• Title/Summary/Keyword: treatment follow-up

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Angiographic Follow-Up for Small Ruptured Intracranial Aneurysm Treated by Endovascular Treatment : Follow-Up Plan and Long-Term Follow-Up Results

  • Kim, Tae Hyung;Ko, Jung Ho;Chung, Jaewoo
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.710-718
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    • 2022
  • Objective : Although endovascular treatment for intracranial aneurysms is considered effective and safe, its durability is still debated. Also, few studies have described angiographic follow-up plan after endovascular treatment of intracranial aneurysm, especially in ruptured cases. Hence, we report the long-term results of follow-up angiography protocol. Methods : Radiological records of 639 cases of coil embolization with ruptured aneurysms from March 2003 to December 2016 were retrospectively reviewed. Patients who received treatment of a saccular aneurysm less than 7 mm resulted with near complete occlusion were included. Two hundred thirty-eight aneuryms which received the follow-up angiography at least once were enrolled. We classified four periods of follow-up as follows : post-treatment 1 year (defined as the first period), from 1 to 2 years (the second period), 2 to 5 years (the third period), and over 5 years (long-term). Results : We identified 14 cases (6.4%) of recurrence from 218 aneurysms in follow-up angiography in the first period. Among 143 aneurysms in the second period, five cases (3.5%) of recurrence were identified. There were no findings suspicious of recanalization in 97 patients in the third period. Of the total 238 cases, there were 19 recurrences, for a recurrence rate of 8.0%. Six (31.6%) out of 19 recurrences showed a tendency toward repeat recurrences even after additional treatment. Twenty-eight received long-term follow-up over 5 years and there was no recurrence. Conclusion : Most of the recurrence were found during the first and the second year. We suggest that at least one digital subtraction angiography examination may be necessary around post-treatment 2 years, especially in ruptured cases. If the angiographic results are favorable at 2 years post-treatment, long-term result should be favorable.

Long-term Evaluation of Conervative Treatment for the Patients with TMJ Closed Lock (악관절 폐구성 과두걸림의 보존적 치료에 대한 장기적 평가)

  • Mi-Suk Seo;Jae-Kap Choi
    • Journal of Oral Medicine and Pain
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    • v.19 no.1
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    • pp.93-103
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    • 1994
  • In order to evaluate thelong-term results of conservative treatment on TMJ closed lock, a follow-up study of thirst-two patients was performed 2 to 7 year after treatment. Evaluating method included the questionnaire, clinical examination, transcranial radiograph and mandibular kinesiography. The results were as follows : Seventy-eight percents of patients reported that symptoms were reduced completely or considerably. Recurrent headache was improved after treatment (72 percents of success rate). There was a significant decrease in VAS after treatment and at follow-up comparing with that of before treatment(p<0.01). Most common variable of Helkimo's clinical dysfunction index at follow-up was impared TMJ function. There was a significant decrease in Fricton's craniomandibular index and dysfunction index(p<0.01) Mean interincisal distance was increased by 14.07mm after treatment and was also increased at follow-up by 2.80mm comparing with that of after treatment(p<0.01). Before treatment, condylar translation measurements of affected and non-affected sides on the transcranial radiograph were 4.89±3.20mm and 9.09±3.73mm respectively and at follow- up examination, those were 14.98±4.77 and 17.05±4.35mm respectively. At follow-up, condylar translation were increased significantly comparing with those of before treatment(p<0.01). In 93.1% of patients, the condylar position of affected side at maximum mouth opening was behind the articular eminence before treatment but the percentage was decreased to 13.8% at follow-up(p<0.01). The pattern and range of mandibular movements at follow-up examination were similar to the typical normal movements. And in 16 cases showing lateral deviation of opening path, the deviation was directed to the affected and non-affected sides with the same frequency.

