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Recurrence and Extraneural Metastasis in 31 Meningeal Hemangiopericytomas (31예 수막 혈관외피세포종에 있어서의 재발 및 신경계외 전이)

  • Kim, Jeong Hoon;Kim, Joon Soo;Kim, Chang Jin;Hwang, Sung Kyun;Jung, Hee Won;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.349-357
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    • 2001
  • Purpose : Meningeal hemangiopericytoma(M-HPC), characterized by a high local recurrency and metastatic potential, is a rare neoplasm arising from perivascular pericytes. A retrospective study was performed to identify the recurrence and extraneural metastasis in M-HPC. Materials and Methods : We reviewed the records of 31 M-HPC patients treated from 1982 through 1999 at our institution. The time to recurrence and the various parameters affecting recurrence were determined. Extreneural metastasis was also analyzed. Results : The rate of local recurrency was 38.7%(12/31). The overall average recurrence-free period(RFP) before the first recurrence was 104 months, with overall recurrence-free rates(RFRs) at 5 and 10 years after first surgery of 59.2% and 33.6%, respectively. Of the 12 patients who experienced local recurrence, 4 had recurrences 5 years later after the first surgery. Complete excision at the first operation significantly extended the average time before first recurrence from 43 to 111 months. The 5-year RFRs for the groups of complete excision and incomplete excision were 72.7% and 20.8%, respectively(p=0.0060). Although there was no statistical significance, complete excision followed by adjuvant radiotherapy of more than 50Gy extended the RFP. The 5-year RFRs for the groups of complete excision and complete excision with adjuvant radiotherapy were 70.3% and 100%, respectively(p=0.3359). Four patients(12.9%) presented one or more extraneural metastases that were developed at an average of 107 months after the first operation with the 5- and 10-year metastasis rates of 4.4% and 24.9%, respectively. Conclusions : M-HPC has a propensity to recur either locally or at distant sites after surgical resection. Complete excision is the most important factor to reduce recurrence. However, even with complete excision, adjuvant radiotherapy of more than 50Gy significantly reduces the risk of recurrence. Local and distant recurrences may occur after a prolonged disease-free interval, emphasizing the need for long-term follow-up.

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A study on the implementation of Medical Telemetry systems using wireless public data network (무선공중망을 이용한 의료 정보 데이터 원격 모니터링 시스템에 관한 연구)

  • 이택규;김영길
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2000.10a
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    • pp.278-283
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    • 2000
  • As information communication technology developed we could check our blood pressure, pulsation electrocardiogram, SpO2 and blood test easily at home. To check our health at ordinary times is able though interlocking the house medical instrument with the wireless public data network This service will help the inconvenience to visit the hospital everytime and will save the individual's time and cost. In each house an organism data which is detected from the human body will be transmitted to the distance hospital and will be essentially applied through wireless public data network The medical information transmit system is utilized by wireless close range network It would transmit the obtained organism signal wirelessly from the personal device to the main center system in the hospital. Remote telemetry system is embodied by utilizing wireless media access protocol. The protocol is embodied by grafting CSMA/CA(Carrier Sense Multiple Access with Collision Avoidance) protocol falling mode which is standards from IEEE 802.11. Among the house care telemetry system which could measure blood pressure, pulsation, electrocardiogram, SpO2 the study embodies the ECC(electrocardiograph) measure part. It within the ECC function into the movable device and add 900㎒ band wireless public data interface. Then the aged, the patients even anyone in the house could obtain ECG and keep, record the data. It would be essential to control those who had a health-examination heart diseases or more complicated heart diseases and to observe the latent heart disease patient continuously. To embody the medical information transmit system which is based on wireless network. It would transmit the ECG data among the organism signal data which would be utilized by wireless network modem and NCL(Native Control Language) protocol to contact through wireless network Through the SCR(Standard Context Routing) protocol in the network it will be connected to the wired host computer. The computer will check the recorded individual information and the obtained ECC data then send the correspond examination to the movable device. The study suggests the medical transmit system model utilized by the wireless public data network.

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Estrogen Replacement Effect of Korean Ginseng Saponin on Learning and Memory of Ovariectomized Mice

