• Title/Summary/Keyword: CM at Risk

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Cell Differentiation Might Predict the Recurrence in Surgically Resected Non-Small Cell Lung Carcinoma (비소세포폐암 수술 후 세포분화도가 재발에 영향을 미친다)

  • Kang, Hyung-Koo;Cho, Sung-Gun;Lee, Hye-Min;Park, Sung-Woon;Lee, Byung-Ook;Lee, Jae-Hee;Kim, Bo-Min;Park, In-Won
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.1
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    • pp.10-15
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    • 2010
  • Background: Lung cancer is the most common cause of cancer mortality in Korea. The TNM stage at presentation in patients with non-small cell lung cancer (NSCLC) has the greatest impact on prognosis. Patients who undergo a complete resection for NSCLC are likely to develop recurrent and/or metastatic disease. There are several factors influencing the development of recurrence. We explored risk factors of recurrence in patients with stages I and II NSCLC, who had undergone curative resection. Methods: We reviewed patients who had complete surgical resection as definitive treatment for stage I or II. Patients followed up for more than 36 months. We evaluated several factors which might have relationship with recurrence, such as patient's demographic factors, TNM staging, pathologic finding, tumor markers and surgical technique. Results: A total of 75 patients were enrolled for analysis, of whom 58 were men and 17 were women with mean age of 61 (range, 37 to 76) years. The average size of tumors was 3.9 cm (0.7 to 10 cm). There were 64 patients with stage I NSCLC and 11 with stage II NSCLC. Among 64 patients with stage I NSCLC, 35 patients showed recurrences whereas 8 patients have recurred in stage II NSCLC. Grade of differentiation of tumor was closely related to the recurrence. Seventy-five percent of patients who had poor tumor differentiation experienced a recurrence. In contrast, 3 patients of twelve had recurrences, who revealed differentiation in their tissue (p<0.05). Conclusion: Tumor differentiation could be a predictive factor for tumor recurrence in patients who have undergone curative resection for stage I or II NSCLC.

A Study on Dose and Image Quality according to X-ray Photon Detection Method in Digital Radiography System (Digital Radiography System에서 X선 광자 검출 방식에 따른 선량 및 화질 특성에 관한 연구)

  • Hong, Sun Suk;Kim, Ho Chul
    • Journal of the Institute of Electronics and Information Engineers
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    • v.50 no.12
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    • pp.247-253
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    • 2013
  • The purpose is a comparative evaluation in the DR System according to the dosimetry and image quality of the quantitative and objective via Direct digital radiography, Indirect digital radiography, Image intensifier (Charge Coupled Device type) digital radiography. The experimental method used rando phantom and measured the entrance surface dose. And through using the measured entrance surface dose and then using the PCXMC program were evaluated risk due to irradiation and the effective dose. SNR and NPS and CNR were measured and analyzed by using 21cm acryl phantom. Significance of measured value was evaluated by statistics method. Entrance surface dose, major organ dose, effective dose all of them were measured the lowest rated in direct DR when it is on the basis of direct DR dose, high-dose ratio were measured in I.I DR approximately 1.3 times, indirect DR approximately 2.4 times. Risk in accordance with radiation also was measured same as dose ratio. On the conclusion that SNR measurement result based on direct DR SNR measurements, low-SNR ratio were measured in I.I DR approximately 7.25 times, indirect DR approximately 1.48 times. On the conclusion that CNR measurement result based on direct DR CNR measurements, high-dose ratio were measured in I.I type DR approximately 1.16 tims and low-dose ratio were measured in indirect DR approximately 0.87 times. Therefore Direct DR system using a-selenium sensing element to detect x-ray photon is thought effectively at the examination such as infant to sensitive irradiation and the genital gland. Because quality image is built by low dose. Also when it is necessary that image test requiring many diagnosis information, indirect DR system is thought effectively.

