• Title/Summary/Keyword: treatment strategy

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Long term management of people with post-tuberculosis lung disease

  • Wan Seo;Hyung Woo Kim;Ju Sang Kim;Jinsoo Min
    • The Korean journal of internal medicine
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    • v.39 no.1
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    • pp.7-24
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    • 2024
  • Post-tuberculosis lung disease (PTLD) is emerging as a significant area of global interest. As the number of patients surviving tuberculosis (TB) increases, the subsequent long-term repercussions have drawn increased attention due to their profound clinical and socioeconomic impacts. A primary obstacle to its comprehensive study has been its marked heterogeneity. The disease presents a spectrum of clinical manifestations which encompass tracheobronchial stenosis, bronchiectasis, granulomas with fibrosis, cavitation with associated aspergillosis, chronic pleural diseases, and small airway diseases-all persistent consequences of PTLD. The spectrum of symptoms a patient may experience varies based on the severity of the initial infection and the efficacy of the treatment received. As a result, the long-term management of PTLD necessitates a detailed and specific approach, addressing each manifestation individually-a tailored strategy. In the immediate aftermath (0-12 months after anti-TB chemotherapy), there should be an emphasis on monitoring for relapse, tracheobronchial stenosis, and smoking cessation. Subsequent management should focus on addressing hemoptysis, managing infection including aspergillosis, and TB-associated chronic obstructive pulmonary disease or restrictive lung function. There remains a vast expanse of knowledge to be discovered in PTLD. This review emphasizes the pressing need for comprehensive, consolidated guidelines for management of patients with PTLD.

The disc morphological changes on CT scan examinations after 5-7years, of acute HIVD patients who underwent oriental medical treatment (조기(早期) 한방치료(韓方治療)를 시행한 요추수핵탈출증(腰椎髓核脫出症) 환자(患者)의 C-T 상(上) 5-7년 후의 추간판(椎間板)의 변화(變化))

  • Mun, Hyung-Cheal;Hwang, Woo-Jun;Lee, Geon-Mok;Cho, Nam-Geun;Gang, Sung-Do;Cho, Jae-Woon;Chang, Byoung-Sun;Jin, Kyong-Son
    • Journal of Acupuncture Research
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    • v.18 no.4
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    • pp.1-12
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    • 2001
  • Study design : A retrospective study of lumbar disc herniations using results of follow-up computed tomographic scan examinations. Objective : Lumbar disc herniations is one of the cause low back pain and lower extremity pain. To clarify the lumbar disc herniations morphological changes over time(mean 5.3 years) in order to establish a strategy for treatment. Methods : Sixteen patients with lumbar disc herniations who underwent follow-up computed tomographic scan examinations were studied. The changes over time in herniated disc size(herniation ratio) were evaluated using this scan technique. The initial computed tomographic scan allowed classification of the herniations according to herniation ratio: small, medium and large. Results : Comparison with follow-up computed tomographic scans showed that of the 16 patients, in 14 patients(88%), the herniation ratio(HR) was decreased and among them, 8 patients had complet resolution of herniated disc. In 2 patients with small herniations, the HR of one case was increased, the other was decreased. In 8 patients with medium herniations, the HR of one case had no change, the others was decreased. In 6 patients with large herniation, the HR of all patients was decreased. Interestingly, 4 of the 16 patients showed calcification change of herniated disc. Conclusion : There is no doubt that herniated disc size is decreased over time. The largest herniations were those which had the greatest tendency to decrease in size. But in some cases, the HR was increased, or calcification change was showed.

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Effect of Scion Age on Survival Rate and Initial Yield of the Grafted Tomato Seedlings (토마토 접목묘 생산시 접수연령이 활착율과 초기 수확량에 미치는 영향)

  • Kim, Sung Eun;Lee, Moon Haeng;Kim, Young Shik
    • Journal of Bio-Environment Control
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    • v.22 no.4
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    • pp.335-340
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    • 2013
  • This research was conducted to know the appropriate leaf number of scion for tube grafting in context with survival rate and quality of seedlings, and early yield of $1^{st}$ and $2^{nd}$ cluster of cherry tomato plants. Scions were grafted when having leaves 1~2 (LF-2), 2~3 (LF-3), or 3~4 (LF-4). The treatment LF-3 showed the highest survival rates and the best results in 6 factors among 12 seedling quality factors. In case of early yield, the treatment LF-2 showed higher yield than others with the big difference. Economic analysis showed that LF-3 is desirable in case of nursery while LF-2 is better in case of farmers. The compromising solution is that farmers buy a little expensive seedlings grafted at the leaf stage of 1~2 from nurseries in terms of win/win strategy.

