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Open Heart Surgery of Congenital Heart Diseases -Report of Four Cases- (선천성심질환(先天性心疾患)의 심폐기(心肺器) 개심수술(開心手術) - 4례(例) 보고(報告) -)

  • Kim, Kun Ho;Park, Young Kwan;Jee, Heng Ok;Kim, Young Tae;Rhee, Chong Bae;Chung, Yun Chae;Oh, Chull Soo
    • Journal of Chest Surgery
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    • v.9 no.1
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    • pp.1-9
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    • 1976
  • The present. study reports four cases of congenital heart diseases, who received open heart surgery by the Sarn's Heart-Lung-Machine in the department of Thoracic Surgery, Hanyang University Hospital during the period between July 1975 and May 1976. The Heart-Lung-Machine consisted of the Sarn's five head roller pump motor system (model 5000), heat exchanger, bubble trap, the Rygg-Kyvsgaard oxygenator, and monitors. The priming of pump oxygenator was carried out by the hemodilution method using Hartman's solution and whole blood. Of the four cases of the heart diseases, three whose body weight were below 30kg, received the partial hemodilution priming and the remaining one whose body weight was 52kg received the total hemodilution priming with Hartman's solution alone. The rate of hemodilution was in the average of 60.5ml/kg. Extracorporeal circulation was performed at the perfusion flow rate of the average 94.0ml/kg/min, and at the moderate hypothermia between 35'5"C and 30'5"C of the rectal temperature. In the total cardiopulmonary bypass, arterial blood pressure was anged between 30 mmHg and 85 mmHg, generally maintaining over 60 mmHg and venous pressure was measured between 4 and $23cmH_2O$, generally maintaining below $10cmH_2O$. The first case: The patient, a nine year old girl having the symptoms and physical signs typical to cardiac anomaly was definitely diagnosed as isolated pulmonary stenosis through the cardiac catheterization. There was, however, no cyanosis, no pathological finding by X-ray and E.C.G. tracings. The valvulotomy was performed through the arteriotomy of pulmouary artery under the total cardiopulmonary bypass. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The second case: A 12 year old boy with congenital heart anomaly was positively identified as having ventricular septal defect through the cardiac catheterization. As in the case with the first case, the patient exhibited the symptoms and physical signs typical to cardiac anomaly, but no pathological abnormality by X-ray and E.C.G. tracings. The septal defect was localized on atrioventricular canal and was 2 by 10 mm in size. The septal defect was closed by direct simple sutures under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle and pulmonary artery were decreased satisfactory. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The third case: The patient, a 19 year old girl had been experienced the clinical symptoms typical to cardiac anomaly for 16 years. The pink tetralogy of Fallot was definitey diagnosed through the cardiac catheterization. The patient was placed on an ablolute bed rest prior to the operation because of severe exertional dyspnea, fatigability, and frequent syncopal attacks. However, she exhibited very slight cyanosis. Positive findings were noted on E.C.G. tracings and blood picture, but no evidence of pathological abnormality on X-ray was observed. All of the four surgical approaches such as Teflon patch closure (3 by 4cm in size) of ventricular septal defect, myocardial resection of right ventricular outflow tract, valvulotomy of pulmonary valvular stenosis, and pericardial patch closing of ventriculotomy wound were performed in 95 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The fourth case: The patient, a 7 1/4 year old girl had the symptoms of cardiac anomaly for only three years prior to the operation. She was positively identified as having acyanotic tetralogy of Fallot by open heart surgery. The patient showed positive findings by X-ray and E.C.G. tracings, but exhibited no cyanosis and normal blood picture. All of the three surgical approaches, such a myocardial resection of hypertrophic sight ventricular outflow tract, direct suture closing of ventricular septal defect and pericardial patch closing of ventriculotomy wound were carried out in 110 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and the symptoms disappeared.