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The fate of overfilling in root canal treatments with long-term follow-up: a case series

  • Vito Antonio Malagnino;Alfio Pappalardo;Gianluca Plotino;Teocrito Carlesi
    • Restorative Dentistry and Endodontics
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    • v.46 no.2
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    • pp.27.1-27.10
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    • 2021
  • This study describes 6 cases of endodontic overfilling with successful clinical outcomes during long-term (up to 35 years) radiographic follow-up. Successful endodontic treatment depends on proper shaping, disinfection, and obturation of root canals. Filling materials should completely fill the root canal space without exceeding the anatomical apex. Overfilling may occur when the filling material extrudes into the periapical tissues beyond the apex. The present case series describes 6 root canal treatments in which overfilling of root canal sealer and gutta-percha accidentally occurred. Patients' teeth were periodically checked with periapical radiographs in order to evaluate the outcomes during long-term follow-up. All cases showed healing and progressive resorption of the extruded materials in the periapex. The present cases showed that if a 3-dimensional seal was present at the apical level, overfilling did not negatively affect the long-term outcomes of root canal treatment.

Liposuction in the Treatment of Lipedema: A Longitudinal Study

  • Dadras, Mehran;Mallinger, Peter Joachim;Corterier, Cord Christian;Theodosiadi, Sotiria;Ghods, Mojtaba
    • Archives of Plastic Surgery
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    • v.44 no.4
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    • pp.324-331
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    • 2017
  • Background Lipedema is a condition consisting of painful bilateral increases in subcutaneous fat and interstitial fluid in the limbs with secondary lymphedema and fibrosis during later stages. Combined decongestive therapy (CDT) is the standard of care in most countries. Since the introduction of tumescent technique, liposuction has been used as a surgical treatment option. The aim of this study was to determine the outcome of liposuction used as treatment for lipedema. Methods Twenty-five patients who received 72 liposuction procedures for the treatment of lipedema completed a standardized questionnaire. Lipedema-associated complaints and the need for CDT were assessed for the preoperative period and during 2 separate postoperative follow-ups using a visual analog scale and a composite CDT score. The mean follow-up times for the first postoperative follow-up and the second postoperative follow-up were 16 months and 37 months, respectively. Results Patients showed significant reductions in spontaneous pain, sensitivity to pressure, feeling of tension, bruising, cosmetic impairment, and general impairment to quality of life from the preoperative period to the first postoperative follow-up, and these results remained consistent until the second postoperative follow-up. A comparison of the preoperative period to the last postoperative follow-up, after 4 patients without full preoperative CDT were excluded from the analysis, indicated that the need for CDT was reduced significantly. An analysis of the different stages of the disease also indicated that better and more sustainable results could be achieved if patients were treated in earlier stages. Conclusions Liposuction is effective in the treatment of lipedema and leads to an improvement in quality of life and a decrease in the need for conservative therapy.

THE EFFECT AND RELAPSE PATTERN OF FACEMASK THERAPY FOR CLASS III MALOCCLUSION CHILDREN (유치열기 3급 부정교합 환아에서 facemask의 효과와 재발 양상)

  • Kim, Ji-Yeon;Yoo, Seung-Eun;Lee, Ji-Hyun;Ki-Tae, Ki-Tae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.3
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    • pp.420-426
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    • 2009
  • The purpose of this study was to evaluate skeletal and soft tissue changes that occur after using a facemask for treatment of skeletal class III malocclusion, and to assess the relapse pattern when no retention appliance was used. Fifteen skeletal class III malocclusion patients were treated with a facemask for an average of 12 months. No retention appliance was used during the 1 year follow-up period. Cephalograms were taken during pretreatment, posttreatment, and the 1 year follow-up. Cephalograms were traced, analyzed, and the results were compared between cephalograms. All patients showed significant sagittal skeletal changes after treatment, but they also showed a significant relapse during the 1 year follow-up period when no retention appliance was used. Despite the relapse, the sagittal skeletal changes that remained were still significant. Vertical skeletal change was also significant after treatment, but the total change was not significant after a 1 year follow-up due to relapse. In soft tissue changes, facial convexity and upper lip position improved after treatment and this change remained significant after the 1 year follow-up period. Facemask therapy is therefore an effective method for treatment of skeletal class III malocclusion, however, retention is imperative to maintain the treatment effect.

