• 제목/요약/키워드: remission

검색결과 585건 처리시간 0.037초

중증 근무력증의 흉선절제술 (Clinical Evaluation of Thymectomy in Myasthenia Gravis)

  • 박창권
    • Journal of Chest Surgery
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    • 제25권8호
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    • pp.844-849
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    • 1992
  • Between 1979 and 1991 thymectomy was performed on 31 patients with myasthenia gravis at the department of thoracic and cardiovascular surgery, Keimyung University medical school. All patients were treated by transsternal thymectomy. During follow-up period that ranged from a month to 10.7 years[mean 2 years], the remission rate for the entire group was 16.1 percent and an additional 71.0 percent had improvement [87.1 percent benefited]. In those 8 patients with thymoma, the remission rate was 12.5 percent with 75.0 percent of the patients benefiting from operations The remainimg 23 patients fared better the operations: 17.4 percent had remission and a total of 91.4 percent benefited. There was no mortality, I concluded that most patients with myasthenia gravis will benefit from thymectomy, and that the improvement persists over an extended period of time in a high percentage of patients.

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세균성 동맥내막염을 동반한 개방성 동맥관의 자연파열;1례 보고 (Subacute bacterial endarteritis associated with patent ductus arteriosus; a case report)

  • 한동기
    • Journal of Chest Surgery
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    • 제26권10호
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    • pp.801-803
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    • 1993
  • Surgical correction of patent ductus arteriosus is,under most circumstances,highly successful and carries a low mortality. But infected PDA is yet potentially dangerous due to its frequent recurrence and resistant organisms to antibiotics. And,in surgical correction,surgeon may face the possibility of tearing of ductus arteriosus arterial end due to friability and adhesion of its surrounding tissue.This report demonstrats another problem in treatment of infected patent ductus arteriosus.This thirteen years old female patient received susceptible combined antibiotics intravenously from the day of admission and remitted from 4th.week of therapy.This remission state continued for 12days without relapse.But the pulmonary artery ruptured in this remission period.In autopsy,bacteria was not found in ductal vegetation.Also,there was no pulmonary artery aneurysm,Our experience show that in infected PDA,pulmonary artery can rupture spontaneously during remission period without aneurysmal formation.

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장기간 천식 관해 청소년에서 지속되는 기관지 과민성과 β2-아드레날린 수용체 유전자 다형과의 연관성 분석 (Analysis of the association between bronchial hyperresponsiveness and genetic polymorphism of β2-adrenoceptor in adolescents with long-term asthma remission)

  • 강희;고영률
    • Clinical and Experimental Pediatrics
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    • 제50권6호
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    • pp.556-564
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    • 2007
  • 목 적 : 본 연구에서는 현증 천식 환자의 BHR에는 기도 염증이 중요한 요인으로 작용하기 때문에 ${\beta}_2$-아드레날린 수용체 유전자와의 연관성이 나타나지 않지만, 청소년기 천식 관해 상태에서 지속되는 BHR에는 상대적으로 유전적인 영향이 강하기 때문에 ${\beta}_2$-아드레날린 수용체 유전자와의 연관성이 나타날 것이라는 가설을 세우고, 이를 검증해 보고자 하였다. 방 법 : 장기간 천식 관해 상태(최근 2년간 천식 증상이 없고 치료가 필요 없었던 경우)에서 BHR이 지속되는 청소년 202명(천식 관해군), 현증 천식 청소년 182명(현증 천식군), 정상군 200명을 대상으로, 메타콜린 기관지 유발검사와 피부단자시험을 시행하였으며 혈청 총 IgE를 측정하였다. ${\beta}_2$-아드레날린 수용체 유전자의 일배체형 분석을 위해 아미노산 16번과 27번을 포함하고 있는 ${\beta}_2$-아드레날린 수용체 유전자 부위를 polymerase chain reaction(PCR)으로 증폭한 뒤, 16번 유전형은 allele specific PCR, 27번 유전형은 PCR-restriction fragment length polymorphism (RFLP) 방법으로 분석하였다. 결 과 : Gly 동형접합자(homozygote)의 빈도는 정상군에서 14.5%, 현증 천식군에서 18.1%, 천식 관해군에서 24.2%로 증가하는 경향이 관찰되었으며(P=0.01), 현증 천식군과 정상군 사이에서는 차이가 없었지만 천식 관해군과 정상군 사이에서는 유의한 차이가 관찰되었다(P=0.01). Gly16-Gln27 일배체형 빈도는 정상군에서 36.5%, 현증 천식군에서 40.4%, 천식 관해군에서 44.6%로 증가하는 경향이 관찰되었으며(P=0.02), 현증 천식군과 정상군 사이에서는 차이가 없었지만 천식 관해군과 정상군 사이에서는 유의한 차이가 관찰되었다(P=0.02). 천식 관해군에서 Gly16-Gln27 일배체형의 수가 증가함에 따라 $PC_{20}$ 기하 평균값이 유의한 차이를 보임으로써(P=0.02) Gly16-Gln27 일배체형과 $PC_{20}$ 사이의 연관성이 관찰되었으나 현증 천식군에서는 이러한 연관성이 관찰되지 않았다. 결 론 : ${\beta}_2$-아드레날린 수용체 유전자가 BHR을 유발하는 유전자적 배경을 가지면서 천식 질병을 조절하는 역할을 하고 있음을 시사한다.