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Comparison of Life Style, School Achievement and Snaking Behaviors among Underweight and Overweight Adolescents (일부 저체중과 과체중 청소년의 생활습관, 학업성취도 및 간식섭취행동의 비교)

  • Kim, Hye-Kyung;Kim, Jin-Hee
    • Journal of Nutrition and Health
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    • v.44 no.2
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    • pp.131-139
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    • 2011
  • The purpose of this study was to obtain information related to life style characteristics, school achievement and snacking behaviors among underweight and overweight adolescents in Ulsan area. The survey was carried out by self-questionnaires with 464 adolescents (333 underweight and 131 overweight). The results were as follows: Average BMI of the subjects was $19.81{\pm}3.10\;kg/m^2$ which was normal range, but average BMI of underweight and overweight were $16.90{\pm}1.19\;kg/m^2$ and $25.38{\pm}2.16\;kg/m^2$ respectively. The 49.5% of underweight and 94.7% of overweight students have correct perception about their body image. In the sleeping time, 58.9% of underweight and 66.4% of overweight students go to bed after PM 12 o'clock. In the regularity of eating breakfast, 68.5% of underweight and 67.9% of overweight students skipping breakfast at least 5 times per week. 32.6% of the subjects had snack once or more a day. Underweight students had more frequently ate snack than overweight students. The criteria of choosing snack were taste (77.4%), nutrition (9.3%), and price (6.3%). Food as snack they frequently had fruits, milk & milk products, cookies in order. Underweight students had more dodkboki & sundae, candy & chocolate and cake & bread than overweight students, although overweight students had more milk & yogurt than underweight students. The group who had a higher school record, they significantly had more fruits, milk & milk products (p < 0.01) and had not less nutritious foods (p < 0.001). This study may provide basic information on weight status, sleeping and snacking behaviors of adolescents. Therefore they should have nutrition education program to improve their life style and snacking patterns for underweight and overweight adolescents toward healthy weight.

Materialistic Characterization of Waste Egg Shell and Fundamental Studies for Its Application to Wastewater Treatment (폐달걀껍질의 활용을 위한 물성조사 및 폐수처리 응용에의 기초연구)

  • Kuh, Sung-Eun;Kim, Dong-Su
    • Journal of Korean Society of Environmental Engineers
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    • v.22 no.4
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    • pp.733-742
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    • 2000
  • Fundamental materialistic characterization and adsorption/neutralization behavior of waste egg shell for heavy metal ion have been studied for its application to wastewater treatment. To investigate the structural change and thermal decomposition characteristics of egg shell. X-ray diffraction and FT-IR analysis were conducted for egg shell treated at $105^{\circ}C$ and $700^{\circ}C$, respectively. For the result of FT-IR analysis, the sample treated at $700^{\circ}C$ showed a reduced C-O absorption band compared with that of egg shell treated at $105^{\circ}C$, which may be due to the $CO_2$ release. Unlike to the result of FT-IR analysis, the XRD patterns of egg shell were almost similar for the cases of $105^{\circ}C$ and $700^{\circ}C$ treatment. however, characteristic diffraction pattern of CaO was observed for $850^{\circ}C$ treatment, at which $CaCO_3$ is known to be completely converted to CaO. TGA/DTA analysis showed a slow decline in weight loss up to $600^{\circ}C$ and, for $600{\sim}800^{\circ}C$ range, the weight loss became drastic by reason of $CO_2$ discharge, which was accompanied by an appearance of major endothermic peak. The ratio of practical breakthrough time to ideal one, total transfer unit, and mass transfer coefficient were observed to be increased as the adsorption was progressed in a multiple-column fixed-bed reactor using egg shell as an adsorbent, which signified the distribution effect of mass transfer for continuous adsorption reaction. The neutralization effect of egg shell for several types of acidic wastewater made of different mineral acids was not much different from each other except for the case of $H_2SO_4$, for which the neutralization reaction was thought to be retarded by the formation of gypsum.