Mortality and Potential Years of Life Lost of Colorectal cancer between Korea and OECD countries before and after the year 2000 (우리나라와 OECD 국가 간의 2000년 전과 후 대장암 사망률과 잠재수명손실연수에 관한 비교)

  • Kim, Dong-Seok;Kang, Soo-Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5261-5270
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    • 2012
  • The present study is designed to compare the mortality and potential years of life lost of colorectal cancer between OECD countries and Korea before (1990-1999) and after (2000-2009) to provide data of more accurate strategy of public health policy and education about cancer treatment and prevention through examining differences of changes among the OECD countries. We statistically compared mortality and potential years of life lost from 32 OECD countries including Korea, except 2 nations with inadequate data, between before (1990-1999) and after the year 2000 (2000-2009) using 'OECD Health Data 2012' using the method of paired t-test. Male mortality of colorectal cancer was increased in 8 OECD countries including Korea and the female mortality was only increased in Chile and Korea. In particular, the increased rate of mortality was significantly high in Korean male and female. Moreover, increased rate of potential years of life lost for colorectal cancer was also significantly high in Korea: the rate in Korean male was increased over three times than in Mexico (2nd rank of the increase) and the rate of female was only increased in Korea compared with other countries, interestingly. Therefore, the present study suggested that most OECD countries well controlled the incidence and treatment of colorectal cancer after 2000 but Korea did not. From these, to control future problems, the further studies for the reason of the increase of potential years of life lost in female will be needed.

The Effect of Grouping on the Basis of Students' Agreeableness in Cooperative Elementary Science Classes (초등 과학 협동학습에서 유화성을 고려한 소집단 구성의 효과)

  • Kang, Suk-Jin;Seo, A-Young;Kwon, Hyeok-Soon
    • Journal of the Korean Chemical Society
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    • v.51 no.3
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    • pp.270-278
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    • 2007
  • In this study, we investigated the effects of grouping with respect to the level of students' agreeableness on 6th graders' science achievement, self-efficacy, and science learning motivation in cooperative learning. Three classes (72 students) from an elementary school were randomly assigned to a control group and treatment groups. An agreeableness test, self-efficacy test, and science learning motivation test were administered as pretests. The students of the treatment groups were grouped either homogeneously or heterogeneously on the basis of their agreeableness levels and were taught with a cooperative learning strategy, whereas the students of the control group were randomly grouped and were taught with a traditional method. The cooperative learning intervention lasted for 5 weeks (16 class periods). After the instructions, tests regarding achievement, self-efficacy, and science learning motivation were administered as posttests. The results indicated that the students of the homogeneous and/or the heterogeneous groups significantly outperformed those of the control group in the achievement test. However, students' achievement was not influenced by the grouping method on the basis of students' agreeableness. No significantly differences among the groups were found in the self-efficacy and science learning motivation.

An Exploratory Study on the Care Farm Governance: Focusing on the Netherlands and Belgium Cases (케어팜 거버넌스에 대한 탐색적 연구: 네덜란드와 벨기에 사례를 중심으로)

  • Hwang, Jeong Seop;Hwang, Yoon Min
    • The Journal of the Korea Contents Association
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    • v.20 no.4
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    • pp.358-372
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    • 2020
  • Recently, there has been growing social interest in the use of care farms as part of therapy for neurological or mental patients and regional innovation for rural areas. Care farm, which combines the health treatment and rural innovation perspectives, is important to establish a proper governance system for mutual collaboration with various stakeholders. However, there is still a lack of research on this. Therefore, this study designed the care farm governance framework and comparatively analyzed the governance between Netherlands paradise care farm and Belgium blue farm, which are major successful care farm cases. The results showed different governance system between Netherlands and Belgium care farm in terms of institutional and financial support, regional characteristics, structure, operation, and strategy. In Netherlands, as the central government-initiated therapy-centric, care farm governance is concentrated in treatment of patient mainly supported by Ministry of Health, Welfare and Sports under the law on social support. Whereas, in Belgium, as local government-initiated agriculture-centric, care farm governance is mainly focused to lead voluntary participation of agricultural cooperatives and medical institutions in regional area. This study provides a theoretical foundation of governance type and system for the care farm research and suggests guidelines of care farm governance for the governments like South Korea consider activating care farm.

