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Clinical Importance of the Resection Margin Distance in Gastric Cancer Patients (위암환자에서 위절제술 시 근위부 절제연거리의 임상적 중요성)

  • Ha, Tae-Kyung;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.277-283
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    • 2006
  • Purpose: The way in which the resection margin distance for gastric cancer patients who undergo a gastric resection influences the recurrence rate, aspects of recurrence, and the prognosis according to the characteristic of the tumor is not known. We aim to find a standard for tailor-made treatment after selecting patients in this point of view who need a more sufficient resection margin. Materials and Methods: A retrospective study was done on 1,472 patients who underwent a gastrectomy due to gastric cancer at our hospital from 1992 to 2005. The median follow-up period was 37 months. Results: There were no significant differences in the recurrence rate, the aspects of recurrence, and the 5-year survival rate between early gastric cancer (EGC) patients with a resection margin distance of less than 2 cm compared with EGC patients with a resection margin distance of greater than 2 cm. However, significant differences in the survival rate were found in advanced gastric cancer (AGC) patients when the patients were classified into groups with resection margin distances less than or greater than 3 cm (P=0.02). Significant differences were noted especially in cases of diffuse histologic-type tumors located in the lower third of the stomach and in cases with Borrmann type-3 and -4 tumors. Conclusion: The distance between the tumor resection margin and the proximal gastric resection margin has no significant influence on the survival rate in EGC patients if the resection margin is negative. However, to improve a patient's survival rate, it is important to guarantee a resection margin of more than 3 cm in AGC patients, especially when the tumor is a diffuse histologic type located in the lower third of the stomach or a Borrmann type 3 and 4.

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Implants in conjunction with removable partial denture (임플란트를 이용한 국소의치 수복)

  • Kim, Seong-Kyun;Yoo, Soo-Yeon;Park, In-Phil;Lee, Joo-Hee
    • The Journal of the Korean dental association
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    • v.49 no.2
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    • pp.77-84
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    • 2011
  • The benefits of implant supported overdenture are readily apparent for the fully edentulous patients and have been well documented, however, there is deficiency of the studies regarding the combination of implants with removable partial dentures for partially edentulous patients. The purpose of this article is to review the literature concerning implants with removable partial dentures and evaluate the evidence for this clinical approach. Through many clinical case reports and studies we have searched from a broad variety of journals, we present the six considerations needed to contemplate respecting implants with removable partial denture in partially edentulous patients. First, the connection between abutment tooth and removable partial denture has to be rigid and the link between implant and removable partial denture should be hinged. Second, a mesial rest acts better in the point of force distribution for distal extension removable partial denture and splinting between implants is also a favorable choice. Third, T bar has an advantage for implants which are used as abutments in distal extension removable partial denture. Forth, as we all known functional impression is better way to reproduce movement for distal extension removable partial denture. Fifth, indirect retainer and guiding plane on the proximal surfaces of terminal abutment teeth are important in preventing denture base lifting. Sixth, implants in conjunction with removable partial denture is superior in the esthetic and phonetic as well as cost-effective point of view. We also suggest that which place we should install implants for force distribution and which diameter and length of implants should be used. in this review article, we recommend to locate the implant near of the abutment tooth for esthetics or near of first molar position for good stress distribution. The diameter and length of implant also influence to stress distribution. When we compare to conservative partial denture, patients go for removable partial denture using implants due to convenience, better support and retention according to several studies. But it is true that we need to study more on this subject and collect long term follow up cases before we discuss on it. So it is enough to bring this subject into the surface of prosthetic treatment by this article.

Blood Flow Simulation in Bifurcated Geometry of Abdominal and Iliac Arteries Based on CT Images (CT영상에 기반한 복부대동맥과 장골동맥 분기관 모델의 혈류유동 해석)

  • Hong Y. S.;Kim M. C.;Kang H. M.;Lee C. S.;Kim C. J.;Lee J. M.;Kim D. S.;Lee K.
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.497-503
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    • 2004
  • Numerical simulation of blood flow has been conducted based on real vessel geometries generated front DICOM medical images of abdominal and iliac bifurcated arteries of a healthy man. A program was developed to read cross sectional images of the three dimensional arteries and smoothly extract boundary coordinates of vessels. Commercial programs were employed for mesh generation and flow simulation. Pressures, velocities, and flow distributions were found to lie within normal physiological ranges. Peak velocity measured in the iliac artery by ultrasound was 20% smaller than that obtained by simulation. The trend of velocity variation in a cardiac cycle was fairly similar between the simulation and the ultrasonic measurements. Simulation based on real vessel geometry of individual patient provides information on pressure, velocity, and its distribution in the diseased arteries or arteries to be surgically treated. The results of simulation may help surgeons to better understand hemodynamic status and surgical need of the patient by revealing variation of the hemodynamic parameters. Futhermore, they may serve as basic data for surgical treatment of arteries. This research is expected to develop to a program in the future that early diagnose atherosclerosis by showing distribution of a hemodynamic index closely related to atherosclerosis in arteries.

