• Title/Summary/Keyword: Treatment Outcomes

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Predictors of favorable soft tissue profile outcomes following Class II Twin-block treatment

  • Kim, Ji-Eun;Mah, Su-Jung;Kim, Tae-Woo;Kim, Su-Jung;Park, Ki-Ho;Kang, Yoon-Goo
    • The korean journal of orthodontics
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    • v.48 no.1
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    • pp.11-22
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    • 2018
  • Objective: The aim of this study was to determine cephalometric factors that help predict favorable soft-tissue profile outcomes following treatment with the Class II Twin-block appliance. Methods: Pre- and post-treatment lateral cephalograms of 45 patients treated with the Class II Twin-block appliance were retrospectively analyzed. Profile silhouettes were drawn from the cephalograms and evaluated by three orthodontists in order to determine the extent of improvement. Samples were divided into a favorable group (upper 30% of visual analogue scale [VAS] scores, n = 14) and an unfavorable group (lower 30% of VAS scores, n = 14). Skeletal and soft-tissue measurements were performed on the cephalograms and an intergroup comparison was conducted. Results: An independent t-test revealed that the following pre-treatment values were lower in the favorable group compared to the unfavorable group: lower incisor to mandibular plane angle, lower incisor to pogonion distance, point A-nasion-point B angle, sella-nasion line (SN) to maxillary plane angle, SN to mandibular plane angle, gonial angle, and symphysis inclination. The favorable group had a larger incisor inclination to occlusal plane. Moreover, the favorable group showed larger post-treatment changes in gonial angle, B point projection, and pogonion projection than did the unfavorable group. Conclusions: Class II malocclusion patients with a low divergent skeletal pattern and reduced lower incisor protrusions are likely to show more improvement in soft-tissue profile outcomes following Class II Twin-block treatment.

Elective neck treatment in clinically node-negative paranasal sinus carcinomas: impact on treatment outcome

  • Lee, Won Hee;Choi, Seo Hee;Kim, Se-Heon;Choi, Eun Chang;Lee, Chang Geol;Keum, Ki Chang
    • Radiation Oncology Journal
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    • v.36 no.4
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    • pp.304-316
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    • 2018
  • Purpose: The indication of elective neck treatment (ENT) for clinically N0 (cN0) paranasal sinus (PNS) carcinoma remains unclear. We aimed to investigate different treatment outcomes regarding ENT and propose optimal recommendations for ENT. Materials and Methods: We identified patients with cN0 PNS carcinoma who underwent curative-intent treatment between 1992 and 2015. Survival outcomes and pattern of failure were compared between patients who received ENT and those who did not. We sought to identify significant patient or pathologic factors regarding treatment outcomes. Results: Among 124 patients meeting the inclusion criteria, 40 (32%) received ENT ('ENT (+) group') and 84 (68%) did not ('ENT (-) group'). With a median follow-up of 54 months, the 5-year overall survival (OS) was 67%, and the 5-year progression-free survival (PFS) was 45%. There was no significant difference between the ENT (+) and ENT (-) groups regarding OS (p = 0.67) and PFS (p = 0.50). Neither group showed a significantly different pattern of failure, including regional failure (p = 0.91). There was no specific benefit, even in the subgroups analysis by tumor site, histologic type, and T stage. Nevertheless, patients who ever had regional and/or distant failure showed significantly worse prognosis. Conclusion: ENT did not significantly affect the survival outcome or pattern of failure in patients with cN0 PNS carcinomas, showing that ENT should not be generalized in this group. However, further discussion on the optimal strategy for ENT should continue because of the non-negligible regional failure rates and significantly worse prognosis after regional failure events.

