Objectives : This study was designed to evaluate the influence of postauricular pain on Bell's palsy patients. Methods : We investigated 71 cases of patients with Bell's palsy and classified them as existence of Postauricural pain, 71 patients were sequentially interviewed and examined. We evaluated the treatment effect of each group by using Gross Grading System of House-Brackmann(H-B grade) before treatment and after final treatment and we researched differences of sequelae of Bell's palsy, period of treatment, changing point -period from onset of Bell's palsy to the day which the change begins to be seen at the face- and improvement -period which Bell's palsy is improved from onset to H-B gradeII. Results : 1. In age, sex, lesion, duration of disease, we found that two groups have no significant differences. 2. In improvement and period of treatment, we found that two groups have significant differences. In changing-point, we found that two groups had the difference of the average, but they were not statistically significant. 3. As a result of evaluation by using H-B grade, treatment score after final treatment was marked higher than that before treatment within each group. 4. After final treatment, Non-postauricular pain group had significant difference(result) on H-B grade compared with Postauricular pain group. 5. In frequency of sequelae symptoms of Bell's palsy, Postauricular pain group had more higher compared with Non-postauricular pain group. Conclusion : These results suggested that Non postauricular pain group should be get better than Postauricular pain group.
Background: Although several efforts have been made recently to grade the severity of sublingual veins, these methods still meet some problems: clinicians' subjectivity and diversity of lighting conditions. Objectives: The purpose of our study was to quantify the severity of sublingual veins using CDs (color differences), and to verify clinical validity of the parameters of sublingual veins using CDs. Methods: We photographed the inferior surface of subjects' tongue from 74 subjects. CDs were computed through two sets of mean $L^*a^*b^*$ values extracted from BRC (black reference color) and the inferior surface of the tongue. We assumed that SVI (sublingual veins index) normalized percentage of a reciprocal of CDs between BRC and the inferior surface of the tongue including sublingual veins and BISV (black index of sublingual veins) percentage of a reciprocal of CDs between BRC and the main trunk of sublingual veins could be applied as quantitative parameters of sublingual veins and examined whether there are meaningful correlations between CDs and subjective grading by the clinicians or not. Results: There were high positive correlations of SVI and BISV to clinician evaluation respectively (r=0.715, 0.634). We computed a multiple regression equation which includes SVI and BISV as independent factors $(r^2=0.60);\;Y=0.711+0.046X_1+0.205X_2$ (Y: the severity of sublingual veins, $X_1:\;SVI,\;X_2:\;BISV$). Conclusions: We conclude that the severity of sublingual veins can be quantified through SVI and BISV, minimizing the clinicians' subjectivity and the diversity of lighting conditions.
Objective: To compare the clinical efficacy of concurrent chemoradiotherapy, neoadjuvant chemotherapy, and intracavity brachytherapy in comprehensive treatment for young patients with stage Ib2 cervical cancer. Methods: One hundred and twelve young patients with stage Ib2 cervical cancer were enrolled retrospectively in our hospital from January 2003 to June 2005. They were categorized into three groups according to preoperative regimens, including the concurrent chemoradiotherapy group (Group 1, n=38), the neoadjuvant chemotherapy (Group 2, n=49), and the intracavity brachytherapy group (Group 3, n=25). Radical hysterectomy was performed following these regimens. Chemotherapy and radiotherapy were given according to pelvic lymph node metastasis, deep cervical stromal invasion, intravascular cancer emboli, histological grading, vaginal stump and positive surgical margin. Results: The cancer disappearance and superficial muscle invasion rates were statistically significantly better in the concurrent chemoradiotherapy group than in the other two groups (P<0.01). No statistically significant difference was noted in the deep muscle invasion rate, surgical time and intraoperative blood loss among three groups, but significantly more postoperative complications occurred in the concurrent chemoradiotherapy group. The 2-year pelvic recurrence was statistically significantly lower in the concurrent chemoradiotherapy group compared to other two groups, while the 5-year survival was higher. Conclusion: Concurrent chemoradiotherapy is efficacious for young patients with stage Ib2 cervical cancer.
Yun, Young-Sun;Yeo, Jinha;Choi, Ji Eun;Son, Young-Ik
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
/
v.24
no.2
/
pp.112-117
/
2013
Background and Objectives : This study aimed to determine the clinical effect of $Artecoll^{(R)}$ injection laryngoplasty for patients with vocal atrophy and mild sulcus vocalis. Materials and Method : Forty-one patients with vocal atrophy and/or mild sulcus vocalis received transcutaneous $Artecoll^{(R)}$ injection into the vocal folds under local anesthesia. Subjective evaluations including voice handicap index (VHI) and perceptual grading with Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scales and objective evaluations including jitter, shimmer, noise-to-harmonic ratio (NHR), speaking fundamental frequency (SFF) and maximum phonation time (MPT) were evaluated before and 3 months after the injection. Results : VHI and Grade, Breathiness and Strain scales in GRBAS showed significant improvement 3 months after injection. SFF and MPT also significantly improved after the injection ; MPT increased and SFF in male patients decreased. Conclusion : Injection laryngoplasty with $Artecoll^{(R)}$ is an effective method for correcting the glottal insufficiency and improving voice quality in patients with vocal atrophy and/or mild sulcus.
