• Title/Summary/Keyword: 간이 진단

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Twelve Years of Experience with Vascular Ring Surgery (혈관륜 수술의 12년 경험 보고)

  • Kim, Yun-Seok;Goo, Hyun-Woo;Jhang, Won-Kyoung;Yun, Tae-Jin;Seo, Dong-Man;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.749-756
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    • 2009
  • Background: Vascular ring is a rare anomaly of the aortic arch. We did surgical repair procedures on 16 cases of vascular ring over the past 12 years. This article reviews our results. Material and Method: Between 1995 and 2007, 16 patients (5 with double aortic arch, 7 with right aortic arch-left ligamentum, 4 with pulmonary artery sling) underwent surgical repair. Mean age at the time of the operation were as follows: double aortic arch, $5.7{\pm}5.5$ years; right aortic arch-left ligamentum, $6.1{\pm}13.4$ years; pulmonary artery sling, $2.9{\pm}2.6$ years. Five patients (71%) with right aortic arch-left ligamentum had an associated Kommerell's diverticulum. Two patients (40%) with double aortic arch, 2 patients (28.6%) with right aortic arch-left ligament and 4 patients (100%) with pulmonary artery sling had associated airway stenosis. Cardiac anomalies were present in 8 of 16 patients. Result: There was no peri-operative or post-operative mortality. The mean hospital stay was $27.1{\pm}38.2$ days. None of our patients underwent reoperation. Conclusion: Vascular ring is rare, but, it needs surgical correction. It is important to suspect the diagnosis and to validate with echocardiography. Preoperative and postoperative computed tomography and bronchoscopy are useful to evaluate the airway and surrounding structures.

A Study of Adjustment for Beginning & Ending Points of Climbing Lanes (오르막차로 시.종점 위치의 보정에 관한 연구)

  • 김상윤;오흥운
    • Journal of Korean Society of Transportation
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    • v.24 no.5 s.91
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    • pp.35-44
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    • 2006
  • Acceleration and deceleration curves have been used for design purposes worldwide. The curve in design level has been regarded as an single deterministic curve to be used for design of climb lanes. It should be noted that the curve was originally made using ideal driving truck and that the curve is applied during design based on the assumption of no difference between ideal and real driving conditions. However. observations show that aged vehicles and lazy behavioring drivers nay make lower performance of vehicles than the ideal performance. The present paper provides the results of truck speeds at climbing lanes then probabilistic variation of acceleration and deceleration corves. For these purposes. a study about identification of vehicle makers, and weights for trucks at freeway toll gates and then observation of vehicle-following speed were performed. The 85%ile results obtained were compared with the deterministic performance curves of 180, 200, and 220 Ib/hp. It was identified that the performance of 85%ile results obtained from vehicle-following-speed observations were lower than one from deterministic performance curves. From these results, it may be concluded that at the beginning Point of climbing lanes additional $16.19{\sim}67.94m$ is necessary and that at the end point of climbing lanes $53.12{\sim}103.24m$ of extension is necessary.

Effects of Fractionated Stereotactic Radiotherapy for Primary Hepatocellular Carcinoma (원발성 간암의 분할 정위방사선치료 효과)

  • Choi Byeong Ock;Kang Ki Mun;Jang Hong Seok;Lee Snag-wook;Kang Young Nam;Chai Gyu Young;Choi Ihl Bhong
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.92-97
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    • 2005
  • Purpose : Reports on the outcome of curative radiotherapy for the primary hepatocellular carcinoma (HCC) are rarely encountered in the literature. in this study, we report our experience of a clinical trial where fractionated stereotactic radiotherapy (SRT) was used in treating a primary HCC. Materials and Methods : A retrospective analysis was peformed on 20 patients who had been histologically diagnosed as HCC and treated by fractionated SRT. The long diameter of tumor measured by CT was $2\~6.5$ cm (average: 3.8 cm). A single dose of radiation used in fractionated SRT was S or 10 Gy: each dose was prescribed based on the planning target volume and normalized to $85\~99\%$ isocenter dose. Patients were treated $3\~5$ times per week for 2 weeks, with each receiving a total dose of 50 Gy (the median dose: 50 Gy). The follow up period was $\~55$ months (the median follow up period: 23 months). Results : The response rate was $50\%$ (12 patients), with 4 patients showing complete response ($20%$), 8 patients showing partial response ($40\%$), and 8 patients showing stable disease ($40\%$). The 1-year and 2-year survival rates were $70.0\%$ and $43.1\%$, respectively, and the median survival time was 20 months. The 1-year and 2-year disease free survival rates were $65\%$ and $32.5\%$, respectively, and the median disease-free survival rate was 19 months. Some acute complications of the treatment were noted as follows: dyspepsia in 12 patients ($60\%$), nausea/emesis in 8 patients ($40\%$), and transient liver function impairment in 6 patients ($30\%$). However, there was no treatment related death. Conclusion : The study indicates that fractionated SRT is a relatively safe and effective method for treating primary HCC. Thus, fractionated SRT may be suggested as a local treatment for HCC of small lesion and containing a single lesion, when the patients are inoperable or operation is refused by the patients. We thought that fractionated SRT is a challenging treatment modality for the HCC.