The Strategy for Diagnosis and Treatment of Isovaleric Acidemia (아이소발레릭산혈증의 신생아선별검사 후 진단 및 치료 전략)

  • Ko, Jung Min;Lee, Kyung-A
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.2
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    • pp.57-61
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    • 2016
  • Isovaleric acidemia (IVA) is an autosomal recessively inherited organic acid disorder due to a defect of the enzyme isovaleryl-CoA dehydrogenase in the leucine metabolic pathway. Deficiency of this enzyme results in the accumulation of derivatives of isovaleryl-CoA. In acute illness in IVA, isovaleric acid and its derivatives accumulate and profound metabolic acidosis with ketosis, characteristic pungent body odor, hypoglycemia, and hyperammonemia can be developed. Additionally, recurrent vomiting, failure to thrive, developmental delay, epilepsy and mental retardation are chronic presenting symptoms and signs for IVA. On the result of newborn screening for inherited metabolic disorders, increased levels of isovalerylcarnitine (C5) are shown. However, C5 elevation can be accompanied with short/branched-chain acyl-CoA dehydrogenase (SBCAD) and therapy with certain antibiotics containing pivalic acid. Quantitative measurement of organic acids in urine and acylcarnitine profiles in plasma are necessary to differential diagnosis. Molecular genetic analysis of the IVD gene for IVA and ACADSB is also helpful to confirm IVA and SBCAD deficiency, respectively. Considering that IVA can be associated with significant morbidity and mortality at acute presentation of metabolic crisis, early diagnosis prior to the onset of symptoms by newborn screening enable to introduction of early treatment and prevention of acute and chronic complications.

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DENS INVAGINATUS AND A VITAL MAXILLARY LATERAL INCISOR WITH LATERAL PERIODONTAL ABSCESS (생활력이 있는 상악측절치에서 치내치로 인한 측방치주농양이 형성된 증례)

  • Bae, Won-Su;Kim, Hyun-Jung;Nam, Soon-Hyun;Kim, Young-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.2
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    • pp.317-322
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    • 1999
  • Dens invaginatus is a developmental anomaly resulting from an invagination of the enamel organ. The incidence is highest with maxillary permanent lateral incisors. The reported occurrence ranges from 0.04 to 10%. This anomaly may involve the pulp and periapical tissues and cause pulpal inflammation, loss of vitality, apical and lateral periodontitis, periapical abscesses and cysts and stimulate internal resorption. Oehlers describes dens invaginatus as occurrence in three forms. In treating type 3 invaginatus, treatment strategy can be determined by considering the complexity and accessibility of invagination. In this case, showing simple invagination, it could be treated by simple endodontic treament confining to invagination without loss of vitality of tooth. After treatment of the present case, the results were as follows: 1. In type 3 dens invagiantus, if the tooth is vital and there is no evidence of communicating between invagination and pulp, we can save the vitality of the tooth and resolve the lesion by endodontic treament confining to the invagination. 2. In the invagination with opened apex, the closure of apex can be induced by apexification procedure doing this, we can avoid the neccessity of surgical intervention.

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The Palliative Care and Hospice for the People Living with HIV (HIV 감염인을 위한 완화의료와 호스피스)

  • Choi, Jae-Phil
    • Journal of Hospice and Palliative Care
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    • v.20 no.3
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    • pp.159-166
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    • 2017
  • According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.

Angiocentric Immunoproliferative Lesions(AILs) in Nose (코의 Angiocentric Immunoproliferative Lesions(AILs))

  • Han Ji-Youn;Kim Jae-You;Lee Youn-Soo;Chung Su-Mee;Kim Min-Shik;Yoon Sei-Chul;Kim Hoon-Kyo;Cho Seung-Ho;Kim Byung-Kee;Lee Kyung-Shik;Kim Dong-Jip
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.16-21
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    • 1996
  • Lymphomatoid granulomatosis, polymorphic reticulosis, midline malignant reticulosis, or lethal midline granuloma have similar histologic features of an angiocentric and angiodestructive lymphoreticular proliferation representing the same nosologic entity. The term 'angiocentric immunoproliferative lesion' (AIL) was proposed by Jaffe, Costa, and Martin. The malignant potential of AILs is originally uncertain, but the facts that AILs have a relatively short survival, and most of them usually progress to an overt malignant lymphoma and survival is inversely proportional to the large, atypical lymphoreticular cells suggest that AILs are malignane. We experienced 17 AILs in nose during 16-year period and retrogradely analized them to recognize the problems in the diagnosis and to establish the further therapeutic strategies. The results were as follows; Twelve of total 17 patients who had diagnosed as histologic grade 1 and 2 had received radiation therapy as an initial treatment and the complete response rate was 91.7%(11/12), but 6 out of 11 had local recurrence and 5 had progress to overt maligant lymphoma within 2years. Three patients with the histologic grade 3 and 2 with unclear histologic grade had received CHOP chemotherapy and there was 1 case with complete response. Two patients with unclear histologic grade had been proved to be malignant histiocytosis by bone marrow biopsy during the clinical course. The overall duration of survival was 2 - 119 months and the 5-year survival rate was 71.9%. And the achievement of initial complete response was the most important prognostic factor of overall survival(P=0.006). Our results suggest that the treatment strategy according to the histologic grading scheme is efficient and more aggressive combination chemotherapy may be necessary to achieve complete response in patients with histologic grade III and II, because most of them progress to overt malignant lymphoma during its process.

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