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Quality of Life after Esophageal Surgery for Esophageal Surgery (식도암 환자의 수술 후 삶의 질에 관한 연구)

  • Kim Chong-Wook;Moon Hye-Won;Kim Yong-Hee;Park Seung-Il
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.310-316
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    • 2006
  • Background: We study the QOL (quality of life) & functional improvement in patients underwent esophageal surgery for cancer by the viewpoint of the patient and would like make the guideline of recovery course. Material and Method: Between Dec. 1996$\sim$Aug. 2002, 250 patients were operated and 57 patients was enable interview, didn't have evidence of recurrence & survived more than 1 year postoperatively at Asan Medical Center. Questionnaire made by direct or telephone interview & include diet habitus, change of body weight, G-E (gastroesophageal) reflux, dumping symptom, change of daily life. Result: There were 53 men (93%), 4 women (7%) with mean age of $62.05{\pm}8.7$ (range: $37{\sim}94$). Operation method was Ivor Lewis operation in 43 case (75.4%), Esophagocolojejunostomy 4 case (7.1%), Mckeown operation 10 case (17.5%). In Diet habitus, 55 patients (96.5%) ate more than three times in a day with mean diet frequency was 3.5 times/day, 51 patients (89.5%) have been ate solid, regular diet, 5 patients (8.8%) enable to eat liquid diet. To compare with preoperative state, 32 patients (56.9%) had a diet speed more than 80%, 28 patients (39.1%) had a diet amount more than 80%. 32 patients (56.9%) had a little change of body weight within a 10%, 25 patients (43%) had a improvement rather than preoperative state. In G-E reflux, 4 patients (7%) had a reflux after every diet, 27 patients (47.4%) had a little reflux after diet. In dumping symptom. 7 patients (12.3%) had a diarrhea after meal. 38 patients (66.6%) had a normal activity 19 patients (33.3%) had a decreased activity. At present state, majority (53 patient-93%) of patient were satisfactory to the operation result, in spite of discomfort from time to time. In the emotional status, 50 patients (88%) had a well sleeping without disturbance. 65% of patients were comfortable in the psychology state. 39% of patients had a libido. Compare with their median age (63 y), it's a normal varient. Conclusion: QOL in patients underwent esophageal surgery for esophageal cancer nearly recovery to preoperative state.

Radiation Therapy for Pituitary Adenoma -Changes in Endocrine Function after Treatment- (뇌하수체선종의 방사선치료후 혈중 호르몬치의 변화)

  • Yoon Sei Chul;Jang Hong Suck;Kim Song Hwan;Shinn Kyung Sub;Bahk Yong Whee;Son Ho Young;Kang Joon Ki
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.185-195
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    • 1991
  • Seventy four patients with pituitary adenoma received radiation therapy (RT) on the pituitary area using 6 MV linear accelerator during the past 7 years at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic University Medical College. Thirty nine were men and 35 were women. The age ranged from 7 to 65 years with the mean being 37 years. Sixty five ($88\%$) patients were treated postoperatively and 9 ($12\%$) primary RT, To evaluate the effects of RT, we analyzed the series of endocrinologic studies with prolactin (PRL), growth hormone (GH), adrenocorticotrophic hormone (ACTH), leuteinizing hormone (LH), follicular stimulating hormone (FSH) and thyroid stimulating hormone (TSH) etc after RT. All but one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with invasive tumor mass around supra- and/or parasella area. The patients were classified as 23 ($29\%$) prolactinomas and 20 ($26\%$) growth hormone (GH) secreting tumors, and 6 ($8\%$ ACTH secreting ones consisting of 4 Cushing's disease and 2 Nelson's syndrome. Twentynine ($37\%$) had nonfunctioning tumor and four ($5\%$) of those secreting pituitary tumors were mixed PRL-GH secreting tumors. The hormonal level in 15 ($65\%$) of 23 PRL and 3 ($15\%$) of 20 GH secreting tumors returned to normal by 2 to 3 years after RT, but five PRL and five GH secreting tumors showed high hormonal level requiring bromocriptine medication. Endocrinologic insufficiency developed by 3 years after RT in 5 of 7 panhypopituitarisms, 4 of seven hypothyroidisms and one of two hypogonadisms, respectively. Fifteen ($20\%$) patients were lost to follow up after RT.