Comparative Review of Current Clinical Trials on Abdominal Obesity (복부비만 관련 임상시험의 국내외 연구경향 고찰)

  • Lim, Je-Yeon;Song, Yun-Kyung;Lim, Hyung-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.2
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    • pp.63-77
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    • 2010
  • Objectives : It is known that abdominal obesity increases the possibility of cardiovascular diseases, early death, and metabolic syndrome including dyslipidemia and insulin resistance. Clinical trials have been under way to verify the effectiveness of treatment for abdominal obesity. The objective of this study is to set criteria about how effective oriental medicine and acupuncture are in abdominal obesity. Methods : I manually search "www.clinicaltrial.gov", 4 Korean medical databases and 4 Korean medical journals of abdominal obesity. Search terms used were "abdominal obesity" or "visceral obesity". In order to see detail review, searching was performed from 01, 01, 2005 to 11, 31, 2009. And I classified all the searched studies into design, intervention, purpose, end point, diseases, condition and etc. Results : 1. I could search total 67 trials in "www.clinicaltrial.gov". I found 9, 10, 13, 8, 6 clinical trial from 2005 to 2009 every year. 2. Test on both gender and adult or adult and senior have been most frequent. 3. Randomization clinical trial is 51 cases that occupied 96.2%. 38 cases use control group. 4. Body mass index(BMI) and waist circunference(WC) are major criteria of abdominal obesity clincal trial. WC, BMI, abdominal fat mass, body weight are measured at end point of abdominal obesity clincal trial. 5. I could search total 86 cases in domestic study. I found 15, 23, 23, 20, 5 cases from 2005 to 2009 every year. 6. Test on female and adult have been most frequent in domestic study. 7. Randomization clincal trial is only 2 cases that occupied 2.3%. 62 cases use control group in domestic study. 8. BMI, body fat percent, WC, visceral-subcutaneous fat ratio(VSR), waist-hip ratio(WHR) are criteria of abdominal obesity clincal trial in domestic study. WC, BMI, abdominal fat mass, body weight are measured at end point of abdominal obesity clincal trial in domestic study. Conclusions : To improve abdominal obesity study in traditional korean medicine, it is need to activate clinical trial, meta analysis, develope of clinical practice guidelines, co-works with conventional medicine and etc.

The Effect of Nutrition Plus Program among 0~5 Year Children in the Yeojoo Area - The Improvement in Nutritional Status of Children after Nutrition Supplement of Children and Nutrition Education in Parents/Guardians - (여주지역 영유아 대상 영양플러스 사업 효과 - 영유아 영양보충 및 보호자 영양교육 실시에 따른 영유아의 영양개선효과를 중심으로 -)

  • Park, Ok-Jin;Lee, Min-June;Kim, Ji-Hyang;Min, Sung-Hee;Lee, Hyun-Sook
    • Korean Journal of Community Nutrition
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    • v.14 no.6
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    • pp.767-776
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    • 2009
  • This study evaluated the effect of nutritional improvement of 0~5 year children of financially poor families after nutrition supplement of children and nutrition education in parents/guardians. The subject selected among applicants for low-income family financing of the government included 198 children (0~12 months:92, 1~5 years:106), and the average ages were 5.3 months and 2.4 years respectively. Food that includes each nutrient factor was provided to the subject for six months. Nutrition education was performed in two ways, through class and private education, once a month for both. Nutritional improvement was evaluated by body measurement and anemia prevalence rate. As to the survey on breast-feeding, complete breast-feeding accounted for 58.7%, weaning food 27.3%, and combined feeding 14.1% respectively, which shows that breast-feeding accounted for the largest percentage. The education program improved knowledge and attitude of the parents/guardians, which brings in positive effects on growth of children as well. The nutrition knowledge score was improved after nutrition education in 0~12 month children $(8.5\pm1.75\;to\;8.9\pm1.69)$ and 1~5 year children $(7.3\pm1.39\;to\;7.8\pm1.30)$. The nutrition attitude score was significantly improved in 0~12month children $(52.0\pm6.99$ to $53.5\pm5.21$, p < 0.001) and 1~5year children ($45.1\pm7.30$ to $49.0\pm5.96$, p < 0.001). In evaluation on nutritional improvement based on body measurements, it turned out that the wasting was reduced as for children in consideration of the height and weight according to the subject's age. The concentration of hemoglobin after the nutrient treatment for six months was significantly improved, and the anemia prevalence rate as well was reduced from 40.6% to 13.5%, which indicates the significant improvement. Based on the findings above, it turned out that providing quality food to children and nutrition education to the parents/guardians poorly fed in low-income families improved knowledge and attitude of the guardians and prevents anemia and improves growth, which brings in positive effects on growth of children. In the results regarding attitude and knowledge on nutrient/dietary life; however, the improvement level was relatively low when the extent before the education was too small, which indicates the need to revise and complement the contents and methods. In addition, as shown in the result of body measurement, long-term and consistent investigation is necessary since it is difficult to judge the effect on growth only based on short-term nutrient supplement.