Efficacy and Safety of Endovascular Treatment in Patients with Internal Carotid Artery Occlusion and Collateral Middle Cerebral Artery Flow

  • Kim, Yong-Won;Kang, Dong-Hun;Kim, Yong-Sun;Hwang, Yang-Ha
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.201-208
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    • 2019
  • Objective : In patients with internal carotid artery (ICA) occlusion, collateral middle cerebral artery (MCA) flow has a protective role against ischemia. However, some of these patients may experience initial major neurological deficits and major worsening on following days. Thus, we investigated the safety and efficacy of endovascular treatment (EVT) for ICA occlusion with collateral MCA flow by comparing clinical outcomes of medical treatment versus EVT. Methods : The inclusion criteria were as follows : 1) acute ischemic stroke with ICA occlusion and presence of collateral MCA flow on transfemoral cerebral angiography (TFCA) and 2) hospital arrival within 12 hours from symptom onset. The treatment strategy was made by the attending physician based on the patient's clinical status and results of TFCA. Results : Eighty-one patients were included (30 medical treatment, 51 EVT). The EVT group revealed a high incidence of intracranial ICA occlusion, longer ipsilesional MCA contrast filling time, and a similar rate of favorable clinical outcome despite a higher mean baseline the National Institutes of Health Stroke Scale (NIHSS) score. By binary logistic regression analysis, intravenous recombinant tissue plasminogen activator and EVT were independent predictors of favorable clinical outcome. In subgroup analysis based on stroke etiology, the non-atherosclerotic group showed a higher baseline NIHSS score, higher incidence of EVT, and a higher rate of distal embolization during EVT in comparison with the atherosclerotic group. Conclusion : In patients with ICA occlusion and collateral MCA flow, decisions regarding treatment strategy based on TFCA can help achieve favorable clinical outcomes. EVT strategy with respect to etiology of ICA occlusion might help achieve better angiographic outcomes.

Clinical presentation and treatment outcomes of primary ocular adnexal MALT lymphoma in Thailand

  • Seresirikachorn, Kasem;Norasetthada, Lalita;Ausayakhun, Sakarin;Apivatthakakul, Atitaya;Tangchittam, Sirima;Pruksakorn, Vannakorn;Wudhikarn, Kitsada;Wiwatwongwana, Damrong
    • BLOOD RESEARCH
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    • v.53 no.4
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    • pp.307-313
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    • 2018
  • Background Primary ocular adnexal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (POML) is the most common subtype of lymphoma involving the eyes in Thailand. We sought to assess the characteristics and treatment outcomes of patients with POML in Thailand. Methods We retrospectively reviewed patient data and included patients diagnosed with POML between January 2004 and December 2016 at Chiang Mai University Hospital and King Chulalongkorn Memorial Hospital, Thailand. We collected and analyzed patients' clinical characteristics and treatment outcomes. Results Among 146 patients with lymphoma involving the eyes, 121 (82%) were diagnosed with POML. Sixty-four (52.9%) were women with median age 58 (range, 22-86) years. The most common presenting symptom was orbital mass (71.1%). Common sites of origin were the orbit (46.3%) and lacrimal gland (34.7%). At presentation, 22.3% of patients had bilateral eye involvement. About half of patients had stage I disease (N=59, 56.2%) and 20% had stage IV. Most patients (73.3%) had a low-risk International Prognostic Index. Radiotherapy was the main treatment for patients with limited-stage disease (66.7% in stage I and 56.5% in stage II). The overall response rate was 100% with complete response rates 80%, 77.3%, and 64.7% for stages I, II, and IV, respectively. Five-year progression-free survival (PFS) and overall survival were 66.1% and 94.0%, respectively. For patients with limited-stage disease, radiotherapy significantly improved PFS compared with treatment not involving radiotherapy (5-year PFS 89.9% vs. 37.3%, P=0.01). Conclusion We revealed that POML has good response to treatment, especially radiotherapy, with excellent long-term outcome.