A Case of a Retroperitoneal Cystic Lymphangioma Treated by Percutaneous Catheter Drainage and Sclerotherapy (경피적 도관 배액술과 경화요법으로 치료한 후복막 낭성 림프관종 1예)

  • Kang, Hyun-Sik;Kim, Seung-Hyung;Kim, Bong-Soo;Kang, Ki-Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.86-91
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    • 2010
  • Retroperitoneal cystic lymphangiomas are benign, extremely rare tumors. Although surgical resection is the treatment of choice, sclerotherapy should be considered initially. A 9-year-old boy was admitted due do worsening abdominal pain of 4 days duration. Serial complete blood counts revealed a hemoglobin level of 12.8 g/dL on admission to 10.6 g/dL on hospital day 3. An abdominal computed tomography (CT) scan showed a large, lobulated, septated, retroperitoneal cystic mass ($10{\times}9.5{\times}5cm$) in the left anterior pararenal space with intracystic hemorrhage surrounding the inferior mesenteric vein (IMV). Because of the high operative risk, we performed a tubogram of the cystic mass, percutaneous catheter drainage (PCD), and ethanol sclerotherapy. The follow-up abdominal CT scan showed that the cystic mass had decreased in size. He is well without relapse of the retroperitoneal cystic mass for 13 months after discharge. Sclerotherapy with PCD should be considered as initial therapy for patients with retroperitoneal cystic lymphangiomas at high surgical risk.

Evaluation of Gestational Diabetes Mellitus Risk Factors Using Abdominal Subcutaneous Fat Thickness for Early Pregnancy in the US Imaging (초음파영상에서의 임신초기 복부피하지방두께를 이용한 임신성당뇨 위험인자 평가)

  • Kim, Changsoo;Yang, Sung-Hee;Kim, Jung-Hoon
    • Journal of radiological science and technology
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    • v.40 no.1
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    • pp.35-40
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    • 2017
  • The purpose of this study was to investigate the relationship between abdominal subcutaneous fat thickness(ASFT) and maternal gestational diabetes mellitus(GDM) measured by ultrasound at period of pregnancy. We compared maternal age, pre-pregnancy body mass index, and weight gain during pregnancy in 286 pregnant women who were diagnosed with early pregnancy ASFT and high GDM screening test(50 g OGTT) of more than 140 mg/dL. ROC curve analysis was used to determine the cut-off value of ASFT for GDM prediction. Maternal age and weight gain during pregnancy were not related to GDM in the mid-trimester and pre-pregnancy body mass index and earely pregnancy ASFT were significantly different between normal and GDM high risk groups. The cut-off value of ASFT for GDM prediction was 2.23 cm(AUC 0.913. Sensitivity 76.19%, Specificity 93.72%). ASFT measured by ultrasound in early pregnancy was useful as an important index for predicting mid-trimester GDM prediction. Therefore, ASFT can be used as an auxiliary diagnostic index for early recognition of GDM.

Changes in Impact Characteristics of the Body by Different Heel Strike Patterns during Running (달리기 시 착지 유형에 따른 인체에 미치는 충격의 변화)

  • Young-Seong Lee;Sang-Kyoon Park
    • Korean Journal of Applied Biomechanics
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    • v.33 no.4
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    • pp.164-174
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    • 2023
  • Objective: The aim of this study was to quantitatively analyze the impact characteristics of the lower extremity on strike pattern during running. Method: 19 young subjects (age: 26.53 ± 5.24 yrs., height: 174.89 ± 4.75 cm, weight: 70.97 ± 5.97 kg) participated in this study. All subjects performed treadmill running with fore-foot strike (FFS), mid-foot strike (MFS), and rear-foot strike (RFS) to analyze the impact characteristics in the lower extremity. Impact variables were analyzed including vertical ground reaction force, lower extremity joint moments, impact acceleration, and impact shock. Accelerometers for measuring impact acceleration and impact shock were attached to the heel, distal tibia, proximal tibia, and 50% point of the femur. Results: The peak vertical force and loading rate in passive portion were significantly higher in MFS and FFS compared to FFS. The peak plantarflexion moment at the ankle joint was significantly higher in the FFS compared to the MFS and RFS, while the peak extension moment at the knee joint was significantly higher in the RFS compared to the MFS and FFS. The resultant impact acceleration was significantly higher in FFS and MFS than in RFS at the foot and distal tibia, and MFS was significantly higher than FFS at the proximal tibia. In impact shock, FFS and MFS were significantly higher than RFS at the foot, distal tibia, and proximal tibia. Conclusion: Running with 3 strike patterns (FFS, MFS, and RFS) show different impact characteristics which may lead to an increased risk of running-related injuries (RRI). However, through the results of this study, it is possible to understand the characteristics of impact on strike patterns, and to explore preventive measures for injuries. To reduce the incidence of RRI, it is crucial to first identify one's strike pattern and then seek appropriate alternatives (such as reducing impact force and strengthening relevant muscles) on that strike pattern.

