• 제목/요약/키워드: Combined modality

검색결과 176건 처리시간 0.031초

Treatment of Unruptured Intracranial Aneurysms in South Korea in 2006 : A Nationwide Multicenter Survey from the Korean Society of Cerebrovascular Surgery

  • Kim, Jeong-Eun;Lim, Dong-Jun;Hong, Chang-Ki;Joo, Sung-Pil;Yoon, Seok-Mann;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • 제47권2호
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    • pp.112-118
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    • 2010
  • Objective : There have been no clinical studies regarding the epidemiology and treatment outcome for unruptured intracranial aneurysm (UIA) in South Korea yet. Thus, The Korean Society of Cerebrovascular Surgery (KSCVS) decided to evaluate the clinical and epidemiological characteristics, and outcome of the treatment of UIA in 2006, using the nationwide multicenter survey in South Korea. Methods : A total of 1,696 cases were enrolled retrospectively over one year at 48 hospitals. The following data were obtained from all patients : age, sex, presence of symptoms, location and size of the aneurysm, treatment modality, presence of risk factors for stroke, and the postoperative 3D-day morbidity and mortality. Results : The demographic data showed female predominance and peak age of seventh and sixth decades. Supraclinoid internal carotid artery was the most common site of aneurysms with a mean size of 5.6 mm. Eight-hundred-forty-six patients (49.9%) were treated with clipping, 824 (48.6%) with coiling, and 26 with combined method. The choice of the treatment modalities was related to hospital (p=0.000), age (p=0.000), presence of symptom (p=0.003), and location of aneurysm (p=0.000). The overall 30-day morbidity and mortality were 7.4% and 0.3%, respectively. The 30-day mortality was 0.4% for clipping and 0.2% for coiling, and morbidity was 8.4% for clipping and 6.3% for coiling. Age (p=0.010), presence of symptoms (p=0.034), size (p=0.000) of aneurysm, and diabetes mellitus (p=0.000) were significant prognostic factors, while treatment modality was not. Conclusion : This first nation-wide multicenter survey on UIAs demonstrates the epidemiological and clinical characteristics, outcome and the prognostic factors of the treatment of UIAs in South Korea. The 30-day postoperative outcome for UIAs seems to be reasonable morbidity and mortality in South Korea.

T3, T4병기 성문암의 치료성적 (Treatment Result in Advanced T3 and T4 Glottic Carcinoma: YUMC Experience)

  • 신현수;이형식;정은지;김귀언;노준규;서창옥;김광문;홍원표
    • Radiation Oncology Journal
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    • 제9권1호
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    • pp.73-79
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    • 1991
  • 1980년 1월부터 1988년 9월사이에 연세대학병원, 연세암센터 치료방사선과 및 이비인후과에서 치료받았던 68예의 T3, T4병기의 성문암 환자를 대상으로 후향적분석을 하였다. 이 중 34명은 방사선 치료 단독으로 치료하였고 34명은 성문절제술후 방사선치료를 하였으며 이들 환자의 최소 추적기간은 2년이었고 54명 $(79\%)$에서 5년 추적조사가 가능하였다. 치료후 국소관해율은 방사선치료 단독군에서는 $51\%$, 수술 및 수술후 방사선치료군에서는 $79\%$이었고 임파절 음성군에서는$72\%,\;76\%$였으며 임파절 양성군에서는$31\%,\;81\%$이었다. 이들의 치료실패요인은 대부분 국소 국한적 이었고 30명 $(44\%)$에서 관찰되었다. 치료에 따른 5년 생존율은 방사선치료 단독군에서는 $37\%$, 수술 및 수술후 방사선치료군에서는 $76\%$로서 T3, T5병기의 성문암환자에 있어서 수술시 행후 방사선치료를 병용하는 복합요법 이 더 좋은 치료결과를 얻을 수 있음을 알았다. 그러나 임파절 음성군에서는 방사선치료 단독군과 수술 및 수술 후 방사선치료군을 비교해 본 결과 5년 생존율이 $55\%$$73\%$로 통계학적으로 유의한 차이를 보이지는 않았다. 따라서 본 저자들은 T3, T4병기의 성문암치료시 수술 및 방사선치료 병용요법이 더 좋은 치료결과 를 얻을 수 있지만 임파절 음성군에서는 기능적인 보존측면에서 방사선치료가 일차적 차료방법으로서 효과적이리라 사료된다.

