• Title/Summary/Keyword: 조직원

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Effects of Modified Ultrafiltration in Pediatric Open Heart Surgery (소아 개심술에 있어서 변형초여과법의 효과)

  • 전태국;박표원
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.591-597
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    • 1997
  • Cardiopulmonary bypass in children is associated with capillary leak which results in an increase in total body water after open heart surgery The purpose of these studies was to assess the cardiopulmonary effects of modified ultrafiltration after pediatric open heart surgery Study h: Twenty-six consecutive children aged 0.1 ~ 10 years(median 7 months) underwent cardiac operation inc rporating modified ultrafiltration. After completion of cardiopulmonary bypass, modified ultrafiltration was commenced at the flow rate of 100~ 15011min for 3 ~ 14 min. After modified ultrafiltration, elevation of hematocrit(28.3% $\pm$ 3.6% vs. 33.8olo $\pm$ 4.Ooloi p < 0.001), increased systolic 1)loots Pressure(66.7 $\pm$ 11.2mmHg vs. 76.2$\pm$ 11.BmmHg, p < 0.02), and decreased central venous pressure(7.8 $\pm$ 3.7mmHg vs. 6.9$\pm$ 2.gmmHg, p<0.001) were observed. Study B: Twenty-six children who underwent cardiac operation with the diagnosis of VSD under 2 years were assigned to control(n= 14) or modified ultrafiltration(n= 12). Peak inspiratory pressure checked immediately after operation was significantly lower in modified ultrafiltration group than in control group(20.0$\pm$ 2.4 cmH20 vs.22.4$\pm$ 2.3cmH20, p < 0.03). Modified ultrafiltration after cardiopillmonary bypass in children improves early homodynamics and pulmonary mechanics, and represents an excellent option for perioperative managemen of accumulation of fluid in the tissues. We will continually employ the modified ultrafiltration technique in pediatric cardiac operations.

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Video-Assisted Thoracic Surgery Lobectomy: Experience with 36 Cases (비디오 흉강경을 이용한 폐엽절제술: 치험 36예)

  • Lee, Hee-Sung;Lee, Jae-Woong;Kim, Kun-Il;Cho, Sung-Woo;Park, Sang-Jun;Kim, Hyoung-Soo;Shin, Yoon-Cheol;Shin, Ho-Seung
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.732-737
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    • 2009
  • Background: Many video-assisted thoracic surgery (VATS) lobectomies are performed as a potential alternative to thoracotomy despite the controversy about the safety and the associated morbidity/mortality rates. Material and Method: Between November 2006 and August 2008, we performed 87 lobectomies (VATS 36, Thoracotomy 51) and we retrospectively reviewed the surgical treatment results. A VATS lobectomy was performed by a 4~5 cm thoracotomy without rib spreading and this included anatomic hilar dissection, individual vessel and bronchus stapling and lymph node dissection. Result: We studied 52 male and 35 female patients whose age ranged from 6 to 79 (average age: $59.8{\pm}15.0$ years). The cases were diagnosed with lung cancer (66) (SQC 24, ADC 38, others 4), pulmonary metastasis (2), carcinoid (2) and benign diseases (17). There was no intraoperative death. Postoperative complications were seen in 5 (15.6%) VATS and 33 (64.7%) thoracotomies, and perioperative death caused by adult respiratory distress syndrome occurred in 1 (2.8%) VATS and 3 (5.9%) thoracotomies. Three patients Underwent conversion to thoracotomy (8.3%). The mean time to chest tube removal was 6 days for VATS and 9.4 days for thoracotomy (p<0.001), and the mean length of the hospital stay was 8 days for VATS and 12.8 days for thoracotomy (p<0.001). Conclusion: VATS lobectomy can be performed safely with low morbidity/mortality rates. Furthermore, all the patients benefited from earlier postoperative rehabilitation and less pain and they were candidates for an earlier return to normal activities.

