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Benefit of Ultrasound-guided Therapeutic Medial Branch Blocks after Percutaneous Epidural Neuroplasty (신경 성형술 후 초음파 유도하 내측 분지 차단술의 유용성)

  • Moon, Sang Ho;Lee, Song;Jung, Jae-Hyun;Shin, Won Shik
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.33-38
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    • 2014
  • Purpose: To determine the therapeutic effectiveness of ultrasound-guided medial branch block (MBB) for the herniated lumbar disc patients who did not relieve their symptoms after percutaneous epidural neuroplasty (PEN). Materials and Methods: From August 2011 to February 2013, 559 patients with herniated lumbar disc have undergone PEN. Among them, ultrasound-guided MBBs were performed for the patients who had sustained low back pain and refered pain to lower extremities. Eighty eight patients were followed at 1 month and 39 patients could be followed at 6 month. All procedures have been performed by the one operator, and 23 G, 10 cm needle was placed and 0.5% lidocaine was injected under ultrasound guide. To target medial branches from L1 to L5, the groove at the root of transverse process and the base of superior articular process has been identified on transverse scan. Patients were evaluated by Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) at each follow-up. Significant pain relief was described as a 50% or more reduction in VAS and significant improvement in function was described as at least a 40% reduction in ODI. Results: VAS showed that preprocedure pain ($7.35{\pm}1.68$; $mean{\pm}SD$) significantly decreased 1 month after block ($3.36{\pm}2.98$) and 6 month ($3.05{\pm}2.27$) (p<0.05). ODI also showed that preprocedure score ($32.82{\pm}8.77$) significantly decreased at 1 month ($15.14{\pm}14.01$) and 6 month ($12.97{\pm}8.82$) (p<0.05). Significant pain relief was observed in 64.49% at 1 month and 64.10% at 6 month. Significant functional improvement in 59.81% at 1 month and 61.54% at 6 month. Conclusion: Ultrasound-guided medial branch block may sufficiently treat the facet problems secondary from disc disease.

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THE INFLUENCE OF CAVITY CONFIGURATION ON THE MICROTENSILE BOND STRENGTH BETWEEN COMPOSITE RESIN AND DENTIN (와동의 형태가 상아질과 복합레진 사이의 미세인장결합강도에 미치는 영향)

  • Kim, Ye-Mi;Park, Jeong-Won;Lee, Chan-Young;Song, Yoon-Jung;Seo, Deok-Kyu;Roh, Byoung-Duck
    • Restorative Dentistry and Endodontics
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    • v.33 no.5
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    • pp.472-480
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    • 2008
  • This study was conducted to evaluate the influence of the C-factor on the bond strength of a 6th generation self-etching system by measuring the microtensile bond strength of four types of restorations classified by different C-factors with an identical depth of dentin. Eighty human molars were divided into four experimental groups, each of which had a C-factor of 0.25, 2, 3 or 4. Each group was then further divided into four subgroups based on the adhesive and composite resin used. The adhesives used for this study were AQ Bond Plus (Sun Medical, Japan) and XenoIII (DENTSPLY, Germany). And composite resins used were fantasists (Sun Medical, Japan) and Ceram-X mono (DENTSPLY, Germany). The results were then analyzed using one-way ANOVA, a Tukey's test, and a Pearson's correlation test and were as follows. 1. There was no significant difference among C-factor groups with the exception of groups of Xeno III and Ceram-X mono (p<0.05). 2. There was no significant difference between any of the adhesives and composite resins in groups with C-factor 0.25, 2 and 4. 3. There was no correlation between the change in C-factor and microtensile bond strength in the Fantasista groups. It was concluded that the C-factor of cavities does not have a significant effect on the microtensile bond strength of the restorations when cavities of the same depth of dentin are restored using composite resin in conjunction with the 6th generation self-etching system.

