• 제목/요약/키워드: symptom-free period

검색결과 24건 처리시간 0.027초

Role of radiotherapy in local control of non-AIDS associated Kaposi's sarcoma patients in Korea: a single institution experience

  • Chang, Ji Hyun;Kim, Il Han
    • Radiation Oncology Journal
    • /
    • 제30권4호
    • /
    • pp.153-157
    • /
    • 2012
  • Purpose: There has been no definite consensus on standard treatment, either local or systemic, for the Kaposi's sarcoma (KS). Radiotherapy (RT) can be a good local therapeutic choice especially in non-AIDS associated KS (NAKS) for its indolent behavior. Materials and Methods: Medical records of 17 KS patients treated with RT at the Seoul National University Hospital from February 1998 to January 2012 were retrospectively reviewed. One human immunodeficiency virus (HIV)+ patient with 3 lesions was excluded. The total number of the lesion was 23 among the 16 patients. The median follow-up period was 27.9 months. Correlation between response and variables was analyzed using the logistic regression model. Median age of the patients was 75 years. All the 23 lesions were located at the extremities. Fourteen (61%) of those had pain or local swelling as the initial presentation. Ten patients had possible causes of immunodeficiency and were regarded as iatrogenic, and other 6 were classic KS. Median dose of RT was 36 Gy. Results: No KS-related death was observed. Excluding 2 with short-term follow-up only, complete response and partial response were obtained in 2 (9%) and 19 (73%) lesions, respectively. Of those, 3 lesions underwent local progression. Six had out-of-field recurrence after RT. Symptom improvement was achieved in 13 (93%) of 14 patients. Grade 2 skin toxicities were found in 9 lesions but all got improvement after treatment. When divided into responsive and progressive group, free from progression was not related to any of the possible variables. Conclusion: RT is effective in local control of NAKS resulting great response rate.

Characteristics and Treatment Outcomes of Patients with Malignant Transformation Arising from Mature Cystic Teratoma of the Ovary: Experience at a Single Institution

  • Oranratanaphan, Shina;Khemapech, Nipon
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권8호
    • /
    • pp.4693-4697
    • /
    • 2013
  • Background: Malignant transformation arising in mature cystic teratoma (MCT) is one of the most serious complications of MCT. Squamous cell carcinoma is the most common malignant change. Some clinical findings such as advanced age group and large tumor size are significant risk factors of malignant transformation. This study was conducted in order to evaluate characteristics, cell types, treatment and outcome of malignant transformation arising from dermoid cysts in our institution. Materials and Methods: A retrospective chart review was performed. General characteristics, operative data, procedure, operative finding and operative outcome were analyzed. Statistical assessment was performed with SPSS version 17.0, using mean, mode, median and percentage to describe those data. Results: During the 10 years period, 11 cases of malignant transformation from a total of 753 cases (1.46% incidence) of MCT were reviewed. Mean age of the patients was 41.2 years (SD 4.34, range 24-70). The most common presenting symptom was a palpable mass (8 cases; 72.7%). Primary surgical staging was performed in 4 patients (36.4%). Re-staging was conducted in the other 4. Complete cytoreduction was obtained in 45.5% (5 cases) and optimal surgical resection was obtained in 36.4% (4 cases). Mean tumor size was 14.1 cm. (SD 1.55, range 6-20). Squamous cell carcinoma was found in 36.4% (4 cases) and mucinous cancer in the other 4. More than half of them were stage Ia (54.5%, 6 cases). All patients whose stage more than Ia received chemotherapy (45.5%). Mean disease free survival was 5.53 years (1.32, 0.3-10). Conclusion: According to our study, the incidence of malignant transformation was consistent with previous studies. The common malignant transformation histologic types are both squamous and mucinous carcinoma which differed from previous reports. Early detection for early stage disease and optimal surgery are important for long term survival.

