• Title/Summary/Keyword: 병행치료

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Pulmonary Resection for Multidrug-Resistant Tuberculosis (다제내성 폐결핵의 폐절제술에 관한 연구)

  • 박승규;윤후식;이창민;허진필;권은수
    • Journal of Chest Surgery
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    • v.34 no.1
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    • pp.72-79
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    • 2001
  • 배경: 일반적으로 다제내성 폐결핵의 경우 화학요법만으로는 치료성적이 만족스럽지 못하였다. 이에 수술적 치료와 항결핵 화학요법의 병합사용이 높은 균음전율과 장기 생존율을 보여주고 있으므로 이러한 치료전략이 다제내성 폐결핵환자의 일반적인 치료방법으로 정립되리라는 전망을 갖게 하고 있다. 대상 및 방법: 1995년 1월부터 1999년 12월까지 국립마산결핵병원에서 폐결핵에 대한 수술을 시행받은 130례 중 다제내성 폐결핵으로 폐절제수술을 받은 49례를 대상으로 의무기록 및 검사기록 등을 근거로 후향적 조사를 실시하였다. 결과: 대상환자들의 평균연령은 35세였고, 내성약제의 수는 평균 4.5였다. 43례(87.8%)의 환자에서 공동성 병소를 보였으며 31례(63.3%)의 환자에서 술전 객담내 균양성 소견을 보였다. 수술술식은 12례에서 전폐적출술을, 28례에서 폐엽절제술을, 7례에서는 폐엽절제술과 구역절제술 혹은 설상절제술 등을, 그리고 설상절제술과 공동성형술을 각각 1례에서 시행하였다. 술후 지속적인 내과적 약물치료를 병합하여 장기적인 균음전율은 93.5%였고 술후 사망환자는 없었다. 술후 합병증으로는 1주일 이상 지속되는 공기유출 6례와 술후 출혈, 창상분열이 각각 1례씩 있었다. 결론: 다제내성 폐결핵환자에서 폐절제 수술에 대해서는 적절한 적응증, 수술후 처방, 그리고 술후 치료기간 등에 대한 이견이 있지만 적극적으로 고려되어야 하며 술후 내과적 치료와 병행함으로 좋은 치료효과를 얻을 수 있었다.

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The Results of Radiation Therapy in Non-Small Cell Lung Cancer (비소세포성 폐암에서의 방사선 치료 결과)

  • Kay Chul-Seung;Jang Hong-Seok;Gil Hack-Jun;Yoon Sei-Chul;Shinn Kyung-Sub
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.175-184
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    • 1994
  • From March 1983 through January 1990, two hundred sixty six patients with non-small cell lung cancer were treated with external radiation therapy at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. A retrospective analysis was performed on eligible 116 patients who had been treated with radiation dose over 40 Gy and had been able to be followed up. There were 104 men and 12 women. The age ranged from 33 years to 80 years (median ; 53 years). Median follow up period was 18.8 months ranging from 2 months to 78 months. According to AJC staging system, there were 18($15.5\%$) patients in stage II, 79($68.1\%$) patients in stage III and 19($16.4\%$) patients in stage IV. The Pathologic classification showed 72($62.8\%$) squamous cell carcinomas, 16($13.8\%$) adenocarcinomas, 7($6\%$) large cell carcinomas, 5($4\%$) undifferentiated carcinomas, and 16($13.8\%$) un-known histology. In Karnofsky performance status, six ($5.2\%$) patients were in range below 50, 12($10.4\%$) patients between 50 and 60, 46($39.6\%$) patients between 60 and 70, 50($44.0\%$) patients between 70 and 80 and only one ($0.8\%$) patient was in the range over 80. Sixty ($51.7\%$) patients were treated with radiation therapy (RT) alone. Thirty three ($28.4\%$) patients were treated in combination RT and chemotherapy, twenty three ($19.8\%$) patients were treated with surgery followed by postoperative adjuvant RT and of 23 Patients above, five ($4.3\%$) patients, were treated with postoperative RT and chemotherapy. Overall response according to follow-up chest X-ray and chest CT scans was noted in $92.5\%$ at post RT 3 months. We observed that overall survival rates at 1 year were $38.9\%$ in stage II, $27.8\%$ in stage III, and $11.5\%$ in stage IV, and 2 year overall survival rates were $11.1\%$ in stage II, $20.8\%$ in stage III and $10.5\%$ in stage IV, respectively. We evaluated the performance status, radiation dose, age, type of histology, and the combination of chemotherapy and/or surgery to see the influence on the results fellowing radiation therapy as prognostic factors. Of these factors, only performance status and response after radiation therapy showed statistical significance (P<0.05)

