• Title/Summary/Keyword: Patient Prescription

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Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

  • Dizman, Aysen;Coskun-Breuneval, Mehtap;Altinisik-Inan, Gonca;Olcay, Gokce Kaan;Cetindag, Mehmet Faik;Guney, Yildiz
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3561-3566
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    • 2014
  • Background: Recurrent nasopharyngeal carcinoma (NPC) after previous radiotherapy is challenging. There is no standard approach for salvage treatment. Here we present toxicity and treatment results for recurrent NFC patients who underwent fractionated stereotactic radiotherapy (FSRT) as second line radiotherapy (RT). Materials and Methods: Between April 2009 and July 2012, 24 patients, with a male to female ratio of 3:1, were treated with CykerKnife$^{(R)}$ FSRT for recurrent NFC in our institution. Seven out of 24 patients had metastatic recurrent disease. Median age was 53 years (range, 20-70 years). Initial RT dose was 70Gy. The time period between initial RT and FSRT was a median of 33.2 months. The median prescription dose for FSRT was 30Gy (range, 24-30 Gy) in a median of 5 fractions (range, 4-6). Results: The median follow-up for all patients was 19.5 months (IQR: 12.2.-29.2 months). The locoregional control; progression free survival and overall survival (OS) rates for 1-, 2- and 3-year were 64%, 38%, 21%; 60%, 30%, 17% and 83%, 43%, 31%, respectively. Median OS for the entire cohort was 22 months (95% CI: 16.5-27.5). On multivariate analysis recurrent tumor stage was the only prognostic factor for OS (p=0.004). One patient exhibited grade III temporal lobe necrosis. One died because of grade IV mucositis and overlapping infection. Conclusions: The treatment of recurrent NPC is controversial. Fractionated stereotactic radiotherapy is promising. However, the published trials are heterogeneous with respect to the selection criteria and treatment details. Prospective studies with long term follow-up data are warranted.

Theoretical Basis and Application of the Neurac Technique Which Uses the Sling Exercise Therapy (슬링운동치료를 이 용한 Neurac 기법의 이론적 근거와 적용방법)

  • Kim, Suhn-Yeop;Kim, Taek-Yean
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.12 no.2
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    • pp.52-65
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    • 2006
  • Sling exercises therapy can speak as appliable comprehensive exercises therapy technique efficiently in general exercise field for injured worker's rehabilitation process and health improvement patient or athlete, injury or disease that have pain or dysfunction to neuromuscular system using that shake. At 1990 an early stage, because physical therapist and doctors of medical treatment developed country norway of north europe cooperate sling exercises therapy's concept trend spreading worldwide establishing theory newly based on scientific basic be. Musculoskeletal system, old man and young child's nervous system injurer's treatment and exercise and industry worker's rehabilitation process, athlete's rehabilitation etc. several fields introduced in early 2000s to Korea apply. Sling exercises therapy neuromuscular system disease continuous abatement as general concept of active exercise and treatment that use sling exercises equipment by purpose know can. This review article wishes to introduce about neuromuscular activation, "Neurac" technique that can speak as step developed more concept based on application principle etc, of basic sling exercises effort's change by suspension point's change that is concept, stability exercises principle, open kinetic chain exercises and closed kinetic chain exercises. Arranged about Plateau potential's characteristic and working mechanism and Neurac technique's application method that can say as Neurac technique's neuro-physiologic base, and presented treatment method of lumbar part disease and cervical part, shoulder joint part disease to application example. Because plateau potential forward player that induce using Neurac technique in part muscles that act role that keep spine surrounding stability in this article keeps muscle's contraction continuously, between global and local muscles, presented several study findings that can cause affirmative change in insufficient muscle adjustment state such as imbalance of muscles' action order. Expect that case studies that use this Neurac technique here after consist continuously.

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Research on Alimentotherapy Definitions and Applied Theories (식치(食治)의 개념 정립 및 적용 이론의 이해)

  • Ahn, Sang-Young;Lee, Min-Ho;Pyo, Bo-Yong;Ha, Jeong-Yong;Ahn, Sang-Woo
    • Korean Journal of Oriental Medicine
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    • v.14 no.2
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    • pp.27-33
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    • 2008
  • Alimentotherapy refers to the treatment or prevention by means of food. As food is consumed in everyday life and its constituents varies enormously. the practice of alimentotherapy was often misunderstood. By the research on ancient classics we could find 3 prospective about this practice. Firstly, alimentotherapy was used during the recovery and also for prevention. This is a type of Life-nurturing method, which we suggest to be called life-nurturing alimentotherapy. Secondly, it was also used as a dietary prescription made by physicians. Sometimes they made prescriptions combining materials derived from food with herbal medication. This practice was exclusively made by physicians as they had to consider the characteristic of each food as well as the condition of the patient. Thirdly, sometime alimentotherapy was used in cuisine form. They used food components in major part and herbal medicine used as additional ingredients. It was primarily focused on the taste and in some part its functional aspects. The underlying theories in alimentotherapy is exactly the same as used for understanding herbal medicine in TKM. Therefore, except in the case of life-nurturing method, it should be used by expert physicians. Finally, we suggest to differentiate the terms of alimentotherapy in the aspect of life-nurturing, dietary prescriptions and cuisine to prevent confusions.

