• Title/Summary/Keyword: 동시치료

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Comparison of Success Rates after Silicone Tube Intubation with or without Lacrimal Endoscopy for Epiphora (눈물흘림 환자에서 눈물길미세내시경의 사용 여부에 따른 실리콘관삽입술의 성공률 비교)

  • Choi, Min Gyu;Lee, Jeong Kyu
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1001-1008
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    • 2018
  • Purpose: To compare the success rates between silicone tube intubation using a lacrimal endoscope and using a conventional nasal endoscope alone in adult patients suffering from epiphora. Methods: We conducted a retrospective chart review of 80 eyes of 55 patients who underwent silicone tube intubation from January 2014 to June 2017. Patients were preoperatively diagnosed with syringing and dacryocystography. The silicone tube was removed 3 months after surgery and success rates were evaluated at 4 and 12 months. Success rates were analyzed by dividing the patients into two groups, according to lacrimal endoscope use. Results: A lacrimal endoscope was used in 40 eyes. In the group using a lacrimal endoscope, preoperative diagnoses were partial obstruction in 26 eyes and complete obstruction in 14 eyes. In the group without lacrimal endoscope use, preoperative diagnoses were partial obstruction in 35 eyes and complete obstruction in 5 eyes (p = 0.018). The success rates at 4 and 12 months after surgery in the two groups (with and without lacrimal endoscope use) were 87.5% and 80.0% and 72.0% and 62.1% (p = 0.546 and p = 0.565), respectively. The success rates of patients with partial obstruction in the two groups were 92.3% and 82.9% at 4 months and 71.4% and 69.2% at 12 months (p = 0.448 and p = 1.000), respectively. The success rates of patients with complete obstruction in the two groups were 78.6% and 60.0% at 4 months and 72.7% and 33.3% at 12 months (p = 0.570 and p = 0.505), respectively. Site differences, the degree of obstruction, and lacrimal endoscope use had a significant impact on the success rate at 4 and 12 months (p = 0.001 and p = 0.022, respectively). Conclusions: Although silicone tube intubation using a lacrimal endoscope cannot guarantee a significant success rate, it is possible to observe the anatomical structure of the nasolacrimal pathway in real time, such that the appropriate diagnosis and treatment can be performed simultaneously. Because patients diagnosed as having a complete obstruction had a good success rate, we can extend indication of silicone tube intubation as a less invasive approach.

An Analysis of Three Stages of Desire in S. Kierkegaard : a Study on the Aesthetic Basis of Juvenile Suicide (키에르케고어의 욕망의 삼 단계 분석 : 청소년 자살의 심미적 토대 연구)

  • Kim, Sun-hye;Park, Jung-sun
    • Journal of Korean Philosophical Society
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    • v.145
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    • pp.167-194
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    • 2018
  • According to the result of 2017 youth statistics, the first rank of the death cause of Korean youth is suicide for nine years. The recent study on factors affecting juvenile suicide presents: family factors; character and psychological factors; mental disease factors; suicide-triggering factors; school factors; and protection factors; and so on. What is required to the youth who are vulnerable to the confusion of identity and the adjustment of emotion or impulse is not only drug treatment or mental therapy but also the support of family or society where adolescents are encouraged to be introspective and form their identity in a healthy approach in the diverse humanistic philosophical dimension. This study is going to pay attention to the aesthetic existence of Kierkegaard who provided the foundation of human existential identity centered on three stages of existence. For this purpose, we attempt to search for the philosophical basis for the understanding of juvenile identity centered on the analysis of Kierkegaard's Either / Or Volume I (Entweder - Oder Teil I). Especially, we are going to attempt the understanding of aesthetics of youth through the analysis of three stages of desire (Begierde) suggested in Chapter 2 of this book. Herewith he suggests aesthetic existence through 'desire', and aesthetic existence as the desire again through three stages of 'dreaming ($tr{\ddot{a}}umend$)' desire, 'searching (suchend)' desire, and 'desiring (begehrend)' desire. Based on this analysis of three stages, we plan to graft the roots of sociological factors presented as the cause of youth's suicide onto the analysis of existential philosophy. Through this, we attempt to grope for the diagnostic and healing discourse which Kierkegaard's existential analysis can present in the formation and recognition of youth identity and disclose a factor of the emotion or the disorder of impulse adjustment as well as depression suggested as the main contributing factor of youth's suicide and search for philosophical discourse for the prevention of juvenile suicide.