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Analysis of Factors that Affect the Follow-up Pattern after Dental Treatment under Conscious Sedation in Children (어린이의 진정법 하 치과치료 후 정기검진에 영향을 미치는 요인 분석)

  • Hwang, Inkyung;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.3
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    • pp.324-333
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    • 2018
  • Children need regularly dental check-ups after dental treatment because there are a lot of changes of oral conditions such as tooth exfoliation and eruption, occlusion, and recurrence of dental caries. The purpose of this study is to determine the factors that affect the follow-up pattern after dental treatment under conscious sedation. Patients who were treated under sedation at the department of pediatric dentistry of Ewha Womans University Mokdong Hospital from 2009 to 2013 were included in this study. The final samples comprised of 562 patients that were classified into 4 groups according to the number of visits during 3 years. The chi-square test was used to determine the factors affecting regular follow-up. There were statistically significant differences between each treatment groups and factors such as the change of doctor, overall treatment time, the number of treated teeth under sedation, restorative treatment, minor operation, and preventive treatment (p < 0.05). This study identified factors that affect regular follow-up after dental treatment under conscious sedation. It is recommended to educate the importance of regular check-ups to parents who are less likely to return.

Clinical Study for Patients with Lumbar Disc Herniation on Change of Magnetic Resonance Imaging at One Year after Conservative Treatment (요추 추간판 탈출증 환자의 보존적 치료 후 변화된 자기공명영상에 따른 1년 후 임상변화 고찰)

  • Kwon, Hyeok-Joon;Park, Young-Hoi
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.2
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    • pp.253-263
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    • 2011
  • Objectives : To analyze the therapeutic outcomes of back pain modalities in patients with disc herniation according to the change of magnetic imaging(MRI) at one year after conservative treatment. Methods : Clinical outcomes of 35 patients diagnosed with lumbar disc herniation by MRI examination, treated conservatively, were analyzed according to MRI follow-up change; improved, unchanged, worsened. Patients underwent MRI examination at baseline and after 24 week of treatment. After 1 year, we followed up 30 patients. The patients' clinical outcomes were assessed at baseline, 24 week, 1 year by visual analogue scale(VAS), oswestry disability index (ODI), and analyzed by each of it's correlation. Results : 1. VAS of sciatica and ODI of disability of daily activities showed significant decrease in patients after 1 year follow up(p<0.05). 2. VAS(low back pain and sciatica) and ODI of disability of daily activities showed significant decrease in "improved" group and VAS(sciatica) and ODI showed significant decrease in "unchanged" group. "worsened" group showed no statistic significance(p<0.05). 3. The 1 year follow-up of VAS(low back pain and sciatica) and ODI change showed relationship with MRI follow-up change(p<0.05). Conclusions : This study suggests that "improved" groups compared to "unchanged" and "worsened" group on MRI follow-up in patients with lumbar disc herniation were more effective at 1 year after conservative treatment. MRI follow-up change affect clinical changes in patients with lumbar disc herniation after 1 year.

Long-term effects of gonadotropin-releasing hormone analogs in girls with central precocious puberty

