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Lung Biopsy after Localization of Pulmonary Nodules with Hook Wire (Hook Wire를 이용한 폐결절의 위치선정 및 생검)

  • Kim, Jin-Sik;Hwang, Jae-Joon;Lee, Song-Am;Lee, Woo-Surng;Kim, Yo-Han;Kim, Jun-Seok;Chee, Hyun-Keun;Yi, Jeong-Geun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.681-686
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    • 2010
  • Background: A chest computed-tomography has become more prevalent so that it is more common to detect small sized pulmonary nodules that have not been found in previous simple chest x-ray. If those detected nodules are undersized or located in pulmonary parenchyma, it is difficult to accomplish a biopsy since it is vulnerable to explore them either grossly or digitally. Thus, in our hospital, a thoracoscopic pulmonary wedge resection was performed after locating a lesion by means of hook wire with CT-guided. Material and Method: 31 patients (17 males and 14 female patients) from December in 2006 to June in 2010 became our subjects; their 34 pulmonary nodules were subjected to the thoracoscopic pulmonary wedge resection after locating a lesion by means of hook wire with CT-guided. Also we analyzed a possibility of hook wire dislocation, a frequency of conversion to open thoracotomy, time consumed to operation after location of a lesion, operation time, post operation complication, and histological diagnosis of the lesion. Result: 12 of 34 cases were ground glass lesion, whereas 22 cases of them were solitary pulmonary lesion. The median value of the lesion was 8mm in size (range: 3 to 23 mm), while the median value was 12.5 mm in depth (range: 1 to 34 mm). The median value of time consumed from location of the lesion to anesthetic induction was 86.5 minutes (41~473 minutes); furthermore the mean value of operation time was 103 minutes (25~345 minutes). Intrathoracic wire dislocation was found in one case, but a target lesion was successfully excised. Open thoracotomy was performed in four cases due to pleural adhesion. However, there was no case of conversion to open thoracotomy due to failure to detect a target lesion. In histological diagnosis, metastatic cancer were found in 15 cases, which were the most common, primary lung cancer were in 9 cases, non-specific inflammation were in 3 cases, tuberculosis inflammation were in 2 cases, lymph nodes were in 2 cases, active tuberculosis were in 1 case, atypical adenomatous hyperplasia was in 1 case and normal lung parenchymal finding was in 1 case, respectively. Conclusion: In our hospital, in order to accomplish a precise histological diagnosis of ground-glass lesion and pulmonary nodules in lung parenchyma, location of pulmonary nodules were exactly located with hook wire under chest computed-tomography, which was followed by lung biopsy. We concluded that this was an accurate, minimally invasive and valuable method to minimize the complications and increase of cost of medical service provided.

Comparison of Fermentation Characteristics of Italian Ryegrass (Lolium multiflorum Lam.) and Guineagrass (Panicum maximum Jacq.) during the Early Stage of Ensiling

  • Shao, Tao;Zhang, Z.X.;Shimojo, M.;Wang, T.;Masuda, Y.
    • Asian-Australasian Journal of Animal Sciences
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    • v.18 no.12
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    • pp.1727-1734
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    • 2005
  • The fermentation characteristics and mono- and di-saccharides compositions during the early stage of ensiling were studied with a temperate grass, Italian ryegrass (Lolium multiflorum Lam.) and a tropical grass, guineagrass (Panicum maximum Jacq.). The laboratory silos were kept in the room set at 25$^{\circ}C$, and then were opened on 0.5, 1, 2, 3, 5 and 7 days (14 days in Italian ryegrass) after ensiling, respectively. The Italian ryegrass silage showed a fast and large pH decrease caused by a fast and large production of lactic acid during the first 5 days of ensiling and succeeded to achieve lactic acid type fermentation; high lactic acid/acetic acid and lactic acid content at the end of ensiling (14 days), low values of pH (3.74), acetic acid, ethanol and ammonia-N/total nitrogen, none or only small amounts of Butyric acid, valeric acid and propionic acid. The guineagrass silage showed a slow decrease in pH and a slow increase in lactic acid content during the full ensiling period, causing a high final pH value, low contents of lactic acid, acetic acid, total volatile fatty acids and total organic acids. In Italian ryegrass silage, mono- and di-saccharides compositions decreased largely within the initial 0.5 day (12 h) of ensiling. Sucrose disappeared rapidly within the initial 0.5 day of ensiling, but fructose and glucose contents showed an initial rise by the activity of enzymes in plant tissues, and then decreased gradually. On the other hand, the contents of monoand di-saccharides in guineagrass showed the largest decreases due mainly to plant respiration within the initial 0.5 day of ensiling, and no initial rises in fructose and glucose contents during the early stage of ensiling because of the absence of fructans which are hydrolyzed into fructose and glucose in temperate grasses. In both silages, the rate of reduction in mono- and di-saccharides compositions within the initial 5 days of ensiling was ranked in the order of glucose>fructose>sucrose, suggesting that glucose and fructose might be more favorably utilized than sucrose by microorganisms and glucose is the first fermentation substrate. It was concluded that the silage made from Italian ryegrass with high moisture content had a good fermentation quality owing to the dominance of lactic acid bacteria and active lactic acid fermentation during the initial stage of ensiling. These results can be explained by rapid plant sap liberation and the high activity of plant enzyme hydrolyzed fructans into fructose and glucose within the initial 2 days of ensiling, which stimulate the homofermentative lactic acid bacteria growth. In ensiling a temperate grass, the physical characteristics may ensure the rapid onset of fermentation phase, which results from the smaller losses of water-soluble carbohydrates during the initial stage of ensiling and providing sufficient water-soluble carbohydrates for lactic acid bacteria. The silage made from guineagrass with intermediate dry matter and high initial mono- and di-saccharides content was stable silage. This could be explained by the higher incorporation of air during the very early stage of ensiling and the restriction of cell breakdown and juice release due to the properties of a tropical grass with coarse porosity and stemmy structures. These physical characteristics delayed the onset of lactic acid bacteria fermentation phase by extending the phases of respiration and aerobic microorganisms activity, causing the higher loss of water-soluble carbohydrates and the shortage of lactic acid bacteria fermentation substrates.

