• 제목/요약/키워드: therapy protocol

검색결과 396건 처리시간 0.027초

연구개인두 폐쇄 부전 환자의 진단과 치료 (The Diagnosis and Management of Velopharyngeal Insufficiency)

  • 이용권;최재평;최진영
    • 대한구순구개열학회지
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    • 제11권1호
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    • pp.13-22
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    • 2008
  • Velopharyngeal insufficiency(VPI), characterized by hypernasal resonance and nasal air emission, is a speech disorder that can significantly compromise speech intelligibility. Cleft palate, previously repaired cleft palate and submucous cleft palate are associated with VPI. Less commonly, patients may acquire it after adenoidectomy with or without tonsillectomy or as a result of neuromuscular dysfunction. Comprehensive evaluation by a VPI team includes medical assessment focusing on airway obstructive symptoms, perceptual speech analysis, MRI and instrumental assessment. Options for intervention include speech therapy, intraoral prosthetic devices and surgery. Surgical methods can be categorized as palatal, palatopharyngeal or pharyngeal procedures. Each surgical approach has its strengths and limitations. Oro-maxillofacial surgeons are increasingly involved in the referral, evaluation, and treatment of velopharyngeal function. Therefore, understanding of physiology, anatomic structures, evaluation and treatment protocols in VPI is very important. This article presents protocol for evaluation of velopharyngeal function with a focus on indications for surgical interventions.

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Revitalization of necrotic mature permanent incisors with apical periodontitis: a case report

  • Nagas, Emre;Uyanik, M. Ozgur;Cehreli, Zafer C.
    • Restorative Dentistry and Endodontics
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    • 제43권3호
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    • pp.31.1-31.7
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    • 2018
  • Despite considerable focus on the regenerative endodontic treatment of immature teeth with necrotic infected pulps and apical periodontitis, little data exist with regard to its possible implementation in necrotic permanent teeth with complete apical and radicular development. The present report describes the procedures and outcome of a regenerative endodontic treatment approach in 2 previously-traumatized incisors with closed apex with apical periodontitis. A 2-visit treatment procedure was employed. At initial visit, the root canals were copiously irrigated, followed by placement of a triple antibiotic paste containing ciprofloxacin, metronidazole, and clindamycin into the root canals. After 4 weeks, the antibiotic paste was removed, and apical bleeding was initiated with size 10 hand files beyond the apices. The root canals were coronally sealed with mineral trioxide aggregate, and the access cavities were restored with bonded resin composite. At post-operative 60 months, both teeth were remained asymptomatic, with the recall radiographs showing complete resolution of apical radiolucency and reestablishment of periradicular tissues. In both teeth, the dimensions of root space remained unchanged as verified by image analysis. The revitalization protocol utilizing root canal disinfection and induced apical bleeding in necrotic, closed-apex incisors may offer a clinically acceptable alternative to conventional root canal treatment.

외측상과염의 침 치료에 관한 최신 연구 동향 -PubMed를 중심으로 (The Study of Acupuncture Treatment of Lateral Epicondylitis. -Based on PubMed)

  • 김영글;유선애;조성우
    • 척추신경추나의학회지
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    • 제12권1호
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    • pp.83-96
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    • 2017
  • Objectives : The purpose of this study is to investigate the trends of acupuncture treatment on lateral epicondylitis. Methods : We investigated the recent clinical studies of acupuncture treatment for lateral epicondylitis via searching PubMed from 2007.1.1. to 2016.1.1. This study examined published years, the authors, journals, countries, types of study and classified articles by techniques of acupuncture. Results : 20 theses out of 38 were included, excluding papers duplicated or whose texts are not identified or not satisfying both acupuncture and lateral epicondylitis simultaneously. The theses were constantly published every year. Analyzed by journal, the most published journal was Zhongguo Zhen Jiu. The studies of China had the greatest number of the searched theses. The types of study were reviews, case series, and study protocol. The acupuncture technique used were Hwachim(burning acupuncture therapy), sweet bee venom pharmacopuncture, percutaneous needle electrolysis, electroacupuncture, small needle-knife, combination with local points and Tianzong(SI11), and anti-ashi-point. Conclusions : In order to develop acupuncture treatment of lateral epicondylitis, clinical studies on high level with objective evaluation scale are needed.

