• 제목/요약/키워드: Complete examination

검색결과 544건 처리시간 0.03초

미분화 갑상선암의 치료 (Treatment of Anaplastic Thyroid Cancer)

  • 장항석;윤종호;정웅윤;이미경;박정수
    • 대한두경부종양학회지
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    • 제14권2호
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    • pp.220-227
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    • 1998
  • The clinical and pathological features of 35 cases of anaplastic thyroid cancer were studied. These tumors occurred in 12 men and 23 women ranging in age from 19 to 83 years(mean age; 61.7 years). A rapidly enlarging thyroid mass was the most common presentation. The duration of the presence of mass varied from 20 days to 12 months with an average of 2.7 months. Systemic metastasis at the time of initial examination was found in 14 patients(40.0%) and the lung was the most common site of involvement. The overall rate of distant metastasis was about 65.7%. The tumors were subdivided morphologically into giant cell type of 10 cases, spindle cell type of 7 cases, epidermoid cell type of 1 cases, and mixed giant cell and spindle cell type of 5 cases. The mean survival period of 6 among 35 patients who had biopsy alone was 1.4 months. The 22 patients underwent the incomplete combined treatment modalities (palliative surgery with or without chemotherpy or radiation therapy) survived for a mean period of 3.0 months, among them, 7 patients who had surgery combined with chemotherapy and radiation therapy showed mean survival period of 3.7 months. The mean survival of 7 patients who had complete combined treatment modality(curative surgery combined with chemotherapy and hyperfractionated radiation therapy) was 6.6 months, only one patient survived for 21 months and one patient has been alive for 1 month after operation, and the others survived for a mean period of 4.8 months. So far, as of July 31, 1998, 34 patients among 35 were died(one has been survived for 1 month) despite the various treatment modalities, and the main cause of death were failure of local control and systemic metastasis. None of the various treatment modalities gave consistently favourable results. However, a combination of surgery, radiation therapy and chemotherapy seemed to have a slight positive effect on survival. Furthermore, the aggressive treatment modalities will be indicated only in the early diagnosed and minimal cases.

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새성기형에 관한 임상적 고찰 (Clinical Analysis of Branchial Anomalies : A Review of 72 Cases)

  • 김무필;최환;박세진;정은재;백승국;우정수;권순영;이남준;정광윤
    • 대한두경부종양학회지
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    • 제25권1호
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    • pp.12-17
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    • 2009
  • Background and Objectives : Branchial anomaly is a common neck pathology seen by otolaryngologist. Although there is still controversy regarding the origin, almost all surgeon agree that branchial anomalies result from incomplete involution of the branchial apparatus. Depending on its anatomic location, branchial anomalies can be classified into first, second, third and fourth anomaly. The purpose of this study is to evaluate the incidence of different categories of branchial anomalies and to determine proper method of diagnosis and treatment. Subjects and Method : A retrospective chart review was conducted for 72 patients with branchial anomalies operated on at the Korea University Anam Hospital from 1996 to 2007. The patient's sex, age, presenting symptoms, classification, site of lesion, diagnostic studies, surgical therapy and post-operative surgical complication were reviewed. Results : Patients were commonly seen in the 3rd decades. Eleven patients(15.3%) were first branchial anomalies, 52(72.2%) were second, 1(1.4%) was third, and 8(11.1%) were fourth. Of the types of anomalies, cyst were most commonly seen. In cases of 3rd and 4th branchial anomalies, barium contrast study can delineate the course of sinus or fistula. All cases was operated on for branchial anomalies, there were no major post-operative complication. Conclusion : Cervical mass and recurrent cervical infection or abscess are suspect for branchial anomalies. Especially, clinical history of dysphagia, and recurrent painful swelling in the thyroid region in young patients should raise the suspicion of 3rd and 4th branchial anomalies. Careful history, clinical examination and radiographic study were essential parts in diagnosis of branchial anomalies. Although surgical management of branchial anomalies depend on its type, nature and extent, complete excision is the major surgical procedure.