Analysis of Anatomical Conformity of Straight Antegrade Humeral Intramedullary Nail in Korean (한국인에서의 직선형 전향적 상완골 골수 내 금속정의 해부학적 적합성 분석)

  • Choi, Sung;Jee, Seungmin;Hwang, Seongmun;Shin, Dongju
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.498-503
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    • 2021
  • Purpose: The aim of this study were to find ideal entry point of straight antegrade humeral intramedullary nail (SAHN) for the treatment of proximal humerus fracture in Korean and to analyze anatomical conformity using computed tomography. Materials and Methods: From May 2014 to October 2016, the study was conducted retrospectively on 74 Korean patients who had taken computed tomography on both normal and affected shoulder joint as result of shoulder injury. The mean age of the patients was 64.5 years (range, 22-95 years). Radiologic evaluation was done using multiplanar reconstruction technique of the computer tomography on normal proximal humerus. We located ideal entry point of SAHN as the point where humerus intramedullary center axis and humeral head meet. Distance between the entry point and local anatomical landmark was measured. We defined the critical distance as the distance between entry point and the most medial point of the supraspinatus attachment site. For adequate fixation and avoidance of injury to rotator cuff, critical distance should be over 8 mm according to Euler, and we defined the critical type when it is less than 8 mm. Critical distance, sex, age, height, body weight, body mass index was evaluated for the statistical significance. Results: The ideal entry point was as follows: the mean anteroposterior distance, the sagittal distance to the lateral margin of bicipital groove, was 11.5 mm and the mean mediolateral distance, the coronal distance to the lateral margin of grater tuberosity, was 20.5 mm. The mean critical distance, distance from the entry point to the just medial to insertion of the supraspinatus tendon, was 8.0 mm. Critical type with critical distance less than 8 mm was found in 41 in 74 patients (55.4%). Conclusion: The ideal entry point of SAHN in Korean was located on 11.5 mm posteriorly from the lateral margin of bicipital groove and 20.5 mm medially from lateral margin of greater tuberosity. More than half of the cases were critical type. Since critical type can possibly cause rotate cuff injury during nail insertion on entry point, surgeon should consider anatomical variance before choosing surgical option.

Current Status of Sericulture and Insect Industry to Respond to Human Survival Crisis (인류의 생존 위기 대응을 위한 양잠과 곤충 산업의 현황)

  • A-Young, Kim;Kee-Young, Kim;Hee Jung, Choi;Hyun Woo, Park;Young Ho, Koh
    • Korean journal of applied entomology
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    • v.61 no.4
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    • pp.605-614
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    • 2022
  • Two major problems currently threaten human survival on Earth: climate change and the rapid aging of the population in developed countries. Climate change is a result of the increase in greenhouse gas (GHG) concentrations in the atmosphere due to the increase in the use of fossil fuels owing to economic and transportation development. The rapid increase in the age of the population is a result of the rise in life expectancy due to the development of biomedical science and technology and the improvement of personal hygiene in developed countries. To avoid irreversible global climate change, it is necessary to quickly transition from the current fossil fuel-based economy to a zero-carbon renewable energy-based economy that does not emit GHGs. To achieve this goal, the dairy and livestock industry, which generates the most GHGs in the agricultural sector, must transition to using low-carbon emission production methods while simultaneously increasing consumers' preference for low-carbon diets. Although 77% of currently available arable land globally is used to produce livestock feed, only 37% and 18% of the proteins and calories that humans consume come from dairy and livestock farming and industry. Therefore, using edible insects as a protein source represents a good alternative, as it generates less GHG and reduces water consumption and breeding space while ensuring a higher feed conversion rate than that of livestock. Additionally, utilizing the functionality of medicinal insects, such as silkworms, which have been proven to have certain health enhancement effects, it is possible to develop functional foods that can prevent or delay the onset of currently incurable degenerative diseases that occur more frequently in the elderly. Insects are among the first animals to have appeared on Earth, and regardless of whether humans survive, they will continue to adapt, evolve, and thrive. Therefore, the use of various edible and medicinal insects, including silkworms, in industry will provide an important foundation for human survival and prosperity on Earth in the near future by resolving the current two major problems.

