• Title/Summary/Keyword: 장기성과

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The Result of the Surgical Treatment for Non-small Cell Lung Cancer (비소세포성 폐암의 외과적 치료에 대한 성적)

  • Park, Jin-Gyu;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.899-907
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    • 1997
  • Recently, primary lung cancer has increased markedly in incidence & prevalence in korea. Prom July 1979 to June 1996, 183 patients were diagnosed and operated for primary non-small cell lung cancer, and evaluated clinically. 1. There were 164 males and 19 females(M:P=8.6: 1), and the peak incidence of age was 50th and 60th decade of life(73.7%). 2. Most of symptoms were respiratory, whitch were cough(44.8%), chest pain(30.1%), dyspnea(20.8%), hemoptysis or blood tinged sputum(19.7%), sputum(15.3%), and asymptomatic cases were 12.0%. 3. Histopathologically, sguamous cell carcinoma was 68.9%, adenocarcinoma 19.7%, bronchioloalveol r cell carcinoma 2.2%, adenosguamous cell carcinoma 1.6%, and large cell carcinoma 7.7%. 4. In the operation, pneumonectomy was 41.0%, lobectomy 42.1%, bilobectomy 13.1%, stagmentectomy or wedge resection 1.6%, and explore tharacotomy 2.2%, and the overall resectability was 97.8%. 5. Postoperative complications were developed in 31.9%, and operative mortality was 1.6%. 6. In postoperative stagings, stage I was 38.3%, stage H 14.8%, stage llla 31.1%, and stage IIIb 15.8%. 7. The overall cumulative survival rates were 1 year 77.8%, 3 year 42.7%, and 5 year 39.5%. The 5 year survival rate according to stage were stage 153.0%, stage H 46.5%, stage I[la 28.2%, and stage IIIb 13.8%(p<0.05), according to operation method were lobectomy 45.0%, and pneumonectomy 30.3%(p<0.05), and according to mediastinal involvement were Nl 32.0%, and N2 11.1%(p<0.05). The 5 year survival rate according to histologic type were squamous cell carcinoma 43.1%, adenocarcinoma 23.3%, and large cell carcinoma 30.3 (p>0.05).

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Development of Calcification-Resistant Bovine Pericardium with $PEO-SO_3$ (I) - An implantation study of bovine pericardium at aorta and pulmonary artery in canine model - ($PEO-SO_3$를 이용한 항석회화 조직첨포의 개발 (I) - 잡견을 이용한 대동맥과 폐동맥 이식 실험연구 -)

  • Kim, Hyoung-Mook;Baek, Man-Jong;Sun, Kyung;Kim, Kwang-Taik;Lee, In-Sung;Kim, Hark-Jei;Lee, Won-Kyu;Park, Ki-Dong
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.919-923
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    • 1998
  • Background: Calcific degeneration is unavoidable in either homo- or heterografts implanted in the human body. We have developed a calcification-resistant cardiovascular tissue patch using a novel technique of anticalcification. Materials and methods: Fresh bovine pericardium was harvested at the slaughter house and transfered to the laboratory in Hank's solution. After trimming and fixing the pericardium, it was embedded in 4$^{\circ}C$ 0.65% glutaraldehyde for a week and then washed by phosphate-buffered saline(PBS) of pH 7.4. This prepared pericardium was then stored in 2.5% sulphonated polyethyleneoxide(PEO-SO3) solution for 2 days at room temperature and reversed by 4$^{\circ}C$ NaBH4 solution for 16 hours. To evaluate the calcification-resistance of surface modified bovine pericardium with PEO-SO3, either glutaraldehyde- treated(GA group, n=4) or PEO-SO3-treated pericardial patch(PEO-SO3 group, n=4) was implanted into adult mongrel dog to reconstruct the main pulmonary artery and the descending aorta using a partial clamp technique. After 1 month follow-up, the implanted patches were retrieved to evaluate the pathologic findings and the content of calcium and phosphorous. Results: The PEO-SO3 group showed substantially less retraction and significantly less calcium deposition than the GA group in both aortic(7.10$\pm$1.05 vs. 13.81$\pm$2.33 mg/g of dried tissue) and pulmonary positions(1.55$\pm$0.29 vs. 6.72$\pm$0.70 mg/g)(p<0.01). Phosphorous contents were also less in the PEO-SO3 group than the GA group significantly, 8.11$\pm$1.07 mg/g vs. 19.33$\pm$4.31 mg/g in the aortic and 2.58$\pm$0.40 vs. 12.60$\pm$3.40 mg/g in thepulmonary position(p<0.01). Conclusions: These findings suggest that PEO-SO3 modified bovine pericardium is highly calcification-resistant but further study is needed to evaluate the long-term biological safety and compatibility of the prosthesis.

