• Title/Summary/Keyword: failure cases

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Radiotherapy of Supratentorial Primitive Neuroectodermal Tumor (천막상부 원시신경외배엽 종양의 방사선요법)

  • Kim Il Han;Yoo Hyung Jun;Cho Young Kan;Kim Dae Yong
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.11-18
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    • 1997
  • Purpose : To evaluate the efficacy of combined treatment of surgery and chemoradiotherapy for supratentorial primitive neuroectodermal tumors (SPNET) and obtain the Prognostic factors and complications Materials and Methods .The a9e of 18 patients ranged from 1 to 27 years (median=5 years). There were 12 males and 6 females The extents of surgery were gross total (n:9), subtotal (n:8), biopsy only (n: 1). Craniospinal radiotherapy was delivered to all the patients except 2 patients who were treated only with the whole brain and primary lesion. Radiation dose were 3120-5800cGy (median=5460) to primary mass, 1500-4200cGy (median=3600cGy) to the whole brain and 1320-3600cGy (median= 2400 cGy) to the spinal axis. Chemotherapy was done in 13 patients. Median follow-up period was 45 months ranged from 1 to 89 months. Results : Patterns of failure were as follows; local recurrence (1), multiple intracranial recurrence (2), spinal seeding (3), craniospinal seeding (2) and multiple bone metastasis (1). Two of two patients who did not received craniospinal radiotherapy failed at spinal area. All the relapsed cases died at 1 to 13 months after diagnosis of progression. The 2- and 5-rear overall survival rates were $61\%\;and\;49\%$, respectively The a9e, sex, tumor location did not influence the survival but aggressive resection with combined chemotherapy showed better outcome. Among 9 survivors, complications were detected as radiation necrosis (n=1), hypopituitarism (n=2), cognitive defect(n=1), memory deficit (n=1), growth retardation (n=1). Conclusion : To improve the results of treatment of SPNET, maximal surgical resection followed by radiation therapy and chemotherapy is necessary. The extended radiation field including craniospinal axis may reduce the recurrence in spinal axis.

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Korea's Terrorist Environment and Crisis Management Plan (한국의 테러환경과 위기관리 방안)

  • Jang, Sung Jin;Kim, Young-Hyun;Shin, Seung-Cheol
    • Korean Security Journal
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    • no.52
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    • pp.73-91
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    • 2017
  • This study is based on the political and economic standpoint of each country, Use advanced equipment to prevent new terrorism from causing widespread damage, In order to establish a countermeasures against terrorism in accordance with the reality of Korea, which is effective in responding to terrorist attacks, Korea conducted a SWOT analysis of the terrorist environment and terrorist environment through specialists. First, internal strengths of Korea 's terrorist environment include stable security situation, weakness of religious and ethnic conflicts, strong regulation and control of firearms, and counter terrorism capabilities and know - how accumulated during major international events. Second, the internal weaknesses of the terrorist environment in Korea include the insecurity of the people, the instability caused by the military confrontation with North Korea, the absence of anti-terrorism law system, the difficulty of terrorism control and management by the development of the Internet and IT technology. Third, the external opportunities for Korea 's terrorist environment are as follows: ease of supplementation and learning through cases of foreign terrorism failure, ease of increase of terrorist budget and support with higher terrorism issues, strengthening of counterterrorism through military cooperation with allied nationsRespectively. Fourth, the external threats to the terrorist environment in Korea are the increase of social dissatisfaction due to the continuous influx of defectors and foreign workers, the goal of terrorism from international terrorist organizations through alliance with the United States,Increased frequency of incidents, and increased IS coverage of terrorism around the world. In addition, the SWOT in - depth interviews on the terrorist environment of the expert group were conducted to diagnose and analyze the problems, terrorism awareness and legal system in the Korean terror environment. The results of the study are summarized as follows.First, the basic law on terrorism should be enacted.Second, the establishment of an integrated anti-terrorism organization.Third, securing and nurturing specialized personnel in response to terrorism.

