• Title/Summary/Keyword: Korean Medicine Hospital

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Curative Radiation Therapy for T2N0M0 Non-small Cell Lung Cancer (T2N0M0 비소세포성 폐암의 근치적 방사선치료)

  • Park, In-Kyu;Kim, Jae-Choel
    • Radiation Oncology Journal
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    • v.13 no.1
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    • pp.19-26
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    • 1995
  • Purpose : Surgery is the treatment of choice for resectable non-small cell lung cancer. For patients who are medically unable to tolerate a surgical resection or who refuse surgery, radiation therapy is an acceptable alternative. A retrospective analysis of Patients with stage I non-samll cell lung cancer treated with curative radiation therapy was performed to determine the results of curative radiation therapy and patterns of failure, and to identify factors that may influence survival. Materials and Methods : From 1986 through 1993, 39 Patients with T2N0M0 non-small cell lung cancer were treated with curative radiation therapy at department of radiation oncology, Kyungpook national university hospital. All Patients were not candidates for surgical resection because of either Patient refusal (16 patients), poor pulmonary function (12 patients), old age (7 patients), Poor Performance (2 patients) or coexisting medical disease (2 patients). Median age of patients was 67 years. Histologic cell type was squamous cell carcinoma in 36, adenocarcinoma in 1, large cell carcinoma in 1 and mucoepidermoid carcinoma in 1. All patients were treated with megavoltage irradiation and radiation dose ranged from 5000cgy to 6150cGy with a median dose of 6000cGy. The median follow-up was 17 months with a range of 4 to 82 months, Survival was measured from the date therapy initiated. Results : The overall survival rate for entire Patients was $40.6\%$ at 2 years and $27.7\%$ at 3 years, with a median survival time of 21 months. The disease-free survival at 2 and 3 years was $51.7\%$ and $25.8\%$, respectively. Of evaluable 20 patients with complete response, 15 patients were considered to have failed. Of these, 13 patients showed local failure and 2 patients failed distantly. Response to treatment (p=0.0001), tumor size (p=0.0019) and age (p=0.0247) were favorably associated with overall survival. Only age was predictive for disease-free survival (p = 0.0452). Conclusion : Radiation therapy is an effective treatment for small (less than 3cm) tumors, and should be offered as an alternative to surgery in elderly or infirm patients. Since local failure is the prominent Patterns of relapse, potential methods to improve local control with radiation therapy are discussed.

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Acupuncture Analgesia : A Sensory Stimulus Induced Analgesia Observed by functional Magnetic Resonance Imaging (침의 진통효과: 체성감각신경자극으로 유도된 진통작용에 대한 기능성자기공명영상장치를 이용한 연구)

  • Cho, Zang-hee;Hwang, Seon-chool;Son, Young-don;Kang, Chang-ki;Wong, Edward K.;Bai, Sun-joon;Lee, Un-jung;Sung, Kang-kyung;Park, Tae-seok;Kim, Young-bo;Min, Hoon-ki;Oleson, Terry
    • Journal of Acupuncture Research
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    • v.21 no.2
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    • pp.57-71
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    • 2004
  • Objective : Physiological evidence regarding acupuncture's effect in human patients is not yet well established, despite considerable evidence for its therapeutic efficacy. Besides target or disease specificity of acupuncture, acupuncture analgesia (AA) appears to be another large subclass that poses many questions, such as whether there is point specificity with respect to which acupoint is most effective for a particular condition. Methods : We observed brain activation with functional magnetic resonance imaging (fMRI) using a set of stimuli that consist of pain, pain following Meridian acupuncture, and pain following Sham acupuncture. Results : Among the new observations, the most interesting fact is that data sets of both Meridian acupuncture and Sham acupuncture show decreased activation of the same brain areas related to the pain processing signals. Present functional MRI study demonstrate two important biological observations that could elucidate AA mechanism in human participants: the effects of acupuncture occur through mediation of the higher brain areas. Sham acupuncture stimulation appears to be almost as effective as traditional Meridian acupoint stimulation, suggesting that acupuncture is not entirely point specific. Decreased activation in the limbic paleo cortical areas appears to be the probable neurological manifestation of AA and strongly implies that acupuncture stimulation inhibits the transmission of ascending pain signals to the higher cortical areas by the previously known descending pain inhibitory circuit. Conclusion : We, therefore, a hypothesized that this pain inhibitory circuit is initiated and mediated via the broad sense Hypothalamus Pituitary Adrenal (BS HPA) axis in conjunction to the "sensory stimulation."

