• Title/Summary/Keyword: First-line treatment

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A Case Report of a Thyroid Cancer Patient with Hypoparathyroidism after Total Thyroidectomy by a Combination of Korean-Western Medicine Treatment Including Insamyangyoung-tang (갑상선 전절제술 후 부갑상선기능저하증이 발생한 갑상선암 환자의 인삼양영탕을 활용한 한양방 복합 치료 증례 보고 1례)

  • Kim, Du-ri;Lee, Su-yeong;Lee, Hyun-seung;Moon, Byung-soon;Yun, Jong-min
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.814-821
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    • 2018
  • Thyroid cancer is one of the most common cancers in Korea, and thyroidectomy is the first-line treatment. Hypoparathyroidism is a common complication of thyroidectomy and can cause symptoms such as numbness, spasm, and anxiety, but these issues have seldom been reported in the Korean medical literature. The present case was a 53-year-old thyroid cancer patient who complained of numbness caused by hypoparathyroidism, general weakness, fatigue, and postoperative pain after total thyroidectomy. The patient was treated with Korean medicine treatment, including herbal medicine, acupuncture, cupping, and moxibustion, and her changes in clinical symptoms were measured with a numeric rating scale (NRS), the Karnofsky performance status scale (KPS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). After treatment, her clinical symptoms were improved, leading to an improvement in her quality of life. Therefore, Korean medicine may be effective in the treatment of thyroid cancer patients who experience numbness caused by hypoparathyroidism, general weakness and fatigue after total thyroidectomy.

Cost-Minimization Analysis of Biologic Disease-Modifying Antirheumatic Drugs Administered by Subcutaneous Injections in Patients with Rheumatoid Arthritis (피하주사로 투여하는 생물학적 항류마티스 제제의 비용 최소화 연구)

  • Park, Seung-Hoo;Lee, Min-Young;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.59-69
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    • 2016
  • Background: The subcutaneous formulation of biologic disease-modifying antirheumatic drugs (DMARDs) was preferred due to favored self-administration and would be an economical treatment option for patients with rheumatoid arthritis. This study was to compare the economic impact of biologic DMARDs administered by subcutaneous injection in patients with rheumatoid arthritis who had inadequate response to conventional DMARDs. Methods: The cost-minimization analysis was conducted to estimate the lifetime health care costs of treatment sequences with subcutaneous biologic DMARDs as first-line therapy from a health care system perspective. The Markov model was developed to represent the transitions through treatment sequences based on American College of Rheumatology response rate and discontinuation rate. The health care costs comprised the cost of medications, administration, dispensing, outpatient visits, test/diagnostic examination, palliative therapy and treatment of serious infection. All costs were expressed in 2016 Korean Won (KRW) and discounted at 5%. Results: The mean lifetime health care cost per patient was lowest in the etanercept sequence, which was estimated at KRW 63,441,679. The incremental costs of the treatment sequence started with adalimumab, golimumab, abatacept, and tocilizumab were KRW 7,985,730, KRW 4,064,669, KRW 2,869,947, and KRW 4,282,833, respectively, relative to etanercept sequence. These differences in costs mainly were attributable to medication costs. One-way and probabilistic sensitivity analyses confirmed that etanercept represented the option with the lowest cost compared with comparators. Conclusion: This study found that etanercept is likely a cost-saving treatment option among subcutaneous biologic DMARDs in patients with rheumatoid arthritis.

