• 제목/요약/키워드: failure treatment

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만성신부전 환자에게 한약투여 후 사구체여과율 및 빈혈 호전 1례 (A Case Report of Improvement of Glomerular Filtration Rate and Anemia in Chronic Renal Failure through Herbal Medication)

  • 김동현;배은주;박성욱;윤성우;고창남;유경환
    • 대한한방내과학회지
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    • 제26권2호
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    • pp.498-505
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    • 2005
  • Renal failure means irreversible damage and depression of renal function, represented by glomerular filtration rate(GFR). A renal failure patient with uremia and anemia is presented. Anemia, in this patient, appeared before uremia did. A 55 year-old male patient was treated for renal failure with Weilingtang. Improvement was observed in, not only GFR, blood urea nitrogen(BUN), and creatinine, but also in such symptoms as difficulty in urine excretion, dyspepsia and abdominal swelling. But anemia appeared during treatment, so a mixture of Dangguibuxuetang(當歸補血湯) and Xiongguitang(芎歸湯) was prescribed. After this treatment, improvement in hemoglobin, and hematocrit was observed.

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보조생식술 실패 후 서각지황탕가미(犀角地黃湯加味) 복용치료를 통해 자연임신에 성공한 난임 환자 치험 2례 (Two Case Report of Spontaneous Pregnancy Treated with Gamiseogagjihwang-tang after Repeated Failure in In Vitro Fertilization or Intrauterine Insemination Treatment)

  • 고지은;유명숙
    • 대한한방부인과학회지
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    • 제28권1호
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    • pp.128-137
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    • 2015
  • Objectives: Spontaneous pregnancy is a rare event after repeated failure of in vitro fertilization (IVF) or Intrauterine insemination (IUI) treatment. So this paper is to report the natural pregnancy of Gamiseogagjihwang-tang treatments on two infertile patients who were repeatedly failed in IVF or IUI. Methods: One patient was a 35-year-old patient diagnosed with the adenomyosis and contralateral tubal obstruction, treated with 90 cc Gamiseogagjihwang-tang two times per day for 6 weeks after second failure of IVF. The other patient was a 34-year-old patient undergone induced abortion by three times, treated with 90 cc Gamiseogagjihwang-tang two times per day for 4 weeks after second failure of IUI. Results: Through taking Gamiseogagjihwang-tang without assisted reproduction techniques, two cases got pregnant naturally. Conclusions: These cases suggest that Gamiseogagjihwang-tang is effective in treating infertile female after failure in IVF or IUI and inducing spontaneous pregnancy. Therefore, there needs to be more trial on infertile patients treated with Seogagjihwang-tang.

An improved model of compaction grouting considering three-dimensional shearing failure and its engineering application

  • Li, Liang;Xiang, Zhou-Chen;Zou, Jin-Feng;Wang, Feng
    • Geomechanics and Engineering
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    • 제19권3호
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    • pp.217-227
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    • 2019
  • This study focuses on an improved prediction model to determine the limiting grouting pressure of compaction grouting considering the ground surface upheaval, which is caused by the three-dimensional conical shearing failure. The 2D-dimensional failure curve in Zou and Xia (2016) was improved to a three-dimensional conical shearing failure for compaction grouting through coordinate rotation. The process of compaction grouting was considered as the cavity expansion in infinite Mohr-Coulomb (M-C) soil mass. The prediction model of limiting grouting pressure of compaction grouting was proposed with limit equilibrium principle, which was validated by comparing the results in El-Kelesh et al. (2001) and numerical method. Furthermore, using the proposed prediction model, the vertical and horizontal grouting tube techniques were adopted to deal with the subgrade settlement in Shao-huai highway at Hunan Provence of China. The engineering applicability and effectiveness of the proposed model were verified by the field test. The research on the prediction model for the limiting grouting pressure of compaction grouting provides practical example to the rapid treatment technology of subgrade settlement.