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Two Cases of Chemical Pneumonitis Caused by Hydrogen Sulfide (황화수소로 인한 화학성 폐렴 2예)

  • Kim, Jung Ha;Lee, Kyung Joo;Jung, Jin Yong;Lee, Eun Joo;Jung, Ki Hwan;Kang, Eun Hae;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.3
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    • pp.210-214
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    • 2008
  • Chemical pneumonitis is an occupational lung disease that's caused by the inhalation of chemical substances. Its severity depends on the characteristics of the substances, the exposure time and the susceptibility of the patients. Hydrogen sulfide is not only emitted naturally, but it also frequently found in industrial settings where it is either used as a reactant or it is a by-product of manufacturing or industrial processes. Inhalation of hydrogen sulfide causes various respiratory reactions from cough to acute respiratory failure, depending on the severity. Two pharmaceutical factory workers were admitted after being rescued from a waste water disposal site that contained hydrogen sulfide. In spite that they recovered their consciousness, they had excessive cough and mild dyspnea. The simple chest radiographs and high resolution computed tomography showed diffuse interstitial infiltrates, and hypoxemia was present. They were diagnosed as suffering from chemical pneumonitis caused by hydrogen sulfide. After conservative management that included oxygen therapy, their symptoms, hypoxemia and radiographic abnormalities were improved.

STUDY OF RAT EPIGASTRIC VESSELS ACCORDING TO THE FREEZING TIME : HISTOLOGIC, HISTOMORPHOMETRIC, IMMUNOHISTOCHEMICAL & SCANNING ELECTRON MICROSCOPIC STUDY (백서 상복부 혈관의 동결시간에 따른 변화에 대한 연구)

  • Kim, Woo-Chan;Lee, Chong-Heon;Kim, Kyung-Wook;Kim, Chang-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.2
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    • pp.89-109
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    • 1999
  • Vascular spasm which has been reported to occur in 25% of clinical cases continues to be a problem in microvascular surgery; When prolonged and not corrected, it can lead to low flow, thrombosis, and replant or free flap failure. Ischemia, intimal damage, acidosis and hypovolemia have been implicated as contributors to the vascular spasm. Although much work has been done on the etiology and prevention of vasospasm, a spasmolytic agent capable of firmly protecting against or reversing vasospasm has not been found. Therefore vascular freezing was introduced as a new safe method that immediately and permanently relieves the vasospasm and can be applied to microsurgical transfers. Cryosurgery can be defined as the deliberate destruction of diseased tissue or relief the vascular spasm in microvascular surgery by freezing in a controlled manner. 96 Sprague Dawley rats each weighing within 250g were used and divided into 2 group, experimental 1 and 2 group. In the experimental 1 group, right epigastric vessels (artery and vein) were freezed with a cryoprobe using $N_2O$ gas for 1 min. In the experimental 2 group, after freezing for 1 min, thawing for 30 secs and repeat freezing for 30 secs. Left side was chosen as control group in both group. We sacrified the experimental animals by 1 day, 3 days, 1 week, 2 weeks, 4 weeks & 5 months and observed the sequential change that occur during regeneration of epigastric vessels using a histologic, histomorphometric, immunohistochemical and SEM study after the vascular freezing. The results were as follows1. In epigastric arteries, internal diameters had statistically significant enlargement in 1 day, 3 days of Exp-1 group and 1 day, 3 days, 1 week & 2 weeks of Exp-2 group. Wall thickness had statistically significant thinning in 2 weeks of Exp-2 group. 2. In epigastric veins, internal diameters had enlargement of statistical significance in 1 day of Exp-1 and Exp-2 group. 3. The positive PCNA reactions in smooth muscle appeared in 1 week and increased until 2 weeks, decreased in 4 weeks. There was no statistical significance between Exp-1 and Exp-2 group. 4. The positive ${\alpha}$-SMA reaction in smooth muscles showed weak responses until 1 week and slowly increased in 2 weeks and showed almost control level in 4 weeks. 5. The positive S-100 reactions in the perivascular nerve bundles showed markedly decrease in 1 day, 3 days and increased after 1 week and showed almost control level in 4 weeks. Exp-1 group had stronger response than Exp-2 group. 6. In SEM, we observed defoliation of endothelial cell and flattening of vessel wall. Exp-2 group is more destroyed and healing was slower than Exp-1 group. To sum up, relief of vasospasm (vasodilatation) by freezing with cryoprobe was originated from the damage of smooth muscle layer and perivascular nerve bundle and the enlargement of internal diameter in vessels was similar to expeimental groups, but Exp-2 group had slower healing course and therefore vessel freezing in microsurgery can be clinically used, but repeat freezing time needs to be studied further.

