• Title/Summary/Keyword: 회복률

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Variation on Estimated Values of Radioactivity Concentration According to the Change of the Acquisition Time of SPECT/CT (SPECT/CT의 획득시간 증감에 따른 방사능농도 추정치의 변화)

  • Kim, Ji-Hyeon;Lee, Jooyoung;Son, Hyeon-Soo;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.2
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    • pp.15-24
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    • 2021
  • Purpose SPECT/CT was noted for its excellent correction method and qualitative functions based on fusion images in the early stages of dissemination, and interest in and utilization of quantitative functions has been increasing with the recent introduction of companion diagnostic therapy(Theranostics). Unlike PET/CT, various conditions like the type of collimator and detector rotation are a challenging factor for image acquisition and reconstruction methods at absolute quantification of SPECT/CT. Therefore, in this study, We want to find out the effect on the radioactivity concentration estimate by the increase or decrease of the total acquisition time according to the number of projections and the acquisition time per projection among SPECT/CT imaging conditions. Materials and Methods After filling the 9,293 ml cylindrical phantom with sterile water and diluting 99mTc 91.76 MBq, the standard image was taken with a total acquisition time of 600 sec (10 sec/frame × 120 frames, matrix size 128 × 128) and also volume sensitivity and the calibration factor was verified. Based on the standard image, the comparative images were obtained by increasing or decreasing the total acquisition time. namely 60 (-90%), 150 (-75%), 300 (-50%), 450 (-25%), 900 (+50%), and 1200 (+100%) sec. For each image detail, the acquisition time(sec/frame) per projection was set to 1.0, 2.5, 5.0, 7.5, 15.0 and 20.0 sec (fixed number of projections: 120 frame) and the number of projection images was set to 12, 30, 60, 90, 180 and 240 frames(fixed time per projection:10 sec). Based on the coefficients measured through the volume of interest in each acquired image, the percentage of variation about the contrast to noise ratio (CNR) was determined as a qualitative assessment, and the quantitative assessment was conducted through the percentage of variation of the radioactivity concentration estimate. At this time, the relationship between the radioactivity concentration estimate (cps/ml) and the actual radioactivity concentration (Bq/ml) was compared and analyzed using the recovery coefficient (RC_Recovery Coefficients) as an indicator. Results The results [CNR, radioactivity Concentration, RC] by the change in the number of projections for each increase or decrease rate (-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.5%, +3.90%, 1.04] at -90%, [-77.9%, +2.71%, 1.03] at -75%, [-55.6%, +1.85%, 1.02] at -50%, [-33.6%, +1.37%, 1.01] at -25%, [-33.7%, +0.71%, 1.01] at +50%, [+93.2%, +0.32%, 1.00] at +100%. and also The results [CNR, radioactivity Concentration, RC] by the acquisition time change for each increase or decrease rate (-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.3%, -3.55%, 0.96] at - 90%, [-73.4%, -0.17%, 1.00] at -75%, [-49.6%, -0.34%, 1.00] at -50%, [-24.9%, 0.03%, 1.00] at -25%, [+49.3%, -0.04%, 1.00] at +50%, [+99.0%, +0.11%, 1.00] at +100%. Conclusion In SPECT/CT, the total coefficient obtained according to the increase or decrease of the total acquisition time and the resulting image quality (CNR) showed a pattern that changed proportionally. On the other hand, quantitative evaluations through absolute quantification showed a change of less than 5% (-3.55 to +3.90%) under all experimental conditions, maintaining quantitative accuracy (RC 0.96 to 1.04). Considering the reduction of the total acquisition time rather than the increasing of the image acquiring time, The reduction in total acquisition time is applicable to quantitative analysis without significant loss and is judged to be clinically effective. This study shows that when increasing or decreasing of total acquisition time, changes in acquisition time per projection have fewer fluctuations that occur in qualitative and quantitative condition changes than the change in the number of projections under the same scanning time conditions.

