• Title/Summary/Keyword: supportive treatment

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Advancements in the treatment of pediatric acute leukemia and brain tumor - continuous efforts for 100% cure

  • Ju, Hee Young;Hong, Che Ry;Shin, Hee Young
    • Clinical and Experimental Pediatrics
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    • v.57 no.10
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    • pp.434-439
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    • 2014
  • Treatment outcomes of pediatric cancers have improved greatly with the development of improved treatment protocols, new drugs, and better supportive measures, resulting in overall survival rates greater than 70%. Survival rates are highest in acute lymphoblastic leukemia, reaching more than 90%, owing to risk-based treatment through multicenter clinical trials and protocols developed to prevent central nervous system relapse and testicular relapse in boys. New drugs including clofarabine and nelarabine are currently being evaluated in clinical trials, and other targeted agents are continuously being developed. Chimeric antigen receptor-modified T cells are now attracting interest for the treatment of recurrent or refractory disease. Stem cell transplantation is still the most effective treatment for pediatric acute myeloid leukemia (AML). However, in order to reduce treatment-related death after stem cell transplantation, there is need for improved treatments. New drugs and targeted agents are also needed for improved outcome of AML. Surgery and radiation therapy have been the mainstay for brain tumor treatment. However, chemotherapy is becoming more important for patients who are not eligible for radiotherapy owing to age. Stem cell transplant as a means of high dose chemotherapy and stem cell rescue is a new treatment modality and is often repeated for improved survival. Drugs such as temozolomide are new chemotherapeutic options. In order to achieve 100% cure in children with pediatric cancer, every possible treatment modality and effort should be considered.

Reconstructive methods to resolve intractable fistulas that develop after radiation therapy in patients with head and neck cancer

  • Choi, Bu Hyeon;Park, Seong Oh;Ahn, Hee Chang
    • Archives of Craniofacial Surgery
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    • v.22 no.5
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    • pp.247-253
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    • 2021
  • Background: Radiation therapy (RT) is frequently used for supportive treatment and management of advanced head and neck cancers. This study performed a retrospective review of the treatment methods that were used for intractable draining fistulas in seven patients who had received RT for head and neck cancers. Treatment methods used for two of the seven patients are presented in detail. Methods: From 2009 to 2020, seven patients underwent reconstructive surgery for intractable fistulas which occurred after RT for head and neck cancers. Patient characteristics, medical history, treatment method, and treatment outcome were reviewed for each case. The type of surgery performed, failure rate, and treatment period were also analyzed. Results: In this study, a total of seven patients received additional management for radiation-induced fistulas. Patients underwent a mean of 3.3±1.4 surgeries (maximum: six surgeries) to resolve their fistulas. The mean time interval from the first surgery to the last surgery for the patients to achieve resolution of the fistula was 8.7 months. Loco-regional flaps have performed an average of 1.9±1.5 times. However, all loco-regional flaps failed. Instead, the patients' intractable fistulas were resolved with the use of distant flaps or free tissue transfers. Conclusion: Fistulas that develop after head and neck cancer treatment following RT are difficult to treat with simple loco-regional flap procedures. Therefore, more aggressive treatment techniques, such as distant flap or free tissue transfer, may be needed to shorten patients' treatment periods and avoid unnecessary surgeries.

Long-term outcomes of adjacent and antagonistic teeth after implant restoration: a focus on patient-related factors

  • Park, Su-Yeon;Kim, Yong-Gun;Suh, Jo-Young;Lee, Du-Hyeong;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.51 no.2
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    • pp.135-143
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    • 2021
  • Purpose: To investigate factors affecting the antagonistic and adjacent teeth in patients after implant restoration and prosthetic rehabilitation. Methods: In total, 160 patients who visited Kyungpook National University Dental Hospital for implant surgery, prosthesis placement, and supportive periodontal therapy (SPT) were included in this study. The average follow-up period was 88.06 months, and the maximum was 175 months. Patients' history of smoking, diabetes, hypertension, and osteoporosis was investigated, and panoramic radiographs were taken after surgery and prosthetic treatment. During the follow-up period, extraction and prosthetic/endodontic treatments of the antagonistic and adjacent teeth were analyzed. The statistical analyses were performed using descriptive statistics, the chi-square test, the Fisher exact test, and multiple logistic regression analyses. Results: Treatment was performed on 29.4% of the studied antagonistic teeth with extraction performed in 20.0% and prosthetic treatment in 10.0%. Furthermore, 19.4% of the studied adjacent teeth underwent treatment, of which extraction was performed in 12.5% and prosthetic treatment in 7.5%. The treatment rate for adjacent teeth was 25.3% in smokers, which was higher than that of non-smokers (12.3%) (P=0.039). Patients who were non-adherent to SPT showed a significantly higher rate (19.6%) of antagonistic prosthetic treatment than did those who were adherent (5.5%) (P=0.006). Conclusions: Implant restoration can affect the adjacent and antagonistic teeth. Smoking, osteoporosis history, and absence of SPT may be risk factors for the treatment of the adjacent and antagonistic teeth.

