• 제목/요약/키워드: First-line treatment

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The use of natural remedies to treat osteoarthritis

  • Tan, Boon Hooi;Ong, Chin Eng
    • 셀메드
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    • 제6권1호
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    • pp.1.1-1.9
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    • 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
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    • 제10권1호
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    • pp.122-129
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    • 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.

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

  • 김태욱;손영익
    • 대한후두음성언어의학회지
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    • 제21권1호
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    • pp.27-31
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    • 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.

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

  • Gerrard, Adam Daniel;Charalambous, Charalambos P.
    • Knee surgery & related research
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    • 제30권4호
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    • pp.356-363
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    • 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.

A Review of Cognitive and Behavioral Interventions for Tic Disorder

  • Kim, Kyoung Min;Bae, Eunju;Lee, Jiryun;Park, Tae-Won;Lim, Myung Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제32권2호
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    • pp.51-62
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    • 2021
  • Objectives: Tic disorder is a neurodevelopmental disorder characterized by multiple involuntary movements of muscles or vocalization. Although tic symptoms subside as the patient ages, some patients suffer from significant functional impairments related to severe tic symptoms. This manuscript aimed to review the latest scientific evidences for the effect of cognitive-behavioral interventions on tic disorder. Methods: The relevant studies were identified by searching medical research databases. We focused our search on studies published between 2000 and 2020 in order to reflect the latest scientific evidence. A total of 821 articles were identified in the initial database search and 27 articles were finally included for the review after the exclusion of duplicated and irrelevant articles. Results: Behavioral therapies including habit reversal training, Comprehensive Behavioral Intervention for Tics, and exposure and response prevention were the most widely studied interventions for tic disorder and are recommended as first-line treatments for tic disorders with high confidence. Cognitive psychophysiologic approaches were also reported to be effective. Conclusion: Further studies are needed to support the future treatment of tics with low-cost and more widely available treatments, in order to ensure better treatment outcomes.

Trigeminal neuralgia management after microvascular decompression surgery: two case reports

  • Hwang, Victor;Gomez-Marroquin, Erick;Enciso, Reyes;Padilla, Mariela
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제20권6호
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    • pp.403-408
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    • 2020
  • Trigeminal neuralgia (TN) involves chronic neuropathic pain, characterized by attacks of repeating short episodes of unilateral shock-like pain, which are abrupt in onset and termination. Anticonvulsants, such as carbamazepine, are the gold standard first-line drugs for pharmacological treatment. Microvascular decompression (MVD) surgery is often the course of action if pharmacological management with anticonvulsants is unsuccessful. MVD surgery is an effective therapy in approximately 83% of cases. However, persistent neuropathic pain after MVD surgery may require reintroduction of pharmacotherapy. This case report presents two patients with persistent pain after MVD requiring reintroduction of pharmacological therapy. Although MVD is successful for patients with failed pharmacological management, it is an invasive procedure and requires hospitalization of the patient. About one-third of patients suffer from recurrent TN after MVD. Often, alternative treatment protocols, including the reintroduction of medications, may be necessary to achieve improvement. This case report presents two cases of post-MVD recurrent pain. Further research is lacking on the success rates of subsequent medication therapy after MVD has proven less effective in managing TN.

Redescription of Previously Unknown Euplotine Ciliates, Euplotes charon and Diophrys oligothrix (Ciliophora: Spirotrichea: Euplotida), from Korea

  • Kwon, Choon-Bong;Shin, Mann-Kyoon
    • Animal Systematics, Evolution and Diversity
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    • 제22권1호
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    • pp.29-35
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    • 2006
  • Two ciliates of suborder Euplotina collected from the two habitats (estuarine littoral and sewage treatment plant) in Ulsan, Korea were Euplotes charon ($M\ddot{u}ller$, 1773) and Diophrys oligothrix Borror, 1965. These two species are reported for the first time from Korea. The description was based on the observation of living and silver impregnated specimens. Diagnostic characteristics of these species are as follows. E. charon: size in vivo about $90-130\times65-80{\mu}m$, adoral zone of membranelles over 79.5% of cell length with 54-80 adoral membranelles; right margin of the peristome shaped sinusoidal form and passed through adoral zone of membranelles; buccal cavity wide anteriorly; 10 frontoventral, 5 transverse, 4 caudal cirri, 12 dorsal kineties, mid-dorsal kinety with 21 -25 dorsal bristles; silver-line system double-eurystomus type. D. oligothrix: size in vivo about $80-90\times30-70{\mu}m$; body shape ovoid with prominent right concave posterio-lateral end, two irregular elongated macronuclei with one micronucleus, respectively; 7 fronto-ventral, 5 transverse, 2 left marginal and 2 caudal cirri, 4 dorsal kineties with prominent bristles about $9-14{\mu}m$ long in vivo.