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SURGICAL REPAIR OF COMPLETE BONY BILATERAL CHOANAL ATRESIA VIA TRANSPALATAL APPROACH (완전 골성 양측성 후비공 폐쇄 환자의 구개부를 통한 외과적 치험례)

  • Kim, Kyoung-Won;Cho, Yong-Seok;Yang, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.2
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    • pp.133-138
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    • 1998
  • Choanal atresia may be membrane or bony, unilateral or bilateral. Approximately 90% of the choanal atresia are bony type. Unilateral choanal atresia often eludes the diagnosis because of the absence of subjective symptoms in the neonatal period. However, bilateral choanal atresia presents at birth with cyclic respiratory distress aggravated by feedings. So complete bilateral choanal atresia is considered as a neonatal emergency. Examinations for the diagnosis of chonal atresia include 1) attempt at passing a rubber catheter or probe through the patient s nose, 2) mirror examination of the nasopharynx, 3) digital examination of the nasopharynx, 4) X-ray examination after installation of radiopaque materal into the nasal cavity. But, computed tomography has become accepted method for evaluation of choanal atresia. Surgical repair of choanal atresia is accomplished via transnasal or transpalatal approach. Advantages of the transpalatal approach are improved exposure and the preservation of mucosal flap along the newly formed apertures. On the other hand, the transpalatal approach carries the risk of injury to the greater palatine neurovascular complex, and requires longer operative time. After careful physical and radiographic examinations, we accomplished the surgical repair of the complete bony bilateral choanal atresia via transpalatal approach without complications.

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Effect of Genetic Predisposition on Blood Lipid Traits Using Cumulative Risk Assessment in the Korean Population

  • Go, Min-Jin;Hwang, Joo-Yeon;Kim, Dong-Joon;Lee, Hye-Ja;Jang, Han-Byul;Park, Kyung-Hee;Song, Ji-Hyun;Lee, Jong-Young
    • Genomics & Informatics
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    • v.10 no.2
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    • pp.99-105
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    • 2012
  • Dyslipidemia, mainly characterized by high triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) levels, is an important etiological factor in the development of cardiovascular disease (CVD). Considering the relationship between childhood obesity and CVD risk, it would be worthwhile to evaluate whether previously identified lipid-related variants in adult subjects are associated with lipid variations in a childhood obesity study (n = 482). In an association analysis for 16 genome-wide association study (GWAS)-based candidate loci, we confirmed significant associations of a genetic predisposition to lipoprotein concentrations in a childhood obesity study. Having two loci (rs10503669 at LPL and rs16940212 at LIPC) that showed the strongest association with blood levels of TG and HDL-C, we calculated a genetic risk score (GRS), representing the sum of the risk alleles. It has been observed that increasing GRS is significantly associated with decreased HDL-C (effect size, $-1.13{\pm}0.07$) compared to single nucleotide polymorphism combinations without two risk variants. In addition, a positive correlation was observed between allelic dosage score and risk allele (rs10503669 at LPL) on high TG levels (effect size, $10.89{\pm}0.84$). These two loci yielded consistent associations in our previous meta-analysis. Taken together, our findings demonstrate that the genetic architecture of circulating lipid levels (TG and HDL-C) overlap to a large extent in childhood as well as in adulthood. Post-GWAS functional characterization of these variants is further required to elucidate their pathophysiological roles and biological mechanisms.

