• Title/Summary/Keyword: treatment failure

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Comparison of Skin Stimulation Method and Topical Anesthetic Cream on Pain and Heart Rate Variability during Arteriovenous Fistula Puncture in Hemodialysis Patients (혈액투석 환자의 동정맥루 천자 시 피부자극법과 국소마취크림 도포에 따른 통증과 심박변이도 비교)

  • Kang, Hyo Young;Chae, Young Ran
    • Journal of Korean Biological Nursing Science
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    • v.21 no.3
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    • pp.207-216
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    • 2019
  • Purpose: The purpose of this was to compare effects of application of the skin stimulation method and topical anesthetic cream on pain, heart rate variability and satisfaction according to nursing intervention methods during arteriovenous fistula puncture in chronic renal failure hemodialysis patients. Methods: This study was a crossover design. Participants were 36 patients with chronic renal failure receiving hemodialysis treatment. Two forms of intervention were applied to participants, and then pain and heart rate variability were measured during the puncture. Results: There were no statistically significant differences according to each treatment in vein pain and artery pain. Also, there were no statistically significant differences according to each treatment in stress index, sympathetic activity (LF), parasympathetic activity (HF) and sympathetic activity/parasympathetic activity (LF/HF ratio). Satisfaction with application of skin stimulation method was statistically higher than that of topical anesthetic cream application. Conclusion: This suggests that application of the skin stimulation method complements disadvantages of topical anesthetic cream application and demonstrates possibility of application as a nursing intervention method which can be conveniently used by nurses in clinical practice.

Long-term results of ipsilateral radiotherapy for tonsil cancer

  • Koo, Tae Ryool;Wu, Hong-Gyun
    • Radiation Oncology Journal
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    • v.31 no.2
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    • pp.66-71
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    • 2013
  • Purpose: We evaluated the effectiveness and safety of ipsilateral radiotherapy for the patient with well lateralized tonsil cancer: not cross midline and <1 cm of tumor invasion into the soft palate or base of tongue. Materials and Methods: From 2003 to 2011, twenty patients with well lateralized tonsil cancer underwent ipsilateral radiotherapy. Nineteen patients had T1-T2 tumors, and one patient had T3 tumor; twelve patients had N0-N2a disease and eight patients had N2b disease. Primary surgery followed by radiotherapy was performed in fourteen patients: four of these patients received chemotherapy. Four patients underwent induction chemotherapy followed by concurrent chemoradiotherapy (CCRT). The remaining two patients received induction chemotherapy followed by radiotherapy and definitive CCRT, respectively. No patient underwent radiotherapy alone. We analyzed the pattern of failure and complications. Results: The median follow-up time was 64 months (range, 11 to 106 months) for surviving patients. One patient had local failure at tumor bed. There was no regional failure in contralateral neck, even in N2b disease. At five-year, local progression-free survival, distant metastasis-free survival, and progression-free survival rates were 95%, 100%, and 95%, respectively. One patient with treatment failure died, and the five-year overall survival rate was 95%. Radiation Therapy Oncology Group grade 2 xerostomia was found in one patient at least 6 months after the completion of radiotherapy. Conclusion: Ipsilateral radiotherapy is a reasonable treatment option for well lateralized tonsil cancer. Low rate of chronic xerostomia can be expected by sparing contralateral major salivary glands.

Successful Bilateral Lung Retransplantation in a Patient with Primary Graft Failure Following a Single Lung Transplantation (일측 폐 이식 후 발생한 이식편 부전으로 양측 폐 재이식을 시행한 1예 보고)

  • Hwang Jung-Joo;Joung Eun-Kyu;Kim Jae-Ho;Lee Doo-Yun;Paik Hyo-Chae
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.490-494
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    • 2006
  • Lung transplantation is the choice of treatment for selected patients with end-stage pulmonary disease. However, retransplantation of the lung due to primary graft failure carries a high risk of morbidity and mortality. This is a case of a 52 year old male with emphysema who continuously needed a ventilator care and a tracheostomy. He underwent a left single lung transplantation but were not able to wean from the ventilator due to primary graft failure, and therefore we decided to do a retransplantation. Bilateral sequential single lung transplantation was performed under the cardiopulmonary bypass. The patient recovered quite well and was discharged and fully active with his work. Retransplantation although it carries a high risk, is a very effective treatment in patients with primary graft failure.

