• Title/Summary/Keyword: Treatment Grade

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Efficacy of Lauromacrogol Injection for Ablation of Benign Predominantly Cystic Thyroid Nodules and Related Factors: A Prospective Study

  • Yi Jie Dong;Zhen Hua Liu;Jian Qiao Zhou;Wei Wei Zhan
    • Korean Journal of Radiology
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    • v.23 no.4
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    • pp.479-487
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    • 2022
  • Objective: To prospectively evaluate the efficacy of lauromacrogol injection for ablation (LIA) of benign predominantly cystic thyroid nodules and its related factors. Materials and Methods: A total of 142 benign predominantly cystic thyroid nodules (median volume, 12.5 mL; range, 0.4-156 mL) in 137 patients (male:female sex ratio, 36:101; mean age ± standard deviation [SD], 49 ± 13 years) were treated with LIA after being confirmed as benign via cytology. The volume reduction rate (VRR) of the nodules and cosmetic score were evaluated during follow-up at 1, 3, and 6 months after treatment and every 6 months thereafter. A VRR of ≥ 50% at the 12-month follow-up was considered to indicate effective treatment. The associations between the clinical factors and nodular ultrasound features, including the initial nodule volume, proportion of solid components, vascularity grade and ineffective treatment (VRR of < 50% at the 12-month follow-up), and regrowth were analyzed. Results: All patients completed follow-up for at least 12 months. The average ± SD follow-up period was 32 ± 11 months (range, 12-54 months). The effective treatment rate was 73.2% (104/142), while the regrowth rate was 12.0% (17/142) at the last follow-up. Grade 2-3 intranodular vascularity in the solid components of the nodules was the only independent factor associated with ineffective treatment, with an odds ratio (reference category, grade 0-1) of 3.054 (95% confidence interval, 1.148-8.127) (p = 0.025). Conclusion: LIA is an effective treatment for predominantly cystic thyroid nodules. Grade 2-3 intranodular vascularity in the solid components of nodules is the only independent risk factor for ineffective LIA.

Surgical Treatment of Pancreatic Trauma in Children (소아의 외상성 췌장 손상의 수술적 치료)

  • Cho, Jae-Hyung;Kim, Hyun-Young;Jung, Sung-Eun;Park, Kwi-Won
    • Advances in pediatric surgery
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    • v.19 no.2
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    • pp.98-107
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    • 2013
  • Debates exist about the appropriate treatment for pancreatic trauma in children. We intended to examine the safety of the operation of pancreatic trauma in children. This is a retrospective study of 13 patients, younger than 15, who underwent surgery for pancreatic trauma, between 1993 and 2011 in Seoul National University Children's Hospital. Medical records were reviewed for mechanism of trauma, clinical characteristics, radiological findings, operation and outcomes. Organ injury scaling from the AAST (American Association for Surgery of Trauma) was used. All injuries were caused by blunt trauma. Patients with grade III, IV, and those who were difficult to distinguish grade II from IV, underwent surgery due to severe peritonitis. Three patients with grade II were operated for reasons of mesenteric bleeding, tumor rupture of the pancreas, and progression of peritonitis. Distal pancreatectomy was performed in 10 patients and subtotal pancreatectomy and pylorus preserving pancreaticoduodenectomy in 1 patient each. The remaining one underwent surgical debridement because of severe adhesions. The location of injury, before and after operation, coincided in 83.3%. The degree of injury, before and after the operation, was identical in all the patients except for those who were difficult to tell apart grade II from grade IV, and those cannot be graded due to severe adhesion. Postoperative complications occurred in 23.1%, which improved with conservative treatment. Patients were discharged at mean postoperative 12(range 8~42) days. Even though patients with complications took longer in time from diagnosis to operation, time of trauma to operation and hospital stay, this difference was not significant. In conclusion, When pancreatic duct injury is present, or patient shows deterioration of clinical manifestation without evidence of definite duct injury, or trauma is accompanied by other organ injury or tumor rupture, operative management is advisable, and we believe it is a safe and feasible method of treatment.

