• Title/Summary/Keyword: long-term results

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Risk Factors of Recurrent Hemoptysis after Bronchial Artery Embolization (기관지동맥 색전술 후 객혈의 재발에 관한 연구)

  • Chung, Wou Young;Byun, Min Kwang;Park, Moo Suk;Hahn, Chang Hoon;Kang, Shin Myung;Lee, Do Yon;Kim, Young Sam;Kim, Se Kyu;Kim, Sung Kyu;Chang, Joon
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.65-71
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    • 2006
  • Background : Hemoptysis, when massive and untreated, has a mortality rate of over 50 percents, is considered as one of most dreaded of all respiratory emergencies and can have a variety of underlying causes. Bronchial artery embolization (BAE) has become an established procedure in the management of massive and recurrent hemoptysis, and its efficacy is widely documented thereafter by number of articles. However, the long-term success rate of BAE is known to be unfavorable. Risk factors influencing that control failure are inevitably needed. Materials and methods : Seventy-five patients underwent bronchial artery embolization due to massive hemoptysis in Severance Hospital from Jan. 2000 to Jan. 2005. Nine patients' data were not available and could not be contacted with. Finally 66 patients' (48 males, 18 females) medical records were analyzed retrospectively during a mean follow up period of 20.4 months (ranging from 1 month to 54 months). Results : Among 66 patients whose data were available, 23(34.9%) patients had recurrent major hemoptysis. Patients' age, sex, underlying disease, previous intervention history, and number of feeding vessels had no statistical validity as risk factors of recurred major hemoptysis. But bilaterality of lesion, amount of hemoptysis, and pleural thickening were revealed as meaningful factors for predicting relapse (p = 0.008, 0.018, and 0.001, respectively). Conclusion : According to our series, patients presenting with larger amount of hemoptysis, pleural thickening of chest radiography and bilateral lesion are associated with increased risk of major hemoptysis in patients treated with BAE.

Effect on Survival and Developmental Competence of Vitrified Mouse Embryos Using Various Cryoprotectants and Cooling Speeds (생쥐 배아의 유리화 동결에 동결액의 조성과 냉각속도의 영향)

  • Park, Jae-Kyun;Go, Young-Eun;Eum, Jin-Hee;Won, Hyung-Jae;Lee, Woo-Sik;Yoon, Tae-Ki;Lee, Dong-Ryul
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.307-319
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    • 2010
  • Objective: Vitrification requires a high concentration of cyroprotectant (CPA) and an elevated cooling speed to avoid ice crystal formation. We have evaluated the effect of different combinations of cooling rate and CPA on embryonic integrity (developmental competence) in order to increase the efficiency of vitrification without impairing embryo viabilit. We hypothesized that the combination of CPA or the increase of cooling rates can reduce the concentration of toxic CPA for vitrification. As consequently, we performed experiments to evaluate the effect of various composition of CPA or slush nitrogen ($SN_2$) on the mouse embryonic development following vitrification using low CPA concentration. Methods: Vitrification of mouse embryos was performed with EM grid using liquid nitrogen ($LN_2$) or $SN_2$ and different composition of CPAs, ethylene glycol (EG) and dimethylsulfoxide (DMSO). After vitrification-warming process, their survival and blastocyst formation rates were examined. For analyzing long-term effect, these blastocysts were transferred into the uterus of foster mothers. Results: Survival and blastocyst formation rates of vitrified embryos were higher in EG+DMSO group than those in EG only. Furthermor, the group using $SN_2$ with a lower CPA concentration showed a higher survival of embryos and developmental rates than group using $LN_2$. Conclusion: The combination of EG and DMSO as CPAs may enhance the survival of mouse embryos and further embryonic development after vitrification. $SN_2$ can generate high survival and developmental rate of vitrified/warmed mouse embryos when a lower concentration of CPA was applied. Therefore, these systems may contribute in the improvement of cryopreservation for fertility preservation.