Effects of Supplemental Alkali Feldspar-Ilite on Growth Performance and Meat Quality in Broiler Ducks (알칼리장석-일라이트가 육용오리의 생산성 및 육질에 미치는 영향)

  • Kook K.;Kim J. E.;Jeong J. H.;Kim J. P.;Sun S. S.;Kim K. H.;Jeong Y. T.;Jeong K. H.;Ahn J. N.;Lee B. S.;Jeong I. B.;Yang C. J.;Yang J. E.
    • Korean Journal of Poultry Science
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    • v.32 no.4
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    • pp.245-254
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    • 2005
  • This experiment was conducted to investigate the effect of the supplemental alkali feldspar-ilite(feldspar) on growth performance and meat quality in broiler ducks for 43 days. One hundred eighty broiler ducks were divided into 5 groups of 12ducks. Dietary levels of feldspar 0, 0+antibiotics, 0.5, 1.0 and $1.5\%$ were added to experimental diets of each of the groups. Daily weight gain was slightly increased in 1.0 and $1.5\%$ feldspar treatments. Feed intake was slightly increased at all feldspar treatments. Glucose concentration of serum profile was decreased whereas BUN concentration was significantly increased (p<0.05) at $0.5\%$ feldspar. Cholesterol concentration was decreased at all feldspar treatments, this difference was especially observed in supplemental levels of $0.5\%$ feldspar(p<0.05). Carcass weight was increased at all feldspar treatments. Moisture and crude fat contents of proximate chemical composition in duck meat were decreased at all feldspar treatment, this difference especially was observed in supplemental levels of $1.5\%$ feldspar(p<0.05) on crude fat content. Lightness and yellowness was increased at all feldspar treatment. Cholesterol contents and TBA in meat were decreased, but this parameters were not difference by feldspar treatment. The composition of saturated fatty acids(SFA) was decreased, whereas unsaturated fatty acids(USFA) was slightly increased by feldspar treatment. The Pb content of heavy metal concentrations was increased with compared control, but not difference. The appearance of sensory evaluation was improved by supplemental feldspar, especially in supplemental feldspar, 1.0 and $1.5\%$(p<0.05). The results of this study indicate that the supplemental alkali feldspar may improve the production and meat quality of broiler ducks.

Effect of Feeding Aspergillus oryzae Inoculant Food-waste Diets on Performance, $NH_3$ Emission and Fecal Microflora in Broiler Chickens (Aspergilius Oryzae 접종 남은 음식물 사료가 육계의 생산성, $NH_3$ 발생량 및 분내 미생물 성상에 미치는 영향)

  • Hwangbo J.;Hong E. C.;Lee B. S.;Bae H. D.;Kim W.;Nho W. G.;Kim J. H.;Kim I. H.
    • Korean Journal of Poultry Science
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    • v.32 no.4
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    • pp.281-289
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    • 2005
  • This study investigated the effect of dried food-waste diets(FW) fermented by Aspergillus oryzae(AO), on broiler growth performance, $NH_3$, emission and fecal microflora. Three hundreds broilers, two week old Hubbard strain, were randomly allotted to 4 experiments and fed with standards early boiler diet replaced with FW and AFW. In experiment 1, eighty four broilers were distributed into 7 treatments with 4 pens at 3 birds per replicate(pen). The dietary treatments ; T1 was com-soy bean meal based broiler diet(Control), T2, T3, T4 were for basal diet replaced with dried food waste without AO(FW) at the level of 20, 40 and $60\%$, respectively and T5, T6 and T7 followed the same levels for the basal diet but using Aspergillus oryzae inoculate food-waste(AFW). For experiments 2, 3, 4, seventy two broilers were distributed into 6 treatments with 4 pens at 3 birds per replicate(pen), respectively. The dietary treatments were the com-soy bean meal based broiler diet replacement with different combinations of FW and AFW, 1:0, 3:1, 1:1, 1:3, 0:1. at level of 20, 40 and $60\%$, respectively. In Exp. 1, it tended to be decreased in weight gain, however, there were no statistical differences among treatments except FW $60\%$ level of replacement(p<0.05). Feed intake and feed efficiency was not different among treatments. Total bacterial counts were not different between the control and FW diet, but E. coli decreased as the AFW levels of replacement were increased(p<0.05). There were no differences in weight gain, feed intake and feed efficiency among treatments in Exp. 2 and weight gains were lower fur FW diet compared with the control and AFW diet in Exp. 3(p<0.05). In Exp. 4, there were no differences in feed intakes among treatments, but lower in weight gain and feed efficiency in FW diet than that the control. In experiment 3, the $NH_3$ emission was the highest among treatments in FW/AFW 1:0 diet(p<0.05). From these results, it seems that FW would be supplemented up to $20\%$ in broiler diets and AO culture extract could improve FW value as feed supplements.

