• Title/Summary/Keyword: 실패 전이

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Clinical Results of Medial Unicompartmental Knee Arthroplasty in Elderly Patients Older than 70 Years of Age (70세 이상의 고령 환자에서 시행한 내측 슬관절 단일구획치환술의 임상 결과)

  • Kim, Kyung Tae;Lee, Song;Kim, Jin Hak;Lee, Ho Young;Kim, Myung Jin
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.34-41
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    • 2021
  • Purpose: To evaluate the long-term clinical results and survivorship of unicompartmental knee arthroplasty (UKA) in elderly patients older than 70 years by analyzing cases that have been implanted for >10 years ago. Materials and Methods: The long-term follow-up results were evaluated in 39 patients (46 cases) who underwent medial UKA from March 2002 to February 2004. The mean age of the patients at the time of surgery was 74.0 years, and the preoperative diagnosis was degenerative arthritis of the knee in all cases. Results: Of the 46 cases, reoperation occurred due to the complications in four cases. In 22 cases without 14 cases of death and six cases of follow-up loss, follow-up more than 10 years was possible. The mean Knee Society knee and function scores improved significantly from 53.0 and 52.5 points pre-operatively to 89.4 and 80.9 points at the last follow-up, respectively (p<0.001). The mean range of motion of the knee recovered to 132.5°, and the mean tibiofemoral angle changed to 5.9° of valgus at the last follow-up. Complications following the UKA occurred in four cases; the most prevalent complication was mobile bearing dislocation (n=2). One case of failure occurred due to aseptic loosening and degenerative arthritis of the lateral compartment, respectively. The cumulative survival rate of the implants was 95.0% at 10 years and 85.7% at 15 years. Of the 40 cases, excluding six cases of follow-up loss, 36 cases (90.0%) could be used without reoperation until death or at the last follow-up after surgery. Conclusion: These results showed the outstanding functions of the knee and satisfactory long-term survivorship after UKA. Therefore, UKA could be a useful method for the treatment of osteoarthritis of the knee in elderly patients older than 70 years of age.

The Results of Radiation Treatment in Carcinoma of the Uterine Cervix (자궁경암의 방사선치료 성적)

  • Lee, Myung-Za;Kim, Jung-Jin
    • Radiation Oncology Journal
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    • v.3 no.2
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    • pp.95-101
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    • 1985
  • From July 1979 through March 1985,112 patients with carcinoma of the uterine cervix were treated by whole pelvis irradiation and intracavitary radiation with Cs-137. The treatment consisted of 3600rad-5200rad to the whole pelvis by parallel opposing portals, 5 days per week, 180-200rad per day. Parametrial boost with 400-800rad was given in 60 patients. 2 intracavitary Cs-137 radiation using TAO applicator were done with 7-10 days interval. Total treatment times were 40-65 days with average 52 days. Total dose of radiation to point A varied from 6820 to 10500rad with average 8388rad and to point B from 4850 to 6899ra0 with average 5898rad. All patients had follow up from 6 months to 75 months and median follow up of 31 months. $9(8\%)$ had stage $14(12.5\%)$ had stage IIa, $50(44.6\%)$ had stage IIb, $33(29.5\%)$ had stage III, $6(5.4\%)$ had stage IV. 110 patients had squamous cell carcinoma and 2 patients had adenocarcinoma. 5 year actuarial survival rates were $61.8\%$ for the entire group, $84.6\%$ for stage Ib,$77.8\%$ for stage IIa, $56.7\%$ for stage IIb, $60\%$ for stage III, $33.3\%$ for stage IV. RT dose to medial parametrium (point A) below 8000rad resulted in $7/18(38.9\%)$ failure (=death) in contrast to 25/94 $(26.5\%)$ failure with dose over 8000rad. RT dose to lateral parametrium (point B) below 6000ra0 yielded 20/63 $(34.9\%)$ failure compared to $10/49(20.4\%)$ failure with dose over 6000rad. Poor survival group of age were between 40-49 years with failure of $14/41(34.1\%)$. There was no increased failure rate below age of 40 with failure of $2111(13.9\%)$. The results suggest that survival is as good as other published data, and that higher doses over 8000rad to point A and 6000rad to point B should be delivered.

