• Title/Summary/Keyword: 방광 천공

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Postnatal Management of Antenatally Diagnosed Patent Urachus with Bladder Prolapse

  • Choi, Hyun-Shin;Kim, Hae-Eun;Kim, Eun-Sun;Oh, Soo-Young;Chang, Yun-Sil;Seo, Jeong-Meen;Park, Won-Soon
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.262-264
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    • 2010
  • A case of bladder prolapse through a patent urachus is reported in a female infant born with a large, red, tubular mass inferior to the umbilical cord. A cystic mass communicating with fetal bladder was detected by prenatal ultrasound performed at $20^{+2}$ weeks of gestation. A fetal MRI was also performed to confirm the diagnosis and to exclude associated fetal anomalies. At $40^{+4}$ weeks, the cystic mass was no longer present and a new small solid mass was noted at the fetal abdominal wall. After birth, a protruded mucosal mass inferior to the umbilical cord was noted, and catheterization confirmed communication between the protruded mass and the urinary bladder. On the second day of life, reduction of the bladder and partial resection of the urachus was performed. A voiding cystourethrogram showed good bladder capacity and no vesicoureteral reflux. The patient voided well and was discharged after 10 days. Here, we present a case of urinary bladder prolapse through a patent urachus, diagnosed by fetal sonography and this is the first case reported that was treated by simple excision without complication.

Effect of Submucosal Formalin Injection on Bladder Wall in Rats (백서에서 Formalin의 방광점막하주사가 방광벽에 미치는 영향)

  • Lee, Dong-Heon;Park, Tong-Choon
    • Journal of Yeungnam Medical Science
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    • v.4 no.2
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    • pp.113-120
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    • 1987
  • The effect of intravesical formalin instillation as a therapeutic modality for intractable bladder hemorrhage is well known. And despite clear evidence of therapeutic efficacy of intravesical cytotoxic drugs and/or BCG immunotherapy, there have been substantial recurrences during followup after transurethral resection for superficial bladder tumor. If formalin injected at the bed of superficial bladder tumor is able to coagulate and necrotize the tumor, it will be greatly helpful to the patients With recurrent bladder tumor developed during followup. Since this technique is applicable on outpatient basis, an economical as well as a psychological burden of the patients can be reduced considerably. The purpose of this study is to evaluate the effect of submucosal formalin injection on rat bladder wall, 36 healthy adult male Sprague-Dawley rats (weighing 350gm in average) were divided into 3 groups: In Group I (control group), 0.01ml of normal saline was injected submucosally at the left posterolateral wall of the bladder opened under intraperitoneal Nembutal anesthesia ; In Group II and III, 0.01 ml of 10% and 4% formalin, respectively, were administered at the same site as in the Group I, two rats in each group were sacrificed at day 1, 2, and 3, and week 1, 2 and 4 after injection, respectively. Gross and microscopic examination of the cystectomized specimen were done in each group. In the Group II, bladder stones were formed at week I, and in both the Group I and III, stones were seen at week 2 post injection. There was no significant difference III histologic findings of the bladder between the group II and III. Mucosal ulcer and/or prominent mucosal disruption was observed at 24 hours after injection in both Group II and III. Epithelial regeneration began at day 2, and was marked at day 3, and epithelial lining was almost normalized one week after injection. Subepithelial edema, telangiectasia and inflammatory reaction were prominent at 24 hours post formalin injection. Subepithelial edema persisted in moderate degree for 1 week. Telangiectasia and inflammatory reaction were noted for 4 weeks. Mild degree of these findings also appeared In the control group. Fibroblastic proliferation appeared at day 2 and persisted in moderate degree for 4 weeks. There has been no mortality or bladder perforation. These results suggest that clinical application of this technique is feasible for the selected cases of recurrent, solitary superficial bladder tumor. However, optimal dosage of formalin in relation to the size of the lesion remains to be investigated.