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Studies on Seed Germination Characteristics of Rice Cultivar ‘Danmi’ and Its Optimum Seeding Rates for Seedling Raising in Machine Transplanting (단미벼의 발아 특성 및 기계이앙 육묘시 적정 파종량)

  • Kim, Sang-Yeol;Oh, Seong-Hwan;Lee, Jong-Hee;Jeong, Kuk-Hyun;Cho, Jun-Hyeon;Lee, Ji-Yoon;Park, Sung-Tae;Song, You-Chun;Yeo, Un-Sang;Kim, Jeong-Il;Seo, Woo-Duck;Kang, Hang-Won
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.55 no.2
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    • pp.126-132
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    • 2010
  • A high sugar rice cultivar 'Danmi' which has been recently developed and released in the Functional Crop Resource Development Division, Department of Functional Crop, National Institute of Crop Science, has high glucose and sucrose contents but has a poor seed development. This defect poses some problem in ensuring stable seedling establishment in the nursery bed. We examined the germination and seedling emergence characteristics of 'Danmi' and determined an optimum seeding rate for seedling establishment. 'Danmi' seeds has a light 1,000-grain weight of 18.2g compared with Ilmibyeo's 26.7g. The 97.4% of 'Danmi' seeds has specific gravity below 1.0 while only 2.0% of seeds was fully developed with specific gravity above 1.12. However, the reverse is true in the Ilmibyeo seed used as a control cultivar. Although the seed germination of Danmi was 89-91% regardless of seed specific gravity but at a slower rate than Ilmibyeo regardless of water soaking temperatures of $20-30^{\circ}C$ because of high seed amount of specific gravity below 1.0 in 'Danmi'. It took 2~4 days longer of seed soaking in the Danmi seeds than Ilmibyeo before germination. 'Danmi' has low normal seedling emergence rate than Ilmibyeo in the seedbed soil due to high percentage of abnormal seedlings like stunting and incomplete growth. Normal seedling emergence rate of 'Danmi' in the seedbed was 62.6~64.9% for 10-day old seedling and 83.5~86.7% for 30-day old seedling which is lower by 29.6~30.0% and 11.3~12%, respectively than Ilmibyeo. Although 'Danmi' has low normal seedling emergence rate, but it has greater seed number per weight basis. Therefore, based on the normal seedling number per unit area of Ilmibyeo(control cultivar) for seedling rate of 10-day and 30-day old seedlings, the recommended seeding rate of 'Danmi' for transplanting rice is 220g seeds for 10-day old seedling and 130g for 30-day old seedling per nursery box, which is equivalent to 1.5 times seed volumes of Ilmibyeo.

The Promotive Effect of NAA, IBA and Ethychlozate on Rooting Cuttings of Certain Ornamental Plants and Some Physiological Studies. (관상식물 삽목발근에 있어서 NAA, IBA 및 Ethychlozate의 발근촉진효과와 그 생리학적연구)

