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Excellent treatment outcomes in children younger than 18 months with stage 4 MYCN nonamplified neuroblastoma

  • Kim, Chiwoo;Choi, Young Bae;Lee, Ji Won;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.61 no.2
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    • pp.53-58
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    • 2018
  • Purpose: Although the prognosis is generally good in patients with intermediate-risk neuroblastoma, no consensus has been reached on the ideal treatment regimen. This study analyzed treatment outcomes and toxicities in patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma. Methods: We retrospectively analyzed 20 patients younger than 18 months newly diagnosed with stage 4 MYCN nonamplified neuroblastoma between January 2009 and December 2015. Patients received 9 cycles of chemotherapy and surgery, with or without local radiotherapy, followed by 12 cycles of differentiation therapy with 13-cis-retinoic acid. Chemotherapy consisted of alternating cycles of cisplatin, etoposide, doxorubicin, and cyclophosphamide (CEDC) and ifosfamide, carboplatin, and etoposide (ICE) regimens. Results: The most common primary tumor site was the abdomen (85%), and the most common metastatic sites were the lymph nodes (65%), followed by the bones (60%), liver (55%), skin (45%), and bone marrow (25%). At the end of induction therapy, 14 patients (70%) achieved complete response, with 1 achieving very good partial response, 4 achieving partial response, and 1 showing mixed response. Nine patients (45%) received local radiotherapy. At a median follow-up of 47 months (range, 17-91 months), none of these patients experienced relapse, progression, or secondary malignancy, or died. Three years after chemotherapy completion, none of the patients had experienced grade ${\geq}3$ late adverse effects. Conclusion: Patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma showed excellent outcomes, without significant late adverse effects, when treated with alternating cycles of CEDC and ICE, followed by surgery and differentiation therapy.

REARING EXPERIMENT OF COMMON CARP IN BRACKISH WATER (염분함유수에서의 잉어사육시험)

  • KIM In-Bae;JO Jae Yoon;CHOI Jae Young
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.8 no.3
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    • pp.181-184
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    • 1975
  • A aeries of experiments on the tolerance and growth of common carp, about 10 cm long in body length, in brackish water containing salinities of 2 to 20 ppt, were carried out in indoor aquariums. All fish well survived in waters containing salinities up to 12 ppt, when transfered directly from fresh water, and fairly well survived at 15 ppt, when acclimated at lower salinities before putting them into higher salinities. The temperature during the experiments was subjected to the room temperature ranging from $14^{\circ}\;to\;27^{\circ}C$. The food efficiency and growth rate were good both for alive Tubifex and pelletized dry feed at salinities from 2 to 8 ppt, but at 12 ppt the result was very poor for alive Tubifex while, for pellet feed, food efficiency was very good though growth rate was relatively low.

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MUCOEPIDERMOID CARCINOMA OF PALATE: REPORT OF A CASE (구개부에 발생한 점액표피양 암종의 치험례)

  • Bae, Jung-Ho;Yoon, Kyu-Ho;Park, Kwan-Soo;Cheong, Jeong-Kwon;Shin, Jae-Myung;Hong, Sung-Chul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.68-72
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    • 2006
  • Mucoepidermoid carcinoma is one of the most common malignant salivary gland neoplasm. It occurs over a wide age range, and is most common in the parotid gland and usually appears as an asymptomatic swelling. Pain or facial nerve palsy may develop. Minor salivary gland tumors also typically appear as asymptomatic swellings, which are sometimes fluctuant and have blue or red color that can be mistaken clinically for a mucocele. Histopathologically the mucoepidermoid carcinoma is composed of a mixture of mucous-producing cells and squamous (epidermoid) cells. Low-grade tumors show prominent cyst formation, minimal cellular atypia, and relatively high proportion of mucous cells. Mucoepidermoid carcinoma of the minor salivary glands are treated usually by assured surgical excision. For low-grade neoplasm, only a modest margin of surrounding normal tissue may need to be removed, but high-grade or large tumors warrant wider resection. Postoperative radiation therapy also may be used for more aggressive tumors. Mucoepidermoid carcinoma of the oral minor salivary glands generally have a good prognosis, because they are mostly low-to intermediate grade tumors. We present a case of mucoepidermoid carcinoma managed with surgical enucleation and postoperative irradiation and a good clinical result with review of literatures.