  • Jung, Jae-Won;Hyewhon Rhim;Bae, Eun-He;Lee, Bong-Hee;Park, Chan-Woong
    • Journal of Ginseng Research
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    • v.24 no.1
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    • pp.8-17
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    • 2000
  • Estrogen can influence on the expression of behaviors not associated directly with reproduction, including learning and memory. Recently estrogen has received considerable attention for its effects on neuroprotection and neural circuits in brain areas associated with cognition. Although estrogen replacement therapy may be helpful to postmenopausal women, it also results in a number of harmful side effects. Ginseng also has steroidal qualities and contains several ginsenoside components which have similar backbone structure to estrogen. The objectives of this experiment were 1) to examine the effects of estrogen and 2) to investigate the effects of ginsenosides as estrogenic agent on learning and memory using the Morris water maze, a traditional experimental task for spatial memory. In the experiments designed here, ovariectomized mice were implanted subcutaneously with Sila, itic capsules containing 17${\beta}$-estradiol (100∼250 $\mu\textrm{g}$/$m\ell$), panaxadiol (PD) and panaxatriol (PT) saponins (15∼100 $\mu\textrm{g}$/$m\ell$) diluted with sesame oil. In the first set of experiment, the effects of estradiol on learning and memory during the Morris water maze was examined. When estradiol was delivered via Silastic capsules following training improved spatial memory performance in ovariectomized female mice. In the second set of experiment, three different PD and PT saponin concentrations were delivered via Silastic implants to ovariectomized female mice and their effects were compared with estrogenic effects. Results of three separate experiments demonstrated that estradiol, PD and PT administrated by Silastic implants for 2 weeks prior to water maze training significantly improved spatial memory performance compared to ovariectomized (OVX) mice, as indicated by lower escape latency over trial. The positive effect of estradiol suggests that estrogen can affect performance on learning and memory. In addition, the positive effect of PD and PT saponins suggest that ginsenosides have an estrogen-like effects in mediating learning and memory related behavior action.

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Complete Myocardial Revascularization Utilizing Parallel Secluential Anastomoses (Parallel sequential anastomosis를 이용한 관상동맥 우회수술의 성적)

  • 박계현;김관민
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.647-655
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    • 1997
  • We evaluated the feasibility and safety of this method by reviewing the early outcome of the patients who underwent coronary artery bypass grafting(CABG) utili ing parallel sequential anastomoses with saphenous vein grafts, comparing with the outcome of the patients revascularized with grafts having only single distal anastomosis. During the one-year period of 1995, a total of 79 patients underwent isolated CABG, among whom 39 patients with sequential vein grafts(sequential group) and 40 patients without sequential grafts(non-sequential group). There was no difference between the two groups in terms of preoperative status, except in the extent of the coronary disease; 87.2% of the sequential group and 45.0% of the non-sequential group had left main andlor triple vessel involvement. 318 distal coronary anastomoses were done; 198 for the sequential group(5.1/patient) and 120 for the non-sequential group(3.0/patient). In the sequential group, the mean durations of cardiopulmonary bypass and aortic clamp per one distal anastomosis were 33.5 and 21.1 minutes, respectively. In the non-sequential group, these were 41.8 and 22.7 minutes. There were two operative deaths, both in the non-sequential group. There was no difference in the incidence of postoperative complications including myocardial infarction. During the follow-up period(2 to 15 months), 8 patients(3 in the sequential and 5 in the nonsequential group) complained of residual or recurrent angina. Comparison of preoperative and postoperative ."'Thallium myocardial perfusion scans in 30 patients showed improved or normal perfusion reserve in 83.3% of segments bypassed with sequential grafts and 82.5% of segments bypassed with non-sequential graft(5), These results show that, utilizing parallel sequential anastomoses with saphenous vein grafts, we could achieve satisfactory short-term clinical results in patients with extensive coronary stenoses. So, we conclude that this technique is a safe, technically feasible strategy for CABG, which can achieve the aim of complete myocardial revascularization with a limited length of graft.raft.

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Neuronal Cell Protective Effects of Hot Water Extracts from Guava (Psidium guajava L.) Fruit and Leaf (구아바 열매와 잎 열수 추출물의 신경세포 보호효과)

  • Jeong, Chang-Ho;Jeong, Hee-Rok;Choi, Gwi-Nam;Kwak, Ji-Hyun;Kim, Ji-Hye;Park, Soo-Jeong;Kim, Dae-Ok;Shim, Ki-Hwan;Choi, Sung-Gil;Heo, Ho-Jin
    • Food Science and Preservation
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    • v.18 no.1
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    • pp.124-129
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    • 2011
  • PC12 neuronal cell-protective effects of hot water extracts of guava fruit and leaf were evaluated. Total phenolic levels in fruit and leaf were 11.75 and 293.25 mg/g, respectively. Gallic acid, the predominant phenoic, was detected in both extracts. Intracellular reactive oxygen species (ROS) accumulation after $H_2O_2$ treatment was significantly reduced when the hot water extract of guava leaf was added to cell medium, compared to PC12 cells treated with $H_2O_2$ only. In a cell viability assay using 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl- tetrazoliumbromide (MTT), the hot water extracts of fruit and leaf protected against $H_2O_2$-induced neurotoxicity. The leaf extract was more effective in terms of inhibition of lactate dehydrogenase (LDH) release into medium, compared to the fruit extract. These in vitro data suggest that hot water extracts of guava fruit and leaf may be useful in treatment of neurodegenerative conditions such as Alzheimer's disease.