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The Role of Radiotherapy in the Treatment of Extrahepatic Bile Duct Carcinoma (간외담도종양에서 방사선치료의 역할)

  • Shin Hyun Soo;Kim Gwi Eon;Lee Hyung Sik;Suh Chang Ok;Loh John JK;Lee Jong Tae
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.253-263
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    • 1991
  • Twenty-seven patients with unresectable extrahepatic bile duct carcinoma (n=21) or with microscopic evidence of tumor rest after aggressive surgery for extrahepatic bile duct carcinoma (n=6) between 1985 and 1990 were given radiotherapy consisting intentionally external radiotherapy and/or intraluminal therapy using Gamma-Med 12i (192-Ir) high dose rate (HDR) remote control afterloading system following bile drainage procedures and Gianturco stent insertion. The objectives of this study has been to assess the feasibility and effects on survival of a combination of external radiotherapy and brachytherapy with which we hope to achieve optimal loco-regional control for patients with unresectable extrahepatic bile duct tumors. Sixteen patients were men and eleven were women, and the mean age was 58 years (34-70). 10MV X-ray was used for radiation therapy, with the total dose ranging from 45 Gy to 55 Gy, and intraluminal brachytherapy performed after external radiotherapy, with the dose of total 15 Gy. The minimum follow up was 12 months. Failure were predominantly local-regional, without distant failure. Median survival was 10 months; 2-year actuarial survival rates was $21\%$. Median survival for common hepatic duct (CHD) cancer was 9 months; for common bile duct (CBD) cancer, was 16 months. And median survival for incomplete surgery/external radiotherapy group and external/intraluminal radiotherapy group was 10 months; for external radiotherapy alone group, was 6 months. Use of chemotherapy and/or hyperthermia were not affected in survival. Therefore, our result is that the survival rates in the group of external/intraluminal radiotherapy were comparable with ones in the group of incomplete resection/external radiotherapy, and so we believe that the aggressive local and regional radiotherapy can improve the quality of life and the survival length.

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The Efficiency of Radiation Therapy in the Treatment of Intracranial Oligodendrogliomas : Factors Influencing the Prognosis (뇌내 희돌기교종의 방사선치료 성적 및 예후인자)

  • Yoon Sei Chul;Kay Chul Seung;Chung Su Mi;Ryu Mi Ryung;Kim Yeon Shil;Hong Yong Kil;Kim Moon Chan;Kang Joon Ki
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.193-198
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    • 2002
  • Purpose : Oligodendrogliomas (ODG) are a rare, slow growing, tumor in the brain, which can be cured by complete surgical resection, but as yet it is not known if postoperative adjuvant radiation therapy (RT) is essential, We analyzed the treatment results of patients with irradiated ODG to investigate the efficacy of RT in terms of survival rates and other influencing prognostic factors. Methods and Materials : Between March 1983 and December 1997, 42 patients with ODG were treated with RT at our hospital. The RT was peformed dally at a dose of $1.8\~2.0\;Gy$, at 5 fractions per week, to a total dose of between 39.6 Gy and 64.8 Gy (mean 53.3 Gy). The ages of the patients ranged between 5 and 62 years, with a median age of 39 years. The mean follow-up period was 63.4 months (8-152 months). The Kaplan-Meier method was used to assess the survival, and 5 year survival rates (5-YSR). Log rank tests and Cox regression analyses were used to define the significance of prognostic factors. Results : The majority of ODG in this study were located in the cerebral hemisphere $(83.3\%)$. ODG are slightly more common in men than women, and commonly occurs in middle age, between the 3rd and 4th decades. It has been recommended that RT is commenced within 4 weeks following surgery (5-YSR; $86\%\;vs.\;49\%;\;p<0.03$). Histologically well differentiated, as opposed to poorly differentiated, tumors were found to have a more favorable prognosis (p<0.02). The actuarial 5-YSR was $65.3\%$ (median survival 90 months). 5-YSR for the various extents of surgical excision, followed by external RT, was superior to that of biopsy only followed by external RT $(69.9\%\;vs.\;25.6\%,\;p<0.01)$. Tumor size and location, overall elapsed irradiation days, age, sex, whole brain irradiation as a course of treatment and chemotherapy, had no influence on the 5-YSR (p>0.05). Conclusion : A local involved field irradiation with conventional fractionation, commencing within 4 weeks following surgical excision of the tumor, was beneficial for the 5-YSR, but a total radiation dose exceeding 60 Gy did not improve the 5-YSR.

