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Transcatheter Arterial Embolization in the Treatment of Massive Hemoptysis (대량 객혈 환자에서 동맥 색전술의 치료 효과)

  • Choi, Wan-Young;Choi, Jin-Won;Lim, Byung-Sung;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Seo, Heung-Suk
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.1
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    • pp.35-41
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    • 1992
  • Background: Massive hemoptysis is a major clinical and surgical problem related to high motality. Bronchial and nonbronchial systemic arteries are considered to be the main source of hemoptysis. Embolization of these arteries has become an accepted treatment in the management of massive hemoptysis. Herein we evaluate the effect of arterial embolization in immediate control of massive hemoptysis and investigate the clinical and angiographic characteristics and the course of patients with recurrent hemoptysis after initial successful embolization. Method: 21 patients (15 men & women, aged 21 to 74 years) underwent transcatheter arterial embolization for the treatment of life-threatening massive hemoptysis from Jan 1988 to July 1991. Seven patients had inactive residual pulmonary tuberculosis, 5 cases aspergilloma, 4 cases active pulmonary tuberculosis, 3 cases bronchiectasis and 2 case lung cancer. Arteriography was done by percutaneous catheterization via the femoral artery, and at the same time, arterial embolization was done with gelfoam particle. Result: Immediate control of massive hemoptysis was achieved in all 21 cases by arterial embolization. Hemoptysis recurred in nine of 21 patients. Four cases were aspergilloma, two inactive tuberculosis, two lung cancer, and one bronchiectasis. The initial angiographic findings revealed that nonbronchial systemic arterial supply, bronchial-pulmonary arterial shunt, and marked vascularity were more frequently, but statistically insignificant, in recurred patients. The following complications occured: fever, chest pain, cough, voiding difficulty, paralytic ileus, paraplegia, and splenic infarction. The course of the recurred patients was as follows: Three patients were died due to recurred massive hemoptysis. one was aspergilloma and two lung cancer. Surgical resection could be performed successfully in two patient with relatively good lung function, one aspergilloma and the other inactive tuberculosis. In 4 patients with poor lung function, repeated embolization or medical conservative treatment was continued. Conclusion: Arterial embolization as initial treatment of massive hemoptysis is most useful and relatively safe, although this is a palliative procedure and the potentiality for recurrence exists. Repeated embolization in inoperable patient with recurrent bleeding may improve the lengthening of life.

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Surgical Treatment of Multidrug-resistant Pulmonary Tuberculosis (다제내성 폐결핵의 수술적 치료)

  • Kim, Jin Hee;Min, Jin Hong;Park, Jun Ho;Park, Seung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.613-618
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    • 2005
  • Background : Recently, medical treatment of multi-drug resistant pulmonary tuberculosis has been unsuccessful. Through analyzing the cases with surgical treatment, we hope to provide some help in treating multi-drug resistant pulmonary tuberculosis in the future. Material and Method : A retrospective review was performed with 138cases of surgical treatment of multi-drug resistant tuberculosis during 10years from January 1994 to December 2003 at National Masan Hospital. Results : The ratio of men to women, 5.1:1 indicates that there were more incidences in men. The number of the resistant drugs was 5.3 with a mean age of 42.6 years. Cavitary lesions on the plain chest X-rays were seen in 94cases (68.1%). 128cases had positive sputum culture preoperatively. Types of operations were 24 pnemonectomies, 83 lobectomies, 10 bilobectomies, 19 lobectomies with segmentectomies or wedge resections, 1 wedge resection, and 1 carvenoplasty. There was no death after operation. There were 6cases of air leakage over a week, 6cases of postoperative bleeding, 8cases of bronchopleural fistula and empyema, 16cases of dead space, 1case of atelectasis, 1case of wound infection, 1case of cyst as postoperative complication. Postoperative complication showed higher long-term negative conversion rate of 92.8%. Conclusion : There has been many discussions about operative indications, postoperative drug regimens, length of postoperative chemotherapy. In our study, we showed higher long-term success rate of postoperative chemotherapy with pulmonary resection on multi-drug resistant pulmonary tuberculosis.