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Predictive Value for Vesicoureteral Reflux in Children with Urinary Tract Infection (요로감염 환아에서 방광요관 역류를 예측할 수 있는 인자에 대한 연구)

  • Lee, Seung-Hyun;Noh, Sung-Hoon;Oh, Jeung-Eun;Kim, Min-Sun;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.62-69
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    • 2008
  • Purpose: The most concerning issue in children with urinary tract infection(UTI) is the probability of underlying genitourinary anomalies and vesicoureteral reflux (VUR), which is frequently associated with renal scarring and eventually end-stage renal disease. Therefore, voiding cystourethrography(VCUG) is usually recommended at the earliest convenient time for children with UTI. However, VCUG is an invasive procedure that requires catheterization and exposure to X-ray. In this study, we aimed to determine the predictability of clinical, laboratory and imaging parameters for VUR in children with UTI. Methods: Data of children with bacteriologically proven UTI who underwent VCUG were evaluated retrospectively for clinical(age, gender, fever), laboratory(leukocytosis, ESR, CRP, pyuria, blood urea nitrogen, serum creatinine) and imaging(renal ultrasound and DMSA renal scan) findings. First, children with UTI were divided into two groups according to the presence of VUR as non-VUR group and with VUR group, and clinical, laboratory variables were compared between these groups. Second, patients who had VUR were reclassified as low-grade VUR(grade I-II) group and high-grade(grade III-V) VUR group according to grading of VUR, and clinical, laboratory and imaging variables were compared between these groups. Results: Among 410 children with UTI, 137 had VUR and 78 high-grade VUR. Fever, leukocytosis, ESR, CRP, pyuria were associated with VUR. In addition, abnormal findings of ultrasonography and DMSA renal scan were closely related to VUR. However, these clinical and laboratory variable in patients with high grade VUR were not different significantly, compared to those with low-grade VUR group. Conclusion: Fever, leukocytosis, ESR, CRP seems to be potentially useful predictors of VUR in pediatric patients with UTI. In addition, renal ultrasonography and DMSA renal scan findings supported the presence of VUR. Further study of these findings could limit unnecessary VCUG in patients with UTI.

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Study of Post Procedural Complications Associated with Voiding Cystourethrography (소아에서 시행한 방광요도 조영술 이후 발생한 합병증에 대한 고찰)

  • Kim, Min-Sun;Lee, Seung-Hyun;Kim, Jeong-Hwa;Chang, Young-Bum;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.65-73
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    • 2007
  • Purpose : Voiding cystourethrography(VCUG) is a commonly performed diagnostic procedure in children with urinary tract infections. Recently, with the widespread use of prenatal ultrasonography, VCUG is performed as part of the postnatal radiological evaluation of asymptomatic infants with prenatally detected hydronephrosis. The procedure is relatively simple but it involves discomfort and some complications. We studied post procedural symptoms and complications in children who underwent VCUG. Methods : This study reviewed 259 patients who underwent VCUG in our hospital between October 2005 and September 2006. We did a chart review and a telephone interview with the patients' parents about symptoms and complications associated with VCUG. Results : Among 269 children, 217 patients(80.7%) were under 2 years of age and 5 patients (1.9%) were over 8 years of age. Their mean age was $13.1{\pm}22.9$ months. After VCUG, dysuria was found in 49 patients presented with dysuria, and irritability in 36 patients with irritability. Other complications were hematuria, fever, frequency, bladder rupture and urinary tract infection. Mean symptoms duration was $1.4{\pm}0.7$ days. There was no significant relationship between prophylactic antibiotics use and complication rate associated with VCUG. Conclusion : Our study demonstrated that 32.7% of patients showed complications including bladder rupture and urinary tract infection after VCUG. We also found that prophylactic antibiotics use did not prevent urinary tract infection nor decrease the rate of complications associated with VCUG. Therefore, we suggest that the procedure must be done carefully and aseptically, and we should closely observe the children who undergo VCUG for development of possible complications.

