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The Effect of Thoracoscopic Sympathicotomy at the 4th Rib (R4) for Treating Palmar Hyperhidrosis (수부 다한증에서 제4번 늑골 위 교감신경절단술(R4)의 효과)

  • Noh, Dong-Sub;Park, Chang-Kwon;Kum, Dong-Yoon;Kim, Jae-Bum
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.343-346
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    • 2008
  • Background: Thoracoscpic sympathicotomy is an effective treatment for essential hyperhidrosis. Patients are generally satisfied with the surgery at the early post operative period, but they suffer from recurrence and compensatory sweating at the late post operative period. There are many sympathicotomy methods for minimizing recurrence and the compensatory sweating. We compared the outcome from between the R3 and R4 sympathicotomy methods for the symptoms, atisfaction, recurrence and compensatory sweating. Material and Method: From January 1999 to July 2007, 39 cases of thoracoscopic sympathicotomy at the 3rd rib (R3) and 72 cases of thoracoscopic sympathicotomy at the 4th rib (R4) for treating palmar hyperhidrosis were compared for the early and late satisfaction, the compensatory sweating and recurrence. Result: There is no difference of gender and age for the 2 groups. Early satisfaction was reported by 94.9% of the R3 patients and by 98.7% of the R4 patients. 84.6% of the R3 patients reported late satisfaction and 87.5% of the R4 patients reported late satisfaction. There were no significant differences between the groups for the early and late satisfaction. But there was a difference between the groups for compensatory sweating (23.1% in the R3 group and 9.7% in the R4 group (p=0.020)). The reoperation rate due to recurrence was 5.1% in the R3 group and 4.2% in the R4 group. There was no significant difference between the groups for recurrence. Conclusion: R4 sympathicotomy has excellent therapeutic results for compensatory sweating as compared to R3 sympathicotomy for treating palmar hyperhidrosis.

A Study on Coagulation and Ozone Treatment of Nonbiodegradable Substances in Landfill Leachate (생물학적 난분해성물질을 함유한 매립장 침출수의 응집 및 오존처리에 관한 연구)

  • Kim, Jong Shik;Choi, Joon Ho
    • Applied Chemistry for Engineering
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    • v.9 no.3
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    • pp.330-335
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    • 1998
  • The objectives of this study are summarized with two. The one is to remove of $COD_{Cr}$, color and turbidity with coagulation and ozonation in nonbiodegradable landfill leachate, the other is to compare of water qualities with pre-ozonation and post-ozonation. The results are summarized as follows ; 1) 90 minutes ozonation with $75mgO_3/min$($4.5gO_3/hr$) was conducted at pH 4,7, 10 to remove $COD_{Cr}$. Removal efficiencies were investigated with 48.2%, 52.6%, and 62.3% respectively. As increasing pH, $COD_{Cr}$ removal efficiencies were increased, it was considered that hydroxyl radical($OH{\cdot}$) which strongly oxdize and nonselectively react with organic compounds, was rapidly produced by ozone self-decomposition at high pH. 2) Alum, ferric chloride and ferrous sulfate were used for coagulation as inorganic coagulant. Ferric chloride was investigated with optimal coagulant, and it removed $COD_{Cr}$ about 12.0% at pH5 and dosage of $2,000m{\ell}/{\ell}$. Cation(C-101P), anion(A-601P) and nonion(SC-050) were tested to remove organic pollutants in landfill leachate. Cation(C-101P) was investigated with the most effective organic coagulant, and removal efficiency of $COD_{Cr}$ was 19.8% at pH5 and dosage of $100m{\ell}/{\ell}$. 3) Color and turbidity were removed up to 88.6%, 97.0% at pH10, when contacted 90 minutes with ozone, respectively. These removal efficiencies were much higher than those of $COD_{Cr}$ and $COD_{Mn}$. It was considered that ozone could oxdize the triggering materials of color and turbidity selectively and preferentially. 4) $COD_{Cr}$, color and turbidity were more effectively removed with pre-ozonation than post-ozonation about 8%, 3.5% and 1% respectively. These results were well corresponed with other's studies that pre-ozonation will increase the effect of coagulation.