Study on the prevalence of allergic diseases based on the health behavior of multicultural families youth - The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014, Centers for Disease Control & Prevention - (다문화가정 청소년의 건강행태에 따른 알레르기질환 유병률 연구 - 질병관리본부 제10차(2014년) 청소년건강행태온라인조사 -)

  • Kim, Hyang-Sug;Jung, Lan-hee
    • Journal of Korean Home Economics Education Association
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    • v.29 no.2
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    • pp.41-52
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    • 2017
  • The purpose of this study was to identify the factors related to allergic diseases based on the health behavior of the youth in multicultural families according to the data from Tenth Korea Youth Risk Behavior Web-Based Survey 2014 (Centers for Disease Control & Prevention). The subjects from 712 multicultural adolescents were analyzed by the SPSS program. For the characteristics of health behavior of the multicultural youth, 267 students (37.5%) have experienced drinking alcohol, 164 students (23.0%) have experienced smoking, and 35 students (4.9%) have experienced taking drugs. Also, 198 students (27.8%) were depressed, 259 students (36.3%) are suffering from stress, and 286 students (40.2%) failed to fully relieve fatigue. In addition, 497 students (69.8%) consider themselves as healthy, 449 students (63.1%) consider themselves as happy, and 251 students (35.3%) consider themselves as overweight. Among the allergic disease of the multicultural youth, 46 middle school students (6.5%) and 35 high school students (4.9%) have asthma, 95 middle school students (13.3%) and 87 high school students (12.2%) have allergic rhinitis, and 67 middle school students (9.4%) and 53 high school students (7.4%) have atopic dermatitis. 47 male students (6.6%) and 34 female students (4.8%) have asthma, 81 male students (11.4%) and 101 female students (14.1%) have allergic rhinitis, and 53 male students (7.4%) and 67 female students (9.4%) have atopic dermatitis. Among the multicultural youth, 81 students (11.4%) have asthma, 182 students (25.5%) have allergic rhinitis, and 120 students (16.8%) have atopic dermatitis. For the allergic diseases from the health behavior of the multicultural youth, depression (p<0.001), alcohol experience (p<0.05), drug experience (p<0.05), health recognition (p<0.05), happiness recognition (p<0.05), and body type recognition (p<0.05) had a statistically significant relationship with asthma. Fatigue recovery recognition (p<0.001), health recognition (p<0.001) and stress recognition (p<0.05) had a statistically significant relationship with allergic rhinitis. Body type recognition (p<0.01), depression (p<0.05), fatigue recovery recognition (p<0.05), health recognition (p<0.05), and happiness recognition (p<0.05) had a statistically significant relationship with atopic dermatitis. Such results show that schools and society need to educate the multicultural youth about health, happiness, and body type recognition which are big factors of allergic diseases. Schools and society also need to be more systematic and continuous in order to help multicultural youth to be have correct recognition of depression, stress and fatigue recovery.

The Effect of Two Terpenoids, Ursolic Acid and Oleanolic Acid on Epidermal Permeability Barrier and Simultaneously on Dermal Functions (우솔릭산과 올레아놀산이 피부장벽과 진피에 미치는 영향에 대한 연구)

  • Suk Won, Lim;Sung Won, Jung;Sung Ku, Ahn;Bora, Kim;In Young, Kim;Hee Chang , Ryoo;Seung Hun, Lee
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.2
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    • pp.263-278
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    • 2004
  • Ursolic acid (UA) and Oleanolic acid (ONA), known as urson, micromerol and malol, are pentacyclic triterpenoid compounds which naturally occur in a large number of vegetarian foods, medicinal herbs, and plants. They may occur in their free acid form or as aglycones for triterpenoid saponins, which are comprised of a triterpenoid aglycone, linked to one or more sugar moieties. Therefore UA and ONA are similar in pharmacological activity. Lately scientific research, which led to the identification of UA and ONA, revealed that several pharmacological effects, such as antitumor, hepato-protective, anti-inflammatory, anticarcinogenic, antimicrobial, and anti-hyperlipidemic could be attributed to UA and ONA. Here, we introduced the effect of UA and ONA on acutely barrier disrupted and normal hairless mouse skin. To evaluate the effects of UA and ONA on epidermal permeability barrier recovery, both flanks of 8-12 week-old hairless mice were topically treated with either 0.01-0.1mg/mL UA or 0.1-1mg/mL ONA after tape stripping, and TEWL (transepidermal water loss) was measured. The recovery rate increased in those UA or ONA treated groups (0.1mg/mL UA and 0.5mg/mL ONA) at 6h more than 20% compared to vehicle treated group (p < 0.05). Here, we introduced the effects of UA and ONA on acute barrier disruption and normal epidermal permeability barrier function. For verifying the effects of UA and ONA on normal epidermal barrier, hydration and TEWL were measured for 1 and 3 weeks after UA and ONA applications (2mg/mL per day). We also investigated the features of epidermis and dermis using electron microscopy (EM) and light microscopy (LM). Both samples increased hydration compared to vehicle group from 1 week without TEWL alteration (p < 0.005). EM examination using RuO4 and OsO4 fixation revealed that secretion and numbers of lamellar bodies and complete formation of lipid bilayers were most prominent (ONA=UA > vehicle). LM finding showed that thickness of stratum corneum (SC) was slightly increased and especially epidermal thickening and flattening was observed (UA > ONA > vehicle). We also observed that UA and ONA stimulate epidermal keratinocyte differentiation via PPAR Protein expression of involucrin, loricrin, and filaggrin increased at least 2 and 3 fold in HaCaT cells treated with either ONA (10${\mu}$M) or UA (10${\mu}$M) for 24 h respectively. This result suggested that the UA and ONA can improve epidermal permeability barrier function and induce the epidermal keratinocyte differentiation via PPAR Using Masson-trichrome and elastic fiber staining, we observed collagen thickening and elastic fiber elongation by UA and ONA treatments. In vitro results of collagen and elastin synthesis and elastase inhibitory activity measurements were also confirmed in vivo findings. These data suggested that the effects of UA and ONA related to not only epidermal permeability barrier functions but also dermal collagen and elastic fiber synthesis. Taken together, UA and ONA can be relevant candidates to improve epidermal and dermal functions and pertinent agents for cosmeseutical applications.

