The Diagnostic Yield and Complications of Percutaneous Needle Aspiration Biopsy for the Intrathoracic Lesions (경피적 폐생검의 진단성적 및 합병증)
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- Tuberculosis and Respiratory Diseases
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- v.43 no.6
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- pp.916-924
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- 1996
Bacground : Percutaneous needle aspiration biopsy (PCNA) is one of the most frequently used diagnostic methcxJs for intrathoracic lesions. Previous studies have reponed wide range of diagnostic yield from 28 to 98%. However, diagnostic yield has been increased by accumulation of experience, improvement of needle and the image guiding systems. We analysed the results of PCNA performed for one year to evaluate the diagnostic yield, the rate and severity of complications and factors affecting the diagnostic yield. Method : 287 PCNAs undergone in 236 patients from January, 1994 to December, 1994 were analysed retrospectively. The intrathoracic lesions was targeted and aspirated with 21 - 23 G Chiba needle under fluoroscopic guiding system. Occasionally, 19 - 20 G Biopsy gun was used for core tissue specimen. The specimen was requested for microbiologic, cytologic and histopathologic examination in the case of obtained core tissue. Diagnostic yields and complication rate of benign and malignant lesions were ca1culaled based on patients' chans. The comparison for the diagnostic yields according to size and shape of the lesions was analysed with chi square test (p<0.05). Results : There are 19.9% of consolidative lesion and 80.1% of nodular or mass lesion, and the lesion is located at the right upper lobe in 26.3% of cases, the right middle lobe in 6.4%, the right lower lobe 21.2%, the left upper lobe in 16.8%, the left lower lobe in 10.6%, and mediastinum in 1.3%. The lesion distributed over 2 lobes is as many as 17.4% of cases. There are 74 patients with benign lesions, 142 patients with malignant lesions in final diagnosis and confirmative diagnosis was not made in 22 patients despite of all available diagnostic methods. 2 patients have lung cancer and pulmonary tuberculosis concomittantly. Experience with 236 patients showed that PCNA can diagnose benign lesions in 62.2% (42 patients) of patients with such lesions and malignant lesions in 82.4% (117 patients) of patients. For the patients in whom the first PCNA failed to make diagnosis, the procedure was repeated and the cumulative diagnostic yield was increased as 44.6%, 60.8%, 62.2% in benign lesions and as 73.4%, 81.7%, 82.4% in malignant lesions through serial PCNA. Thoracotomy was performed in 9 patients with benign lesions and in 43 patients with malignant lesions. PCNA and thoracotomy showed the same pathologic result in 44.4% (4 patients) of benign lesions and 58.1% (25 patients) of malignant lesions. Thoracotomy confirmed 4 patients with malignat lesions against benign result of PCNA and 2 patients with benign lesions against malignant result of PCNA. There are 1.0% (3 cases) of hemoptysis, 19.2% (55 cases) of blood tinged sputum, 12.5% (36 cases) of pneumothorax and 1.0% (3 cases) of fever through 287 times of PCNA. Hemoptysis and blood tinged sputum didn't need therapy. 8 cases of pneumothorax needed insertion of classical chest tube or pig-tail catheter. Fever subsided within 48 hours in all cases. There was no difference between size and shape of lesion with diagnostic yield. Conclusion: PCNA shows relatively high diagnostic yield and mild degree complications but the accuracy of histologic diagnosis has to be improved.
