• Title/Summary/Keyword: 치료법

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Bladder Preservation by Combined Modality Therapy for Invasive Bladder Cancer : A Five-Year Follow-up (근침윤성 방광암에서 화학방사선 병용을 통한 방광보존치료)

  • Cho Jae Ho;Lim Jihoon;Seong Jinsil;Pyo Hong Ryull;Koom Woong Soup;Suh Chang Ok;Hong Sung Jun
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.359-368
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    • 2001
  • Purpose : To determine the long-term results of bladder-preserving approach by transurethral resection of the bladder (TURB), systemic chemotherapy, and radiation therapy for muscle-invasive bladder cancer Methods and materiaals : From 1991 Jan. through 1994 Dec., 25 patients with muscle invading clinical stage T2 to T4NxM0 bladder cancer were treated with induction by maximal TURB and (arm 1, n=4) three cycles of chemotherapy [MVAC(methotrexate, vincristine, adriamycin, ciplatin)] followed by 64.8 Gy of radiation with concomitant cisplatin, or two cycles of chemotherapy [MCV (methotrexate, ciplatin, vincristine)] after irradiation with concomitant cisplatin (arm 2, n=14), or concurrent chemoradiation only (arm 3, n=7). Tumor response was scored as a clinical complete response (CR) when the cystoscopic tumor-site biopsy and urine cytology results were negative. Those with less than a CR underwent cystectomy. The median follow-up of all patients was 70 months. Resulst : Most treatment toxicities were mild to moderate. Grade 3 acute hematologic toxicity and chronic cystitis were observed in only 1 and 2 patients, respectively. Overall 5 year survival was $67.3\%$. Complete remission rate was $80\%$ (20/25). Sixty-three percent of all survivors retained their bladders. In multivariate analysis, prognostic factors that significantly affect survival were T-stage (p=0.013) and Complete remission (p=0.002). Conclusion : Combined modality therapy with TURB, chemotherapy, and radiation has a $67.3\%$ overall 5 year survival rate. This result is similar to cystectomy-based studies for patients of similar clinical stages.

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Treatment of Pectus Carinatum with a Compressive Brace (압박 교정기를 이용한 새가슴의 치료)

  • Son, Jin-Sung;Jeon, Cheol-Woo;Lee, Seong-Jin;Lee, Chol-Sae;Lee, Kihl-Rho;Lee, Seock-Yeol
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.369-375
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    • 2007
  • Background: Patients suffering with pectus carinatum complain of cosmetic problems when they stand and this in spite of wearing cloths. The standard surgical treatment of pectus carinatum is resection of the deformed cartilages, but the wide operative scar, post-operative pain and complications related with such an operation can occur. Therefore, we have peformed compressive brace therapy as a non-operative treatment for pectus carinatum and we observed the effects and the efficiency of this treatment. Material and Method: From January, 2001 to December, 2006, 109 patients wore the compressive brace for all day. The degree of satisfaction was evaluated after $6\sim9$ months of wearing the compressive brace. The degree of satisfaction was evaluated by a score of from $1\sim4$. A score of 1 was assigned when the status was worse, 2 when it was the same, 3 when there was partial improvement and 4 when remarkable improvement was observed. The degree of satisfaction was assessed subjectively by the parent if the patient was a child younger than middle school age, and the patients older than middle school age assessed the score themselves. Result: The mean score of the overall degree of satisfaction was $3.93{\pm}0.33$. Recurrence of pectus carinatum after removal of compressive brace occurred in 6 patients (5.5%) of the total 109 patients. But 4 patients of the total 6 recurred patients stopped wearing of compressive brace against our advice. The 6 recurred patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed the compressive brace. The complications were discomfort with initially wearing the compressive brace, which occurred in all patients, skin rash due to the compressive brace for 76 patients (69.7%) and skin discolorization with excessive compression for f6 patients (5.5%). The skin rash and discolorization returned to normal within a few months after removal of the compressive brace. Conclusion: This study demonstrated that non-surgical treatment with using the compressive brace for patients with pectus carinatum was effective, and especially for children and teenagers. Non-surgical treatment with using a compressive brace would be helpful for the patients suffering with pectus carinatum and who dislike surgical operations because of their fear about general anesthesia and operation-related complications. Yet long-term follow up is necessary to accurately evaluate the effectiveness of this compressive brace and the recurrences after removal of the compressive brace.

