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Clinical Evaluation of Esophageal Cancer (식도암의 임상적 고찰)

  • 박기성;박창권;최세영;이광숙;유영선;금동윤
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.149-154
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    • 1998
  • We retrospectively analyzed 54 patients with esophageal cancer treated surgically between 1992 and 1996. They composed of 51(94.4%)men, 3(5.6%)women, and the age ranged from 42 to 78, the mean was 58.7$\pm$8.37. Symptoms were varied with dysphagia(72.2%), epigastric discomfort(16.6%), chest pain (5.6%), and so on(5.6%). Transthoracic esophagectomy(TTE) with esophagogastrostomy was done in 36 case, TTE with esophagocologastrostomy in 4 case, and transhiatal esophagectomy(THE) with esophagogastrostomy in 14 case. The operative mortality was 12.9%(7/54); 6 underwent TTE with esophagogastrostomy, and 1 underwent TTE with esophagocologastrostomy. Postoperative complications were of anastomotic leakage in 7 case, wound infection in 10 case, anastomotic stricture in 9 case, vocal cord paralysis in 2 case, bronchial tearing in 1 case, and pneumothorax in 3 case. Locations of esophageal cancer were upper thoracic esophagus in 4 case, middle thoracic esophagus in 34 case and lower thoracic esophagus in 16 case. Histological types were adenocarcinoma in 1 case and squamous cell carcinoma in 53 case. During the follow-up period, 25 cases died. Cumulative survival rate was 52.7% in 1 year, 45.5% in 2 year, 45.5% in 3 year, 45.5% in 4 year, 45.5% in 5 year.

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Measles Specific IgG in Adolescents (청소년기의 홍역 특이 IgG)

  • Yoon, Jae Kyun;Shin, Young Kyoo;Lee, Kee Hyoung;Choung, Ji Tae;Tockgo, Young Chang
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.133-139
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    • 1997
  • Purpose : To determine the age-specific seropositivity and the level of measles specific IgG in vaccinated adolescents, the measles specific IgG titers were measured from the sera of junior & senior high school students in Seoul, Korea. Methods : From May to July in 1996, 216 sera were collected from junior & senior high school students(male : 110, female : 106) aged 12 to 17 years who were vaccinated and had no history of natural measles. Measles specific IgG titers were measured using ELISA method($SIA^{TM}$ Measles IgG Kit, Sigma Co. St. Louis, Mo). Results : The seropositivity of measles specific IgG in vaccinated adolescents aged 12 to 17 years was 91.2%. There were no significant correlations between age and seropositivity as well as between age and measles specific IgG level. Conclusions : We consider that our data suggest the necessity of revaccination of measles in adolescents. Further considerations should be required to establish an appropriate revaccination method and to evaluate the efficacy of revaccination of previously vaccinated adolescents.

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Recent Trends in the Prevalence of Mycoplasma pneumoniae Pneumonia According to Age (연령에 따른 Mycoplasma pneumoniae 폐렴 발병의 최근 경향)

  • Lee, Hyo Sang;Choi, Kyong Min
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.162-166
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    • 2008
  • Purpose : It has been previously reported that for patients with Mycoplasma pneumoniae pneumonia was previously recognized that overt illness is unusual under the age of three and the peak incidence of illness occurs in school-aged children. However, a higher incidence of this illness in younger children has been recently noted. Thus we investigated the incidence of M. pneumoniae pneumonia. Methods : The study subjects were 414 children who were diagnosed with M. pneumoniae pneumonia from January 2004 to December 2006 at Myong Ji Hospital were enrolled. The diagnostic criteria consisted of an anti-mycoplasma antibody (AMA) titer greater than 1: 320 or a four-fold rise in the titer at follow up. Results : The age distribution was as follows: before 2 years of age: 58 patients (14%), 2-4 years of age 157 patients (37.9%) and 5-15 years of age 199 patients (48.1%). The yearly incidence for the children before 5 years of age was 52 (44%), 49 (44.6%) and 114 (61.3%), respectively. The distribution according to the antibody titer was as follows; 1: 320 in 130 patients, 1:640 in 63 patients and greater than 1:1,280 in 221 patients. The hospital stay according to the antibody titer was not significant according to either age or the AMA titers. Conclusion : M. pneumoniae pneumonia showed a peak incidence in preschool children with a higher prevalence in children under the age of three than was previously recognized. The emergence of M. pneumoniae pneumonia as a cause of community acquired pneumonia in younger children calls for an epidemiologic study to investigate the changes of the pathogens in this age group and to recommend the proper treatment.