Purpose : We evaluated clinical result of arthroscopic and open Bankart repair in anterior shoulder instability to identify factors iuluencing operative result and prognosis. Materials & Methods . We reviewed 24 patients of anterior shoulder instability treated with arthroscopic Bankart repair in 16 cases and open Bankart repair in 8 cases. Average age was 26 years old and involved in dominant arm in 15 cases. Patients were suffered instability for 3.1 years before operation and mean follow-up was 2 year 9 months ( 1 you 9 months -4year 10 months). Results : Post operative pain was subsided in 2 weeks in arthroscopic surgery and 3 weeks in open surgery. The final range of motion after arthroscopic repair were flekion in 168" , external rotation in 54" , and internal rotation in 79, and after open repair 168" ,49" , and 78 respectively. In arthroscopic surgery,2 cases (13%) were redislocated, and 4 cases(25%) showed mild instability. In open case,1 case (11%) showed mild instability. According to function- al result by Rowe grading scale, satisfactory results were 12case (76%) in arthroscopic repair and 7 cases (88%) in open cases. Conclusions Both arthroscopic or open Bankart could get good results in the treatment of anterior instability of shoulder. In arthroscopic repair, perioperative morbidity was lower than open repair, but it needs careful rehabilitation program to prevent redislocation and to return to sports activity.
This study evaluated the relationship between pretreatment hemoglobin (Hb) and prognostic factors in Thai patients with endometrial cancer. Medical records of 228 patients who had undergone surgery between January 2005 and December 2007 were retrospectively reviewed. Associations between clinicopathological variables and pretreatment Hb levels were described using Pearson's chi square test or two-tailed Fisher's exact test. Survival analysis was performed with Kaplan-Meier estimates. Univariate and Cox-regression models were used to evaluate the prognostic impact of various factors, including Hb levels, in term of disease-free survival. The median duration of follow-up was 38.2 months. Eighty-nine patients (39%) had a preoperative Hb level of <12 g/dL, these having significantly higher rates of non-endometrioid histology, advanced FIGO stage, lymphovascular space invasion, cervical involvement, adnexal involvement, positive peritoneal cytology, and lymph node involvement than patients with Hb ${\geq}12$ g/dL. The 5-year disease-free and overall survival were significantly lower in patients with pretreatment Hb levels <12 g/dL compared with those with Hb ${\geq}12$ g/dL (79.3% vs. 89.2%, p=0.044 and 87.6% vs. 99.3%, p<0.001, respectively). In the multivariate analysis only histology, myometrial invasion, and lymphovascular invasion proved to be independent prognostic factors, whereas tumor grading, stage, cervical involvement, adnexal involvement, positive peritoneal cytology, lymph node involvement, and low Hb were not. In conclusion, presence of anemia before treatment may reflect poor prognostic factors in patients with endometrial cancer and low pretreatment hemoglobin level may have a prognostic impact on clinical outcome.
Background: The incidence of prostate cancer, one of the most common cancers in elderly men, is increasing annually in Thailand. Matrix metalloproteinase 11 (MMP-11) is a member of the extracellular matrix metalloproteases which has been associated with human tumor progression and clinical outcome. Aim: To quantify MMP-11 expression in prostatic adenocarcinoma tissues and to determine whether its overexpression correlates with survival outcome, and to assess its potential as a new prognostic marker. Materials and Methods: Expression of MMP-11 was analyzed using immunohistochemistry in 103 Thai patients with prostatic adenocarcinoma. Overall survival was analyzed using Kaplan-Meier methods and Cox regression models. Results: Immunoreactivity of MMP-11 was seen in the stroma of prostatic adenocarcinoma tissue samples, high expression being significantly correlated with poor differentiation in Gleason grading, pathologic tumor stage 4 (pT4), and positive-bone metastasis (p<0.05), but not age and prostatic-specific antigen (PSA) level. Patients with high levels of MMP-11 expression demonstrated significantly shorter survival (p<0.001) when compared to those with low levels. Multivariate analysis showed that MMP-11 expression and pT stage were related with survival in prostatic adenocarcinoma [hazard ratio (HR)=0.448, 95% confidence interval (95%CI)=0.212-0.946, HR=0.333, 95%CI=0.15-0.74, respectively]. Conclusions: Expression of MMP-11 is significantly associated with survival in prostatic adenocarcinoma. High levels may potentially be used for prediction of a poor prognosis.
