• Title/Summary/Keyword: 단일요법

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Surgical management ofuniventricular heart (단일심실증의 수술요법)

  • No, Jun-Ryang;Kim, Eung-Jung
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.618-626
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    • 1986
  • Univentricular heart is a rare congenital cardiac anomaly in which the atrial chambers are connected to only one ventricular chamber and it consists of a diverse group of cardiac malformation characterized by both AV valves or a common AV valve opening into the same ventricle, or the presence of only a solitary AV valve. In spite of recent development in cardiac surgery, corrective operations for univentricular heart still have high mortality and complication rate. Twenty eight patients underwent corrective operation for univentricular heart at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital from February 1979 to July 1986. Of the 28 patients, 7 patients were operated on by ventricular septation and 21 patients by modified Fontan operation. Of the 28 patients, 19 patients were male and 9 patients female and ages ranged from 5 months to 18 years old with the average age of 7.3 years. There were 2 mortalities in 7 patients operated on by septation with the mortality rate of 28.6% and 5 complications, 3 complete AV block, 1 low cardiac output and 1 arrhythmia. All survived patients are being followed up without specific problem till now. There were 10 mortalities in 21 patients operated on by modified Fontan operation with the mortality rate of 47.6% and 10 complications, 2 low cardiac output, 2 respiratory failure necessitating tracheostomy, 2 persistent cyanosis, 2 arrhythmia, 1 missing of left AV valve in situs inversus patient due to misdiagnosis and one rupture of closed right AV valve. Incremental risk factors for operative mortality are young age less than 5 years old, anomalous pulmonary and systemic venous drainage and atrial septation procedure. In 11 survived patients, 9 patients show good follow-up results but one patient complains of persistent cyanosis and another one patient is suffered from CHF. In our series, results of corrective operation for univentricular heart shows continuing improvement but still high mortality and complication rate. So there must be continuing improvement in surgical result by selection of patient, by adequate decision making for timing and method of operation and by improving operative methods.

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Efficacy of Inhalation Therapy using Zizyphus jujuba var. spinosa Blended Oil and Spa Therapy on Stress : A Double-blind, Randomized, Single center Clinical Trial (산조인 복합오일을 이용한 향기건식 흡입요법과 스파 프로그램이 스트레스에 미치는 효과 : 이중맹검, 무작위배정, 단일기관 임상시험)

  • Oh, Seo Young;Kang, Jae Hui;Jang, Tae Soo;Choi, Hee Jeong;Ahn, Taek Won
    • Journal of Haehwa Medicine
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    • v.26 no.1
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    • pp.49-57
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    • 2017
  • Objectives : The purpose of this study was to investigate the efficacy of inhalation therapy using Zizyphus jujuba var. spinosa blended oil and spa therapy on stress in adults. Methods : The study design was a double blind, randomized, single center clinical trial. A total of 30 volunteers who were highly stressed and were over 9 points on POMS(profile of mood states) participated in this study. Inhalation therapy using Zizyphus jujuba var. spinosa blended oil and spa therapy were applicate for the experimental group and Jojoba oil inhalation and spa therapy was given for the control group. During the 2 weeks, the participants were treated about inhalation and spa therapy twice a week. The treatment sequence is spa therapy after inhalation therapy. Result : The improvement of stress was evaluated by POMS, HRV(Heart Rate Variability), EEG(Electroencephalography), PSQI(Pittsburgh Sleep Quality Index), salivary cortisol. After treatment, POMS was significantly decreased between the experimental group and the control group. In other measurement(HRV, EEG, PSQI, salivary cortisol) except POMS, there were not significant. Overall, however, they showed a tendency to alleviate stress in the experimental group. Conclusions : We suggest that inhalation therapy using Zizyphus jujuba var. spinosa blended oil and spa therapy might be effective on stress.