A Study on the Volatility of Global Stock Markets using Markov Regime Switching model (마코브국면전환모형을 이용한 글로벌 주식시장의 변동성에 대한 연구)

  • Lee, Kyung-Hee;Kim, Kyung-Soo
    • Management & Information Systems Review
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    • v.34 no.3
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    • pp.17-39
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    • 2015
  • This study examined the structural changes and volatility in the global stock markets using a Markov Regime Switching ARCH model developed by the Hamilton and Susmel (1994). Firstly, the US, Italy and Ireland showed that variance in the high volatility regime was more than five times that in the low volatility, while Korea, Russia, India, and Greece exhibited that variance in the high volatility regime was increased more than eight times that in the low. On average, a jump from regime 1 to regime 2 implied roughly three times increased in risk, while the risk during regime 3 was up to almost thirteen times than during regime 1 over the study period. And Korea, the US, India, Italy showed ARCH(1) and ARCH(2) effects, leverage and asymmetric effects. Secondly, 278 days were estimated in the persistence of low volatility regime, indicating that the mean transition probability between volatilities exhibited the highest long-term persistence in Korea. Thirdly, the coefficients appeared to be unstable structural changes and volatility for the stock markets in Chow tests during the Asian, Global and European financial crisis. In addition, 1-Step prediction error tests showed that stock markets were unstable during the Asian crisis of 1997-1998 except for Russia, and the Global crisis of 2007-2008 except for Korea and the European crisis of 2010-2011 except for Korea, the US, Russia and India. N-Step tests exhibited that most of stock markets were unstable during the Asian and Global crisis. There was little change in the Asian crisis in CUSUM tests, while stock markets were stable until the late 2000s except for some countries. Also there were stable and unstable stock markets mixed across countries in CUSUMSQ test during the crises. Fourthly, I confirmed a close relevance of the volatility between Korea and other countries in the stock markets through the likelihood ratio tests. Accordingly, I have identified the episode or events that generated the high volatility in the stock markets for the financial crisis, and for all seven stock markets the significant switch between the volatility regimes implied a considerable change in the market risk. It appeared that the high stock market volatility was related with business recession at the beginning in 1990s. By closely examining the history of political and economical events in the global countries, I found that the results of Lamoureux and Lastrapes (1990) were consistent with those of this paper, indicating there were the structural changes and volatility during the crises and specificly every high volatility regime in SWARCH-L(3,2) student t-model was accompanied by some important policy changes or financial crises in countries or other critical events in the international economy. The sophisticated nonlinear models are needed to further analysis.

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Efficacy of a Preoperative Concurrent Chemoradiotherapy for the Locally Advanced Unresectable Rectal Cancer (국소진행성 직장암에서 수술 전 방사선 및 항암화학 동시요법의 효과)

  • Cho Jae Ho;Seong Jinsil;Keum Ki Chang;Kim Gwi Eon;Suh Chang Ok;Roh Jae Kyung;Chung Hyun Cheol;Min Jin Sik;Kim Nam Kyu
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.293-299
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    • 2000
  • Purpose :We conducted a prospective non-randomized clinical study to evaluate the efficacy and toxic of the preoperative concurrent chemoradiotherapy for locally advanced unresectable rectal cancer. Materials and Methods: Between January 1995 and June 1998, 37 conecutive patients with locally unresectable advanced rectal cancer were entered into the study. With 3- or 4- fields technique, a total of 45 Gy radiation was delivered on whole pelvis, followed by 5.4 Gy boost to the primary tumor in some cases. Chemotherapy was done at the first and fifth week of radiation with bolus i.v. 5-Fluorouracil (FU) 370$\~$450 mg/m$^{2}$, days 1$\~$5, plus Leucovorin 20 mg/m$^{2}$, days 1$\~$5. OF 37 patients, 6 patients did not receive all planned treatment course (refusal in 4, disease progression in 1, metastasis to lung in 1). Surgical resection was undergone 4$\~$6 weeks after preoperative concurrent chemoradiotherapy. Results :Complete resection rate with negative margins was 94$\%$ (29/31). Complete response was seen in 7 patients (23$\%$) clinically and 2 patients (6$\%$) pathologically. Down staging of tumor occured in 21 patients (68$\%$). Treatment related toxicity was minimal except grade III & IV leukopenia in 2 patients, respectively. Conclusion : Preoperative concurrent chemoradiotherapy in locally advanced rectal cancer was effective in inducing down staging and complete resection rate. Treatment related toxicity was minimal. Further follow up is on-going to determine long term survival following this treatment.

