• Journal of Trauma and Injury
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• 제18권2호
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• pp.161-171
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• 2005

Background: The management of hepatic injuries has changed dramatically during the past two decade after the technologic breakthroughs in radiologic imaging techniques. Recently, the non-operative management of blunt hepatic trauma has become the standard of care in hemodynamically stable patients. We reviewed our experience of the non-operative management of blunt hepatic trauma. And the purpose of this study was to examine the prognostic factors and indicators affecting the decision for treatment modality of emergent hepatic trauma. Methods: The medical records of 84 patients who were treated for blunt hepatic injury at Masan Samsung Hospital from January 2002 to December 2003. The patients were divided two groups, non-operative(Non-OP) and operative(OP), according to the treatment modality. The two groups were compares for age, sex, mechanism of injury, grade of liver injury scale, combined injury, systolic blood pressure, pulse rate, hemoglobin, hematocrit, WBC count, S-GOT, S-GPT, ALP, transfusion amount during initial 24 hours, amount of infused crystalloid fluid, length of ICU stay, length of ward care, morbidity and mortality. The grade of the liver injury were determined by using the organ injury scale(OSI). Results: Among the 84 patients, 46 cases(54.8%) were managed non-surgically, and 3 cases of Non-OP group were treated by transarterial embolization. Between the two groups, there were significant difference in age, injury grade, combined injury, hemoglobin, hematocrit, initial systolic blood pressure, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, and length of ICU care, morbidity and mortality.(p<0.05) The overall mortality rate was 8.3%, but 2.2% mortality in the non-operative group. Conclusion: Non-operative management may be considered as a first choice in hemodynamic stable patients with blunt liver trauma. The reliable indicators affecting the treatment modality of blunt hepatic trauma were systolic BP, Hb, Hct, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, liver injury grade and combined injury. Strict selection of treatment madality and aggresive monitoring with intensive care unit were more important.

• 한국응용곤충학회지
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• 제55권3호
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• pp.277-283
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• 2016

무가온 시설토마토 재배지내에서 토마토녹응애 발생양상은 4월 중하순경 최초로 발생하기 시작하여 6월 중하순경 최대 발생을 나타냈다. 하지만 야간기온이 낮을 경우 번식력이 증가하게 되고 주간기온이 높을 경우에는 분산이 활발해져 고온기인 7월에도 지속적으로 증가하는 것으로 조사되었다. 유기농업자재 11종에 대한 토마토녹응애의 살충독성 실내검정 결과, EOIMa (Matrin 0.6%), EOICo (Clove oil 10%)가 500배에서 각각 92.1%와 95.1%로 90% 이상의 살충효과를 보였다. 특히 EOIMa 1,000배에서는 90.4%로 90%, EOIMa 2,000배에서는 88.2%의 높은 살충효과를 보였다. 포장검정에서도 EOIMa 1,000배와 EOICo 500배는 각각 91.5%와 93.9%의 살충효과를 보여 두 약제 모두 농약을 대체하기에 충분하였고 EOIMa의 경우 2,000배에서도 살충효과가 90%에 가까웠기 때문에 예방적 활용도 가능할 것으로 판단되었다.

• 한국응용곤충학회지
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• 제62권1호
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• pp.43-48
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• 2023

