• Title/Summary/Keyword: Solitary Death

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Primary Invasive Mucinous Adenocarcinoma of the Lung: Prognostic Value of CT Imaging Features Combined with Clinical Factors

  • Tingting Wang;Yang Yang;Xinyue Liu;Jiajun Deng;Junqi Wu;Likun Hou;Chunyan Wu;Yunlang She;Xiwen Sun;Dong Xie;Chang Chen
    • Korean Journal of Radiology
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    • v.22 no.4
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    • pp.652-662
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    • 2021
  • Objective: To investigate the association between CT imaging features and survival outcomes in patients with primary invasive mucinous adenocarcinoma (IMA). Materials and Methods: Preoperative CT image findings were consecutively evaluated in 317 patients with resected IMA from January 2011 to December 2015. The association between CT features and long-term survival were assessed by univariate analysis. The independent prognostic factors were identified by the multivariate Cox regression analyses. The survival comparison of IMA patients was investigated using the Kaplan-Meier method and propensity scores. Furthermore, the prognostic impact of CT features was assessed based on different imaging subtypes, and the results were adjusted using the Bonferroni method. Results: The median follow-up time was 52.8 months; the 5-year disease-free survival (DFS) and overall survival rates of resected IMAs were 68.5% and 77.6%, respectively. The univariate analyses of all IMA patients demonstrated that 15 CT imaging features, in addition to the clinicopathologic characteristics, significantly correlated with the recurrence or death of IMA patients. The multivariable analysis revealed that five of them, including imaging subtype (p = 0.002), spiculation (p < 0.001), tumor density (p = 0.008), air bronchogram (p < 0.001), emphysema (p < 0.001), and location (p = 0.029) were independent prognostic factors. The subgroup analysis demonstrated that pneumonic-type IMA had a significantly worse prognosis than solitary-type IMA. Moreover, for solitary-type IMAs, the most independent CT imaging biomarkers were air bronchogram and emphysema with an adjusted p value less than 0.05; for pneumonic-type IMA, the tumors with mixed consolidation and ground-glass opacity were associated with a longer DFS (adjusted p = 0.012). Conclusion: CT imaging features characteristic of IMA may provide prognostic information and individual risk assessment in addition to the recognized clinical predictors.

Modified Fontan Procedure for Single or Dominant Right Ventricle (우세우심실 또는 우단심실증에서의 변형 Fontan 수술)

  • 백완기
    • Journal of Chest Surgery
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    • v.24 no.3
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    • pp.310-321
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    • 1991
  • Between April 1986 and September 1990, 34 patients with a single or dominant right ventricle underwent modified Fontan procedure for definite palliation in Seoul National University Children`s Hospital. Their age at operation ranged from 8 months to 14 years [Mean 5.5 years]. The ventricular chamber was solitary and of indeterminate trabecular pattern in 6 patients. 28 patients had posteriorly located rudimentary chamber, all of which were trabecular pouches having no communication with outlet septum. The patterns of atrioventricular connection were common inlet[9], double inlet [11], left atrioventricular valve atresia [12] and right atrioventricular valve atresia with L-loop [2]. Pulmonary outflow tracts were atretic in 7 patients and stenotic in 26 patients. Major associated anomalies included anomalous systemic venous drainage [15], dextrocardia [12] and total anomalous pulmonary venous connection[3]. Shunt operations were previously performed in 13 patients and pulmonary artery banding and atrial septectomy in 1 patients. Surgery included intraatrial baffling in 26 patients, bidirectional cavopulmonary shunt in 13 patients, atrioventricular valve obliteration in 3 patients and atrioventricular valve replacement in 3 patients. Central venous pressure measured postoperatively at intensive care unit ranged from 18cm H2O to 28cm H2O [mean 23.2cm H2O]. Hospital mortality was 35.3% [12/34], all died out of low output syndrome. Suspected causes of low output syndrome include ventricular dysfunction [8], hypoplastic or tortuous pulmonary artery [2] and elevated pulmonary vascular resistance [2]. 19 patients had 31 major complications including low output syndrome [18], arrhythmia [4], acute renal failure [3] and respiratory failure [3]. Mortality rate was significantly higher in the groups receiving intraatrial baffling and AV valve replacement respectively [p<0.05]. 20 patients were followed up postoperatively with the mean follow-up period 15.0$\pm$11.6 months. There were no late death and follow-up catheterization was performed in 10 patients. Mean right atrial pressure was 15.4$\pm$6.8mmHg and ventricular contraction was reasonable in all but one case. Thus, Fontan principle can be applied successfully to all the patients with complex cardiac anomaly of single ventricle variety and better results can be anticipated with judicious selection of patient and improvement of postoperative care.