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Coronary Fistulas -20 years experience - (관상동맥루)

  • Lee Jeong Ryul;Jung Yo Chun;Choi Chang Hyu;Kim Woong Han;Kim Yong Jin;Bae Eun Jung;Noh Chung Il
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.609-615
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    • 2005
  • Background: Some controversy still exists concerning the operative indications of coronary fistulas. Nevertheless, a short-term and long-term outcomes are excellent with surgical interventions. In this study, we assessed our surgical results on this disease entity during the last 20 years. Anatomic diversity was described as well. Material and Method: From April 1986 to March 2005, 20 patients with coronary fistulas underwent surgical correction in Seoul National University Children's Hospital. Their medical records were reviewed retrospectively. Result: Twelve patients ($60\%$) were asymptomatic prior to surgery. All had electrocardiogram and echocardiogram and all but 3 had coro-nary angiogram preoperatively. Anatomically, none of them had two or more coronary fistulas. The sites of origin were left coronary system in 11 patients and right in 9. The draining sites were right ventricle in 11, right atrium in 3, left ventricle in 3, main pulmonary artery in 2, and superior vena cavae in 1. All of the involved, the coro-nary arteries were dilated or aneurismal. In 1 case, there was atherosclerotic change but no ischemic evidence in preoperative electrocardiogram. Operative techniques included external obliteration (13), internal obliteration (5), and both (2). External obliteration was done by ligation of the fistulous tract only in T patients, by fstula ligation plus plication in 3 and by plication or patch closure via fistulotomy in 3. There was no operative mortality. All of postoperative morbidities including transient sinus arrhythmia (2), complete atrioventricular block (1), decreased left ventricular function (2), ventricular tachycardia (1), pericarditis (1), and seizure (1) improved on discharge. The mean follow-up was 55.1$\pm$50.2 months (4.0 months${\~}$18.0 years) and there were no recurrences of fistula. There was 1 second operation for aortic root aneurysm, which developed after external patch closure of right coronary fistula. Conclusion: We demonstrated here that coronary fistulas can be cured with excellent clinical outcome and low operative risk under precise diagnosis. Understanding the anatomic diversity will help to construct surgical plans.

Establishment of a Buddhist Arboretum through a Survey of Temple Managers and Laypersons (사찰림 관리자와 일반인의 인식조사를 통한 불교수목원 조성방안)

  • Yi, Young-Kyoung;Yi, Pyong-In
    • Journal of the Korean Institute of Landscape Architecture
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    • v.42 no.1
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    • pp.104-114
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    • 2014
  • Nowadays, forests have been recognized as valuable resources for biological diversity and tourism/recreation. Temple forests occupy 1.3% of all the Korean forest and are under weak management although their ecological states are very good. Currently in the Buddhist society, the concern for the Buddhist arboretum has been raised as a good alternative for the practical use of temple forests to secure the sustainability of the temple forests as well as to actively meet the demand of the times for forests. This study aims to suggest establishment measures of Buddhist arboretum. This survey was performed on 105 temple forest managers and 130 laypersons. To summarize the results, the two groups differ in opinion. The temple forest managers more concerned for advertizing Buddhist culture and enhancing the image of the temple, while the laypersons had higher expectations for relaxation and education. However, they are similar in putting more emphasis on the conserving the heritage value of the temple and managing the temple forest. Above all, both groups evaluated the needs higher than the urgency and perceived managing temple forest as the most crucial function of a Buddhist arboretum. They also thought that a Buddhist arboretum should be planned to respond to the ecological characteristics of the temple area as well as to be non-exclusive to its users. Based on the important findings, five suggestions for a Buddhist arboretum were proposed. First, a Buddhist arboretum should be carried forward from a long-term point of view, developing a bond of sympathy between members of Buddhist society as well as conducting promotion and education to the general public. Second, the most significant function of a Buddhist arboretum should be preserving the temple forest, with the emphasis on relaxation and education. Third, in order to provide nonexclusive use, a Buddhist arboretum should provide mixed programs applicable to diverse user groups for high user satisfaction and educational effects. Fourth, the Buddhistic identification could be obtained through variety of plants closely associated with Buddhist culture. Lastly, in the process of collecting plants, it is also crucial to reflect the image of the temple and resource property so as to contribute itself in conservation and management of original temple forests. Thereby all Buddhist Arboretum can be classified into two types; preservation/collection and display/education/rest.

