• Title/Summary/Keyword: clinical analysis

Search Result 12,304, Processing Time 0.049 seconds

Analysis of Characteristics and Prognostic Factors in Adult Patients Receiving Mechanical Ventilation in the Medical Intensive Care Unit of a University Hospital (한 대학병원 내과계 중환자실의 기계환기 시행 환자의 현황 및 예후인자의 분석)

  • Song, Jin Woo;Choi, Chang-Min;Hong, Sang-Bum;Oh, Yeon-Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
    • /
    • v.65 no.4
    • /
    • pp.292-300
    • /
    • 2008
  • Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit. Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation for more than 48 hours in the medical ICU of one tertiary referral hospital. Results: The mean age of the patients was $60.3{\pm}15.6$ years and 34.0% were female. The initial mean APACHE III score was $72.3{\pm}25$. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score >70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality. Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly associated with the outcome of mechanical ventilatory support in patients with respiratory failure.

The Significance of Ku70 Expression in Patients with Nasopharyngeal Carcinoma (비인강암에서 방사선치료의 예측인자로써 Ku70 발현의 의의)

  • Song Si Yeol;Lee Sang-wook;Yu Eunsil;Cho Kyung-Ja;Park Jin-hong;Kim Sang Yoon;Nam Soon Yuhl;Lee Bong-Jae;Kim Sung Bae;Choi Seung-Ho;Ahn Seung Do;Shin Seong Soo;Choi Eun Kyung
    • Radiation Oncology Journal
    • /
    • v.23 no.1
    • /
    • pp.1-8
    • /
    • 2005
  • Purpose : The objective of this study was to determine whether the expressions of the two components of DNA-dependent protein kinase, Ku70 and DNA-PKcs, influence the response to radiotherapy (RT) and outcome of treatment of non-disseminated nasopharyngeal carcinoma (NPC) in patients who received definitive RT. Materials and Methods : Sixty-six patients with NPC who were treated with radiotherapy alone or with concurrent chemotherapy between June 1995 and December 2001 were divided into groups based on the levels of immunoreactivity for Ku70 and DNA-PKcs in pretreatment biopsy specimens. The over-expression of Ku70 or DNA-PKcs groups Included patients whose biopsy specimens showed at least 50% immunopositive tumor cells; patients in which less than 50% of the tumor cells in the biopsy tissues were immunopositive were placed in the low Ku70 and DNA-PKcs groups. The immunoreactivities for Ku70 and DNA-PKcs were retrospectively compared with the sensitivity of the tumor to radiation and the patterns of therapy failure. Univariate analyses were peformed to determine the prognostic factors that influenced locoregional control of NPC. Results : The five-year locoregional control rate was significantly higher in the low Ku70 group (Ku(-)) (85%) than in the high Ku70 group (Ku(+)) (42%) (p=0.0042). However, there were no differences in the metastases-free survival rates between the two groups (Ku70 (+), 82%; Ku70 (-), 78%; p=0.8672). Univariate analysis indicated that the over-expression of Ku70 surpassed other well-known predictive clinocopathologic parameters as an Independent prognostic factor for locoregionai control. Eighteen of 22 patients who had locoregional recurrences of the tumor displayed an over-expression of Ku70. No significant association was found between the level of DNA-PKcs expression and the clinical outcome. Conclusion : Our data suggest that the level of Ku70 expression can be used as a molecular marker to predict the response to RT and the locoregional control after RT and concurrent chemotherapy in patients with non-disseminated NPC.

Arm Morbidity after Breast Cancer Treatments and Analysis of Related Factors (유방암 환자의 상지 부작용과 관련 요인)

  • Chun Mi Son;Moon Seong Mi;Lee hye Jin;Lee Eun-Hyun;Song Yeoung Suk;Chung Yong Sik;Park Hee Bung;Kang Seung Hee
    • Radiation Oncology Journal
    • /
    • v.23 no.1
    • /
    • pp.32-42
    • /
    • 2005
  • Purpose : To evaluate the incidence of arm morbidity following breast cancer surgery including axillary dissection and to identify related factors. Materials and Methods : One hundred and fifty nine patients were studied using a self-report questionnaire and a clinical examination. Lymphedema, reduction of range of motion in shoulder joint and subjective symptoms (pain, impaired arm movement, numbness, stiffness) were evaluated. As related factors, demographic, oncologic characteristics and types of treatment were analysed. Results : The incidence of lymphedema ($\geqq$2 cm difference comparing to unaffected arm) was $6.3\%$, $10.7\%$, $22.5\%$ and $23.3\%$ at each 10 cm, 20 cm, 30 cm, and 40 cm from wrist. Reduction of range of motion in shoulder joint ($\geqq$ 20 degree difference comparing to unaffected arm) was noted In more than 1/3 patients for flexion, abduction and internal rotation. Especially the reduction of range of motion in internal rotation was severe ($>50\%$ reduction) in 1/3 patients. Approximately 50 to $60\%$ of patients complained impaired arm movement, numbness, stiffness and pain. Body mass index (BMI) was the significant risk factor for lymphedema. Conclusion : Lymphedema was present in 1/3 of patients and the common sites of edema were 30 cm 40 cm proximal from the wrist. Also most severe reduction of range of motion in shoulder joint was with internal rotation. There needs weight control for lymphedema because BMI was the significant risk factor for lymphedema. Also rehabilitation program for range of motion especially internal rotation In shoulder joint should be developed.

