• Title/Summary/Keyword: 동시 시행군

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The Effectiveness of Arthroscopic Debridement with Mini-Open Ulnar Nerve Decompression in Primary Osteoarthritis of the Elbow with Ulnar Neuropathy (척골 신경 병증을 동반한 주관절 퇴행성 관절염에서 최소 절개 척골 신경 감압술과 동시에 시행한 관절경적 변연 절제술의 효과)

  • Jegal, Midum;Yu, Kun-Woong;Park, Sung-Bae;Kim, Jong-Pil
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.15-24
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    • 2017
  • Purpose: The aim of this study was to determine the effectiveness of arthroscopic debridement with mini-open ulnar nerve decompression in primary osteoarthritis of the elbow with ulnar neuropathy. Materials and Methods: Between May of 2006 and July of 2014, a total of 43 patients who had undergone surgery for primary osteoarthritis of the elbow with ulnar neuropathy were included in this study. We divided the subjects into two groups according to the method of surgery: group 1 (n=18) received mini-open ulnar nerve decompression only, and group 2 (n=25) received arthroscopic debridement with mini-open ulnar nerve decompression. Patients were assessed for the following clinical outcomes: visual analogue scales (VAS) score, range of motion of the elbow joint, Mayo elbow performance score (MEPS), and disabilities of the arm, shoulder and hand (DASH) at the time before surgery and 6 months after surgery. We analyzed the recovery of the ulnar nerve by the McGowan grade and Bishop rating score preoperatively and at 6 months after the surgery. Results: The VAS score, range of motion of the elbow joint, MEPS, and DASH showed significant statistical difference after the surgery (p<0.05). However, between the 2 groups, there was no significant difference. For the McGowan grade, all cases of both groups-except one case each group-showed at least one grade improvement. Moreover, group 2 showed a greater significant difference than group 1 (p=0.001). At the final follow-up, according to the Bishop rating score, group 2 had a greater significant difference than group 1 (p=0.036). Conclusion: Arthroscopic debridement with mini-open ulnar nerve decompression in primary osteoarthritis of the elbow with ulnar neuropathy is a useful technique, which has several advantages, including the benefits associated with a minimally invasive surgery and also the improvement of elbow joint function and excellent recovery of the ulnar nerve.

Low Dose Cisplatin as a Radiation Sensitizer in Management of Locally Advanced Scluamous Cell Carcinoma of the Uterine Cervix : Evaluation of Acute Toxicity and Early Response (국소 진행된 자궁경부암의 방사선치료와 저용량 cisplatin 항암요법 동시치료시 급성독성 밀 초기반응 평가)