  • Jeong, Hae-Jun;Gwak, Byeong-Hwa
    • The Journal of Natural Sciences
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    • v.1
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    • pp.115-198
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    • 1987
  • The present studies were undertaken to elucidate the influence of auxins, auxin-like substance-ethychlozate ("Figaron"),and pH and sort of rooting media on rooted propagation of certainornamental woody plant cuttings, and to see possible changes in internal compositions characterizing after root-promoting treatment as the cutting stage proceeded. The experimental check-up srevealed and summarized as seen in the following;I. Effect of three different auxin treatments on rooting cuttings: 1) Promotive influence of auxin varied according to different concentration levels, hours of dipping treatment of the auxins, and kind of plants. The greatest effect was obtained for Forsythia ksreana with NAA and IBA, for Ligustrurn obtusifolium var. variegatum with NAA and ethychlozate, for Hydrangea macrophylla, Magnolia kobus, and Magnolia liliflora with NAA, lBA and ethychlozate also. The most effective level of the promotive agents was found 200mg/l for NAA, 1000mg/l for IBA, and 200mg/l for ethychlozate. For Weigela florida and Gardenia jasminoides, range of the most effective level was shown relatively wide spread. 2) NAA was more effective at its optimal level of the rooting agent than ethychiozate for Weigela florida, Viburnum awabuki, Forsythia koreana, Acer palmatum 'Nomura', Bouga invillea glabra, Elaeagnus umbellata, Prunus tomentosa, Ligustrum obtusifolium, Pyracantha coccinea, Cestrum noctu rnum, Hydrangea macrophylla, Codiaeum variegatum, Rhododen dron lateritium, and Ilex crenata var. macrophylla, and yet ethychlozate was found either as equally as effective or more so than NAA for Zebrina pendula, Hibiscus syriacus, Fatshedera lizei, Schefflera arboricola, Campsis grandiflo ra, Ixora chinensis, Euonymus japonica, and Magnolia liliflora. On the contrary, no the auxin effect was noted with Lagerstroemia indica, Trachelospermum asiaticum, and Syringa vulgaris. This probably indicates that these species are genetically different for the auxin response.II. Effect of different pH and sorts of cutting media on rooting cuttings: 1) Bougainvillea showed best in rooting for the number and dry weight at pH 6.5, more with ethychlozate than NAA, while Ligustrum did at pH 5.0 more with NAA than ethychlozate. pH 4.0 medium resulted in the best rooting for Rhododendron with NAA, more than ethychlozate. 2) Use of cutting medium with peat: perlite: vermiculite = 1:1:1 showed to give the greatest rooting percent and dry weight, apart from considering the number of roots. This apparently meant the fact that cutting medium has more to do with root growth than root differentiation. Rhododendron yet showed results with cutting media that use of peat: perlite = 2:1 mixed is more effective on rooting than using peat alone.III. Effect of auxinic treatments on rooting cuttings and change in some cutting compositions: 1) Under the climatic conditions of July having temperature $26.3\pm$$2.4^{\circ}C$for cutting bed, new roots of Magnolia started to show up generally 20 days after the cutting was made, whereas Cestrum did much earlier than that, namely 14 days after. 2) Although total carbohydrate content of Magnolia cuttings showed no marked change without auxin treatment, it did so with the treatment, especially 30 days after the start of cutting. Cestrum cuttings demonstrated a gradual in crease in total carbohydrate content as rooting took place, and the content became reduced more with auxin than with out, just about when rooting proceeded to 14 days after the start of cutting. 3) Magnolia generally showed an increase in total nitrogen content as rooting proceeded more, and Cestrum showed a decrease in total nitrogen of cuttings. The auxin treatment exhibited no pertinent relation with change in plant nitro gen when rooting is promoted with auxin treatment. 4) An abrupt drop of total sugar and reducing sugar was noticed as Magnolia rooting started, and this reduction was parti cularly outstanding with auxin treatment. Starch content also was decreased in the later stage of cutting with auxin treatment, and was rather increased without auxin. Although sugar content soon increased as cutting started with auxin treatment in the case of Cestrum, it became reduced after rooting took place. 5) Total phenol content increased with rooting, and this was especially true when rooting started. This increase was reversed somehow regardless of auxin treatment. A decrease in phenol of Magnolia was found more striking with auxin than without in the later stage of the cutting period. 6)Avena coleoptile test for auxin-like substances presented the physiologically active factor is more in easy-to-root Magnolia liliflora than hard-to-root Magnolia kobus, and the activity of auxin-like substances was much increased with auxin treatment. The increase in the growth promoting substances was markedly pronounced when rooting just started. The active growth substances decreased in the later stage of cutting, and certain inhibitory substances started appearing. Cestrum also showed physiologically similar growth promoting substances accompanying auxin-like active substances if auxin is treated, and some strong inhibitory substances seemed to appear in the later stage of cutting. 7) Mung-bean-rooting test indicated biologically that endogenous growth substances in Magnolia all promoted mung-bean rooting, and activity of the growth substances apparently stimulated mung-bean rooting with auxin more than without. Here auxin treatment seemed to give a rise to an increased activity of endogenous growth substances in cuttings. This activity was found much greater with either NAA or IBA than ethychlozate, and showed its peak of the activity when rooting first started taking place. Certain inhibitory substances for Avena coleoptile growth strongly promoted mung-bean rooting, and it was also much like in the case of Cestrum.