Congenital Cystic Adenomatoid Malformation of Lung in Adults: Clinical, Pathologic and Radiologic Evaluation of Six Patients (성인에서 진단된 선천성 낭포성 유선종 폐기형 6예)

  • Park, Young Jin;Jung, Hoon;Park, I-Nae;Choi, Sang Bong;Hur, Jin-Won;Lee, Hyuk Pyo;Yum, Ho-Kee;Choi, Soo Jeon;Koo, Ho-Seok;Lee, Yang-Haeng;Choi, Suk-Jin;Jung, Soo-Jin;Lee, Hyun-Kyung;Kim, Ae Ran
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.110-115
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    • 2008
  • Background: Congenital cystic adenomatoid malformation of the lung (CCAM) is a rare congenital developmental anomaly of the lower respiratory tract. Most cases are diagnosed within the first 2 years of life, so adult presentation of CCAM is rare. We describe here six adult cases of CCAM and the patients underwent surgical resection, and all these patients were seen during a five and a half year period. The purpose of this study was to analyze the clinical, radiological and histological characteristics of adult patients with CCAM. Methods: Through medical records analysis, we retrospectively reviewed the clinical characteristics, the chest pictures (X-ray and CT) and the histological characteristics. Results: Four patients were women and the mean age at diagnosis was 23.5 years (range: 18~39 years). The major clinical presentations were lower respiratory tract infection, hemoptysis and pneumothorax. According to the chest CT scan, 5 patients had multiseptated cystic lesions with air fluid levels and one patient had multiple cavitary lesions with air fluid levels, and these lesions were surrounded by poorly defined opacities at the right upper lobe. All the patients were treated with surgical resection. 5 patients underwent open lobectomy and one patient underwent VATS lobectomy. On the pathological examination, 3 were found to be CCAM type I and 3 patients were CCAM type II, according to Stocker's classification. There was no associated malignancy on the histological studies of the surgical specimens. Conclusion: As CCAM can cause various respiratory complications and malignant changes, and the risks associated with surgery are extremely low, those patients who are suspected of having or who are diagnosed with CCAM should go through surgical treatment for making the correct diagnosis and administering appropriate treatment.

Factors Affecting Intention to Experience of 6th Industry (6차 산업 체험 의향에 영향을 미치는 요인에 관한 연구)

  • Choi, Yang-ae
    • Journal of Venture Innovation
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    • v.3 no.1
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    • pp.117-142
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    • 2020
  • The purpose of this study is to explore the factors affecting the 6th industry experience by Schmitt experience model. The newly introduced variables are the cognitive experience, emotional experience, and social experience that are reconstructed based on Schmitt's experience theory and gender, family as a moderrating variable and trust as a mediation variable. In addition to experience intention. The hypothesis was set as follows. the experience factors that are the cognitive factor, the emotional factor, and the social factor will have a positive(+) influence on the intention to experience. Mooring factors will have a negative(-) effect on intention to experience. For statistical analysis, SPSS 24 and AMOS 23 statistical packages were used to test the research hypothesis. The research was based on 320 questionnaire data and tested by 314 valid responses were analyzed. As a result of the research, First, cognitive, emotional, and social factors had positive(+) effects on experience intention. Among the factors that directly affect the experience intention, the magnitude of influence appeared in the order of cognitive factors > social factors > emotional factors > mooring factors. Second, mooring factors have negative(-) effects on experience intention. Third, Trust has been partially influenced by factors of attraction, cognitive, emotional, and social. Fourth, there are significant statistical differences between men and women in cognitive and mooring factors in the path differences. Fifth, Social factors and mooring factors differed significantly in the composition of the household. Social factors with significant differences in path analysis have also been statistically demonstrated. The results of this study are academically verified that the cognitive, emotional, and social factors have an important influence on the experience intention in the 6th industry experience and the Schmitt's experience model proposed in this study is useful framework of analysis. In practical terms, it could provide implications for what factors should be strategically and marketingly focused to activate the 6th industry experience.

