• Title/Summary/Keyword: Cessation of treatment

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Hydroxyurea Treatment for Unresectable and Recurrent Meningiomas - Preliminary Report - (재발하였거나 수술적 제거가 불가능한 뇌수막종에 대한 Hydroxyurea 치료 - Preliminary Report -)

  • Lee, Jeong-Hwan;Kim, Oh-Lyong;Kim, Seong-Ho;Bae, Jang-Ho;Choi, Byung-Yon;Cho, Soo-Ho
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.120-123
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    • 2001
  • Objectives : The present study was performed to analyze results of hydroxyurea treatment for unresectable and recurrent meningiomas as adjuvant chemotherapeutic agent. Material and Methods : Among 87 cases of meningioma patients who treated surgically between Jauary 1988 and December 1997 in our department, unresectable and recurrent cases were 4 cases. Histologically, 3 cases were meningothelial type, 1 case was angiomatous type. Tumor orgin was cerebellopontine angle(CPA) in 3 cases, cavernous sinus in 1 case. Three of 4 cases received radiation treatment. All patients received a daily dosage of 20mg/kg/day of hydroxyurea. Hematological monitorning was performed monthly and tumor measurement was assessed by MR imaging before treatment and every 6 months. Mean follow-up period was 34 months. Rerults : All cases showed no enlargement of tumor mass without any shrinkage. Trigeminal neuralgia in 1 case was improved and external herniation of brain on craniectomy site in 1 case was shrunken. None of the patients had any serious side effects. White blood cell count fell below $3000/{\mu}l$ in 1 case, but recovered 2 weeks later with cessation of medication. Conclusion : Hydroxyurea stopped cell growth by triggering the apoptotic cascade. Our preliminary data indicate that hydroxyurea provides adjuvant medical treatment in patients of unresectable and recurrent meningiomas

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Clinical effects of AF-365 for maintenance therapy in chronic stages of asthmas (천식 완해기 유지치료로서 AF-365의 임상적 효과)

  • Jeong, Seung-Yeon;Lee, Jae-Sung;Choi, Jun-Yong;Lee, Kun-Young;Jung, Hee-Jae;Rhee, Hyung-Koo;Bae, Hyun-Su;Jung, Sung-Ki
    • The Journal of Internal Korean Medicine
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    • v.26 no.1
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    • pp.1-11
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    • 2005
  • Backgrounds : Gamichungsangboha-tang extract has been known to improve pulmonary functions and quality of life within four weeks of treatment. Cessation of treatment causes recurrence of symptoms and regression of pulmonary function and poorer quality of life. Long-term herbal therapy is difficult to maintain due to economic burden and other reasons. AF-365 is made with reduced dosage of Gamichungsangboha-tang extract. This study was designed to evaluate the effectiveness of AF-365 for maintenance therapy. Materials and Methods : The subjects consisted of 27 patients with asthma who had beed treated with AF-365 for four weeks. First, patients were treated with Gamichungsangboha-tang extract for four weeks. Second patients stopped herbal medicine for four weeks and after that they took AF-365. Pulmonary function test(PFT) was checked before and after four weeks of treatment. Quality of Life Questionnaire for Adult Korean Asthmatics(QLQAKA) was checked every two weeks from the beginning. The effects of AF-365 were analysed throughout the last four weeks. Results : Treatment of AF-365 for four weeks resulted in significant increase in PEFR%, QLQAKA. The QLQAKA of the step3, step4 group classified by Global initiative for asthma(GINA) showed significant improvement, and the QLQAKA of the step2 group showed no significant difference. In step3 group, PEFR% increased significantly. Conclusions : This study supports a role for AF-365 in maintenance of pulmonary function and quality of life, especially in persistent symptomatic asthmatics.