The Results of Postoperative Radiotherapy for Hypopharyngeal Carcinoma (하인두암 환자에서의 수술 후 방사선치료의 결과)

  • Kim Won Taek;Ki Yong Kan;Nam Ji Ho;Kim Dong Won;Lee Byung Ju;Wang Su Gun;Kyuon Byung Hyun
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.254-264
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    • 2004
  • Purpose: This study was carried out to confirm clinical values and limitations of postoperative radiotherapy for hypopharyngeal carcinoma, to evaluate various prognostic factors which may affect to the treatment results and to use these results as fundamental data for making a new treatment strategy. Methods and Materials:. A retrospective analysis was peformed on 64 previously untreated patients with squamous cell carcinoma of the hypopharynx, seen between 1988 and 1999 at Pusan National University Hospital. Most of patients were treated by laryngopharyngectomy and neck dissection followed by conventional fractionated postoperative radiotherapy on surgical bed and cervical nodal areas. Results: The five-year overall survival rate and cause-specific survival rate were 42.2 percent and 51.6 percent, respectively. Univariate analysis of various clinical and pathologic factors confirmed the overall stage, TN-stage, secondary primary cancers, surgical positive margin, nodal extracapsular extension, total radiation doses as significant prognostic factors of hypopharyngeal carcinomas. But in multivariate analysis, TN-stage, surgical positive margin and extracapsular extesion were only statistically significant. Conclusion: In resectable cases of hypopharyngeal carcinoma, combined surgery and postoperative radio-therapy obtained good treatement results, even though sacrificing the function of larynx and pharynx. But in advanced and unresectable cases, with respect to survivals and qualify of life issues, we were able to confirm some limitations of combined therapy. So we recommend that comparative studies of recent various chemo-radiotherapy methods and advanced radiotherapy techniques with these data should be needed.

The Prognostic Effect of Subpleural Lesions in Early Stage Non-small Cell Lung Cancer - Preliminary Report - (초기 비소세포 폐암 환자의 늑막하 병변이 예후에 미치는 영향; 예비 보고)

  • Lee, Ho-Jun;Lee, Hyung-Sik;Hur, Won-Joo;Lee, Ki-Nam;Choi, Pill-Jo
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.425-431
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    • 1998
  • Purpose : We retrospectively analyzed the impact of subpleural lesions of early stage non-small cell lung cancer on the patterns of failure to support selection of postoperative adjuvant therapy. Methods and Materials : The study included 91 patients who underwent surgery for early stage non-small cell lung cancer at Dong-A University Hospital from Dec 1990 to Sep 1996. Twenty five patients were excluded due to postoperative mortality (four patients, 4.4$\%$) and stage III (21 patients). Of 66 patients, 22 patients were subpleural lesions (15 patients in stage I, and seven patients in stage II). Postoperative adjuvant radiation therapy was given to seven patients with T2Nl disease. The median follow-up duration was 29.5 months (range; 8-84 months). Results : The overall survival rate was 69.5$\%$ at 3 years. For all patients who presented with (22 patients) and without (44 patients) subpleural lesions, 3-year overall survival rates were 35.5$\%$ and 84.6$\%$, respectively (p=0.0017). For stage I patients who presented with (15 patients) and without (29 patients) subpleural lesions, 3-year overall survival rates were 33.1$\%$ and 92.3$\%$, respectively (p=0.001). For stage II patients who presented with (7 patients) and without (15 patients) subpleural lesions, 3-year overall survival rates were 53.3$\%$ and 45.7$\%$, respectively (p=0.911). For patients with T2N0 disease (34 patients) who presented with (11 patients) and without (23 patients) subpleural lesions, 3-year overall survival rates were 27.3$\%$ and 90.3$\%$, respectively (p=0.009). Conclusion : These observations suggest that the subpleural lesion play an important role as a prognostic factor for early stage non-small cell lung cancer. Especially for T2N0 disease, patients with subpleural lesions showed significantly lower survival rate than those without that.

