Objective : To observe the efficacy and safety of CheungYeolYiSeup-tang and Hwangbaek external dressings on dampness-heat pattern atopic dermatitis(AD) in a non-comparative study. Methods : 10 patients with AD were included for 4 weeks of treatment. Efficacy and safety assessment included the scoring atopic dermatitis index(SCORAD), typical signs and symptoms of AD, results of some laboratory tests related to toxicity, and the incidence of adverse events. Results : Improvements in efficacy parameters were observed and produced no significant changes in laboratory tests related to toxicity in these patients. Their SCORAD results significantly decreased after 4weeks(P value<.01, according to the Wilcoxon sum of ranks test). Similarly, significant reductions from baseline in subjective pruritus scores and (P value<.05 by the Wilcoxon sum of ranks test) and the mean average of individual signs and symptoms of AD were reported after 4 weeks(P value<.05, P<0.01 by the Wilcoxon sum of ranks test). There were no significant changes in eosinophil, neutrophil, lymphocyte, immunoglobulin E and ESR in blood serum by paired ttest. Conclusion :CheungYeolYiSeup-tang administration and Hwangbaek external dressings are an effective and safe treatment for the management of dampness-heat pattern atopic dermatitis.
Liver biopsy is the gold standard for diagnosing liver fibrosis, but it is invasive and has a risk for complications. For this reason, recently, study has been actively conducted on non-invasive liver fibrosis evaluation method. But, there is no established standard for the type of diffuse liver disease. Therefore, this study was suggest the usefulness and cut-off values of Fibroscan, FIB-4, APRI and AAR of patients with hepatitis C in Korea. According to the diagnosis, 240 people in hepatitis C are classified into fatty liver, chronic hepatitis, and liver cirrhosis. The statistical analysis was performed by ANOVA to verify difference between groups. The ROC curve was analyzed to determine the usefulness and practical cut-off value. As a result, for all diseases, the AUC value for Fibroscan was 0.8 over and the APRI was 0.7 over. Cut-off value of serum based liver fibrosis markers was increased in order of fatty liver, chronic hepatitis and liver cirrhosis. If Fibroscan and serological liver fibrosis markers are applied to predict liver fibrosis, it is expected that excessive liver biopsy can be reduced.
Objective: To evaluate the application value of serum CA19-9, CEA, CA125 and CA242 in diagnosis and prognosis of pancreatic cancer cases treated with concurrent chemotherapy. Materials and Methods: 52 patients with pancreatic cancer, 40 with benign pancreatic diseases and 40 healthy people were selected. The electrochemiluminescence immunoassay method was used for detecting levels of CA19-9, CEA and CA125, and a CanAg CA242 enzyme linked immunoassay kit for assessing the level of CA242. The Kaplan-Meier method was used for analyzing the prognostic factors of patients with pancreatic cancer. The Cox proportional hazard model was applied for analyzing the hazard ratio (HR) and 95% confidential interval (CI) for survival time of patients with pancreatic cancer. Results: The levels of serum CA19-9, CEA, CA125 and CA242 in patients with pancreatic cancer were significantly higher than those in patients with benign pancreatic diseases and healthy people (P<0.001). The sensitivity of CA19-9 was the highest among these, followed by CA242, CA125 and CEA. The specificity of CA242 is the highest, followed by CA125, CEA and CA19-9. The sensitivity and specificity of joint detection of serum CA19-9, CEA, CA125and CA242 were 90.4% and 93.8%, obviously higher than single detection of those markers in diagnosis of pancreatic cancer. The median survival time of 52 patients with pancreatic cancer was 10 months (95% CI7.389~12.611).. Patients with the increasing level of serum CA19-9, CEA, CA125, CA242 had shorter survival times (P=0.047. 0.043, 0.0041, 0.029). COX regression analysis showed that CA19-9 was an independent prognostic factor for patients with pancreatic cancer (P=0.001, 95%CI 2.591~38.243). Conclusions: The detection of serum tumor markers (CA19.9, CEA, CA125 and CA242) is conducive to the early diagnosis of pancreatic cancer and joint detection of tumor markers helps improve the diagnostic efficiency. Moreover, CA19-9 is an independent prognostic factor for patients with pancreatic cancer.