Effect of Bloodletting Therapeutics Complex Therapy on Peripheral Facial Paralysis Patients with Back of the Affected Ear Pain (이후통(耳後痛)을 동반한 말초성 안면신경마비에 대한 자락요법(刺絡療法) 복합치료 효과)

  • Oh, Myung Jin;Song, Ho Sueb
    • Journal of Acupuncture Research
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    • v.30 no.2
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    • pp.1-8
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    • 2013
  • Objectives : This study was done for reporting the effect of bloodletting therapeutics on peripheral facial paralysis patients with back of the affected ear pain. Methods : We investigated 37 cases of peripheral facial paralysis patients with postauricular pain, and devided patients into two groups : We treated one group by complex oriental medical treatment with bloodletting therapeutics, and did the other group by complex oriental medical treatment without bloodletting therapeutics. Visual analogue scale(VAS) and gross grading system of House-Brackmann(H-B grade) and at baseline and final were used for evaluating the effect of the treatment. Results : 1. In bloodletting therapeutics group and non-bloodletting therapeutics group, compared with baseline, at final, VAS and H-B grade was significantly decreased. 2. At final, bloodletting therapeutics group showed significant decrease on VAS and H-B grade compared with non-bloodletting therapeutics group. Conclusions : Bloodletting therapeutics showed significant improvement in peripheral facial palsy with postauricular pain.

Thalidomide Combined with Chemotherapy in Treating Patients with Advanced lung Cancer

  • Li, Li;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2583-2585
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    • 2016
  • Objectives: To evaluate efficacy and toxicity in patients with advanced lung cancer, including non-small cell and small cell variants (NSCLC and SCLC), treated with thalidomide plus chemotherapy. Methods: Fourteen patients with advanced lung cancer were scheduled to receive chemotherapy combined with thalidomide. All patients in this study received thalidomide (100 mg orally per night before sleeping, produced by Changzhou Pharmaceutical Factory Co.Ltd) after the start of chemotherapy for at least 14 days. Chemotherapy was administered according to the condition of patients. After at least 14 days of treatment, efficacy and toxicity were evaluated. Results: There were 6 female and 8 male patients with advanced lung cancer recruited into this study, including 2 with SCLC and 12 with NSCLC. The median age was 56.7 (44-65) years. Progressive disease was observed in 12 patients (12/14), and stable disease in 2 (2/14). Grade 1 to 2 myelosuppression was observed in 4/14 patients, and Grade 1 to 2 elevation of hepatic enzymes was recorded in 5/14 patients. Adverse effects on the gastrointestinal tract were documented in 2/14 patients, all beingGrade 1. No Grade 3-4 toxicity was recorded. No treatment related deaths occurred. Conclusions: Our results demonstrate that thalidomide combined with chemotherapy is mildly effective and safe for treating patients with advanced lung cancer. However, further evaluation of this combination is warranted.

The clinical study on 44 cases of patient with Thoracolumbar Compression Fracture (흉(胸)·요추(腰椎) 압박골절(壓迫骨折) 환자(患者)에 대한 임상적(臨床的) 고찰(考察))

  • Lim, Jeoung-Eun;Kim, Kee-Hyun;Hwang, Hyeon-Seo
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.41-51
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    • 2000
  • Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

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Treatment Interruption During Concurrent Chemoradiotherapy of Uterine Cervical Cancer; Analysis of Factors and Outcomes