Infliximab: The Benefit for Refractory Crohn Disease and Top-down Induction Therapy in Severe Crohn Disease (Infliximab: 불응성 크론병 치료법으로서의 유용성과 Top-down 관해 유도 요법으로서의 가능성)

  • Lee, Jee-Hyun;Lee, Hae-Jeong;Park, Sung-Eun;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.28-35
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    • 2008
  • Purpose: The aim of this study is to report the efficacy of infliximab, a monoclonal antibody directed against tumor necrosis factor alpha which is used for both treatment of refractory pediatric Crohn disease (CD) and induction of remission. Methods: Among pediatric patients who were diagnosed with CD at Samsung Medical Center between March 2001 and August 2007, a total of 16 patients were given infliximab to treat conventional therapyresistant refractory CD and severe active CD for induction of remission. Patients needing maintenance therapy were treated with an infliximab infusion every 8 weeks, and fistulizing CD patients occasionally received the infusion upon the condition that a fistula developed. The efficacy of treatment was assessed by comparing the Pediatric Crohn Disease Activity Index (PCDAI), Hct, ESR, CRP, and serum albumin levels using paired t-test. Results: The male/female ratio was 13:3, and the median age was 13 years (range, 21 months~15 years). The patients included 7 cases of therapy-resistant refractory CD, 7 cases of severe active CD, and 2 cases of fistulizing CD. Mean PCDAI before infliximab therapy was 34.19${\pm}$14.96, and mean follow-up PCDAI within 2 to 4 weeks after the last infusion was significantly lower, at 6.88${\pm}$10.31 (p=0.000). Hematological markers such as ESR (p=0.000), serum albumin (p=0.016), and CRP (p=0.009) also improved significantly after infusion. Remission was achieved in 2 of 4 patients refractory to conventional therapy. Among 3 steroid-dependent patients, 2 were able to discontinue steroid therapy, and dose reduction was possible in 1 patient. Remission after top-down therapy without prior use of other immunomodulators was achieved in 6 weeks in all 7 of the patients who had severe CD. Nine of ten refractory fistulizing CD patients also showed improvement after infliximab therapy. Conclusion: Infliximab was effective in pediatric refractory CD for induction of remission and maintenance therapy, as well as in severe CD for top-down induction therapy. Furthermore, infliximab has contributed to steroid cessation and dose reduction. Long-term follow-up evaluation is needed to determine safety and efficacy of infliximab in the future.

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Current Status of Children on Peritoneal Dialysis in Korea : A Cross-Sectional Multicenter Study (소아복막투석의 현황: 다기관 공동연구 결과보고)

  • Youn, Ji-Seok;Lee, Joo-Hoon;Park, Young-Seo;Yim, Hyung-Eun;Paik, Kyung-Hoon;Yoo, Kee-Hwan;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.176-188
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    • 2009
  • Purpose : Peritoneal dialysis (PD) is the major form of dialysis in use for infants and children with end-stage renal disease (ESRD). The aim of this study was to gain insight into the current status of children on PD in Korea. Methods : In May 2008, questionnaires were sent to the pediatric nephrologists via e-mail. Four centers replied and those data were reviewed. Results : A total of 103 patients were included in this study. Male to female ratio was 1.6:1. Mean age was $11.5{\pm}4.9$ years (0-19 years). Primary renal diseases diagnosed were as follows: primary glomerular disease (34%), chronic pyelonephritis-reflux nephropathy (14.6%), systemic disease (9.7%), renal hypoplasia/dysplasia (8.7%), heredofamilial disease (6.8%), vascular disease (3.9%), drug-induced nephropathy (1.0%), and unknown (12.6%). PD modalities were as follows: CAPD (42.7%), CCPD (27.2%), NIPD (11.7%), and Hybrid (18.4%). Weekly total Kt/V was $2.1{\pm}0.7$ (0.3-4.1). Results of peritoneal equilibrium test were as follows: low 36.8%, low average 31.6%, high average 19.7%, and high 11.8%. Z-score for weight was $-1.00{\pm}1.20$ (-4.54~+2.50). Z-score for height was $-1.55{\pm}1.65$ (-9.42~+1.87). Growth hormone was administered in 24.3% of patients. Anti-hypertensive drugs were administered in 64.0% of patients. Laboratory findings were as follows: hemoglobin $10.5{\pm}1.4$ g/dL, calcium $9.7{\pm}0.7$ mg/dL, phosphorus $5.4{\pm}1.4$ mg/dL, and parathyroid hormone $324.2{\pm}342.8$ pg/mL. Conclusion : Primary glomerular disease was the most common cause of ESRD. CAPD was the most prevalent PD modality. Low and low average peritoneal transport type were common. Growth disturbance were noted in many patients. Some patients had hypertension even with anti- hypertensive drugs. Calcium-phosphorus levels were maintained adequately, but many patients had secondary hyperparathyroidism.