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Usefulness of Photodynamic Therapy in the Management of Early Central Lung Cancer: A Report of Three Cases

  • Lee, Jong Hoo;Jeon, Kyeongman;Koh, Won-Jung;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Han, Joungho;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • 제67권4호
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    • pp.338-344
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    • 2009
  • In photodynamic therapy, a chemical photosensitizer is activated by light of a specific wavelength., Photodynamic therapy has been combined with bronchoscopy in patients who are ineligible for surgical resection in order to treat patients with early central lung cancer. Here, we describe 3 patients with early central lung cancer who were treated effectively using photodynamic therapy. Our experience shows that this approach is a useful modality in the therapy of these types of tumors.

원격전이의 증거가 없는 식도암의 방사선치료 성적 (Result of Radiotherapy in Non-metastatic Esophageal Cancer)

  • 채규영;장정순;이종석
    • Radiation Oncology Journal
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    • 제13권1호
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    • pp.27-31
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    • 1995
  • Purpose : This study was done to evaluate preliminarily the role of intraluminal brachytherapy in the radiation treatment of non-metastatic esophageal cancer, Materials and Methods: We analyzed follow-up result of 21 patients treated at the dept. of therapeutic radiology in Gyeongsang national university hospital between April, 1989 and August, 1992. All patients received neoadjuvant chemotherapy(5-FU, Cispl-atin). Fifteen Patients were treated with external beam alone, and in remaining 6 patients, the external beam radiotherapy followed by intraluminal brachytherapy was done. Results : Among 21 patients, 7 patients showed complete tumor regression after completion of radiotherapy. But 2 of these complete responder recurred at the site of primary disease, so ultimate local control rate was $23.8\%$(5/21). Local control rate according to radiation treatment modality was $6.7\%$(1/15) in patients treaed with external irradiation only, and $66.7\%$ in patients treated with combined external irradiation and intraluminal brachytherapy. The 2 year NED survival rate was $6.6.\%$ in the former and $66.7\%$ in the latter. Conclusion: Although there should be consideration about case selection for addition of intraluminal brachytherapy intraluminal brachytherapy may be considerded as one of the method to enhance the local control probability of esophageal cancer.

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하지정맥류의 임상양상 - 227 수술예의 분석 - (Clinical Analysis of Varicose Veins in the Lower Extremities - an analysis of 227 operative cases -)

  • 최수승
    • Journal of Chest Surgery
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    • 제32권11호
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    • pp.1036-1041
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    • 1999
  • Background: To know the clinical aspects of varicose vein and the effectiveness of operative treatment, the patients who had been operated during the five and a half years were reviewed. Material and Method: From September 1993 to February 1999, 227 patients with varicose vein were operated upon. These patients were reviewed with history taking, physical examination, laboratory tests, operation and follow up visits at an out patient department. Result: The ages of the patients were from 20 to 69 years, mean 40.2 years. varicose veins. Occupations of the patients include housewives, store or factory owners, cooks, waiter or waitresses in a restaurant, salary men(women), teachers, hair stylists, professional athletes, in sequence, most of them require standing all day long. The 126 women had experienced child birth, among them 116 patients delivered more than 2 babies. All patients had protruding leg veins as the symptom. Most of them(61%) had pain. Other additional symptoms were heaviness, heatness, tingling, cramp, fatigue, etc. 68.3% of the patients had the symptoms for more than 10 years. Anatomical location of varicose vein was in long saphenous vein in 157 patients, in small saphenous vein in 27, and in other regions(combined or perforating vein) in 43 patients. There was no operative mortality. There were 2 patients who underwent reoperation due to recurrence during this study period. In one patient, it recurred in the distal perforating vein in small saphenous vein. The other patient had recurrence at the saphenofemoral junction in groin. The patients are doing well after the reoperation, but a long term observation is needed. Conclusion: Clinical aspects of varicose vein were reviewed. For the patients with varicose vein who had saphenofemoral regurgitation, operative treatment seemed to bea safe and effective modality of treatment.