Effects of Addition Level and Chemical Type of Propionate Precursors in Dicarboxylic Acid Pathway on Fermentation Characteristics and Methane Production by Rumen Microbes In vitro

  • Li, X.Z.;Yan, C.G.;Choi, S.H.;Long, R.J.;Jin, G.L.;Song, Man K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.22 no.1
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    • pp.82-89
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    • 2009
  • Two in vitro experiments were conducted to examine the effects of propionate precursors in the dicarboxylic acid pathway on ruminal fermentatation characteristics, $CH_4$ production and degradation of feed by rumen microbes. Fumarate or malate as sodium salts (Exp. 1) or acid type (Exp. 2) were added to the culture solution (150 ml, 50% strained rumen fluid and 50% artificial saliva) to achieve final concentrations of 0, 8, 16 and 24 mM, and incubated anaerobically for 0, 1, 3, 6, 9 and 12 h at $39^{\circ}C$. For both experiments, two grams of feed consisting of 70% concentrate and 30% ground alfalfa (DM basis) were prepared in a nylon bag, and were placed in a bottle containing the culture solution. Addition of fumarate or malate in both sodium salt and acid form increased (p<0.0001) pH of culture solution at 3, 6, 9 and 12 h incubations. The pH (p<0.0001) and total volatile fatty acids (VFA, p<0.05) were enhanced by these precursors as sodium salt at 3, 6 and 9 h incubations, and pH (p<0.001) and total VFA (p<0.01) from fumarate or malate in acid form were enhanced at a late stage of fermentation (9 h and 12 h) as the addition level increased. pH was higher (p<0.001) for fumarate than for malate as sodium salt at 3 h and 6 h incubations. Propionate ($C_3$) proportion was increased (p<0.0001) but those of $C_2$ (p<0.05) and $C_4$ (p<0.01 - p<0.001) were reduced by the addition of sodium salt precursors from 3 h to 12 incubation times while both precursors in acid form enhanced (p<0.011 - p<0.0001) proportion of $C_3$ from 6h but reduced (p<0.018 - p<0.0005) $C_4$ proportion at incubation times of 1, 3, 9 and 12 h. Proportion of $C_3$ was increased (p<0.05 - p<0.0001) at all incubation times by both precursors as sodium salt while that of $C_3$ was increased (p<0.001) from 6h but $C_4$ proportion was decreased by both precursors in acid form as the addition level increased. Proportion of $C_3$ was higher (p<0.01 - p<0.001) for fumarate than malate as sodium salt from 6 h incubation but was higher for malate than fumarate in acid form at 9 h (p<0.05) and 12 h (p<0.01) incubation times. Increased levels (16 and 24 mM) of fumarate or malate as sodium salt (p<0.017) and both precursors in acid form (p<0.028) increased the total gas production, but no differences were found between precursors in both chemical types. Propionate precursors in both chemical types clearly reduced (p<0.0001 - p<0.0002) $CH_4$ production, and the reduction (p<0.001 - p<0.0001) was dose dependent as the addition level of precursors increased. The $CH_4$ generated was smaller (p<0.01 - p<0.0001) for fumarate than for malate in both chemical types. Addition of fumarate or malate as sodium type reduced (p<0.004) dry matter degradation while both precursors in both chemical types slightly increased neutral detergent fiber degradability of feed in the nylon bag.

