• Title/Summary/Keyword: failure treatment

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The Failure of Initial Treatment for TNM Stage I & II Squamous Cell Carcinomas of the Oral Cavity (조기(TNM Stage I & II) 구강 편평세포암종의 초치료 실패)

  • Lee Hyun-Seok;Jeong Han-Sin;Kim Tae-Wook;Son Young-Ik;Baek Chung-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.1
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    • pp.26-31
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    • 2005
  • Backgrounds and Objectives: Squamous cell carcinomas of the oral cavity(SCOC) in TNM stage I & II have relatively high chance to be cured compared to those in the advanced stage, but sometimes result in the treatment failure with poor prognosis. There have been few reports on the patterns of failure and the clinical courses for SCOC in stage I & II after the failure of initial treatment. This study is directed at identifying the clinical outcomes of stage I & II SCOC and the salvage rate after initial treatment and suggesting an optimal level of treatment by analyzing the patterns of failure. Material and Methods: The medical records of 36 patients with SCOC, initially diagnosed between 1995 and 2001 as TNM stage I & II were reviewed retrospectively. The patterns of failure, salvage treatment, clinical courses, and the survival of these subjects were analyzed. The minimum follow-up period of no-evidence of disease(NED) was 12 months with an average of 32.2 months. Results: Overall rate of the treatment failure in SCOC of stage I & II was 41. 7%(15/36 cases). Most of the treatment failure in the subjects with stage I tumors occurred in regional lymph node. Local failure was the most frequent form of failure in the subjects with stage II tumors after wide excision of primary tumor with elective neck dissection and/or radiation therapy. No significant correlation was noted between the safety margin and the local failure. Elective neck dissections in stage I & II SCOC had a tendency to reduce regional failure (p=0.055). The salvage rates at 24 months were 85.7% in stage I, and 37.5% in stage II. The 3-year survival rate after the failure of initial treatment was 55.0%. Conclusion: SCOC of stage I & II after the failure of initial treatment showed poor prognosis despite of the salvage treatments. This study implies that the elective neck dissections for regional lymph node should be required for SCOC of stage I & II to reduce the treatment failure.

Computed Tomography Findings Associated with Treatment Failure after Antibiotic Therapy for Acute Appendicitis

  • Wonju Hong;Min-Jeong Kim;Sang Min Lee;Hong Il Ha;Hyoung-Chul Park;Seung-Gu Yeo
    • Korean Journal of Radiology
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    • v.22 no.1
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    • pp.63-71
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    • 2021
  • Objective: To identify the CT findings associated with treatment failure after antibiotic therapy for acute appendicitis. Materials and Methods: Altogether, 198 patients who received antibiotic therapy for appendicitis were identified by searching the hospital's surgery database. Selection criteria for antibiotic therapy were uncomplicated appendicitis with an appendiceal diameter equal to or less than 11 mm. The 86 patients included in the study were divided into a treatment success group and a treatment failure group. Treatment failure was defined as a resistance to antibiotic therapy or recurrent appendicitis during a 1-year follow-up period. Two radiologists independently evaluated the following CT findings: appendix-location, involved extent, maximal diameter, thickness, wall enhancement, focal wall defect, periappendiceal fat infiltration, and so on. For the quantitative analysis, two readers independently measured the CT values at the least attenuated wall of the appendix by drawing a round region of interest on the enhanced CT (HUpost) and non-enhanced CT (HUpre). The degree of appendiceal wall enhancement (HUsub) was calculated as the subtracted value between HUpost and HUpre. A logistic regression analysis was used to identify the CT findings associated with treatment failure. Results: Sixty-four of 86 (74.4%) patients were successfully treated with antibiotic therapy, with treatment failure occurring in the remaining 22 (25.5%). The treatment failure group showed a higher frequency of hypoenhancement of the appendiceal wall than the success group (31.8% vs. 7.8%; p = 0.005). Upon quantitative analysis, both HUpost (46.7 ± 21.3 HU vs. 58.9 ± 22.0 HU; p = 0.027) and HUsub (26.9 ± 17.3 HU vs. 35.4 ± 16.6 HU; p = 0.042) values were significantly lower in the treatment failure group than in the success group. Conclusion: Hypoenhancement of the appendiceal wall was significantly associated with treatment failure after antibiotic therapy for acute appendicitis.