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백서 하악골에서 신연골형성술시 압축력의 효능에 관한 실험적 연구 (EXPERIPENTAL STUDY OF ROLE OF COMPRESSION FORCES ON DISTRACTION OSTEOGENESIS ON THE RAT MANDIBLE)

  • 강항립;김철훈;신상훈;정인교;김욱규
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권5호
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    • pp.368-379
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    • 2004
  • Distraction osteogenesis is a biologic process of new bone formation between the surfaces of bone segments that are gradually separated by incremental traction. Distraction osteogenesis is clinically applied as a new treatment modality of mandibular hypoplasia or bony defect area in maxillofacial area by many studies of distraction devices and method. But disadvantage of distraction osteogenesis shows unfavorably long consolidation period and relapse tendency. Therefore. this experiment was designed to investigate the effectiveness of combined application of distraction and compression force for improving of bone quality and shortening of treatment period during distraction osteogenesis. Twenty-one Sprague-Dawley rats with $300{\sim}350gm$ were used. These were divided into two group as distraction group and combination group was applied with compression force in the consolidation period. The rat were sacrificed for gross finding, radiographic and histologic findings. at 2, 4 weeks after distraction. The result were follow : 1. On radiographic finding, all experimental groups appeared more radiopacity than control groups both at 2, 4 weeks after distraction. 2. On histologic finding, trabeculae of bone and mature lamellar bone were showed increasingly in experimental group. Ossification occured rapidly. From this study, we may suggest that compression force application in consolidation period during distraction osteogenesis can be useful method improve bone quality and to shorten the treatment period. But more experimental and clinical studis are necessitated on effects of compression force application during distraction osteogenesis.

원발성 폐암 154례에서의 수술율 및 술후 생존 (An Analysis of the 154 Cases of Lung Cancer)

  • 손광현
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.81-91
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    • 1987
  • During the period of 10 years from July, 1976 to July, 1986, 154 cases of primary carcinoma of the lung - by the cell type, stage, operability, and survival rate in the resectable cases - are analyzed at the Dept. of Thoracic Surgery, Paik Hospital in Seoul. The results are as follows: 1] Histopathological types are squamous cell carcinoma 49% [76 cases], adenocarcinoma 25% [39 cases], undifferentiated large cell carcinoma 9% [14 cases], undifferentiated small cell carcinoma 6% [9 cases], bronchioloalveolar carcinoma 4% [6 cases] and adenosquamous carcinoma 3% [4 cases]. 2] Peak incidence is observed in the 4th decade of life [33%], then 5th [29%] and 3rd [21%] respectively. Male to female ratio is 4 to 1. 3] Evidence of inoperability is observed in 64% [99 cases] by clinical staging workup. Thirty six percent [55 cases] were operated. Of these, post-surgical stage I was 5% [3 cases], stage II, 64% [35 cases] and stage III, 31% [17 cases]. Among total 17 cases of stage III, 14 cases were unresectable with evidence of T2N2M0, while 3 cases were resectable. Resectability is 27%, [41 cases] from the total number of 154 cases. And the resectability for the ex 55 cases is 75% [41 cases]. 4] By cell type, highest resectabitity is the squamous cell carcinoma, 49% [20 cases]. Adenocarcinoma is 32% [13 cases] and bronchioloalveolar, 12% [5 cases]. 5] Survival rate is evaluated for 38 cases of 41 resectable stage I, II and III. Overall 5 year survival rate is 24%, 3 year 32% and 10 year 8%. Survival rate in stage II for 5 year is 25%. In squamous cell type for, 5 year is 42%. Authors believe when surgeons continuous effort of early detection is met with patients early visit, 5 year survival rate for the stage I K II resectable patients will improve more effectively. As well, When the efforts are added to combined modality with radiotherapy and chemotherapy for the stage III selected cases of non-small cell carcinoma patients, the enhancement in survival rate is expected.