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Comparison of Viral Hepatitis-Associated Hepatocellular Carcinoma Due to HBV and HCV - Cohort from Liver Clinics in Pakistan

  • Munaf, Alvina;Memon, Muhammad Sadik;Kumar, Prem;Ahmed, Sultan;Kumar, Maheshwari Bhunesh
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7563-7567
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    • 2014
  • Background: Hepatocellular carcinoma (HCC) is the first cause of death in cirrhotic patients, mostly due to viral hepatitis with HCV or HBV infection. This study was performed to estimate the true prevalence of viral hepatitis-related HCC and the demographic and clinical-pathological associations with the two virus types. Materials and Methods: This cross sectional observational study enrolled clinical data base of 188 HCC patients and variables included from baseline were age, sex, area of residence, clinical-pathological features such as underlying co-morbidity, presence or absence of liver cirrhosis, macrovascular involvement, tumor extension and metastasis, liver lobes involved, serum alpha-fetoprotein level, and hepatitis serologies. Results: Overall prevalence of HCV- and HBV-related HCC was 66.0% and 34.0%, respectively. Patients with HCV were more likely to develop HCC at advanced age ($52.4{\pm}11.9$ vs. $40.7{\pm}12.09$ years), with highly raised serum AFP levels (${\geq}400ng/ml$) 78.2% (HBV 67.1%), large tumor size (HCV-66% >5 cm, HBV-59.3%), and presence of portal vein thrombosis (8.06%, HBV 1.56%). A binominal multivariate analysis showed that HCV-HCC group were more likely to be cirrhotic (OR=0.245, 95%CI: 0.117, 0.516) and had more than two times higher rate of solitary macrovascular involvement (OR=2.533, 95%CI: 1.162, 5.521) as compared with HBV associated HCC. Conclusions: Statistically significant variations were observed from baseline to clinical-pathological characteristics in HCV vs HBV associated HCC. Our study suggests prompt and early screening for high risk patients so that the rate of progression of these chronic viral diseases to cirrhosis and cancer can be decreased.

Establishment and evaluation of the VX2 orthotopic lung cancer rabbit model: a ultra-minimal invasive percutaneous puncture inoculation method

  • Wang, Lijuan;Che, Keke;Liu, Zhonghong;Huang, Xianlong;Xiang, Shifeng;Zhu, Fei;Yu, Yu
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.3
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    • pp.291-300
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    • 2018
  • The purpose of the present work is to establish an ultra-minimal invasive percutaneous puncture inoculation method for a VX2 orthotopic lung cancer rabbit model with fewer technical difficulties, lower mortality of rabbits, a higher success rate and a shorter operation time, to evaluate the growth, metastasis and apoptosis of tumor by CT scans, necropsy, histological examination, flow cytometry and immunohistochemistry. The average inoculation time was 10-15 min per rabbit. The tumorbearing rate was 100%. More than 90% of the tumor-bearing rabbits showed local solitary tumor with 2-10 mm diameters after two weeks post-inoculation, and the rate of chest seeding was only 8.3% (2/24). The tumors diameters increased to 4-16 mm, and irregularly short thorns were observed 3 weeks after inoculation. Five weeks post-inoculation, the liquefaction necrosis and a cavity developed, and the size of tumor grew further. Before natural death, the CT images showed that the tumors spread to the chest. The flow cytometry and immunohistochemistry indicated that there was less apoptosis in VX2 orthotopic lung cancer rabbit model compared to chemotherapy drug treatment group. Minimal invasive percutaneous puncture inoculation is an easy, fast and accurate method to establish the VX2 orthotopic lung cancer rabbit model, an ideal in situ tumor model similar to human malignant tumor growth.

Psychological Symbolism of the Shamanic Song of Princess Bari : From the Perspective of Analytical Psychology (무가 바리공주의 심리학적 상징성 : 분석심리학적 입장에서)

