• Title/Summary/Keyword: Treatment Outcomes

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A systematic review of the survival rate on short implants (짧은 임플란트의 생존율에 관한 고찰)

  • Lee, Eun-Jeong;Kim, Won;Choi, Ji-Young;Kim, Seong-Mi;Oh, Nam-Sik
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.4
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    • pp.457-462
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    • 2009
  • Purpose: The objective of this systematic review was to obtain the comprehensive survival rates of short implants. Then it was examined that whether treatment using short implants has favorable results. Methods: A MEDLINE search was performed, the data obtained from many articles about length, diameter, site of placement, surface treatment and prosthetic design were analyzed. Results and discussion: The data obtained from many articles were analyzed, and it was found that the survival rate of short implants was 95.87%, short implants has similar outcomes to those reported for standard implants. On the other hand, in the comparison the survival rate of 3 groups divided by the diameter of implants under 4 mm, 4-5 mm, and above 5 mm, a statistically significant difference was detected in under 4mm group. In implant group with 6-7 mm length, a group with 5-6 mm diameter has survival rate of 97.01%, groups with 3.1-4.8 mm diameter has survival rate of 92.96%, which was statistically significantly different. In the result of surface feature, the roughed surface groups of short implant showed a higher survival rate by approximately 6.3% than machined surface group. In the result of prosthetic design, survival rate of short implant was considerably lower for the single implant crown group (94.3%) than splinting group (99.4%).

Evaluation of Therapeutic Differences of Angiotensin II Receptor Blockers and Calcium Channel Blockers Among Hypertensive Patients Classified by Oriental Traditional Way (한국적 의학 기준에 근거한 고혈압환자의 Angiotensin II Receptor Blockers와 Calcium Channel Blockers의 약물 평가)

  • Lee, Ok Sang;Cheon, Young Ju;Ye, Kyong Nam;Yoon, Hee Young;Kim, Jung Tae;Lee, Yun Jeong;Lim, Sung Cil
    • YAKHAK HOEJI
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    • v.58 no.2
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    • pp.141-149
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    • 2014
  • Background: Oriental lifestyle for treating diseases has been developed and well-accepted for a long time among Koreans. Sasang Constitution theory, originated from Korean traditional medicine, suggests that medication treatment should be differentiated by each patient's body classification (So-yang [SY], So-eum [SE], Tae-yang [TY], and Tae-eum [TE]), in contrary to western medicine's theory that medication should be applied equally by disease indication without such classification. However, the pharmacotherapeutic outcomes of these theories have not been compared to date. In this study, we aimed to compare the two theories by evaluating blood pressure (BP), which is lowered as a therapeutic outcome, among hypertensive patients taking angiotensin II receptor blockers (ARBs) or calcium channel blockers (CCBs), two most commonly used antihypertensive classes in Korea. Methods: From April 2006 to June 2012, we retrospectively collected data on hypertensive patients with Sasang Constitution classification at Kyunghee University Hospital at Gangdong, one of the East-West collaborative medical centers in Korea. We collected information on age, gender, underlying diseases, antihypertensive drugs (ARB, CCB, ARB+CCB), and BP by reviewing the electronic medical records. We excluded patients with missing blood pressure at baseline or follow-up, or those who had a change in their antihypertensive drug class during follow-up. Results: We selected a total of 573 patients (SY: 165, SE: 158, TY: 0, TE: 250). Baseline BPs were on average 139.0/82.0 mmHg for SY, 137.8/78.5 mmHg for SE, and 138.7/79.2 mmHg for TE. In all three groups, CCBs were the most prescribed, followed by combination therapy with ARB+CCB, then ARBs. BP reduction after 1 month of initial medication was significantly different among the drug classes, but not in Sasang constitutional classification (ARB [SY: -12.4/-4.7, SE: -12.3/-2.5, TE: -8.6/-1.8], CCB [SY: -12.3/-5.4, SE: -13.0/-2.3, TE: -10.8/-6.0], ARB+CCB [SY: -15.6/-6.7, SE: -18.4/-8.1, TE: -20.2/-6.7], drug [$P{\leq}0.05$/P>0.05], constitutional type [P>0.05/P>0.05]). Conclusion: We observed significant differences in reduction of blood pressure by classes of drugs (ARB+CCB>CCB>ARB) but not by Sasang constitutional classification. Therefore, current approach of antihypertensive pharmacotherapy assisted by Western medicine is appropriate for treatment of hypertension. However, further larger scale or prospective studies are required in order to confirm these results.