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Serial Determinations of Serum Squamous Cell Carcinoma Antigen (SCC) during Radiotherapy for Uterine Cervix Cancer (자궁경부암에서 방사선치료 중 혈중 Squamous Cell Carcinoma Antigen 값의 변화)

  • Yun, Hyong-Geun;Park, Seok-Kun
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.136-141
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    • 2001
  • Purpose : To evaluate the significance of serum SCC for the monitoring of treatment response and the early detection of distant metastasis during radiotherapy (RT). Materials and Methods : In 13 patients with histologically proven primary squamous cell carcinoma of uterine cervix, serum SCC values were checked in pre-RT point, weekly during RT, and in post-RT point. Results : In 4 of 13 cases, metastasis appeared at the end of external RT, so that intracavitary radiation couldn't be peformed.01 these 4 cases,3 with elevated pre-RT SCC level, who resulted in lung metastasis on chest PA at the end of external RT showed decreased post-RT SCC value despite of metastasis. Of all 10 cases with elevated pre-RT SCC value (including 3 with metastasis at the end of external RT), SCC value was higher than pre-RT value in 7 at 9 Gy and the difference was statistically significant. At 18 Gy, SCC was higher in 4 and lower in 6 than pre-RT value. After 18 Gy, SCC value decreased continuously to the end of RT in all 10 cases. Conclusion : During RT, SCC value increased initially at 9 Gy. To 18 Gy, SCC value decreased to the nearly same with pre-RT value. After 18 Gy, to the end of RT, SCC value decreased continuously and normalized in completely responded cases. In cases with appearance of lung metastasis, SCC value also decreased with the disappearance of main mass of uterine cervix despite metastasis.

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Human Lung Cancer Cell Xenografts Implanted under the Capsule of Kidney, Spleen and Liver (폐암 세포주를 사용한 신, 비장 및 간 피막하 분식법의 비교)

  • 김수현;김종인;이해영;조봉균;박성달;김송명
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.711-720
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    • 2003
  • Bakground : Complete resection by the surgery has been selected as the treatment of choice in lung cancer patients, but in cases of recurrence after excision or inoperable cases, the importance of anticancer chemotherapy has been emphasized. If one can select a set of the sensitive chemotherapeutic agents before anticancer chemotherapy, it will give more favourable results. Subrenal capsular assay has been recognized as a useful in-vivo chemosensitivity test of thoracic and abdominal tumors and it can be done in a short time for a rapid interpretation of tumor responsiveness to anticancer chemotherapeutic drugs. It has been reported that various kinds of cancer cells can be implantable to the kidney, but so far there is no comparative study of xenogeneic cell implantation on liver, spleen and kidney. The author implanted the human lung cancer cells under the capsule of S.D rat's liver, spleen and kidney respectively and compared the pattern of growth and histology. Material and Method: After incubation of human lung cancer cell line (SW-900 G IV) in RPMI 1640 (Leibovitz L-15 medium) culture media, 3${\times}$3${\times}$3 mm size fibrin clots which contain 108 cancer cells were made. Thereafter the fibrin clots were implanted at subcapsule area of liver, spleen and kidney of S.D. female rat. For immune suppression, cyclosporin-A (80 mg/Kg) was injected subcutaneously daily from post-implantation first day to sixth day. The body weight was measured at pre and post implantation periods. The growth pattern and the size of tumor mass were observed and the pathologic examination and serum tumor marker tests were performed. Result: Body weight increased in both of control and experimental groups. Serum Cyfra 21-1 was not detected. Serum levels of CEA and NSE revealed no significant change. The SCC-Ag increased significantly in implanted group. The growth rate of human lung cancer cells which was implanted on spleen was higher than on liver or kidney. The surface area, thickness, and volume of tumor mass were predominant at spleen. The success rates of implantation were 80% on kidney, 76.7% on spleen and 43.3% on liver. Pathologic examination of implanted tumors showed characteristic findings according to different organs. Tumors that were implanted on kidney grew in a round shape, small and regular pattern. In the spleen, tumors grew well and microscopic neovascularization and tumor thrombi were also found, but the growth pattern was irregular representing frequent daughter mass. Human lung cancer cells that were implanted in the liver, invaded to the liver parenchyme, and had low success rate of implantation. Microscopically, coagulation necrosis and myxoid fibrous lesion were observed. Conclusion: The success rate of implantation was highest in the kidney. And the mass revealed regular growth that could be measured easily. The SCC-Ag was presented earlier than CEA or Cyfra21-1. The Cyfra21-1 was not detected at early time after implantation. The best model for tumor implantation experiment for chemosensitivity test was subrenal capsular analysis than liver and spleen and the useful serum tumor marker in early period of implantation was the SCC-Ag.