Changes of lateral cephalometric values according to the rotation of head (두부회전에 따른 측모두부방사선 계측치의 변화)

  • Kim, Kwang-Soo;Hwang, Mee-Sun;Choi, Eui-Hwan;Kim, Kwang-Won;Yoon, Young-Jooh
    • The korean journal of orthodontics
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    • v.30 no.1 s.78
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    • pp.53-66
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    • 2000
  • This study was performed to find out the effect of projection errors on cephalometric linear and angular measurements according to head rotation during taking lateral cephalometric radiographs. Seventeen skulls with permanent dentition and no gross asymmetry were obtained from the Department of Anatomy, Medical School, Chosun University. Total 527 x-ray films were taken with $1^{\circ}$ interval from the reference position($0^{\circ}$) to ${\pm}15^{\circ}$ around the vertical axis (Z axis) which is perpendicular to the midpoint of the line connecting the center of two ear rods in submento-vertex direction. Statistical analysis was performed by paired t-test if there were statistically significant differences between the mean of the reference position($0^{\circ}$) and that of each rotation angle. The following results were obtained. 1. The projection errors of angular measurements were smaller than those of linear measurements. 2. The projection errors of angular measurements including midline landmarks were smaller than those including bilateral landmarks. 3. The horizontal linear measurements were gradually decreased when the stroll was rotated toward the film, but slightly increased and then decreased when the skull was rotated toward the focal spot. However, the changes were smaller in focal direction. 4. The projection errors of horizontal linear measurements were larger than those of vertical linear measurements. 5. The projection errors of vertical linear measurements were increased with increased distance from the rotation axis to vertical measurements. It is concluded that the use of angular measurements rather than linear measurements is recommended to minimize the projection errors.

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SEMI-LONGITUDINAL STUDY ON GROWTH AND DEVELOPMENT OF CHILDREN AGED 6 TO 17 Part II : GROWTH CHANGE OF CRANIOFACIAL SOFT TISSUE (한국인 6-17세 아동의 성장과 발육에 관한 준종단적 연구 제 2 세부과제 : 두개 및 안면 연조직의 성장변화)

  • Park, Young-Chel;Lee, Kee-Joon;Han, Hee-Kyoung;Lee, Jang-Yeol
    • The korean journal of orthodontics
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    • v.26 no.4
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    • pp.325-340
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    • 1996
  • Along with traditional goal of 'straightening teeth', today's orthodontics put more and more emphasis on facial esthetics. Naturally, the importance of soft tissue, which dictates one's facial form, is noticed. There have been many cephalometric studies on growth of hard tissue ; however, only a few on that of soft tissue. In Korea, various methods of sampling, measuring and analysing were used to study soft tissue changes, and yet, soft tissue changes along with process of normal growth have not been studied. The author carried out this study as a part of semi-longitudinal study on craniofacial growth and development of Korean children from ages of six to seventeen. 409 boys and 436 girls who'd had no systemic disease for the last three years and shown normal developmental and occlusal status were chosen as subjects. Cephalometric X-rays were taken of each subject, and facial form, lip position & form, nose form, and lip thickness were measured. Mean values and standard deviations were calculated according to age and gender, and figures and tables were drawn accordingly. The following results were obtained: 1. In respect to facial form, boys showed growth for longer period compared to girls. Also, lower face showed higher growth rate than upper face. 2. There was not much change in thickness of upper and lower lips with age; however, they appeared more prominent compared to caucasian children. 3. Nose grew horizontally with age. 4. Horizontal thickness of lower face increased with age, and upper lip thickness at nose base[A-Sn(FH)] showed more growth than anywhere else.