Receptive Aspects of Rituals appearing in Korean Theatric Arts - With a focus on ritualistic characteristics presented in the play "Sanssikgim" and "Ohgu-formality of death" (한국 연극에 나타난 제의 수용 양상 - 연극 「산씻김」과 「오구-죽음의 형식」에 나타난 제의적 특성을 중심으로)

  • Choi, Kyoungsung
    • (The) Research of the performance art and culture
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    • no.23
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    • pp.245-280
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    • 2011
  • One of the major streams of modern play in Korea is the work of introducing Korea's traditional ritual-'gut' into a play. Such work, together with the stream of diversification of culture, has brought about the tendency to induce 'gut' into a play in a creative way. The research on ritual plays in Korea has been done in the direction of studying the ritual plays in the West centering on the work of theoretically inquiring into histrionic features inhering in 'gut' as a ritual. This research made an analysis of the receptive aspect of rituals and histrionic characteristics presented in Korea plays through "Sanssikgim" and "Ogu" on the basis of the theory of ritual plays established by Artaud. In an effort to understand the receptive aspect of rituals, this research analyzed what forms these Korean works are borrowing from "Ssikgim gut" and "Ogu gut" while analyzing these works differently from the viewpoint of Artaud regarding characteristics of ritual plays. Accordingly, this research made an analysis of the structure and characteristic of "gut" with the aim of understanding in what form "gut" is absorbed into Korean plays by looking at the theatric receptive forms of "gut." The ritual plays in Korea originated in "gut." Likewise, the theater of cruelty by Artaud was greatly influenced by the belly dance stemming from "mudang-gut" in Asia. Accordingly, there is considerably exposed something in common between the ritual play in Korea and Artaud's theater of cruelty. "Gut" in Korea, or ritual plays are a little different from Artaud's work which makes its audience feel unfamiliar in that 'gut' or ritual plays in Korea are pursuing ritualistic quality and playing quality simultaneously, but there exists a similarity between the two in that they both desired to have communication with audiences. This researcher strongly believes that for the time to come, when the receptive aspect of the modern play assuming ritualistic quality is developed using the medium of communication with audiences, purification and play therapy, its direction will be more noticeably exposed.

Measuring Intracellular Mycobacterial Killing Using a Human Whole Blood Assay (인체 전혈 모델을 이용한 세포내 결핵균 살균력에 관한 연구)

  • Cheon, Seon-Hee;Song, Ho-Yeon;Lee, Eun-Hee;Oh, Hee-Jung;Kang, In-Sook;Cho, Ji-Yoon;Hong, Young-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.497-509
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    • 2002
  • Background : The mechanisms through which cellular activation results in intracellular mycobacterial killing is only partially understood. However, in vitro studies of human immunity to Mycobacterium tuberculosis have been largely modeled on the work reported by Crowle, which is complicated by several factors. The whole blood culture is simple and allows the simultaneous analysis of the relationship between bacterial killing and the effect of effector cells and humoral factors. In this study, we attempted to determine the extent to which M. tuberculosis is killed in a human whole blood culture and to explore the role of the host and microbial factor in this process. Methods : The PPD positive subject were compared to the umbilical cord blood and patients with tuberculosis, diabetes and lung cancer. The culture is performed using heparinized whole blood diluted with a culture medium and infected with a low number of M. avium or M. tuberculosis $H_{37}Ra$ for 4 days by rotating the culture in a $37^{\circ}C$, 5% $CO_2$ incubator. In some experiments, methlprednisolone- or pentoxifyline were used to inhibit the immune response. To assess the role of the T-cell subsets, CD4+, CD8+ T-cells or both were removed from the blood using magnetic beads. The ${\Delta}$ log killing ratio was defined using a CFU assay as the difference in the log number of viable organisms in the completed culture compared to the inoculum. Results : 1. A trend was noted toward the improved killing of mycobacteria in PPD+ subjects comparing to the umbilical cord blood but there was no specific difference in the patients with tuberculosis, diabetes and lung cancer. 2. Methylprednisolone and pentoxifyline adversely affected the killing in the PPD+ subjects umbilical cord blood and patients with tuberculosis. 3. The deletion of CD4+ or CD8+ T-lymphocytes adversely affected the killing of M. avium and M. tuberculosis $H_{37}Ra$ by PPD+ subjects. Deletion of both cell types had an additive effect, particularly in M. tuberculosis $H_{37}Ra$. 4. A significantly improved mycobacterial killing was noted after chemotherapy in patients with tuberculosis and the ${\Delta}$ logKR continuously decreased in a 3 and 4 days of whole blood culture. Conclusion : The in vitro bactericidal assay by human whole blood culture model was settled using a CFU assay. However, the host immunity to M. tuberculosis was not apparent in the human whole blood culture bactericidal assay, and patients with tuberculosis showed markedly improved bacterial killing after anti-tuberculous chemotherapy compared to before. The simplicity of a whole blood culture facilitates its inclusion in a clinical trial and it may have a potential role as a surrogate marker in a TB vaccine trial.