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Bladder And Rectum Dose Define 3D Treatment Planning for Cervix Cancer Brachtherapy Comparison of Dose-Volume Histograms for Organ Contour and Organ Wall Contour (자궁경부암의 고선량률 근접치료시 장기묘사 방법에 따른 직장과 방광의 선량비교 분석)

  • Kim, Jong-Won;Kim, Dae-Hyun;Choi, Joon-Yong;Won, Yeong-Jin
    • Journal of radiological science and technology
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    • v.35 no.4
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    • pp.327-333
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    • 2012
  • Purpose: To analyze the correlation between dose volume histograms(DVH) based on organ outer wall contour and organ wall delineation for bladder and rectum, and to compare the doses to these organs with the absorbed doses at the bladder and rectum. Material and methods: Individual CT based brachytherapy treatment planning was performed in 13 patients with cervical cancer as part of a prospective comparative trial. The external contours and the organ walls were delineated for the bladder and rectum in order to compute the corresponding dose volume histograms. The minimum dose in 0.1 $cm^3$, 1 $cm^3$, 2 $cm^3$, 5 $cm^3$, 10 $cm^3$ volumes receiving the highest dose were compared with the absorbed dose at the rectum and bladder reference point. Results: The bladder and rectal doses derived from organ outer wall contour and computed for volumes of 2 $cm^3$, provided a good estimate for the doses computed for the organ wall contour only. This correspondence was no longer true when large volumes were considered. Conclusion: For clinical applications, when volumes smaller than 5 $cm^2$ are considered, the dose-volume histograms computed from external organ contours for the bladder and rectum can be used instead of dose -volume histograms computed for the organ walls only. External organ contours are indeed easier to obtain. The dose at the ICRU rectum reference point provides a good estimate of the rectal dose computed for volumes smaller than 2 $cm^2$ only for a midline position of the rectum. The ICRU bladder reference point provides a good estimate of the dose computed for the bladder wall only in cases of appropriate balloon position.

Preliminary Results of Concurrent Chemotherapy and Radiation Therapy using High-dose-rate Brachytherapy for Cervical Cancer (자궁경부암에 항암화학요법과 동시 병용요법으로 외부 방사선조사와 고선량률 강내조사의 예비적 치료 결과)

  • Lee, Kyung-Ja;Lee, Ji-Hye;Lee, Re-Na;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.171-178
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    • 2006
  • [ $\underline{Purpose}$ ]: To determine the efficacy and safety of concurrent chemotherapy and radiation therapy with high-dose-rate brachytherapy for cervical cancer. $\underline{Materials\;and\;Methods}$: From January 2001 to December 2002, 30 patients with cervical cancer were treated with concurrent chemotherapy (cisplatin and 5-FU) and definitive radiation therapy. The median age was 58 (range $34{\sim}74$) year old. The pathology of the biopsy sections was squamous cell carcinoma in 29 patients and one was adenocarcinoma. The distribution to FIGO staging system was as follows: stage IB, 7 (23%); IIA, 3 (10%); IIB, 12 (40%); IIIA, 3 (10%); IIIB, 5 (17%). All patients received pelvic external beam irradiation (EBRT) to a total dose of $45{\sim}50.4\;Gy$ (median: 50.4 Gy) over $5{\sim}5.5$ weeks. Ir-192 HDR intracavitary brachytherapy (ICBT) was given after a total dose of 41.4 Gy. HDR-ICBT was performed twice a week, with a fraction point A dose of 4 Gy and median dose to point A was 28 Gy (range: $16{\sim}32\;Gy$) in 7 fractions. The median cumulative biologic effective dose (BED) at point A (EBRT+ICBT) was $88\;Gy_{10}$ (range: $77{\sim}94\;Gy_{10}$). The median cumulative BED at ICRU 38 reference point (EBRT+ICBT) was $131\;Gy_3$ (range: $122{\sim}140\;Gy_3$) at point A, $109\;Gy_3$ (range: $88{\sim}125\;Gy_3$) at the rectum and $111\;Gy_3$ (range: $91{\sim}123\;Gy_3$) at the urinary bladder. Cisplatin ($60\;mg/m^2$) and 5-FU ($1,000\;mg/m^2$) was administered intravenously at 3 weeks interval from the first day of radiation for median 5 (range: $2{\sim}6$) cycles. The assessment was performed at 1 month after completion of radiation therapy by clinical examination and CT scan. The median follow-up time was 36 months (range: $8{\sim}50$ months). $\underline{: The complete response rate after concurrent chemoradiation therapy was 93.3%. The 3-yr actuarial pelvic control rate was 87% and 3-yr actuarial overall survival and disease-free survival rate was 93% and 87%, respectively. The local failure rate was 13% and distant metastatic rate was 3.3%. The crude rate of minor hematologic complications (RTOG grade 1-2) occurred in 3 patients (10%) and one patient had suffered from severe leukopenia (RTOG grade 4) during concurrent treatment. Acute minor enterocolitis (RTOG grade 1-2) occurred in 11 patients (37%) and one patient (3%) was suffered from colon perforation during radiation therapy. Late colitis of RTOG grade 1 occurred in 5 patients (15%). Acute cystitis of RTOG grade 1 occurred in 12 patients (40%) and late cystitis of RTOG grade 2 occurred in one patient (3%). No treatment related death was seen. $\underline{Conclusion}$: The results of this study suggest that the concurrent chemoradiation therapy with HDR brachytherapy could be accepted as an effective and safe treatment for cervical cancer.

