• Title/Summary/Keyword: Neck surgery

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Comparison of Treatment Compliance and Nutritional Outcomes among Patients with Nasopharyngeal Carcinoma with and without Percutaneous Endoscopic Gastrostomy during Chemoradiation

  • Peerawong, Thanarpan;Phungrassami, Temsak;Pruegsanusak, Kovit;Sangthong, Rassamee
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5805-5809
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    • 2012
  • Aims: The study aimed to compare treatment compliance and nutritional outcomes in nasopharyngeal carcinoma (NPC) patients during chemoradiation. Methods: Clinical information of patients with NPC that underwent chemoradiation during 2004-2009 were retrieved from the hospital database and retrospectively reviewed. Patients were categorised into a prophylactic percutaneous endoscopic gastrostomy (PPEG) group and a non-PPEG group. Clinical information including treatment compliance, weight, haematological and renal toxicity was compared. Results: A total of 219 patients were reviewed and categorised into PPEG (n=77) and non-PPEG (n=142). Significant differences in absolute percentage weight loss between groups were found from the $3^{rd}$ cycle of chemotherapy. There were 24.2, 20.3 and 24.8% in the third, the fourth and the fifth cycles of chemotherapy, respectively. Migration of grade 2 to grade 3 weight loss was obviously seen in the $3^{rd}$ cycle as well. A significant difference of grade 3 or more hypokalemia was found with values of 14.3% and 50% in the PPEG and non-PPEG groups, respectively. Other toxicity parameters and treatment compliance were not different between the groups. Conclusions: Use of PPEG resulted in decreased severe weight loss, reduced migration from grade 2 to grade 3 weight loss and reduced hypokalaemia. However, benefits in treatment compliance could not be detected. So consideration of PPEG in NPC patients requires care.

Effectiveness of Self-efficacy Promoting Vestibular Rehabilitation Program for Patients with Vestibular Hypofunction (전정기능저하 어지럼 환자를 위한 자기효능증진 전정재활운동 교육의 효과)

  • Lee, Hyun Jung;Choi-Kwon, Smi
    • Journal of Korean Academy of Nursing
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    • v.46 no.5
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    • pp.710-719
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    • 2016
  • Purpose: In this study an examination was done of the effect of self-efficacy promoting vestibular rehabilitation (S-VR) on dizziness, exercise self-efficacy, adherence to vestibular rehabilitation (VR), subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness in patients with vestibular hypofunction. Methods: This was a randomized controlled study. Data were collected 3 times at baseline, 4 and 8 weeks after beginning the intervention. Outcome measures were level of dizziness, exercise self-efficacy, and level of adherence to VR. Subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness were also obtained. Data were analyzed using Windows SPSS 21.0 program. Results: After 4 weeks of S-VR, there was no difference between the groups for dizziness, subjective and objective vestibular functions. However, exercise self-efficacy and adherence to VR were higher in the experimental group than in the control group. After 8 weeks of S-VR, dizziness (p =.018) exercise self-efficacy (p <.001), adherence to VR (p <.001), total-dizziness handicap inventory (DHI) (p =.012), vision analysis ratio (p =.046) in the experimental group differ significantly from that of the control group. The number of patients with recurring dizziness were higher in the control group than in the experimental group (p <.001). Conclusion: The results indicate that continuous 8 weeks of S-VR is effective in reducing dizziness, and improving exercise self-efficacy, subjective vestibular function and adherence to VR. Objective vestibular function and vestibular compensation were also improved in the experimental group at the end of 8 weeks of S-VR.

Analysis of maxillofacial prosthetics at university dental hospitals in the capital region of Korea

  • Kim, Jee-Hwan;Shin, Soo-Yeon;Paek, Janghyun;Lee, Jong-Ho;Kwon, Ho-Beom
    • The Journal of Advanced Prosthodontics
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    • v.8 no.3
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    • pp.229-234
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    • 2016
  • PURPOSE. The purpose of this study was to investigate the demographic patterns of maxillofacial prosthetic treatment to identify the characteristics and geographic distribution of patients with maxillofacial prosthetics in the capital region of Korea. MATERIALS AND METHODS. This retrospective analytical multicenter study was performed by chart reviews. This study included patients who visited the department of prosthodontics at four university dental hospitals for maxillofacial prosthetic rehabilitation. Patients with facial and congenital defects or with insufficient medical data were excluded. The patients were classified into three categories based on the location of the defect. Patients' sex, age, and residential area were analyzed. Pearson's chi-square test with a significance level of 0.05 was used to analyze the variables. RESULTS. Among 540 patients with maxillofacial prosthetics, there were 284 (52.59%) male patients and 256 (47.41%) female patients. The number of the patients varied greatly by hospital. Most patients were older than 70, and the most common defect was a hard palate defect. Chi-square analysis did not identify any significant differences in sex, age, and distance to hospital for any defect group (P>.05). CONCLUSION. The results of this study indicated that there was imbalance in the distribution of patients with maxillofacial prosthetic among the hospitals in the capital region of Korea. Considerations on specialists and insurance policies for the improvement of maxillofacial prosthetics in Korea are required.

