• Title/Summary/Keyword: therapeutic case report

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Photodynamic Therapy for Neoplasms in Intrathoracic Constructed Stomach (식도암 수술 후 흉곽 내 위장에 발생한 원발성 위암에 대한 광역동치료 -1예 보고 -)

  • Park, Ki-Sung;Ko, Moo-Sung;Kwon, Oh-Choon;Lee, Sub;Kim, Jong-Ki;Jheon, Sang-Hoon
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.794-797
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    • 2003
  • Photodynamic therapy (PDT) is a local, endoscopically controlled nonoperative therapeutic technique based on selective sensitization of mucosal, malignant and precancerous lesions of the esophagus, trachea and bronchus prior to light-induced tissue destruction in the department of thoracic and cardiovascular surgery. PDT is effective and safe for palliative treatment of neoplasms in the stomach, esophagus, and lung. But skin phototoxicity is unsatisfactory, therefore optimization of management of post-PDT is necessary for preventing phototoxic side effects of skin. Careful patient education in photoprotection techniques, close patient follow-up, early dermatologic referral and medical treatment are recommended. We performed PDT in a patient with intrathoracic constructed stomach. We report this case with a brief review of literatures, therefore.

Role of Surgery in Ewing's Sarcoma Treatment (유잉 육종의 치료에서 수술의 역할)

  • Jeon, Dae-Genn;Lee, Jong-Seok;Kim, Sug-Jun;Park, Hyun-Soo;Jang, Jin-Dae;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.38-46
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    • 1996
  • The traditional methodology in Ewing's sarcoma was chemotherapy and radiotherapy. Recently surgery is reemerging as an important therapeutic tool and some paper report increased survival with it. The purpose of this nonrandomized study is to evaluate our result of Ewing's sarcoma with surgery, retrospectively. We experienced 30 cases for seven years and among them 6 were extraskeletal. In location, axial was 10 cases and peripheral was 20. By Enneking's classification, state IIB was 26 cases and IIIB was 4. Eighteen patients took operation, chemotherapy and/or radiotherapy, and remaining twelve took chemotherapy and/or radiotherapy only. Type of operation was limb salvage in 16 cases and amputation 2. Average dosage of radiation was 45.1Gy. Six kinds of chemotherapeutic regimen were used, but among them main protocols were Ifosfamide-Adriamycin(17 cases) and IESS(Cytoxan, Adriamycin, Methotrexate, Vincristine:8 cases). Complications were as follows. In operation group, there were 3 local recurrence and one case of nonunion. In nonoperated group, one local recurrence and one pancytopenia resulting in death. Average follow up was 29.7 months. Kaplan-Meier's ten year actuarial survival rate for the whole 30 cases was 26.8%. Significant difference in survival exists between central and peripheral lesions(p=0.05, by log rank test). Types of chemotherapy and surgery itself showed no significance. But surgery is important in function and local control. More intensive chemotherapeutic regimen to prevent distant metastasis and combined surgery and radiotherapy may be needed in Ewing's sarcoma.

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A Study on the System of Collaborative Practice between Korean Traditional Medicine and Western Medicine for Dementia based on a Case Study (증례를 통해 본 치매의 한양방 협진 모델 연구)

  • Lee, Go-Eun;Yang, Hyun Duk;Jeon, Won Kyung;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.3
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    • pp.211-228
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    • 2013
  • Objectives : This report describes the diagnostic and therapeutic procedures of Collaborative Practice between Korean Traditional Medicine and Western Medicine for two dementia patients. Furthermore, through these cases, we suggest a model of collaborative practice between Korean traditional medicine and western medicine for the treatment of dementia. Methods : Two patients suffering from several symptoms related to dementia received collaborative practice between Korean traditional medicine and western medicine. Physicians of deparment which paient first visit interviewed patient and patient's guardians, discussed the symptoms and the status of the patient. Since then, the medical team made a differential diagnosis based on the results of brain imaging, hematology, urine test. and apprehended the status of dementia by the neuropsychological test. Korean traditional physicians examined the physical symptoms and identified the pattern of dementia in Korean traditional medicine. Following this, they decided on the method of acupuncture, moxibustion, cupping and herbal treatment. Western physicians decided on the type of medication after consideration of the patient's other medical conditions. Every intervention was decided by both Korean traditional physicians and western physicians after discussion. The medical team provided education on dementia and counseled the guardians. They also wrote the paper for using the long-term care insurance for the aged. Results : Two patients showed no improvement on the neuropsychologic and activity of daily living tests. However, the patients' subjective physical symptoms were improved. The collaborative practice between Korean traditional medicine and western medicine improved the patients' and guardians' satisfaction. Conclusions : Through these cases, we propose a model of collaborative practice between Korean traditional medicine and western medicine for dementia categorized diagnosis-test, treatment, prevention, management. More specifically, we supplement qigong and psychotherapy which was inadequate in these cases.