본 연구에서는 소나무재선충의 매개충인 솔수염하늘소와 북방수염하늘소에 대하여 무인항공기 (무인헬리콥터)를 이용하여 스피네토람의 약효 및 약해를 조사하였다. 하늘소를 대상으로 등록된 펜토에이트 유제, 비펜트린 액상수화제, 하늘소를 제외한 딱정벌레가 대상인 에토펜프록스 유제, 디플루벤주론 수화제와 나방류에 방제 약제로 등록된 인독사카브 수화제, 스피네토람 액상수화제 6종을 ULV기로 살포하여 솔수염하늘소에 대한 섭식독과 접촉독을 확인한 후 선발하였다. ULV 시험 결과, 펜토에이트, 비펜트린, 인독사카브, 스피네토람의 33배, 55배 희석배수액은 처리후 3일차에 접촉독과 섭식독에서 100% 살충율을 보였으나, 에토펜프록스는 7일차 접촉독 살충율 88.9%(33배), 88.9%(50배), 섭식독 살충율 93.4%(33배, 50배), 디플루벤주론은 7일차 접촉독 살충율 83.3%(33배), 섭식독 80.3%, 53.9%(50배)로 조금 낮은 살충률을 보였다. ULV 시험에서 선발된 가장 적합한 스피네토람의 33배액을 무인항공기로 살포하여 솔수염하늘소와 북방수염하늘소에 대한 감수성을 평가한 결과, 98.6% - 100%의 살충율을 보였다. 그러나, 해당 약제의 매개충 방제에 적용하기 전에 항공 살포에 의한 꿀벌에 대한 위해성 평가가 필요할 것으로 판단되었다.

• 한국간담췌외과학회지
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• 제28권2호
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• pp.144-154
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• 2024

Backgrounds/Aims: Socioeconomic determinants of health are incompletely characterized in cholangiocarcinoma (CCA). We assessed how socioeconomic status influences initial treatment decisions and survival outcomes in patients with CCA, additionally performing multiple sub-analyses based on anatomic location of the primary tumor. Methods: Observational study using the 2018 submission of the Surveillance, Epidemiology, and End Results (SEER)-18 Database. In total, 5,476 patients from 2004-2015 with a CCA were separated based on median household income (MHI) into low income (< 25th percentile of MHI) and high income (> 25th percentile of MHI) groups. Seventy-three percent of patients had complete follow up data, and were included in survival analyses. Survival and treatment outcomes were calculated using R-studio. Results: When all cases of CCA were included, the high-income group was more likely than the low-income to receive surgery, chemotherapy, and local tumor destruction modalities. Initial treatment modality based on income differed significantly between tumor locations. Patients of lower income had higher overall and cancer-specific mortality at 2 and 5 years. Non-cancer mortality was similar between the groups. Survival differences identified in the overall cohort were maintained in the intrahepatic CCA subgroup. No differences between income groups were noted in cancer-specific or overall mortality for perihilar tumors, with variable differences in the distal cohort. Conclusions: Lower income was associated with higher rates of cancer-specific mortality and lower rates of surgical resection in CCA. There were significant differences in treatment selection and outcomes between intrahepatic, perihilar, and distal tumors. Population-based strategies aimed at identifying possible etiologies for these disparities are paramount to improving patient outcomes.

• 대한기관식도과학회지
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• 제10권2호
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• pp.5-8
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• 2004

Stenosing airway disease is classified as intraluminal obstruction, extrinsic compression, and malacia by the anatomical site of the lesion. Stenting therapy is indicated for symptomatic relief of life-threatening dyspnea caused by the last two types. Airway stents are made with metal mesh and/or silicone rubber, and currently more than 20 kinds of stent are available. Among many kinds of silicone stent, the Dumon stent is mostly widely used for benign and malignant airway stenoses, but general anesthesia and rigid bronchoscopy are needed for insertion. It can be removed when the stenosing airway disease subsides completely. In many clinical studies, most patients $(85-90\%)$ improved immediately after stenting, and procedure-related mortality was low $(<3\%)$ in experienced centers. Stent displacement, mucus impaction, and granulation tissue formation are potential complications. Stenting is one of many effective therapeutic modalities for stenosing central airway disease. Careful patient selection, experiences, and continuous development of new technology will bring better results.

