• Title/Summary/Keyword: WHO grade II

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The Effect of the Extents of Pleural Thickening in Tuberculous Pleurisy on the Impairment of Pulmonary Function (흉막비후의 정도가 폐기능에 미치는 영향)

  • Lee, Young-Kyoung;Na, Moon-Jun;Yun, Bo-Ra;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.240-247
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    • 2001
  • Background : Tuberculous pleurisy treatments improve symptoms such as fever, chest pain, cough, and prevents the progression to active pulmonary tuberculosis and the development of residual pleural thickening that decrease diaphragm and rib cage movement This study investigated how the degree of residual pleural thickening affects the pulmonary function. Methods : Fifty seven patients who were initially diagnosed as having tuberculous pleurisy, were treated with anti-tuberculous medication for 6 months and had residual pleural thickening between May 1998 and January 2000 at the Eulji university hospital were reviewed. A chest X-ray and pulmonary function test(PFT, Sensormedics 2200) were performed. The predicted value(%) of the forced vital capacity(FVC), forced inspiratory vital capacity(FNC) and total lung capacity(TLC) were measured. The residual pleural thickening was defined the average of the summation in the lateral chest at the level of the imaginary line intersecting from the cardiophrenic angle to the diaphragmatic dome and the lowest part of the costophrenic angle between them. The results were sorted into three grades according to pleural thickness ; <2mm(grade I), 2~10mm(grade II), 10mm(grade III). Results : 1. FVC(% pred) and FIVC(% pred) were statistically different between grade I and III, and II and III. However, there was no difference between the TLC(% pred) between each of the groups. 2. The pleural thickness that cause restrictive dysfunction(FVC<80%) and a statistically difference, is 3mm. Conclusion : The larger the extent of the residual pleural thickness after antituberculous medication, the greater the reduction in the FVC, FIVC, TLC. A pleural thickness of 3mm is recommended as a guideline for diagnosing a restrictive pulmonary dysfunction.

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Low Grade Astrocytoma-Need Postoperative Radiotherapy or Not? (저분화 성상세포종-수술후 방사선치료가 필수적인가 ?)

  • Hong Seong Eon;Choi Doo Ho;Kim Tee Sung;Leem Won
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.171-180
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    • 1992
  • The precise role of radiotherapy for low grade gliomas including the optimal radiation dose and timing of treatment remains unclear. The information given by a retrosepctive analysis may be useful in the design of prospective randomized studies looking at radiation dose and time of surgical and radiotherapeutic treatment. The records of 56 patients (M:F = 29:27) with histologically verified cerebral low grade gliomas (47 cases of grade 1 or 2 astrocytomas and 9 oligodendrogliomas) diagnosed between 1979 and 1989 were retrospectively reviewed. The extent of surgical tumor removal was gross total or radical subtotal in 38 patients ($68\%$) and partial or biopsy only in the remaining 18 patients ($32\%$). Postooperative radiation therapy was given to 36 patients ($64\%$) of the total 56 patients with minimum dose of 5000 cGy (range=1250 to 7220 cGy). The 5-and 10-year survival rates for the total 56 patients were $44\%$ and $32\%$ respectively with a median survival of 4.1 years. According to the histologic grade the 5- and 10-year survivals were $52\%$ and $35\%$ for the 24 patients respectively with grade I astrocytomas compared to $20\%$ and $10\%$ for the 23 patients with grade II astrocytomas. Survival of oligodendroglioma patients was greater than those with astrocytoma ($65\%$ vs $36\%$ at 5 years), and the difference was also remarkable in the long term period of follow up ($54\%$ vs $23\%$ at 10 years). Those who received high-dose radiation therapy ($\geq$5400 cGy) had significant better survival than those who received low-dose radiation (< 5400cGy) or surgery alone (p<0.05). The 5- and 10-year survival rates were, respectively $59\%$ and $46\%$ for the 23 patients receiving high-dose radiation, $36\%$ and $24\%$ for the 13 patients receiving low-dose radiation, and $35\%$ and $26\%$ for the 20 patients with surgery alone. Survival rates by the extent of surgical resection were similar at 5 years ($46\%$ vs $41\%$), but long term survival was quite different (p<0.01) between total/subtotal resection and partial resection/biopsy ($41\%$ and $12\%$, resepctively). Previously published studies have identified important prognostic factors in these tumor: age, extent of surgery, grade, performance status, and duration of symptoms. But in our cases statistical analysis revealed that grade I histology (p<0.025) and young age (p<0.001) were the most significant good prognostic variables.

