• Title/Summary/Keyword: early treatment

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A Result and Prognostic Factors of Hypofractionation Radiation Therapy in Early Glottic Cancer (초기 성문암 환자에서 소분할조사법의 방사선 치료 결과와 예후 인자)

  • Lee Mi-Jo;Kim Hun-Jung;Kim Woo-Chul;Loh Jun-Gou
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.132-138
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    • 2005
  • Purpose: The purpose of this study was to establish general guidelines for the treatment of patients with early glottic cancer(T1-2N0M0), by assessing the role of primary radiation therapy and by analyzing the tumor-related and treatment-related factors that influence treatment results. We also studied the results of hypofractionated radiation therapy for early glottic cancer. Material and Methods: This retrospective study comprised 48 patients who suffered from early glottic cancer and were treated by primary radiotherapy at Inha University Hospital, between May 1997 and October 2004. T-stage distribution showed 38 patients as T1 and 10 patients as stage T2. Thirty-eight patients underwent hypofractionated radiotherapy using a 6 MY photon beam, a total tumor dose of 63Gy, in 5 weekly fractions of 2.25Gy, with an overall radiation treatment time of 38 days. Ten patients in the T2 stage tolerated a total dose of 63-72 Gy(median 68.4Gy) in 5 weekly fractions of 1.8-2.0Gy, with an overall radiation treatment time of 40-87 days(median 51 days). All patients were followed up for at least 3 years. Univariate and multivariate analyses were performed to identify the prognostic factors affecting the treatment results. Result: The 5-year survival rate was 92% for all patients, 94% for T1 patients and 91% for T2 patients. The local control rate was 93.5% for all patients, 95% for T1 and 92.2% for T2 patients. Three patients suffered a relapse following radiotherapy, and underwent subsequent salvage surgery. We included T-stage, tumor location, total radiation dose, field size and overall radiation treatment time as potential prognostic factors. Only T-stage was found to be statistically significant in the univariate analysis, but in the multivariate analysis, it was not found to be significant. Conclusion: High curative and voice preservation rates were obtained with hypofractionated radiotherapy. Further study with a larger number of patients is needed to determine the prognostic factors affecting treatment results.

Physical Therapy of Male External Genitalia Lymphedema from Urological Cancer -Case Report- (비뇨기 암으로 인한 남성 외성기 림프부종의 물리치료 -사례연구-)

  • So, Woon-Young;Kim, Sung-Joong
    • The Journal of Korean Physical Therapy
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    • v.21 no.4
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    • pp.103-109
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    • 2009
  • Purpose: Cases of male external genitalia lymphedema are relatively uncommon in the clinical physical therapy field. Of more than two thousand clinical cases treated by the author in the lymphedema treatment center, only 4~5 cases of male external genitalia lymphedema were encountered. The present case report presents the experience and treatment results of male external genitalia lymphedema from urological cancer. Method: This case was a 47-year-old man, who was treated with complex decongestive physical therapy consisting of manual lymph drainage, compression bandage (including the external genitalia), remedial exercise, skin care. Result: The results were relatively good. The clinical experience would suggest that early treatment and education can reduce the external genitalia lymphedema. However, the treatment efficacy remains limited. Therefore, early treatment is vital for more successful outcomes. Conclusion: The relief of symptoms and a decrease in male external genitalia lymphedema may be the best result from long-term conservative management.

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Evaluation of various cephalometric measurements to predict the prognosis of early Class III malocclusion treatment (III급 부정교합의 조기 치료 예후 예측를 위한 두부방사선 계측 변수의 평가)

  • Son, Myung-Ho;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.34 no.3 s.104
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    • pp.205-218
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    • 2004
  • The aims of this study were to investigate the differences in the early craniofacial morphology of Class III malocclusions with good, fair and poor occlusal stability and to elucidate a key determinant for distinguishing the cases. Lateral cephalograms of 30 subjects with Class III malocclusion in the mixed dentition were analyzed at the start of treatment (mean age of $8.58\pm1.47$). All subjects were reevaluated after a mean period of $7.50\pm1.94$ years comprising active treatment and retention. At this time, the samples were divided into three groups: good (10 subjects), fair (10 subjects) and poor (10 subjects) occlusal stability groups. According to the results of ANOVA, there were significant morphological differences in the early stage among the good, fair and poor occlusat stability groups, especially in variables that represented the vertical skeletal relationships. As well, there were already more dental compensations in the poor occlusal stability group. Stepwise discriminant analysis on the measurements at the time of first observation identified only one predictive variable: AB to mandibular plane angle(AB-MP). With this discriminant function, $83.3\%$of the original grouped cases were correctly classified and the canonical correlation coefficient was 0.857. In conclusion, AB-MP can be a possible predictor for the eventual prognosis of early Class III treatment. If it is below 60, the prognosis of early Class III treatment is expected to be poor, while if it is above 65, a good prognosis is expected.