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Type 2 Diabetes Mellitus in Children (소아연령에서의 2형 당뇨병의 임상적 고찰)

  • Park, Jee Min;Yoo, Eun Gyong;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.646-653
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    • 2002
  • Purpose : The incidence of type 2 diabetes mellitus in children has been increasing worldwide recently, which is thought to be related to the increasing prevalence of obesity. We investigated to evaluate the incidence and the characteristics of type 2 diabetes mellitus in children and also analysed the relationship between intrauterine growth retardation and type 2 diabetes mellitus. Methods : We investigated 25 children diagnosed as type 2 diabetes mellitus between March 1990 and December 2000. The analysis was performed retrospectively with medical records based on the clinical characteristics and laborotory findings. Results : Incidence of type 1 and type 2 diabetes mellitus in children has been increasing since 1990. We demonstrated an increase in the percentage of type 2 diabetes mellitus children from 5.3% in 1990 to 21.0% in 2000. Sixty eight percent of patients(17/25) were classified as obese group. Initial symptoms at first visit were polyuria, polydipsia and polyphagia 48%(12/25), asymptomatic glycosuria 40% (10/25), weight loss 8%(2/25) and obesity 4%(1/25). The mean age at diagnosis was $12.9{\pm}1.8$ years. 64%(16/25) of patients had positive family history of type 2 diabetes mellitus. Autoanti-bodies were positive in 18.1%(4/22) of patients. Twenty eight percent (7/25) of patients had an associated disease and two patients had fatty liver in association with obesity. Treatment consisted of diet, exercise, education and oral hypoglycemic agents. Three patients were treated with insulin as well as oral hypoglycemic agents because of poor blood glucose control. Long-term diabetic complications occurred in 4 patients. Intrauterine growth retardtion was found in 34.6%(9/25); 88.9% (8/9) of these patients were non-obese group. Conclusion : The increase in the incidence of type 2 diabetes mellitus in children is thought to be related to the increasing prevalence of obesity. The non-obese group of patients might be associated with intrauterine growth retardation.

Endocrine dysfunction after bone marrow transplantation during childhood and adolescence (소아 및 청소년기에서 골수이식 후에 발생할 수 있는 내분비 기능 부전)

  • Jin, Hye Young;Choi, Jin-Ho;Im, Ho-Joon;Seo, Jong-Jin;Moon, Hyung-Nam;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.420-427
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    • 2010
  • Purpose : Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT. Methods : One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis, age at BMT, conditioning regimen, presence of graft-versus-host disease (GVHD), growth pattern, thyroid function, and pubertal status were retrospectively reviewed to evaluate risk factors associated with endocrine dysfunction. Results : Height standard deviation score (SDS) at BMT, after 1 year of BMT, and at the last visit were $0.08{\pm}1.04$, $-0.09{\pm}1.02$, and $-0.27{\pm}1.18$, respectively (P =0.001). Height SDS significantly decreased in patients who received total body irradiation (TBI) (P =0.017). One of the patients who received TBI demonstrated growth hormone deficiency. Thirty (31.9%) of 94 patients had compensated hypothyroidism. Incidence of compensated hypothyroidism was higher among those who had GVHD (odds ratio 2.82, P =0.025). Of the 32 patients (17 males, 15 females) who were over 14 years in male and 13 years in female at the last visit, 16 (3 males, 13 females) had increased luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Abnormal elevation of LH or FSH was more common in females (odds ratio 30.3, P =0.001). Conclusion : The most common endocrine dysfunction was ovarian insufficiency. Regular check-up for endocrine function needs to be required due to high incidence of endocrine dysfunction in patients with BMT.