The Clinical Effectiveness of Atipamezole as a Medetomidine-Tiletamine/Zolazepam Antagonist in Dogs (개에서 Medetomidine-Tiletamine/Zolazepam 마취에 대한 Atipamezole의 길항 효과)

  • Kwon, Young-sam;Joo, Eun-jung;Jang, Kwang-ho
    • Journal of Veterinary Clinics
    • /
    • v.20 no.3
    • /
    • pp.286-293
    • /
    • 2003
  • The cardiopulmonary and antagonistic effects of atipamezole, to medetomidine (30 ug/kg, IM)-tiletamine/zolazepam (10 mg/kg, IV) were determined. Twelve healthy mongrel dogs ,(4.00$\pm$0.53 kg, mean$\pm$SD) were randomly assigned to the four experimental groups (control, A30; atipamezole 30 ug/kg, A60; atipamezole 60 ug/kg, A150; atipamezole 150 ug/kg) with 3 dogs in each group. Atropine (0.03 mg/kg, IM), medetomidine, and tiletamine/zolazepam (TZ) were injected 10 minute intervals. Atipamezole was injected intravenously 15 minutes after TZ injection. Mean arousal time (MAT) was 52.50$\pm$4.98, 43.06$\pm$2.60, 32.83$\pm$8.13, and 14.36$\pm$1.60 minutes in control, A30, A60, and Al50 groups respectively. In Al50 group, MAT was significantly reduced (P < 0.05). but mean walking time (MWT) was similar to that in control group. In recovery period, the higher doses of atimapezole, the rougher recovery including head rocking, hypersalivation, and muscle twitching. Five of twelve dogs vomited within 5 minutes after medetomidine injection. In Control group, heart rate significantly decreased in all recording stages except 15 minutes after TZ injection, 10 minutes after medetomidine injection in all groups, and 40 minutes after atipamezole injection in A30 group (P < 0.05). In Al50 group, atipamezole reversed the respiratory depression induced by medetomidine. Arterial blood pressure was significantly decreased 10minutes after medetomidine injection and 15 minutes after TZ injection in almost dogs in this study (P < 0.05). From 10 minutes after atipamezole injection to arousal time, arterial blood pressure was progressively increased in A60 and A150 group. Any value of blood gas analysis and CBC, and serum chemistry values were not significantly changed except pH of Al50 at 10 minutes after medetomidine injection. As shown in present study, atipamezole(150 ug/kg) is considered to exert a useful reversal effect in dogs anesthetized with medetomidine-tiletamine/zolazepam combination.

Effect of Cholesterol Supplementation in Freezing Medium on the Survival and Integrity of Human Sperm after Cryopreservation (콜레스테롤이 동결-해동 후 인간정자의 생존과 기능보존에 미치는 영향)