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Complication and Failure Analysis of Endodontically Treated Teeth Restored with Post and Cores (포스트로 수복한 근관 치료된 치아의 임상적 상태에 대한 평가)

  • Yun, Mi-Jung;Kim, Mu-Hyon;Jeong, Chang-Mo;Huh, Jung-Bo;Jeon, Yeong-Chan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.359-370
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    • 2012
  • The endodontically treated tooth is generally restored with post and core, owing to the brittle and the loss of large amount of tooth structure. The purpose of this study was to evaluate the clinical status of fixed prostheses to improve the quality of dental care. In order to assess the clinical status of fixed prostheses, a total of 101 individuals (aged 30-89, 66 women and 35 men loaded with 125 fixed prostheses) who treated in the Department of Prosthodontics, Pusan National University Dental Hospital, between January 1990 to December 2005 were examined. The results of this study were as follows: 1. Length of service of fixed prostheses was $9.7{\pm}3.4$ years (mean), 11.1 years (median). 2. Age and sex of patient was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 3. Location of fixed prostheses was found to have statistically significant influence on longevity of fixed prostheses (P<.05). The longevity of fixed prostheses was low in anterio-posterior combination region (median:9.2 years). 4. Longevity of fixed prostheses made of base metal ceramic(median:12.0 years) and noble metal ceramic (median:11.3 years) is long (P<.05). 5. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 6. Condition of opposing dentition was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 7. Dental caries, periapical disease, tooth fracture were frequent complications. In 51.9% of the cases, abutment state after removing fixed prostheses was needed to be extracted.

The Evolution of Cyber Singer Viewed from the Coevolution of Man and Machine (인간과 기계의 공진화적 관점에서 바라본 사이버가수의 진화과정)

  • Kim, Dae-Woo
    • Cartoon and Animation Studies
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    • s.39
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    • pp.261-295
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    • 2015
  • Cyber singer appeared in the late 1990s has disappeared briefly appeared. although a few attempts in the 2000s, it did not show significant successes. cyber singer was born thanks to the technical development of the IT industry and the emergence of an idol training system in the music industry. It was developed by Vocaloid 'Seeyou' starting from 'Adam'. cyber singer that differenatiated typical digital characters in a cartoon or game may be subject to idolize to the music as a medium. They also feature forming a plurality of fandom. therefore, such attempts and repeated failures, this could be considered a fashion, but it flew content creation and ongoing attempts to take advantage of the new media, such as Vocaloid can see that there are expectations for a true Cyber-born singer. Early-Cyber singer is made only resemble human appearance, but 'Sciart' and 'Seeyou' has been evolving to becoming more like the human capabilities. in this paper, stylized cyber singer had disappeared in the past in the process of developing the technology to evolve into own artificial life does not end in failure cases, gradually led to a change in public perceptions of the image look looking machine was an attempt in that sense. With the direction of the evolution of the mechanical function to obtain a human, fun and human exchanges and mutual feelings. And it is equipped with an artificial life form that evolved with it only in appearance and function. in order to support this logic, I refer to the study of the coevolution of man and machine at every Bruce Mazlish. And, I have analyzed the evolution of cyber singer Bruce research from the perspective of the development process since the late 1990s, the planning of the eight singers who have appeared and design of the cyber character and important voices to be evaluated as a singer (vocal). The machine has been evolving coevolution with humans. cyber singer ambivalent development targets are recognized, but strive to become the new artificial creatures of horror idea of human desire and death continues. therefore, the new Cyber-organisms are likely to be the same style as 'Seeyou'. because, cartoon forms and whirring voice may not be in the form of a signifier is the real human desires, but this is because the contemporary public's desire to be desired and the technical development of this type can be created at the point where the cross-signifier.