Background : The 2015 American thyroid association (ATA) guidelines greatly expanded section on risk stratification of thyroid cancer. Definition of "Low risk of recurrence" has expanded, by inclusion of small volume lymph node involvement, such as less than 5 lymph node metastases each smaller than 2mm in central compartment. Purpose : We evaluated the number of positive nodes, Positive node ratio (PNR), recurrence, and radioablation therapy. Also, evaluated the safety of omitting strategy of radioablation after total thyroidectomy with PTC, especially on low-PNR N1a patients compared with high-PNR N1a patients. Methods : Consecutive 147 N1a and 216 N0 patients who underwent total thyroidectomy with central neck dissection between 2003 and 2004 were enrolled. We divided 147 N1a patients into two groups, such as 96 high-PNR versus 51 low-PNR group according to 50% of PNR, and compared these two groups with N0 group. Results: 7.2% (26/363) recurrences were occurred, and 21/147 (14.3 %) recurrences were on N1a patients, and 5/216 (2.3 %) were on N0 patients. Of these 21 recurrences in N1a stage patients, 20 (95.2 %) recurrences were occurred in high-PNR N1a group and only 1 (4.8 %) recurrence was in low-PNR N1a group. The recurrence of low-PNR N1a group was significantly lower than high-PNR N1a group (Log-rank p value = 0.003), but significantly not different from N0 group (Log-rank p value = 0.889). Although this study was a retrospective non-randomized trial with small number of patients, the 10-year recurrence of omitting RAI in low-PNR N1a patients with less than 50% of PNR were shown to be comparable with 216 N0 low risk patients. Conclusion : Positive node ratio could be a useful predictor of recurrence and useful guidance postoperative management -rather than absolute number of positive node.
Jo, Janghwan;Kim, Joongsuck;Kim, Yeongcheol;Chung, Ilyong;Park, Jongmin;Ahn, Eunjung;Kim, Eunyoung;Park, Seihyeog;Kim, Seongyup
Journal of Trauma and Injury
/
v.27
no.4
/
pp.145-150
/
2014
Purpose: To assess the accuracy and role of single-contrast computed tomography (CT) in the management of anterior abdominal stab wound (AASW). Methods: During 8-years period, single-contrast CT was performed in 21 hemodynamically stable AASW patients (age range, 22-64 years; median age, 45 years), including 19 men and 2 women. CT scans were evaluated by one trauma surgeon and one senior resident to determine the depth of injury(peritoneal violation or not), and abnormal findings of intraperitoneal cavity associated with stab injury. We retrospectively reviewed medical records regarding operative findings. Results: Nine patients underwent abdominal surgery and 12 patients nonoperative management. In the abdominal surgery group, abnormal CT findings included peritoneal violation in 14 patients and abnormal intraperitoneal cavity findings in 5 patients. There was no statistical significant difference regarding abnormal CT findings between abdominal surgery group and nonoperative management group. Among the nine abdominal surgery patients, therapeutic laparotomy was performed on 4 patients. The positive predictive value (PPV) and negative predictive value (NPV) of peritoneal violation to predictive therapeutic laparotomy were 28.6% and 100%, respectively. In addition, the PPV and NPV of abnormal intraperitoneal cavity CT findings to predict therapeutic laparotomy were 40.0% and 87.5%, respectively. There was no statistical significant difference regarding the abnormal CT findings between therapeutic laparotomy group and non therapeutic laparotomy group. Conclusion: CT is a good adjunctive method to evaluate hemodynamicaly stable AASW patients. If peritoneal violation is not seen on CT scan, conservative treatment on local wound may be safely performed without additional abdominal surgery. However, further study is warranted to evaluate the exact role of CT in the diagnostic workup of AASW patients.
Objective: To prospectively evaluate the outcomes of ultrasound (US)-guided radiofrequency ablation (RFA) in tertiary hyperparathyroidism (THPT). Materials and Methods: Patients with THPT underwent RFA between September 2017 and January 2022. Laboratory parameters, including serum intact parathyroid hormone (iPTH) levels, were monitored for 48 months after RFA and compared with the levels at baseline. Complications related to RFA and changes in hyperparathyroidism-related clinical symptoms were recorded before and after RFA. Results: A total of 42 patients with THPT were recruited for this study. Ultimately, 36 patients with renal failure and 2 patients who underwent successful renal transplantation (male:female, 17:21; median age, 54.5 years) were enrolled. The follow-up time was 21.5 ± 19.0 months in the 36 patients with renal failure. In these 36 patients, iPTH levels were significantly decreased to 261.1 pg/mL at 48 months compared with the baseline value of 1284.9 pg/mL (P = 0.012). Persistent hyperparathyroidism, defined as iPTH levels maintained at > 585.0 pg/mL for 6 months after treatment, occurred in 4.0% of patients (1/25). Recurrent hyperparathyroidism, defined as iPTH levels > 585.0 pg/mL after 6 months, were 4.0% (1/25) and 0.0% (0/9) at 6 months and 4 years after treatment, respectively. In two patients with THPT after successful renal transplantation, iPTH decreased from the baseline value of 242.5 and 115.9 pg/mL to 171.0 and 62.0 pg/mL at 6 months after treatment. All complications resolved within 6 months of ablation without medical intervention, except in 10.5% (4/38) patients with permanent hypocalcemia. The overall symptom recovery rate was 58.8% (10/17). The severity scores for bone pain, arthralgia, and itchy skin associated with hyperparathyroidism improved after treatment (P < 0.05). Conclusion: US-guided RFA is an effective and safe alternative to surgery in the treatment of patients with TPTH and improves hyperparathyroidism-related clinical symptoms.
