• Title/Summary/Keyword: therapeutic case report

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Trastuzumab in a Patient with Metastatic Salivary Duct Carcinoma : A Case Report (트라스투주맙 치료에 반응을 보인 HER2/neu 양성 전이성 타액관 암종 1예)

  • Kong, Bong Han;Lee, Jieun;Choi, Sang-Su;Park, Jinhee;Kim, Yeon Shil;Kim, Min-Sik;Lee, Youn-Soo;Lee, Ji-Yeon;Hong, Sook Hee;Kang, Jin Hyoung
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.2
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    • pp.90-94
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    • 2014
  • Salivary duct carcinoma(SDC) is rare malignancy, accounting for approximately 1-3% of all malignant salivary gland tumors. Systemic chemotherapy has been used for stage IV SDC, but there is no consensus on the standard treatment. SDC is histologically similar to ductal carcinoma of breast and often overexpress HER2/neu, hence HER2/neu targeted therapy could be one of treatment options. A 75-year-old Arabian man was diagnosed as SDC of right parotid gland with extensive metastases. He received oral 5-FU as palliative chemotherapy, but he was intolerable to oral chemotherapy due to severe oral mucositis. Considering immunohistochemical stain of tumor tissue showing strong positive for HER2/neu, we decided to administer an anti-HER2/neu antibody, trastuzumab. Follow-up CT scans before the third dose of trastuzumab demonstrated remarkable regression of multiple metastases as well as primary tumor. This case suggests that HER2/neu targeted therapy may be a potential therapeutic option for the SDC patient with overexpression of HER2/neu.

A Case of Pulmonary Sequestration Treated with Arterial Embolization (동맥색전술로 시술한 폐격리증 1예)

  • Lee, Gun-Wha;Kim, Dong-Kyun;Na, Hyun-Sik;Bae, Jun-Yong;Choi, Jun-Ho;Kim, Yang-ki;Kim, Ki-up;Uh, Soo-taek;Kim, Dong-hoon;Hwang, Jung Hwa;Goo, Dong-Erk
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.68-73
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    • 2005
  • Pulmonary sequestration is a very rare congenital malformation in which a mass of pulmonary tissue is detached from the normal lung and receives its blood supply from a systemic artery. It may be clinically asymptomatic or it has a wide spectrum of various clinical manifestations. The clinical therapeutic approach is to resect the sequestered lobe to prevent frequent complication such as infection. The arterial embolization of feeding artery is a new technique and a less invasive treatment than conventional surgical removal. We have experienced a 17-year-old male with pulmonary sequestration whose complaints were pain in left lower chest. He was diagnosed by computed tomography and aortography and successfully treated with embolization of feeding artery. We report a case of pulmonary sequestration treated with arterial embolization instead of surgery.

Benign Tumors of the Talar Body (거골 체부에 발생한 양성 종양)

  • Suh, Sung-Wook;Lee, Sang-Hoon;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.3
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    • pp.76-82
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    • 2002
  • Purpose: Benign bone tumor of the talar body have rarely been evaluated according to the therapeutic methods because of the scarcity of their incidence. Here, we report our experience of 8 cases who were treated by using of posterior approach and curettage through the posterior process of the talus. Materials and Methods: Between February 1986 and October 2001, we experienced 8 cases of benign bone tumor occurring in the talar body. They included two osteoid osteomas, two giant cell tumors, one capillary hemangioma, one chondroblastoma, one simple bone cyst, and one osteochondroma. Their mean age was 22.1 years (ranging from 10 to 41 years). Mean follow-up period was 7.7 years (ranging from 1 to 16 years). All patients were treated by using of posterior approach. Two osteoid osteomas and one osteochondroma were treated by excision of tumors. Other cases were treated with curettage through the cortical window on the posterior process of the talus. Results: There was no recurrence during the follow-up period. one infection occurred. Except this case, all patients had no pain in weight-bearing, and complete range of movement at the ankle joint was reserved in each case. Conclusion: In this study, we suppose that posterior approach to the talar body may be a safe method with minimal damage of normal tissues and sufficient of curettage is capable through the cortical window on the posterior process of the talus.

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A Case of Successful Management of Sarcoidosis with Chylothorax Using Octreotide (옥트레오타이드를 이용한 유육종증과 동반된 유미흉의 보존적 치료 1예)

  • Jung, Kyung Soo;Moon, Ji Ae;Yoon, Sul hee;Byun, Min Kwang;Jung, Woo Young;Jung, Jae Hee;Choi, Sang Bong;Kim, Dae Joon;Pyo, Ju Yeon;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Park, Moo Suk
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.2
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    • pp.119-124
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    • 2007
  • Sarcoidosis is a multi-system granulomatous disorder of an unknown etiology and affects individuals worldwide. It is characterized pathologically by the presence of non-caseating granulomas in more than one involved organ. However, pleural involvement of sarcoidosis is rare and there are no reported cases in Korea. Traditionally, sarcoidosis has often been treated with systemic corticosteroids or cytotoxic agents. In particular, chylothorax with sarcoidosis is usually treated with corticosteroid for approximately 3~6 months, followed by repeated therapeutic thoracentesis, talc pleurodesis, dietary treatment, or thoracic duct ligation where needed. We encountered a 46 years old female patient presenting with cough, dyspnea and both hilar lymphadenopathy (stage I) on chest radiograph. The patient was diagnosed with a non-caseating granuloma, sarcoidosis by a mediastinoscopic biopsy. For one month, she had suffered from dyspnea due to right side pleural effusion, which was clearly identified as a chylothorax on thoracentesis. Corticosteroid therapy with dietary adjustment was ineffective. She was treated successfully with a subcutaneous injection of octreotide for 3 weeks and oral corticosteroid. We report a case of successful and rapid treatment of chylothorax associated with sarcoidosis using octreotide and oral corticosteroid.

