• 제목/요약/키워드: WHO grade II

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Polyetheretherketone Cage with Demineralized Bone Matrix Can Replace Iliac Crest Autografts for Anterior Cervical Discectomy and Fusion in Subaxial Cervical Spine Injuries

  • Kim, Soo-Han;Lee, Jung-Kil;Jang, Jae-Won;Park, Hyun-Woong;Hur, Hyuk
    • Journal of Korean Neurosurgical Society
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    • 제60권2호
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    • pp.211-219
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    • 2017
  • Objective : This study aimed to compare the clinical and radiologic outcomes of patients with subaxial cervical injury who underwent anterior cervical discectomy and fusion (ACDF) with autologous iliac bone graft or polyetheretherketone (PEEK) cages using demineralized bone matrix (DBM). Methods : From January 2005 to December 2010, 70 patients who underwent one-level ACDF with plate fixation for post-traumatic subaxial cervical spinal injury in a single institution were retrospectively investigated. Autologous iliac crest grafts were used in 33 patients (Group I), whereas 37 patients underwent ACDF using a PEEK cage filled with DBM (Group II). Plain radiographs were used to assess bone fusion, interbody height (IBH), segmental angle (SA), overall cervical sagittal alignment (CSA, C2-7 angle), and development of adjacent segmental degeneration (ASD). Clinical outcome was assessed using a visual analog scale (VAS) for pain and Frankel grade. Results : The mean follow-up duration for patients in Group I and Group II was 28.9 and 25.4 months, respectively. All patients from both groups achieved solid fusion during the follow-up period. The IBH and SA of the fused segment and CSA in Group II were better maintained during the follow-up period. Nine patients in Group I and two patients in Group II developed radiologic ASD. There were no statistically significant differences in the VAS score and Frankel grade between the groups. Conclusion : This study showed that PEEK cage filled with DBM, and plate fixation is at least as safe and effective as ACDF using autograft, with good maintenance of cervical alignment. With advantages such as no donor site morbidity and no graft-related complications, PEEK cage filled with DBM, and plate fixation provide a promising surgical option for treating traumatic subaxial cervical spine injuries.

소아 요로 감염 및 의심 환아에서 신 실질 병변 및 방광요관 역류와 임상 변수와의 연관성 (The relationships between clinical variables and renal parenchymal disease in pediatric clinically suspected urinary tract infection)

  • 변정림;이상택;정소정;김교순
    • Clinical and Experimental Pediatrics
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    • 제53권2호
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    • pp.222-227
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    • 2010
  • 목 적 : 본 연구는 소아 요로 감염증에서 치료 전 발열 기간과 치료 후 발열 기간 등의 임상변수와 혈액 및 소변 등의 검사 결과가 신 실질 병변 및 방광요관 역류 등을 예측하는 데 있어서 인자로 작용할 수 있는지를 평가해 보고자 하였다. 방 법 : 2005년 7월부터 2008년 7월까지 첫 번째 열성 요로 감염으로 본원 소아과에 입원한 1개월부터 만 17세까지의 환아 180명을 대상으로 하였다. 환아의 혈액 검사 소견 중 C-반응 단백, 백혈구수와 소변 검사 중 배양 검사 결과, 소변 질산염 및 치료전 발열기간, 치료 후 발열 기간 등을 변수로 하여 신장 초음파 배뇨 방광, 요도 조영술, 신 스캔 등의 영상 검사 결과와 비교하여 연관성을 평가하였다. 결 과 : C-반응 단백 수치가 높고 백혈구 증가증이 있으며 입원 치료 후 긴 발열 기간을 가진 경우 신 실질 병변이 유의하게 증가하였고 3단계 이상의 방광 요관 역류 발생도 높았다. 신 스캔 검사상 이상 소견을 보인 경우는 신 스캔 검사상 정상 소견을 가진 군과 비교하였을 때 3단계 이상의 방광 요관 역류가 더 증가되어 있었다. 결 론 : C-반응 단백 수치, 백혈구 증가증, 입원 치료 후 긴 발열기간 등의 임상 변수는 신 실질 병변과 3단계 이상의 방광 요관 역류의 예측 인자가 될 수 있을 것으로 사료된다.

