• 제목/요약/키워드: acute

검색결과 11,570건 처리시간 0.038초

Long-term Results of Radiotherapy for Subfoveal Choroidal Neovascularization (CNV) in Age-related Macular Degeneration (ARMD) (연령관련 황반하 맥락막 신생혈관증에서 방사선의 장기적 치료 결과)

  • Kim, Bo-Kyong;Kim, Il-Han
    • Radiation Oncology Journal
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    • 제25권2호
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    • pp.63-69
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    • 2007
  • [ $\underline{Purpose}$ ]: We performed this prospective randomized study to evaluate the efficacy and the complications of radiotherapy for Subfoveal CNV in ARMD and to compare the treatment results at two dosages (14.4 Gy and 19.8 Gy). $\underline{Materials\;and\;Methods}$: 60 eyes of 55 patients were enrolled, and randomized into 14.4 Gy (31 eyes) or 19.8 Gy (29 eyes) groups. CT was used to plan the radiotherapy. All patients received radiotherapy with a 1.8 Gy daily dose using 4 MV photon. We categorized treatment results as improved, stable, or deteriorated based on visual acuity changes of more than 2 lines on the ETDRS chart. $\underline{Results}$: Median follow-up period was 33.5 months. At 12 months, visual acuity improved in 9 (16.7%), stable in 41 (75.9%), and aggravated in 4 (7.4%) of 54 evaluated eyes. At 24 months, 49 eyes (81.7%) were evaluated. Visual acuity improved in 6 (12.2%), was stable in 33 (67.4%), and deteriorated in 10 (20.4%). At 36 months, 37 eyes were evaluated. Six (16.2%) eyes were improved, 21 (56.8%) stable, and 10 (27.0%) deteriorated. No significant difference in response was observed between the 14.4 Gy and 19.8 Gy groups (Mantel-Haenszel $x^2=0.4756$). The proportion of eyes with a vision of $20/100{\leq}increased$ from 28.3% initially to 32.7% after 24 months of radiotherapy. There were no severe acute or chronic complications. $\underline{Conclusion}$: External beam radiotherapy with doses of 14.4 or 19.8 Gy may be an effective treatment for subfoveal CNV in ARMD. No dose-response relationships with respect to treatment response or toxicity were observed between the 14.4 Gy and 19.8 Gy groups.

Radiation Therapy in Elderly Skin Cancer (노령의 피부암에서 방사선치료)

  • Kim, Jin-Hee
    • Radiation Oncology Journal
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    • 제26권2호
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    • pp.113-117
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    • 2008
  • Purpose: To evaluate the long term results(local control, survival, failure, and complications) after radiation therapy for skin cancer in elderly patients. Material and Methods: The study spanned from January 1990 to October 2002. Fifteen elderly patients with skin cancer were treated by radiotherapy at the Keimyung University Dongsan Medical Center. The age distribution of the patients surveyed was 72 to 95 years, with a median age of 78.8 years. The pathologic classification of the 15 patients included squamous cell carcinoma(10 patients), basal cell carcinoma(3 patients), verrucous carcinoma(1 patient) and skin adnexal origin carcinoma(1 patient). The most common tumor location was the head(13 patients). The mean tumor diameter was 4.9 cm(range 2 to 9 cm). The radiation dose was delivered via an electron beam of 6 to 15 MeV. The dose range was adjusted to the tumor diameter and depth of tumor invasion. The total radiation dose ranged from $50{\sim}80$ Gy(mean: 66 Gy) with a 2 Gy fractional dose prescribed to the 80% isodose line once a day and 5 times a week. One patient with lymph node metastasis was treated with six MV photon beams boosted with electron beams. The length of the follow-up periods ranged from 10 to 120 months with a median follow-up period of 48 months. Results: The local control rates were 100%(15/15). In addition, the five year disease free survival rate(5YDFS) was 80% and twelve patients(80%) had no recurrence and skin cancer recurrence occurred in 3 patients(20%). Three patients have lived an average of 90 months($68{\sim}120$ months) without recurrence or metastasis. A total of 9 patients who died as a result of other causes had a mean survival time of 55.8 months after radiation therapy. No severe acute or chronic complications were observed after radiation therapy. Only minor complications including radiation dermatitis was treated with supportive care. Conclusion: The results suggest that radiation therapy is an effective and safe treatment method for the treatment of skin cancer in elderly patients who achieved a good survival rate and few minor complications.

