• Title/Summary/Keyword: 이식 전이

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Evaluation of the Potential of Retrograde Flow Competition in the Right Gastroepiploic Artery Graft for Coronary Artery Bypass Grafting (우위대망동맥을 이용한 관상동맥우회술 후 역행성 혈류 발생가능성의 연구)

  • Chung, Bong-Kyu;Sun, Kyung;Kwon, Joon;Kim, Kwang-Ho;Jung, Jae-Seung;Son, Ho-Sung;Lee, Sung-Ho;Kim, Kwang-Taik;Kim, Hyung-Mook
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.20-26
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    • 2002
  • Background: Due to the concern of flow competition or retrograde steal, it has been generally suggested that the right gastroepiploic artery(RGEA) pedicled graft should be used in critical coronary stenosis lesion. The study was designed to evaluate the potential of retrograde flow competition in the RGEA pedicled graft by measuring the native pressure differences(PD) between the normal coronary artery and celiac arterial pressure, which would be compared with trans-stenosis pressure gradients(TSPG) in coronary artery occlusive disease. Material and Method: Between July, 1998 and February, 1999, pressures of the right coronary artery and the right gastroepiploic artery(or the celiac artery) were measured in patients with the patent right coronary artery(n=12). The PD between the arteries was compared with the TSPG in the occlusive coronary arteries(n=32). Result: The pressures of the normal right coronary artery and celiac artery were 143$\pm$23 vs. 134$\pm$17mmHg in systole(p<0.005), 74$\pm$13 vs. 73$\pm$14mmHg in diastole(p=NS), and 100$\pm$16 vs. 97$\pm$15mmHg in mean (p<0.05). The PD between the arteries were -8~25mmHg in systole, -4~7mmHg in diastole, and -1~10mmHg in mean. The TSPG measured in the occlusive coronary arteries were -4~19(7$\pm$5.8)mmHg in the lesion less than 75% stenosis vs. 7~74(27$\pm$18.3)mmHg in the 75% or over stenosis lesion(p<0.005). The normally existing pressure difference between the coronary arteries and RGEA(15~20mmHg) was significantlyless than the TSPG in .the occlusive coronary artery with 75% or over stenosis(p<0.001). Conclusion: If the pressure gradient between the RGEA and the coronary artery distal to the stenosis is the main determinant of development of retrograde flow competiton in the RGEA pedicled graft, the above data suggests that there will be little chance of competition when It is used in the coronary lesion with 75% or over stenosis.

Pulmonary Toxicity Following High-Dose Chemotherapy With Peripheral Blood Stem Cell Transplantation (고용량 항암화학요법 후에 발생한 폐손상)

  • Lee, Sun-Min;Park, Kwang-Joo;Oh, Yoon-Jung;Cheong, Seong-Cheoll;Hwang, Sung-Chul;Lee, Yi-Hyung;Kim, Hyun-Soo;Lim, Ho-Yeong;Kim, Hugh-Chul;Yim, Hyun-Ee;Hahn, Myung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.77-89
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    • 1999
  • Background: High-dose chemotherapy is increasingly employed in many refractory malignant diseases. This therapy has been reported to increase response rate and survival benefits but it is also associated with higher treatment-related morbidity and mortality. We evaluated clinical characteristics and course of the pulmonary toxicity following high-dose chemotherapy with peripheral blood stem cell transplantation. Methods: Ninety-seven patients who had received high-dose chemotherapy with peripheral blood stem cell transplantation were evaluated. Five patients who developed lung lesions which were not related to infection nor primary malignant disease underwent transbronchial lung biopsy. The patients' clinical characteristics, treatments, and prognosis were reviewed retrospectively. Results: Five patients(5.1%) developed idiopathic pneumonia syndrome. The high dose chemotherapy regimens employed were cyclophosphamide, BCNU, and cisplatin in 3 cases, one case of BCNU, etoposide, Ara-C, and cyclophosphamide combination, and a regimen consisting of BCNU, etoposide, Ara-C, and melphalan. The total dose of BCNU used was 300-400 mg/$m^2$ and that of cyclophosphsmide was 6,000 mg/$m^2$. All of 5 patients received radiation therapy before this treatment. After an average duration of 14 weeks (4-26 weeks) of high-dose chemotherapy, patients developed cough, dyspnea and fever. The chest X-rays showed bilateral diffuse infiltration in 3 cases and the focal infiltration in the other 2 cases. All the patients received corticosteroid therapy as a treatment for the lung lesions. Two of them progressed to acute respiratory distress syndrome and died. Three patients recovered without residual lung lesion but one of them died of dilated cardiomyopathy. Conclusion: High-dose chemotherapy with peripheral blood stem cell transplantation especially which containing BCNU regimen may develop idiopathic pneumonia syndrome related to pulmonary toxicity and corticosteroid therapy may be bel1eficial in some cases.