  • Kim Hunjung;Cho Young Kap;Kim Chulsu;Kim Woo Chul;Lee Sukho;Loh J K
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.113-119
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    • 1999
  • Purpose : To evaluate possible acute toxicity and early response of concurrent radiation therapy and low dose daily cisplatin as a radiosensitizer in patients with locally advanced uterine cervical carcinomas. Materials and Method : From December 1996 to January 1999, 38 previously untreated Patients with locally advanced squamous cell carcinoma of the uterine cervix (from stage IIB to stage IIIB) were treated at Inha University Hospital. All patients underwent standard pretreatment staging Procedures after the initial evaluation by gynecologists and radiation oncologists. Sixteen Patients with huge cervical mass (>4 cm) were submitted to the group treated with concurrent radiation therapy and low dose daily cisplatin while the remainder was treated with radiation therapy alone. Radiation therapy consisted of 4500 cGy external beam irradiation to whole pelvis (midline block after 3000 cGy), 900$\~$1000 cGy boost to involved parametrium, and high dose-rate intracavitary brachytherapy (a total dose of 3000$\~$3500 cGy/500 cGy per fraction to point A, twice per week). In the group treated with low dose cisplatin concurrently, 10 mg of daily intravenous cisplatin was given from the 1st day of radiation therapy to the 20th day of radiation therapy. Acute toxicity was measured according to expanded common toxicity criteria of the NCI (C) Clinical Trials. Early response data were analyzed at minimum 4 weeks' follow-up after completion of the treatment protocol. Results: Hematolgic toxici쇼 was more prominent in patients treated with radiation therapy and cisplatin. Six of 16 patients (37.5$\~$) treated with radiation therapy and cisplatin and one of 22 patients (4.5$\~$) treated with radiation therapy alone experienced grade 3 leukopenia. In Fisher's exact test, there was statistically significant difference between two groups regarding leukopenia (P=0.030). There was no apparent difference in the frequency of gastrointestinal and genitourinary toxicity between two groups (P=0.066). Three of 16 patients (18.7$\~$) treated with radiation therapy and cisplatin and two of 22 patients (9.1$\~$) treated with radiation therapy alone experienced more than 5 kg weight loss during the treatment. There was no statistically significant difference on weight loss between two groups (P=0.63). Two patients on each group were not evaluable for the early response because of incomplete treatment. The complete response rate at four weeks' follow-up was 80$\~$(16/20) for the radiation therapy alone group and 78$\~$ (11/14) for the radiation therapy and cisplatin group. There was no statistically significant difference in early response between two treatment groups (P=0.126). Conclusion : This study led to the conclusion that the hematologic toxicity from the treatment with concurrent radiation therapy and low dose daily cisplatin seems to be more prominent than that from the treatment of radiation therapy alone. There was no grade 4 hematologic toxicity or mortality in both groups. The hematologic toxicity in both treatment groups seems to be well managable modically. Since the risk factors were not balanced between two treatment groups, the direct comparison of early response of both groups was not possible. However, preliminary results regarding early response for patients with bulky cervical tumor mass treated with radiation therapy and low dose daily cisplatin was encouraging. Longer follow-up is necessary to evaluate the survival data. A phase III study is needed to evaluate the efficacy of concurrent daily low dose cisplatin with radiation therapy in bulky cervical cancer.

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해운이슈 - 현대경제연구원, 주요국 해운업 지원 정책과 시사점 발표

  • 한국선주협회
    • 해운
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    • s.96
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    • pp.16-23
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    • 2013
  • 해운업은 국민경제의 기간산업으로 타산업에 대한 파급효과가 큰 고부가가치 산업이며, 동시에 제4군으로 국방기능을 수행하는 국가안보산업이다. 글로벌 금융위기 이후 해운업 침체가 지속됨에 따라 세계 주요국들은 자국의 해운선산에 대해 강력한 지원 및 보호정책을 시행하고 있다. 중국과 덴마크, 독일, 프랑스의 경우 자국 해운사에 대한 대출 및 융자보증 등의 지원을 확대하고 있으며, 선박투자회사 및 선박 대출기관 설립, 보조금 지원 등 다양한 방식을 통해 해운업을 지원하고 있다. 다음은 현대경제연구원이 발표한 "주요국 해운업 지원 정책과 시사점"의 주요 내용을 요약 정리한 것이다.

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Clinical significance of follow-up laboratory tests, performed at 6 weeks after the onset of Kawasaki disease (가와사끼병에서 발병 6주째에 시행하는 추적검사의 임상적 유용성에 관한 고찰)