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Hypofractionated Radiotherapy for Small-sized Hepatocellular Carcinoma as Salvage Therapy: Sustained Local Control and Safety (작은 크기의 재발성 간세포암에 대한 구제치료로 소분할 방사선치료: 국소 제어율과 안전성)

  • Bae, Sun-Hyun;Park, Hee-Chul;Lim, Do-Hoon;Lee, Jung-Ae;Choi, Moon-Seok;Lee, Joon-Hyoek;Koh, Kwang-Cheol;Paik, Seung-Woon;Yoo, Byung-Chul
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.85-90
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    • 2010
  • Purpose: To evaluate the rate of tumor response, local control, and treatment-related complications after hypofractionated radiotherapy for recurrent hepatocelluar carcinoma (HCC) less than 5 cm in size. Materials and Methods: Among the HCC patients who were treated by radiotherapy (RT) between 2006 and 2007 after the failure of previous treatment, a total of 12 patients were treated with hypofractionated RT. The criteria for hypofractionated RT was as follows: 1) HCC less than 5 cm, 2) HCC not adjacent to a critical organ, 3) HCC without portal vein tumor thrombosis, and 4) less than 15% of normal liver volume that irradiated 50% of the prescribed dose. Hypofractionated RT was performed with 50 Gy delivered in 10 fractions, at a rate of 5 fractions per week. The evaluation of tumor response was determined by CT scans performed at 3 months after the cessation of RT, followed by the evaluation of toxicity by Common Terminology Criteria for Adverse Events version 3.0. The median follow-up period after radiotherapy was 18 months. Results: A complete response (CR) was achieved in 5 of 12 lesions (41.7%) at CT performed at 3 months after the cessation, whereas the overall complete response was observed in 7 of 12 cases (58.3%). In-field local control rate was sustained in 83.3% of patients. All patients developed intra-hepatic metastases except for 2 patients. The overall survival rate was 90.0% at 1 year and 67.5% at 2 years, respectively. Three patients developed Grade 1 nausea during RT and 1 patient showed a progression of ascites after RT. There was no grade 3 or greater treatment-related toxicities. Conclusion: Hypofractionated RT for small-sized HCC as a salvage therapy showed a 58.3% CR rate and 83.3% of local control. Fifty Gy administered in 10 fractions of partial liver irradiation is considered as a tolerable dose that does not cause severe complications.

TREATMENT OF IMPACTED MAXILLARY CENTRAL INCISORS USING ORTHODONTIC TRACTIONS (매복된 상악 중절치의 교정적 처치를 통한 치험례)

  • Kim, Nam-Hyuk;Kim, Seong-Oh;Song, Je-Seon;Son, Heung-Kyu;Choi, Byung-Jai;Lee, Jae-Ho;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.109-116
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    • 2010
  • Impaction is defined as a cessation of the eruption of a tooth caused by a clinically or radiographically detectable physical barrier in the eruption path or by an ectopic position of the tooth. The reasons for impaction of the maxillary central incisor are supernumerary tooth, odontoma, ectopic position of tooth germ, dilacerated tooth and so force. Impacted tooth cause space loss due to proximal movement of adjacent tooth, malocclusion, root resorption of adjacent tooth, cyst formation, so careful observation and early detection is important and exact treatment should be applied to prevent these results. The treatment options of impacted tooth include induction an eruption through extraction of deciduous tooth or surgical exposure, reposition of impacted tooth by surgical method or orthodontic treatment. Orthodontic traction is recommended when an eruption does not happen after removal of barrier or surgical exposure, when eruption path is too transpositioned to be corrected spontaneously so eruption does not expected. In these cases, traction of impacted maxillary central incisor was carried out using orthodontic method with closed eruption technique and it showed good clinical results so we report these cases.

Foramen Magnum Decompression with Duraplasty Using Lyoplant® for Caudal Occipital Malformation Syndrome in a Dog

  • Park, Wan-Sang;Kang, SungHun;Kim, Jun-Su;Park, Sung-Guon;Moon, Hee-Sup;Kim, Sang-yeon;Hong, Sung-Jin;Hwang, Tae-Sung;Lee, Hee-Chun;Hwang, Yong-Hyun;Park, Hyun;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.449-453
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    • 2017
  • A 3-year-old castrated male Maltese dog, weighing 4.8 kg was referred with hindlimb ataxia and right forelimb proprioceptive deficits were shown for 20 months. Chiari-like malformation and syringomyelia diagnosed through MRI at a local animal hospital and Knuckling of right forelimb and reluctance to walk were managed with steroid. The medical management was getting ineffective to manage for the symptoms one month before referred. Physical and neurological examinations, radiography, computed tomography, and magnetic resonance imaging were performed and diagnoses of caudal occipital malformation syndrome (COMS) and subsequent syringomyelia (SM) were made. Given that pharmacological treatment was previously ineffective, surgical intervention was recommended. Foramen magnum decompression with duraplasty using $Lyoplant^{(R)}$ was performed. Three days post-surgery, the dog showed improved gait and activity. After 2 months, the dog received no additional prescription medications. At the 12-month follow-up after surgery, the dog showed no clinical problems or recurrences, despite complete cessation of pharmacological treatment. In present report, we applied $Lyoplant^{(R)}$ as a dural graft has been carried out in a dog with COMS. Surgical decompression with $Lyoplant^{(R)}$ was an effective long-term (12-month) treatment for COMS without the need for any pharmacological treatment.

