• Title/Summary/Keyword: clinician

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Detection of Circulating Melanoma Cells by a Two-marker Polymerase Chain Reaction Assay in Relation to Therapy

  • Bitisik, Ozlem;Camlica, Hakan;Duranyildiz, Derya;Tas, Faruk;Kurul, Sidika;Dalay, Nejat
    • BMB Reports
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    • v.36 no.2
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    • pp.173-178
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    • 2003
  • Malignant melanoma is one of the most rapidly increasing cancer types, and patients with metastatic disease have a very poor prognosis. Detection of metastatic melanoma cells in circulation may aid the clinician in assessing tumor progression, metastatic potential, and response to therapy. Tyrosinase is a key enzyme in melanine biosynthesis. The gene is actively expressed in melanocytes and melanoma cells. Melan A is a differentiation antigen that is expressed in melanocytes. The presence of these molecules in blood is considered a marker for circulating melanoma cells. In this study, we analyzed the usefulness of this marker combination I evaluating the response to therapy in the blood of 30 patients with malignant melanoma. Circulating cells were detected by a reverse-transcriptase-polymerase-chain reaction. The tyrosinase expression was observed in 9 (30%) patients and Melan A in 19 (63.3%) patients before therapy. Following treatment, the tyrosinase mRNA was detected in only one patient, while Melan A transcripts were still present in 14 patients. We suggest that this molecular assay can identify circulating melanoma cells that express melanoma-associated antigens and may provide an early indication of therapy effectiveness.

Multidimensional Rehabilitation in Patients with Aspiration Following Head and Neck Cancer Treatment (두경부암 치료에 따라 발생한 흡인 환자에 대한 다각적 재활운동 치료)

  • Jung, Young Ho;Jin, Young Ju
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.5-8
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    • 2018
  • Patients who have the head and neck cancer are usually treated by surgery, radiation therapy, chemotherapy, or combinations of them. These treatments can induce variable degree of aspiration with dysphagia. The type and severity of aspiration depends on the size and location of the original tumor, the structures involved, and the treatment modality used for treatment. The management of aspiration after the head and neck cancer's treatment begins with an accurate evaluation for the cause and mechanism of aspiration through modified barium swallow (MBS) and fiberoptic endoscopic examination of swallowing (FEES). Then, the clinician can use postures, maneuvers, and exercises to treat the swallow disorder and to help the patient achieve optimal function. To achieve optimal swallowing without aspiration, multidimensional rehabilitation by various medical personnel is definitely necessary.

Clinical Meaning of Hallucinatory Experience among PTSD Patients (외상 후 스트레스 장애 환자에서 발생한 환각 경험의 임상적 의미)

  • Park, Ji Hoon;Yi, Jung Seo;Lee, Hong Seock
    • Anxiety and mood
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    • v.9 no.2
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    • pp.113-120
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    • 2013
  • Objectives : The aim of this study was to investigate clinical meaning of hallucination among patients with posttraumatic stress disorder (PTSD). Methods : PTSD patients with hallucination (n=50) were selected and matched with the PTSD patients without hallucination (n=50) by age and sex. The patients were evaluated in two different aspects, pathologic aspects which can develop after traumatic event, and positive/adaptive aspects which are concerned in positive psychology. In addition to these, temperament and character features between two groups were also evaluated using the Temperament and Character Inventory (TCI). Results : Except for the total score of DES (Dissociative Experience Scale) and the score of re-experience subscale of CAPS (Clinician Administered PTSD Scale), clinical characteristics did not show any significant difference between the two groups. Among the comparison of seven higher dimensions in TCI profiles, only Self-transcendence showed significant difference between the two groups. Conclusion : The two groups did not show significant differences in pathologic aspects except for factors that may contribute to development of hallucination. Furthermore, authors could not find any differences in positive/adaptive aspects.