  • Krusun, Srichai;Pesee, Montien;Supakalin, Narudom;Thamronganantasakul, Komsan;Supaadirek, Chunsri;Padoongcharoen, Prawat
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5653-5657
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    • 2014
  • Background: To evaluate factors which effect treatment interruption during concurrent chemoradiotherapy (CCRT) and overall survival in patients with uterine cervical cancer stage IB2-IVA in Srinagarind Hospital. Materials and Methods: Between January 2006 and December 2007, 107 patients with stage IB2-IVA as FIGO staging, 2000, were treated with CCRT in Srinagarind Hospital. Factors which caused treatment interruptions and impacted on overall survival were reviewed and analyzed. Results: Twenty of 107 patients had treatment interruption during CCRT in patients with uterine cervical cancer stage IB2-IVA in Srinagarind Hospital. The causes of treatment interruption were as follows: hematologic toxicity was found in 16 of 20 cases, 12 cases with grade 2 and 4 cases with grade 3; three of 20 cases had gastrointestinal toxicities, 1 case with grade 2 and 2 cases with grade 3; one case had grade 3 skin toxicity. The mean total treatment time of the uninterrupted and interrupted groups were significantly different (78.98 days vs 161.80 days, p <0.001). The patients who could tolerate ${\geq}5$ cycles of cisplatin administration had significantly higher mean white blood counts (WBC) ($9,769cells/mm^3$ vs $7,141cells/mm^3$, p=0.02). The mean initial hemoglobin (Hb) in the uninterrupted group was significantly higher than the interrupted group (11.5 mg% vs 10.3 mg%, p=0.03). Other factors including age, KPS, initial platelets, initial serum creatinine levels showed no statistical significance. The 3-year overall survival of the uninterrupted group was better than in the interrupted group (78.6% vs 55.0%, p=0.03). Conclusions: The initial Hb and WBC levels were significantly correlated with treatment interruption during CCRT in patients with uterine cervical cancer. The 3-year overall survival of the uninterrupted group was significantly better than interrupted group. These factors may then be used indirectly to predict the outcomes of treatment.

The Diagnostic Accuracy of Endoscopic Biopsy for Gastric Dysplasia

  • Lee, Sung-Bae;Kang, Hye-Yun;Kim, Kwang-Il;Ahn, Dae-Ho
    • Journal of Gastric Cancer
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    • v.10 no.4
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    • pp.175-181
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    • 2010
  • Purpose: There is controversy over the treatment for low grade dysplasia, while resection is recommended for high grade dysplasia. But the concordance of the grade of dysplasia between pre- and post-resection is low because of sampling errors with endoscopic biopsy. We attempted to establish a clearer direction for the treatment of dysplasia by clarifying the discrepancy between the pre- and postresection diagnoses. Materials and Methods: We performed a retrospective review of 126 patients who had undergone resection with the diagnosis of dysplasia on biopsy at Bundang CHA Hospital from 1999 to 2009. Results: Seventy patients were diagnosed with low grade dysplasia and 56 patients were diagnosed with high grade dysplasia. Among the 33 patients who received gastrectomy with lymph node dissec-tion, 30 patients were revealed to have invasive cancers and 4 patients showed lymph node metastasis. Discordance between the diagnoses from biopsy and resection occurred in 55 patients (44%). There was no correlation on the comparative analysis between the size, location or gross type of lesion and the grade of dysplasia. Conclusions: The rate of discordance between the diagnoses of endoscopic biopsy and the post resection pathologic report was as high as 44%. Endoscopic mucosal resection was not sufficient for some patients who were diagnosed with dysplasia on biopsy due to the presence of lymph node metastasis. It is necessary to be prudent when determining the follow-up and treatment based solely on the result of the biopsy.

EFFECT OF DENTAL EXPERIENCE ON ATTITUDE OF CHILDREN TOWARD THE DENTIST AND DENTAL TREATMENT (치과 치료 경험이 아동의 치과의사와 치과 치료에 대한 태도에 끼치는 영향에 관한 조사 연구)

  • Moon, Pill-Sung;Hur, Yong-Wook;Kim, Dae-Eop;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.2
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    • pp.461-476
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    • 1996
  • The purpose of this study was to investigate the effect of dental experience on the attitude of children toward the dentist and the dental treatment. The subjects of the study were 1,090 children from second grade to forth grade of three elementary schools of the Iksan city. The children were investigated by the questionnaire which consisted of seven items about the attitude toward the dentist, the attitude toward the dental treatment, the dental reatment experience, the number of times of dental treatment, the last time of the dental visit, pain of dental treatment, and fear of dental treatment. There were significant differences among the grades in the attitude toward the dental treatment and in the attitude toward the dentist (P<0.01). Second grade children had the most negative attitudes. But, there were no differences between boys and girls. Girls felt more pain and fear than boys (P<0.01). There were significant relationships between the pain and the attitude toward the dentist, between the pain and the attitude toward the dental treatment, between the fear and the attitude toward the dentist, and between the fear and the attitude toward the dental treatment (P<0.01, all). The number of dental visit had significant relationship with the attitude toward the dental treatment (P<0.05). There were significant relationships between the pain and the fear and between the attitude toward the dentist and the attitude toward the dental treatment.

