• 제목/요약/키워드: recurrent disease

검색결과 669건 처리시간 0.028초

관절경을 이용한 오스굿씨 병(Osgood-Schlatter's Disease)의 골편 제거술 (Arthroscopic Removal of Ossicles Associated with Osgood-Schlatter's Disease)

  • 안진환;하권익;하철원;이석재
    • 대한관절경학회지
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    • 제4권1호
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    • pp.67-70
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    • 2000
  • 오스굿씨 병은 일반적으로 보존적 방법으로 치료하지만 이에 호전되지 않는 지속적 혹은 재발성 통증이 있는 경우 수술적 가료가 필요한 경우가 있다. 대부분의 저자들이 슬개건 원위 골부착 부위에 골편이 존재하는 경우에 이를 제거하는 것으로 좋은 결과를 얻을 수 있다고 보고해 왔다. 저자들은 경골결절 전면부에 절개를 가하여 슬개건을 박리 후 골편을 제거하는 기존의 방식대신 관절경을 이용하여 슬개건의 뒤쪽으로부터 골편에 접근하여 골편을 제거하는 수기를 보고하고자 한다. 관절경을 이용한 오스굿씨 병의 골편제거술은 슬개건에의 손상을 최소화 할 수 있고, 빠른 술후 회복을 기대할 수 있으며, 경골 결절 전방부에 절개를 가하지 않음으로써 절개창 치유 후에 잔존할 수 있는 무릎을 꿇을 때의 반흔부 불편감의 발생을 예방할 수 있고, 보다 미용적이라는 장점이 있는 술식으로 사료된다.

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소아 위식도 역류에서 시행한 복강경 Nissen식 위바닥 주름술 (Laparoscopic Nissen Fundoplication in Children for Treatment of Gastroesophageal Reflux Disease)

  • 남소현;김대연;김성철;김인구
    • Advances in pediatric surgery
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    • 제13권1호
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    • pp.13-22
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    • 2007
  • Fundoplication is accepted as an effective treatment of gastroesophageal reflux disease. The recent results of laparoscopic fundoplication demonstrated safety and less morbidity, shorter hospital stay and less pulmonary complication compared to the open operation. Laparoscopic fundoplication has been our first choice of operation for gastroesophageal reflux disease since 2003. Among 29 cases, there were 2 conversion cases because of severe distension of transverse colon and hepatomegaly. We studied 27 consecutive patients operated upon from January 2003 through December 2004. There were 15 boys and 12 girls, ages from 1.5 months to 12 years (median 25.3 months). Body weight ranged from 2.9 kg to 37 kg (median 9.8 kg). Neurological abnormalities were present in 23 patients. Indications for surgery included medically refractory reflux associated with vomiting, pneumopathy, otorhinolaryngologic pathology, failure to thrive, esophagitis, apnea and bradycardia. We used 4-5 trocars of 5 mm or 12 mm with $30^{\circ}$ telescope and performed the Nissen technique in all patients. In neurological impaired patients, gastrostomy tube was placed at the time of fundoplication. Median operative time was 130 minutes (70 - 300 minutes). There was no mortality nor intraoperative complication. Twenty-six patients were followed for median of 19 months (8 - 31 months). Four patients (15.4 %), who were all neurological impaired, developed recurrent symptoms of gastroesophageal reflux disease. Two of these patients had reoperation (1 laparoscopic approach, 1 open method). There were significant increases in body weight in 11 patients after fundoplication. Laparoscopic fundoplication is acceptable as a safe and effective method for gastroesophageal reflux disease.