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A Randomized, Double-Blind, Placebo-Controlled Trial of Early Ursodeoxycholic Acid Administration for Prevention of Total Parenteral Nutrition-Induced Hepatobiliary Complications (총정맥영양법의 간담도 합병증에 대한 Ursodeoxycholic Acid 조기투여의 이중맹검 위약대조군 연구)

  • Choe, Yon-Ho;Beck, Nam-Sun;Kim, Ji-Hee;Lee, Suk-Hyang;Park, Tae-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.174-180
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    • 2002
  • Purpose: Ursodeoxycholic acid (UDCA) is known to decrease hepatic injury by promoting the biliary secretion of retained toxic endogenous bile acids in hepatobiliary diseases complicated by total parenteral nutrition (TPN). However, most studies have focused on treatment for complications after TPN. We investigated the preventive role of early administration of UDCA in TPN-induced hepatobiliary complications by a randomized, double-blind, placebo-controlled trial. Methods: Between May 2000 and May 2002, thirteen patients, who were given TPN more than 10 days in the hospital, were assigned randomly to two groups. One was the case group (7 patients) who were given UDCA simultaneously with TPN regimen, and the other, the control group (6 patients) who were given placebo. Their age ranged from 1 day to 13 years. They were affected with diseases impossible for enteral nutrition, such as prematurity, cerebral palsy, chronic diarrhea, anorexia nervosa, pancreatitis, and cyclic vomiting. The duration of TPN ranged from 10 to 70 days. Hematologic parameters including liver function test were measured at regular intervals, and the duration, composition, administration rate, total calorie of TPN were recorded. The serum levels of total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase were compared between groups after cessation of the study. Results: The autoregressive coefficient of the control group was 0.4419 (p=0.0651) in bilirubin, -0.0431 (p=0.7923) in AST, 0.2398 (p=0.2416) in ALT, and 0.2459 (p=0.1922) in alkaline phosphatase by mixed procedure model when the parameters were referred to the case group. Conclusion: The serum level of total bilirubin did not increase in comparison with that of the control group, but statistically insignificant, when both TPN and UDCA were administered simultaneously from the beginning.

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Severe Pneumonia Caused by 2009 Pandemic Influenza A (H1N1) Virus in Children and Corticosteroid Treatment (소아에서 2009 신종 인플루엔자 A (H1N1) 중증 폐렴과 스테로이드 치료)

  • Sohn, Yu Rak;Kim, Jong Hee;Ma, Sang Hyuk;Lee, Kyung Yil;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.193-200
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    • 2011
  • Purpose : The effect of corticosteroid on severe pneumonia caused by 2009 pandemic influenza (H1N1) A virus is controversial. This study was aimed to present the effects of early, short-term corticosteroid treatment for severe pneumonia with this virus infection. Methods : A retrospective analysis was performed on severe pneumonia patients (37 patients) who had severe respiratory distress at presentation requiring oxygen therapy and received intravenous methylprednisolone (MP, 8-10 mg/kg, divided in 4 doses/day for 2-3 days) with oseltamivir. The clinical and laboratory characteristics of the patients were evaluated through the medical records and chest radiographic findings. Results : The mean age and male-to-female ratio of the patients were 6.5${\pm}$2.9 years of age, and 3.4:1 (male 29 patients), respectively. The 5-9 aged group was predominant among the age groups (25 patients, 67.6%). Duration of fever prior to admission was 1.4${\pm}$0.6 days and dyspnea developed within 24 h after beginning of respiratory symptoms in all patients. All patients were previously healthy and received oseltamivir within 48 h. Thirteen patients (35.1%) developed dyspnea during oseltamivir treatment. Following MP infusion, all 37 patients including 13 progressive pneumonia patients during oseltamivir treatment showed an immediate halt in the progression of pneumonic infiltration with rapid clinical improvement. There were no side-effects following steroid use. Conclusion : For severe pneumonia patients, early corticosteroid treatment halted clinical exacerbation, and possibly prevented progression to acute respiratory distress syndrome. Further controlled clinical studies are needed for the role of corticosteroids and antivirals on severely affected patients with influenza virus infections.

Fish Community Structure Analysis and Ecological Health Assessments in the Headwater Watershed of Nakdong River (낙동강 상류 수계의 어류 군집 구조 분석 및 생태건강도 평가)

  • Lee, Jae-Hoon;Hong, Young-Pyo;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.40 no.3
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    • pp.403-411
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    • 2007
  • The purpose of the study was to evaluate fish community, based on conventional at Shannon-Weaver diversity index (H'), and ecological health, based on the Index of Biological Integrity (IBI) using fish assemblage in the eight sites of Nakdong River during June${\sim}$August 1999. Total number of species sampled was 19 species, and two sensitive species of Zacco temminckii (51%) and Rhynchocypris oxycephalus (28%) dominated the fish community. Also, trophic guild analyses showed that insectivore was 87% of the total and omnivore was rare, indicating that the ecological health is well maintained in the system. The pattern of spatial variation in the diversity index(H') was very similar to patterns of the species number and individual number, whereas the pattern of H' was not matched with the tolerance and trophic guild data. The diversity index (H') showed highest (1.56) in Site 6 where the proportion of sensitive species and tolerant species was minimum and maximum, respectively, and where the insectivore and omnivore were minimum and maximum. In other words, the diversity index was not matched at all with the trophic and tolerant guilds, indicating that the conventional index did not reflect the ecological characteristics of fish community in the system. In the mean time, the ecological health (IBI) averaged 33.5 (n=8), indicating "good${\sim}$fair condition" and the IBI values matched with trophic and tolerance guilds. Maximum IBI occurred in Site 2 where the sensitive and msectivore species were nearly maximum, and the tolerant and omnivore species were almost minima, indicating that IBI values were closely associated with the ecological functions and health conditions. Overall data suggest that the conventional diversity index may not effective for a evaluation of fish community, and that in contrast the IBI approach may be a useful tool for diagnosis of stream community.