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Radiation Therapy for Operable Breast Cancer after Conservative Surgery (유방암환자의 유방보존수술 후 방사선 치료 성적)

  • Lee, Myung-Za;Chun, Ha-Chung
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.309-315
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    • 2002
  • Purpose : To evaluate the result of conservative management on recurrence, survival and prognostic factors of patient with operable breast cancer. Materials and Methods : Fifty three patients, treated for localized breast cancer by lumpectomy or quadrantectomy followed by radiotherapy between January 1985 and December 1996, were retrospectively studied. All patients followed up for at least five years. Their median age was 43 years $(range\;24\~72)$. The tumor stages were as follows : T1 in 30 patients, T2 in 21, Tis in 2. Thirty-eight patients had negative and 15 had positive axillary nodes. The histological types were 42 infiltrating ductal, 2 infiltrating lobular, and 2 intraductal carcinomas with 7 other histologies. The tumor locations were the outer quadrant in 38 breasts, the inner quadrant in 13 and central in 2. Radiation doses of $46\~50\;Gy$ were given to the entire breast areas with additional doses of 14-18 Gy delivered to the tumor bed areas. Results : The overall five and 10 yea actuarial and disease free survivals were $94.3\%\;and\;92.4\%,\;91.2\%\;and\;81\%$, respectively. The overall five year survivals were $100\%$ in stage I and IIa, and $66.7\%$ in stage IIb and IIIa tumors. Seven patients failed either locally or distantly. Incidence of local failure and distant metastasis for the first failure were $7.5\%\;and\;5.7\%$, respectively. Local recurrence appeared within 2 years of treatment at the primary site and after more than 8 years outside of primary lesion, whereas distant metastasis appeared between 2 and 6 years following treatment. The overall recurrences were high at a young age (< or = 35 years), with 5 out of 12 (2 local, 3 distant), and in T2 lesions with 5 out of 21 (1 local, 3 distant, and 1 in both). Distant metastasis was high in the positive axillary lymph node group with 4 out of 15 $(26.6\%)$. A high incidence in the axillary node was noted at a young age with 7 out of 12 $(58.3\%)$ and in T2 lesions with 8 out of 21 $(38.4\%)$. A young age, positive axillary node and large tumor size were all related with poor survival. Conclusion : Based on this study, lumpectomy or quadrantectomy, followed by radiation appears to be an adequate therapeutic method in operable breast cancer. A long term follow-up is necessary because a recurrence of breast can occur long time after treatment. The poor prognostic group, especially young patients with an aggressive biological behavior needs more effective treatment modalities to improve their survival.

Growth promoting effect of combined gonadotropin releasing hormone analogue and growth hormone therapy in early pubertal girls with predicted low adult heights (예측성인신장이 작은 조기사춘기 여아에서 성선자극호르몬 방출호르몬 효능약제와 성장호르몬 병합치료의 성장획득 효과)

  • Hong, Eun-Jeong;Han, Heon-Seok
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.678-685
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    • 2007
  • Purpose : Recent reports pointed out that gonadotropin releasing hormone analogue (GnRHa) therapy alone is not so promising for improving adult height in precocious puberty. So, that we studied the growth promoting effect of combined therapy with GnRHa and growth hormone (GH) in early pubertal girls. Methods : Twenty three early pubertal girls ($9.73{\pm}1.59yr$) with predicted adult heights (PAH) below-2 standard deviation score (SDS) were included. They were divided into two groups as follows; Group I before menarche (n=19) and Group II after menarche (n=4). After combined therapy, various growth parameters were compared between two groups and between the before and after therapy. Results : Between the two groups before therapy, chronologic age (CA), growth velocity (GV), body mass index (BMI), target height (TH), PAH and serum insulin-like growth factor binding protein-3 were not different, but BA, height and difference between bone age (BA) and CA were significantly higher and insulin-like growth factor-1 (IGF-1) was marginally higher in group II. After therapy, BA still remained higher in group II, but other parameters were not different. In both groups, after therapy, the difference between BA and CA, the ratio of BA over CA, and GV were significantly decreased, but PAH, height SDS and BMI were significantly increased. Regarding IGF-1 level, a significant increase was noted in group I, but not in group II. Conclusion : With combined therapy of GnRHa and GH, PAH in early pubertal girls might be improved significantly and even approach TH. Among them, those who were before menarche might have greater potential for the height gain than those after menarche in view of IGF-1 changes during therapy.