Patterns of failure after the reduced volume approach for elective nodal irradiation in nasopharyngeal carcinoma

  • Seol, Ki Ho;Lee, Jeong Eun
    • Radiation Oncology Journal
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    • 제34권1호
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    • pp.10-17
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    • 2016
  • Purpose: To evaluate the patterns of nodal failure after radiotherapy (RT) with the reduced volume approach for elective neck nodal irradiation (ENI) in nasopharyngeal carcinoma (NPC). Materials and Methods: Fifty-six NPC patients who underwent definitive chemoradiotherapy with the reduced volume approach for ENI were reviewed. The ENI included retropharyngeal and level II lymph nodes, and only encompassed the echelon inferior to the involved level to eliminate the entire neck irradiation. Patients received either moderate hypofractionated intensity-modulated RT for a total of 72.6 Gy (49.5 Gy to elective nodal areas) or a conventional fractionated three-dimensional conformal RT for a total of 68.4-72 Gy (39.6-45 Gy to elective nodal areas). Patterns of failure, locoregional control, and survival were analyzed. Results: The median follow-up was 38 months (range, 3 to 80 months). The out-of-field nodal failure when omitting ENI was none. Three patients developed neck recurrences (one in-field recurrence in the 72.6 Gy irradiated nodal area and two in the elective irradiated region of 39.6 Gy). Overall disease failure at any site developed in 11 patients (19.6%). Among these, there were six local failures (10.7%), three regional failures (5.4%), and five distant metastases (8.9%). The 3-year locoregional control rate was 87.1%, and the distant failure-free rate was 90.4%; disease-free survival and overall survival at 3 years was 80% and 86.8%, respectively. Conclusion: No patient developed nodal failure in the omitted ENI site. Our investigation has demonstrated that the reduced volume approach for ENI appears to be a safe treatment approach in NPC.

재치료실패 폐결핵 환자의 위험인자 분석 (The Analysis of Risk Factors of Pulmonary Tuberculosis Patients Failed in Retreatment)

  • 김형수;이원진;공석준;손말현
    • Tuberculosis and Respiratory Diseases
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    • 제49권6호
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    • pp.684-690
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    • 2000
  • 배경 : 폐결핵의 치료에 있어서 실패하는 가장 중요한 원인은 항결핵제의 조기중단과 불규칙적인 복용이다. 특히 재치료를 시행하는 환자는 장기간 동안 항결핵제를 규칙적으로 복용하는 것이 치료에 가장 중요하다. 본 연구는 재치료를 시행한 폐결핵 환자들의 재치료 실패의 원인이 될 수 있는 위험인자들을 알아내어 폐결핵의 재치료 성공률 향상과 더불어 난치성 관리에 대해 기초자료로 삼고자 하였다. 대상 및 방법 : 1994년 1월부터 1995년 12월까지 국립목포결핵병원에서 입원하여 재치료를 시행한 62명의 환자를 대상으로 하였다. 재치료에 실패한 환자군(1군)과 성공한 환자군(2군)으로 나누어 재치료 실패를 유발할 수 있는 인자들을 알아내기 위하여 성별, 연령, 과거의 치료력, 치료약제의 개수 및 내성 약제의 개수, 치료 약제중 살균제의 개수와 감수성이 있는 약제의 비율, 다재내성균의 발현율, 흉부 X-ray상 NTA 분류를 이용한 병변의 정도 및 공동의 유무등을 조사하여 독립표본 T-검정, ${\chi}^2$검정 및 Fisher의 정확확률 검정을 이용하여 비교 분석하였다. 결과 : 1군과 2군을 비교한 결과, 성별, 나이, 과거의 치료 실패율, 흉부 방사선 검사상 병변의 정도, 공동의 유무, 내성 약제의 개수, 치료약제중 감수성 약제의 비율과 감수성이 있는 살균제의 개수 및 다재내성균의 발현율에서 통계학적 유의성(p>0.05)은 관찰되지 않았다. 과거에 결핵치료를 받은 횟수에서는 1군에서 $2.4{\pm}0.8$, 2군에서 $1.6{\pm}0.9$로 통계학적 유의성(p<0.05)을 관찰할 수 있었다. 결론 : 폐결핵의 재치료 실패의 위험인자는 과거의 불규칙한 치료력임을 알 수 있었다. 따라서 재치료 실패를 감소시키기 위해서 초치료 폐결핵의 관리를 철저히 하여 실패하지 않도록 보다 큰 노력이 필요하다고 생각된다.

