• Archives of Plastic Surgery
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• 제32권3호
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• pp.314-318
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• 2005

For treatment of full thickness skin defects caused by trauma or infections, skin grafts or flaps have been the treatment of choice to date. However, in patients who are not candidates for surgery, either due to his general conditions or refusal to receive treatment, supportive methods have been the only means of care, which inherently caused psychological trauma to the patient due to uncertainties of ultimate outcome and the length of treatment. This study aimed to heal full thickness skin defects through application of topical epidermal growth factor in patients who have received 2 to 3 weeks of conservative management using medifoam $B^{(R)}$ without improvement. Six patients from March 2002 to July 2004 were enrolled. The mean size of defects was $5.4{\times}4.6cm$ in 4 patients with carcinoma and $6.4{\times}4.1cm$ in 2 patients with osmidrosis. Commercially available 0.005% EGFR solution was used, and dressing was performed once daily. All patients benefitted from the use of EGF, with closure of skin defects taking an average of 28 days in cancer patients and 22.5 days in osmidrosis cases. EGF can be used as a supportive mean of treatment in the inoperable patients with skin defects, with resultant hastening of healing shortening duration of treatment.

• Journal of Periodontal and Implant Science
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• 제35권1호
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• pp.43-52
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• 2005

This study was performed to evaluate the relation between the interval of supportive periodontal therapy and the prevalence of the subgingival microflora. The subgingival plaques from 108 patients were used in the study. Control group were the patients with no periodontal treatment and test groups were assigned into 3 groups according to the period of recall check: group 1; 1-2 months, group 2; 3-4 months, group 3; 6months or more. The polymerase chain reaction (PCR) used for direct identification of periodontal pathogens (P. gingivalis, T. forsythensis, T. denticola) in subgingival plaque. The results of this study were as follows. 1. The prevalence of P. gingivalis, T. forsythensis, T. denticola in control group were 100%, 87%, 90%. 2. In clinical parameters such as plaque index, gingival index, bleeding on probing, control group was not significant different with group 1 but Significant different with group 2, group 3. 3. In group 1, the majority of P. gingivalis had type II fimA. 4. When group 3 were compared with group 1, the prevalence of P. gingivalis increased. But the prevalence of P. gingivalis with type II fimA, which have the virulence factor, decreased. 5. We were unable to find the correlation between P. gingivalis with type IV fimA and periodontal disease. 6. The prevalence of T. forsythensis, T. denticola in test group were 85%, 93% or more. From the above results, we were able to find the relation between the interval of supportive periodontal therapy and the prevalence of the subgingival microflora and the need of the strict supportive periodontal therapy to prevent recurrence of periodontal disease, because there were high prevalence of periodontal pathogens.

• 성인간호학회지
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• 제25권1호
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• pp.62-73
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• 2013

Purpose: This study was conducted to examine the effects of tailored supportive education on physical, psychological status and quality of life in the patients with congestive heart failure (CHF) who had not participated previously in cardiac rehabilitation program. Methods: This study was used a non-equivalent control pre-post design, conducted on 64 CHF patients under medical treatment in a hospital. The experimental group (n=31) received the tailored supportive educational program (once 1~2 days before discharge and 6 times after discharge through outpatient visits or telephone contact: once every week for the first 4 weeks after discharge and once every 2 weeks for the remaining 4 weeks). The control group (n=33) received a traditional discharge education. Data were analyzed using descriptive statistics, ${\chi}^2$-test, Fisher's exact test, t-test and repeated measure ANOVA using the SPSS/ WIN 18.0 program. Results: Participants in the experimental group showed the significantly increased scores of the quality of life (F=16.01, p<.001), and the significantly decreased scores of physical function (F=7.27, p=.009), depression (F=8.25, p=.006) and anxiety (F=4.11, p=.047), when compared to those of the control group. Conclusion: The findings indicated tailored supportive education was an effective intervention care in physical, emotional status and quality of life for CHF patients.

• Journal of Korean Neurosurgical Society
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• 제53권5호
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• pp.303-304
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• 2013

Rhabdomyolysis is a rare but potentially life-threatening disorder caused by the release of injured skeletal muscle components into the circulation. The authors report a case of severe head injury, in which a hyperosmolar state and continuous seizure complicated by severe rhabdomyolysis and acute renal failure evolved during the course of treatment resulted in a fatal outcome despite intensive supportive treatment. Our bitter experience suggests that rhabdomyolysis should be born in mind in patients with severe head injury who may develop hyperosmolar state and continuous seizure.

• 대한기관식도과학회지
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• 제9권2호
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• pp.44-48
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• 2003

Rupture of the esophagus is an uncommon condition that can be a formidable challenge to treat. Unless early treatment is applied, life-threatening complications, such as mediastinitis, sepsis, occurs and continue to be associated with a mortality rate of more than 20%. Definitive repair of esophageal perforation is considered the preferred treatment in the past. In the present study, conservative treatment acquired a good results by help of the development of antibiotics and nutritional supportive methods. Iatrogenic causes constituted most of the injuries, followed by external trauma, spontaneous, ingested foreign bodies, and malignancy. The incidence of perforation following ingestion of foreign bodies is very rare, so recommendations regarding treatment remain controversial. We analyzed the course of 31 patients with esophageal perforation by foreign bodies, concentrating on the diagnostic & treatment delay and methods of treatment, complications.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7669-7674
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• 2013