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Treatment and Outcomes of Ewing Sarcoma in Turkish Adults: A Single Centre Experience

  • Seker, Mehmet Metin;Kos, Tugba;Ozdemir, Nuriye;Seker, Ayse;Aksoy, Sercan;Uncu, Dogan;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권1호
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    • pp.327-330
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    • 2014
  • Background: Ewing sarcoma is a small round cell tumor arising from soft tissue and bone that predominantly affects children and adolescents. The most unfavorable prognostic factor is the presence of distant metastasis at the time of diagnosis. Materials and Methods: The records of 26 Ewing sarcoma patients (14 male, 12 female) were re-evaluated retrospectively. Results: The median age was 26.5 (19-42) years. Eight patients (31%) showed a primary tumor in their extremities, 8 (31%) in the thorax, 4 (15%) at the vertebra, 4 (15%) in the head and neck, and 2 (8%) in the abdomen. Five patients (19%) had distant metastasis at diagnosis. The median progression-free survival was 72 months and 10 months in localized and metastatic disease, respectively (p=0.005). The overall survival rate was 19 months in metastatic disease, and the 5-year overall survival rate was 64% in localized disease (p=0.006). Patients who had localized disease in the extremities and were under age 30 had a favorable prognosis. Conclusions: Although Ewing sarcoma is a tumor affecting children and adolescents, it may be seen in adults, where the prognosis is generally worse. Although it is a highly malignant tumor, it is possible to achieve improved survival with combined modality treatments.

Treatment Outcome for Head and Neck Squamous Cell Carcinoma in a Developing Country: University Malaya Medical Centre, Malaysia from 2003-2010

  • Wong, Yoke Fui;Yusof, Mastura Md;Ishak, Wan Zamaniah Wan;Alip, Adlinda;Phua, Vincent Chee Ee
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권7호
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    • pp.2903-2908
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    • 2015
  • Background: Head and neck cancer (HNC) is the eighth most common cancer as estimated from worldwide data. The incidence of HNC in Peninsular Malaysia was reported as 8.5 per 100,000 population. This study was aimed to determine the treatment outcomes for HNC patients treated in the Oncology Unit of University Malaya Medical Centre (UMMC). Materials and Methods: All newly diagnosed patients with squamous cell carcinoma of head and neck (HNSCC) referred for treatment to the Oncology Unit at UMMC from 2003-2010 were retrospectively analyzed. Treatment outcomes were 5-year overall survival (OS), cause specific survival (CSS), loco-regional control (LRC) and radiotherapy (RT) related side effects. Kaplan-Meier and log rank analyses were used to determine survival outcomes, stratified according to American Joint Committee on Cancer (AJCC) stage. Results: A total of 130 cases were analysed. Most cases (81.5%) were at late stage (AJCC III-IVB) at presentation. The 5-year OS for the whole study population was 34.4% with a median follow up of 24 months. The 5-year OS according to AJCC stage was 100%, 48.2%, 41.4% and 22.0% for stage I, II, III and IVA-B, respectively. The 5-year overall CSS and LCR were 45.4% and 55.4%, respectively. Late effects of RT were documented in 41.4% of patients. The most common late effect was xerostomia. Conclusions: The treatment outcome of HNSCC at our centre is lagging behind those of developed nations. Efforts to increase the number of patients presenting in earlier stages, increase in the use of combined modality treatment, especially concurrent chemoradiotherapy and implementation of intensity modulated radiotherapy, may lead to better outcomes for our HNC patients.

부산대학교병원 소아치과에서 시행한 전신마취에 대한 연구 (A SURVEY OF GENERAL ANESTHESIA IN PEDIATRIC DENTAL CLINIC AT PUSAN NATIONAL UNIVERSITY)

  • 금진은;노홍석;김재문;정태성
    • 대한장애인치과학회지
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    • 제3권1호
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    • pp.11-16
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    • 2007
  • The use of general anesthesia as a special method of behavior management is necessary if certain handicapped or disabled child patient to receive dental treatment. This study was designed to report the results of 53 cases of complete oral rehabilitation under general anesthesia. The data were obtained from patients who were provided with dental treatment under general anesthesia for last 3years managed at the Dept. of pediatric dentistry in PNU Hospital. The distribution of age, gender, primary reason for general anesthesia, duration of dental procedure, number of treated tooth and periodic recall check-up were surveyed. In distribution of age, most(78%) were younger than 10 years and mean was 13.0 years. The reasons for providing general anesthesia were lack of cooperation due to various mental and physical handicapped situation(74%), congenital heart disease(13%), combined with medically compromised and behavior problem and others. The average duration of the treatments was 2 hours and 41 minutes and average duration of the anesthesia was 3 hours and 6minutes. The mean number of treated with restoration a children were 16.7 teeth. From the results, total dental rehabilitation under general anesthesia is a favorable modality to improve for disabled children's oral condition.

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