The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

Application of a Modified Triple Pelvic Osteotomy for Treatment of Hip Dysplasia in Dogs (개의 고관절 이형성 치료를 위한 변형 3중 골반 절골술의 적용)

  • Kim Young-Sam;Lim Ji Hey;Jung Chang-soo;Byeon Ye-eun;Kanaya Tomohiro;Nagaoka Katsuyoshi;Kweon Oh-kyeong
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.328-335
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    • 2005
  • The objective of this study was to evaluate tire effects of modified triple pelvic osteotomy(TPO). The procedures of modified TPO were composed of two iliac osteotomies and a pubic symphysiotomy at a tittle. Medical records of modified TPO treatment on 36 dogs and of unilateral TPO on 7 dogs were reviewed on the basis of signalment, body weight, operation time, Healing time of osteotomy sites and complications from October 2002 to September 2004. The values of clinical status and hip dysplasia, Norberg angle, percentage of femoral head coverage and pelvic diameter from radiographs taken preoperative, immediately postoperative, 2, 4, 8, 12 and 24 weeks after operation, respectively, were measured. In .unilateral TPO, the dogs could start standing without assistance from $3.0\pm1.0days$ and walking from $8.3\pm0.6days$ (n=3). Mean clinical grade before and 24 weeks after surgery were $2.2\pm0.42$(n=6) and $3.5\pm0.7$ (n=2), respectively. Mean operation time was $107.3\pm38.9$ minutes (n=4). In modified TPO, the dogs were seen to staff standing without assistance from $4.9\pm3.7$ days and walking from $7.3\pm4.8days$ (n=25). Mean clinical grade before surgery and 24 weeks after surgery were $2.3\pm1.5$ (n=27) and $3.2\pm0.7$)(n=9), respectively. Postoperative clinical grade significantly improved against preoperative clinical grade (P<0.01). Mean operation time was $143\pm42.8$ minutes (n=24). This was shorter than time f3r twice unilateral TPO. By comparison with preoperative values, postoperative mean radiographic grade, percentage of femoral head coverage and Norberg angle measured at the recheck time point significantly increased (P<0.01). Mean postoperative pelvic diameter was significantly larger than preoperative pelvic diameter in modified TPO (P<0.01) but not in unilateral TPO. These results indicated that modified TPO was effective technique for the treatment of hip dysplasia in dogs.

The Ability of Anti-tumor Necrosis Factor Alpha(TNF-${\alpha}$) Antibodies Produced in Sheep Colostrums