센서 네트워크용 초소형 OS

  • Song, Jun-Geun;Ma, Pyeong-Su;Park, Seung-Min
    • Information and Communications Magazine
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    • v.24 no.7
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    • pp.26-35
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    • 2007
  • 최근 몇 년간 유비쿼터스 서비스를 구현하기 위한 핵심 기술 중 하나인 무선 센서 네트워크에 대한 관심이 높아지고 있다. 무선 센서 네트워크 기술은 물류, 유통, 환경 감시, 홈오토메이션, 군사 분야 등 다양한 분야에 적용 될 수 있기 때문에 앞으로 관련 분야의 시장 또한 커질 것으로 예상되고 있다 [1]. 무선 센서 네트워크는 기존 유선 센서 네트워크나 무선 네트워크 환경과는 많은 차이를 가진다. 우선 극도로 제한된 시스템 자원만을 가질 수 있으며, 열악한 환경 속에서 무선매체를 통해 유기적으로 동작하여야 하는 특징을 가지고 있다. 적게는 수십 개에서 많게는 수백, 수천 개의 자율적인 하드웨어 노드들로 구성되는 무선 센서 네트워크에서 제한된 자원을 효과적으로 활용하기 위해서는 센서 노드에 적합한 운영체제가 필수적으로 요구된다. 지난 몇 년간 센서 노드하드웨어의 발달과 더불어 많은 센서 네트워크용 초소형 운영체제가 개발되어왔다. 현재 많이 알려져 있는 센서 네트워크용 OS로는, 가장 활발한 참여를 보이고 있는 TinyOS[3]부터 SOS[4], MANTIS[5], Contiki[6], T-kernel[7] 등이 있으며, 국내 기술로 개발된 Nano-Qplus[8] 등이 존재한다. 본고에서는 우선 센서 네트워크에 대한 배경 지식과 플랫폼 등에 대한 내용을 간단히 다루고, 본론에서 센서 네트워크용 운영체제가 가져야 할 조건과 현재 개발되어 있는 센서 네트워크 OS들의 특징에 대해 간략히 살펴보도록 하겠다. 또한 센서 네트워크 OS와 밀접한 연관성을 가지는 분야에 대해 간단히 살펴보고, 마지막으로 앞으로의 방향에 대해 알아본다.고려해 볼 때 atlas의 장축의 시계방향 회전은 액티베이터의 사용 효과로 생각되며, 이는 차후 II급 부정교합자에서 액티베이터 치료 효과를 판단하는 또 하나의 지표가 될 수 있다고 생각한다.인해 한반도를 포함한 동아시아 대륙이 태평양판 쪽으로 밀려감으로써 섭입하던 태평양판의 각도가 급해져 동아시아 연변에 강력한 흡입력이 발생하였으며, 이 때문에 태평양판의 운동 방향이 북북서에서 서북서방향으로 회전되었을 가능성이 있다. 따라서 약 51 Ma부터 한반도 동남부에는 지판 경계의 강력한 흡입력으로 동서 내지 서북서-동남동의 인장력이 작동되어 B그룹 암맥군이 관입한 것으로 해석된다.Ledge는 세 군 모두에서 나타나지 않았다. 4. 파일 binding 횟수는 MC군이 가장 적고 PT군이 가장 많았다 (p < 0.05). 이상의 결과를 볼 때, Mtwo 전동 파일을 crown-down technique으로 사용하는 것이 single length technique과 유사한 성형 효율을 보이면서도 더 안전할 것으로 추정된다.고 1명(3%)에서 원격전이를 보였다. 치료 중 급성 합병증으로 11명(37%)에서 RTOG grade 1-2의 장염을 보였으며 1명은 대장의 천공이 발생하여 수술로 치유되었다. 12명(40%)에서 RTOG grade 1-2의 급성 방광염을 보였다. 3명(10%)에서 RTOG grade 1-2의 백혈구 감소증이 보였으며 1명에서 심한 백혈구 감소증(RTOG grade 4)이 나타났으나 회복되어 치료를 완료하였다. 만성 합병증으로 5명(15%)에서 RTOG grade 1-2의 만성 장염을 보였으며 별다른 치료 없이 지내고 있으며