Substrate reduction therapy as a new treatment option for patients with Gaucher disease type 1: A review of literatures

  • Sohn, Young Bae;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.13 no.2
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    • pp.59-64
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    • 2016
  • Gaucher disease type 1 (GD1) is an inherited lysosomal storage disorder caused by deficiency of acid ${\beta}$-glucosidase. The diminished enzyme activity leads to the accumulation of substrates and results in multi-systemic manifestations including hepatosplenomegaly, anemia, thrombocytopenia, and bone diseases. Enzyme replacement therapy (ERT) by infusion of recombinant protein has been the standard treatment for over 20 years. Despite the successful long-term treatment with ERT, several unmet needs remain in the treatment of GD1 such as severe pulmonary and skeletal manifestations. Substrate reduction therapy (SRT) reduces the accumulation of substrates by inhibiting their biosynthesis. Eliglustat, a new oral SRT, was approved in United States and Europe as a first-line therapy for treating adult patients with GD1 who have compatible CYP2D6 metabolism phenotypes. Although eliglustat is not yet available in Korea, introduction and summary of this new treatment modality are provided in this paper by review of literatures. Despite the fact that there are only limited studies to draw resolute conclusions, the current data demonstrated that eliglustat is not inferior to ERT in terms of its clinical efficacy. The approval of eligustat enables eligible adult GD1 patients to have the option of oral therapy although it still needs further studies on long-term outcomes. The individual patient should be assessed carefully for the choice of treatment modality when eliglustat becomes available in Korea. Furthermore, the clinical guidelines for Korean patients with GD1 regarding the use of eliglustat needs to be developed in near future.

Prevalence and Alternative Treatment of Head-Lice Infestation in Rural Thailand: A Community-Based Study

  • Singhasivanon, On-uma;Lawpoolsri, Saranath;Mungthin, Mathirut;Yimsamran, Surapon;Soonthornworasiri, Ngamphol;Krudsood, Srivicha
    • Parasites, Hosts and Diseases
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    • v.57 no.5
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    • pp.499-504
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    • 2019
  • Head-lice infestation, pediculosis capitis, remains a public-health burden in many countries. The widely used first-line pediculicides and alternative treatments are often too costly for use in poor socio-economic settings. Ivermectin has been considered an alternate treatment for field practice. This study was composed of 2 parts, a cross-sectional survey and an intervention study. The main objectives were to determine the prevalence and potential factors associated with head-lice infestation, and to evaluate the effectiveness and safety of oral ivermectin administration. A community-based cross-sectional survey was conducted among 890 villagers in rural areas along Thai-Myanmar border. Females with infestations were eligible for the intervention study, and 181 participated in the intervention study. A post-treatment survey was conducted to assess acceptance of ivermectin as a treatment choice. Data analysis used descriptive statistics and a generalized-estimation-equation model adjusted for cluster effect. The study revealed the prevalence of head-lice infestation was 50% among females and only 3% among males. Age stratification showed a high prevalence among females aged <20 years, and among 50% of female school-children. The prevalence was persistent among those with a history of infestation. The major risk factors were residing in a setting with other infected cases, and sharing a hair comb. The study also confirmed that ivermectin was safe and effective for field-based practice. It was considered a preferable treatment option. In conclusion, behavior-change communication should be implemented to reduce the observed high prevalence of head-lice infestation. Ivermectin may be an alternative choice for head-lice treatment, especially in remote areas.

Thyroid Radiology Practice: Diagnosis and Interventional Treatment of Patients with Thyroid Nodules (갑상선 영상의학 진료: 갑상선 결절 환자의 진단과 중재적 치료)

  • Jung Hwan Baek;Dong Gyu Na
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.530-548
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    • 2020
  • Thyroid radiology practice is a medical practice in which thyroid diseases are diagnosed using imaging modality and treated by imaging-based interventional techniques, and the primary care target is thyroid nodular disease. Diagnosis of thyroid nodules is primarily done by ultrasound imaging and biopsy; thyroid nodules can be treated by non-surgical interventional treatment and thyroidectomy. Ethanol ablation is the first-line treatment for cystic benign nodules, and radiofrequency ablation is used for the treatment of benign solid nodules and recurrent thyroid cancers. Thyroid radiology practice has an essential clinical role in diagnosis and nonsurgical treatment of thyroid nodular diseases, and treatment should be performed based on standard care guidelines for proper patient care. In order to provide the best care to patients with thyroid nodular disease, it is desirable to treat patients in the radiology outpatient clinic. Thyroid radiology practice centered on outpatient clinic practice needs to be expanded.