  • Lim, Jung-Jin;Sung, Su-Ye;Kim, Kye-Seong;Song, Seung-Hon;Lee, Woo-Sik;Yoon, Tae-Ki;Lee, Dong-Ryul
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.35 no.3
    • /
    • pp.203-212
    • /
    • 2008
  • Objective: During cryopreservation process, cold shock and cryo-injury affect the fertilizing capacity of the sperm by damaging cell membranes with loss of functional integrity. A longstanding concept for preventing the cryo-damage is to stabilize the plasma membrane by incorporating cholesterol. This study was to determine the effects of cholesterol in freezing media on the motility and functional integrity of human sperm after cryopreservation. Methods: Control group (non-cholesterol treated) and different concentrations of cholesterol-treated sperm (14 healthy males) were frozen and thawed. After freezing and thawing of sperm, the quality of sperm was evaluated by sperm analysis, acrosome reaction test and sperm chromatin structure assay. Results: When human sperm were incubated in sperm freezing medium (SFM) containing $0.5{\mu}g$ cholesterol and then freezing/thawing, the motility of sperm have significantly improved compared to those untreated cholesterol ($33.46{\pm}1.48%$ vs. $30.10{\pm}1.07%$, p<0.05). The rate of calcium ionophore-induced acrosome reactions in post-thawed sperm was significantly higher than that ($53.60{\pm}1.60%$ vs. $47.40{\pm}1.86%$, p<0.05) in SFM containing cholesterol. Sperm chromatin structure assay revealed that DNA damage to the sperm in the cholesterol-treated group was lower than that of non-treated group. Conclusion: These results suggest that increased cholesterol content of sperm plasma membrane by supplementation of cholesterol in SFM improves sperm motility, capacitation status, and DNA integrity. Therefore, addition of cholesterol into SFM could be a useful for protecting human sperm from cold shock and cryo-injury during cryopreservation.

Predictor of IVF Outcomes Following Single Embryo Transfer in Poor Responder Patients (저반응군의 체외수정에서 한 개의 배아 이식 시 임신에 영향을 주는 요인)

  • Kim, Hye-Ok;Kim, Min-Ji;Yeon, Myeong-Jin;Cha, Sun-Wha;Koong, Mi-Kyoung;Song, In-Ok
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.35 no.3
    • /
    • pp.213-221
    • /
    • 2008
  • Objective: To evaluate predictor of IVF outcomes following single embryo transfer in patients with decreased ovarian reserve. Methods: A retrospective review was performed in 919 IVF cycles with elevated basal serum FSH (${\geq}12\;mIU/mL$), the number of retrieved oocytes ${\geq}4$ and serum $E_2$ concentration on hCG day <500 pg/ml between Jan. 1996 and Dec. 2006. Two hundred thirty five IVF cycles following single embryo transfer were included. Pregnancy rates and live birth rates was evaluated according to maternal age, serum $E_2$ on hCG day, basal FSH level, the number of blastomere on day 3 ET, stimulation protocol, the number of cycles of ET. Statistical analysis was used SPSS 12.0 program. Results: OPU cancellation rates were 25.6% (235 cycles), OPU failure rates were 18.5% (170 cycles), embryo transfer cancellation rates were 14.0% (129 cycles). Pregnancy rates following single embryo transfer was 8.1% (19 cycles) and live birth rates was 4.7% (11 cycles). Pregnancy rates and live birth rates of women under 35 years old was statistically higher than those of women above 35 years old (20% vs. 3.5% (p<0.0001), 12.3% vs. 1.8%, (p=0.002)). There was no difference in basal FSH, serum $E_2$ on hCG day, and the number of blastomere on ET, and stimulation protocol. Cumulative pregnancy rates according to the number of cycles of ET were $1^{st}$ 8.1%, $2^{nd}$ 9.2%, $3^{rd}$ 9.7%, $4^{th}$ 9.0%, and $5^{th}$ 9.5%. Conclusion: Pregnancy rates and live birth rates of IVF-ET cycles following single embryo transfer in patients with decreased ovarian reserve are statistically increased in women under 35 yrs old. There is no difference in cumulative pregnancy rates. These data may be helpful for counseling women with decreased ovarian reserve in attempting IVF with their own eggs or when choosing donor oocytes.

The Results of Various Vestibular Function Tests in Young Male Adult (장정에 시행한 몇가지 평가기능 검사성적에 대한 고찰)

