Background: This study was performed to evaluate the safety and efficacy of performing additional tetracycline pleurodesis during the thoracoscopic treatment of primary spontaneous pneumothorax. Material and Method: Between March 2004 and December 2007, 91 cases of primary spontaneous pneumothorax were treated by video-assisted thoracoscopic surgery. The thoracoscopic procedures included resection of the blebs and mechanical pleurodesis by scrubbing the parietal pleura. For 27 cases (Tetracycline group, group I), 20 mg/kg tetracycline was instilled into the pleural space through a trocar before closing the chest. The control group (group II) consisted of 64 cases of primary spontaneous pneumothorax for which the same thoracoscopic procedures alone were performed during the same study period. Result: There was no significant difference between the two groups in terms of the demographic data, the operative findings and the operation time. The percentage of cases that needed intravenous analgesics and the duration of intravenous analgesics were comparable in both groups. There was no significant difference in the duration of air leaks and complications between the two groups. The patients treated with tetracycline pleurodesis had a longer period of postoperative chest drainage (4.2 days vs 3.5 days, respectively, p=0.03) and hospitalization (5.0 days vs 4.0 days, respectively, p=0.006). During the follow up period, the ipsilateral recurrence rate was much lower for the patients who were treated with tetracycline pleurodesis (0% vs 10.9%, respectively, p=0.099), and freedom from recurrence tended to be more favorable for group I (p=0.077), although this was not statistically significant. Conclusion: Additional tetracycline pleurodesis during thoracoscopic treatment for primary spontaneous pneumothorax caused prolongation of chest drainage and a prolonged hospital stay. However, further investigations are needed because tetracycline pleurodesis can be performed safely without serious complications and it showed a distinct tendency to reduce the rate of recurrence.
Kim, Young-Woo;Park, Neung-Hwa;Ji, Sang-Keun;Choi, Hyun-Muck;Lee, Sin-Hwa;Lee, Keum-Hee;Jang, Tae-Won;Jung, Maan-Hong
Tuberculosis and Respiratory Diseases
/
v.42
no.1
/
pp.76-83
/
1995
Background: Despite advances in chemotherapy, the treatment of inoperable non-small cell carcinoma of the lung remains poor. According to the recent reports, the response rates of mitomycin, vinblastine, and cisplatin(MVP) chemotherapy are higher than those of other cisplatin based polychemotherapy and MVP chemotherapy can be used as neoadjuvant chemotherapeutic regimen. But the overall response rates of MVP chemotherapy range from 17 to 53 percent, so we studied the effect of MVP chemotherapy in advanced non-small cell lung cancer. Method: We treated forty patients with stage III or IV non-small cell lung cancer with two courses of MVP chemotherapy($8mg/m^2$ of mitomycin on day 1, $6mg/m^2$ of vinblastine on day 2 & day 14, and $100mg/m^2$ of cisplastin on day 1) at 4 weeks interval. Then all patients were evaluated the response of chemotherapy 4 weeks later, and received further chemotherapy, palliative radiotherapy or supportive therapy according to the patient's condition. We also determined the median survival time and prognostic factors. Results: 1) Nine patients(23%) had a partial reponse, 23 patients(57%) had a stable disease, and disease progressed in 8 patients(20%). There were no patients with complete response. 2) The overall median survival time was 36 weeks(range, 9 to 119+ weeks). The median survival time of responder(partial response) and non-responder(stable and progressed) groups were 60 weeks(range, 36 to 82+ weeks) and 31 weeks(range, 9 to 119+ weeks) respectively(p=0.03). 3) The median survival time of the female group was 71 weeks and significantly prolonged in comparision with 35 weeks of the male group(p=0.01). But, the other prognostic factors didn't affect the survival time and response rate. 4) The median survival times of chemotherapy group and chemotherapy with palliative radiotherapy group were not significantly different. Conclusion: MVP combined chemotherapy is unsatisfactory in improving survival in advanced non-small cell lung cancer. Therefore, further studies are needed to find more active new agents and to estabilish the efficacy of the combined treatment with radiotherapy and/or surgery.
