• 제목/요약/키워드: prognosis evaluation

검색결과 396건 처리시간 0.032초

중합방법에 따른 여러 이중중합 레진 시멘트의 기계적 성질 평가 (Evaluation of mechanical properties of several dual-cure resin cements by curing modes)

  • 김수연;박세희;김진우;조경모
    • 구강회복응용과학지
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    • 제31권1호
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    • pp.1-9
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    • 2015
  • 목적: 중합방법 및 측정시기에 따른 여러 이중중합 레진 시멘트의 기계적 성질인 압축강도와 간접인장강도를 비교 평가하는 것이다. 연구 재료 및 방법: 1개의 레진강화형 글래스아이오노머 시멘트인 FujiCEM 2, 2개의 전통적인 이중중합 레진 시멘트인 RelyX ARC와 Multilink N, 2개의 이중중합 자가접착 레진 시멘트인 RelyX U200과 G-CEM LinkAce를 사용하였다. 제조사의 지시에 따라 시멘트를 혼합하여 압축강도와 간접인장강도 측정을 위한 시편을 제작하였다. 중합방법 및 측정시기의 영향을 평가하기 위해 시멘트에 따라 4가지 실험 조건으로 나눴고, 만능시험기로 압축강도와 간접인장강도 측정하였다. 각각의 강도 값을 계산 후 통계처리 하였다. 결과: 압축강도에서는 RelyX ARC의 광중합과 Multilink N의 광중합, 간접인장강도에서는 RelyX ARC의 광중합을 제외하고 모든 중합방법에서 24시간 뒤 측정된 강도가 즉시 측정한 강도보다 더 높은 값을 보여주었다. FujiCEM 2는 시멘트간 비교에서 가장 낮은 강도 값을 보였다(P < 0.05). 결론: 치과용 시멘트 중에서 최근 출시된 이중중합 자가접착 레진 시멘트는 기존의 레진 시멘트와 비교시 제품별로 차이가 있었으나, 압축강도와 간접인장강도에서는 유의한 차이를 보이지 않았다.

하악골에서 발생한 Burkitt 림프종의 조기발견과 진단 (Early Diagnosis of Burkitt Lymphoma on the Mandible: A Case Report)

  • 김미애;박지현;마연주
    • 대한소아치과학회지
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    • 제43권4호
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    • pp.452-460
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    • 2016
  • Burkitt 림프종은 소아에서 호발하는 악성 종양의 하나로 non-Hodgkin B 림프종의 한 형태이다. 매우 빠르게 증식하는 종양으로 구강 내에서 발생시 안면부 부종 및 이환 치아의 동요도와 변위, 치은의 발적 및 부종 등의 증상을 보인다. 본 증례는 5세 남환으로 왼쪽 하악부의 통증과 안면부 부종으로 개인병원에서 의뢰되었다. 왼쪽 하악골부터 관골까지 퍼진 안면부 부종을 보였으며 좌측 하악 유구치는 심한 충치가 없음에도 불구하고 중등도의 동요도를 보이고 타진에 양성 반응을 보였다. 방사선학적 소견으로는 좌측 하악 제2유구치와 제1영구치의 치조 백선 소실이 관찰 되었으며, 좌측 하악골에는 방사선 투과성의 골용해성 소견과 피질골의 파괴가 관찰되었다. 환아는 임상적, 방사선학적, 면역조직학적 검사를 바탕으로 Burkitt 림프종으로 진단되었고, 전신적인 검사와 항암 화학요법을 위해 본원 소아과로 의뢰되었다. 화학요법을 시작한 지 3개월만에 안면부 및 치은의 부종이 소실되었고, 치아의 동요도 및 위치도 정상으로 회복되었다. Burkitt 림프종으로 진단된 본 환아는 조기 진단과 집중적인 화학요법으로 좋은 예후를 보였기에 이를 보고하는 바이다.