Incidence of Parasitic Infections and Diseases in Rearing and Fattening Cattle Raising in Gyeongbug District (경북지방(慶北地方)의 육성우(育成牛) 및 비육우(肥育牛)에 있어서 기생충(寄生蟲)의 감염(感染)과 질병실태조사(疾病實態調査))

  • Lee, Cha Soo;Lee, Jae Hyun;Byun, Myung Dae;Park, Cheong Kyu;Lee, Hi Suk;Moon, Moo Hong
    • Korean Journal of Veterinary Research
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    • 제20권2호
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    • pp.179-197
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    • 1980
  • A survey was made from March 1978 through Feb. 1979 to know infection rate of parasites and incidence of diseases in 1968 cattle of 240 rearing and fattening cattle herds (1746 Korean native cattle, 186 Holstein, 34 Charolais and 2 Hereford) raising in 28 cities and counties of Gyeongbug district. The results obtained are summarized as follows: 1. The rate of nematoda infection was about 49.0% in the examined cattle. These nematodes were identified as Mecistocirrus sp., Oesophagostomum sp., Bunostomum sp., Trichostrongylus spp., Strongyloides sp. and other 3 species. Infection rate of nematoda in fattening and breeding cattle was higher than that in rearing calves, 44.3% of the positive cattle were infected with 2 to 5 species, and incidence of mixed infection was high in fattening cattle. 2. The rate of coccidal infection was 10.9%. Eimeria $z{\ddot{u}}rni$, Eimeria bovis and Eimeria bukidnonensis were mainly found in the examined cattle. The infection rates of cocidia in Holstein, breeding Korean cows, rearing Korean calves and fattening Korean cattle were 27.3%, 15.8%, 11.2% and 9.1%, respectively. 3. The rate of trematoda was 14.6% with Fasciola spp. (11.2%), Eurytrema spp. (2.0%), and Paramphistomum spp. infections (1.4%). Breeding Korean cows, fattening Korean cattle, Holstein and rearing Korean calves indicated 47.4%, 26.4%, 18.2% and 6.3% incidence of trematoda infections, respectively. of trematoda positive cattle, 76.6% were infected with Fasciola spp., 4. The rate of Theileria and Babesia infection was 62.7% in the examined cattle. Of these positive cattle 5.4% were infected with both parasites, 57.3% with Theileria, and 1.3% of rearing Korean calves and 22.6% of Holstein were found to have parasitized erythrocytes over 1.0%. 5. The incidence of diseases in 1968 cattle of 240 herds was 564 cattle (28.7%) of 154 herds (64.2%). of the diseases observed of skin occurred in 354 cattle (18.0%) of 61 herds (25.4%), diseases of respiratory system in 121 cattle (6.1%) of 34 herds (14.2%), diseases of digestive system in 38 cattle (1.9%) of 22 herds (9.2%), diseases of eye in 21 cattle (1.1%) of 13 herds (5.4%), diseases of urogenital system in 8 cattle (0.4%) of 8 herds (3.3%) and the other diseases in 24 cattle (1.2%) of 22 herds (9.2%). 6. Diseases of skin in 1968 cattle of 240 herds werds were observed in the highest incidence. Ringworm was observed in 13.3% of the examined herds, rearing Korean calves and Holstein showed high incidence. Scabies caused by Chorioptes bovis and alopecia localis along with infestation of lice (Damalinia bovis, Linognathus vituli) were observed in fattening Korean cattlein winter. 7. Diseases of respiratory system occurred frequently in rearing Korean cattle and Holstein. In the diseases of digestive system acute indigestion occurred in fattening Korean cittle, enteritis in rearing Korean calves and Holstein, and coccidiosis in rearing Korean calves maninly. 8. Infectious keratoconjunctivitis occurred in a fattening Korean cattle herd, sterility (2.0%) in breeding Korean cows, and theileriosis in Holstein calves were also occurred. In addition, poisoning and heat stroke were observed in several cattle.