Role of Intra-aortic Balloon Pump in High Risk Patients undergoing Off-Pump Coronary artery bypass graft (심폐바이패스 없이 시행하는 관상동맥 우회술시 고위험군 환자에서 대동맥내 풍선 펌프의 유용성)

  • Cho, Suk-Ki;Jang, Woo-Ik;Lim, Cheong;Lee, Cheul;Lee, Jae-Ik;Kim, Yong-Lak;Ham, Byung-Moon;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.895-900
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    • 2001
  • Background : This study aimed to evaluate the usefulness of preoperative placement of intraaortic balloon pump(IABP) in reducing operative risk and facilitating posterior vessel OPCAB in high risk patients with left main disease( 75% stenosis), intractable resting angina, postinfarction angina, or left ventricular dysfunction(ejection fraction 35%). Material and Method : One hundred eighty- nine consecutive patients who underwent multi-vessel OPCAB including posterior vessel revascularization were studied. The patients were divided into group I(n=74) that received preoperative or intraoperative IABP and group II(n=115) that did not receive IABP. In group I, there were 39 patients with left main disease, 40 patients with intractable resting angina, 14 patients with left ventricular dysfunction and 7 patients with postinfarction angina. Ten patients received intraoperative IABP support due to hemodynamic instability during OPCAB. Result : There was one operative mortality in group I and two mortalities in group II. The average number of distal anastomoses was not different between group I and group II(3.5$\pm$0.9 vs 3.4$\pm$0.9, p=ns). There were no significant differences in the number of posterior vessel anastomosis per patient between the two groups. There were no differences in ventilator support time, length of hospital stay, and morbidity between the two groups. There was one case of IABP-related complication in group I. Conclusion : IABP facilitates posterior vessel OPCAB in high risk patients, with comparable surgical results to low risk patients

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In-Hospital Outcomes of Acute Renal Failure Requiring Continuous Renal Replacement Therapy in Patients with On-pump CABG (심폐기 가동하 관상동맥우회술 후 발생한 급성신부전 환자들에 있어 지속적 신대체요법의 병원 내 결과)

  • Kim, Young-Du;Park, Kuhn;Kang, Chul-Ung;Yoon, Jeong-Seob;Moon, Seok-Whan;Wang, Young-Pil;Jo, Kuhn-Hyun
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.32-36
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    • 2007
  • Background: Although acute renal failure (ARF) after coronary artery bypass graft (CABG) is relatively rare, but devastating complication with high mortality. Our study aims to evaluate the effectiveness of early application of CRRT in patients with ARF which developed after on-pump CABG. Material and Method: Two hundred and eighty seven patients underwent isolated on-pump CABG between May 2002 and Feb. 2006 at our institution, of whom 15 (5.2%) needed CRRT (11 patients for postoperatively developed ARF and the remaining 4 patients with preexisting dialysis-dependent chronic renal failure (CRF) for postoperative hemodynamic and metabolic control). Criteria for early application of CRRT were as follows; decreased urine output less than 0.5cc/h/kg for 2 consecutive hours and elevated serum creatinine level greater than 2.0 mg/dL. Result: The incidence of ARF requiring CRRT after on-pump CABG was 3.9% (11/283) and the overall hospital mortality of patient with CRRT was 33.3% (5/15). Of 5 deaths, 4 were patients with postoperatively developed ARF, and 1 was a patient with pre-existing dialysis-dependent CRF patient. The mean time between the operation and the initiation of CRRT was $25.8{\pm}5.8$ hours and the mean duration of CRRT was $62.1{\pm}41.2$ hours. Of the 7 survivors who were not on dialysis-dependent preoperatively, 6 patients fully recovered renal function during hospital stay and 1 patient required permanent renal supportive treatment after discharge from hospital. Conclusion: Early application of CRRT could maintain stable postoperative hemodynamic status and make outcomes better than those of previous reports in patients with ARF which developed after on-pump CABG.