Purpose : To determine whether there exist gender differences in pain in Korean cancer patients and whether the depression and performance that are often expressed differently between men and women with cancer interact with pain. Method : The results of survey were collected from 140 in- and out-patients (78 male and 62 female) who had cancer treatment at one of the university hospital in Seoul for four months from February of 1999. The severity and interference of pain were examined with the self-reported survey based on Korean version of Brief Pain Inventory (BPI-K). Demographic and clinical information for all patient were compiled by reviewing their medical records, and the level of depression was examined with the Korean version of Beck Depression Inventory (BDI-K). Usual statistical methods, e.g., frequences, means and SDs were used to characterize the sample. The chi-square tests for categorical data and t-test for numerical data were used for group comparison. And the correlation between variables were performed using Pearson correlation coefficient. Resuts : 1) The mean scores of the worst pain for last 24-hours measured with the pain severity of BPI-K were 5.77 in male and 6.45 in female. The pain interference of BPI-K in men was in the order of mood (5.49), enjoy (5.36), and work (5.00), and in women were work (7.48), enjoy (7.16), and mood (6.53). 2) In pain severity, significant difference was found between men and women in the average pain for last 24-hours (t=-2.130, P=.035). In pain interference, significant difference was found between men and women in activity (t=-2.450, P=.015), mood (t=-2,321, P=.022), walk (t=-2.762, P=.007), work (t=-4.946, P=.000), relate (t=-2.595, P=.010), sleep (t=-2.071, P=.040), enjoy (t=-3.198, P=.001). 3) It was found that the items of pain and depression are significantly correlated in men but not in women. Men also exhibited higher correlation in the items of pain and performance status than women. Conclusions : Women report significantly greater average pain for last 24-hours and for all items of pain interference than men. Pain and depression are significantly correlated in men. The results of this study suggest that gender differences in pain should be considered for planning effective pain management program.
'Sukchunjeahdo' illustration-book, which was left by Han, Pil-gyo(韓弼敎 : 1807~1878)in the late Joseon Dynasty, includes pictorial record paintings containing government offices, Eupchi, and Feng Shui condition drawn by Gyehwa(界畵) method Sabangjeondomyobeop(四方顚倒描法) and is the rare historical material that help to understand spatial structure and landscape characteristics. Youngyuhyun(永柔縣) and Sincheongun(信川郡) town, the case sites of this study, show Feng Shui foundation structure and placement rules of government offices in the Joseon Period are applied such as 3Dan 1Myo(三壇一廟 : Sajikdan, Yeodan, Seonghwangdan, Hyanggyo), 3Mun 3Jo(三門三朝 : Oeah, Dongheon, Naeah) and Jeonjohuchim(前朝後寢) etc. by setting the upper and lower hierarchy of the north south central axis. The circulation system is the pattern that roads are segmented around the marketplace of the entrance of the town and the structure is that heading to the north along the internal way leads to the government office and going out to the main street leads to the major city. Baesanimsu(背山臨水 : Mountain in backward and water in front) foundation, back hill pine forest, intentionally created low mountains and town forest etc. showed landscape aesthetics well suited for the environmental comfort condition such as microclimate control, natural disaster prevention, psychological stability reflecting color constancy principle etc. and tower pavilions were built throughout the scenic spot, reflecting life philosophy and thoughts of contemporaries such as physical and mental discipline, satisfied at the reality of poverty, returning to nature etc. For government office landscape, shielding and buffer planting, landscape planting etc. were considered around Gaeksa(客舍), Dongheon(東軒), Naeah(內衙) backyard and deciduous tree s and flowering trees were cultivated as main species and in case of Gaeksa, tiled pavilions and pavilions topped with poke weed in tetragonal pond were introduced to Dongheon and Naeah and separate pavilions were built for the purpose of physical and mental discipline and military training such as archery. Back hill pine tree forest formed back landscape and zelkova, pear trees, willow trees, old pine trees, lotus, flowering trees etc. were cultivated as gardening trees and Feng-Shui forest with willow trees as its main species was created for landscape and practical purposes. On the other hand, various cultural landscape elements etc. were introduced such as pavilions
Genetic studies on the
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
As the importance of providing customized services to individuals becomes important, researches on personalized recommendation systems are constantly being carried out. Collaborative filtering is one of the most popular systems in academia and industry. However, there exists limitation in a sense that recommendations were mostly based on quantitative information such as users' ratings, which made the accuracy be lowered. To solve these problems, many studies have been actively attempted to improve the performance of the recommendation system by using other information besides the quantitative information. Good examples are the usages of the sentiment analysis on customer review text data. Nevertheless, the existing research has not directly combined the results of the sentiment analysis and quantitative rating scores in the recommendation system. Therefore, this study aims to reflect the sentiments shown in the reviews into the rating scores. In other words, we propose a new algorithm that can directly convert the user 's own review into the empirically quantitative information and reflect it directly to the recommendation system. To do this, we needed to quantify users' reviews, which were originally qualitative information. In this study, sentiment score was calculated through sentiment analysis technique of text mining. The data was targeted for movie review. Based on the data, a domain specific sentiment dictionary is constructed for the movie reviews. Regression analysis was used as a method to construct sentiment dictionary. Each positive / negative dictionary was constructed using Lasso regression, Ridge regression, and ElasticNet methods. Based on this constructed sentiment dictionary, the accuracy was verified through confusion matrix. The accuracy of the Lasso based dictionary was 70%, the accuracy of the Ridge based dictionary was 79%, and that of the ElasticNet (
Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.
