• Title/Summary/Keyword: necrotic

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Clinical Experience of Photodynamic Therapy in Five Patients with Advanced Lung Cancer (진행성 폐암에서 광역동 치료로 호전된 5례에 관한 임상적 경험)

  • Kim, Yang-Ki;Lee, Young-Mok;Kim, Ki-Up;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.72-77
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    • 2004
  • Background : A tracheobronchial obstruction in lung cancer is associated with significant morbidity and mortality due to dyspnea, cough, hemoptysis, and recurrent respiratory infection. It is well known that one of standard treatments is photodynamic therapy (PDT) in tracheobronchial obstruction after radiotherapy, chemotherapy, and/or surgery. We reported here the role of PDT in airway obstruction in patients advanced lung cancer. Method : Pre-treatment protocol consisted of clinical, radiologic, and bronchoscopic examination, pulmonary function test, and assessment of Karnofsky performance status. A 2 mg/kg of porfimer sodium was injected intravenously, and then followed by cylindrical and/or interstitial irradiation with 630 nm of laser after 48 hours. The repeated bronchoscopy for debridement of necrotic tissue and re-illumination was performed after 48 hours. Result : Improved airway obstruction and selective tumor necrosis were achieved by photodynamic therapy in all cases. Dyspnea and performance status were improved in three cases. A purulent sputum, fever and hemoptysis were improved in one of five cases. After PDT, all patients showed temporarily aggravation of dyspnea, two of five showed febrile reaction for a few days and nobody presented photosensitivity reaction, hemoptysis and respiratory failure. Conclusion : Our experiences of PDT are effective in palliation of inoperable advanced lung cancer in terms of tracheobronchial obstruction.

Measurement of Apparent Diffusion Coefficient Values from Diffusion-Weighted MRI: A Comparison of Manual and Semiautomatic Segmentation Methods

  • Kim, Seong Ho;Choi, Seung Hong;Yoon, Tae Jin;Kim, Tae Min;Lee, Se-Hoon;Park, Chul-Kee;Kim, Ji-Hoon;Sohn, Chul-Ho;Park, Sung-Hye;Kim, Il Han
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.2
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    • pp.88-98
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    • 2015
  • Purpose: To compare the interobserver and intraobserver reliability of mean apparent diffusion coefficient (ADC) values using contrast-enhanced (CE) T1 weighted image (WI) and T2WI as structural images between manual and semiautomatic segmentation methods. Materials and Methods: Between January 2011 and May 2013, 28 patients who underwent brain MR with diffusion weighted image (DWI) and were pathologically confirmed as having glioblastoma participated in our study. The ADC values were measured twice in manual and semiautomatic segmentation methods using CE-T1WI and T2WI as structural images to obtain interobserver and intraobserver reliability. Moreover, intraobserver reliabilities of the different segmentation methods were assessed after subgrouping of the patients based on the MR findings. Results: Interobserver and intraobserver reliabilities were high in both manual and semiautomatic segmentation methods on CE-T1WI-based evaluation, while interobserver reliability on T2WI-based evaluation was not high enough to be used in a clinical context. The intraobserver reliability was particularly lower with the T2WI-based semiautomatic segmentation method in the subgroups with involved $lobes{\leq}2$, with partially demarcated tumor borders, poorly demarcated inner margins of the necrotic portion, and with perilesional edema. Conclusion: Both the manual and semiautomatic segmentation methods on CE-T1WI-based evaluation were clinically acceptable in the measurement of mean ADC values with high interobserver and intraobserver reliabilities.

A Case of Primary Endobronchial Leiomyosarcoma Noticed by Massive Hemoptysis (대량객혈로 발견된 원발성 기관지내 평활근육종 1예)

  • Kim, Woo Youl;Kang, Gu Hyun;Lee, Jin Ho;Park, Sun Hyo;Kang, Kyung Woo
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.484-489
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    • 2006
  • A primary pulmonary leiomyosarcoma is a very rare pulmonary malignancy that arises from smooth muscle of either the bronchial or arterial walls. Common symptoms of the tumor are cough, dyspnea, chest pain and hemoptysis. The diagnosis of a primary pulmonary sarcoma can be established only after extensive clinical and radiologic examinations have failed to identify an alternative primary source. The only effective treatment for the tumor is a complete surgical resection when feasible. The type of resection is dictated by the local anatomic extent of the tumor. We report a case of a 21-year-old male with a primary endobronchial leiomyosarcoma who presented with massive hemoptysis. A necrotic ulcerative endobronchial lesion was observed in the orifice of left lower lobe bronchus on a bronchoscopic examination. He was treated with a complete sleeve resection of the left lower lobe. Three months later, local recurrence of the tumor was noticed on the follow up bronchoscopy and a then left pneumonectomy was then performed. Fifteen months later, the patient died from empyema with a bronchopleural fistula that was associated with tumor recurrence at the stump of the pneumonectomy.