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A study on the Severity Scoring Systems of Atopic Dermatitis ; comparison, Analysis and Establishment of childhood patients in Oriental Medicine (아토피 피부염의 중증도 평가방법에 대한 제언 ; 비교 분석 및 소아 환자의 평가방법에 대한 설립)

  • Seo, Jung-Min;Kim, Sang-Chan;Hwang, Sun-Yi;Hwang, Bo-Min;Jee, Seon Young;Lee, Sang-Gon;Baek, Jung-Han
    • The Journal of Pediatrics of Korean Medicine
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    • v.20 no.1
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    • pp.1-14
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    • 2006
  • Objective : As prevalence of atopic dermatitis(AD) rises and medicine of atopic dematitis develops, the methods of measurement for atopic dermatitis have developed. Therefore, we aimed to establish a new sconring system in oriental medicine for a childhood atopic dematitis, by comparison, analysis of various sconing systems. Method : We searched for the data related to severity sconing systems of atopic dermatitis in Entrez PubMed on abroad thesis and KISS(Korenstdued Information Service System) on domestic thesis from 1990 to 2005. Result : Severity sconing systems for atopic dermatitis satisfy validity, reliability, sensitivity of change and verification of this. The essential items of severity sconing systems are extent, intensity and subjective symptoms. The lesion is divided into 9 areas(head and neck, upper limbs, elbow, hands, trunk, hip and inguinal, lower limbs, knee, feet). The items of intensity are erythema, oedema and induration and papulation, oozing and weeping and erosion, excorition, scaling, lichenification. The subjective symptom is pruritis, evaluated according to sleep loss and obstruction of play and study. The extent and intensity is evaluated in combination. We suggested that extent and intensity occupied for 70% and subject symptoms accounted for 30% of total score.

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A Case Report of Ascites in Liver cirrhosis with Herbal Prescription (복수 동반 간병변 환자의 평위산(平胃散) 합(合) 위령탕가미방 투여 호전 1례)

  • Kim, Jin-Won;Jeong, Byeong-Ju;Woo, Sung-Ho;Shim, Hyo-Ju;Na, Eu-Jin;Kim, Yong-Ho;Seo, Ho-Seok;Lee, Won-Hui;Kim, Byung-Chul
    • The Journal of Internal Korean Medicine
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    • v.27 no.4
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    • pp.962-968
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    • 2006
  • Background : Liver cirrhosis is a disease of the liver in which normal cells are replaced by scar tissue. This condition results in the failure of the liver to perform many of its usual functions. Liver cirrhosis includes ascites, jaundice, portal hypertension, varices etc. Objectives : This study was to see if there is a decrease in ascites of liver cirrhosis to under acupuncture and herbal treatment to test their validity. Methods : Measuring the response to treatment of ascites by giving pyengwie-san hap wieryungtang gamibang and treating the patient with acupuncture, these clinical symptoms were observed: weight, abdominal circumference, abdominal SONO, chest X-ray, and lab findings. Results : Over 18 days the daily average loss of weight and abdominal circumference 0.43kg and 0.56cm, respectively. Lab findings of liver functions showed improvement. Conclusions : This report shows a role for acupuncture and herbal treatment for treating ascites in liver cirrhosis.

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A Case Report of Hyperlipidemia and Constipation in a Patient with Cerebral Infarction Treated with Herbal Prescription. (뇌경색 후유증 환자의 고지혈증과 변비에 대한 함초환(鹹草丸) 호전 1례)

  • Woo, Sung-Ho;Kim, Byung-Chul;Kim, Jin-Won;Jeong, Byeong-Ju;Na, Eu-Jin;Shim, Hyo-Ju;Kim, Yong-Ho;Seo, Ho-Seok;Lee, Won-Hui
    • The Journal of Internal Korean Medicine
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    • v.27 no.4
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    • pp.945-953
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    • 2006
  • Hyperlipidemia is one of the major factors causing the atherosclerosis of coronary arteries and a well-documented modifiable risk factor for stroke, especially of the ischemic type. Constipation is the condition of being unable to empty the bowels frequently enough or effectively. However, it is usually temporary and not a serious disease. Salicornia herbacea is a sea coast plant that grows on the western and southern coastal beaches and salt flats of the Korean peninsula. Belonging to Chenopodiaceae by biological classification. Salicornia herbacea is not known from research except that it contains plenty of minerals. The purpose of this study was to evaluate the effect of treatment with Hamcho-hwanand to observe changes in total cholesterol (T-Chol) high-density lipoprotein cholesterol (HDL), triglyceride (TG) and constipation. After treatment, total cholesterol decreased from 273mg/dl to 235mg/dl. Triglyceride decreased from 201mg/dl to 126mg/dl. HDL cholesterol increased from 30mg/dl to 40mg/dl. Constipation changed for the better. These results support a role for oriental medical therapy in treating hyperlipidemia and constipation. Further case studies of herbal treatment of this ailment are needed.