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Outcome of patients with neuroblastoma aged less than 1 year at diagnosis (진단 시 1세 이하인 신경모세포종 환자의 치료성적)

  • Suh, Jung Min;Lee, Sang Goo;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe;Kim, Ju Youn;Cho, Eun Joo;Lee, Suk Koo;Kim, Jhingook;Lim, Do Hoon
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.93-98
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    • 2009
  • Purpose : The purpose of this study was to evaluate the clinical characteristics and outcomes of patients with neuroblastoma aged less than 1 year. Methods : From January 1997 to December 2007, 41 patients aged less than 1 year were diagnosed with neuroblastoma. Patients were divided into 3 risk groups according to the stage of the disease and N-myc amplification. Low-risk patients underwent surgery with (stage 2) or without (stage 1) short-term chemotherapy. Intermediate-risk patients underwent chemotherapy and surgery with or without local radiation therapy. High-risk patients underwent chemotherapy, surgery, radiation therapy, and high-dose chemotherapy/autologous stem cell rescue (HDCT/ASCR). Results : While tumor relapse occurred in only 1 patient, 7 patients died of treatment-related toxicities. Causes of treatment- related death included infection during conventional chemotherapy in 5 patients and acute myocarditis during HDCT/ASCR in 2 patients. The overall 5-year survival (${\pm}$ standard error) and 5-year event-free survival (EFS) rates after diagnosis for all 41 patients were $82.8{\pm}5.9%$ and $80.0{\pm}$6.3%$, respectively, with a median follow-up of 58 (9-137) months. The 5-year EFS rates for low-risk, intermediate-risk, and high-risk patients were 100%, $68.4{\pm}10.8%$, and $66.7{\pm}19.3%$, respectively. Conclusion : Increased efforts to reduce infection-associated toxicity deaths during conventional chemotherapy are needed to further improve the survival of patients with neuroblastoma aged less than 1 year.

In Pediatric Leukemia, Dose Evaluation according to the Type of Compensators in Total Body Irradiation (소아백혈병 환자의 전신방사선조사 시 조직보상체의 재질변화에 따른 선량평가)

  • Lee, Dongyeon;Kim, Changsoo;Kim, Junghoon
    • Journal of radiological science and technology
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    • v.38 no.1
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    • pp.17-21
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    • 2015
  • Total body irradiation(TBI) and chemotherapy are the pre-treatment method of a stem cell transplantations of the childhood leukemia. in this study, we evaluate the Quantitative human body dose prior to the treatment. The MCNPX simulation program evaluated by changing the material of the tissue compensators with imitation material of pediatric exposure in a virtual space. As a result, first, the average skin dose with the material of the tissue compensators of Plexiglass tissue compensators is 74.60 mGy/min, Al is 73.96 mGy/min, Cu is 72.26 mGy/min and Pb 67.90 mGy/min respectively. Second, regardless of the tissue compensators material that organ dose were thyroid, gentile, digestive system, brain, lungs, kidneys higher in order. Finally, the ideal distance between body compensator and the patient were 50 cm aparting each other. In conclusion, tissue compensators Al, Cu, Pb are able to replace of the currently used in Plexiglass materials.

