• Title/Summary/Keyword: treatment protocol

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Neoadjuvant Chemotherapy and Radiotherapy in the Treatment of Advanced Head and Neck Cancer : Protocol Based Study (진행성 두경부암에서 선행항암요법과 방사선요법의 치료성적)

  • Kim Chul-Ho;Choi Jin-Hyuk;Lee Jin-Seok;Oh Young-Taek
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.2
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    • pp.172-176
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    • 2004
  • Background and Objectives: Standard treatment of locally advanced laryngeal, hypopharyngeal, and some oropharyngeal cancers includes total laryngectomy. In an attempt to preserve the larynx through induction chemotherapy, we designed induction chemotherapy followed by definitive radiation in patients with potentially respectable head and neck cancer to determine whether organ preservation is feasible without apparent compromise of survival. Materials and Methods: The twenty-six patients diagnosed advanced head and neck squamous cell carcinoma, Stage III or IV (AJCC 2002) and performed organ preservation protocols in Ajou university hospital from 1994 to 2001 were included in this study. Results: Neoadjuvant chemotherapy showed an overall response rate of 84.6% and a complete remission (CR) rate was 59.1% following neoadjuvant chemotherapy and radiation. Seven of thirteen patients were able to preserve their larynges for more than two years by chemotherapy and radiation. There were no treatment related mortality after 2 cycles of induction chemotherapy. Conclusion: Although Organ preservation protocol through neoadjuvant chemotherapy and radiation need more controlled randomized study, it was considered alternative treatment modality in advanced head and neck cancer.

The Clinical Effect of Korean Medical Rehabilitation Protocol for Total Knee Replacement: A Report of 4 Cases (슬관절 전치환술 후 한방 재활치료 프로토콜 적용의 임상적 효과: 증례 보고)

  • Han, Soo-Yeon;Kim, Mi-Hyun;Park, Eun-Sang;Kang, Jun-Hyuk;Kim, Dong-Yeong
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.219-231
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    • 2020
  • The objective of this study is to propose a Korean medical rehabilitation protocol for total knee replacement (TKR) and to report its effectiveness. This study was conducted as a retrospective study which analyzes the medical records of 4 patients undergoing Korean medical rehabilitation with protocol and continuous passive motion exercise for more than two weeks after TKR. We evaluated the outcome checking physical examination findings of the knee joint, numeric rating scale (NRS), Lysholm knee score (LKS) and walking state. After the treatment, we observed that the function of knee joint, NRS, LKS, walking state of patients were improved. This study showed that Korean medical rehabilitation protocol has effect on knee joint recovery after TKR. The limitation of this study was the insufficient number of cases and short-term follow up. Further studies should be done steadily to report the effectiveness of a Korean Medical rehabilitation protocol for TKR.

Clinical Trial Protocol Development of Acupuncture for Disaster Survivors: Results from an Expert Survey (전문가 설문조사에 기반한 재난 경험자에 대한 침치료 임상연구 프로토콜 개발)

  • Huiyong Kwak;Chanyoung Kwon;Jungtae Leem;Sang-Ho Kim
    • Journal of Oriental Neuropsychiatry
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    • v.35 no.1
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    • pp.15-26
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    • 2024
  • Objectives: The objective of this study is to develop a specialized clinical research protocol for acupuncture treatment specifically designed for disaster survivors based on insights from an expert survey. Methods: An expert panel comprising specialists in neuropsychiatry, acupuncture, and clinical research methodology was assembled. Initial data to inform the clinical research protocol design was collected utilizing open-ended responses, multiple-choice questions, and a 5-point Likert scale to gauge agreement levels. Next, this data was disseminated to a panel of experts. A cohesive clinical research protocol was then formulated during a core panel meeting by integrating insights from a panel of 10 experts. Results: The protocol developed herein entails a non-randomized controlled study involving participants aged 19~64 years old who have been identified as high-risk or cautious according to the National Trauma Center screening test. The study design includes the establishment of an active control group, which allows for the assessment of an additional effect through comparison with conventional therapy. The selected acupuncture approach involves a combination of manual acupuncture and ear acupuncture. For clinical outcome assessment, the Clinician-Administered Posttraumatic Stress Disorder Scale for DSM-5 was proposed to gauge trauma symptoms. Representative scales for various domains such as depression, anxiety, anger, insomnia, pain, and quality of life were also provided for reference. Conclusions: The developed protocol is anticipated to streamline the swift design and initiation of clinical trials during disaster scenarios. It is also designed to be scalable, thereby enabling its application in both non-randomized control group studies and single-group before-and-after comparisons.

