• 제목/요약/키워드: necrosis rate

검색결과 370건 처리시간 0.029초

선형가속기를 이용한 뇌수막종의 뇌정위적 방사선수술 (Stereotactic LINAC Radiosurgery of Meningiomas)

  • 류경식;손병철;김문찬;서태석;계철승;윤세철;강준기
    • Journal of Korean Neurosurgical Society
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    • 제29권3호
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    • pp.317-323
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    • 2000
  • Objective : To evaluate the role of stereotactic LINAC radiosurgery in treatment of meningiomas, the authors retrospectively analyzed the result of radiosurgery in our institute. Method: During last ten years, twenty patients underwent stereotactic LINAC radiosurgery(LINAC SRS) for meningiomas. The mean age of the patients was 51 years(22-78 years). The most common tumor location for radiosurgery was parasagittal, sphenoid wing and tentorial area. With regards to indications of radiosurgery for meningiomas, LINAC radiosurgery was done for primary treatment in six patients, for postoperative residual tumors in eleven patients, for postoperative regrowth in three patients. Mean tumor volume was $5.14cm^3$($0.28-15.1cm^3$), mean field diameter was 2.01cm(1.2-3cm). The mean marginal dose was 20.55Gy(13-30Gy). The follow-up evaluation was done annually with radiologic findings and clinical status. The mean follow-up period was 46.8(24-120) months. Result : In the radiologic response, the tumor volume was reduced in five(25%) of twenty patients, fourteen showed arrested growth(70%), but one patient showed increased growth(5%). In the clinical response, nine patients improved clinically(45%), ten patients was stable(50%) and one patient worsened during follow-up period. With regards to correlation with radiologic and clinical response, in nineteen patients who showed radiologic response to radiosurgery(decreased and arrested growth after radiosurgery), nine patients(47.4%) improved and ten patients (52.6%) showed no change, one patient(5%) had symptomatic radiation necrosis at four years after SRS, which needed craniotomy. Conclusion : The overall control rate of meningiomas with LINAC radiosurgery was 95% in radiologic follow up and 95% clinically. The radiation complication rate was 5%. These results indicate that LINAC radiosurgery can be considered as safe and effective method for meningiomas.

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Correlation between Cytokine and Chemokine levels and Clinical Severity in Children with Mycoplasma pneumoniae Pneumonia

  • Choi, Hee Joung;Kim, Yeo Hyang
    • Pediatric Infection and Vaccine
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    • 제26권1호
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    • pp.51-59
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    • 2019
  • 목적: 소아 마이코플라즈마 폐렴의 임상 중증도와 cytokine, chemokine의 상관 관계를 살펴보았다. 방법: 대상 환아의 임상소견과 검사소견을 후향적으로 조사하였고, interleukin (IL)-6, IL-8, IL-10, IL-18, inducible protein (IP)-10, macrophage inflammatory protein $(MIP)-1{\beta}$와 tumor necrosis factor $(TNF)-{\alpha}$를 비교 분석하였다. 결과: 총 72명이 포함되었고, 흉부 사진에서 대엽성 병변을 보이는 경우(29명)에서 기관지-미만성 병변을 보이는 경우(43명)보다 erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)와 IL-18 수치가 의미 있게 높았다. 하지만, 스테로이드 사용 여부에 따른 차이는 보이지 않았다. CRP, ESR, lactate dehydrogenase (LDH), IL-18 그리고 IP-10 수치는 입원 전 발열 기간과 양의 상관관계를 보였다. 또한 ESR과 CRP 수치는 IL-18과, LDH는 IP-10과 양의 상관관계를 보였다. 결론: CRP, ESR, IL-18 그리고 IP-10 수치는 대엽성 폐렴이나 긴 발열 기간과 같은 질병의 중증도와 연관성을 가진다.

Anti-BV의 봉약침 항체 효능에 관한 실험적 연구 (Experimental Study on Anti-body effects of Anti-BV on the Bee Venom Herbal Acupuncture)