Studies on the Woody Vegetation in the Edge of Natural River for Ecological Restoration in Korea (하천의 생태적 복원을 위한 자연하천변의 목본성 식물군락에 대한 연구)

  • Bang, Je-Yong;Hu, Un-Bok;Kim, Hyea-Ju;You, Young-Han
    • Journal of Wetlands Research
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    • v.17 no.2
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    • pp.124-129
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    • 2015
  • In order to get as ecological basic data for river restoration, vegetation investigation was conducted in natural river and analysed it synecological methods, such as ordination cluster. 29 plant communities units were identified and the major dominant plant communites were Quercus mongolica community, Pinus densiflora community, Populus davidiana community, Q. variabilis community and Prunus sargentii community. River vegetations were classified into ravine and gorge forest type and riverine softwood forest type. Ravine and gorge forest was dominanted by hardwood which located in steep slope and in high elevation, and riverine softwood forest by softwood, salix spp. Naturality was an important criterion for the selection of rivers, so many of the selected rivers are located in the upper stream and mid stream rather than the lower stream, where more human intervention is involved. Plant communities were consisted of hardwood forest(44 plots, 92%) and softwood forest(4 plot, 8%), respectively. PCA with total layer data showed 5 groups of communities: Q. mongolica community group, Prunus sargentii community group, Pinus densiflora community group, Prunus sargentii community - Pinus densiflora community group and the rest communities group. PCA with tree layer showed 3 groups: Q. mongolica community group, Prunus sargentii community group, and the rest community group. Cluster analysis also a showed a similar communities group to PCA ordination, but Magnolia sieboldii community and Prunus sargentii community were distinguished from the PCA result. From the result, it can be concluded that the plant communities of riparian be divided into hardwood and softwood forest by statistical techniques. It was appropriate to plant species such as Quercus mongolica, Pinus densiflora, Populus davidiana, Quercus variabilis and Prunus sargentii, at levee zone and high water level. And Sliax spp. were appropriate for planted plants at waterfront and low water level. The herb species to be planted on the floodplain were recommanded in the species composition co-occurred with the woody species.

The Effect of the Optical Points Difference between Finished-Reading Glasses and Dispensing Reading Glasses (완성품 돋보기와 조제가공된 돋보기가 광학적 요소에 미치는 영향)

  • Shim, Young-Cheol;Yoo, Gun-Chang;Kim, In-Suk
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.3
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    • pp.65-71
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    • 2008
  • Purpose: This paper studied the effect of eyes on the comparison between the distance optical centers problem of dispensing reading glasses made by optician and finished reading glasses in the current market. Methods: The method of this study has been measured by eleven different categories from +1.00D to +4.00D. This study also separated into three groups by their optical frame size and measured optical center point (O.C) and optical center height (O.H) with 200 peoples of man and females over 40 years old without ocular disease living in Gwang-san gu, Gwang-Ju city. Results: As a result, optical center point ranged from 57 mm to 80 mm and it turned to be most common range is from 61 mm to 65 mm (64.6%). Moreover, the optical center height ranged from 1 mm to 8mm and most common ranged (23%) were 4 mm. In other words, finished reading glasses have irregular optical ranges. After observing 200 people who are over 40 years old men and women, result shows that more than 75.5% (151 people) currently use finished reading glasses. Survey of 151 people, most common error between the finished reading glasses's O.C and the wearers P.D were 4 mm (45%). Furthermore, the most common error between the finished reading glassses's O.H and the wearers O.H ranged from 3 mm to 4 mm. Astonishingly, the entire 151 people who wear finished reading glasses appeal that they feel tiredness on their eyes when they wear finished reading glasses. 53 people (35%) claimed that they feel tiredness on their eyes after 10 to 20 minutes wearing finished reading glasses. Base on the research, We conducted more experiment to find the value of prism of optical centers err because it will tell us whether the finished reading glasses are good enough to wear or not. We multiplied diopter by the difference between finished reading glasses's O.C. and wearer's P.D. Consequently, We found out that the finished reading glasses counter to the German RAL-RG 915 policy. And We also found that it is relative to the diopter of lenses. In conclusion, based on the researched that wearing finished reading glasses have a dangerous factor for our vision. Therefore optician must need to recommend correctly made dispensing reading glasses based on the optical center point.