Cell transformation of bisphenol A in Syrian hamster embryo cells and mouse embryo BalB/c 3T3 cells (Syrian hamster embryo 세포와 mouse embryo BalB/c 3T3 세포에서의 bisphenol A의 세포 형질전환 연구)

  • 김종원;한의식;박미선;엄미옥;전혜승;민수진;김인숙;정해관;심웅섭
    • Environmental Mutagens and Carcinogens
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    • v.21 no.1
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    • pp.44-50
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    • 2001
  • To identify nongenotoxic carcinogen determined as negative by ICH guideline-recommended standard genotoxicity test battery; Ames test, chromosome aberration assay, mouse lymphoma $tk^{+/-}$ assay, in vivo micronucleus assay, we picked bisphenol A as a model compound. In this study, we applied in vitro BalB/c 3T3 cell transformation assay and Syrian hamster embryo (SHE) cell transfarmation assay. Bisphenol A was treated upto $769.2 ug/m{\ell}$ in BalB/c 3T3 cells and upto $125 ug/m{\ell}$ in SHE cells. bisphenol A didn't induced morphological transformation both with one stage treatment protocol and with two stage treatment protocol. But, treated far 48 hr, Bisphenol A induced morphological transformation significantly in SHE cells.

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Clinical Effectiveness of Korean Medical Rehabilitation Treatment after Patellar Fracture: A Report of 4 Cases (무릎뼈 골절 후 한방 재활치료의 임상적 효과: 증례 보고)

  • Geum, Ji-Hye;Woo, Hyeon-Jun;Kim, Jong-gyu;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.203-217
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    • 2020
  • The aim of this study was to propose our rehabilitation protocol involving Korean medicine for patients with patellar fracture and report its effectiveness. Further, for the same patellar fracture patients, we created different protocols for those who underwent surgical treatment and those who required conservative treatment. Among patients who received inpatient treatment at our hospital for three years from August 2017 to August 2020, we included three patients who underwent surgical treatment for patellar fracture and one patient who required conservative treatment for patellar fracture. The degree of improvement of the patients was evaluated using physical examination findings of the knee joint, numeric rating scale, pain disability index, Lysholm knee score, and walking state. After each treatments, we observed that the range of motion of the knee joint, numeric rating scale, pain disability index, Lysholm knee score, and walking state improved in the patient groups. Even with the same patellar fracture, we observed that different rehabilitation treatments involving Korean medicine should be applied to patients who underwent surgical treatment and those who required conservative treatment. However, further studies are needed to design a rehabilitation protocol involving Korean medicine.

Use of Two Estrus Synchronization Protocols and Their Success on Pregnancy in Zebu and Crossbred Heifers at Char Areas of Bangladesh

  • Ghosh, Tapas;Paul, Ashit Kumar;Talukder, Anup Kumar;Alam, M. Golam Shahi;Bari, Farida Yeasmin
    • Journal of Embryo Transfer
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    • v.27 no.4
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    • pp.223-228
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    • 2012
  • This study was designed to adopt two estrus synchronization protocols in zebu and crossbred heifers and their effects on pregnancy rate after timed artificial insemination (TAI). A number of 120 cyclic heifers were allotted for two different treatment groups and one control group. Heifers under protocol A were injected with GnRH at first day followed by a single dose of $PGF_{2{\alpha}}$ at Day 11 and injection of GnRH at the day of AI; and heifers belonged to protocol B were treated with GnRH, two $PGF_{2{\alpha}}$ injections at 11 days apart and injection of GnRH at AI. AI was done at fixed time (within 72~96 hours after $PGF_{2{\alpha}}$ injection) in both protocols and pregnancy was confirmed by rectal palpation on 80~120 days of post AI. In control group; local heifers were conceived higher (30%) proportion than that of crossbred heifers (25%; p<0.05). In protocol A, the local breed were conceived higher (38.9%) proportion compared with crossbred (25%; p<0.05). In protocol B, local breed heifers were conceived higher (38.9%) proportion compared with crossbred heifers (33.3%; p<0.05). The overall pregnancy rate in protocol A and protocol B was 33.3% and 36.6%, respectively. The proportion of pregnancy rate of local heifers (38.9%; Protocol A) was significant (p<0.05) in comparison with local heifers (30%) in control group (p<0.05). The overall pregnancy rate between pooled control group (28.3%) and treatment group (35%) was significantly (p<0.05) differ from each other's. Results of present study concluded that estrus synchronization followed by fixed time AI could be applied for higher pregnancy rate in zebu and crossbred heifers.

Surgical Treatment of Ruptured Renal Artery Aneurysm: A Report of 2 Cases

  • Seo, Pil Won
    • Journal of Chest Surgery
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    • v.46 no.6
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    • pp.467-470
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    • 2013
  • The rupture of a renal artery aneurysm is a rare disease that is difficult to diagnose. Although we usually consider the appropriate treatment to be open laparotomy with aortic aneurysm surgery or stenting with graft insertion through intravascular intervention, thus far, there is no general consensus on the treatment protocol for renal artery aneurysm. Notably, ruptured renal artery aneurysm is a true critical emergency that may result in a fatal outcome. We are reporting two renal artery aneurysm patients who had ruptured and underwent emergency laparotomy.

