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Surgical Treatment of Multidrug-resistant Pulmonary Tuberculosis (다제내성 폐결핵의 수술적 치료)

  • Kim, Jin Hee;Min, Jin Hong;Park, Jun Ho;Park, Seung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.613-618
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    • 2005
  • Background : Recently, medical treatment of multi-drug resistant pulmonary tuberculosis has been unsuccessful. Through analyzing the cases with surgical treatment, we hope to provide some help in treating multi-drug resistant pulmonary tuberculosis in the future. Material and Method : A retrospective review was performed with 138cases of surgical treatment of multi-drug resistant tuberculosis during 10years from January 1994 to December 2003 at National Masan Hospital. Results : The ratio of men to women, 5.1:1 indicates that there were more incidences in men. The number of the resistant drugs was 5.3 with a mean age of 42.6 years. Cavitary lesions on the plain chest X-rays were seen in 94cases (68.1%). 128cases had positive sputum culture preoperatively. Types of operations were 24 pnemonectomies, 83 lobectomies, 10 bilobectomies, 19 lobectomies with segmentectomies or wedge resections, 1 wedge resection, and 1 carvenoplasty. There was no death after operation. There were 6cases of air leakage over a week, 6cases of postoperative bleeding, 8cases of bronchopleural fistula and empyema, 16cases of dead space, 1case of atelectasis, 1case of wound infection, 1case of cyst as postoperative complication. Postoperative complication showed higher long-term negative conversion rate of 92.8%. Conclusion : There has been many discussions about operative indications, postoperative drug regimens, length of postoperative chemotherapy. In our study, we showed higher long-term success rate of postoperative chemotherapy with pulmonary resection on multi-drug resistant pulmonary tuberculosis.

The Analysis of Post Operative Treatment of Malignant Melanoma Using High Dose Interferon-${\alpha}2b$ Immunotherapy: Preliminary Report (악성흑색종 환자군에서 수술적 치료 후 시행한 고용량 인터페론-${\alpha}2b$ 면역요법에 의한 보조적 치료 결과 분석: 예비보고)

  • Chung, So Hak;Jo, Hyun Ik
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.78-82
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    • 2012
  • Purpose: Interferon-${\alpha}2b$ using immunotherapy of malignant melanoma is known to increase the microscopic enemies that remain after surgical resection of the tumor to prevent recurrence, disease-free survival and overall survival. Authors in patients with malignant melanoma after surgical resection and high-dose interferon-${\alpha}$ immunotherapy treated group of disease-free survival and overall survival compared with the results of the treatment of immune therapy to a preliminary report. Materials and Methods: From February 2010 to October 2012 at our institution between being diagnosed with malignant melanoma after surgical immunotherapy treated patients were analyzed. Patients was evaluated using the stage AJCC stage IIA 3 cases, IIB 1 cases, IV 1 were as follows. Follow-up period of at least 7 months, and a maximum of 32 months. As maintenance therapy after the first induction therapy group underwent immunotherapy interferon-${\alpha}$ of body-surface area per 200,000 IU five times in a week for 4 weeks sedentary and body surface area a total of 48 weeks per week to 100,000 IU three times subcutaneously. These patients for local recurrence and metastases, and distant metastasis were investigated disease-free survival was investigated. Results: Interferon-evaluation through follow-up chest computed tomography (CT) and positron emission computed tomography (PET CT) in patients who underwent the ${\alpha}$ immunotherapy results above both local recurrence and metastases without evidence of distant metastases. Conclusion: The high-dose ${\alpha}2b$ immunotherapy performed in patients to prevent the local recurrence of the tumor and metastasis to the current or future ultimate survival and disease-free survival improvement achieved is additional study and follow-up will be needed.