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전립선(前立腺) 질환(疾患)에 대한 활혈거어법(活血祛瘀法)의 효과(效果) (Effect of The activating blood flow and removing blood stasis Method to Prostatic disease)

  • 송봉근;김중길;박승원;송운용;정인석
    • 대한한방내과학회지
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    • 제21권4호
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    • pp.615-619
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    • 2000
  • Objective : The prostatic disease is characterized as relatively incurable, chronic and recurrent illness. Because of this property, we have the difficulty in treating this illness. Besides, the drug selectivity is restricted to the specific prostatic membrane, the barrier of prostate. This study was to evaluate the efficency of the activating blood flow and removing blood stasis Method to Prostatic disease. Methods : We investigated 51 prostatic patiens with NIH chronic prostatitis symptom index, digital rectal examination(DRE), expressed prostatic secretion(EPS). After investigation we treated the patients with herb which was aimed to activate the blood flow and remove the blood stasis method to prostatic disease. Results : After the treatment, symptom index score of the prostatic patients was reduced from 11.7 to 7.4. The cure rate of 51 prostatic patients was 76.5%. Also the cure rate of the patients who was treated over 4 weeks was higher than the patients treated below 4 weeks, 87.5% to 66.7% respectively. conclusions : These results indicate that oriental medical theraphy is useful enough to treat the prostatic patients. Therefore, the more research about the herb which has activating blood flow and removing blood stasis effect is necessary.

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다발성 폐공동을 형성한 베체트병 1예 (A Case of Behcet's Disease with Multiple Cavitary Lung Lesion)

  • 윤세희;손지웅;정청일;최유진
    • Tuberculosis and Respiratory Diseases
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    • 제61권1호
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    • pp.65-69
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    • 2006
  • 저자들은 43세 남자환자에서 반복적인 구강궤양을 가지고 있으며 안증상으로 진단한 베체트병 환자에서 폐동맥 색전증, 폐동맥류, 상대정맥 협착등 다양한 폐혈관 침범과 함께 폐아스페르길루스종을 동반한 다발성 공동 형성을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

피부질환에 대한 온청음의 국외 임상연구 동향 (Overseas Clinical Research Trends of On Cheong Eum on Skin Disease)

  • 한정민;이성은;정혜진;최승배;서형식;정현아;고우신;윤화정
    • 한방안이비인후피부과학회지
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    • 제30권1호
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    • pp.1-9
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    • 2017
  • Objectives : This study was performed to review the overseas clinical research trends on the effect of On cheong eum on skin disease. Methods : We searched articles in the Pubmed using keywords "On cheong eum", "On sei in", "Wen qing yin", "Jie du si wu tang" and "Jie du si wu decoction". We also searched in the China National Knowledge Infrastructure(CNKI) using key words "温清饮" and "解毒四物汤", We selected 5 studies after excluding non-clinical or unrelated studies. Results : One pre-post comparison study and four controlled clinical trials were performed. On cheong eum and modified On cheong eum were used for the treatment of skin disease-recurrent aphthous ulcer, psoriasis vulgaris, neurodermatitis, and skin pruritus. All of the studies showed positive results, and they reported that the treatment group had higher effective rate than control group. However, the quality of these clinical studies were not evaluated. Conclusions : According to this study, On cheong eum would be an effective and safe intervention in skin disease. Therefore, based on this study, more clinical research using On cheong eum should be performed in Korean medicine in the near future.

Tertiary Cytoreduction for Recurrent Epithelial Ovarian Cancer: a Multicenter Study in Turkey

  • Arvas, Macit;Salihoglu, Yavuz;Sal, Veysel;Gungor, Tayfun;Sozen, Hamdullah;Kahramanoglu, Ilker;Topuz, Samet;Demirkiran, Fuat;Iyibozkurt, Cem;Bese, Tugan;Ozgu, Burcin Salman;Vatansever, Dogan;Tokgozoglu, Nedim;Berkman, Sinan;Turan, Hasan;Bengisu, Ergin;Sofiyeva, Nigar;Demiral, Irem;Meydanli, Mutlu
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.1909-1915
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    • 2016
  • Background: The purpose of this study was to determine the benefit of tertiary cytoreductive surgery (TC) for secondary recurrent epithelial ovarian cancer (EOC), focusing on whether optimal cytoreduction has an impact on disease-free survival, and whether certain patient characteristics could identify ideal candidates for TC. Materials and Methods: Retrospective analysis of secondary recurrent EOC patients undergoing TC at three Turkish tertiary institutions from May 1997 to July 2014 was performed. All patients had previously received primary cytoreduction followed by intravenous platinum-based chemotherapy and secondary cytoreduction for first recurrence. Clinical and pathological data were obtained from the patients' medical records. Survival analysis was caried out using the Kaplan Meier method. Actuarial curves were compared by the two tailed Logrank test with a statistical significance level of 0.05. Results: Median age of the patients was 49.6 years (range, 30-67) and thirty-eight (72%) had stage III-IV disease at initial diagnosis. Twenty six (49%) had optimal and 27 (51%) suboptimal cytoreduction during tertiary debulking surgery. Optimal initial cytoreduction, time to first recurrence, optimal secondary cytoreduction, time interval between secondary cytoreduction and secondary recurrence, size of recurrence, disease status at last follow-up were found to be significant risk factors to predict optimal TC. Optimal cytoreduction in initial and tertiary surgery and serum CA-125 level prior to TC were independent prognostic factors on univariate analysis. Conclusions: Our results and a literature review clearly showed that maximal surgical effort should be made in TC, since patients undergoing optimal TC have a better survival. Thus, patients with secondary recurrent EOC in whom optimal cytoreduction can be achieved should be actively selected.