Reparability and Surgical Indications of Rotator Cuff Tears (회전근 개 파열의 봉합 가능성 및 수술 적응증)

  • Ko, Sang-Hun;Park, Han-Chang;Lee, Seon-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.92-97
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    • 2012
  • Purpose: The reparability of rotator cuff tears is very important to establish the indication of the surgical treatment of rotator cuff tears. We reviewed the factors that effect to reparability of rotator cuff tears, and considered about the surgical indication of rotator cuff tears. Materials and Methods: The reparability was considered by the surgical reparability and the postoperative healing potentials of rotator cuff. The natural history of rotator cuff tear gives us the information to make decision about the surgical treatment or the conservative treatment. Results: There are 3 general categories of factors that help predict the healing potential of a rotator cuff tear. These include surgical technique, biology, and environmental issues. Surgeon can control the surgical technique by himself. The control of biology comes from careful operative indications by age, acute trauma history, chronicity, and tear size. And the control of environmental factor can give better outcomes by cessation of smoking and nonsteroidal anti-inflammatory drug (NSAID). Conclusion: A better understanding of the natural history and the reparability of rotator cuff tear will help us to estabilish the indication of surgical treatement of rotoator cuff tears, and lead to satisfactory clinical outcomes.

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Stomal Recurrence after Total Laryngectomy - A Critical Analysis of Etiology and Therapeutic Problems­ (후두전적출술 후 기공주변의 재발)

  • Choi Jong-Duck;Jung Kwang-Yoon;Oh Jae-Hoon;Kim Young-Hwan;Kim Byong-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.152-156
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    • 1994
  • Stomal recurrence after total laryngectomy presents serious therapeutic problems despite aggressive treatment methods. The purpose of this study is to evaluate the critical analysis of etiology and treatment results and to clarify the treatment plans and prevention of stomal recurrence. Among 159 cases who had undergone total laryngectomy for cancers of larynx(135 cases) and hypopharynx(24 cases) during recent 10 years, stomal recurrence occured in 12 cases(1 case with type I, 2 cases with type II, 2 cases with type III, 3 cases of type IV and unclassified 4 cases according to Sisson's classification) and the retrospective analysis of results were as follows: 1) Average duration of stomal recurrence was $8.2{\pm}4.35$ months after cessation of primary treatment. 2) The overall incidence of stomal recurrence was 7.6%. 3) The suggested etiology in the pathogenesis of stomal recurrence could be inadequate surgical margin, delayed laryngectomy after initial tracheostomy and improper management of metastatic nodes. 4) Mean survival time was $7.3{\pm}5.61$ months and one case with type I underwent surgical salvage is still alive out of 7 cases with chemotherapy and radiotherapy and 5 cases with surgical salvage and adjacent therapy. In summary, aggressive surgical resection should be recommended in cases with high risks of stomal recurrence.

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Clinical significance of drug cessation on medication-related osteonecrosis of the jaw in patients with osteoporosis

