• Title/Summary/Keyword: treatment timing

검색결과 368건 처리시간 0.026초

배양 인체 백혈구의 chromosome replication에 미치는 DNA hypomethylation의 영향 (Hypomethvlation of DNA with 5-Azacvtidine Alters Chromosome Replication Patterns in Cultured Human Lvmphocvtes)

  • 원태웅;이석우김우갑
    • 한국동물학회지
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    • 제37권4호
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    • pp.437-477
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    • 1994
  • The DNA replication of human Iyrnphocvtes was studied using Bromodeo3fyuridine incorporation. The characteristic patterns of dvnamlc banding were analysed. Human chromosomal ONA was synthesized in a segmental but highly coordinated fashion. Each chromosome replicates according to its innate pattern of chromosome structure (bandinsl. R-positive bands are demonstrated as the initiation sites of DNA synthesis, and G-bnads initiate replication after it has been completed in the autosomal R-bands. Many researchers demonstrated that developmental or induced methvlation of DNA can inactivate the associated gene loci. Such DNA methylation can be reversed and specific genes reactivated by treatment with 5-azacvtidine. We treated the hvpomethvlating agent 5-azacvtidine and tested for changes of DNA replication pattern. Treatment with 5-azacytidine causes an advance in the time of replication. These observed changes in timing of replication suggest that DNA methvlation may modify regional groups of genes in concert.

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Epidural Blood Patch for the Treatment of Abducens Nerve Palsy due to Spontaneous Intracranial Hypotension - A Case Report -

  • Kim, Yeon-A;Yoon, Duck-Mi;Yoon, Kyung-Bong
    • The Korean Journal of Pain
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    • 제25권2호
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    • pp.112-115
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    • 2012
  • Intracranial hypotension is characterized by a postural headache which is relieved in a supine position and worsened in a sitting or standing position. Although less commonly reported than postural headache, sixth nerve palsy has also been observed in intracranial hypotension. The epidural blood patch (EBP) has been performed for postdural puncture headache, but little is known about the proper timing of EBP in the treatment of sixth nerve palsy due to intracranial hypotension. This article reports a case of sixth nerve palsy due to spontaneous intracranial hypotension which was treated by EBP 10 days after the onset of palsy.

Current concepts of craniofacial fibrous dysplasia: pathophysiology and treatment

  • Dong Yeon Kim
    • 대한두개안면성형외과학회지
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    • 제24권2호
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    • pp.41-51
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    • 2023
  • Fibrous dysplasia is an uncommon genetic disorder in which bone is replaced by immature bone and fibrous tissue, manifesting as slow-growing lesions. Sporadic post-zygotic activating mutations in GNAS gene result in dysregulated GαS-protein signaling and elevation of cyclic adenosine monophosphate in affected tissues. This condition has a broad clinical spectrum, ranging from insignificant solitary lesions to severe disease. The craniofacial area is the most common site of fibrous dysplasia, and nine out of 10 patients with fibrous dysplasia affecting the craniofacial bones present before the age of 5. Surgery is the mainstay of treatment, but the technique varies according to the location and severity of the lesion and associated symptoms. The timing and indications of surgery should be carefully chosen with multidisciplinary consultations and a patient-specific approach.

Benign osteoblastoma of the mandible: a case report

  • Maria del Carmen Navas-Aparicio
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제49권1호
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    • pp.49-52
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    • 2023
  • Osteoblastoma is a rare benign neoplasm formed by osteoid tissue and well-vascularized bone that occurs mainly in children and adolescents. It appears primarily in the long bones, vertebral column, and small bones of the hands and feet, and not typically in the skull and maxillary bones. The purpose of this study is to present the case of an 8-year-old girl with a diagnosis of right mandibular osteoblastoma and a review of the relevant literature. The goals of treatment were to preserve dental occlusion, masticatory function and facial symmetry while minimizing the effects on patient body image and quality of life. Osteoblastoma, although it is benign, can be aggressive, and its treatment will depend on the timing of diagnosis, size and location. Early diagnosis is essential to avoid not only radical surgery as in the case presented, but also to help minimize the risk of possible relapse and potential malignancy of a benign osteoblastoma.