  • Kim, Eun Young
    • Clinical and Experimental Pediatrics
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    • v.58 no.1
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    • pp.1-7
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    • 2015
  • Gonadotropin-releasing hormone analogs (GnRHa) are widely used to treat central precocious puberty (CPP). The efficacy and safety of GnRHa treatment are known, but concerns regarding long-term complications are increasing. Follow-up observation results after GnRHa treatment cessation in female CPP patients up to adulthood showed that treatment (especially <6 years) was beneficial for final adult height relative to that of pretreated or untreated patients. Puberty was recovered within 1 year after GnRHa treatment discontinuation, and there were no abnormalities in reproductive function. CPP patients had a relatively high body mass index (BMI) at the time of CPP diagnosis, but BMI standard deviation score maintenance during GnRHa treatment seemed to prevent the aggravation of obesity in many cases. Bone mineral density decreases during GnRHa treatment but recovers to normal afterwards, and peak bone mass formation through bone mineral accretion during puberty is not affected. Recent studies reported a high prevalence of polycystic ovarian syndrome in CPP patients after GnRHa treatment, but it remains unclear whether the cause is the reproductive mechanism of CPP or GnRHa treatment itself. Studies of the psychosocial effects on CPP patients after GnRHa treatment are very limited. Some studies have reported decreases in psychosocial problems after GnRHa treatment. Overall, GnRHa seems effective and safe for CPP patients, based on long-term follow-up studies. There have been only a few long-term studies on GnRHa treatment in CPP patients in Korea; therefore, additional long-term follow-up investigations are needed to establish the efficacy and safety of GnRHa in the Korean population.

Comparison of Dental Outcomes after General Anesthesia According to the Follow-up Pattern in Special Health Care Needs Patients (장애인 환자의 전신마취 하 치과 치료 후 정기검진 패턴에 따른 치과치료 결과 비교)

  • Kim, Jihyun;Nam, Okhyung;Kim, Misun;Lee, Hyoseol;Choi, Sungchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.2
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    • pp.145-150
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    • 2016
  • Special Health Care Needs (SHCN) patients need regular follow-up because of high incidence and severity of oral disease. The aim of this study was to evaluate the dental treatment outcomes of SHCN patients according to follow-up patterns. SHCN patients who were treated under general anesthesia (GA) at Kyung Hee University Dental Hospital from 2006 to 2014 were included in this study. The final samples comprised of 53 patients that were divided into regular (33 patients) and irregular (20 patients) follow-up groups according to their follow-up patterns. The type of dental treatment after GA during the follow-up periods were compared. In the irregular group, aggressive treatment including endodontic, prosthetic treatment, and extraction were predominant, compared with the regular group (p < 0.05). In addition, all patients who had dental treatment under GA in follow-up periods were in the irregular group (p < 0.05). In conclusion, the results of this study provide the importance of regular follow-ups with SHCN patients and emphasize responsibilities of dentists for educating patients and their guardians.

Matrixplasty for the Treatment of Pincer Nail with Nail Growth Plate Deformity (성장판 변형을 동반한 집게 발톱 변형의 매트릭스플라스티를 이용한 치료)

  • Cho, Young-A;Choi, Kyung-Jin;Song, Young-Joon;Suh, Dong-Won
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.139-143
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    • 2011
  • Purpose: The purpose of this study was to introduce the 'Matrixplasty' for the treatment of a severely incurved toenail with growth plate deformity and to report our results treating this disease entity. Materials and Methods: Between January 2010 and May 2010, 48 consecutive patients (62 cases) underwent treatment of symptomatic incurved toenails with the 'matrixplasty'. The mean period of time at last follow-up was $14.0{\pm}1.3$ months. The recurrence rate and complication rate were evaluated. An American Orthopedic Foot and Ankle Society (AOFAS) forefoot hallux score was assigned and patients were evaluated at pretreatment and the last follow-up meeting. For evaluation of improvement in toenail shape, the center to edge angle of the toenail was measured at pretreatment and last follow-up. Results: All ingrown toenails healed and the nail deformity was corrected within 3 weeks after the procedure. Among the 62 cases, four cases had recurred by the last follow-up. The mean pretreatment AOFAS forefoot hallux score was $73.1{\pm}12.8$, and it improved to $98.7{\pm}1.1$ by the last follow-up (p<0.01). The mean center to edge angle of the toenail improved from $53.3{\pm}12.9$ degrees to $18.2{\pm}7.4$ degrees by the last follow-up (p<0.01). Minor paronychia, which was managed with local wound dressing and oral antibiotics, was identified in eight cases. Conclusion: Matrixplasty showed excellent clinical results in the treatment of severe incurved toenail (pincer nail) and this procedure also showed great improvement of the deformed toenail and its growth plate.