항암화학요법후 골수억제가 수반된 진행암환자에서 rh GM-CSF(LBD-005)의 제1b 상 및 약동태학 연구

  • 라선영;이경희;이혜란;최진혁;정현철;노형근;김범수;노재경;한지숙
    • 한국응용약물학회:학술대회논문집
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    • 한국응용약물학회 1994년도 춘계학술대회 and 제3회 신약개발 연구발표회
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    • pp.314-314
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    • 1994
  • 대상환자는 15예로, 14예에서 평가 가능하였으며 남녀비는 8:6, 중앙연령 32세(10-70세) 이었고, 대상질환은 악성골옥종 7예, 악성임파종 2예, 위암 2예, 폐암 2예, 그리고 자궁평활근육종 1예였다. rhGM-CSF 50 $\mu\textrm{g}$/$m^2$ 3예, 100 $\mu\textrm{g}$/$m^2$ 3예, 150 $\mu\textrm{g}$/$m^2$ 3예, 250 $\mu\textrm{g}$/$m^2$ 3예, 350 $\mu\textrm{g}$/$m^2$ 3예, 500 $\mu\textrm{g}$/$m^2$ 6예, 700 $\mu\textrm{g}$/$m^2$ 용량 3예에서 시행되었다. 1주기 시행한 환자는 7예, 2주기 5예, 3주기, 4주기 각각 1예씩 있다. 부작용은 50-150 $\mu\textrm{g}$/$m^2$에서 WHO grade I의 발열, 전신쇠약, 식용부진등이 관찰되었으나 grade II이상의 부작용은 없었다. 250 $\mu\textrm{g}$/$m^2$이상의 용량에서도 grade II의 발열이 관찰되었을 뿐 다른 중증의 부작용은 관찰되지 않았다. 최고용량인 700 $\mu\textrm{g}$/$m^2$ 에서도 grade II의 발열외의 중한 부작용은 관찰되지 않았다. 각 용량에 따른 백혈구 증가율(%투여제2일/투여제1일)은 130-500% 이었다. rhGM-CSF는 투여 2-4 시간후 혈중최고치 (0.42-15.4 ng/ml)가 관찰되었으며 투여 12시간까지 0.2-2 ng/ml 의 농도가 지속되었다. 소변내 rh GM-CSF 배설량은 총투여량의 1% 미만이었다.

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Mortality and Morbidity of Aneurysmal Neck Clipping during the Learning Curve

  • Lee, Sang-Ho;Hwang, Hyung-Sik;Moon, Seung-Myung;Kim, Sung-Min;Choi, Sun-Kil
    • Journal of Korean Neurosurgical Society
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    • 제40권1호
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    • pp.16-21
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    • 2006
  • Objective : Young neurosurgeons need to focus on the mortality and morbidity of aneurysmal neck clipping to develop a personal experience with an initial series. Methods : Total 88 aneurysms from 75 patients who underwent neck clipping by the same operator from 2001 to 2004 were reviewed. Patients were divided into three groups : first year [Group I], second year [Group II], and third year [Group III] in each group. Location of aneurysm, age, Fisher grade, Hunter-Hess grade [H-H grade], postoperative Glasgow outcome scale [GOS], and complications related to surgical procedures were evaluated with Chi-square and logistic regression analyses. Results : Fourteen patients had complications related to surgery [18.7%]. The major causes of mortality and morbidity related to surgery were cerebral infarction, hemorrhage and brain swelling due to intraoperative rupture, brain retraction and vasospasm. Among the 4 cases of mortality were 2 patients in Group I, 1 patient in Group II and 1 patient in Group III, and location of aneurysms were 2 internal carotid artery[ICA] and 2 posterior communicating artery[PCoA] aneurysms. There were 4 morbidity and new neurological deficits in Group I, 4 in Group II and 2 in Group III. Although mortality and morbidity during the learning curve had a statistical significance in H-H grade, age [>60 years old], and aneurysm location [especially ICA aneurysm] as variables, mortality mainly occurred in ICA and PCoA aneurysms. Conclusion : Experienced supervision or endovascular approach should be considered for the treatment of ICA and PCoA aneurysms during the learning curve.

