• Title/Summary/Keyword: Treatment Efficacy

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Complications Related to Transarterial Treatment of Hepatocellular Carcinoma: A Comprehensive Review

  • Hyoung Nam Lee;Dongho Hyun
    • Korean Journal of Radiology
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    • v.24 no.3
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    • pp.204-223
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    • 2023
  • Currently, various types of transarterial treatments are performed for hepatocellular carcinoma from the early to advanced stages. Its indications and efficacy have been widely investigated. However, procedure-related complications have not been updated in the literature, although new types of transarterial treatments, such as drug-eluting bead transarterial chemoembolization and transarterial radioembolization, are common in daily practice. Herein, a comprehensive literature review was carried out, and complications were organized according to the organs affected and treatment modalities.

Mahaenggamsuktang for treating Mycoplasma pneumonia in Children: Systematic Review and Meta-analysis of Randomized Controlled Trials (RCTs) (마행감석탕의 소아 마이코플라즈마 폐렴 치료에 대한 체계적 문헌 고찰 및 메타분석)

  • Lee, Yoo Been;Jeong, Aram
    • The Journal of Pediatrics of Korean Medicine
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    • v.34 no.2
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    • pp.90-108
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    • 2020
  • Objectives The purpose of this study is to evaluate efficacy and safety of Mahaenggamsuktang for treating mycoplasma pneumonia in children based on the randomized controlled trials (RCTs). Methods Literatures were searched from OASIS, KISS, NDSL, CNKI, Cochrane, Embase and Pubmed, and the search was conducted on January 29, 2020. Only RCTs published since 2000 were included. Trials comparing Mahaenggamsuktang combined with antibiotics or antibiotics treatment alone for the treatment of mycoplasma pneumonia in children were included. Results 17 trials, including 2,241 participants with mycoplasma pneumonia were included in this review. As a result of the meta-analysis, total effective rate of combination of Mahaggamsuktang and antibiotics was 1.24 times higher than that of the antibiotics alone, which was statistically significant. Symptoms with fever, lung sounds, cough, chest X-ray lesion findings, wheezing were also significantly reduced in the treatment group with Mahaenggamseoktang and antibiotics. Also, Serum CRP level was significantly lower with combination treatment. The incidence of adverse reactions was lower in the treatment group with Mahaenggamseoktang and antibiotics, but it was not statistically significant. Conclusions As a result of meta-analysis, combination treatment of Mahaenggamseoktang and antibiotics seems significantly effective for the treatment of mycoplasma pneumonia in children. In order to have a higher level of evidence for efficacy and safety of Mahaenggamsuktang in treating mycoplasma pneumonia, additional RCTs with good qualities are required.

A prospective study to assess the efficacy and safety of oral propranolol as first-line treatment for infantile superficial hemangioma

  • Yun, Yeong Ju;Gyon, Yun Hee;Yang, Sohyoung;Lee, Youn Kyung;Park, Joohyun;Park, Meerim
    • Clinical and Experimental Pediatrics
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    • v.58 no.12
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    • pp.484-490
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    • 2015
  • Purpose: To determine the efficacy and safety of oral propranolol as a first-line treatment for superficially located infantile hemangioma (IH) and propose an assessment tool to measure treatment response. Methods: Patients with superficial IH under 1 year of age were prospectively recruited between May 2012 and December 2013 at the Department of Pediatrics of Chungbuk National University Hospital. Propranolol was administered to 12 infants (median age, 3.8 months) while monitoring cardiovascular and adverse metabolic effects. If a patient showed no adverse events, the dosage was gradually increased up to 3 mg/kg/day and maintained for 1 year. We used our own scoring system to assess treatment response using parameters like change in color, and longest diameter, and thickness of the IH. Results: Eleven out of 12 patients completed the protocol with consistent improvement of hemangiomas during therapy. Patients on propranolol showed a more than 50% involution in the first 3 months, with additional steady involution until 1 year. Patients with the highest scores at 1 month maintained their score and showed better responses until treatment termination. The patient with the lowest score at 1 month did not show any further regression and stopped propranolol treatment 4 months after initiation. In two children with recurrences after successful therapeutic regression, propranolol was effective after being reintroduced. Propranolol treatment was not interrupted in any patient due to adverse events. Conclusion: Oral propranolol at 3 mg/kg/day showed a consistent, rapid, and therapeutic effect on superficial IHs without significant adverse events.

