Kim Myung Se;Kim Kyung Ae;Kim Sung Kyu;Shin Sei One;Lee Sung Ho;Chang Jae Chun
Radiation Oncology Journal
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v.7
no.1
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pp.59-70
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1989
Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still $44\%$ of patient will develop recurrent cancer. This result suggests that more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease. 96 cases of invasive cervical cancer, treated with postoperative or primary radiation therapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen Which is $5500\~1000 CGy$ higher than Other institution. Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was $46\%$, but only 1 patient $(1\%)$ had operative treatment because of incomplete obstruction of small bowel. Most symptoms appeared within 12 months and most common complaints were frequent bowel movement. Barium enema and sigmoidoscopy were performed for persistent symptomatic patients. Only one patient had abnormal finding in barium enema which showed inefficiency of this method for detecting bowel complication. Patient's age, total tumor dose, total TDF, rectal dose were not significant risk factors for complication, but boost dose, previous history of operation had some relationship with complication risk. Even though dose of point A and rectum is $500\~1,000cGy$ higher than other institution, such a low rate of severe complications may suggest that fear of complications should not be overestimated than cure rate and the possibility of more aggressive treatment for better local control should not be underestimated.
Background: Postpneumonectomy empyema(PPE) is an infrequent but potentially life-threatening complication. To date, various surgical efforts have been made to manage this complication. We reviewed our 20-year surgical experience of PPE and long-term follow-up data. Material and Method: Total of 37 patients who were treated for PPE between fan, 1980 and Jun, 2000 were included. Various clinical factors such as micro-organism, operative method and timing, presence of bronchopleural fistula(BPF), underlying disease and fate of empyema cavity were retrospectively reviewed and analyzed. Result: Majority of patients(34) underwent Eloesser operation for effective drainage. There was only one operative mortality. The causative organisms were Staphylococcus species and Pseudomonas species in 46% BPF was found in 20 cases, among which spontaneous closures took place in 4 cases. The chest wall was closed in 40%(8/20) of patients with BPF, compared to 59%(10/17) without BPF. The closure rate was statistically better in patients without BPF(p=0.006). Even though the patients with benign disease showed higher closure rate(50%) than those with lung cancer (31%), the difference was not significant(p=0.25). Conclusion: Eloesser procedure was an effective method for initial drainage of PPE cavity with low operative mortality. Given the findings of low spontaneous closure rate of BPF, aggressive approach to close the BPF is mandatory to achieve the final goal of chest wall closure. It was found that majority of patients still left their chest cavity opened, even after controlling the active inflammation of the empyema cavity. More aggnessive approach for chest wall closure is recommended in all patents with benign disease and in selective patients with lung cancer if there is no evidence of recurrence at several years after the initial operation.
Kim, Kwang-Ho;Kim, Joung-Taek;Lee, Seo-Won;Kim, Hae-Sook;Lim, Hyun-Kung;Lee, Choon-Soo;Sun, Kyung
Journal of Chest Surgery
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v.32
no.4
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pp.373-378
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1999
Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.
Background: Emergency airway access is essential when a patient has dyspnea that's due to tracheal or bronchial obstruction. Such methods as laser therapy and PDT are now being used for the treatment of tracheal obstruction that's due to benign diseases or nonsurgical malignant diseases. Cryotherapy is a method that uses extreme hypothermia for freezing a tumor to cause necrosis. In this study, we have evaluated the clinical effectiveness of performing endobronchial cryoablation through a flexible bronchoscope. Material and Method: 10 patients with tracheal obstruction that was due to endotracheal tumors were evaluated between May 2005 and May 2007. Eight were male and the mean age of the 10 patients was $59.4{\pm}18.4$ years. Three cases of tracheal obstruction were due to benign tumors and 7 were due to malignant tumors. The obstruction sites were 3 at the trachea, 3 at the carina and 4 at the bronchus. A flexible bronchoscope was inserted and the tumor was eliminated using a flexible cryoprobe. Follow up bronchoscopy was performed at 1 week and 1 month after cryoablation, and then we evaluated the decrease of dyspnea, the improvement of the performance and the complications of the procedures. Result: Complete remission was achieved in 4 patients and partial remission was achieved in 6 patients. Complications such as hemoptysis (100%), and cough (50%) were noted. Hemoptysis was spontaneously resolved in 3 to 8 days (mean: 4.9 days). A decrease in dyspnea and improvement in the performance was noted in all patients. Conclusion: Endobronchial stenosis plays a detrimental role in the life quality of a terminal cancer patient. Due to its simplicity and effectiveness for controlling bleeding, endobronchial cryoablation is considered to be a safe method that is clinically applicable to a wide range of tumors, including the removal of large tumors. We concluded that endobronchial cryoablation through a flexible bronchoscope is a safe, effective method for treating tracheobroncheal obstructions.
