• 제목/요약/키워드: radical operation

검색결과 206건 처리시간 0.037초

폐암의 외과적 치료 (Surgical Treatment of Lung Cancer)

  • 신현종
    • Journal of Chest Surgery
    • /
    • 제20권3호
    • /
    • pp.473-482
    • /
    • 1987
  • The records of 65 patients with a confirmed diagnosis of primary lung cancer who underwent surgical therapy at the Department of Thoracic and Cardiovascular Surgery of the Keimyung University Hospital were analyzed during the period of 8 years and 4 months, from August, 1978 to December, 1986. The peak incidence was observed in the 5th decade of life and the mean age was 52.9 years old. Male versus female ratio was 8.3:1 Cough was the most frequent presenting symptom, 76.9% then chest discomfort, hemoptysis and dyspnea followed in order. 44.6% of the patient had 2 months of prediagnostic symptomatic period, 72.3% had 5 months, and the mean was 5.7 months. As for preoperative diagnosis, 62 of total 65 patients revealed the mass lesion on simple chest x-ray, and 56 of 65 patients on bronchoscopic biopsy, 10 of 37 patients on sputum cytology and 15 of 15 patients on computerized tomography of the chest were positive. Of the 65 patients, 35 [53.9%] had squamous cell carcinoma, 18 [27.7%] adenocarcinoma, 3 [4.6%] large cell carcinoma, and 3 [4.6%] small cell carcinoma all which was oat cell carcinoma. 83.1% of the total patient was resectable, and 34 underwent pneumonectomy and 20 lobectomy. Of these 65 operations, 29 was radical resection, 25 palliative, and 11 exploratory thoracotomy. As for clinical stagings, 23 patients were in Stage, I, another 23 in Stage II and 19 in Stage III, while 16 was in stage, I, 14 in stage ll and 35 in stage III in postoperative staging evaluation. In correlation of postoperative TNM classification and radical resection, those patients who had lung cancer of stage I [14/16] and stage II [9/13] had more radical resection. As postoperative complications, one patient had massive bleeding, two empyema, one empyema with bronchopulmonary fistula, and one cardiac herniation. Operative mortality rate was 1.5% [1 patient]. Mean duration between 1st operation and discovering recurrence in 18 patients was 12.7 months.

  • PDF

PEMFC 고분자 막의 전기화학적 열화에 미치는 온도의 영향 (Effect of Temperature on Electrochemical Degradation of Membrane in PEMFC)

  • 이호;김태희;손익제;이종현;임태원;박권필
    • Korean Chemical Engineering Research
    • /
    • 제47권4호
    • /
    • pp.441-445
    • /
    • 2009
  • 고분자전해질 막의 전기화학적 열화에 미치는 온도의 영향에 대해 연구하였다. 가속 열화 조건(OCV, anode 무가습, cathode 65% RH)에서 셀 온도를 변화시켜 144시간 운전한 후 셀 성능은 12에서 35%까지 감소하였다. 이러한 성능 감소는 FER(Fluoride Emission Rate) 측정에서 알 수 있듯이 과산화수소 혹은 산소라디칼(${\cdot}OH$, $HO_2{\cdot}$)의 공격에 의한 막의 열화에 따른 것으로 라디칼 형성을 위한 가스 crossover의 증가를 가져왔다. 전극에서의 라디칼 생성은 ESR로 확인하였다. 고분자막 열화의 온도 의존성을 나타내는 Arrhenius plot에 얻어진 활성화 에너지 값은 66.2 kJ/mol이었다. 셀 작동온도 증가는 라디칼 형성속도와 라디칼이 막을 공격하는 반응 속도뿐 아니라 가스 crossover 속도도 증가시켜 막 열화를 가속화시켰다.

