• Title/Summary/Keyword: medical clinic

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Second-Line Irinotecan after Cisplatin, Fluoropyrimidin and Docetaxel for Chemotherapy of Metastatic Gastric Cancer

  • Kucukzeybek, Yuksel;Dirican, Ahmet;Erten, Cigdem;Somali, Isil;Can, Alper;Demir, Lutfiye;Bayoglu, Ibrahim Vedat;Akyol, Murat;Medeni, Murat;Tarhan, Mustafa Oktay
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2771-2774
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    • 2012
  • Aim: Tumors of upper gastrointestinal tract are among the cancers that have a quite lethal course. Cytotoxic chemotherapy is the most efficient therapeutic modality for metastatic gastric cancer. In patients who do not respond to first-line treatment, the response rate to second-line therapies is generally low and the toxicity rates high. This study concerned the efficacy and the side effect profile of second-line therapy with irinotecan in the patients who were being followed-up with the diagnosis of metastatic gastric cancer in $\dot{I}$zmir, Turkey. Materials and Methods: We retrospectively evaluated the efficacy and toxicity in 31 patients with metastatic gastric adenocarcinoma who presented to the polyclinic of Medical Oncology of Izmir Ataturk Education and Research Hospital between May 2008 and July 2011. All received chemotherapy regimens containing cisplatin, fluoropyrimidine (5-FU) and docetaxel as the first-line therapy for late stage disease. Irinotecan as a single agent was given at a dose of 210 mg/$m^2$ on each 21 days. Irinotecan (180 mg/$m^2$ on day 1), 5-FU (500 mg/$m^2$ on days 1-2) and leucovorin (LV; 60 mg/$m^2$ on days 1-2) as a combined regimen were given over a 14 day period. Results: Median age was 54 (range, 31-70). Irinotecan was given as a combined regimen for median 6 cycles (range, 3-12) and as a single agent for median 3 cycles (range, 1-10). Metastases were detected in one site in six patients (19%), in two different sites in 17 patients (55%) and in three or more sites in eight patients (26%). Four patients (12.9%) showed partial response and six patients (19.3%) showed stable disease. Progression-free survival (PFS) was found to be 3.26 months (95% CI, 2.3-4.2). Median overall survival (OS) was found to be 8.76 months (95% CI, 4.5-12.9). The most commonly seen grade 3/4 side effect was neutropenia but the the therapy was generally well-tolerated. Conclusions: In this study, it was demonstrated that second-line therapy with irinotecan given following the first-line therapy with cisplatin, fluoropyrimidine (5-FU) and docetaxel was efficient and safe. Further studies are needed for confirmation.

A case study on a patient of developmental disabilities with ADHD (시호가룡골모려탕(柴胡加龍骨牡蠣湯)을 이용한 발달장애 환자의 ADHD증상 관리 1례)

  • Jung, Myung-Ju;Park, Jong-Chan;Lee, Eun-Kyung;Yang, Duk-Mo;Yu, Dong-In
    • 대한상한금궤의학회지
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    • v.5 no.1
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    • pp.61-73
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    • 2013
  • Objective : The purpose of this report is to submit a case study on a patient of developmental disabilities with ADHD by taking "Sihogayonggolmoryeo-tang". Methods : We gave herbal medicine to a patient and observe the progress as the way of Cornners Abbreviated Rating Scale(CARS), ADHD Rating Scale (K-ARS), The ADD-H Comprehensive Teacher's Rating Scale(ACTeRS), Child Attention Problem(CAP), IOWA Conners Rating Scale, Conners Teacher Rating Scale(CTRS), Conners Parents Rating Scale (CPRS), Home Situation Questionnaire(HSQ), School Situation Questionnaire(SSQ). Results : The total score of CARS, ACTeRS and other scales were decreased by taking herbal medicine, and especially hyperactive scores were significantly decreased. Conclusions : Patient's symptom was significantly improved by using "diagnostic system based on Shanghanlun six meridian patterns and provisions" and analyzing patient's psychological and physical conditions.

Effect of thoracic kyphosis and lumbar lordosis by Korean Medical treatment involving The Jeongham Therapy: 8 cases (정함요법을 포함한 한의학적 치료방법이 흉추후만 요추 전만에 미치는 영향: 환자 8례)

  • Park, Geun-Yong;Yu, Seung-Ho;Kim, Tae-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.1
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    • pp.121-127
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    • 2011
  • Objectives : To introduce the Jeongham Therapy which means a mandibul-rectifying treatment. And to show meaningful changes of thoracic kypkosis and lumbar lordosis by the Jeongham Therapy. Methods : We reviewed 8 patients having abnormal thoracic kyphosis and lumbar lordosis who were treated at the JeongHam Korean Medical Clinic. We measured thoracic kyphosis and lumbar lordosis by 3D Body Analyzer 'IBS 2000'. Results : Between before and after the Jeongham Therapy, statically significant differences were found in the thoracic kyphosis and lumbar lordosis. And in these values of measurements, the thoracic kyphosis and lumbar lordosis diminish after the Jeongham Therapy. Conclusion : These results suggest that the Jeongham Therapy is a meaningful therapy to diminish the thoracic kyphosis and lumbar lordosis.