Clinical characteristics and progress of Kawasaki disease patients who had early treatment with intravenous immune globulin (가와사끼병에서 면역글로불린 조기 투여군의 임상적 특성 및 치료 경과)

  • Park, So-Yoon;Lee, Young Hwan
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.1005-1010
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    • 2007
  • Purpose : To determine the optimal time of high dose intravenous immune globulin (IVIG) treatment, we analysed the clinical characteristics and progress of a group of Kawasaki disease patients who had early treatment with IVIG. Method : A retrospective study was conducted of 188 patients with Kawasaki disease who were admitted to Yeungnam University Medical Center from January 2000 to December 2005. All patients were treated with a high dose IVIG and high dose aspirin for the initial acute phase treatment. The early treatment group consisted of 94 patients who received treatment before 5 days of fever, and the conventional group consisted of 94 patients who were treated on or after day 5. The patients' sex, age, laboratory findings, total duration of fever, duration of fever after initial IVIG, need for additional IVIG and coronary artery status were noted. Result : There were no significant differences between the two groups in sex ratio and age. No significant differences were noted in the level of WBC count, ESR, CRP, serum albumin, LDH, total duration of fever and coronary abnormality. But the value of ALT($151.8{\pm}17.3$ vs. $81.9{\pm}13.4$, P=0.002), duration of fever after initial IVIG ($3.8{\pm}0.5days$ vs. $2.1{\pm}0.2days$, P=0.003), and rate of additional IVIG (15.9% vs. 6.3%, P=0.037) were significantly higher in the early treatment group. There was no significant difference in initial dose of IVIG, but dosage of aspirin was lower in early treatment group (P=0.037). Conclusion : There is no evidence that early treatment of IVIG has greater efficacy in preventing cardiac sequelae than conventional treatment. In addition, early treatment is likely to result in a greater requirement for additional IVIG treatment.

The conservative care by early endodontic drainage of infected teeth in the line of a mandibular fracture: report of a case (조기 치근관 배농술을 이용한 하악 골절선상 감염치아들의 보존적 관리: 증례보고)

  • Mo, Dong-Yup;Yoo, Jae-Ha;Choi, Byung-Ho;Seol, Sung-Han;Kim, Ha-Rang;Lee, Chun-Ui
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.309-313
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    • 2010
  • The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound (pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.

Korean Medical Treatment of Early Dumping Syndrome after Gastrectomy: A Case Report (위절제술 후 발생한 조기 덤핑증후군에 대하여 한방치료로 호전된 환자 1례 증례보고)

  • Yi, Chan-sol;Noh, Hyeon-seok;Ha, You-kyung;Park, Song-won;Hong, Seung-cheol;Lim, Sung-woo
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.736-743
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    • 2017
  • This clinical study describes the effect of Korean medicine as a treatment for early dumping syndrome. The patient was treated with herbal medicine (Sogeonjung-tang and Jeongjeon-gami-ijin-tang), acupuncture, and moxibustion for 34 days. The degree of treatment was measured by the amount of oral intake and the number of vomiting incidents. During the treatment, the patient's symptoms were relieved and the amount of oral intake increased. At first, the patient vomited once or twice per day, and the amount of oral intake was about 600-700 cc. After the treatment, the patient did not vomit and oral intake increased about two fold. This clinical case study shows the positive effect of herbal medicine, acupuncture, and moxibustion on relief of symptoms of early dumping syndrome.

Intensity-modulated radiation therapy in early stage squamous cell carcinoma of the larynx: treatment trends and outcomes

  • Wegner, Rodney E.;Abel, Stephen;Bergin, John J.;Colonias, Athanasios
    • Radiation Oncology Journal
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    • v.38 no.1
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    • pp.11-17
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    • 2020
  • Purpose: Definitive radiotherapy remains a primary treatment option for early stage glottic cancer. Intensity-modulated radiation therapy (IMRT) has emerged as the standard treatment technique for advanced head and neck cancers, whereas three-dimensional conformal radiotherapy (3D-CRT) has remained standard for early glottic cancers. We used the National Cancer Database (NCDB) to identify predictors of IMRT use and effect on outcome in these patients. Materials and Methods: We queried the NCDB from 2004-2015 for squamous cell carcinoma of the glottic larynx staged Tis-T2N0 treated with radiation alone. Logistic regression was used to identify predictors of IMRT. Cox regression was used to identify factors predictive of overall survival. Propensity matching was conducted to account for indication bias. Results: We identified 15,627 patients, of which 11% received IMRT. IMRT use rose from 2% in 2004 to 16% in 2015. Predictors of IMRT include: increased comorbidity, T2 stage, urban location, chemotherapy, treatment at an academic center, and later treatment year. Predictors of improved survival were female gender, higher income, lower stage, no chemotherapy, academic facility, and more remote year. There was no difference in survival between 3D-CRT and IMRT across all stages. Conclusions: The rate of IMRT use for early stage glottic laryngeal cancer has increased over time. There was no difference in outcome in patients receiving IMRT versus 3D-CRT across the cohort.