중증 근무력증의 수술적 치료 (Surgical Treatment of Myasthenia Gravis)

  • 강정수;김길동
    • Journal of Chest Surgery
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    • 제29권9호
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    • pp.1010-1016
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    • 1996
  • 중증근무력증환자에 있어서 흉선 절제술은 대상이 되는 환자의 선택 기준이나 수술시기, 수술 방법에 있어서 아직까지 논란이 되고 있지만 긍정적으로 적용될 수 있는 치료 방법이다. 연세대학교흉부외과 학교실 신촌 세브란스병원에서는 1983년 1월부터 1994년 12월까지 중증근무력증으로 흉선 절제술을 시행한 82명의 환자를 대상으로 연구하였다. 수술 사망은 1명에서 발생하였고 수술 후 추적은 75명에서 가능하였고 평균 추적기간은 56.9개월 이었다. 완전관해된 28명(37.3%)을 포함하여 64명(85.3%)에서 수술로 인한 효과를 볼 수 있었다. 동반된 질환으로는 갑상선 질환이 8예로 가장 많았는데 이중 7명(87. 5%)이 완전관해를 보여 갑상선 질환을 동반하지 않은 환자 67명중 21명(31.3%)의 완전관해보다 높은 치료 성공율을 나타내었다. 수술 전 병력 기간이 2년 미만인 환자 32명중 16명(50%), 2년 이상인 환자 43명중 12명(27.4%)이 완전관해를 보여 수술전병력 기간이 2년 미만인 경우 높은 치료율을 보였다. 결론적으로 중증근무력증환자에 있어서 흉선 절제술 후 완전관해율은 갑상선 질환의 동반 여부와 수술 전 병력기간에의해 영향을 받음을 알 수 \ulcorner었으며 병의 발생 연령(40세 이상),흉선종의 동반,고령 및 남자의 경우 수술 후 완전관해율을 떨어뜨리는 것으로 나타났지만 통계적 의의는 없었다. 흉선의 조 직학적 소견으로 정상과 흉선 비후사이에 있어서 완전관해율의 차이는 보이지 않았다. 일반적으로 흉선 절제술은 대부분의 중증근무력증환자에 있어서 효과가 있었으나 임상증상적 분류로 기 속한 환자군은 수술로 인한 효과가 없었다.