독창적 아이디어에서 창조적 혁신까지 : 인공씨감자 기술혁신 성공사례 분석

  • 현재호
    • Proceedings of the Technology Innovation Conference
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    • 1997.07a
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    • pp.222-223
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    • 1997
  • By analyzing the successful innovation case of potato microtuber mass production technology, a representative case of technology-push type creative innovation in an imitation oriented research culture, this paper attempts to figure out conceptual model of creative innovation that is initiated by the public laboratories in catching-up country, Stages of creative innovation can be divided into the internal R&D stage and the external commercialization stage. Success of the internal R&D stage depended on autonomy to secure creative research idea and commitment of individual researchers. Psychological pressure evoked from sportlights of mass media and commitment of sponsor increased the intensity of research efforts of the researcher Recognition of research problem and its significance was intensified by site visits of agricultural fields, and the recognized higher impacts of expected research results and knowledge creation achieved were a fundamental source of self-motivation. In the stage of commercialization stage, various legal, socio-economic, and psychological barriers were confronted. In a catching-up country lacking of experiences of creative innovation, creative innovation process can be regarded as a barrier elimination and cultural revolution process. Among the barriers, psychological refusal of farmers to corn-sized potato seeds was critical, which finally enforced to further researches to enlarge the size of potato seeds. In addition, the researcher has concentrated his research efforts in one specialized research area by getting a series of similar research project funds rather than diversification. It was lucky for him to have a chance to carry out a series of similar researches in one research area during the last 10 years. In getting research funds from government and private companies continuously in one research area, both internal and external promoters played significant roles.

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Development and Application of the Slope Management Program in Urban Area (대도시 사면관리프로그램 개발 및 적용)

  • Kim, Kyeong-Su;Chae, Byung-Gon;Cho, Yong-Chan;Lee, Choon-Oh;Song, Young-Suk
    • The Journal of Engineering Geology
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    • v.17 no.1 s.50
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    • pp.15-25
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    • 2007
  • In general, the life and asset casualties that occur due to landslide or slope failure in urban areas are larger than that in rural areas. In order to reduce the casualties, a slope management program is necessary to categorize slopes based on properties and to manage them systematically. The slope management system is the establishment of the data base for the geological and geotechnical factor according to slope stability, and the utilization of the data base to manage slopes. The suitable system must develop to slopes in urban area through the survey, analysis and evaluation process. Based on the above necessity, the slope management program which is applicable to slope management in an urban area has been developed at Hwangryung Mt. in Busan as a target area. The developed slope management program has various functions such as slope ID number of each slope or sub-region of a mountain, making a slope data sheet, analysis and grouping of slope stability, and establishment of a data base. The slope management program is constructed by use of GIS, and the survey, test and analysis data according to all slopes can be input and edited into the program. The program can also be utilized practically by end users due to the convenient input, edition printing, management and operation of slope data. Therefore, the slope management system has been established on the application of the developed program in Busan which is located in slope area. As the system is widely applied to other cities, the slope in urban area can be managed systematically and the slope hazards can be minimized.