  • 박찬일;추광철;노관택
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1972.03a
    • /
    • pp.2.3-2
    • /
    • 1972
  • The vestibular function test reveals the objective findings of the impairment of the vestibular labyrinth. It's purpose is based on the analysis of the findings and detect the location and etiology of the labyrinthine impairment. In the vestibular function test, the vestibulo-spinal reflex has the clinical significance upon the tonus of the striated muscles by the labyrithine stimulation and contribute to regulating the posture and the position, at rest as well as in motion. The vestibulo-spinal reflex must performe as one of the routine vestivular function test because it can be evoked in man by such weak stimuli to the labyrinth as cannot induce vestibulo-ocular reflex. Authors performed the vestibular function test such as one leg test, gait test, stepping test and vertical writing test to one hundred of healthy and young male adult and received the following results. Results 1. One leg test: In 30 seconds, the frequency of dropping the leg on the ground was between 0 to 3 times in Rt., and 0 to 5 times in Lt. The mean frequency was 0.48 times in Rt., and 0.68 times in Lt. 2. Gait test: In forward gait; the range of the deviation was distributed 0 to 100 cm and mean range was 22.5cm to the Rt., 26.1cm to the Lt. In backward gait; the range deviation was distributed 0 to 140cm and mean range was 35.4cm to the Rt., 33.0cm to the Lt. 3. Stepping test: In normal head position; forward movement war 93% and backward 5%. The angle of displacement deviated to the Rt. side in 36%, and Lt. in 50%. The angle of rotation deviated to the Rt. side in 53 %, and Lt. in 36%. The mean values: angle of displacement was 22.05 degrees, angle of rotation was 24.40 degrees, distance of displacement was 48.95cm. In backward head position; Forward movement was 94% and backward was 3%. The angle of displacement deviated in 34%, and Rt. in 55%, to the Rt. side The angle of rotation deviated to the Rt. side in 50%, and Lt. in 42%. The mean values; angle of displacement was 29.72 degrees, angle of rotation was 39.53 degrees, distance of displacement was 44.17cm. 44.17cm. 4. Vertical writing test: The angle of deviation was between 0 to 16 degrees in all cases, and was between 0 to 12 degrees in the cases of normal head position. The mean angle of deviation was between 4.15 to 5.76 degrees on each side. The direction of deviation to the Rt. side was 54~69%, Lt. was 25~40% and 3~7% was vertical without deviation.

  • PDF

A Study on Bone Formation & Osteoporosis by Taeyoungion-Jahage Extracts

  • Kim, Yi-Geun;Seong, Jun-Ho;Kim, Dong-Il;Lee, Tae-Kyun;Kim, Jun-Ki;Park, Young-Duck
    • The Journal of Korean Obstetrics and Gynecology
    • /
    • v.15 no.4
    • /
    • pp.45-60
    • /
    • 2002
  • Mouse calvarial osteoblast cells were isolated and cultured. To examine whether the cells produce active gelatinases in culture medium or not,the cells were analyzed using by zymograsphic analysis on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). We show that mouse calvarial osteoblasts in culture constitutively synthesize progelatinase- A. Then, mouse osteoblasts, which were stimulated by PTH, $1,25(OH)_2D_3$, mononuclear cell conditioned medium (MCM) and IL-1 as bone resorption agent's, showed increased collagenolysis by producing the active gelatinase. However, treatment of indomethacin and dexamethasone significantly decreased those effects of collagenolysis in mouse osteoblastic cells. On the other hand, IL-1 in stimulating bone resorption was examined using fetal mouse long bone organ culture. IL-1 stimulated bone resorption and produced marked resorption when present simultaneously. Furthermore, when it was examined the effects of indomethacin and dexamethasone on the dose dependent responses of $IL-1{\alpha}$, indomethacin and dexametasone produced a rightward shift in the IL-1 dose response curve. The results of in vitro cytotoxicities showed that Taeyoungjon-Jahage water extracts(T.Y.J-J.H.G extracts) have no any cytotoxicities in concentrations of $1-200\;{\mu}g/ml$ and furthermore there is no any cytotoxicity even in concentration of $300\;{\mu}g/ml$ on mouse calvarial bone cells. T.Y.J.-J.H.G. extracts had protective activity against PTH (2 units/mI), or MCM (5%, v/v), or $rhIL-1{\alpha}$ (1 ng/mI) or $1,25(OH)_2D3$ (10 ng/ml) , $IL-1{\alpha}$ and $IL-1{\beta}-induced$ collagenolysis in the mouse calvarial cells. Pretreatment of the T.Y.J.-J.H.G.extracts for 1 h, which by itself had little effect on cell survival, did not enhance the collagenolysis, nor significantly reduced the collagenolysis by pretreatment. Furthermore. the medicinal extracts were shown to have the protective effects against collagenolysis induced by $IL-1{\alpha}$ and $IL-1{\beta}$. Pretreatment of the extracts for 1 h significantly reduced the collagenolysis. Interestingly, the T.Y.J.-J.H.G. extracts were shown to have the inhibiting effects against gelatinase enzyme and processing activity induced by the bone resortion agents of PTH, $1,25(OH)_2D_3$, $IL-1{\beta}$ and $IL-1{\alpha}$, with strong protective effect in pretreatment with the extracts. T.Y.J.-J.H.G. extracts were shown to have the inhibiting effects against $IL-1{\alpha}-$ and $IL-1{\beta}-stimulated$ bone resorption and the effect of the pretreatment with a various concentrations of the medicinal extracts were significant. The inhibition extent and phenomena of IL-1 stimulated bone resorption by nonsteroidal anti-inflammatory agents of indomethacin and dexamethasone were similar to those obtained by T.Y.J.-J.H.G. extracts treatment in the mouse calvarial tissue culture system. These results indicated that the T.Y.J.-J.H.G.-water extracts are highly stable and applicable to clinical uses in osteoporosis.