The Effect of Manual Stretching and Positioning and Developmental Treatment in Congenital Muscular Torticollis: randomized Controlled Trials (선천성 근성 사경 환아에서 수기신장과 자세와 발달을 이용한 치료의 효과에 대한 무작위 연구)

  • Lee, In-Hee
    • Physical Therapy Korea
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    • v.16 no.1
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    • pp.34-41
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    • 2009
  • The purpose of this study is to compare the outcomes of manual stretching treatment with those of motor development and positioning physical therapy (MDPPT) for congenital muscular torticollis (CMT). This study was designed to be randomized controlled trials and to evaluate the outcomes of 43 consecutive patients with CMT who were first seen when they were average 26 days old. Before treatments, the patients were unintentionallv classified into two clinical groups along with the treatment methods. Among the 43 patients, 22 were classified to the manual stretching group and 21 to the MDPPT group. By means of independent t-test on the result. the duration of treatment according to methods was not significantly different in two groups (p>.05). The duration of treatment in accordance with head tilt level was not significantly different in two groups (p>.05). There was change of mass diameter, between at the beginning day of treatment and after treatment in manual stretching group with a strong positive linear correlation (p=.000, r=.734), but slightly positive linear correlation in MDPPT group. The result of this study indicates that two therapeutic methods make little difference in effectiveness.

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Analysis of the Result of Korean Medicine Treatment for Female Subfertility Using Herbal Medicine, Acupuncture and Moxibustion Treatment

  • Jeong, Jae-Cheol;Choi, Min-Sun;Yoon, Sang-Ho;Kim, Dong-Il
    • The Journal of Korean Medicine
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    • v.36 no.2
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    • pp.1-7
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    • 2015
  • Objectives: To report on the result of infertility treatment with Korean medicine in clinical settings. Methods: This study was single arm, retrospective observational study. Analysis of the medical records on thirty four infertile women who were treated by acupuncture, moxibustion, herbal medicine(Jokyungjongoktang-gagambang, Sutaehwan-gagambang). Pregnancy rate(PR) and Live birth rate(LBR) were analyzed as the primary outcomes. Changes of AMH, FSH, LH, $E_2$, $P_4$, endometrial thickness, fat mass, and BMI were also analyzed as the secondary outcomes. Results: A total of 34 patients were treated in the traditional Korean medical clinic. Nine patients were dropped, and 25 subjects completed the final examination at the end of this treatment schedule. Five of 25 subjects conceived during treatment, reaching 20% PR and LBR was also 20%. Except for FSH level, the results of the remaining outcome measures, including LFT, showed no significant changes. No serious adverse event has been reported. Conclusion: Although no significant changes in bio-markers were observed, complex treatment using Korean medicine has shown effectiveness on women's infertility. In addition, the safety of the treatment has been verified.

Treatment Outcomes of Maxillectomy for Squamous Cell Carcinomas of the Maxillary Sinus (상악동 편평세포암종에 대한 상악절제술의 치료 결과)

  • Jeong Han-Sin;Son Young-Ik;Chung Man-Ki;Min Jin-Young;Oh Jae-Won;Hong Sang-Duk;Lee Hyun-Seok;Baek Chung-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.1
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    • pp.23-28
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    • 2006
  • Background and Objectives: Maxillectomy is the mainstay of treatment for malignant tumors of the maxillary sinus(MS). Nevertheless, few have been reported on the surgical outcomes of maxillectomy for malignant tumors of MS in Korean literature. Based on our clinical experience, the authors aimed to present the treatment outcomes of maxillectomy for squamous cell carcinomas(SCC) of MS. Subjects and Methods: We reviewed the medical records of 26 cases of maxillectomies with see of MS, who were treated from 1995 to 2004 at Samsung Medical Center. Most patients(73.1%) were locally advanced stage(T3 or T4a) at initial presentation. Total maxillectomy was performed in 18 cases, which is the most frequent procedure(69.2%). We analyzed the treatment outcomes of see of MS and several variables includeing tumor stage and resection margin to identify predictors for treatment failure after maxillectomy. Follow-up duration ranged from 7 to 89 months with a mean of 33 months. Results: Treatment failure occurred in 7 cases(26.9%), among which 3 were salvaged. Three of 26 maxillectomies(11.5%) showed the positive or close(less than 5mm) resection margin in their posterior resection sites; however it did not coincide with the site of recurrence after radiation therapy. Among patients who had been followed up for more than 6 months, disease-free 3 year survival rate was 100.0% in T1 and T2, 76.2% in T3, 60% in T4a, and 69.6% in total. Conclusion: Even though most of see of MS were detected at locally advanced stage, maxillectomy with or without postoperative radiation therapy for resectable MS see(T1-T4a) provided the acceptable treatment outcome(70%, 3Y disease-free survival rate).

