• Title/Summary/Keyword: treatment strategy

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Effective strategy in the treatment of aortobronchial fistula with recurrent hemoptysis

  • Son, Shin-Ah;Lee, Deok Heon;Kim, Gun-Jik
    • Journal of Yeungnam Medical Science
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    • v.37 no.2
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    • pp.141-146
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    • 2020
  • Aortobronchial fistula (ABF) involves the formation of an abnormal connection between the thoracic aorta and the central airways or the pulmonary parenchyma and is associated with an increased risk of mortality. An ABF typically manifests clinically with symptoms of hemoptysis, and currently, there is a lack of defined guidelines for its treatment. Here, we report the cases of two patients who suffered from recurrent hemoptysis due to ABF with pseudoaneurysm. We propose that removal of the aorta with concomitant lung resection and coverage of the aorta using the pericardial membrane is a definite treatment to lower recurrence of ABF and persistent infection.

Anti-Tumor Necrosis Factor Therapy in Intestinal Behçet's Disease

  • Park, Jihye;Cheon, Jae Hee
    • Gut and Liver
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    • v.12 no.6
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    • pp.623-632
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    • 2018
  • Intestinal Behçet's disease is a rare, immune-mediated chronic intestinal inflammatory disease; therefore, clinical trials to optimize the management and treatment of patients are scarce. Moreover, intestinal Behçet's disease is difficult to treat and often requires surgery because of the failure of conventional medical treatment. Administration of anti-tumor necrosis factor-${\alpha}$, a potential therapeutic strategy, is currently under active clinical investigation, and evidence of its effectiveness for both intestinal Behçet's disease and inflammatory bowel diseases has been accumulating. Here, we review updated data on current experiences and outcomes after the administration of anti-tumor necrosis factor-${\alpha}$ for the treatment of intestinal Behçet's disease. In addition to infliximab and adalimumab, which are the most commonly used agents, we describe agents such as golimumab, etanercept, and certolizumab pegol, which have recently been shown to be effective in refractory intestinal Behçet's disease. This review also discusses safety issues associated with anti-tumor necrosis factor-${\alpha}$, including vulnerability to infections and malignancy.

Elicitor-treated extracts of Saururus chinensis inhibit the expression of inducible nitric oxide synthase and cyclooxygenase-2 enzyme expression in Raw cells for suppression of inflammation

  • Lee, Eun-Ho;Park, Hye-Jin;Kim, Dong-Hee;Jung, Hee-Young;Kang, In-Kyu;Cho, Young-Je
    • Journal of Applied Biological Chemistry
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    • v.62 no.2
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    • pp.149-155
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    • 2019
  • Elicitor treatment was performed to increase the anti-inflammatory activity of useful biological sources. The result showed that elicitor-treated Saururus chinensis leaf extracts positively affected nitric oxide (NO) production, and the expression of inducible NO synthase and cyclooxygenase-2 compared to extracts not exposed to elicitor treatment. This finding identified elicitor treatment as a suitable strategy for increasing the biological activity of S. chinensis. Therefore, elicitor-treated S. chinensis is useful both as health functional and medicinal materials.

Cause of Aspiration During HNC Treatment (두경부암 치료 중 나타나는 흡인의 원인)

  • Yeo, Seong Chul;Woo, Seung Hoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.1
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    • pp.5-8
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    • 2019
  • Aspiration, the entry of material into the airway below the true vocal folds, has been reported in various type of postsurgical head and neck patients. The important of correctly identifying the cause of aspiration in the head and neck surgical patient. Clearly each cause represents a different physiologic or anatomic disorder which requires different management strategy. We discuss about the cause of aspiration during head and neck treatment.

