• Title/Summary/Keyword: treatment of choice

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Korean Guidelines for the Treatment of Panic Disorder 2018 : Psychosocial Treatment Strategies (2018 한국형 공황장애 치료지침서 : 정신사회적 치료전략)

  • Gim, Minsook;Kim, Min-Kyoung;Lee, Jae-Hon;Kim, Won;Moon, Eunsoo;Seo, Ho-Jun;Koo, Bon-Hoon;Yang, Jong-Chul;Lee, Kang Soo;Lee, Sang-Hyuk;Kim, Chan-Hyung;Yu, Bum-Hee;Suh, Ho-Suk
    • Anxiety and mood
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    • v.15 no.1
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    • pp.13-19
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    • 2019
  • Objective : The purpose of this study was to investigate consensus relative to treatment strategies for psychosocial treatment in panic disorder, that represents one subject addressed by the Korean guidelines for treatment of panic disorder 2018. Methods : The executive committee developed questionnaires relative to treatment strategies for patients with panic disorder based on guidelines, algorithms, and clinical trials previously published in foreign countries and Korea. Seventy-two (61.0%) of 112 experts on a committee reviewing panic disorder responded to the questionnaires. We classified the consensus of expert opinions into three categories (first-line, second-line, and third-line treatment strategies), and identified treatment of choice using the Chi-square test and 95% confidence intervals. Results : For psychosocial treatment of panic disorder, individual and group cognitive behavior therapy (CBT) were recommended treatments of choice, and mindfulness based cognitive therapy (MBCT) was recommended as first line strategy. There was statistically significant consensus among experts regarding usefulness of each component of CBT and MBCT, for treatment of patients with panic disorder. Conclusion : Results, that reflect recent studies and clinical experiences, may provide the guideline for psychosocial treatment strategies for panic disorder.

OK-432 Intralesional Injection Therapy for Lymphangioma in Children (소아 림프관종의 OK-432 병변내 주사요법)

  • Kim, Kyung-Hun;Kim, Hyun-Hahk;Lee, Suk-Koo;Seo, Jeong-Meen;Chang, Weon-Young;Lee, Byung-Boong
    • Advances in pediatric surgery
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    • v.7 no.2
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    • pp.142-146
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    • 2001
  • Lymphangioma is a congenital malformation of the lymphatic system, commonly seen in the neck. Operation was the treatment of choice but it is difficult to resect the lymphangiomas completely. The aim of this study is to evaluate the result of intralesional injection of OK-432 as a treatment strategy of lymphangioma in children. Medical records of 51 cases of lymphangioma from March 1996 to February 2001 were reviewed retrospectively. Intralesional injection of 0.1mg OK-432 in 10ml normal saline was performed after the aspiration of as much fluid as possible. The location of the lesion was the face and neck in 26 patients, the chest wall in 14, the extremities in 9, and the abdominal wall in 2. The cystic type was present in 45 patients and the cavernous type in 6. Four postoperative recurrent cases were included. Fluid aspiration from the lesion was impossible in 5 patients. Development of fever after injection was observed in 27 patients and local inflammatory reaction was in 5 patients. There was no scar formation at injection sites. Complete shrinkage was observed in 20 patients, remarkable shrinkage in 23, slight shrinkage in 3, and no response in 5. Cystic type or aspiration-possible cases showed better outcome than cavernous type or aspiration-impossible cases. All of four recurrent cases after surgical excision showed at least remarkable shrinkage. These results indicate that intralesional injection of OK-432 is a safe and satisfactory treatment modality of lymphangiomas in children and might be considered as a treatment of choice, even in recurrent cases.

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Microsurgical reconstruction of posttraumatic large soft tissue defects on face (광범위한 안면외상 환자에서의 미세술기를 이용한 재건술)

  • Baek, Wooyeol;Song, Seung Yong;Roh, Tai Suk;Lee, Won Jai
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.724-731
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    • 2018
  • Our faces can express a remarkable range of subtle emotions and silent messages. Because the face is so essential for complex social interactions that are part of our everyday lives, aesthetic repair and restoration of function are an important tasks that we must not take lightly. Soft-tissue defects occur in trauma patients and require thorough evaluation, planning, and surgical treatment to achieve optimal functional and aesthetic outcomes, while minimizing the risk of complications. Recognizing the full nature of the injury and developing a logical treatment plan help determine whether there will be future aesthetic or functional deformities. Proper classification of the wound enables appropriate treatment, and helps predict the postoperative appearance and function. Comprehensive care of trauma patients requires a diverse breadth of skills, beginning with an initial evaluation, followed by resuscitation. Traditionally, facial defects have been managed with closure or grafting, and prosthetic obturators. Sometimes, however, large defects cannot be closed using simple methods. Such cases, which involve exposure of critical structures, bone, joint spaces, and neurovascular structures, requires more complex treatment. We reviewed and classified causes of significant trauma resulting in facial injuries that were reconstructed by microsurgical techniques without simple sutures or coverage with partial flaps. A local flap is a good choice for reconstruction, but large defects are hard to cover with a local flap alone. Early microsurgical reconstruction of a large facial defect is an excellent choice for aesthetic and functional outcomes.