Evaluation of interdental distance of natural teeth with cone-beam computerized tomography (콘빔형 전산화단층영상을 이용한 자연치 치간거리의 평가)

  • Oh, Sang-Chun;Kong, Hyun-Jun;Lee, Wan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.4
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    • pp.278-283
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    • 2017
  • Purpose: The aim of this study was to evaluate the interdental distances of anterior, premolar, and molar teeth at the cementoenamel junction (CEJ) and 2 mm below the CEJ in healthy natural dentition with cone-beam computerized tomography (cone-beam CT) in order to provide valuable data for ideal implant positioning relative to mesiodistal bone dimensions. Materials and Methods: Two hundred patients who visited Dental Hospital, Wonkwang University, who had natural dentition with healthy interdental papillae, and who underwent cone-beam CT were selected. The cone-beam CT images were converted to digital imaging and communication in medicine (DICOM) files and reconstructed in three-dimensional images. To standardize the cone-beam CT images, head reorientation was performed. All of the measurements were determined on the reconstructed panoramic images by three professionally trained dentists. Results: At the CEJ, the mean maxillary interdental distances were 1.84 mm (anterior teeth), 2.07 mm (premolar), and 2.08 mm (molar), and the mean mandibular interproximal distances were 1.55 mm (anterior teeth), 2.20 mm (premolar), and 2.36 mm (molar). At 2mm below the CEJ, the mean maxillary interdental distances were 2.19 mm (anterior teeth), 2.51 mm (premolar), and 2.60 mm (molar), and the mean mandibular interproximal distances were 1.86 mm (anterior teeth), 2.53 mm (premolar), and 3.01 mm (molar). Conclusion: The interdental distances in the natural dentition were larger at the posterior teeth than at the anterior teeth and also at 2 mm below the CEJ level compared with at the CEJ level. The distances between mandibular incisors were the narrowest and the distances between mandibular molars were the widest in the entire dentition.

Development and Validation of Reference Material for Proficiency Testing of Blood Heavy Metals in Environmental Biomonitoring (환경 바이오모니터링에서의 혈중 중금속 분석 숙련도 시험을 위한 표준물질 제조 및 적용성 평가)

  • Im, Hosub;Yang, Minho;Oh, Selim;Kim, Soyoung;Jung, Hojun;Cho, Yong Min;Lee, Jung Sub;Kim, Hyun Jeong;Lee, Chae Kwan;Moon, Chan-Seok;Lee, Jong-Wha
    • Journal of Environmental Health Sciences
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    • v.42 no.6
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    • pp.450-464
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    • 2016
  • Objectives: This study developed and validated reference materials (RMs) to analyze metal compounds in blood. Methods: We referred to KoNEHS (Korea National Environmental Health Survey) to estimate concentrations of blood metals (cadmium, Cd; lead, Pb; mercury, Hg) and applied analytical methods (inductively coupled plasma - mass spectroscopy, ICP-MS, for Cd and Pb; graphite furnace - atomic absorption spectrometry, GF-AAS, for Cd and Pb; and direct mercury analyzer, DMA, for Hg). Homogeneity and stability tests were carried out. In addition, certified values and uncertainties of RMs were calculated through internal and external experiments. All RMs were developed and assessed in various forms according to element, analytical method, and two types of concentration levels high concentration for occupational exposure and low concentration for environmental exposure. Results: All samples showed acceptable homogeneity, except for low concentration of Cd in the GF-AAS method. Short- and long-term stabilities were satisfied by ANOVA testing. In the inter-laboratory comparison, robust medians were lower than the certified values of all RMs (robust median/reference value; $1.301/1.327{\mu}g/L$ for Cd, ICP-MS, low concentration; $3.152/3.388{\mu}g/L$ for Cd, ICP-MS, high concentration; $1.219/1.301{\mu}g/L$ for Cd, GF-AAS, low concentration; $3.074/3.321{\mu}g/L$ for Cd, GF-AAS, high concentration; $14.473/14.516{\mu}g/L$ for Pb, ICP-MS, low concentration; $50.069/50.114{\mu}g/L$ for Pb, ICP-MS, high concentration; $12.881/14.147{\mu}g/L$ for Pb, GF-AAS, low concentration; $47.015/47.591{\mu}g/L$ for Pb, GF-AAS, high concentration; $4.059/4.218{\mu}g/L$ for Hg, DMA, low concentration; $11.474/11.181{\mu}g/L$ for Hg, DMA, high concentration). Conclusion: This study demonstrates procedures for developing and validating RMs for biomonitoring in the field of the environmental health.

gyrA Mutations Found Among Ofloxacin-resistant Mycobacterium tuberculosis is Isolated from Korea

