• Title/Summary/Keyword: Time of medical treatment

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Five-Year Survival and Median Survival Time of Nasopharyngeal Carcinoma in Hospital Universiti Sains Malaysia

  • Siti-Azrin, Ab Hamid;Norsa'adah, Bachok;Naing, Nyi Nyi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6455-6459
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    • 2014
  • Background: Nasopharyngeal carcinoma (NPC) is the fourth most common cancer in Malaysia. The objective of this study was to determine the five-year survival rate and median survival time of NPC patients in Hospital Universiti Sains Malaysia (USM). Methods: One hundred and thirty four NPC cases confirmed by histopathology in Hospital USM between $1^{st}$ January 1998 and $31^{st}$ December 2007 that fulfilled the inclusion and exclusion criteria were retrospectively reviewed. Survival time of NPC patients were estimated by Kaplan-Meier survival analysis. Log-rank tests were performed to compare survival of cases among presenting symptoms, WHO type, TNM classification and treatment modalities. Results: The overall five-year survival rate of NPC patients was 38.0% (95% confidence interval (CI): 29.1, 46.9). The overall median survival time of NPC patients was 31.30 months (95%CI: 23.76, 38.84). The significant factors that altered the survival rate and time were age (p=0.041), cranial nerve involvement (p=0.012), stage (p=0.002), metastases (p=0.008) and treatment (p<0.001). Conclusion: The median survival of NPC patients is significantly longer for age ${\leq}50$ years, no cranial nerve involvement, and early stage and is dependent on treatment modalities.

Analysis of Factors Influencing on the Early Treatment of Children With Developmental Disability (발달장애아의 조기치료에 영향을 미치는 요인 분석)

  • Park, Hye-Jeong;Kim, Sun-Hye
    • Physical Therapy Korea
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    • v.6 no.1
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    • pp.47-61
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    • 1999
  • The purpose of this study was to investigate factors influencing on the early treatment of children with developmental disability. Data was collected from 102 mothers of children with developmental disability who were treated at 4 rehabilitation facilities in Kyunggi-Do and Kangwon-Do. The results were as follows: 1) Of a total of 102, 63 children began to receive rehabilitation therapy during the period 0~12 months (early treatment group), 38 children after 1 year of age (delayed early treatment group). 2) There were statistically significant differences between the early treatment group and delayed early treatment group for prematurity, low birth weight, the time to discover developmental abnormalities, the time of first diagnosis, and first treatment (p<0.05). 3) There were no statistically significant differences in the two groups for level of education, economic status, risk factors (except prematurity and birth weight), home care, family's cooperation and commuting time (p>0.05). Based on this study, the important factors for early treatment were early detection, early diagnosis and constant follow-up for high-risk babies.

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Randomized Control Study of Nedaplatin or Cisplatin Concomitant with Other Chemotherapy in the Treatment of Advanced Non-small Cell Lung Cancer

  • Li, Chun-Hong;Liu, Mei-Yan;Liu, Wei;Li, Dan-Dan;Cai, Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.731-736
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    • 2014
  • Objective: To observe the short-term efficacy, long-term survival time and adverse responses with nedaplatin (NDP) or cisplatin (DDP) concomitant with other chemotherapy in treating non-small cell lung cancer. Materials and Methods: A retrospective, randomized, control study was conducted, in which 619 NSCLC patients in phases III and IV who were initially treated and re-treated were randomly divided into an NDP group (n=294) and a DDP group (n=325), the latter being regarded as controls. Chemotherapeutic protocols (CP/DP/GP/NP/TP) containing NDP or DDP were given to both groups. Patients in both groups were further divided to evaluate the clinical efficacies according to initial and re-treatment stage, pathological pattern, type of combined chemotherapeutic protocols, tumor stage and surgery. Results: The overall response rate (ORR) and disease control rate (DCR) in the NDP group were 48.6% and 95.2%, significantly higher than in the DDP group at 35.1% and 89.2%, respectively (P<0.01). In NSCLC patients with initial treatment, squamous carcinoma and phase III, there were significant differences in ORR and DCR between the groups (P<0.05), while ORR was significant in patients with adenocarcinoma, GP/TP and in phase IIIa (P<0.05). There was also a significant difference in DCR in patients in phase IIIb (P<0.05). According to the statistical analysis of survival time of all patients and of those in clinical phase III, the NDP group survived significantly longer than the DDP group (P<0.01). The rates of decreased hemoglobin and increased creatinine, nausea and vomiting in the NDP group were evidently lower than in DDP group (P<0.05). Conclusion: NDP concomitant with other chemotherapy is effective for treating NSCLC, with higher clinical efficacy than DDP concomitant with chemotherapy, with advantages in prolonging survival time and reducing toxic and adverse responses.

