• 제목/요약/키워드: Aggravation factors

검색결과 49건 처리시간 0.022초

Clinicopathological Characteristics and Prognosis of Remnant Gastric Cancer

  • Lee, Sang-Bong;Kim, Jae-Hun;Kim, Dae-wan;Jeon, Tae-Yong;Kim, Dong-Heon;Kim, Gwang-Ha;Park, Do-Youn
    • Journal of Gastric Cancer
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    • 제10권4호
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    • pp.219-225
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    • 2010
  • Purpose: The long-term survival rate of gastric cancer patients after surgery has recently increased as a result of making an early diagnosis of gastric cancer. Therefore, the incidence of remnant gastric cancer is increasing. This study was performed to evaluate the clinicopathological characteristics and prognosis of patients with remnant gastric cancer. Materials and Methods: From January 2005 to December 2009, twenty-nine patients with remnant gastric cancer and who underwent surgery at Pusan National University Hospital were enrolled in this study. We retrospectively reviewed and analyzed their medical records. We also divided them into two groups: the remnant gastric cancer (RGC)-B group (first operation for benign disease) and the RGC-M group (first operation for malignant disease). Results: The RGC-B group included ten patients and the RGC-M group included nineteen patients. The mean interval between the first and second operations was 17 years. The curative resection rate was 93.1% (27/29). The postoperative complication rate was 20.7% (6/29) and there was no perioperative mortality. Ten (37%) of twenty-seven patients experienced recurrence after curative resection and eight patients (27.6%) expired due to aggravation of remnant stomach cancer. An advanced TNM stage and non-curative resection were the negative prognostic factors for survival for patients with remnant stomach cancer (P=0.0453 and P<0.001). The RGC-M group showed a shorter interval (P<0.001) and the RGC-B group had more advanced TNM stage (P=0.003). Conclusions: Long-term follow-up should be considered not only for patients who undergo an operation for malignant disease, but also for the patients who underwent an operation for benign disease. When remnant gastric cancer is diagnosed, curative resection is essential to improve the survival.

Balloon-Occluded Retrograde Transvenous Obliteration versus Transjugular Intrahepatic Portosystemic Shunt for the Management of Gastric Variceal Bleeding

  • Gimm, Geunwu;Chang, Young;Kim, Hyo-Cheol;Shin, Aesun;Cho, Eun Ju;Lee, Jeong-Hoon;Yu, Su Jong;Yoon, Jung-Hwan;Kim, Yoon Jun
    • Gut and Liver
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    • 제12권6호
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    • pp.704-713
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    • 2018
  • Background/Aims: Gastric varices (GVs) are a major cause of upper gastrointestinal bleeding in patients with liver cirrhosis. The current treatments of choice are balloon-occluded retrograde transvenous obliteration (BRTO) and the placement of a transjugular intrahepatic portosystemic shunt (TIPS). We aimed to compare the efficacy and outcomes of these two methods for the management of GV bleeding. Methods: This retrospective study included consecutive patients who received BRTO (n=157) or TIPS (n=19) to control GV bleeding from January 2005 to December 2014 at a single tertiary hospital in Korea. The overall survival (OS), immediate bleeding control rate, rebleeding rate and complication rate were compared between patients in the BRTO and TIPS groups. Results: Patients in the BRTO group showed higher immediate bleeding control rates (p=0.059, odds ratio [OR]=4.72) and lower cumulative rebleeding rates (logrank p=0.060) than those in the TIPS group, although the difference failed to reach statistical significance. There were no significant differences in the rates of complications, including pleural effusion, aggravation of esophageal varices, portal hypertensive gastropathy, and portosystemic encephalopathy, although the rate of the progression of ascites was significantly higher in the BRTO group (p=0.02, OR=7.93). After adjusting for several confounding factors using a multivariate Cox analysis, the BRTO group had a significantly longer OS (adjusted hazard ratio [aHR]=0.44, p=0.01) and a longer rebleeding-free survival (aHR=0.34, p=0.001) than the TIPS group. Conclusions: BRTO provides better bleeding control, rebleeding-free survival, and OS than TIPS for patients with GV bleeding.