기무라 병 환자에서 수술적 치료 및 술 후 스테로이드 병합요법의 치험2례 (Case report of Kimura's disease Treated by Radical resection and Post Operative Steroid therapy)

  • 김정태;김기웅;이경묵;김연환
    • Archives of Plastic Surgery
    • /
    • 제36권2호
    • /
    • pp.229-232
    • /
    • 2009
  • Purpose: Kimura's disease is a relatively rare head and neck tumor that frequently occurs in young orientals accompanied with eosinophila. We shared our experience of two cases of Kimura's disease, treated by radical resection and post operative steroid therapy, so we report the correlation of eosinophil counts and disease progression. Methods: A 25 years old male came to the clinic with a mass localized to the right cheek inferior to the right auricle. We could not resect the mass totally. During the follow up period, we checked the eosinophil counts, and steroid therapy was started 7 months after the surgery. A 34 year old female came to the clinic with a mass localized inferior to the left auricle reaching from the posterior portion of the auricle to the left temporal portion. We tried to remove as much tumor as possible, save the temporal region, in regard to the impairment of blood supply to the auricle. After operation, steroid therapy was started. Results: In the first case, the tumor was easily approachable, and radical resection of the tumor with post operative steroid therapy was an effective treatment. In tumors located at difficult regions to remove, as in the second case, optimal debulking and post operative steroid therapy was also effective in treating Kimura's. There were no recurrences in both cases. Eosinophil counts were always reduced after surgery and steroid therapy, and during the period with low eosinophil counts, there was no recurrence of Kimura's disease. Conclusion: Surgery and post operative steroid therapy were effective in treatment of Kimura's disease, and we could assume eosinophil counts as a good indicator for evaluation of the prognosis of Kimura's disease during the follow up period.

코로나 방전 시스템을 이용한 연소가스중의 NOx, $SO_2$제거 (Removal of NOx and $SO_2$ from Combustion Flue Gases by Corona Discharge Systems)

  • 박재윤
    • E2M - 전기 전자와 첨단 소재
    • /
    • 제10권8호
    • /
    • pp.830-835
    • /
    • 1997
  • In this study an experimental investigation has been conducted to remove NOx and SO$_2$simultaneously from a combustion flue gases were consisted of NO-SO$_2$-$CO_2$-$N_2$-O$_2$([NO]o:200ppm and [SO$_2$]o:800ppm) and the injection gases used as radical source gases were NH$_3$-Ar-air and CH$_4$-Ar-air. NOx and SO$_2$removal efficiency and the other by-products were measured by Fourier Transform Infrared(FTIR) as well as SO$_2$, NOx and NO$_2$gas detectors. and SEM images after sampling. The results showed that a significant Nucleating Particle Counter(CNPC) and SEM images after sampling. The results showed that a significant aerosol particle formation was observed during a simultaneous NOx and SO$_2$removal operation in corona radical shower systems. The diameter of aerosol particles was in the range of 0.18 to 3.6${\mu}{\textrm}{m}$ with a maximum fraction of particles at particles diameter of 1${\mu}{\textrm}{m}$. The NOx removal efficiency significantly increased with increasing applied voltage and NH$_3$molecule ratio. The SO$_2$removal efficiency was not significantly effected by applied voltage and slightly increased with increasing NH$_3$molecule ratio. It could be found that it is possible to use CH$_4$for NOx and SO$_2$removal by corona radical shower systems.

  • PDF

코로나 샤워 시스템을 이용한 NOx제거에서 $SO_2$의 영향 (The $SO_2$ effect on NOx removal by Corona Shower System)

  • 박재윤;김익균;이재동;김종달;이덕출
    • 대한전기학회:학술대회논문집
    • /
    • 대한전기학회 1998년도 하계학술대회 논문집 E
    • /
    • pp.1794-1796
    • /
    • 1998
  • In this study, the $SO_2$ addition effect on NOx removal has been conducted from a combustion flue gases by the do corona discharge-activated radical shower systems. The simulated flue gases were consisted of NO-O_2-$N_2$, NO-$CO_2-N_2-O_2$ and $NO-SO_2-CO_2-Na-O_2$([NO]o:200ppm and $[SO_2]o$:800ppm). The injection gases used as radical source gases were $NH_3$-Ar-air. $SO_2$ and NOx removal efficiency and the other by-products were measured by Fourier Transform Infrared(FTIR) as well as $SO_2$. NOx and $NO_2$ gas detectors. By-product aerosol particles were also observed by Condensation Nucleation Particle Counter(CNPC) and SEM images after sampling. The results showed that asignificant aerosol Particle formation was observed during a removal operation in corona radical shower systems. The NOx removal efficiency significantly increased with increasing applied voltage and $NH_3$ molecule ratio. The $SO_2$ removal efficiency was not significantly effected by applied voltage and slightly increased with increasing $NH_3$ molecule ratio. The NOx removal efficiency for NO-$SO_2-CO_2-N_2-O_2$ was better than that for NO-$CO_2-N_2-O_2$.