Preliminary Results of Concurrent Chemotherapy and Radiation Therapy using High-dose-rate Brachytherapy for Cervical Cancer (자궁경부암에 항암화학요법과 동시 병용요법으로 외부 방사선조사와 고선량률 강내조사의 예비적 치료 결과)

  • Lee, Kyung-Ja;Lee, Ji-Hye;Lee, Re-Na;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.171-178
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    • 2006
  • [ $\underline{Purpose}$ ]: To determine the efficacy and safety of concurrent chemotherapy and radiation therapy with high-dose-rate brachytherapy for cervical cancer. $\underline{Materials\;and\;Methods}$: From January 2001 to December 2002, 30 patients with cervical cancer were treated with concurrent chemotherapy (cisplatin and 5-FU) and definitive radiation therapy. The median age was 58 (range $34{\sim}74$) year old. The pathology of the biopsy sections was squamous cell carcinoma in 29 patients and one was adenocarcinoma. The distribution to FIGO staging system was as follows: stage IB, 7 (23%); IIA, 3 (10%); IIB, 12 (40%); IIIA, 3 (10%); IIIB, 5 (17%). All patients received pelvic external beam irradiation (EBRT) to a total dose of $45{\sim}50.4\;Gy$ (median: 50.4 Gy) over $5{\sim}5.5$ weeks. Ir-192 HDR intracavitary brachytherapy (ICBT) was given after a total dose of 41.4 Gy. HDR-ICBT was performed twice a week, with a fraction point A dose of 4 Gy and median dose to point A was 28 Gy (range: $16{\sim}32\;Gy$) in 7 fractions. The median cumulative biologic effective dose (BED) at point A (EBRT+ICBT) was $88\;Gy_{10}$ (range: $77{\sim}94\;Gy_{10}$). The median cumulative BED at ICRU 38 reference point (EBRT+ICBT) was $131\;Gy_3$ (range: $122{\sim}140\;Gy_3$) at point A, $109\;Gy_3$ (range: $88{\sim}125\;Gy_3$) at the rectum and $111\;Gy_3$ (range: $91{\sim}123\;Gy_3$) at the urinary bladder. Cisplatin ($60\;mg/m^2$) and 5-FU ($1,000\;mg/m^2$) was administered intravenously at 3 weeks interval from the first day of radiation for median 5 (range: $2{\sim}6$) cycles. The assessment was performed at 1 month after completion of radiation therapy by clinical examination and CT scan. The median follow-up time was 36 months (range: $8{\sim}50$ months). $\underline{: The complete response rate after concurrent chemoradiation therapy was 93.3%. The 3-yr actuarial pelvic control rate was 87% and 3-yr actuarial overall survival and disease-free survival rate was 93% and 87%, respectively. The local failure rate was 13% and distant metastatic rate was 3.3%. The crude rate of minor hematologic complications (RTOG grade 1-2) occurred in 3 patients (10%) and one patient had suffered from severe leukopenia (RTOG grade 4) during concurrent treatment. Acute minor enterocolitis (RTOG grade 1-2) occurred in 11 patients (37%) and one patient (3%) was suffered from colon perforation during radiation therapy. Late colitis of RTOG grade 1 occurred in 5 patients (15%). Acute cystitis of RTOG grade 1 occurred in 12 patients (40%) and late cystitis of RTOG grade 2 occurred in one patient (3%). No treatment related death was seen. $\underline{Conclusion}$: The results of this study suggest that the concurrent chemoradiation therapy with HDR brachytherapy could be accepted as an effective and safe treatment for cervical cancer.