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A Clinical Study on Factors affecting Spontaneous Resolution of Vesicoureteral ,Reflux in Children (방광요관역류의 완해에 영향을 미치는 인자에 관한 연구)

  • Song, Byung-Ho;Oh, Chang-Weon;Kim, Ki-Bok
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.152-160
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    • 1998
  • Purpose : Vesicoureteral reflux (VUR), which can result in renal failure in children, is expected to resolve spontaneously in mild cases, but severe cases require surgical correction, posing dilemma in deciding the right measures in some cases. Therefore, to delineate the factors affecting spontaneous resolution of VUR and to apply them in assessing the prognosis, we reviewed the patients with VUR who had been treated medically. Patients and Methods : 32 children (49 renal units) with reflux who had been admitted during the 5-year period from Jan '92 to Dec '96 were classified into 4 groups (Resolved, Improved, Unchanged, and Worsened) and analyzed. Results : 1) 25 were boys and 7 girls. The age at diagnosis ranged from 13 days to 9 years (mean $24.6{\pm}11.4$ mo) 2) Among 49 refluxing ureters, 4 were below 1 me of age,21 between 1 me to 1 yr, 16 between 1 yr to 6 yr, 8 beyond 6 yr. Two belonged to Grade I, 16 to Crade II, 17 to Grade III, 12 to Grade IV, and 2 to Grade V. 3) Spontaneous resolution rates of reflux were 100, 81, 47, 8, 0$\%$ for each Grade, respectively. Resolution plus improvement rates in Grade III and IV were 71 and $50\%$, each. 4) Resolution rates in relation to the age at diagnosis were $100\%$ for below 1 mo, $48\%$ between 1 mo to 1 yr, $56\%$ between 1 to 6 yr, and $13\%$ beyond 6 yr. 5) Of 15 unilateral refluxing ureters, 14 ($93\%$) resulted in resolution. Of 34 bilateral refluxing ureters, 11 ($32\%$) resolved spontaneously 6) Resolution occurred within 1 year in 20 units of 24 renal units in regular follow-up. Conclusion: The lower the initial grade and the younger the patient, the sooner the reflux resolved. Resolution was better when VUR was unilateral than bilateral. Long-term regular follow-up is essential because even the cases falling in Grades III and IV have high rates of spontaneous resolution and improvement with medical treatment.

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Pediatric blunt pancreatic trauma at a single center in Korea: a retrospective review from 2007 to 2022

  • Joong Kee Youn;Hee-Beom Yang;Dayoung Ko;Hyun-Young Kim
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.242-248
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    • 2023
  • Purpose: Blunt pancreatic trauma in pediatric patients is relatively rare, yet it is associated with high risks of morbidity and mortality This study aimed to review pediatric patients with blunt pancreatic trauma treated at a single center and provide treatment guidelines. Methods: This study included patients under the age of 18 years who visited our center's pediatric emergency department and were diagnosed with pancreatic injury due to abdominal trauma via radiological examination between January 2007 and December 2022. Patients' medical records were retrospectively reviewed and analyzed. Results: Among 107 patients with abdominal trauma, 14 had pancreatic injury, with a median age of 8.2 years (interquartile range, 3.1-12.3 years). Eight patients were male and six were female. The most common mechanism of injury was falls from a height and bicycle handlebars (four cases each). Six patients had associated injuries. Two patients had American Association for the Surgery of Trauma grade I or II, eight had grade III, and four had grade IV or V injuries. Eight patients underwent surgical resection, and four were discharged with only an intervention for duct injuries. Conclusions: Patients with blunt pancreatic trauma at our center have been successfully treated with surgical modalities, and more recently through nonsurgical approaches involving active endoscopic and radiologic interventions.