An Influence of Modified Robicsek Sternal Wiring after Median Sternotomy on the Postoperative Sternal Wound Infection (정중 흉골 절개 후 시행한 변형 Robicsek 흉골 봉합법이 수술 후 흉골감염에 미치는 영향)

  • Chang, Won-Ho;Youm, Wook;Kim, Dong-Hyun;Oh, Hong-Chul;Han, Jung-Wook;Kim, Hyun-Jo
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.763-769
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    • 2009
  • Background: In the majority of cases, sternal instability and wound infection concomitantly present after a cardiac operation following conventional median sternotomy, and these complications have a major influence on the postoperative course. The aim of this study is to compare the results of the different sternal wiring techniques of sternal infection. Material and Method: Between April 2004 and December 2008, 157 adult patients underwent cardiac in group A, whereas 71 patients who had undergone modified Robicsek sternal wiring were included in group B. The incidences of sternal wound complications in the two groups were assessed. Result: The mean age of the group B patients was older than that of the group A patients ($61{\pm}10$ years vs $57{\pm}13$ years). The incidence of preoperative left ventricular dysfunction (ejection fraction <30%), chronic obstructive pulmonary disease, renal failure requiring dialysis and diabetes mellitus were significantly higher in Group B, whereas the other perioperative risk factors for infection were not significantly different between the two groups. Two patients in group A experienced superficial wound infection, whereas 4 patients in group B displayed superficial wound infection, but the difference was not statistically significant (p=0.255). Yet poststernotomy deep sternal wound infection appeared in 6 patients of group A, whereas none of the patients in group B displayed this malady. Conclusion: The modified Robicsek sternal wiring technique showed greater sternal stability even for the patient with a high risk for infection, and the technique caused a lower incidence of deep sternal wound infection.

Cause-specific Analysis of Risk Factors in Completely Resected Pathologic Stage Ia Non-small Cell Lung Cancer (병리학적 병기 Ia기 비소세포폐암 환자에서 완전절제술 후 사망의 원인에 따른 위험인자 분석)

  • Park, Seong-Yong;Park, In-Kyu;Byun, Chun-Sung;Lee, Chang-Young;Bae, Mi-Kyung;Kim, Dae-Joon;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.725-731
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    • 2009
  • Background: Lobectomy and more extended anatomic resection are regarded as standard treatment for stage Ia non-small cell lung cancer, but approximately 15~40% of patients suffer from treatment failures such as cancer recurrence or death. The authors analyzed types and causes of treatment failures in surgically treated cases of stage Ia non small cell lung cancer. Material and Method: We retrospectively reviewed the medical records of 156 patients who had undergone complete resection for stage Ia NSCLC between Jan 1992 and Aug 2005. Patients were divided into two different treatment failure groups: cancer-related deaths and non-cancer-related deaths. Risk factors were analyzed in each group by the Kaplan-Meyer survival method and the Cox proportional hazard model. Result: Among the 156 patients, 93 were males; the mean age was 61. The median follow-up period was 33.8 months. The 5 year survival rate was 87.6%. Microscopic lympho-vascular permeation was reported in 10 patients. Recurrence was reported in 19 patients and 12 patients died due to recurrent lung cancer. Noncancer related deaths occurred in 16 patients. Risk factors for cancer recurrence and cancer related death were microscopic lympho-vascular permeation (HR=6.81, p=0.007, HR=7.81, p<0.001); for non-cancer related death, risk factors were pneumonectomy (HR=25.92, p=0.001) and postoperative cardiopulmonary complications (HR=29.67, p=0.002). Conclusion: After complete resection of stage Ia non small cell lung cancer patients, mortality includes not only cancer related deaths but also cancer unrelated deaths. Adjuvant chemotherapy is advised for patients who show microscopic lympho-vascular permeation, which is a risk factor for recurrence and for cancer related death. Patients who had pneumonectomy or who suffered from cardiac or respiratory complications need meticulous care in order to reduce comorbidity-induced death.

