• 제목/요약/키워드: Multidisciplinary treatment

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과민성폐렴의 진단, 임상 경과 및 치료 (Diagnosis, Clinical Course and Treatment of Hypersensitivity Pneumonitis)

  • 박종선
    • The Korean Journal of Medicine
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    • 제99권2호
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    • pp.69-77
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    • 2024
  • Hypersensitivity pneumonitis (HP) is an inflammatory and fibrosing interstitial lung disease caused by inhaled antigens in susceptible individuals. Various environmental materials can serve as inciting agents of HP. Recent guidelines have defined typical radiologic and histopathologic findings of HP, classifying it into nonfibrotic and fibrotic HP categories, as this classification better correlates with clinical outcomes. Diagnosing HP poses challenges, necessitating multidisciplinary discussions based on clinical assessments and radiologic or histopathological features. The cornerstone of treatment lies in avoiding the causative antigen. Oral glucocorticoids serve as the initial treatment for symptomatic HP. Immunosuppressants may be employed in patients who do not respond to initial treatment, and antifibrotics could be considered for patients displaying progressive fibrosis. This review outlines the clinical features, diagnostic evaluation, and treatment of HP.

An integrated approach with homeopathic medicine and electro-acupuncture in anaesthesiology during breast cancer surgery: Case reports

  • Bosco, F;Cidin, S;Maceri, F;Ghilli, M;Roncella, M;De Simone, L
    • 대한약침학회지
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    • 제21권2호
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    • pp.126-131
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    • 2018
  • This study investigates the effect of a combination of homeopathic medicine and electro- acupuncture in two patients with breast cancer and severe liver disease who could not receive standard anaesthesia therapy due to liver problems. Specifically, measurable and quantifiable parameters were used to evaluate whether an integrated approach-consisting of electro- acupuncture and a homeopathic medicine diluted above Avogadro's limit (that is, above a potency of 12CH) during the pre-surgical, surgical and post-surgical phases -can improve general well-being of a patient undergoing breast cancer surgery. In breast cancer surgery, we employed an integrated approach consisting of induction with hypnotics and muscle relaxants, followed by maintenance with anaesthetic gas, combined with a homeopathic treatment (Arnica montana 15CH and Apis mellifica 15CH) before and after surgery and an electro- acupuncture treatment performed in the pre- and post-surgical phases without any analgesic/pain relieving medications. Both of the patients treated with the integrated approach improved their overall condition without need for other common pain relieving medicines. Additionally, thanks to their rapid awakening, the patients were not relocated to a protected area and the hospitalization was shorter. A multidisciplinary approach incorporating homeopathic medicine and electro-acupuncture can be a solution for patients who need or ask about a different and/or safer alternative to the standard treatment. This approach can offer a safe, much less expensive, non-invasive and viable alternative for such cases. Moreover it can be useful for an opioids free anesthesia.

골격성 3급 부정 교합을 지닌 법랑질 형성 부전증 환자의 복합적 치료 (MULTIDISCIPLINARY MANAGEMENT FOR AMELOGENESIS IMPERFECTA PATIENT WITH SKELETAL C III MALOCCLUSION)

  • 오정환;김학렬;황윤태;김여갑;류동목;이백수;윤병욱;전준혁
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권1호
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    • pp.91-96
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    • 2007
  • 법랑질 형성부전증은 전치부 개교합과 같은 골격적인 문제를 자주 동반하며, 이러한 경우 구강악안면외과, 보철과, 보존과, 교정과 의사들이 함께 치료하여야 한다. 본 증례는 법랑질의 약화와 치아 우식증 등의 이유로 일반적인 교정치료를 시행할 수 없어 보철적 방법으로 치료하였다. 보존적, 보철적 방법을 이용하여 술전 교정과 같은 안정된 교합을 형성하였다. 악교정 수술을 시행하고 SAS 등을 이용하여 악간고정을 시행하여 양호한 결과를 얻을 수 있었다.