Preparation of Highly Active Metathesis Catalyst from Rhenium Carbonyl and its Catalysis (레늄카보닐에 의한 고활성 메타세시스 촉매제조 및 그의 촉매작용)

  • Ahn, Ho-Geun
    • Applied Chemistry for Engineering
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    • v.9 no.1
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    • pp.115-120
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    • 1998
  • The surface chemistry of $Re_2(CO)_{10}$ deposition for preparing highly dispersed rhenium catalysts and the formation of active site for the metathesis were studied. Alumina as support was treated at 1223K(DA) and 773k(PDA), respectively. The metathesis activity of the catalysts at 298K was measured by using pure propene under atmospheric pressure. The oxidation number of rhenium on PDA was very high, and that on DA was zero-valent with highly dispersed state. The prepared Re/DA catalyst was easily activated by treating with oxygen gas at low temperatures after thermal decomposition at high temperatures. The activity of Re/DA catalyst, even with very low rhenium loading, was much higher than that of Re/PDA or conventional $Re_2O_7/Al_2O_3$ catalysts. Therefore, rhenium carbonyl was effective for preparing a highy active metathesis catalyst with very low rhenium loading. Rhenium ion on Re/DA catalyst seemed to be bonded to two oxygen atoms on DA surface, that is, two-valent. The two-valent rhenium ion was changed to about six-valent by treating with oxygen. It could be considered that propene metathesis occurred through carbene complex which was formed on the six-valent rhenium ions.

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Life Expectancy and Causes of Death for the elderly of Korea, USA, and Japan (한미일 노인의 기대여명과 사망원인)

  • 박경애
    • Korea journal of population studies
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    • v.22 no.2
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    • pp.97-119
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    • 1999
  • 한국, 일본, 미국의 생명표, UN의 인구연감, WHO의 세계보건통계연감 등 공식통계를 활용하여, 한국 노인의 기대여명 및 사망원인별 사망력을 미국 및 일본과 비교하여 파악하고 있다. 한국 노인의 기대여명은 미일보다 빠른 속도로 증가하고 있는데, 1970년대 중반 이후는 미국처럼 여자보다 남자 노인의 기대여명 증가가 빠르면서, 남녀 노인의 기대여명 차가 감소하고 있다. 1997년 현재 65세시 기대여명은 남자 13.64세, 여자 17.26세로 남녀간 3.62세 차이를 보이며, 출생후 남자 72%, 여자 88%가 65세까지 생존한다. 노인의 주요 사인은 미일과 마찬가지로 순환기계질환 및 악성신생물인데, 순환기계질환중 한일은 뇌혈관질환이, 미국에서는 허혈성 심장질환이 노인의 주된 사망원인이 된다. 한국 남녀 노인의 연령층과 상관없이 허혈성 심장질환 및 폐렴 사망률은 미일보다 낮고, 뇌혈관질환, 고혈압성질환, 위암, 간암, 결핵, 당뇨병, 정신 및 행동장애, 간질환 및 교통사고 사망률은 미일보다 높다. 대부분의 사망원인에서 남자사망률이 여자사망률보다 높지만, 한국의 고혈압성 질환, 간암, 폐암 및 간질환에 의한 성별 사망률 격차가 미일보다 크며, 한미일 모두 75세 이상 노인의 정신 및 행동장애에 의한 여자 사망률보다 남자사망률보다 높게 나타난다. 사망원인 생명표 작성결과를 보면, 1997년 현재 한국의 65세 남성과 여성은 순환기계질환 제거시 각각 3.47년과 2.7년을, 악성신생물 제거시 각각 3.87년과 1.58세의 기대여명 증가를 예상할 수 있고, 일본에 비해 특정 사인을 제거시 상대적으로 많은 기대여명 증가를 기대할 수 있는 사망원인은 남자 노인의 간질환 및 교통사고를 들 수 있다.