Purpose: The purpose of this study was to analyze risk factors in predicting medical patients transferred to Intensive Care Unit (ICU) on the general ward. Methods: We reviewed retrospectively clinical data of 120 medical patients on the general ward and a Modified Early Warning Score (MEWS) between ICU group and general ward group. Data were analyzed with multivariate logistic regression and the area under the receiver operating characteristic curves using SPSS/WIN 18.0 program. Results: Fifty-two ICU patients and 68 general ward patients were included. In multivariate logistic regression, the MEWSs (Odds Ratio [OR], 1.91; 95% confidence interval [CI], 1.32-2.76), sequential organ failure assessment score (OR, 1.28; 95% CI, 1.10-1.72), $PaO_2/FiO_2$ ratio (OR, 0.98; 95% CI, 0.98-0.99), and saturation (OR, 0.93; 95% CI, 0.88-0.99) were predictive of ICU transfer. The sensitivity and the specificity of the MEWSs used with a cut-off value of six were 80.8% and 70.6% respectively for ICU transfer. Conclusion: These findings suggest that early prediction and treatment of patients with high risk of ICU transfer may improve the prognosis of patients.
Background: Opioids can present intolerable adverse side-effects to patients who use these analgesics to mitigate chronic pain. In this retrospective analysis, cooled radiofrequency (CRF) denervation was evaluated to provide pain and disability relief and reduce opioid use in patients with sacroiliac joint (SIJ) derived low back pain (LBP). Methods: Twenty-seven patients with pain from SIJ refractory to conservative treatments, and taking opioids chronically (> 3 mo), were included. Numeric rating scale (NRS) and Oswestry disability index (ODI) scores were collected at 1, 6, and 12 months post-procedure. Opioid use between baseline and each follow-up visit was compared for the entire group and for those who experienced successful (pain reduction ≥ 50% of baseline value) or unsuccessful CRF denervation. Results: Severe initial mean pain (NRS score: 7.7 ± 1.0) and disability (ODI score: 50.1 ± 9.0), and median opioid use (morphine equivalent daily dose: 40 ± 37 mg) were significantly reduced up to 12 months post-intervention. CRF denervation was successful in 44.4% of the patients at 12 months. Regardless of procedure success, patients demonstrated similar opioid reductions and changes in opioid use at 12 months. Two patients (7.4%) experienced neuritis following CRF denervation. Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain.
Hemodialysis is a way of treatment for the patients with acute and chronic renal failure. "Marginal man" depicts the enormous amount of stress that hemodialytic patients suffer. It is known that family with chronic illness get stressed along with the patients and they need nursing care also. This qualitative study was conducted in order to identify the family adaptation process in patients with hemodialysis. 6 dyads of hemodialytic patients and caregivers were interviewed for this research. By way of grounded theoretical strategy the data was collected from October 20, 1999 to November 20, 1999. at a hemodialytic unit that was located in Iksan, Chonbuk by the researcher. The main research questions were "What's the adaptation experience of a patient since after being received with hemodialysis?" to the patients, and "What's the family adaptation experience of hemodialysis?" to the caregivers. The collected data was analyzed by grounded theoretical strategy built by Glaser & Strauss in 1967. Results were as follows; 7 grounded concepts were observed from the patients with hemodialysis and 4 grounded concepts were found from the caregivers. Two categories were derived ; 1) Holding hope that is related with treatment 2) Changing a value system.
Mammadov, Elnur;Aslan, Guven;Tuna, Burcin;Bozkurt, Ozan;Yorukoglu, Kutsal
Asian Pacific Journal of Cancer Prevention
/
v.15
no.23
/
pp.10401-10405
/
2015
Background: Molecular prognostic markers have been under investigation for the last decade and no validated marker to date has been proven to be used in daily clinical practice for urinary bladder cancers. The aim of the present study is to evaluate the significance of HYAL-1 expression in prediction of recurrence and progression in pT1 urothelial carcinomas. Materials and Methods: Eighty-nine urothelial carcinoma cases staged as T1 according to 2004 WHO classification were studied. Representative sections from every case were stained immunohistochemically for HYAL-1 and scored between 0 and +3, according to staining density, and graded as low and high for the scores 0-1 and 2-3, respectively. Results: Of the 89 pT1 bladder cancer patients, HYAL-1 expression was high in 92.1% (82 patients; 72 patients +3 and 10 patients +2) and low in 7.9% (only 7 patients; 6 patients +1 and 1 patient 0) of the cases. Of the 89 patients, 38 (42.7%) had recurrence and 22 (24.7%) showed progression. HYAL-1 staining did not show significant characteristics for tumor grade, accompanying CIS, multiplicity, tumor size, age and sex. HYAL-1 expression did not have any prognostic value in estimating recurrence or progression. Conclusions: HYAL-1 expression was found to be high, but did not have any prognostic importance in T1 bladder urothelial carcinomas.
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