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Characteristics and Clinical Course of Ovarian Hernias in Infants (1세 미만 여아 난소 탈장의 특성과 임상 경과)

  • Choi, Kyoung-Eun;An, So-Yoon;Kim, Kyung-Ah;Ko, Sun-Young;Lee, Yeon-Kyung;Shin, Son-Moon;Han, Byung-Hee
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.80-83
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    • 2008
  • Purpose : Inguinal hernias are common in children and sometimes are associated with dangerous complications, such as incarceration. There are no established management guidelines for ovarian hernias. We have reviewed the clinical course of ovarian hernias in infants. Methods : We reviewed the medical records of female infants diagnosed with ovarian hernias by ultrasonogram at Kwandong University College of Medicine, Cheil General Hospital, and the Women's Healthcare Center between March 2001 and August 2007. We analyzed the patients gestational age, birth weight, age at the time of detection of the inguinal mass, the patients chief complaints, operative time, post-operative complications, and ultrasonographic findings. Results : Eight female infants had ovarian hernias, four of whom were born prematurely. Seven infants had left-sided ovarian hernias, and one infant had a right-sided ovarian hernia. Five infants underwent surgery and there were no postoperative complications or recurrences. Three girls did not have surgery, and the ovarian hernias regressed spontaneously, with no recurrences or complications. The regression time of inguinal masses ranged from 70-161 days after birth. Conclusion : Physical examination to detect movable masses within the labium major in premature female infants is important because the incidence of premature inguinal hernias is much higher than in term infants. No rational medical treatment plans for female ovarian hernias have been published to date. We cared for three girls with spontaneous regression of ovarian hernias. Pediatricians should be aware whether emergent surgery for ovarian hernias is indicated.

Convenient Nucleic Acid Detection for Tomato spotted wilt virus: Virion Captured/RT-PCR (VC/RT-PCR) (Tomato spotted wilt virus를 위한 간편한 식물바이러스 핵산진단법: Virion Captured/RT-PCR (VC/RT-PCR))

  • Cho Jeom-Deog;Kim Jeong-Soo;Kim Hyun-Ran;Chung Bong-Nam;Ryu Ki-Hyun
    • Research in Plant Disease
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    • v.12 no.2
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    • pp.139-143
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    • 2006
  • Virion captured reverse transcription polymerase chain reaction (VC/RT-PCR) could detect plant virus quickly and accurately. In the VC/RT-PCR, no antibody is needed unlike immuno-captured RT-PCR (IC/RT-PCR) which had been improved method of RT-PCR for plant viruses, and virus nucleic acids can be obtained easily within 30minutes by property of polypropylene PCR tube which is hold and immobilized viral particles on its surface. For the virion capture of Tomato spotted wilt virus (TSWV), the extraction buffer was tested. The optimum macerating buffer for TSWV was 0.01M potassium phosphate buffer, pH 7.0, containing 0.5% sodium sulfite. The viral crude sap was incubated for 30 min at $4^{\circ}C$. The virions in the PCR tubes were washed two times with 0.01M PBS containing 0.05% Tween-20. The washed virions were treated at $95^{\circ}C$ immediately for 1 min containing RNase free water and chilled quickly in the ice. Disclosed virions' RNAs by heat treatment were used for RT-PCR. Dilution end point of $10^{-5}$ from plant's crude sap infected with TSWV showed relatively higher detection sensitivity for VC/RT-PCR. During multiple detection using two or more primers, interference was arisen by interactions between primer-primer and plant species. The result of multiplex RT-PCR was influenced by combinations of primers and the kind of plant, and the optimum extraction buffer for the multiplex detection by VC/RT-PCR should be developed.

