• 제목/요약/키워드: Multiple Primary

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폐의 원발성 비호지킨림프종의 임상상 (Clinical Feature of Primary Pulmonary Non-Hodgkin's Lymphoma)

  • 오동규;노재형;송진우;김동순
    • Tuberculosis and Respiratory Diseases
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    • 제69권5호
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    • pp.354-360
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    • 2010
  • Background: Primary non-Hodgkin's lymphoma of the lung is a rare entity. It is represented commonly as marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type. Although there have been a few reviews of this lymphoma, clinical features, radiologic findings, management and prognosis have not been well defined. Methods: We reviewed the medical records of 24 patients with primary pulmonary lymphoma between January 1995 and September 2008; all diagnoses had been confirmed based on pathology. Results: The median follow-up time was 42.3 months (range, 0.1~131.2 months). Five (20.8%) patients were asymptomatic, 17 (70.8%) patients had pulmonary symptoms, and the remaining 2 (8.3%) patients presented with constitutional symptoms. There were 16 (66.7%) patients with MALT lymphoma, 4 (16.7%) patients with diffuse large B-cell lymphoma and 4 (16.7%) patients with lymphoma that had not received a WHO classification. Radiologic findings of primary pulmonary lymphoma were diverse and multiple nodule or consolidation was the most common finding regardless of pathologic lymphoma type. PET scan was carried out in 13 (54.2%) patients and all lesions showed notable FDG uptake. MALT lymphoma showed a trend of better prognosis (3-year survival, 78.8% vs. 70.0%; 5-year survival, 78.8% vs. 52.5%; p=0.310) than non-MALT lymphoma. Conclusion: Primary non-Hodgkin's lymphoma of the lung occurs with nonspecific clinical features and radiologic findings. MALT lymphoma is the most common pathologic type of primary pulmonary lymphoma. This entity of lymphoma appears to have a good prognosis and in this study, there was a trend of better outcome than non-MALT lymphoma.

Predictors of Intensive Care Unit Morbidity and Midterm Follow-up after Primary Repair of Tetralogy of Fallot

  • Egbe, Alexander C.;Nguyen, Khanh;Mittnacht, Alexander J.C.;Joashi, Umesh
    • Journal of Chest Surgery
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    • 제47권3호
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    • pp.211-219
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    • 2014
  • Background: Our objectives were to review our institutional early and midterm experience with primary tetralogy of Fallot (TOF) repair, and identify predictors of intensive care unit (ICU) morbidity. Methods: We analyzed perioperative and midterm follow-up data for all cases of primary TOF repair from 2001 to 2012. The primary endpoint was early mortality and morbidity, and the secondary endpoint was survival and functional status at follow-up. Results: Ninety-seven patients underwent primary repair. The median age was 4.9 months (range, 1 to 9 months), and the median weight was 5.3 kg (range, 3.1 to 9.8 kg). There was no early surgical mortality. The incidence of junctional ectopic tachycardia and persistent complete heart block was 2% and 1%, respectively. The median length of ICU stay was 6 days (range, 2 to 21 days), and the median duration of mechanical ventilation was 19 hours (range, 0 to 136 hours). By multiple regression analysis, age and weight were independent predictors of the length of ICU stay, while the surgical era was an independent predictor of the duration of mechanical ventilation. At the 8-year follow-up, freedom from death and re-intervention was 97% and 90%, respectively. Conclusion: Primary TOF repair is a safe procedure with low mortality and morbidity in a medium-sized program with outcomes comparable to national standards. Age and weight at the time of surgery remain significant predictors of morbidity.

Effect of glide path preparation with PathFile and ProGlider on the cyclic fatigue resistance of WaveOne nickel-titanium files

  • Uslu, Gulsah;Inan, Ugur
    • Restorative Dentistry and Endodontics
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    • 제44권2호
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    • pp.22.1-22.8
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    • 2019
  • Objectives: The aim of this study was to investigate the effect of glide path preparation with PathFile and ProGlider nickel-titanium (NiTi) files on the cyclic fatigue resistance of WaveOne NiTi files. Materials and Methods: Forty-four WaveOne Primary files were used and divided into four groups (n = 11). In the first group (0 WaveOne), the WaveOne Primary files served as a control group and were not used on acrylic blocks. In the 1 WaveOne Group, acrylic blocks were prepared using only WaveOne Primary files, and in the PF+WaveOne group and PG+WaveOne groups, acrylic blocks were first prepared with PathFile or ProGlider NiTi files, respectively, followed by the use of WaveOne Primary files. All the WaveOne Primary files were then subjected to cyclic fatigue testing. The number of cycles to failure was calculated and the data were statistically analyzed using one-way analysis of variance (ANOVA) and the Tukey honest significant difference multiple-comparison test at a 5% significance level. Results: The highest number of cycles to failure was found in the control group, and the lowest numbers were found in the 1 WaveOne group and the PF+WaveOne group. Significant differences were found among the 1 WaveOne, PF+WaveOne, and control groups (p < 0.05). No statistically significant differences were found between the PG+WaveOne group and the other three groups (p > 0.05). Conclusion: Glide path preparation with NiTi rotary files did not affect the cyclic fatigue resistance of WaveOne Primary files used on acrylic blocks.