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A Case of Chest Pain in Taeumin Caused by Aortic Regurgitation Treated with Gamijoripewontang (대동맥판(大動脈瓣) 폐쇄불전증(閉鎖不全症)으로 흉통(胸痛)을 호소하는 태음인(太陰人)환자의 가미조리폐원탕(加味調理肺元湯) 치험례)

  • Kim, Dong-Woo;Kim, Soo-Yong;Han, Chang-Ho;Rhee, Sung-Hwan;Lee, Dong-Min;Ha, Sang-Kyu
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.464-472
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    • 2004
  • Aortic regurgitation occurs when there is a leakage of the valve backward into the left ventricle during diastole. Chronic aortic regurgitation may be present for decades before any symptoms occur. The left ventricle is able to compensate for the large volume of blood that flows backward by enlarging the cavity and increasing the thickness of the muscle. This mechanism allows the heart to pump out both the amount of blood required by the body and the blood that has gone backward into the left ventricle. One patient who had chest pain from exercise was treated. He was diagnosed with aortic regurgitation LVH by echocardiography. Signs showed him to be of Taeumin-type within Sasang Constitutional Medicine. He was prescribed Gamijoripewontang for 75 days, and improvement of clinical symptoms were observed. Results support prescription of Gamijoripewontang as an effective treatment for Taeumin-type patients suffering chest pain caused by aortic regurgitation.

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A Case Report of a Tracheostomized Patient with Stroke Suffering from Sputum Secretion Treated with Herbal Prescriptions for dispelling Dam-eum (기관절개술을 시행한 중풍 환자의 객담에 대한 담음(痰飮) 처방 투여 1예(例))

  • Kwon, Tae-Wook;Ahn, Lib;Kim, Myung-Ho;Lee, Sang-Ah;Jang, Myung-Woong;Choi, Dong-Jun
    • The Journal of Internal Korean Medicine
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    • v.34 no.3
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    • pp.329-337
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    • 2013
  • This is a case report of a tracheostomized 80-year-old man suffering from sputum after stroke. His symptoms were watery sputum production requiring frequent sputum suction. The subject was diagnosed as having a deficiency of spleen qi and was treated with Gami-ijung-tang, Yukgunja-tang, Soeumin Bojungikgi-tang, and Ijin-tang extract in the herbal prescription known to dispell Dam-eum (phlegm-retained fluid). Frequency of ssputum suction and condition of sputum were checked everyday. Gamiijung-tang, Soeumin Bojungikgi-tang with Ijin-tang extract led to improvement by reducing sputum secretion. There were limitations on frequency of suction and condition of sputum which were thought to be derived from tracheostomy, however. Consequently, pathology and treatment of sputum will be different whether tracheostomy was performed or not.

The Awareness and Satisfaction of Herbal Medicine Preparations of Korean Medicine Doctor (한의사의 한약제제 인식도와 만족도)

  • Kim, Kyeong Han;Lee, Eun-Kyoung;Go, Ho-Yeon;CHANG, SeoKWon;JU, SungWan;Jang, Bo-Hyoung;Shin, Yong-Cheol;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.2
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    • pp.15-22
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    • 2017
  • Objectives : This study was conducted to identify awareness and satisfaction of herbal medicine preparations in Korean medicine doctor(KMD). Methods : The questionnaire consisted of three professors of Korean medicine based on previous researches and reports. The pilot survey was conducted to five KMDs who work in local clinic to get face validity. Based on the results of the pilot survey, three professors of Korean medicine completed the final version. Online surveys was conducted to member of the association of Korean medicine from march 25 to april 6 in 2016. Results : The proportion of patients who prescribe herbal medicine was not significantly correlated to gender (p=0.346), but significantly correlated to age(p<0.01), specialty(p=0.017), monthly income(0.022), and clinical experience(p<0.001). The most common reason for using the herbal preparations which is covered by NHI (National Health Insurance) was due to patient's payment(39.3%). Likewise, the most common reason for using the herbal preparations which is not covered by NHI was various kind of prescription(34.1%). Conclusions : The utilization of herbal preparations could be enhanced by expansion of NHI cover range of herbal preparations.

Development of efficiency indicators for medical resources use using Delphi technique (델파이 조사법을 이용한 의료 자원 사용의 효율성 평가지표 개발)

  • Choi, Yoon-Jung;Kwon, Young-Dae;Kim, Chang-Soo;Kim, Yoon
    • Health Policy and Management
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    • v.22 no.1
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    • pp.65-84
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    • 2012
  • Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.