An Analysis of Prognostic Factors Affecting the Outcome of Radiation Therapy for Nasopharyngeal Carcinoma (비인강암의 방사선치료 곁과 및 생존율에 관한 예후인자 분석)

  • Jung, Young-Yeon;Kim, Ok-Bae;Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.71-77
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    • 2005
  • Purpose: This retrospective study was conduced to analyze the treatment results and to evaluate the prognostic factors affecting the survival of nasopharyngeal carcinoma patients. Materials and Methods: From 1987 to 2002, we analyzed 43 patients who had nasopharyngeal carcinomas that were histologically confirmed and who had also completed the planned radiation therapy course at Keimyung University Dongsan Medical Center According to the 6th edition of American Joint Committee on Cancer staging system, 12 patients ($27.9\%$) were at Stage 11, 13 ($30.2\%$) were at Stage III and 18 ($41.9\%$) were at Stage IV Histopathologically, there were 15 ($34.9\%$) squamous cell carcinomas, 8 ($18.5\%$) nonkeratinizing carcinomas, 17 ($39.5\%$) undifferentiated carcinomas, and 3 ($7.0\%$) lymphoepitheliomas. Among the total 43 patients, 31 patients ($72.1\%$) were treated with only radiation therapy. Neoadjuvant chemotherapy was peformed on 7 patients ($16.3\%$) and concurrent chemoradiotherapy was performed on S patients ($11.6\%$). Cisplatin and 5-Fluorouracil were administered to 11 patients for 4 cycles, and Cisplatin and Taxotere were administered to 1 patient for 6 cycles. The range of the total radiation dose delivered to the primary tumor was from 61.2 to 84 Gy (median 70.4 Gy), The follow-up period ranged from 2 to 197 months with median follow-up of 84 months. Results: The local control rate at 6 months after radiation therapy was $90.7\%$. The five year overall survival and disease free survival rates were $50.7\%$ and $48.9\%$, respectively. On the multivariate analysis, the age, T-stage ($T_{1-3}\;vs\;T_4$), N-stage and AJCC stage were the statistically significant prognostic factors affecting survival (p<0.05). The patterns of failure were as follows: local failure only in 3 patients ($7.0\%$), local and systemic failure in 1 patient ($2.3\%$), and distant metastasis only in 11 patients ($25.6\%$). Conclusion: The prognostic factors affecting the outcome of nasopharyngeal carcinoma were age, T-stage (7$T_{1-3}\;vs\;T_4$), N-stage and stage. Because systemic metastasis was the main failure pattern noted for nasopharyngeal carcinoma, systemic chemotherapy is needed to decrease the rate of distant metastasis for nasopharyngeal carcinoma. In audition, research for more effective chemotherapeutical regimens and schedules is also needed.

Reirradiation in Rcurrent Cervical Cancer Following Definite Radiation Therapy (근치적 방사선치료 후 재발한 자궁경부암의 재 방사선치료)

  • Kim, Jin-Hee;Choi, Tae-Jin;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.230-236
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    • 2001
  • Purpose : To evaluate treatment results in terms of local control, complications and survival after reirraidiation in recurrent cervical cancer following definite radiation therapy. Material and methods : From November 1987 through March 1998, eighteen patients with recurrent cervical cancer following definite radiation therapy were subsequently treated with reirradiation at Keimyung University Dongsan Medical Center. In regard to the initial FIGO stage, one patient was stage la, five were stage IIa, three were IIb, two were IIb and two were IVa. The age range was 37 to 79 years old with median age of 57. The time interval from initial definite radiation therapy to recurrence ranged from 6 to 122 months with a median of 58 months. The recurrent sites were the uterine cervix in seven patients, vagina in ten and pelvic lymph node in one. Reirradiation was peformed with external radiation and intracavitary radiation in twelve patients, external radiation and implantation in four and external radiation alone in two. The range of external radiation dose was $2,100\~5,400\;cGy$ and the range of the total radiation dose was $3,780\~8,550\;cGy$. The follow-up periods ranged from 8 to 20 months with median of 25 following reirradiation. Results : Fourteen of eighteen patients $(78\%)$ had local control just after reirradiation. The two year disease free survival (2YDFS) rate was $53.6\%$. There were statistically significant differences in the 2YDFS according to both recurrent site (2YDFS $28.5\%$ in uterine cervix, $71.4\%$ in vagina, (p=0.03)) and the total dose (2YDFS $71.8\%$ in >6,000 cGy , $25\%$ in $\leq6,000$ cGy, p=0.007). Seven of ten patients who were followed for more than 20 months remain alive and disease free (7/18, $39\%$). Patients treated with external radiation and intracavitary radiation had a higher rate of 2YDFS. Seven patients including 4 patients with no local control experienced local failure in the uterus or vagina and two patients died with distant metastasis. Complications included rectal bleeding in 3 patients, bowel obstruction treated with surgery in two, hematuria in one, radiation cystitis in two, soft tissue swelling in two and vaginal necrosis spontaneously healed in one. There was no statistical difference in complications according to the total dose or the time to recurrence from initial radiation. Conclusion : In patients with recurrence following definite radiation therapy in the uterine cervical cancer, reirradiation may be effective but requires an effort to reduce radiation induced severe complications.