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A Pilot Randomized Trial of As-Needed Budesonide-Formoterol for Stepping Down Controller Treatment in Moderate Asthma with Complete Remission

  • Nakwan, Narongwit;Ruklerd, Thidarat;Taptawee, Pattarawadee
    • Tuberculosis and Respiratory Diseases
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    • 제85권3호
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    • pp.227-236
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    • 2022
  • Background: The use of low-dose inhaled corticosteroid-formoterol as reliever monotherapy has recently been recommended in the asthma treatment guidelines. However, the efficacy of this treatment strategy has not yet been determined during the stepping-down period in moderate asthma. This study aimed to evaluate the feasibility of reducing treatment to as-needed budesonide-formoterol (BFM) in moderate asthma with complete remission. Methods: We randomly assigned 31 patients (8 males and 23 females with a mean age of 57.2 years) with complete remission of asthma by inhaled BFM (160/4.5 ㎍) twice daily to receive BFM (160/4.5 ㎍) as needed (16 patients), or budesonide (BUD) (200 ㎍) twice daily (15 patients). The study was an open-label study done for 48 weeks, with the primary outcome as the cumulative percentages of patients with treatment failure (asthma exacerbation or loss of asthma control or lack of satisfaction after using medications) in the two groups. Results: Six patients (42%) using as-needed BFM had treatment failure, as compared with three patients (21.4%) using BUD maintenance (hazards ratio for as-needed BFM, 1.77; 95% confidential interval, 0.44-7.12; p=0.41). The changes in forced expiratory volume in 1 second were -211.3 mL with as-needed BFM versus -97.8 mL with BUD maintenance (difference, 113.5 mL; p=0.75) and the change in fractional exhaled nitric oxide was significantly higher in both groups, at 8.68 parts per billion (ppb) in the as-needed BFM group and 2.5 ppb. in the BUD maintenance group (difference, 6.18 ppb; p=0.049). Conclusion: Compared with BUD maintenance, there were no significant differences in treatment failure rate in patients who received as-needed BFM during the stepping down period in moderate asthma. However, they showed reduced lung function and relapsed airway inflammation. The results are limited by imprecision, and further large RCTs are needed.

당뇨병성 족부 감염에서 항생제 혼합 시멘트 충전물 사용의 치료 실패 위험 인자 분석 (Risk Factors for the Treatment Failure of Antibiotic-Loaded Cement Spacer Insertion in Diabetic Foot Infection)

  • 박세진;송승철
    • 대한족부족관절학회지
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    • 제23권2호
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    • pp.58-66
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    • 2019
  • Purpose: To evaluate the efficacy of antibiotic-loaded cement spacers (ALCSs) for the treatment of diabetic foot infections with osteomyelitis as a salvage procedure and to analyze the risk factors of treatment failure. Materials and Methods: This study reviewed retrospectively 39 cases of diabetic foot infections with osteomyelitis who underwent surgical treatment from 2009 to 2017. The mean age and follow-up period were $62{\pm}13years$ and $19.2{\pm}23.3months$, respectively. Wounds were graded using the Wagner and Strauss classification. X-ray, magnetic resonance imaging (or bone scan) and deep tissue cultures were taken preoperatively to diagnose osteomyelitis. The ankle-brachial index, toe-brachial index (TBI), and current perception threshold were checked. Lower extremity angiography was performed and if necessary, percutaneous transluminal angioplasty was conducted preoperatively. As a surgical treatment, meticulous debridement, bone curettage, and ALCS placement were employed in all cases. Between six and eight weeks after surgery, ALCS removal and autogenous iliac bone graft were performed. The treatment was considered successful if the wounds had healed completely within three months without signs of infection and no additional amputation within six months. Results: The treatment success rate was 82.1% (n=32); 12.8% (n=5) required additional amputation and 5.1% (n=2) showed delayed wound healing. Bacterial growth was confirmed in 82.1% (n=32) with methicillin-resistant Staphylococcus aureus being the most commonly identified strain (23.1%, n=9). The lesions were divided anatomically into four groups; the largest number was the toes: (1) toes (41.0%, n=16), (2) metatarsals (35.9%, n=14), (3) midfoot (5.1%, n=2), and (4) hindfoot (17.9%, n=7). A significant difference in the Strauss wound score and TBI was observed between the treatment success group and failure group. Conclusion: The insertion of ALCSs can be a useful treatment option in diabetic foot infections with osteomyelitis. Low scores in the Strauss classification and low TBI are risk factors of treatment failure.