중학생들의 구강보건인식이 구강건강상태와 구강건강행위에 미치는 영향 (The Effect of Middle Schoolers' Oral Health Awareness on Oral Health Condition and Oral Health Behavior)

  • 조은숙
    • 한국산학기술학회논문지
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    • 제14권10호
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    • pp.5020-5028
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    • 2013
  • 본 연구는 제 2대구치가 맹출 하고, 영구치 치열이 완성을 이루어 평생 치열을 완성하는 중요한 시기인 중학생들 대상으로 구강보건인식이 구강건강상태와 구강건강행위에 어떠한 영향을 미치는지 조사하여 청소년들의 구강건강 프로그램 개발에 기초자료로 사용하고자 전주시 일부지역 소재의 중학교에 방문해 구강상태를 검진하고, 구강보건인식 및 행위에 대한 설문조사를 실시하였다. 구강검진 결과 치아우식증은 여학생이 치주질환은 남학생이 높게 나타났으며, 부정교합은 여학생이 높게 나타났다(p<0.038).구강보건인식은 남,녀간의 유의한 차이는 없었으나 5점 척도중 M=4.08로 높게 나타났다. 구강건강행위는 '잇몸에서 피가 날 때 치과를 방문한다.의 문항에서는 여학생(M=4.508)이 남학생(M=4.257)보다 더 높게 나타났다(p<0.05). '잇솔질 후 치과용 실을 사용한다'의 문항에서도 여학생(M=4.547)이 남학생(M=4.333)보다 더 높게 나타났다(p<0.05).구강보건인식은 구강건강행위에 95% 신뢰수준에서 유의미한 영향을 미치는 것으로 나타났다. 따라서 구강건강을 증진하기 위해 구강건강행위에 대한 교육이 요구되며, 행위에 영향을 미치는 구강보건인식 및 지식에 대한 프로그램 개발을 제시하는 연구가 필요하다.

Treatment with Rutin - A Therapeutic Strategy for Neutrophil-Mediated Inflammatory and Autoimmune Diseases - Anti-inflammatory Effects of Rutin on Neutrophils -

  • Nikfarjam, Bahareh Abd;Adineh, Mohtaram;Hajiali, Farid;Nassiri-Asl, Marjan
    • 대한약침학회지
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    • 제20권1호
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    • pp.52-56
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    • 2017
  • Objectives: Neutrophils represent the front line of human defense against infections. Immediately after stimulation, neutrophilic enzymes are activated and produce toxic mediators such as pro-inflammatory cytokines, nitric oxide (NO) and myeloperoxidase (MPO). These mediators can be toxic not only to infectious agents but also to host tissues. Because flavonoids exhibit antioxidant and anti-inflammatory effects, they are subjects of interest for pharmacological modulation of inflammation. In the present study, the effects of rutin on stimulus-induced NO and tumor necrosis factor $(TNF)-{\alpha}$ productions and MPO activity in human neutrophils were investigated. Methods: Human peripheral blood neutrophils were isolated using Ficoll-Hypaque density gradient centrifugation coupled with dextran T500 sedimentation. The cell preparations containing > 98% granulocytes were determined by morphological examination through Giemsa staining. Neutrophils were cultured in complete Roswell Park Memorial Institute (RPMI) medium, pre-incubated with or without rutin ($25{\mu}M$) for 45 minutes, and stimulated with phorbol 12-myristate 13-acetate (PMA). Then, the $TNF-{\alpha}$, NO and MPO productions were analyzed using enzyme-linked immunosorbent assay (ELISA), Griess Reagent, and MPO assay kits, respectively. Also, the viability of human neutrophils was assessed using tetrazolium salt 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), and neutrophils were treated with various concentrations of rutin ($1-100{\mu}M$), after which MTT was appended and incubated at $37^{\circ}C$ for 4 hour. Results: Rutin at concentrations up to $100{\mu}M$ did not affect neutrophil viability during the 4-hour incubation period. Rutin significantly decreased the NO and $TNF-{\alpha}$ productions in human peripheral blood neutrophils compared to PMA-control cells (P < 0.001). Also, MPO activity was significantly reduced by rutin (P < 0.001). Conclusion: In this in vitro study, rutin had an anti-inflammatory effect due to its inhibiting NO and $TNF-{\alpha}$ productions, as well as MPO activity, in activated human neutrophils. Treatment with rutin may be considered as a therapeutic strategy for neutrophil-mediated inflammatory/autoimmune diseases.