노인 환자에게 투석이 필요한가? (Do Elderly Patients Need Dialysis?)

  • 선인오
    • The Korean Journal of Medicine
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    • 제99권4호
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    • pp.165-168
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    • 2024
  • Initiating dialysis at an advanced age is both a clinical challenge and an ethical dilemma, because the benefits in older adults with advanced chronic kidney disease may be offset by high rates of dialysis-related morbidity. Geriatric conditions, such as aging, frailty, functional impairment, and cognitive impairment, significantly influence the prognosis of elderly patients. Therefore, it becomes important to provide patients and families with prognostic information regarding timing of initiation, which is further complicated by the competing mortality risk. Shared decision-making by clinicians and patients can yield better clinical outcomes and quality of life. Through this approach, patients can opt for the most appropriate treatment based on their personal values, which often entails conservative management.

타과와의 협진을 통한 다수치 결손을 동반한 성장기 환자의 보철 수복 증례 (Interdisciplinary approach on oral rehabilitation of an adolescent patient with multiple missing teeth: a clinical report)

  • 권긍록;백장현;이현우
    • 대한치과보철학회지
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    • 제51권4호
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    • pp.339-346
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    • 2013
  • 외상이나 선천적 결손에 의한 영구치아의 결손은 치료 방법과 적용 시기의 결정이 치료의 예후에 중요한 영향을 미친다. 본 증례는 성장기 환자로서 치아와 두개안면골 상태에 대한 정확한 진단 및 적절한 치료방법을 선택하고 성장 양식을 고려해서 일정기간 임시수복물과 임시 가철성 보철물을 사용하였으며, 성장 완료 후 임플란트 등을 이용한 고정성 보철수복 치료를 시행한 경우로써 교정과와 보철과의 협진 진료, 붕괴된 교합고경의 재확립 과정, 임플란트 보철치료 시 고려해야할 사항들에 대해 발표하고자 한다.

The impact of radiotherapy on clinical outcomes in parameningeal rhabdomyosarcoma

  • Choi, Yunseon;Lim, Do Hoon
    • Radiation Oncology Journal
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    • 제34권4호
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    • pp.290-296
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    • 2016
  • Purpose: Radiotherapy (RT) is considered a mainstay of treatment in parameningeal rhabdomyosarcoma (PM-RMS). We aim to determine the treatment outcomes and prognostic factors for PM-RMS patients who treated with RT. In addition, we tried to evaluate the adequate dose and timing of RT. Materials and Methods: Twenty-two patients with PM-RMS from 1995 to 2013 were evaluated. Seven patients had intracranial extension (ICE) and 17 patients had skull base bony erosion (SBBE). Five patients showed distant metastases at the time of diagnosis. All patients underwent chemotherapy and RT. The median radiation dose was 50.4 Gy (range, 40.0 to 56.0 Gy). Results: The median follow-up was 28.7 months. Twelve patients (54.5%) experienced failure after treatment; 4 local, 2 regional, and 6 distant failures. The 5-year local control (LC) and overall survival (OS) were 77.7% and 38.5%, respectively. The 5-year OS rate was 50.8% for patients without distant metastases and 0% for patients with metastases (p < 0.001). Radiation dose (<50 Gy vs. ${\geq}50Gy$) did not compromise the LC (p = 0.645). However, LC was affected by ICE (p = 0.031). Delayed administration (>22 weeks) of RT was related to a higher rate of local failure (40.0%). Conclusion: RT resulted in a higher rate of local control in PM-RMS. However, it was not extended to survival outcome. A more effective treatment for PM-RMS is warranted.