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Hepatic Solitary Metastasis of Gastric Cancer: Radiofrequency (위암의 단일결절 간전이에 대한 고주파 열치료(Radiofrequency))

  • Ryu, Keun-Won;Kim, Min-Ju;Park, Sook-Ryun;Lee, Jong-Seok;Lee, Jun-Ho;Kim, Young-Woo
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.10-13
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    • 2009
  • The prognosis of gastric cancer with hepatic metastasis is very poor, even though several treatment modalities exist, such as surgical resection. Indeed, a standard therapy has not been established in such patients. Recently, attempts were made to treat hepatic metastasis of gastric cancer with radiofrequency (RF), which was originally used in primary or metastatic liver cancer. RF has been reported to show similar survival compared to surgical resection and is emerging as a new treatment modality even though it is still not conclusive with respect to efficacy and safety due to the paucity of reports. A prospective study is warranted to evaluate the efficacy of RF in the treatment of gastric cancer with hepatic metastasis compared with conventional modalities.

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Acute Kidney Injury and Postobstructive Diuresis Caused by a 4 mm Urinary Calculus (작은 요로 결석에 의한 급성 신후성 신부전 및 폐쇄 후 이뇨 1례)

  • Jung, Eui Seok;Yang, Eun Mi;Kim, Chan Jong
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.117-121
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    • 2013
  • Urinary obstructions from ureteral calculi are one of the causes of postrenal acute kidney injury (AKI). Here we present a case of AKI caused by a 4 mm ureteral calculus with postobstructive diuresis following the spontaneous passage of the calculus. A 13-year-old girl who underwent nephrectomy for the removal of a neuroblastoma eight years previously, visited our institution because anuria had developed over the preceding five days. The serum creatinine level was elevated at 13.4 mg/dL. Radiological examinations showed the right solitary kidney with moderate hydronephrosis and a 4 mm calculus in the upper right ureter. The patient immediately underwent hemodialysis. After the ureteral calculus was passed spontaneously on day 2 of hospitalization, urinary output increased to more than 5,200 mL per day. Intravenous fluid replacement with careful monitoring of weight, intake, output, and serum and urine electrolytes was performed. On day 5 of hospitalization, the patient's condition stabilized.

Effects of Meaning Enhancement Program on Meaning of Life for Korean College Students: A Systematic Review (의미증진 프로그램이 우리나라 대학생의 삶의 의미에 미치는 효과: 체계적 문헌고찰)

  • Do, Eunna;Cho, Sunhee
    • Journal of Industrial Convergence
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    • v.19 no.5
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    • pp.79-90
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    • 2021
  • This study aimed to review the literature on the effects of the meaning enhancement program for college students studied in Korea, and to analyze the content and formal characteristics and the meaning enhancement effects of the program for college students. The literature was collected for studies aimed at enhancing meaning of life in college students among research papers and dissertations published in Korea until May 2021. Six databases were used to conduct searches with 'logotherapy' in Korean and English OR "meaning therapy" OR "meaning of life" OR 'meaning'. Two independent researchers performed an assessment of bias risk and research quality using a standardized tool, with seven final selected papers. All seven meaning enhancement programs were effective in discovering the meaning of life among college students, and both single and merged interventions were found to be effective. In order to analyze the effect size of meaning enhancement programs for college students, randomized control experimental studies need to be conducted in the future.

Efficacy and safety of oxcarbazepine in epileptic children (소아 간질 환자에서 oxcarbazepine의 효용성과 안전성)