Wheel Balance Cancer Therapy in the Treatment of Metastatic Gastric Carcinoma : A Retrospective Analysis of 62 Patients (수레바퀴 암 치료법을 시행받은 진행성 위암환자 62명에 대한 후향적 코호트 분석)

  • Park, Jeong-Seok;Yoo, Hwa-Seung;Lee, Yeon-Weol;Cho, Jung-Hyo;Son, Chang-Gue;Cho, Chong-Kwan
    • The Journal of Internal Korean Medicine
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    • v.28 no.3
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    • pp.531-543
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    • 2007
  • Backgrounds : Gastric cancer is one of the most frequent causes of cancer-related deaths worldwide. Gastric cancer patients frequently exhibit distant metastasis at the time of diagnosis and at present, there is no standard regimen after operation or chemotherapy to prevent metastasis and recurrences. Aims : The objective of the study was to compare the overall survival and disease free survival in patients treated with wheel balance therapy (WBT) with patients treated with WBT alone or the combination of WBT and conventional therapy and see if there were any significant improvements in survival between the two groups. Setting & Design : East-West Cancer Center at Daejeon University: retrospective study. Materials & Methods : We retrospectively analyzed 62 patients with stage III (40 patients) and stage IV (22 patients) gastric cancer who have received operation or chemotherapy 2 months prior to beginning WBT. The patients followed the WBT protocol which includes herbal medicine such as PSM capsules, OnePlus syrup, or HAD capsules which prevent metastasis and recurrences. Overall survival and disease free survival were analyzed and the patients were treated for 89.55 weeks and 49.27 weeks (median value) for stages III and IV, respectively. Statistical analysis used : Overall survival and disease free survival were estimated using the Kaplan-Meier method and the WBT and combination treatment arms were compared using the log rank test. Results : For stage III, the 3 year overall survival was 78.5% and disease free survival was 78.3%. Metastasis and recurrence occurred in 13 of 40 patients (32.5%). For stage IV, the 2 year overall survival was 18.2% and disease free survival was also 18.2%. Metastasis and recurrence occurred in 19 of 22 patients (86.4%). No significant difference was found statistically between the WBT alone and combination treatment arms though the combination regimen showed superiority (overall survival p=0.5093, disease free survival p=0.5175). Conclusions : WBT yielded satisfactory results in prolonging survival and preventing metastasis and recurrence in gastric cancer patients. The major treatment unit of WBT is composed of herbal medications (HAD, PSM capsules, OnePlus syrup) and a randomized, prospective study should be carried out using only this treatment unit in the future.

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Development and Assessment Individual Maximum Permissible Dose Method of I-131 Therapy in High Risk Patients with Differentiated Papillary Thyroid Cancer (물리학 선량법을 이용한 갑상선암의 개인별 최대안전용량 I-131 치료법 개발과 유용성 평가)

  • Kim, Jeong-Chul;Yoon, Jung-Han;Bom, Hee-Seung;JaeGal, Young-Jong;Song, Ho-Chun;Min, Jung-Joon;Jeong, Heong;Kim, Seong-Min;Heo, Young-Jun;Li, Ming-Hao;Park, Young-Kyu;Chung, June-Key
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.110-119
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    • 2003
  • Purpose: Radioiodine (I-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. Materials and Methods: Therapeutic effects of MPD was evaluated in 58 patients (49 females and 9 males, mean age $50{\pm}11$ years) of papillary thyroid cancer. Among them 43 patients were treated with ${\Leq}7.4GBq$, while 15 patients with ${\geq}9.25GBq$. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up I-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. Results: MPD measured by CF method using tracer and therapeutic doses were $13.3{\pm}1.9\;and\;13.8{\pm}2.1GBq$, respectively (p=0.20). They showed a significant correlation (r=0.8, p<0.0001). Exposed doses to blood measured by CF and biological methods were $1.54{\pm}0.03\;and\;1.78{\pm}0.03Gy$ (p=0.01). They also showed a significant correlation (r=0.86, p=0.01). High-dose group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (p=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, p=0.46). Conclusion: Measurement of MPD using CF method is reliable, and the high-dose I-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.

