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Salvage Chemotherapy in Recurrent Platinum-Resistant or Refractory Epithelial Ovarian Cancer with Carboplatin and Distearoylphosphatidylcholine Pegylated Liposomal Doxorubicin (Lipo-Dox®)

  • Khemapech, Nipon;Oranratanaphan, S.;Termrungruanglert, W.;Lertkhachonsuk, R.;Vasurattana, A.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2131-2135
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    • 2013
  • Background: To evaluate the efficacy and safety of distearoylphosphatidylcholine pegylated liposomal doxorubicin (DPLD) combined with carboplatin for the treatment of platinum resistant or refractory epithelial ovarian cancer (EOC) or fallopian tube cancer. Materials and Methods: A retrospective analysis of women who received DPLD with carboplatin for recurrent EOC or fallopian tube cancer in King Chulalongkorn Memorial Hospital Thailand from January 2006 to August 2011 was conducted. Patients were identified from the medical records and data on demographic factors, stage, histology, surgical findings, cytoreduction status, and prior chemotherapies were abstracted. The efficacy and toxicity of DPLD/carboplatin were evaluated. Progression-free (PFS) and overall survival (OS) were estimated by the Kaplan-Meier method. Results: A total of 65 patients, 64 with platinum resistant or refractory epithelial ovarian cancer and 1 with fallopian tube cancer, were enrolled. DPLD and carboplatin were given for an average of 4.46 cycles per patient with a total of 273 cycles. Among the 65 evaluable patients, 0% achieved CR, 7.69% PR, 15.4% SD and 76.% PD. The overall response rate was 23.1%. With a median follow-up of 27.4 months, the median progression-free and median overall survival in the 36 patients was 4.46 months and 8.76 months respectively. In the aspect of side effects, palmar-plantar erythrodysesthesia (PPE) occurred in 33.3% (Grade I 22.2%, Grade II 11.1%) and mucositis in 41.7% (Grade I 27.8%, Grade II 13.9%) of all treatment cycles, all Grade 1 or 2. Anemia, leukopenia and thrombocytopenia occurred in 58.3% (Grade I 41.7%, Grade II 16.7%), 66.7% (Grade I 47.2%, Grade II 19.4%), and 22.2% (Grade I 16.6%, Grade II 5.56%) of cycle respectively, and were mostly Grade 1 or 2. Conclusions: DPLD, the second-generation PLD drug combined with carboplatin every 4 weeks, is effective and has low toxicity for treatment of patients with recurrent platinum-resistant or refractory epithelial ovarian cancer.

Storage Stability of Pork Fatty with Mugwort Powder (쑥 분말을 첨가한 돼지고기 patty의 저장 안정성)

  • 정인철;문윤희;강세주
    • Journal of Life Science
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    • v.14 no.1
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    • pp.198-203
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    • 2004
  • This study was carried out to investigate the effect of mugwort podwer and carcass grade on the shelf-life of pork patty. Pork patty was prepared by four types such as grade B pcrk patty without mugwort powder (A patty), grade B pork patty with mugwort podwer (B patty), grade I pork patty without mugwort powder (C patty) and grade E pork patty with mugwort powder (D patty) and the residual nitrite, surface color, pH, VBN (volatile basic nitrogen), TBARS (2-thiobarbituric acid reactive substances) and total bacterial counts of the sample were determined during storage at 4$^{\circ}C$. The residual nitrite of pork patties with mugwort powder was highly decreased until storage for 2 weeks, pork patties without mugwort powder highly decreased until storage for 4 weeks, therefore addition of mugwort powder reduced residual nitrite of pork patty. The L* value of pork patty was the highest at early stage of storage, pork patties with mugwort powder were lower than that of pork patties without mugwort powder, and grade B pork patties were higher than that of the grade I pork patties. The a value of grade I pork patties were higher than that of grade B pork patties, and changes during storage were no significant difference. The b value of grade B pork patties were higher than that of grade I pork patties. The pH of pork patties decreased during storage. The VBN, TBARS and total bacterial counts added significantly during storage, and the addition of mugwort powder were not affected during storage.