Purpose: Laparoscopy-assisted gastrectomy (LAG) is gaining wider acceptance as a minimally invasive treatment for early gastric cancer, but the safety, efficacy and clinical benefits of this type of surgery are still unclear. The purpose of this study is to compare laparoscopy-assisted gastrectomy (LADG) and conventional open distal gastrectomy (CODG) for early gastric cancer (EGC) according to the changes of the postoperative nutritional status and acute inflammatory reaction. Materials and Methods: Eighty seven patients with EGC and who underwent a LADG between March 2006 and May 2009 at Daegu Catholic University Hospital, was enrolled. Over the same period, we enrolled 30 patients who underwent CODG and they were confirmed to have EGC from their pathology. The clinico-pathological features and serologic parameters were evaluated from the medical records and then retrospectively analyzed. Results: There were no differences in the preoperative white blood cell (WBC), C-reactive protein (CRP) level, albumin level, the T4/T8 ratio and the other clinical data between the two groups. The total WBC counts gradually increased and they were significant lower at the $1^{st}$ and $3^{rd}$ postoperative days in the LADG group than that in the CODG group (P=0.001 and 0.008, respectively). The postoperative CRP levels were significantly lower at postoperative $5^{th}$ day in the LADG group (P<0.001). The postoperative albumin and T4/T8 ratio gradually decreased, and the T4/T8 ratio was significantly higher at the $3^{rd}$ postoperative day in the LADG group compared to that in the CODG group (P=0.003). Conclusion: This study demonstrates that the LADG has less of an influence on an acute inflammatory reaction than does CODG. Therefore, it is one of the safe and feasible procedures for the treatment of early gastric cancer.
Hong, Ji Hyun;Lee, Hyung Seok;Jung, Seung Hyun;Kim, Gyu Won;Eom, Kwang-Seok;Lee, Jae Myung;Jang, Seung Hun;Kim, Dong Gyu;Hyoen, In Gyou;Lee, Myoung Koo;Park, Yong Bum;Jung, Ki-Suck;Lee, Young Kyoung
Tuberculosis and Respiratory Diseases
/
v.54
no.3
/
pp.295-303
/
2003
Backgroung : The incidence of penicillin-resistant streptococcus pneumoniae(PRSP) accounts for almost 70% of all pneumococcal pneumonia cases in Korea. It is still unclear as to whether the efficacy of penicillin or equally active beta-lactam agents is compromised in PRSP pneumonia. This study investigated the prevalence of PRSP in community-acquired pneumonia and its clinical course. Methods : A total of 42 patients with community-acquired pneumococcal pneumonia were evaluated from July 1999 to May 2001. The cultured strains of Streptococcus pneumoniae were divided into susceptible, intermediately resistant, and resistant strains by an E-test, and the effect of the clinical course was investigated. Results : From a total of 42 patients, 22 (52.4%) patients had an intermediate resistance (MIC $0.1-1{\mu}g/m{\ell}$) and six (14.3%) showed a high resistance ($MIC{\geq}2.0{\mu}g/m{\ell}$) with current penicillin susceptibility categories. However, according to the classification of the DRSPTWG (Drug Resistant Streptococcus pneumoniae Therapeutic Working Group), there were 11 cases (26.2%) of intermediate resistance and no case of high resistance. Under empirical antimicrobial treatment, there was no difference in the clinical outcome between the penicillin susceptible and resistant group. Conclusion : The clinical outcome of PRSP pneumonia with empirical therapy was acceptable. These results suggest that the current MIC breakpoint for penicillin resistance in Streptococcus pneumoniae has been set at a very low level and penicillin resistance according to the NCCLS classification does not significantly influence the outcome of the empirical treatment for pneumococcal pneumonia.
Jang, Tae Won;Park, Jung Pil;Kim, Hee Kyoo;Ok, Chul Ho;Jeung, Tae Sig;Jung, Maan Hong
Tuberculosis and Respiratory Diseases
/
v.57
no.3
/
pp.257-264
/
2004
Background : There are many combinations of treatment for locally advanced non-small cell lung cancer (NSCLC). Recent studies have showed the efficacy of concurrent chemoradiotherapy (CCRT) in NSCLC. At present, however, there is no consensus about the optimal dosages and timing of radiation and chemotherapeutic agents. The aims of study were to determine the feasibility, toxicity, response rate, and survival rate in locally advanced NSCLC patients treated with doxetaxel and cisplatin based CCRT. Method : Sixteen patients with unresectable stage III NSCLC were evaluated from May 2000 until September 2001. Induction chemoradiotherapy consisted of 3 cycles of docetaxel (75 $mg/m^2/IV$ on day 1) and cisplatin (60 $mg/m^2/IV$ on day 1) chemotherapy every 3 weeks and concomitant hyperfractionated chest irradiation (1.15 Gy/BID, total dose of 69 Gy) in 6 weeks. Patient who had complete or partial response, and stable disease were applied consolidation chemotherapy of docetaxel and cisplatin. Results : All patients showed response to CCRT. Four patients achieved complete response (25%), partial responses in 12 patients (75%). The major common toxicities were grade III or more of neutropenia (87.3%), grade III esophagitis (68.8%), pneumonia (18.8%) and grade III radiation pneumonitis (12.5%). Thirteen patients were ceased during follow-up period. Median survival time was 19.9 months (95% CI; 4.3-39.7 months). The survival rates in one, two, and three years are 68.7%, 43.7%, and 29.1%, respectively. Local recurrence was found in 11 patients (66.8%), bone metastasis in 2, and brain metastasis in 1 patient. Conclusion : The response rate and survival time of CCRT with docetaxel/cisplatin in locally advanced NSCLC were encouraging, but treatment related toxicities were high. Further modification of therapy seems to be warranted.