Semi-Jailing Technique Using a Neuroform3 Stent for Coiling of Wide-Necked Intracranial Aneurysms

  • Ko, Jun Kyeung;Cho, Won Ho;Cha, Seung Heon;Choi, Chang Hwa;Lee, Sang Weon;Lee, Tae Hong
    • Journal of Korean Neurosurgical Society
    • /
    • 제60권2호
    • /
    • pp.146-154
    • /
    • 2017
  • Objective : The semi-jailing technique (SJT) provides stent-assisted remodeling of the aneurysm neck during coil embolization without grasping the coil delivery microcatheter. We retrospectively evaluated the efficacy and safety of SJT using a Neuroform3 stent for coiling of wide-necked intracranial aneurysms. Methods : We collected the clinical and radiological data between January 2009 and June 2015 of the wide-necked aneurysms treated with SJT using a Neuroform3 stent. Results : SJT using a Neuroform3 stent was attempted in 70 wide-necked aneurysms (68 patients). There were 56 unruptured and 14 ruptured aneurysms. The size of aneurysm ranged from 1.7 to 28.1 mm (mean 6.1 mm). The immediate angiographic results were complete occlusion in 55 aneurysms (78.6%), neck remnant in 7 (10.0%), and aneurysm remnant in 8 (11.4%). Overall, periprocedural complications occurred in 13 patients (19.1%), including asymptomatic thromboembolism in 7 (10.3%), symptomatic thromboembolism in 4 (5.9%), and symptomatic hemorrhagic complications in 2 (2.9%). Conventional angiography follow-up was obtained in 55 (78.6%) of 70 aneurysms (mean, 10.9 months). The result showed progressive occlusion in 7 aneurysms (12.7%) and recanalization in 1 aneurysm (1.8%). At the end of the observation period (mean, 17.5 months), all 54 patients without subarachnoid hemorrhage showed excellent clinical outcomes (modified Rankin Scale [mRS] 0), except two (mRS 1 or 2) and seven of 14 patients with subarachnoid hemorrhage remained symptom-free (mRS 0). Conclusion : In this report of 70 aneurysms, SJT using a Neuroform3 stent for coiling of wide-necked intracranial aneurysms showed good technical safety, as well as favorable clinical and angiographic outcomes.

무지 외반증을 동반한 중족골통에 대한 Weil씨 절골술 (Weil osteotomy for metatarsalgia of lesser toes with hallux valgus)

  • 이진우;권세광;한수봉;강응식
    • 대한족부족관절학회지
    • /
    • 제7권1호
    • /
    • pp.47-54
    • /
    • 2003
  • Introduction: Painful plantar callosities under the second and third metatarsal heads are not uncommonly associated with hallux valgus and there have been controversies concerning its treatment modalities. We performed the Weil osteotomy in patients with painful callosities under the second and third metatarsal head associated with hallux valgus, and evaluated the outcome clinically & radiologically. Materials and Methods: From November 2000 through November 2001, out of 51 patients diagnosed with hallux valgus, the Weil osteotomy was performed in 5 women associated with painful callosities under the second and third metatarsal heads. The mean age was 53.4 years (range, 31-66) with a minimum follow-up period of 12 months(range, 12-16). Results: The mean AOFAS lessor metatarso-phalangeal-interphalngeal Scale(LMIS) improved from 61.2 points preoperatively to 88.8 points postopertively. Mean decreases in length of the second and third metatarsal after surgery were 3.2mm and 3mm. Conclusion: We experienced improvement of metatarsalgia in 80% of patients by Weil osteotomy and all patients were symptom-free at last follow-up, suggesting that the Weil osteotomy is an effective procedure in treating painful plantar callosities under the second and third metatarsal heads associated with hallux valgus.

  • PDF

Evaluation of Bt-cotton Genotypes for Resistance to Cotton Leaf Curl Disease under High Inoculum Pressure in the Field and Using Graft Inoculation in Glasshouse

  • Akhtar, Khalid Pervaiz;Hussain, Manzoor;Hassan, Mahmood-Ul;Sarwar, Muhammad;Sarwar, Nighat
    • The Plant Pathology Journal
    • /
    • 제31권2호
    • /
    • pp.132-139
    • /
    • 2015
  • Bt-cotton germplasm, consisting of 75 genotypes was evaluated against cotton leaf curl disease (CLCuD) under high inoculum pressure in the field and using graft inoculation in glasshouse by visual symptom scoring assessments. None of the tested genotype was found disease free under both evaluation tests. Under field conditions in 2011, 3 genotypes were found resistant, 4 moderately resistant, 3 tolerant, 2 moderately susceptible and one susceptible; in 2012, 3 genotypes were tolerant, 7 moderately susceptible, 5 susceptible and 38 highly susceptible; in 2013, one was moderately susceptible and 51 were highly susceptible with varying degree of percent disease index (PDI) and severity index (SI). However, through graft evaluation in glasshouse, none of the graft inoculated plant was symptomless. All tested genotypes showed disease symptoms with SI values ranging between 5.0 and 6.0, and latent period between 12 and 14 days. Of the 75 genotypes evaluated using graft inoculation, 11 were found susceptible with SI values of 5.0 to 5.4 while remaining 64 were highly susceptible with SI values of 5.5 to 6.0. Inoculated plants of all tested genotypes exhibited severe disease symptoms within 10 days after the appearance of initial symptoms. No reduction in SI value was observed until the end of the experiment i.e., 90 days after grafting. Information generated under the present study clearly demonstrates that no sources of resistance to CLCuD are available among the tested Bt-cotton genotypes. So, a breeding programme is needed to introgress the CLCuD-resistance from other resistant sources to agronomically suitable Bt-cotton genotypes.

