• Title/Summary/Keyword: Obstruction rate

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The Results of Postoperative Radiation Therapy in the Rectal Cancer (직장암의 수술 후 방사선치료성적)

  • Lee Kyung-Ja
    • Radiation Oncology Journal
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    • v.12 no.1
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    • pp.91-98
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    • 1994
  • Purpose: Despite apparently complete resection of cancer of the rectum, local recurrence rate was high. Radiation therapy has been used either alone or in combination with chemotherapy as an adjunct to surgery to reduce the risk of recurrence. This study was designed to evaluate the prognostic factors, survival rate and local recurrence rate of the rectal cancer who had received postoperative radiation therapy by retrospective analysis. Method: From 1982 to 1990, 63 patients with cancer of the rectum surgically staged as B2 or C disease received postoperative adjuvant radiation therapy after curative resection of tumor for cure. Postoperative radiation therapy was given to the whole pelvis(mean dose: 5040 cGy in 5-6weets) and perineum was included in irradiated field in case of abdominoperineal resection. Results: Three-year actuarial survival rate was 73.2$ \% $ overall, 87.7$ \% $ in stage B2+3 and 62.9$ \% $ in stage C2+3. Three-year disease-free survival rate was 69.5$ \% $ overall, 87.7$ \% $ in stage B2+3 and 56.8$ \% $ in stage C2+3, Three-year disease-free survival rate in anterior resection was 77.8$ \% $ and 44.4$ \% $ in abdominoperineal resection. The local recurrence rate was 15.9$ \% $ and distant failure rate was 20.6$ \% $. Severe late complication was small bowel obstruction in 6 patients and surgery was required in 4 patients(6.3$ \% $). The prognostic factors were stage(p=0.0221) and method of surgery(p= 0.0414) (anterior resection vs abdominoperineal resection). Conclusion: This study provides evidence supporting the use of postoperative radiation therapy for reducing the local recurrence rate in patients who have had curative resection of rectal cancer with involvement of perirectal fat or regional nodes or both(stage B2 and C).

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Measurements of Flow Rate and Pressure Changes in Femoral Artery Model during Catheterization (대퇴골 동맥 모델내에 카테터 삽입시 유량 및 압력 변화 측정)

  • Kim, J.K.;Park, C.Y.;Chung, C.;Chang, J.K.;Han, D.C.;Yoo, J.Y.;Min, B.G.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.11
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    • pp.7-10
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    • 1996
  • The purpose of this experimental investigation is to examine the influence of the catheter on local pressure changes and flow rate in an arterial branch model similar to the femoral artery of man. Effects of branch to main lumen flow rate ratios and the locations of catheter tip were found to be significant on the local pressure changes. Relatively large pressure drops due to obstruction effects may induce endothelial cell damage, which have been reported to be the primary cause of the initiation of the atherosclerosis.

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A Study on Building an Optimized Defense System According to the Application of Integrated Security Policy Algorithm (통합 보안정책 알고리즘 적용에 따른 최적화 방어 시스템 구축에 관한 연구)

  • Seo, Woo-Seok;Jun, Moon-Seog
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.21 no.4
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    • pp.39-46
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    • 2011
  • This study is conducted to examine the optimal integrated security policy based on network in case of attacks by implementing unique security policies of various network security equipments as an algorithm within one system. To this end, the policies conduct the experiment to implement the optimal security system through the process of mutually integrating the unique defense policy of Firewall, VPN(Virtual Private Network), IDS(Intrusion Detection System), and IPS(Intrusion Prevention System). In addition, this study is meaningful in that it designs integrated mechanism for rapid detection of system load caused by establishment of the security policy and rapid and efficient defense and secures basic network infrastructure implementation.

Assessment of Wavelet Technique Applied to Incident Detection - Case of Seoul Urban Freeway (Naebusunhwallo) - (돌발상황 검지를 위한 Wavelet 기법의 적용성 평가 - 서울특별시 도시고속도로를 중심으로 -)

  • Kim, Dong Sun;Baek, Joo Hyun;Song, Ki Han;Rhee, Sung Mo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.26 no.4D
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    • pp.581-586
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    • 2006
  • Incidents, which is unexpected unusual events such as traffic accidents, have increased on the most roads in Korea. The obstruction of a fluent traffic flow occurred by incidents causes the traffic congestion and decreases the capacity. The Wavelet technique was applied to detect the road section and the happening time of incidents on urban freeways in this study, and this technique has been widely used in many engineering fields such as an electrical engineering, etc. The availability and validity of the Wavelet technique to the detection of incidents was examined by the occupancy rate, the important element of traffic flows, which is extracted from the data of detectors installed on Seoul Urban freeways. Then, this result is compared to the California Algorithm and the Low-Pass Filtering Algorithm among basic present detection algorithms, which are based on the occupancy rate. As a result, the false alarm rate of this method was similar as that of the California algorithm and the Low-Pass Filtering algorithm, but the detection rate is higher.