Park Seong-Shik;Ahn Sung-Ryou;Lee Ju-Suk;Kim Su-Yung
Childhood Kidney Diseases
/
v.6
no.2
/
pp.198-208
/
2002
Purpose : There is no scientific basis for an immunization policy for children with renal disease who have increased risk of infection in Korea. As an initial step in approaching this problem, this survey of pediatric nephrologists was undertaken to determine the current recommendations of practicing pediatric nephrologists Methods : Questionnaires were sent to the members of Korean Society of Pediatric Nephrology via mail and E-mail. The questionnaire was designed to obtain information about the immunization practice of basic vaccination schedule for nephrotic syndrome, the side effects after vaccination and the immunization practice about recommended vaccines for children with renal disease. Results : Questionnaires were sent to 56 pediatric nephrologists. 35 replies were received (response rate: 62.5%). Almost of the respondents (82.8%) reported practicing at university hospital. All respondents reported modified vaccination schedule. 65.7% of the respondents immunized nephrotic children with live vaccines some time later after discontinuation of corticosteroids treatment and 57.1% of respondents immunized them with killed vaccines during medication of low doses of corticosteroids. Respondents experienced relapse of nephrotic syndrome after vaccination are nine, lack of vaccine efficacy are three and infection by organisms of live vaccines are two. 71.4% of respondents reported vaccinating children with renal disease for hepatitis B, pneumococcus and influenza during medication of low doses of corticosteroids. But There is few difference of the rates of respondents vaccinating them for Hemophilus influenzae type b between during medication of low doses of corticosteroids and after discontinuation of corticosteroids treatment (45.7% us 42.9%). Almost of respondents reported vaccinating renal failure children without immunosuppression for hepatitis B, pneumococcus, influenza and H. influenzae type b ($54.3{\sim}77.1%$). Conclusion : Pediatric nephrologists practiced modifying vaccination schedules for children with renal disease in Korea and there was variation according to the progression of disease and the doses of corticosteroids. It is necessary to establish the immunization guideline for children with renal disease through the prospective studies.
Background: Endovenous laser treatment (EVLT) has recently been introduced as a less invasive technique for treating an incompetent small saphenous vein and many good results have been reported. The purpose of this study is to assess the efficacy and safety of EVLT combined with high ligation in patients with an incompetent small saphenous vein. Material and Method: The study included 60 patients (66 limbs) who were treated with EVLT combined with high ligation of an incompetent small saphenous vein between January 2006 and May 2009. The preoperative clinical findings, the postoperative results and the postoperative ultrasonography follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were observed in 17 patients (15 limbs, 28.3%) and postoperative paresthesia occurred in 5 limbs (7.6%), but there was no deep vein thrombosis. Ultrasonography follow up at 3 month was performed in 93.9% of the limbs (62/66). The vein occlusion rate at 1 and 3 months were found to be 91.9% (57/62) and 90.3% (56/62), respectively. Conclusion: We performed EVLT combined with high ligation and ambulatory phlebectomy in patients with an incompetent small saphenous vein, and this all revealed relatively satisfactory results with a low complication rate, but it showed a relatively low cure rate even though we also performed EVLT combined with high ligation altogether. We need to determine whether EVLT combined with a high ligation procedure will improve the venous occlusion rate. We also need to investigate how we can minimize the occurrence of nerve injury.
The purpose of this study was to evaluate tooth color and microhardness after 15% carbamide peroxide(CP) bleaching treatments with/without potassium nitrate and fluoride(PF), which were used home bleaching. Thirty tooth specimens were obtained from thirty premolar and were randomly divided into three groups: 1, untreated controls(Distilled water): 2, treatment with 15% CP bleaching agent; 3, treatment with 15% CP bleaching agent (contained 3% potassium nitrate and 0.11% fluoride). All groups were treated 6h per day for 14 days then immersed in distilled water. Changes in enamel color were evaluated on Baseline and Day 14. Microhardness were evaluated on Baseline, Days 7 and 14. All the bleached enamel specimens revealed increased whiteness without control group. Groups 2 and 3 showed significantly decreased enamel microhardness compared to control group. On Day 7, Groups 2-3 showed significantly decreased enamel microhardness compared to control group and respective baseline data. The percentage microhardness loss(PML) look at Day 7 and 14 for Group 1, respectively, there was little difference between 1.7 and 0.8. However, Group 2 was 21.9 and 3.5, Group 3 was 16.7 and 1.4 as a baseline and Day 7 were significantly different (p<0.05). The PML of group 2 was significantly highest than that of group 3 on Day 7. As a result, the data indicate that the addition of PF did not influence the whitening efficacy of the bleaching agent negatively. PF-containing bleaching agent reduce the percentage microhardness loss. PF-containing tooth bleaching your teeth with a whitening effect can be reduced by decreasing the hardness of enamel.