Optimal timing of percutaneous transhepatic gallbladder drainage and subsequent laparoscopic cholecystectomy according to the severity of acute cholecystitis

  • Jung Suk Lee;Seung Jae Lee;In Seok Choi;Ju Ik Moon
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.2
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    • pp.159-167
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    • 2022
  • Backgrounds/Aims: The optimal timing of percutaneous transhepatic gallbladder drainage (PTGBD) and subsequent laparoscopic cholecystectomy (LC) according to the severity of acute cholecystitis (AC) has not been established yet. Methods: This single-center, retrospective study included 695 patients with grade I or II AC without common bile duct stones who underwent PTGBD and subsequent LC between January 2010 and December 2019. Difficult surgery (DS) (open conversion, subtotal cholecystectomy, adjacent organ injury, transfusion, operation time ≥ 90 minutes, or estimated blood loss ≥ 100 mL) and poor postoperative outcome (PPO) (postoperative hospital stay ≥ 7 days or Clavien-Dindo grade ≥ II postoperative complication) were defined to comprehensively evaluate intraoperative and postoperative outcomes, respectively. Results: Of 695 patients, 403 had grade I AC and 292 had grade II AC. According to the receiver operating characteristic curve and multivariate logistic regression analyses, an interval from symptom onset to PTGBD of > 3.5 days and an interval from PTGBD to LC of > 7.5 days were significant predictors of DS and PPO, respectively, in grade I AC. In grade II AC, the timing of PTGBD and subsequent LC were not statistically related to DS or PPO. Conclusions: In grade I AC, performing PTGBD within 3.5 days after symptom onset can reduce surgical difficulties and subsequently performing LC within 7.5 days after PTGBD can improve postoperative outcomes. In grade II AC, early PTGBD cannot improve the surgical difficulty. In addition, the timing of subsequent LC is not correlated with surgical difficulties or postoperative outcomes.

Comparison of Video Laryngoscope and Direct Laryngoscope on Rapidity and Accuracy in Tracheal Intubation by Paramedic (1급 응급구조사의 비디오후두경 기관삽관과 직접후두경 기관삽관의 신속성 및 정확도 비교)

  • Sim, Gyu-Sik
    • The Korean Journal of Emergency Medical Services
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    • v.14 no.1
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    • pp.5-18
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    • 2010
  • Objective : This study compares Video laryngoscope and Direct laryngoscope in tracheal Intubation on rapidity and accuracy by paramedic and aims to improve efficiency of airway management and survival rate in pre-hospital treatment for the patients with severe trauma, cardiac arrest or dyspnea caused by acute diseases. Methods : 60 paramedics were recruited from 13 fire stations located in C province. With the consent of the paramedics, likelihood ratio test was carried out and they were divided into two different groups; DL group (30) and GVL group (30). Regarding intubation conditions, difficult airway grade I, grade II and grade III as well as sniffing position and neutral position were examined. This study also compared between ambulance in motion and in stand still. Frequency, average and standard deviation were analyzed with statistics program, SPSS WIN 17.0 and repeated measure design was introduced to examine inter-relations between position, grade and groups. Results : Intubation was performed more rapidly in neutral position and GVL than in sniffing position and DL(F = 15.260, p = .000). Rapidity value was better with grade I and grade II than grade III and better with GVL than DL(F = 32.629, p = .000). Accuracy value was higher with neutral position and GVL than sniffing position and DL(F = 5.008, p = .011). grade III was less accurate than grade I, grade II and GVL was more accurate than DL(F = 10.966, p = .000). Ambulance motion status did not show any statistically significant differences in accuracy and rapidity. Conclusion : Given this study results, neutral position is better for the patient with severe trauma. For a better survival, GVL intubation can be considered since GVL can enhance accuracy as well as rapidity regarding difficult airway. Since there is no significant differences in ambulance motion factors, intubation can be recommended even in moving ambulance for shortening traveling time to a hospital.