Effect of Nutrient Solution Strength on pH of Drainage Solution and Root Activity of Strawberry 'Sulhyang' in Hydroponics (배양액의 농도가 배액의 pH와 딸기 '설향' 뿌리의 활성에 미치는 영향)

  • Jun, Ha-Joon;Byun, Mi-Soon;Liu, Shi Sheng;Jang, Mi-Soon
    • Horticultural Science & Technology
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    • v.29 no.1
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    • pp.23-28
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    • 2011
  • Experiments were conducted to investigate the optimum concentration of the nutrient solution in strawberry 'Sulhyang' with hydroponics in relationship between root activity and nutrient concentrations. Nutrient solutions for strawberry, made by Yamazaki, were supplied EC 0.5, 1.0, 2.0 $dS{\cdot}m^{-1}$ during experiment period. Growth of shoot and root of strawberries grown in visible plastic pot was observed during experiment. Petiole length was longest in plants grown in EC 1.0 $dS{\cdot}m^{-1}$, followed by 2.0 and 0.5 $dS{\cdot}m^{-1}$. Leaf width was longest in plants grown in EC 1.0 $dS{\cdot}m^{-1}$, followed by 0.5 and 2.0 $dS{\cdot}m^{-1}$. Fruit length, fruit diameter, fruit weight and yield were higher in EC 0.5 and 1.0 $dS{\cdot}m^{-1}$ than 2.0 $dS{\cdot}m^{-1}$ treatment but, soluble solids of the fruit did not show statistical differences among treatments. Shoot dry weight was heaviest in EC 1.0 $dS{\cdot}m^{-1}$, followed by 0.5 and 2.0 $dS{\cdot}m^{-1}$. Root dry weight was heavier in EC 0.5 and 1.0 $dS{\cdot}m^{-1}$ but significantly light in 2.0 $dS{\cdot}m^{-1}$. pH of the drainage solution was elevated in low nutrient concentration and lowered in high concentration. Also root activity was high in low nutrient concentration and low in high concentration. As a result, the optimum EC for strawberry 'Sulhyang' was EC 1.0 $dS{\cdot}m^{-1}$ in this experiment. It was confirmed that there was high relationship between root activity and pH of drainage solution. This result will be utilized as an indicator for strawberry hydroponics.

Effects on senior fitness, cognitive function and daily living activity of female elderly with light dementia by continuous and intermittent exercises (연속적.간헐적 운동이 경증치매 여성고령자의 기능적 체력, 인지기능 및 일상생활수행능력에 미치는 영향)

  • Kang, Joo-Seong;Jeang, Il-Hong;Yang, Jum-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.11
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    • pp.4234-4243
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    • 2010
  • Dementia such as poor concentration, anxiety and tension makes it hard to continue exercise in reality. For this, intermediate exercise is suggested in this study. And the study investigates the effects on senior fitness, cognitive function(MMSE-K) and daily living activity(ADL) by continuous exercise and intermittent exercise, which helps to provide proper exercise treatment to them. For this, female elderly patients at A dementia hospital in B Metropolitan city are selected and they have been diagnosed with possible Alzheimer's disease according to DSM-IV. Among them, six(6) are grouped for continuous exercise and five(5) for intermediate exercise, total 11 people are finally tested. They are given hand&foot exercise, Korean folk dance and band exercise three times a week for the total 12 weeks. The continuous exercise group does their exercise one time of 30 minutes a day while the intermediate exercise group for three times of each 10 minute a day. For the result, SPSS Ver. 18.0 is used to get mean value(M) and standard deviation(SD) and in order to verify the interaction effect between exercise group and time, two-way repeated ANOVA is applied and statistical significance level is set at .05. The result shows that there is significant difference in time between senior fitness and cognitive function. But there is no significant difference in group and time${\times}$group. And there is no significant difference in time, group and time${\times}$group for daily living activity. Continuous exercise group and intermediate exercise group both have the similar effects. That does not mean that intermediate exercise is the best for all people with dementia, but in terms of exercise time, intermittent exercise may be effective for patients of light dementia.