슬관절 퇴행성 관절염에서 관절경적 내측 반월상 연골 절제술의 효과 (The Effect of Arthroscopic Medial Meniscectomy in Degenerative Arthritis of the Knee)

  • 김도연;최윤진;이승주;고민석;최종혁
    • 대한정형외과스포츠의학회지
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    • 제9권2호
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    • pp.79-84
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    • 2010
  • 목적: 퇴행성 관절염에서 발견되는 반월상 연골 병변에 대한 치료의 필요성에 대하여는 논란이 많다. 본 연구의 목적은 슬관절 퇴행성 관절염 환자에서 내측 반월상 연골 파열에 대한 치료로 관절경적 내측 반월상 연골 절제술을 시행하였을 경우의 치료 효과에 대하여 알아보고, 적절한 적응증과 위험 요소를 찾는 것이다. 대상 및 방법: 2006년에서 2008년 사이에 287명이 본원에서 내측 반월상 연골 파열에 대하여 관절경적 수술을 시행 받았다. 이 중 Kellgren-Lawrence grade II, III 슬관절 퇴행성 관절염이 확인되고, 나이가 50세 이상이며, 외래 추시가 1년 이상인 환자 103명을 대상으로 하였다. 수술 비디오, 방사선 사진, 의무기록, 설문지와 인터뷰를 통해 후향적으로 임상적 결과를 평가하였다. 시각 상사 척도(VAS) 점수와 Lysholm 점수를 통해 통증과 기능의 호전을 평가하였다. 결과: Lysholm 점수는 수술 전의 평균 69점에서 수술 후에 평균 85점으로 증가하였고, VAS 점수는 수술 전의 평균 7점에서 수술 후에 평균 3.1로 통증이 호전되었다. Kellgren-Lawrence grade II 환자군에서 III 환자군보다, Outerbridge grade I 환자군에서 III와 IV 환자군보다 의미있게 통증이 호전되었다. 외상력이 있는 환자군에서 없는 환자군보다 의미있게 통증이 호전되었고 기능의 회복이 관찰되었다. 다중 회귀 분석에서 확인된 Lysholm 점수의 호전에 영향을 미치는 인자로는 외상력과 Outerbridge grade였다. 결론: 1년 단기 추시에서 Kellgren-Lawrence grade II, III 슬관절 퇴행성 관절염 환자에서 내측 반월상 연골 병변에 대하여 시행한 관절경적 내측 반월상 연골 절제술은 환자의 통증 호전과 기능의 회복에 도움을 줄 수 있다. 특히 Kellgren-Lawrence grade가 낮은 경우와 외상력이 있는 환자, 관절 연골 손상이 심하지 않은 환자에서 좋은 결과를 기대할 수 있다.

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Multicenter Retrospective Analysis of Intraperitoneal Paclitaxel and Systemic Chemotherapy for Advanced Gastric Cancer with Peritoneal Metastasis