Emerging Treatment in Metastatic Colorectal Cancer (전이성 대장암에서 표적치료와 면역치료)

  • Jae Hyun Kim;Seun Ja Park
    • Journal of Digestive Cancer Research
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    • v.6 no.2
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    • pp.45-49
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    • 2018
  • Colorectal cancer (CRC) is the third most common cause of cancer-related death in the world. Although the long-term outcome of patients with metastatic CRC is still poor, target therapy including anti EGFR agents and anti VEGF agents and immunotherapy including anti PD-1 antibody and anti CTLA-4 antibody have shown clinical benefits in the treatment of patient with metastatic CRC. In the future, the personalized treatment strategy based on the clinical characteristics and biologic features of patients with metastatic CRC will be necessary. In this review, we summarized the mechanisms and clinical evidences of target therapy and immunotherapy, and the guideline of clinical practice in patients with metastatic CRC.

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Current Treatment Strategy for Superficial Nonampullary Duodenal Epithelial Tumors

  • Tetsuya Suwa;Kohei Takizawa;Noboru Kawata;Masao Yoshida;Yohei Yabuuchi;Yoichi Yamamoto;Hiroyuki Ono
    • Clinical Endoscopy
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    • v.55 no.1
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    • pp.15-21
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    • 2022
  • Endoscopic submucosal dissection (ESD) is the standard treatment method for esophageal, gastric, and colorectal cancers. However, it has not been standardized for duodenal lesions because of its high complication rates. Recently, minimally invasive and simple methods such as cold snare polypectomy and underwater endoscopic mucosal resection have been utilized more for superficial nonampullary duodenal epithelial tumors (SNADETs). Although the rate of complications associated with duodenal ESD has been gradually decreasing because of technical advancements, performing ESD for all SNADETs is unnecessary. As such, the appropriate treatment plan for SNADETs should be chosen according to the lesion type, patient condition, and endoscopist's skill.

Changes in the Treatment Strategies for Helicobacter pylori Infection in Children and Adolescents in Korea

  • Jun, Jin-Su;Seo, Ji-Hyun;Park, Ji-Sook;Rhee, Kwang-Ho;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.5
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    • pp.417-430
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    • 2019
  • The policies developed for the treatment of Helicobacter pylori infection in adults may not be the most suitable ones to treat children and adolescents. Methods used to treat children and adolescents in Europe and North America may not be appropriate for treating children and adolescents in Korea due to differences in epidemiological characteristics of H. pylori between regions. Moreover, the agreed standard guidelines for the treatment of H. pylori infection in children and adolescents in Korea have not been established yet. In this study, the optimal treatment strategy for H. pylori infection control in children and adolescents in Korea is discussed based on these guidelines, and recent progress on the use and misuse of antimicrobial agents is elaborated. Non-invasive as well as invasive diagnostic test and treatment strategy for H. pylori infection are not recommendable in children aged less than ten years or children with body weight under 35 kg, except in cases of clinically suspected or endoscopically identified peptic ulcers. The uncertainty, whether enough antimicrobial concentrations to eradicate H. pylori can be maintained when administered according to body weight-based dosing, and the costs and adverse effects outweighing the anticipated benefits of treatment make it difficult to decide to eradicate H. pylori in a positive noninvasive diagnostic test in this age group. However, adolescents over ten years of age or with a bodyweight of more than 35 kg can be managed aggressively as adults, because they can tolerate the adult doses of anti-H. pylori therapy. In adolescents, the prevention of future peptic ulcers and gastric cancers is expected after the eradication of H. pylori. Bismuth-based quadruple therapy (bismuth-proton pump inhibitor-amoxicillin/tetracycline-metronidazole) with maximal tolerable doses and optimal dose intervals of 14 days is recommended, because in Korea, the antibiotic susceptibility test for H. pylori is not performed at the initial diagnostic evaluation. If the first-line treatment fails, concomitant therapy plus bismuth can be attempted for 14 days as an empirical rescue therapy. Finally, the salvage therapy, if needed, must be administered after the H. pylori antibiotic susceptibility test.