Safety and Efficacy of the Mandibular Advancement Device 'Bioguard' for the Treatment of Obstructive Sleep Apnea : A Prospective, Multi-Center, Single Group, and Non-Inferiority Trial (폐쇄성 수면무호흡증의 치료에 사용되는 하악전방이동장치-'바이오가드'의 안전성과 유효성 검증을 위한 전향적, 다기관, 단일군 및 비열등성 연구)

  • Kim, Hyoung Wook;Hwang, Chungpoong;Eun, Hun Jeong
    • Sleep Medicine and Psychophysiology
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    • v.23 no.2
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    • pp.84-92
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    • 2016
  • Objectives: The purpose of this study was to estimate the safety and efficacy of a mandibular advancement device (MAD), 'Bioguard,' for the treatment of obstructive sleep apnea (OSA). Methods: In this 5-week prospective, multi-center, single group, and non-inferiority trial, patients who chose 'Bioguard' as their treatment option were evaluated using both questionnaires (Pittsburgh Sleep Quality Index (PSQI), Epworth sleepiness scale (ESS)) and polysomonography (PSG) (apnea hypopnea index (AHI), oxygen saturation). All patient data, including clinical records, PSG studies (both pre- and post-treatment), and adverse events (AEs), were reviewed and analyzed. Results: Results were obtained for 59 of 62 patients (95.16%). No significant difference in success rate was found between the MAD treatment and surgical treatment (95% CI). AHI, PSQI, ESS and oxygen saturation demonstrated significant improvement (p < 0.001) after MAD treatment, and 39 of 62 patients (62.9%) reported 85 AEs. 79 of the 85 AEs (91.8%) were mild cases, and there were no severe AEs related to the MAD treatment. Conclusion: The MAD 'Bioguard' should be considered as an alternative treatment option for OSA patients.

THE EFFECT OF GENETIC VARIATION IN THE DNA BASE REPAIR GENES ON THE RISK OF HEAD AND NECK CANCER (DNA 염기손상 치유유전자의 변이와 두경부암 발생 위험성)

  • Oh, Jung-Hwan;Yoon, Byung-Wook;Choi, Byung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.5
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    • pp.509-517
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    • 2008
  • DNA damage accumulates in cells as a result of exposure to exogenous agents such as benzopyrene, cigarette smoke, ultraviolet light, X-ray, and endogenous chemicals including reactive oxygen species produced from normal metabolic byproducts. DNA damage can also occur during aberrant DNA processing reactions such as DNA replication, recombination, and repair. The major of DNA damage affects the primary structure of the double helix; that is, the bases are chemically modified. These modification can disrupt the molecules'regular helical structure by introducing non-native chemical bonds or bulky adducts that do not fit in the standard double helix. DNA repair genes and proteins scan the global genome to detect and remove DNA damage and damage to single nucleotides. Direct reversal of DNA damage, base excision repair, double strand break. DNA repair are known relevant DNA repair mechanisms. Four different mechanisms are distinguished within excision repair: direct reversal, base excision repair, nucleotide excision repair, and mismatch repair. Genetic variation in DNA repair genes can modulate DNA repair capacity and alter cancer risk. The instability of a cell to properly regulate its proliferation in the presence of DNA damage increase risk of gene mutation and carcinogenesis. This article aimed to review mechanism of excision repair and to understand the relationship between genetic variation of excision repair genes and head and neck cancer.

Well-Managed Myelodysplastic Syndrome Patients Treated with Traditional Korean Medicine; Report of Two Cases (한방 치료를 통한 골수이형성증후군 치험례 2례)