Minimally invasive treatment for esthetic enhancement of white spot lesion in adjacent tooth

  • Lee, Ji-Hye;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of Advanced Prosthodontics
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    • 제5권3호
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    • pp.359-363
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    • 2013
  • This article describes the treatment provided to a patient with the maxillary anterior teeth exhibiting severe secondary caries beneath the previous restoration and a white spot lesion on the adjacent incisor. Two implants were placed after extraction of hopeless teeth with the guided bone regeneration technique. A white spot lesion of the adjacent incisor was treated with minimally invasive treatment. This clinical report describes the multidisciplinary treatment for the white spot lesion and esthetic restoration of missing anterior teeth.

소아 후두기관 협착의 치료 (Management of Pediatric Laryngotracheal Stenosis)

  • 이윤세
    • 대한후두음성언어의학회지
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    • 제33권3호
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    • pp.123-129
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    • 2022
  • Pediatric laryngotracheal stenosis occurs by either congenital or acquired causes and usually indicates subglottic stenosis. The main goals of treatment are decannulation, preserving phonation, and normal swallowing function. Various types and degrees of stenosis and combined anomalies would be the main barriers to reaching successful treatment results unless comprehensive understanding of stenosis. Multidisciplinary team approaches encompassing initial assessment, treatment, and postoperative care, are also necessary to achieve the best treatment outcome. Therapeutic approaches are divided into conservative, endoscopic, and open surgical approaches at length, which are not exclusive to each other. Here, an adequate selection of each therapeutic option and postoperative management will be introduced to achieve decannulation without leaving phonatory or swallowing complications.

Contemporary Strategies: Incorporating Immunotherapy into Stage 3 Non-small Cell Lung Cancer Treatment

  • Da Hyun Kang;Chaeuk Chung
    • Tuberculosis and Respiratory Diseases
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    • 제87권3호
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    • pp.292-301
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    • 2024
  • Stage 3 non-small cell lung cancer (NSCLC) exhibits significant diversity, making it challenging to define an optimal treatment. A collaborative multidisciplinary approach is essential in crafting individualized treatments. Previously, targeted therapies and immunotherapies were commonly used to treat patients with advanced and metastatic lung cancer. Such treatments are now being extended to individuals considered surgery, as well as patients once considered unsuitable for surgery. These changes have increased surgical success and substantially reduced postoperative recurrence. However, the possibility of severe adverse effects from immunotherapy can deter some patients from performing surgery. It is essential to carefully explore the clinical traits and biomarkers of patients who may benefit the most from immunotherapy, and patients for whom immunotherapy should not be prescribed. In summary, it's crucial to effectively integrate the latest immunotherapy in treating stage 3 NSCLC patients, thereby increasing their opportunities for surgical intervention, and ensuring they receive the best possible care.

Freeman-Sheldon Syndrome의 치료에 대한 고찰 (MULTIDISCIPLINARY CARE OF FREEMAN SHELDON SYNDROME)

  • 김지훈;이정섭;장채리
    • 대한소아치과학회지
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    • 제37권4호
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    • pp.545-550
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    • 2010
  • Freeman-Sheldon Syndrome(FSS)은 드물게 발생하는 선천성 유전 질환으로 휘파람을 부는 듯한 특징적인 안모로 인해 'Whistling face syndrome'으로 불리워진다. 또한 편평한 안모, 긴 인중(philtrum), 낮은 비연골이 나타나 두드러진 안면이상을 보이고, 내반족(club foot, 內反足), 손가락의 관절구축(joint contracture)으로 인한 풍차 모양의 손을 가지며, 지능은 보통 정상이다. 본원에 내원한 환아는 이 질환의 특징적 양상인 구강 주위 근육의 수축으로 소구증 및 개구제한, 높은 구개 및 부정교합, 치열의 심한 총생을 보여 구강위생이 매우 불량하였고 치과치료에 비협조적이었다. 소아치과적 행동조절 및 구강위생관리, 섭식장애의 상담으로 치과적 문제는 다소 개선되었으나, 안과 및 정형외과, 신경정신과, 교정과, 마취과적 문제로 인해 다양한 협진이 필요하며 계속적인 관찰 및 치료가 요구되기에 이를 보고하는 바이다.