Ahmed Valve Implantation for Early Glaucoma Treatment in Dogs (개의 초기 원발성 녹내장안에서 Ahmed valve 이식술의 적용)

  • Park, Shin-Ae;Jeong, Man-Bok;Park, Young-Woo;Kim, Won-Tae;Kim, Se-Eun;Seo, Kang-Moon
    • Journal of Veterinary Clinics
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    • v.25 no.5
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    • pp.385-390
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    • 2008
  • The purpose of this study was to compare the long term prognosis of Ahmed valve implantation and medical therapy in dogs with early primary glaucoma. The medical records of dogs with early primary glaucoma from the Veterinary Medical Teaching Hospital of Seoul National University between January 2005 and May 2008 were reviewed. Five dogs underwent Ahmed valve implantation and medical therapy was performed in six dogs. Breeds of the dogs included Shih Tzu(n = 7), American cocker spaniel(n = 2), and miniature poodle(n = 2). Adequate intraocular pressure(IOP) was better maintained in the Ahmed valve implantation group than in the medical treatment group throughout the follow-up period. Mean time for vision loss to develop after treatment in the Ahmed valve implantation group($198.0{\pm}115.4$ days) was significantly longer than that in medical treatment group($43.2{\pm}30.4$ days, p < 0.05). Post-operative complications included occlusion of the tube by fibrin in the anterior chamber (n = 1), fibrous capsule about the episcleral base of the device(n = 1), and dislocation of the valve body(n = 1). It is considered that Ahmed valve implantation is more effective strategy to control IOP and maintain vision than medical treatment in early glaucomatous dogs.

Factors Influencing Treatment Result and Early Complication in Inpatients with Psychiatric Comorbidity (정신질환 동반 입원 환자의 치료결과와 조기합병증에 영향을 미치는 요인)

  • Kim, Sang-Mi;Lee, Hyun-Sook
    • Korea Journal of Hospital Management
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    • v.22 no.4
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    • pp.113-122
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    • 2017
  • The purpose of the study was to investigate the patient, disease and hospital characteristics which affect treatment result and early complication for inpatients with psychiatric comorbidity. We analyzed data on 19,806 patients of the Korea Centers for Disease Control and Prevention from 2012 to 2014, Korea National Hospital discharge in-depth data. Frequency, chi-square and logistic regression analysis was performed, using STATA 12.0. According to logistic regression analysis, gender(Odds ratio(OR)=0.776, 95% confidence interval(CI)=0.686-0.878), insurance type(OR=0.853, CI=0.731-0.995), operation(OR=0.424, CI=0.350-0.513), disposition(OR= 39.307, CI=34.394-44.923), beds(300-499, OR=0.470, CI=0.377-0.585; 500-999, OR=0.462, CI=0.395-0.541; 1000 over, OR=0.598, CI=0.480-0.745) were significant predictors of treatment result. And insurance type(OR=1.527, CI=1.241-1.879), CCI(3 over, OR=1.865, CI=1.534-2.266), operation(OR=5.399, CI=4.562-6.389), disposition(OR=1.279, CI=1.013-1.614), district(Metropolitan city, OR=0.519, CI=0.407-0.661; Non-metropolitan OR=0.469, CI=0.383-0.574), beds(500-999, OR=2.799, CI=1.986-3.944; 1000 over, OR=2.109, CI=1.429-3.113) were significant predictors of early complication. This research would be used as a basic data of high quality of medical care and efficient resource utilization in order to detect and minimize the negative medical treatment results of inpatients with psychiatric comorbidity.

Risk of Lymph Node Metastases from Early Gastric Cancer in Relation to Depth of Invasion: Experience in a Single Institution

  • Wang, Zheng;Ma, Li;Zhang, Xing-Mao;Zhou, Zhi-Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5371-5375
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    • 2014
  • Background: An accurate assessment of potential lymph node metastasis is important for the appropriate treatment of early gastric cancers. Therefore, this study analyzed predictive factors associated with lymph node metastasis and identified differences between mucosal and submucosal gastric cancers. Materials and Methods: A total of 518 early gastric cancer patients who underwent radical gastrectomy were reviewed in this study. Clinicopathological features were analyzed to identify predictive factors for lymph node metastasis. Results: The rate of lymph node metastasis in early gastric cancer was 15.3% overall, 3.3% for mucosal cancer, and 23.5% for submucosal cancer. Using univariate analysis, risk factors for lymph node metastasis were identified as tumor location, tumor size, depth of tumor invasion, histological type and lymphovascular invasion. Multivariate analysis revealed that tumor size >2 cm, submucosal invasion, undifferentiated tumors and lymphovascular invasion were independent risk factors for lymph node metastasis. When the carcinomas were confined to the mucosal layer, tumor size showed a significant correlation with lymph node metastasis. On the other hand, histological type and lymphovascular invasion were associated with lymph node metastasis in submucosal carcinomas. Conclusions: Tumor size >2 cm, submucosal tumor, undifferentiated tumor and lymphovascular invasion are predictive factors for lymph node metastasis in early gastric cancer. Risk factors are quite different depending on depth of tumor invasion. Endoscopic treatment might be possible in highly selective cases.