Factors impacting time to total shoulder arthroplasty among patients with primary glenohumeral osteoarthritis and rotator cuff arthropathy managed conservatively with corticosteroid injections

  • Dhruv S. Shankar;Edward S. Mojica;Christopher A. Colasanti;Anna M. Blaeser;Paola F. Ortega;Guillem Gonzalez-Lomas;Laith M. Jazrawi
    • Clinics in Shoulder and Elbow
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    • 제26권1호
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    • pp.32-40
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    • 2023
  • Background: The purpose of this study was to identify predictors of the time from initial presentation to total shoulder arthroplasty (TSA) in patients with primary glenohumeral osteoarthritis (OA) and rotator cuff (RTC) arthropathy who were conservatively managed with corticosteroid injections. Methods: We conducted a retrospective cohort study of patients who underwent TSA from 2010 to 2021. Kaplan-Meier survival analysis was used to estimate median time to TSA for primary OA and RTC arthropathy patients. The Cox proportional hazards model was used to identify significant predictors of time to TSA and to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Statistical significance was set at P<0.05. Results: The cohort included 160 patients with primary OA and 92 with RTC arthropathy. In the primary OA group, median time to TSA was 15 months. Significant predictors of shorter time to TSA were older age at presentation (HR, 1.02; 95% CI, 1.00-1.04; P=0.03) and presence of moderate or severe acromioclavicular joint arthritis (HR, 1.45; 95% CI, 1.05-2.01; P=0.03). In the RTC arthropathy group, median time to TSA was 14 months, and increased number of corticosteroid injections was associated with longer time to TSA (HR, 0.87; 95% CI, 0.80-0.95; P=0.003). Conclusions: There are distinct prognostic factors for progression to TSA between primary OA patients and RTC arthropathy patients managed with corticosteroid injections. Multiple corticosteroid injections are associated with delayed time to TSA in RTC arthropathy patients.

의원의 특성에 따른 상병진단군의 분포에 대한 연구 (Chracteristics of Primary Health Practice and Diagnosis-Cluster Pattern in Health Insurance)

  • 윤종률;문옥륜;허정;김창엽
    • 보건행정학회지
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    • 제3권2호
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    • pp.100-129
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    • 1993
  • This study is designed to find out some intra-clinic factors affecting the content of practice provided by primary care physicians in Korea, and proposed factors in this study are characteristcs of each private clinc --- physician-related variables(age, sex, specialty), bfed-related variables for inpatient care, laboratory-related variables for precise diagnosis. We have tried to estimate the difference of disease entities cared by each primary care physician according to above factors by analyzin gdisease data claimed during one month(April, 1992) to National Federation of Medical Insurance. The diagnosis codes by ICD-9 in the research disease data were reclassified to 'diagnosis clusters' by virtue of clinical similarities for effective analyses. We have converted frequent-tsing ICD-9 codes to 86 diagnosis clusters, which incorporated 97.4 percents of all ambulatory visits to private clinics. This result means proposed diagnosis-cluster method is effective tool for analysis of the content of ambulatory medical care carried out by primary care physicians. Comparisons and analyses of multiple diagnosis-clusters made on the basis of presented factors were done and the results were as follows; - Major factors affecting the difference between diagnosis-cluster pattern by each variables were phyusician's age, sex, specialty and bed counts of each private clinic for inpatient care and the size of laboratories of each clinic. - Middle aged(30th to 40th) group physicians are providing more comprehensive care than 20th or above 50th aged groups. Male physicians are more adequate for comprehensive care than female physicians, because woman-doctors are providing narrow-spectrum care. The content of practice of obstetricians and gynecologists shows much difference from primary medical practice, and they cannot be included in primary care physician, this study suggested. Pediatricians are also providing short-spectum acre, and nearly all visits to pediatricians were incorporated only 2-3 diagnosis-clusters. General surgeons' practices are very similar to general practioners' or family physicians' practices, the means they are providing primary care rather than special surgical care. And small number of beds(under 5 beds) and only basic(2-3 sorts of)diagnostic apparatuses are sufficient for primary physicians' clinic to carry out primary care. In conclusion, to reinforce primary care department in Korea, there must be support with health policy to expand office-based primary care practice-- with small number of beds for inpatient care and only basic laboratories-- provided by general practitioner of family physician.