An Open-Label Study of the Improvements in Clinical Symptoms and Neurocognitive Functions in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder after Treatment with Metadate CD (국내 주의력결핍 과잉행동장애 아동 및 청소년에서 메타데이트CD의 임상증상 및 신경인지기능 개선 효과에 대한 개방 연구)

  • Yoo, Han-Ik K.;Kim, Bong-Seog;Joung, Yoo-Sook;Bahn, Geon-Ho;Song, Dong-Ho;Ahn, Dong-Hyun;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.4
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    • pp.253-261
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    • 2011
  • Objectives : This study aimed to investigate the efficacy and safety of Metadate CD (MCD) when given to Korean children and adolescents with attention-deficit hyperactivity disorder (ADHD). We also explored the effects of the drug on diverse neuro-cognitive functions. Methods : Ninety-one subjects with ADHD (mean age 8.6${\pm}$2.2 years) were recruited at 6 outpatient clinics in Seoul, Korea. We used the ADHD Rating Scale (ARS), Clinical Global Impression (CGI), and comprehensive attention test (CAT) to measure the drug's effects. Results : After 0.92${\pm}$0.32mg/kg/day of MCD were administered for 57.4${\pm}$7.6 days, there was a 48.5% reduction in the mean total ARS scores (p<.001). Fifty-seven subjects (64.8%) showed either much improved or very much improved outcomes on the CGI-Improvement scale. The CGI-Severity scale also decreased from an average of 4.7 to an average of 2.9 (p<.001). Errors and response time standard deviations of the CAT, sustained attention test-to-response tasks, the flanker test, and divided attention test scores decreased after treatment (p<.05). The forward memory span of the spatial working memory test scores increased (p<.05). Thirty-five patients (39.8%) experienced side effects, of which the most common were headache (14.8%), nausea (12.5%), and anorexia (9.1%). Conclusion : This open-label study suggests that MCD is effective and safe in improving the symptoms and neurocognitive functions of Korean children and adolescents with ADHD.

Comparative Study of Pneumonia Caused by Streptococcus pneumonia and Legionella pneumophila (레지오넬라 폐렴과 폐렴구균 폐렴 환자의 임상 양상에 대한 비교)

  • Lyu, Ji-Won;Song, Jin-Woo;Choi, Chang-Min;Oh, Yeon-Mok;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Mi-Na;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.2
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    • pp.74-79
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    • 2010
  • Background: Legionella pneumophila has been recognized as an important cause of pneumonia. However, limited data are available in the literature regarding legionella pneumonia in Korea. The objective of this study was to compare epidemiological data and clinical presentation of legionella pneumonia and pneumococcal pneumonia. Methods: We retrospectively compared clinical, radiological, and laboratory data, antimicrobial treatment, and treatment outcomes between 28 cases of legionella pneumonia and 56 cases of pneumococcal pneumonia. Diagnoses of both legionella and pneumococcal pneumonia were based on commercial urinary antigen tests. Results: Legionella pneumonia patients included 23 men and 5 women, with a mean age of 61.6 years (range 36~88). Fifteen were smokers and 26 had some underlying diseases. Legionella pneumonia occurred more frequently in healthcare-associated settings than pneumococcal pneumonia (42.9% vs 21.4%, respectively, p=0.040). There were no significant differences in clinical signs and symptoms. Compared to patients with pneumococcal pneumonia, patients with legionella pneumonia presented more frequently with anemia (39.3% vs 8.9%, p=0.001), increased C-reactive protein (57.1% vs 30.4%, p=0.018) and increased alkaline phosphatase (46.4% vs 16.1%, p=0.003). Also, legionella pneumonia patients more often showed pleural effusion on simple chest X-rays (50.0% vs 12.5%, p<0.001). Conclusion: Legionella pneumonia and pneumococcal pneumonia can not be distinguished by clinical manifestations alone. However, legionella pneumonia occurred as a healthcare-associated pneumonia more frequently and was more often associated with anemia and increased CRP and alkaline phosphatase levels.

Pyloric Obstruction with Advanced Gastric Cancer: Stent vs. Bypass (악성 위출구 폐쇄 치료의 선택: 스텐트 삽입술 혹은 수술적 우회술?)