국소재발된 두경부종양의 무고정틀 정위적 분할방사선치료 (Frameless Fractionated Stereotactic Radiaton Therapy in Recurrent Head & Neck Cancers)

  • 김인아;최일봉;장지영;강기문;조승호;김형태;이경진;최창락
    • 대한두경부종양학회지
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    • 제14권2호
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    • pp.156-163
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    • 1998
  • Background & Objectives: Frameless fractionated stereotactic radiotherapy(FFSRT) is a modification of stereotactic radiosurgery(SRS) with radiobiologic advantage of fractionation without losing mechanical accuracy of SRS. Local recurrence of head and neck cancer at or near skull base benefit from reirradiation. Main barrier to successful palliation is dose limitation secondary to normal tissue tolerance. We try to evaluate the efficacy and safety of FFSRT as a new modality of reirradaton in these challenging patients. Materials & Methods: Seven patients with recurrent head & neck cancer involving at or near skull base received FFSRT from September 1995 to November 1997. Six patients with nasopharyngeal cancer had received induction chemotherapy and curative radiation therapy. One patient with maxillary sinus cancer had received total maxillectomy and postoperative radiation therapy as a initial treatment. Follow-up ranged from 11 to 32 months with median of 24 months. Three of 7 patients received hyperfractionated radiation therapy(1.1-1.2Gy/fraction, bid, total 19.8-24Gy) just before FFSRT. All patients received FFSRT(3-5Gy/fraction, total 15-30Gy/5-10fractions). Chemotherapy(cis-platin $100mg/m^2$) were given concurrently with FFSRT in four patients. Second course of FFSRT were given in 4 patients with progression or recurrence after initial FFSRT. Because IF(irregularity factor; ratio of surface area of target to the surface area of sphere with same volume as a target) is too big to use conventional stereotactic RT using multiple arc method for protection of radiation damage to critical normal tissue, all patients received FFSRT with conformal method using irregular static ports. Results: Five of 7 patients showed complete remission in follow-up CT &/or MRI. Three of these five patients who developed marginal, in-field, and out-field recurrences, respectively. Another one of complete responders has been dead of G-I bleeding without evidence of local recurrence. One partial responder who showed progressive disease 15 months after initial FFSRT has received additional FFSRT, and then he is well-being with symptomatic improvement. One minmal responder who showed progression of locoregional disease 9 months after $1^{st}$ FFSRT has received 2nd FFSRT, and then he is alive with stable disease. Five of 7 case had showed direct invasion to skull base and had complaint headache and various symptoms of cranial nerve involvement. Four of these five case showed improvement of neurologic symptoms after FFSRT. No significant neurologic complicaltion related to FFSRT was observed during follow-up periods. Tumor volumes were ranged from 3.9 to 50.7 cc and surface area ranged from 16.1 to $114.9cm^2$. IF ranged from 1.21 to 1.74. The average ratio of volume of prescription isodose shell to target volume was 1.02 that indicated the improvement of target coverage and dose distribution with FFSRT with conformal method compared to target coverage with FFSRT with multiple arc method. Conclusion: Our initial experience suggests that FFSRT with conformal method was relatively effective and safe modality in the treatment of recurrent head and neck cancer involving at or near skull base. Treatment benefit included good palliation of symptoms and reasonable radiographic response. However, more experience and additional follow-up are needed to better assess its ultimate role in treating these challenging patients.