Surgical Treatment of Dermatofibrosarcoma Protuberans of the Chest Wall (흉벽의 융기피부섬유육종의 수술적 치료)

  • Cho, Hyun-Min;Kim, Young-Jin;Lee, Tae-Yeon;Lee, Chan-Kyu;Seok, June-Pill;Lee, Yong-Hae
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.790-792
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    • 2010
  • A 77-year-old man presented with a huge protruding mass on the left anterior chest wall. The tumor was resected and diagnosed as dermatofibrosarcoma protuberans (DFSP). DFSP is an uncommon, intermediate-grade mesenchymal cutaneous tumor which extends deep into subcutaneous tissue and may invade through the fascial planes and into muscle but rarely metastasize. Histologically, DFSP is composed of spindle cells arranged in an irregularly whorled or storiform pattern. The histological diagnosis can be confirmed with immunohistochemical staining for CD34. We report a case of DFSP. The tumor was completely excised and the chest wall was reconstructed using latissimus dorsi muscle flap and skin graft.

A Clinical Study of the Severe Degenerative Diseases of Temporomandibular Joint (퇴행성 악관절 질환에 대한 임상적 연구)

  • Kim, Il-Kyu;Oh, Seong-Seob;Choi, Jin-Ho;Kim, Hyung-Don;Oh, Nam-Sig
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.3
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    • pp.270-276
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    • 1999
  • 저자등은 1996년 5월 부터 1999년 4월까지 인하대병원 치과에 악관절 질환을 주소로 내원한 958명의 환자 중 병력, 임상소견, 방사선학적 검사 결과 퇴행성 악관절 질환으로 진단된 68명에서 병록지 상에 기록된 환자의 성별, 나이, 주소, 병력, 현증상, 방사선학적 소견 및 치료방법 등에 관해 검사 후 다음과 같은 결론을 얻었다. 1. 남녀 발병 비율은 1:2로 여성에서 높았다. 2. 발병나이는 20대, 30대. 40대, 10대 순이었다. 3. 병력기간은 2년이상, 6개월이하, 1 - 2년 순이었다. 4. 전 환자에서 악관절 동통을, 44명의 환자에서 관절잡음을, 26명의 환자에서 개구제한을 호소하였다. 5. 그밖에 26명의 환자에서 관절부위에 민감성을, 5명의 환자에서 안면 비대칭을, 또한 개교합, 섬유성 악관절강직의 소견이 각각 2명의 환자에서, 양측성질환의 소견이 4명의 환자에서 관찰되었다. 6. 방사선학적 소견상, 15명 환자의 과두부에서 증식성 재성형소견(progressive remodeling)이, 51명의 환자에서 침식성 재성형소견(regressive or erosive remodeling)이 관찰되었으며, 침식성 재성형 환자 중 11명에서 과두주변부 증식성 재성형소견(peripheral remodeling or marginal lipping)이 관찰되었다. 7. 골증식체(osteophyte) 및 소성체(loose body)의 소견이 각각 2명의 환자에서 관찰되었다. 8. 약물에 의한 보존적 치료방법이 1차로 모든 환자에서 시행되었으며, 이중 12명의 환자는 교합안정장치를 병행하여 치료하였다. 9. 관절강내 스테로이드 주사요법에 의한 치료환자가 2명, 관절원판절제술 및 이개연골 이식술을 동반한 악관절성형술 환자가 각각 1명 및 2명이었다.

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Effect of Concentration of Carbon and Nitrogen Sources on the Sporulation and the Life Cycles of Zygosaccharomyces (Zygosaccharomyces 의 포자형성(胞子形成)과 Life Cycle 에 미치는 배지중(培地中)의 당농도(糖濃度) 및 질소농도(窒素濃度)의 영향(影響))

  • Ha, Duk-Mo
    • Applied Biological Chemistry
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    • v.10
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    • pp.101-105
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    • 1968
  • The effect of concentration of carbon and nitrogen sources on the sporulation and the life cycles of three strains of Zygosaccharomyces was investigated. The results are as follows: 1) The good sporulation of Zygosaccharomyces bisporus, delbruekii, and Z. steineri was obtained on solid medium containing 0 to 0.001% of nitrogen and 10 to 20% of glucose. The high content of nitrogen was detrimental to sporulation and asci were formed under 0.01% of nitrogen. 2) It is widely accepted that the life cycle of Zygosaccharomyces proceeds in the following way: Ascospore...Vegetative cells...Conjugation of vegetative cells...Sporulation...Ascopores But zygotes of Z. bisporus proceeded to vegetative cells when transfered to the suitable medium for vegetative reproduction, and then formed asci.