Long-term Prognosis and Physiologic Status of Patients Requiring Ventilatory Support Secondary to Chest wall Disorders (흉벽질환에 의한 급성호흡부전 환자의 생리적 특성과 장기적인 예후)

  • Yoon, Seok Jin;Jun, Hee Jung;Kim, Yong Joo;Lee, Seung Jun;Kim, Eun Jin;Cha, Seung Ick;Park, Jae Yong;Jung, Tae Hoon;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.265-272
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    • 2006
  • Background: Chest wall deformities such as kyphoscoliosis, thoracoplasty, and fibrothorax cause ventilatory insufficiency that can lead to chronic respiratory failure, with recurrent fatal acute respiratory failure(ARF). This study evaluated the frequency and outcome of ARF, the physiologic status, and the long-term prognosis of these patients. Methods: Twenty-nine patients with chest wall disorders, who experienced the first requirement of ventilatory support from ARF were examined. The mortality and recurrence rate of ARF, the pulmonary functions with arterial blood gas analysis, the efficacy of home oxygen therapy, and the long-term survival rate were investigated. Results: 1) The mortality of the first ARF was 24.1%. ARF recurred more than once in 72.7% of the remaining 22 patients, and overall rate of successful weaning was 73.2%. 2) Twenty-two patients who recovered from the first ARF showed a restrictive ventilatory impairment with a mean FVC and TLC of 37.2% and 62.4 % of predicted value, respectively, and a mean $PaCO_{2}$ of 57mmHg. Among the parameters of pulmonaty functions. the FVC(p=0.01) and VC(p=0.02) showed a significant correlation with the $PaCO_{2}$ level. 3) There were no significant differences between the patients treated with conservative medical treatment only and those with additional home oxygen therapy due to significant hypoxemia in the patients with recurrent ARF and the mortality. 4) The 1, 3, 5-year survival rates were 75%, 66%, and 57%, respectively, in the 20 patients who had recovered from the first ARF, excluding the two patients managed by non-invasive nocturnal ventilatory support. Conclusion: These results suggest that active ventilatory support should be provided to patients with ARF and chest wall disorders. However, considering recurrent ARF and weak effect of home oxygen therapy, non-invasive domiciliary ventilation is recommended in those patients with these conditions to achieve a better long-term prognosis.

Characteristics of the Fruits and Flesh Softening Delay Induced by GA3 and Thidiazuron (TDZ) Treatment in 'Heukboseok' Grape ('흑보석' 포도의 GA3와 Thidiazuron(TDZ) 처리에 따른 과육 연화 지연 및 과실특성)

  • Jung, MyungHee;Lee, ByulHaNa;Park, YoSup;Oh, Jin Pyo;Kim, HeeSeob;Park, Hee-Seung
    • Horticultural Science & Technology
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    • v.33 no.2
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    • pp.186-195
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    • 2015
  • This research was conducted to investigate effect the plant growth regulators (PGRs) on the characteristics of fruit and flesh softening, using GA3 and thidiazuron (TDZ) treatments in 'Heukboseok' grapes. The total yield obtained under PGR treatment was 88.3% lower than the target production when a single treatment with $GA_3$ of low concentrations was used, but the expected yield was recovered by combined treatment with TDZ and $GA_3$. When harvested on the basis of color, the harvest rate up to 100 days after full bloom (DAFB) was low with the $GA_3$ single treatment, but was increased by the addition of TDZ, with the second TDZ mixed treatment being particularly effective. The soluble solids content in the PGR-treated samples demonstrated no significant changes after 90 DAFB, while the acidity content decreased rapidly starting from 90 DAFB. Measured on the basis of sugar and acidity content, maturity was reached much earlier in treated fruit than in the non-treated fruit. Firmness was maintained at a higher level until the final harvest time after PGR treatment compared to untreated grapes according to epidermis thickness and flesh density increase to activity cell division and expansion by $GA_3$ and TDZ. In particular, the fruit quality was improved based on the delay of softening in primary and secondary treatments of $25mg{\cdot}L^{-1}\;GA_3+2.5mg{\cdot}L^{-1}$ TDZ. The production of seedless fruit was difficult, even with the inclusion of TDZ, reaching the highest seedless rate of only 65.5%. Fruit cracking was rare, occurring at a rate of about 0.0~0.9% in all treatments. Accordingly, 'Heukboseok' grapes should be harvested within 100 days after full bloom (DBFB) before a rapid decrease of firmness, conferred by primary and secondary treatments with $25mg{\cdot}L^{-1}\;GA_3+2.5mg{\cdot}L^{-1}$ TDZ.