  • PDF

The Radiation Therapy for Spinal Cord Compression in Hematologic Malignancy (혈암에서 발생한 척추압박증상의 방사선 치료)

  • Kim In Ah;Choi Ihl Bohng;Chung Su Mi;Kang Ki Mun;Kay Chul Seong;Choi Byung Ok;Jang Ji Young;Shinn Kyung Sub;Kim Chun Choo
    • Radiation Oncology Journal
    • /
    • v.12 no.3
    • /
    • pp.393-399
    • /
    • 1994
  • Spinal cord compression, an oncologic emergency, is a rare complication of hematologic malignancy Our experience was obtained with a series 32 Patients following retrospective analysis for assessing the role of radiation therapy and identifying the prognostic factors affecting on treatment outcome. Diagnosis was usually made by means of radiologic study such as myelography or computerized tomography (CT) or magnetic resonance imaging (MRI) and neurologic examination. Five cases were diagnosed by subjective symptom only with high index of suspicion. In 31 cases, the treatment consisted in radiation therapy alone and the remained one patient had laminectomy before radiation therapy because of diagnostic doubts. Total treatment doses ranged from 800 cGy to 4000 cGy with median of 2000 cGy. Initially large fraction size more than 250 cGy were used in 13 patients with rapidly progressed neurologic deficit. The clinical parameters considered in evaluating the response to treatment were backache, motor-sensory performance and sphincter function. Half of all patients showed good response. Partial response and no response were noted in $37.5\%$ and $12.5\%$, respectively. Our results showed higher response rate than those of other solid tumor series. The degree of neurologic deficit at that time of diagnosis was the most important predictor of treatment outcome. The elapsed time from development of symptoms to start of treatment was significantly affected on the outcome. But histology of primary tumor total dose and use of initial large fraction size were not significantly affect on the outcome. These results confirmed the value of early diagnosis and treatment especially in radiosensitive hematologic malignancy.

  • PDF

Comparison of Ovariectomy and Ovariohysterectomy in Terms of Postoperative Pain Behavior and Surgical Stress in Dogs (개에서 난소자궁절제술과 난소절제술 후 나타나는 통증 행동과 스트레스 반응의 비교)

  • Lee, Scott-S.;Lee, Seung-Yong;Park, Se-Jin;Kim, Young-Ki;Seok, Seong-Hoon;Hwang, Jae-Min;Lee, Hee-Chun;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
    • /
    • v.30 no.3
    • /
    • pp.166-171
    • /
    • 2013
  • This study was conducted to evaluate the clinical relevance and effectiveness of ovariectomy (OVE) and ovariohysterectomy (OVH) in terms of postoperative pain behavior and surgical stress. Thirteen healthy intact mongrel purpose-bred female dogs were used in this study. OVE was performed in six dogs whereas OVH was performed in seven dogs. Prior to, 1, 2, 4, 6, 12, and 24 h after surgery, pain assessment was performed by using the Short form of Composite Measure Pain Scale (CMPS-SF) and blood analysis for the determination of glucose, creatine kinase (CK), and cortisol were done. Also, surgical time, duration of anesthesia, and incision length were compared between two groups. As a result, OVH group as opposed to OVE group showed significantly longer in surgical time, duration of anesthesia, and incision length. Also, based on the two-way ANOVA test, the CMPS-SF had significant differences (p < 0.05) between two groups, with the OVE dogs having lower values at 1, 2, 4, and 6 h postoperatively. In addition, in terms of CK, the value at 1, 2, 4, 6, and 12 h were significantly (p < 0.05) increased from the baseline value for the OVH group. However, as for CK in OVE group, the values at 4, 6, and 12 h were significantly increased from the baseline value. As for blood glucose, a significant (p < 0.05) increase from the baseline was shown at 1 h postoperatively in OVH group and no significant increase was shown in OVE group. In terms of serum cortisol level, the values at the 1 and 2 h were significantly (p < 0.05) increased from the baseline value for both groups. In conclusion, our study has shown that OVE can be considered as a superior choice in terms of sterilization technique in female dogs, considering shorter incision length, surgical time, duration of anesthesia along with lower pain and surgical stress response than OVH.