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Clinical Experience with IABP in Cardiac Surgery (개심술시 Intra-aortic balloon pump (IABP)의 임상적 적용)

  • 옥창석;지현근
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.34-39
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    • 1997
  • Between May, 1994 and December, 1995, 122 adult cardiac surgical procedures requiring cardiopulmonary bypa s were performed at Kang Dong Sacred Heart Hospital, including 18 cases(14.8%) that were associated with preoperative(n:9), intraoperative(n=7), postoperative(n:2) use of an IABP (intra-aortic balloon pump). The reasons for IABP were low cardiac output and PTCA(percutaneous transluminal coronary angioplasty) failure in preoperative period, CPB(cardiopulmonary bypass) weaning difficulty in intraoperative period, and intractable arrhythmia in postoperative period. The mean age of the IABP patients was 61.8 $\pm$ 6.9 years(range, 39 to 75years). The overall hospital mortalities in patients with preoperative and intraoperative IABP insertion were 3 and 42.9% respectively. Two patients with postoperative IABP insertion are alive. The rate of IABP weaning is 66.7% for preoperative group, 85.7% for intraoperative group and 100% for postoperative group . In conclusion, if there were no irreversible myocardial damages, IABP could be used safely and emergently at any perioperative period for hemo ynamic stability, CPB weaning, and to overcome low cardiac output syndrome.

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Isolation Frequency of Candida species from Clinical Specimens (임상검체에서 Candida spp.에 대한 분리빈도)

  • Shin, Hyun-Sung;Park, Youn-Bo;Shin, Du-Sik
    • The Korean Journal of Mycology
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    • v.38 no.2
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    • pp.146-151
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    • 2010
  • A total of 167,955 microorganisms were isolated from 366,661 clinical specimens. Among them, 6,517 strains of the Candida spp. were isolated from the department of laboratory medicine in "C" hospital from Jan. 1, 2005 to Dec. 31, 2009. All clinical specimens were reviewed by the medical records of patients with Candida by the method of retrospectiveness. From this, we got the some isolated pure cultured yeasts. We identified these yeast by the identification kit system of VITEKII and VITEKII-ID-YST card. The isolation frequencies of Candida spp. were as follows. 56.4%,of C. albicans, 17.7% C tropicalis, 10.7% C glabrata and 9.5% C parapsilosis. The isolated frequency of Candida spp. in 2009 was 1.9 times higher than that in 2005. The clinical materials showing over 10.0% isolation rate were in sputum (30.1%), random urine (25.0%), 15.8% blood (15.8%) and catheterized urine (13.5%) in Candida spp.. The clinical department of showing over 7.0% isolation rate were in pulmonary medicine (20.5%), renal medicine (11.0%), infection disease medicine (10.4%), critical care medicine (10.0%), hematooncology (9.6%), general surgery (7.5%) and gastrointestinal medicine (7.4%) in Candida spp.. In monthly analysis, Candida spp. were most friquency isolated in July (10.6%), but lowest one in February (6.1%). Candida spp. were most frequently isolated in patient of over 50 years old (16.7-40.1%) than those isolated from the patients under the age of 0-49 (1.3-7.5%).

Characterization of SAL plasmid isolated from Pseudomonas putida (Pseudomonas putida에서 분리한 SAL 플라스미드의 특성)

  • 김희윤;임영복;이영록
    • Korean Journal of Microbiology
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    • v.25 no.1
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    • pp.9-16
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    • 1987
  • Three strains of bacteria utilizing salicylate, KU801(pKU5, pKU8), KU803(pKU6, pKU9), and KU806(pKU7, pKU10), were selected from the isolates and identified as Pseudomonas putida. By agarose gel electrophoresis, it was found that the strains had two plasmids each. All three strains were resistant to antibiotics such as ampicillin, tetracyclin, and chloramphenicol, and did not utilize other aromatic and aliphatic hydrocarbons examined except salicylate. The plasmids (pKU5, pKU6, and pKU7) of larger molecular weight were cured by treatment with mitomycin C and frequencies of curing were 0.4%, 1.67%, and 0.75%, respectively. Cured strains did not degrade salicylate and still had antibiotic resistances, which were identical with wild strains. The genes for salicylate degradation were proved to be enclded on thier plasmids. The molecular weights of pKU5 and pKU6 were estimated as 103.5Md, and that of pKU 7 as 101 Md. The new SAL plasmids, pKU5, pKU6, and pKU7 were transferred to P. putida and P. aeruginosa, but not to E. coli.

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