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Postoperative Radiation Therapy of Astrocytoma and Glioblastoma Multiforme (성상세포종과 교아세포종의 수술후 방사선치료)

  • Park, Moon-Baik;Hong, Seong-Eon
    • Radiation Oncology Journal
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    • v.7 no.1
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    • pp.23-27
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    • 1989
  • Forty-four patients with brain astrocytoma and glioblastoma were rested with surgical resection and postoperative radiation from January 1980 through May 1987, Four patients were lost to follow up, and in 40 patients survival time was evaluable. Three year actuarial survival rate was $66.7\%$ in Grade I and II astrocytoma, $30\%$ in Grade III, and $20.4\%$ in glioblastoma multiforme patients. The prognostic factors affecting survival rate were histologic grade in all cases, age, and total radiation dose in Grade III and glioblastoma.

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The Effect of Sesamoid Position on Results of Treatment for Hallux Valgus (무지외반증에서 종자골 전이 정도가 치료결과에 미치는 영향)

  • Yoo, Chong-Il;Lee, Dong-Ho;Kim, Hui-Taek
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.131-137
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    • 2004
  • Purpose: We evaluated the results of various surgical treatments for hallux valgus with and without attempting to correct sesamoid subluxation. Materials and Methods: Thirty-one cases in 26 patients were involved in this study: Group I (15 cases) - surgery performed only to correct the hallux valgus angle (HVA) and the first-second intermetatarsal angle (IMA) in AP view; Group II (16 cases) - surgery performed to correct HVA and IMA and also to reduce the subluxation of sesamoid. The degree of sesamoid subluxation was measured from a pre- and intraoperative sesamoid tangential views. For both groups, we analysed the status of the sesamoid in pre- and postoperative radiographs and performed clinical evaluation using the Mayo clinic forefoot scoring system. Results: The average amount of correction during postoperative period and loss of correction at last follow-up in the sesamoid tangential view were as follows: soft tissue procedures (5 cases) - group I: grade $1.0{\pm}0.4/1.5{\pm}0.3$ and group II: grade $2.0{\pm}0.9/0.5{\pm}0.08$; chevron osteotomy (12 cases) - group I: grade $1.0{\pm}0.5/1.2{\pm}0.3$ and group II: grade $2.2{\pm}0.7/0.9{\pm}0.2$; proximal metatarsal osteotomy (14 cases) - group I: grade $4.0{\pm}0.4/1{\pm}0.2$ and group II: grade $4.7{\pm}1.1/0.8{\pm}0.1$. In clinical evaluation, more than 93% of the feet had a good result in both groups. The analysis of these data for each treatment type did not show any statistically significant differences between groups I and II. Conclusion: The radiologic and clinical results did not validate our attempts to reduce the sesamoid during surgery.

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Effects of Glycerol Equilibration and Embryo Quality before Freezing and the Embryo Quality after Thawing in Mouse (생쥐에 있어서 Glycerol 평형단계 및 동결전 수정란 상태가 융해후 상태에 미치는 영향)

  • 조남기
    • Korean Journal of Animal Reproduction
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    • v.11 no.2
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    • pp.122-126
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    • 1987
  • This study was carried out to investigate the effects of the glycerol equilibration methods and embryo grades before freezing on the survival rate after thawing in mouse embryos. The results obtained from this study were as follows: 1. The number of embryos of grade I(Excellent), II(Good) and III(Fair) before freezing in this study was 97(27.4%), 160(45.2%) and 97(27.4%), respectively. 2. The average survival rate of frozen-thawed embryos in 3 and 5 steps glycerol equilibration was 66.7% and 64.1%, and the rate of transfererable embryos after culture was 68.9% and 69.0%, respectively. 3. Out of embryo grade I and II before freezing, the transferable rate after thawing was 75.2% and 48.1%, respectively, and grade I embryos before freezing was higher transferable rate than that of grade II.

