• Title/Summary/Keyword: Re-diagnosis

Search Result 268, Processing Time 0.026 seconds

Preoperative Long Course Chemoirradiation in a Developing Country for Rectal Carcinoma: Kuala Lumpur Hospital Experience

  • Lee, Wei Ching;Yusof, Mastura Md.;Lau, Fen Nee;Ee Phua, Vincent Chee
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.6
    • /
    • pp.3941-3944
    • /
    • 2013
  • Background: The use of preoperative chemoirradiation is the commonest treatment strategy employed in Malaysia for locally advanced rectal cancer. We need to determine the local control and survival rates for comparison with established rates in the literature. Materials and Methods: This retrospective study analyzed all newly diagnosed patients with rectal adenocarcinoma who underwent long course preoperative radiotherapy (RT) at the Department of Radiotherapy and Oncology, Kuala Lumpur Hospital (HKL) between $1^{st}$ January 2004 and $31^{st}$ December 2010. The aim of the study was to determine the radiological response post radiotherapy, pathological response including circumferential resection margin (CRM) status, 3 years local control, 3 years overall survival (OS) and 3 years disease free survival (DFS). Statistical analysis was performed using the SPSS software. Kaplan-Meier and log rank analysis were used to determine survival outcomes. Results: A total of 507 patients with rectal cancer underwent RT at HKL. Sixty seven who underwent long course preoperative RT were eligible for this study. The median age at diagnosis was 60 years old with a range of 26-78 years. The median tumour location was 6 cm from the anal verge. Most patients had suspicion of mesorectum involvement (95.5%) while 28.4% of patients had enlarged pelvic nodes on staging CT scan. All patients underwent preoperative chemo-irradiation except for five who had preoperative RT alone. Only 38 patients underwent definitive surgery (56.7%). Five patients were deemed to be inoperable radiologically and 3 patients were found to have unresectable disease intraoperatively. The remaining 21 patients defaulted surgery (31.3%). The median time from completion of RT to surgery was 8 weeks (range 5.6 to 29.4 weeks). Fifteen patients (39.5%) had surgery more than 8 weeks after completion of RT. Complete pathological response was noted in 4 patients (10.5%). The pathological CRM positive rate after RT was 18.4%. With a median follow-up of 38.8 months, the 3 year local control rate was 67%. The 3 years rate for CRM positive (<2 mm), CRM clear (>2 mm) and pCR groups were 0%, 88.1% and 100% respectively (p-value of 0.007). The 3 year OS and DFS were 57.3% and 44.8% respectively. Conclusions: In conclusion, the approach of long course preoperative chemoirradiation for rectal cancer needs to be re-examined in our local setting. The high rate of local recurrence is worrying and is mainly due to patient defaulting post-preoperative chemoirradiation or delayed definitive surgery.

Effect of human chorionic gonadotrophin injection after artificial insemination on pregnancy establishment in dairy cattle

  • Lim, Hyun-Joo;Lee, Ji Hwan;Kim, Hyun Jong;Kim, Min Su;Kim, Tae Il;Park, Soo Bong
    • Journal of Embryo Transfer
    • /
    • v.33 no.3
    • /
    • pp.149-157
    • /
    • 2018
  • The objective of this study was to evaluate the effect of treating dairy cattle with exogenous human chorionic gonadotrophin (hCG), five (5) days post artificial insemination (AI) on serum progesterone (P4) concentration and pregnancy rate. In this experiment, five days after AI, cows were assigned randomly to two groups namely: a) treated group (67) which were administrered with 1500 IU hCG (Chorulon) and b) control group (61), which received no treatment. On day 5, 10, 15 and 20 after the artificial insemination, blood samples from a total of 8 cows (4 from each group) were collected and were analyzed for serum P4 concentration. Cows were detected for estrus according to standing heat by visual observation. Cows that were detected still in estrus after days 18-24 were re-inseminated and recorded as not pregnant (open). Pregnancy diagnosis was conducted by ultrasonographic examination and transrectal palpation of the uterus on approximately 60 days in cows that observed to be not in estrus. The conception rate in hCG treated and control groups were 52.5 and 36.1%, respectively. The results proved that there were no significant differences in conception rate between two groups (p=0.0568). However, pregnancy rates were reduced by hCG treatment. Average serum P4 concentrations did not differ between Hcg-treated and control groups on day 5 (0.377 versus 0.375 ng/ml). On day 20 serum P4 concentrations were greater in the treated group compared with the control group (3.085 versus 2.010 ng/ml). The treatment with hCG seemed to increase P4 level compared with the control. In conclusion, the results of this study showed that 1500 IU of hCG administered on 5 day post AI increased conception rate in dairy cows. This was supported by the results on serum P4 concentration which was greater in hCG treated group.