Changes in atlas position with Class ll activator treatment in Class II malocclusion patients (II급 부정교합자에서 액티베이터 사용에 따른 atlas의 위치 변화에 관한 연구)

  • Cho, Moon-Ki;Cha, Kyung-Suk;Chung, Dong-Hwa;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.37 no.1 s.120
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    • pp.44-55
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    • 2007
  • Objective: Previous studies have reported that morphological features of the first cervical vertebra (atlas) have been associated with mandibular growth direction. The purpose of this study was to show the possible positional and morphological changes of the Atlas from activator treatment in Class II malocclusion patients. Methods: Lateral cephalometric radiograph tracings were made at initial, middle and final stages of treatment. Angular and linear measurements of skeletal and morphological features were measured on the anatomical landmarks and reference planes. Results: The skeletal effects of activator treatment on Class II malocclusion patients were evident on ramal height, body length, effective body length, ANB, and overjet. Clockwise rotation of the long axis of the Atlas was found in Group 1, but there was no inclination change of the Atlas in groups 2 and 3. There was no significant correlation between anterior and posterior positions of the atlas or morphological change in all groups. - except for posterior movements of the Atlas found in group 1. Conclusion: Clockwise rotation of the atlas axis resulted from activator treatment in Cl II malocclusion patients. Change in atlas axis can be thought of as an indicator for success of activator treatment.

Comparison of the Result of Radiation Alone and Chemoradiation in Cervical Cancer (자궁 경부암에서 방사선 단독치료와 방사선 및 화학요법 병행치료의 비교)

