• Title/Summary/Keyword: 비만 수술

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Limited Lateral Retinacular Release for Treatment of Painful Bipartite Patella (통증이 있는 이분슬개골의 제한적인 외측 지대 유리술 치료)

  • Yi Seung Rim;Hahn Sung Ho;Yang Bo Kyu;Chung Shun Wook;Ha Jung Hyun;Ahn Young Joon;Chung Byung June;Jeon Do Hwan;Bin Sung Woo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.60-65
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    • 2004
  • Purpose: The purpose of this study was to evaluate the results of limited vastus lateralis release for treatment of painful bipartite patella. Materials and Methods: From Jan. 1995 to Jun. 2002, we performed limited lateral retinacular release in 14 patients(16 cases) for treatment of painful bipartite patella. All patients were men and mean age was 22.3 years old. The opeative techique was that insertion of the vastus lateralis to the painful patellar fragment is detached subperiosteally. We evaluated the clinical results by degree of pain and level of activity. Also we analyzed the radiologic findings by measuring fragment tilting angle and gap between fragments. The mean follow up period was 14 months. Results: At final follow up, all of the patients showed pain relief and can be returned to more than recreational sports activity after the operation. On radiologic findings, fragment tilting angle and gap between fragments were reduced at statistically significant level. Conclusion: The limited lateral retinacular release for treatment of painful bipartite patella is one of good methods which is less invasive and shows good results in clinical and radiologic findings.

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Clinical Analysis of Fractures by Inline Skating Injury (인라인 스케이트시 발생된 골절의 임상적 고찰)

  • Choi Hyung Suk;Doh Hyun Woo;Lee Byung Ill;Min Kyung Dae;Rah Soo Kyun;Kim Yeon Ill;Seo Yoo Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.87-91
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    • 2004
  • Purpose: The purpose of this study is to investigate the incidence and patterns of fractures occurred in Inline skating accident. Materials and Method: We evaluated 20 patients, 20 cases(from september 2002 to August 2003) with fractures occurred during Inline skating. The incidence, sex, age, fracture site, associated injuries, causes of Inline skating injuries were analysed. The cases were male in 18(90$\%$), and female in 2(10$\%$). The most common distribution of age was in twenties and thirties. Result: The patients(12cases 60$\%$) with upper extremity fracture were more common than patients(8cases 40$\%$) with lower extremity fracture. Patients who had fracture in ankle were 35$\%$(7cases), forearm 20$\%$(4cases), wrist 20$\%$(4cases), elbow 15$\%$(3cases), thigh 5$\%$(1cases). According to the The Lauge-Hansen classification in ankle fractures there were four patients of supination-external rotation type, two patients of supination-abduction type, and 1 patient of pronation-external rotation type. In forearm and hand fractures, there were three distal radius fractures, one radio-ulnar shaft fracture, 2 scaphoid fractures, and two meta-carpal fractures. In elbow fractures, there were two supracondyle fractures, and one lateral condyle fracture. There were three epiphyseal plate injuries (Salt-Harris type II) in children, and all of them were treated by conservative method. Six fractures were intra-articular fractures. The most common associated injury was contusion(8cases 42.1$\%$). The number of patients who only rode Inline skating less than 3months(8cases 40$\%$) was the greatest. The number of non-contact injury(14cases, 70$\%$) in Inline skating was more than contact(6cases,30$\%$) injury. 11cases(55$\%$) had operative treatment, and 9cases(45$\%$) had conservative treatment, and there was not any complication. The more detailed study is required since the materials were only limited to fracture patients, and the follow up period was short. Conclusion: The most common age for fracture in Inline skating was in twenties, and thirties, and ankle was the most common fracture site.