  • Kezia Rachellea Mustakim;Mi Young Eo;Ju Young Lee;Mi Hyun Seo;Soung Min Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.2
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    • pp.75-85
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    • 2023
  • Objectives: Suspending bisphosphonates (BPs) to reduce the risk and severity of medication-related osteonecrosis of the jaw (MRONJ) remains controversial. In this study, we quantitatively evaluated the clinical significance of BP suspension before surgery in osteoporosis patients with MRONJ. Materials and Methods: We analyzed 24 osteoporosis patients with MRONJ who were treated from 2012 to 2020 at Seoul National University Dental Hospital and compared the treatment outcomes of those who suspended BPs with those who did not. The number of surgical interventions, follow-up panoramic radiographs for relative bone density measurement, and laboratory blood tests including white blood cells, erythrocyte sedimentation rate, absolute neutrophil count, hemoglobin, hematocrit, and alkaline phosphatase were analyzed. ANOVA, Student's t-test, and Mann-Whitney U tests were used to compare results. Fisher's exact test was used to discover the association between treatment outcome and BP suspension, and Pearson's correlation test was used to measure the statistical relationship between the changes in serum inflammatory markers. Results: The number of interventions was significantly higher in the non-drug suspension group due to recurrence (P<0.05). The relative bone density in patients who suspended BPs was significantly different over time (P<0.05), with the highest density at one-year follow-up. Fisher's exact test shows an association between successful treatment outcomes and BP suspension. The alkaline phosphatase and erythrocyte sedimentation rate levels decreased significantly in the BP-suspended group, and a positive correlation was found between these elevated markers. Conclusion: A significant increase in bone density throughout follow-up and a lower number of interventions were found in the BP suspension group compared to the non-drug suspension group. Also, BP suspension decreased inflammatory markers in the serum after surgery, resulting in good treatment outcomes. BP suspension is a prognostic factor for MRONJ and should be implemented before surgery.

A Case Report on Korean Medical Treatment of a Patient with Abnormal Liver Function Induced by Rovazet (로바젯정으로 유발된 간수치 상승 환자의 한방 치료 증례 보고)

  • Kang, Hee-kyung;Cho, Im-hak;Lee, Chan;Heo, Gi-yoon;Kim, Min-hwa;Kwon, Jung-nam;Kim, So-yeon;Park, Seong-ha;Yun, Young-ju;Lee, In;Choi, Jun-yong;Hong, Jin-woo;Han, Chang-woo
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.846-852
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    • 2021
  • Objective: This study evaluated a clinical case of a patient with Rovazet-induced abnormal liver function treated with intradermal acupuncture. Method: A 59-year-old woman with abnormal liver function induced by Rovazet ceased taking the drug and instead received intradermal acupuncture treatment. After 15 days, clinical symptoms and laboratory test results were evaluated. Results: Aspartate aminotransferase and alanine aminotransferase levels decreased, and clinical symptoms such as nausea and fatigue improved after treatment with intradermal acupuncture and cessation of the Rovazet. Conclusion: This study meaningfully examined a clinical case of a patient with abnormal liver function induced by a lipid-lowering agent, which is uncommon in Korea. Unfortunately, the lack of clear evidence and the use of only one case are limitations of the study.

Efficacy of Acupuncture in Treating Upper Abdominal Pain in Cancer Patients: Study Protocol for A Randomized Controlled Pilot Clinical Trial (암환자의 상복부 통증 치료에 대한 침의 효과: 무작위배정 대조군 연구 예비임상시험 프로토콜)

  • Jung, Jin-Yong;Lee, Hyun-Jong;Seo, Jung-Chul;Min, Bo-Mi;Cho, Min-Su;Shin, Im-Hee;Roh, Woon-Seok;Kwak, Min-Ah
    • Korean Journal of Acupuncture
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    • v.31 no.1
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    • pp.33-39
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    • 2014
  • Objectives : This study was designed to evaluate the feasibility of further acupuncture research as an effective and safe treatment for reducing cancer-related upper abdominal pain in patients treated with Neurolytic celiac plexus block(NCPB). Methods : This study is a randomized controlled pilot clinical trial of 3-week duration. Fourteen patients will be recruited and randomly allocated to 2 groups: an acupuncture plus NCPB group(experimental group) and a NCPB group(control group). All patients will undergo one session of NCPB, but only the experimental group will receive three acupuncture sessions a week for 2 weeks(6 in total). The primary outcome will be measured using the visual analogue scale, and the secondary outcome will be measured using the Painvision system and the consumption of additional analgesics. Assessments will be made at baseline and at 1, 2, and 3 weeks thereafter(that is, the 3-week assessment will be made 1 week after treatment cessation). Conclusions : This clinical trial will inform the design of a full-scale trial. The outcomes will provide information to facilitate the incorporation of acupuncture into existing pain management methods such as NCPB in the treatment of cancer-related upper abdominal pain patients.