Prognostic Factors for Second-line Treatment of Advanced Non-small-cell Lung Cancer: Retrospective Analysis at a Single Institution

  • Inal, Ali;Kaplan, M. Ali;Kucukoner, Mehmet;Urakci, Zuhat;Karakus, Abdullah;Isikdogan, Abdurrahman
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1281-1284
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    • 2012
  • Background: Platinum-hased chemotherapy for advanced non-small cell lung cancer (NSCLC) is still considered the first choice, presenting a modest survival advantage. However, the patients eventually experience disease progression and require second-line therapy. While there are reliable predictors to identify patients receiving first-line chemotherapy, very little knowledge is available about the prognostic factors in patients who receive second-line treatments. The present study was therefore performed. Methods: We retrospectively reviewed 107 patients receiving second-line treatments from August 2002 to March 2012 in the Dicle University, School of Medicine, Department of Medical Oncology. Fourteen potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Result: The results of univariate analysis for overall survival (OS) were identified to have prognostic significance: performance status (PS), stage, response to first-line chemotherapy response to second-line chemotherapy and number of metastasis. PS, diabetes mellitus (DM), response to first-line chemotherapy and response to second-line chemotherapy were identified to have prognostic significance for progression-free survival (PFS). Multivariate analysis showed that PS, response to first-line chemotherapy and response to second-line chemotherapy were considered independent prognostic factors for OS. Furthermore, PS and response to second-line chemotherapy were considered independent prognostic factors for PFS. Conclusion: In conclusion, PS, response to first and second-line chemotherapy were identified as important prognostic factors for OS in advanced NSCLC patients who were undergoing second-line palliative treatment. Furthermore, PS and response to second-line chemotherapy were considered independent prognostic factors for PFS. It may be concluded that these findings may facilitate pretreatment prediction of survival and can be used for selecting patients for the correct choice of treatment.

Reconstruction with fibular osteocutaneous free flap in patients with mandibular osteoradionecrosis

  • Kim, Min Gyun;Lee, Seung Tae;Park, Joo Yong;Choi, Sung Weon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.7.1-7.7
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    • 2015
  • Background: Osteoradionecrosis is a delayed complication from radiation therapy which causes chronic pain, infection and constant deformity after necrosis. Most of the osteoradionecrosis occurs spontaneously or after the primary oncologic surgery, dental extraction or by trauma of prosthesis. The treatment of osteoradionecrosis relies on both conservative measures and surgical measures. The fibular osteocutaneous free flap has become more popular choice for reconstruction of maxillofacial defects as a treatment of osteoradionecrosis. Methods: We presented our experiences from 7 patients with osteoradionecrosis who have had reconstruction surgery with fibular osteocutaneous free flap at National Cancer Center during the recent 5 years. We performed segmental mandibular resection with fibular osteocutaneous free flap for all 7 patients of advanced osteoradionecrosis who were not controlled by conservative treatment such as wound irrigation, debridement, and antibiotics. Results: A wide range of techniques were available for the reconstruction of composite defects resulted from the treatment of advanced mandibular osteoradionecrosis. Significant improvement was noted in relieving pain and treating trismus after the surgery however difficulty in swallowing and xerostomia showed less improvement. Conclusions: We concluded that fibular osteocutaneous free flap can be performed safely in patients with osteoradionecrosis and yields positive outcomes with significantly increased success rate. The fibular osteocutaneous free flap was our preferred choice for the mandibular reconstruction due to its versatility and predictability.

Pulp treatment for immature permanent teeth (미성숙 영구치의 치수치료)

  • Song, Je Seon
    • The Journal of the Korean dental association
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    • v.57 no.8
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    • pp.464-473
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    • 2019
  • For dental pulp treatment of immature permanent teeth, direct pulp capping or partial/cervical pulpotomy (apexogenesis) procedures can be used if the dental pulp is vital. MTA (Mineral Trioxide Aggregate) is regarded as the first choice dressing material for these procedures because its higher success rate. It can be also used successfully for devitalized dental pulp which has been treated by calcium hydroxide. This apexification procedure with MTA has a few advantage such as short treatment period and increase of resistance against root fracture. Recently, regenerative endodontic treatment was introduced for devitalized immature pulp. It can maintain pulp vitality and lead to continuing root development although the dental pulp was devitalized.