Relation between Ki-67, ER, PR, Her2/neu, p21, EGFR, and TOP II-α Expression in Invasive Ductal Breast Cancer Patients and Correlations with Prognosis

  • Yan, Jian;Liu, Xiao-Long;Han, Lu-Zhe;Xiao, Gang;Li, Ning-Lei;Deng, Yi-Nan;Yin, Liang-Chun;Ling, Li-Juan;Yu, Xiao-Yuan;Tan, Can-Liang;Huang, Xiao-Ping;Liu, Li-Xin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.823-829
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    • 2015
  • The aim of the present study was to investigate the expression of the transcription factor Ki-67, ER, PR, Her2/neu, p21, EGFR, and TOP II-${\alpha}$ in the tumor tissue of patients with invasive ductal carcinoma(IDC); in addition, we examined correlations between these markers. Two hundred and sixteen IDC patients, who were not previously been treated with chemo- or radiotherapy, were included in the study. All tumors were grade I-III. Expression of molecular markers was determined by immunohistochemical analysis on paraffin-embedded tissue sections. Follow-up data were collected for 3 months to 10 years and analyzed for tumor recurrence, survival time, and prognostic risk factors. We determined Ki-67 expression correlates with the expression of ER, PR, HER-2, EGFR, and TOP-${\alpha}$, as well as lymph node involvement, high tumor grade, lymphovascular invasion, high tumor stage, and high TNM stage in IDC. Positive Ki-67 expression was a risk factor for rapid tumor recurrence and may help tumor progression, leading to poor prognosis in IDC. Ki-67 was directly correlated with EGFR, TOP II-${\alpha}$, lymph node involvement, high tumor grade, lymphovascular invasion, high tumor stage, and high TNM stage in the hormone receptor subtypes of breast cancer. In triple negative breast cancer, Ki-67 correlated with TOP II-${\alpha}$. Expression of Ki-67 correlated with that of ER, PR, HER-2, EGFR, TOP II-${\alpha}$, and p21. In addition, the biomarker Ki-67 has a role as a prognostic factor and indicates a poor prognosis in IDC.

First-Pass Recanalization with EmboTrap II in Acute Ischemic Stroke (FREE-AIS): A Multicenter Prospective Study

  • Jang-Hyun Baek;Byung Moon Kim;Sang Hyun Suh;Hong-Jun Jeon;Eun Hyun Ihm;Hyungjong Park;Chang-Hyun Kim;Sang-Hoon Cha;Chi-Hoon Choi;Kyung Sik Yi;Jun-Hwee Kim;Sangil Suh;Byungjun Kim;Yoonkyung Chang;So Yeon Kim;Jae Sang Oh;Ji Hoe Heo;Dong Joon Kim;Hyo Suk Nam;Young Dae Kim
    • Korean Journal of Radiology
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    • v.24 no.2
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    • pp.145-154
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    • 2023
  • Objective: We aimed to evaluate the efficacy of EmboTrap II in terms of first-pass recanalization and to determine whether it could yield favorable outcomes. Materials and Methods: In this multicenter, prospective study, we consecutively enrolled patients who underwent mechanical thrombectomy using EmboTrap II as a front-line device. The primary outcome was the first pass effect (FPE) rate defined by modified Thrombolysis In Cerebral Infarction (mTICI) grade 2c or 3 by the first pass of EmboTrap II. In addition, modified FPE (mFPE; mTICI grade 2b-3 by the first pass of EmboTrap II), successful recanalization (final mTICI grade 2b-3), and clinical outcomes were assessed. We also analyzed the effect of FPE on a modified Rankin Scale (mRS) score of 0-2 at 3 months. Results: Two hundred-ten patients (mean age ± standard deviation, 73.3 ± 11.4 years; male, 55.7%) were included. Ninety-nine patients (47.1%) had FPE, and mFPE was achieved in 150 (71.4%) patients. Successful recanalization was achieved in 191 (91.0%) patients. Among them, 164 (85.9%) patients underwent successful recanalization by exclusively using EmboTrap II. The time from groin puncture to FPE was 25.0 minutes (interquartile range, 17.0-35.0 minutes). Procedure-related complications were observed in seven (3.3%) patients. Symptomatic intracranial hemorrhage developed in 14 (6.7%) patients. One hundred twenty-three (58.9% of 209 completely followed) patients had an mRS score of 0-2. Sixteen (7.7% of 209) patients died during the follow-up period. Patients who had successful recanalization with FPE were four times more likely to have an mRS score of 0-2 than those who had successful recanalization without FPE (adjusted odds ratio, 4.13; 95% confidence interval, 1.59-10.8; p = 0.004). Conclusion: Mechanical thrombectomy using the front-line EmboTrap II is effective and safe. In particular, FPE rates were high. Achieving FPE was important for an mRS score of 0-2, even in patients with successful recanalization.