Fluvial Deposits Distributed along the Seomjin River (섬진강 유역의 하성 퇴적층에 관한 연구)

  • You, Hoen-Su;Cho, Seok-Hee;Koh, Yeong-Koo
    • Journal of the Korean earth science society
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    • v.21 no.2
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    • pp.174-187
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    • 2000
  • The Quaternary coarse-grained sandy sediments are distributed along the channels of Seomjin River. The fluvial sediments were sedimentologically studied in horizontal and vertical distributions. To analyze depositional environments and facies changes in the sediments, sediment sampling from river mouth to upper stream and desctriptive approaches to the sediment profiles outcropped near Kurye were carried out. The sediments along the stream lines of the river are assigned to very coarse to coarse sand in grain size. The sediment grains are widely scattered in sorting and moderately sorted in average. For skewness and kurtosis, the sediments ranges from very fine to very coarse skewed and from very lepto-kurtic to extremelyl epto-kurtic states, respectively. The sediments are divided into slightly gravelly sand, gravelly sand and sandy gravel in sediment type. The pain shape in the sandy sediments are dominant in equant and tabular forms showing wide varieties. The sandy sediments are mostly poorly sorted and are highly variable in surface texture with SEM. Some smaller grains in the sediments ordinarily show polished surfaces. Of those grains, quartz ones are commonly angular to surounded. On the basis of facies changes and sedimentary structures, outcropped fluvial sediment profiles in Kurye are classified into xGyS, mGyS, gGyS, xSM, xS, mS, mGyM, IgM in facies. These eight facies are reformed as facies assemblage I and ll. The facies assemblage I and II are interpreted as the products of the channel deposits in braided stream and flood plain ones besides channels, respectively. The change facies assemblage I with facies assemblage ll imply that depositional environments hadbeen migrated from braied sream to flood plain ones.

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Expression of Clusterin in the Salivary Gland under Restraint Stress (구속 스트레스에 의한 타액선 조직내의 Clusterin 발현)

  • Park, Hee-Kyung;Chun, Yang-Hyun;Hong, Jung-Pyo;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
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    • v.33 no.3
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    • pp.247-256
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    • 2008
  • The belief that stress leads to illness has a long history. A number of the orofacial disease are also closely associated with stress. Despite research in the relationship of stress and the orofacial diseases leading to statistically significant correlations, the pathology remains vague. In the present study, the expression of clusterin, a stress protein responsible for antiapoptosis and cytoprotection, under restraint stress condition was observed in the submandibular gland, one of the major salivary glands. Sprague-Dawley rats were divided into 2 groups: normal group and restraint stress group. The rats of restraint stress group were placed in the stress cages and then sacrificed at day 0, 3 and 5 day of the experiment. After that, the submandibular glands of all the rats were excised immediately. The levels of clusterin proteins and mRNA in the tissues were measured by immunohistochemistry and Northern blot analyses, respectively. The results were as follows: 1. In the immunohistochemistry, clusterin protein was detected only immediately after the application of restraint stress. 2. In the restraint stress group, at day 3 and 5, histologically apoptosis was induced with karyorrhectic and pyknotic changes. 3. By the restraint stress, acinic cells were destructed earlier than ductal cells. 4. In the Northern blot, mRNA of clusterin was expressed only immediately after the application of restraint stress. The overall results suggest that as an early response to stress, clusterin is expressed in the glands to protect the glandular cells from the stress. But if stress is so strong and prolonged that it can exceed the stress adaptability of the cells, then the cells may undergo apoptosis instead of producing clusterin. An Epidemiologic Study of Symptoms of Temporomandibular Disorders in Korean College Students.

The Correlation of Sonographic Finding of Fatty Liver with Hematologic Examination and Body Fat Percentage (초음파상 지방간과 혈액학적 검사 및 체지방률과의 상관관계)

  • Cheon, Hae-Kyung;Lee, Tae-Yong;Kim, Young-Ran
    • Journal of radiological science and technology
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    • v.32 no.4
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    • pp.437-444
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    • 2009
  • Ultrasonography has been used as a basic examination of a medical check up for prevention and diagnostics of diseases. Even the person who has no particular subjective symptoms can have a variety of diseases. Especially fatty liver is found in many cases. In this study, we tested 3582 persons who are in between the ages of 15 to 81 and observed that 1390 persons had fatty liver while 2192 persons are normal. We classified the grade of fatty liver and compared their life styles with the results of liver function test and BMI. The results are as follows. Ratio of the subjects who had a fatty liver is 38.8%. Male and female ratio was 46.2% and 24.2%. On the correlation among the fatty liver, the body mass index and the body fat%, the average value of body mass index and body fat% were significantly higher in the group of the fatty liver than in those of the normal liver. The influence of the related factor and the correlation on the fatty liver was shown that it was more related with the order of age, body mass index, triglyceride, ALT, body fat%, sex, HDL-Cholesterol, LDL-Cholesterol, and GGT. The result of the ultrasonography carried out for the purpose of regular health check up indicates that even the 38.8% of those who was diagnosed as normal condition could have the fatty liver and have possibility of other diseases. Therefore, if there are any troubles related to liver function and lipid through hematologic examination or when practicing follow-up study with ultrasonography concerning the correlation relation between the body fat% and dietary preference, alcohol consumption and exercise, the ultrasonography is definitely useful for prevention and treatment of diseases.