Survey on Radiographic Works in Hospitals and Clinics (병(病)-의원(醫院)의 X선촬영업무(線撮影業務)에 관한 실태조사(實態調査))

  • Choi, Song-Hak;Jeon, Man-Jin;Park, Sung-Ock;Lim, Han-Young;Kim, Keon-Chung;Huh, Joon;Choi, Jong-Woon
    • Journal of radiological science and technology
    • /
    • v.7 no.1
    • /
    • pp.3-11
    • /
    • 1984
  • The major findings of this investigation on radiographic works in 125 medical institutions around Seoul and Kyung-Ki area, from March 1983 to February 1984, are summarized as follows. 1. The number of references provided on radiographic techniques were 3 to 5 in general hospitals (52.1%), in hospitals (58.5%), and clinics (44.5%), and only the 10.4% of general hospitals had 11 or more. 2. The relatively high percentages of 75.0% of general hospitals and 68.3% of hospitals have established the standardized radiographic methods for regions examined, but most clinics (61.1%) have not. 3. As a log system for the radiographic request, the method of "routine study, or all the x-ray examinations are marked as 0 on a printed form" was most commonly used by general hospitals (62.5%) and hospitals (51.2%), and "the doctors employ their own methods" in most clinics (44.6%). 4. In the 85.4% of general hospitals, the 68.3% of hospitals and the 38.9% of clinics, the data such as diagnosis, clinic history, purpose of x-ray examination were recorded on a radiographic request at all times, or at least in part. 5. On a scale of hardness and easiness of order of doctors, the greatest response was "fairly easy to understand", and the 37.5% of general hospitals responded as "sometimes hard". 6. In determining the standards for radiographic factors, the general hospitals (62.5%) and hospitals (65.9%) adapted mostly "a departmental check list", and the clinics (61.1%) used mainly "a personal decision". 7. In using the immobilizing devices, angligner, and radiographic accessories, the Percentages were high in general hospitals and hospitals on the one hand, and were low in clinics on the other. 8. A consideration with regard to the devices for an improvement of examination of the same patients was totally ignored by the 50.0% of clinics, the 26.8% of hospitals and the 20.8% of general hospitals. 9. The causes of re-examination were due largely to patients (33.6%), and followed proportionately by incorrect exposure (22.8%), errors in positioning (22.0%), film processing faults (9.2%), conditions of x-ray equipments (8.8%), and quality of x-ray films (3.6%). 10. The conference on radiography was conducted regularly or irregularly by the 87.5% of general hospitals, the 56.1% of hospitals, and the 27.7% of clinics, and the meeting was proceeded only by radiologic technologists.

  • PDF

CLINICAL CATEGORIES OF ADOLESCENT BORDERLINE STATE (청소년 경계선 상태의 임상적 분류)

  • Hong, Kang-E;Jeon, Seong-Ill;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.6 no.1
    • /
    • pp.18-33
    • /
    • 1995
  • The Purpose of this article is to identify the specific characteristics of borderline disorder in adolescence to conceptualize the borderline state as an adolescent process different from borderline personality disorder in adult, and to classify them according to it's unique clinical feature, porcess and outcome. The development of borderline disorder in adolescent, epidemiology, comorbid disorders and differential diagnosis, pre-existing sub-classification systems, and etiology in theories of psychodynamics, biological theories, experimental studies, and follow-up studies are reviewed. The authors conceptualize the adolescent borderline state include all clinical states generated by re-emergence of unresolved rapproachement conflicts in adolescent, and propose that there are four subgroups in adolescent borderline state. (1) Borderline state as an adolescent process. (2) Borderline state associated with psychotic disorders (3) Borderline state as an initial stnge of typical borderline personality disorder (4) Borderline state associated with organic problems. Conceptually, borderline state in adolescence is not a simple continuation of primary failure of separation-individuation but a struggle for mastering unresolved separation-individuation conflicts in adolesance i.e., the second separation-individuation state, and if it fails this time, the struggle might continue into adult life as borderline personality disorder.