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The Effectiveness of Cognitive Monitoring Skills of Elementary Students on Science (초등학생의 과학에 대한 인지모니터링 기능의 효율성 분석)

  • Ko, Kawng-Byung;Ko, Se-Hwan;Kim, Beom-Ki;Choi, Kwan-Soon
    • Journal of The Korean Association For Science Education
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    • v.24 no.6
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    • pp.1173-1180
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    • 2004
  • The purpose of this study was to investigate the effectiveness of cognitive monitoring skills of elementary students on science by the grade and sex. The subject of this study was 1001 elementary students of $2{\sim}6$ grade from 5 schools. The instrument of study, TSCM I (Test of Science Cognitive Monitoring I ) for $2{\sim}4$ grade and TSCM II for $4{\sim}6$ grade were developed. The results of this study showed that the effectiveness of cognitive monitoring skills was 63.4% for $2{\sim}4$ grade and 57.4% for $4{\sim}6$ grade. The effectiveness of cognitive monitoring skills of 3 and 4 graders was significantly higher than 2, while 5 and 6 was higher than 4 graders. Girls were higher than boys for 2 and 3 grade, but 4${\sim}$6 graders were not significantly different by the sex.

EXPERIMENTAL RECONSTRUCTION OF LARYNX WITH STERNOMASTOID MYOPERIOSTEAL FLAP (흉유돌근골막 피판을 이용한 후두 재건)