치아 상실 및 치아의 병적 이동이 일어난 환자의 다과간 협력진료 증례 (Multidisciplinary approach for a patient with teeth loss and pathologic teeth migration: case report)

  • 강성남;김형문;이지영;손미경
    • 구강회복응용과학지
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    • 제30권4호
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    • pp.329-338
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    • 2014
  • 치주질환이나 우식으로 인해 구치부 치아가 상실된 환자들은 잔존하고 있는 전치부 및 소구치부 치아로 안정된 교합고경을 유지하기 어렵다. 구치의 상실로 대합치의 정출이나 인접치의 경사가 발생되는 경우 교합평면이 붕괴되거나 부적절한 교합간섭을 야기하게 된다. 만약 치아 상실 상태가 지속된 경우에는 하악의 전방이동으로 인해 상악 전치의 동요와 순측 이개를 초래하게 되며 치주질환이 동반된 경우에는 더욱 심각한 상황으로 변화한다. 이와 같이 치아의 병적 이동이 일어난 환자의 치료는 보존 및 치주치료, 교정 치료를 통한 재배열, 그리고 상실된 치아의 보철수복을 통한 교합 고경의 재설정 및 유지와 같은 다과간 협력 진료가 매우 중요하다.

교정적 치아 재배열을 포함한 다학제적 접근(multidisciplinary approach)을 통한 상악 전치부의 나사 유지형 임플란트 보철 수복 증례 (Cases of screw-retained implant prosthesis in the anterior maxilla through multidisciplinary approach, including orthodontic teeth alignment)

  • 김효선;이원섭;이수영
    • 대한치과보철학회지
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    • 제58권3호
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    • pp.244-250
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    • 2020
  • 상악 전치부에서 임플란트의 순구개측 식립 위치는 보철물의 심미성을 결정하는 중요한 요소이다. 그러나 상악 전치부의 얇은 순측골은 발치 후에 상당한 양이 흡수되어, 임플란트가 이상적 식립 위치보다 구개측에 식립될 수 있다. 본 상악 중절치 상실 증례들에서 다소 구개측에 식립된 임플란트의 보철 수복을 위하여 UCLA 지대주를 이용하였다. 또한 타과와 협진으로 발치 후 흡수된 치조골 외형과 치은의 형태 회복을 위하여 골유도재생술을 시행하였고, 인접전치를 재배열 하였다. 충분한 임시 보철물 수복 기간으로 치은 형태의 심미적 회복을 확인한 뒤에 최종 보철 시행하였으며, 임플란트 보철을 통한 치아 상실 부위의 기능, 심미 회복이 만족할 만한 결과를 보였다.

Phase analysis of simulated nuclear fuel debris synthesized using UO2, Zr, and stainless steel and leaching behavior of the fission products and matrix elements

  • Ryutaro Tonna;Takayuki Sasaki;Yuji Kodama;Taishi Kobayashi;Daisuke Akiyama;Akira Kirishima;Nobuaki Sato;Yuta Kumagai;Ryoji Kusaka;Masayuki Watanabe
    • Nuclear Engineering and Technology
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    • 제55권4호
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    • pp.1300-1309
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    • 2023
  • Simulated debris was synthesized using UO2, Zr, and stainless steel and a heat treatment method under inert or oxidizing conditions. The primary U solid phase of the debris synthesized at 1473 K under inert conditions was UO2, whereas a (U, Zr)O2 solid solution formed at 1873 K. Under oxidizing conditions, a mixture of U3O8 and (Fe, Cr)UO4 phases formed at 1473 K, whereas a (U, Zr)O2+x solid solution formed at 1873 K. The leaching behavior of the fission products from the simulated debris was evaluated using two methods: the irradiation method, for which fission products were produced via neutron irradiation, and the doping method, for which trace amounts of non-radioactive elements were doped into the debris. The dissolution behavior of U depended on the properties of the debris and aqueous solution for immersion. Cs, Sr, and Ba leached out regardless of the primary solid phases. The leaching of high-valence Eu and Ru ions was suppressed, possibly owing to their solid-solution reaction with or incorporation into the uranium compounds of the simulated debris.