Digital Marketing in the Condition of Wartime Posture in Ukraine

  • Dubovyk, Tetiana;Buchatska, Iryna;Diachuk, Iryna;Zerkal, Anastasiia
    • International Journal of Computer Science & Network Security
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    • 제22권7호
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    • pp.206-212
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    • 2022
  • Strengthening global geopolitical instability in the world leads to an aggravation of international conflicts; it destabilizes the domestic political situation in countries, violates the rights and freedoms of man and citizen, and also activates economic crime. The full-scale invasion of the Russian Federation on the territory of Ukraine and the deployment of military operations in a large territory of a sovereign country have created a number of destabilizing factors in the development of digital technologies and negatively affect the state and trends of digital marketing, which allows establishing interaction with a wide audience and facilitating the search for new customers in various places. The purpose of the research lies in substantiating the theoretical and applied principles for studying the features of digital marketing in the conditions of wartime posture in Ukraine. In the course of the research, general and special methods of economic analysis have been used and applied, namely: analysis and synthesis; analogies and comparisons; generalization and systematization; graphic and tabular methods. Regarding the results of the research of digital marketing in the conditions of wartime posture in Ukraine, it has been established that the intensification of the development of digital marketing is caused by the crisis phenomena of social-economic, social-political and military nature, as well as exacerbated by the challenges of the COVID-19 pandemic. It has been proven that highly developed countries use innovative digital technologies more effectively in the field of marketing, which indicates the importance of the Multidimensional Index of Digitization (the USA - MID: 0,92-0,92; the UK - MID: 0,80-0,97; Japan - MID: 0,80-0,88; Canada - MID: 0,78-0,81; Germany - MID: 0,78-0,88; France - MID: 0,72-0,76), however, the developing countries record much lower values (Ukraine - MID: 0,22-0,48). Accordingly, the level of cybersecurity in highly developed countries is also significantly higher than in transitive countries, in particular, in the United States (GCI: 0,919-0,999); Great Britain (GCI: 0,783-0,995); Canada (GCI: 0,818-0,978) and in Ukraine (GCI: 0,501-0,661).

집단민원의 감성분석을 이용한 공간빅데이터 시각화 방안 (A Study on the Visualization of Geospatial Big Data using Sentiment Analysis of Collective Civil Complaints)

  • 주용진
    • 한국지리정보학회지
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    • 제26권1호
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    • pp.11-20
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    • 2023
  • 전통적으로 공공 서비스에 대한 만족도 요인을 측정하기 위해 설문조사나 인터뷰 연구가 주를 이뤄 왔다. 민원의 단순 빈도를 떠나 민원에 내포된 감정의 경중까지 고려되지 않아 민원인이 체감하는 민원의 시급성, 고충의 심각 정도를 판단하기 어렵다. 이에 본 연구의 목적은 헤도노미터 단어별 행복도 점수를 활용해 집단민원이 내포하는 부정적 감성수치를 산정하는 방안을 제시하였다. 국민권익위원회의 2021년 지역별 상위 민원 토픽과 연관키워드 데이터를 대상으로 헤도노미터를 적용하여 민원의 주제별 부정적 감성수치를 산출하고, 지역별로 분포를 가시화하였다. 본 연구결과로 도출된 부정적 감성수치를 이용해 민원에 내포된 감정의 경중을 고려하여 민원인이 체감하는 민원의 시급성, 고충의 심각 정도를 판단하는데 도움이 될 수 있을 것으로 기대된다.

단일맹검시험을 통한 대황(大黃) 상용량(常用量)의 독성작용 평가 (Evaluation on Toxicity of Habitual dose of Extract of Rheum Palmatum through Single Blinded Pilot Study)