  • Kim, Dong-Wook;Jee, Ye Seob;Kim, Chang Hyun;Kim, Jin-Jo;Park, Sungsoo;Choi, Sung Il;Park, Joong-Min;Kim, Jong-Han
    • Journal of Gastric Cancer
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    • 제20권1호
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    • pp.50-59
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    • 2020
  • Purpose: The objective of the present retrospective analysis was to describe the experience of intraperitoneal (IP) paclitaxel and systemic chemotherapy in patients with peritoneal metastasis (PM) of advanced gastric cancer (AGC) in a multicenter setting in Korea. Materials and Methods: The medical records of patients with AGC, who were diagnosed with PM between January 2015 and December 2018, were reviewed. IP catheter was placed in the pouch of Douglas and was used for the administration of IP paclitaxel chemotherapy. Results: We reviewed the clinical outcomes of IP paclitaxel and systemic chemotherapy administration in 82 patients at six institutions in Korea. Mean number of IP chemotherapy cycles was 6.6. The mean peritoneal cancer index (PCI) was 21.9. Postoperative complications related to IP catheter and port were observed in 15 patients. The overall median survival was 20.0 months. A significant difference was observed in the survival rate according to the ascites grade (grade I and II, 24.1 months; grade III and IV, 15.3 months; P=0.014) and PCI grade (grade I, 25.6 months; grade II and III, 16.3 months; P=0.023). Conclusions: The feasibility of IP paclitaxel and systemic chemotherapy administration was demonstrated in this experience-based retrospective analysis suggesting that the procedure is beneficial in patients with PM of AGC.

초등학교와 중학교 수학성적의 상관관계에 대한 연구 (The Correlation Between Elementary School And Middle School Mathematics Record)

  • 윤홍분
    • 한국학교수학회논문집
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    • 제2권1호
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    • pp.145-156
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    • 1999
  • The purpose of this study is to consider students′ scholastic relationship in mathematics between elementary school and middle school from the 3rd grade in elementary school to the 2nd and the 3rd grades in middle school. The following are the results: 1. CONCLUSIONS 1. Students′ present scores are most closely related to those of their previous grade. The data are based on the two groups of the 3rd grade middle school students - one is honhappan(mixed students from different elementary school) and the other shinaepan(the students from the same elementary school in kong ju city). This close relation between present and previous scores in mathematics may well be reasonable since mathematics is systemized hierarchically. Among the score data in elementary school, the scores in the 5th grade are meaningfully related to present score data in mathematics. 2. Two pans (as I mentioned above, honhap and shinae) are divided into groups and their scores are traced from the 3rd grade in elementary school and the data show that the high-levelled students have little changes in their scores, but low-levelled students have dropped radically in their scores from the first grade in middle school. 3. In terms of students′ interests, students who answered, "I′m very interested in mathematics." have no distinguished characteristics in their scores while those who answered, "I have little interest in mathematics" shows a decrease in their scores. 4. Among the reasons for their lack of interests, the replies are "because of exams," "because of teaching methods," and "because of the textbooks." II. Suggestion To compensate the limitation and difficiency of this study, the foll owing is suggested for the following studies related to this one. 1. This study was limited to gathering students′ score data from female students in a small city. For a more accurate statistic a bigger population is needed as well as varied geographical and social economical area is suggested. A good idea is to study homogeneous sex groups as well as heterogeneous sex groups 2. It is easy to find out what grade is closely related to the present scores by statistical analysis, but the reasons for their relationship have to be found out through the following studies 3. There are many studies on cognitive domain in math but it is expected to have more studies on affective domain as well.

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Microsurgical Fenestration of Middle Cranial Fossa Arachnoid Cyst

  • Kim, In-Soo;Kim, Dong-Won
    • Journal of Korean Neurosurgical Society
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    • 제40권2호
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    • pp.69-73
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    • 2006
  • Objective : The optimal surgical treatment for symptomatic middle cranial fossa arachnoid cysts is controversial. Therapeutic options include endoscopic fenestration, excision, cyst shunting, and craniotomy for fenestration of basal cistern. We reviewed the results of surgically treated middle cranial fossa arachnoid cysts. Methods : We performed a retrospective study in 18 cases of middle cranial fossa arachnoid cysts who had been treated with microsurgical fenestration between 1995 to 2003. The analysis was based on the results of the patients' age, sex distribution, developed area, clinical symptoms, treatment method, and complications. Results : Eighteen surgical treated middle cranial fossa arachnoid cysts patients were evaluated. The age range of cyst development was between 2 years and 44 years with the average of 16.4 years. The follow-up periods averaged 31.48 months. There were 15 male and 3 female patients, with significantly more cyst development in males than females. The most common clinical symptom was headache, followed by seizure. In the entire series, 77.8% of patients demonstrated a decrease in cyst size In serial imaging studies. Of them, 67.3% demonstrated a complete cyst effacement. Overall, 100% of patients with Grade I cysts, 81.8% of patients with Grade II cysts, 60% of patients with Grade III cysts exhibited evidence of decrease in cyst size during long-term monitoring. Complications included headache, meningitis, and hydrocephalus. Conclusion : Patients who were treated with microsurgical fenestration showed good outcome with acceptable complications. We concluded that microsurgical fenestration is a safe and effective surgical method for middle cranial fossa arachnoid cysts.