Management of Ipsilateral Fractures of Humerus and Forearm in Adults (성인에서 동측에 발생한 상완골과 전완골 골절의 치료)

  • Sohn Sung-Keun;Kim Byeong-Hwan;Yang Sung-Wook
    • Clinics in Shoulder and Elbow
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    • v.1 no.2
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    • pp.212-220
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    • 1998
  • Concomitant ipsilateral fractures of the humerus, radius and ulna are uncommon combined injury and are also called "floating elbow". It was found that this injury was usually a result of rather severe trauma and frequently associated injuries to other organ systems. It is controversial in the treatment of the "floating elbow", but the current treatment recommendations are open reduction and internal fixation of both the humerus and the forearm fracture with early initiation of range of motion exercises. The authors reviewed thirteen cases of ipsilateral fractures of the humerus, radius and ulna treated in our clinic from January 1992 to March 1997, and average follow-up period was over 18 months(range, 12 to 36 months). The results obtained were as follows; 1. The most common cause of injury was traffic accident and most common location of fractures was mid-third in both humerus and forearm. 2. The shape of fractures was transverse or comminuted in most cases. 3. The good clinical results were obtained by open reduction and internal fixation of both the humerus and the forearm fracture with early initiation of range of motion exercises. 4. The recovery was affected by the severity of the initial trauma and method of the treatment. 5. According to the Lange and Foster method, the functional result was good in 8 cases, fair in 4 cases and poor in 1 cases.

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Research for Generation of Accurate DEM using High Resolution Satellite Image and Analysis of Accuracy (고해상도 위성영상을 이용한 정밀 DEM 생성 및 정확도 분석에 관한 연구)

  • Jeong, Jae-Hoon;Lee, Tae-Yoon;Kim, Tae-Jung
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.26 no.4
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    • pp.359-365
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    • 2008
  • This paper focused on generation of more accurate DEM and analysis of accuracy. For this, we applied suitable sensor modeling technique for each satellite image and automatic pyramid matching using image pyramid was applied. Matching algorithm based on epipolarity and scene geometry also was applied for stereo matching. IKONOS, Quickbird, SPOT-5, Kompsat-2 were used for experiments. In particular, we applied orbit-attitude sensor modeling technique for Kompsat-2 and performed DEM generation successfully. All DEM generated show good quality. Assessment was carried out using USGS DTED and we also compared between DEM generated in this research and DEM generated from common software. All DEM had $9m{\sim}12m$ Mean Absolute Error and $13m{\sim}16m$ RMS Error. Experimental results show that the DEMs of good performance which is similar to or better than result of DEMs generated from common software.

Srugical treatment of aortic arch syndrome -Two cases report- (대동맥궁 증후군의 수술치료 -2례 보고-)