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Clinical Courses of Cavitary Lesions in Pulmonary Tuberculosis (처음 진단시 발견된 공동성병변의 경과)

  • Park, Seung-Kyu;Choi, In-Hwan;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.323-330
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    • 1996
  • Objective : Cavitary lesion in pulmonary tuberculosis sometimes makes problems in the course of treatment. Especially, retreatment cases tend to respond poorly to current antituberculosis agents. So, authors tried to render a guideline for clinical approach toward cavitary lesions in pulmonary tuberculosis. Methods : Retrospective analysis of 33 pulmonary tuberculosis patients with cavitary lesions was made. All the patients had got treatment at National Masan Tuberculosis Hospital from Jan. 1995 to Aug. 1995. Results: The ratio between male and female was 10:1. Age distribution was 69.7% in 3rd and 4th decades. The locations of cavitary lesion were 60.6% in right upper lung field and 36.4% in left upper lung field. In the extent of disease, there were 12 cases(36.4%) in moderate advanced and 21 cases in far advanced. Cavitary lesions were closed in 5 eases and remained in 28 eases. In the cases of closed cavity, it was happened within $10.6{\pm}4.72$ months after they took treatment, the size of cavity was $35.5{\pm}17.1$ in long diameter, $27.0{\pm}12.2$ in short diameter and $4.6{\pm}2.1\;mm$ in wall thickness. In the cases of remained cavity, the size of cavity was $31.9{\pm}12.3$ in long diameter, $21.0{\pm}9.8$ in short diameter and $5.04{\pm}2.0\;mm$ in wall thickness. In terms of negative conversion, it took $3.8{\pm}2.17$ months in the case of closed cavity but it was happened within 5 months for only 4 patients in the case of remained cavity. In the point of past medication history, there was none in closed cavities but there were none in 1 case, once in 3 cases, two times in 9 cases and more than three times in 13 cases among remained cavitary lesions. Conclusion : In the retreatment cases of pulmonary tuberculosis with cavitary lesions, they tend to respond poorly to current antituberculosis agents. So, if the lesions are localized, operative intervention may be a proper method as adjunctive treatment.

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Increased Expression of Phospholipase C-$\gamma1$ Activator Protein, AHNAK in Human Lung Cancer Tissues (인체 폐암조직에서 Phospholipase C-$\gamma1$의 활성화 단백, AHNAK의 발현양상)

  • Oh, Yoon-Jung;Park, Chun-Seong;Choi, So-Yeon;Cheong, Seong-Cheoll;Lee, Sun-Min;Hwang, Sung-Chul;Lee, Yi-Hyeong;Hahn, Myung-Ho;Lee, Kyi-Beom;Ryu, Han-Young;Ha, Mahn-Joon;Bae, Yoon-Su;Rhee, Seo-Goo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.347-355
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    • 1999
  • Background: Phospholipase C(PLC) plays a central role in cellular signal transduction and is important in cellular growth, differentiation and transformation. There are currently ten known mammalian isozymes of PLC reported to this date. Hydrolysis of phosphatidylinositol 4,5-bisphosphate($PIP_2$) by PLC produces two important second messengers, inositol 1,4,5-trisphosphate($IP_3$) and diacylglycerol. PLC-${\gamma}1$, previously, was known to be activated mainly through growth factor receptor tyrosine kinase. Other mechanisms of activating PLC-yl have been reported such as activation through tau protein in the presence of arachidonic acid in bovine brain and activation by $IP_3$, phosphatidic acid, etc. Very recently, another PLC-${\gamma}1$ activator protein such as tau has been found in bovine lung tissue, which now is considered to be AHNAK protein. But there has been no report concerning AHNAK and its associated disease to this date. In this study, we examined the expression of the PLC-${\gamma}1$ activator, AHNAK, in lung cancer specimens and their paired normal. Methods: From surgically resected human lung cancer tissues taken from twenty-eight patients and their paired normal counterparts, we evaluated expression level of AHNAK protein using immunoblot analysis of total tissue extract Immunohistochemical stain was performed with primary antibody against AHNAK protein. Results: Twenty-two among twenty-eight lung cancer tissues showed overexpression of AHNAK protein (eight of fourteen squamous cell lung cancers, all of fourteen adenocarcinomas). The resulting bands were multiple ranging from 70 to 200 kDa in molecular weight and each band was indistinct and formed a smear, reflecting mobility shift mainly due to proteolysis during extraction process. On immunohistochemistry, lung cancer tissues showed a very heavy, dense staining with anti-AHNAK protein antibody as compared to the surrounding normal lung tissue, coresponding well with the results of the western blot Conclusion: The overexpression of PLC-${\gamma}1$ activator protein, AHNAK in lung cancer may provide evidence that the AHNAK protein and PLC-${\gamma}1$ act in concerted manner in carcinogenesis.