  • Oh, Il Ji;Moon, Kyung Hee;Hong, Myung Eun;Kim, Yeon Soon;Lee, Chang Woo;Yoon, Hyang Suk
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.672-676
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    • 2006
  • Purpose : Low dose aspirin is used due to its antiplatelet effect for the subacute phase of Kawasaki disease(KD). It is usually used for 6-8 weeks, then various hematologic laboratory tests and follow up echocardiography for evaluating coronary abnormalities are performed. Our review investigated the usefulness of various follow up laboratory tests performed at 6 weeks after the onset of KD. Methods : Two hundred eighty-two children diagnosed and hospitalized with KD were identified by reviewing patient's charts. Cases which were diagnosed between January 1997 and December 2004 were included in this study. We reviewed laboratory data including leukocytes, platelet counts, antistreptolysin O(ASO), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), aspartate aminotransferase(AST), alanine aminotransferase(ALT), urinalysis, and echocardiograms performed at admission and 6 weeks after the onset of KD. Paired t-test and Fisher's exact test, as well as logistic regression tests, were used for the statistical analysis. Results : At 6th week data, ESR and CRP were still elevated in 35(12.4 percent) and 12(4.3 percent) patients, respectively. Sterile pyuria were all normalized. But, 36 patients(12.8 percent) showed thrombocytosis, 22(7.8 percent) elevated AST, 15(5.3 percent) leukocytosis, and 6(2.1 percent) coronary abnormalities. Coronary abnormalities at the 6th week were only shown in patients with initial abnormalites. Younger age and initial thrombocytosis were risk factors for thrombocytosis at the 6th week. Conclusion : All children with initial coronary abonormalites should have an echocardiogram at 6 weeks after the onset of fever. In view of case-effectiveness, additional echocardiographic studies are justified only if abnormalities are present at admission. ESR, CRP, and urinalysis performed at the 6 weeks after onset of KD is not significant for clinical information of progression. Platelet count should be estimated at 6th week for a judgement of continuous antiplatelet therapy.

Study on attachment of bacteria to tonsillar epithelial cell during acute tonsillitis (급성편도선염에서 편도상피세포의 세균부착성에 관한 연구)

  • 이흥만;정형목;최충식;이우섭;이상학;황순재
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.98-98
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    • 1993
  • To cause invasive disease, microorganism must attach firmly to the tonsillar epithelial cell. Once attached, the microorganisms can proliferated, form colonies and release extracillular toxins which can injure the underlying cells. The purpose of present study was to asertain whether or not there exist in vivo differences in bacterial attachment between patients with acute tonsillitis and healthy individuals as a control. This study was carried out on 20 patients suffering from acute tonsillitis and 20 healthy persons used as control. After scraping of the surface of tonsil, cellular mixture was stained with Acridine orange and the number of attached bacteria was calculated using a fluorescent microscope. The adherence rate was calculated as number of bacteria attached to each of 50 epithelial cells. simultaneously, we peformed conventional bacterial culture. Conclusively, the attachment of more than 10% bacteria to the tonsillar epithelial cell was significantly greater in acute tonsillitis group than control group, and there was a significant correlation between age and the number of the attached bacteria to the epithlium.

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A Study into the Effect of the CT Simulation Program on Clinical Education (전산화단층촬영 시뮬레이션 프로그램의 임상교육 효과에 관한 연구)

  • Kim, Yong-Wan;Kim, Jung-Sam;Lee, Kyung-Rok
    • Journal of radiological science and technology
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    • v.32 no.4
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    • pp.445-451
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    • 2009
  • The computed tomography(CT) simulation tool provides virtual experimental environment without using a high cost medical equipment. We made teaching materials for the CT simulation tools and educated the students and entry level of radio-technologists. We divided the experimental objects into two groups; students who took only theoretical classes (group 1) and students who took both theoretical and simulation classes (group 2). The results showed that the group 2 outperformed group 1 significantly, which indicates that the simulation program provides a good educational material for not only students but also radio-technologists.

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Effect of Simultaneous Use of Platelet Glycoprotein IIb / IIIa Receptor Blocker and Thrombus Aspiration in Patients with Coronary Artery Stent Thrombosis (관상동맥 스텐트 혈전증 환자에서 혈소판 당단백 IIb/IIIa 수용체 차단제와 혈전흡입술 동시시행의 임상결과)