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Epidemiology and Survival of Hepatocellular Carcinoma in North-east Peninsular Malaysia

  • Norsa'adah, Bachok;Nurhazalini-Zayani, Che Ghazali Che
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6955-6959
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    • 2013
  • The incidence of hepatocellular carcinoma (HCC) is relatively high in Southeast Asia. Globally, HCC has a high fatality rate and short survival. The objectives of this retrospective cohort study were to review the epidemiology and survival of HCC patients at a tertiary centre in north-east of Peninsular Malaysia. Subjects were adult HCC patients diagnosed by histopathology or radio-imaging. Secondary liver carcinoma was excluded. Kaplan Meier and multiple Cox proportional hazard survival analyses were used. Only 210 HCC cases from years 1987-2008, were included in the final analysis. The number of cases was increasing annually. The mean age was 55.0 (SD 13.9) years with male:female ratio of 3.7:1. Approximately 57.6% had positive hepatitis B virus, 2.4% hepatitis C virus, 20% liver cirrhosis and 8.1% chronic liver disease. Only 2.9% had family history and 9.0% had frequently consumed alcohol. Most patients presented with abdominal pain or discomfort and had hepatomegaly, 47.9% had an elevated ${\alpha}$-fetoprotein level of 800 IU/ml or more, 51.9% had multiple tumors and 44.8% involved multiple liver lobes. Approximately 63.3% were in stage 3 and 23.4% in stage 4, and 82.9% did not receive any treatment. The overall median survival time was 1.9 months (95% confidence interval (CI): 1.5, 2.3). The 1-month, 6-month, 1-year and 2-year survival rates were 71.8%, 23.3%, 13.0% and 7.3% respectively. Significant prognostic factors were Malay ethnicity [Adjusted hazard ratio (AHR) 1.6; 95%CI: 1.0, 2.5; p=0.030], no chemotherapy [AHR 1.7; 95%CI: 1.1, 2.5; p=0.017] and Child-Pugh class C [AHR 2.6; 95%CI: 1.4, 4.9; p=0.002]. HCC in our study affected a wide age range, mostly male, in advanced stage of disease, with no treatment and very low survival rates. Primary prevention should be advocated in view of late presentation and difficulty of treatment. Vaccination of hepatitis virus and avoidance of liver toxins are to be encouraged.

Endometrial Stromal Sarcoma Presented as an Incidental Lung Mass with Multiple Pulmonary Nodules

  • Kang, Dong Oh;Choi, Sue In;Oh, Jee Youn;Sim, Jae Kyeom;Choi, Jong Hyun;Choo, Ji Yung;Hwang, Jin Wook;Lee, Seung Heon;Lee, Ju-Han;Lee, Ki Yeol;Shin, Chol;Kim, Je Hyeong
    • Tuberculosis and Respiratory Diseases
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    • 제76권3호
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    • pp.131-135
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    • 2014
  • Low-grade endometrial stromal sarcoma (ESS) is an uncommon gynecologic malignancy of mesodermal origin. Pulmonary metastasis of low-grade ESS can occur years and decades after the treatment of the primary disease. Low-grade ESS is frequently mistaken as benign uterine neoplasm like uterine leiomyoma, which can potentially lead to a misdiagnosis. We present a case of a 42-year-old woman with low-grade ESS, that initially presented as an incidental lung mass with multiple pulmonary nodules, seven years after an uterine myomectomy. A $6.9{\times}5.8cm-sized$ intrapelvic mass suspected of uterine origin was discovered while searching for potential extrathoracic primary origin. A pelviscopy and simultaneous thoracoscopic lung biopsy were conducted for pathologic diagnosis. Finally, the diagnosis was confirmed as low-grade ESS with lung metastasis based on the histopathologic examination with immunohistochemical stain, which was showed positive for CD10 and hormone receptor markers (estrogen and progesterone receptors) in both pelvic and lung specimens.

