• Journal of Chest Surgery
• /
• 제55권4호
• /
• pp.293-300
• /
• 2022

Lung transplantation is the only treatment option for patients with end-stage lung disease. Although more than 4,000 lung transplants are performed every year worldwide, the standardized protocols contain no guidelines for monitoring during lung transplantation. Specific anesthetic concerns are associated with lung transplantation, especially during critical periods, including anesthesia induction, the initiation of positive pressure ventilation, the establishment and maintenance of one-lung ventilation, pulmonary artery clamping, pulmonary artery unclamping, and reperfusion of the transplanted lung. Anesthetic management according to the special risks associated with a patient's existing lung disease and surgical stage is the most important factor. Successful anesthesia in lung transplantation can improve hemodynamic stability, oxygenation, ventilation, and outcomes. Therefore, anesthesiologists must have expertise in transesophageal echocardiography, extracorporeal life support, and cardiopulmonary anesthesia and understand the pathophysiology of end-stage lung disease and the drugs administered. In addition, communication among anesthesiologists, surgeons, and perfusionists during surgery is important to achieve optimal patient results.

• Journal of Trauma and Injury
• /
• 제32권2호
• /
• pp.111-114
• /
• 2019

Minimal change disease (MCD) in children has a favorable long-term prognosis, and development of end-stage renal disease is very uncommon; less than 5%. In the first case of its kind, we report a 21-year-old female with a history of MCD at the age of 6, who had late relapse subsequent to a motorcycle accident resulting in a de-gloving skin injury and intensive care unit admission. MCD was confirmed by normal light microscopy, podocyte effacement on electron microscopy and absence of any deposits on immunofluorescence 3 weeks after the incident due to critical illness. It is postulated that the skin injury is what caused the relapse of MCD.

• Journal of Gastric Cancer
• /
• 제18권3호
• /
• pp.274-286
• /
• 2018

Purpose: The aim of this study was to investigate the impact of preoperative low body mass index (BMI) on both the short- and long-term outcomes in patients with gastric cancer. Materials and Methods: A total of 510 patients with gastric cancer were divided into the following 3 groups: low BMI group (${\leq}18.5kg/m^2$, n=51), normal BMI group ($18.6-24.9kg/m^2$, n=308), and high BMI group (${\geq}25.0kg/m^2$, n=151). Results: There were significantly more stage III/IV patients in the low BMI group than in the other groups (P=0.001). Severe postoperative complications were more frequent (P=0.010) and the survival was worse (P<0.001) in the low BMI group. The subgroup analysis indicated that survival was worse in the low BMI group of the stage I/II subgroup (P=0.008). The severe postoperative complication rate was higher in the low BMI group of the stage III/IV subgroup (P=0.001), although the recurrence rate and survival did not differ in the stage III/IV subgroup among all the BMI groups. Low BMI was an independent poor prognostic factor in the stage I/II subgroup (disease-free survival: hazard ratio [HR], 13.521; 95% confidence interval [CI], 1.186-154.197; P=0.036 and overall survival: HR, 5.130; 95% CI, 1.644-16.010; P=0.005), whereas low BMI was an independent risk factor for severe postoperative complications in the stage III/IV subgroup (HR, 17.158; 95% CI, 1.383-212.940; P=0.027). Conclusions: Preoperative low BMI in patients with gastric cancer adversely affects survival among those with stage I/II disease and increases the severe postoperative complication rate among those with stage III/IV disease.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권3호
• /
• pp.881-887
• /
• 2015

Purpose: To analyze treatment modalities and prognostic factors in patients with Stage I-II endometrial stromal sarcoma (ESS). Materials and Methods: Twenty four patients (nineteen with low-grade ESS [LGESS] and five with high-grade ESS [HGESS]) were assessed retrospectively in terms of general characteristics, prognostic factors, treatment methods and survival. Results: Twenty patients were at Stage I and three were at Stage II. The stage of one patient could not be determined. With respect to age and comorbidity, no statistically significant difference was found among disease-free survival (DFS) (p=0.990; p=0.995). However, DFS was significantly shorter in Stage II than Stage I patients (p=0.002). It was also significantly shorter in HGESS patients than in LGESS patients (p=0.000). There was no statistically significant differences among the overall survival (OVS) times of patients with respect to age at diagnosis and comorbid disease (p=0.905; p=0.979) but OVS was significantly shorter in patients with HGESS (p=0.00) and Stage II disease (p=0.001). No statistically significant difference was found with respect to OVS between patients who received radiotherapy (RT) and those who did not receive RT (p=0.055). It was not statistically possible to include other treatment modalities in the analysis because of the small sample size. Conclusions: Grade and stage of a tumour were found to be the most important prognostic factors. It was not possible to determine the optimal surgical method and the effect of adjuvant treatment since the number of cases was insufficient.