  • PDF

근칙적 절제술과 술후 방사선치료를 시행한 자궁경부암 환자의 치료성적, 예루인자와 실패양상 (Adjuvant Radiotherapy Following Radical Hysterectomy and Bilateral Pelvic Lymph Node Dissection for the Uterine Cervical Cancer : Prognostic Factors and Failure Patterns)

  • 최두호
    • Radiation Oncology Journal
    • /
    • 제15권4호
    • /
    • pp.357-367
    • /
    • 1997
  • 목적 : 근치적 절제술과 골반림프절 절제술을 시행한 자궁경부암 환자 중에서 치료실패의 위험인자가 있어서 술후 방사선치료를 시행한 환자를 대상으로 치료성적, 예후인자, 실패양상을 알아보기 위하여 후향적 분석을 시행하였다. 대상 및 방법 : FIGO 병기 IB, IIA와 IIB 환자 중에서 근치적 수술과 방사선치료를 시행하고 추적조사가 가능하였던 124명을 대상으로 하였다. 환자들은 1985년 3월부터 1994년 3원까지 수술후 방사선치료를 시행하였으며 최소 추적기간은 24개월이었다. 모든 환자는 4-MV 선형가속기를 이용한 외부방사선치료를 전골반에 50-6OGy를 조사하였고 일부 환자는 코발트를 이용한 고선량율 강내치료를 추가하였다. 결과 : 전체 환자의 5년 생존율과 5년 무병 생존율은 각각 $75.4\%,\;73.5\%$였고, 단변수 분석상 5년 무병 생존율에 영향을 미치는 인자는 림프절 전이 유무, 개수와 위치, 종양의 크기, 자궁체부 침운, 자궁주위조직 침윤, 병기, 자궁경부벽 침윤정도, 질 절제면 양성, 그리고 치료 관계 인자로 방사선량, 강내치료, 항암제 등이 통계상 유의하였으며, 다변량 분석상 림프절 전이와 종양의 크기, 질 절제면 양성이 유의하였다. 치료 실패는 33명이었고 2명은 다른 원인으로 사망하였고 부위별로는 국소재발이 13명, 원격전이 13명 국소-원격 동시 실패가 7명이었고 추적 종료시점까지 5명이 생존하였다. 국소재발은 병기 IB, 림프절 전이 양성 또는 질 절제면 양성 환자에서 많이 발생하였으며 림프절 전이 음성환자에서는 빈도는 낮았으나 원격전이가 상대적으로 더 많았다. 그리고 병기 lIB에서 5년 생존율 은 $56\%$ 였고 22명 중에서 9명이 재발하였다. 결론 : 수술후 방사선치료는 비교적 효과적인 방법이지만 다수의 재발 위험인자들을 가진 환자에게 술후 방사선치료만으로는 재발을 막기가 충분하지 않으므로 방사선감작제의 추가나 동시방사선-항암치료 등의 보다 효과적인 방법이 필요할 것으로 성각되며, 술혹 방사선치료의 효율을 정하기 위하여 무작위 표본 추출에 의한 전향적 연구가 필오하다. 그리고 병기 IIB는 항암치료와 수술후 방사선치료를 시행해도 치료 성적이 나쁘므로 일차적으로 근치적 방사선치료를 시행해야한다.