Surgical Result of the Modified Blalock-Taussig Shunt in Early Infancy (조기 영아기에서의 변형 블라록-타우시히 단락술의 수술 결과)

  • 이정렬;곽재건;최재성
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.573-579
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    • 2002
  • Background: In this study, the role and the surgical outcome of the modified Blalock-Taussig shunt in the treatment of the infants with cyanotic complex congenital heart diseases were investigated. Material and Method: Over the last 12 years, 105 modified BT shunts were performed in 100 infants. Postoperative course, shunt patency rate, complications, mortality and its risk factors were reviewed restrospectively. Result: The mean age at operation was 43.0$\pm$36.6 days. Sex ratio was 60:40(M:F). The postoperative oxygen saturations were lowest after mean duration of 11 hours after the shunt procedure. The operative mortality was 8%(8) with 3 late deaths. Causes of operative death included failure of maintenance of minimum oxygenation during the procedure(2), immediate postoperative shunt occlusion(2), respiratory failure(2), low cardiac output due to heart failure and pericardial effusion(2) and sepsis(2). Late deaths resulted from acute cardiac arrest during the follow up cardiac catheterization, hypoxic myocardial failure, and arrhythmia. Year of surgery, shunt size, age at operation, and complexity of the anomalies were not the risk factors for mortality. Six month shunt patency rate was 97% and overall patency rate was 96%. Postoperative complications comprised of shunt occlusion(6), phrenic nerve palsy(3), and wound infection(2). Conclusion: We demonstrated that modified Blalock-Taussig shunt was a useful tool to palliate the infants with complex cyanotic heart disease in whom early complete repair was not feasible with acceptable mortality and patency rate. An adequate postoperative management and a meticulous surgical technique may be key factors for the better results.

Open Heart Surgery without Transfusion (수혈 없이 시행한 개심술)

  • Kim, Kun-Il;Lee, Weon-Yong;Kim, Hyoung-Soo;Kim, Shin
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.184-192
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    • 2009
  • Background: Although complications from transfusion are known to happen, transfusion is performed during most open heart surgeries. The aim of this study was to investigate the possibility of performing cardiac surgery without allogenic blood transfusion. Material and Method: Between January to August 2007, 44 consecutive patients who underwent open heart surgery with using various blood conservation methods were retrospectively enrolled. They were divided into group I (the onpump group, n=17) and group II (the offpump group, n=27). The blood conservation methods were intraoperative autologous donation, cell saver, retrograde autologous priming, conventional ultrafiltration and modified ultrafiltration. Antianemic agents were administered to all the patients postoperatively. We analyzed the possibility of bloodless operations, the causes of homologous transfusion, the serial change of the hematocrit and the postoperative chest tube drainage, and we compared the results between the two groups. If comparison between the two groups was not reasonable, then we compared two groups with the individual control groups I and II (49 patients) in 2006. Result: 40 (90.9%) of 44 patients were successfully operated on without transfusion and the success rate was 88.2% (15/17) for group I and 92.6% (25/27) for group II. There was no statistical difference between the two groups (p=NS). The causes of transfusion were 2 cases of postoperative bleedings, 1 case of intraoperative bleeding and 1 mistake of the indication for transfusion. There was no statistical difference of the total chest tube drainage (Group I: $417{\pm}359mL$, Group II: $451{\pm}237mL$) (p=NS), but the total chest tube drainages of the two groups were less than each of the control groups 1 and II (p<0.05). The lowest hematocrit level of Group I was $16.4{\pm}2%$, and this occurred just after infusion of cardioplegics and the hematocrits of both groups were recovered to the preoperative level at 2 months postoperatively. Conclusion: In this study, bloodless open heart surgery could be performed in 90.9% of the patients with intraoperative autologous donation, cell saver, retrograde autologous priming, conventional ultrafiltration and modified ultrafiltration. A combination of various blood conservation methods is the most important and bloodless cardiac surgery could be performed with meticulous bleeding control and strictly following the transfusion indications.