치과용 자석부착장치의 물리적, 생물학적 특성에 관한 연구 (A STUDY ON THE PHYSICAL PROPERTIES AND BIOLOGICAL CHARACTERISTICS OF DENTAL MAGNETIC ATTACHMENTS)

  • 임용식;김영수;김창회;김용호
    • 대한치과보철학회지
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    • 제37권1호
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    • pp.1-22
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    • 1999
  • In order to investigate various physical and biological properties of dental magnetic attachments studies on retentive characteristics, corrosion properties, cytotoxicity of different magnetic systems for dental applications were done. For the study of retentive characteristics changes of retentive force by increasing air gap, wear properties of various attachment systems and loss of magnetic force by heat treatment were measured. Forte study of corrosion property of magnet covering metal electrochemical corrosion was done in artificial saliva and 0.9% NaCl solution between $-1,000mV_{SCE}\;and\;+1,000mV_{SCE}$. Anodic polarization curves are obtained about 6 types of samples and 2 types of solution. Corroded surfaces were examined with metallurgical microscope, scanning electron microscope and surface profilometer. For the study of cytotoxicity of magnetic attachment and its field cell growth and agar overlay test were done. The results of this study were as follows. 1. In Magnetic attachments using closed circuit retentive force at zero air gap was greater than magnets using open circuit, but decrease of retentive force by increasing air gap was also greater than open systems. 2. After 40,000 cycles of wear test all mechanical attachment resulted in varing degree of retention loss but in magnetic attachments no loss of retentive force was observed. 3. The magnetic attachment using Neodymium magnet showed early loss of retentive force about $200^{\circ}C$ but attachment using Samarium magnet showed some resistance to heat treatment and complete retention loss was observed about $500^{\circ}C$. The keeper was not influenced by heat treatment in retention. 4. In electrochemical corrosion test Dyna magnetic attachment covering metal showed the highiest corrosion resistance and Shiner magnet covering metal showed the least corrosion resistance and examination of corroded surface with metallurgical microscope, scanning electron micro-scope and surface profilometer also showed same results with anodic polarization corves. 5. The result of cell culture tests on the magnet covered with metal showed least recognizable cytotoxicity.

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소아 요막관 기형 (Urachal Anomalies in Children)

  • 강은영;이철구;박관현;서정민;이석구
    • Advances in pediatric surgery
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    • 제11권2호
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    • pp.150-156
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    • 2005
  • Failure of the urachus to regress completely results in anomalies that may be classified as patent urachus, urachal sinus, urachal cyst and bladder diverticula. The presenting symptoms of children with urachal anomalies are variable and uniform guidelines for diagnosis and treatment are lacking. The purpose of this study was to analyze our experience and develop conclusions regarding the presentation, diagnosis and treatment of urachal anomalies. We retrospectively analyzed the records of 32 patients who were admitted for urachal anomalies from March 1995 to February 2005. The age distribution of these patients at presentation ranged from 1 day to 14 years old (median age 1 month). There were 20 boys and 12 girls. The 32 cases comprised 13 cases of urachal sinus (40.6 %), 10 urachal cyst (31.3 %), and 9 patent urchus (28.1 %). In 30 patients ultrasonography was used for diagnosis and 2 patients with patent urachus were explored without using a diagnostic method. Twenty-three patients were confirmed by ultrasonography alone and 7 patients were examined using additional modalities, namely, computed tomography for 2 patients with an urachal cyst, magnetic resonance imaging for 1 patient with an urachal cyst, and fistulography for 3 patients with an urachal sinus. The presenting symptoms were umbilical discharge (14 patients), umbilical granuloma (8), abdominal pain and fever (3), fever (3), abdominal pain (2), and a low abdominal mass (2). Excision was performed in 29 patients, and 3 patients were conservatively managed. Urachal anomalies in children most frequently presented in neonates, and the most common complaint was umbilical discharge with infection. Urachal anomalies can be diagnosed by a physical examination and an appropriate radiographic test. Ultrasound was the most useful diagnostic method. Complete surgical excision of an urachal anomaly is recommended to avoid recurrence, and the rare development of carcinoma.