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Concurrent Chemoradiation in Patients with Cancer of the Esophagus (식도암에서의 동시화학방사선요법)

  • Lee Kang Kyoo;Park Kyung Ran;Lee Jong Young;Shin Hyun Soo;Lee Chong In;Chang Woo Ick;Shim Young Hak
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.7-16
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    • 1998
  • Purpose : To evaluate survival rate and prognostic factors affecting survival of patients with esophageal cancer treated with concurrent chemoradiation. Materials and Methods : Eligibility included biopsy proven invasive carcinoma of the cervical or thoracic esophagus, confined to esophagus and mediastinum with or without regional lymph node and supraclavicular lymph node, and ECOG Performance status $H_0-H_2$. Patients received radiation therapy with 5940cGy over 7 weeks and chemotherapy, consisted of 5-FU(1000 $mg/m^2/day$ in continuous infusion for 5 days, days 1 to 5 and days 29 to 33) and mitomycin C($8mg/m^2$ intravenous bolus at day 1). After concurrent chemoradiation, maintenance chemotherapy was followed with 5-FU(1000 $mg/m^2/day$ in continuous infusion for 5 days at 9th, 13th, and 17th weeks) and cisplatin($80mg/m^2$ intravenous bolus at the first day of each cycle). Results : From November 1989 to November 1995, 44 patients were entered in this study. After treatment, complete response rate and partial response rate were $59\%$ and $41\%$. Overall 1, 2, and 5-year survivals were $59\%$, $38\%$, and $9.6\%$(median 17 months), Prognostic factors affecting survival were response to treatment and T-stage. Among 26 complete responders, there were 6 local recurrences, 3 distant recurrences, 1 local and distant recurrence, and 2 unknown site recurrences Acute and chronic complication rates with grade 3 or more were $20\%$ and $13.0\%$ and there was no treatment-related mortality. Conclusion : Concurrent chemoradiation, compared with historical control groups that treated with radiation alone, improved median survival and did not significantly increase treatment-related complications. Complete responders had longer survival duration than partial responders. Predominant failure pattern was local failure. So, efforts to improve local control should be proposed.

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Nutritional Assessment and Dietary Management during Anti-Cancer Chemotherapy in Pediatric Oncology Patients (항암 화학요법 중인 소아암 환자의 영양 평가 및 식이 관리)

  • Jang, Se-Ri;Kim, Hee-Sun;Lee, Young-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.204-210
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    • 1999
  • Purpose: We assessed the nutritional status and the alterations of oral diets during anti-cancer chemotherapy in pediatric oncology patients. Methods: Twenty children with malignancy were evaluated from day 0 until day 21 of post-chemotherapy. Nutritional status was assessed by body weight and biochemical parameters. The amount and calories of oral diets were assessed and food preference before and during chemotherapy were analysed by questionnelle. Results: 1) The underlying diseases of 20 patients were 11 acute lymphoblastic lekemia, 2 non-Hodgkin's lymphoma, 2 Langerhans cell histiocytosis, 2 Wilm's tumor, 2 brain tumor, 1 rhabdomyosarcoma. 2) There were weight loss during chemotherapy in 8 patients (40.0%), weigt gain in 5 patients (25.0%), and no significant changes in 7 patients (35.0%). 3) Biochemical parameters showed no significant interval changes during chemotherapy except elevation of serum ALT level. 4) The daily caloric intakes of oral diets during chemotherapy were 310~600 Kcal which was much lower than average of daily recommended calory for Korean children. 5) The most favorate food was altered by chemotherapy, from meats to carbonated beverages and unfavorate food was not altered as vegetables. Conclusion: The periodic assessment of nutritional status and dietary supplements according to preferred foods of patients will be required for the optimal nutrition care in cancer patients.