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Long-term Outcome of Treatment of Mycobacterium Abscessus Pulmonary Disease (Mycobacterium abscessus 폐질환 치료의 장기 성적)

  • Jo, Kyung Uk;Park, Soo Jung;Hong, Seok Chan;Oh, Yeon-Mok;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.2
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    • pp.98-104
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    • 2007
  • Background: Although there is an increasing incidence of Mycobacterium abscessus pulmonary disease in Korea, the optimal therapeutic regimen has not yet been established and there are no reports of the long-term treatment outcomes. This study examined the long-term treatment outcomes of M. abscessus pulmonary disease. Methods: Twenty-nine patients diagnosed with M. abscessus pulmonary according to the American Thoracic Society criteria and treated from January 1996 to December 2003 were enrolled in ghis study. The clinical characteristics, radiological findings, treatment outcome, and follow up data were analyzed retrospectively. Results: The mean age of the 29 patients was 56.1 (${\pm}13.6$) years and there was a female (22/29) dominance. The chest radiography revealed the nodular bronchiectatic type to be dominant (69%, 20/29). Twenty-seven (93.1%) were prescribed clarithromycin-containing regimens, and injectable drugs, mainly aminoglycosides, were included in the regimen of nineteen patients. The most predominant regimen (48.3%) consisted of clarithromycin and amikacin. The treatment success, failure, and default were achieved in 19(65.5%), 9(31.0%), and 1(3.4%), respectively. The median duration to culture conversion was 42 days (range 15-362) and the median duration of treatment in the success group was 543 days (range 176-1,160). An adjunctive surgical resection was performed in five patients, which resulted in treatment success in two patients. After the completion of treatment, nineteen patients were followed up for a median duration of 931 days (range 230-2,294). Only one (5.3%) patient relapsed 45 days after completing treatment. Conclusion: Treatment with clarithromycin-containing regimens resulted in a successful treatment in approximately two thirds of patients with M. abscessus pulmonary disease. The long-term relapse rate was also quite low.

Analysis of Relative Output Factors for Cyberknife: Comparison of Son Chambers, Diode Detector and Films (사이버나이프 출력인자 분석: 전리함, 다이오드 검출기 및 필름)

  • Jang Ji-Sun;Shin Dong-Oh;Choi Byung-Ock;Lee Tae-Kyu;Choi Ihl-Bohng;Kim Moon-Chan;Kwon Soo-Il;Kang Young-Nam
    • Progress in Medical Physics
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    • v.17 no.1
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    • pp.47-53
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    • 2006
  • The accuracy of the dosimetry in the Cyberknife system is accomplishing important role from all processes of the stereotactic radiosurgery. In this study, we estimated relative output factors for Cyberknife. All measurements were peformed by six different detectors: diode detector, X-Omat V film, Gafchromic EBT film, 0.015 cc, 0.125 cc and 0.6 cc ionization chamber The diode detector and three ionization chambers peformed using water phantom at 80 cm SSD and 1.5 cm depth. When the film measurements were peformed, the water phantom was replaced with a solidwater phantom. Each collimator normalized with respect to the output factor of the largest collimator (60 mm). For the collimators over than 30 mm, the output factors from the different detectors showed a good agreement within 0.5% except 0.6 cc ion chamber For the collimators less than 15 mm, there were substantial differences In the output factors among different detectors. That is, the value of output factor for the 5 mm collimator of a diode and Gafchromic film was each $0.656{\pm}0.009$ and $0.777{\pm}0.013$. In the ion chamber and diode detector, those difference were due to the presence of large dose gradients and lack of electronic equilibrium in narrow megavoltage x-ray beams Therefore, the Gafchromic EBT film were considered more accurate than the others detectors.

