• 제목/요약/키워드: First-line treatment

검색결과 604건 처리시간 0.028초

Long COVID의 주요 증상에 대한 한의학적 고찰과 치료 제안 (Korean Medicine Review and Treatment Suggestions for the Main Symptoms of Long COVID)

  • 황요순;이은아;김형우
    • 동의생리병리학회지
    • /
    • 제36권5호
    • /
    • pp.155-162
    • /
    • 2022
  • Even after testing negative for COVID-19, some patients continue to struggle with a variety of symptoms such as fatigue, shortness of breath, gastrointestinal problems and neurological problems. The World Health Organization (WHO) defined long COVID (Post COVID-19 conditions) as "A disease occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months, that cannot be explained by an alternative diagnosis." As a possible pathological mechanism of long COVID, three hypotheses are proposed: the persistence of the infectious state due to the residual virus, the persistent inflammatory response, and the autoimmune response. The main symptoms of long COVID are shortness of breath (dyspnea), abdominal pain and dyspepsia, fatigue, cognitive problems (brain fog), anosmia and dysgeusia, and chest pain, palpitations and tachycardia. In the Chinese guidelines, COVID-19 patients were divided into mild, moderate, severe, and recovery, and prescriptions with effective therapeutic effects were summarized to encourage combined treatment of chinese and western medicine. Globally, only symptomatic therapy is recommended for long COVID, but a specific treatment has not yet been proposed. Recently, morbidity code for post COVID-19 conditions was created, and it is planned to announce guidelines for long COVID treatment and management in the first half of 2023. In line with this trend, the Korean medical community needs to make efforts to prepare treatment guidelines for patients with long COVID.

확장기 소세포폐암에서 1차 치료로서 Irinotecan + Cisplatin 복합요법의 임상적 결과 (Phase II Study of Irinotecan Plus Cisplatin as First Line therapy in Extensive Small-Cell Lung Cancer)

  • 황기은;김소영;정종훈;박성훈;박정현;김휘정;김학렬;양세훈;정은택
    • Tuberculosis and Respiratory Diseases
    • /
    • 제61권2호
    • /
    • pp.143-149
    • /
    • 2006
  • 연구배경: Toptisomerase I 억제제인 irinotecan 과 소세포폐암 치료의 근간인 cisplatin의 복합화학용법을 확장기 소세포폐암 환자에게 1차 치료법으로 실시하여 반응률, 생존율 및 부작용을 확인하였다. 방 법: 2002년 6월부터 2005년 2월까지 확진된 확장기 소세포폐암 환자 39명에게 irinotecan $60mg/m^2$, 제 1, 8, 15일째 cisplatin $60mg/m^2$ 제1일째에 28일 간격으로 4회 투여하였다. 결 과: 반응률은 77%(완전반응 8%), 중앙생존기간은 14.8개월, 1-및 2-년 생존율은 60.9%, 27.6%였으며, 중앙 무진행생존기간은 8.4개월, 6-및 12-개월 무진행생존율은 75.0%, 18.8%였다. WHO grade 3 이상의 부작용은 백혈구 감소증 23%, 설사 26%였으나, 심한 설사때문에 2명은 치료방법을 바꾸었고, 1명은 사망하였다. 결 론: Irinotecan과 cisplatin 복합화학요법은 확장기 소세포폐암 환자의 1차 치료법으로 유용하며, 부작용으로서 설사에 대해서는 치명적일수 있으므로 심각한 주의가 요망된다.

경부에 재발한 투명세포땀샘종의 치료에 대한 증례 보고 (A Treatment of Recurrent Clear Cell Hidradenoma on the Neck: A Case Report)

  • 김순제;양희상;신정민;오상하
    • 대한두경부종양학회지
    • /
    • 제36권2호
    • /
    • pp.41-44
    • /
    • 2020
  • Clear cell hidradenoma is a skin adnexal tumor originating from eccrine glands. The risk of local recurrence after surgical resection exceeds 50%, and 6-19% of cases are malignant. The rarity of clear cell hidradenoma and its diverse histological findings make this type of tumor a diagnostic challenge. We present a case of recurrent clear cell hidradenoma of the posterior neck in a 70-year-old woman. The tumor recurred once after complete excision, and did not recur again after 1-cm wide excision and reconstruction with a local bilobed flap. Recurrent clear cell hidradenomas are activated by surgical stimulation, increasing the risk for metastasis. Therefore, we suggest that wide excision with confirmation of a tumor-free margin by frozen-section biopsy should be the first-line treatment for recurrent benign clear cell hidradenoma.