Treatment of Osteoporosis after Hip Fracture: Survey of the Korean Hip Society

  • Jung-Wee Park;Je-Hyun Yoo;Young-Kyun Lee;Jong-Seok Park;Ye-Yeon Won
    • Hip & pelvis
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    • v.36 no.1
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    • pp.62-69
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    • 2024
  • Purpose: To assess current practice in the treatment of osteoporosis in patients who underwent treatment for hip fracture in South Korea. Materials and Methods: A survey of 97 members of the Korean Hip Society, orthopedic hip surgeons who administer treatment for hip fractures in South Korea, was conducted. The survey was conducted for assessment of demographic data and perceptions regarding the management of osteoporosis in patients who have undergone treatment for hip fracture. Analysis of the data was performed using descriptive statistical methods. Results: The majority of participants were between the age of 41 and 50 years, and 74% were practicing in tertiary hospitals. Testing for serum vitamin D levels (82%) was the most commonly performed laboratory test. Calcium and vitamin D were prescribed for more than 80% of patients by 47% and 52% of participants, respectively. Denosumab was the most commonly used first-line treatment option for osteoporosis in hip fracture patients. Bisphosphonate was most often perceived as the cause of atypical femoral fractures, and the most appropriate time for reoperation was postoperative 12 months. Teriparatide was most preferred after cessation of bisphosphonate and only prescribing calcium and vitamin D was most common in high-risk patients for prevention of atypical femoral fracture. Conclusion: The results of this study that surveyed orthopedic hip surgeons showed that most participants followed the current strategy for management of osteoporosis. Because the end result of osteoporosis is a bone fracture, active involvement of orthopedic surgeons is important in treating this condition.

Synergistic anticancer effect of acteoside and temozolomide-based glioblastoma chemotherapy

  • Tae Woong Hwang;Dong Hun Kim;Da Bi Kim;Tae Won Jang;Gun-Hwa Kim;Minho Moon;Kyung Ah Yoon;Dae Eun Choi;Jae Ho Park;Jwa-Jin Kim
    • International Journal of Molecular Medicine
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    • v.43 no.3
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    • pp.1478-1486
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    • 2019
  • Temozolomide (TMZ) is an alkylating agent commonly used as a first-line treatment for high-grade glioblastoma. However, TMZ has short half-life and frequently induces tumor resistance, which can limit its therapeutic efficiency. In the present study, it was hypothesized that combined treatment with TMZ and acteoside has synergistic effects in glioblastoma therapy. Using cell viability and wound-healing assays, it was determined that this treatment regimen reduced cell viability and migration to a greater extent than either TMZ or acteoside alone. Following previous reports that TMZ affected autophagy in glioma cells, the present study examined the effects of TMZ + acteoside combination treatment on apoptosis and autophagy. The TMZ + acteoside combination treatment increased the cleavage of caspase-3 and levels of B-cell lymphoma 2 (Bcl-2)-associated X protein and phosphorylated p53, and decreased the level of Bcl-2. The combination treatment increased microtubule-associated protein 1 light chain 3 and apoptosis-related gene expression. It was also determined that TMZ + acteoside induced apoptosis and autophagy through the mitogen-activated protein kinase signaling pathway. These findings suggest that acteoside has beneficial effects on TMZ-based glioblastoma therapy.

A Study on an Improvement for Management System of Municipal Sewage Sludge through an investigation of MSS Treatment Facilities (하수오니 처리시설 현황분석을 통한 처리체계 개선 방안 연구)

  • Kim, Young-Koo;Phae, Chae-Gun;Ryu, Don-Sik
    • Journal of the Korea Organic Resources Recycling Association
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    • v.14 no.2
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    • pp.121-128
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    • 2006
  • In this study, the existing MSS facilities were investigated for examination the the present condition of MSS treatment system. There are 23 MSS treatment facilities across the country, In total facilities, 6 facilities have economical problems, and 2 facilities were stopped the operation of establishments for technical problems, and most facilities are suffering from environmental problems, for example, odor and waste water. These kinds of problems play a role as obstacle to treat MSS efficiently. Accordingly, to reform current MSS treatment system, a few adequate measures are required. First a Guide line, which is a manual for establishment of MSS treatment facilities efficiently and environmentally friendly, must be offered from the agencies concerned of the Ministry of Environment to local governments. Second, to devise a plan for MSS treatment, Ministry of Environment and all local governments should devise a long-range policy synthetically not fragmentarily and temporarily.