Sequential Management of Pierre Robin Sequence: Case Report (상기도 폐쇄를 보이는 Pierre Robin Sequence 환아의 순차적 치료: 증례보고)

  • Kim, Bae-Kyung;Kwon, Yong-Dae;Ryu, Sun-Youl;Choi, Yong-Ha;Ohe, Joo-Young;Suh, Joon-Ho;Ko, Su-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.3
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    • pp.270-275
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    • 2011
  • Pierre Robin Sequence (PRS) is known as an anomaly consisting of respiratory obstruction with glossoptosis, micrognathia and cleft palate in a newborn. The etiology of PRS is not known, but several factors may be involved simultaneously. Mortality rate of PRS is about 5~30% and the treatment method is divided into both conventional treatments and surgical interventions. If the respiratory obstruction is not resolved by the conventional method, surgical treatment, such as subperiosteal release of the floor of the mouth, tongue-lip adhesion, tracheostomy, distraction osteogenesis may be needed. This study reports a case of PRS in a newborn male at 20 days, with dyspnea and feeding difficulties. Clinical examination showed micrognathia with glossoptosis and cleft palate as the typical PRS triad. We tried surgical intervention with subperiosteal release of the floor of the mouth and tongue-lip adhesion and surgery was successful. At $19^{th}$ months, we also repaired the incomplete cleft palate successfully using 2-Flap palatoplasty.

Computational Study on the Hemodynamics of the Bypass Shunt Directly Connecting the left Ventricle to a Coronary Artery

  • Shim Eun Bo;Lee Byung Jun;Ko Hyung Jong
    • Journal of Mechanical Science and Technology
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    • v.19 no.5
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    • pp.1158-1168
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    • 2005
  • A shunt from the left ventricle to the left anterior descending artery is being developed for coronary artery occlusive disease, in which the shunt or conduit connects the the left ventricle (LV) with the diseased artery directly at a point distal to the obstruction. To aid in assessing and optimizing its benefit, a computational model of the cardiovascular system was developed and used to explore various design conditions. Computational fluid dynamic analysis for the shunt hemodynamics was also done using a commercial finite element package. Simulation results indicate that in complete left anterior descending artery (LAD) occlusion, flow can be returned to approximately 65% of normal, if the conduit resistance is equal for forward and reverse flow. The net coronary flow can increase to 80% when the backflow resistance is infinite. The increases in flow rate produced by asymmetric flow resistance are enhanced considerably for a partial LAD obstruction, since the primary effect of resistance asymmetry is to prevent leakage back into the ventricle during diastole. Increased arterial compliance has little effect on net flow with a symmetric shunt, but considerably augments it when the resistance is asymmetric. The computational results suggest that an LV-LAD conduit will be beneficial when the resistance due to artery stenosis exceeds 27 PRU, if the resistance is symmetric. Fluid dynamic simulations for the shunt flow show that a recirculating region generated near the junction of the coronary artery with the bypass shunt. The secondary flow is induced at the cutting plane perpendicular to the axis direction and it is in the attenuated of coronary artery.

Polypectomy by Intraoperative Total Gut Endoscopy in a Child with Peutz-Jeghers Syndrome (소아 Peutz-Jeghers 증후군 환자에서 전장 내시경술에 의한 용종 절제술 1례)

  • Kwak, Jeong Won;Kim, Hae Young;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.76-80
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    • 2005
  • Peutz-Jeghers syndrome is an autosomal dominant inherited syndrome characterized by mucocutaneous pigmentation and gastrointestinal hamartomatous polyps. The most important complications that increase morbidity are intussusception, bleeding and obstruction. Most patients with Peutz-Jeghers syndrome may undergo multiple laparotomies for complications such as intussusception or bleeding every 2 to 3 years during adolescence and early adulthood. To decrease the relaparotomy rate, intraoperative endoscopy may be useful in the treatment of complications that are related to Peutz-Jeghers syndrome. Use of intraoperative endoscopy can lead to a healthier life and to a longer life expectancy for the patient. We describe a case of Peutz-Jeghers syndrome, who underwent polypectomy by total gut endoscopy in an 11-year-old girl presented with intestinal obstruction and anemia. During the course of the operation, the endoscope was inserted per the enterostomy and colostomy sites, and 16 polyps in the small and large intestine were removed endoscopically using a snare.