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폐렴과 급성 호흡부전으로 나타난 흉막의 고립성 섬유성 종양 1예 (A Case of a Solitary Fibrous Tumor of the Pleura Presenting as Pneumonia and Acute Respiratory Failure)

  • 박혜선;곽현정;박동원;구태연;김혜영;박소연;안성은;김상헌;김태형;손장원;정원상;윤호주;신동호;박성수
    • Tuberculosis and Respiratory Diseases
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    • 제65권4호
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    • pp.334-338
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    • 2008
  • 흉막의 고립성 섬유성 종양은 주로 흉막통, 호흡곤란, 기침 등의 증상으로 발현하거나 무증상으로 발견되는 경우가 대부분이다. 본 증례의 환자는 흉막의 고립성 섬유성 종양의 거대한 종괴 영향에 의한 압박증상과 동반된 폐렴, 패혈 쇼크와 급성 호흡곤란의 진행으로 매우 치명적인 임상 양상을 보였으며, 기계환기법과 항생제, 승압제 등의 치료 후에 종양절제술로 호전되었다. 저자들은 흉막의 고립성 섬유성 종양으로 인한 치명적인 임상 경과를 보인 증례 1예를 경험하였기에 문헌고찰과 함께 보고한다.

난포낭종우에서 GnRH 또는 GnRH와$PGF_2{\alpha}$병용치료에 대한 난소 및 낭종의 반응 (Response of Ovaries and Cysts According to Treatment with GnRH or Combination of GnRH and $PGF_2{\alpha}$ in Dairy Cows with Follicular Cysts)

  • 강현구;김일화;손창호
    • 한국임상수의학회지
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    • 제21권4호
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    • pp.384-394
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    • 2004
  • This study was carried out to monitor the response of ovaries and cyst according to treatment with GnRH or combination of GnRH and $PGF_2{\alpha}$ in dairy cows with ovarian follicular cysts. Thirty cows were diagnosed as having follicular cysts by rectal palpation, ultrasonography and progesterone (P4) assays. Ten cows were treated with GnRH (control), and the other twenty were treated with $PGF_2{\alpha}$ at 10 days after GnRH treatment. All the animals were re-examined by ultrasonography and blood was collected for the measurement of plasma P4 concentration at day 0 (the day of treatment), day 7, day 10, day 13, day 24 and day 34, respectively. In 30 cows that were diagnosed with follicular cysts, mean plasma P 4 concentrations on day -II and day -I were 0.3 ng/ml and 0.4 ng/ml. On day 10 increased as 2.7$\pm$0.2 ng/ml. Mean cystic wall thickness by ultrasonography on day -11 and day -I were 2.1 mm and 2.2 mm. In 9 cows responded on luteinization of cystic wall, cystic wall thickness was 3.9$\pm$0.5 mm at day 10 after GnRH treatment. The responses of ovaries until day 10 after GnRH treatment included development of corpus luteum in the ovary bearing the cyst or in the contralateral ovary (12 cows), luteinization of cystic wall (6 cows) and clouding of the anechoic antrum of cysts (2 cows). The ovarian responses according to the combination of GnRH and $PGF_2{\alpha}$ included regression of the corpus luteum (12 cows), increase (1 cow) and no change (1 cow) of cyst size until last examination, and complete disappearance on day 13 (6 cows), 23 (6 cows) and 34 (4 cows). Combination treatment group of GnRH and $PGF_2{\alpha}$ showed a higher pregnancy rate within 100 days after initial treatment (40.0 vs 65.0%) and shorter intervals from the treatment to conception (45.4$\pm$25.8 vs 53.5$\pm$31.4 days) compared with control. It was concluded that the administration of $PGF_2{\alpha}$ following GnRH treatment is effective in shortening the interval from treatment to conception in cows with follicular cyst. Also, this study suggested that the response of the cyst according to treatment revealed various types. Therefore, veterinarians should pay attention to monitor of the response of cystic ovaries after treatment, specially no change, slowly decrease or increasement of cyst size after treatment.