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Whole Exome Sequencing in Patients with Phenotypically Associated Familial Intracranial Aneurysm

  • Yunsun Song;Jong-Keuk Lee;Jin-Ok Lee;Boseong Kwon;Eul-Ju Seo;Dae Chul Suh
    • Korean Journal of Radiology
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    • v.23 no.1
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    • pp.101-111
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    • 2022
  • Objective: Familial intracranial aneurysms (FIAs) are found in approximately 6%-20% of patients with intracranial aneurysms (IAs), suggesting that genetic predisposition likely plays a role in its pathogenesis. The aim of this study was to identify possible IA-associated variants using whole exome sequencing (WES) in selected Korean families with FIA. Materials and Methods: Among the 26 families in our institutional database with two or more IA-affected first-degree relatives, three families that were genetically enriched (multiple, early onset, or common site involvement within the families) for IA were selected for WES. Filtering strategies, including a family-based approach and knowledge-based prioritization, were applied to derive possible IA-associated variants from the families. A chromosomal microarray was performed to detect relatively large chromosomal abnormalities. Results: Thirteen individuals from the three families were sequenced, of whom seven had IAs. We noted three rare, potentially deleterious variants (PLOD3 c.1315G>A, NTM c.968C>T, and CHST14 c.58C>T), which are the most promising candidates among the 11 potential IA-associated variants considering gene-phenotype relationships, gene function, co-segregation, and variant pathogenicity. Microarray analysis did not reveal any significant copy number variants in the families. Conclusion: Using WES, we found that rare, potentially deleterious variants in PLOD3, NTM, and CHST14 genes are likely responsible for the subsets of FIAs in a cohort of Korean families.

The Effects of Nerve Blocks in the Management of Occipital Neuralgia (후두신경통과 신경차단)

  • Jeong, Eui-Taeg;Choi, Hong-Cheol;Lim, So-Young;Shin, Keun-Man;Hong, Soon-Yong;Choi, Young-Ryong;Jeong, Yong-Joong
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.390-394
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    • 1996
  • Background: Occipital neuralgia is characterized by pain, usually deep and aching, in the distribution the second and/or third cervical dorsal root. Two broad groups of patients include primary occipital neuralgia with no apparent etiology and secondary neuralgia with structural pathology. Patients with occipital neuralgia can develop autonomic changes and hyperesthesia. In patients who have not improved with conservative treatment, we have carried out various nerve blocks and evaluated the effectiveness. Methods: In a series of 20 occipital neuralgia patients with no apparent etiolgy, we have carried out great occipital nerve blocks with needle TEAS. In patients who have not improved more than 75% on VAS with great occipital block, we have carried out C2 ganglion blocks and in patients who have not improved more than 75% with C2 ganglion block, C3 root blocks, C2/C3 facet joint blocks have been carried out in due order. Results: In 3 patients out of 10 patients who have not improved with great occipital nerve block, C2 ganglion block led to pain relief. A good response of C3 root block was achived in 2 of 7 patients without response to C2 ganglion block and C2/C3 facet joint block led to improvement in 1 of 5 patients without response to C3 root block. Conclusions: Nerve blocks like great occipital nerve block, C2 ganglion block, C3 root block, or C2/C3 facet joint block were effective in the patients who have not improved with conservative treatment.

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A Case Report of Precocious Puberty in a Female Patient : Significant Improvement in Controlling the Sex Hormone Levels (성조숙증으로 진단된 여자 환아에서 호르몬 수치가 개선된 치험 1례)

  • Lim, Youngkwern;Hur, Kwang-Wook;Park, Song Yi;Suh, Kyeung Suk;Chun, Sang Yeol;Lee, Suk Jin;Lee, Hoon;Kim, Hocheol
    • The Journal of Pediatrics of Korean Medicine
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    • v.28 no.4
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    • pp.64-70
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    • 2014
  • Objectives The purpose of this study is to find out how taking oriental herbal medicine may affect the sex hormone levels in a patient who was diagnosed with prematurity. Methods We prescribed 120 cc of oriental herbal medicine twice daily for a month to a patient suspected of the precocious puberty due to 11 pg/ml of the estradiol level. Upon finishing the course of oriental herbal medicine, the patient was retested for the follicular stimulating hormone, luteinizng hormone and estradiol levels. Results After administration, all levels of luteininzing hormone, follicular stimulating hormone and estradiol were decreased. There was no diagnosable evidence for the idiopathic central precocious puberty in the gonadotropin releasing hormone stimulation. Conclusions Oriental herbal medicine is a good alternative treatment of choice for the precocious puberty. However, more in-depth studies are to be followed.