급성 글루포시네이트 암모늄 중독환자에서 혈중 Neuron specific enolase 수치와 경련발생 간의 연관성 (Relationship between Serum Neuron Specific Enolase Level and Seizure in Patients with Acute Glufosinate Ammonium Poisoning)

  • 안교진;이윤석;차용성;김현
    • 대한임상독성학회지
    • /
    • 제16권1호
    • /
    • pp.49-56
    • /
    • 2018
  • Purpose: Glufosinate ammonium poisoning can cause seizures, even after a symptom-free period. This study was conducted to evaluate the relationship between serum neuron specific enolase (NSE) level and the occurrence of seizures in patients with acute glufosinate ammonium poisoning. Methods: For this retrospective observational study, data from patients diagnosed with acute glufosinate ammonium poisoning were collected between January 2016 and June 2016. Serum NSE was measured within 2 hours of arrival at the emergency department. The patients were divided into a seizure group and a non-seizure group. Results: The seizure group included eight of the 15 total patients (53.3%). The serum NSE level was significantly higher in the seizure group than in the non-seizure group ($32.4{\pm}11.9ng/mL$ vs. $19.5{\pm}5ng/mL$, p=0.019). The amount of glufosinate ingested and initial and peak serum ammonia levels were significantly higher in the seizure group than in the non-seizure group. There was no significant difference in the area under the curve of the serum NSE level or the initial and peak serum ammonia levels in terms of predicting the occurrence of seizures. Conclusion: In acute glufosinate poisoning, initial serum NSE levels may help in prediction of seizures.

외국인 노동자의 특성과 의료이용 실태 (The Characteristics and Medical Utilization of Migrant Workers)