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Treatment Strategies for Psychotic Depression (정신병적 우울증의 치료 전략)

  • Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.234-243
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    • 2006
  • Objectives : Several factors, such as biological markers, clinical correlates, and course of the depressive disorders with psychotic symptoms differ from those without psychotic symptoms. Therefore, specification of a treatment algorithm for depressive disorder with psychotic symptoms is legitimated. This article provides a systematic review of somatic treatments for depressive disorder with psychotic symptoms. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, first, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders with psychotic symptoms(until July 2006). Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Treatment options, such as a combination of an antidepressant and an antipsychotic versus an antidepressant or an antipsychotic alone are summarized. In addition, issues regarding the electroconvulsive therapy( ECT), combination therapy, and maintenance treatment are discussed. Conclusion : In former times, the combination of an antidepressant and an antipsychotic or ECT were recommended as the first line treatment for depressive disorder with psychotic symptoms. Recently, however, there was a suggestion that there was no conclusive evidence that the combination of an antidepressant and an antipsychotic drug is more effective than an antidepressant alone. More evidence regarding the pharmacological treatment for depressive disorder with psychotic symptoms is needed.

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An analysis of the dental arch and skeletal characteristics in adult patients exhibiting open bite (Openbite을 나타내는 성인의 치열 특성 및 그에 따른 골격적 특성 분석)

  • Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.34 no.4 s.105
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    • pp.289-301
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    • 2004
  • It is the purpose of this study to characterize oral symptoms and to comprehend the cause and the relapse possibility of patients with open bite. This case study examines the orthodontic treatment of a group of female patients with open bite and Angle's Class I malocclusion. A cephalograph of the patient was taken and tracing of the radiograph was completed. In addition to Bjork and Ricketts analysis, additional measurements of specific areas were taken. The occlusal plane was determined by drawing a line connecting the mesiobuccal cusp tip of the maxillary first molar and the incisal edge of the maxillary central incisors. Patients were divided into two groups depending on the relationship between the marginal ridge of the maxillayy first premolar and the drawn line. Those patients with marginal ridges above the occlusal plane were placed into Group 1, while Group 2 subjects exhibited marginal ridges lower than the occlusal plane. The common characteristics within each group and the characteristic differences between each group both prior to and after orthodontic treatment were examined, and finally, the functional oral volume of each patient was analyzed. The results of the case study were as follows: 1. An examination of the skeletal relationship and anatomical form for both Group 1 and 2 showed that all subjects exhibited hyperdivergent skeletal forms, but Group 2 subjects generally demonstrated underdevelopment of the mandible and a smaller articular angle, resulting in an anterior positioning tendency of the mandible. 2. An analysis of the maxillary arches of Group 1 subjects prior to and after orthodontic treatment showed that the antero-inferior direction had changed to an antero-superior directional tendency, while the maxillary arches of the Group 2 patients showed a trend from an antero-superior direction to an antero-inferior relationship. The mandibular arches in both groups showed a change to an antero-superior direction. 3. Functional space analysis showed that Group 2 patients exhibited a greater tendency of haying palatal planes that drop in a postero-inferior direction, resulting in a more severe open bite than their Group 1 counterparts. The results of this case study show that although patients belonging to either Group 1 or 2 exhibited few external differences in the appearance of open bite, an examination of the dental and skeletal relationships by analyzing patient cephalographs showed that patients presenting with flat maxillary occlusal planes exhibited more severe open bite relationships than patients with curved occlusal planes.