Gender Differences of Vertical Drop Landing Strategies in College Students

  • Yi, Chung-Hwi;Park, So-Yeon;Yoo, Won-Gyu
    • Physical Therapy Korea
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    • v.11 no.4
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    • pp.1-6
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    • 2004
  • The kinematics involved in different landing strategies may be related to the occurrence of trauma. Several sources suggest that the angle of knee extension on touchdown and impact with the ground determines the magnitude of the impact force and, indirectly, knee loading. This study compared the initial knee angle and maximum knee flexion angle at the instant of impact on drop-landings between healthy men and women. In this study, 60 participants (30 males, 30 females) dropped from a height of 43 cm. A digital camera and video motion analysis software were used to analyze the kinematic data. When landing, there was significant difference between the two groups ($15.67{\pm}6.05^{\circ}$ in male, $24.10{\pm}6.34^{\circ}$ in female) in the mean knee flexion angle. The range of knee flexion on landing ($44.06{\pm}10.97^{\circ}$ in male, $36.96{\pm}9.99^{\circ}$ in female) also differed significantly (p<.05). The greater knee flexion that was observed in the male subjects would be expected to decrease their risk of injury. Women land with smaller range of knee flexion than men and this might increase the likelihood of a knee injury.

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Clinical and Hemodynamic Investigation of Atrial Septal Defect (심방중격결손증의 혈류역학적 상관관계 및 임상적 고찰)

  • 정상조
    • Journal of Chest Surgery
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    • v.24 no.5
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    • pp.445-450
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    • 1991
  • Forty eight patients diagnosed as atrial septal defect, had been operated from April 1986 to December 1990 at the Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, were analysed retrospectively. Of the 48 patients, 12 patients, were male and 36 patients were female, Their ranged from 8 months to 51 years old, and the mean was 18.0 years old. The proceeding two symptoms were exertional dyspnea and frequent upper respiratory infection. But 10 patients [20.8%] were asymptomatic. Electrocardiographic findings were regular sinus rhythm in 100.0%, RVH in 29.2%, incomplete RBBB in 27.1%, and first degree AV block in 2.1%. Hemodynamic studies were performed in 38 of 48 patients. Significant pulmonary hypertension[over 50mmHg in systolic pulmonary arterial pressure], which is the most serious risk factor, was developed in 4 patients[8.3%]. There was statistical significance between size of defect[cm2/BSA-M2] and systolic pulmonary arterial pressure[sPAP] retrospectively[p=0.036]. We could not find the correlationship between age and Qs % size. Anatomically, secundum type constituted 97.9%, in which 43 patients were PFO type[91.6%] and 3 patients were IVC type[6.3%]. 38 of 48 ASD patients were repaired with patch closure[72.9%] and remains were repaired with direct closure[27.1%]. The operative result was excellent except two cases of transient postoperative arrhythmia. There was no operative mortality.