  • PDF

Video-Assisted Thoracic Surgery Under Epidural Anesthesia -in High-Risk Group (경막외마취하에 비디오 흉강경수술 - 고위험군에서)

  • Lee, Song-Am;Kim, Kwang-Taik;Kim, Il-Hyeon;Park, Sung-Min;Baek, Man-Jong;Sun, Kyung;Kim, Hyoung-Mook;Lee, In-Sung
    • Journal of Chest Surgery
    • /
    • v.32 no.8
    • /
    • pp.732-738
    • /
    • 1999
  • Background: Video-assisted thoracoscopic surgery has become a standard therapy for several diseases such as pneumothorax, hyperhidrosis, mediastinal mass, and so on. These methods usually required single-lung ventilation with double-lumen endobronchial tube to collapse the lung under general anesthesia. However, risks of general anesthesia itself and single-lung ventilation must be considered in high-risk patients. Material and method: Between December 1997 and July 1998, eight high-risk patients (6: empyema, 1: intractable pleural effusion, 1: idiopathic pulmonary fibrosis) with underlying pulmonary disease and poor general condition were treated by video-assisted thoracoscopic surgerys under epidural anesthesia and spontaneous breathing. Result: Video-assisted thoracoscopic surgerys were successfully per formed in 7 patients. Conversion to general anesthesia was required in 1 patient because of decrease in spontaneous breathing. But, conversion to open decortication was not required. In two patients with chronic empyema, one patient required thoracoplasty as a second procedure and one patient required re-video-assisted thoracoscopic procedure due to a recurrence. The mean operative time was 31.8$\pm$15.2 minutes. No significant postoperative respiratory com plication was encountered. Conclusion: Video-assisted thoracoscopic surgerys can be per formed safely under epidural anesthesia for the treatment of empyema and diagnosis of pulmonary abnormalities in high-risk patients.

  • PDF

A research on the background of ZhuDanXi(朱丹溪)‘s medical theory -Based on ${\ulcorner}$GeZhiYuLun(格致餘論)${\lrcorner}$- (주단계(朱丹溪) 의학사상(醫學思想)의 배경(背景)에 관한 연구(硏究) -"격치여론(格致餘論)"을 중심(中心)으로-)

  • Park, Hyun-Kook;Kim, Ki-Uk
    • Journal of Korean Medical classics
    • /
    • v.18 no.4 s.31
    • /
    • pp.1-14
    • /
    • 2005
  • Zhu Dan Xi's name is ZhenHeng(震亨) and was also called by the title of YanXiu(彦修). Early in his life, he started to study JuZiYe(擧子業), and went on to study DaoDeXingMingXue(道德性命學) under the teachings of XueQian(許謙), who as one of fourth generation disciple of ZhuZi(朱子) was teaching in BaHuaShan(八華山). His well-known literary works are ${\ulcorner}$JuFangFaHui(局方發揮)${\lrcorner}$, ${\ulcorner}$GeZhiYuLun${\lrcorner}$, ${\ulcorner}$ShangHanBianYi(傷寒辨疑)${\lrcorner}$, ${\ulcorner}$BenCaoYanYiBuYi(本草衍義補遺)${\lrcorner}$, ${\ulcorner}$WaiKeJingYaoXinLun(外科精要新論)${\lrcorner}$. Zhu Dan Xi learnt the studies of Liu(劉), Zhang(張), Li(李) from LouZhiTi(羅知悌) and adopted the advantages and abolished disadvantages from it. The southern district being low and damp, which also leads to a geographical condition with a lot of ShiReXiangHuo(濕熱相火) disease and with the social background of people exhausting their QingYu(情欲) and damaging QLXie(氣血), he came out with the theory of 'YangYouYuYinBuZu(陽有餘陰不足)', 'XiangHuo(相火)' and became a well renowned expert in diagnosis and treatment of QiXieTanYuHuo(氣血痰鬱火). As a result, the writer has performed a research based on Liu's works and related theories, GuWuZhiZhi theory, the understanding of TaiJiZhiLi(太極之理), the inner meaning of YinYang and YouYuBuZu(redundancy-and-deficit), YinYangDongJingGuan, physiology and pathology, the medical reason of lust damaging QingYuYangYin and YangSheng(養生)(preservation of health), which are the main medical theory of ZhuDanXi, comments of later generations and is reporting the outcome.