  • 주선미
    • 한국직업건강간호학회지
    • /
    • 제7권2호
    • /
    • pp.164-176
    • /
    • 1998
  • This study deals with the current medical utilization for migrant workers and the characteristics of them. The purpose of this study is to provide the basic information to establish proper medical policy. For the study self-made questionnaire was used, which was answered by 453 migrant workers working in the area of manufacturing and non-technical work in 10 cities like Seoul, Inchon, Namyangju, Sungnam, Kwangju, Pyungchon, Kunpo, Kimpo, Masuk in Kyungki-do and Chunan in Chungchungnam-do. Besides, 303 medical records of those who had visited free medical check-up center were analyzed. The period of accumulating data is 6 months, from November 1st, 1996 to April 30th, 1997. The characteristics of migrant workers and current medical utilization are analyzed by percentage and the relation between characteristics and current medical utilization were analyzed using ${\chi}^2$-test, t-test, ANOVA. The finding of this study was as follows : 1) The number of nationality was 16. The first majority was Philippians as 32.0%. Among 16 nationalities Southeastern and Northern Asians were 48.9%, Southwestern Asian was 46.5%, the rest was 7.3%. Men were 81.0%, those who are aged from 26 to 30 were 39.0%, Graduatee from high school 92.7%, Christians 56.3%, unmarried 55.4% and salary from 600,000 Won to 800,000 Won 53.8% averaging monthly payment 669,810 Won. As for their residence, those who resided over 3 years were 31.9% and the illegal residence reached 77.4%. As for Korean language, those who speak in middle level were 5.6%. 2) As for kind of work and circumstances, manufacturing was 81.1%, 4 off-days per month 72.2% and 9-10 working hours per day 42.1%. As for accommodation, residence in fabric was 62.6% and one or two members as roommate 40.2%. 3) The characteristics of health behavior showed that 89.4% of migrant workers had 3 meals, 70.9% of them did not drink alcohol, 73.5% of them did not smoke. 4) As a characteristic of health status, 71.8% of them perceived of their health. 76.1% thought that they had no illness before coming Korea. Among them who recognized their illness, those who had problem in circulatory system was 35.3%, respiratory system ENT 19.1% and nervous system 19.1%.66.2% of those having illness had already had sickness when coming to Korea. 5) During last one month, 79.2% of them were known as ones having no illness. Among the sick, those who had problem in circulatory system was 31.6%, nervous system 23.7% and respiratory system 21.1%. 60.3% of the sick were not cured at that time. 6) Sorting the symptom of those who visited free medical check up, dental care was 24.2%, orthopedic 14.0% and digestive system 13.8%. Teethache was 34.4%, stomach problem 11.6%, upper respiratory inflammation 10.2% and back pain 5.9%. Averagely they visited free medical check up 1-2 times. According to symptom, epilepsy 25.5 times, heart and vascular disease 9 times, constipation 2.8%, neurosis 2.38 times and stomach problem 2.34 times. 7) The most frequently visited medical service by migrant workers was hospital. The most mentioned reason was good healing as 36.3%. The medical service satisfied migrant workers mostly was hospital as 64.3%. The reason of satisfaction was also good healing as 45.9%. 8) 77.2% of respondents did not spend money for medical check. Average monthly medical cost was 25,100 Won, 3.7% of income. Those who had no medical security was 73.4%. In their case, 67.7% got discount from hospital or support from working place and religious organization. 9) As for the difference of medical utilization according for the characteristics of migrant workers, legal workers and no-Korean speaker used hospital more frequently. 10) Those who were satisfied most of all with the service of hospital were female workers, hinduists and buddhists, legal workers or manufacture workers. 11) Christians, those who have 3 meals or recognize themselves as healthy ones mostly had no illness. As a result, the most of migrant workers in Korea are from Asia. They are good educated but are working in manufacturing and illegal. Their average income is under 700,000 Won which in not enough for medical cost. They have no medical security and medical fee is supported by religious organization or discounted. Considering these facts the medical policy by government is to be established.

  • PDF

주의력결핍 과잉활동아의 모-자 상호행동 (MOTHER-CHILD INTERACTION PATTERNS OF ADHD CHILDREN)

  • 하은혜;오경자;홍강의
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • 제3권1호
    • /
    • pp.84-96
    • /
    • 1992
  • 본 연구에서는 주의력결핍 과잉활동 증상으로 진단한 5${\sim}$10세의 남자아동 15명과 그 어머니와의 상호행동을 녹화하여 Mash, Terdal과 Anderson(1973)의 반응유목 행렬표(Response Class Matrix)를 이용하여 평가한 후, 이들의 상호행동 양상과 아동, 어머니의 특성들과의 상관관계를 조사하였다. 이와함께 이들에게 중추신경각성제인 Methylphenidate를 1일 몸무게 기준 0.5mg을 한 달간 투약하여 치료 전파 치료 후 모-자 상호행동 양상을 비교하였다. 그 결과 아동과 어머니의 부정적 상호행동은 서로 상관이 높으며, 양자의 상호행동에 일관되게 상관이 높은 변인은 아동의 인지적, 행동적 증상의 심각성으로 아동의 증상이 심할수록 부정적인 모-자 상호행동이 두드러졌다. 그리고, 한달간의 약물치료 후 과제수행단계에서 아동과 어머니 모두 부정적-공격적 행동이 감소하였다. 이와 같은 결과는 어머니의 부정적 상호행동은 아동의 인지적, 행동적 증상에 따른 반응적인 것임을 시사하고 있다.

  • PDF

축제식양식장에서 사육한 돌돔, Oplegnathus fasciatus의 백점충, Crytocaryon irritans 감염 특성 (Characteristics on the Crytocaryon irritans of Rock bream, Oplegnathus fasciatus in the embankment fish farm)