Clinical Application of Transcatheter Arterial Chemoembolization Combined with Synchronous C-arm Cone-Beam CT Guided Radiofrequency Ablation in treatment of Large Hepatocellular Carcinoma

  • Wang, Zhi-Jun;Wang, Mao-Qiang;Duan, Feng;Song, Peng;Liu, Feng-Yong;Wang, Yan;Yan, Jie-Yu;Li, Kai;Yuan, Kai
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1649-1654
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    • 2013
  • Objective: This work aimed to evaluate the safety and clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with c-arm cone-beam CT guided synchronous radiofrequency ablation (RFA) in treatment of large hepatocellular carcinoma (HCC). Methods: 21 patients with large HCC were studied from January 2010 to March 2012. TACE combined with synchronous C-arm cone-beam CT guided RFA were performed on a total of 25 lesions. Conventional imaging examination (CEUS, enhanced CT or MRI) and AFP detection were regularly conducted to evaluate the technical success rate of combined treatment, complications, treatment response, time without disease recurrence and survival rate. Results: The technical success rate of combined treatment was 100%, without any significant complication. After 1 month, there were 19 cases with complete response and 2 cases with partial response, with an complete response rate of 90.4% (19/21) and a clinical effective rate of 100% (21/21). The complete response rates of single nodular lesions (100%, 17/17) was significantly higher than that of multiple nodular lesions (50%, 2/4) (P<0. 05). During 2 to 28 months of follow-up, in 19 cases with complete response, the average time without disease recurrence was $10.8{\pm}6$ months. The total survival rates of 6, 12 and 18 months in 21 patients were 100%, respectively. Conclusion: TACE combined with synchronous C-arm CT guided RFA is safe and effective for treatment of large HCC. The treatment efficacy for single nodular lesion is better than that for multiple nodular lesions.

Comparison on the Efficacy of Quetiapine Versus Haloperidol in the Treatment of Delirium : Prospective, Randomized Trial (섬망 환자에서 Quetiapine과 Haloperidol의 치료 효과 비교 : 전향적, 무작위 연구)

  • Lee, Yu-Jin;Jung, Han-Yong;Lee, Soyoung Irene;Kim, Shin Gyeom;Park, Joon Ho
    • Korean Journal of Biological Psychiatry
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    • v.16 no.1
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    • pp.15-24
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    • 2009
  • Objectives : The purpose of this study is to examine the efficacy and side effects of quetiapine and haloperidol for the treatment of symptoms of delirium. Methods : One hundred and seven patients with delirium were recruited and randomly assigned to receive a flexible-dose regimen of quetiapine or haloperidol over 7days and seventy-seven patients completed the study(quetiapine group N=40, haloperidol group N=37). The severity of delirium was assessed by using Memorial Delirium Assessment Scale(MDAS) scores, the psychiatric and behavioral symptoms were assessed by Neurobehavioral Rating Scale(NRS) scores, and the cognitive status was measured by Mini-mental state examination Korean version(MMSE-K) scores. The side effects were measured by Drug Induced Extrapyramidal Symptoms Scale(DIEPSS) scores. Results : MDAS scores significantly improved in both treatment groups. NRS scores also significantly improved in both treatment group, but the group-by-time effect approached significance, likely caused by the greater decrease in scores of the quetiapine group. MMSE-K scores significantly improved only in the quetiapine group. Side effects associated with treatment were not significant in either treatment groups. Conclusion : This study suggests that quetiapine is as efficacious as haloperidol in the treatment of delirium. In particular, quetiapine seems to improve psychiatric and behavioral problems of delirium and was more effective than haloperidol in cognitive improvement.

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Research Trends in Pharmacopuncture Treatment for Lateral Epicondylitis

  • Yoo, Jae Hee;Ko, Hong Je;Jeong, Sang Jun;Kim, Min Wook;Kim, Soo Hyun;Kim, Seon Woo;Jang, Seung Won;Shin, Jeong Cheol
    • Journal of Acupuncture Research
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    • v.37 no.1
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    • pp.35-41
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    • 2020
  • The aim of this study was to examine pharmacopuncture treatment for lateral epicondylitis, and to contribute to developing a standardized treatment regimen by reviewing trends in clinical trials. Five randomized controlled trials, 1 case-control study, and 8 cohort studies published after 1999, that involved pharmacopuncture for lateral epicondylitis, were selected from Korean and international online databases (n = 8). The type of pharmacopuncture, dose, frequency, efficacy, and adverse events were analyzed. Seven types of pharmacopuncture were used, namely Bee Venom, Illicium henryi Diels, Akebiae Caulis, Angelicae sinensis Diels, Ligusticum chuanxiong Hort, Hominis Placenta, and Salviae Miltiorrhizae Radix. Dose, treatment duration, and treatment frequency varied widely. One study assessed the treatment efficacy according to frequency. Nine studies lacked data on adverse events. The quality of 5 randomized controlled trials was low. Although pharmacopuncture treatment appeared to be effective for lateral epicondylitis, it was difficult to standardize the regimen for lateral epicondylitis.