Hydrophilic Modification of Porous Polyvinylidene Fluoride Membrane by Pre-irradiating Electron Beam (전자빔 전조사를 이용한 Polyvinylidene Fluoride 다공막의 친수화 개질)

  • Choi, Yong-Jin;Lee, Sung-Won;Seo, Bong-Kuk;Kim, Min
    • Membrane Journal
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    • v.21 no.2
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    • pp.118-126
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    • 2011
  • A method of light pre-irradiation, one of methods modifying hydrophobic surface to hydrophilic surface in a membrane, was proposed to overcome the drawback of previous methods such as blending, chemical treatment and post-irradiation, Process of membrane preparation in the study was comprised of 4 parts as follows: firstly process of precursor preparation to introduce hydrophilic nature under atmosphere and aqueous vapor by irradiating electron beam (EB), secondly process of dope solution preparation to cast on non-woven fabrics, thirdly process of casting to prepare membrane and finally process of coagulation in non-solvent to form porous structure. The merit of this method might show simple process as well as homogenous modification compared to previous methods. To carry it out, precursor was prepared by irradiating EB to powder PVDF at 75~125 K Gray dose. Precursor prepared was analyzed by FTIR, EDS and DSC to confirm the introduction of hydrophilic function and its mechanism. From their results, it was inferred I conformed that hydrophilic function was hydroxy1 and it was introduced by dehydrozenation. Hydrophilicity of membranes prepared was evaluated by contact angle (pristine PVDF : $62^{\circ}$, 125 K Gray-PVDF$13^{\circ}$). Porosity was evaluated by mercury intrusion method, simultaneously morpholoy and surface pore size were observed by SEM phothographs. The result showed the trend that more dose of EB led to smaller pore size and to lower porosity (pristine PVDF : 82%, 125 K Gray-PVDF : 63%). Trend of water permeability was similar to result above (pristine PVDF : 892 LMH, 125 K Gray-PVDF : 355 LMH).

Outcome of Tumor Prosthetic Reconstruction in Osteosarcoma Patient (골육종 환자에서 종양 대치물을 이용한 재건술의 치료결과)

  • Kim, Jae-Do;Kim, Cheung-Kue;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.79-86
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    • 2011
  • Purpose: Modular tumor prosthesis is the most popular recontructive modality after resection of malignat tumor in extremity. Complications and survival of tumor prosthesis reconstruction are well-known. however, reports on the long-term outcome of tumor prosthesis in osteosarcoma patientss are scarece. Materials and Methods: In 158 cases as diagnosed as osteosarcoma from feburary 1989 to December 2006 in a single cancer center. We retrospectively reviewd 48 osteosarcoma patients who under went tumor prosthetic reconstruction. Mean follow up preiod was 75.6 months (range; 60 to 179 months). There were 28 males, 20 females and mean age was 22.4 years (range; 11-71). Pathologic subtypes were conventional central osteosarcoma in 46 cases and periosteal in 2 cases. The location of the tumor was proximal tibia (26 cases), distal femor (20 cases), femor diaphysis (1 case), and tibia diaphysis (1 case). In 41 cases built-up-type tumor prosthesis have been used and 7 cases expansion-type tumor prosthesis have been used. We used Musculoskeletal tumor society (MSTS) grading system to asses post operation function, and we analyzed survival rate of patient and tumor prosthesis and complication. Results: The overall survival rate was 77.7% and disease free survival rate was 68.9%. The survival rate of tumor prosthesis was 73%, in last follow up tumor prosthesis has been removed in 12 cases. All of them, 17 complications occurred, which included infection in 16 cases, Periprosthetic Fracture and Loosening of tumor prosthesis in 4 cases, articular instability in 4 cases. MSTS functional score was 74.1% in post operation. Conclusion: In long term follow up result, Primary tumor prosthesis -a reconstruction method after a wide extensional resecion of a bone tumor- can be a effective treatment method in asepect of survival rate, functional assesment and complication.