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Detection of Osteomyelitis Using a Tc-99m Labeled Antigranulocyte Antibody Immunoscintigraphy (Tc-99m 표지 항과립구항체 면역신티그라피를 이용한 골수염의 진단)

  • Kang, Won-Jun;Chung, June-Key;Yeo, Jeong-Seok;Hong, Mee-Kyoung;Jeong, Jae-Min;Lee, Dong-Soo;Lee, Sang-Hoon;Choi, In-Ho;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • 제32권4호
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    • pp.344-353
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    • 1998
  • Purpose: The purpose of this study was to evaluate the diagnostic accuracy of Tc-99m labeled antigranulocyte antibody immunoscintigrapy in the diagnosis of osteomyelitis and compare with the results of triphasic bone scan. Materials and Methods: The study population was 39 patients (22 male, 17 female) who had uncertain diagnoses of osteomyelitis. Fifteen patients had history of orthopedic surgery, and 5 had previous fracture. One milligram of monoclonal antibody against NCA-95 was labeled with 370 MBq of Tc-99m, injected intravenously, and 4 hour images were obtained. Triphasic bone scan images were obtained in 30 patients. The final diagnosis was confirmed by bacteriologic culture, biopsy or long term clinical follow up. Results: Twenty one patients were confirmed to have osteomyelitis (1 acute, 20 chronic). Eighteen patients were without osteomyelitis. Antigranulocyte antibody immunoscintigraphy had a sensitivity of 71% (15/21), and a specificity of 89% (16/18), while the sensitivity and specificity of triphasic bone scan was 93% (13/14) and 38% (6/16), respectively. Antigranulocyte antibody scan showed higher specificity of 100% (11/11) in comparison with 33% (3/9) of triphasic bone scan in patients with history of orthopedic surgery or fracture. Conclusion: Antigranulocyte antibody immunoscintigraphy is more specific than that of triphasic bone scan and may be helpful in patients with history of surgery or fracture. However, sensitivity is lower than triphasic bone scan in the detection of chronic osteomyelitis.

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The Relation between Collateral Circulation and $^{99m}Tc$-MIBI Heart SPECT (심근경색에서 측부순환 유무에 따른 $^{99m}Tc$-MIBI 심근 SPECT 소견)

  • Kim, Jae-Man;Na, Deug-Young;Park, Eun-Kyung;Yang, Hyung-In;Kim, Deog-Yoon;Kang, Heung-Sun;Choue, Chung-Whee;Kim, Kwon-Sam;Kim, Myung-Shick;Song, Jung-Sang;Bae, Jong-Hoa
    • The Korean Journal of Nuclear Medicine
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    • 제28권1호
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    • pp.37-43
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    • 1994
  • The coronary collateral vessels have revealed their significance in terms of reduction of infarct size, preservation left ventricular function, and prevention of left ventricular aneurysm in patients with myocardial infarction. The purpose of this study were to evaluated the relation between collateral circulation and $^{99m}Tc$-MIBI Heart SPECT in patient with acute myocardial infarction and their clinical significance. The fifty six MI patients with antegrade TIMI perfusion grade 0 and 1 were studied. The patients were classified into two groups; Group I inclueded 30 patients with grade 2, 3 Collateral flow. Group II inclueded 26 patients with grade 0, 1 Collateral flow. Collateral filling were graded from 0 to 3: 0- none, 1- Filling of side branch only, 2- Partial filling of the epicardial segment, 3- Complete filling of epicardial segment. Clinical variables, left ventricular function, $^{99m}Tc$-MIBI Heart SPECT were analyzed with angiographic finding. Results were following: 1) Collateral visualization was found to be greater in patient with involvement of right coronary artery (RCA). The collateral development site of infarct related artery was RCA 15 cases, left anterior descending artery (LAD) 10 cases, left circumflex artery (LCX) 5 cases, and the collateral circulation from LAD to RCA was 13 cases (40.6%). 2) There was a tendency to be decreased in peak CK activity with group I. 3) The presence of good collateral channels was more frequently $^{99m}Tc$-MIBI reversible perfusion defect (83.4% vs 15.3%, p<0.05). 4) No differences of left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), ejection fraction (EF) were noted between group I and group II. The presence of good collateral channels did affect the frequency of occurrence of $^{99m}Tc$-MIBI reversible perfusion defect.