Cryopreservation of Human Immature Follicular Oocyte (인간의 미성숙난자의 동결보존에 관한 연구)

  • Kim, Eun-Kyung;Son, Weon-Young;Chi, Hee-June;Ko, Jung-Jae;Yoon, Tae-Ki;Cha, Kwang-Yul
    • Clinical and Experimental Reproductive Medicine
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    • v.19 no.2
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    • pp.163-168
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    • 1992
  • This study was carried out to set up the ovum bank for ovum donation and to determine the best freezing method for human immature oocytes. Human immature follicular oocytes were cryopreserved by slow freezing and rapid thawing method. Immature follicular oocytes were treated by propanediol(PROH) solution by 2 and 4 step method in protocols A & B, respectively. In protocol C, immature oocytes were exposed to sucrose prior to treatment of PROH by 4 step method. We compared survival rate, maturation rate, and fertilization rate of immature oocytes among three protocols. Results were as follows. 1. Oocytes treated by the protocol C showed the highest survival rate( 70.3 %) and maturation rate(34.6%) after thawing. 2. Survival rate of oocytes treated by the protocol C was significantly higher than that of the protocol B after thawing(p<0.05). In conclusion, treatment of oocytes with sucrose prior to expose PROH was the best freezing method. Sucrose may have reduced the toxic effect of cryoprotectant to oocytes. We failed to induce fertilization of oocytes, which were treated by any protocols, by conventional insemination method, but obtained 28.8% fertilization rate by using partial zona dissection(PZD) method. This result suggests that micromanipulation(PZD) of the thawed oocytes before insemination will improve the fertilization rate.

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Evaluation of the effective dose and image quality of low-dose multi-detector CT for orthodontic treatment planning (3차원 안모분석을 위한 저선량 Multi-detector CT 영상의 유효선량 및 화질 평가)

  • Chung, Gi-Chung;Han, Won-Jeong;Kim, Eun-Kyung
    • Imaging Science in Dentistry
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    • v.40 no.1
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    • pp.15-23
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    • 2010
  • Purpose : This study was designed to compare the effective doses from low-dose and standard-dose multi-detector CT (MDCT) scanning protocols and evaluate the image quality and the spatial resolution of the low-dose MDCT protocols for clinical use. Materials and Methods : 6-channel MDCT scanner (Siemens Medical System, Forschheim, Germany), was used for this study. Protocol of the standard-dose MDCT for the orthodontic analysis was 130 kV, 35 mAs, 1.25 mm slice width, 0.8 pitch. Those of the low-dose MDCT for orthodontic analysis and orthodontic surgery were 110 kV, 30 mAs, 1.25 mm slice width, 0.85 pitch and 110 kV, 45 mAs, 2.5 mm slice width, 0.85 pitch. Thermoluminescent dosimeters (TLDs) were placed at 31 sites throughout the levels of adult female ART head and neck phantom. Effective doses were calculated according to ICRP 1990 and 2007 recommendations. A formalin-fixed cadaver and AAPM CT performance phantom were scanned for the evaluation of subjective image quality and spatial resolution. Results : Effective doses in ${\mu}Sv$ ($E_{2007}$) were 699.1, 429.4 and 603.1 for standard-dose CT of orthodontic treatment, low-dose CT of orthodontic analysis, and low-dose CT of orthodontic surgery, respectively. The image quality from the low-dose protocol were not worse than those from the standard-dose protocol. The spatial resolutions of both standard-dose and low-dose CT images were acceptable. Conclusion : From the above results, it can be concluded that the low-dose MDCT protocol is preferable in obtaining CT images for orthodontic analysis and orthodontic surgery.

Acute cardiovascular complications in patients with diabetes and hypertension: management consideration for minor oral surgery

  • Jadhav, Ajinath Nanasaheb;Tarte, Pooja Raosaheb
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.4
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    • pp.207-214
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    • 2019
  • Objectives: Medically compromised patients often fear required dental surgical procedures that can increase the risk of medical emergency when combined with reduced tolerance for stress. A stress reduction protocol (SRP) helps doctors minimize treatment-related stress and improves patient management with minimum complications. Diabetes and co-morbid hypertension carry 4-fold risk of aggravation of cardiovascular emergencies and 7.2-fold risk of mortality. Diabetic neuropathy can result in difficult diagnosis of myocardial infarction and reduces chances of surviving a myocardial infarction compared with a non-diabetic person. The aim of the study was to assess the feasibility of a protocol for management of patients having both diabetes and hypertension who required minor oral surgery to minimize the rate of cardiovascular emergencies. Materials and Methods: A prospective study was conducted in 140 patients having both diabetes and hypertension who required minor oral surgical procedures. A systematic approachable protocol was designed for management of such patients. Results: Among 140 patients, 6 patients (4.3%) had cardiovascular complications, while 3 patients (1 with syncope and 2 with hypertension) did not require any intervention other than observation. Two patients were managed with aspirin and nitroglycerin, and 1 patient had possible myocardial infarction (overall incidence 0.7%) with chest pain, S-T segment elevation on electrocardiogram, and troponin level of 0.60 ng/mL. Conclusion: The proposed protocol helps to improve management of patients having both diabetes and hypertension. We recommend that patients with uncontrolled diabetes and uncontrolled hypertension and/or patients having history of cardiovascular complication should be treated in a medical facility with a readily available cardiology unit. This facilitates prompt response to emergency and instant implementation of treatment, helping to reduce morbidity and mortality.