  • 채성수
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.170-174
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    • 1983
  • Aortic arch syndrome is an unusual disease entity characterized by the narrowing or obliteration of major branches of the arch of the aorta regardless of etiology. We have experienced 2 cases. One of them was 22 years old office girl with 3 months history of headache, intermittent syncope and weakness and claudication on left arm especially during her physical exercise. On physical examination, pulseless on left antecubital and radial artery and blood pressure on left arm was inable to check and coldness with weakness were noted on the same side. Aortic angiography reealed 34% narrowing of left subclavian artery as that of right. But both common carotid artery and both axillary arterial patency were relatively good. Through right supraclavicular and left axillary incision, bypass graft with Gore-tex prosthesis (I.D. 6mm, Length 25 cm) was implanted from right subclavian artery on 2cm distal to origin of right common carotid arery to left axillary artery distal to axillary fossa. End to side anastomosis with preservation of left subclavian artery was done. Postoperative state was stable with blood pressure of 110/70 mmHg on left arm and palpable antecubital and radial pulsation. Another one was 41 year old male patient with 8 months history of pain and numbness on right upper arm and shoulder. On admission, right arm blood pressure was 110/80 mmHg, left arm was 160/110 mmHg, but other physical findings had no abnormalities. Angiography revealed segmental narrowing of right axillary artery on the beginning with 2 cm in length. Operative treatment with right wupraclavicular and right axillary incision, bypass graft with great saphenous vein (Length; 15 cm) from right subclavian artery between scalenus anticus and medius to axillary artery at distal end of axillary fossa was done. The authors report two cases of Aortic arch syndrome treated with bypass graft using Autograft or Gore-tex with good result.

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Development of Sports Ethics Consciousness Scale for Preventing Fixing Game (승부조작 예방을 위한 스포츠 윤리의식 척도개발)

  • Kwon, Ki-nam;Lee, Jung-Rea;Lee, Hyuck Gi
    • 한국체육학회지인문사회과학편
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    • v.58 no.4
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    • pp.127-138
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    • 2019
  • The purpose of this study was to develop sports ethics consciousness scale for preventing fixing game, based on foreign data but considering the actual conditions of Korea. Respondents were elite sports athletes from D-city. This study was conducted on 304 elite sports athletes from middle, high school and college students selected by purposeful sampling, for three months from May to July 2018. In the date analysis stage, the descriptive statistic analysis was performed for understanding the item characteristic and the internal consistency coefficient(α), the exploratory factor analysis and the confirmatory factor analysis were perforned for analysing the credibility, the validity. There were five sub-factors of sports ethics consciousness scale, consisting of ethics of autonomy, ethics of collectivism, ethics of common good, ethics of dignity, and ethics of productivity, which were identified through 23 questions. It was proved that the scale have enough suitability (χ2=420.151, df=220, p=.000, GFI=.996, NFI=.979, TLI=.960, CFI=.978, RMSEA=.055).

RECENT TRENDS IN INCIDENCE AND MANAGEMENT OF CLEFT LIP AND PALATE (구순열과 구개열의 발생요인 및 치료 경향)

  • Yoon, Chun-Ju;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.4
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    • pp.295-309
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    • 2006
  • The present study was aimed to evaluate the incidence, etiological factors, and management of cleft lip and palate. Two hundred and twenty patients with cleft lip and/or cleft palate who were treated at Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital, during the period between January 1994 and December 2003 were reviewed. The ratios of cleft lip : cleft lip with cleft palate : and cleft palate were 0.4:1.1:1. Males were more common than females in cleft lip (1.3:1) and cleft lip and palate (2.5:1), while females were more common than males in cleft palate (1:1.3). In the cleft side, left clefts were more prevalent than right clefts (cleft lip 1.3:1, cleft lip and palate 1.6:1). Unilateral clefts were more common than bilateral clefts in cleft lip (79:21). Cleft lip and cleft palate were more common in those with blood type A (34.5%) than those with other types. There was no significant relationship between birth season and frequency of clefts. The clefts were common in the first-born (48.8%), and in mothers aged between 25 and 29 (51.7%). Medication (24.7%) and stress (16.7%) during the first trimester were noted. Positive familial history was noted in 13 cases (5.9%). Thirty-two cases (15%) were associated with other congenital anomalies, in which tonguetie (40.6%) and congenital heart disease (21.9%) were most common. Among 100 patients with cleft palate, 77 patients had middle ear disease (77%), which occurred predominently in the incomplete cleft palate. Seventy-six among the 77 patients received myringotomy and ventilation tube insertion, and the remaining one received antibiotic medication only. Cleft lips were treated primarily at 3 to 6 months, and cleft palates were at 1 to 2 years. Treatment regimens included modified Millard method mainly in the cleft lip, and Wardill V-Y, Dorrance method, and Furlow method in the cleft palate. The percentage of palatal lengthening as type of cleft palate was greater in the incomplete cleft palate group (11.2%) than in the complete cleft palate group (9.6%). The percentage of palatal lengthening as operating method was no difference between the Furlow method (10.9%) and the push back method (10.7%). As postoperative complications, hypertrophic scar was most frequent in the cleft lip, and oronasal fistula in the cleft palate. In summary, it was shown that medication and stress during the first trimester of pregnancy were frequently associated with cleft lip and cleft palate, adequate timing and selection of method of operation are important factors to obtain morphologically and functionally good results. Furthermore prevention and treatment of middle ear disease are important in cleft palate patients because of its high co-occurrence.