Experiments were conducted to evaluate the efficacy of ground and foliar sprinkling of natural water for control of the pine needle gall midge, Thecodiplosis japonensis, by disturbing the reproductive behavior of adults such as copulation and oviposition. Diurnal ground spray for whole area application and foliar spray for single tree treatment were tested at day time during the period of adult emergence. The results obtained are as follows : 1. The population density of overwintering larvae in soil was not affected by the water spray during the adult emergence period. 2. Spraying the water showed no effect on the whole period and number of adult emergence, but retarded early emergence and facilitated Late emergence. The difference in the emerging time by 50% emergence day was approximately 7 days. 3. Ground spray was significantly different from control in gall formation rates but was not sufficient for effective control. As a single-tree treatment, the foliar spray was found to be highly effective for control of the pine needle gall midge, Average gall formation of spray plots and untreated ones were 2.6% and 38%, respectively ; control value exceeded 90%. 4. Ground spray of water was not effective in reducing larvae in gall of needle. Foliar spray, however, reduced 45% of larval numbers. 5. Foliar spray accelerated shoot growth by 15%-18%. 6. Foliar spray was highly effective for the control of sucking insects, such as mites and aphids on pine trees.
Feeding trials using weanling pigs and broiler chicks were conducted to evaluate the efficacy of different metal-amino acid chelates and complexes at various levels of copper and zinc on the performance and fecal excretions. A total of 200 weanling pigs (Large White ${\times}$ Yorkshire ${\times}$ Duroc, $11.20{\pm}0.81kg$) were randomly assigned to 5 dietary treatments following a randomized complete block design. Each treatment was replicated 4 times with 10 pigs per pen. The dietary treatments were designated as : A-diet containing 170 ppm Cu from $CuSO_4$ and 120 ppm Zn from $ZnSO_4$, B-diet containing 85 ppm Cu from Cu-amino acid chelate (CAC) and 60 ppm Zn from Zn-amino acid chelate (ZAC), C-diet containing 170 ppm Cu from CAC and 120 ppm Zn from ZAC, D-diet containing 85 ppm Cu from Cu-lysine complex (CL) and 60 ppm Zn from Zn-methionine complex (ZM), and E-diet containing 170 ppm Cu from CL and 120 ppm Zn from ZM. On the other trial, 144 of one day old broiler chicks were randomly distributed to 6 dietary treatments following a completely randomized design. Each treatment was replicated 3 times with 8 chicks per replicate. The dietary treatments were as follows: 1-diet with 60 ppm Cu from $CuSO_4$ and 40 ppm Zn from $ZnSO_4$, 2-diet with 120 ppm Cu from $CuSO_4$ and 80 ppm Zn from $ZnSO_4$, 3-diet with 60 ppm Cu from CAC and 40 ppm Zn from ZAC, 4-diet with 120 ppm Cu from CAC and 80 ppm Zn from ZAC, 5-diet with 60 ppm Cu from CL and 40 ppm Zn from ZM, and 6-diet with 120 ppm Cu from CL and 80 ppm Zn from ZM. In Exp. 1 with pigs, there was no difference on average daily gain and average daily feed intake observed among treatments. There was improvement (p<0.05) on the overall feed conversion ratio (FCR) of pigs fed diet containing 120 ppm Zn and 170 ppm Cu from metal-amino acid chelates relative to those fed diet containing inorganic sources of Cu and Zn but equally efficient as those fed diet containing metal-amino acid complexes. Pigs fed diet containing either metal-amino acid chelates or complexes as sources of Cu and Zn had higher (p<0.05) Cu and Zn concentration in serum and lower (p<0.05) in feces than those receiving diet with inorganic sources. In Exp. 2 with broiler chicks, the overall FCR was not different among treatments. Higher (p<0.05) Cu and Zn concentration in serum was obtained from birds fed diet with 60 ppm Cu and 40 ppm Zn from metal-amino acid chelates compared to those fed diet with inorganic sources of Cu and Zn. Also, the feces collected from birds fed diet with either metal-amino acid chelates or complexes contained generally lower Cu and Zn than those birds fed diet with inorganic sources. The higher the dietary level of Cu and Zn the higher the Cu and Zn concentration in the feces. Based on the results, both metal-amino acid chelates and complexes of Cu and Zn at low levels (Zn 60 ppm, Cu 85 ppm for weanling pigs and Zn 40 ppm, Cu 60 ppm for broiler chicks) are not different from that of high levels of inorganic sources in maintaining growth performance and serum concentration. The fecal excretions for Cu and Zn were greatly reduced when organic sources were used.
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