  • Young Hee Kim
    • Sim-seong Yeon-gu
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    • v.36 no.1
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    • pp.1-54
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    • 2021
  • Princess Bari, the seventh daughter of the King and Queen, is abandoned at birth. She one day embarks on a solitary journey into the underworld to seek the antidote she needs to save her ailing father. The shamanic myth then depicts terrible ordeals, after which the Princess manages to obtain the elixir of life to bring her parents back to life, leading to her deification as the Queen of all shamans. The life of Princess Bari as the ancestor of shamans incorporates the necessary rite of passage to become a shaman, persevering through all manner of trials and tribulations until death and then being reborn. Princess Bari's story of deification as the goddess of shamans constitutes the archetype or the primitive image of the collective unconscious, the mytheme. From the perspective of analytical psychology, Princess Bari, who became the Queen of shamans after undergoing a process of pain, death, and then rebirth demonstrates a facet of the individuation process, evident in heroic mythology. Princess Bari not only cured her parents of disease but also brought them back to life. What enabled her to obtain the elixir to resurrect her parents was her love and compassion for them based on self-sacrifice, enduring all the trivial and repetitive undertakings of everyday life. She viewed the world and behaved from the perspective of a broader Self. Making herself a powerful healer through the ordeals in the underworld, Princess Bari is the psychopomp as well as the healer archetype. The sacred power of healing that goes beyond the Princess' sufferings represents the Self Archetype inherent in the mentality of the Koreans, in other words, a symbolic power that indicates the divine representation of a healer.

A Study on the Application of Universal Design Principles to Collective Housing for Senior citizen who lives alone - Focused on the 'Carnation House' in Gyeounggi-do ara - (독거노인을 위한 노인공동생활시설의 유니버설 디자인 적용성 평가 연구 - 경기도 지역 '카네이션하우스'를 중심으로 -)

  • Moon, Ja-Young;Nam, Kyung-Sook
    • Korean Institute of Interior Design Journal
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    • v.23 no.6
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    • pp.95-104
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    • 2014
  • Today, the number of the elderly living alone without any family members is on a sharp rise, and those aged people living alone are making these social issues such as solitary death, depression and suicide more popular. In order to resolve the issues, some of the local governments have been supporting the elderly living alone in common houses that would be used by senior citizens only. This study became interested in this 'carnation house' which has been carried out targeting the elderly living alone in Gyeonggi-do, and selected elementary universal design factors that should be applied to general residential environments of the aged people and analyzed the factors. As a case study, this research investigated four carnation houses as research subjects and came up with these following ideas about how to make improvements. First, the study found out that all the entrances did not have raised letters and that UD has not been satisfactorily applied to both the thresholds and the effective widths, and that is considered something to be fixed. Second, in case of regular rooms and living rooms, none of the rooms failed to have safety doorknobs which should have been installed and plus, thresholds and stepped pulleys need to be removed, Third, it goes the same with the kitchens, and the thresholds should be eliminated while cabinets are secured. In addition, furniture that understands the elderly's measurements should be used. Fourth, in terms of restrooms, they should be designed to be spacious enough not to cause anyone in wheelchairs inconvenience, and the study suggests that the effective widths should be widened and that both the safety doorknobs and the emergency calls must be installed. Basically, after the test on the UD adaptability, the study concluded that the application rates in connection with the adaptability were low which led the study to assume that such result has been gained due to the lack of installation standards in relation to the common living facilities of the elderly. The study now argues that purposes of buildings should be first clarified and then, these detailed space planning guidelines that deal with general characteristics of the aged people should be established.

The Hope of the Stroke Patients (뇌졸중환자의 희망)

  • 김이순
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.212-227
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness. sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 years old and belong to low income-level. The data were collected from Jan. to Sep. 1995. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After intergrating the focal meaning and make the situated structural description as the meaning of the hope experience identified on each subject's point. After intergrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point then the systemizing of the structure of the hope experienced phenomena and the flowing of the conciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under 〈mutual relations to others : spouse, children, relatives, fellow believer. health professioner. associate patient group〉, 〈spiritual dependence〉. 〈recovery of physical function〉. 〈rumination of the past life〉, 〈expectation of the future〉. 〈economic power〉, 〈belief〉, 〈ability〉. 〈spontaneous participation〉 and 〈recovery of roles〉. Their hope was spoken out by the following two kinds of linguistics. First. the hope was expressed in the affirmative expression as follows : 〈 to be dependable〉, 〈to make efforts〉, 〈to keep under control〉, 〈to desire〉, 〈to be pleasant〉, 〈to be peaceful〉, 〈to be grateful〉, 〈to give help〉, 〈self-confidence. Courage〉, 〈to be happy〉, 〈to satisfy oneself〉, 〈to share with others〉, 〈to understand〉 and 〈to be affected, be impressed〉 Second, the hope was expressed in the negative on pression as under : 〈to be distressed〉, 〈to be uneasy〉, 〈to be sorry, be unsatisfied〉 〈despair〉, 〈to abandon〉, 〈to be fearful〉, 〈to suffer〉, 〈to bear a burden〉 〈to be confused〉, 〈to be solitary〉, 〈chest trouble〉, 〈to feel heavy〉 〈grief〉, 〈to be daunted〉, 〈to get angry〉, 〈to be uncomfortable〉, 〈to have something regretable〉 and 〈to feel guilty〉. And their hope was expressed by the following four behavioral expressions : 〈physical sphere〉, 〈psychological sphere〉, 〈social support sphere〉 and 〈spiritual sphere〉. The reaction patterns of their hope experience appeared in the following 4 coping method : 〈conquest type〉, 〈dependence type〉, 〈adaptation type〉 and 〈fate type〉. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty, When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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Surgical Treatment of Benign Lung Tumor (양성 폐종양의 수술적 치료)