  • Kim, In Soo;Choi, Nam Gil;Kong, Chang gi;Eun, Sung jong;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.359-369
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    • 2019
  • To evaluate the effect of simultaneous use of platelet glycoprotein IIb / IIIa receptor blocker and catheter assisted thrombus aspiration in the treatment of coronary stent thrombosis. 267 patients ($64.6{\pm}12.1years$, 187 men) with stent thrombosis on coronary angiography at Chonnam National University Hospital from July 2008 to July 2017 were enrolled. We devided two groups based on treatment modalities: Group I (N=32, platelet glycoprotein IIb / IIIa receptor blocker and thrombo-aspiration), Group II (N =235, either platelet glycoprotein IIb /IIIa receptor blocker or thrombo-aspiration, or none of both), and the major cardiac events including death, revascularization and stent thrombosis were followed up for 1 year. There were no significant differences in clinical characteristics between the two groups including age (Group I: $60.8{\pm}12.9$ vs. Group II: $65.1{\pm}11.9$, p= 0.603), male (Group I: 75.0% vs. Group II: 69.4%, p=0.681), and left ventricular ejection fraction (Group I: $58.1{\pm}9.0%$ vs. Group II: $59.5{\pm}11.9%$, p= 0.127). The major cardiac events did not differ between the two groups (Group I: 12.5% vs. Group II: 23.8%, p=0.180). The secondary endopoints were as followings: The mortality rate (Group I: 0% vs. 13.2%, Group II: p=0.034), target lesion revascularization (Group I: 9.4% vs Group II: 6.4%, p=0.461) and stent thrombosis (Group I: 3.1% vs. Group II: 4.7%, p=1.000). In conclusion, in the treatment of coronary artery stent thrombosis, simultaneous use of platelet glycoprotein IIb / IIIa receptor blocker and thrombus aspiration was associated with better clinical outcomes regarding 1 year mortality.

External Beam Irradiation for Squamous Cell Carcinoma of the Maxillary Sinus (상악동 편평세포암종에서의 방사선치료)

  • Kim Tae-Hyun;Yoon Won-Sub;Yang Dae-Sik;Kim Chul-Yong;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.19-26
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    • 2003
  • Purpose : Maxillary sinus cancers are usually locally advanced, and involve the structures around sinus, but the regional lymphatic spread is uncommon. Therefore, the local control of these cancers is important for their cure. We reviewed our experience of 55 patients with squamous cell carcinomas of the maxillary sinus, treated with radiation therapy, and looked for the role of radiation therapy in maxillary sinus cancers. Materials and Methods : Between November 1982 and October 1999, 55 patients with squamous cell carcinomas of the maxillary sinus underwent either radiation therapy only, or combined with surgery or with concurrent chemoradlation therapy. All patients were restaged according to the 1997 AJCC staging systems. The T classifications of the tumors of the patients were as follows 1.8$\%$ (1/55) for 72, 81.8$\%$ (45/55) for 73 and 16.4$\%$ (9/55) for 74. Thirteen patients were diagnosed with lymph node involvement. With the surgical procedures, 12 patients were managed by biopsy only, 21 were resected by FESS (funclienal endoscopic sinus surgery) and 22 by partial/medical/total rnaxillectomies. The details of the treatments were as follows 8 patients were treated with radiation therapy only, 17 with a combination of FESS and radiation therapy, 22 with a combination of a maxillectomy and radiation therapy, 4 with a combination of preoperative radiation therapy and surgery, and 4 with concurrent chemoradiation therapy. The mean follow-up for all patients was 25 months, ranging from 2.8 to 125 months. Results : The 4-year local control and survival rates for all Patients were 45.5 and 33.3$\%$, respectively. The 4-year local control and suHival rates, due to the extent of surgery, were as follows 32.1, and 21.4$\%$ for biopsy; 41.9, and 31.7$\%$ for FESS; and 56.8, and 52.7$\%$ for maxillectomy, respectively. Twenty-nine (52.7$\%$) patients were not cured, and of these 29 patients, 23 (79.3$\%$) patients had a iocal recurrence following treatment. Conclusions :This study has shown that the major failure sites following treatment to be the local regions, and that the completeness of surgery was important for improving the local control and survival of patients with squamous cell carcinoma of the maxillary sinus.