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A Study of Optimized MRI Parameters for Polymer Gel Dosimetry (중합체 겔 선량측정법을 위한 최적의 자기공명영상 변수에 관한 연구)

  • Cho, Sam-Ju;Chung, Young-Lip;Lee, Sang-Hoon;Huh, Hyun-Do;Choi, Jin-Ho;Park, Sung-Ill;Shim, Su-Jung;Kwon, Soo-Il
    • Progress in Medical Physics
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    • v.23 no.2
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    • pp.71-80
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    • 2012
  • In order to verify exact dose distributions in the state-of-the-art radiation techniques, a newly designed three-dimensional dosimeter and technique has been took strongly into consideration. The main purpose of our study is to verify the optimized parameters of polymer gel as a real volumetric dosimeter in terms of the various study of MRI. We prepared a gel dosimeter by combing 8% of gelatin, 8% of MAA, and 10 mM of THPC. We used a Co-60 gamma-ray teletherapy unit and delivered doses of 0, 2, 4, 6, 8, 10, 12, and 14 Gy to each polymer gel with a solid phantom. We used a fast spin-echo pulse to acquire the characterized T2 time of MRI. The signal noise ratio (SNR) of the head & neck coil was a relatively lower sensitivity than the body coil; therefore the dose uncertainty of head & neck coil would be lower than body coil's. But the dose uncertainty and resolution of the head & neck coil were superior to the body coil in this study. The TR time between 1,500 ms and 2,000 ms showed no significant difference in the dose resolution, but TR of 1,500 ms showed less dose uncertainty. For the slice thickness of 2.5 mm, less dose uncertainty of TE times was at 4 Gy, as well, it was the lowest result over 4 Gy at TE of 12 ms. The dose uncertainty was not critical up to 6 Gy, but the best dose resolution was obtained at 20 ms up to 8 Gy. The dose resolution shows the lowest value was over 20 ms and was an excellent result in the number of excitation (NEX) of three. The NEX of two was the highest dose resolution. We concluded that the better result of slice thickness versus NEX was related to the NEX increment and thin slice thickness.

MRI Findings of Triple Negative Breast Cancer: A Comparison with Non-Triple Negative Breast Cancer (삼중음성 유방암의 자기공명영상 소견: 비삼중음성 유방암과의 비교)

  • Choi, Jae-Jeong;Kim, Sung-Hun;Cha, Eun-Suk;Kang, Bong-Joo;Lee, Ji-Hye;Lee, So-Yeon;Jeong, Seung-Hee;Yim, Hyeon-Woo;Song, Byung-Joo
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.2
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    • pp.95-102
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    • 2010
  • Purpose : To evaluate the magnetic resonance imaging (MRI) and clinicopathological features of triple negative breast cancer, and compare them with those of non-triple negative breast cancer. Materials and Methods : This study included 231 pathologically confirmed breast cancers from January 2007 to May 2008. We retrospectively reviewed the MRI findings according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon: mass or non-mass type, mass shape, mass margin, non-mass distribution, and enhancement pattern. Histologic type, histologic grade, and the results for epidermal growth factor receptor, p53, and Ki 67 were reviewed. Results : Of 231 patients, 43(18.6%) were triple negative breast cancer. Forty triple negative breast cancers (93.0%) were mass-type lesion on MRI. A round or oval or lobular shape (p=0.006) and rim enhancement (p=0.004) were significantly more in triple negative breast cancer than non- triple negative breast cancer. In contrast, irregular shape (p=0.006) and spiculated margins (p=0.032) were significantly more in non-triple negative breast cancer. Old age (p=0.019), high histologic grade (p<0.0001), EGFR positivity (p<0.0001), p53 overexpression (p=0.038), and Ki 67 expression (<0.0001) were significantly associated with the triple negative breast cancer. Conclusion : MRI finding may be helpful for differentiation between triple negative and non-triple negative breast cancer.