  • 권혁;지규용;엄현섭
    • 동의생리병리학회지
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    • 제24권3호
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    • pp.390-400
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    • 2010
  • This study is aimed to test physiological and hematological actions of Rheum palmatum through clinical pilot study optimized for usual oriental medicine prescription. Thirty-one cases were finally collected and the sample extract 100 $m{\ell}$ of Rheum palmatum (ERP) was administered two times in a day during 3 days and checked with blood CBC test, urinalysis, liver function test, abdominal X-ray as well as general diagnostic process of oriental medicine; pattern identification, assessment of shapes and constitution. The total toxic effective rate of ERP was 9.68% in 3 cases of the whole in case of consistent uneasy state in the subjective symptomatic assessment and aggravation of blood and urine examination. The relevant diagnostic factors were so-eum constitution and essence type subject, carapaces species, lung type in the aspect of Jisan shape theory. On the other hand, the positive effective rate of ERP was 29.03% manifesting improvement of vital signs or present illness and no abnormal changes of blood chemistry and urinalysis and simple abdomen radiology. The relevant diagnostic factors were tae-eum constitution, energy type subject, aves species, heart and liver type in Jisan's shape theory. And the other cases were manifesting no specific change through the administration of ERP. The ratio of the numbers of decrease and increase was 44:5 in the tenderness and hardness of abdominal palpation. But if the pattern identification doesn't comply with the aim of rhubarb application despite of constipation and abdominal pain, the tendeness and biochemical report was shown in abnormal change. The mean number of diarrhea by ERP was $16.77{\pm}6.95$ during 3 days after administration, and the frequent areas of abdominal pain were lower>middle>upper in order, and it meant the target site of ERP too. Besides, the toxic reaction against ERP was expressed highly in case of decrease in blood cell count and hemoglobin, hematocrit having blood deficiency syndrome. Likewise, the toxicity of ERP was influenced by pattern identification manifesting present disease condition and diagnostic factors of four constitutions, Jisan's shape theory collaterally. In conclusion, evaluation of herbal toxicity in order for using as a clinical guideline, various diagnostic pattern information and shape features like the above should be studied together with other pharmacologic toxicology test for the future.

중등증 이상의 COPD 환자에서 흡입용 스테로이드와 지속성 β2-항진제 복합제제사용시 용량의 차이가 급성악화에 미치는 영향 (The effect of Combination Therapy of Inhaled Corticosteroids and Long-acting Beta2-agonists on Acute Exacerbation in Moderate to Severe COPD Patients)

  • 정혜철;하은실;정진용;이경주;이승현;김세중;이은주;허규영;이승룡;김제형;이상엽;신철;심재정;인광호;강경호;유세화
    • Tuberculosis and Respiratory Diseases
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    • 제59권2호
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    • pp.164-169
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    • 2005
  • 연구배경 : ICS/LABA는 천식에서 효과가 입증되었으나 COPD에서는 덜 알려져 있다. 최근 COPD 환자에서 고용량의 ICS/LABA의 사용시 급성악화를 줄인다고 보고되고 있다. 본 연구는 중등도와 고용량의 ICS/LABA사용시 용량에 차이에 따른 COPD의 급성악화를 비교하였다. 방 법 : 2001년 1월 1일부터 2004년 8월 31일 사이에 고대안암병원에 내원하여 진단된 46명의 중등증 이상의 COPD 환자를 대상으로 하였다. flu/sal $250{\mu}g/50{\mu}g$ 하루 2번 사용한 군(A군)과 flu/sal $500{\mu}g/50{\mu}g$ 하루 2번 사용한 군(B군)으로 나누어 1년 기간 동안 급성악화의 횟수 및 입원 횟수, 처음악화까지 걸린 기간을 분석하였다. 결 과 : A 군 26명중 11명에서 급성악화를 경험하였고, 평균 악화 횟수는 0.96회, 입원횟수는 0.15 회였다. B군 20명중 11명에서 급성 악화를 경험하였고 평균 악화 횟수는 1.05회, 입원횟수는 0.30 회였다. 두 군간에 통계적으로 유의한 차이가 없었고 처음악화까지 걸린 시간도 차이가 없었다. 결 론 : 중등증 이상의 COPD 환자에서 ICS 와 LABA 복합제제를 사용 할 때 고농도와 중등도 용량에서 급성 악화에 미치는 영향은 통계적으로 차이가 없었다. 향후 COPD 에서 ICS/LABA 사용시 효과적인 용량에 대한 연구가 좀 더 필요할 것으로 사료된다.