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2 Cases of Bilateral Choanal Atresia (후비공 폐쇄 2례)

  • 심강석;이석용;문태용;윤강묵
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.18.3-19
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    • 1983
  • Choanal atresia, described first by Johann Roedere (1755) is an obstruction between the nasal cavity and nasopharyngeal vault, and the diagnosis and treatment were developed because of severity of the disease. Embryologically, incomplete development of olfactory pit, or failure of nasobuccal membrane to rupture, or persistent remaining of buccopharyngeal membrane, etc, all forms the congenital choanal atresia. And the acquired type was the result from syphilis or diphtheria with a resultant stenosing cicatrix and after the inexpert surgery and the trauma. Multiple abnormalities may be present particularly affecting the head, the heart and the alimentary system in the congenital type. The operative technique employed would depend upon the type of obstruction(whether membranous or bony), the age of the patient, and the presence or absence of any associated pathologic condition. Since Emmert (1853) first tried blind puncture of the atretic plate with the trocar, other surgical techniques have been introduced over the years for the correction of choanal atresia, which were the transnasal, transpalatal, transantral and the transseptal approach. Among them, transpalatal approach was proved to be a popular technique, that it provides a direct route, thus permitting an exact reconstruction and low restenosis rate. Recently, we have experienced two cases of choanal atresia and treated successfully with transpalatal approach, so authors report these cases with a review of the literature.

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Meconium Obstruction in Neonates-Clinical Characteristics and Treatment (태변성 장 폐쇄의 임상적 특성 및 치료)

  • Chang, Eun-Young;Lee, Mi-Jung;Kim, Myung-Joon;Shin, Jae-Ho;Chang, Hye-Kyung;Han, Seok-Joo;Oh, Jung-Tak
    • Advances in pediatric surgery
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    • v.17 no.1
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    • pp.15-22
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    • 2011
  • Meconium obstruction (MO) in neonates arises from highly viscid meconium and the poor motility of the premature gut. Recently the incidence of the MO in neonates has been Increasing, but, the diagnosis and treatment of this disease have not yet been clarified. Between March 2004 and April 2010, 24 neonates were treated for MO at Severance Children's Hospital. Their clinical characteristics and treatment were reviewed retrospectively. Twenty neonates were diagnosed with MO and 4 neonates were diagnosed with Hirschsprung's disease (HD). The mean birth weight and gestational age of the 20 neonates with MO were $1.45{\pm}0.90kg$ and $31.1{\pm}4.6$ weeks, respectively. Thirteen neonates (65 %) diagnosed with MO weighed less than 1.5 kg and 10 neonates (50 %) weighed less than 1 kg. Half of the neonates with MO were treated by non-operative methods and the other half were treated by operative methods. Compared with the group that weighed over 1.5 kg, the group that weighed less than 1.5 kg were more frequently operated upon (61.5% vs. 28.5%), and contrast enemas were performed later and more frequently. Also the group that weighed less than 1.5 kg had a higher mortality rate (15.4% vs. 0%). Three of the four neonates with HD were diagnosed with long-segment aganglionosis. In conclusion, MO occurred in very low birth weight neonates more often and must be differentiated from HD. Also, MO in very low birth weight neonates should be treated with special attention due to more a complicated clinical course.

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Prospective Multicenter Study of the Challenges Inherent in Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction

  • Yang, Min Jae;Kim, Jin Hong;Hwang, Jae Chul;Yoo, Byung Moo;Lee, Sang Hyub;Ryu, Ji Kon;Kim, Yong-Tae;Woo, Sang Myung;Lee, Woo Jin;Jeong, Seok;Lee, Don Haeng
    • Gut and Liver
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    • v.12 no.6
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    • pp.722-727
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    • 2018
  • Background/Aims: Although endoscopic bilateral stent-instent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic re-intervention. This study aimed to evaluate the technical accessibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Methods: Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Results: Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases of technical success. Stent occlusion occurred in 63.2% of the patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months postoperatively, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Conclusions: Large cell-type stents for endoscopic bilateral stent-in-stent placement had acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.