Clinical Information Interchange System using HL7-CDA

  • Jung, Yong Gyu;Lee, Young Ho
    • International journal of advanced smart convergence
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    • v.1 no.2
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    • pp.47-51
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    • 2012
  • In highly developed society, information and communication technologies are widely used for better medical services. These information and communication technologies should be more and more acceptable in all hospitals for exchange medical records. EMR becomes more convenient than the previously used paper charts. It will be able to record medical institutions every time and dual treatment. Each is different specifications for each medical institution to use the program or document to exchange it. The personal clinic records still does not exchange well. To solve this gap between medical alienation, this paper describes the concepts of HL7-CDA and proposes types of telemedicine system. To resolve time and space constraints, new form of treatment methods presents in future directions after described about related systems. CDA enables electronic medical records to the each medical center and gradually expanded by exchanging the patient's medical records. This paper is using XML-based CDA documents as a hierarchical for medical information exchange standards compliant HL7-CDA documents. It could be possible currently used structural variety of multimedia data. Thus It is able to send and receive HL7-CDA-based medical information and clinical information to identify the medical institutions of medical information with interchange system design and building standards, and through mutual exchange of clinical information.

Calcium Ion Dynamics after Dexamethasone Treatment in Organotypic Cultured Hippocampal Slice

  • Chae, Hee-Jung;Kang, Tong-Ho;Park, Ji-Ho
    • The Korean Journal of Physiology and Pharmacology
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    • v.9 no.6
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    • pp.363-369
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    • 2005
  • It is imperative to analyse brain injuries directly in real time, so as to find effective therapeutic compounds to protect brain injuries by stress. We established a system which could elucidate the real time $Ca^{2+}$ dynamics in an organotypic cultured hippocampal slice by the insults of artificial stress hormone, dexamethasone. The real time $Ca^{2+}$ dynamics could continuously be detected in cornus ammonis 3 (CA3) of the organotypic hippocampus for 8 hours under confocal microscopy. When dexamethasone concentration was increased, the $Ca^{2+}$ was also increased in a dose dependent manner at $1{\sim}100{\mu}M$ concentrations. Moreover, when the organotypic cultured hippocampal slice was treated with a glutamate receptor antagonist together with dexamethasone, the real time $Ca^{2+}$ dynamics were decreased. Furthermore, we confirmed by PI uptake study that glutamate receptor antagonist reduced the hippocampal tissue damage caused by dexamethasone treatment. Therefore, our new calcium ion dynamics system in organotypic cultured hippocampal slice after dexamethasone treatment could provide real time analysis method for investigation of brain injuries by stress.

The Importance of the Trauma Surgeon: A Reflection on the Management of Hemodynamically Unstable Pelvic Trauma Patients (혈역학적으로 불안정한 골반외상 환자의 치료를 통해 본 외상전문의의 필요성)

  • Shin, Sung;Kyung, Kyu Hyuk;Kim, Ji Wan;Kim, Jung Jae;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.254-259
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    • 2009
  • Purpose: Pelvic trauma is a serious skeletal injury with high mortality. Especially in cases of severe injury trauma, treatment outcomes depend on early diagnosis and intervention. We expect trauma surgeon to play an important role in the management of severe multiple trauma patients. Methods: A retrospective study was performed on pelvic trauma patients with hemodynamic instability between March 2005 and September 2009. We divided the time period into period I (March 2005~Feburary 2009) and period II (March 2009~September 2009). The trauma surgeon and team started to work from period II. Data were collected regarding demographic characteristics, mechanism of injury, type of pelvic fracture, ISS(injury severity score), treatment modality, transfusion requirement, time to definitive treatment, and mortality. Results: During period I, among 7 hemodynamically unstable patients, 4(57.1%) patients died. However during Period II, only one of 6(16.6%) patients died. The demographic data and injury scores showed no differences between the two time periods, but the time to definitive treatment was very short with trauma team intervention(14.4 hrs vs. 3.9 hrs). Also, the amount of transfusion was less(41.1 U vs. 13.9 U). With arterial embolization, early pelvic external fixation led to less transfusion and made patients more stable. Conclusion: This study demonstrated the importance of the trauma surgeon and the trauma team in cases of hemodynamically unstable pelvic trauma. Even with the same facility and resources, an active trauma team approach can increase the survival of severely injured multiple trauma patients.

Concurrent Chemoradiation with Weekly Cisplatin for the Treatment of Head and Neck Cancers: an Institutional Study on Acute Toxicity and Response to Treatment

  • Ghosh, Saptarshi;Rao, Pamidimukkala Brahmananda;Kumar, P Ravindra;Manam, Surendra
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7331-7335
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    • 2015
  • Background: Concurrent chemoradiation with three weekly high dose cisplatin is the non-surgical standard of care for the treatment of locally advanced head and neck cancers. Although this treatment regime is efficacious, it has high acute toxicity, which leads not only to increased treatment cost, but also to increased overall treatment time. Hence, the current study was undertaken to evaluate the acute toxicity and tumor response in head and neck cancer patients treated with concurrent chemoradiation using $40mg/m^2$ weekly cisplatin, which has been our institutional practice. Materials and Methods: This single institution retrospective study included data for 287 head and neck cancer patients treated with concurrent chemoradiation from 2012 to 2014. Results: The mean age of the patients was 48.8 years. The most common site of involvement was oral cavity. Most of the study patients presented with advanced stage disease. The mean overall treatment time was 56.9 days. Some 67.2% had overall complete response to treatment as documented till 90 days from the start of treatment. According to the Radiation Therapy Oncology Group (RTOG) acute radiation morbidity scoring criteria, mucositis was seen in 95.1% of the patients. Dermatitis and emesis were observed in 81.9% and 98.6%, respectively. Regarding haematological toxicity, 48.8% and 29.6% suffered from anaemia and leukopenia, respectively, during treatment. Acute kidney injury was assessed using the Common Terminology Criteria for Adverse Events (CTCAE), and was found in 18.8% of the patients. Conclusions: Concurrent chemoradiotherapy with weekly cisplatin is an effective treatment regime for head and neck cancers with reasonable toxicity which can be used in developing countries, where cost of treatment is so important.