다발성 회전근 개 파열에서 시행한 관절경적 회전근 개 복원술 후 MRI 추적 검사 (MRI Follow-up Study After Arthroscopic Repair of Multiple Rotator Cuff Tendons)

  • 태석기;김진영;박재식
    • Clinics in Shoulder and Elbow
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    • 제11권2호
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    • pp.96-103
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    • 2008
  • 목적: 다발성 건을 침범한 관절경적 회전근 개 복원 술 후 재 파열의 발생률 및 관련된 요인을 알아 보고자 하였다. 대상 및 방법: 극상건과 극하건을 포함한 회전근 개 파열을 보인 22예의 관절경적 복원 술 후(평균 파열크기 3.2 cm, 평균 연령: 58세) 평균 10개월 후 자기공명영상으로 조사 하였다. 복원된 건의 상태 평가는 Sugaya의 분류를 이용하였으며 근육의 상태 변화는 Goutallier의 등급을 이용하였다. 결과: 총 22예 중 7예(32%)에서 재파열을 보였다(Sugaya 분류 IV, V형). 3 cm이상의 파열에서 높은 재파열률 을 보였으며(67%) 반면 3 cm 이하에서는 8%의 재파열률 을 보였다. 재파열을 보인 경우 수술 후 Goutallier II등급 이상의 근육의 변성을 보였다. 반면 재파열이 발생하지 않은 군에서도 근 위축이 호전된 경우는 볼 수 없었다. 결론: 다발성 건을 침범한 회전근 개 파열에서 관절경 적 복원 술 후 32%의 재파열을 보였다. 파열의 크기가 재파열의 중대한 요소이며 파열의 크기가 3 cm 이상인 경우 재파열이 더 자주 발생하였다. 재파열을 보인 경우 근 위축은 진행 하였으며 복원상태가 유지 되어도 근 위축이 호전된 경우는 볼 수 없었다.

Restoration planning of the Seoul Metropolitan area, Korea toward eco-city

  • Lee, Chang Seok
    • 한국환경생물학회:학술대회논문집
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    • 한국환경생물학회 2003년도 학술대회
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    • pp.1-5
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    • 2003
  • In order to prepare a basis for ecological restoration of the Seoul Metropolitan area, ecological diagnoses on soil physico-chemical properties and vegetation structure were carried out. Land use patterns, actual vegetation, and biotope patterns were also investigated based on aerial photograph interpretation and field checks. I formulated landscape elements overlaying those data and evaluated the ecological value of each element. Soil pollution was evaluated by analyzing soil samples collected in each grid on the mesh map, divided by 2km $\times$ 2km intervals. Soil samples were collected in forests or grasslands escaped from direct human interference. Soil pollution evaluated from pH, and SO$_4$, Ca, Mg, and Al contents of soil was more severe in the urban outskirts than in the urban center. Those soil environmental factors showed significant correlation with each other. Vegetation in the urban area was different in species composition from that in suburban areas and showed lower diversity compared with that in the suburban areas. Successional process investigated by population structure of major species also showed a difference. That is, successional trend was normal in suburban areas, but that in urban areas showed a retrogressive pattern. The landscape ecological map of Seoul indicates that the urban center lacks vegetation and greenery space is restricted in urban outskirts. Such an uneven distribution of vegetation has caused a specific urban climate and thereby contributed to aggravation of air and soil pollution, furthermore causing vegetation decline. From this result, it was estimated that such uneven distribution of vegetation functioned as a trigger factor to deteriorate the urban environment. I suggested, therefore, a restoration plan based on landscape ecological principles, which emphasizes connectivity and even distribution of green areas throughout the whole area of the Seoul to solve this complex environmental problem. In this restoration plan, first of all, I decided the priority order for connection of the fragmented greenery spaces based on the distances from the core reserves comprised of green belt and rivers, which play roles as habitats of wildlife as well as for improvement of urban environment. Next, I prepared methods to restore each landscape element included in the paths of green network to be constructed in the future on the bases of such preferential order. Rivers and roads, which hold good connectivity, were chosen as elements to play important roles in constructing green network by linking the fragmented greenery spaces.