A Study of the Effect, Safety and Saving Expense by Reusing Hemodialyzer (재사용(再使用) 투석기(透析器)의 효과(效果) ${\cdot}$ 안정성(安定性) 및 비용절감(費用節減)에 관한 연구(硏究))

  • Jung, Ha-Chung
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.93-106
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    • 1997
  • By the increase of the rate of existence of the hemodialyzing patients, they were required the long run treatment. Regardless of medical insurance expansion, hemodialyzing cost much expenses so that hospital has been considering the reuse of hemodialyzer and flowing euqipments along with the diverse study and progress of the ways of hemodialyzing and medical instruments. This study was aimed to provide the basic materials regarding the reuse of hemodialyzer which is used for the patients of chronic renal disease. The reusing program in the artificial kidney center of K hospital has been used for this study from 50 patients aften one year result from Sep. 1995 through Aug. 1996. Automatic equipment of DRS-4 made by Seratronic Co., was used as the equipment and it was retreated with the function test simultaneously. Compliaction and confirmation of the infection were by the records of the hemodialysis of the patients. SPSS was used for the analysis of the materials by computerization. The character of the patients and the rate of removal was by mistake and percentage, function test and rate of complication by Ftest(ANOVA) and the rate of complication per items by ${\chi}^2$ and Ftest. As the post test the Duncan's test was used for the statistically significant different variables in the standard of p<.05 after Ftest. The followings are the summary of the result : 1) In the function test of the new hemodialyzer and the reused one, and in all of CA110 and CF15.11, the dialyzer ultrafiltration coeffient(KUf) was appeared to have been higher in the reusing groups than the first use ones. This has been the normal limit showing no troubles with them. 2) In the function test of the new and reused hemodialyzer, in all of CA110 and CF15.11, the total blood volume was appeared to have been the less value in the reuse groups than the new ones. This was the price within 80% of the first price that both showed possible for use. 3) The result of reuse hemodialyzer of CA110 was $29.48{\pm}7.83$ in average in the test of leak test while $17.3{\pm}7.96$ in reuse of CF15.11. The normal limit of <60 was the leak test result. So both of the hemodialyzer was normal for reuse. 4) The rate of removal of Blood Urea Nitrogen(BUN) was 72.25% in CA110 hemodialyzer by reusing 16-20 times as the highest rate showing the better result in the reuse hemodialyzer, while in CF15.11 hemodialyzer showed 71.16% by highest rate in the first use by the highest rate with no difference from the reuse. 5) The rate of removal of serum creatinine of CA110 was 64.08% by highest rate in reuse of 1-5 times by showing better result in reuse hemodialyzer. While in CF15.11 66.47% the highest by reuse of 16-20 times showing no difference from each other. 6) No patients were admitted or precribed by antibiotics in relation with reuse dialyzer and no reports were shown about hepatitis $B{\cdot}C$. AIDS in fection. 7) Of the total 248 episods of complication due to the hemodialyzing, 86 by first use, 73 by 1-5 times, 35 by 6-10 times, 35 by 11-15 times and 19 by 16-20 times have been shown which have had no significant difference between the groups. 8) In the comparison of the expense for the hemodialyzer, there was the effect of saving 11,597.6 Won between the first and reuse hemodialyzer. And by decreasing the extracted materials, they did the great role of disposing the waste matters.

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Ethnography of Caring Experience for the Senile Dementia (노인성 치매 환자의 돌봄경험에 대한 문화기술지)

  • 김귀분;이경희
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.1047-1059
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    • 1998
  • Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

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Assessment of Breast Cancer Knowledge among Health Workers in Bangui, Central African Republic: a Cross-sectional study

  • Balekouzou, Augustin;Yin, Ping;Pamatika, Christian Maucler;Nambei, Sylvain Wilfrid;Djeintote, Marceline;Doromandji, Eric;Gouaye, Andre Richard;Yamba, Pascal Gastien;Guessy, Elysee Ephraim;Ba-Mpoutou, Bertrand;Mandjiza, Dieubeni Rawago;Shu, Chang;Yin, Minghui;Fu, Zhen;Qing, Tingting;Yan, Mingming;Mella, Grace;Koffi, Boniface
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3769-3776
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    • 2016
  • Background: Breast cancer is the leading cause of cancer deaths among women worldwide. High breast cancer mortality has been attributed to lack of public awareness of the disease. Little is known about the level of knowledge of breast cancer in Central African Republic. This study aimed to investigate the knowledge of health professionals on breast cancer. Materials and Methods: This cross-sectional study was conducted among 158 health professionals (27 medical; 131 paramedical) in 17 hospitals in Bangui using a self-administered questionnaire. Descriptive statistical analysis, Person's ${\chi}^2$ test and ANOVA were applied to examine associations between variables with p < 0.05 being considered significant. Results: Data analyzed using SPSS version 20 indicates that average knowledge about breast cancer perception of the entire population was 47.6%, diagnosis method 45.5%, treatment 34.3% and risk factors 23.8%. Most respondents (65.8%) agreed that breast cancer is important in Central African Republic and that family history is a risk factor (44.3%). Clinical assessments and mammography were considered most suitable diagnostic methods, and surgery as the best treatment. The knowledge level was significantly higher among medical than paramedical staff with regard to risk factors, diagnosis and treatment. However the trainee group had very high significant differences of knowledge compared with all other groups. Conclusions: There is a very urgent need to update the various training programs for these professionals, with recommendations of retraining. Health authorities must create suitable structures for the overall management of cancer observed as a serious public health problem.