Acupuncture Treatment in Feline Horner's Syndrome: Case Report (고양이 Horner's syndrome에 대한 침치료(針治療) 증예보고(症例報告))

  • Hsu, Chin-Yuan;Hsu, Chin-ling;Hsu, Chin-Hwang;Liao, Jim-Cai;Chueh, Hao-Jen;Cheng, Han-Wen;Jun, Hyeong-Kyou;Kim, Duck-Hwan
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.214-217
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    • 2007
  • A about 2-month- old, mixed female cat was referred to Yeon Chang Veterinaly Clinic in Taiwan. Because this patient was wandering cat, precise history was not blown. At first admission, miosis, ptosis and protrusion of the nictitating membrane was observed in the right sided eye, and also slight miosis was found in the left sided eye. The patient was diagnosed into feline HS. Oculo-AP and injection-AP with dexamethasone were applied to this patient. Oculo-AP at Shang Jiao regions of both eyes was done for 10 minutes. In addition, injection-AP with dexamethasone (0.2 ml/acupoint) at BL01-Jing Ming, BL02-Zan Zhu and ST01-Cheng Qi. After AP treatment, prolapse of the nictitating membrane was amazingly disappeared and pupil was dilatated at session 1. Ocular findings at session 2 (one day after session 1) were maintained with nearly normal state. Accordingly, the present patient was a case with feline HS that showed favorable therapeutic effect by AP treatment.

Emergency preoperative angioembolization without computed tomography to treat unstable pelvic fractures with bowel perforation (장 천공을 동반한 혈역학적으로 불안정한 골반골 골절에서 전산화 단층촬영 전 시행한 혈관색전술의 지혈효과: 증례보고)

  • Park, Chan-Yong;Kang, Wu-Seong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.417-422
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    • 2019
  • Hemodynamically unstable pelvic fractures show a remarkably high mortality rate of 40% to 60%. However, their standard of care remains controversial. We report here a case of a 78-year-old woman who was admitted to the Emergency Department with pelvic pain following a fall. Based on pelvic radiography, she was diagnosed with an unstable pelvic fracture. Her blood pressure was 60/40 mmHg, and owing to her unstable vital signs, emergency angiography was performed without computed tomography (CT). Both internal iliac arteries were embolized without sub-branch selection for prompt control of pelvic bleeding. Following embolization, her vital signs were stabilized. Subsequent CT revealed free intra-abdominal air, suggesting bowel perforation had occurred and necessitating emergency laparotomy. An approximately 1 cm-sized free perforation of the small intestine was identified intraoperatively, and primary closure was performed. A retroperitoneal hematoma identified intraoperatively was not explored further because it was a non-expanding and non-pulsatile mass. The patient was admitted to the Intensive Care Unit and transferred to the general ward on postoperative day 3. In this case, the hemodynamically stable pelvic fracture with bowel perforation was successfully and safely treated by prompt angioembolization without conducting CT.

A Case of Cytomegalovirus Retinitis during Maintenance Chemotherapy for Acute Leukemia

  • Ahn, Bin;Song, Seungha;Han, Mi Seon;Oh, Baek Lok;Choi, Jae Hong;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.27 no.3
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    • pp.198-204
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    • 2020
  • Cytomegalovirus (CMV) disease is rare in children who receive anticancer chemotherapy and have no history of stem cell transplantation (SCT). We report a case of CMV retinitis that developed during maintenance chemotherapy for acute leukemia. A 7-year-old boy developed decreased visual acuity and persistent pancytopenia during maintenance chemotherapy. Laboratory investigations initially showed significant CMV antigenemia (51 positive cells/200,000 leukocytes); however, antiviral therapy was not deemed necessary in this patient who had no history of SCT. CMV antigenemia worsened to 170 positive cells/200,000 leukocytes over 3 weeks. Ophthalmological examination revealed multiple bilateral retinal infiltrates and granular lesions. He was diagnosed with CMV retinitis and was treated with a 4-week course of intravenous ganciclovir and intravitreal injection of ganciclovir 6 times, followed by a 1-month course of orally administered valganciclovir. A CMV antigenemia assay showed negative results, and follow-up fundoscopy revealed lesser retinal infiltration after the sixth intravitreal ganciclovir injection. Future studies should focus on the development of standardized screening methods and preemptive therapeutic strategies for CMV disease in high-risk children.