근관 치료의 숨겨진 실패 원인- Coronal leakage (Coronal leakage- The hidden cause of endodontic failure)

  • 김의성;김일규;최진호;오남식;오성섭;김형돈
    • 대한치과의사협회지
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    • 제38권3호통권370호
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    • pp.288-292
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    • 2000
  • Perhaps the most frustrating scenario in dentistry lies in the apparently well-instrumented and well-obturated tooth that, becomes symptomatic after treatment of shows a periapical lesion on recall examination. Conventional root canal treatment demands stringent adherence to asepsis, awareness of canal morphology, and mastery of a variety of clinical techniques. But the risk of endodontic failure does not end with canal obturation. The quality of the coronal restoration may have a greater bearing on the ultimate success of a case than the quality of the root canal treatment itself. This review of the endodontic literature will define coronal leakage, describe its influence on endodontic treatment failures, and make specific recommendations on prevention.

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주타액선에서 발생한 선양낭세포암종의 방사선치료성적 (Treatment Results for Adenoid Cystic Carcinoma of the Major Salivary Gland)

  • 이상욱;김귀언;박정수;최은창;이강규;박원;서창옥
    • 대한두경부종양학회지
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    • 제18권2호
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    • pp.197-202
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    • 2002
  • Purpose: This study was to investigate clinical feature of adenoid cystic carcinoma (ACC) in the major salivary gland. Materials and Methods: A retrospective analysis was undertaken for 23 patients with adenoid cystic carcinoma of the major salivary gland, who completed postoperative radiotherapy at the Yonsei Cancer Center, Yonsei University Hospital between May 1981 and December 1999. The male to female ratio was 1.1:1. Median age was 50. Follow up periods were 12-180 months with the median follow-up time of 59 months. Results: Parotid gland, submandibular gland and sublingual gland were 17, 5 and 1 respectively. Overall failure rate was 26%. Local failure was observed in two patients with parotid gland origin. Five cases showed distant failure. Overall and disease free survival rate were 68% and 72% respectively. Conclusion: Major pattern of failure was distant failure. Resection margin status had not prognostic significance. Postoperative radiation treatment is an effective to control in the adenoid cystic carcinoma of the major salivary gland.

비귀금속합금 표면처리방법과 레진시멘트 종류가 접착인장강도에 미치는 영향에 관한 연구 (A STUDY OF TENSILE BOND STRENGTH ACCORDING TO VARIED TREATMENT METHODS OF NONPRECIOUS METAL SURFACE AND RESIN CEMENTS)

  • 양태진;임주환;조인호
    • 대한치과보철학회지
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    • 제34권2호
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    • pp.335-348
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    • 1996
  • Retention is one of the major factors deciding the success and longevity of resin bonded restorations. The purpose of this study was to find a better resin cement and metal surface treatment method that would enhance the bonding strength. The bonding surfaces of Verabond, one of Ni-Cr-Be alloys, were treated with sandblasting(Group 1), sandblasting and EZ-Oxisor(Group 2), sandblasting and silicoating(Group 3), and than thay were bonded with All-Bond C & B, Panavia 21, Superbond C & B. The specimens were thermocycled, and the tensile bond strength was measured using the unive-rsal testing machine. Also the mode of bond failure was observed. The results were as folows. 1. The Superbond C & B showed the highest bond strength among the three resin cements and decreased in the order of Panavia 21, All-Bond C & B. There was significant differe-nce among them(p<0.05). 2. Group 3 showed the highest bond strength among the three metal surface treatment methods, and there was significant difference compared with Group 1 and Group 2(p<0.05). But there was no significant difference between Group 1 and Group 2. 3. Observing the mode of bond failure, Superbond C & B and Panavia 21 showed mostly cohesive failure in all groups. All-Bond C & B showed all types of bond failure in Group 3, but Group 1 and Group 2 showed only adhesive failure. 4. According to the results of this study, the silicoating method and 4-META containing resin cement were considered to be more acceptable for resin bonded restoration.

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