Cytokeratin의 RT-PCR 및 면역조직화학적 분석을 이용한 구강편평세포암종의 임파절 미세전이 진단과 예후인자 효용성 평가 (DIAGNOSIS OF MICROMETASTASIS IN LYMPH NODE AND CLINICAL EVALUATION OF PROGNOSTIC FACTOR OF ORAL SCC USING RT-PCR AND IMMUNOHISTOCHEMISTRY FOR CYTOKERATIN)

  • 박성진;이원덕;임구영;강진한;명훈;이종호;김명진
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제31권2호
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    • pp.105-115
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    • 2005
  • Purpose: The lymph node status assessed by conventional histological examination is the most important prognostic factor in patients undergoing surgery for oral squamous cell carcinoma. The presence of lymph node metastasis has a strong adverse impact on patient survival even after extended radical resection. Despite these findings, tumour recurrence is not rare after surgery, even when histological examination shows no lymph node metastasis. Recently, molecular-genetically and immunohistochemically demonstrated micrometastasis to the lymph nodes has been shown to have a significant adverse influence on survival in patients with squamous cell carcinoma and histologically negative nodes. The present study sought to determine the incidence and clarify the clinical significance of molecular-genetically and immunohistochemically demonstrated nodal micrometastases and to correlate these data with the stage of oral cancer. Methods: Lymph nodes systematically removed from 71 patients who underwent curative resection between 1998 and 2003 with head and neck squamous cell carcinoma were examined molecular-genetically to detect cytokeratin 5 mRNA with RT-PCR and immunohistochemically to detect cells that stained positively for cytokeratins with the monoclonal antibody cocktail AE1/AE3. The postoperative course and survival rates were compared among patients with and without micrometastases, after numerical classification of overt metastatic nodes. Results: micrometastases were detected in 43(60%) of 71 patients by RT-PCR and 26(36%) of 71 patients by immunohistochemistry. By RT-PCR analysis, patients exhibiting a positive band for CK 5 mRNA had a significantly worse prognosis than those were RT-PCR negative. By immunohistochemistry, the presence of micrometastasis did not predict patient outcome. Conclusion: Micrometastases detected by RT-PCR may be of clinical value in identifying patients who may be at high risk for recurrence and who are therefore likely to benefit from systemic adjuvant therapy.

말초성 동맥 질환에 있어서 $^{201}T1$을 이용한 말초혈관 관류스캔의 유용성 (Thallium-201 Perfusion Scan in Peripheral Arterial Disease)

  • 나정일;우인숙;김덕윤;고은미;김진우;김영설;김광원;최영길
    • 대한핵의학회지
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    • 제25권2호
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    • pp.192-199
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    • 1991
  • Peripheral arterial disease, because of it's significant and prolonged morbidity and related mortality is a major medical and surgical problem. Contrast angiogram remains the essential standard for the anatomic demonstration of disease. It does not, however, provide data suitable for quantification or any evaluation of the microcirculation. For these reasons, radionuclide studies are playing an increasingly important role by not only confirming the diagnosis and offering objective data on the physiologic significance of anatomic lesions, but by offering prognosis of healing and prediction of therapeutic results. In addition, radionuclide procedures offer means to safely and repeatedly monitor response to therapy and long term follow up. The object of this study was to evaluate the clinical availability of $^{201}T1$ perfusion scan in patients with peripheral arterial diseases. We performed $^{201}T1$ perfusion scans in patients with five Buerger' s disease (10 legs), six DM gangrenes (12 legs) and classified three perfusion pattern groups. Finally we compared treatment modalities among each groups and compaired T1-201 perfusion scan findings with angiographic findings in six patients with Buerger's disease. The results were as follows: 1) Seven legs showed increased perfusion in stress image and normal or increased perfusion in resting image (type 1). Six legs showed decreased perfusion in stress image and improved in resting image (type II). Of total 13 legs, only 1 leg needed to amputation. 2) Three legs showed decreased perfusion in stress and resting image (type III), and subsequently all cases were received surgical amputation. 3) In six Buerger's disease patients, there were disagreements in two patients (2 legs) between $^{201}T1$ scan and angiography, in which angiograms were normal but $^{201}T1$ scans showed 'type II' perfusion patterns.