Experimental study on the periodontal regenerative capacity of moldable synthetic peptide domain gel in degree III furcation defect of beagles (성견의 3급 이개부 병변에서 성형성 합성 펩타이드 젤의 치주재생 능력에 관한 실험적 연구)

  • Kim, Jeong-Beom;Park, Yoon-Jeong;Lee, Sang-Cheol;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Gu, Young;Rhyu, In-Chul;Han, Soo-Boo;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.38 no.4
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    • pp.621-628
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    • 2008
  • Purpose: Osteopontin is one of the major non-collagenous protein of hard tissue. Use of peptide domain of biologically active protein has some advantages. The objective of this experimental study is evaluation of periodontal regenerative potency of synthetic peptide gel which containing collagen binding domain of osteopontin in the degree III periodontal defect of beagle dogs. Material and Methods: Experimental degree III furcation defect was made in the mandibular third and fourth premolar of beagles. Regenerative material was applied during flap operation. 8 weeks after regenerative surgery, all animals were sacrificed and histomorphometric measurement was performed to calculate the linear percentage of the new cementum formation and the volume percentage of new bone formation. Result: The linear percent of new cementum formation was 41.6% at control group and 67.1% at test group and there was statistically significant difference. The volume percent of new bone formation was 52.1% at control group and 58.9% at test group. Conclusion: As the results of present experiment, synthetic peptide gel containing collagen binding domain of osteopontin significantly increase new bone and cementum formation in the degree III furcation defect of canine mandible.

Design and Fabrication of Nasal-Implant-Shaped Scaffold and Regeneration of Nasal Cartilage Tissue for Rhinoplasty (코 성형을 위한 코 보형물 형태의 인공지지체 설계 및 제작과 코 연골조직의 재생)

  • Jung, Jin-Woo;Jang, Jin-Ah;Shim, Jin-Hyung;Kim, Sung-Won;Cho, Dong-Woo
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.36 no.11
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    • pp.1111-1117
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    • 2012
  • Implants for rhinoplasty should ideally be biocompatible and possess long-term stability after implantation. Silicone implants are most widely used for rhinoplasty. However, these implants suffer from problems related to high extrusion and infection rates. To minimize these complications, we propose a novel augmentation rhinoplasty technique using tissue engineering. To demonstrate its feasibility, a nasal-implant-shaped scaffold was designed using commercialized CAD software and fabricated using a Multi-head Deposition System, which is a solid freeform fabrication system that dispenses material. In vitro cell proliferation and chondrogenic differentiation tests were carried out using nasal septal chondrocytes.

A Case Study on Cervical Alignments Affecting by Activator (액티베이터가 경추의 정렬에 미치는 영향에 관한 사례 연구)

  • Kim, Han-Soo;Lee, Jae-Hong;Kwon, Won-An
    • The Journal of Korean Physical Therapy
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    • v.14 no.1
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    • pp.187-195
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    • 2002
  • This study was performed to assess the efficacy of Activator for the patient with chronic neck pain. Mail, 26 years old, is treated with Activator, which was applied for 15 minutes every two days during the 4 weeks. The results of this study are as follows: 1. The treated case compared with the previous case showed that R.O.M particularly increased in flexion and extension. 2. The atlas/skull angle compared with the previous case showed that the angle increased from $0.8^{\circ}$ to $1.5^{\circ}$. In the atlas/skull, normal angle is $5.6^{\circ}$. 3. The angle of cervical curve lordosis compared with the previous case showed that the angle increased from $38.3^{\circ}$ to $48.1^{\circ}$. In the healthy spine, the angle is $42.0^{\circ}$. 4. The anterior curvature compared with the previous case showed that curve radii decreased from 7,220mm to 200mm. In the spine, normal curvature is 165mm. 5. Rush Jackson's angle compared with the previous case showed that the angle increased from $14.8^{\circ}$ to $29.1^{\circ}$. In the healthy spine, normal angle is $39.9^{\circ}$. We can not find significant level for Activator, but it is considered that activator method of chiropractic technique is effective.

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Preparation and Characterization of Pioglitazone Loaded PLGA Nanospheres for the Treatment of Type 2 Diabetes (제2형 당뇨병 치료제인 Pioglitazone을 봉입하기 위한 PLGA 나노입자 제조 및 분석)

  • Woo, Hyun-Ju;Kim, Jin-Soo;Kim, Jun-Gi;Nurunnabi, Md.;Huh, Kang-Moo;Cho, Kwang-Jae;Lee, Yong-Kyu
    • Polymer(Korea)
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    • v.34 no.6
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    • pp.527-533
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    • 2010
  • The pioglitazone loaded poly(lactide-co-glycolide)(PLGA) nanospheres were prepared by emulsion-evaporation method and optimized for particle size and entrapment efficiency. The optimized particles were 125~170 nm in size with narrow size distribution and showed above 85% entrapment efficiency at 30% of pioglitazone loading when prepared with 3% w/v of poly(vinyl alcohol) (PVA) as a surfactant. These particulate carriers exhibited a controlled in vitro release of pioglitazone for 40 days at a nearly constant rate. The pioglitazone loaded PLGA nanospheres were not only effective to reduce the blood sugar level of diabetic rats but also non-toxic for the animal body, in particular for sensitive organs like kidney, liver, heart, lung and spleen. These results indicate that PLGA nanospheres have a great potential for oral delivery of pioglitazone.