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중등도-중증 궤양성 대장염 환자에서 infliximab의 치료효과에 대한 메타분석 (Meta-analysis of the Efficacy of Infliximab in Patients with Moderate-Severe Ulcerative Colitis)

  • 김종윤;이숙향;유기연
    • 한국임상약학회지
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    • 제22권3호
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    • pp.251-259
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    • 2012
  • Ulcerative colitis (UC) is characterized by a life-long chronic course with remissions and exacerbations. Use of biological therapies may reduce or delay the surgical procedures in patients with UC. The aim of this study was to determine the impact of infliximab (IFX) use on the rate of remission, surgical interventions, and the effect on quality of life in patients with moderate to severe UC. Literature was searched for studies that investigated the efficacy of IFX on the rate of remission, colectomy and quality of life (QoL) between January 1990 and June 2012 at MEDLINE, January 1988 and June 2012 at EMbase and others. Eleven trials were included in the meta-analysis; divided into placebo controlled 8 trials and intravenous corticosteroid controlled group 3 trials. In comparison to placebo control groups, patients who received IFX had an odds ratio (OR) of 3.712 (95% CI: 2.714, 5.079) for the short-term clinical remission, and 3.053 (95% CI: 2.044, 4.559) for the rate of long-term remission. In colectomy rate and quality of life (QoL), odds ratio were 0.566(95% CI: 0.387, 0.827) and 0.658 (0.505, 0.811) respectively. Any adverse reactions including infections, infusion reaction, rash and arthralgia were equivalent in both groups. Compared with intravenous corticosteroid controlled group, patients who received IFX had lower remission rate with short-term odds ratio 0.227 (95% CI: 0.033, 1.556) and long-term odds ratio 1.054 (95% CI: 0.317, 3.502) respectively. However, statistical significance was not showed with both two analyses. The higher adverse drug reaction (ADR) rates were occurred in the corticosteroid controlled groups. 73.3% of patients treated corticosteroid reported Cushing-like syndrome with moon face. In conclusion, IFX does increase remission rate and decrease the rate of colectomy in patients with UC without elevating any adverse reactions significantly. IFX also improves QoL in moderate to severe UC patients. It would not exceed the efficacy of intravenous corticosteroid, whereas intravenous corticosteroid also reported high rate of adverse reactions.

한국형 공황장애 약물치료 알고리듬 2008 : 공황장애의 진단, 치료 반응과 관해의 평가 (Korean Medication Algorithm for Panic Disorder 2008 : Diagnosis, Treatment Response and Remission of Panic Disorder in Korea)

  • 김민숙;유범희;김찬형;윤세창;이상혁;서호석;양종철;한국형 공황장애 약물치료 알고리듬 2008 연구그룹
    • 대한불안의학회지
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    • 제4권1호
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    • pp.49-54
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    • 2008
  • Objective : This article is a part of the Korean Medication Algorithm Project for Panic Disorder, which aims to build consensus regarding the diagnosis, treatment response and achievement of clinical remission for patients with panic disorder in Korea. Methods : The questionnaire used in this article had parts : 1) diagnosis, 2) treatment response, and 3) remission for patients with panic disorder. The questionnaire was completed by each of 54 Korean psychiatrists who had much experience in treating patients with panic disorder. We classified the experts' opinions into 3 categories (first-line, second-line, and third-line) using the ${\chi}^2$-test. Results : Five factors were considered in this research : panic attack, anticipatory anxiety, phobic avoidance, severity of illness, and psychosocial disability. Most reviewers agreed that the presence of a panic attack was the most important factor in the diagnosis of patients with panic disorder. Phobic avoidance was included in the first-line category, whereas the severity of illness and psychosocial disability were included in the second-line category. Most reviewers also agreed that the presence of a panic attack was the most important factor in determining the appropriate treatment response, and it was included in the first-line category along with several other items. To determine remission status, the patients' scores on tests pertaining to the severity of panic attack, anticipatory anxiety, phobic avoidance, severity of illness and psychosocial disability should be less than 3.0-3.3 on a 9-point Likert scale. Conclusion : We suggest useful information for making a diagnosisof panic disorder, determining the appropriate treatment response and identifying remission in panic disorder patients on the basis of the results of a nationwide survey of experts in Korea.

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Advances in management of pediatric chronic immune thrombocytopenia: a narrative review

  • Jae Min Lee
    • Journal of Yeungnam Medical Science
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    • 제40권3호
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    • pp.241-246
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    • 2023
  • Immune thrombocytopenia (ITP) is a disease in which thrombocytopenia occurs because of immune-mediated platelet destruction and decreased platelet production. Although many pediatric patients with ITP experience spontaneous remission or reach remission within 12 months of first-line therapy, approximately 20% progress to chronic ITP. Patients who do not respond to first-line treatment or experience frequent relapses are of great concern to physicians. This review summarizes recent treatments for second-line treatment of pediatric chronic ITP.