  • Kim, Jun-young;Joung, Jin-yong;Son, Chang-gue;Cho, Jung-hyo
    • The Journal of Internal Korean Medicine
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    • v.37 no.3
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    • pp.539-547
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    • 2016
  • Myelodysplastic syndrome (MDS) is a typical myeloid malignancy characterized by cell dysplasia in bone marrow. Currently, there is no therapeutic treatment for MDS. The only available therapies either relieve symptoms or prevent the development of acute myeloid leukemia (AML). This study aimed to report the effects of traditional Korean medicine (TKM) on MDS by presenting two case reports. The patient in Case 1 was diagnosed with primary MDS and regularly received acupuncture treatments and herbal medicine. In Case 2, a patient with ovarian cancer was diagnosed with secondary MDS, which resulted from an adverse reaction to chemotherapy. This patient took herbal medicine for four years and was hospitalized three times. In order to have their condition evaluated, both patients underwent regular blood tests. The patient in Case 1, who showed blood transfusion dependency, received only two blood transfusions after TKM treatment, and the person’s health condition was stable as of January 2016 without any signs of AML development. The patient in Case 2 also has stable health condition. TKM treatment effectively treated their MDS symptoms and improved their general health conditions without any adverse effects. It also prevented the rapid development of AML and maximized the effects of conservative therapy.

The Production, Distribution, and Utilization of Rice in Japan (일본의 쌀 생산, 유통 및 이용 현용)

  • Inouchi, Naoyoshi
    • Food preservation and processing industry
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    • v.1 no.1
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    • pp.17-26
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    • 2002
  • 일본은 기후적으로도 쌀의 생산에 적합하며 쌀은 일본의 주곡이다. 1893년 국립농업연구소가 설치된 이래로 쌀은 품질과 단보당 생산량이 꾸준히 개선되어와 116의 노동시간으로 생산량은 2.5배의 증가를 가져왔다. 이러한 진전은 재배방법의 개선, 비료, 농약, 재배기술, 기계화, 관개배수, 농지개량 등의 요인들로 볼 수 있다. 현재 일본에서 생산되고 있는 주요 쌀 품종으로는 코시히카리($35.5\%$), 히토메보레($9.7\%$), 히노히카리($9.0\%$), 아키다코마치($8.5\%$), 키라라($4.8\%$) 등 10여 품종이며 최근에는 형질전환 품종의 연구와 함께 생물공학적 연구 ,생리, 품질, 곤충과 잡초, 토양, 식품가공 등 기본적인 연구에 심혈을 기울이고 있다. 새로운 형태의 쌀 품종으로는 냉동조리쌀밥, 초밥, 레토르트룡 쌀 등 가공용으로 적합하도록 하기 위하여 아밀로오즈의 함량을 $5-15\%$로 낮춘 쌀이나 카레, 필라프, 튀김 쌀 등의 용도에 적합하도록 아밀로오스의 함량을 $30\%$이상으로 높인 쌀뿐만 아니라 곡립의 크기와 길이 등을 변형시킨 쌀, 유색미, 향미, 단백질 함량 조절 쌀, 거대 배아미, lipoxygenase 활성을 없앤 쌀, 단맛나는 쌀 등이 연구, 생산되고 있다. 일본에서의 쌀이용은 먼저 가공용 쌀을 들 수 있다. 밥, 청주, 스낵, 쌀가루, 미소발효 등 다양하게 이용이 되고 있으며 parboiled rice와 이의 색과 향을 개선한 converted rice, 현미를 이용한 가공쌀, 쌀빵, 현미가루, 세척미, 쌀국수, 쌀스낵, 당과, 죽, 쌀은 채소아 함께하는 타키코미고한, 초밥, 냉동쌀밥, 무균포장밥, 건조밥, 즉석밥 등 매우 다양하다.는 일, 쌀 재배구조 조정과 함께 높은 미질을 가지는 품종육종, 기계화를 비롯한 경작기술의 발달, 쌀과 부산물 가공기술의 개발연구, 특정기능을 함유하는 유전공학적 기술의 적용, 토지와 도시화 그리고 식량순환에 시스템의 개혁 등 과학기술을 고양하는 일 등을 들 수 있다.하는데 도움이 되리라 생각된다.=0.002)가 통계적으로 유의한 인자였다. 결론 : 본 기관에서 시행되어진 근침윤성 방광암에 대한 방광보존치료법은 기존의 근치적 방광절제술에 비하여 대등한 치료성적을 내는 동시에 $63\%$에서 장기보존이 가능하였다. 따라서 본 치료법이 방광암의 치료에 적극적으로 적용되어야 할 것으로 생각하며 향후 여러 기관이 참여하는 활발한 연구를 통해 한국인에게 가장 적절한 치료법을 개발해야 될 것으로 생각한다. B2+3, C1, C2+3군에서 수술달독군과 방사선치료 추가군의 골반종양제어율은 각각 $79\%$$75\%$ (p=0.88), $100\%$$100\%,\;44\%$$68\%$ (p=0.01)이었다. 전체 환자를 대상으로 다요인 분석을 시행한 결과 생존율과 무병생존율에 병기만이 유의하였고 두 치료 군에서도 역시 병기가 유의한 인자로 나타났다. 전체환자에서 골반종양제어율에 유의한 예후인자로 다요인분석을 시행한 결과 병기와 수술방법이 유의하였다. 수술단독군에서는 병기만이 유의하였고 방사선치료 추가군에서는 수술방법만이 유의하여 복부회음절제술군의 골반종양재발률이 높았다. 결론 : 본 후향적 연구에서 수술 후 보조적 방사선치료를 시행하여 수술단독군에 비해 병기 C2+3군에서 골반종양제어율이 향상되었음을 알 수 있었다. 그러나 병기 B2이상의 모든 환자에서 골반종양제어율 뿐만 아니라 생존율의 향상을 가져오기