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Return-to-Work Experiences among Nurses after Receiving Cancer Treatment (암 치료를 받은 간호사의 직장복귀 경험)

  • Kim, Mi-Hye;Kim, Jeong-Seon;Kim, Han-Na
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.6
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    • pp.215-225
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    • 2016
  • The purpose this study was to explore the return-to-work experience of nurses after receiving cancer treatment. The participants of this research were 6 registered nurses who were working when they were diagnosed with cancer. Data were collected by individual in-depth interviews from January 5 to January 29, 2016 and analyzed using phenomenological methodology by Colaizzi(1978). The study results revealed that the return-to-work experiences of nurses after receiving cancer treatment may be categorized as 'Enduring hardly', 'Living a balance in my turning point', 'Reborn' and may be identified with 9 theme clusters and 27 themes. Their experience of returning to work as a nurse after cancer treatment consisted of expressing difficulty in handling both work and treatment. Despite that, they came to live a more mature life after their disease and came to affirm their existence through their work. Thus, an improved working environment to manage both work and treatment and continual support and assistance from society is deemed necessary.

Well-being of young and middle aged diabetic patients with medication according to combination of non-pharmacological treatment: a path analysis (청장년층 약물치료 당뇨환자의 비약물적치료 병행 여부에 따른 웰빙: 경로분석)

  • Kim, Sun-Kyung;Kim, Yu-Mi;Kim, Sun-Ae
    • Journal of the Korea Convergence Society
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    • v.11 no.6
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    • pp.401-410
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    • 2020
  • The purpose of this study was to investigate predictors and mediating effects of physical activity and nourishment regulation on well-being among young and middle aged patients on DM medication and to compare between those with non-pharmacological treatment and those without. Data were obtained from 2017 community health survey including 1,480 DM patients with oral medication in the age between 20 and 49. Using SPSS 25.0 and AMOS 25.0, path analysis was performed to explore the association between personal factors (socio-economic status, health habit, eating habit and compliance of health examination) and well-being, along with mediating effects of physical activity. Results demonstrated the different mediating role of physical activity. In medication only group, there was no direct effect of physical activity and no indirect effect of personal factors. Direct effect of physical activity and indirect effects of predictors were found in those with non-pharmacological treatment group. When developing strategies to enhance well-being of young and middle aged diabetic patients, proper reflection of their age specific traits and disease management capability are essential.

One Case of Combination Therapy of Acupuncture, Herbal medication and Thought Field Therapy on Hysterical Aphonia lasting for 1 year (1년 이상 지속된 히스테리성 실성증(失聲症)의 사고장요법(Thought Field Therapy)과 한방요법 병행치료 1례)

  • Park, Jong-Hoon;Cho, Sung-Hoon;Chung, Sun-Yong;Hwang, Ui-Wan;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.14 no.2
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    • pp.183-189
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    • 2003
  • Hysterical aphonia is one of the frequent symptoms in conversion disorders. If it has a recent onset, a manifest induced factor, and a good premorbid adaptation, and another mental disorder is not accompanied, its prognosis is good. We report one case of hysterical aphonia that was bad prognosis. This patient was suffering traumatic event before and after onset, and major depressive disorder was accompanied. Having hysterical aphonia, the patient who had no progress after over an years medicine therapy and often felt strong suicidal urge, was successfully treated by TFT(Thought field therapy) and oriental medicine therapy. Several case studies on hypnotic cure of hysterical aphonia has been reported but they are uncommon internally and have good prognosis. In addition, there were no relevant studies concerning alternative therapy and oriental medication. Our case report is focused on treatment through these methods.