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Temozolomide Salvage Chemotherapy for Recurrent Anaplastic Oligodendroglioma and Oligo-Astrocytoma

  • Gwak, Ho-Shin;Yee, Gi Taek;Park, Chul-Kee;Kim, Jin Wook;Hong, Yong-Kil;Kang, Seok-Gu;Kim, Jeong Hoon;Seol, Ho Jun;Jung, Tae-Young;Chang, Jong Hee;Yoo, Heon;Hwang, Jeong-Hyun;Kim, Se-Hyuk;Park, Bong Jin;Hwang, Sun-Chul;Kim, Min Su;Kim, Seon-Hwan;Kim, Eun-Young;Kim, Ealmaan;Kim, Hae Yu;Ko, Young-Cho;Yun, Hwan Jung;Youn, Ji Hye;Kim, Juyoung;Lee, Byeongil;Lee, Seung Hoon
    • Journal of Korean Neurosurgical Society
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    • 제54권6호
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    • pp.489-495
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    • 2013
  • Objective : To evaluate the efficacy of temozolomide (TMZ) chemotherapy for recurrent anaplastic oligodendroglioma (AO) and anaplastic oligoastrocytoma (AOA). Methods : A multi-center retrospective trial enrolled seventy-two patients with histologically proven AO/AOA who underwent TMZ chemotherapy for their recurrent tumors from 2006 to 2010. TMZ was administered orally (150 to 200 $mg/m^2/day$) for 5 days per 28 days until unacceptable toxicity occurred or tumor progression was observed. Results : TMZ chemotherapy cycles administered was median 5.3 (range, 1-41). The objective response rate was 24% including 8 cases (11%) of complete response and another 23 patients (32%) were remained as stable disease. Severe side effects (${\geq}$grade 3) occurred only in 9 patients (13%). Progression-free survival (PFS) of all patients was a median 8.0 months (95% confidence interval, 6.0-10.0). The time to recurrence of a year or after was a favorable prognostic factor for PFS (p<0.05). Overall survival (OS) was apparently differed by the patient's histology, as AOA patients survived a median OS of 18.0 months while AO patients did not reach median OS at median follow-up of 11.5 months (range 2.7-65 months). Good performance status of Eastern Cooperative Oncology Group 0 and 1 showed prolonged OS (p<0.01). Conclusion : For recurrent AO/AOA after surgery followed by radiation therapy, TMZ could be recommended as a salvage therapy at the estimated efficacy equal to procarbazine, lomustine, and vincristine (PCV) chemotherapy at first relapse. For patients previously treated with PCV, TMZ is a favorable therapeutic option as 2nd line salvage chemotherapy with an acceptable toxicity rate.

Efficacy of Taxane-Based Regimens in a First-line Setting for Recurrent and/or Metastatic Chinese Patients with Esophageal Cancer

  • Jiang, Chang;Liao, Fang-Xin;Rong, Yu-Ming;Yang, Qiong;Yin, Chen-Xi;He, Wen-Zhuo;Cai, Xiu-Yu;Guo, Gui-Fang;Qiu, Hui-Juan;Chen, Xu-Xian;Zhang, Bei;Xia, Liang-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5493-5498
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    • 2014
  • Objective: To compare the efficacy of taxane-based regimens in the first line setting retrospectively in Chinese patients with recurrent and/or metastatic esophageal cancer. Methods: We analyzed 102 recurrent and/or metastatic esophageal cancer patients who received taxanes-based regimens in a first-line setting from January 2009 to December 2013. Sixteen (15.7%) patients were administered Nab-PTX based chemotherapy and 86 patients (84.3%) received paclitaxel (PTX) or docetaxel (DTX) based chemotherapy. Patients in the PTX/DTX group could be further divided into TP (71 patients) and TPF (15 patients) groups. Results: The objective response rate (ORR) of all patients was 20.6%, and the disease control rate (DCR) was 67.6%. The median overall survival (OS) was 10.5 months (95% CI 10.1-16.4) and the median progression-free survival (PFS) was 6.04 months (95% CI 5.09-7.91). The DCR was higher in the TPF group than the TP group (93.3% vs. 59.1%; p = 0.015 ). There were no significant differences in ORR, OS, and PFS among Nab-PTX, TPF and TP groups. Conclusions: The three regimens of Nab-PTX based, TP and TPF proved active in a first line setting of Chinese patients with recurrent and/or metastatic esophageal cancer, and should thus be regarded as alternative treatments.