Emerging Targets for Systemic Treatment of Gastric Cancer: HER2 and Beyond

  • In-Ho Kim
    • Journal of Gastric Cancer
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    • 제24권1호
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    • pp.29-56
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    • 2024
  • In recent years, remarkable progress has been made in the molecular profiling of gastric cancer. This progress has led to the development of various molecular classifications to uncover subtype-specific dependencies that can be targeted for therapeutic interventions. Human epidermal growth factor receptor 2 (HER2) is a crucial biomarker for advanced gastric cancer. The recent promising results of novel approaches, including combination therapies or newer potent agents such as antibody-drug conjugates, have once again brought attention to anti-HER2 targeted treatments. In HER2-negative diseases, the combination of cytotoxic chemotherapy and programmed cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) inhibitors has become the established standard of care in first-line settings. In the context of gastric cancer, potential biomarkers such as PD-L1 expression, Epstein-Barr virus, microsatellite instability, and tumor mutational burden are being considered for immunotherapy. Recently, promising results have been reported in studies on anti-Claudin18.2 and fibroblast growth factor receptor 2 treatments. Currently, many ongoing trials are aimed at identifying potential targets using novel approaches. Further investigations will be conducted to enhance the progress of these therapies, addressing challenges such as primary and acquired resistance, tumor heterogeneity, and clonal evolution. We believe that these efforts will improve patient prognoses. Herein, we discuss the current evidence of potential targets for systemic treatment, clinical considerations, and future perspectives.

Pimecrolimus increases the melanogenesis and migration of melanocytes in vitro

  • Xu, Ping;Chen, Jie;Tan, Cheng;Lai, Ren-Sheng;Min, Zhong-Sheng
    • The Korean Journal of Physiology and Pharmacology
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    • 제21권3호
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    • pp.287-292
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    • 2017
  • Vitiligo is an intriguing depigmentary disorder and is notoriously difficult to be treated. The ultimate goal of vitiligo treatment is to replenish the lost melanocytes by immigration from hair follicle and to restore the normal function of melanogenesis by residual melanocytes. There are two types of topical calcineurin inhibitors called tacrolimus and pimecrolimus, and are recommended as the first-line treatments in vitiligo. Although pimecrolimus is efficacious for the repigmentation of vitiligo, its intrinsic mechanisms have never been investigated in vitro. This research aimed to study the ability of pimecrolimus on stimulating melanogenesis, melanocyte migration and MITF (microphthalmia associated transcription factor) protein expression. Results showed that pimecrolimus at the dosages of 1, 10, $10^2$nM were neither mitogenic nor cytotoxic to melanocytes. The addition of pimecrolimus at 10, $10^2$ and $10^3nM$ significantly increased intracellular tyrosinase activity, which was consistent with the elevated content of melanin content at the same concentrations. The peak effect was seen at 72 h in response to $10^2$nM pimecrolimus. Results of the wound scratch assay and Transwell assays indicate that pimecrolimus is effective in facilitating melanocyte migration on a collagen IV-coated surface. In addition, MITF protein yield reached the highest by pimecrolimus at $10^2nM$. In brief, pimecrolimus enhances melanin synthesis as well as promotes migration of melanocytes directly, possibly via their effects on MITF protein expression.

Cone beam형 전산화단층촬영장치를 이용한 하악 제1대구치 근심 치근의 danger zone에 관한 연구 (Evaluation of danger zone in mesial root of mandibular first molar by cone beam computed tomography (CBCT))

  • 장유리;최용석;최기운;박상혁
    • Imaging Science in Dentistry
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    • 제37권2호
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    • pp.103-110
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    • 2007
  • Purpose: To examine the danger zone of mesial root of mandibular first molar of patient without extraction using CBCT (cone-beam computed tomography) to avoid the risk of root perforation. Materials and Methods: 20 mandibular first molars without caries and restorations were collected, CT images were obtained by CBCT ($PSR9000N^{TM}$, Asahi Roentgen Co., Japan), reformed and analyzed by V-work 5.0 (CyberMed Inc., Korea), Distance between canal orifice and furcation was measured. In cross sectional images at 3, 4 and 5 mm below the canal orifice, distal wall thickness of mesiobuccal canal (MB-D), distal wall thickness of mesiolingual canal (ML-D), distal wall thickness of central part (C-D), mesial wall thickness of mesiobuccal canal (MB-M) and mesial wall thickness of mesiolingual canal (ML-M) were measured, Results: The mean distance between the canal orifice and the furcation of the roots is 2.40 mm, Distal wall is found to be thinner than mesial wall. Mean dentinal wall thickness of distal wall is about 1 mm, The wall thickness is thinner as the distance from the canal orifice is farther. But significant differences are not noted between 4 mm and 5 mm in MB-D and C-D, MB-D is thinner than ML-D although the differences is not significant. Conclusion: The present study confirmed the anatomical weakness of distal surface of the coronal part of the mesial roots of mandibular first molar by CBCT and provided an anatomical guide line of wall thickness during endodontic treatment.

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