  • Lee, Beom-Jae;Park, Jong-Jae
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.1-5
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    • 2009
  • In the past, conservative bypass surgery was usually performed for palliation of malignant obstruction of the gastrointestinal tract. However, endoscopic stenting was developed recently, and technical advances and clinical experience have made it possible to establish stent implantation as one of the main treatment options. There are several advantages in stent implantation over bypass surgery, such as high feasibility and technical success rate, non-invasiveness, rapid symptomatic response, short hospitalization, and cost-effect benefits. Complications, such as stent ingrowth, stent injury by bile or acid, and migration, may occur and early re-insertion is frequently needed. Recently, diverse novel stents which are powered to predict stent migration or ingrowth have been developed and are being used in the clinical setting. In general, stent implantation is known to be beneficial in patients who are expected to survive <6 months, and surgical bypass may be more effective in patients who can survive >6 months. In this review, we have compared the technical feasibility, clinical outcomes, complications, and cost-benefit between stent implantation and bypass surgery, and determined the optimal treatment strategy in malignant upper gastrointestinal obstruction.

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Short-term Nutrient Enrichment Bioassays (NEBs) by Manipulation of TN:TP Ratios and the Response of Primary Productivity (as Chlorophyll-a) (N:P Ratio 조절에 의한 단기 영양염 첨가 바이오에세이(NEBs) 및 1차 생산력(엽록소-a)의 반응성 테스트)

  • Jeong, Da-Bin;An, Kwang-Guk
    • Korean Journal of Environmental Biology
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    • v.31 no.4
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    • pp.383-392
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    • 2013
  • The objective of this study was to determine the effects of N:P ratio on primary productivity measured as chlorophyll-a (CHL) using the approach of In Situ Nutrient Enrichment Bioassays (NEBs) in Daechung Reservoir. The effects of NEBs on the N:P mass ratios were compared with the field data obtained from monthly-chemical monitoring during 2009~2012. The short-term NEBs showed that the response of primary productivity in the phosphorus spiked treatments (5, 15, 20 and 30 N:P ratios) were greater than the responses in the control (C) and nitrogen spiked treatment (N:P ratio=150, $T_{VI}$). The response in the nitrogen treatment (N:P ratio=150, $T_{VI}$) was less compared to control and all five treatments ($T_I{\sim}T_{VI}$). The outcomes of the NEBs suggest that phosphorus limited the phytoplankton growth and nitrogen addition inhibited the algal growth. In the analysis of nutrients and CHL from the ambient epilimnetic water in Daechung Reservoir, minimum N:P ratios resulted in maximum concentrations of CHL. Overall, our results suggest that the N:P ratio was the key factor in regulating the phytoplankton growth in NEB experiments.

Clinical Result of Surgical Treatment for Atherosclerosis Obliterans of Lower Extremity (하지의 폐쇄성 동맥경화증에 대한 외과적 치료의 성적)

  • Park Jeong-Ok;Seo Pil-Won;Ryu Jae-Wook
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.298-303
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    • 2006
  • Background: This study was performed to investigate the outcomes of vascular operations that were done in patients with atheroscerosis obliterans (ASO) of lower limb. Material and Method: Forty patients underwent vascular operations from December 1996 to June 2004. The patient's records were analyzed retrospectively. Mean age was $66{\pm}8$ years (range, $47{\sim}81$ years). Gender ratio was 37:3 (male:female). Result: The operations were done on 50 lower limbs of 40 patients. The names of operations were femoropopliteal bypass in 12 patients (30%), femorofemoral bypass in 12 (30%), femorofemoral bypass and femoropopliteal bypass in five (12.5%), aorta-lower limb artery bypass in five (12.5%), axillofemoral bypass in two (5%), iliopopliteal bypass in two (5%), and endarterectomy in two (5%). All bypass surgeries were done with prosthetic conduits. Mean follow up period was $33.2{\pm}23.2$ months (range, $3.8{\sim}90.2$ months). The cumulative patency rates of 1 and 5 years were 75.5 and 58.7% respectively. In six patients, amputation of the lower limb was done. In eight patients, 12 complications occurred. After the first operation, 10 patients underwent reoperations. Conclusion: Our lower limb arterial bypass surgery revealed acceptable patency rate, but not a few patients required reoperations. An epochal treatment modality that can inhibit the progress of ASO and improve long term patency should be established.

Use of radiotherapy in patients with palliative double bypass for locally advanced pancreatic adenocarcinoma