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Current Trends in Research on Conservative Treatment of Scoliosis (척추 측만증의 보존적 치료에 관한 최신 지견 - PubMed 검색을 위주로 2008년 이후 -)

  • Cho, Sung Woo;Lee, Seung Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.27 no.1
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    • pp.15-25
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    • 2013
  • Objectives Scoliosis is that spine's arrangement was changed to be curved. Mostly scoliosis was found at childhood and recently rate of scoliosis is increasing. Causes of scoliosis were very various, but the patients are due to idiopathic reasons. Scoliosis was treated by conservative treatment or surgery treatment. If scoliosis is diagnosed early enough, it can be treated with conservative treatment. Methods We are searching PubMed by keywords and found 47 theses complied with requirements. Results Studies of conservative treatment of Scoliosis were active. Conservative treatments are considered before surgery treatment and there was a set guideline of conservative treatment. Also, there were several studies about effectiveness of conservative treatment and quality of life, mental stress. Studies about various kinds of conservative treatment were found as well. There were brief studies about introduction of new brace, effectiveness of several braces, and case studies. Conclusions Conservative treatment is very effective choice before surgery treatment at Scoliosis patient.

The Changes of Health Care Utilization and Cause of Outpatients at an Oriental Medicine Hospital

  • Kim, Ji-Yong;Park, Seong-Sik
    • The Journal of Korean Medicine
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    • v.28 no.4
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    • pp.95-103
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    • 2007
  • Objectives : The aim of this study was to investigate the changes of attitude toward the oriental medicine for 10 years. Methods : A questionnaire was done about general characteristic of patient, the decision-maker of use and the reason of choice or alteration for oriental medicine hospital. Results : The results of this survey are as follows: For 10 years, sex ratio of outpatients is similar, but age distribution is even at all ages. The choice for oriental medicine is more determined by oneself than by others. The recommenders are more variable increasingly. The most common cause of moving from western medicine is to get the more effective treatment. The more the concomitant users are increasing, the more the patients that did not give notice to the western doctor about the dual therapies is increasing, also. The most frequent reason without a notice is "being afraid of western doctor's bias". Conclusions : The appropriate transfer system between oriental and western clinic must be constructed and the proper recognition about dual therapies will be needed among patients and especially dual doctors.

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Implant overdenture using milled bar and attachment in partially edentulous mandible: a case report (하악 부분 무치악 환자에서 Milled Bar와 부착장치를 이용한 임플란트 피개의치 수복 증례)

  • Kim, Min-Jung;Huh, Jung-Bo;Jeong, Chang-Mo;Yun, Mi-Jung;Lee, So-Hyoun;Jo, Yong-Bum
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.1
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    • pp.71-79
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    • 2022
  • Excessive crown height space increases can cause crestal bone loss and screw loosening after prosthesis is placed. Milled bar and implant overdenture can be used as a treatment method for partially edentulous patients who have severe alveolar bone loss and excessive crown height space. Milled bar can provide primary splinting effect and stability between implants. Also, milled bar with additional retention device such as Advanced Dental Device-Treatment Of Choice (ADD-TOC) and magnet can provide additional retention force for implant overdenture. In this case, the patient has a partially edentulous mandible that has severe alveolar bone loss and multiple number of teeth loss after excision due to leiomyosarcoma. Because of the long-term loss of mandibular molars, the opposing teeth were extruded. Maxillary left molars were corrected to the occlusal plane through molar intrusion, and mandibular left molar region were treated with implant overdenture, using milled bar with ADD-TOC and magnet after implant placement. The clinical result was satisfactory on the aspect of esthetic and masticatory function.

An Optimal Placement of passive Constrained Layer Damping Treatment for Vibration Suppression of Automotive Roof (차량루프의 진동저감을 위한 수동구속감쇠처리의 위치 최적화)

  • Lee, Ki-Hwa;Kim, Chan-Mook;Kang, Young-Kyu
    • Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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    • 2004.11a
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    • pp.349-353
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    • 2004
  • A study on optimal placement of constrained layer damping treatment for vibration control of automotive panels is presented. The effectiveness of damping treatment depends upon design parameters such as choice of damping materials, locations and size of the treatment. This paper proposes a CAE (Computer Aided Engineering) methodology based on finite element analysis to optimize damping treatment. From the equivalent modeling technique, it is found that the best damping performance occurs as the viscoelstic patch is placed by means of the modal strain energy method of bare structural panels to identify flexible regions, which in turn facilitates optimizations of damping treatment with respect to location and size. Different configurations of partially applied damping layer treatment have been analyzed for their effectiveness in realizing maximum system damping with minimum mass of the applied damping material. Moreover, simulated frequency response function of the automotive roof with and without damping treatments are compared, which show the benefits of applying damping treatment. Finally, the optimized damping treatment configuration is validated by comparing the locations and the size of the treatment with that of an experimental modal test conducted on roof compartment.

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