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The Efficacy of Surgical Treatment with Flexible Alligator Forceps in Dogs with Heartworm Infection (심장사상충 감염견에서 Flexible Alligator Forceps을 이용한 외과적 치료)

  • Yoon Hun-young;Jeong Soon-wuk;Kim Jun-young;Han Hyun-jung;Jang Ha-young;Lee Bora;Namkung Hyo-sun
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.309-313
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    • 2005
  • This study was performed to assess the efficacy of surgical treatment with flexible alligator forceps (FAF) on heartworm infected dogs. Twenty dogs (10 males and 10 females) with heartworm infection, age $5.3\pm3.0\;(mean{\pm}S.D.)$ years and weight $9.3\pm6.5(mean{\pm}S.D.)kg$ were treated with FAF. Adult heartworms were removed by fluoroguided technique with FAF under inhalation anesthesia with isoflurane. For evaluation of the efficacy, removal rate and surgical time were measured, and removal sites were found. Antigen ELISA kit test and autopsy were performed to examine remained adult heartworms. Removal rate of total heartworms was $91.4\%$ including 15 complete retrieval cases and surgical time was $30.0\pm7.6(mean{\pm}S.E.)$ minutes. Heartworms were removed from the right ventricle, main pulmonary artery, and right and left pulmonary artery. Surgical treatment with FAF is an effective method with high removal rate, short surgical time, and various removal sites and it could be considered for the removal of adult heartworms in a dog.

Development of Individually Adapted Electromagnetic Therapy System in Incontinence (환자 맞춤형 전자기장 요실금 치료 시스템 개발)

  • Noh, Si-Cheol;Kang, Kyu-Hong;Lee, Jeong-Seok;Min, Kwon-Sik;Kwon, Jang-Woo;Choi, Heung-Ho
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.45 no.4
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    • pp.51-59
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    • 2008
  • Incontinence is the urination disorder as the leakage of urine without her own volition and the woman's representative disease which reduce the life quality. The electromagnetic therapy has high possibility of development cause it has no needs of operant exercise, no arousing of shame and impossibility of infection. But, it has improvement points such as uniformity of the treatment protocol, patient dependance and absent of patient monitoring system. With these demands, the system which stimulate the pelvic flaw muscle with electromagnetic and monitoring the patient status during the therapy is proposed, in this study. And individually adapted electromagnetic therapy system for incontinence patient is also suggested. The proposed system consisted of electromagnetic generation device, cooling device, treating chair, patient monitoring device with pulsation and control software. The simulation for high power system and evaluation confirm was performed. With the development of control software, the convenience of using and maintenance are ensured and the patient adapted therapy protocol is applied. The developed patient adapted electromagnetic therapy system with monitoring device is regarded as the patient affinitive treating method by reducing the riskiness, improving the efficiency with patterned protocol and pre/post therapy. These results, in this study, can bring the safe and organized treatment method to incontinence patients and can lead the variable study for electromagnetic therapy in incontinence.