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A retrospective statistical analysis of dental implants (치과 임플란트 환자의 통계 분석에 관한 후향적 연구)

  • Zhao, Chun-Ri;Cho, In-Ho;Moon, Eun-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.3
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    • pp.266-272
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    • 2009
  • Statement of problem: The number of edentulous patients is increasing due to an aging society, which leads to increased demands and interests on implant restorations. Implant restorations are an effective treatment method for both complete and partially edentulous patients, and the success rate has been reported to be high. But because of the increased use of implants in various situations have resulted in frequent reports of failures on implant restorations. Various efforts to overcome these failures have been made. Purpose: The aim of this study was to investigate the statistic survival rate of dental implants on patients who were treated at Dankook University Dental Hospital during the past 10 years based on their charts. Materials and methods :The research was made for two different periods of time; The first investigation was for patients from August, 1998 to August, 2003 and the second was for patients from September, 2003 to April, 2007. Information on the number of implants placed, the location and distribution of implants, the duration between the first and second surgery, and the survival rate of implants were investigated from the patients'charts. Results: 1. According to the first investigation, 1680 implants were placed on 612 patients and the second investigation showed 2438 implants placed on 933 patients. Thus a total of 4118 implants on 1545 patients. 2. Among the 1545 patients, 884 patients were male (57.2 %) and 661 patients were female (42.8%). Out of 4118 implants, 1739 implants (42.2%) were placed on the maxilla, and 2379 implants (57.8%) on the mandible. Implants were placed most frequently in the posterior region of the mandible. A total of 2043 implants (53.2%) were placed in this region. 3. According to the first investigation, 57 out of 1680, implants failed, while from the second investigation, 17 out of 2438 implants were reported as failure. In total, 74 implants failed, which results in a 98.2% survival rate. 4. The average duration between the first and the second surgeries in maxillas decreased from 7.4 months to 6.8 months. The duration also decreased from 5.6 months to 5.0 months in mandibles. Conclusion: As shown in the results, the number of placed implants and the survival rate of implants were higher in the second investigation than that of the first investigation. And the time spent after the first surgery to the second surgery was less in the second investigation. Consequently, it can be presumed that the demand and consumption of dental implants as well as the survival rate will increase in the future.

The Outcome of Postoperative Radiation Therapy for Patients with Stage II Pancreatic Cancer (T3 or N1 Disease) (2기(T3 또는 N1) 췌장암 환자들의 수술 후 방사선치료의 성적 및 고찰)

  • Kim, Sang-Won;Kim, Myung-Wook;Kim, Wook-Hwan;Kang, Seok-Yun;Kang, Seung-Hee;Oh, Young-Taek;Lee, Sun-Young;Yang, Ju-No;Chun, Mi-Sun
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.213-218
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    • 2007
  • Purpose: To analyze retrospectively the outcome of postoperative radiation therapy with or without concurrent chemotherapy for curatively resected stage II pancreatic cancer with T3 or N1 disease. Materials and Methods: Between January 1996 and December 2005, twenty-eight patients completed adjuvant radiation therapy at Ajou University Hospital. The patients had either pathologic T3 stage or N1 stage. The radiation target volume encompassed the initial tumor bed identified preoperatively, resection margin area and celiac nodal area. In the case of N1 patients, the radiation field extended to the lower margin of the L3 vertebra for covering both para-aortic lymph nodes bearing area. The median total radiation dose was 50 Gy. Ten patients received concurrent chemotherapy. Results: Thirteen patients (46%) showed loco-regional recurrences. The celiac axis nodal area was the most frequent site (4 patients). Five patients showed both loco-regional recurrence and a distant metastasis. Patients with positive lymph nodes had a relatively high probability of a distant metastasis (57.1%). Patients that had a positive resection margin showed a relatively high local failure rate (57.1%). The median disease-free survival period of all patients was 6 months and the 1-and 2-year disease free survival rates were 27.4% and 8.2%, respectively. The median overall survival period was 9 months. The 2-and 3-year overall survival rates were 31.6% and 15.8%, respectively. Conclusion: The pancreatic cancer patients with stage II had a high risk of local failure and a high risk of a distant metastasis. We suggest the concurrent use of an effective radiation-sensitizing chemotherapeutic drug and adjuvant chemotherapy after postoperative radiation therapy for the treatment of patients with stage II pancreatic cancer.