• Journal of Acupuncture Research
• /
• 제23권6호
• /
• pp.153-164
• /
• 2006

Introduction : The Aim of the Study Is to Investigate the Characteristics of Yangdorak m the Patients with Idiopathic Parkinson's Disease. Methods : Subjects Were Voluntarily Recruited by Newspapers And Internet. All the Subjects Were Confirmed as Idiopathic Parkinson's Disease by a Neurologist. The Patient's Symptoms Were Assessed by Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn-Yahr (H-Y) Stage, Schwab & England Activity of Daily Living And Freezing of Gait Questionnaire(FOGQ). Sasang Constitution Was Differentiated by QSCCII. Yangdorak Was Measured after 15 minutes' Bed Rest Results : The Results Were as Follows; 1. The Average Value of Yangdorak m 50 Patients with Parkinson's Disease Was $39.01{\pm}17.97$. 2. The Mean Values of Fl, F2, F3, F4, F5 and F6 were under 40. 3. The Number of Pyesaek Was Significantly Increased According to H-Y Stage. 4. The Yangdorak Value Had No Significant Correlation between UPDRS, H-Y Stage and Duration. 5. There Was No Significant Difference in the Value of Yangdorak among Sasang Constitutions. Conclusion : This Study Suggests that Yangdorak Can Be Used as a Assistant Tool to Investigate the Patients of Parkinson's Disease. Further Study on the Yangdorak And Parkinson's Disease Is Recommended.

• Tuberculosis and Respiratory Diseases
• /
• 제81권4호
• /
• pp.281-288
• /
• 2018

Background: There are limited number of studies that investigate clinical variables instead of chronic obstructive lung disease (COPD) management according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification. The aim of the study was to investigate whether there was a difference between GOLD 2017 classification and spirometric stage in clinical variables in patients with COPD. The data of 427 male patients with stable COPD were investigated retrospectively. Methods: Patients were allocated into combined assessment of GOLD 2017 and spirometric stage. Age, amount of smoking, pulmonary function, modified Medical Research Council (mMRC), incremental shuttle walk test (ISWT), Hospital Anxiety-Depression Scale (HADS), St. George's Respiratory Questionnaire (SGRQ), body mass index (BMI), and fat free mass index (FFMI) were recorded. Results: Seventy-three (17%) patients were in group A, 103 (24%) constituted group B, 38 (9%) were included in group C, and 213 (50%) comprised group D according to the combined assessment of GOLD 2017. Twenty-three patients (5%) were in stage 1, 95 (22%) were in stage 2, 149 (35%) were in stage 3, and 160 (38%) were in stage 4 according to spirometric stage. According to GOLD 2017, age, amount of smoking, mMRC, BMI, FFMI, SGRQ, HADS, forced vital capacity, forced expiratory volume in 1 second ($FEV_1$), and ISWT were significantly different between groups. Ages, amount of smoking, FFMI, BMI, HADS of group A were different from B and D. Smiliar values of $FEV_1$ were found in A-C and B-D. A and C had smiliar ISWT. According to spirometric stage, BMI, FFMI of stage 4 were statistically different. mMRC, ISWT, and SGRQ of stages 3 and 4 were different from other stages, amongst themselves. $FEV_1$ was correlated with mMRC, SGRQ, anxiety scores, BMI, FFMI, and ISWT. Conclusion: This study showed that the GOLD ABCD classification might not represent the severity of COPD sufficiently well in terms of lung function or exercise capacity. The combination of both spirometric stage and combined assessment of GOLD 2017 is important, especially for estimating clinical variables.

• 사상체질의학회지
• /
• 제28권2호
• /
• pp.184-192
• /
• 2016

Objectives The purpose of this case study is to report significant improvement of headache, constipation and a slight improvement of tremor after treatment with Hyeongbangjihwhang-tang in a Soyangin patient with Parkinson's disease.Methods This Soyangin patient is treated by Hyeongbangjihwhang-tang and acupuncture therapy. The progress was evaluated using the Unified Parkinson Disease Rating Scale before and after treatment. Secondary results assessments include Global Assessment Scale, change of patient's omniloquilism, Xerostomia and Cold hands & Feet Syndrome.Results and Conclusions The patient's symptoms of headache, constipation and tremor were improved after using Hyeongbangjihwhang-tang. and UDPRS score decreased in Part Ⅰ, Part Ⅱ, and Part Ⅲ. In conclusion, this study shows that Hyeongbangjihwhang-tang can be effective treatment for Soyangin patient with early-stage Parkinson''s disease. Overall, Sasang medicine can be a solution of the symptoms caused by Parkinson's disease. Through Sasang medicine we can contribute Parkinson's disease Patient's quality of life get better.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권6호
• /
• pp.2541-2546
• /
• 2014