Multiple shoot induction and plant regeneration from axillary buds of Magnolia 'Vulcan'

  • Kim, Tae-Dong;Kim, Ji-Ah;Lee, Na-Nyum;Choi, Chang-Ho
    • Journal of Plant Biotechnology
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    • 제47권1호
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    • pp.40-45
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    • 2020
  • An efficient protocol for multiple shoot induction and plant regeneration from axillary bud culture of Magnolia 'Vulcan' was developed in the present study. Primary shoots were obtained from axillary bud explants cultured on Murashige and Skoog (MS) medium containing 1.0 mg/L 6-benzylaminopurine (BA). To induce multiple shoots effectively, primary shoot tips were cultured on MS medium supplemented with different concentrations of BA and zeatin at 0, 0.2, 0.5, and 1.0 mg/L. Of these treatments, the MS medium with 0.5 mg/L BA resulted in the highest number of shoots per explant with an average value of 5.9, and it produced the greatest shoot height at 4.8 cm after 12 weeks of culturing. In the rooting of in vitro produced shoots, the greatest percentage of explants forming roots (91.3%), number of roots per explant (9.7), and root length (2.8 cm) were obtained in half-strength MS medium supplemented with 6.0 mg/L indole-3-butyric acid (IBA). Regenerated plantlets were successfully acclimatized and hardened off inside the culture room with 87.5% survival rate. Plants were transferred to a greenhouse with a 97.2% survival rate. The highly efficient shoot multiplication and plant regeneration system reported herein can be used for large-scale clonal propagation of valuable Magnolia species or cultivars.

초등학생의 건강증진행위 실천에 영향을 미치는 요인 - 초등학교 6학년을 중심으로 - (The Related Factors on the Health Promotion Behavior of Primary School Students)

  • 한창현;김귀영;김동식
    • 보건교육건강증진학회지
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    • 제22권2호
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    • pp.155-171
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    • 2005
  • Objectives: The purpose of this study is to find out how well the primary school students are practicing the health promotion behaviors and the factors relating their health promotion behavior. Methods: This study was carried out by using questionnaires with 1,215 students attending at a 6th grade, 16 primary schools which arranged the school health teachers in Kyoungpook, Chilkok Gun from the 21th through 22th of December 2004. Among them, 1,189 were included in final analysis. The collected data was analyzed through frequency, percentage mean and standard deviation, multiple regression. Results: According to the data from multiple regression of analysis which has the health promotion behavior practice as a subordinate variable, in male students' case the degree of health promotion behavior practice becomes high in proportion to their parents' interest in health, to their perceived self efficacy, and in case of the barriers of the health promotion behavior practice. As to the female students, their health behavior practice becomes high in proportion to their parents' interest in health. It also becomes high in proportion to the perceived health status, the understanding of the importance of the health, internal health locus of control in personality, the perceived self efficacy and the perceived benefit of the health promotion behavior. But in case of the barriers of the health promotion behavior, it was the same as the male students' case. Conclusions: As the results of study, it showed that the knowledge to importance of health, the self efficacy, the knowledge of benefit of health promotion behaviors and the health concern to the children of the parents were related to health promotion behaviors of the primary school students. So, through the systematic development of health education program, we induced to desirable direction for the changeable factors of actions to health promotion for the health, and through the connective guidelines between the School and the Home, we have to adapt to effective health promotion program for the health management of the young boys and girls.

상이한 지반조건을 갖는 아치구조물의 지진응답 분석 (Seismic Response of Arch Structure Subjected to Different Ground Motion)

  • 김기철;강주원
    • 한국공간구조학회논문집
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    • 제13권1호
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    • pp.113-119
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    • 2013
  • Spatial structures have the different dynamic characteristics from general rahmen structures. Therefore, it is necessary to accurately analyze dynamic characteristics and seismic response of spatial structure for seismic design of spatial structure. An arch structure is used as an example structure because it has primary characteristics of spatial structures. Multiple support excitation may be subjected to supports of a spatial structure because ground condition of spatial structures is different. In this study, the response analysis of the arch structure under multiple support excitation and simple support excitation is studied. By means of the pseudo excitation method, the seismic response is analyzed for long span spatial structure. It shows that the structural response is divided into two parts, ground displacement and structural dynamic response due to ground motion excitation. It is known that the seismic response of spatial structure under multiple support excitation and simple support excitation are the different in some case. Therefore, it has to be necessary to analyze the seismic response of spatial structure under multiple support excitation because the spatial structure supports may be different.