  • 권기록;이광호;박원필
    • 대한약침학회지
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    • 제8권1호
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    • pp.21-30
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    • 2005
  • Objectives : To observe physiological anti-body effects of anti-BV, acute toxic response, measurement of $LD_{50}$, and the effects of anti-body were evaluated. Methods : $LD_{50}$ of Anti-Bee Venom were measured, and to analyze acute toxic responses, weight, and the anti-body effects various concentrations of Anti-BV were diluted and the survival rate was measured. Cell blood count (CBC), liver, spleen, and kidney pathologies were observed from the histological aspects. Results : Experiment was conducted to observe Anti-BV as the anti-body to the bee venom and the following results were obtained : 1.anti-BV was injected intraperitoneally and no toxic responses were witnessed. All of the experiment subjects stayed alive during the experiment, making $LD_{50}$ analysis impossible. 2.Anti-BV was injected intraperitoneally in mice and no significant weight changes were measured between the control group and the experiment groups. 3. Measuring the concentration dependent survival rate, the highest survival rate was at the concentration of $1.25{\times}10^2mg/kg$(1/2.000) for Anti-BV. 4. No particular results were shown in the CBC test. 5. Observation of changes in the organ tissues, Anti-BV was found to suppress blood stasis in the liver and inhibit necrosis of the cells. Conclusion : Above results suggest that Anti-BV doesn't cause any toxic responses in the body and works as an anti-body to the bee venom. Further studies must be followed to secure the findings.

Skoog씨 변법을 이용한 액취증의 치료 (The Treatment of Osmidrosis Axillae by Use of Modified Skoog's Method)

  • 임영민;최종우;김기호
    • Archives of Plastic Surgery
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    • 제32권2호
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    • pp.245-249
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    • 2005
  • Various surgical procedures have been described for treating osmidrosis axillare. Elimination of the apocrine glands is prime goal. Optimal operative procedure is characterized as follows: minimal axillary scar(which has cosmetic merits), less complications such as hematoma and seroma, short and less painful recuperating period, minimal damage to the skin and low recurrence rate. Three types of incision technique in subdermal shaving method have beeb commoly used. First, single incision method has an advantage of minimal scarring but more recurrence due to incomplete removal of apocrine glands may occur. Second, double incision technique(Bipedicled flap) has advantages of complete excision, low recurrence rate and relatively minimal scarring, but it could cause frequent necrosis of skin and folding of skin flap. Skoog's method is the third method, which makes four flaps by offset cruciate incisions. It is a better technique in aspect of complete excision of apocrine glands and low recurrence rate but has disadvantages such as development of hypertrophic scar or scar contracture in the line that lies perpendicular to natural axillary skin crease. We used a modified procedure which has shorter length in vertical and transverse incision compared with the classic Skoog's method. We dissected further subcutaneous tissue through the diamond-shaped incision and utilize wide operation field that provide adequate excision of subdermal tissue and proper hemostasis. Between 1999 and 2004, we operated 160 osmidrosis axillare in 80 patients in this technique. Most patients obtained satisfactory result with very low complications. Hematoma or seroma 3.1% Infection 0.6% Partial wound disruption 10% Recurrence 1.2%. Modified Skoog's method for treating osmidrosis axillae could be a optimal technique providing wide operation field for adequate excision of apocrine glands and proper hemostasis and leaving relatively inconspicuous scar and low incidence of scar contracture.

A Case of Radiation Bronchitis Induced Massive Hemoptysis after High-Dose-Rate Endobronchial Brachytherapy

  • Lee, Seok Jeong;Lee, Jong-Young;Jung, Soon Hee;Lee, Shun Nyung;Lee, Ji-Ho;Kim, Chong Whan;Jung, Saehyun;Jung, Ye-Ryung;Lee, Won-Yeon
    • Tuberculosis and Respiratory Diseases
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    • 제73권6호
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    • pp.325-330
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    • 2012
  • High-dose-rate endobronchial brachytherapy (HDREB) have been used as the treatment of early endobronchial cancer, as well as for palliation of advanced cancer. However, fatal hemoptysis can occur after HDREB at the rate of 7~32%. We report a case of massive hemoptysis due to radiation bronchitis developed after HDREB. A 67-year-old man was treated with HDREB for early endobronchial cancer on the left upper lobe bronchus. He complained of persistent cough from 4 weeks after completion of HDREB. Radiation bronchitis was observed on the bronchoscopy at 34 weeks, and it was progressed from mucosal swelling and exudate formation to necrosis and ulceration without local relapse. In addition, he died of massive hemoptysis after 15 months. The patient had no sign or radiologic evidences to predict the hemoptysis. This case implies that HDREB directly contributes to an occurrence of a fatal hemoptysis, and follow-up bronchoscopy is important to predict a progression of radiation bronchitis and fatal hemoptysis.