Caregivers' adherence factors affecting maintenance treatment in children with well-controlled asthma : A qualitative analysis through in-depth interview (천식 조절 상태 환아의 유지 치료에 대한 보호자 순응 요인: 심층 면담을 통한 질적 분석)

  • Choi, Ic Sun;Cho, Saeng Koo;La, Kyong Suk;Byeon, Jung Hye;Song, Dae Jin;Yoo, Young;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.364-372
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    • 2010
  • Purpose : Good adherence of caregivers is essential for successful health outcomes in the treatment of childhood asthma. The purpose of this study was to identify the factors contributing to good adherence of maintenance treatment in children with well-controlled asthma. Methods : Children with well-controlled asthma being treated with a daily controller for at least 3 months in Korea University Anam Hospital were selected. Their caregivers who had good adherence to maintenance treatment were recruited. Qualitative study through in-depth interviews was conducted with 18 caregivers who agreed to the study. Results : The 18 caregivers (mean age, 40.0 years) consisted of 15 mothers, 2 grandmothers, and 1 father. The resulting consensus were identified and grouped into 2 domains: the caregiver/patient aspect with 8 theme factors and the treatment aspect with 4 theme factors. The main theme factors in the caregiver/patient aspect were enabling participation in physical activities and exercise (77.8%), perceptions regarding asthma and the need for long-term treatment (50.0%), and perceived value of the medications outweighing the risk of side effects (38.9%). The main theme factors in the treatment aspect were trust in the physician (77.8%), general satisfaction with the manner and attitude of the physician (77.8%) and verification of the necessity of further treatment by performing tests (38.9%). Conclusion : Efforts to improve caregivers' adherence to the treatment of childhood asthma must include a range of factors related to both caregiver/patient aspects and treatment aspects. Among all of these factors, it may be most important to establish a physician-caregiver partnership.

Angiotensin Converting Enzyme Inhibition and Antihypertensive Effects of Phyllostachys pubescens Culm Extracts in Spontaneously Hypertensive Rats (맹종죽 줄기 추출물을 투여한 본태성 고혈압 쥐(SHR)의 ACE 저해 활성 및 혈압 강하 효과)

  • Kim, Jung-Suk;Kim, Mi-Jeong;Park, Min-Hee;Ryu, Bog-Mi;Moon, Gap-Soon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.1
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    • pp.27-34
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    • 2008
  • This study investigated the anti-hypertensive effect of Phyllostachys pubescens culm extract (PCE) by examining its effects on renal angiotensin-converting enzyme (ACE) inhibition and blood pressure using the spontaneously hypertensive rat (SHR) system. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured weekly for 8 weeks. Also, total antioxidant capacity and protein oxidation of tissues were examined by plasma Trolox Equivalent Antioxidant Capacity assay (TEAC) and hepatic protein carbonyl values, respectively. Twenty male SHR were randomly divided into four groups: PCE50, PCE100, and PCE500 (50, 100, and 500 mg of PCE per kilogram bodyweight daily, respectively), and control group. At week 2, the SBP in all PCE groups appeared to be significantly lower than the control (p<0.05), whereas the DBP were not different until week 4 (p<0.05). At week 8, SBP in the PCE500 was lower by 20% than the control. PCE groups considerably suppressed ACE dose-dependently compared with the control. Plasma TEAC and hepatic protein carbonyl values indicated increased antioxidative activity due to the PCE feed. No adverse effect was observed on the liver of SHR as there was no difference for the GOT and GPT values among the groups. Results of this study suggest that ACE inhibition may be one possible mechanism for the blood pressure lowering effect of PCE; thus, long term consumption of PCE may be beneficial in preventing high blood pressure along with the increased antioxidative status.

