• Title/Summary/Keyword: 임상 경과

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Diagnosis of Meniscal Tear of the Knee Using Proton-weighted Fast Spin-Echo MR Imaging : Can be an Alternative to Conventional Spin-Echo Imaging\ulcorner (양지밀도강조 고속 스핀에코 자기공명영상을 이용한 슬관절 반월판 열상의 진단 : 고식적 스핀에코를 대체할 수 있는가\ulcorner)

  • 김기준;이재희;주종관;이성용
    • Investigative Magnetic Resonance Imaging
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    • v.3 no.1
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    • pp.73-77
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    • 1999
  • Purpose : The purpose of the study was to evaluate the sensitivity and specificity of proton-weighted fast spin-echo MR imaging in diagnosing the meniscal tear of knee as an reasonable substitute for conventional spin-echo imaging. Materials and Methods : 102 consecutive patients, proved by surgery, proved by surgery, were participated in this study. All of them were suspected internal derangement of knee, examined by fast spin-echo MR imaging including sagittal and coronal images on a 1.5T MR imager and underwent arthroscopic or open surgery of knee joint within 2 months. These images were reviewed retrospectively by three radiologists. The sensitivity and specificity of meniscal tear were calculated. Results : The sensitivity and specificity of meniscal tear using proton-weighted fast spin-echo MR imaging were 94%, 93% inmedialmeniscus and 92%, 88% in lateral meniscus. Conclusion : The sensitivity and specificity of meniscal tear using proton weighted fast-spin echo MR images were as high as those using conventional spin-echo images. The proton-weighted fast-spin echo MR imaging can be an alternative to conventional spin-echo MR imaging in diagnosing meniscal tear of the knee.

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Remote Afterloading High Dose Rate Brachytherapy AMC EXPERIANCES (원격조정 고선량 근접 치료)

  • Park, Su-Gyeong;Chang, Hye-Sook;Choi, Eun-Kyong;Yi, Byong-Yong;Kim, Jae-Sung
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.267-275
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    • 1992
  • Remote afterloading high dose rate brachytherapy (HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures peformed at Asan Medical Center for 3 years. From Sep. 1989 to Aug 1992, 471 procedures of intracavitary radiation in 58 patients of cervical cancer and 26 of nasopharyngeal cancer,79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range $1\~31$ months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, $80{\%}$ achieved palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.

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Regression of Left Ventricular Hypertrophy after AVR in Aortic Valvular Stenosis (대동맥판막협착증 환자에서 판막치환 후 좌심실심근비후의 변화)

  • 이재원;최강주;송명근
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.586-590
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    • 1998
  • Background: The regression of the left ventricular hypertrophy after prosthetic valve replacement in patients with aortic valvular stenosis is an important factor to determine the appropriateness of the replaced prosthetic valvular size. Methods: To assess the regression of myocardial hypertrophy, a retrospective analysis of Doppler echocardiographic and electrocardiographic data was undertaken before, soon after(7.5$\pm$2.1 day), and late after(10.7$\pm$1.8 months) surgery in 36 patients(22 males, 14 female, mean age 54$\pm$12.1 years, mean BSA 1.61$\pm$0.15m2) with predominant aortic valvular stenosis. The patients underwent St. Jude Medical aortic valve replacement. By the size of the valves used, the patients were divided into three groups(19, 21 and 23+). Results: The mean body surface area(1.48$\pm$0.13) in the patients with the 19 mm valve was smaller than that in the other groups(1.63$\pm$0.12)(p<0.05). No significant changes of ejection fraction were detected in all groups over time. Left ventricular muscle mass index(gm/m2) was reduced significantly in the 21 and 23+ groups over time(p<0.05), but there were no significant changes in the 19 mm valve group. The electric voltage height on EKG at the period of late after surgery was reduced significantly in all groups(p<0.05). Conclusion: Despite clinical improvement, the LVH was not reduced significantly in 19 mm valve group. Thus we suggest that more attention and additional procedures such as annular enlargement should be taken in patients who will undergo the replacement of 19 mm prosthetic valve.

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Needle Thoracoscopic Sympathectomy for Essential Hyperhidrosis (2 mm 흉강내시경을 이용한 흉부교감신경 절제술)