A Case of Complete Remission to Advanced Esophageal Cancer by a Palliative Chemotherapy (고식적 항암화학요법으로 완치가 된 진행성 식도암 환자 1예)

  • Dae Hyun Tak;Hee Seok Moon;Hyun Yong Jeong;Jae Kyu Sung;Sun Hyung Kang
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.64-67
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    • 2014
  • Esophageal cancer has a poor prognosis, because the progression rate is faster compared to that of other cancers, Up to 30-40% of cases are inoperable at diagnosis, and most cases occur in the elderly. By this time, surgery has been regarded as the treatment of choice in patients suffering esophageal cancer and recent improvements in surgical techniques and perioperative management have significantly increased the resection rate and reduced the operative mortality. And Although the combination of chemotherapy and radiation therapy has been reported to be an effective treatment for esophageal cancer, most cases show only partial remission. Moreover, radiation therapy alone or chemotherapy alone has limited efficacy. We report a rare case of an 80-year-old man who presented with a chief complaint of dysphasia and was diagnosed with advanced esophageal cancer, with a review of the literature. Considering his advanced age, generally poor performance status, and the risk of fistula development after radiation therapy due to indentation of esophageal cancer into the main bronchus, palliative, rather than therapeutic, chemotherapy was performed, and complete remission was obtained.

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Fontan Conversion with Arrhythmia Surgery in a Jehovah′s Witnesses (여호와의 증인 환자의 폰탄전환술 및 부정맥수술)

  • Ryu, Jae-Wook;Kim, Woong-Han;Na, Chan-Young;Oh, Sam-Se;Kim, Soo-Cheol;Lim, Cheong;Baek, Man-Jong;Jong, Joon-Hyuk;Lee, Jae-Young;Park, Young-Kwan;Kim, Chong-Hwan
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.48-51
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    • 2002
  • The conversion of failing Fontan circuit to total cavopulmonary connection(TCPC) is recommended as a therapeutic option in patients with late Fontan complications such as atrial arrhythmia, atrial enlargement, pulmonary venous obstruction, and ventricular dysfunction. Combined TCPC with extracardiac conduit and cryoablation of arrhythmia circuit is preferred for treatment of failing Fontan coulection with atrial lachyarrhythrnia. We report a case of conversion of atriopulmonary connection to extracardiac conduit Fontan and cryoablation of atrial arrhythmia circuit in a patient with tricuspid atresia, who also had ectopic atrial tachycardia, right atrial thrombi, pulmonary venous obstruction, and ventricular dysfunction. This patient and the parents were Jehovah's Witnesses; therefore, the patient underwent the procedure without blood transfusion.

Thoracoscopic Sympathectomy for a Patient with Facial Hyperhidrosis -A case report- (흉강경하 흉부교감신경절제술을 이용한 안면다한증 치료 -증례보고-)

  • Moon, Dong-Eon;Park, Byung-Cheul;Kim, Byung-Chan;Kim, Sung-Nyeon
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.399-402
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    • 1996
  • Endoscopic transthoracic sympathectomy (ETS) has recently become estabilished as a successful treatment for severe palmar and axillary hyperhidrosis. Descriptions have been published of neurolytic, operative and alternative endoscopic procedures involving thermocoagulation, laser coagulation, or or nonvideo-assisted ganglionectomy using equipment not widely available, with low morbidity and excellent results. All methods have advantage and disadvantages. A 19-year-old male who suffered from severe hyperhidrosis on face, palms and axillary areas, has been initially treated with stellate ganglion block in other pain clinic. He was transfered to our pain clinic for endoscopic thoracic sympathectomy. The patient was intubated left side 34 Fr. double lumen tube and positioned left semi-lateral position for right sympathectomy. Right side pneumothorax was created by clamping the ipsilateral side of the double lumen tube and aspiration of air. 11-mm trocar was introduced through incision at the third intercostal space in anterior axillary line, and then additional two 11-mm and 5-mm trocar was introduced through second and fifth intercostal space in mid axillary line. The lung was gently retracted and the parietal pleura over the heads of the appropriate ribs excised using 5-mm sharp insulated coagulating microprocesss. The T4, T3, and T2 ganglions, as well as accompanying rami communicantes, and other branchs arising from upper thoracic nerves to the brachial plexus and surrounding tissues were carefully dissected, coagulated. During sympathectomy, skin temperature of middle was continuously monitored. Elevation of palmar skin temperature intraoperatively indicated an adequate sympathectomy with a definite therapeutic effect. A No. 28 Fr. thoracotomy tube was introduced through a troca under video guidance, placed under water seal after the lung was reinflated. the controlateral side was performed same procedure. After bilateral sympathectomy, chest tubes were removed, and then, he was discharged 2 days after operation with great satisfaction. The ETS provides a well-tolerated, cost-effective alternative to thoracic sympathectomy for primary hyperhidrosis and sympathetic mediated neuropathic pain disorder. And T2 ganglion is considered the key ganglion for the treatment of primary hyperhidrosis. The low incidence of compensatory sweating may by explained by the limited extent of the sympathectomy.

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