  • 조재식;안병현;김선태;이종원
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.28-28
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    • 1991
  • 후두암의 수직절제 수술후의 후두 재건 목적은 기관절개를 통하지 않고 후두를 통한 호흡이 가능하도록 하면서 연하시 기도흡인을 피하기 위한 sphincter 능력의 보존, 그리고 발성이 가능하도록 성대진동 mechanism을 재건하는데 있다. 오늘날 수많은 후두학자들에 의해서 고안 개발된 다양한 재건 방법이 있다. 연자는 광범위한 후두절제에 따른 큰 결손을 메우기 위해 bulky하면서도 점막 상피의 재생이 용이한 재건 피판으로 흉유돌근골막 피판을 이용하여 후두 결손부를 재건하여 보았다. 방법은 성견 3마리를 대상으로하여 thiopental sodium 정맥주사로 전신마취를 시행한 후 설골에서부터 흉골상까지 경부 정중앙의 피부를 절개하고 후두를 노출시켜 후두 수직절제술을 시행하였다. 흉유돌근과 흉골에 부착된 골막을 박리하여 흥유돌근골막 피판을 제작한 후 골막이 후두강 안쪽으로 되도록하여 골막연과 후두점막을 봉합하였다. 그리고 3, 5, 9개월에 후두적출술을 시행하여 병리조직학적 및 수술후 경과를 관찰하였다. 3실험견 모두 기관절개술 없이 후두를 통한 호흡이 가능하였고 흡입성 폐렴이나 피하기종등의 합병증없이 창상이 치유되었으며 발성도 양호하였다. 이식된 골막위로 신생혈관의 출현과 함께 점막재생이 잘되 있었다. 단지 봉합사 주위에 소량의 육아종이 관찰되었다. 조직학적으로는 섬유조직위로 편평상피가 재생되었으며 성문하부에서는 일부 섬모가 있는 호흡기 점막도 관찰되고 골막하부에 신생골 형성은 관찰할 수 없었다. 골막 피판은 그 유연성 때문에 결손부위의 점막연에 맞춰도 tension이 없고 공기 누출이 되지 않게 봉합이 가능할 뿐 아니라 점막이 재생할 수 있는 frame-work의 역할을 하는 것으로 사료되었다. 이상과 같은 사실로 미루어 흉유돌근 자체가 견실하고 골막에 혈류공급이 잘되어 창상치유에 좋을 뿐 아니라 큰 후두결손부의 재건이 가능하리라고 사료되었다.로서 몇가지 앞으로의 치료지침에 도움이 되는 결과를 얻었기에 보고하는 바이다. 1) 성별 분포는 남자 16(39 %), 여자 25 (61%)이었으며 1 : 1.5의 빈도를 보였다. 2) 연령 분포는 20대와 30대에서 남녀 모두 25명으로 대부분을 차지하였다. 3) 부식제의 종류는 빙초산이 26명 (63.4 %)으로 대부분을 차지하였고 염산 7 (17.1 %) Lye 3 (0.7 %) 의 순이었다. 4) 음독후 12시간내에 식도경술을 받은 환자가 3명(0.7 %) 12-24시간에 받은 환자가 17명(41.5 %), 24 - 48시간에 받은 환자가 11명(26. 8%)으로 48시간 내에 시행받은 환자가 전체의 75.6%를 차지하였다. 5) 식도경 검사상 나타난 식도화상은 Grade I 11명 (26.8%) G.ade II 18(43.9%) Grade III 7명(17.1%) 이었으며 Grade II 인 경우가 18명(43.9%)로 가장 많았으며 Grade I 11명(26.8 %), Grade III 7명 (17.1 %) Normal 5명 (12.2 %) 순이었다. 6) 조기 식도경 검사에서 41명중 oral cavity burn이 없었던 경우가 15명(36. 1 %) 이었으며, oral cavity burn이 있었던 26명중 5명(19 .2 %)에서 Esophageal burn이 없었다 특히 Esophageal burn의 Grade II, III 25명 중 9명(29.6 %)에서 oral cavity burn이 없었다. 7) 식도 부식중 환자의 치료 원칙으로 Grade I, II, III에서 항생제 및 보존적 치료를 하였으며 Grade I에선 oral feeding을 시켰고 Steroid는 경우에 따라 투여하였으며 Grade III에선 원칙적으로 사용치 않았다. 식도조영술은 Grade I II III에서 3주 후에 모두 시행하였다. 8) 3주 후 식도조영술을 실

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Natural History of Conservatively Treated Posterior Cruciate Ligament Injury (보존적으로 치료된 급성 단독 후방십자인대 손상의 자연 경과)

  • Ahn, Jin-Hwan;Seo, Hee-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.13-19
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    • 2007
  • Purpose: We investigated the natural history of acute, isolated posterior cruciate ligament injuries treated conservatively. Materials and Methods: Between February 1999 and October 2006, we evaluated retrospectively the results of acute, isolated posterior cruciate ligament injuries treated conservatively. The subjects consisted of 21 patients. At initial and follow up visits physical examination, $KT-2000^{TM}$ arthrometer and MRI were performed to assess improvement on the knee stability and continuity of the posterior cruciate ligament. IKDC (International Knee Documentation Committee) knee scoring and quadriceps muscle strength were also checked in all population. Comparing the results of initial and follow up examinations we assessed the natural history of acute, isolated posterior cruciate ligament injuries treated conservatively. The mean follow up period was 22.7 months. Results: The posterior drawer test showed 14 cases of Grade I, 6 cases of Grade II and 1 case of Grade III progressing 18 cases of Grade I and 3 cases of Grade II. The mean difference of 5.7mm by $KT-2000^{TM}$ arthrometer was changed Into 2.7mm and the continuity of posterior cruciate ligament initially checked by 48.1% on MRI increased to 69.7%. The mean quadriceps muscle strength was grade 'Good' and mean IKDC knee score was nearly grade 'A'. Conclusion: Our study suggests that patients with acute, isolated posterior cruciate ligament injuries treated conservatively may get good clinical outcomes on clinical situation and MRI.

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