  • PDF

Prostatic Bleeding after Prostatic Biopsy Effects Oncological Outcomes with Laparoscopic Radical Prostatectomy

  • Takai, Tomoaki;Inamoto, Teruo;Komura, Kazumasa;Tsujino, Takuya;Matsunaga, Tomohisa;Yoshikawa, Yuki;Uchimoto, Taizo;Saito, Kenkichi;Tanda, Naoki;Minami, Koichiro;Uehara, Hirofumi;Ibuki, Naokazu;Takahara, Kiyoshi;Nomi, Hayahito;Kiyama, Satoshi;Azuma, Hayahito
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권3호
    • /
    • pp.1373-1377
    • /
    • 2016
  • Background: We vigorously reviewed patients' operation record who had adhesion of the Denonvilliers' fascia and found out most of these patients had prostatic bleeding after prostatic gland biopsies. We examined the magnitude of prostatic bleeding and frequency after biopsies and the relationship with oncological outcomes. Materials and Methods: A total of 285 patients were selected for the final analyses. Inclusion criteria were as follows: receiving MRI three weeks after biopsiesand laparoscopic radical prostatectomy within 300 days after biopsy. We divided the patients into two groups with (group A) or without (group B) prostatic bleeding. We examined the magnitude of prostatic bleeding after biopsies and the relationship with operation time (OT), positive surgical margin (PSM), biochemical recurrence (BCR) and other factors. Furthermore, we created a logistic-regression model to derive a propensity score for prostatic bleeding after biopsies, which included all patient and hospital characteristics as well as selected interaction terms, and we examined the relationship with PSM and BCR. Results: In all patients, the OT in the group B was shorter than the group A (p < 0.001). Prostatic bleeding was associated with PSM (p=0.000) and BCR (p=0.036). In this propensity-matched cohort, 11 of 116 patients in the group B had PSM as compared with 36 of 116 patients from group A (match-adjusted odds ratio, 4.30; 95%CI confidence interval, 2.06 to 8.96; P=0.000). In addition, eight of 116 patients in group B encountered BCR, as compared with 18 of 116 patients in group A (match-adjusted odds ratio, 2.48; 95%CI, 1.03 to 5.96; P=0.042). Kaplan-Meier analysis in the propensity matching cohort showed a significant biochemical recurrence-free survival advantage for being free of prostate bleeding after biopsies. Conclusions: Our findings in the present cohort should help equip surgeons to pay attention to careful excision especially for those who experienced deferred prostatic bleeding.

Influence of Autologous and Homologous Blood Transfusion on Interleukins and Tumor Necrosis Factor-α in Peri-operative Patients with Esophageal Cancer

  • Xing, Yue-Li;Wang, Yan-Chun
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권18호
    • /
    • pp.7831-7834
    • /
    • 2014
  • Objective: To explore the influence of different ways of blood transfusion on the expression levels of interleukins (IL) and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) inperi-operative patients with esophageal cancer. Materials and Methods: A total of 80 patients with esophageal cancer who underwent radical operations were selected as study patients and randomly divided into an observation group (treated with autologous blood transfusion) and control group (with homologous blood transfusion). Changes of intra-operative indexes and peri-operative blood indexes, from hemoglobin (Hb) and hematocrit value (Hct), to levels of inflammatory factors like interleukins-6 (IL-6), IL-8, IL-10 and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) were compared. Results: Operations for patients in both groups were successfully conducted, and no significant differences in mean surgical duration and intra-operative hemorrhage volume, fluid infusion volume and blood transfusion volume were detected (p>0.05). Compared with values before surgery, Hb and Hct levels decreased significantly while white blood cell count (WBC) increased 1, 5 and 7 d after operation (p<0.05, p<0.01). In addition, WBC was apparently higher in observation group than in control group 5 and 7 d after operation (p<0.01). Compared with before surgery, in the observation group, levels of IL-6, IL-8 and IL-10 had no significant differences after operation (P>0.05), but TNF-${\alpha}$ level increased y (p<0.01), whereas in control group, IL-6 level had no significant difference (p>0.05), IL-8 level decreased obviously (p<0.05), IL-10 level increased markedly first and then decreased gradually as time passed but its level remained elevated (p<0.01), and TNF-${\alpha}$ level increased first and then decreased, and there was no significant difference 7 d after operation (p>0.05). Conclusions: Decreased IL-8 and increased IL-10 levels are two important reasons for immunosuppression after homologous blood transfusion, whereas autologous blood transfusion can alleviate this while increasing the TNF-${\alpha}$ level, which also has potential to improve anti-tumor immunity in the human body.