Malignant Melanoma (악성 흑색종)

  • Rhee, Seung-Koo;Kang, Yong-Koo;Park, Won-Jong;Chung, Yang-Guk;Lee, Hyuk-Je
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.1
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    • pp.13-19
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    • 2001
  • Background : The incidence of malignant melanoma is currently increasing at a rate greater than any other cancer occuring in human. At this time, early diagnosis and surgical excision were the mainstay of treatment for patients with malignant melanoma. We reviewed the results of average 4 years of follow-up after surgical excision of total 16 cases of malignant melanoma since 1985. Materials and Methods : There were 16 patients (mean age 58.5 years, 5 men, 11 women). The site of the primary lesion was foot and toe (6), back (3), hand (2), thigh (2), shoulder (1), lower abdomen (1) and lip (1). The lymph node was involved at 9 patients. The histologic diagnosis was made with H-E, S-100 stain, and HMB-45 stain as a special stain. Results : Histologically, there were Clark's stage I for 3 patients, II in 4, III in 2, IV in 3, and stage V in 4 patients. The wide excision only greater than 2cm margin was performed for 4 patients. The wide excision and lymph node dissection were performed for 4 patients. The amputation was only performed for 3 patients, and the amputation and lymph node dissection were performed for 5 patients. After surgical excision, chemotherapy was done with Taxol for each 2 patients of stage IV and V. After long term follow-up for mean 4 years, 4 patients died related with melanoma, 1 patient was recurred, and 11 patients were cured. Conclusion : The incidence of malignant melanoma was rare in Korea, but early involvement of lymph node at initial diagnosis was found in many cases (9/16, 56%). And then, early detection and appropriated excision as well as careful dissection of adjacent lymph nodes will offer the patient the best chance for cure.

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A Study and Investigation for the Attitude about Smoking of Boys' and Girls' High School in Seoul (서울시내 남녀고교생의 흡연에 관한 태도 조사연구)

  • Sim Young Ae
    • Journal of Korean Public Health Nursing
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    • v.3 no.1
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    • pp.74-100
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    • 1989
  • Inspite of the lots of studies on the harmfulness of cigarette smoking to the body published by many researchers since 1950, cigarette smoking people are increasing in number especially, cigarette smoking by young and women causes a serious problem. Examining the physiological motives of youth shows that, impulse which the youth want to immitate the adults, alluring curiousity, and defiant physiology of escaping from the norm of traditional groups which has been banned are cooperated well compoundly. As the period of the youth is the one which they accumulate knowledge and charactor by learning as well as the period of growth mentally, and physically they should be rightly educated about smoking before they addicted to smoking and it is desirable for us to make the youth to understand how harmfully the smoking is to effect to their growth and mental soundness simply not as a social norm which they should not smoke. The main motive of this study on the attitude of smoking by the youth is to give basic materials related on this field. For this study, 647 questionnaires were used as studying material which were able to analyze among 720 questionnaires of 2 classes of each grade of 3 high schools among the high schools of boys, girls and co-educated in Seoul from Oct. 21, 1988 through Oct. 26, 1988. Study Instrument are graded in Likert's 5 point from 40 questions which are 20 questions m affirmations and 20 questions in negations after analyzing the factors on 60 simple sentence questions which the students showed in preliminary studies. And these are systemized to be measured from 1 point which means they think smoking IS very bad to 5points which means they think smoking is really good. In these collected materials, technical statistics of frequency. percentage, average, standard deviation are used for general character and smoking attitude, $X^2-test$ for examinning Independant variables of physical. emotional, ethical and other areas pearson's coefficient of correlation for related direction and degree" and step­regression analysis for the degree of relative contribution of all variables which effect smoking attitude. The results of this study are as follows; 1. The smoking attitude of high school boys and girls showed average of 1.78 in physical area, 2.63 in emotional area, 2.61 in ethical area, 2.29 in other area respectively in a negative attitude generally also the negative attitude are expressed most strongly in physical area. I've can also say by this results that smoking is harmful to their health and further more it can be judged that this proves the youth in the period of preparation be adults have a strong curiousity in the emotional, ethical and other areas. 2. The most influential variables in each field as related factors effecting smoking attitude of the student can be explained from 13.2 in physical area the lowest experienced variables to 25.2 in emotional area the highest of degree of smoking experience. The fact that the more the smoking experienced students are increasing in number the higher tendency which accept the' smoking tells as the importance of health education about the population of latest student's smoking as important variables shown equally in each area. Those of grade, age, numbers of smoking people in house are showed meaningful in pure interrelation. Those related to the acceptance of teacher's smoking, sex, mothors education are shown meaningful in opposite interrelations. This means that the' increasing number' of smoking people in grade age, the number of smoker in family have a affirmative attitude. And people who are not interested in teacher's smoking wants to quit it, and whose mother's education is higher have a negative attitude. 3. The most negatively answered questions of the smoking attitude In physical, emotional, ethical and other areas are as belows; Firstly too much smoking is harmful to our health is 1.12 point. Secondly smoking have a ill-effect on pregnancy and embryo is 1.13 point. Thirdly smoking is harmful· to our health is 1.27 point. Fourthly smoking in crowed area with the people such as In a bus or subway should be prohibited is 1.27point. Fifthly smoking can ruin lungs is 1.31 point. And the most affirmatively answered questions are also as below; Firstly we showed smoke depending on time and place is 3.96 points. Secondly smoking is just habit is 3.83 points. Thirdly smoking people seem to be unable and deplorable is 3.69 point. Fourthly smoking should be prohibited by law is 3.56 points. Fifthly high school student's smoking is immitation of adults is 3.52 points.