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해면상 혈관종의 자연 경과와 치료 전략 (Cavernous Angioma : Natural History and Management Strategies)

  • 임효주;권양;안재성;김정훈;김창진;이정교;권병덕
    • Journal of Korean Neurosurgical Society
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    • 제29권8호
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    • pp.1001-1007
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    • 2000
  • Objective : We analysed diverse clinical features of the cavernous angioma. Also, we report the experience in differ-ent methods of the management and their results. Method : Data from 80 patients who were confirmed pathologically or diagnosed radiologically between Jan. 1990 and Sept. 1998 at our hospital were analysed. Variable factors that were examined were : clinical features, effects of treatment, and complications. Results : There were 47 male and 33 female patients. The age at the first presentation was from 3 to 57(mean 34.1) years old. Clinical features were seizure in 28 cases(38%), bleeding in 24 cases(32%), neurologic deficits in 12 cases(16%), headache in 10 cases(14%), and six incidental cases. The locations of lesion were cerebral and cerebellar hemisphere in 45 cases(56.2%), brainstem, basal ganglia, and thalamus in 32 cases(40%), multiple in 3 cases (3.8%). Seizure was common at the third decade and occurred frequently with the cavernous angioma in temporal (43%) or frontal lobe(39%). Bleeding was frequent after the third decade with peak at the fourth decade and had high incidence in brainstem or thalamus. The gamma-knife radiosurgery was done in 47 cases. Rebleeding occurred in 3 cases, but it was within postradiosurgery 1 year. Symptomatic radiation change occurred in 2 cases of 8 radiation change on MRI. On follow-up MRI, no evidence of rebleeding was found in 30 cases. Also, The lesion size was decreased in 3 cases. Resection was performed in 23 cases ; total 20, subtotal 2, partial 1. Postoperative complication occurred in 6 cases(26.1%). After surgery, 7(63.6%) of 11 seizure patients had outcome of seizure-free. Subclinical rebleeding occurred in one of two subtotal resected cases. In 11 patients, conservative management was done. There was neither rebleeding nor symptom aggravation during follow-up period of mean 17.2 months. Conclusion : The solution for prevention of rebleeding is complete removal of the lesion located at noneloquent area or accessible region, especially for the patients who presented symptoms or intractable seizure. However, the Gamma knife radiosurgery is considered when the lesions are located at eloquent area or when severe postoperative morbidity is expected.

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경희의료원 제3 중환자실(동서협진중환자실)에 입원한 89명의 중증 급성기 뇌경색 환자에 대한 임상적 고찰 (Clinical Analysis of 89 Patients with Severe Acute Ischemic Stroke from 3rd Intensive Care Unit(East-West Integrated Intensive Care Uint) of Kyung Hee Medical Center)

  • 허홍;소형진;임주혁;조인영;이혜영;민경윤;류재환;이범준
    • 대한한방내과학회지
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    • 제28권4호
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    • pp.863-871
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    • 2007
  • Objects : To gain better insights of East-west integrated treatment of ischemic stroke. We analyzed 89 patients with severe acute ischemic stroke who were admitted to the East-west integrated intensive care unit. Methods : Subjects enrollment was from the East-west integrated intensive care unit of Kyung Hee Medical Center from March 2006 to February 2007. Patients were admitted within 14 days after the onset of ischemic stroke. We assessed the subjects' general characteristics, risk factors, admitting routes and periods, diagnostic imaging, process of western treatment and Korean traditional treatment, complication and consequence. Results : The proportion of males was 50.6%, of females 49.4%, average age was male 66.0$\pm$10.3 and female 71.1$\pm$10.5. Average length of hospital stays was 19.5 days. Monthly admissions were highest in November and December. The admission route was through emergency room (61.8%) or ward (34.8%). Mean Glasgow coma scale score was 10.0$\pm$2.5, average time from symptom of onset to hospital admission was 2.3$\pm$2.2 days. Dominant ischemic vascular territory was middle cerebral artery (66.3%). Initial western treatment was argatroban (22.5%), urokinase (28.1%), and heparinization (38.2%). Distribution of Sasang constitution of So-yang to Tae-eum to So-eum was equal to 5.4 to 2.9 to 1.5. Major complications were observed in 40 (42.7%) patients. In hospital mortality was 12.4% (11 deaths), all of them caused by aggravation of neurological deficit and only 3 of them with major complications. There appears to be a significant positive relationship between length of hospital stay and occurrence of complications (P<0.05). After discharge from the ICU, 64 (71.9%) patients were improved, 11 (12.4%) patients had expired, and 14 (15.8%) patients were transferred. Conclusions : From this study, we suggest that patients with severe acute ischemic stroke should be treated with East-west integrated therapy for more favorable consequences and decreased mortality.

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