The Relationship between the Growth of Cranial Base and the Position of Maxilla, Mandible in Complete Unilateral Cleft Lip and Palate Patients (완전 편측성 순구개열자의 두개저 성장과 상,하악골 위치의 상관 관계에 관한 연구)

  • Baek, Jae-Ho;Son, Woo Sung
    • The korean journal of orthodontics
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    • v.30 no.4 s.81
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    • pp.399-411
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    • 2000
  • This study was designed to evaluate the correlations between the morphology and growth of cranial base and the position of nasomaxillary complex and mandible in complete unilateral cleft lip and palate patients. Craniofacial skeletal morphology Pattern was analyzed on the lateral cephalometric radiographs of the 100 subjects of complete unilateral cleft lip and palate group and the 100 normal grower group and each group was divided three sub-groups by age-range like spheno-ethmoidal synchodrosis growing group, spheno-occipital synchondrosis growing group and finished synchondrosis growth group. These data were statistically analyzed to examine significant difference between both groups and between each sub-groups. The results of this study were as follows: 1. In complete unilateral cleft group, the length, thickness of clivus, and the rate of increase in length of clivus showed smaller amount by adolescence. The anterior length of cranial base and the rotation pattern of clivus with age showed no significant difference between two group. 2. In complete unilateral cleft group, nasomaxillary complex were located more posteriorly. This difference between two groups is larger by adolescent group than adult. Vertical position showed no significant difference between two groups. There was significant correlation between the cranial base of cleft group and the horizontal measurements(p<0.01). PtmS showed no significant increment in cleft group. This showed the deficiency of growth in posterior part of maxilla. 3. In mandible, there was no significant difference between normal group and complete unilateral cleft group but articular angle showed significantly smaller in cleft group than in normal one. And the measurements of nasomaxillary complex position, cranial base and the position of mandible had significant correlation(p<0.01).

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Oral Cleft Risk Factors in Rural Area of Indonesia(Sintang) (인도네시아 농촌지역의 구순구개열 위험요인 사례조사)

  • Park, Dae-jin;Lim, Young-soo;Oh, Jee-young;Koh, Kwang-Wook;Song, Sung-Eun;Jo, Eun-Joo
    • Journal of agricultural medicine and community health
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    • v.31 no.2
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    • pp.187-208
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    • 2006
  • Objectives: This study was carried out to evaluate the risk factors of Oral cleft and to inspect the living environments of the rural areas of Sintang, Indonesia Methods: During 3 to 9 August 2004, A questionnaire survey was done for the risk factors of oral cleft. Case group was composed of 11 oral cleft patients who admitted Missionary Hospital whose mother's bloods were analyzed for anemia and hyperlipidemia. Control group was composed of 56 reproductive rural women recruited from near rural villages. Also we surveyed 4 rural areas of Indonesia with simple water test kits. $x^2-test$ for significant difference was analysed. Results: Drinking water was statistically significant risk factor(p<0.05) of oral cleft. Other factors had no statistical significancy. The kind of drinking water was river-originated water. In rural villages, water sanitation state, even boiled water, was very poor. Although $NO_2-N$, $NO_3-N$ was negative, E. coli-form microorganisms were strongly positive in most samples. Total food intake amount was not enough, and vitamin supplements were also under the need. Conclusions: Drinking the contaminated river-water around pregnancy was supposed to be one of the risk factors of oral cleft in Indonesia. Further study is needed for nitrate and mercury.

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