Biodiesel Production and Nutrients Removal from Piggery Manure Using Microalgal Small Scale Raceway Pond (SSRP) (미세조류 옥외배양 시스템을 이용한 돈분 액체 비료의 영양염류 제거 및 바이오디젤 생산)

  • Choi, Jong-Eun;Kim, Byung-Hyuk;Kang, Zion;Oh, Hee-Mock;Kim, Hee-Sik
    • Korean Journal of Environmental Biology
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    • v.32 no.1
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    • pp.26-34
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    • 2014
  • Due to the rapid energy consumption and fossil fuel abundance reduction, the world is progressively in need of alternative and renewable energy sources such as biodiesel. Biodiesel from microalgae offers high hopes to the scientific world for its potential as well as its non-competition with arable lands. Taking consideration to reduce the cost of production as well as to attain twin environmental goals of treatment and use of animal waste material the microalgal cultivation using piggery manure has been tested in this study. Unialgal strains such as Chlorella sp. JK2, Scenedesmus sp. JK10, and an indigenous mixed microalgal culture CSS were cultured for 20 days in diluted piggery manure using Small Scale Raceway Pond (SSRP). Biomass production and lipid productivity of CSS were $1.19{\pm}0.09gL^{-1}$, $12.44{\pm}0.38mgL^{-1}day^{-1}$, respectively and almost twice that of unialgal strains. Also, total nitrogen and total phosphorus removal efficiencies of CSS was 93.6% and 98.5% respectively and 30% higher removal efficiency compared to the use of unialgal strains. These results indicate that the piggery manure can provide microalgae necessary nitrogen and phosphorus for growth thereby effectively treating the manure. In addition, overall cost of microalgal cultivation and subsequently biodiesel production would be significantly reduced.

Viability Determination of Pinus rigida Seeds Using Artificially Accelerated Aging (노화처리를 이용한 리기다소나무 종자의 활력 평가)

  • Han, Sim-Hee;Koo, Yeong-Bon;Kim, Chan-Soo;Oh, Chang-Young;Song, Jeong-Ho
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.8 no.1
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    • pp.10-14
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    • 2006
  • We tested the seed viability of Pinus rigida using accelerated aging to discover optimum times and temperatures far artificially accelerated aging. Seeds were artificially aged at different temperatures and during different tines. The seed viability was affected by the accelerated aging and by temperature with a decline in germination and seed vigor. The aging index of P. rigida seed was 0.31 at $35^{\circ}C$ and seed viability was nearly lost after aging treatment at $40^{\circ}C$ for 15 days. The optimum temperature of P. rigida far the aging test was decided to be approximately $37^{\circ}C$ on the basis of the aging index. Inorganic materials and conductivity of leaching solution from aging seeds increased with the increase of aging period. The accelerated aging test was considered to be a suitable method to evaluate the seed viability of tree species. Because seed characters are much different among tree species, however, more studies need to be done to discover the optimum conditions for aging by tree species.