CLINICAL APPLICATION OF MTA(MINERAL TRIOXIDE AGGREGATE) FOR APEXIFICATION (치근단 형성술(Apexification)에 있어서 MTA(Mineral Trioxide Aggregate)의 적용)

  • Baik, Byeoung-Ju;Jeon, So-Hee;Kim, Young-Sin;Kim, Jae-Gon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.4
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    • pp.700-708
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    • 2001
  • Traumatic injuries in young patients can result in the interruption of the development of the incompletely formed roots. In teeth with incomplete root-end formation and necrotic pulps, the root canals must be completely debrided. Because of a lack of an apical stop and the presence of thin and fragile walls in these teeth, it is imperative to perform apexification to obtain an adequate apical seal. Calcium hydroxide has become the material of choice for apexification. Despite its popularity for the apexification procedure, calcium hydroxide therapy has some inherent disadvantages that include variablility of treatment time, unpredictability of apical closure, difficulty in patient follow-up, and delayed treatment. An alternative treatment to long-term apexification procedure is the use of an artificial apical barrier that allows immediate obturation of the canal. MTA(Mineral Trioxide Aggregate) is a powder consisting of fine hydrophilic particles of tricalcium silicate, tricalcium aluminate, tricalcium oxide and silicate oxide. MTA has a pH of 12.5 after setting, similar to calcium hydroxide. This may impart some antimicrobial properties. MTA has low solubility and a radiopacity slightly eater than that of dentin. Also, MTA leaked significantly less than other materials and induced hard-tissue formation more than other materials.

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Effects of Samgi-eum(Sānqì-yǐn) Treatment on the Monosodium Iodoacetate-induced Osteoarthritis in Rats (삼기음(三氣飮)이 흰쥐의 Monosodium Iodoacetate 유발 골관절염에 미치는 영향)

  • Lee, Kyung-Moo;Jeong, Su-Hyeon;Kim, Soon-Joong;Seo, Il-Bok
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.2
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    • pp.17-31
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    • 2008
  • Objectives : This study was carried out to investigate the effects of Samgi-eum($S{\bar{a}}nq{\grave{i}}-y{\check{i}}n$) on the monosodium iodoacetate-induced osteoarthritis in rats. Methods : Osteoarthritis was induced by injection of monosodium iodoacetate intraarticularly in both knee joints. Arthritic rats were divided into control and treated group. Control group were taken distilled water for 20days. Treated group were taken extracts of Samgi-eum($S{\bar{a}}nq{\grave{i}}-y{\check{i}}n$) by orally for the same duration. Normal group were injected normal saline and taken distilled water. Body weights were measured at 0, 5th, 10th, 15th, 20th day after injection. At the end of the experiment, gross and histopathological examination on the articular cartilages of the knee joints were performed. Proteoglycan contents of articular cartilages were analyzed by safranine O staining method. The contents of $TNF-{\alpha}$, $IL-1{\beta}$ and IL-6 in synovial fluids were analyzed by ELISA method. Results : 1. Body weights of the treated group were significantly increased compared with control at 20days after injection. 2. Grossly, the severity of osteoarthritis in the treated group were alleviated compared with control. 3. Histopathologically, degenerative and necrotic lesion of articular cartilages in the treated group were alleviated compared with those of the control and histopathological scores of treated group were significantly decreased compared with control. 4. PG contents in articular cartilages of the treated group were significantly increased compared with control. 5. $TNF-{\alpha}$ contents in synovial fluids of the treated group were significantly decreased compared with control. Conclusions : According to above results, Samgi-eum($S{\bar{a}}nq{\grave{i}}-y{\check{i}}n$) has anti-arthritic effects on the monosodium iodoacetate-induced osteoarthritis in rats. And it is related with reduced secretion of $TNF-{\alpha}$ from osteoarthritic chondrocytes and synovial membranes.