Antimicrobial activity of eight root canal sealers before and after setting (8종 root canal sealers의 경화 전, 후의 항균효과에 관한 연구)

  • Fang, Denny Y.;Lee, Woo-Cheol;Lai, Chern H.
    • Restorative Dentistry and Endodontics
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    • v.27 no.2
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    • pp.207-211
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    • 2002
  • 항균 활성도는 Root canal sealer가 갖추어야 할 필수요소 중 하나이다. 본 연구는 최근 임상술식에 사용되고 있는 8종의 root canal sealer의 근관내 혐기성 세균에 대한 항균효과를 알아보기 위해 시행되었다. 또한 본 연구에서는 혼합직후의 경화되지 않은 sealer와 경화 7일 후 sealer의 항균효과도 비교하였다. 항균효과 측정을 위해 사용된 균주는 최근 실패한 근관치료 증례에서 배양되어 보고된 바 있는 Enterococcus faecalis와 근관내 주요 감염균인 그램음성 혐기성세균인 Staphylococcus aureus를 대상으로 하였고, Agar diffusion test 방법을 사용하였다. 실험방법으로는 2개의 paper disk에 신선하게 혼합한 각각의 sealer를 도포하여 한개의 disk는 즉시 실험에 사용하고 다른 한개의 disk는 일주일간 혐기성 배양기에서 경화시킨 다음 사용한다 각각의 균주를 Brucellar blood agar plate에 접종한 다음, sealer가 도포된 paper disk를 plate상에 올려놓는다. 대조군으로는 식염수에 침윤시킨 disc를 같은 방법으로 각 실험단계에 사용한다. 각 plate를 혐기성 배양기에서 48시간동안 배양한 뒤 실험에 사용한 sealer의 항균효과를 6mm paper-disk를 둘러싼 inhibition zone을 측정하여 평가한다. Fisher's PLSD분석방법 결과 E. faecalis에 대하여 경화 전과 후의 AH26모두 경화 전과 후의 Roth 801, Dentalis, Apexit, AH Plus, RSA그리고 경화 후의 MCS보다 유의성 있게 강한 항균효과를 나타내는 것으로 보고되었으며. 경화 후의 AH26은 경화 전의 AH 26, 경화 전의 Ketac Endo, 경화 전의 MCS보다 통계학적으로 유의성이 있는 항균작용을 하는 것이 관찰되었다 (p<0.05). 경화 후 Roth 801, 경화전과 후의 Dentalis, AH plus, Apexit, RSA는 E. faecalis에 대한 항균효과를 나타내지 못하였다. S. aureus에 대하여 경화후의 AH26이 경화 전과 후의 Roth 801, Apexit, AH Plus, RSA보다 유의성있는 항균효과를 보이는 것을 발견 할 수 있었고, 경화 전의 AH 26이 경화 후의 AH plus보다 나은 항균효과를 나타냄을 알 수 있었다. 또, 경화 전과 후의 Apexit, 경화 후의 AH Plus, 경화 전과 후의 RSA에서는 S. aureus에 대한 항균작용이 발견되지 않았다. 본 실험의 결과 AH26이 가장 강한 항균 작용을 갖는 것을 알 수 있었으며, 각 sealer의 경화 전과 후의 항균효과는 AH26이 경화 전보다 경화 후에서 더 강한 항균효과를 나타내는 것 이외에는 효과의 차이가 없었다.

The Results and Prognostic Factors of Chemo-radiation Therapy in the Management of Small Cell Lung Cancer (항암화학요법과 방사선 치료를 시행한 소세포폐암 환자의 치료 성적 -생존율과 예후인자, 실패양상-)