Song, Gi Seon;Lee, You-Rim;Kim, Sungmin;Kim, Wontae;Choi, Jungwon;Yoo, Dahyeon;Yoo, Jungyoung;Jang, Kyung-Tae;Lee, Jaewang;Jun, Jin Hyun
Korean Journal of Clinical Laboratory Science
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v.52
no.3
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pp.284-295
/
2020
In December 2019, the first coronavirus disease- 2019 (COVID-19) patient was reported in Wuhan, Hubei Province, China. Since then, the number of patients who suffered severe acute respiratory syndrome caused by the novel Coronavirus (SARS-CoV-2 or 2019-nCoV) has increased dramatically in Korea. This new variant virus induces pulmonary diseases, including cough, sore throat, rhinorrhea, dyspnea, and pneumonia. Because SARS-CoV-2 is an RNA virus, real-time reverse-transcriptase PCR has been used widely to diagnose COVID-19. As the Korea Centers for Disease Prevention and Control (KCDC) and Ministry of Food & Drug Safety (MFDS) approved emergency use authorization, clinical specimens collected from COVID-19 patients and even healthy people have been clinically diagnosed by laboratory medicine. Based on a literature search, this paper reviews the epidemiology, symptoms, molecular diagnostics approved by KCDC, a current diagnosis of COVID-19 in the laboratories, the difference between molecular and serological diagnosis, and guidelines for clinical specimens. In addition, the Korean guidelines of biosafety for clinical laboratory scientists are evaluated to prevent healthcare-associated infection. The author's experience and lessons as clinical laboratory scientists will provide valuable insights to protect the domestic and international health community in this COVID-19 pandemic around the world.
It is quite difficult to actually prove the effectiveness of so-called target-hardening, one of the various strategies used to reduce crime, one of the serious problems in society recently. In particular, three to five minutes is often used as golden time for intruders to give up or stop, which is based on foreign and some indirect research cases in Korea, but there were no studies that more directly identified the average break-in operation time or the abandonment time based on the elapsed time when the shield hardware resists intruders. This study was the first of its kind in Korea to investigate and verify samples of 90 inmates of break-in burglars who were imprisoned in August 2018 by profiling the average criminal experience, education level, age, height and weight of typical Korean professional break-in thieves, and specific criminal methods, average break-in operation time, and the criteria for giving up if not breached. According to the analysis results, in the survey on the number of pre-invasion theft crimes by intruders, many of the respondents who participated in the survey were criminals of professional invasions, and by their physical characteristics, there was not much difference from ordinary adult men. Residential facilities were the highest in the world, followed by commercial and educational facilities. According to the survey on the types of facilities that committed intrusion into residential facilities, it was not safe to say that single-family housing accounted for the largest portion of single-family housing, multi-family housing, apartment high-rise (more than three stories), and apartment low-rise (more than one to three stories) among residential facilities, and that the ratio of apartment high-rise was higher than expected. Based on the average time required to break into a place for an intrusion crime, it is assumed that the psychological time worked in a place where the break-in was difficult, since the break-in was not performed while measuring the time of the break-in operation. In the case of time to give up a crime, more than half of the respondents said they would give up the crime even in less than four minutes, suggesting that a significant number of intrusive crimes can be prevented even if the facility has four minutes of intrusion resistance. This proves that most intruders will give up the break-in if the break-in resistance performance of the security facility is exercised for more than five minutes.
Kim, Chang-Seok;Lee, Sun-Dong;Kim, Pan-Gyi;Lee, Jang-Woo;Park, Hae-Mo
Journal of Society of Preventive Korean Medicine
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v.9
no.2
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pp.59-75
/
2005
The experiments were undertaken to evaluate the effects of Bosaengtang in pregnant rats and fetuses. Female Sprague-Dawley rats were orally administered with Bosaengtang at the dose of 5mg/kg/day for 20 days. Pregnant rats were sacrificed at the 20th day of gestation, and observed internal and reproductive organs. Fetuses were randomly selected and fixed in 95% ethanol. Fetuses were stained with alcian blue and alizarin red S, and observed skeletal malformations. The results obtained were as follows : Bosaengtang administered group showed higher maternal body weight than the control group, but both groups showed increase in weight. Bosaengtang administered group showed lower than the control group, and higher liver and kidney weight than the control group, but the differences were minimal. There were no significant changes between the control and treated group in blood chemistry values and hematological values but all the groups were within in normal ranges. There were no significant changes in the number of corpus luteum, implantation, live fetus and implantation rate, delivery rate, late resorption rate, sex ratio, but Bosaengtang administered group showed higher early resorption rate than control group. comparing the control and Bosaengtang group, neonatal body weight and the number of fetuses were increased in Bosaengtang group. The fetuses of dams treated with Oriental medicine didn't showed external malformation. Vertebral and sternal variations were observed in Bosaengtang group, but the differences were not apparent compared to the control group. The number of ribs, cervical, thoracic and lumbar vertebrae were normal. The number of sacral was similar and the number of caudal was increased. Fetuses showed significant difference in the number of caudal vertebrae. (P<0.01) From these results, we can carefully conclude that Bosaengtang showed beneficial effects on maternal body weight, early resorption rate, number of live fetus. There were no significant changes in organ weight, hematoscopy, reproduction organs. External malformation wasn't visible. Skeletal variations were showed in vertebrae and sternum but compared to the control group, these variations weren't much different.