근치적 방사선치료 후 재발한 자궁경부암의 재 방사선치료 (Reirradiation in Rcurrent Cervical Cancer Following Definite Radiation Therapy)

  • 김진희;최태진;김옥배
    • Radiation Oncology Journal
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    • 제19권3호
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    • pp.230-236
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    • 2001
  • 목적 : 저자들은 근치적 방사선치료를 시행받고 골반 내에 재발하여 재 방사선치료를 받은 자궁경부암 환자를 대상으로 생존률, 부작용 등 결과를 분석하고자 하였다. 대상 및 방법 : 1987년 11월부터 1998년 3월까지 계명대학교 동산의료원 치료방사선과에서 근치적 방사선치료를 받고 추적 관찰 중 골반내에 재발하여 재 방사선치료를 받은 환자 18명을 대상으로 하였다. 처음 진단당시 병기로는 Ia 1명, Ib 5명, IIa 5명, IIb 3명, IIIb 2명, IVa 2명으로 평균연령은 57세($37\~79$세)이었다. 재발기간은 6개월에서 122개월로 평균 58개월이었다. 재발부위는 7명에서 자궁경부, 10명에서 질부, 1명에서 골반내 림프절에 재발하였다. 12명은 외부방사선치료와 강내 방사선치료를, 4명은 외부방사선치료와 자입방사선치료를, 2명은 외부방사선치료단독를 시행하였다. 재 방사선치료의 외부방사선량은 $2,100\~5,400\;cGy$이었고 방사선총량은 $3,780\~8,550\;cGy$이었다. 재발 후 추적기간은 8개월에서 80개월로 평균 25개월이었다. 결과 : 재 방사선치료 직후 전체 18명 중 14명$(78\%)$에서 국소 제어가 되었으며 재 방사선치료를 시행한 후 2년 무병생존률은 $53.6\%$이었다. 재발부위에 따라 2년 무병생존률이 질에 재발한 환자 10명에서는 $71.4\%$, 자궁에 재발한 환자 7명에서는 $28.5\%$ (p=0.03)를 나타내어 통계적으로 유의한 차이를 보였다. 재 방사선총량에 따라 2년 무병생존률이 통계적으로 유의하게 차이를 보였다$(>6,000\;cGy\;71.8\%,\;{\leq}6,000\;cGy\;25\%\;p=0.007)$. 재 방사선치료 후 20개월 이상 추적 관찰된 환자 10명중 7명에서 무병생존 중이다(7/18, $39\%$). 외부방사선치료와 강내방사선치료를 시행한 환자에서 가장 좋은 생존률을 보였다. 재 방사선치료 후 실패양상은 국소 재발이 국소 제어 안된 4명을 포함한 7명 $(39\%)$에서 자궁 및 질에 재발하였고 2명에서 원격 전이되어 사망하였다. 부작용으로는 장출혈이 3명에서 있었으며 수술을 요하는 장폐쇄가 2명, 방광손상에 의한 혈뇨가 1명, 2도 방광염이 2명, 연부 부종이 2명, 질부조직괴사가 1명에서 있었으나 자연 치유되었다. 재 방사선치료총량이나 재발기간에 따른 부작용의 차이는 없었다. 결론 : 근치적 방사선치료 후 재발한 경우, 재 방사선치료는 도움이 될 것으로 사료되나 심각한 부작용을 줄이는 노력이 더 요구된다.

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