A Survey of Low Back Pain for the Rural Woman and Home Extension Worker Related Education (농촌 부녀자와 농촌 생활지도사의 요통 교육에 관한 조사)

  • Kim, Soon-Ja
    • Journal of Korean Physical Therapy Science
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    • v.2 no.2
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    • pp.509-515
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    • 1995
  • The purpose of this study was to assess the rural women's general status in relation with low back pain. This survey was done after teaching them the prevention and treatment of low back pain with Meckenzie Method. 84 rural resident women including rural life guidance. The results were as follows. 1. The average age of rural were $35{\sim}50$ years old and the guidance's age were $21{\sim}25$ years old. The educational level of rural women were highest in primary school(46.67 %) and the home extension worker were college education(83.67 %). 2. 75 % of rural woman complained low back pain while 17.33 % of the home extension worker had back pain. 3. The home extension worker feel the necessity of the education in low back pain(100 %) while 88.89 % of the rural woman agreed. 4. All the rural women and the home extension worker had the concept of back pain and its prevention(100 %). 5. After this education, the confidence in prevention and treatment were each 78.79 % with rural women and 91.84 % with home extension worker. 6. The necessity for the treatment of low back pain were : first, the correction of posture, second, the activity posture correction, third, the supportive roll of back curve. 7. There were no statistical significant outcome specifically.

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Compressive Neuropathy in Upper Extremity (상지의 압박 신경병증)

  • Park, Jong Woong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.99-106
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    • 2009
  • Compressive neuropathy in the upper extremity can be clinically diagnosed by careful history taking, physical examination of the involved nerve. Electrodiagnosis for the suspected nerve informs severity of compression of the involved nerve and indicates specific site of the lesion. In the early stage of the disease, non-operative treatment generally cures the symptom, however, if the conservative treatment fails, confirmation of the exact site of the lesion should be preceded before the operation. Recently, ultrasonography, as a supportive tool for the diagnosis of compressive neuropathy has increasing popularity for its ability to find space occupying lesion, anatomical change of the nerve, and the pathologic change in the nerve itself. For the successful treatment of the compressive neuropathy, these various diagnostic tools have to be introduced in the orthopaedic clinic.

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Radiation Induced Lung Injury: Prediction, Assessment and Management

  • Giridhar, Prashanth;Mallick, Supriya;Rath, Goura Kishore;Julka, Pramod Kumar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2613-2617
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    • 2015
  • Radiation induced lung injury has long been considered a treatment limiting factor for patients requiring thoracic radiation. This radiation induced lung injury happens early as well as late. Radiation induced lung injury can occur in two phases viz. early (< 6 months) when it is called radiation pneumonitis and late (>6 months) when it is called radiation induced lung fibrosis. There are multiple factors that can be patient, disease or treatment related that predict the incidence and severity of radiation pneumonitis. Radiation induced damage to the type I pneumocytes is the triggering factor to initiate such reactions. Over the years, radiation therapy has witnessed a paradigm shift in radiation planning and delivery and successfully reduced the incidence of lung injury. Radiation pneumonitis is usually a diagnosis of exclusion. Steroids, ACE inhibitors and pentoxyphylline constitute the cornerstone of therapy. Radiation induced lung fibrosis is another challenging aspect. The pathophysiology of radiation fibrosis includes continuing inflammation and microvascular changes due to pro-angiogenic and profibrogenic stimuli resembling those in adult bronchiectasis. General supportive management, mobilization of airway secretions, anti-inflammatory therapy and management of acute exacerbations remains the treatment option. Radiation induced lung injury is an inevitable accompaniment of thoracic radiation.