  • Shin, Hye Kyung;Lee, Yoon;Lee, Jee-Yeon;Choi, Wooksun;Eun, So-Hee;Eun, Baik-Lin;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.162-169
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    • 2008
  • Purpose : Oxcabarzepine (OXC), newly recommended antiepileptic drug, has been prescribed for patients with partial seizures and generalized tonic clonic seizures in Korea from 1999. There are limited reports about an efficacy of OXC therapy in epileptic children in Korea. This study evaluated the efficacy and safety of OXC in the light of our experience. Methods : The patients, who had visited the pediatric neurology clinic of Korea University Guro Hospital from January 2001 to December 2006, were included. The data of 144 patients who were administrated OXC as monotherapy or polytherapy, was summarized retrospectively and we evaluated the efficacy and safety of OXC. Results : After 6 months of OXC therapy, 77 patients (53.5%, n=144) achieved seizure freedom, 48 patients (33.3%) experienced >50% improvement. After 12 months of OXC therapy, cessation of seizure was observed in 88 patients (61.1%, n=133), and 27 patients (18.8%) manifested an improvement. Monotherapy group showed superior efficacy to polytherapy one. The frequent side effects of OXC were drowsiness (20.1%), headache (12.5%), dizziness (9.7%) and rash (8.3%). They did not related to patient's age or sex, and dosage of OXC. Twenty four patients (16.7%) experienced hyponatremia, but which were neither symptomatic nor significant one. Conclusion : The efficacy and safety of OXC in our patients were excellent and had less significant side effects than established international one. We expect this report contributes toward OXC therapy in epileptic children.

Comparison of Clinical Progress between Single- and Multiple-dose Surfactant Treatment in Neonatal Respiratory Distress Syndrome (신생아 호흡곤란증후군에서 폐 표면활성제 단일 투여군과 재투여군의 임상경과 비교)

  • Kil, Chang Hee;Jeon, Ho Sang;Bae, Chong Woo
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1090-1095
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    • 2005
  • Purpose : In the case of serious respiratory distress syndrome(RDS) or relapse of clinical appearances after single treatment, we obtained more effective results with multiple-dose surfactant replacement therapy. We carried out this investigation for comparing and observing clinical progress between single-dose(group S) and multiple-dose(group M) pulmonary surfactant treatment group of neonatal RDS. Methods : We investigated 48 neonates who were diagnosed as RDS and treated with pulmonary surfactant(PS) replacement therapy in NICU of Kyunghee University hospital from January 2002 to March 2004, then we compared and verified clinical progress of 32 neonates in group S with that of 16 neonates in group M. Results : There were no significant statistical differences in average birth weights, average gestational periods, initial pH values of birth, whether operation of resuscitation at that time of birth was made or not, whether prenatal steroid prescription for mother, RDS classification standardized by Bomsel, and ventilation index(VI) before instillation of PS of two groups. However, there was significant statistical difference in a/A $PO_2$(P<0.05). We could observe changes of VI and a/A $PO_2$ within 72 hours have been continuously improved at group S rather than group M. In spite of relapses, group M changed for the better after second dose. There were also no significant differences between the two groups in duration of ventilator therapy, mortality within 28 days after birth, intraventricular hemorrhage by complication, retinopathy of premature, necrotizing enterocolitis, chronic lung diseases, sepsis, and DIC. Conclusion : In these relapse cases, as there were no significant differences in the mortality rate and the occurence of complication between group S and group M, the requirement of multiple-dose PS replacement therapy which brought improvement of prognosis was emphasized.

Outcome after relapse in childhood and adolescent osteosarcoma : single institution experience in Korea (소아 청소년 골육종 재발 후 치료성적 : 한국의 단일기관 성적)

  • Lee, Yun-Jeong;Lee, Hyun-Jae;Kim, Dong-Ho;Lim, Jung-Sub;Lee, Jun-Ha;Park, Kyung-Duk;Jeon, Dae-Geun;Lee, Soo-Yong
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.78-83
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    • 2008
  • Purpose : Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Although survival rate of osteosarcoma patients has markedly improved, about 20-30% of patients still have a relapse. This study was aimed to find factors that influence postrelapse survival of osteosarcoma in childhood and adolescents. Methods : Between 1985 and 2004, of 461 patients who were diagnosed and treated as osteosarcoma in Korean Cancer Center Hospital, 180 patients with recurrent osteosarcoma were retrospectively reviewed. We examined survival rates and analyzed prognostic factors, such as relapse site, post-relapse treatment methods, pathologic response to neoadjuvnat chemotherapy, metastasis at first diagnosis, and relapse free interval. Results : The overall recurrence rate of patients with osteosarcoma was 39%. The 5-year and 10-year postrelapse survival rates in the recurrent osteosarcoma were 13% and 4%, respectively. The 5-year post-relapse survival rate was influenced by site of relapse (lung, 39%; local, 0%; lung & bone, 25%; others, 12%; P<0.05), relapse-free interval (<12 months, 13%; ${\geq}12$ months, 44%, P<0.05), and post-relapse treatment methods (with surgery, 38%; without surgery, 11%; P<0.05). Conclusion : The survival rate of recurrent case is very low after 10 years, so new second-line chemotherapy and active treatment is needed to increase survival. Aggressive surgery with the removal of recurrence sites combined with multi-agent chemotherapy could either cure patients with recurrent osteosarcoma or significantly prolong their survival.