Atypical Giant Cell Tumor: A Case Report (비전형적 거대세포종의 치험례)

  • Hwang, So Min;Ahn, Sung Min;Jung, Pil Ku;Oh, Kyoung Seok;Kim, Jin Hyeong
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.796-798
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    • 2007
  • Purpose: Giant cell tumor is the second most common benign neoplasm in upper extremity. Unlike usual chief complaint of painless mass, an atypical case with giant cell tumor presented a distinguishing characteristics of which accompany pain and tenderness and is histologically giant-cell free. Methods: A 31-year-old male patient complained of a rapid growing painful mass on the proximal phalanx of the left ring finger. Under microscopic operation, a $1.6{\times}1.3cm$ sized mass was found to be surrounded by areolar tissue and attached to a tendon sheath, encircling the digital nerve and artery. Diagnostic confirmation was assisted by positive finding in histologic immunohistochemical stain-CD68. Characteristic pathologic finding is an atypical distribution of spindle cells & histiocytes without giant cells in fascicular pattern. Results: Giant cell tumor was carefully removed under microscopic approach, while preserving digital nerve & artery. In postoperative 13th month, the patient presented with a 6mm of static two-point discrimination test, similar to that of the adjacent fingers. Conclusion: We report an atypical case with painful mass on tendon sheath, surrounding the digital nerve and artery that was diagnosed of giant cell tumor, but without giant cells on pathology. This case provides broader understanding of the giant cell tumor that should not only rely its typical findings of the painless mass and positive sign on H&E stain.

A Study of Surgical Outcome for Multiple Intracranial Aneurysms (다발성 뇌동맥류의 수술적 치료 결과에 대한 연구)

  • Kim, Kyu Hong;Choi, Jung Hoon;Bae, Sang Do
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1322-1327
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    • 2000
  • Objectives : To assess the surgical results for patients with multiple intracranial aneurysms and factors related to prognosis of patients. Materials and Methods : We retrospectively analyzed the clinical characteristics of 47 patients with multiple intracranial aneurysms and assessed the types of surgical treatment and prognosis of 44 patients who received surgical treatment from January 1986 to March 1999. Results : The 47 patients presented altogether 108 aneurysms with male to female ratio of 1 : 3.7, and average age 54.9 years(range 33-81 years). Common locations for multiple aneurysms were P-com(31%), MCA(30%) and Acom( 15%). The postoperative good and poor outcomes were 30 cases(68%) and 11 cases(25%), respectively and there were 3 deaths(7%). The analyzed results for 44 surgically treated patients were as follows ; 1) The size of aneurysm was relevant to frequency of rupture ; the lowest for lesions less than 1cm(21%), rising to 85% for lesions greater than 3cm(p<0.05). 2) The surgical outcome was significantly correlated with preoperative clinical status of the patients(p<0.05). 3) The good outcome was associated with surgery within 7 days(especially 24 hours) after clinical onset of symptoms but not with type of operation and laterality of aneurysms. Conclusion : With regard to the surgical treatment for multiple aneurysm cases, surgeons should consider the salient factors in a good prognosis such as patient's preoperative status, size of aneurysm, timing of surgery, and type of operation.

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