Critical Pathway for Management of Primary Spontaneous Pneumothorax (원발성 자연기흉의 치료지침)

  • 전상훈;이응배;조준용;장봉현;이종태;김규태;배지훈;강형석;김병호
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.43-47
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    • 2002
  • Background: With the advances of video technology, thoracoscopic surgery has been applied to various areas of the thoracic surgical fields including major surgeries. Now a days,-thoracoscopic surgery is Performed as a procedure of choice for primary spontaneous pneumothorax. But the operative indication for the primary spontaneous pneumothorax has not been changed since the last few decades, although the procedure of choice was changed from open thoracotomy to thoracoscopy. Therefore, we thought new treatment strategy will be necessary for the management of primary spontaneous pneumothorax. Material and Method: Between January 1998 and December 1999, 149 primary spontaneous pneumothorax patients were admitted to the Kyungpook National University Hospital. Result: Of these patients, 177 were first attack pneumothoraces and the number of total attacks were 250. Conclusion: Analyzing the amount of pneumothorax, methods of treatment, number of recurrences, recurrence rate and hospital stay, we propose a critical pathway for establishing new treatment strategy for the management of primary spontaneous pneumothorax.

Estimation of Carbon Emissions and Energy Self-Sufficiency in Sewage Treatment plant's Improvement by using Life Cycle Management Tool (LCM 기법을 이용한 하수처리장 개선에 따른 탄소배출량 및 에너지 자립율 평가)

  • Moon, Jin-Young;Park, Ji-Hyoung;Hwang, Yong-Woo;Park, Kwang-Ho
    • Journal of Korean Society of Water and Wastewater
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    • v.27 no.2
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    • pp.223-232
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    • 2013
  • In this study, carbon emissions and energy consumption were evaluated to establish a design strategy which has low energy consumption and carbon emission production, by using life cycle energy (LCE) and life cycle $CO_2(LCCO_2)$ calculation methods in life cycle management(LCM) tools. After improvement design projects, the energy consumption and $CO_2$ emission were calculated and compared in three sewage treatment plants (STPs), which are A STP, B STP, and C STP. The reduction of carbon emissions was 28,020.1 ton $CO_{2-}e/yr$, 37,399.6 ton $CO_{2-}e/yr$ and 8,788.3 ton $CO_{2-}e/yr$, respectively. Production of energy was 792 TOE/yr, 1,235 TOE/yr and 1,023 TOE/yr, respectively. As a result, the estimation of energy and energy self-sufficiency was 5.1 %, 14.5 % and 23.5 %, respectively. The result of this study shows the LCM can be contributed to establish strategy for energy and carbon emission reduction in sewage treatment plants.

Successful strategy of treatment used to rhBMP-2 and LFA-collagen scaffold for BRONJ (임상가를 위한 특집 3 - rhBMP-2와 LFA-collagen scaffold를 이용한 BRONJ의 성공적인 치료 전략)

  • Kwon, Kyung-Hwan
    • The Journal of the Korean dental association
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    • v.52 no.4
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    • pp.218-233
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    • 2014
  • Bispbosphonates are a class of pharmaceutic agents, which induce apoptosis of osteoclast as well as impair osteoclastic activity to suppress bone resorption. Thus, bisphophonates are effectively used to treat osteoporosis, multiple myeloma and to prevent bone metastases of malignant cancer. However, recently dental disease have been reported associated with Bisphosphonates. Thus, there are a number of discussions about proper prevention and treatment of bisphosphonate-related osteonecrosis of jaw(BRONJ). Marshall R. Urist in 1965 made the seminal discovery that a specific protein, BMP(bone morphogenetic protein), found in the extracellular matrix of demineralized bone could induce bone formation newly when implanted in extraosseous tissues in a host. BMPs are multi-functional growth factors which are members of the transforming growth factor-beta super family and their ability is that plays a pivotal roll in inducing bone. About 18 BMP family members have been identified and characterized. Among of them, BMP-2 and BMP-7 have significant importance in bone development. In this study, patients of BRONJ were recieved who visited Department of oral and maxillofacial surgery, school of dentistry, Wonkwang university for past 3 years from 2011 to 2013. We focused on the results of the surgical intervention. We suggest that new strategy of treatment used to rhBMP-2 and LFA(Lidocaine-Fibrinogen-Aprotinin)-collagen scaffold for patients of BRONJ. The purpose of this paper is to give a brief overview of BMPs and to critically review the clinical data currently available on rhBMP-2 and LFA collage scaffold.