  • Yun, Sung-Seob
    • 한국유가공학회:학술대회논문집
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    • 2007.09a
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    • pp.49-58
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    • 2007
  • Inflammatory process leads to the well-known mucosal damage and therefore a further disturbance of the epithelial barrier function, resulting abnormal intestinal wall function, even further accelerating the inflammatory process[1]. Despite of the records, etiology and pathogenesis of IBD remain rather unclear. There are many studies over the past couple of years have led to great advanced in understanding the inflammatory bowel disease(IBD) and their underlying pathophysiologic mechanisms. From the current understanding, it is likely that chronic inflammation in IBD is due to aggressive cellular immune responses including increased serum concentrations of different cytokines. Therefore, targeted molecules can be specifically eliminated in their expression directly on the transcriptional level. Interesting therapeutic trials are expected against adhesion molecules and pro-inflammatory cytokines such as TNF-${\alpha}$. The future development of immune therapies in IBD therefore holds great promises for better treatment modalities of IBD but will also open important new insights into a further understanding of inflammation pathophysiology. Treatment of cytokine inhibitors such as Immunex(Enbrel) and J&J/Centocor(Remicade) which are mouse-derived monoclonal antibodies have been shown in several studies to modulate the symptoms of patients, however, theses TNF inhibitors also have an adverse effect immune-related problems and also are costly and must be administered by injection. Because of the eventual development of unwanted side effects, these two products are used in only a select patient population. The present study was performed to elucidate the ability of TNF-${\alpha}$ antibodies produced in sheep colostrums to neutralize TNF-${\alpha}$ action in a cell-based bioassay and in a small animal model of intestinal inflammation. In vitro study, inhibitory effect of anti-TNF-${\alpha}$ antibody from the sheep was determined by cell bioassay. The antibody from the sheep at 1 in 10,000 dilution was able to completely inhibit TNF-${\alpha}$ activity in the cell bioassay. The antibodies from the same sheep, but different milkings, exhibited some variability in inhibition of TNF-${\alpha}$ activity, but were all greater than the control sample. In vivo study, the degree of inflammation was severe to experiment, despite of the initial pilot trial, main trial 1 was unable to figure out of any effect of antibody to reduce the impact of PAF and LPS. Main rat trial 2 resulted no significant symptoms like characteristic acute diarrhea and weight loss of colitis. This study suggested that colostrums from sheep immunized against TNF-${\alpha}$ significantly inhibited TNF-${\alpha}$ bioactivity in the cell based assay. And the higher than anticipated variability in the two animal models precluded assessment of the ability of antibody to prevent TNF-${\alpha}$ induced intestinal damage in the intact animal. Further study will require to find out an alternative animal model, which is more acceptable to test anti-TNF-${\alpha}$ IgA therapy for reducing the impact of inflammation on gut dysfunction. And subsequent pre-clinical and clinical testing also need generation of more antibody as current supplies are low.

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The Efficacy of the Change in Belly Board Aperture Location by the Addition of Bladder Compression Device for Radiotherapy of Rectal Cancer (직장암 환자의 골반 방사선치료에서 벨리보드 하위 경계 위치 변화의 영향)

  • Yoon, Hong-In;Chung, Yoon-Sun;Kim, Joo-Ho;Park, Hyo-Kuk;Lee, Sang-Kyu;Kim, Young-Suk;Choi, Yun-Seon;Kim, Mi-Sun;Lee, Ha-Yoon;Chang, Jee-Suk;Cha, Hye-Jung;Seong, Jin-Sil;Keum, Ki-Chang;Koom, Woong-Sub
    • Radiation Oncology Journal
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    • v.28 no.4
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    • pp.231-237
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    • 2010
  • Purpose: We investigated the effect of location changes in the inferior border of the belly board (BB) aperture by adding a bladder compression device (BCD). Materials and Methods: We respectively reviewed data from 10 rectal cancer patients with a median age 64 years (range, 45~75) and who underwent computed tomography (CT) simulation with the use of BB to receive pelvic radiotherapy between May and September 2010. A CT simulation was again performed with the addition of BCD since small bowel (SB) within the irradiated volume limited boost irradiation of 5.4 Gy using the cone down technique after 45 Gy. The addition of BCD made the inferior border of BB move from symphysis pubis to the lumbosacral junction (LSJ). Results: Following the addition of BCD, the irradiated volumes of SB and the abdominopelvic cavity (APC) significantly decreased ($174.3{\pm}89.5mL$ vs. $373.3{\pm}145.0mL$, p=0.001, $1282.6{\pm}218.7mL$ vs. $1,571.9{\pm}158mL$, p<0.001, respectively). Bladder volume within the treated volume increased with BCD ($222.9{\pm}117.9mL$ vs. $153.7{\pm}95.5mL$, p<0.001). The ratio of irradiated bladder volume to APC volume with BCD ($33.5{\pm}14.7%$) increased considerably compared to patients without a BCD ($27.5{\pm}13.1%$) (p<0.001), and the ratio of irradiated SB to APC volume decreased significantly with BCD ($13.9{\pm}7.6%$ vs. $24.2{\pm}10.2%$, p<0.001). The ratios of the irradiated SB volume and irradiated bladder volume to APC volume negatively correlated (p=0.001). Conclusion: This study demonstrated that the addition of BCD, which made the inferior border of BB move up to the LSJ, increased the ratio of the bladder to APC volume and as a result, decreased the irradiated volume of SB.