Etiology and Treatment of Revision Shoulder Arthroplasty (견관절 인공관절 재치환술의 원인과 치료)

  • Kim, Young-Kyu;Jung, Kyu-Hak
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.100-109
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    • 2019
  • The rapidly increasing rate of shoulder arthroplasty is certain to increase the number of revision arthroplasties because of parallel increases in complication numbers. It has been widely reported that the causes of revision shoulder arthroplasty include rotator cuff deficiency, instability, glenoid or humeral component loosening, implant failure, periprosthetic fracture, and infection. Revision arthroplasty can be technically challenging, and surgical options available for failed shoulder arthroplasty are limited, especially in patients with glenoid bone loss or an irreparable rotator cuff tear. Furthermore, the outcomes of revision arthroplasty are consistently inferior to those of primary arthroplasty. Accordingly, surgical decision making requires a good understanding of the etiology of failure. Here, we provide a review of indications of revision arthroplasty and of the surgical techniques used by failure etiology.

Comparison of Shear Bond Strength in Novel Calcium Silicate-Based Materials to Composite Resin

  • Wonkyu Shin;Hyuntae Kim;Ji-Soo Song;Teo Jeon Shin;Young-Jae Kim;Jung-Wook Kim;Ki-Taeg Jang;Hong-Keun Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.4
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    • pp.443-451
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    • 2023
  • The purpose of this study was to evaluate whether the newly introduced calcium silicate-based materials with fast-setting properties could be appropriately used as basement materials in indirect pulp treatment (IPT). This was performed by quantifying the durability of adhesion between the material and composite resin, measured by the shear bond strength (SBS). Five calcium silicate-based materials, TheraCal LC® (TLC), TheraCal PT® (TPT), TheraBase® (TB), Well-RootTM PT (WPT), and Endocem® MTA (EMTA), as well as two glass ionomer-based materials, Fuji II and Fuji II LC, were included. Specimens containing these materials were manufactured and bonded to composite resin with a universal adhesive applied in self-etch mode. The SBS values and failure modes were recorded, and the mean SBSs of the materials were compared. Both TPT and TB exhibited SBS values that were similar to TLC, while both WPT and EMTA appeared to have statistically lower SBS values. Mixed failure was commonly observed in TLC and TPT, while all WPT and EMTA samples showed cohesive failure. In comparison with TLC and TPT, more samples with cohesive failure were observed in TB, implying that this material forms a stronger bond with composite resin. Together with the ability of TB to chemically bind to dentin due to its 10-methacryloyloxydecyl dihydrogen phosphate component, TB seems to be a promising material for IPT within the limitations of this in vitro study.

EFFECT OF CONTAMINANTS ON THE PUTTY-WASH BOND STRENGTH IN TWO-STEP RELINE TECHNIQUE USING VINYL POLYSILOXANE IMPRESSION MATERIALS (Vinyl Polysiloxane 인상재를 이용한 이회 인상법에서 contaminants가 putty-wash 결합력에 미치는 영향)