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Surgical Results of Fontan Operation (Fonatan 수술성적에 대한 평가)

  • Seo, Gyeong-Pil;Seong, Suk-Hwan
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.22-29
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    • 1987
  • From Sep. 1978 to Aug. 1986, 44 cases of Fontan operation were performed at Seoul National University Hospital. 1] The diagnoses were TA in 13 [38.6%], UVH in 21 [47.79`], DORV in 3 [6.8%], TGA in 2 [4.5%] and C-ECD with DORY in 1[2.3%]. 2] There were 20 operative deaths [44.5%]. 3] The operative risk factors were early date of operation between 1978 and 1983, young age below 3 years old, direct atriopulmonary anastomosis without roofing, and postoperative high CVP above 25cmH,O. But the relation between operative mortality and various cardiac diseases was absent. 4] survived patients were followed from 1 to 54 months except 3 patients who were lost to follow up. 16 patients were in functional class I and 1 in class II, 2 of the above 17 patients were reoperated due to residual right to left shunt. In remained 4 patients, 3 patients persisted cyanosis after operation and 1 patients died 1 month postoperatively due to pulmonary embolism. 5] As 4 result, the Fontan procedure can be done with a good result for tricuspid atresia and other complex lesions. The operative mortality can be reduced further with a correct anatomical diagnosis preoperatively, rigid operative criteria to pulmonary vascular resistance, direct atriopulmonary anastomosis with roofing, and use of `Venous Assist Device` postoperatively in low cardiac output patients.

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A New Method of Approach for Percutaneous Thoracic Vertebroplasty in Vertebral Compression Fracture -Case report- (흉추 압박골절환자를 위한 경피적 척추성형술의 새로운 접근법 -증례 보고-)

  • Shin, Keun-Man
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.237-241
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    • 2000
  • Vertebral compression fractures commonly afflict the elderly. Some patients suffer from severe mechanical pain in spite of treatments with strong analgesics and bracing. Vertebroplasty, which was originally used for vertebral hemangioma, is effective for patients who do not respond to these more conservative treatments. However, the procedure has some risk. Leaks of bone cement into perineural tissues can be a serious complication. In contrast to the lumbar vertebrae, the outer margin of the pedicle of the thoracic vertebrae is almost in line with the outer margin of the body. This, combined with the thinner pedicle of the thoracic vertebrae, makes proper needle placement difficult. The posterolateral approach is preferred to the transpedicular approach in order to avoid the danger of destroying the inner cortex of the pedicle. But there can be a problems with the standard posterolateral approach. The rib can be broken, the pleura can be punctured. A new and safer approach is possible. Before penetrating the bone, the needle is positioned at the upper margin of the transverse process, 5 mm away from the pedicle. To achieve this positioning, the needle must puncture the skin 1~1.5 cm laterally and 3~5 mm cranially to the target point on the bone. This approach was used for 10 patients and we achieved good results with no serious complication.

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Reliability of Transcranial Doppler Examination in the Diagnosis of Delayed Ischemia after Subarachnoid Hemorrhage (지주막하출혈에 의한 지연성 허혈신경장애의 진단에 있어서 경두개도플러 검사의 신뢰도)

  • Kim, Jong Moon;Kang, Sung Don
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.923-928
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    • 2000
  • Objective : The reliability of transcranial doppler sonography(TCD) for predicting delayed ischemic neurologic deficit( DIND) was investigated in patients with aneurysmal subarachnoid hemorrhage(SAH). Methods : The velocity of blood flow through the middle cerebral artery was measured by TCD in 70 patients treated surgically within 72 hours due to ruptured cerebral aneurysm. A correlation between measured maximal mean blood flow velocities and clinical factors including age, hypertension, Hunt-Hess grade, Fisher grade, DIND, and outcome was made. Results : An age-dependent reduction of the measured maximal mean velocities was found(r=-0.4043, p<0.001). Flow velocities in hypertensive patients were significantly lower than in the normotensive individuals(two-tailed T test, p<0.05). There was no significant difference between the flow velocities and evaluated other clinical factors. When the flow velocities of 14 patients who developed DIND were compared with those of patients without deficits, no significant difference was seen. A significant increase in flow velocities in the days before the onset of DIND was found only in 4 of 14 cases. High flow velocities did not necessarily mean impending neurological deficits : 6 of 70 patients tolerated flow velocities over 160cm/s. Conclusion : We suggest that TCD readings have limited utility for predicting DIND following SAH, especially in older or hypertensive patients. More direct measurements of blood flow are necessary to adequately predict which patients are at high risk of DIND.

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