The effect of needle tip position on the analgesic efficacy of pulsed radiofrequency treatment in patients with chronic lumbar radicular pain: a retrospective observational study

  • Kim, Won-Joong;Park, Hahck Soo;Park, Min Ki
    • The Korean Journal of Pain
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    • v.32 no.4
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    • pp.280-285
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    • 2019
  • Background: Pulsed radiofrequency (PRF) is a treatment modality that alleviates radicular pain by intermittently applying high-frequency currents adjacent to the dorsal root ganglion. There has been no comparative study on analgesic effect according to the position of the needle tip in PRF treatment. The objective of this study is to evaluate the clinical outcomes of PRF according to the needle tip position. Methods: Patients were classified into 2 groups (group IP [group inside of pedicle] and group OP [group outside of pedicle]) based on needle tip position in the anteroposterior view of fluoroscopy. In the anteroposterior view, the needle tip was advanced medially further than the lateral aspect of the corresponding pedicle in group IP; however, in group OP, the needle tip was not advanced. The treatment outcomes and pain scores were evaluated at 4, 8, and 12 weeks after applying PRF. Results: At 4, 8, and 12 weeks, there were no significant differences between the successful response rate and numerical rating scale score ratio. Conclusions: The analgesic efficacy of PRF treatment did not differ with the needle tip position.

Recent Trends in the Treatment of Voice Disorders: Evidence-based Practice and Translational Biology Research (음성 장애 치료 연구의 최근 동향: 증거에 기초한 임상 치료 및 전이 생물학적 연구)

  • Choi, Seong-Hee
    • Phonetics and Speech Sciences
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    • v.2 no.1
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    • pp.99-112
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    • 2010
  • This study attempted to review the recent, high-quality evidence-based practical research related to the treatment effectiveness of voice disorders which focus on randomized controlled trials (RCTs) and translational research of vocal fold tissue engineering for vocal fold regeneration. Methodology including PICO (P; Populations or Patients, I; Interventions, C; Comparison group (control, placebo, gold standard), O; Outcomes or measures made) information for RCTs and animal models (species), regenerative therapy method, and outcomes of translational research for clinical application was summarized and discussed for future voice disorder research.

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Recent Improvements in the Treatment of High-Risk Thyroid Cancer (예후가 좋지 않은 갑상선암에 대한 최신 치료 방침)

  • Lee, Eun Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.1-9
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    • 2022
  • Thyroid cancer is one of the slow-growing tumors with excellent oncological outcomes. However, a small set of patients with unexpectedly severe outcomes are usually ignored. Anaplastic thyroid cancer (ATC) remains one of the most aggressive and lethal solid tumors. Recently, dabrafenib and trametinib combination therapy or neoadjuvant BRAF induction therapy has shown promising results. In addition, a combination of targeted drugs, immunotherapy, surgery, and radiation therapy can improve overall survival in ATC patients. Another disease for which there is no breakthrough treatment is radioactive iodine-refractory differentiated thyroid cancer (DTC). To date, multikinase inhibitors (sorafenib, lenvatinib) targeting the growth factor signaling pathway have been developed and approved as anticancer agents for patients with advanced DTC. This review includes results from multikinase inhibitors to the emergence of new target molecules, including rearrangements during transformation (RET) and tropomyosin receptor kinase (TRK).