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개에서 포도중독에 의한 급성신부전의 임상병리학적 평가 (Clinicopathological Analyses and Outcome of Acute Renal Failure with Grape Ingestion in Dogs)

  • 박선일
    • 한국임상수의학회지
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    • 제30권1호
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    • pp.57-60
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    • 2013
  • 개에서 포도중독에 의한 신부전 치료결과에 대한 임상적 분석을 위하여 205-2008년 기간 중 강원대학교 수의과대학 동물병원에 내원한 환자의 의료기록부를 분석하였다. 총 11두 (암컷 8두) 중 4두는 완전히 회복하였고, 3두는 폐사, 4두는 안락사로 처리되었다. 1두를 제외한 모든 환자는 포도를 섭취하였으나 정확한 섭취량은 알 수 없었다. 환자의 평균 연령은 5.3세 (범위 0.2-11.3세), 체중은 4.1 kg (범위 1.4-13 kg)였으며, 평균 입원기간은 7.1일 (범위 2-22일)로 나타났다. 모든 환자에서 구토와 식욕부진 증상을 보였으며, 일부 환자는 설사 (4두), 핍뇨 (5두), 무뇨 (4두) 소견을 보였다. 모든 환자에서 혈청 phosphorous, creatinine, BUN 농도가 증가된 소견을 보였으며, 고칼슘혈증 2두, 저칼슘혈증 2두, 나머지 7두는 정상소견이었다. 혈청 농도가 증가한 항목은 amylase 8두, ALP 7두, ALT 5두였으며, 혈액 가스 분석에서 8두는 대사성산증을 보였다. 경미하거나 중등도의 빈혈 소견이 5두에서 관찰되었으며, 회복한 환자와 비교할 때 폐사축의 경우 혈소판과 림프구 수가 상대적으로 낮았다.

불안정성 족근관절 골절의 수술적 치료 결과에 영향을 미치는 임상적 예후 인자에 대한 분석 (The Evaluation of Clinical Prognostic Factors for the Surgically Treated Unstable Ankle Fractures)

  • 정홍근;유문집;유석주;이성철;박진영;김태원;김명호
    • 대한족부족관절학회지
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    • 제5권2호
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    • pp.112-119
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    • 2001
  • Purpose: The purpose of this study is to analyze the clinical prognostic factors which may affect the postoperative clinical results of the unstable ankle fractures. Materials and Methods: This study is based on 62 unstable ankle fractures treated by open reduction and internal fixation from May 1994 to June 2000, with a minimum follow-up period of 12 months(range: 13 months-7 years 3 months). The 62 patients were average 39.1 years old with male: female ratio of 41:21. Based on Lauge-Hansen classification, the supination-external rotation type was the most common with 36 (58.1%) cases. The clinical results was assessed by American Orthopaedic Foot and Ankle Society(AOFAS) functional scale. The sex, age, body weight, trauma-operation interval, operation time, cause of injury, fracture type were statistically analyzed as the possible postoperative clinical prognostic factors. Results: Postoperative AOFAS functional scale was average 82.1 points with 22(35.5 %) cases excellent, 12(19.4%) good. 16(25.8%) fair and 12(19.4%) cases poor results. The age and the operation time were found to be statistically significant factors affecting the prognosis(p<0.001). The sex, weight, trauma-operation interval factors did not significantly affect the clinical results. The pronation-external rotation type showed better clinical tendency among the fracture types, but without the statistical significance. Conclusion: The surgically treated unstable ankle fractures in patients whose age was above 41 years old or operation time exceeding 90 minutes showed significantly poor clinical results.

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Retrospective Analysis of Cerebrospinal Fluid Profiles in 228 Patients with Leptomeningeal Carcinomatosis : Differences According to the Sampling Site, Symptoms, and Systemic Factors