Analysis of Treatment Failures in Early Uterine Cervical Cancer (조기 자궁경부 악성종양의 치료실패에 대한 분석)

  • Kim Joo-Young;Lee Kyu-Chan;Choi Hyung-Sun
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.285-291
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    • 1991
  • One hundred and twenty six patients with early uterine cervical cancer who had been treated at Departmen of Radiation Oncology of Korea University Hospital from Jan.1981 to Dec.1988 were analysed retrospectively by the treatment result and pattern of of failures. All patients had stage Ia to IIa disease and were grouped whether they had combination of operation and postop irradiation or radiation therapy alone. 1) Sixty six patients belonged to the combination treatment group and 60 patients to the radiation alone group. 2) Combination group consisted of $18.1\%$(12/66) stage Ia, $71.2\%$(47/66) stage Ib and $10.6\%$ (7/66) stage IIa patients. There were no stage Ia, 18.8$\%$(l1/60) stage Ib and 81.6$\%$(49/60) stage IIa patients for RT alone gronp. 3) There were total 23$\%$(29/126) treatment failures,13 patients in combination group and 16 patients in RT alone group. In 66 patients of combination group, they were found to have 5 locoregional failures, 7 distant failures and 1 at both sites. In 60 patients of RT alone group, 9 locoreginal failure and 7 distant failures occured. Eighty six percent (25/29) of total failures appeared within 18 month after completion of treatment. About 60$\%$ of the patients with regional recurrences which were located at pelvic side wall or pelvic lymph nodes paesented their recurrent disease after 1 year of completion of treatment, whereas same percent of distant failures appeared within 6 month. 5) In RT alone group, the first sites of distant failure were mostly para-aortic lymph node and/or left supraclavicular lymph node (71.4$\%$,5/7). In combination group, various sites such as inguinal lymph node, mediastinal lymph node, liver, lung and bone appeared first or at the same time with para-aortic and supraclavicular lymph node metastasis. 6) Logistic regression analysis was done for multivariate analysis of the factors contributing to locoregional and distant failures. In combination group, adequacy of the resection margin and the presence of positive pelvic node were found to be the most significant factors (p=0.0423 & 0.0060 respectively). In RT alone group, less than complete regression of the tumor at the end of treatment was the only significant contributing factor for the treatment failures (p=0.0013) with good liklihood ratio.

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Radiation Therapy for Superior Vena Cava Syndrome (상대정맥증후군의 방사선치료)

  • Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.78-84
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    • 2005
  • Purpose: The studied the effect of such variables as the symptom improvement rate, survival and prognostic factors on the treatment results of radiation therapy for Superior Vena Cava Syndrome (SVCS). Materials and Methods: From 1988 to 2003, seventy two patients with SVCS were treated with radiation therapy at the Department of Radiation Oncology, Keimyung University Dongsan Medical Center. The patients' ages ranged from 10 to 83 years old with the median age being 61, and sixty four patients were male. For the causes of the SVCS, 64 patients had lung cancer, four had metastatic lung cancer, two had malignant lymphoma and two had thymoma. The radiotherapy was delivered with 6-MV X-rays and all patients received above 900 cGy up to 6,600 cGy, with the median dose being 4,000 cGy The follow-up periods were from 1 to 180 months with a median of 5.6 months. Results: The main clinical manifestations were dyspnea ($84.7\%$), facial edema ($81.9\%$), arm edema ($22.2\%$), neck vein distension ($25\%$), hoarseness ($12.5\%$) and facial plethora ($5.6\%$). Eighty percent of patients achieved excellent to good symptom improvement and $19.4\%$ experienced minimal improvement. The median survival period was 5.1 months, and overall survival rates were $17.7\%$ at 2 years (2YOS) and $14.8\%$ at five years (5YOS) for all the patients. The median survival period, the two and five year disease free survival rates were 4.3 months, $16.7\%$ and $13.4\%$ for the lung cancer patients, respectively. The total tumor dose was a statistically significant survival factor on the univariate analysis for the patients with lung cancer (2YSR; > 30 Gy, $25.6\%$, $\leq$ 30 Gy $6.7\%$, p<0.01). On the multivariated analysis, a higher total tumor dose (p<0.01) and younger age (p<0.05) were statistically significant factors of survival for the lung cancer patients. Patients with NSCLC showed better survival than did the patients with SCLC, but this was not statistically significant (p > 0.05), Conclusion: Radiation therapy for the patients with SVCS due to malignancy could be an effective treatment. We considered that radiation therapy above 30 Gy of the total tumor dose may improve survival for SVCS due to lung cancer.