납(Pb)에 노출된 바지락, Ruditapes philippinarum의 생물지표 변화 (Changes of Biomarker in Manila clam, Ruditapes philippinarum Exposed to Lead)

  • 신윤경;박정준;임현식;이정식
    • 한국패류학회지
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    • 제29권1호
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    • pp.7-13
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    • 2013
  • 본 연구는 납에 노출된 바지락, Ruditapes philippinarum 의 생물학적 반응을 알아보고자 하였다. 실험기간은 4주였으며, 실험구는 대조구 1개와 납 노출구 3개 (0.25, 0.50 and 1.00 mg/l) 였다. 실험 결과 납은 바지락의 생존율과 산소 소비율의 저하 및 기관계의 조직학적 변성을 유도하는 것이 확인 되었다. 납 노출구에서 산소소비율은 25-72% 감소하였다. 기관계의 조직학적 분석 결과, 외투막 상피층과 결합조직층의 변성, 아가미 점액세포의 증가와 상피세포의 괴사, 발에서는 상피층의 붕괴, 점액세포의 감소 및 혈림프동의 확장과 결합조직층의 변성을 나타냈다. 소화맹낭의 소화선세관에서는 호염기성세포와 상피세포의 위축 및 농도 의존적으로 lipofuscin의 축적이 확인되었다.

Establishment and evaluation of the VX2 orthotopic lung cancer rabbit model: a ultra-minimal invasive percutaneous puncture inoculation method

  • Wang, Lijuan;Che, Keke;Liu, Zhonghong;Huang, Xianlong;Xiang, Shifeng;Zhu, Fei;Yu, Yu
    • The Korean Journal of Physiology and Pharmacology
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    • 제22권3호
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    • pp.291-300
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    • 2018
  • The purpose of the present work is to establish an ultra-minimal invasive percutaneous puncture inoculation method for a VX2 orthotopic lung cancer rabbit model with fewer technical difficulties, lower mortality of rabbits, a higher success rate and a shorter operation time, to evaluate the growth, metastasis and apoptosis of tumor by CT scans, necropsy, histological examination, flow cytometry and immunohistochemistry. The average inoculation time was 10-15 min per rabbit. The tumorbearing rate was 100%. More than 90% of the tumor-bearing rabbits showed local solitary tumor with 2-10 mm diameters after two weeks post-inoculation, and the rate of chest seeding was only 8.3% (2/24). The tumors diameters increased to 4-16 mm, and irregularly short thorns were observed 3 weeks after inoculation. Five weeks post-inoculation, the liquefaction necrosis and a cavity developed, and the size of tumor grew further. Before natural death, the CT images showed that the tumors spread to the chest. The flow cytometry and immunohistochemistry indicated that there was less apoptosis in VX2 orthotopic lung cancer rabbit model compared to chemotherapy drug treatment group. Minimal invasive percutaneous puncture inoculation is an easy, fast and accurate method to establish the VX2 orthotopic lung cancer rabbit model, an ideal in situ tumor model similar to human malignant tumor growth.

Ultrasonic dissection versus electrocautery for immediate prosthetic breast reconstruction

  • Lee, Dongeun;Jung, Bok Ki;Roh, Tai Suk;Kim, Young Seok
    • Archives of Plastic Surgery
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    • 제47권1호
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    • pp.20-25
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    • 2020
  • Background Ultrasonic dissection devices cause less thermal damage to the surrounding tissue than monopolar electrosurgical devices. We compared the effects of using an ultrasonic dissection device or an electrocautery device during prosthetic breast reconstruction on seroma development and short-term postoperative complications. Methods We retrospectively reviewed the medical records of patients who underwent implant-based reconstruction following mastectomy between March 2017 and September 2018. Mastectomy was performed by general surgeons and reconstruction by plastic surgeons. From March 2017 to January 2018, a monopolar electrosurgical device was used, and an ultrasonic dissection device was used thereafter. The other surgical methods were the same in both groups. Results The incidence of seroma was lower in the ultrasonic dissection device group than in the electrocautery group (11 [17.2%] vs. 18 [31.0%]; P=0.090). The duration of surgery, total drainage volume, duration of drainage, overall complication rate, surgical site infection rate, and flap necrosis rate were comparable between the groups. Multivariate analysis revealed that the risk of seroma development was significantly lower in the ultrasonic dissection device group than in the electrocautery group (odds ratio for electrocautery, 3.252; 95% confidence interval, 1.242-8.516; P=0.016). Conclusions The findings of this study suggest that the incidence of seroma can be reduced slightly by using an ultrasonic dissection device for prosthesis-based breast reconstruction. However, further randomized controlled studies are required to verify our results and to assess the cost-effectiveness of this technique.