  • Shim, Youngbo;Gwak, Ho-Shin;Kim, Sohee;Joo, Jungnam;Shin, Sang-Hoon;Yoo, Heon
    • Journal of Korean Neurosurgical Society
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    • 제59권6호
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    • pp.570-576
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    • 2016
  • Objective : Elevated cell counts and protein levels in cerebrospinal fluid (CSF) result from disease activity in patients with leptomeningeal carcinomatosis (LMC). Previous studies evaluated the use of CSF profiles to monitor a treatment response or predict prognosis. CSF profiles vary, however, according to the sampling site and the patient's systemic condition. We compared lumbar and ventricular CSF profiles collected before intraventricular chemotherapy for LMC and evaluated the association of these profiles with patients' systemic factors and LMC disease activity. Methods : CSF profiles were retrospectively collected from 228 patients who underwent Ommaya reservoir insertion for intraventricular chemotherapy after a diagnosis of LMC. Lumbar samples taken via lumbar puncture were used for the diagnosis, and ventricular samples were obtained later at the time of Ommaya reservoir insertion. LMC disease activity was defined as the presence of LMC-related symptoms such as increased intracranial pressure, hydrocephalus, cranial neuropathy, and cauda equina syndrome. Results : Cell counts (median : 8 vs. 1 cells/mL) and protein levels (median : 68 vs. 17 mg/dL) significantly higher in lumbar CSF than in ventricular CSF (p<0.001). Among the evaluated systemic factors, concomitant brain metastasis and previous radiation were significantly correlated with higher protein levels in the lumbar CSF (p=0.01 and <0.001, respectively). Among the LMC disease activity, patients presenting with hydrocephalus or cauda equina syndrome showed higher lumbar CSF protein level compared with that in patients without those symptoms (p=0.049 and p<0.001, respectively). The lumbar CSF cell count was significantly lower in patients with cranial neuropathy (p=0.046). The ventricular CSF cell counts and protein levels showed no correlation with LMC symptoms. Carcinoembryonic antigen (CEA), which was measured from ventricular CSF after the diagnosis in 109 patients, showed a significant association with the presence of hydrocephalus (p=0.01). Conclusion : The protein level in lumbar CSF indicated the localized disease activity of hydrocephalus and cauda equina syndrome. In the ventricular CSF, only the CEA level reflected the presence of hydrocephalus. We suggest using more specific biomarkers for the evaluation of ventricular CSF to monitor disease activity and treatment response.

한국(韓國)에 만연(蔓延)하고 있는 만성간염(慢性肝炎)의 자연병력(自然病歷) (Natural History of Chronic Hepatitis in Korea)

  • 정환국
    • 보험의학회지
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    • 제2권1호
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    • pp.34-36
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    • 1985
  • Korea is an endemic area of chronic hepatitis in the world. Liver cirrhosis and liver cell carcinoma, presumed to be related to such chronic hepatitis, are the major causes of death in this country. The purpose of this study is disclosing the sources of chronic hepatitis in Korea establishing its histologic characteristics, disclosing the patterns of progression in chronic hepatitis, delineating its prognosis and finally speculating its etiology. The study group was composed of 183 patients with biopsy-proven acute icteric viral hepaticis, 32 patients with biopsy- proven anicteric hepatitis and 260 patients with biopsy- proven chronic hepatitis. These patients submitted to long-term follow-up by means of liver needle biopsy and/or clinicolaboratory evaluation. The period of follow-up ranged from two months to 18 years. The histological features of the initial biopsy specimens of chronic hepatitis permitted a division of the cases cases into the following five types: Type I. Persisting portal hepatitis : so called persisting hepatitis 43 Type II. Chronic inactive hepatitis with incomplete strand septal fibrosis. This type has thin fibrotic septation in addition to Type I with portal sclerosis 38 Type III. Chronic active periportal hepatitis(CAPH) : so called aggressive hepatitis, characterized by marked piecemeal necrosis. This type has been subdivided further into three groups: AB and C on the basis of histologic features. A CAPH without cirrhosis 15 B CAPH with cirrhosis 99 C CAPH with diffuse acinus type parenchymal nodules; characterized by rosette-forming micronodules 21 Type IV. Subacute hepatic necrosis; characterized by multilobular and/or bridging necrosis. 14 Type V. Persisting lobular hepatitis; characterized by spotty necrosis, which looks very similar to acute viral hepatitis. Such histologic changes should be persisted for more than six months 30 In Korea the main source of chronic hepatitis is the anicteric type. Of the chronic hepatitis observed in the hospital, Type IIIb was the most frequent in its incidence and occasionally exhibited development of hepatocellular carcinoma, but the mortality was highest in Type IIIc during the period of follow-up. Histologic characteristics of these five types suggest a spectrum of chronic hepatitis in Korea from an early and mild stage to advanced and fatal cirrhosis, which is occasionally associated with primary hepatic cell carcinoma. It seems that Type IV can be followed by flare-up of various stages of acute and chronic hepatitis with HBsAg and that many cases of liver cirrhosis prevalent in Korea occur through such an active process of Type IV. The etiology is not established, but in Korea it is mainly related to HBsAg.