  • Kim Eun-Seog;Choi Doo-Ho;Won Jong-Ho;Uh Soo-Taek;Hong Dae-Sik;Park Choon-Sik;Park Hee-Sook;Youm Wook
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.433-440
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    • 1998
  • Purpose : Although small ceil lung cancer (SCLC) has high response rate to chemotherapy and radiotherapy (RT), the prognosis is dismal. The authors evaluated survival and failure patterns according to the prognostic factors in SCLC patients who had thoracic radiation therapy with chemotherapy. Materials and Methods : One hundred and twenty nine patients with SCLC had received thoracic radiation therapy from August 1985 to December 1990. Seventy-seven accessible patients were evaluated retrospectively among 87 patients who completed RT. Median follow-up period was 14 months (2-87months). Results : The two years survival rate was 13$\%$ with a median survival time of 14 months. The two year survival rates of limited disease and extensive disease were 20$\%$ and 8$\%$, respectively, with median survival time of 14 months and 9 months, respectively. Twenty two patients (88$\%$) of limited disease showed complete response (CR) and 3 patients (12$\%$) did partial response (PR). The two year survival rates on CR and PR groups were 24$\%$ and 0$\%$, with median survival times of 14 months and 5 months. respectively (p=0.005). No patients with serum sodium were lower than 135 mmol/L survived 2years and their median survival time was 7 months (p=0.002). Patients whose alkaline phophatase lower than 130 IU/L showed 26$\%$ of 2 year survival rate and showed median survival time of 14 months and those with alkaline phosphatase higher than 130 IU/L showed no 2 year survival and median survival time of 5 the months, respectively (p=0.019). No statistical differences were found according to the age, sex, and performance status. Among the patients with extensive disease, two rear survivals according to the metastatic sites were 14$\%$, 0$\%$, and 7$\%$ in brain, liver, and other metastatic sites, respectively, with median survival time of 9 months, 9 months, and 8 months, respectively (p>0.05). Two year survivals on CR group and PR group were 15$\%$ and 4$\%$, respectively, with a median survival time of 11 months and 7 months, respectively (p=0.01). Conclusion : For SCLC, complete response after chemoradiotherapy was the most significant prognostic tactor. To achieve this goal. there should be further investigation about hyperfractionation, dose escalation, and compatible chemo-radiation schedule such as concurrent chemo-radiation and early radiation therapy with chemotherapy.

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Radiation Therapy in Carcinoma of the Vulva A Review of Fifteen Patients (외음부 암의 방사선 치료)

  • Lee H. S.;Oh W. Y.;Suh C. O.;Kim G. E.;Park C. K.
    • Radiation Oncology Journal
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    • v.3 no.1
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    • pp.51-58
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    • 1985
  • This study analyzes fifteen patients who underwent a course of radiation therpy for their vulva cancer in the Department of Radiation Oncology, College of Medicine, Yonsei University from January, 1971 to April, 1985. Four patients had initial surgery for their vulva cancer and were subsequently treated by a course of adjuvant radiation therapy. Eleven patients were given radiation therapy as the initial course of therapy, and one of these was in adjuvant setting before radical surgery. Treatment in each instance was individuilzed and usually consisted of some components of external beam, brachytherapy, and/or electron beam therapy. Primary local control rate in all cases was $53\%(8/15),\;40\%(4/10)$ in the radiation therapy alone group and $80\%(4/5)$ in the radiation therapy combined with surgery group. Treatment failures were noted in 7/10 in the radiation therapy alone group and 2/5 in the radiation therapy combined with surgery group. The most common failure site was primary site failure(vulva).

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Prognostic factors influencing clinical outcome of nonsurgical endodontic treatment (비외과적 근관치료의 임상적 성공에 영향을 미치는 예측 인자들의 평가)

  • Kim, Seon-Ah
    • Restorative Dentistry and Endodontics
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    • v.35 no.6
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    • pp.436-444
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    • 2010
  • Objectives: This study aimed to assess prospectively the clinical outcome of nonsurgical endodontic treatment and identify patient- and tooth-related factors, rather than treatment-related factors, that were the best predictors of this outcome. Materials and Methods: The inception cohort comprised 441 teeth (320 patients) and 175 teeth (123 patients) were followed up for 1-2 years. Age, gender, presence of medical disease, number of canals, previous endodontic treatment, presence of sensitivity and pain, pulp vitality, swelling or sinus tract of pulpal origin on the gingiva, periapical radiolucency and tendency of unilateral bite on the affected tooth were recorded at treatment start. Results: The outcome was classified on the basis of periapical radiolucency as healed or non healed. The overall healed rate in these cases, including nonsurgical retreatment, was 81.1%. Four tooth-related factors had a negative impact in the bivariate analysis: previous endodontic treatment, necrotic pulp, preoperative gingival swelling or sinus tract of pulpal origin, and preoperative periapical radiolucency. Stepwise logistic regression analysis including patient-, tooth-related factors and level of the root canal filling as a treatment-related factor showed that preoperative gingival lesion (odds ratio [OR]: 4.4; p = 0.005), preoperative periapical radiolucency (OR: 3.6; p = 0.011), and $\leq$ 1-2 mm under root filling length (OR: 9.6; p = 0.012) were significant predictors of failure. Conclusions: A preoperative gingival lesion of pulpal origin can influence the outcome of nonsurgical endodontic treatment in addition to preoperative periapical radiolucency.