Management Outcomes of Basilar Bifurcation Aneurysms (기저동맥 분지부 동맥류의 치료결과)

  • Ahn, Jae Sung;Kim, Jung Hoon;Kwon, Yang;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.918-922
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    • 2000
  • Objective : The authors analyzed the results of management outcomes for basilar bifurcation aneurysms treated with transcranial surgery and endovascular surgery. Methods : At the authors' institution between May 1989 and December 1998, 47 aneurysms with 45 patients were treated with transcranial surgery including surgical clipping/wrapping and endovascular surgery for basilar bifurcation aneurysms. The medical records and neuroimaging studies of the patients were reviewed retrospectively. Results : Of the 45 patients, 87 percent of the aneurysms were ruptured and 13% unruptured. Forty six percent of the patients had multiple aneurysms including basilar bifurcation aneurysm. Of the 39 patients with subarachnoid hemorrahge, 77% were in good neurological status(Hunt Hess grade I-III), 23% were in poor grade(H-H grade IV-V). Thirty two patients were treated with transcranial surgery and 15 patients were treated with endovascular surgery. Two patients who had treated with wrapping surgery later bled during follow-up period and treated with endovascular surgery. The management outcome of the transcranial surgery was : Glasgow outcome scale(GOS) I 66%, GOS II 12.5%, GOS III 6.3%, GOS IV 6.3% and GOS V(death) 9.4%. The major causes of morbidity related to transcranial surgery were perforator occlusion, vasospasm and retraction injury. The management outcome of the endovascular surgery was : GOS I 66.7%, GOS II 6.7%, and GOS V 26.7%. The major causes of mortality related to endovascular surgery were related to intraoperative aneurysmal bleeding. Conclusion : This report documents that more than 75% of patients undergoing treatment either transcranial or endovascular surgery can expect good clinical outcomes. Treatment modality in management of basilar bifurcation aneurysm must be carefully selected based on various considering factors.

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An Analysis and Survey on the Status of the Korean Middle School Science Curriculum(II): Students' Cognitive Level and their Achievement (중학교 과학과 교육과정 및 그 운영진단 (II) -지적 발달수준과 학업성취도-)

  • Kwon, Jae-Sool;Choi, Byung-Soon;Hur, Myung
    • Journal of The Korean Association For Science Education
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    • v.7 no.2
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    • pp.1-14
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    • 1987
  • To examine the effect of students' Cognitive level upon their achievement on Science. the students' cognitive levels were tested by using GALT(Group Assessment of Logical Thinking) and examined the Correlation between the cognitive level and achievement According to the results, most students were still in the conerete level. Only 60% of 9th grade students could handle the logic of displacement volume. In case of proportional logic and logic of probability, only 40% of 9th graders could handle them. Only 10% of the students could understand Correlational logic. Cognitive level and students achievement were estimated to be in a very closely related. Students who were in a high cognitive level showed better achievement scores on knowledge, comprehensive, inquiry, and application items than those who were in low cognitive level. Therefore, this study suggests that the content of the current middle school science should be revised in away to match the students' cognitive level.