Efficacy of methotrexate therapy in patients with tubal pregnancy and a serum human chorionic gonadotropin level above 10,000 IU/L

  • Kim, Kidong;Suh, Dong Hoon;Cheong, Hyun Hoon;Yoon, Sang Ho;Lee, Taek-Sang;No, Jae Hong;Kim, Yong-Beom
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.1
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    • pp.33-36
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    • 2014
  • Objective: To estimate the failure rate of medical treatment and to identify variables associated with treatment failure in patients with tubal pregnancy and an initial serum level of human chorionic gonadotropin (HCG) over 10,000 IU/L. Methods: The inclusion criteria were tubal pregnancy diagnosed using ultrasonography, primary treatment of intramuscular methotrexate injection at one of the four institutions between January 2003 and December 2011, a serum HCG level within two days before treatment >10,000 IU/L, and follow-up data to determine treatment success or failure. Exclusion criteria were other primary treatments besides intramuscular methotrexate injection. The clinicopathologic data of 36 patients were collected and analyzed. Results: Medical treatment failed and surgery was performed in 19 (53%) patients. In univariable analysis, age, parity, and size of the gestational sac were associated with treatment failure, but none of the variables were associated with treatment failure in multivariable analysis. The failure rate in the subgroup with age<33 years and size of gestational sac ${\geq}1.1cm$ was significantly higher than those of the other subgroups (82% vs. 41% [mean of the other subgroups], respectively). Conclusion: Patients with a serum HCG level >10,000 IU/L who received medical treatment had a high failure rate. Among them, patients aged<33 year and with a gestational sac ${\geq}1.1cm$ had an extremely high failure rate.

One Case of Pregnancy and Delivery in Premature Ovarian Failure by Korean Traditional Medicine (Daeyeongjeon-gamibang) (대영전가미방(大營煎加味方)으로 월경회복, 자연임신 및 출산에 성공한 조기난소부전 1례 증례보고)

  • Bae, Kwang-Rok;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.1
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    • pp.160-167
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    • 2020
  • Objectives: To report the Pregnancy and delivery in Premature Ovarian Failure after Korean Traditional Medicine Treatment. Methods: The patients who diagnosed as premature ovarian failure was treated with herbal medicine (Daeyeongjeon-gamibang). Results: After the treatment, symptoms of premature ovarian failure such as vaginal dryness, hot flush were improved. The patient got regular menstruation cycle and she was pregnant during the treatment. Conclusions: The case report shows that Korean medical treatment can be an effective for infertile female with premature ovarian failure.

Prediction of Pumping Efficacy of Left Ventricular Assist Device according to the Severity of Heart Failure: Simulation Study (심실의 부하감소 측면에서 좌심실 보조장치의 최적 치료시기 예측을 위한 시뮬레이션 연구)

  • Kim, Eun-Hye;Lim, Ki Moo
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.12 no.4
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    • pp.22-28
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    • 2013
  • It is important to begin left ventricular assist device (LVAD) treatment at appropriate time for heart failure patients who expect cardiac recovery after the therapy. In order to predict the optimal timing of LVAD implantation, we predicted pumping efficacy of LVAD according to the severity of heart failure theoretically. We used LVAD-implanted cardiovascular system model which consist of 8 Windkessel compartments for the simulation study. The time-varying compliance theory was used to simulate ventricular pumping function in the model. The ventricular systolic dysfunction was implemented by increasing the end-systolic ventricular compliance. Using the mathematical model, we predicted cardiac responses such as left ventricular peak pressure, cardiac output, ejection fraction, and stroke work according to the severity of ventricular systolic dysfunction under the treatments of continuous and pulsatile LVAD. Left ventricular peak pressure, which indicates the ventricular loading condition, decreased maximally at the 1st level heart-failure under pulsatile LVAD therapy and 2nd level heart-failure under continuous LVAD therapy. We conclude that optimal timing for pulsatile LVAD treatment is 1st level heart-failure and for continuous LVAD treatment is 2nd level heart-failure when considering LVAD treatment as "bridge to recovery".

Risk factors for orthodontic fixed retention failure: A retrospective controlled study