Adenocarcinoma of the Uterine Cervix (자궁경부선암의 방사선 치료)

  • Chung Eun Ji;Shin Hyun Soo;Lee Hyung Sik;Kim Gwi Eon;Loh John Juhn-Kyu;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.277-284
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    • 1991
  • Survival data, prognostic factors, and patterns of failure were retrospectively analyzed for a total of 76 patients with adenocarcinoma of the uterine cervix treated between January 1981 and December 1987, which represents $4.1\%$ of all primary cervical carcinomas treated, at Department of Radiation Oncology, Yensei Cancer Center, Yonsei University College of Medicine. The mean age of the patients was 49 years (range, $27\~79$ years) and the peak incidence was in the group 50 to 59 years of age. More half of the patients were postmenopausal (46/76= $60.5\%$). Most patients ($76\%$) had abnormal vaginal bleeding either alone or in combination with other symptoms. The proportion of stage IIb was $43.4\%$. There were 4 major histologic subtypes: pure adenocarcinoma (48/76=$63.2\%$), adenosquamous carcinoma (20/76=$26.3\%$), papillary (5/76=$6.6\%$) and clear cell carcinoma (3/76=$3.9\%$). Of the many clinicopathologic variables evaluated for prognosis, the most significant prognostic factors were stage of disease and the size of tumor. The overall 5-year survival rate was $68\%$, and the 5-year survival rates for stage Ib, II and III were $90\%,\;66\%\;and\;54\%$, respectively. Control of pelvic tumors was achieved in $93.8\%,\;90.2\%\;and\;50.0\%$ of cases of stage Ib, II and III disease, respectively. In present study, treatment modalities (radiation therapy alone/combined operative and radiation therapy) did not affect the local control of tumor and the survival.

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Results of Preoperative Chemoradiotherapy in Low Rectal Cancer (하부 직장암의 수술 전 화학방사선요법 결과)

  • Yun Hyong-Geun
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.21-29
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    • 2006
  • Purpose: This study explored the anal sphincter-saving rate and down-staging rate after preoperative chemoradiotherapy for treating lower rectal cancer. We also explored the prognosis of the patients who refused surgery after preoperative chemoradiotherapy. Materials and Methods: Thirty seven patients with histologically proven lower rectal cancer who underwent preoperative chemoradiotherapy were retrospectively analyzed. In each case, the tumor location was 0 to 5 em from the anal verge, and curative resection of the cancer with performing a sphincter-saving procedure was not feasible before chemoradiotherapy. In each case, the staging examinations, including biopsy, were done before starting radiotherapy and this was repeated at 1 month after radiation therapy. Results: After chemoradiotherapy, among the 37 included patients, 56.8% and 32.4% were downstaged to the T stage and N stage, respectively, when comparing the postradiotherapy stage with pre-radiotherapy stage. Twenty five patients underwent complete resection of cancer at 6 weeks after radiotherapy: eleven, eight and six patients underwent abdominoperineal resection, low anterior resection and local excision, respectively. The sphincter-saving rate among the 24 completely resected cases was 54.2%. Twelve patients refused surgery after radiotherapy. Among 6 patients who refused surgery with biopsy-proven complete remission after chemoradiotherapy, 5 patients were alive without disease at a median follow up period of 31 months, and only 1 patient had local failure. Conclusion: For lower rectal cancer, a high sphincter-saving rate was accomplished with preoperative chemoradiotherapy. The prognosis of the patients who refused surgery with biopsy proven complete remission after chemoradiotherapy was good and these patients need to be kept under close surveillance.