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Growth of Tomato and Pepper Grafted Plug Seedlings under Different Shading Condition During Acclimatization after Graft-taking (접목활착 후 순화시 차광조건에 따른 토마토와 고추 접목묘의 생육)

  • Jo, Hyeon Gyu;Jeong, Hyeon Woo;Lee, Hye Ri;Kwon, Su Min;Hwang, Hee Sung;Hwang, Seung Jae
    • Journal of Bio-Environment Control
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    • v.30 no.1
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    • pp.10-18
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    • 2021
  • Acclimatization after grafting and graft-take that in order to produce plug seedlings of high-quality are important plug seedling stage which not reduce the plug seedlings quality before shipment. Appropriate acclimatization environment can not only increase seedling quality before secondary growth period, but also effective in promoting the growth of plug seedlings. This study was conducted to determine the optimal the shading period and shading level for acclimatization of tomato and pepper grafted plug seedlings after graft-take. The tomato and pepper seedlings were used in this experiment, and after graft-take, a tunnel was installed on a bed in glasshouse of venlo type to started shading treatment. The shading levels were 35, 55, 75 and 95%, and the shading periods were 1 and 2 weeks, and non-treatment was set as the control. In the case of tomato grafted plug seedling, plant height, stem diameter, dry weight of root, leaf area were significantly higher at the shading period of 1 week and the shading level was 55%. In the case of pepper grafted plug seedling, plant height, stem diameter, and leaf area were the highest in the shading period of 2 weeks and the shading level was 35%. However, dry weight of root, compactness, and T/R ratio, which seedling quality indicators, were lower than in the shading period of 1 week and the shading level 55%. Therefore, considering the quality of seedlings, it is suggested that shading period of 1 week with shading level of 55% treatment can be suitable to produce high quality grafted plug seedlings of tomato and pepper.

Hydroponic Nutrient Solution and Light Quality Influence on Lettuce (Lactuca sativa L.) Growth from the Artificial Light Type of Plant Factory System (인공광 식물공장에서 수경배양액 및 광질 조절이 상추 실생묘 생장에 미치는 영향)

  • Heo, Jeong-Wook;Park, Kyeong-Hun;Hong, Seung-Gil;Lee, Jae-Su;Baek, Jeong-Hyun
    • Korean Journal of Environmental Agriculture
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    • v.38 no.4
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    • pp.225-236
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    • 2019
  • BACKGROUND: Hydroponics is one of the methods for evaluating plant production using the inorganic nutrient solutions, which is applied under the artificial light conditions of plant factory system. However, the application of the conventional inorganic nutrients for hydroponics caused several environmental problems: waste from culture mediums and high nitrate concentration in plants. Organic nutrients are generally irrigated as a supplementary fertilizer for plant growth promotion under field or greenhouse conditions. Hydroponic culture using organic nutrients derived from the agricultural by-products such as dumped stems, leaves or immature fruits is rarely considered in plant factory system. Effect of organic or conventional inorganic nutrient solutions on the growth and nutrient absorption pattern of green and red leaf lettuces was investigated in this experiment under fluorescent lamps (FL) and mixture Light-Emitting Diodes (LEDs). METHODS AND RESULTS: Single solution of tomatoes (TJ) and kales (K) deriving from agricultural by-products including leaves or stems and its mixed solution (mixture ration 1:1) with conventional inorganic Yamazaki (Y) were supplied for hydroponics under the plant factory system. The Yamazaki solution was considered as a control. 'Jeockchima' and 'Cheongchima' lettuce seedlings (Lactuca sativa L.) were used as plant materials. The seedlings which developed 2~3 true leaves were grown under the light qualities of FL and mixed LED lights of blue plus red plus white of 1:2:1 mixture in energy ratio for 35 days. Light intensity of the light sources was controlled at 180 μmol/㎡/s on the culture bed. The single and mixture nutrient solutions of organic and/or inorganic components which controlled at 1.5 dS/m EC and 5.8 pH were regularly irrigated by the deep flow technique (DFT) system on the culture gutters. Number of unfolded leaves of the seedlings grown under the single or mixed nutrient solutions were significantly increased compared to the conventional Y treatment. Leaf extension of 'Jeockchima' under the mixture LED radiation condition was not affected by Y and YK or YTJ mixture treatments. SPAD value in 'Jeockchima' leaves exposed by FL under the YK mixture medium was approximately 45 % higher than under conventional Y treatment. Otherwise, the maximum SPAD value in the leaves of 'Cheongchima' seedlings was shown in YK treatment under the mixture LED lights. NO3-N contents in Y treatment treated with inorganic nutrient at the end of the experiment were up to 75% declined rather than increased over 60 % in the K and TJ organic treatment. CONCLUSION: Growth of the seedlings was affected by the mixture treatments of the organic and inorganic solutions, although similar or lower dry weight was recorded than in the inorganic treatment Y under the plant factory system. Treatment Y containing the highest NO3-N content among the considered nutrients influenced growth increment of the seedlings comparing to the other nutrients. However effect of the higher NO3-N content in the seedling growth was different according to the light qualities considered in the experiment as shown in leaf expansion, pigmentation or dry weight promotion under the single or mixed nutrients.