  • PDF

Ductal carcinoma in situ arising within a fibroadenoma of breast (유방의 섬유선종에서 발생한 관상피내암)

  • Won, Tae Wan
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.18 no.11
    • /
    • pp.454-458
    • /
    • 2017
  • Fibroadenoma are one of the most common benign tumors of the breast in young women. Fibroadenoma may be associated with fibrocystic change, proliferative epithelial changes, and extremely rarely with carcinoma. We report here two cases of malignancy arising from a breast fibroadenoma. The patients were 19 and 51 years old and presented with a lump of recent onset. A 19-year-old female patient was diagnosed with mass excision at another hospital, and re-excision was performed at the hospital. Ultrasonography and cytologic examination revealed fibroadenoma and malignancy in a 51-year-old female patient, who was treated with wide excision. The pathological report of the two cases was revealed as DCIS in a fibroadenoma. Because carcinoma arising within a fibroadenoma is so rare, there are few reports of its characteristics or guidelines for treatment. Careful analysis of the unusual carcinoma arising within a fibroadenoma of the breast led to appropriate diagnosis and treatment of various types of lesions. Herein, we report two cases of DCIS arising within a fibroadenoma of the breast and provide a review of the literature.

Measurement from Moving Vehicle Health Screening Outside of The Leakage Dose (이동건강검진차량에서 외부의 누설선량 측정)

  • Han, Beom-Hee;Han, Sang-Hyun;Mo, Eun-Hee;Kim, Chong-Yeal
    • The Journal of the Korea Contents Association
    • /
    • v.15 no.3
    • /
    • pp.192-198
    • /
    • 2015
  • Checked out by the moving vehicle health checks for patients, practitioners, and the increase in radiation dose outside the vehicle, but an investigation into the leakage of radiation can still be negligible. In this study, through experimental results were as follows: Dose that occurs most often where the leak in the right door $1.14{\pm}1.75mR/h$, X-ray generator in terms of proximity to the top $0.65{\pm}1.25mR/h$, X-ray generator and away to the bottom in terms $0.91{\pm}1.25mR/h$, the adjacent rear detector in the upper part $96.98{\pm}158.88mR/h$ dose of the leak appeared in various locations. By measuring position from the rear of the adjacent detector $67.48{\pm}97.03mR/h$ dose had the highest leakage into. Generating device for diagnosis of radiation safety regulations regarding the maximum leakage dose per week, but all met back when it is displayed in the leakage dose Hourly rates do not ignore the leakage radiation dose were measured. Therefore, a mobile health screening in a vehicle outside of the leakage radiation dose to the liver and move on we are not interested twelve barrier leakage radiation dose of defense has a chance to re-evaluate the standards required, and move the vehicle health check using the X-ray increases as the dose per hour, depending on the criteria for choosing the appropriate measures that will require effort.

Effects of Manual Intervention and Self-Corrective Exercise Models of the General Coordinative Manipulation on Balance Restoration of Spine and Extremities Joints

  • Moon, Sang Eun;Kim, Mi Hwa
    • Journal of International Academy of Physical Therapy Research
    • /
    • v.4 no.2
    • /
    • pp.573-587
    • /
    • 2013
  • The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) II III IV of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTII IV I. 3) In case of thoracic-lumbar scoliosis and head rotation facial asymmetric cervical scoliosis ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTIII I, ribcage forward and thoracic scoliosis GBTII IV. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation patella high umbilicus tilt and hallux valgus foot longitudinal arch: FLA patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTIII I and patella high-direction GBTIV II I. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.

Surgical Treatment of Pulmonary Mucormycosis (폐 모균증의 외과적 치료)

  • Kim, Ju-Hyeon;Park, Seong-Sik;Sin, Yun-Cheol;Seong, Suk-Hwan
    • Journal of Chest Surgery
    • /
    • v.29 no.3
    • /
    • pp.350-354
    • /
    • 1996
  • Pulmonary mucormycosis is a very rare but often fatal opportunistic fungal infection caused by the order Mucorales in class Zygomycetes. Reported overall mortality exceeds 70% and the diagnosis is often made post-mortem. We experienced 2 cases of typical form of pulmonary mucormycosis. One patient was a poorly controlled diabetic and the other suffered from acute Iymphocytic leukemia (ALL). The former was diagnosed by a bronchoscopic biopsy and the latter by a pathologic examination from the percutaneous drain of a subphrenic abscess. Both of them underwent a surgical excision of the involved lung tissue. The patient with diabetes mellitus was successfully treated by surgical resection and discharged without complications. The other with ALL underwent a second operation and was transferred to the department of internal medicine for further management of his relapse of lettkemia. Recent literat re suggests that early aggressive diagnostic effort and treatment including surgical resection in the case of localized forms of the disease results in a good prognosis.

  • PDF