  • Kim Junho;Kim Yeun;Bae Kiho;Song Taek-Sun;Cho Sang-Nae;Lee Hyeyoung
    • Biomedical Science Letters
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    • v.11 no.4
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    • pp.465-471
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    • 2005
  • Ofloxacin has antimycobacterial activity that possibly contributes a pivotal role in the second-line drug regimens that are used for the treatment of multidrug-resistant tuberculosis. However, in some communities, the resistance rate of Mycobacterium tuberculosis to this agent is surging. Therefore, a rapid and accurate method that can be used to determine the resistance of M tuberculosis to the ofloxacin can be very useful for effective treatment of the patients. As an effort to develop such a method, this study was set up to reveal general types of mutations that are related to ofloxacin resistance of M tuberculosis. From previous studies, it has been well known that ofloxacin resistance is associated with mutations in a gene encoding the gyrase A subunit protein. In this study, we obtained 43 ofloxacin-resistant and 50 ofloxacin-susceptible M tuberculosis clinical isolates from Masan National TB Hospital, and sequences of DNA fragment of 320 bp, region of gyrA corresponding to the ofloxacin resistance-determining region were analyzed. In brief, the results showed that a total of seven mutation types were found at gyrA. Theses mutations were all clustered within nucleotides 2574 to 2586 of the gyrA gene (codons 88 to 94). Codon 94 was the most frequently substituted site. Twenty-four of the 43 isolates had mutations at this position resulting in a total of five different types of amino acid changes $(Asp{\to}Ala,\;Asp{\to}Gly,\;Asp{\to}His,\;Asp{\to}Tyr,\;and\;Asp{\to}Asn)$. Five isolates contained a mutation at codon 90 resulting $Ala{\to}Val$ change. Four isolates had mutations at codon 91 causing a $Ser{\to}Pro$ change at this site. Two isolates contained a mutation at codon 88 and each of them resulted in different types of amino acid changes $(Gly{\to}Cys,\;Gly{\to}Ala)$. On the other hand, polymorphic site at codon 95 was found in both ofloxacin-resistant and ofloxacin-susceptible isolates. From these results, we concluded that the rate of mutations present in gyrA among ofloxacin-resistant M. tuberculosis in Korea is similar to the general rates of mutations found throughout the world. Subsequently, an oligonucleotide probe was designed based on the results of sequence analysis and was used to develop a dot blot hybridization assay system to determine ofloxacin-resistance of M tuberculosis. To evaluate this probe, dot-blot hybridization was carried out using other 57 clinical isolates, and the results showed that the dot-blot hybridization assay is good for detecting sequence alterations atgyrA gene.

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Stabilization of Recurrent Medial Shoulder Luxation by Use of Three Bone Anchors in a Dog (재발성 내측 어깨 탈구를 보이는 개에서 본 앵커를 이용한 외과적 치료 증례)

  • Yoon, Hun-Young;Roh, Mi-Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.30 no.1
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    • pp.45-48
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    • 2013
  • A 12-year-old male poodle weighing 2.0 kg presented for evaluation of right thoracic limb lameness. The owner reported that the dog showed recurrent bilateral shoulder joint luxation after a car accident for a year. Recently, the left shoulder joint appeared well maintained, but right shoulder joint luxation was exacerbated. On physical examination, the dog showed non-weight bearing lameness on the right thoracic limb. Craniocaudal radiographic views revealed medial displacement of the right humerus. Mediolateral radiographic views revealed overlap of the glenoid cavity and humeral head. Muscle atrophy of the right thoracic limb, reduced biceps brachii muscle tendon tone, a tear of the medial glenohumeral ligament, and a rupture of the subscapularis tendon were identified intraoperatively. Transposition of the biceps muscle tendon was performed. However, at 7 days, there was evidence of right shoulder reluxation on radiographs. The second surgery was performed with two $2mm{\times}6mm$ cortical bone anchors and a $4mm{\times}6mm$ cancellous bone anchor placed in the cortical bone of the distal scapula and the cancellous bone of the proximal humerus respectively. Two scapular bone anchors were then connected with a humeral bone anchor using heavy nylon suture to minimize shoulder abduction range of motion. On radiographs right after surgery and 6 weeks after surgery, the affected limb revealed no evidence of medial shoulder luxation. At 6 months, no evidence of lameness was noted on the right thoracic limb.