Studies on the Germination Characters of Korean Ginseng (Panax ginseng C.A. Meyer) Seed (고려인삼종자(高麗人蔘種子)의 발아특성(發芽特性)에 관(關)한 연구(硏究))

  • Won, Jun Yeon;Jo, Jae Seong
    • Korean Journal of Agricultural Science
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    • v.15 no.1
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    • pp.47-68
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    • 1988
  • This study was conducted to define the optimal conditions for embryo growth during seed stratification and for breaking dormancy as well as seed germination of stratified ginseng seeds. The experiments were also carried out to detect some materials which were expected to induce seed dormancy in the ginseng seeds. The results summarized as follows; 1. The growth of embryo during seed stratification was significantly inhibited by the existence of endocarp. The fastest embryo growth was resulted at $15^{\circ}C$ and an estimated optimal temperature for embryo growth was about $18^{\circ}C$. 2. There was no significant difference between the embryo growth and germination ratio of ginseng seeds which were sown in seed bed at Aug-5 without seed stratification and that of artificial seed stratification. 3. Embryo growth and germination ratio was significantly inhibited by high temperature treatment at $30^{\circ}C$ for 24 hours or respiration stress by immersing seeds in water for 10 days or more. 4. When the seed stratification was started at $10^{\circ}C$, growth of embryo in the ginseng seeds were almost stopped. But, when the seeds were stratified first at $20^{\circ}C$ for 50 days and next at $10^{\circ}C$ for 50 days, the embryo growth was significantly promoted compared with the embryo growth in the seeds which were stratified at $20^{\circ}C$ for 100 days. 5. The successive embryo growth after seed stratification was significantly accelerated at $10^{\circ}C$ but the seeds chilled at $5^{\circ}C$ for 100 days were resulted in the highest germination ratio as well as the shortest days for germination. 6. The successive embryo growth during chilling treatment and seed germination were significantly inhibited by immersing seeds in water just before chilling treatment or during chilling treatment and by interruption of chilling treatment with raising temperature to $20^{\circ}C$ for 20 days during chilling treatment. 7. The germination ratio of ginseng seeds which finished chilling treatment was highest at $10^{\circ}C$ and 62.5% was the estimated soil moisture for the best germination of ginseng seeds. The ginseng seeds were found to require high amount of oxygen for germination. 8. Only water soluble material in homogenized ginseng seeds showed a significant inhibiting effect on the seed germination of sesame, millet and soybean. Water soluble material dissolved from undehisced ginseng seeds showed stronger inhibiting effect on the seedling growth of sesame than material from dehisced ginseng seeds. Extraction temperature did not influence the inhibiting effect of the material dissolved from ginseng seeds on the seedling growth of sesame. 9. Water soluble materials dissolved from the berry pulps, leaves, fresh roots and dried roots also showed a significant inhibiting effect on the seedling growth of sesame. 10. Water soluble materials dissolved from the ginseng seeds, leaves and fresh roots showed a significant inhibiting effect on the germination of true fungi and the growth of spawn but the growth of phytopathogenic bacteria was not. 11. Among the water soluble materials dissolved from ginseng seeds, the materials of low molecular weight less than 3,000 were resulted a significant inhibiting effect on the seedling growth of sesame and the materials of high molecular weight also showed an inhibiting effect.