Changes of C-Reactive Protein and Erythrocyte Sedimentation Rate Level from Infection and Non-Infection after the Artificial Joint Surgery (인공관절 수술 후 감염과 비 감염에 따른 C-반응성단백과 적혈구침강속도의 변화 추이)

  • Kim, Min-Ju;Kim, Hye-Jeong
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.4
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    • pp.321-326
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    • 2016
  • This study aimed to analyze the changes of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) measured in acute infection within four weeks post artificial joint surgery to predict potential infection in early stages, provide rapid treatment, and prevent the abuse of antibiotics. This study included 50 patients with acute infection and 50 patients without any symptoms of infection, among patients who received artificial joint replacement surgery on the lower limbs in a four-week period. CRP was the highest two-to-three days after surgery. with $5.77{\pm}3.69$ and $5.17{\pm}3.48$, respectively, in those with infection and without infection. Thereafter, the value rapidly reduced in those without infection. However, it increased again to $3.16{\pm}2.87$ in the group with infection according to the bimodal curve (p<0.001). ESR was the highest two-to-three days after surgery, with $58.8{\pm}24.63$ and $44.08{\pm}21.48$, respectively. Thereafter, the value slowly reduced in those without infection. However, it was increased again to $47.62{\pm}26.26$ in those with infection according to the bimodal curve p<0.001). As this study shows, if there is an increasing trend for CRP and ESR after artificial joint replacement surgery, it may be possible to question whether patients are acutely infected post surgery. In particular, this result is expected and regarded as a useful factor for diagnosing infection due to the high level of sensitivity and uniqueness for CRP.

A comparative study on denture cleansers for food stain removal on the denture of elders in domiciliary care (재가복지 노인의치 세정제의 음식물 세정효과 비교연구)

  • Lee, Nam-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.1
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    • pp.331-336
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    • 2018
  • Oral health is an essential requirement for maintaining and promoting health and quality of life while aging. It is known that there is a deep connection with hygienic management of dentures. However, despite the emphasis on the importance of clean management of dentures, there is a lack of quantitative research on denture-related detergents. Therefore, the purpose of this study is to evaluate food stain removal performance of three denture cleansers containing proteolytic enzymes. In addition, this study provides basic data on self-cleaning methods using detergents and suggests ways to improve effective treatment for oral health of elders in domiciliary care. In order to obtain quantitative data concerning food stain removal performance of each proteinase denture cleaner, the test evaluation method proposed by the Korean Consumer Agency, ISO 20795, was used. A total of 18 specimens were discolored for 48 hours in water dissolved with turmeric, and then washed with each denture cleaner for 24 hours. The cleaned denture specimens were measured quantitatively using a spectrophotometer to measure the color values of the denture specimens before the discoloration as well as the color values of the discolored specimens after cleaning with the denture cleanser. The experimental values were analyzed through one-way ANOVA with post-hoc Tukey's test, and statistically significant differences were found among the experimental groups. It was found that C had statistically significant stain removal performance compared with A and B(p<.05). All experiments were conducted for a total of 21 days, from July 3- 23, 2017. This study confirms that denture cleansers is a beneficial self-denture management method for domiciliary seniors. Therefore, it is necessary to extend accessibility for denture cleansers in order to to optimize domiciliary care for elderly oral hygiene and health.

Transection of the posterior horn of the medial meniscus at the posterior tibial attachment - Clinical features and A new repair technique (Pullout suture) - (내측 반월상 연골 후각의 후방 경골 부착부위의 절단 파열 - 임상 양상 및 새로운 봉합 수기(pullout suture) -)