Accidental Subdural Steroid Injection during Intended Epidural Block Relieves Intractable Radiculopathy in Failed Back Surgery Syndrome -A case report- (경막외차단 중 발생된 우발적 경막하 스테로이드 주입에 의한 난치성 요추수술 후 실패증후군의 치료 경험 -증례 보고-)

  • Jung, Gi-Seung;Song, Sun-Ok;Cho, Young-Woo
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.104-109
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    • 2001
  • We describe the accidental injection of local anesthetics containing steroid into the subdural space during an attempted lumbar epidural injection for intractable radiculopathy in a patient with failed back surgery syndrome. A 24-year-old man complained of severe radiating pain to left lower extremity and showed a walking disturbance and severe lumbar scoliosis. The MRI finding was a left paramedian recurred disc herniation on L4-5 in a laminectomy state. Several therapeutic modalities such as epidural steroid injection, transforaminal injection, L2 root block, medication, and exercise therapy, etc failed. Initially, during epidural block at L4-5 under fluoroscopic guidance, a railroad track appearance appeared on epidurogram suggesting the presence of a subdural space. A second epidural block was tried at L5-S1. Following confirmation of epidural space upon epidurogram, 6 ml of 0.5% lidocaine including triamcinolone 40 mg was injected. The patient showed signs of the subdural injection including an unexpectedly high sensory block (T2) and a motor weakness of both lower extremities. Following this event, the severe radiculopathy and lumbar scoliosis were improved. Therefore, we conclude that subdural injection of steroid could be helpful in intractable radiculopathy, especially in the failed back surgery syndrome. However, it must be used cautiously with careful patient selection.

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Successful treatment by exchange transfusion of a young infant with sodium nitroprusside poisoning

  • Baek, Jong-Geun;Jeong, Hoar-Lim;Park, Ji-Sook;Seo, Ji-Hyun;Park, Eun-Sil;Lim, Jae-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang;Yeom, Jung-Sook
    • Clinical and Experimental Pediatrics
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    • v.53 no.8
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    • pp.805-808
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    • 2010
  • Although sodium nitroprusside (SNP) is often used in pediatric intensive care units, cyanide toxicity can occur after SNP treatment. To treat SNP-induced cyanide poisoning, antidotes such as amyl nitrite, sodium nitrite, sodium thiosulfate, and hydroxycobalamin should be administered immediately after diagnosis. Here, we report the first case of a very young infant whose SNP-induced cyanide poisoning was successfully treated by exchange transfusion. The success of this alternative method may be related to the fact that exchange transfusion not only removes the cyanide from the blood but also activates detoxification systems by supplying sulfur-rich plasma. Moreover, exchange transfusion replaces cyanide-contaminated erythrocytes with fresh erythrocytes, thereby improving the blood's oxygen carrying capacity more rapidly than antidote therapy. Therefore, we believe that exchange transfusion might be an effective therapeutic modality for critical cases of cyanide poisoning.

Percutaneous Laser Discectomy in Lumbar Disc Herniation -A case report- (요추간판 탈출증에서 레이저를 이용한 경피적 추간판절제술 -증례 보고-)

  • Kim, Won-Oak;Yoon, Duck-Me;Jang, Won-Suck;Oh, Kyung-Me;Kim, Hyo-Eun
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.234-238
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    • 2001
  • Percutaneous laser discectomy has potential advantages over conservative therapy and classical open surgery as a minimally invasive procedure, although clinical experiences are limited. We experienced a patient treated with herniated lumbar discs using Nd:YAG laser. A 55-year-old woman complained of severe back pain with sciatica on L4/5 and L5/S1 dermatome for several months. The MRI finding showed bulging discs at L4/5 and L5/S1. Epidural, transsacral and root block treatments were attempted without effect. Under fluoroscopic guidance, a 14 G biopsy needle was inserted into the L4/5 and L5/S1 disc spaces to the margin of the nucleus pulposus. Laser irradiation for vaporization of tissue was performed at 20 W/second to 1200 J. A laser fiber ($600{\mu}m$) was advanced 1 cm from the tip of the needle. At the end of the procedure, the patient began to feel relief of pain (VAS changed from 9 to 4) and was discharged the same day after staying 2 hours in the recovery room. Antibiotics were administered for prevention of discitis. She had no complaints of pain until the 1-month follow up visit. Percutaneous laser discetomy technique has the disadvantages of expensive equipment, high temperature and amount of vaporing disc tissue is empirical. However, this technique, as one of the therapeutic modalities for disc herniation, provides faster relief from acute attack than conservative management techniques in carefully selected patients with sciatica due to disc prolapse.