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Study on the Usefulness of Using Anterior and Posterior Views for Calculation of Total Relative Uptake Ratio in 99mTc-DMSA Renal Scan (99mTc-DMSA 검사에서 상대 신섭취율 산출 시 양면상 촬영의 유용성에 대한 고찰)

  • Kim, Joo-Yeon;Lee, Han-Wool;Kwon, O-Jun;Kim, Jung-Yul;Park, Min-Soo;Cho, Seok-Won;Kang, Chun-Goo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.1
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    • pp.37-43
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    • 2015
  • Purpose $^{99m}Tc-DMSA$ renal scintigraphy serves as location, size and shape of kidney, so it has been used for diagnosis and passage observation after the operation or treatment. There are 3 methods of calculating the relative renal uptake ratio such as geometric mean of the counts from the anterior and posterior views, arithmetical mean from the only posterior view and posterior view which applied the renal depths. In this study, we seek to correlation between the change of total relative uptake ratio according to different inspection methods of obtaining the renal count rate. Materials and Methods The phantom experiments proceeded 5 times depending on each renal depth with the kidney phantom and tissue equivalent materials. In the clinical research, we investigated 36 adult patients who had visited our hospital from february to october, 2014 and received $^{99m}Tc-DMSA$ renal scan. The equipment was used as a gamma camera named INFINIA (General Electric Healthcare, milwaukee, USA) and we drew the region of interests through semiautomatic method by using Xeleris Ver. 2.1220 of GE. In addition, we obtained the lateral view of kidney to measure the renal depth of each patient. Then the results were compared with 3 methods of calculating relative renal uptake ratio. Results The phantom studies show when the difference between the left ant right kidney depth were less than 1 cm, there were no statistically significant difference among values calculated through anterior and posterior views and only posterior view (P>0.05), while the excess of 1cm, the results showed a statistically significant change in the value (P<0.05). In case of clinical research, the correlation between total relative uptake ratio by obtaining both sides of image and posterior view applied the kidney depth (r=0.999) was higher than by obtaining only posterior view and applying the kidney depth to one side image (r=0.988). Conclusion This study has found that, the difference of calculating total relative uptake ratio compared with obtaining anterior and posterior views and only posterior view. In order to reduce the error, we recommend the method of obtaining anterior and posterior views and is considered to be useful, particularly the patients have similar uptake ratio of left and right kidney and difficulties of measurements of kidney depth.

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Characteristics and Formation conditions of the Rhodoliths in Wu Island beach, Jeju-do, Korea: Preliminary Report (제주도 우도의 홍조단괴 해빈 퇴적물의 특징과 형성조건 : 예비연구 결과)

  • 김진경;우경식;강순석
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.8 no.4
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    • pp.401-410
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    • 2003
  • Three beaches of the Seogwang-ri coast in the western part of Wu Island, Jeju-do, are solely composed of rhodoliths (red algal nodules). The beach sediments are coarse sand to granule in size and they show the banded distribution according to size. Commonly the larger pebble-sized rhodoliths are concentrated near the rocky coast, resulting from the transportation of the nodules from shallow marine environments by intermittent typhoons. Based on the internal texture of the rhodoliths, it appears that crustose red algae, Lithophyllum sp., is the main contributor for the formation of the rhodolith. The coarse sand to granule-sized grains show that they started to grow from the nucleus as rhodoliths, but the surface was severely eroded by waves. However, the pebble to cobble-sized grains exhibit the complete growth pattern of rhodoliths and sometimes contain other calcareous skeletons. It is common that encrusting red algae are intergrown with encrusting bryozoan. The surface morphology of rhodolith tends to change from the concentric to domal shape towards the outer part. This suggests that the rhodolith grew to a certain stage by rolling, but it grew in more quiet condition without rolling as it became larger. Aragonite and calcite cements can be found in the pores within rhodoliths (conceptacle, intraskeletal pore in bryozoan, and boring), and this means that shallow marine cementation has occurred during their growth. Growth of numerous rhodoliths in shallow marine environment near the Seogwang-ri coast indicates that this area has suitable oceanographic conditions for their growth such as warm water temperature (about 19$^{\circ}C$ in average) and clear water condition due to the lack of terrestrial input of volcanoclastic sediments. Fast tidal current and high wave energy in the shallow water setting can provide suitable conditions enough for their rolling and growth. Typhoons passing this area every summer also influence on the growth of rhodoliths.