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Chemistry of mist deposition of organic polymer PEDOT:PSS on crystalline Si

  • Shirai, Hajime;Ohki, Tatsuya;Liu, Qiming;Ichikawa, Koki
    • Proceedings of the Korean Vacuum Society Conference
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    • 2016.02a
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    • pp.388-388
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    • 2016
  • Chemical mist deposition (CMD) of poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) was investigated with cavitation frequency f, solvent, flow rate of nitrogen, substrate temperature $T_s$, and substrate dc bias $V_s$ as variables for efficient PEDOT:PSS/crystalline (c-)Si heterojunction solar cells (Fig. 1). The high-speed camera and differential mobility analysis characterizations revealed that average size and flux of PEDOT:PSS mist depend on f, solvent, and $V_s$. The size distribution of mist particles including EG/DI water cosolvent is also shown at three different $V_s$ of 0, 1.5, and 5 kV for a f of 3 MHz (Fig. 2). The size distribution of EG/DI water mist without PEDOT:PSS is also shown at the bottom. A peak maximum shifted from 300-350 to 20-30 nm with a narrow band width of ~150 nm for PEDOT:PSS solution, whose maximum number density increased significantly up to 8000/cc with increasing $V_s$. On the other hand, for EG/water cosolvent mist alone, the peak maximum was observed at a 72.3 nm with a number density of ~700/cc and a band width of ~160 nm and it decreased markedly with increasing $V_s$. These findings were not observed for PEDOT:PSS/EG/DI water mist. In addition, the Mie scattering image of PEDOT:PSS mist under white bias light was not observed at $V_s$ above 5 kV, because the average size of mist became smaller. These results imply that most of solvent is solvated in PEDOT:PSS molecule and/or solvent is vaporized. Thus, higher f and $V_s$ generate preferentially fine mist particle with a narrower band width. Film deposition occurred when $V_s$ was impressed on positive to a c-Si substrate at a Ts of $30-40^{\circ}C$, whereas no deposition of films occurred on negative, implying that negatively charged mist mainly provide the film deposition. The uniform deposition of PEDOT:PSS films occurred on textured c-Si(100) substrate by adjusting $T_s$ and $V_s$. The adhesion of CMD PEDOT:PSS to c-Si enhanced by $V_s$ conspicuously compared to that of spin-coated film. The CMD PEDOT:PSS/c-Si solar cell devices on textured c-Si(100) exhibited a ${\eta}$ of 11.0% with the better uniformity of the solar cell parameters. Furthermore, ${\eta}$ increased to 12.5% with a $J_{sc}$ of $35.6mA/cm^2$, a $V_{oc}$ of 0.53 V, and a FF of 0.67 with an antireflection (AR) coating layer of 20-nm-thick CMD molybdenum oxide $MoO_x$ (n= 2.1) using negatively charged mist of 0.1 wt% 12 Molybdo (VI) phosphoric acid n-Hydrate) $H_3(PMo_{12}O_40){\cdot}nH_2O$ in methanol. CMD. These findings suggest that the CMD with negatively charged mist has a great potential for the uniform deposition of organic and inorganic on textured c-Si substrate by adjusting $T_s$ and $V_s$.

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An Analysis of BMD Changes With Preoperative and Postoperative Premenopausal Breast Cancer Patient (폐경 전 유방암 환자의 치료 전.후 골밀도 변화 분석)

  • Kim, Su-Jin;Son, Soon-Yong;Choi, Kwan-Woo;Lee, Joo-Ah;Min, Jung-Whan;Kim, Hyun-Soo;Ma, Sang-Chull;Lee, Jong-Seok;Yoo, Beong-Gyu
    • Journal of radiological science and technology
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    • v.37 no.4
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    • pp.279-286
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    • 2014
  • The purpose of this study is to provide basic data of comparing BMD(bone mineral density) value of preoperative breast cancer patient and postoperative breast cancer patient due to bone loss with radiation/chemical therapy. The participants consisted of 254 breast cancer patients with BMD after having surgery and treatment from March 2007 to September 2013. Except for 84 patients with menopause or hysterectomy and we have analysed 171 patients. The BMD value(lumbar spine and femur) of before and after treatment from PACS by dure-energy X-ray absorptiometry was analyzed. First, we found variation of entire BMD and BMD according to treatment type, and analyzed detailed correlation by using marital status, number of children, presence of feeding, age of menarche, breast cancer therapy types as variable. Data was analyzed by using SPSS for Windows Program(version 18.0). BMD was decreased 7.1% in lumbar spine, 3.1% in femur respectively(p<.01). Also there is relatively high decrement($0.067g/cm^2$) in group who had just chemotherapy in femur(p<.05). There is decrement depend on marital status, number of children, presence of feeding, age of menarche, breast cancer therapy types but there was no statistical significance. The results show that BMD was decreased after treatment in premenopausal breast cancer patient, patient who had relatively high decrement need to be included high-risk group. As a result, aggressive prevention policy would be necessary.