Mid-Term Results of Mitral Valve Repair Using a Partial Flexible Band and a Completely Rigid Ring in Patients with Degenerative Mitral Regurgitation (퇴행성 승모판막역류 환자에서 Partial Flexible Band와 Complete Rigid Ring을 이용한 승모판막 성형술의 중기 결과 비교)

  • Kim, Kyung-Hwan;Ahn, Hyuk;Hwang, Ho-Young;Choi, Jin-Ho;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.475-481
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    • 2010
  • Background: We evaluated mid-term results of mitral annuloplasty using a flexible band and a completely rigid ring for mitral valve repair in patients with degenerative mitral regurgitation (MR). Material and Method: From January 2004 to September 2008, 71 patients (M:F=36:35, $55{\pm}13$ years) underwent mitral valve repair with mitral annuloplasty for degenerative MR. Ring annuloplasty was done using a Cosgrove-Edwards flexible band (Group I, n=43) or a Carpentier-Edwards classic ring (Group II, n=28). There were no differences in preoperative characteristics of the participants. Average duration of follow-up was 36 months (range: 2~69 mos). Result: There was no in-hospital mortality. Postoperative morbidity, which included atrial fibrillation (n=7) and low cardiac output syndrome (n=5) in groups I and II were similar. There was one late death in group II. The proportion exhibiting freedom from recurrent mitral regurgitation ($\geq$moderate) at 4 years in Groups I and II were, respectively, 94.5 and 91.8%, (p=0.695). Left ventricular ejection fraction decreased in the early postoperative period ($7{\pm}2$ days) and recovered by last follow-up ($25{\pm}16$ mos; p=0.002). The pattern was similar in groups I and II (p=0.905). Re-operation was performed in 3 patients (1 in Group I and 2 in Group II, p=0.316). Four-year event-free survival (free of adverse valve-related events) was 95.2% for Group I and 92.6% for Group II; this difference was not significant, p=0.646). Conclusion: The type of technique used in mitral annuloplasty to repair the mitral valve repair after degenerative MR did not affect mid-term clinical and functional results.

Effect of Auriculotemporal Nerve Block Anesthesia on Manual Reduction of Disc Displacement without Reduction of the Temporomandibular Joint (악관절의 비정복성관절원판변위의 수조작 정복에 대한 이개측두신경 전달마취의 효과)

  • Kim, Sook-Young;Kim, Ji-Yeon;Hong, Su-Min;Kim, Byung-Gook;Park, Byung-Ju;Im, Yeong-Gwan
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.71-79
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    • 2011
  • Aim: Disc displacement without reduction of the temporomandibular joint (TMJ) has been managed by mandibular manipulation to reduce the displaced disc but with a low success rate. The purpose of this study was to determine whether auriculotemporal nerve block anesthesia had an effect on the reduction of the displaced disc and to analyze the factors that influenced the result. Methods: 112 patients were diagnosed with disc displacement without reduction and treated by mandibular manipulation. Disc was recaptured in 35 patients. Among the 77 patients with whom disc recapture had failed, the auriculotemporal nerve was blocked with a local anesthetic in the 49 patients (mean $age \;{\pm}\; SD\; =\; 34.4\;{\pm}\; 15.1$; male 24, female 25) and then mandibular manipulation was performed again. Factors including age, elapsed time from the onset, and opening amount were analyzed in association with disc reduction rate with the auriculotemporal nerve block. Results: Among 49 patients who did not respond to manipulation only, manual reduction with auriculotemporal nerve block anesthesia was successful in 19 patients (38.8%). Maximum unassisted opening amount significantly increased in the 19 patients with successful recapture of the disc ($mean \;{\pm}\; SD\; =\; 46.1 \;{\pm}\; 4.5\; mm$), in contrast to the limited opening amount of the 49 patients before local anesthesia of the auriculotemporal nerve ($mean \;{\pm}\; SD\; =\; 25.7 \;{\pm}\; 6.0\; mm$). Age, elapsed time after the onset, and preoperative opening amount were not associated with the reduction rate. Conclusion: The results of this study suggest that auriculotemporal nerve block anesthesia increases the reduction rate of the disc displacement without reduction of the TMJ when combined with mandibular manipulation, and such anesthesia should be applied at the first stage of manual treatment of disc displacement without reduction.