Effects of Limestone Powder and Silica Fume on the Hydration and Pozzolanic Reaction of High-Strength High-Volume GGBFS Blended Cement Mortars (고강도 고함량 고로슬래그 혼합 시멘트 모르터의 수화 및 포졸란 반응에 미치는 석회석 미분말과 실리카퓸의 영향)

  • Jeong, Ji-Yong;Jang, Seung-Yup;Choi, Young-Cheol;Jung, Sang-Hwa;Kim, Sung-Il
    • Journal of the Korea Concrete Institute
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    • v.27 no.2
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    • pp.127-136
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    • 2015
  • To evaluate the effects of limestone powder and silica fume on the properties of high-strength high-volume ground granulated blast-furnace slag (GGBFS) blended cement concrete, this study investigated the rheology, strength development, hydration and pozzolanic reaction characteristics, porosity and pore size distribution of high-strength mortars with the water-to-binder ratio of 20, 50 to 80% GGBFS, up to 20% limestone powder, and up to 10% silica fume. According to test results, compared with the Portland cement mixture, the high-volume GGBFS mixture had much higher flow due to the low surface friction of GGBFS particles and higher strength in the early age due to the accelerated cement hydration by increase of free water; however, because of too low water-to-binder ratio and cement content, and lack of calcium hydroxide content, the pozzolanic reactio cannot be activated and the long-term strength development was limited. Limestone powder did not affect the flowability, and also accelerate the early cement hydration. However, because its effect on the acceleration of cement hydration is not greater than that of GGBFS, and it does not have hydraulic reactivity unlikely to GGBFS, compressive strength was reduced proportional to the replacement ratio of limestone powder. Also, silica fume and very fine GGBFS lowered flow and strength by absorbing more free water required for cement hydration. Capillary porosities of GGBFS blended mortars were smaller than that of OPC mortar, but the effect of limestone powder on porosity was not noticeable, and silica fume increased porosity due to low degree of hydration. Nevertheless, it is confirmed that the addition of GGBFS and silica fume increases fine pores.

Annual Variations of Litterfall Production in a Broadleaved Deciduous Forest at the Mt. Keumsan LTER Site (금산 장기생태연구 조사지 낙엽활엽수림 낙엽낙지량의 연변동)

  • Kim, Choonsig;Lim, Jong Hwan;Lee, Im Kyun;Park, Byung Bae;Chun, Jung Hwa
    • Journal of Korean Society of Forest Science
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    • v.102 no.2
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    • pp.210-215
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    • 2013
  • Litterfall production represents a major contribution of carbon and nutrient cycling in forest ecosystems. This study was carried out to determine the litterfall production in a broadleaved deciduous forest at the Mt. Keumsan Long Term Ecological Research (LTER) site, Southern Korea. Littefall was collected monthly or bimonthly from the site for 7 years from 2004 to2010. Leaf and reproductive (catkins) litters showed a seasonal variation, but litters of needle, branch, and barks were not changed across the seasons. Annual leaf litter of Quercus serrata and Carpinus laxiflora were significantly different (p<0.05) but that of C. cordata, Chamaecyparis obtusa, and Pinus thunbergii was not significantly changed for 7 years (p>0.05). Annual average litterfall production was 5,223 kg/ha, but annual variations were very large with minimum of 4,110 kg/ha/yr in 2004 and maximum of 6,002 kg/ha/yr in 2007. Total litterfall comprised of 2,323 kg/ha/yr in Q. serrata, 442 kg/ha/yr in C. laxiflora, 157 kg/ha/yr in C. cordata, 131 kg/ha/yr in Acer pseudosieboldianum, 390 kg/ha/yr in other deciduous tree species, 74 kg/ha/yr in P. thunbergii, 37 kg/ha/yr in C. obtusa, 672 kg/ha/yr in branches, 515 kg/ha/yr in miscellaneous, 448 kg/ha/yr in reproductive parts, and 54 kg/ha/yr in barks. respectively. The results indicate that litterfall production of the Mt. Keumsan LTER site was yearly fructurated with the positive linear relationship between leaf or total litterfall and annual mean temperature if no disturbance such as a typoon, and was lower than that of other Korean LTER sites.