  • Park, Kuhn;Cho, Deog-Gon;Park, Jae-Kill;Jo, Geon-Hyon;Wang, Young-Pil;Kwack, Moon-Sub;Kim, Se-Wha;Lee, Hong-Kyun
    • Journal of Chest Surgery
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    • v.25 no.3
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    • pp.258-270
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    • 1992
  • Benign lung tumors have been considered as relatively rare disease, which comprise approximately 8 to 15% of all solitary pulmonary lesions that are detected radiographically. We clinically analized 30 cases of benign lung tumors underwent the operation from Jan. 1970 to Aug.1991 in the department of thoracic and cardiovascular surgery, Catholic University Medical College. We adopted the classification presented by the World Health Organization[WHO], modified from Liebow, and added benign mesothelioma. There were 11 males & 19 females ranging in age from 2 years to 68 years old % the mean age was 38 years old. Of all 30 benign lung tumors, hamartomas [14 cases, 49%] were the most common & followed by hemangiomas [9 cases, 30%], 3 cases of benign mesotheliomas % a case of teratoma, papilloma, arteriovenous malformation and inflammatory pseudotumor. 14 cases of tumors were asymptomatic & were incidentally detected by plane chest x-ray In other cases, chief complaints at admission were coughing, chest discomfort, dyspnea, hemoptysis, and fever. Diagnosis were made by pathological examination; exploratory thoracotomy in 23 patients[76.7%], bronchoscopy in 4 patients and percutaneous needle aspiration biopsy in 3 patients. Precisely, preoperative diagnosis for confirmation of benign lung tumor was made only in 7 cases[23.6%]. Tumors were located on Rt.side[24 cases], especially Rt. middle lobe, and Lt.side[6 cases]. Operation methods were as follows: 21 cases [70%] of lobectomy, 2 cases of segmentectomy, 2 cases of wedge resection, 1 case of pneumonectomy, 1 case of bronchotomy, 2 cases of wedge resection, 1 case of pneumonectomy, 1 case of bronchotomy removal of the endobronchial hamartoma which located at the rt. main stem bronchus and 3 cases of complete resection in benign mesotheliomas. There were no operative death. The post operative complications were developed in 3 cases; post pneumonectomy empyema, wound infection and atelectasis. In conclusion, benign lung tumors must be histologically diagnosed to confirm of benignity and to provide limited resection for preservation of the lung tissue, whenever possible.

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A Comparative Study on the Population Change and the Aged in Korea and Japan (인구변화 및 노년인구에 관한 한국과 일본의 비교연구)

  • 조혜종
    • Journal of the Korean Geographical Society
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    • v.36 no.4
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    • pp.356-381
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    • 2001
  • This study has three objectives. One of them is to debate on the incompatible Neo-Malthusianism and Comucopianism, which give us a comparative gauge for analysis of the population elements in Korea and Japan. The other is to investigate how a variety of population elements are related to specific regions, Korea and Japan. And the last is to compare and analyze the residential preference pattems and the degree of care for the future life for the aged over 50 ages. Various elements in population show that Japan is of type superior to Korea, and that the gap between two countries is getting narrow every year. Wiber's migration expectancy is much higher in Kwangiu-si and Chollanam-do than in Hiroshima-ken. Burial customs in funeral ceremony has been vanished in Japan, but only 30 percents in Korea is crematory. This burial customs being much stiff existent in Korea, the effect of the population decrease caused by the death is reduced. A case study through questionnaire on the residential preference patterns for the aged over 50 years old shows that Japanese than Korean are more dependent on their sons and daughters, and ‘loneliness of solitary life’is the first reason in both countries. The degree of care for the future life is also remarkably higher in Japanese than in Korean. These are related in various ways to their ages, scholarships and local areas(si or gun). A general cognition in which the shortage of labour forces comes into existence in aged society is of misconception, because it comes from taking labour forces away from the aged, not from being old society. Even a minute population change is worth notice since the inertia law is also applied to the population phenomenon. Malthusinism hold fairly good even now, and the notion is very important in which population, resources and environmental problems are no longer personal or a regional matters, but the global family's issues.

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