  • 이두연;윤용한;홍윤주;문동석
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.598-603
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    • 1998
  • Excessive sweating of the palms, axillae, and face has a strong negative impact on the quality of life for many people. The existing non-operative therapeutic options seldom give sufficient relief and have a transient effect. But a definitive cure can be obtained by upper thoracic sympathectomy. From June 1997 to October 1997, 117 cases of the needle (2 mm) thoracoscopic thoracic sympathectomies were performed in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center Yong-dong Severance Hospital in Seoul, Korea. We have followed up on 94 cases which include palmar hyperhidrosis (n=85), facial hyperhidrosis(n=5) and axillary hyperhidrosis(n=4). There were 42 males and 52 females whose ages ranged from 14 to 63 years(median:23 years). The T2 ganglia and T3-4 ganglia were excised by electrocuting with a hook and endoscissors and were removed for histologic examination. There have been no mortalities or life-threatening complications. The surgical results were classified as excellent(much improvement,very dry) in 93.6%, good(some improvement, minimally wet) in 2.1%, and fair(slight improvement, still wet) in 4.2%. Five patients(5.3%) required closed thoracostomy drainage because of pneumothorax in the immediate postoperative day. Horner's syndrome occurred in one case. The compensatory sweating occurred in 67 cases(71.2%) and was embarrassing in 21 cases(22.3%) and disabling in 9 cases(9.6%) of these cases. Primary failure occurred in one case. The patient with primary failure underwent successful operation. Fifty-one patients had concomitant hyperhidrosis. Our experiences indicate needle thoracoscopic sympathectomy is a very effective, safe, and time- saving procedure for essential hyperhidrosis.

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Community dynamics of Salix species during the sedimentation in Paksil-nup Wetland, Hapcheon (합천 박실늪의 퇴적에 따른 버들류 (Salix sp.)의 군집 동태)

  • Kim, Cheol-Soo;Lee, Pal-Hong;Son, Sung-Gon;Oh, Kyung-Hwan
    • Journal of Wetlands Research
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    • v.2 no.1
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    • pp.19-29
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    • 2000
  • The physico-chemical characteristics of core sediment, community dynamics of Salix species during the sedimentation were investigated in 1990~1997 for the purpose of inquiry to reveal the effects of terrestrialization on the environment and plant community in a natural wetland. The study site, Paksil-nup wetland was a valley blocked lake located near Hwang-River, Hapcheon-gun, Gyeongsangnam-do, Korea. The values of conductivity, organic matter, total nitrogen, exchangeable K, and exchangeable Ca were higher, and pH was lower in the upper layer of the core sediment. Soil properties such as available phosphorus, exchangeable Ca, exchangeable Na increased, and organic matter, total nitrogen, exchangeable K decreased during the sedimentation. Salix nipponica was the dominant species, and Salix glandulosa was subdominant among 10 Salix species. Sahx species were supposed to be the pioneer plants in shrub and tree layers during the succession in Paksil-nup wetland. Age class of SaliX species community from the epilittoral zone to the infralittoral zone were low, and age of Saljx species distributed from 2 years to 11 years. DBH, height, mean number of branches, number of herb species, and light intensity were increased, whereas density was decreased from a lower age to a higher age community. Salix nipponica was superior than Sahx purpurea var. japonica and other Salix species during the interspecific competition among Salix species.

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Review of Clinical Studies on Oriental Medicine Treatment for Obesity in the Korean Literature (비만의 한방 치료에 대한 국내 임상 논문 고찰)

  • Moon, Su-Jeong;Kong, Jae-Cheol;Kwon, Young-Dal;Song, Yong-Sun;Han, A-Lum;Kwon, Young-Mi;Lee, Su-Kyung
    • Korean Journal of Oriental Medicine
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    • v.16 no.3
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    • pp.85-93
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    • 2010
  • The aim of this review is to investigate clinical studies on oriental medicine treatment for obesity in Korean literature and to propose for the better method of clinical studies in order to seek more effective treatment. Electric searches were performed with NDSL, National assembly library, RISS4U, DBPIA, KISS, KMBASE, KoreaMed, Korean traditional knowledge portal and Oasis. Also, 21 major journals associated with oriental medicine in Korea were searched manually. Eighty three studies were included and analyzed in terms of study design, subjects, interventions, results and evaluation of safety. The numbers of controlled, non-controlled and case studies are respectively 26(31%), 43(52%) and 14(17%). Studies using sample size less than 30 accounts for 49% and studies using subjects diagnosed as obese or overweight by specific criteria were 35(42%). Studies which used more than 2 interventions or co-interventions were 76%. Clinical studies which used single herbal medicine were few and clinically studied single herbal medicine were limited to ephedra. More than half of 83 studies were studied for 8 weeks and less. 12% of 69 studies(except case studies) were not statistically analyzed and studies which evaluated safety of intervention were 22(27%) and reported adverse events were 9(11%). To improve the quality of clinical studies on oriental medicine treatment for obesity, studies need to use restricted number of interventions and subjects need to specifically diagnosed as overweight or obese. In addition, various kinds of single herbs need to be clinically studied based on experimental studies and herbalogy.