Possible Role of Matrix Metalloproteinase in Osteolytic Intracranial Meningiomas

  • Moon, Hyung-Sik;Jung, Shin;Jung, Tae-Young;Cao, Van Thang;Moon, Kyung-Sub;Kim, In-Young
    • Journal of Korean Neurosurgical Society
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    • 제47권1호
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    • pp.11-16
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    • 2010
  • Objective: Abnormalities of the bone are frequently encountered in patients with meningioma, and hyperostosis and endostosis are common bone alterations in these tumors. Extensive bony destruction is very unusual in patients with meningioma. We report six cases of intracranial meningioma associated with an osteolytic lesion of the skull and discuss the underlying mechanisms that may be responsible for bone destruction in patients with meningioma. Methods: Six patients were classified into three groups, severe, moderate and mild, according to the degree of osteolytic bony destruction. The tumor was classified as intracranial or extracranial, depending on its location. We investigated the potential role of matrix metalloproteinase (MMP) in meningioma-associated osteolysis. The levels of MMP expression were determined by gelatin zymography, reverse transcription-quantitative PCR analysis (RT-PCR) and immunohistochemical analysis. Results: Complete surgical removal of the lesion was performed in each patient. Histological examination revealed benign meningioma in four cases, and two cases of atypical meningioma. Patients did not have a poor prognosis except one case of recurred atypical meningioma. Gelatin zymography and RT-PCR detected high levels of MMP-2 in almost all extracranial masses in comparison with the intracranial masses and MMP9 in two. There was no difference in the severity of bone destruction. Immunohistochemical analysis revealed MMP-2 expression in the vicinity of the bone destruction, and a few MMP-9-positive stainings were observed. Conclusion: Osteolysis of the skull in patients with meningiomas might not be indicative of malignant pathological features and poor prognosis. Invasion to the extracranial portion and osteolysis might be associated with MMP-2 expression in meningioma.

Canine Mast Cell Tumor에서 Adjuvant Glucocorticoids 치료 (Adjuvant Glucocorticoids Therapy in Canine Mast Cell Tumor)

  • 김명진;이재일;김영석;손화영;전무형;박창식;김명철
    • 한국임상수의학회지
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    • 제22권3호
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    • pp.264-267
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    • 2005
  • 구토와 식용부진을 3일전부터 나타내고, 2년전부터 좌측 후지 상부에 종괴를 갖고 있는 12년령, 8.0kg, 난소 제거 잡종 암캐 1두가 충남대학교 부속동물병원에 내원하였다. 환자는 fine-needle aspiration (FNA) 세포진단학 검사에 의하여 mast cell tumor로 진단하였다. Mast cell tumor 진단을 위한 WHO clinical staging system에 의하여 stage IIIa로 분류하였다. 환자는 adjuvant corticosteroid 요법에 의하여 투약되었으며, 축주의 요구에 의하여 완전 외과 절제는 실시하지 아니 하였다. 초기에 adjuvant corticosteroid 단독 요법에 의하여 종괴의 크기가 점차 감소하였으며, 환자의 전신상태는 호전되었다. 그러나 그 후에는 더 이상 glucocorticoid에 반응을 하지 아니 하였으며, 종괴의 크기가 증가하였고, 2개월 후에 간헐적 구토와 심한 호흡곤란 때문에 안락사 하였다. 비장 종괴, 십이지장 궤양, 간 종괴와 후지 상부 근육부위에 침윤된 mast cell tumor가 부검 시에 발견되었다. Mast cell tumor는 grade I 또는 II에서 그리고 .조직학적으로 well-differentiated된 상태에서 외과적 완전절제, 방사선요법, adjuvant corticosteroid 요법, 화학요법을 병용 하여야 양호한 예후를 나타낼 것으로 기대된다.