Outcomes of Surgical Management of Xanthelasma Palpebrarum

  • Lee, Hoon Young;Jin, Ung Sik;Minn, Kyung Won;Park, Young-Oh
    • Archives of Plastic Surgery
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    • 제40권4호
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    • pp.380-386
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    • 2013
  • Background Xanthelasma palpebrarum (XP) is a benign disorder manifesting as yellowish cholesterol-laden plaques on the eyelids. This paper presents the outcomes in patients with XP who have undergone surgical excision as the main modality of treatment. Methods A retrospective review of patients who received surgery for xanthelasma palpebrarum from March 2007 to March 2011 was conducted. Patients were classified into four grades according to the location and extent of the lesion, with grade I being the mildest and grade IV being the most diffuse. Simple excision was performed in grade I and II lesions, while local flaps and skin grafts were performed in the more advanced grades. Results Ninety-five cases from March 2007 to March 2011 were included in this study. 66 cases (70%), were treated by simple excision. Twenty-four cases (25%) and 5 cases (5%) were treated by simple excision in combination with or without local flaps and skin grafts. In approximately 1/4 of the patients, orbicularis oris muscle involvement was observed. 4 patients (4.2%) developed scar contracture postoperatively, which required a secondary procedure. Recurrence was reported in 3 patients (3.1%). Otherwise. There were no other reports of major complications or disfigurement. Conclusions We found that for lesions involving the deep dermis and/or muscle, surgical excision was the most appropriate therapeutic option.

환경교육 전.후 학생들의 환경문제에 대한 태도와 인식변화에 관한 연구(II) (A Study on The Change of University Student's Consciousness and Behavior for Environmental Problems Before and After Environmental Education(II))

  • 박기학;이덕난
    • 환경위생공학
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    • 제22권4호
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    • pp.105-117
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    • 2007
  • The research was conducted based on the 1012 cases questionnaire for the purpose of to evaluate the change effect of university student's consciousness and behavior before and after lecture on environmental problems. And this questionnaires were performed with self-administered by the university student who made a application for liberal arts related to environmental subjects. The results were as follows. According to the analysis results the most students responded that the most serious problem of environmental pollution before the lecture on environmental education was a genetic modified organism(3.64/4.00), but the most serious problem of environmental pollution was changed to the topic of water pollution(3.96/4.00) after the lecture on environmental problem. And also according to the analysis results dributed by gender were that boy students show a higher concerning(170%) than that of girl students(150%). The most good results obtained after lecture on environmental problem were water pollution(23.0%), air pollution(11.5%), waste material pollution(10.9%), food additives (10.0%), genetic modified organism(8.0%), endocrine disrupter(7.5%), respectively. And according to the analysis results distributed by a grade were that the concerning of a low grade(freshman, sophomore)were higher than that of a high grade(junior, senior) in the topic of water pollution, air pollution, waste material pollution. But there were high level of awareness on the topic of food additives, genetic modified organism, endocrine disrupter to the all students(freshman to senior). And according to the analysis results distributed by a major field of study were that students who major in art & athletics, liberal art and etc(public health) were show a deep concerning than that of science & engineering. Finally, the environmental education during the university class were effectively contribute to increase the awareness of the seriousness of environmental pollution problem(8.2%) and also contribute to the practical life after class also increase their consciousness of environmental problem(59.8%).