Effects of Dietary Sources Containing ω-3 Fatty Acids on the Fatty Acid Composition of Meats in Korean Native Chickens (오메가 3계열 지방산을 함유하는 사료의 급여가 육용 토종닭 계육 내 지방산 조성에 미치는 영향 탐색)

  • Oh, Sung-Taek;Jhun, Heung-Kyu;Park, Jung-Min;Kim, Jin-Man;Kang, Chang-Won;An, Byoung-Ki
    • Food Science of Animal Resources
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    • v.32 no.4
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    • pp.476-482
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    • 2012
  • Estimations were made of oxidative susceptibility and fatty acid composition of edible meats of native chickens fed various dietary sources containing ${\omega}-3$ polyunsaturated fatty acids (PUFA). A total of 240 Korean native chickens were divided into 4 groups, placed into 3 replicates per group, and were fed a commercial diet (Control) or one of the three experimental diets containing 10% perilla meal (PM group), 10% perilla meal-5% full fat flaxseed (PM+FS group), or 10% perilla meal-5% full fat flaxseed-1% fish oil (PM+FS+FO group) for 20 days. Final body weight, weight gain, feed intake, and feed conversion rate among the groups were not significantly different. Dietary treatments did not affect the relative weights of liver, abdominal fat, and breast muscle. The leg weight was increased from the feeding of ${\omega}-3$ PUFA sources. The TBA reactive substance in the edible meat was not different with the dietary treatments. The total ${\omega}-3$ PUFA in chickens that were fed diets containing ${\omega}-3$ PUFA sources increased compared to that of the control. The level of longer chain ${\omega}-3$ PUFAs, such as C20:5 ${\omega}3$ and C22:6 ${\omega}3$ in the PM+FS+FO group, was much higher than that of the others. The addition of local ingredients, such as perilla meal with conventional sources, could be used to obtain value-enhanced meat by enhancing ${\omega}-3$ PUFA.

Effect of Quality Grades on Carcass Characteristics, Physico-chemical and Sensory Traits of Longissimus Dorsi in Hanwoo (한우 육질등급에 따른 도체등급 요인, 이화학적 및 관능특성)

  • Lee, Jong-Moon;Choe, Ju-Hui;Lee, Hyeon-Kyeong;Na, Jae-Cheon;Kim, Yuen-Ho;Cheon, Dong-Won;Sea, Sang-Chul;Hwang, Kyu-Seok
    • Food Science of Animal Resources
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    • v.30 no.3
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    • pp.495-503
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    • 2010
  • Analyses were conducted to estimate the effect of quality grade on the carcass characteristics, physico-chemical and sensory traits of Longissimus dorsi in Hanwoo. A total of 42,113 carcasses were selected on the basis of five quality grades (grade $1^{++}$, $1^+$, 1, 2, and 3) and an additional 258 samples of Longissimus dorsi were used to evaluate the beef quality. The increase in quality grade from grade 3 to grade $1^{++}$ was significant (p<0.05) for carcass weight (from 338.7 kg to 387.2 kg), backfat thickness (from 7.45 mm to 12.23 mm) and marbling score (from 1.09 to 8.31). In contrast, significantly decreased levels of meat color, fat color, texture and maturity were apparent with increasing quality grade (p<0.05). Increasing quality grade was also correlated with significant increases (p<0.05) in crude fat contents (from 3.57% to 25.68%) and water holding capacity (from 52.41% to 58.03), and a decrease of the Warner-Bratzler shear force from 8.29 kg to 2.83 kg. The highest $L^*$ value (41.53) and highest cooking loss (22.11%) were observed with grade $1^{++}$ and 3 beef, respectively. There was no difference observed on $pH_{24}$ (5.53 to 5.66) among the quality grades, which were within the normal range. Sensory evaluation experiments revealed that quality grades were associated with significantly altered (all p<0.05) tenderness, juiciness, flavor, and overall acceptability. The crude fat contents showed significant correlation with juiciness (r=0.59), tenderness (r=0.71), flavor (r=0.55), and overall acceptability (r=0.69). The lower sensory trait scores were related to higher WBs. Grade $1^+$ Hanwoo beef had a significantly higher WBs and lower fat contents when compared to grade $1^{++}$ Hanwoo beef (p<0.05).