Patient Position Verification and Corrective Evaluation Using Cone Beam Computed Tomography (CBCT) in Intensity.modulated Radiation Therapy (세기조절방사선치료 시 콘빔CT (CBCT)를 이용한 환자자세 검증 및 보정평가)

  • Do, Gyeong-Min;Jeong, Deok-Yang;Kim, Young-Bum
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.2
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    • pp.83-88
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    • 2009
  • Purpose: Cone beam computed tomography (CBCT) using an on board imager (OBI) can check the movement and setup error in patient position and target volume by comparing with the image of computer simulation treatment in real.time during patient treatment. Thus, this study purposed to check the change and movement of patient position and target volume using CBCT in IMRT and calculate difference from the treatment plan, and then to correct the position using an automated match system and to test the accuracy of position correction using an electronic portal imaging device (EPID) and examine the usefulness of CBCT in IMRT and the accuracy of the automatic match system. Materials and Methods: The subjects of this study were 3 head and neck patients and 1 pelvis patient sampled from IMRT patients treated in our hospital. In order to investigate the movement of treatment position and resultant displacement of irradiated volume, we took CBCT using OBI mounted on the linear accelerator. Before each IMRT treatment, we took CBCT and checked difference from the treatment plan by coordinate by comparing it with the image of CT simulation. Then, we made correction through the automatic match system of 3D/3D match to match the treatment plan, and verified and evaluated using electronic portal imaging device. Results: When CBCT was compared with the image of CT simulation before treatment, the average difference by coordinate in the head and neck was 0.99 mm vertically, 1.14 mm longitudinally, 4.91 mm laterally, and 1.07o in the rotational direction, showing somewhat insignificant differences by part. In testing after correction, when the image from the electronic portal imaging device was compared with DRR image, it was found that correction had been made accurately with error less than 0.5 mm. Conclusion: By comparing a CBCT image before treatment with a 3D image reconstructed into a volume instead of a 2D image for the patient's setup error and change in the position of the organs and the target, we could measure and correct the change of position and target volume and treat more accurately, and could calculate and compare the errors. The results of this study show that CBCT was useful to deliver accurate treatment according to the treatment plan and to increase the reproducibility of repeated treatment, and satisfactory results were obtained. Accuracy enhanced through CBCT is highly required in IMRT, in which the shape of the target volume is complex and the change of dose distribution is radical. In addition, further research is required on the criteria for match focus by treatment site and treatment purpose.

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DEVELOPMENT OF A LYMAN-α IMAGING SOLAR TELESCOPE FOR THE SATELLITE (인공위성 탑재용 자외선 태양카메라(LIST) 개발)

  • Jang, M.;Oh, H.S.;Rim, C.S.;Park, J.S.;Kim, J.S.;Son, D.;Lee, H.S.;Kim, S.J.;Lee, D.H.;Kim, S.S.;Kim, K.H.
    • Journal of Astronomy and Space Sciences
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    • v.22 no.3
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    • pp.329-352
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    • 2005
  • Long term observations of full-disk Lyman-o irradiance have been made by the instruments on various satellites. In addition, several sounding rockets dating back to the 1950s and up through the present have measured the $Lyman-{\alpha}$ irradiance. Previous full disk $Lyman-{\alpha}$ images of the sun have been very interesting and useful scientifically, but have been only five-minute 'snapshots' obtained on sounding rocket flights. All of these observations to date have been snapshots, with no time resolution to observe changes in the chromospheric structure as a result of the evolving magnetic field, and its effect on the Lyman-o intensity. The $Lyman-{\alpha}$ Imaging Solar Telescope(LIST) can provide a unique opportunity for the study of the sun in the $Lyman-{\alpha}$ region with the high time and spatial resolution for the first time. Up to the 2nd year development, the preliminary design of the optics, mechanical structure and electronics system has been completed. Also the mechanical structure analysis, thermal analysis were performed and the material for the structure was chosen as a result of these analyses. And the test plan and the verification matrix were decided. The operation systems, technical and scientific operation, were studied and finally decided. Those are the technical operation, mechanical working modes for the observation and safety, the scientific operation and the process of the acquired data. The basic techniques acquired through the development of satellite based solar telescope are essential for the construction of space environment forecast system in the future. The techniques which we developed through this study, like mechanical, optical and data processing techniques, could be applied extensively not only to the process of the future production of flight models of this kind, but also to the related industries. Also, we can utilize the scientific achievements which are obtained throughout the project And these can be utilized to build a high resolution photometric detectors for military and commercial purposes. It is also believed that we will be able to apply several acquired techniques for the development of the Korean satellite projects in the future.