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Effect of Artemisia iwayomogi Ethanol Extract on Hypoglycemic and Antioxidant Activities in Diabetic Rats (더위지기 추출물이 당뇨 흰쥐의 혈당과 항산화 효소 활성도에 미치는 영향)

  • Han, Hye Kyoung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.12
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    • pp.1716-1726
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    • 2012
  • This study was undertaken to evaluate the antihyperglycemic, antilipid peroxidative, and antioxidant effects of the ethanol extracts of Artemisia iwayomogi (Ai) in streptozotocin (STZ)-induced diabetic rats. Diabetes was induced in Sprague-Dawley rats with a single intravenous injection (45 mg/kg b.w.) of STZ. The diabetic rats were then randomized to the diabetic and Ai extract therapy groups which were treated with Ai extract at doses of 1, 2, and 3 g/kg b.w./day, respectively, for 14 days. Oral administration of Ai (2 g/kg b.w.) significantly decreased their intake of food. Dosage of 2 g/kg of the extract significantly decreased blood glucose levels in the glucose level in diabetic rats after 4 day, there was no significant difference observed at 1 and 3 g/kg. A dose of 2 or 3 g/kg of the Ai extract significantly reduced plasma glucose levels in STZ-induced hyperglycemic rats at 7 days. The hypoglycemic effect of Ai at a dose of 2 g/kg was significantly more effective than that of STZ-control. The effect was more pronounced in 2 g/kg than 1 g and 3 g/kg. A significant reduction in triglycerides (TG) and free fatty acids (FFA), and a significant increase in liver glycogen were observed in treated diabetic rats at doses of 2 g/kg after 14 days of treatment. Administration of Ai extracts to diabetic rats showed a significant decrease in liver malondialdehyde (MDA) levels. The activity of superoxide dismutase (SOD) was significantly increased in the 3 g extract-supplemented groups. The activities of glutathione peroxidase (GSH-px) and catalase (CAT) were significantly increased in the 1 g and 3 g extract-supplemented groups. Ai extract significantly increased glutathione-S transferase (GST) activity in a dose-dependent manner compared with treatment in STZ-control rats. Our result supports the fact that the administration of Ai extract is able to reduce hyperglycemia and hyperlipidemia risk, and also reduce the oxidative stress in diabetic rats.

Prevention of Quality Changes in the Cultured Wild Ginseng During Storage (산삼배양근의 저장 중 품질변화 억제)

  • Whang, Jong-Hyun;Yu, Kwang-Won;Park, Sung-Sun;Koh, Jong-Ho;Oh, Sung-Hoon;Suh, Hyung-Joo;Lee, Sang-Hwa
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.10
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    • pp.1312-1317
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    • 2008
  • Physicochemical changes were investigated for the shelf-life extension of cultured wild-ginseng roots during storage with various pre-treatments with blanching, CAMICA-SD and DF-100 and treatments with citric acid and vitamin C. The pH of cultured wild-ginseng roots showed the range of $6.06{\sim}6.42$ at $10^{\circ}C$, but showed higher ranges of $6.08{\sim}6.91$ and $6.08{\sim}8.68$ at 20 and $30^{\circ}C$, respectively. Browning index (a/b) was increased with increasing storage temperature, and the index at 10 and $30^{\circ}C$ were 0.405 and 0.469 after 2 weeks, respectively. Browning index and viable cell number of CAMICA-SD pre-treatment showed little changes compared to pre-teatment with blanching or DF-100. When the cultured wild-ginseng roots were treated with 1.0% citric acid and 0.2% DF-100 after pre-treatments with CAMICA-SD, viable cell number was slightly increased to $4.9{\times}10^2CFU/g$ for 3 weeks storage at $10^{\circ}C$. The mixture of citric acid and DF-100 was also used to prevent the growth of microbiology and to reduce browning reaction, especially enzymatic browning reaction. The mixture might effectively extend shelf life of the cultured wild-ginseng roots.