유방암 절제술 후 환자의 어깨관절 가동범위 조사 (Shoulder Range of Motion in Postmastectomy Patients)

  • 엄애용;이은옥
    • 종양간호연구
    • /
    • 제4권1호
    • /
    • pp.62-70
    • /
    • 2004
  • The purpose of this study was to use as a basic data to develop suitable nursing intervention program and decide an appropriate intervention time after assessing shoulder range of motion in postmastectomy from 2 weeks to 3 month. 147 patients are chosen as study subject among patients who were in recovery of 2weeks, 1month, 2months and 3 months after surgical operation which is modified radical mastectomy. Data were collected at oncology medicine local and general surgery local in Seoul National University Hospital from May, 2003 to October, 2003. The range of motion of the shoulder(flexion, extension, abduction, internal rotation, external rotation) were examined. Analysis of data that shoulder range of motion average and standard deviation, percentage of the unaffected side and affected side compare with normal shoulder range of motion. Paired t-test was adopted to analyze the difference between affected side and unaffected side. Conclusion from this study is as following, 1. The most serious problem was external rotation (0.56%) and internal rotation is the next (19.9%) in 5 kinds of shoulder range of motion in 2 weeks after surgical operation 2. There was no difference in internal rotation after post operation 3 months but there were differences and shown to recover more than 90% in flexion and abduction. Also shoulder function incresed in flextion less than 80% and more than 80% in external rotation. As this study finding was shown that shoulder range of motion did not get back perfectly except of internal rotation and extension in point of 3 months after breast cancer surgical operation. External rotation was specially shown the lowest result so it is needed to exercise for improving their physical functioning recovery in postmastectomy patients. And it is suggested to study for helping to postmastectomy patients' physical and psycosocial functions with the early rehabilitation program which is based on these results.

  • PDF

변형 근치 유방절제술 후 Becker 확장형 보형물을 이용한 유방 재건술 (Breast Reconstruction after Modified Radical Mastectomy with Becker Permanent Tissue Expander)

  • 홍용택;윤을식;최규진;동은상;손길수
    • Archives of Plastic Surgery
    • /
    • 제34권2호
    • /
    • pp.222-228
    • /
    • 2007
  • Purpose: Report of the good results of breast reconstruction using Becker permanent tissue expander that showed a short operation time and a quick post-operation recovery time, little side effects and usually superb aesthetic results without the need for additional incisions or donor site morbidity. The authors, after carrying out breast reconstruction operations using Becker permanent tissue expander on patients with appropriate indications, attempted to analyze several factors such as complication rates and patient satisfaction measurements. Methods: 11 cases of breast reconstruction using Becker expander implants were carried out on a total of 10 patients between March 2000 and February 2003. The patients were followed up at outpatient visit for an average of 6 months. Results: The most common post-operation complication was pain resulting from saline injection into the expanders, complained by 5 patients(50%). rib fractures, skin necrosis, implant removal due to infection, and breast cancer recurrence each occurred in 1 patient (9.9%). There was no occurrence of skin contracture complications which occurs frequently in case of silicone implant insertion. Patient complacency was surveyed by patient interviews made right after the operations and during outpatient follow-up periods: 5(50%) patients out of 10 showed excellent, 3(30%) good, and 2(20%) showed fair, leaving no patients who were disappointed with operation results. On routine follow-up, 80% of patients expressed satisfaction with the cosmetic outcome of their post-mastectomy beast reconstruction. Conclusion: Breast reconstruction using the Becker expander is a reliable alternative to other reconstructive methods but good patient selection is essential for satisfactory results.