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Radiotherapy in Incompletely Resected Gastric Cancers (불완전 절제된 위암의 방사선 치료)

  • Kim Jong Hoon;Choi Eun Kyung;Cho Jung Gil;Kim Byung Sik;Oh Sung Tae;Kim Dong Kwan;Chang Hyesook
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.17-25
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    • 1998
  • Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.

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The Study of Effect and Safety related to Dong-gi Acupuncture(DGA) and Complex therapy on Lumbago due to blood stasis and sprain (좌섬(挫閃)·어혈(瘀血) 요통(腰痛)에 동기침법(動氣鍼法) 및 복합치료(複合治療)의 유효성(有效性) 및 안정성(安定性) 연구(硏究))

  • Kim, Kee-Hyun;Lim, Hyung-Ho;Hwang, Hyeon-Seo;Song, Ho-Sueb;Song, Young-Sang;Kwon, Soon-Jung;Kim, Kyung-Nam;Ahn, Koang-Hyun;Lee, Seong-No;Kang, Mi-Suk;Gyun, Im-Jung
    • Journal of Acupuncture Research
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    • v.19 no.3
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    • pp.107-114
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    • 2002
  • Objective : This study was designed to find the most effective and safest way to overcome Lumbago due to blood stasis and sprain involved in a few Meridian Tendino-musculatures by evaluating the effect of two kinds of Dong-gi(Dong-qi) Acupuncture(DGA) and by reporting their side effects. Material : 97 patients of out and admission patients were selected, who were diagnosed with lumbar sprain caused by repetitive bending, heavy weight lifting, unsuitable posture, concussion and falling down and whose Lumbago due to blood stasis and sprain in the concept of oriental medicine. Methods : 97 patients were divided into three groups. One is exclusive DGA group to which DGA and the method retaining needles on the acupoints for about 20 minutes were applied, the other is DGA combined active exercise group in which patients stretched their Meridian Tendino-muscuIatures with their hips moving up and downward repeatedly during DGA, the third is DGA combined passive exercise group in which patients were made to flex or extend their bodies on the auto flexion-distraction table in a prone position, from 10 to 20 degree, during DGA. In each group, bed rest, physical therapy and herbal medicine were used according to symptoms, in addition to DGA. In DGA method, "Su(Shu)" points of the meridian related to the involved Meridian Tendino-musculature were mainly chosen, that is, Sokkol(Shugu, B65), Hugye(Houxi, SI3), ChungJo(Zhongzhu, TE3) were used, for most LBP belonged to Bladder and Gallbladder Meridian Tendino-musculature disorders. Pyong-Bo-Pyong-Sa(Ping-Bu-Ping-Xie) such as Dong-Gi and Yeom-Jeon(Nian-Zhuan) was applied as Bo-Sa method. For evaluation of effectiveness, new score system was devised by severity of pain and range of movement. the score was given twice at patients' first and last visit and the difference between first and last score was regarded as a evaluation scale, the effectiveness was classified into four grade by evaluation scale.(scale : 12-15; excellent, 8-11; good, 4-7; fair, 0-3; bad) Results : 1. Exclusive DGA, DGA combined active exercise and DGA combined passive exercise group showed 97, 87 and 89% in effectiveness. 2. Exclusive DGA, DGA combined active exercise and DGA combined passive exercise group showed no aggravation of pain, range of movement. 3. In blood test of 34 patients, only one patient showed abnormal rise of sGOT, sGPT and $\gamma$-GTP at his first visit and the others didn't show any detrimental change. DGA had no bad influence upon BUN and creatinine of patients. Conclusion : For complex theraphy combining DGA, exercise, physical therapy and Herbal medicine proved to be highly effective on treating lumbago due to blood stasis and sprain, this is expected to be available for clinical use.

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