Background: Primary hepatic neuroendocrine carcinoma (PHNEC) is rarer than extrahepatic gastrointestinal neuroendocrine carcinoma (NEC). It is difficult to make a correct diagnosis and poses a challenge for management. Materials and Methods: Ten PHNEC patients were admitted to our hospital from June 2006 to June 2011. Laboratory tests and imaging scans were performed for diagnosis and exclusion of extrahepatic NEC. All patients were AFP - and CA199-. Seven patients had solid tumors with cystic changes on ultrasonography, CT and/or MRI. For the initial treatment, four patients received combined-therapy and six monotherapy. Considering overall treatment, six patients received combined-therapy and four patients monotherapy. Staging criteria of primary hepatocellular carcinoma (PHC, AJCC 7th edition) were used to differentiate the stage of all patients: 3 patients were stage I, 2 stageII, 4 patients stageIII and 1 stageIV. All patients were followed up and clinical data were gathered. Results: The median follow-up duration was 38.5 months. The 1-year, 2-year, 3-year and 6-year disease-free survival was 80.0%, 46.2% and 46.2% and 0% respectively. The overall survival rates were 100%, 67.1%, 67.1% and 33.6% respectively. Patients in early-stages (I/II) had similar disease-free and overall survival as those in advanced-stages (III/IV). Patients with monotherapy had significant shorter disease-free and overall survival than the patients with combination-therapy. Conclusions: PHNEC has a unique specificity during its occurrence and development. The staging criteria of PHC might not be suitable for the PHENT. More convenient and effective features need to be found in imaging and laboratory detection. Surgical resection, TACE, chemotherapy and radiofrequency ablation should be performed in combination and actively for patients with PHNEC or recurrence to get the best effectiveness; they might extend the disease-free and overall survival.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권2호
• /
• pp.737-740
• /
• 2015

Purpose: The study aim was to assess factors that impact on the outcome of radioiodine therapy in patients diagnosed with differentiated thyroid carcinoma (DTC). Materials and Methods: We performed a retrospective cohort study on 256 patients with DTC who underwent thyroidectomy and received radioiodine therapy during December 2003 to January 2012. All patients were followed up for at least 1 year. They were considered diseasefree by the criteria of the revised American Thyroid Association Management Guideline for Patients with Thyroid nodules and DTC (ATA guideline 2009). Results: On Cox univariate analysis, factors associated with disease-free status were age<45, stage I tumor, low risk group by histopathology, unifocal tumor involvement, stimulated serum Tg level at 1st dose of radioiodine therapy and no distant metastasis from 1st post-treatment WBS (post RxWBS). On multivariate analysis, stage I tumor and stimulated serum Tg level at 1st dose of radioiodine therapy < 30 ng/mL were the significant prognostic factors that increased disease-free rate by 1.73 times and 2.60 times, respectively (P-value <0.05). Conclusions: Factors affecting the outcome of radioiodine therapy in our study were age, stage, risk of recurrence by histopathology, unifocal tumor involvement and 1st postRxWBS findings. From these factors, stage I tumor and stimulated serum Tg level at 1st dose of radioiodine therapy were independent prognostic factors that substantial increase the disease-free rate.

• 식물병연구
• /
• 제13권1호
• /
• pp.20-23
• /
• 2007

2002년부터 2005년까지 4년간 벼 흰잎마름병 초발병 조사결과 2002년보다 초발병일이 20$\sim$30일 이상 빨라지고 있음을 확인하였다. 벼 흰잎마름병 발병시기 및 병반면적율에 따라 수량이 감소하였는데 병반면적률이 10% 이하에서는 피해가 적었으나, 병반적율이 증가함에 따라서 수량감소가 점점 많아졌고, 25% 이상일 때부터 수량감소 및 현미천립중 등에서 현저히 낮아지고 병반면적율이 50% 이상이고 유수형성기 발병시 수량 29%, 현미천립중 2.3g, 현미완전립률 18%까지 감소되었다. 밥맛의 기준이 되는 식미치인 점도에서도 병반면적율이 증가함에 따라 낮은 식미치를 보였다.