  • Kim, Jae-Cheol;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.191-198
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    • 1995
  • Purpose: This analysis was to compare the result of radiation alone and chemoradiation in cervical cancer in terms of response, survival, failure, and complication. Materials and Methods: A retrospective analysis of 135 cervical cancer patients treated with definitive radiotherapy from November 1985 to December 1991 was performed. Fifty-six patients were treated with radiation alone and 79 patients were treated with cisplatin-based chemotherapy plus radiation. Follow-up period ranged from 5 to 105 months with a median 47 months. According to the FIGO classification, the patients were subdivided into 18 $(13.3\%)$ stage IB, 7 $(5.2\%)$ stage IIA, 97 $(71.9\%)$ stage IIB, and 9 $(6.7\%)$ stage IIIB. Results: A complete response was noted in 51 patients $(91.1\%)$ of the radiation alone group, and 68 patients $(86.1\%)$ of the chemoradiation group. There was no statistical difference in complete response rate between the two groups. Overall survival rate at 5 years was $73.3\%$. According to stage, overall survival rates at 5 years were $88.9\%$ in stage IB, $85.7\%$ in stage IIA, $73.8\%$ in stage IIB, and $37.5\%$ in stage IIIB, respectively. According to treatment modality, overall survival rates at 5 years were $81.9\%$ in the radiation alone group, $67.0\%$ in the chemoradiation group (p=0.22). Disease-free survival rate at 5 years were $70.4\%$ in the radiation alone group. $68.5\%$ in the chemoradiation group (p=0.85) Locoregional control rates at 5 years were $76.1\%$ in the radiation alone group, $73.8\%$ In the chemoradiation group (p=0.70). Distant disease-free survival rates at 5 years were $83.9\%$ in the radiation alone group, $90.3\%$ in the chemoradiation group (p=0.59). Treatment-related bone marrow suppressions were noted in 3 $(5.4\%)$ patients of the radiation alone group, 14 patients $(17.7\%)$ of the chemoradiation group (p(0.05). Grade 2 vesical complications were noted in 14 patients of the radiation alone group. and 10 Patients of the chemoradiation group. Grade 2 rectal complications were noted in 2 patients of the radiation alone group, and 3 Patients of the chemoradiation group. One case of rectal perforation was noted in the chemoradiation group, and grade 2 small bowel obstructions were noted in 2 patients of the radiation alone group. There were no statistical differences in the incidence of vesicar, rectal, and small bowel complicaions between the two groups. Conclusion: No statistical difference was found between the radiation alone group and the chemoradiation group in terms of response, survival, and failure. but the incidence of bone marrow suppression was higher in the chemoradiation group.

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Hue Shift Model and Hue Correction in High Luminance Display (고휘도 디스플레이의 색상이동모델과 색 보정)

  • Lee, Tae-Hyoung;Kwon, Oh-Seol;Park, Tae-Yong;Ha, Yeong-Ho
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.44 no.4 s.316
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    • pp.60-69
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    • 2007
  • The human eye usually experiences a loss of color sensitivity when it is subjected to high levels of luminance, and perceives a discrepancy in color between high and normal-luminance displays, generally known as a hue shift. Accordingly, this paper models the hue-shift phenomenon and proposes a hue-correction method to provide perceptual matching between high and normal-luminance displays. The value of hue-shift is determined by perceived hue matching experiments. At first the phenomenon is observed at three lightness levels, that is, the ratio of luminance is the same between high and normal-luminance display when the perceived hue matching experiments we performed. To quantify the hue-shift phenomenon for the whole hue angle, color patches with the same lightness are first created and equally spaced inside the hue angle. These patches are then displayed one-by-one on both displays with the ratio of luminance between two displays. Next, the hue value for each patch appearing on the high-luminance display is adjusted by observers until the perceived hue for the patches on both displays appears the same visually. After obtaining the hue-shift values, these values are fit piecewise to allow shifted-hue amounts to be approximately determined for arbitrary hue values of pixels in a high-luminance display and then used for correction. Essentially, input RGB values of an image is converted to CIELAB values, and then, LCh (lightness, chroma, and hue) values are calculated to obtain the hue values for all the pixels. These hue values are shifted according to the amount calculated by the functions of the hue-shift model. Finally, the corrected CIELAB values are calculated from corrected hue values, after that, output RGB values for all pixels are estimated. For evaluation, an observer's preference test was performed with hue-shift results and Almost observers conclude that the images from hue-shift model were visually matched with images on normal luminance display.