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Radiotherapy Results in Stage IIB Uterine Cervix Cancer (자궁경부암 병기 IIB의 방사선치료결과)

  • Kil Whoon Jong;Chun Mison;Kang Seunghee;Oh Young Taek;Ryu Hee Sug;Ju Hee Jae;Lee Eun Ju
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.345-352
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    • 2001
  • Purpose : To evaluate the treatment results and prognostic factors after radiotherapy in stage IIB uterine cervix cancer. Materials and methods : We retrospectively analyzed the records of 90 patients with stage IIB uterine cervix cancer who received radiotherapy between 9/94 and 12/99. Age was ranged from 28 to 79 years (median 57). Tumor size was $\geq4\;cm$ in 64 patients. Preteatment SCC level was measured in 75 patients. Twenty nine patients received conventional radiotherapy (QD) and the others received modified hyper-fractionated radiotherapy (BID). Only 7 patients in BID had tumor size <4 cm. All patients received high dose rate brachytherapy $(4\;Gy\times7\;or\;5\;Gy\times6)$. No Patient received concurrent chemotherapy during radiotherapy. Follow up period was ranging from 9 to 76 months (median 38). Results : The 5-year overall and disease free survival rates were $73.4\%\;and\;71.6\%$, respectively. Local recurrences occurred in $10\%$ of patients, and distant metastasis in $18.9\%$. There was a significant correlation between OS/DFS and tumor size $(<4cm;\;OS\;95.2\%,\;DFS\;91.4\%,\;\geq4cm;\;OS\;63.4\%,\;DFS\;63.4\%)$. Pretreatment SCC level was one of prognostic factors only in univariate analysis. Conclusion : With modified hyperfractionated radiotherapy, there was very low local recurrence rate $(6.6\%)$ and high 5-year overall and disease free survival rate $(75.4\%\;and\;70.5\%)$, which is comparable to results after concurrent chemoradiotherapy in bulky, locally advanced stage IIB uterine cervix cancer.

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Palliative Irradiation Using Helical Tomotherapy in Recurrent Pelvic Tumors with Prior Radiotherapy (방사선치료 후 재발한 골반암에서 토모테라피를 이용한 고식적 재치료)

  • Kay, Chul-Seung;Yoo, Eun-Jung;Kim, Ji-Hoon;Ro, Duck-Young;Kim, Ki-Jun
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.133-140
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    • 2010
  • Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

Early and Mid-Term Results of MIDCAB (최소 침습적 관상 동맥 우회술의 중단기 성적)

  • 손호성;방영호;황진욱;민병주;조양현;박성민;이성호;김광택;선경
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.827-832
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    • 2004
  • Background: The significance of MIDCAB is emerging topics recently as OPCAB is going to be universalized, and long-term outcome of bypass graft surgery was proved to be more excellent than balloon dilation or stent insertion. We report our MIDCAB results in 73 patients in the last three years. Material and Method: Retrospective analysis of medical records was done from November 1, 2000 through November 31, 2003. There were 47 males and 26 females ranging in age from 31 years to 79 years (average $61.3\pm9.8$ years). Observation periods after operative procedures were 10 to 1238 days (average $763\pm319.8$ days). Left longitudinal parasternal incision as a standard procedure was done to approach the heart after dissection of the left internal thoracic artery by partial or total resection of 3rd to 5th ribs. Result: Of those patients, 46 patients were transferred to ICU after extubation at operation room and 58 patients were extubated within 3 hours after operation. Average ICU staying periods was $26.8\pm11.5$ hours. Follow-up angiography during admission was done in 36 patients and showed 100% patency. Only one patient died on the 10$^{th}$ post operative day because of sudden CVA. Complications included wound problems in 4 patients, and constructing pericardial window using thoracoscopy due to continuous pericardial effusion in 1. Permanent pacemaker was inserted in one patient owing to sick sinus syndrome. In one patient with recurrence of angina 8 months after operation, stenosis at anastomic site was found and improved with balloon dilatation. Conclusion: We were satisfied with our results of MIDCAB in single and multi-vessel coronary artery disease. These results have made the cardiologists tried to operate positively and we expect widening operative indications including hybrid revascularization.