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스노젤렌 중재연구 논문분석 (The Analysis of Intervention Studies for Snoezelen)

  • 박영례;오두남;김금순;김진아;위휘
    • 재활간호학회지
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    • 제14권2호
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    • pp.95-102
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    • 2011
  • Purpose: The purpose of this study was to analyze intervention studies related to Snoezelen (multisensory environment). Methods: Studies related to Snoezelen (multisensory environment) published between 1995 and 2010 in both Korean and International journals were systematically reviewed, and analyzed following guidelines. Based on inclusion criteria, 23 studies including 5 Korean and 18 International articles were selected. Results: Most studies were conducted in various area of research such as medicine, nursing, and occupational therapy. There was no publication related to Snoezelen (multisensory environment) in Korean nursing journals. In terms of target population, more than 65 % of the study subjects were patients with dementia, mental retardation, and learning disability. Intervention was implemented mostly in less than 30 minutes, once a week for 2 to 4 weeks. The effects on behavior, physical, and psychological contexts were assessed as outcome indicators. There was more 'positive' than 'no effect' in self-stimulatory behaviors, problem behaviors, heart rate, pain, mood state, and anxiety, whereas more 'no effect' than 'positive' in blood pressure, respiration, enjoyment, and relaxation. Conclusion: Future studies are needed to develop the protocol and outcome indicators for effective use of this new intervention in Korea.

한국 침구외과 지표기술 및 지표문헌 DB 구축을 위한 범위 설정과 모델링 연구 - 침구기법과 외과적 수기법을 중심으로 - (A Study on Modeling Index Literatures and Index Techniques for Establishing DB of Korean Acupuncture, Moxibustion and Surgical Techniques)

  • 차웅석;김민선;김동율;안상우
    • 한국의사학회지
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    • 제28권2호
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    • pp.73-85
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    • 2015
  • This paper is the result of a research conducted for "Knowledge Resource Development by Excavation and preservation and DB Establishment of Traditional Home Remedy", a part of Korean Medicine knowledge infrastructure establishment and Korean Medicine therapy development project executed by Korea Institute of Oriental Medicine. This paper is a part of the plans to standardize Korean acupuncture and moxibustion and surgical techniques in order to make new techniques derived from Korean traditional medicine patentable, as presented in the Nagoya Protocol. By first reviewing traditional text sources and classifying them into index literature and index techniques, we can see a mutual relationship between these two categories. Based on current research papers, this study has established a total of 121 pieces of index literature as well as extracted 64 types of index techniques in acupuncture and surgery technique. Both index literature and index technique have been concurrently visualized in this paper in the "Korean Acupuncture & Moxibustion Technique and Surgical Manipulation Base Map".

Multimodal Treatment Strategies in Esophagogastric Junction Cancer: a Western Perspective

  • Goetze, Thorsten Oliver;Al-Batran, Salah-Eddin;Berlth, Felix;Hoelscher, Arnulf Heinrich
    • Journal of Gastric Cancer
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    • 제19권2호
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    • pp.148-156
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    • 2019
  • Esophagogastric junction (EGJ) cancer is a solid tumor entity with rapidly increasing incidence in the Western countries. Given the high proportion of advanced cancers in the West, treatment strategies routinely employed include surgery and chemotherapy perioperatively, and chemoradiation in neoadjuvant settings. Neoadjuvant chemoradiation and perioperative chemotherapy are mostly performed in esophageal cancer that extends to the EGJ and gastric as well as EGJ cancers, respectively. Recent trials have tried to combine both strategies in a perioperative context, which might have beneficial outcomes, especially in patients with EGJ cancer. However, it is difficult to recruit patients for trials, exclusively for EGJ cancers; therefore, the results have to be carefully reviewed before establishing a standard protocol. Trastuzumab was the first drug for targeted therapy that was positively evaluated for this tumor entity, and there are several ongoing trials investigating more targeted drugs in order to customize effective therapies based on tissue characteristics. The current study reviews the multimodal treatment concept for EGJ cancers in the West and summarizes the latest reports.

갑상선암 수술과 수술 전후 음성관리 (Perioperative Management of the Voice in Thyroid Cancer)

  • 윤소연;홍현준
    • 대한후두음성언어의학회지
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    • 제31권2호
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    • pp.49-55
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    • 2020
  • Evaluating the patient's voice before thyroidectomy is useful for the purpose of identifying patients with vocal cord paralysis without symptoms, identifying other patient's voice abnormalities, and whether it is related to voice disorders that may occur after surgery. Also voice evaluation after thyroid surgery is helpful in diagnosis, treatment, and rehabilitation and follow-up of voice disorders that occur without clear nerve damage after thyroidectomy. And it is helpful for rapid recovery through active early rehabilitation treatment for patients who complain of speech impairment without paralysis. In particular, neck exercise can improve the adhesion of the surgical site and increase the range of motion of the neck as well as improve subjective neck discomfort. In addition, hearing, voice and breathing functions should be improved, and voice hygiene education and counseling should be provided. Vocal cord injection is the first treatment option for unilateral vocal cord palsy. By establishing a protocol for voice disorders before and after thyroid surgery and providing appropriate treatment, the quality of life of patients can be improved.