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In Vitro Performance Assessment of a Bioartificial Liver Packed with Polyurethane Foam (다공성 폴리우레탄 충진형 생인공간의 체외 성능 평가)

  • 이두훈;이지현;김성구;박정극
    • KSBB Journal
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    • v.16 no.1
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    • pp.24-29
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    • 2001
  • Recently hepatocyte-based bioartificial liver (BAL) and hepatocyte transplantation have been actively investigated to treat acute hepatic failure. The BAL acts as a bridge to provide patients with more time until a donor organ becomes available for transplantation or until their own liver can be regenerated. In this study, we manufactured a polyurethane foam (PUF) using 15% NCO-prepolymer with a pore opening that allows it to be used as a hepatocyte immobilizing material. Cubes of PUF (3 mm dim.) were seeded with rat primary hepatocytes at a density of 5.5$\pm$1.1$\times$ $10^6$ cells/$cm^3$ PUF by centrifuging them together. The cell laden PUF cubes were packed into a prototype reactor and perfused with a hormonally defined medium for a week. Hepatocytes in the pores of the PUF formed spheroids that showed stable ammonia removal and urea synthesis activities. The albumin production level was comparable to other BAL systems. The PUF packed hepatocyte bioreactor has the potential to be used as a BAL.

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Persistence of Cyanofenphos on Chinese Cabbage (배추중(中) Cyanofenphos의 잔류소장(殘留消長))

  • Lee, Hae-Keun;Park, Young-Sun;Hong, Jong-Uck;Talekar, N.S.
    • Korean Journal of Environmental Agriculture
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    • v.1 no.2
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    • pp.89-92
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    • 1982
  • Persistence of cyanofenphos on Chinese cabbage under the different climate conditions was studied by spraying the insecticide at the rate of 0.5 and 0.75 ㎏ AI/ha at 22 and 36 days after transplanting and monitoring its residues upto 35 days after the final spray. At both spraying rates the degradation patterns of the insecticide, regardless of climate condition, showed similar trends; cyanofenphos residues on Chinese cabbage declined rapidly upto 14 days after the final spray but more slowly thereafter. Half-life for cyanofenphos on Chinese cabbage was $6{\sim}7$ days. The half-life was little affected by the spraying rate and time. Based on the FAO/WHO maximum residue limit of cyanofenphos on common cabbage (2 ppm), it is recommended that the pre-harvest intervels of the insecticide on Chinese cabbage could be 16 and 19 days for 0.5 and 0.75 ㎏ AI/ha, respectively.

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Clinical Study of Surgical Treatment of Aortic Aneurysm (대동맥류의 수술적 치료에 관한 임상적 연구)

  • Ryu, Ji-Yun;Jeon, Hong-Ju;Jo, Gwang-Hyeon
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.300-307
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    • 1997
  • We have experienced 25 cases of aortic aneurysm from October 1987 to January 1996. Patients ranged in age from 26yrs to 73yrs(mean age 52. Syrs). There were 13 males and 12 females. Eighteen cases were thoracic aneurysm and seven were abdom nal aneurysm. The cause of aneurysm were dissecting in 16cases aneurysms and non-dissecting in 9 cases. Risk factors of aortic aneurysm were hypertension, hypercholesterolemia, Marfan's syndrome. In thoracic aneurysm patients, 1'S cases of dissecting aneurysm underwent aneurysmectomy and replacement of vessel interposition graft with or without coronary artery implantation on the graft. 6 cases of non-dissecting aneurysm underwent operation with same policy as dissecting aneurysm. In 7 case of abdominal aneurysm,all patients underwent aneurysmectomy and graft interposition with straight i)r Y graft. Thcre were 5 postoperative death(mortality 20%). Several cases of complications were improved with proper managements. All survivors showed improvement in clinical symptom and sign and discharged without specific complications.

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