A New Viewpoint Drowned Repetitive Cycle of Flow vs Float Regulating History of Pansory and Floating Possibility of Lost Pansori in Age of Image Media (판소리사를 잠류·부상의 반복 싸이클로 보는 새로운 관점과 영상매체 시대 재매개화를 통한 실전판소리의 부상 가능성 - 실전판소리 <옹고집전>과 영화 <광해>를 통해)

  • Kwon, Do-Kyung
    • Cross-Cultural Studies
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    • v.42
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    • pp.165-203
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    • 2016
  • This study attempted to reconsider the existing viewpoint on the history of Pansori transmission and suggested a new viewpoint on lostPansori transmission. Untill now, lost seven songs have been criticized for failure in Pansory's transmission history because it ceased to satirize negativity of abnormal character without creating a bearer of new value goals in the new age this paper resulted in another conclusion which extends Pansori history's process to modern times in the point of succession and duration of Pansori esthetics. Currently the above reason creats a problem ofcomplete nonmention that confront Pansori's twelve songs which does not apply to lost seven songs. If the evaluation standard of literary history used for lost seven songs is applied to inherited five songs, The inherited five songs also failed in the esthetic cultural history of present times. To resolve this issue, this study suggested a new viewpoint to replace the existing viewpoint that label Pansori's history as a historical structure consisting of success of inherited five songs and failure of lost seven songs repetitive replacement cycle of float and flow. This study provided constructive on lost Pansory of premodern times and presented entire Pansori as a flowing state. This paper futher identified the stages of decline the lost seven songs since the 20thcentury but sets the stage or finding a new qualitative possibility. This new theory was suggested through extant aspects of the movie that was a reproduction of in the present media age.

Pre-radiotherapy and Post-radiotherapy Serial Serum Squamous Cell Carcinoma Antigen (SCC) and Carcinoembryonic Antigen (CEA) in the Monitoring of Squamous Cell Carcinoma of Uterine Cervix (자궁경부암 방사선치료시 Squamous Cell Carcinoma Antigen(SCC) 고k Carcinoembryonic Antigen(CEA) 의 종양표지자로서의 의의)

  • Yun, Hyong-Geun;Park, Choong-Hak
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.30-35
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    • 1999
  • Purpose : To evaluate the significance of squamous cell carcinoma antigen (SCC) and carcinoembryonic antigen (CEA) as tumor markers in uterine cervix carcinoma. Materials and Methods : In 22 patients with histologically proven primary squamous cell carcinoma of uterine cervix, tumor volume was checked either by using MRI (in 20 patients) or ultrasound (in 2 patients). Pre-treatment serum SCC levels were checked in 22 patients and CEA levels in 21 patients. After curative radiotherapy, post-treatment SCC and CEA were checked regularly. Results : SCC was raised In 68.2$\%$ and CEA was raised in 19.0$\%$ before treatment. The coefficient of correlation between tumor volume and pre-reatment SCC was 0.59382 when one extremely deviated case was excluded. And there was no correlation between tumor volume and CEA. After the treatment, SCC was raised En 9.1$\%$ and CEA was raised in 4.8$\%$. In further follow up measurement, raise of SCC was associated with clinical relapse or persistence of disease. The specificity of raised SCC level in association with recurrent or persistent disease was 93.8$\%$ . The sensitivity in association with recurrent or persistent disease was 100$\%$. The positive predictive values was 85.7$\%$. The median lead time for recurrence was 1.2 months. Conclusions: Both SCC and CEA were good tumor markers for monitoring treatment effect in patients with raised pre-treatment levels. But the sensitivity of pretreatment CEA was low, while that of pretreatment SCC was high. And there was no additional gain by adding CEA measurements to SCC measurements.

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