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Effects of Dietary Addition of Pegmatite on Body Weight Gain, Blood Characteristics, and Immunity and Carcass Grade for Fattening Hanwoo (거정석 첨가 급여가 비육한우의 체중 증가량, 혈액 성상, 면역성 및 도체등급에 미치는 영향)

  • Kim, Byung Ki;Ha, Jae Jung;YI, Jun Koo;Oh, Don Yep;Jung, Dae Jin;Hwang, Eun Gyeong;Choi, Seong Bok
    • The Korean Journal of Food And Nutrition
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    • v.30 no.4
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    • pp.703-709
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    • 2017
  • This study analyzed the effect on weight and average daily gain, carcass grade, and blood characteristics and immunity in case of dietary addition of pegmatite to Hanwoo steers. Relative to Hanwoo steers, initial body weight was $257.3{\pm}11.74kg$ (8-months old after birth). Forty-eight Hanwoo steers were fed for 24 months using random arrangement (4 treatment plots${\times}$4 heads${\times}$3 repeat). The treatment plot (498.75~500.82 kg) had higher weight during the early fattening stage compared with that of the control plot (474.37 kg) (p<0.05). Regarding total cholesterol of the blood, the value was similar to one during initiation of testing, but the value increased gradually based on the progress of fattening. In addition, the triglyceride was considerably low in T2~T3 plots with high addition of pegmatite during the late fattening stage compared with other treatment plots (p<0.05). This study revealed a tendency in the IgG content that represented immunity as the addition of pegmatite became higher (p>0.05). This study found that the treatment plot (441.55~452.10 kg) had higher carcass weight compared with the control plot (436.30 kg). However, this study revealed that the treatment plot (2.30~2.55 points) had higher carcass quantity grade compared with the control plot (2.11 points). This study found that the control plot (3.55 points) had higher carcass quality grade compared with the treatment plot (2.67~3.09 points) (p>0.05). With studies combined, it was determined that dietary addition of pegmatite to the feed as clay minerals in fattening Hanwoo steers would improve feed intake, body weight gain and carcass quantity grade.

Korean Medical Treatment for Improving Symptoms of Four Patients Diagnosed with Grade II Lumbar Spondylolisthesis

  • Park, Han Sol;Kim, Min Chul;Kim, Seh Young;Seo, Young Woo;Seo, Young Hoon;Lee, Sang Min;Lee, Seung Won;Kim, Ki Ok;Kim, Tae Hun
    • Journal of Acupuncture Research
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    • v.31 no.2
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    • pp.153-163
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    • 2014
  • Objectives : To investigate the clinical results of patients who were diagnosed with grade II spondylolithesis treated with Korean medicine of relaxative Chuna and Gangchuk herbal medicine. Methods : We reviewed medical records of four patients diagnosed with grade II spondylolisthesis. Each patient has taken intensive Korean medical admission treatment at Mokhuri Hospital. All patients received treatments of Gangchuk herbal medicine, relaxative Chuna and acupuncture during admission period. Before treatment and every after 7-day treatment the patient's pain and walking distance without pain were assessed. The zero minimum to ten maximum pain numeric rating scale(NRS) was used to determine the degree of pain. Results : Average admission duration was 23 days. All the patients' NRS decreased from median figure of 7.5[the minimum 7 to the highest 8] to median figure of 1[the minimum 0 to the highest 2]. Walking distance without pain increased from a median of 55 m[the minimum 20 m to the highest 100 m] to median of 165 m[the minimum 100 m to the highest 250 m]. Conclusions : Intensive conservative korean medical treatment was effective in reducing pain and functional improvement for grade II lumbar spondylosisthesis patients.