Background: The hypothesis that patients who primarily progress on two consecutive chemotherapy regimens without evidence of clinical benefit may opt for supportive care was investigated. The purpose was to determine the quality of life in recurrent ovarian cancer patients choosing to receive salvage chemotherapy in addition to supportive care or palliative care alone. A secondary objective was to evaluate factors that affect quality of life in ovarian cancer patients. Materials and Methods: A descriptive study was conducted in patients who had histological confirmed epithelial ovarian cancer and failed to respond to at least one regimen of chemotherapy, coming for treatment at the King Chulalongkorn Memorial Hospital in Bangkok, Thailand over a six-month period from August 2012-March 2013. Each patient was asked to complete the FACT-G and a general personal questionnaire. The median quality of life score was analyzed. The Mann Whitney U Test was used to compare the difference between salvage chemotherapy and palliative care groups, and the Kruskal Wallis was used to evaluate other variables. Results: Thirty-eight ovarian cancer patients were identified who failed to respond to chemotherapy. Of the 38, 30 chose salvage chemotherapy and eight palliative care for further treatment. By histology the carcimnomas were predominantly endometrioid subtype and poorly differentiated. The majority of patients in this study had FIGO stage III, and ECOG status 0-1. The median quality of life score was 76.3 (35.8-94.0), with no significant differences between the groups. Factors associated with the quality of life were the ECOG score and number of chemotherapeutic courses. Conclusions: In the setting of refractory or recurrent epithelial ovarian cancer, patients who receive salvage chemotherapy have comparable quality of life scores with patients treated with palliative care alone, providing a contrast with previous studies.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1593-1596
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• 2013

Background: To evaluate outcomes using a Thai herbal medicine, Vilac Plus (G716/45) with standard radiotherapy in comparison with historic controls from literature reports of the results of treatment in stage IIIB cervical cancer. Materials and Methods: Between March 2003 and June 2005, thirty patients with advanced cervical cancer stage IIIB-IV who had a poor performance status were treated by palliative radiotherapy along with an adjuvant daily dose of 15-30 ml of Thai herbal tonic solution (Vilac Plus G716/45) administered orally three times after meals as an additional supportive therapy. The results were analyzed from the aspect of the overall survival rates with curves estimated by the Kaplan-Meier method. Results:.The median follow -up time for stage IIIB was 4.2 years with a range of 7.9 months - 6.1 years. The overall 1, 3, and 5 year survival rates for stage IIIB were 88%, 60% and 52%. Conclusions: The overall 5 year survival rate for stage IIIB with a poor performance status was 52% when compared with 34-54.8% for historic controls. The combined complementary palliative radiotherapy (CCPR) had low rates of radiation morbidity. It was a simple technique and feasible for developing countries. The pilot study was limited by the small number of patients and further research will be necessary to assess interrelated and confounding factors in treatment of cervical cancer patients.

• Journal of Medicine and Life Science
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• 제18권3호
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• pp.61-65
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• 2021

Although re-expansion pulmonary edema (RPE) is rare (incidence rate <1%), it is associated with a mortality rate of >20%; therefore, early diagnosis and treatment are important. We report a case of RPE following chest tube insertion in a patient with spontaneous pneumothorax. We have specifically focused on the mechanism underlying RPE and the possible etiology. An 82-year-old man with a history of chronic anemia, chronic obstructive pulmonary disease, diabetes mellitus, and hypertension was referred to the emergency department for management of recurrent right-sided pneumothorax. We performed emergency closed thoracostomy for suspected tension pneumothorax, which led to stabilization of the patient's vital signs; however, he coughed up frothy pink sputum accompanied by severe right-sided chest pain 30 min postoperatively. The patient showed new-onset right pulmonary consolidation on chest radiography, as well as desaturation, tachycardia, and tachypnea and was diagnosed with RPE. He was transferred to the intensive care unit for mechanical ventilation and supportive treatment using diuretics, ionotropic agents, and prophylactic antibiotics. RPE gradually resolved, and the patient was extubated 3 days after admission. He has not experienced recurrent pneumothorax or pulmonary disease for 4 months. We emphasize the importance of RPE prevention and that aggressive ventilator care and supportive treatment can effectively treat RPE following an accurate understanding of the underlying pathogenetic mechanisms and risk factors.

• Journal of Korean Dental Science
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• 제9권2호
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• pp.81-89
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• 2016

Necrotizing periodontal diseases, especially acute necrotizing ulcerative gingivitis (ANUG), it should be noted, occur abruptly and progress rapidly, eventually causing severe soft-tissue and alveolar bone loss. This report presents the cases of two ANUG patients and provides a brief treatment protocol for easy and effective clinical management. After proper diagnosis, sequential treatment with cessation of mechanical brushing, along with a prescription of systemic antibiotics and chlorhexidine as a mouth rinse, scaling, root planing, and supportive periodontal therapy, was utilized. In all cases discussed in this report, there was marked improvement in a few days. ANUG, though an uncommon disease, can be efficiently managed with proper diagnosis and immediate treatment.

• Tuberculosis and Respiratory Diseases
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• 제78권1호
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• pp.36-40
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• 2015

Malignant pleural mesothelioma (MPM) is an aggressive, treatment-resistant, and generally fatal disease. A 68-year-old male who was diagnosed with MPM at another hospital came to our hospital with dyspnea. We advised him to take combination chemotherapy but he refused to take the treatment. That was because he had already received chemotherapy with supportive care at another hospital but his condition worsened. Thus, we recommended photodynamic therapy (PDT) to deal with the dyspnea and MPM. After PDT, the dyspnea improved and the patient then decided to take the combination chemotherapy. Our patient received chemotherapy using pemetrexed/cisplatin. Afterwards, he received a single PDT treatment and then later took chemotherapy using gemcitabine/cisplatin. The patient showed a survival time of 27 months, which is longer than median survival time in advanced MPM patients. Further research and clinical trials are needed to demonstrate any synergistic effect between the combination chemotherapy and PDT.