  • 최혜승;방종득;박명애
    • 한국어병학회지
    • /
    • 제23권3호
    • /
    • pp.281-291
    • /
    • 2010
  • 2009년 7~12월, 축제식 양식장에서 돌돔의 백점충 감염 조사결과, 감염률은 20.0~88.0%로 9월이 높았고 7월이 낮았다. 7, 8월에는 죽는 개체가 없었으나 9월 중순 이후에는 폐사가 발생하였다. 수온 $19.3{\sim}24.3^{\circ}C$, 용존산소 5.0~7.1 mg/L, pH 8.0~8.1, 염분 31.9~33.7psu로 폐사 발생시의 수온은 약 $24.0^{\circ}C$ 였다. 백점충 감염초기의 외부증상으로는 돌돔의 활력은 양호하였으나 체표에 점액분비로 번들거림을 확인 수 있었으며, 대량폐사가 발생한 시기인 10월에는 점액분비 과다, 꼬리지느러미 탈락 및 발적, 체표 출혈반점과 안구충혈 증상을 보였으며 유영력이 매우 저하되어 있었다. 내부증상으로 간, 장 충혈 및 비장비대 증상을 나타내었다. 백점충은 아가미의 호흡상피 아래 조직 내에 매몰되어 기생기와 자유유영기 상태였음을 확인하였다. 백점충은 7월경에 감염되어 수온 상승과 함께 사료급이량 증가와 돌돔의 빠른 성장이 백점충 증식의 호조건 조성으로 폐사가 더욱 가중된 것으로 추정되었다. 조사기간 중 간중량지수 (HSI)는 $1.9{\pm}1.1{\sim}3.5{\pm}1.7$ %로 폐사발생기인 9월에 가장 낮았으며, 11월에 가장 높았다. 백점충에 감염된 돌돔 혈액의 헤마토크릿트 값은 7, 8월에 각각 37.3%, 41.0%, 9, 10월에 각각 32.14%, 24.17%로 차이를 보였다. 총콜레스테롤, 중성지방은 7, 8월에 비해 10월에 급격한 저하를 보였고, 폐사 발생후 AST는 약 7배, ALT는 약 5배 높았다.

상대정맥증후군의 방사선치료 (Radiation Therapy for Superior Vena Cava Syndrome)

  • 김진희
    • Radiation Oncology Journal
    • /
    • 제23권2호
    • /
    • pp.78-84
    • /
    • 2005
  • 목적: 악성종양에 의한 상대정맥증후군에서 방사선치료 후의 증상완화율, 생존율, 예후인자를 알아보기 위해 연구를 시행 하였다. 대상 및 방법: 1988년부터 2003년까지 계명의대 동산의료원 방사선종양학과에서 상대정맥증후군으로 방사선치료를 받고 추적관찰이 가능했던 72명의 환자를 대상으로 하였다. 남자가 64명, 여자가 8명이었으며 연령은 10세에서 83세로 평균 61세였고 원인으로는 폐암 64명, 전이성 폐암 4명, 림프종 2명, 흉선종 2명이었다. 방사선 치료는 모든 환자를 900 cGy 이상 조사하였으며 총방사선량이 6,600 cGy까지 조사하여 중앙값은 4,000 cGy였다. 추적기간은 1개월에서 180개월로 중앙값 5.6개월이었다. 결과: 주증상은 호흡곤란 $84.7\%$, 안면부종 $81.9\%$, 팔부종 $22.2\%$, 경정맥확장 $25\%$, 애성 $12.5\%$, 안면홍조 $5.6\%$순이었다. 방사선치료 후 $80.6\%$에서 매우 우수(excellent)또는 우수(good)한 증상완화를 보였고 $19.4\%$에서는 변화가 없거나 경미한(minimal) 증상완화가 있었다. 전체 환자의 중앙생존기간은 5.1개월이었고 2년 생존율은 $17.7\%$, 5년 생존율은 $14.8\%$이었다. 폐암환자에서는 각각 4.3개월, $16.7\%$, $13.4\%$였다. 단변량분석에서 폐암환자는 총방사선량을 30 Gy초과로 조사 받은 군이 그 미만의 방사선을 조사 받은 군보다 통계적으로 유의하게 생존율의 차이를 보였다(2YSR; 30 Gy 초과 $25.6\%$, 30 Gy 이하 $6.7\%$, p<0.01). 다변량분석에서도 폐암에 의한 상대정맥증후군의 예후인자로는 총방사선량(p<0.01)과 연령(p<0.05)이 통계적으로 유의한 인자였다. 비소세포성폐암이 소세포성폐암보다 생존율이 높았으나 통계적으로 유의하지 않았다. 결과: 악성종양에 의한 상대정맥증후군에서 방사선치료는 효과적인 치료방법이며 폐암으로 인한 상대정맥증후군에서 총방사선량을 30 Gy 이상 조사하는 적극적인 치료로 생존율이 연장될 수 있으리라 생각된다.