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Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary center

  • Jo, Tae Kyoung;Suh, Hyo Rim;Choi, Bo Geum;Kwon, Jung Eun;Jung, Hanna;Lee, Young Ok;Cho, Joon Yong;Kim, Yeo Hyang
    • Clinical and Experimental Pediatrics
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    • 제61권7호
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    • pp.210-216
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    • 2018
  • Purpose: The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. Methods: Twenty with PA VSD and 9 with TOF and severe PS needed initial palliation. Reintervention after initial palliation, complete repair, and progress were reviewed retrospectively. Results: Among 29 patients, 14 patients underwent right ventricle to pulmonary artery (RV-PA) connection, 11 palliative BT shunt, 2 central shunt, and 2 ductal stent insertion. Median age at the initial palliation was 13 days (1-98 days). Additional procedure for pulmonary blood flow was required in 5 patients; 4 additional BT shunt operations and 1 RV-PA connection. There were 2 early deaths among patients with RV-PA connection, one from RV failure and the other from severe infection. Finally, 25 patients (86%) had a complete repair. Median age of total correction was 12 months (range, 2-31 months). At last follow-up, 2 patients had required reintervention after total correction; 1 conduit replacement and 1 right ventricular outflow tract (RVOT) patch enlargements. Conclusion: For initial palliation of patients with PA VSD or TOF with severe PS, not only shunt operation but also RV-PA connection approach can provide an acceptable outcome. To select the most proper surgical strategy, we recommend thorough evaluation of cardiac anomalies such as RVOT and PA morphologies and consideration of the patient's condition.

Development of a Breast Cancer Awareness Scale for Thai Women: Moving towards a Validated Measure

  • Rakkapao, Nitchamon;Promthet, Supannee;Moore, Malcolm A;Hurst, Cameron P
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.851-856
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    • 2016
  • Background: Breast cancer is a major health problem among women around the world. Recent developments in screening and treatment have greatly improved the prognosis of patients with breast cancer in developed countries. However, in developing countries breast cancer mortality remains high.Breast cancer awareness is a first and important step in reducing breast cancer mortality. The development of a validated instrument to measure breast cancer awareness is crucial for the understanding and implementation of suitable health education programs to facilitate early deletion and minimize mortality. Objective: The objective of this study was to develop an instrument for the assessment of breast cancer awareness in Thai women. Materials and Methods: This methodological study was conducted in two stages: (1) literature searches and semi-structured interviews were conducted to generate items of the breast cancer awareness scale (B-CAS) which were subsequently examined for content and face validity, and (2) an exploration of the factor structure of the resulting instrument and an examination of its reliability. Data were collected using a self-administered questionnaire in Thai women aged 20-64 in August, 2015. Results: A total of 219 women (response rate 97.4 %) participated in this validation study. The B-CAS contains five domains with 53 items on breast cancer awareness: 1) knowledge of risk factors, 2) knowledge of signs and symptoms, 3) attitude to breast cancer prevention, 4) barriers of breast screening, and 5) health behavior related to breast cancer awareness. Items with a content validity index < 0.80 were excluded, and factor structure for the remaining items reflected the hypothesized five factor model. The scales based on all retained items was shown to have strongly internal consistency reliability (Cronbach's ${\alpha}=0.86$). Conclusions: The B-CAS provides good psychometric properties to assess breast cancer awareness in women. It can be used to examine breast cancer awareness in Thai women and it could lead to the development and evaluation of suitable educational interventions for raising breast cancer awareness. Future research should focus on further validating the B-CAS including an assessment of construct and criterion-based validity.