The Rearch Of Method in the Appropriate number of Demand and Supply of OMD (한의사인력(韓醫師人力) 공급(供給)의 적정화방안(適定化方案) 연구(硏究))

  • Lee, Jong-Soo
    • The Journal of Korean Medicine
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    • v.19 no.1
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    • pp.299-326
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    • 1998
  • 1. Comparison of demand and supply A. Assumption of estimation of demand and supply we will briefly assumptions used for presumption once more before comparing the result of estimation of demand and supply examined previously 1) supply - The average applying rate for state. examination of graduate: ${\alpha}$=1.03109 - The ratio of successful applicants of state examinations: ${\beta}$=0.97091 - Mortality classified by age : presumed data of the Bureau of statistics - Emigrating rate: 0 % - Time of retire: unconsidered - An army doctor number: unconsidered and regard number of employed oriental medicine doctor. - Standard of 1995 : The number of survival oriental medicine doctor is 8195. the number of employed oriental medicine doctor is 7419. 2) demand - derivated demand method Daily the average amount of medical treatment: according to medical insurance federation data. there is 16 or 6 non allowance patient, we consider amount of medical treatment as 22 persons in practical because 21.94 persons (founded practical examination) are converted to allowance in comming demand. Daily the proper amount of medical treatment: 7 hours form -35 persons 5 hours 30 minutes form -28 persons. Yearly medical treatment days: 229 days. 255 days. 269 days . Increasing rate of visiting hospital days: -1996 year. 1997 year. 1998 year- . Rate of applying insurance: yearly average 71.51% (among the investigated patient) B. Comparison of total sum result 1) supply (provision) Table Ⅳ-1 below shows the estimation of the oriental medicine doctor in the future.

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  • Oriental Medical Treatment System Based on Mobile Phone (모바일폰 기반 한방 의료 치료 시스템)

    • Hong, You-Shik;Lee, Sang-Suk;Park, Hyun-Sook;Kim, Han-Gyu
      • The Journal of the Institute of Internet, Broadcasting and Communication
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      • v.14 no.3
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      • pp.199-208
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      • 2014
    • At present, the effect of oriental treatment system is proved in the west and using the data of tongue and pulse of body, the doctor can decide the patient's body state without Xray and CT data of large machines. In this paper, the patient's medical data is transmitted to the doctor and the real time decision algorithm is developed and so the doctor can decide the medical treatments. Using the mobile phone, the pulse data and bio data can be sent to the doctor and therefore the patients, who can't care in real time, can be treated in real time in the impossible medical treatment areas. Therefore in this paper, the oriental medical treatment system algorithm and artificial intelligence electrical needle simulation are processed for real time and checked and treated, so anyone can decide patient's state using mobile phone.

    Minimization of Treatment Time Using Partial-Arc Volumetric Modulated Arc Therapy with Bladder Filling Protocol for Prostate Cancer

    • Hojeong Lee;Dong Woon Kim;Ji Hyeon Joo;Yongkan Ki;Wontaek Kim;Dahl Park;Jiho Nam;Dong Hyeon Kim;Hosang Jeon
      • Progress in Medical Physics
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      • v.33 no.4
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      • pp.101-107
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      • 2022
    • Purpose: Radiotherapy after bladder filling protocol (BFP) is known to enhance treatment quality and reduce side effects in prostate cancer, a common male solid cancer globally. However, due to the need to hold back urine during treatment, patients frequently complain of discomfort, and treatment is frequently suspended when patients urinate during treatment and urine penetrates the treatment device, causing malfunction. Therefore, the effect of minimizing treatment time when partial-arc volumetric modulated arc therapy (VMAT) was used instead of full-arc was assessed in this study. Methods: A total of 70 plans were created in 10 patients using 7 different arc sizes, and the treatment time for each plan was calculated. Results: Reduced arc size by half resulted in a 54.4% decrease in mean treatment duration, with a proportional tendency observed. Furthermore, the effect of VMAT arc size reduction on target dose homogeneity was significantly limited, and the effect on surrounding organs at risk (OAR) was negligible. It should be noted, however, that when the arc size decreases by >40%, the dose increases in the area without OAR around the target. Conclusions: The results of this study demonstrated that partial-arc VMAT for enhancing treatment convenience and efficacy of prostate cancer patients undergoing BFP can achieve a considerable reduction in treatment time while preserving treatment quality, and it is expected to be useful for partial-arc VMAT plan design and implementation in practice.


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