  • Glinka, Juan;Diaz, Federico;Alva, Augusto;Mazza, Oscar;Claria, Rodrigo Sanchez;Ardiles, Victoria;Santibanes, Eduardo de;Pekolj, Juan;Santibanes, Martin de
    • Radiation Oncology Journal
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    • v.36 no.3
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    • pp.210-217
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    • 2018
  • Purpose: Pancreatic cancer (PC) has not changed overall survival in recent years despite therapeutic efforts. Surgery with curative intent has shown the best long-term oncological results. However, 80%-85% of patients with these tumors are unresectable at the time of diagnosis. In those patients, first therapeutic attempts are minimally invasive or surgical procedures to alleviate symptoms. The addition of radiotherapy (RT) to standard chemotherapy, ergo chemoradiation, in patients with locally advanced pancreatic cancer (LAPC) is still controversial. The study aims to compare outcomes in patients with a double bypass surgery due to LAPC treated or not with RT. Materials and Methods: A retrospective cohort study of patients with double bypass for LAPC were registered and divided into two groups: treated or not with postoperative RT. Baseline characteristics, postoperative complications, those related to RT and their relation to the main event (mortality) were compared. Results: Seventy-four patients were included. Surgical complications between the groups did not offer significant differences. Complications related to RT were mostly mild, and 86% of patients completed the treatment. Overall survival at 1 and 2 years for patients in the exposed group was 64% and 35% vs. 50% and 28% in the non-exposed group, respectively (p = 0.11; power 72%; hazard ratio = 0.53; 95% confidence interval, 0.24-1.18). Conclusion: We observed a tendency for survival improvement in patients with postoperative RT. However, we've not had enough power to demonstrate this difference, possibly due to the small sample size. It is indispensable to develop randomized and prospective trials to guide more specific treatment lines in this patients.

A Convergence Study of Insole Inserted Indoor Sandal Effectiveness in School Aged Flexible Flat-foot Patients (학령기 유연성 편평족 환아에서 치료용 깔창이 삽입된 실내화의 효과에 관한 융합 연구)

  • Lee, Jun Young;Moon, Jeong Eun;Cho, Yong Jin
    • Journal of the Korea Convergence Society
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    • v.10 no.11
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    • pp.199-207
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    • 2019
  • This study was a convergence study of pre- and post-treatment clinical outcomes and radiologic results of school aged flexible flat foot using insole inserted indoor sandal. Thirty five subjects were asked to wear insole inserted indoor sandals at least five times a week and at least four hours a day. Before and after the $4^{th}$ and $8^{th}$ week of the treatment, foot radiography and FAOS questionnaire were performed. Statistical analysis was performed using repeated measure ANOVA. The clinical results showed statistically significant improvement in FAOS symptom and pain category. Radiological results showed a tendency of improvement in the Anterioposterior Talo-$1^{st}$ Metatarsal angle, the Lateral Talo-$1^{st}$ Metatarsal angle, and the Talo-Horizontal angle, but no statistical significance was found. In this study, the use of insole inserted indoor sandal during the majority of the indoor life in school aged flexible flat foot patients is effective in alleviating symptoms and pain relief in the short term.

Efficacy of ketamine in the treatment of migraines and other unspecified primary headache disorders compared to placebo and other interventions: a systematic review

  • Chah, Neysan;Jones, Mike;Milord, Steve;Al-Eryani, Kamal;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.5
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    • pp.413-429
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    • 2021
  • Background: Migraine headaches are the second leading cause of disability worldwide and are responsible for significant morbidity, reduction in the quality of life, and loss of productivity on a global scale. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of ketamine on migraines and other primary headache disorders compared to placebo and other active interventions, such as midazolam, metoclopramide/diphenhydramine, and prochlorperazine/diphenhydramine. Methods: An electronic search of databases published up to February 2021, including Medline via PubMed, EMBASE, Web of Science, and Cochrane Library, a hand search of the bibliographies of the included studies, as well as literature and systematic reviews found through the search was conducted to identify randomized controlled trials (RCTs) investigating ketamine in the treatment of migraine/headache disorders compared to the placebo. The authors assessed the risk of bias according to the Cochrane Handbook guidelines. Results: The initial search strategy yielded 398 unduplicated references, which were independently assessed by three review authors. After evaluation, this number was reduced to five RCTs (two unclear risk of bias and three high risk of bias). The total number of patients in all the studies was 193. Due to the high risk of bias, small sample size, heterogeneity of the outcomes reported, and heterogeneity of the comparison groups, the quality of the evidence was very low. One RCT reported that intranasal ketamine was superior to intranasal midazolam in improving the aura attack severity, but not duration, while another reported that intranasal ketamine was not superior to metoclopramide and diphenhydramine in reducing the headache severity. In one trial, subcutaneous ketamine was superior to saline in migraine severity reduction; however, intravenous (I.V.) ketamine was inferior to I.V. prochlorperazine and diphenhydramine in another study. Conclusion: Further double-blind controlled studies are needed to assess the efficacy of ketamine in treating acute and chronic refractory migraines and other primary headaches using intranasal and subcutaneous routes. These studies should include a long-term follow-up and different ketamine dosages in diagnosed patients following international standards for diagnosing headache/migraine.