Anterolateral Thigh Free Flap for Reconstruction after Wide Resection of Soft Tissue Sarcoma (악성 연부조직 종양의 광범위 절제 후 전외측 대퇴부 유리 피판을 이용한 재건술)

  • Park, Jong-Hyuk;Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.119-124
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    • 2008
  • Purpose: To present our experience with soft tissue reconstruction using anterolateral thigh free flap after resection of soft tissue sarcoma. Materials and Methods: Between January of 2003 and June of 2007, we treated 7 patients with soft tissue reconstruction using anterolateral thigh free flap after wide resection for soft tissue sarcoma. We retrospectively analyzed type and size of tumors, resection margin, size of defect after resection, time of operation, flap survival and complication. Results: The type of sarcoma was 3 synovial sarcoma, 2 malignant fibrous histiocytoma, 1 leimyosarcoma and 1 fibrosarcoma. The size of tumor varied from $3{\times}5\;cm$ to $7{\times}8\;cm$. The resection margins of tumors were negative in all cases. The size of soft tissue defect after resection varied from $6{\times}8\;cm$ to $15{\times}10\;cm$. The mean time of operation was 3.6 hours. All flaps were survived. Conclusion: Anterolateral thigh free flap appear to be ideal for reconstruction after wide resection of soft tissue sarcoma.

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Tissue conditioner in edentulous patients, depending on the time and the thickness of the changes affect the dimensional stability (무치악 환자에서 조직양화제(tissue conditioner)가 시간과 두께에 따라 체적안정성의 변화에 미치는 영향)

  • Shim, Youn-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.10
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    • pp.3794-3801
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    • 2010
  • This study evaluated the linear dimensional changes with the factor of time and thickness using of three commercially available tissue conditioners (Coe-Comport, Visco-Gel, Soft-Liner). The thickness of materials were changed (1.5mm, 3.0mm) and the percentage changes in dimension were measured at 1h(baseline), 12h, 24h, 3 days and 7days after specimen preparation. The obtained data were analyzed by ANOVA with the SAS/PC statistical package. From the results, large differences appear between the various tissue conditioners. The results suggested that the period recommended for forming functional impression would be 36h to 3days after insertion in the mouth. Depending on the type of tissue conditioner over time, as there were significant differences in the elastic change(p<0.05). Tissue conditioner of the 1.5mm, 3.0mm thickness were significantly different by the dimensional stability(p<0.05). Elastic deformation of the ideal itself, and resilient when compared only the look, Visco-Gel 3.0mm group, stability was the most stable volume. In addition, it is important to select tissue conditioners suitable for functional impression because of the wide range of dimensional stability among the materials.

Video Assisted Thoracic Surgery of Spontaneous Pneumothorax (비디오 흉강경을 이용한 자연성 기흉 수술)

  • Ryu, Ji-Yun;Kim, Seung-U;Jo, Gwang-Hyeon
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.512-516
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    • 1997
  • We have experienced 66 cases of video assisted thoracic surgery(VATS) of spontaneous pneumothorax. The patients ranged in age from 1 Syears to 46years(mean age, 22.3years) and male patients were sixty three. The indications of video assisted thoracic surgery of spontaneous pneumothorax were recurrence, continuous air leakage, visible blabs on the chest X-ray & others. Infraoperative findings were as follows; blabs, pleural adhesion and pleural effusion. The operation was performed under general anesthesia wit double lumen endobronchial tube. Operative procedures included blebectomy and/or wedge resection of lung, vibramycin Pleurodesis with mechanical abrasion. In most cases, postoperative courses were uneventful and patients were discharged without significant complications. VATS provided the benefits of lesser postoperative pain, rapid recovery, short hospitalization, and smaller scar of wound. Conclusively VATS is a new interesting modality of surgical treatment of spontaneous pneumothorax and also can be extensively applicable in the diagnosis and treatment of other intrathoracic disease.

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BORDERLINE DISORDER OF CHILDHOOD : 8 CASES (아동기 경계선 장애 : 8증례)

  • Hong, Kang-E;Lee, Jeong-Seop;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.3-17
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    • 1995
  • The so-called borderline children are characterised by disturbances in the sense of reality and interpersonal relationships, lack of control, fluctuation of functioning, uneven development and excessive anxiety. But the concept of borderline disorder of childhood is very difficult to define and diagnose in current classification system. The present study adapted the consensus symptoms in borderline children by Bemporad and Vera eight cases aged 7-11 were examined in 37 variables. Results are as follows 1) All subjects are boys and girl hardly be diagnosis n current diagnostic system and have many concurrent diagnoses. Common chief complaints in the sense of reality. 2) In KEDI-WISC test, the borderline children showed average intelligence, but performance IQ tends to be higher than verbal IQ. In Rorscharch test, they showed high thought disorder index, emotional instabilities and aggressive impulses. The results of TOVA suggested attentional deficit in half of the subjects. The organicity is not prominent. 3) Many of the borderline children were unwanted baby. Although primary care takers of all the subjects were their mothers there were moderate problems in caring attitude of their children and marital relationship with their husband. Sccioeconomic status was generally below middle class. Most of all subjects have delayed language development, but have overcome subsequently. Many subjects were rejected by peers because of their aggression. 4) The first visit of the subjects was about 6 years of age. Average duration of treatment was 2 years. All of them were treated in the outpatient basis except one. The effect of pharmacotherapy was doubtful and the necessity of long term play therapy was suggested. Although there were many limitations of method in present study, it was suggested that further research is needed for diagnostic criteria, epidemiology and treatment.

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