Medical Accessibility and Its Effects on Medical Care Utilization -Experiences from Yonsei Health Insurance Cooperatives- (의료근접도 및 용이성이 의료이용에 미치는 영향 -연세건강공제회원의 외래의료이용을 중심으로-)

  • Oh, Hee-Chul
    • Journal of Preventive Medicine and Public Health
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    • v.12 no.1
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    • pp.99-106
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    • 1979
  • Accessibility to medical facilities and personnels has been known as one of important determinants of medical care utilization. This study attempted to identify the effects of medical accessibility in terms of geographical distance and occupational opportunity to the medical utilizations. Two-year-experiences of Yonsei University Health Insurance Cooperatives were used as the sources of data. Out patient utilization patterns of 713 members sampled from 4,352 members of Health Insurance Cooperatives were analyzed in order to identify the effects of medical accessibilities. Findings: 1 Average clinic visit rate of Yonsei Health Insurance is 1.66 per person per year. 2. The utilization rates of geographically more accessible group were 33% higher than that of less accessible group. 3. No marked difference in clinic visit rate were observed between medical and non-medical personnel and their family members. 4. Clinic visit rates among occupationally accessible group were slightly higher than those of less accessible. The utilization rate was more sensitively changed by the insurance policy changes in occupationally accessible group.

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Effect on Medical Expenses Request due to Medical Clinic Administrative Staff's Existence or Not (의원급 의료기관에서 행정인력 현황에 따른 진료비 청구에 미치는 영향)

  • Yun, Jong-Sel;Kim, Kwang-Hwan
    • Journal of Digital Convergence
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    • v.10 no.1
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    • pp.407-412
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    • 2012
  • From Jan. 1 2009 to Mar. 31 2009, a study surveyed 295 national clinic medical institutions that was newly enrolled in Health Insurance Review and Assessment Service to identify the factors depending on whether the administrative personnel influences on the management of the clinic medical institutions. The survey showed that the medical institutions with administrative personnels affected more adjustments than those without administrative personnels and it appeared to be statistically significant except one time(p<0.01). The result of the survey tells whether the administrative personnel is or not in medical institutions has important effects on the reduction. So, it is considered that the placement of administrative specialists in the hospital is very important for medical institutions.

A Clinical Study on Outpatients in Oriental Neuropsychiatry Clinic of an Oriental Medicine Hospital (서울소재 동서한방병원 한방신경정신과 외래 환자의 임상고찰)

  • Kim, Joo-Won;Shin, Hyun-Kwon;Chu, Ching-Nai;Lee, Ji-Won;Park, Se-Jin;Kim, Kyeong-Hye;Seo, Joo-He
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.3
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    • pp.123-134
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    • 2007
  • The aim of this study was to show the clinical aspects in outpatients who visited Oriental Neuropsychiatry Clinic. Method : We studied 419 patients who visited Oriental Neuropsychiatry Clinic of Dong-Sea Medical Center from march, 2007 to August, 2007. Results & Conclusion : 1. The ratio of male to female patients was 1:2 and age distribution was most frequent in 50s. 2. From onset, 32% of patients visited Oriental Neuropsychiatry Clinic in a week, 58% of patients visited in a month. 3. Oriental Neuropsychiatry diseases were 80%, Non-Oriental Neuropsychiatry diseases were 20%. The most common Oriental Neuropsychiatry diseases were Somatoform Disorders. 4. The most common diagnosises of the Oriental Neuropsychiatry diseases were Psychosomatic diseases. 5. The most common cheif corn1ains were Headache. 6. The most commonly used herbal medicine was Gamiondam-tang and Guibi-tang

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Effects of Oriental Medical Treatment on ADHD - A retrospective clinical survey - (ADHD에 대한 한방치료의 효과에 대한 후향적 관찰 연구)

  • Byun, Ki-Won;Kim, Joo-Ho;Kim, Jong-Woo;Chung, Sun-Yong
    • The Journal of Korean Medicine
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    • v.32 no.4
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    • pp.75-82
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    • 2011
  • Objectives: This case report aimed to evaluate whether oriental medical treatment was effective on ADHD through a records review of a local oriental medical clinic. Methods: We reviewed clinical charts of a local oriental medical clinic between December 2007 and September 2010 to select ADHD patients. Among those patients, for comparison before and after treatment, we selected cases which had at least twice Stroop test results and 2 months of treatment. Baseline, 3-month and 6-month Stroop test results were compared. Oriental medical treatment consisted of 2 months' herbal medicine, periodic acupuncture and exercise. Results: 1. 3-month data showed that subjects were 12 and improved word score and word-color score of Stroop test. 2. 6-month data showed that subjects were 20 and improved word score, color score, and word-color score of Stroop test. Conclusions: 1. Relatively short term herbal medication and exercise are effective on the word score and word-color score of the Stroop test. 2. After short term herbal medication, continuous exercise maintained the effects of short term oriental medical treatment. 3. We need to consider the balance of left and right as an important point of exercise, but further study is needed.