Comparative analysis of proximal humerus fracture management in elderly patients: complications of open reduction and internal fixation by shoulder surgeons and non-shoulder surgeons-a retrospective study

  • Rui Claro;Bianca Barros;Carlos Ferreira;Ana Ribau;Luis Henrique Barros
    • Clinics in Shoulder and Elbow
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    • 제27권1호
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    • pp.32-38
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    • 2024
  • Background: Open reduction and internal fixation (ORIF) with a locking plate is a popular surgical treatment for proximal humeral fractures (PHF). This study aimed to assess the occurrence of complications in elderly patients with PHF treated surgically using ORIF with a locking plate and to investigate the potential differences between patients treated by shoulder surgeons and non-shoulder surgeons. Methods: A retrospective study was conducted using a single-center database to identify patients aged ≥70 years who underwent ORIF for PHF between January 1, 2011, and December 31, 2021. Data on the Neer classification, follow-up, occurrence of avascular necrosis of the humeral head, implant failure, and revision surgery were also collected. Statistical analyses were performed to calculate the overall frequency of complications according to the Neer classification. Results: The rates of implant failure, avascular osteonecrosis, and revision surgery were 15.7%, 4.8%, and 15.7%, respectively. Complications were more common in patients with Neer three- and four-part fractures. Although the difference between surgeries performed by shoulder surgeons and non-shoulder surgeons did not reach statistical significance, the rate of complications and the need for revision surgery were nearly two-fold higher in the latter group. Conclusions: PHF are highly prevalent in the elderly population. However, the ORIF surgical approach, as demonstrated in this study, is associated with a considerable rate of complications. Surgeries performed by non-shoulder surgeons had a higher rate of complications and a more frequent need for revision surgery. Future studies comparing surgical treatments and their respective complication rates are crucial to determine the optimal therapeutic options. Level of evidence: III.

골육종에서 술전 항암화학요법의 효과 판정 (Evaluation of Neoadjuvant Chemotherapy Effect in Osteosarcoma)

  • 주민욱;강용구;유이령;최우희;정양국;김동현;강진우
    • 대한골관절종양학회지
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    • 제20권2호
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    • pp.66-73
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    • 2014
  • 목적: 골육종에 대한 술전 항암화학요법의 효과를 조기에 비침습적으로 평가하기 위해 다양한 영상 진단 기법들을 사용해 왔다. 저자들은 골육종에 대한 술전 항암화학요법의 효과를 예측하는 데 있어 단순 촬영 및 양전자 방출 단층 촬영과 같은 영상 검사들의 효용성을 평가하고 양성자 방출 단층 촬영에서 얻어진 값들을 해석하는 데 있어서의 통칙을 정해 보고자 하였다. 대상 및 방법: 2주기 술전 항암화학요법 후 외과적 절제를 시행한 18명의 골육종 환자들을 대상으로 하였다. 남자 13명, 여자 5명이었으며, 연령의 중위수는 19세였다. 술전 항암화학요법의 전후로 단순 촬영 및 양전자 방출 단층 촬영을 시행하였다. 절제된 종양에 대해 병리검사를 시행하여 조직학적 반응 등급을 확인하였다. 조직병리학적 괴사 정도와 방사선학적 소견, 술전 항암화학요법 후 최대 표준섭취계수(maximum standardized uptake value), 평균 표준섭취계수(average standardized uptake value), 대사종양용적(metabolic tumor volume) 및 해당 값들의 감소율에 대해 통계학적 분석을 시행하였다. 결과: 조직학적 평가 상, 8명의 환자에서 술전 항암화학요법에 대해 좋은 반응을 확인하였다. 최대 표준섭취계수 감소율의 중위수는 좋은 반응을 보인 군에서 74 (23-77) %였고, 나머지에서 42 (-32-76) %였다. 대사종양용적 감소율의 중위수는 좋은 반응을 보인 군에서 93.5 (62-99) %였고 나머지에서 46 (-81-100) %였다. 방사선학적 소견의 범주는 조직학적 반응에 따른 차이가 없었지만 (p=1.0), 최대 표준섭취계수의 감소율은 유의한 차이를 보였다(p=0.041). 대사종양용적의 감소율 차이는 통계학적 유의성에 근접하였다(p=0.071). 결론: 본 연구에서 방사선학적 소견의 범주는 골육종에 대한 술전 항암화학요법의 효과를 평가하는 데 있어 신뢰할 수 없었지만, 최대 표준섭취계수는 유용한 척도였다. 양전자 방출 단층 촬영에서 얻어지는 값들은 여러 요인에 의해 영향을 받으므로, 각 기관은 기왕의 연구들을 참고로 각자의 판단 기준을 마련하기 위해 노력해야만 한다.