤양에서 진균감염의 유병률 (Prevalence of Fungal Infection in Diabetic Foot Ulcer)

  • 유연식;한승규;김우경
    • Archives of Plastic Surgery
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    • 제35권2호
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    • pp.134-138
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    • 2008
  • Purpose: In a diabetic foot ulcer, superficial fungal infection of the foot may disrupt the skin integrity and provide an avenue for bacterial infection. The prevalence of fungal infection in diabetic foot ulcer has been reported as 12-30% in Caucasian patients. However, no data are available for Korean patients. The purpose of the study was to examine the prevalence of fungal infection in diabetic foot patients admitted in our clinic. Methods: This study included consecutive 30 diabetic foot ulcer patients(24 males and 6 females) admitted from May 2007 to July 2007. The mean age was 60.5 years. All patients underwent mycological examination including direct microscopic examination in KOH and culturing on slants and tubes with Sabouraud's glucose agar. Results: Clinical signs of presumed fungal infection, which were examined by dermatologists, were found in all patients included in this study. Direct microscopic examination was positive for the specimens of the skin and the toenails in 28(93.3%) and 25(83.3%) patients, respectively. In addition, culture result was positive for the specimens of the skin and the toenails in 5(16.73%) and 7(23.3%) patients, respectively. Conclusion: The prevalence of fungal infection in diabetic foot ulcer patients admitted in our clinic is much higher than that in Caucasian patients(83.3-93.3% vs 12-30%).

척추전방전위증 환자와 추간판탈출증 환자의 요부근 기능과 굴곡/신전근 비율에 관한 비교연구 (Comparison Study on Lumbar Strength and Lumbar Flexor/Extensor Ratio of Spondylolisthesis Patients and Herniated Disc Patients)

  • 지용석;유병규;이완희
    • The Journal of Korean Physical Therapy
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    • 제14권3호
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    • pp.136-144
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    • 2002
  • The Purpose of this study was to compare the lumbar strength and lumbar flexor/extensor ratio between spondylolisthesis and herniated disc patients. The patients who had a subacute low back pain have been proved to each disease through MRI and we measured the maximal isometric strength of all patients(28) through MedX lumbar extension machine(Ocala, FL). In all patients, males had higher lumbar extensor strength than that of females. Especially, the spondylolisthesis patients had lower lumbar extensor strength than that of herniated disc patients. The statistical significant(p<.05, p<.01) differences were manifested in $48^{\circ},\;60^{\circ}\;and\;72^{\circ}$ between male groups. Also the statistical significant (p<.05) differences were manifested in $60^{\circ}\;and\;72^{\circ}$between female groups. In the lumbar flexor/ extensor ratio, the males of spondylolisthesis groups represented the functional weakness in the flexed portion of the range of motion, and the females of spondylolisthesis and the all patients of herniated disc represented the functional weakness in the extended portion of the range of motion. In conclusion, we may propose the program such that the spondylolisthesis males must increase the ratio of extended portion exercise, and the spondylolisthesis females and herniated disc patients must increase the ratio of flexed portion exercise.

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Takayasu 동맥염의 외과적 경험 (Surgical Experience of Takayasu` Arteritis)

  • 김욱성
    • Journal of Chest Surgery
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    • 제26권12호
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    • pp.926-933
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    • 1993
  • We experienced 20 patients with Takayasu`s disease who required 22 surgical procedures for critical arterial stenoses, aneurym of descending thoracic aorta, and aortic regurgitation from 1986 to 1993.Five patients had type I arteritis, seven patients had type II , seven patients had type III, and one patients had type IV.15 patients were female and 5 patients were male.Patients` ages ranged from 17 to 47 years and mean age was 29.1 years. The surgical procedures were as follows;autotransplantations of kidney[3], aortic valve replacements[2], ascending aorta-bilateral internal carotid artery bypasses[2], unilateral renal artery bypasses[2], bilateral renal artery bypasses[3], replacement of descending thoracic aorta[1], ascending aorta-abdominal aorta bypass[1], ascending aorta-right internal carotid artery bypass[1], ascending aorta-right internal carotid artery and left subclavian artery bypass[1], left common carotid artery-left-subclavian artery bypass[1], pulmonary artery angioplasty[1], left femoro-bilateral axillary bypass[1] and others[2]. There was no hospital death.Mean duration of follow-up was 42.7 months[ranged from 3 to 96 months].There was one late death and late mortality rate is 5.9%.Two patients was underwent second vascular procedures, one after 5 years and the other after 5 months.The other patients have done well after surgery.

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