Material Properties of Ultra Rapid Hardening Mortar for Repairing Sewage Treatment Concrete Pipes (콘크리트 하수관거 보수용 초속경 수중불분리 모르타르의 재료적 특성)

  • Lee, Byungjae;Lee, Sunmok;Bang, Jin-wook;Kim, Yun-yong
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.24 no.3
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    • pp.57-62
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    • 2020
  • Among the sewage pipes installed in Korea, the length of concrete pipes exceeding 20 years is 66,334 km (42.5%). Deteriorated concrete sewer pipes need to be repaired due to the leakage of internal sewage, which causes problems such as sink holes by expanding the cavity around the pipeline. In this study, we tried to apply anti-washout underwater mortar with ultra rapid hardening cement and segregation reducing agent to sewage pipe repair. As a result of the setting time test, the final set time was delayed by up to 172% by incorporating segregation reducing agent. In the test for measuring the degree of mortar segregation in water, it was measured at pH 12 or less under all mixing conditions. In addition, the suspension amount was measured to be 50 mg / l or less to satisfy the KCI-AD102 standard by incorporating a segregation reducing agent. In terms of the average value of mortar compressive strength, by incorporating segregation reducing agent, the strength of the specimens produced in air was more than 80% of that of the specimens produced in water. Conversely, the bond strengths of the specimens produced in water were measured to be higher than those of the specimens produced in air. Water resistance was evaluated by measuring water absorption and water permeability. Water absorption and water permeability were reduced by 42.6% and 36.6%, respectively, by mixing segregation reducing agent.

A study on the optimization of referring method about medical images using MIH(Medical Image History) (MIH(Medical Image History)을 이용한 의료영상조회의 최적화 연구)

  • Kim, Sun-Chil;Kim, Jung-Min
    • Journal of radiological science and technology
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    • v.25 no.2
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    • pp.57-64
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    • 2002
  • The recent development of embodiment technology of the medical images makes most medical institutions introduce PACS(Picture Archiving and Communication System) in haste. However lots of PACS solutions, currently developed and distributed, haven't been able to serve the convenience of users and to satisfy user's demand because of economic limitations and administrator-oriented considerations in the process of development. So we have developed MIH(Medical Image History), by which we can search and refer to the patient's medical images and information with few restrictions of time and space for diagnosis and treatment. This program will contribute to the improvement in the medical environment and meet the clients' need. We'll make more effort to develop the application which insures the better quality of medical images. MIH manages the patient's image files and medical records like film chart in connection with time. This trial will contribute to the reduction of the economical loss caused by unnecessary references and improve the quality in the medical services. The demand on the development or the program which refers to the medical +ata quickly and keeps them stable will be continued by the medical institute. This will satisfy the client's demand and improve the service to the patients in that tile program will be modified from the standpoint of the users. MIH is trying to keep user-oriented policy and to apply the benefit of the analog system to the digital environment. It is necessary to lead the public to the better understanding that the systematic management and referring of the medical images is as important as the quality of the images.

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Immediate Breast and Chest Wall Reconstruction for Advanced Breast Cancer (진행성 유방암에서 즉시 유방 및 흉벽 재건술)

  • Yang, Jung-Dug;Kim, Hak-Tae;Chung, Ho-Yun;Cho, Byung-Chae;Choi, Kang-Young;Lee, Jung-Hun;Lee, Jeong-Woo;Park, Ho-Yong;Jung, Jin-Hyang;Chae, Yee-Soo
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.627-635
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    • 2011
  • Purpose: Advanced breast cancer traditionally has been perceived as a contraindication to immediate breast reconstruction, because of concerns regarding adjuvant treatment delays and the cosmetic effects of radiotherapy to breast reconstruction, so delayed reconstruction is usually preferred in advanced breast cancer patients undergoing mastectomy. However, with the improved outcome using multimodality therapy, consisting of perioperative chemotherapy and radiotherapy, immediate breast reconstruction is now being performed as surgical option for selected advanced breast cancer patients. Additionally, advanced breast cancer patients may be needed soft tissue coverage of an extensive skin and soft tussue defect after mastectomy. Current authors have experienced several types of immediate breast and chest wall reconstruction for advanced breast cancer. Methods: From December of 2007 to June of 2009, 14 women performed for immediate breast and chest wall reconstruction for advanced breast cancer. They had been treated with neoadjuvant chemotherapy or chemoradiotherapy followed by modified radical mastectomy or radical mastectomy. Four different techniques were used immediate breast and chest wall reconstruction, which are pedicled TRAM flap (4 cases), extended LD flap with STSG (3 cases), thoracoabdominal flap (4 cases) and thoracoepigastric flap (3 cases). Results: The mean age was 53 years and mean follow up period was 9 months. Patients' oncologic status ranged stage IIIa to stage IV. Two patients had major complications: partial flap necrosis of TRAM flap and one distal necrosis of thoracoabdominal flap. Three patients with stage IV disease died from metastases. Conclusion: The result of this study suggests that immediate breast and chest wall reconstruction can be considered as surgical option for advanced breast cancer. But we need long term follow up and large prospective studies for recurrence and survival.