Second Primary Malignant Neoplasms: A Clinicopathological Analysis from a Cancer Centre in India

  • Hulikal, Narendra;Ray, Satadru;Thomas, Joseph;Fernandes, Donald J.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6087-6091
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    • 2012
  • Context: Patients diagnosed with a cancer have a life time risk of developing another de novo malignancy depending on various inherited, environmental and iatrogenic risk factors. Of late the detection of new primary has increased mainly due to refinement in both diagnostic and treatment modalities. Cancer victims are surviving longer and thus are more likely to develop a new metachronous malignancy. Aims: To report our observed trend of increase in prevalence of both synchronous and metachronous second malignant neoplasms among cancer victims and to review the relevant literature. Settings and Design: A hospital based retrospective collection of prospective data of patients diagnosed with second denovo malignancy. Materials and Method: The study was conducted over a 5 year period from July 2008 to June 2012. All patients diagnosed with a histologically proven second malignancy as per Warren Gate's criteria were included. Various details regarding sex, age at presentation, synchronous or metachronous, treatment and outcome were recorded. Conclusions: The occurrence of multiple primary malignancies is not rare. Awareness of the possibility alerts the clinician in evaluation of patients with a known malignancy presenting with unusual sites of metastasis. Individualizing the treatment according to the stages of the primaries will result in durable cancer control particularly in synchronous double malignancy.

Barriers to Participation in a Randomized Controlled Trial of Qigong Exercises Amongst Cancer Survivors: Lessons Learnt

  • Loh, Siew Yim;Lee, Shing Yee;Quek, Kia Fatt;Murray, Liam
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6337-6342
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    • 2012
  • Background: Clinical trials on cancer subjects have one of the highest dropout rates. Barriers to recruitment range from patient-related, through institutional-related to staff-related factors. This paper highlights the low response rate and the recruitment barriers faced in our Qigong exercises trial. Materials and Method: The Qigong trial is a three-arm trial with a priori power size of 114 patients for 80% power. The University Malaya Medical Centre database showed a total of 1,933 patients from 2006-2010 and 751 patients met our inclusion criteria. These patients were approached via telephone interview. 131 out of 197 patients attended the trial and the final response rate was 48% (n=95/197). Results: Multiple barriers were identified, and were regrouped as patient-related, clinician-related and/or institutional related. A major consistent barrier was logistic difficulty related to transportation and car parking at the Medical Centre. Conclusions: All clinical trials must pay considerable attention to the recruitment process and it should even be piloted to identify potential barriers and facilitators to reduce attrition rate in trials.

Reliability of Computerized Measurement of Laryngeal Erythema (후두 발적에 대한 컴퓨터 평가 시스템의 신뢰도 연구)

  • Moon, Byoung-Jae;Nam, Soon-Yuhl;Kim, Sang-Yoon;Choi, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.16 no.1
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    • pp.19-22
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    • 2005
  • Background and Objectives : While considerable progress has been made in enhancing the quality of laryngoscopy and image processing, the evaluation of laryngeal erythema is still based on the clinician's judgement. The purpose of this study is to quantitatively measure the degree of erythema and to examine the relationship with clinical grading. Materials and Methods : Color images of larynx from 100 subjects were captured from video-documented examinations of laryngoscopy. The amount of erythema within the digitized larynx image was quantified using software developed and was compared with a grading system (0 to 3 scale) based on visual inspection by 4 experienced clinicians. The results were compared by deriving Kappa, Kendall and Spearman statistic. Results : There was high intra-observer(R=0.402-0.755) and inter-observer correlation (R=0.789). Among parameters, the red composite value had most remarkable agreement with clinical grading(R=0.827). Conclusion : The result suggest that the computer based analysis of laryngeal erythema can provide quantiative data on degree of erythema and the basis for further development of an expert system.