Resistant Gestational Trophoblastic Neoplasia Patients Treated with 5-Fluouracil plus Actinomycin D

  • Manopunya, Manatsawee;Suprasert, Prapaporn
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제13권1호
    • /
    • pp.387-390
    • /
    • 2012
  • A combination of 5-fluorouracil plus actinomycin D (5FU plus Act D) is the regimen that has been commonly administered to Chinese and Japanese gestational trophoblastic neoplasia patients as the first or second line of treatment with an excellent outcome. However, the efficacy of this regimen in a salvage setting was unclear. To evaluate the efficacy and safety of the 5 FU plus Act D regimen utilized in this condition, all GTN patients resistant to at least three previous chemotherapy regimens who received the 5 FU plus Act D regimen between August 2009 and January 2011 at Chiang Mai University Hospital were reviewed. There were five cases who met the criteria. Four of those patients were in FIGO stage III to IV with a WHO scoring of more than 12. The median number of cycles for each patient was two and only one case achieved remission while four of the cases were unresponsive. The toxicity was evaluated in 12 cycles. Common complications were uncomplicated myelosuppression and mucositis. In conclusion, this regimen revealed modest efficacy in a salvage setting with manageable toxicity.

Survival Outcomes of Advanced and Recurrent Cervical Cancer Patients Treated with Chemotherapy: Experience of Northern Tertiary Care Hospital in Thailand

  • Boupaijit, Kuanoon;Suprasert, Prapaporn
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권3호
    • /
    • pp.1123-1127
    • /
    • 2016
  • Chemotherapy is the primary treatment for advanced and recurrent cervical cancer. To evaluate the survival outcomes of chemotherapy and the prognostic factors in this setting, we conducted a retrospective study by reviewing the medical records of advanced and recurrent cervical cancer patients treated with systemic chemotherapy at our institute between January, 2008 and December, 2014. One hundred and seventy-three patients met the criteria with a mean age of 50.9 years. 4.1% of them were HIV positive. The most common initial stage was stage IVB (30.1%) and the most common histology was squamous cell carcinoma (68.6%). Ninety-two (53.2%) patients were previously treated with concurrent chemoradiation with 53% developing combined sites of recurrence. The median recurrence free interval was 16.7 months. Cisplatin + 5 fluorouracil (5FU) (53.2%) was the most frequent first line chemotherapy followed by carboplatin + paclitaxel (20.2%) with an objective response of 39.3%. Seventy-two patients received subsequent chemotherapy. The median overall survival of all studied patients was 13.2 months. Only a recurrence free interval of less than 12 months was an independent prognostic factor for survival outcome. In conclusion, chemotherapy treatment for advanced and recurrent cervical cancer patients showed modest efficacy with a shorter recurrence free survival less than 12 months as a significant poor prognosis factor.

인공신경망 모형을 이용한 급속혼화공정에서 적정 응집제 주입농도 결정 및 응집처리후 탁도의 예측 (Prediction of Turbidity in Treated Water and the Estimation of the Optimum Feed Concentration of Coagulants in Rapid Mixing Process using an Artificial Neural Network Model)

  • 정동환;박규홍
    • 한국물환경학회지
    • /
    • 제21권1호
    • /
    • pp.21-28
    • /
    • 2005
  • The training and prediction modeling using an artificial neural network was implemented to predict the turbidity of treated water as well as to estimate the optimized feed concentration of polyaluminium chloride (PACl) in a water treatment plant. The parameters used in the input layers were pH, temperature, turbidity and alkalinity, while those in output layers were PACl and turbidity of treated water. Levenberg-Marquadt method of feedforward back-propagation perceptron in the neural network toolbox of MATLAB program was used in this study. Correlation coefficients of the training data with the measured data were 0.9997 for PACl and 0.6850 for turbidity and those of the testing data with measured data were 0.9140 for PACl and 0.3828 for turbidity, when four parameters at input layer, 12-12 nodes each at both the first and the second hidden layers, and two parameters(PACl and turbidity) at output layer were used. Although the predictability of PACl was improved, compared to that of the previous studies to use the only coagulant dose as output layer, turbidity in treated water could not be predicted well. Acquisition of more data through several years obtained with the advanced on-line measuring system could make the artificial neural network useful and practical in actual water treatment plants.