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A Comparative Study of the Logical Thinking Skills and Integrated Process Skills of Junior High School Students in Korea and Japan (중학생의 논리적 사고력과 통합적 과학탐구 능력에 관한 한.일 비교연구)

  • Soh, Won-Joo;Woo, Jong-Ok
    • Journal of The Korean Association For Science Education
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    • v.14 no.3
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    • pp.312-320
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    • 1994
  • The purpose of this study is to analyze the relationship of logical thinking skills and integrated process skills, and to investigate the differences in general tendency of subskills by grade level and gender between Korean middle school students and Japanese one. The performance level of skills was measured using GALT and TIPS II. The results are compared with those of Japan (Mattheis et al., 1992). Summary of the results are as follow. 1. Percentages of formal and transitional stage of males are more than females in developmental level. It has been found out that the males attained significantly higher scores of logical thinking skills than the females in middle school stage. The significant differences in scores by gender show a good correlation with those for Japanese middle school students. Developmental level of Korean middle school students shows a remarkable improvement as they move up from 8th grade to 9 one. The significant differences in developmental level by grade also show a good correlation with those for Japanese middle school students. Total scores of GALT for Japanese middle school students are higher than Korean one, but it has been found nearly same scores for 9th grade in both countries. Scores of subskills of logical thinking skills, except correlational reasoning, for Korean students show lower than those for Japanese students. It could be noted that the combinatorial reasoning is considered to be easiest and the correlational reasoning to be most difficult in both countries. 2. It also has been found out similar pattern for integrated process skills in both countries because the males and females did not examplify significant differences, although males gain somewhat higher scores than females in Korea. Scores of subskills of integrated process skills for Japanese middle school students show higher them Korean one. It could be noted that the identifying variables is considered to be easiest and stating hypothesis to be most difficult in both countries. 3. There was a significant relationship (r= .65) between logical thinking skills and integrated process skills, and there were statistically significant differences of the integrated process skills for developmental level. In integrated process skills, the students who belong to the higher grade levels acquired better score than who belong to the lower grade level. It has been also found remarkable improvement between 8th and 9th grade, and there are significant differences for grade level in both countries.

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Estimation of Number of Dentists Required for the Systematic School Dental Programmes (학교구강보건계속관리사업을 위한 치과의료인력 수요 추계)

  • Kwon, Ho-Kwun
    • Journal of Preventive Medicine and Public Health
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    • v.15 no.1
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    • pp.115-123
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    • 1982
  • The systematic school dental health programmes have been recognized as one of the most effective national dental health measures. This study was conducted to estimate the number of dentists required for the systematic school dental programmes in Korea applying the methodology recommended by WHO. Information necessary for the study was obtained by a mass oral examination to the 1241 primary and middle school students in Kang Wha area. First and 6th grade students from primary school and 3rd year students from middle school were specifically selected for the examination. The results are summarized below: 1) For the Type I program recommended by WHO, 1.8 dentists per 10,000 primary school children were estimated to be necessary. For the Type II program 2.5 dentists, Type III program 2.0 dentists, Type IV program 3.6 dentists per 10,000 primary school children were estimated to be necessary. In order to extend the systematic school dental programmes to the middle students, 2.0 dentists for the Type I program and 2.4 dentists for the Type II program 2.2 dentists for the Type III program, 3.6 dentists for the Type IV program per 10,000 students were estimated to be necessary. 2) If we assume that prophylaxis are done by hygienist, for the Type I program 1.3 dentists and 0.5 hygienist, for the Type II program 1.8 dentists and 0.7 hygienist, for the Type III program 1.3 dentists and 0.7 hygienist, for the Type III program 2.2 dentists and 1.4 hygienists per 10,000 primary school students were estimated to be necessary. In order to extend this program to the middle school, 1.4 dentists and 0.6 hygienist for the Type I program, 1.6 dentists and 0.8 hygienist for the Type II program, 1.4 dentists and 0.8 hygienist for the Type III program, 2.2 dentists and 1.4 hygienist for the Type IV program per 10.000 students were estimated to be necessary.

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