Role of Postoperative Radiation Therapy in the Management of Cervical Cancer (자궁경부암에서 수술 후 방사선치료의 역할)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.265-270
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    • 2004
  • Purpose: To evaluate the effectiveness of postoperative radiation therapy in cervical cancer patients and define the prognostic factors to affect survival rates. Materials and Methods: Eighty one patients with cervical cancer who were treated with postoperative radiation therapy following surgery at our institution between May 1992 and April 2000 were retrospectivelv analyzed. Forty two patients had stage IB disease, 17 had stage IIA disease, and remaining 22 had stage IIB disease, respectively. Histological examination revealed 76 squamous cell carcinoma and 5 adenocarclnoma. Sixty one patients were noted to have stromal invasion greater than 8 mm and 20 patients were noted to have stromal invasion 7 mm or less. Sixteen patients had parametrial invasion and 65 patients did not. Positive vaginal resection margin was documented in only eight patients and positive lymphovascular invasion was in twelve patients. All of the patients were treated with external beam radiation therapy alone. Majority of the patients were treated with 4 field brick technique to encompass whole pelvis. Total of 5,500 cGy was delivered to the primary surgical tumor bed. Minimum follow up period was four years. Results: Actuarial disease free survival rates for entire group of the patients were 95% and 89% at 2 and 5 years, respectively Five year disease free survival rates for patients with stage IB, IIA, and IIB disease were 97%, 87% and 70%, respectivelv. Local recurrences were documented in 5 patients. Cumulative local failure rate at 3 years was 6% Five year disease free survival rates for patients with stromal invasion greater than 8 mm and 7 mm or less were 88% and 92%, respectively (p>0.05). Five year disease free survival rate for patients with parametrial invasion was significantly lower than those with no invasion (72% vs 92%, p<0.05). Also there was significantly lower survival in patients with positive vaginal resection margin, compared with patients with negative resection margin (64% vs 94%, p<0.05). However, lymphovascular invasion was not a statistically significant prognostic factor Parametrial invasion and positive surgical resection margins were noted to be significant prognostic factors. Conclusions: Postoperative radiation therapy appears to be beneficial in controlling local disease in cervical cancer patients with high pathologic risk factors. Parametrial invasion and positive resection margins were noted to be significant prognostic factors to affect survival and more effective treatment should be investigated in these patients.

Factors Affecting Herbicidal Phytotoxicity and Efficacy of Antidote, CGA 123' 407, in Rice Nursery (못자리용(用) 제초제(除草劑)의 약해발생(藥害發生) 요인(要因)과 해독제(解毒劑) "CGA 123' 407" 효과(效果))

  • Kim, Soon-Chul;Lee, Soo-Kwan
    • Korean Journal of Weed Science
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    • v.5 no.1
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    • pp.63-72
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    • 1985
  • To establish the method of integrated weed management in rice nurserybed, phytotoxic factors of herbicide and antidote efficacy were evaluated at the Yeongnam Crop Experiment Station in 1982 and 1984. Seven hundred eighty four research items were carried out as weed control research since 1961. While 65% of these were belonged to rice research, only 6% was attributed to nurserybed among rice research. More herbicidal phytotoxicity exhibited when seedbed was pressed just after seeding than sand covered or uncovered seedbed and also this phytotoxic symptom enhanced by using intact seed compared to pregerminated seed. Rinsing practice of seedbed reduced the phytotoxic effect of butachlor and this effect was more pronounced with the number of rinsing operation increase and at the pressed plot. However, herbicidal efficacy was not significantly decreased by rinsing operation. Growth of rice seedling hardly affected where the herbicide was absorbed through root only compared to absorption from both of root and shoot for pyrazolate, butachlor and thiobencarb. Herbicide antidote `CGA 123'407' completely protected from the phytotoxic effect of pretilachlor without arising any adversal effect in weed control. However, without antidote, pretilachlor showed the most severe phytotoxic symptom among used herbicides.

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