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A Study of Clinical Manifestations of Gastrointestinal Symptoms in Children with Henoch-Schönlein Purpura (소아 Henoch-Schönlein Purpura 환아에서 위장관 증상 유무에 따른 임상 소견에 대한 연구)

  • Oh, Se-Whung;Choe, Jae-Hyung;Kim, Yong-Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제9권2호
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    • pp.183-192
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    • 2006
  • Purpose: This study was undertaken to evaluate the factors correlated with the clinical course and outcome in patients of Henoch-Sch${\ddot{o}}$nlein Purpura. Methods: The medical records of 104 children diagnosed with Henoch-Sch${\ddot{o}}$nlein Purpura (HSP) from January 1996 to April 2006 were reviewed retrospectively. The patients were divided into two groups: patients with Gastrointestinal (GI) symptoms and those without GI symptoms. When there were joint, scrotum, and renal symptoms except for skin lesion in whole HSP, those patients were excluded. The history of acute infection, duration of admission, treatment requirement, recurrence of HSP, CBC, stool occult blood test, abdominal ultrasonographic findings and GI endoscopic findings were reviewed. Results: Among 104 patients, patients with GI symptoms included 66 cases (63.5%), those without GI symptoms accounted for 38 cases (36.5%). GI symptoms included: abdominal pain in 57 cases (54.8%), vomiting 21 cases (20.2%), GI bleeding 5 cases (4.8%), nausea 3 cases (2.9%) and diarrhea 3 case (2.9%). Positive GI symptoms and GI mucosal lesions on GI endoscopy had a statistically significant correlation with increased admission duration, treatment requirement, recurrence of HSP, and positive stool occult blood. Six cases with small intestinal wall thickening were noted on abdominal ultrasonography. Six cases of hemorrhagic gastritis and hemorrhagic duodenitis, 3 cases of duodenal ulcer, 3 cases of hemorrhagic gastritis and duodenal ulcer, 2 cases of hemorrhagic duodenitis and colitis, and 1 case of colitis were noted on GI endoscopy. Conclusion: These results suggest that GI endoscopic examination may be helpful for the diagnosis and treatment of children with HSP.

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Gastrointestinal Mucosal Lesions in Children with Short-Term Abdominal Pain (급성 복통을 호소하는 환아에서 위장관 점막병변에 관한 연구)

  • Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제9권2호
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    • pp.176-182
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    • 2006
  • Purpose: The aim of this study was to investigate the spectrum of gastrointestinal mucosal lesions in the children presenting with short-term abdominal pain. Methods: Thirty one children with short term abdominal pain for less than 1 month from January 1995 to May 2004 who were examined using gastrointestinal (GI) endoscopy were reviewed retrospectively. Children presenting with acute abdominal pain unrelated to proper GI were excluded from this study. Results: Male patients were 16 and female were 15. Three patients were 1~5 years old, 15 were 6~10 years old, and 13 were 11~15 years old. The duration of the abdominal pain was less than 7 days in 23 patients, 10 days in 1, 20 days in 2, and 30 days in 4. The major accompanying symptoms were vomiting (15), diarrhea (4), melena (1), hematemesis (1), and fever (2). Using endoscopy, 6 patients were found to have hemorrhagic gastritis, 5 nodular gastritis, 4 duodenal ulcer, 3 gastric ulcer, 3 reflux esophagitis, 2 nodular duodenitis, 2 superficial gastritis, 2 erosive hemorrhagic duodenitis, 2 ulcerative colitis, 1 duodenogastric reflux, and 1 esophageal polyp. Helicobacter pylori (H. pylori) infection was positive in 10 patients. The age and sex ratio, duration of abdominal pain, site of abdominal pain, and duration of abdominal pain between H. pylori- positive and negative children were different. However, only the site of abdominal pain (epigastric) showed statistical significance. All symptoms improved with medication for the GI mucosal lesions noted by the endoscopic findings. Conclusion: The author suggests that GI endoscopy be one of the important first steps in examinations to find out diverse GI mucosal lesions in the patients with short-term abdominal pain. Additionally, the examinations for H. pylori infection are important for these patients, also.

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Clinical Features of Non-A, B, C Viral Hepatitis in Children (소아에서 발생한 비-A, B, C형 바이러스성 간염의 임상 고찰)