Outcome of Endoscopic Transsphenoidal Surgery in Combination with Somatostatin Analogues in Patients with Growth Hormone Producing Pituitary Adenoma

  • Zhou, Tao;Wang, Fuyu;Meng, Xianghui;Ba, Jianmin;Wei, Shaobo;Xu, Bainan
    • Journal of Korean Neurosurgical Society
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    • 제56권5호
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    • pp.405-409
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    • 2014
  • Objective : To determine the efficacy of endoscopic surgery in combination with long-acting somatostatin analogues (SSAs) in treating patients with growth hormone (GH)-secreting pituitary tumor. Methods : We performed retrospective analysis of 133 patients with GH producing pituitary adenoma who underwent pure endoscopic transsphenoidal surgery in our center from January 2007 to July 2012. Patients were followed up for a range of 3-48 months. The radiological remission, biochemical remission and complication were evaluated. Results : A total of 110 (82.7%) patients achieved radiological complete resection, 11 (8.2%) subtotal resection, and 12 (9.0%) partial resection. Eighty-eight (66.2%) patients showed nadir GH level less than 1 ng/mL after oral glucose administration. No mortality or severe disability was observed during follow up. Preoperative long-acting SSA successfully improved left ventricle ejection fraction (LVEF) and blood glucose in three patients who subsequently underwent success operation. Long-acting SSA (20 mg every 30 days) achieved biochemical remission in 19 out 23 (82.6%) patients who showed persistent high GH level after surgery. Conclusion : Endoscopic transsphenoidal surgery can biochemically cure the majority of GH producing pituitary adenoma. Post-operative use of SSA can improve biochemical remission.

Concurrent Chemoradiotherapy Versus Radiotherapy Alone for Locoregionally Advanced Nasopharyngeal Carcinoma

  • Yu, Hong-Sheng;Wang, Xin;Song, Ai-Qin;Liu, Ning;Zhang, Wei;Yu, Li
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권8호
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    • pp.3961-3965
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    • 2012
  • Objective: To compare the clinical effects of concurrent radiochemotherapy with those of radiotherapy in treating locally advanced nasopharyngeal carcinoma (Stage III~IVa). Methods: A total of 95 patients suffering from nasopharyngeal carcinoma (Stage III~IVa) were divided into two groups: concurrent radiochemotherapy (Group CCRT, n=49) and radiotherapy (Group RT, n=46). The two groups were both delivered conventional fractionated radiotherapy, while Group CCRT also received three cycles of PF (DDP+5-Fu) or PLF (DDP+5-Fu+CF) chemotherapy. Results: The complete remission rate and total remission rate of Group CCRT were higher than those of Group RT ($X^2$=4.72~7.19, P<0.05). The one-year overall survival (OS) rate calculated by the life table method, was also higher than that of Group RT ($X^2$=4.24, P<0.05) as well as the 3-year OS rate, nasopharyngeal control rate and cervical lymph nodes' control rate ($X^2$=4.28~4.40, P<0.05). In addition, the 5-year OS and metastasis-free rates of Group CCRT were higher than those of Group RT and the differences were of statistical importance ($X^2$=3.96~8.26, P<0.05). However, acute toxicity was also obviously higher, the difference in gastrointestinal reactions being statistically significant ($X^2$=11.70, P<0.05). Conclusion: This study demonstrated that concurrent radiochemotherapy could improve the remission rate, overall survival rate and locally control rate. The toxicity of concurrent radiochemotherapy could be tolerated by the patients.

신경계 증상을 동반한 부분적으로 자연완화된 소세포폐암 (Partial spontaneous remission of small cell lung carcinoma with neurologic symptom)

  • 윤경현;송성헌;김충현;황찬희;이준호;최재형;김선영
    • Journal of Yeungnam Medical Science
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    • 제34권2호
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    • pp.275-278
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    • 2017
  • Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-year-old man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.