To reduce both the floatation of the seedling of rice and the failure in standing in the paddy field when the barley straw was applied to paddy field before planting the rice, we tested the effect of rice rooting with plowing methods and irrigation rates for 2 years from 2003 to 2004. This study was carried out in paddy field with Fluvio-Marine deposit in Jeonbug series and the operating accuracy and the change of soil physico-chemical properties depending on plowing methods and irrigation rates following the barley straw applying were examined. There was a less floatation of barley straw in the dry-rotaryI+water-rotaryI(DRI+WRI) plot than in the plowing+water-rotary(PL+WRI) plot. The ratio of miss-planted and floating seedling also decreased by 1.7%, 2.6% in the DRI+WRIplot compared with PL+WRI plot. The soil physical property was improved with the decreasing soil hardness, bulk density and increasing soil porosity after the application of barley straw, especially enhanced greatly in the increase of porosity, gaseous phase and with the decrease of soil hardness, bulk density of subsurface soil in DRI+WRI plot. And the change of soil chemical property were increased the content of total carbon
The purpose of this study was to investigate the actual conditions of the subjective oral malodor perception of the survey subjects. Through the subjective questionnaire method over about 3 months from June to August in 2007, the data was collected targeting 275 adults. Statistical methods used were Chi-square test, Fisher's exact test and One-way ANOVA. And, the following results were obtained. 1. When having seen the ratio of those who were conscious of oral malodor, the adults, who responded with saying of feeling oral malodor at present and at ordinary times, accounted for 68.4% and 79.3%, respectively. And, the adults, who responded with saying of not feeling, were indicated to be 31.6%(at present) and 20.7%(at ordinary times), respectively. 2. Almost 83.5% of total people answered that they had most severe oral malodor at the time of awakening and 51.9% of subjects answered tongue contributed to the their oral malodor. 3. About the type of oral malodor, although 37.2% of the group thought the type of oral malodor was a food smell and fetid smell was second general burning smell occurred the time of hunger(22.5%). 4. In the answers of hoping for treatment of oral malodor, 66.9% of the people showed positive response to dental treatment for controlling their oral malodor. Especially 7.3% of subjects showed very big desire for treatment. 5. In the level of oral malodor that is felt now according to the time of a meal, the case of within 1 hour after having a meal was responded to be not felt the oral malodor with 44.7%. And, there was response with saying of not feeling oral malodor in 37.6% as for 1-2 hours, 16.3% as for 2-3 hours, 14.8% as for 3-4 hours, and 23.7% as for more than 4 hours. Thus, the level of oral malodor according to the time of a meal showed the statistically significant difference(p<0.01). Through the results of this study, it could be known about whether or not being conscious of oral malodor in general people, the main cause and region for oral malodor, the importance and practicing method of tongue brush through literature. Accordingly, there is necessity of further researching and comparing whether or not being conscious of oral malodor by diversely surveying relevancy with factors of causing oral malodor based on the objective oral malodor measurement value. The future diverse researches are thought to be necessarily performed in order to prevent or reduce oral malodor.