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Systemic review: The study on Rhinitis with acupuncture in PubMed and Chinese medical journals (비염(鼻炎)의 침구치료(鍼灸治療)에 대한 최근(最近) 연구(硏究) 동향(動向) -Pubmed와 중의학(中醫學) 학술지(學術紙)를 중심으로-)

  • Kim, Jeung-shin;Kim, Yong-suk;Nam, Sang-soo
    • Journal of Acupuncture Research
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    • v.21 no.1
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    • pp.70-85
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    • 2004
  • Objective: To research the trends of study related to rhinitis and acupuncture in PubMed, and to establish the hereafter direction of treating rhinitis with acupuncture Methods: We searched PubMed and chinese medical journals related to rhinitis and acupuncture. Results: 1. The pattern of the study was as follows: Review article(3), Randomized controlled trials(2), Clinical trial(11), Case report(12). 2. The effect of acupuncture on rhinitis is reported as follows: Acupucture treatment improves the scale of symptoms, nasal airways resistance and velocity of the mucociliary transport, decreasing absolute numbers of blood eosinophils, serum IgE and percentage of nasal eosinophils. Immunologically acupuncture treatment could reduce plasma IL-10 level, control IL-2, and balance between cell-specific pro-inflammatory and anti-inflammatory cytokines, TNF-${\alpha}$ and IL-10. After acupuncture treatment, there is statistically significant changes in IgA, IgE, E-rosette formative rate. 3. Many of these article have affirmative view for therapeutic effect of rhinitis with acupuncture. Statistical test was done only in 6 papers. There showed statically significant results in 4 articles, and in 2 article there showed some clinical improvement but no statically significant changes. 4. In Western countries, alternative treatments are frequent among adults with rhinitis or other allergic disease, and affirmative tendency for acupuncture treatment is increased.

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Transcatheter Embolotherapy of Giant Pulmonary Arteriovenous Malformation Using Amplatzer® Vascular Plug (Amplatzer® 혈관폐색장치를 이용한 거대 폐동정맥기형 색전술 1예)

  • Jung, Ki Hwan;Lee, Seung Hwa;Shin, Chol;Kim, Je Hyeong
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.1
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    • pp.52-58
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    • 2009
  • Pulmonary arteriovenous malformation (PAVM) is a rare pulmonary vascular anomaly due to an abnormal communication between the pulmonary artery and vein. The most common presenting symptom is a dyspnea on exertion related to this right-to-left shunt. If left untreated, PAVM has been known to result in serious complications. Incomplete pulmonary capillary network can be the cause of cerebral abscesses and other noninfectious neurological complications, such as stroke and transient ischemic attacks due to paradoxic embolism Transcatheter embolotherapy, using coils or balloons, has replaced surgical resection as the treatment of choice for PAVM. However, the risk of device embolization has limited the use of coil embolotherapy, while the size of PAVM is huge. Recently, Amplatzer$^{(R)}$ Vascular Plug has been proposed as an alternative endovascular occlusion device for arteriovenous malformation. We report a case of 81-year-old male patient with a giant PAVM, which was successfully treated by transcatheter embolotherapy using the Amplatzer$^{(R)}$ Vascular Plug.

Surgical Treatment of Thoracic Desmoid Tumors -2 case reports- (흉부 데스모이드 종양에 대한 수술적 치험 - 2예 보고 -)

  • Yang, Jin-Sung;Won, Yong-Soon;Her, Keun;Oh, Hong-Cheul;Shin, Hwa-Kyun
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.212-216
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    • 2010
  • Desmoid tumor is histologically benign, but this tumor is clinically considered to be malignant. Surgical resection is one of the most effective therapeutic options for patients with this tumor and resection is the best choice for cases of recurrence. We experienced two cases of recurrence of thoracic desmoid tumor, and the patients were repeatedly treated by surgical resection. The patients were discharged without any complications, and careful follow up has been performed periodically. Therefore, we report on these cases of recurrent desmoid tumor along with a review of the related literature.

Organ-sparing Surgery in Treating Patients with Liposarcoma of the Spermatic Cord: Institutional Experience and Pooled Analysis

  • Cao, Ming-Xin;Chen, Jie;Zhang, Jun-Long;Wei, Xin;Liang, Yue-You
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3419-3423
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    • 2015
  • Background: Liposarcoma of the spermatic cord is rare and frequently misdiagnosed. The standard therapeutic approach has been radical inguinal orchiectomy with wide local resection of surrounding soft tissues. The current trend of organ preservation in the treatment of several cancers has started to evolve. Herein we present our testis-sparing surgery experience in the treatment of spermatic cord liposarcoma and a pooled analysis on this topic. Materials and Methods: Clinical information from patient receiving organ-sparing surgery was described. Clinical studies evaluating this issue were identified by using a predefined search strategy, e.g., Pubmed database with no restriction on date of published papers. The literature search used the following terms: epidemiology, surgery, chemotherapy, radiotherapy, testis sparing surgery, spermatic cord sarcomas/liposarcomas. Results: Patient received a complete excision of the lesion, preserving the spermatic cord and the testis. The final pathological report showed a well differentiated liposarcoma with negative surgical margins and no signs of local invasion. After 2-year of follow-up, there was no evidence of local recurrence. Since the first case reported in 1952, a total of about 200 well-documented spermatic cord liposarcoma cases have been published in English literature. Among these patients, only three instances were reported to have received an organ-sparing surgery in the treatment of spermatic cord liposarcoma. Conclusions: Radical inguinal orchiectomy and resection of the tumor with a negative microscopic margin is the recommended treatment for liposarcoma of the spermatic cord. But for small, especially well-differentiated, lesions, testis-sparing surgery might be a good option if an adequate negative surgical margin is assured.