Effectiveness of Acupuncture, Mind and Body Practices, and Natural Products for Insomnia: an overview of systematic reviews

  • Yeo, Jin Ju;Lee, Jang Won;Kim, Kyung Sik;Hyun, Min Kyung
    • 대한약침학회지
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    • 제25권3호
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    • pp.186-198
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    • 2022
  • Objectives: This overview summarizes the evidence for the effectiveness and safety of complementary therapies for insomnia through systematic reviews (SRs) and meta-analyses (MAs). Methods: A comprehensive literature search on SRs and MAs for complementary therapies for insomnia was conducted using six databases. Results: This overview included 30 SRs/MAs. The Pittsburgh Sleep Quality Index (PSQI) analysis of insomnia included 383 randomized controlled trials and 31,748 participants. Twenty-four SRs/MAs (80%) out of 30 SRs/MAs reported a positive result, and six SRs/MAs reported a partially positive result. The most frequently used form of acupuncture reported a positive effect in 89.5% (17/19) of SRs/MAs and a superior effect to western medicine, sham/placebo, and no treatment. The lack of protocol registration and the excluded studies list resulted in generally poor methodological and reporting quality in SRs/MAs with AMSTAR 2. Conclusion: This overview confirmed that complementary therapies positively affected the PSQI scores in patients with insomnia. However, better-designed primary studies are needed to strengthen the relevant evidence in the future. A more stringent assessment of multiple systematic reviews 2 must be followed when performing SR and MA.

Treatment Protocol for Secondary Burning Mouth Syndrome in Candida albicans- or Non-albicans-Positive Patients

  • Ju, Hye-Min;Jeong, Sung-Hee;Ahn, Yong-Woo;Jeon, Hye-Mi;Ok, Soo-Min
    • Journal of Oral Medicine and Pain
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    • 제47권3호
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    • pp.126-134
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    • 2022
  • Purpose: This study aimed to propose an efficient treatment approach for infection with different candida species. Methods: Fifty-three patients who presented with a chief complaint of oral mucosal pain and exhibited positive candida culture findings were divided into two groups (Candida albicans and non-albicans). Pain, mucosal manifestations, salivary flow rates, durations of disease and treatment, and responses to treatment (nystatin and clonazepam) were investigated in both groups. Results: Patients in the C. albicans group exhibited more prominent clinical characteristics (erythematous lesions, tongue coatings, and hyperalgesia) than those in the non-albicans group. In total, 70% of patients in the non-albicans group showed no abnormalities in the oral mucosa. Patients in the C. albicans group showed increased resistance to nystatin treatment compared to those in the non-albicans group, especially with longer disease durations. The patients resistant to nystatin treatment showed positive responses to clonazepam. Conclusions: Patients with oral mucosal pain should be tested for the presence of Candida, even in the absence of mucosal abnormalities, especially those infected with non-albicans species. If no response to antifungal therapy is observed, treatment with clonazepam should be initiated, especially in patients infected with C. albicans.

통합 의학 치료로 5년 생존 및 완전 관해에 도달한 췌장암 증례 보고 1례 (Case Report on the Five-year Survival and Complete Response of a Patient with Pancreatic Cancer Treated with Integrative Medicine)

  • 정유진;김지수;박경덕;오유나;정범진;방선휘
    • 대한한방내과학회지
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    • 제44권3호
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    • pp.562-577
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    • 2023
  • Objectives: This is a five-year survival and complete response (CR) report on pancreatic cancer treated with western medicine and Korean traditional medicine. Method: A 59-year-old woman diagnosed with pancreatic cancer visited ○○ Korean traditional medicine hospital after neoadjuvant chemotherapy and pylorus-preserving pancreaticoduodenectomy. She was treated with Korean traditional medicine, including acupuncture, abdominal moxibustion, wild ginseng pharmacopuncture, and herbal medicine, which was based on integrated medicine therapy (IMT), from March 2018 to September 2022. The tumor size was measured by scanning with computed tomography (CT), magnetic resonance imaging, and positron-emission tomography/CT. Adverse events were evaluated using laboratory conclusion and National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. Result: During four years and three months of treatment, IMT maintained safety. The patient finally reached five-year survival without any recurrence or complication (CR) on October 26, 2022. Conclusion: We suggest that an integrative approach including Korean traditional medicine can be a meaningful treatment option for pancreatic cancer. Further studies should be performed to establish the proper treatment protocol of integrative medicine for pancreatic cancer.