• 보험의학회지
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• 제2권1호
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• pp.3-16
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• 1985

Necessity of life insurance is stronger for people who feel some anxiety of their health. However, in fact, it is not permitted for them to get a contract, because life insurance stands on the mutual benefit system. Life insurance must be impartial to all applicants. However, it is very reasonable that an applicant, who has high medical impairment like heart infarction or cancer, is rejected, to have a contract by underwriting decision. On the other hand, if his medical impairment is not so severe, we might accept his application by giving some restriction. Numericalratingsystem by hunter-rogers gave us one of solutions to this problem. We can keep impartiality by using more restrictive decision, in order that we demand additional payment to the impairment applicant according to his mortality. We call this system as substandard life insurance. In this system we need detail information about impairments of applicants in order to decide the condition of substandard risks. Therefore, medical examiners are required to have high diagnostic technique.

• 대한핵의학회지
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• 제36권1호
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• pp.39-45
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• 2002

Clinical application of positron emission tomography (PET) is rapidly increasing for the defection and staging of cancer at whole-body studios performed with the glucose analogue tracer 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Although FDG PET cannot match the anatomic resolution of conventional imaging techniques in the liver and the other abdominal organs, it is particularly useful for identification and characterization of the entire body simultaneously. FDG PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can aid in the characterizing of indeterminate soft-tissue masses. Most abdominal cancer requires surgical management. FDG PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. The abdominal cancers, such as gastroesophageal cancer, colorectal cancer, liver cancer and pancreatic cancer, are common malignancies in Korea, and PET is one of the most promising and useful methodologies for the management of abdominal cancers.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 2002년도 춘계학술대회 및 총회
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• pp.9-13
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• 2002

Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studios performed with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Although many cancers can be detected by FDG-PET, there has been limited clinical experience with FDG-PET for the defection of gynecological cancers including malignancies in uterus and ovary. FDG-PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can and in the characterization of indeterminate soft-tissue masses. Most gynecological cancers need to surgical management. FDG-PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG-PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. In this review, I discuss the clinical feasibility and limitations of this imaging modality in patients with gynecological cancers.

• Journal of Chest Surgery
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• 제27권5호
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• pp.407-412
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• 1994

Congenital long-segment tracheal stenosis which involves nearly entire trachea and carina is very rare disease, but leads to life threatening obstruction in infancy and childhood. Symptoms are ranged from stridor and wheezing to severe cyanosis and respiratory failure. Routine chest X-ray is somewhat helpful to diagnose it, but definitive diagnosis can be made by bronchoscopy or tracheogram for severely narrowed tracheal lumen.Recently, we experienced a case of congenital tracheal stenois, type 1 by Cantrell classification with carinal involvement. After costal cartilage was designed as oval shaped flap and covered with pericardium, anterior and posterior augmentation was done with prepared costal cartilage.This patient died of respiratory failure at 13 days postoperatively, probably due to sustaining obstruction in association in with failure to make a sufficient widening at carinal level.Important issues in the management of congenital tracheal stenosis are rapid diagnosis, selection of appropriate surgical procedure, and detailed anesthetic schedule.In the future, more biocompatible material and more effective surgical procedures should be studied to reduce the surgical mortality and morbidity of the complicated tracheal stenosis.

• Korean Journal of Radiology
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• 제20권5호
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• pp.695-708
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• 2019

Atrial fibrillation (AF) is the most common arrhythmia associated with the risk of morbidity and mortality in clinical patients. AF is considered as an arrhythmia type that develops and progresses through close connection with cardiac structural arrhythmogenic substrates. Since the introduction of catheter ablation-mediated electrical isolation of arrhythmogenic substrates, cardiac imaging indicates improved treatment outcome and prognosis with appropriate candidate selection, ablation catheter guidance, and post-ablation follow-up. Currently, cardiac computed tomography (CCT) and cardiovascular magnetic resonance (CMR) imaging are essential in the case management of AF at both pre-and post-procedural stages of catheter ablation. In this review, we discuss the roles and technical considerations of CCT and CMR imaging in the management of patients with AF undergoing catheter ablation.