The use of natural remedies to treat osteoarthritis

  • Tan, Boon Hooi;Ong, Chin Eng
    • 셀메드
    • /
    • 제6권1호
    • /
    • pp.1.1-1.9
    • /
    • 2016
  • Osteoarthritis (OA) is the leading medical condition for which patients use alternative treatments including the natural remedies. The aim of this review is to describe the dietary supplements and herbal remedies most commonly used in patients with osteoarthritis with an emphasis on the efficacy and safety of these natural remedies. Glucosamine and chondroitin sulfate, two of the molecular building blocks found in articular cartilage, are the most commonly used remedies in OA treatment. Most clinical researches suggest that glucosamine and chondroitin show efficacy in reducing or improving symptoms and their ability to arrest progression of the disease or regenerate damaged cartilage. Patented formulations of both remedies are recommended by several therapeutic guidelines for use as first line background OA treatment. Reliable evidence that the combination is more effective than either agent alone is however still lacking. Several other herbs or remedies are promoted for treating osteoarthritis such as S-adenosylmethionine, methylsulfonylmethane, Harpagophytum procumbens (devil's claw), Curcuma longa (turmeric), Zingiber officinale (ginger), and capsaicin but there is no reliable evidence on long-term efficacy or safety. The clinical usefulness of these remedies is therefore rather limited currently.

테니스엘보의 통증감소 효과에 관한 연구 - 곡지(曲地).주료.족림읍(足臨泣) 혈(穴)에 황두침(黃頭針)으로 1회 자침시(刺針時) - (The research about the pain-relieving effects of the tennis elbow - only one time shot with yellow-head acupuncture on Quchi, Zhouliao and Zulingqi -)

  • 박철휘;김찬규;조병모
    • 대한물리치료과학회지
    • /
    • 제10권1호
    • /
    • pp.122-129
    • /
    • 2003
  • In this study, a group of 25 patients between the ages of $22{\sim}55$ received acupuncture treatments for tennis elbow. The variance has some high value. 1. The distribution of an age group in 22 to 55 and the average age of men is $40.9{\pm}9.3$ and the average age of women is $39.5{\pm}3.6$. Total average age is $40.4{\pm}8.4$. 2. Before the acupuncture treatments the average pain degree for the group is $4.72{\pm}0.6$ and after treatments, it is $2.36{\pm}1.6$. Statistically, the variance has some high value. 3. There were statistically significant difference in the pain degree before and after the acupuncture treatment according to the age. By these results, acupuncture treatments will be useful to the first-line treatment for tennis elbow.

  • PDF

불완전 성대 마비: 논란과 합의 (Vocal Fold Paresis: Controversies and Consensus)

  • 김태욱;손영익
    • 대한후두음성언어의학회지
    • /
    • 제21권1호
    • /
    • pp.27-31
    • /
    • 2010
  • Mild vocal fold hypomobility is a common finding of which clinical significance is incompletely understood. Recently, electrophysiologic investigations have shown that vocal fold hypomobility is a continuum of neurogenic dysfunction ; partial denervation (paresis), complete denervation (paralysis), and variable degrees and patterns of reinnervation. Despite a sound pathophysiological basis for its existence, interest in and acceptance of the diagnosis of vocal fold paresis is relatively recent. Vocal fold paresis may be a relatively common and often overlooked condition that can be difficult to diagnose since laryngoscopy does not reliably distinguish innocent laryngeal asymmetry from hypomobility caused by paresis. Although not entirely free from error, laryngeal electromyography seems to hold more promise as a means of reliable diagnosis than laryngoscopy, and should be employed systematically in the evaluation of suspected paresis. The means to help most patients with paresis already exists in the repertoire of interventions developed to treat paralysis. However, since the vocal fold retains substantial movement, more conservative treatment strategy is recommended as a first line of treatment. The authors reviewed the representative reports of vocal fold paresis and summarized the controversies and consensus regarding the vocal fold paresis.

  • PDF

Arthroscopic Excision of Medial Knee Plica: A Meta-Analysis of Outcomes

  • Gerrard, Adam Daniel;Charalambous, Charalambos P.
    • Knee surgery & related research
    • /
    • 제30권4호
    • /
    • pp.356-363
    • /
    • 2018
  • Purpose: A meta-analysis was performed to assess the outcomes following surgical intervention for medial knee plica. Materials and Methods: A literature search of Medline, EMBASE, CINAHL and Cochrane CENTRAL was performed using relevant key words. The primary outcome was patient-reported postoperative scores of "good" and "excellent". Meta-analyses were performed using a random effects model. Results: The literature search identified 731 articles. After removing duplicates and those not meeting the inclusion criteria, 12 articles reporting on a total of 643 knees were included for analysis, and of these, 7 articles including 235 knees were used for meta-analysis. The overall rate of good and excellent outcomes following surgery was estimated at 84.2% (95% confidence interval [CI], 72.8-91.4). In those cases that had non-surgical therapy prior to surgery, the rate of good and excellent outcomes of surgery was estimated at 76.1% (95% CI, 60.1-87). Conclusions: Arthroscopic surgical management of symptomatic medial knee plica results in favourable outcomes. Our results suggest that arthroscopic surgical excision should be considered as a treatment modality in patients with pathological medial plica disease of the knee either as a first-line treatment or when symptoms have not responded to non-surgical interventions. Level of Evidence: IV.