  • Kim, Mu-Hyon;Jeong, Chang-Mo;Jeon, Young-Chan;Hwang, Hie-Seong
    • The Journal of Korean Academy of Prosthodontics
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    • v.34 no.2
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    • pp.266-276
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    • 1996
  • Numerous factors are known to affect the accuracy of elastomeric impression materials. Factor often overlooked is the quality of the bond between putty and wash during corrective reline impression technique. The putty-wash bond strength must be strong enough to over-come the local stress at putty-wash interface. It is not always possible to avoid saliva contamination in making corrective wash impres-sion. And putty preliminary impression material con be used as a template for provisional restoration. Human saliva and the residual monomer of autopolymerizing acrylic resin are thought to affect the bond strength and the failure type. This study examined the effect of contaminants like human saliva, and residual resin monomer on the putty-wash bond strength and the effectiveness of treatment. 1. Of the tested three brands of Vinyl Polysiloxane impession meterial, Express Exhibited the greatest bond strength followed by Eamix and Perfect showed the lowest putty-wah bond strength. 2. Coating the putty substrates with human saliva did not produce decreased failure load in all the breands of Vinyl Polysiloxane impression meterail. 3. Of the three brands of VPS impression material that were exposed to methhylmethacry-late resin(Jet), only the putty-wash bond strength of the Perfect group diminished signifi-cantly. Moreover, all the specimens from group C of Perfect exhibited adhesive failure. 4. Exposing the substrates to ethylmethacrylate resin(SNAP. diminished the putty-wash bond strength significantly. With Perfect and Examix, failure occurred cohesively through the light-body, whereas with Express, failure occurred adhesive-cohesively. 5. Removing approximately 1mm thickness of the contaminated putty interface was the most effective treatment in countering the undesirable effect caused by residual resin monomer. The putty-wash bond strength of the groups that were treated with 1mm even putty reduction was not significantly different from those of control groups. With Perfect and Examix, cleaning the specimens with gauze soaked in 70% isopropyl alcohol increased the putty-wash bond strength, but was not as effective as 1mm even reduction of contaminated putty substrates. With Express, 70% isoproryl alcohol treatment exhibi0ted comparable putty-wash bond strength to that of control group.

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Prognosis following dental implant treatment under general anesthesia in patients with special needs

  • Kim, Il-hyung;Kuk, Tae Seong;Park, Sang Yoon;Choi, Yong-suk;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.3
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    • pp.205-213
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    • 2017
  • Background: This study retrospectively investigated outcomes following dental implantation in patients with special needs who required general anesthesia to enable treatment. Method: Patients underwent implant treatment under general anesthesia at the Clinic for the Disabled in Seoul National University Dental Hospital between January 2004 and June 2017. The study analyzed medical records and radiographs. Implant survival rates were calculated by applying criteria for success or failure. Results: Of 19 patients in the study, 8 were males and 11 were females, with a mean age of 32.9 years. The patients included 11 with mental retardation, 3 with autism, 2 with cerebral palsy, 2 with schizophrenia, and 1 with a brain disorder; 2 patients also had seizure disorders. All were incapable of oral self-care due to serious cognitive impairment and could not cooperate with normal dental treatment. A total of 27 rounds of general anesthesia and 1 round of intravenous sedation were performed for implant surgery. Implant placement was performed in 3 patients whose prosthesis records could not be found, while 3 other patients had less than 1 year of follow-up after prosthetic treatment. When the criteria for implant success or failure were applied in 13 remaining patients, 3 implant failures occurred in 59 total treatments. The cumulative survival rate of implants over an average of 43.3 months (15-116 months) was 94.9%. Conclusion: For patients with severe cognitive impairment who are incapable of oral self-care, implant treatment under general anesthesia showed a favorable prognosis.

Feasibility on Statistical Process Control Analysis of Delivery Quality Assurance in Helical Tomotherapy (토모테라피에서 선량품질보증 분석을 위한 통계적공정관리의 타당성)

  • Kyung Hwan, Chang
    • Journal of radiological science and technology
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    • v.45 no.6
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    • pp.491-502
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    • 2022
  • The purpose of this study was to retrospectively investigate the upper and lower control limits of treatment planning parameters using EBT film based delivery quality assurance (DQA) results and to analyze the results of statistical process control (SPC) in helical tomotherapy (HT). A total of 152 patients who passed or failed DQA results were retrospectively included in this study. Prostate (n = 66), rectal (n = 51), and large-field cancer patients, including lymph nodes (n = 35), were randomly selected. The absolute point dose difference (DD) and global gamma passing rate (GPR) were analyzed for all patients. Control charts were used to evaluate the upper and lower control limits (UCL and LCL) for all the assessed treatment planning parameters. Treatment planning parameters such as gantry period, leaf open time (LOT), pitch, field width, actual and planning modulation factor, treatment time, couch speed, and couch travel were analyzed to provide the optimal range using the DQA results. The classification and regression tree (CART) was used to predict the relative importance of variables in the DQA results from various treatment planning parameters. We confirmed that the proportion of patients with an LOT below 100 ms in the failure group was relatively higher than that in the passing group. SPC can detect QA failure prior to over dosimetric QA tolerance levels. The acceptable tolerance range of each planning parameter may assist in the prediction of DQA failures using the SPC tool in the future.