The dynamics of inorganic nutrients and phytoplankton population were examined at eight stations of Shihwa Reservoir, which situated near the cities newly constructed and the industrial complex of West-sea in Korea, from January to December 1999. Among environmental factors, average concentration of $NH_4$, SRP and SRSi were $522.7\;{\mu}g\;N/l$, $9.8\;{\mu}g\;N/l$ and $0.26\;{\mu}g\;Si/l$, respectively. Water quality was extremely deteriorated by a great amount of pollutants load into inner reservoir after the event of rainfall. Nutrients concentration was suddenly decreased toward the lower part. While $NO_3$ concentration did not much varied among stations, but it was relatively high in winter season. Chlorophyll-a concentration was high at the upper part of the reservoir, with average of $37.2\;{\mu}/l$, and closely related to the fluctuation of $NH_4$, SRP and SRSi concentrations. The phytoplankton development in the water column was dominated by diatom (autumn), prasinoid (winter) and dinoflagellate (summer). Dominant phytoplankton were composed to Skeletonema costatum of diatom, Prorocentrum minimum of dinoflagellate, Chroomonas spp. of cryptomonad, Eutreptiella gymnastica of euglenoid and Pyramimonas spp. of prasinoid. The large bloom of phytoplankton at the upper zone of the Shihwa Reservoir after inflow of a seawater were consistently observed. In consequence, water quality management of the inlet stream was assessed to be very important and urgent.
Purpose: Adaptive statistical iterative reconstruction (ASIR) technique is a reconstruction method of CT image using statistical noise modeling which is known to reduce image noise and to preserve image quality despite reducing radiation dose. The aim of this study is to evaluate images using ASIR on bone SPECT/CT which is primarily performed in our hospital. Materials and Methods: We compared the images of applied ASIR (ASIR level: 20-80%) and none ASIR by changing the mA based on 120 kVp, 100 mA using Discovery NM/CT 670 (GE, U.S.A). First, we evaluated attenuation correction in SPECT image by changing the ASIR level using Anthropomorphic phantom. Second, we compared the contrast to noise ratio (CNR), image noise and spatial resolution in CT image using ACR phantom. Third, after selecting the ASIR level applicable patient using lower torso phantom, we examined 2 patients who followed up bone SPECT/CT and we performed blind test. Results: The degree of attenuation correction in SPECT image showed no significant difference between applied ASIR and none ASIR (P>0.05). When applied ASIR, the noise of CT image were reduced at least 17 up to 52% by changing the mA. The CNR of image with ASIR was maintained more than 0.8 at 40 mA (ASIR 60%) while those without ASIR showed 0.42 at standard 40 mA. In comparison of the high contrast object, we distinguished 12 line pairs/cm at 40 mA regardless of appling ASIR. Comparison of the patients image applied ASIR level 60% (40 mA) which found out by spine image of lower torso phantom showed no signigicant difference between applied ASIR and none ASIR in blind test. The CTDIvol and DLP for applied ASIR 60% showed decreased by 60%, 60% on average than using standard mA. Conclusion: The study show that the radiation dose in SPECT/CT using ASIR can be reduced despite degradation of SPECT and CT images. In addition, higher ASIR level could be possibly applied characteristics of SPECT/CT that region of interest is limited to bone.
Kim, Kil-Ja;Kim, Da-Mi;An, Ho-Sub;Choi, Jin-Kyung;Kim, Seon-Gon
Journal of Mushroom
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v.17
no.4
/
pp.211-217
/
2019
Currently, cultivation of mushrooms using the Information and Communication Technology (ICT)-based smart farming technique is increasing rapidly. The main environmental factors for growth of mushrooms are temperature, humidity, carbon dioxide (CO2), and light. Among all the mentioned factors, currently, only temperature has been maintained under automatic control. However, humidity and ventilation are controlled using a timer, based on technical experience.Therefore, in this study, a Pleurotus eryngii first-generation smart farm model was set up that can automatically control temperature, humidity, and ventilation. After installing the environmental control system and the monitoring device, the environmental condition of the mushroom cultivation room and the growth of the fruiting bodies were studied. The data thus obtained was compared to that obtained using the conventional cultivation method.In farm A, the temperature during the primordia formation stage was about 17℃, and was maintained at approximately 16℃ during the fruiting stage. The humidity was initially maintained at 95%, and the farm was not humidified after the primordia formation stage. There was no sensor for CO2 management, and the system was ventilated as required by observing the shape of the pileus and the stipe. It was observed that, the concentration of CO2 was between 700 and 2,500 ppm during the growth period. The average weight of the mushrooms produced in farm A was 125 g, and the quality was between that of the premium and the first grade.In farm B. The CO2 sensor was in use for measurement purposes only; the system was ventilated as required by observing the shape of the pileus and the stipe. During the growth period, the CO2 concentration was observed to be between 640 and 4,500 ppm. The average weight of the mushrooms produced in farm B was 102 g.These results indicate that the quality of the king oyster mushroom is determined by the environmental conditions, especially by the concentration of CO2. Thus, the data obtained in this study can be used as an optimal smart farm model, where, by improving the environmental control method of farm A, better quality mushrooms were obtained.
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