Twenty-one Year Experience with Right Ventricle to Pulmonary Artery Conduit Interposition (우심실-폐동맥 간 도관 이식술의 21년간의 경험)

  • Kwak, Jae-Gun;Yoo, Jae-Suk;Kim, Yong-Jin;Kim, Woong-Han;Lee, Jeong-Ryul
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.417-422
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    • 2008
  • Background: The aim of this study is to evaluate the long term results of creating various right ventricle to pulmonary artery conduits for treating complex congenital heart disease. Material and Method: Between June 1986 and July 2006, we retrospectively reviewed 245 patients who underwent reconstruction of the right ventricular outflow tract with various kinds of conduits. 410 operations were done in 245 patients, the mean age at operation was $3.2{\pm}4.9$ years (range: 7 days$\sim$45 years) and the mean body weight was $12.5{\pm}8.7\;kg$ (range: $2.4\sim76.3\;kg$). Result: We used the following conduits: Polystan conduit, Shelhigh conduit, Carpenter-Edward conduit, Dacron graft with an artificial valve, valveless Gore Tex vascular graft, homograft and hand-made bovine or autologous pericardial conduit. The mean follow up duration was $6.3{\pm}5.2$ years. Redo operation for RV-PA conduit dysfunction was performed in 131 patients, a second redo was done in 31 and a third redo was done in 3. The reoperation free rates were 67.3%, 48.5% and 39.4% for 5 years, 10 years and 15 years, respectively. The homograft showed the best durability, followed by the Dacron graft with artificial valve and the Carpentier-Edward conduit. The larger sized conduit showed better durability. Conclusion: The homograft showed lowest reoperation rate and a smaller size of conduit showed the highest reoperation rate. The reoperation rate for the RV-PA conduit was about 35% at 5 years, so it is mandatory to develop the more durable conduit for RV outflow.

The Effects of Mortierella alpina Fungi and Extracted Oil (Arachidonic Acid Rich) on Growth and Learning Ability in Dam and Pups of Rat (흰쥐의 Mortierella alpina 균사체와 추출유의 섭취에 의한 생육 효과와 학습능력 비교)

  • 이승교;강희윤;박영주
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.6
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    • pp.1084-1091
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    • 2002
  • Mortierella alpina, a common soil fungus, is the most efficient organism for production of production acid presently known. Since arachidonic acid are important in human brain and retina development, it was undertaken the growing effect containing diet as a food ingredient. Arachidonic acid rich oil derived from Mortierella alpina, was subjected to a program of studies to establish for use in diet supplement. This study was compared the growth and learning effect of fungal oil rich in arachidonic acid by incorporated into diets ad libitum. Sprague-Dawley rats received experimental diets 5 groups (standard AIN 93 based control with beef tallow, extract oil 8%, and 4%, and Mortierella alpina in diet 10% and 20%) over all experiment duration (pre-mating, mating, gestation, lactation, and after weaning 4 weeks). Pups born during this period consumed same diets after wean for 4 weeks. There was no statistical significance of diet effects in reproductive performance and fertility from birth to weaning. But the groups of Mortierella alpine diet were lower of weight gain and diet intake after weaning. The serum lipids were significantly different with diet groups, higher TG in LO (oil 4%) group of dams, and higher total cholesterol in LF (M. alpina 10%) of pups, although serum albumin content was not significantly different in diet group. The spent-time and memory effect within 4 weeks of T-Morris water maze pass test in dam and 7-week- age pups did not differ in diet groups. On the count of backing error in weaning period of pups was lower in HO(extracted oil 8%) group. In the group of 10% and 20% Mortierella alpina diet, DNA content was lower in brain with lower body weight, but liver DNA relative to body weight was higher than control. Further correlation analyses would be needed DNA and arachidonic acid intakes, with Mortierella alpina diet digestion rate.