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Biologic rationale of cancer treatment with hyperthermia (고온온열치료장치를 사용한 종양치료의 생물학적 원리)

  • 김명세
    • Proceedings of the Korea Electromagnetic Engineering Society Conference
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    • 1999.07a
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    • pp.47-55
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    • 1999
  • 고온온열치료는 radiofrequency, ultrasound , microwave, 원적외선 등을 이용하여 신체의 부분 혹은 전신을 4$0^{\circ}C$ 이상으로 가열하여 암을 치료하는 방법이다. 우리나라에 도 입된 15기의 기계중 현재까지 사용되고 있는 것은 대부분이 radiofrequency를 사용하는 기 계이며 현재 고신의대, 동아의대, 부산메리놀병원, 여의도 성모병원, 영남의대, 전주예수병원 등에서 환자치료에 사용하고 있다. 고온 온열치료제(hyperthermia)는 직접 암세포를 죽이는 작용, 방사선치료나 항암제치료와 병행하여 그 효과를 증강시키는 작용으로 크게 나눌수 있 다. 직접 암세포를 죽이기 위하여는 43$^{\circ}C$이상의 고온을 사용하여야 하나 인체에서는 42.5$^{\circ}C$ 이상으로 가온하기가 쉽지않아 4$0^{\circ}C$~42$^{\circ}C$ 정도의 온도에서 방사선 치료나 항암제 치료효과 를 증진시키는 작용을 임상에서 주로 사용하고 있다. 특히 방사선 치료와 병합 사용시 그 효과가 뛰어나 간암, 난소암, 대장 직장암, 식도암, 위암, 자궁암, 전립선안, 췌장암, 폐암등, 거의 모든 암에서 부작용을 증가시키지 않으면서 그 효율을 1.1-6.14배나 증가시킨다고 보 고되고 있어 지난 10여 년간 제자리걸음을 하고 있는 암의 치료에 희망을 주고 있다. 방사 선 치료와 병합시 효과를 증대시키는 기전은 1)세포의 핵 합성기 (S-phase)는 방사선 치료 에는 매우 저항력이 강하여 잘 죽지 않으나 고온온열치료에는 예민함으로 암세포는 정상조 직에 비해 산소가 부족하여 염기성대사(anaerobic metabolism)를 많이 함으로 그 부산물인 유산 (lactic acid)이 많이 생성됨으로 정상조직보다 pH가 낮아 암 조직이 정상조직에 비해 고온온열치료에 더 잘 듣는 원인이 된다. 3) 영양이 부족한 상태의 세포는 고온온열치료에 훨씬 예민하다. 4) 암조직은 혈관상태가 정상조직에 비해 좋지 않음으로 정상조직보다 쉽게 가온이 되며, 일단 가온된 온도는 잘 식지 않음으로 정상조직에 비해 훨씬 효율적이다. 5)고 온온열치료는 4$0^{\circ}C$~43.5 $^{\circ}C$정도에서만 이 작용이 일어남으로 정상인체에서 43$^{\circ}C$이상의 가온 은 쉽지 않음으로 이 효과는 암조직에서 주고 일어나게 된다. 6)고온온열치료는 방사선치료 후에 생기는 손상의 재생을 억제함으로 방사선의 치료효과를 높인다. 7)38.5$^{\circ}C$~41.5$^{\circ}C$의 낮 은 온도에서도 암조직의 산소 상태를 호전시켜 방사선 치료효과를 증대시키는 역할을 한다.

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The Role of Radiotherapy for Carcinomas of the Gall Bladder and Extrahepatic Biliary Duct: Retrospective Analysis (담낭 및 간외담도계 악성종양의 방사선치료결과)