Compression Plate Fixation with Autogenous Bone Graft for Humerus Shaft Nonunion (상완골 간부 불유합에 대한 금속판 고정 및 자가골 이식술)

  • Cho, Chul-Hyun;Song, Kwang-Soon;Bae, Ki-Cheor;Kim, In-Kyoo;Kwon, Doo-Hyun
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.33-37
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    • 2009
  • Purpose: To evaluate the results of the compression plate fixation and autogenous bone graft in the management of humerus shaft nonunion. Materials and Methods: Eighteen cases were treated for humerus shaft nonunion using compression plate fixation and an autogenous iliac bone graft. The mean follow-up period was 28 months. Bony union was confirmed from the serial radiographs and the clinical outcomes were assessed according to ASES scoring system. Results: In 12 cases of initial plate fixation, the causes of nonunion were 6 cases of inadequate plate length, 2 with a broken plate, 2 with screw loosening, 1 infection and 1 noncompliance of a psychiatric patient. In 3 cases of initial intramedullary fixation, the cause of nonunion was a distraction of the fracture site. In 3 cases of external fixation, the cause of nonunion was inadequate fixation. All cases showed bony union after an average of 24 weeks. The clinical outcomes were 11 excellent, 6 good and 1 fair. Conclusion: In the treatment for nonunion, compression plate fixation with autogeneous bone graft after complete removal of the fibrous and necrotic tissue is believed to give satisfactory results.

The Effects of Melatonin on Cisplatin-Induced Renal Cortical Cell Injury in Rabbits

  • Kim, Chung-Hui;Han, Jin;Kim, Na-Ri;Park, Ju-Hee;Yang, Young-Churl;Kim, Eui-Yong
    • The Korean Journal of Physiology and Pharmacology
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    • v.5 no.3
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    • pp.223-230
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    • 2001
  • Melatonin, a pineal gland hormone, is believed to act as an antioxidant via the stimulation of radical detoxifying enzymes and scavenging of free radicals. In this study, effects of in vitro and in vivo treatments of melatonin on the cisplatin-induced lipid peroxidation, LDH release and plasma creatinine were determined in rabbit renal cortical cells. The level of malondialdehyde (MDA) was assayed as an index of lipid peroxidation and the level of LDH release as an indicator of cellular damage. In in vitro studies, cisplatin increased the levels of MDA and LDH release in a concentration-and time-dependent manner. Melatonin inhibited the cisplatin-induced lipid peroxidation and LDH release in a concentration-dependent manner. The minimal effective concentration of melatonin that significantly reduced the $300\;{\mu}M$ cisplatin-induced lipid peroxidation and LDH release was 1 mM. In in vivo studies, the levels of lipid peroxidation and LDH release in renal cortical cells increased significantly 24 or 48 hours after a single injection of cisplatin (6 mg/kg). When the cisplatin-injected rabbits were pretreated with 10 mg/kg of melatonin, a significant reduction in both lipid peroxidation and LDH release was observed. The plasma creatinine level increased from $0.87{\pm}0.07$ mg/dl in control to $6.33{\pm}0.54$ mg/dl in cisplatin-injected rabbits (P<0.05). Melatonin partially prevented the increase in serum creatinine level $(1.98{\pm}0.11\;mg/dl)$ by cisplatin (P<0.05). In the proximal tubules from cisplatin-treated group, tubular cells had microvilli of variable heights. Necrotic debris was seen in tubular lumens. In most of cells, the mitochondria and lysosomes were increased in frequency. The endocytic vacuoles were not prominent and distribution of the brush border was irregular and shortened. These cisplatin-induced morphological changes were moderate in the melatonin-pretreated group. These results suggest that the toxicity of cisplatin is associated with the generation of reactive oxygen free radicals and that melatonin is a powerful antioxidant, which prevents some of the adverse effects of cisplatin.

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Changes in Chlorophyll Content and Leaf Damages of Liliodendron tulipifera L. Seedlings Treated with Simulated Acid Rain (인공산성비 처리에 의한 백합나무 묘목의 엽피해와 엽록소함량 변화)

  • Yoon, Jun-Hyuck;Lee, Do-Hyung;Woo, Kwan-Soo
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.10 no.3
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    • pp.75-81
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    • 2008
  • This study was conducted to analyze the influence of simulated acid rain on leaves of Liliodendron tulipifera seedlings. The seedlings were treated with four levels of simulated acid rain with pH of 5.6, 4.9, 3.9 and 2.9, and then chlorophyll contents and the degree of foliar damage were investigated. Differences were statistically significant among treatments in chlorophyll contents in all of the tested soils. The total contents of chlorophyll tended to decrease as the simulated acid rain treatment was maintained. Chlorophyll contents, however, did not decrease according to the decrement of pH levels. Foliar damage increased as the simulated acid rain was maintained in all tested soils. Especially, the damage dramatically increased between May and July as the acidity increased. As the treatment of simulated acid rain continued, deformed new leaves appeared. In all treatments except the control, the leaves turned brown and the damage increased with time. Necrotic spots appeared during the first month of treatment at the pH level of 2.9 in all soil types. The damage by acid rain should be considered when we plant Liliodendron tulipifera.