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Psychiatric Considerations on Pediatric Psychosomatic Disorders with Gastrointestinal Symptoms (소화기 증상을 보이는 소아 정신신체 질환에 대한 정신과적 고찰)

  • Yoo, Hanik K.;Paik, Kyoung-won
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.sup1
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    • pp.85-92
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    • 2009
  • Gastrointestinal (GI) symptoms in children and adolescents are influenced by diverse psychiatric components such as psychosocial stresses, familial environment, school-related situations, and comorbid psychiatric conditions. Absolutely psychiatric symptoms of pediatric patients are also affected by problems of GI system. Lots of symptoms including anorexia, dyspepsia, nausea and so on are commonly originated from either GI or psychiatric causes or both. Sometimes the negative interactions between GI and psychiatric problems aggravate the severity and eventually decline the functions of children and adolescents with GI symptoms. We summarized the common GI and psychiatric conditions which have GI and psychiatric associations. To a clinician who manages pediatric GI disorders, psychiatric considerations can be beneficial to understand the clinical manifestations of patients and to find the way to relieve them. This short and somewhat superficial review may help to have a bird's-eye view on this topic.

Recurrent Bacterial Meningitis Secondary to Cochlear Aplasia, Right and Acquired Cribriform Plate Defect due to Trauma (두개골의 결손과 동반된 재발성 세균성 뇌막염 2례)

  • Chang, Soo Hee;Kim, Sun Jun;Kim, Jung Soo
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.283-288
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    • 1998
  • Recurrent meningitis in children is not only a potentially life threatening condition, but often involves the child in the trauma though repeated hospital admissions and multiple invasive investigations to find the underlying causes. Symptoms and signs of CSF rhinorrhea or otorrhea are infrequent in these patients and difficult to diagnose in young children. All young children treated for meningitis should then be administered an evoked potential audiometry as a post-treatment test. If sensorineural hearing loss is identified, the clinician should be alerted to the possibility of CSF leakage as the cause of the meningitis. Radiologic studies should be performed to rule out preexisting congenital, or acquired, abnormalities requiring surgical exploration. Two young children with recurrent meningitis due to a right cochlear aplasia and a cribriform plate defect caused by trauma are presented to illustrate the problems of diagnosis and management. A review of literatures will also be presented briefly.

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Intravenous Sedation using Propofol and Midazolam in The Exaggerated Gag Reflex Patient's Dental Implant Treatment -A Case Report- (구역반사가 심한 환자의 임플란트 치료에서 프로포폴과 미다졸람을 이용한 정주진정법 -증례 보고-)

  • O, Se-Ri;Lee, Jun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.10 no.1
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    • pp.27-33
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    • 2010
  • The gag reflex is a physiologic reaction which safeguards the airway from foreign bodies. But, an exaggerated gag reflex can be a severe limitation to a patient's ability to accept dental care and for a clinician's ability to provide it. The overactive gag reflex can be due to psychological factors or physiological factors, or both. Psychological factors can include fear of loss of control and past traumatic experiences. A 58-year-old man, scheduled for extraction of left upper second molar, left lower second and third molar and implantation of left upper second molar, and left lower second molar had no specific underlying medical problems. He had exaggerated gag reflex. Dental treatment was successfully performed using intravenous sedation. Intravenous sedation with midazolam and propofol was a useful management technique for reflex control during dental treatment extended to the posterior regions in the oral cavity.

Fixed Prosthodontic Restorations after Forced Eruption of Traumatised Anterior Teeth (치아 정출술을 이용한 고정성 보철 수복)

  • Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.3
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    • pp.243-251
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    • 2008
  • A subgingival crown-root fracture presents a restorative problem to the clinician because restoration is complicated by the need to maintain the sound tooth structures. Forced eruption offers a method of treatment of teeth fractured close to the alveolar crest. Extrusion of such teeth allows elevating the fracture line above the epitherial attachment and so the proper finishing margins can be prepared. The purpose of this case is to report successful tooth restoration using forced eruption in case of crown-root fractures.