  • Jeong Hyeon Ju;Lee Hyun Ju;Yang Kwang Mo;Suh Hyun Suk;Kim Re Hwe;Kim Sung Rok;Kim Hong Ryong
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.43-49
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    • 1998
  • Purpose : Carcinomas arising in the gall bladder(GB) or extrahepatic biliary ducts are uncommon and generally have a poor prognosis. The overall 5-year survival rates are less than $10\%$. Early experiences with the external radiation therapy demonstrated a good palliation with occasional long-term survival. The present report describes our experience over the past decade with irradiation of primary carcinomas of the gallbladder and extrahepatic biliary duct. Materials and Methods : From Feb. 1984 to Nov. 1995, thirty-three patients with carcinoma of the GB and extrahepatic biliary duct were treated with external beam radiotherapy with curative intent at our institution. All patients were treated with 4-MV linear accelerator and radiation dose ranged from 31.44Gy to 54.87Gy(median 44.25Gy), and three Patients received additional intraluminal brachytherapy(range, 25Gy to 30Gy). Twenty-seven Patients received postoperative radiation. Among 27 patients, Sixteen patients underwent radical operation with curative aim and the rest of the patients either had bypass surgery or biopsy alone. In seventeen patients, adjuvant chemotherapy was used and eleven patients were treated with 5-FU, mitomycin and leucovorin. Results : Median follow up period was 8.5 months(range 2-97 months). The overall 2-year and 5-year survival rates in all patients were $29.9\%$ and $13.3\%$ respectively. In patients with GB and extrahepatic biliary duct carcinomas, the 2-year survival rates were $34.5\%$ and $27.8\%$ respectively. Patients who underwent radical operation showed better 2-year survival rates than those who underwent palliative operation($43.8\%\;vs.\;20.7\%$), albeit statistically insignificant(p>0.05). The 2-year survival rates in Stage I and II were higher than in Stage III and IV with statistical significance(p<0.05). Patients with good performance status in the beginning showed significantly better survival rates than those with worse status(p<0.05). The 2-year survival rates in combined chemotherapy group and radiation group were $40.5\%$ and $22.0\%$ respectively. There was no statistical differences in two groups (p>0.05). Conclusion : The survival of patients with relatively lower stage and/or initial good performance was significantly superior to that of others. We found an statistically insignificant trend toward better survival in patients with radical operation and/or chemotherapy, More radical treatment strategies, such as total resection with intensive radiation and/or chemotherapy may offer a better chance for cure in selective patients with carcinoma of gall bladder and extrahepatic biliary ducts.

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Three Cases of Chronic Relapsing Cystitis with Herb-medicine and Sweet Bee Venom Pharmacopuncture (한약과 봉약침(Sweet BV)으로 병행치료한 만성 재발성 방광염 환자 치험 3례)

  • Cho, Seong-Hee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.2
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    • pp.113-120
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    • 2016
  • Objectives: This study aims to report the effects of Korean medicine treatment by pattern identification and Sweet Bee Venom Pharmacopuncture on Chronic Relapsing Cystitis Methods: The patients was treated with Korean medicine by pattern identification and Sweet Bee Venom Pharmacopuncture at Qugu (CV2), Guanyuan (CV4). We evaluated treatment effects by changes of symptoms and urine analysis (UA) finding. Results: After treatments, the clinical symptoms such as painful urination, dysuria, frequent urination were improved and the state of urinalysis was improved. Conclusions: This clinical study suggests that Korean medicine treatment by pattern identification and Sweet Bee Venom Pharmacopuncture are significantly effective in treatment of a Chronic Relapsing Cystitis

A Clinical Case Study on Intersection Syndrome with Direct Moxibustion (직접구 병행치료로 호전된 손목의 교차증후군 1례)

  • Choi, Yong-Hun;Yoon, Il-Ji
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.1
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    • pp.149-153
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    • 2011
  • This study was performed to report the effectiveness of direct moxibustion on a patient with intersection syndrome. The patient was diagnosed as intersection syndrome and treated with acupuncture, direct moxibustion and physical therapy. We have evaluated curative efficacy with measuring changes of visual analogue scale before and after treatment. After treatment, visual analogue scale decreased. These results suggest that direct moxibustion was effective on patient with intersection syndrome.

A Study on the Efficiency of Riluzole and Oriental Medical Treatment in Amyotrophic Lateral Sclerosis (근위축성 측삭 경화증에서 Riluzole과 한방 병행치료에 대한 고찰)

  • Lee, Eun;Ko, Heung;Park, Byung-Wook
    • The Journal of Internal Korean Medicine
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    • v.22 no.2
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    • pp.279-283
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    • 2001
  • We had one female ALS patient. The patient was diagnosed with ALS by EMG and Symptoms. We diagnosed the patient as Jinshang(筋傷) and Pishenyangxu(脾腎陽虛). We gave Shaoyaogancao-tang jiami(芍藥甘草湯加味) and Sijunzi-tang he Lizhong-tang jiami(四君子合理中湯加味) based on the differentiation of symtoms. We report the changes of the ALS patient's disphagia, lalopathy, and hypotonia after two months treatment with Riluzole and oriental medical treatment.

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