  • Son, Seung Kook;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제8권1호
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    • pp.41-48
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    • 2005
  • Purpose: Non-A, B, C viral hepatitis is the name given to the disease with clinical viral hepatitis, but in which serologic evidence of A, B, C hepatitis has not been found. Little is known about the etiology and clinical features of non-A, B, C viral hepatitis in children. Methods: A clinical analysis of 45 cases with non-A, B, C viral hepatitis who were admitted to the Department of Pediatrics, Pusan National University Hospital, from January 2001 to June 2004 was carried out retrospectively. Patients who were positive for HBsAg, anti-HAV and anti-HCV and had toxic, metabolic, autoimmune, or neonatal hepatitis were excluded in this study. Results: Among 45 cases of non-A, B, C viral hepatitis, the etiology was unknown in 26 (57.8%), CMV (cytomegalovirus) in 14 (31.1%), EBV (Epstein Barr virus) in 2 (4.4%), HSV (herpes simplex virus) in 2 (4.4%) and RV (rubella virus) in 1 (2.2%). Twenty seven out of 45 (60.0%) patients were under 1 year of age. Sixteen (33.3%) patients had no specific clinical symptoms and were diagnosed incidentally. On physical examination, twenty seven out of 45 patients (60.0%) had no abnormal findings. Forty three out of 45 patients (95.6%) showed classic clinical course of acute viral hepatitis, whereas fulminant hepatitis developed in two patients. Mean serum ALT (alanine aminotransferase) level was $448.7{\pm}771.9IU/L$. Serum ALT level was normalized in 31 out of 45 patients (81.6%) within 6 months and all patients within 18 months. Aplastic anemia was complicated in a case. Conclusion: Although most patients with non-A, B, C viral hepatitis showed a good prognosis, a careful follow-up would be necessary because some of them had a clinical course of chronic hepatitis, fulminant hepatitis and severe complication such as aplastic anemia.

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Analysis of Linear Growth in Children after Living-related Liver Transplantation (소아 생체 부분 간이식 후의 성장 분석)

  • Rim, Sun-Hee;Yun, Hye-Jin;Suh, Young-Mee;Choi, Bo-Hwa;Kim, Kyung-Mo;Lee, Young-Joo;Lee, Sung-Gyu
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제4권1호
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    • pp.63-70
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    • 2001
  • Purpose: The aim of this study is to evaluate the effective role of living-related liver transplantation (LRLT) on posttransplant linear growth in children. Methods: Thirty six children were enrolled who received LRLT at Asan Medical Center from December, 1994 to February, 1999 and showed more than one-year postoperative survival. Mean height standard deviation score (zH) was analyzed according to medical records including heights during pretransplant and posttransplant follow-up periods. Results: zH of total children showed significant linear growth after LRLT from -1.58 to 0.33 at 24 posttransplant month (p<0.05). zH in children under 6 years of age, to exclude the effect of adolescent linear growth spurt, showed increment in height (p<0.05). Linear growth of children with liver cirrhosis improved and that with fulminant hepatitis was matained same. While stunted children (mean zH=-2.30) achieved good catch-up growth after transplantation, children with normal growth remained same. Children with significant hepatic dysfunction after LRLT such as chronic rejection or posttransplant lymphoproliferative disorder showed retarded posttrasplant linear growth. There was no statistical difference according to the type of immunosuppressants. Conclusion: LRLT resulted in adequate or catch-up linear growth in children with acute, chronic and metabolic liver disease. Successful LRLT suggested to be a promising option not only in long term survival but also in normal linear growth.

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The Role of GADD45 ${\beta}$ in Acute Myocardial Injury (급성 심근 손상에서 GADD45 ${\beta}$의 역할)

  • Cho, Suk-Ki;Hong, Jong-Myeon;Lee, Hak-Mo;Oh, Byong-Chul;Lee, Jae-Woong;Lee, Jeong-Ryul
    • Journal of Chest Surgery
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    • 제41권1호
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    • pp.25-33
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    • 2008
  • Background: A critical shortage of donor organs has necessitated an investigation of new strategies to increase the availability of additional organs available for human transplantation. We investigated the amount of apoptosis and expression of GADD45 ${\beta}$ in two groups, a GADD45 ${\beta}$-transfected group and untransfected group. Material and Method: The experimental groups consist of a control group (normal H9C2 cell line) and GADD45 ${\beta}$-transfected group. After injury of the each group, we evaluated the expression of GADD45 ${\beta}$ and the level of apoptosis in each group. Result: There was a significant increase in the expression of GADD45 ${\beta}$ in the GADD45 ${\beta}$-transfected group at 1 hour, 2 hours, and 3 hours after stimuli as compared with the control group. The amount of cardiac myoblast cell line apoptosis was significantly lower in the GADD45 ${\beta}$-transfected group as compared with the control group. The concentration of annex in in the GADD45 ${\beta}$-transfected group was significantly lower than that of the control. group after cell. injury. Conclusion: Transfection of a rat myoblast cell line with the GADD45 ${\beta}$ gene results in. decreased susceptibility to cell injury of human serum.