Clinical and Microbiological Study about Efficacy of Air-polishing and Scaling and Root-planing

  • Yang, Keon-Il;Park, Do-Young;Kim, Byung-Ock;Yu, Sang-Joun
    • International Journal of Oral Biology
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    • v.40 no.2
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    • pp.93-101
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    • 2015
  • The efficacy of air-polishing on subgingival debridement, as compared to scaling and root planning (SRP), was evaluated clinically and microbiologically. Fifteen patients diagnosed as chronic periodontitis, and having single-root tooth over 5 mm of pocket depth symmetrically in the left and right quadrant, were investigated. Subgingival debridement was performed by SRP and air-polishing. The results were evaluated and compared clinically and microbiologically. Probing pocket depth (PPD), bleeding on probing (BOP), relative attachment level (RAL) and change of gingival crevicular fluid (GCF) were assessed before treatment, and at 14 and 60 days after treatment. Microbial analysis was done pre-treatment, post-treatment, and at 14 and 60 days after treatment. Results of air polishing showed that post treatment, the PPD and BOP decreased, and attachment gain was observed. There was no clinical difference when compared to SRP. The volume of GCF decreased at 14 days, and increased again at 60 days. Compared to SRP, there was a statistical significance of the volume of GCF at 60 days in air-polishing. In the microbial analysis, high-risk bacteria that cause periodontal disease were remarkably reduced. They decreased immediately after treatment, but increased again with the passage of time. Thus, our results show that subgingival debridement by air-polishing was effective for decrease of pocket depth, attachment gain, decrease of GCF and inhibition of pathogens. Further studies are required to compare air-polishing and SRP, considering factors such as degree of pocket depth and calculus existence.

Influence of Fatigability on the Timing of Reassessment in the Treatment of Posterior Canal Benign Paroxysmal Positional Vertigo (후반고리관 양성돌발두위현훈의 치료에서 재평가 시기에 대한 피로 현상의 영향)

  • Kim, Chang-Hee;Shin, Jung Eun;Shin, Yong Gook;Song, Mee Hyun;Shim, Dae Bo
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.12
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    • pp.658-662
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    • 2018
  • Background and Objectives The early assessment of treatment is not done for benign paroxysmal positional vertigo (BPPV) since the well-known phenomenon of fatigability after a repeated positional test can mimic successful treatment. The aim of this study is to evaluate the clinical implication of 'fatigability' after Epley maneuver and to identify the therapeutic efficacy of Epley maneuver in posterior canal BPPV (PC-BPPV). Subjects and Method This study was prospectively conducted by two dizziness clinics on 51 consecutive patients diagnosed with PC-BPPV. All patients included in the study received Epley maneuver treatment. The therapeutic results were reassessed immediately after a single trial of Epley maneuver. After 30 minutes, results were reassessed repeatedly to confirm the fatigability of diagnostic procedure immediately after treatment. If the treatment was not successful after 30 minutes, Epley maneuver was repeatedly performed until complete resolution. Results Immediately after the first maneuver, 45 of 51 (88.2%) patients had neither vertigo nor nystagmus during the positional test. All patients demonstrated complete resolution after receiving one to three Epley maneuvers on the day of diagnosis. 'Fatigability (false negative result)' was confirmed for only one case (1 of 6 patients, 16.7%), in which nystagmus was observed after 30 minutes but not identified immediately after the first Epley maneuver. Conclusion The therapeutic efficacy of Epley maneuver is very high in PC-BPPV. Considering the possibility of fatigability when reassessment is performed immediately after therapeutic maneuver, clinicians should avoid assessing the outcome immediately after treatment in patients with PC-BPPV.

Efficacy of Combination Treatment of Herbal Medicine and Western Medicine for the Treatment of Type 1 Diabetes in children : Systemic Review and Meta-analysis (소아 1형 당뇨의 한약과 양약 병용 치료에 대한 체계적 문헌 고찰 및 메타분석)

  • Kim, Mi Yeon;Kang, Jeong In;Jeong, Min Jeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.33 no.3
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    • pp.15-29
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    • 2019
  • Objectives The purpose of this study is to investigate the clinical studies on the effect of herbal medicine in type 1 diabetes in children and to seek better approach of herbal medicine to treat type 1 diabetes in children. Methods This study researched randomized controlled trials through various databases in the world about herbal medicine treatments in type 1 diabetes in children. Results 10 out of 337 studies were selected and analyzed. All studies were conducted in China. All studies were using herbal medicines, as an adjunctive treatment to the main regimen. As a result, the integrated Chinese medicine and western medicine lowered FPG by -1.56 mmol/L and 2hPG by -1.94 mmol/L on average, respectively. The HbA1c also decreased by -1.11% in the treatment group compared to the control group. Total efficacy of the treatment was 1.21 times more effective in the treatment group than in the control group. Conclusions Based on the results of the studies, it seems that the herbal medicine for the treatment of type 1 diabetes in children will be effective as a combination with conventional medicines. Further research is needed to prove the findings of this observatoional studies.