Kim, Min-Jeong;Park, Sang-Dong;Lee, A-Ram;Kim, Kyung-Ho;Jang, Jun-Hyouk;Kim, Kap-Sung
Journal of Acupuncture Research
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v.19
no.2
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pp.238-249
/
2002
Facial palsy is commonly encountered disease in the clinic but bilateral facial palsy is known as rare disease. Type of facial nerve paralysis include unilateral, recurrent ipsilateral, recurrent alternating and bilateral simultaneous palsies. Among the types, the reported incidence of bilateral simultaneous palsy is 0.3~2% of facial paralysis patients. We experienced I case of patient with bilateral simultaneous facial palsy that was concluded as bilateral bell's palsy. Objective : The purpose of this paper is to report the patient with bilateral facial palsy, who improved by oriental medical treatment. Another purpose is to review the current literature and to differential diagnosis of bilateral facial paralysis. Methods and Results : The patient was treated by acupuncture, herb medication and self-massage on facial muscle for 14 weeks. House-brackmann grading score was improved into I/I (Rt/Lt) from IV/IV. Conclusion : Through reviewing some literatures and reports, It is concluded that bilateral facial palsy was related to many other disorders and more ominous than unilateral facial palsy. therefore, its work-up should include a complete neurologic assesment and thorough evaluation. also, we consider that bilateral Bell's palsy can improve by oriental medical treatments.
Background : Atopic Dermatitis is a chronic and recurrent skin disease. it is characterized as itch-scratch cycle and topical or systemic use of corticosteroids is required in western medicine. Though its effects on major symptoms are impressive, these treatments are prone to several side effects and tend to recur after months or years. So potential treatments have been actively studied in Estern medicine, especially Sasang constitutional therapy, which has fewer side effects. Objectives : The purpose of this study was to examine the effect of Sasang constitutional therapy on treating severe adult Atopic Dermatitis and preventing its recurrent symptoms. Methods : fifteen patients who had severe adult Atopic Dermatitis attended treatment of Sasang constitutional therapy and were followed up for one year. An oriental internal specialist first isolated Sasang constitution and a distinctive body type. Grading of Atopic dermatitis was measured by the guidelines offered by Rajka G. and Langeland T. Results : After treatment with Sasang constitutional therapy, the patients symptoms were improved and the mean Rajka and Langeland score reduced significantly from $7.73{\pm}0.79\;to\;3.4{\pm}10.91$. During the follow-up period of one year, the mean Rajka and Langeland score was $2.72{\pm}2.06$ which was lower than last treatment. Conclusions : The results of this study support Sasang constitutional therapy as an effective therapy for severe adult Atopic Dermatitis. Follow up data suggest that this Eastern medical approach is of greater clinical value than the western medical approach in the long term.
In 1968, Carpentier and his associates introduced glutaraldehyde as a compound for preparing cardiac tissue valve, and this technique has provided a considerably more suitable and durable tissue valve substitute. To increase further durability of valve tissue, Reis and his colleagues designed a flexible stent to reduce the stress on the heterogeneous tissue valve mounted. However with the advent of more innovative mechanical valve currently, many bioprosthetic valves are being substituted by mechanical valves at our department of cardiothoracic surgery because of bioprosthetic valve failure. Main cause of bioprosthetic valves failure were calcification or/and tear of tissue valves. The purpose of this retrospective study is to clarify the relationship between the patients clinical profile during implantation of tissue valves and pathologic features of the failed bioprosthetic valve. From March, 1982 through June, 1988, 53 bioprosthetic heart valves that had been ex-planted from 45 patients at the department of cardiac surgery of Yonsei University Hospital were subjected to this study. The patients were 10 to 65 year-old [mean age: 30.3 yr] with 17 males and 28 females. Re-replacements of prosthetic valves were carried out twenty nine in mitral position, eight in aortic position and eight in both aortic and mitral position simultaneously. The grading and location for calcification of valves were verified by radiograms. The calcification of the explanted valves leaflets was graded from 0 to 4 plus according to Cipriano and associates method. The types of tear and perforation of leaflet were classified into four types as Ishihara has adopted initially in 1981. In younger age group under thirty three years, explanted tissue valves were significantly more affected in terms of grades of severity of valve calcification as compared with older age group [p < 0.035]. Valve calcification appeared more severe in male as compared to female [p< 0.002]. Ionescu-Shiley bovine pericardial bioprosthetic valves showed more severe calcification than Hancock porcine tissue valves [p< 0.035]. Calcium deposit was found very prevalent at the area of commissural attachment [86 % of all]. Type I of valve rupture was shown to be related with simultaneous calcification. However, the relation of explanted valve position, duration of implanted prosthetic valve, atrial fibrillation and anticoagulant therapy to the severity of bioprosthetic valve calcification were not significantly clear statistically [p > 0.05].
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