A case of hepatoma patient with lungs and brain metastasis (폐와 뇌에 전이를 동반한 간암환자 1례에 대한 보고)

  • Yoo, Hwa-Seung;Lee, Yong-Yeon;Song, Kee-Cheol;Choi, Byung-Lyul;Seo, Sang-Hoon;Choi, Woo-Jin;Cho, Jung-Hyo;Lee, Yeon-Weol;Son, Chang-Gue;Cho, Chong-Kwan
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.7 no.1
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    • pp.131-139
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    • 2001
  • Objectives: This study was designed to evaluate the effects of symptom differentiated treatment on cancer patient. Methods: We retrospectively analyzed the medical record of a case of hepatoma patient with lungs and brain metastasis who had been treated with oriental medicines from 16 august 2001 through 5 september 2001. Results: For the 21 hospital days, he was treated with oriental medicines. Not only all most symptoms were disappeared but also hematological and radiological examinations were improved. According to the results, it could be suggested that symptom differentiated treatment has significant effects on improving symptoms and quality of life as a supportive or palliative therapy for cancer patients.

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Carbon monoxide releasing molecule-2 protects mice against acute kidney injury through inhibition of ER stress

  • Uddin, Md Jamal;Pak, Eun Seon;Ha, Hunjoo
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.5
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    • pp.567-575
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    • 2018
  • Acute kidney injury (AKI), which is defined as a rapid decline of renal function, becomes common and recently recognized to be closely intertwined with chronic kidney diseases. Current treatment for AKI is largely supportive, and endoplasmic reticulum (ER) stress has emerged as a novel mediator of AKI. Since carbon monoxide attenuates ER stress, the objective of the present study aimed to determine the protective effect of carbon monoxide releasing molecule-2 (CORM2) on AKI associated with ER stress. Kidney injury was induced after LPS (15 mg/kg) treatment at 12 to 24 h in C57BL/6J mice. Pretreatment of CORM2 (30 mg/kg) effectively prevented LPS-induced oxidative stress and inflammation during AKI in mice. CORM2 treatment also effectively inhibited LPS-induced ER stress in AKI mice. In order to confirm effect of CO on the pathophysiological role of tubular epithelial cells in AKI, we used mProx24 cells. Pretreatment of CORM2 attenuated LPS-induced ER stress, oxidative stress, and inflammation in mProx24 cells. These data suggest that CO therapy may prevent ER stress-mediated AKI.

A study of psychotherapy by means of oriental medicine though the Giungoroen(至言高論)-Focusing on Ancient clinical document (지언고론(至言高論)에 의한 한의학적(韓醫學的) 정신치료(精神治療)에 대(對)한 연구(硏究) (의안(醫案)을 중심으로))

  • Gu Byong-Su;Kim Geun-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.12 no.1
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    • pp.29-45
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    • 2001
  • Objectives: In order to overcome psychotherapeutic problems though the theory of oriental medicine by means of the Giungoroen(至言高論-wise saying and lofty opinion). Methods: This research was done by comparing the contents of psychotherapeutic ancient clinical document with the western medical method of psychotherapy Results: 1. Inquire into the clinical document, the psychotherapy is used treatment of wide area disease inclusive of neuropsychiatric disease different from the western medicine. 2. Inquire into the method of psychotherapy, the supportive psychotherapy and behavior therapy is applied. 3. In case of psychotherapy and treatment of medicines is done at the same time, treatment of medicines followed psychotherapy. 4. A viewpoint of Yusic(唯識-vijnaptim-atra)-a field of Buddhism, possibility of psychotherapy is showed. 5. A doctor's oriental thought and oriental medical Preservation of Health view was based. 6. The change of patient's the emotion and will is focused than disease itself. Conclusion: When western medical method of psychotherapy is complemented by a oriental thought and oriental medical Preservation of Health view, the good effects is hoped in psychotherapy.

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Management of Hypertension and Proteinuria after Treatment with Lenvatinib for Radioiodine Refractory Papillary Thyroid Carcinoma: a Case Report (렌바티닙 사용과 관련된 고혈압과 단백뇨의 관리: 증례 보고)

  • Song, Eyun;Kim, Won Gu
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.78-81
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    • 2018
  • Lenvatinib, an oral multi-kinase inhibitor, is a valuable treatment option for advanced differentiated thyroid carcinoma. However, severe treatment-related adverse events occur up to 30% of the patients receiving lenvatinib, making it a challenge for clinicians to maintain this drug and therefore affecting the outcome of therapy. Blood vessel related events, such as hypertension or proteinuria, are among the most frequent adverse events. We present a case of 65-year-old man with radioactive iodine refractory papillary thyroid carcinoma with cervical lymph node metastasis and tracheal invasion receiving lenvatinib who developed proteinuria and worsening of hypertension. Management with repeated dose reductions and using supportive medications allowed this patient to continue lenvatinib with his disease stably controlled. Early detection of patients at risk for these adverse events and cautious administration of lenvatinib at appropriate level are crucial in managing patients receiving lenvatinib.