Epidural Steroid Injection in the Treatment of Cervical Radiculopathy (Cervical Radiculopathy에 대한 경막외 Steroid 주입에 관하여)

  • Choe, Huhn;Han, Young-Jin;Baek, Hae-Jung;Kim, Dong-Chan
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.152-156
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    • 1991
  • Cervical radiculopathy has been recognized as a common cause of neck, shoulder, and arm pain. It was conventionally treated with rest, traction, cervical collars, manipulation, transcutaneous electrical nerve stimulation, and nonsteroidal anti-inflammatory drugs with varying results. Surgery has not always been successful so the idea of epidural steroid injection was developed as in the case of lumbar epidural injections, for the treatment of low back pain and sciatica. Thirty one patients with evidence of cervical radiculopathy were treated with injections of triamcinolone acetate into the cervical epidural space. The effect of the steroid injection could be evaluated in twenty one patients who received epidural injections more than twice. No improvement was seen in 6 patients and 15 patients showed good to excellent pain relief for a week to over 6 months. Epidural steroid injection seems to have a positive role in the treatment of cervical radiculopathy.

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Complementary Management of Residual Intracranial Aneurysms after Endovascular or Surgical Treatment

  • Shin, Byoung-Gook;Kim, Jong-Soo;Hong, Seung-Chyul;Roh, Hong-Gee
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.179-186
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    • 2005
  • Objective: The purpose of this paper is to report our experiences in managing seventeen cases of residual intracranial aneurysms following surgical or endovascular treatment and discuss the incidence of residual aneurysms, the indications and technique of retreatment of residual aneurysms. Methods: During a period of 42 months, we treated 391 aneurysms in 339 patients with microsurgical clipping or GDC embolization as a primary treatment. In 39 of them, follow-up angiography revealed residual aneurysms and seventeen of whom were retreated. There were eleven cases in ACoA, three cases in distal ICA, one, in each of MCA, ACA and basilar artery. We reviewed retrospectively the clinical notes, operation records and cerebral angiograms of seventeen patients who had been treated for residual aneurysms. Results: Complementary treatment was performed in 8 cases by means of surgery and in 9 cases by means of GDC embolization. There were eleven females and six males with an age variation between 29 and 78 years. The mean duration of angiographic follow-up was 17.3 months. Of the seventeen cases that were treated for residual aneurysms, fourteen achieved complete occlusion. Of 17 retreated patients, fifteen patients had good recovery according to the Glasgow Outcome Scale. Conclusion: When occlusion after endovascular or surgical treatment is incomplete, a new multidisciplinary approach should be carried out. Given our experiences, we recommend coil embolization of the choice in cases that the residual aneurysmal neck had been narrowed by previous clipping. On the other hand, if the residual aneurysm has enough space to clip but not enough to coil, we recommend the microsurgical clipping.

Effectiveness of Selective Peripheral Denervation for the Treatment of Spasmodic Torticollis

  • Huh, Ryoong;Ahn, Jung-Yong;Chung, Young-Sun;Chang, Jong-Hee;Chang, Jin-Woo;Chung, Sang-Sup
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.344-349
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    • 2005
  • Objective : The Bertrand's method of selective peripheral denervation for spasmodic torticollis has already been established as being an effective and safe method. However, such effectiveness has not yet been established in Korea. The authors have performed several cases of selective denervation for the treatment of spasmodic torticollis and we hereby describe the details of the operative method to determine the effectiveness of the method. Methods : Ten patients who had the selective denervation for the spasmodic torticollis from October 1997 to December 2003, were analyzed. There were 4 rotational and 6 combined types [3 rotational plus retrocollis, 3 rotational plus laterocollis]. We performed preoperative electromyograms and neck muscle tonograms in all cases. The technique was used to involve denervation of the ipsilateral posterior paraspinal muscles. Denervation of the sternocleidomastoid muscle was performed on the contralateral side for rotational torticollis and on the ipsilateral side for laterocollis combined type. The surgery was followed by a rigorous physical therapy program. Results : The surgical results were divided into 4 groups labeled excellent, good, fair, and poor. There were 5 excellent patients who showed no detectable abnormal movements, 4 good patients who showed slight residual deviations or slight residual abnormal movements, and 1 fair patient with appreciable residual abnormal movements. Postoperative pain was well tolerated. There was no significant surgical complications. Conclusion : The study confirms that selective peripheral denervation for the treatment of spasmodic torticollis is a very useful and safe surgical technique.