Changes of Coagulability after Off-pump CABG: Comparison with On-pump CABG (심폐바이패스 없이 시행하는 관상동맥우회술 후 혈액응고 기늠의 변화: 심폐바이패스하 관상동맥우회술 후 혈액응고 상태와의 비교)

  • 장우익;김기봉;김욱성;정철현;허재학;장지민;이동순;한규섭
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.245-251
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    • 2004
  • Hemostatic function is regarded to be preserved after an off-pump coronary artery bypass grafting (CABG), compared to conventional CABG, and the preserved hemostatic function may increase thrombotic occlusion of the graft. We studied the changes of hemostatic variables in patients undergoing off-pump CABG, and compared to those of on-pump CABG. We studied the changes of coagulation function in 11 patients who underwent off-pump CABG (group I), and compared them with those of 11 patients who underwent on-pump CABG and Dor procedure (group II). Coagulation status was evaluated by thromboelastography and blood coagulation test preoperatively, postoperative 1$^{st}$ day, 2$^{nd}$ day, 3$^{rd}$ day, and 5$^{th}$ day, respectively. Among the variables measured by thromboelastography (such as r time, k time, $\alpha$ angle, and MA value) and blood coagulation test (such as factor Ⅶ, protein S, protein C, antithrombin III, activated protein C resistance test, plasminogen, D-dimer, prothrombin time, activated partial thromboplastin time, platelet count, hemoglobin, and fibrinogen), there were significant differences in the MA value, $\alpha$ angle, and platelet counts between the two groups. MA values were 140$\pm$72% and 153$\pm$98% in group I, and 87$\pm$27% and 78$\pm$28% in group II, at postoperative 3$^{rd}$ and 5$^{th}$ days, respectively (p<0.05). $\alpha$ angle was 122$\pm$92% in group I and 69$\pm$23% in group II at postoperative 3$^{rd}$ day (p=0.09). Platelet count was 63$\pm$55% in group I and 33$\pm$13% in group II at postoperative 3$^{rd}$ day (p<0.05). Patients who underwent off-pump CABG showed increased coagulability during postoperative periods, compared to those who underwent on-pump CABG. Our data suggest that aggressive perioperative anticoagulation therapy is warranted in patients undergoing off-pump CABG. CABG.

Comparison of occurrence rate of the epileptiform discharge between awake EEG and sleep EEG in childhood epilepsy (소아청소년 간질 환자에서 수면 뇌파와 각성 뇌파의 간질파 발현율의 비교)

  • Jung, Yu Jin;Kwon, Kyoung Ah;Nam, Sang Ook
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.861-867
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    • 2008
  • Purpose : We carried out this study to determine if there is any difference in the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG and if there are any factors influencing on the occurrence rate of EEG. Methods : This study included 178 epileptic children who had visited neurology clinic of the department of pediatrics, Pusan National University Hospital from July 2005 to July 2006. The medical and EEG records of these children who had had both awake EEG and sleep EEG were reviewed. We analysed the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG. We investigated the related clinical factors which included sex, seizure types, underlying causes, age at first seizure, antiepileptic drug (AED) medication, age at recording, and background activity. Results : Among 178 epileptic children, 91 patients (51.1%) showed epileptiform discharge in awake or sleep states, 10 patients (11.0%) abnormal only in awake, 40 patients (44.0%) abnormal only in sleep, 41 patients (45.0%) abnormal in both awake EEG and sleep EEG. The occurrence rate of sleep EEG was 81 of 178 patients (45.5%) which was more than that of the awake EEG (28.7%) (P<0.001). The occurrence rate of sleep EEG is more than that of the awake EEG regardless of sex and underlying causes. But there is no significant difference from awake EEG and sleep EEG in finding the epileptiform discharge in the patient with generalized seizure, younger than 5 years old at first seizure, younger than 10 years old at recording, no antiepileptic medication, and abnormal background activity. Conclusion : The sleep EEG is thought to be more helpful in the diagnosis of childhood epilepsy.