Relation Between Oral Health Knowledge and Behavior of Mother and a Oral Health Condition of Children (일부 어머니의 구강건강 지식 및 행동과 초등학교학생들의 구강건강상태와의 관련성)

  • Choi, Sung-Suk
    • Journal of dental hygiene science
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    • v.5 no.4
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    • pp.245-250
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    • 2005
  • This study was executed from June first to 30th. 2005. The target was first and second graders of Bok-Hyun elementary school and their mothers. The total of participants was 275 persons and the component ratio was 135 first graders and 140 second graders, also 82 boys and 193 girls. They answered to the question sheet by writing out with their own hands. Among the 300 question sheets that were answered, 275 sheets were analyzed, excepting 25 sheets that got poor answer. The results were as follows; (1) About the behavior of mothers and their children for oral health, In mothers' case, 68.8% of them answered that they brush teeth more than 3 times a day and 31.3% answered that they brush teeth less than 2 times a day, so those who brush teeth more than 3 times were more than those who brush teeth less than 2 times In children's case, on the contrary, 14.2% of them answered that they brush teeth more than 3 times a day and 85.8% answered that they brush teeth less than 2 times a day, so those who brush teeth less than 2 times were more. (2) In 7 questions for researching mothers' knowledge level about fluorine, 55.3% of them answer 3~4 questions correctly. In 7 questions for researching mothers' knowledge level about Periodontal disease, 47.3% of them answer 3~4 questions correctly and it was highest. (3) In a case of the relation between oral health knowledge and behavior of mother and frequency of brushing teeth of children, statistical similarity on frequency of brushing teeth was shown(p < 0.05). (4) In a case of the relation between social-anthropological features of mother and frequency of brushing teeth of children, there was no statistical similarity on age, mothers' educational level, monthly income. However, statistical similarity was shown about existence of mothers' occupation(p < 0.05).

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Clinical Results of 100 Cases of Coronary Artery Bypass Grafting without Cardiopulmonary Bypass (심폐바이패스 없이 시행한 관상동맥 우회술 100예의 임상적 고찰)

  • 방정희;우종수
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.322-327
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    • 2004
  • Coronary artery bypass grafting on the beating heart is no longer a new methods for any cardiac surgeon. We evaluated the application of the off-pump coronary artery bypass procedure relative to safety and efficiency as measured by postoperative complication and operative mortality. Material and Method: We used our retrospective database to compare the patients having off-pump coronary surgery (n=100) with those having on-pump coronary surgery (n=100) between June, 1999 and August, 2002. Patients whom underwent associated valvular or aortic aneurysmal operation were excluded. Result: Neither groups showed any differences in the patient's risk factors and extent of coronary disease. Off-pump CABG group did not have significantly less mean operation time (295$\pm$73 min vs 323$\pm$83 min, p=ns) and mean hospital day (15.34$\pm$6.02 day vs 13.80$\pm$4.95 day, p=ns). However, off-pump CABG group had significantly shorter mean ventilation time (17.3$\pm$11.27 hour vs 24.98$\pm$16.1 hour, p<0.05). No patients were converted to on-pump CABG in off-pump CABG. Intraoperative hemodynamic instability in off-pump CABG were 6 cases, of whom 2 cases were in lateral wall approach and 4 cases in right coronary anastomosis. Postoperative mortality was 1 case in off-pump CABG and 2 cases in on-pump CABG. Intra-aortic ballon pump (IABP) was applied in 1 case with off-pump CABG and in 2 cases with on-pump CABG. No patients presented postoperative cerebral infarction & stroke in off-pump CABG but 2 patients in on-pump CABG. Postoperative arrhythmia presented in 4 cases with off-pump CABG and in 6 cases with on-pump CABG. Acute renal failure (ARF) was complicated in 3 cases with off-pump CABG and in 2 cases with on-pump CABG. Conclusion: This study documented the immediate safety and efficiency of the off-pump CABG procedure.