Allogeneic Hematopoietic Stem Cell Transplantation in Juvenile Myelomonocytic Leukemia (연소형 골수단구성 백혈병에서의 동종 조혈 모세포 이식)

  • Yoo, Keon Hee;You, Dong Kil;Lee, Soo Hyun;Sung, Ki Woong;Cho, Eun Joo;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.178-185
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    • 2005
  • Purpose : The purpose of this study was to evaluate the outcome of children with juvenile myelomonocytic leukemia(JMML) treated with allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods : Eleven JMML patients aged 8-39 months underwent allo-HSCT. The sources of grafts were unrelated donors(n=7), HLA-matched siblings(n=3) and an HLA 1-antigen mismatched familial donor. All patients had received chemotherapy ${\pm}13$-cis-retinoic acid(CRA) before transplant, and CRA was used, posttransplant, in six patients. Results : Only three patients were in complete remission(CR) at the time of transplantation. Initial chimeric status revealed complete donor chimerism(CC) in five patients, mixed chimerism(MC) in five and autologous recovery(AR) in one. One patient with MC having persistent splenomegaly eventually turned to CC and CR after rapid tapering of cyclosporine, combined with daily use of CRA. An AR case relapsed shortly after transplant but was rescued with second, unrelated cord blood transplantation. Ultimately, six patients are alive, event-free, with a median follow-up of 15.5 months posttransplant. All three deaths occurred in patients who failed to achieve CC, leading to disease progression. Conclusion : We suggest that graft-versus-leukemia effect play an important role and CRA a possible role in posttransplant leukemic involution in JMML. In patients whose leukemic burden is still high with MC after transplant, early tapering of immunosuppressants and introduction of CRA might provide a chance of a cure for some patients.

Results of Coventional Radiotherapy for Carcinomas of the Tonsillar Region (편도암의 방사선 치료 성적)

  • Nah Byung Sik;Nam Taek Keun;Ahn Sung Ja;Chung Woong Ki
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.97-104
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    • 1997
  • of $PLC-\gamma$ 1 activity. Results : In the immunohistochemistry, the expression of $PLC-\beta$ was negative for all grnups. The expression of $PLC-\gamma$ 1 was highest in the group III followed by group II in the proliferative zone of mucosa. The expression of PKC-01 was strong1y positive in group I followed by group II in the damaged surface epithelium. The above findings were also confirmed in the immunoblotting study. In the irnrnunoblotting study, the expressions of $PLC-\beta,\;PLC-\gamma\;1,\;and\;PLC-\delta$ were the same as the results of immunohistochemistry The expression of ras oncoprotein was weakly Positive in groups II, III and IV. The of EGFR was the highest in the group II, III, followed by group W and the expression of PKC was weakly positive in the group II and III. Conclusion : $PLC-\gamma$ 1 mediated signal transduction including ras oncoprotein, EGFR, and PKC play a significant role irL mucosal regeneration after irradiation. $PLC-\delta$ 1 mediated signal transduction might have an important role in mucosal damage after irradiation. Further studies will be necessary to confirm the signal transduction mediating the $PLC-\delta$ 1.

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