Effect of Calcium Extracted from Salted Anchovy (Engraulis japonicus) on Calcium Metabolism of the Rat (멸치젓에서 추출한 칼슘이 흰쥐의 칼슘대사에 미치는 영향)

  • Kim, Hyang Suk;Choi, Eun Ok;Kim, Man Do;Choi, Yung Hyun;Kim, Byung Woo;Kim, Soo Yeon;Hwang, Hye Jin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.2
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    • pp.182-187
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    • 2013
  • This study was conducted to examine the effect of calcium extracted from salted anchovy (Engraulis japonicus) on the calcium metabolism of rats. Sprague-Dawley male rats were fed low-calcium diets (0.15%) for 2 weeks after the adjustment period. Rats were divided into five groups and were fed experimental diet for four weeks. Experimental diets were low calcium (LC, 0.15% $CaCO_3$), 0.5% $CaCO_3$ (CC), seaweed calcium (SC), calcium lactate (LC), anchovy calcium (AC). The low-calcium diet group (LC) showed the lowest weight gain and had no differences among the groups with adequate calcium intake. Calcium retention was lowest in the LC group and higher in the CL, SC, AC groups than in SC groups. Serum alkaline phosphatase (ALP) level was highest in LC group, and significantly low in the CC and AC groups (p<0.05). Parathyroid hormone and osteocalcin levels showed no differences among experimental groups. The urine deoxypyridinoline (DPD) level was lower in AC and CC groups compared to the LC group (p<0.05). The dry weight of the femur showed no significant differences among normal calcium groups. The bone mineral density of the femur in AC and CC group were significantly higher than the LC group (p<0.05). From these results, calcium extracted from salted anchovy can be useful as a calcium supplement comparable with calcium carbonate.

Clinical Features of Patients with Stage IV Gastric Cancer (4기 위암 환자의 임상적 특성)

  • Kim, Yoo Seok;Kim, Sung Soo;Min, Young Don
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.91-96
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    • 2008
  • Purpose: The early detection of gastric cancer and accuracy of preoperative staging has currently been on the increase due to the development of endoscopy and imaging techniques, but there are still many cases of advanced gastric cancer detected at the first diagnosis and there are also many cases of stage IV gastric cancer diagnosed after a postoperative pathological examination. Although the prognosis of stage IV gastric cancer is very poor, this study was performed to determine the value of the use of aggressive treatment determined after a clinical analysis. Materials and Methods: We retrospectively analyzed 150 patients that were diagnosed with stage IV gastric cancer among 1376 patients who underwent a laparotomy for gastric cancer from January 1994 to December 2006. Results: Of the 150 patients with stage IV gastric cancer who underwent a laparotomy, there were 104 men and 46 women. The mean patient age was 57.8 years (age range, 28~93 years). A subtotal gastrectomy or total gastrectomy was performed in 119 patients and 31 patients underwent an explorative laparotomy. The mean survival time of patients that underwent a gastrectomy and patients that did not undergo a gastrectomy was 722 days (range, 14~4,559 days) and 173 days (range, 16~374 days), respectively this result was statistically significant. When patients that underwent a gastrectomy were classified according to the TNM stage, the mean survival time of 33 patients with stage T4 disease was 534 days (range, 17~3,378 days) and the mean survival time of 63 patients with stage N3 disease was 521 days (range, 14~4,190 days), but there was no statistical significance. Chemotherapy was administered to 98 patients and 52 patients did not receive chemotherapy. The mean survival time of patients that received chemotherapy was 792 days (range, 36~4,559 days) and the mean survival time of patients that did not receive chemotherapy was 243 days (range, 14~2,413 days), with statistical significance. Conclusion: If there is no evidence of distant metastasis in stage IV gastric cancer, one can expect improvement of the survival rate by the use of aggressive treatment, including curative gastric resection with radical lymph node dissection and chemotherapy.

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