Radiological Recurrence Patterns after Bevacizumab Treatment of Recurrent High-Grade Glioma: A Systematic Review and Meta-Analysis

  • Se Jin Cho;Ho Sung Kim;Chong Hyun Suh;Ji Eun Park
    • Korean Journal of Radiology
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    • v.21 no.7
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    • pp.908-918
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    • 2020
  • Objective: To categorize the radiological patterns of recurrence after bevacizumab treatment and to derive the pooled proportions of patients with recurrent malignant glioma showing the different radiological patterns. Materials and Methods: A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed to identify studies reporting radiological recurrence patterns in patients with recurrent malignant glioma after bevacizumab treatment failure until April 10, 2019. The pooled proportions according to radiological recurrence patterns (geographically local versus non-local recurrence) and predominant tumor portions (enhancing tumor versus non-enhancing tumor) after bevacizumab treatment were calculated. Subgroup and meta-regression analyses were also performed. Results: The systematic review and meta-analysis included 17 articles. The pooled proportions were 38.3% (95% confidence interval [CI], 30.6-46.1%) for a geographical radiologic pattern of non-local recurrence and 34.2% (95% CI, 27.3-41.5%) for a non-enhancing tumor-predominant recurrence pattern. In the subgroup analysis, the pooled proportion of non-local recurrence in the patients treated with bevacizumab only was slightly higher than that in patients treated with the combination with cytotoxic chemotherapy (34.9% [95% CI, 22.8-49.4%] versus 22.5% [95% CI, 9.5-44.6%]). Conclusion: A substantial proportion of high-grade glioma patients show non-local or non-enhancing radiologic patterns of recurrence after bevacizumab treatment, which may provide insight into surrogate endpoints for treatment failure in clinical trials of recurrent high-grade glioma.

Evaluation of the Cell-Mediated Immunity in Treatment Failure Pulmonary Tuberculosis (치료실패 폐결핵 환자의 세포성면역반응에 관한 연구)

  • Park, Jeong-Kyu;Park, Jang-Seo;Kim, Hwa-Jung;Jo, Eun-Gyeong;Min, Dul-Lel;Lim, Jae-Hyun;Suhr, Ji-Won;Paik, Tae-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.13-25
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    • 1999
  • Background: Ineffective cell-mediated immune response in human tuberculosis is associated with a depressed Thl cytokine response and reduced production of IFN-$\gamma$. Most persons infected with Mycobacterium tuberculosis are healthy tuberculin reactors with protective immunity, but a minority with ineffective immunity develop extensive pulmonary tuberculosis. The cell-mediated immune response is an important aspect of host resistance to mycobacterial infection and is believed to be tightly regulated by a balance between Th1 cytokines including IFN-$\gamma$, IL-12, IL-18, regulated on activation, normal T cell expressed and secreted (RANTES) and Th2 counterparts such as IL-4, monocyte chemoattractant protein-l (MCP-l). Methods: Proliferation and mRNA expression of IFN-$\gamma$, RANTES and MCP-l by RT-PCR in peripheral blood mononuclear cells (PBMCs) in response to in vitro stimulation with mycobacterial antigens were compared in pulmonary tuberculosis patients with cured and treatment failure and in tuberculin-positive and tuberculin-negative healthy subjects. Results: Defective proliferative responsiveness to aqueous TSP antigen was involved with treatment failure tuberculosis patients. Aqueous TSP antigen-induced IFN-$\gamma$ and RANTES mRNA expression was decreased in treatment failure tuberculosis patients compared with healthy tuberculin reactors and cured tuberculosis patients (23.1 % versus 90.0% for IFN-$\gamma$ and 46.2% versus 70.0% versus 46.2% for RANTES). The frequency of MCP-l mRNA expression to aqueous TSP antigen in treatment failure tuberculosis patients was greater than in healthy tuberculin reactors and cured tuberculosis patients (76.9% versus 40.0%). Conclusion: The increasing expression of MCP-1 mRNA in response to aqueous TSP antigen might be predicted to favor Th1 responses and restricted Th1 responses in treatment failure of pulmonary tuberculosis.

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