The Radioprotective Effect and Mechanism of Captopril on Radiation Induced Lung Damage in Rat (방사선조사에 의한 쥐 폐손상에 방사선보호제로서 Captopril의 역할에 관한 연구)

  • Song Mi Hee;Lee Kyung Ja;Koo Heasoo;Oh Won Young
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.190-198
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    • 2001
  • Purpose : It was reported that Captopril (angiotensin converting enzyme inhibitor) had an effect to reduce the pneumonitis and pulmonary fibrosis induced by radiation in rat. We peformed this study to investigate the radioprotective effect and mechanism of Captopril. Methods and Materials : The comparison was made between the radiation only group and the combined Captopril and radiation group by examining histopathologic findings and immunohistochemical stains $(TNF\alpha\;and\;TGF\beta1)$ at 2 and 8 weeks after irradiation. Each group has 8 to 10 rats (Sprague-Dawley). 12.5 Gy of X-ray was irradiated to the left hemithorax in a single fraction. Captopril (50 mg/kg/d) mixed with water was given per oral and continuously from 1 week prior to irradiation up to 8th week of the experiment. Result : In the combined Captopril and radiation group, the histopathologic changes which were hemorrhage into alveolar space, changes of alveolar epithelium, bronchial epithelium and blood vessels, and perivascular edema were less severe than in the radisation only group at 2 weeks. At 8 weeks, the alveolar epithelial changes and perivascular edema were less prominant in the combined Captopril and radiation group. At 2 weeks, the $TNF\alpha$ expression of the combined Captopril and radiation group was markedly decreased at the alveolar epithelium (p<0.01), lymphoid tissue (p=0.06) and the macrophage of alveolar space (p<0.01) compared with the radiation only group. Furthermore the $TGF\beta1$ expression was significantly prominant at the alveolar epithelium (p<0.02) and the macrophage in alveolar space (p<0.02). At 8 weeks, the expression of $TNF\alpha\;and\;TGF\beta1$ of most sites, except $TGF\beta1$ of the macrophage of alveolar space (p=0.09), showed no significant difference between 2 groups. Conclusion : This study revealed that early lung damage induced by irradiation was reduced with the addition of Captopril in the latent and early pneumonitis phase. The expression of $TNF\alpha\;and\;TGF\beta1$ at 2 weeks and $TGF\beta1$ at 8 weeks was further decreased in the combined Captopril and radiation group than the radiation only group. From these results, it may be concluded that the proinflammatoy cytokine $(TNF\alpha)$ and fibrogenic cytokine $(TGF\beta1)$ probably play the role of the radioprotective mechanism in Captopril.

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Adjuvant Postoperative Radiation Therapy for Carcinoma of the Uterine Cervix (자궁경부암의 수술 후 방사선치료)

  • Lee Kyung-Ja;Moon Hye Seong;Kim Seung Cheol;Kim Chong Il;Ahn Jung Ja
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.199-206
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    • 2003
  • Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.

A Longitudinal Study on the Skeletal Maturity of the Hand and Wrist among Various Malocclusion Groups(I) (부정교합자의 수완부 골성숙도에 관한 누년적 연구(I))

  • Kim, Kyung-Ho
    • The korean journal of orthodontics
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    • v.29 no.2 s.73
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    • pp.183-195
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    • 1999
  • Growth and development evaluation of patients with growth potential is of great importance for orthodontic treatment planning. Timing of orthodontic intervention greatly depends on one's developmental status, thus if there is a difference in skeletal maturation among malocclusion types different treatment timing should be applied. The objective of this study was to evaluate and compare skeletal maturation among different malocclusion types. The samples used in this study was 38 Class I, 36 Class II and 33 ClassIII females aging from 8 to 10 years. Handwrist X-rays were taken with 6 month interval till 12-13 years of age. The results were as follows. 1. There was no skeletal maturity difference among different malocclusion types. 2. The hamular process of hamate was observed at $9.16{\pm}0.72$ years, pisiform bone at $9.13{\pm}0.71$ years and the ulnar sesamoid at $10.34{\pm}0.84$ years. 3. The timing of epiphyseal capping on the third finger was $10.96{\pm}0.80$ years for distal phalanx and $11.27{\pm}0.87$ years for middle phalanx, $11.12{\pm}0.85$ years for proximal phalanx of the first finger, $11.21{\pm}0.82$ years for radius and $11.62{\pm}0.85$ years for middle phalanx of the fifth finger. 4. The appearance of pisiform bone showed high correlation with appearance of hamular process of hamate(r=0.91) and ulnar sesamoid bone appearance showed high correlation with advanced ossification of hamular process(r=0.86). Timing of epiphyseal capping among different parts showed high correlation(r=0.80-0.90). 5. The shape of middle phalanx of the fifth finger showed the highest variability ($20.6\%$).

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