  • Ahn, Jin-Hwan;Ha, Chul-Won;Kim, Ho;Kim, Sung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.109-114
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    • 1999
  • Purpose : The importance of meniscal repair is well recognized. But transeciton of the posterior horn of the medial meniscus at the posterior tibial attachment is rarely documented and known irreparable. We experienced 9 cases of transection, and present clinical features and pull out suture technique. Methods and Materials : There were 9cases of transection of the posterior horn of medial meniscus from September 1998 to July 1999 in our hospital. Age was 59.3 years in average and ranged from 38 to 70years. Clinical features and MRI made diagnosis in all cases. We confirmed the diagnosis with arthroscopy and repaired the transection with pullout suture technique. Clinical features : Transection of the posterior horn of the medial meniscus at the posterior tibia attachment occurred frequently in middle aged people. They complained posterior knee pain, but they have no history of definitive trauma. Characteristically they had difficulty in full flexion of the knee and in having a squatting position. MRI is very important in diagnosis of transection, especially in coronal view, there is separation of the posterior horn of the meniscus from the posterior tibial attachment. Surgical technique : Pullout suture technique includes debridement of fibrous or scar tissue, exposure of the subchondral bone of the posterior tibial attachment site, suture the transected end of the meniscus with PDS suture, bone tunnel formation from the anteromedial aspect of the proximal tibia, insertion of wire loop through the tibia tunnel, pull the PDS suture through the tibia tunnel out of the joint and stabilize the PDS with post-tie technique to the proximal tibia. Conclusion : Transection of the posterior horn of the medial meniscus at the posterior tibial attachment is not common clinically and rarely documented. Clinical features and MRI are very important in diagnosis of this type tear. Arthroscopic pullout sutures is useful for treatment of this type tear of the meniscus.

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Long term results of surgical treatment of lung carcinoma (원발성 폐암의 장기 성적)

  • 이두연
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.328-341
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    • 1987
  • We reviewed 147 cases of primary carcinoma of the lung between January 1975 and December 1986 at the Thoracic and Cardiovascular Department, Yonsei university College of Medicine, Seoul, Korea. There were 116 males and 31 females with 93.72% ranging in age from 40 to 69 years. The mean age was 61.01 years. To 69 years of age with 61.01 years of mean age. There were 92 [62.59%] cases of squamous cell carcinoma, 29 [19.73%] cases of adenocarcinoma, 8 [5.44%] cases of undifferentiated large cell carcinoma, 8 [5.44%] cases of undifferentiated small cell carcinoma and 10 [6.8%] cases of bronchoalveolar cell carcinoma. 50 [34.01%] patients in stage I and 49 [33.26%] patients in stage II underwent pneumonectomies and lobectomies with a 67.27% rate of resection, where as only 49.12% of stage III patients were resected. Also 7 [30.43%] of the 23 stage IV cases were surgically resected and confirmed stage IV after surgical resection. The actuarial survival rate according to classification are as follows. The one and 3 year survival rate of the patients in stage I were 96% and 84% respectively. The one and `3 year survival rate of the patients in stage II were 100% and 66.6%, whereas the one and 3 year survival rate of the patients in stage III, T3 were 78.57% and 69.84%. The survival rates of patients in stage I, II, III T3 were better than those of the other stages. There were significant differences in observed survival for patients with stage II as compared with the patients with stage Ill, T3. [p=0.0005]. An aggressive surgical approach still offered the greatest chance for long-term survival even in stage Ill, T3. The survival rate in patients with resectable cases including stage III, T3 might be improved with an aggressive surgical approach. The one and 3 year survival rates of patients in stage III, N2 were 56.67% and 43.7 I%. The one and 3 year survival rates of patients in stage IV were 21.43% and 3.57%. Patients in stage III, N2 or IV had markedly decreased survival rates. When the carcinoma cell type was the basis for the determination of rate of survival, the result were as follows; The one, 3 and 5 year survival rates of squamous cell carcinoma were 78.33%, 60.19%, and 57.32%, and the one and 3 year survival rates of adenocarcinoma were 55.56% and 44.49%. The survival rates of large cell carcinoma were 66.67%, and 44.45%, at one, three and five years respectively. The one and 3 year survival rates of bronchoalveolar cell carcinoma were 71.43% and 47.62%, the one, 3 and 5 year survival rates of small cell carcinoma were 40%, 20% and 20%. The survival rate of squamous cell carcinoma was better than that of other cell carcinomas, the survival rate of small cell carcinoma was the worst. The operative mortality rate was 1.36%. There were 10 cases of post-operative complications including 2 cases of bleeding which required further surgery, 2 cases of wound infection, and 4 cases of empyema thoracis. The length of survival of three of the empyema thoracis cases was 16, 98 and 108 months respectively, Four male patients all older than 47 years survived more than 9 years, post surgery, although one developed empyema thoracis. These four cases were initially classified as 2 cases of stage I and one each of stage II and stage III, T3. We have concluded that the survival rates of patients in stages I, II and III, T3 were improved after complete surgical resection.

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