Longitudinal management of recurrent temporomandibular joint ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment

  • Lim, Seung-Weon;Choi, Jin-Young;Baek, Seung-Hak
    • 대한치과교정학회지
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    • 제49권6호
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    • pp.413-426
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    • 2019
  • This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

Optimal timing for salvage surgery after definitive radiotherapy in hypopharyngeal cancer

  • Chun, Seok-Joo;Keam, Bhumsuk;Heo, Dae Seog;Kim, Kwang Hyun;Sung, Myung-Whun;Chung, Eun-Jae;Kim, Ji-hoon;Jung, Kyeong Cheon;Kim, Jin Ho;Wu, Hong-Gyun
    • Radiation Oncology Journal
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    • 제36권3호
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    • pp.192-199
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    • 2018
  • Purpose: Use of radiotherapy combined with chemotherapy is increasing in hypopharyngeal cancer. However, many show residual tumor after radiotherapy. Timing for treatment evaluation and salvage therapy is essential. However, optimal timing for salvage surgery has not been suggested. In this study, we tried to evaluate optimal timing for salvage surgery. Methods and Materials: Patients who were diagnosed with hypopharyngeal squamous cell carcinoma between 2006 and 2015 were retrospectively analyzed. All patients received definitive radiotherapy with or without chemotherapy. Response of all treated patients were analyzed at 1, 3, and 6 months after radiotherapy. Any patients with progression before 6 months were excluded. Results: A total of 54 patients were analyzed. Complete remission (CR) rates at 1 month (CR1), 3 months (CR3) and 6 months (CR6) were 66.7%, 81.5%, and 90.7%, respectively. Non-CR at 1 month (NCR1), 3 months (NCR3), and 6 months (NCR6) showed poor locoregional recurrence-free survival rates (1-year rates of 63.7%, 66.7%, and 0.0%, respectively) compared to CR1, CR3, and CR6 (1-year rates 94.3%, 88.0%, and 91.5%, respectively). Particularly significant differences were seen between CR6 and NCR6 (p < 0.001). Of 10 patients with NCR3, 5 showed CR at 6 months (NCR3/CR6). There was no statistical difference in locoregional recurrence-free survival between CR3 and NCR3/CR6 group (p = 0.990). Conclusion: Our data suggest half of patients who did not show CR at 3 months eventually achieved CR at 6 months. Waiting until 6 months after radiotherapy may be appropriate for avoiding additional salvage therapy.

A Clinical Study of Collaboration between Western and Korean Medicine for the Treatment of Peripheral Facial Palsy in a Korean Medicine Hospital

  • Kim, Jaewon;Kim, Yongsuk
    • Journal of Acupuncture Research
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    • 제37권3호
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    • pp.161-166
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    • 2020
  • Background: The purpose of this study was to investigate the characteristics and direction of treatment for peripheral facial palsy (PFP) based on medical collaboration between Western and Korean medicine departments. Methods: There were 195 outpatients with PFP identified retrospectively by examining electronic medical records. These patients were treated with Korean and Western medicine from January 1st, 2018 to December 31st, 2018 at the Kyung Hee University hospital. Records were analyzed according to the patients' demographic characteristics and clinical features of the collaborative combined treatment. Results: According to the collaborative treatment pathway, the number of patients consulted from Western medicine departments was more than consulted from Korean department for the first time. The time taken by the Western medicine departments to consult with the patients at the Korean center for the first time was 14.9 days from the onset of symptoms. Acupuncture was the most frequently used Korean medicine treatment. The total treatment period for Korean medicine sessions and intervals were 91.9 days, 23 times and 3.6 days, respectively. When the Korean medicine center consulted with Western medicine departments, the time taken until the first consultation was 8.5 days from the onset of symptoms. Medication was the most used treatment, prescribed after 3.1 days. The most frequently used clinical test was an electromyogram, and this was performed after 20.5 days. The total treatment period, sessions and intervals were 21.2 days, 2.8 times and 5 days, respectively. Conclusion: The clinical status of collaborative treatment for PFP was determined including the timing and interval of consultation according to treatments.