Reconstruction of Soft Tissue Defects after Snake Bites (뱀교상 후 발생한 연부조직 결손의 재건)

  • Lee, Jang Hyun;Jang, Soo Won;Kim, Cheol Hann;Ahn, Hee Chang;Choi, Matthew Seung Suk
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.605-610
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    • 2009
  • Purpose: Substantial tissue necrosis after snake bites requiring coverage with flap surgery is extremely rare. In this article, we report 7 cases of soft tissue defects in the upper and the lower extremities caused by snake bites, which needed to be covered with flaps. Among the vast mass of publications on snake bites there has been no report that focuses on flap coverage of soft tissue defects due to snake bite sequelae. Methods: Seven cases of soft tissue defects with tendon, ligament, or bone exposure after snake bites were included. All patients were males without comorbidities, the average age was 35 years. All of them required coverage with a flap. In 6 cases, the defect was localized on the upper extremity, in one case the lesion was on the lower extremity. Local flaps were used in 6 cases, one case was covered with a free flap. The surgical procedures included one kite flap, one cross finger flap and digital nerve reconstruction with a sural nerve graft, one reverse proximal phalanx island flap, one groin flap, one adipofascial flap, one neurovascular island flap, and one anterolateral thigh free flap. The average interval from injury to flap surgery was 23.7 days. Results: All flaps survived without complication. All patients regained a good range of motion in the affected extremity. Donor site morbidities were not observed. The case with digital nerve reconstruction recovered a static two point discrimination of 7 mm. The patient with foot reconstruction can wear normal shoes without a debulking procedure. Conclusion: The majority of soft tissue affection after snake bites can be treated conservatively. Some severe cases, however, may require the coverage with flap surgery after radical debridement, especially, if there is exposure of tendon, bone or neurovascular structures. There is no doubt that definite coverage should be performed as soon as possible. But we also want to point out that this principle must not lead to a premature coverage. If the surgeon is not certain that the wound is free of necrotic tissue or remnants of venom, it is better to take enough time to get a proper wound before flap surgery in order to obtain a good functional and cosmetic result.

Intratumoral distribution of 64Cu-ATSM and 18F-FDG in VX2tumor xenografted rabbit

  • Yoo, Ran Ji;Lee, Ji Woong;Lee, Kyo Chul;An, Gwang Il;Ko, In Ok;Chung, Wee Sup;Park, Ji Ae;Kim, Kyeong Min;Choi, Yang-Kyu;Kang, Joo Hyun;Lim, Sang Moo;Lee, Yong Jin
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.1 no.2
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    • pp.123-129
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    • 2015
  • $^{64}Cu$-labeled diacetyl-bis($N^4$-methylthiosemicarbazone) is a promising agent for internal radiation therapy and imaging of hypoxic tissues. In the study, we confirmed hypoxia regions in VX2 tumor implanted rabbits with injection $^{64}Cu$-ATSM and $^{18}F$-FDG using positron emission tomography (PET)/computed tomography (CT). PET images with $^{18}F$-FDG and $^{64}Cu$-ATSM were obtained for 40 min by dynamic scan and additional delayed PET images of $^{64}Cu$-ATSM the acquired up to 48 hours. Correlation between intratumoral $O_2$ level and $^{64}Cu$-ATSM PET image was analyzed. $^{64}Cu$-ATSM and $^{18}F$-FDG were intravenously co-injected and the tumor was dissected and cut into slices for a dual-tracer autoradiographic analysis. In the PET imaging, $^{64}Cu$-ATSM in VX2 tumors displayed a specific uptake in hypoxic region for48 h. The uptake pattern of $^{64}Cu$-ATSM in VX2 tumor at 24 and 48 h did not match to the $^{18}F$-FDG. Through ROI analysis, in the early phase (dynamic scan), $^{18}F$-FDG has positive correlation with $^{64}Cu$-ATSM but late phase (24 and 48 h) of the $^{64}Cu$-ATSM showed negative correlation with $^{18}F$-FDG. High uptake of $^{64}Cu$-ATSM in hypoxic region was responded with significant decrease of oxygen pressure, which confirmed by $^{64}Cu$-ATSM PET imaging and autoradiographic analysis. In conclusion, $^{64}Cu$-ATSM can utilize for specific targeting of hypoxic region in tumor, and discrimination between necrotic- and viable hypoxic tissue.