Inhibitory Effect on Infection of Plant Viruses by Filtrate Powder from Culture Broth of Acinetobacter sp. and Its Mode of Action (Acinetobacter sp. 배양여과액 분말제제의 식물바이러스에 대한 감염억제 효과 및 작용)

  • Kim Mi-Soon;Jung Min-Young;Kim Yun-Sung;Jang Cheol;Hwang In-Cheon;Ryu Ki-Hyun;Choi Jang-Kyung
    • Research in Plant Disease
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    • v.12 no.2
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    • pp.91-98
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    • 2006
  • A filtrate powder, designated as KNF2022, produced from culture broth of Acinetobacter sp. KTB3 was tested for their inhibitory effects on Pepper mild mottle virus (PMMoV) infection to Nicotiana glutinosa or N. tabacum cv. Xanthi nc. When 1/100 dilution with distilled water was treated to the plants and PMMoV was inoculated, the inhibition was estimated to be 94.3 and 95.6%, respectively. The same concentrations of KNF2022 inhibited infections of Pepper mottle virus (PepMoV) and Cucumber mosaic virus (CMV) on Chenopodium amaranticolor by 97.1 and 92.5%, respectively. Duration of inhibitory activity of the filtrate powder from Acinetobacter sp. culture broth against PMMoV infection on N. glutinosa was maintained for 2 days at 80% inhibition level, however, the inhibitory effect was diminished from 4 days after treatment to 50% levels. To evaluate inhibitory effects on systemic host plants of the antiviral agent, symptom developments of PMMoV, PepMoV and CMV on KNF2022-treated pepper plants were investigated. Delayed symptom developments until 10 days after inoculation (DAI) were observed for all the three viruses when the viruses were inoculated individually, and these delayed symptom development effects were maintained until 30 DAI in case of PepMoV. Moreover, PepMoV was not detected by RT-PCR and ELISA until 30 DAI. These delayed symptom development effects were diminished in all combinations of three virus co-inoculations due to synergism of three viruses on symptom developments. Inhibitory effect of KNF2022 was verified under electron microscopic examinations using purified virus preparations. Particles of PMMoV and PepMoV were observed on specimens from 5 min after KNF2022 treatment, and the particle sizes were reached in the range of 200-250 nm and 400-600 nm, respectively. Furthermore, the viral particles were destructed and particle sizes were reached in the range of 100-150 nm and 300-500 nm, respectively, on 60 min after treatments. Reduction of local lesion numbers on N. tabacum cv. Xanthi nc and C. amaranticolor were accompanied with reduction of virus particle sizes. In the case of CMV destructed particle numbers were also increased according to incubation period after KNF2022 treatment and local lesions on C. amaranticolor were reduced.

A Randomized, Double-Blind, Placebo-Controlled Trial of Early Ursodeoxycholic Acid Administration for Prevention of Total Parenteral Nutrition-Induced Hepatobiliary Complications (총정맥영양법의 간담도 합병증에 대한 Ursodeoxycholic Acid 조기투여의 이중맹검 위약대조군 연구)

  • Choe, Yon-Ho;Beck, Nam-Sun;Kim, Ji-Hee;Lee, Suk-Hyang;Park, Tae-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.174-180
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    • 2002
  • Purpose: Ursodeoxycholic acid (UDCA) is known to decrease hepatic injury by promoting the biliary secretion of retained toxic endogenous bile acids in hepatobiliary diseases complicated by total parenteral nutrition (TPN). However, most studies have focused on treatment for complications after TPN. We investigated the preventive role of early administration of UDCA in TPN-induced hepatobiliary complications by a randomized, double-blind, placebo-controlled trial. Methods: Between May 2000 and May 2002, thirteen patients, who were given TPN more than 10 days in the hospital, were assigned randomly to two groups. One was the case group (7 patients) who were given UDCA simultaneously with TPN regimen, and the other, the control group (6 patients) who were given placebo. Their age ranged from 1 day to 13 years. They were affected with diseases impossible for enteral nutrition, such as prematurity, cerebral palsy, chronic diarrhea, anorexia nervosa, pancreatitis, and cyclic vomiting. The duration of TPN ranged from 10 to 70 days. Hematologic parameters including liver function test were measured at regular intervals, and the duration, composition, administration rate, total calorie of TPN were recorded. The serum levels of total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase were compared between groups after cessation of the study. Results: The autoregressive coefficient of the control group was 0.4419 (p=0.0651) in bilirubin, -0.0431 (p=0.7923) in AST, 0.2398 (p=0.2416) in ALT, and 0.2459 (p=0.1922) in alkaline phosphatase by mixed procedure model when the parameters were referred to the case group. Conclusion: The serum level of total bilirubin did not increase in comparison with that of the control group, but statistically insignificant, when both TPN and UDCA were administered simultaneously from the beginning.

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