Clinical Evaluation of Thoracostomy Treatment on the Pathological Changes in Pleural Cavity (흉강병변에 대한 흉강삽관술 246례의 임상적 고찰)

  • Rhee, Chong-Bae;Kim, Geun-Ho
    • Journal of Chest Surgery
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    • v.10 no.2
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    • pp.205-213
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    • 1977
  • In order to evaluate the therapeutic effect of thoracostomy on the patients with pathological changes in pleural cavity which were caused by various etiological factors, a clinical study was carried out during a period of 5 and half years from May 1972 to September 1977 in the department of thoracic surgery, Hanyang University Hospital, and the following results were obtained. Of a total of 264 patients, 205 cases were male, and 59 female, exhibiting the ratio of male to female being 3.5 to 1. The pathological changes in pleural cavity could occur at any age from 4 months after birth to 76 years old, the peak incidence being in the third decade in either male or female. The incidence decreased in the second, fifth and fourth decade in order. The type of pathological changes observed and their frequencies of occurrences were 93 cases [35.2%] in pneumothorax, 62 cases [23.5%] in hemothorax, 48 cases [18.2%] in pyothorax, 46 cases [17. 4%] in hemopneumothorax, 13 cases [4.9%] in hydropneumothorax, and one case each in hydrothorax and chylothorax. The incidence of the primary diseases which predisposed the pathological changes in pleural cavity were, 119 cases [45-1%] in trauma, 64 cases [24.2%]in lung tuberculosis, 38 cases [14.4%] in pneumonia or empyema, 14 cases [5.3%] in lung emphysema and blebs, 13 cases [4.9%] in process after thoracotomy, 3 cases [1.1%] each in lung malignant tumor and lung paragonimiasis, one case in mechanical ventilator and 9 cases [3.4%] in unknown origin. The pathological changes in pleural cavity were located in the right side of the cavity in 124 cases, in the left side in 133 cases and in both sides in 7 cases, indicating that the difference between the incidence of the left and rightside occurences was insignificant. Of 93 cases of pneumothorax studied, 63 cases were found to have been tension pneumothorax and 30 cases non-tension pneumothorax, showing greater prevalence of tension type over non-tension type. Of 119 cases of trauma observed, 82 cases were accompanied with rib fractures and 37 cases were without any fracture [non-bone fracture]. Patients with the rib fractures were characterized by multiple rib fractures and multiple double fractures of ribs, accompanying with or without fracture of bones other than ribs, and patients with non-bone fracture were characterized by penetrating stab wound and blunt trauma. Of 264 cases who received thoracostomy, 207 cases [78.4%] demonstrated that their pathological changes in pleural cavity were removed and subsided by a simple measure of thoracostomy. In 43 cases [16.3%], various surgical measures including radical operation and thoracotomy were required for complete healing, since their pathological changes were not abolished by thoracostomy alone. The rest 14 cases [5.3%] were expired following thoracostomy.

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A Study on the Relationship between School-age Obesity and Type of Feeding in Infant Period (영아시기 수유 방식과 초기 학동기 비만과의 관련성에 관한 연구)

  • Cho, Kyung Lae;Kim, Soo Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1166-1171
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    • 2005
  • Purpose : The aim of this study was to evaluate whether breast milk feeding at infancy has the effect of a programming agent preventing school-age obesity, or whether formula milk feeding is the cause of elementary school-age obesity. Methods : We randomly selected 4 elementary school in Masan and Changwon city. We calculated the BMI and obesity degree from height and weight data on the school record of 1,275 children of first and second grade. The parents of 1,275 children were asked to a questionnaire about their birth history and feeding modality during infancy. Based on these data, we categorized them into 4- different groups : breast fed for less than 2 months; breast fed for 2-6 months; breast fed more than 6 months; mixed fed. We compared the mean BMI, obesity degree and prevalence rates of obesity of each groups. Results : There was no statistical difference on the prevalence rates of overweight and obesity, which was defined by BMI, according to the duration of breast feeding. The same was true for mild obesity and moderate obesity, which was defined by obesity degree. The mean BMIs and the mean obesity degree were not different among different feeding types. Conclusion : There seems to be no protective effect of breast feeding during infancy on reducing the prevalence rates of overweight and obesity. However, even wider and larger studies considering confounding factor might be needed to reach a definite conclusion in the future.