  • Kaat Verschueren;Amit Arvind Rajbhoj;Giacomo Begnoni;Guy Willems;Anna Verdonck;Maria Cadenas de Llano-Perula
    • The korean journal of orthodontics
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    • v.53 no.6
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    • pp.365-373
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    • 2023
  • Objective: To investigate the potential correlation between fixed orthodontic retention failure and several patient- and treatment-related factors. Methods: Patients finishing treatment with fixed appliances between 2016 and 2017 were retrospectively included in this study. Those not showing fixed retention failure were considered as control group. Patients with fixed retention failure were considered as the experimental group. Additionally, patients with failure of fixed retainers in the period of June 2019 to March 2021 were prospectively identified and included in the experimental group. The location of the first retention failure, sex, pretreatment dental occlusion, facial characteristics, posttreatment dental occlusion, treatment approach and presence of oral habits were compared between groups before and after treatment separately by using a Fisher exact test and a Mann-Whitney U test. Results: 206 patients with fixed retention failure were included, 169 in the mandibular and 74 in the maxillary jaws. Significant correlations were observed between retention failure in the mandibular jaws and mandibular arch length discrepancy (P = 0.010), post-treatment growth pattern (P = 0.041), nail biting (P < 0.001) and abnormal tongue function (P = 0.002). Retention failure in the maxillary jaws was more frequent in patients with IPR in the mandibular jaws (P = 0.005) and abnormal tongue function (P = 0.021). Conclusions: This study suggests a correlation between fixed retention failure and parafunctional habits, such as nail biting and abnormal tongue function. Prospective studies with larger study populations could further confirm these results.

Immunogenicity of botulinum toxin

  • Wee, Syeo Young;Park, Eun Soo
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.12-18
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    • 2022
  • Botulinum toxin treatment is the most common non-surgical cosmetic treatment. Although there are many available treatments using botulinum toxin, their effects are temporary and repeated injections are required. These frequent injections can trigger an immunological response. In addition, botulinum toxin acts as an antigen in the body; thus, its effect disappears progressively due to this immunological reaction, which may cause treatment failure. Active botulinum toxin consists of a core neurotoxin and complexing proteins, the exact effects of which remain unclear. However, the complexing proteins are closely related to the immune response and the formation of neutralizing antibodies. Since neutralizing antibodies can lead to treatment failure, their formation should be prevented. Furthermore, various methods of detecting neutralizing antibodies have been used to predict treatment failure.

Microbial etiology of endodontic treatment failure

  • Kum, Kee-Yeon
    • Proceedings of the KACD Conference
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    • 2003.11a
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    • pp.606-606
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    • 2003
  • There have been many studies that have evaluated success and failure of endodontic treatment (Nair, Sjogren), but there is remarkably limited information concerning the specific microorganisms that are involved in the teeth with treatment failure. Microorganisms that survive root canal treatment to cause a persistent infection must possess specific characteristics to avoid the host defense. These can be broadly classified as; 1. Sequestration:A physical barrier between the microbe and the host. 2. Cellular evasion:Microorganisms avoid leukocyte dependent antibacterial mechanisms. 3. Humoral evasion:Extracellular bacteria avoid the hosts antibodies and complement.(omitted)

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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.

Diffusion-weighted Magnetic Resonance Imaging for Predicting Response to Chemoradiation Therapy for Head and Neck Squamous Cell Carcinoma: A Systematic Review

  • Sae Rom Chung;Young Jun Choi;Chong Hyun Suh;Jeong Hyun Lee;Jung Hwan Baek
    • Korean Journal of Radiology
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    • v.20 no.4
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    • pp.649-661
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    • 2019
  • Objective: To systematically review the evaluation of the diagnostic accuracy of pre-treatment apparent diffusion coefficient (ADC) and change in ADC during the intra- or post-treatment period, for the prediction of locoregional failure in patients with head and neck squamous cell carcinoma (HNSCC). Materials and Methods: Ovid-MEDLINE and Embase databases were searched up to September 8, 2018, for studies on the use of diffusion-weighted magnetic resonance imaging for the prediction of locoregional treatment response in patients with HNSCC treated with chemoradiation or radiation therapy. Risk of bias was assessed by using the Quality Assessment Tool for Diagnostic Accuracy Studies-2. Results: Twelve studies were included in the systematic review, and diagnostic accuracy assessment was performed using seven studies. High pre-treatment ADC showed inconsistent results with the tendency for locoregional failure, whereas all studies evaluating changes in ADC showed consistent results of a lower rise in ADC in patients with locoregional failure compared to those with locoregional control. The sensitivities and specificities of pre-treatment ADC and change in ADC for predicting locoregional failure were relatively high (range: 50-100% and 79-96%, 75-100% and 69-95%, respectively). Meta-analytic pooling was not performed due to the apparent heterogeneity in these values. Conclusion: High pre-treatment ADC and low rise in early intra-treatment or post-treatment ADC with chemoradiation, could be indicators of locoregional failure in patients with HNSCC. However, as the studies are few, heterogeneous, and at high risk for bias, the sensitivity and specificity of these parameters for predicting the treatment response are yet to be determined.