Park, Eun Ho;Jang, Tae Won;Jang, Li La;Paek, Jong yun;Oak, Chul Ho;Jung, Mann Hong;Jang, Hee Kyung
Tuberculosis and Respiratory Diseases
/
v.62
no.3
/
pp.203-210
/
2007
Background: The incidence of adenocarcinoma of the lung has been increasing worldwide, and it has been generally been accepted to be relatively unrelated to smoking with a female preponderance. The aim of this study was to examine the gender-related pathological and survival differences in patients with an adenocarcinoma of the lung. Material and Method: A retrospective review of the clinical information of patients diagnosed with an adenocarcinoma of the lung at Kosin Medical Center from January 1999 to September 2005 was performed. The patient's demographics (age, gender), smoking history, stage, serum tumor marker, pathology classification, EGFR mutation, K-ras mutation, treatment methods, and survival time were analyzed. Result: Of the 438 patients, 179 (40.9%) were female. The median age at the diagnosis was 58 years for females and 59 years for males. However, 25.8% of women and only 17.7% of men were under 50 years of age (p=0.02). The distribution of the disease stage was similar in both men and women. The bronchioloalveolar carcinoma component was diagnosed more often in women (11.2%) than in men (5.0%). The overall survival rate was higher in women than in men (p=0.01), and women had a superior therapeutic response to a combined treatment of surgery and chemotherapy. Conclusion: This study showed significant genders differences in terms of the smoking history, bronchioloalveolar carcinoma component, overall survival, and survival after combined treatment of surgery and chemotherapy. Therefore, gender differences should be considered when diagnosing and treating adenocarcinomas of the lung.
Park, Kang-Gyun;Yu, Young-Bin;Yook, Keundol;Kim, Sang-Ha;Kim, Sunghyun;Kim, Young Kwon
Korean Journal of Clinical Laboratory Science
/
v.49
no.3
/
pp.279-284
/
2017
The results of rapid antimicrobial susceptibility test (AST) in blood cultures were obtained by inoculating the bacteria directly into the VITEK MS and the VITEK 2 systems without subculturing in the blood culture positive medium. The obtained results were compared with the results using a standard method to evaluate their reliability and accuracy. The direct AST results in blood culture positive specimens were 97.9% (1,936/1,978), consistent with the standard AST results. Gram-positive bacteria showed a concordance rate of 97.2% (1,051/1,081), a very major error rate of 0.5% (5/1,081), a major error rate of 0.1% (1/1,081), and a minor error rate of 2.2% (24/1,081). Staphylococcus epidermidis was the main cause of discordance, and gentamicin (N=9) and fusidic acid (N=8) showed high errors. The overall concordance rate and minor error among the Gram-negative bacteria were 98.6% (885/897) and 1.4% (12/897), respectively. Escherichia coli and Pseudomonas aeruginosa were the major causative bacteria of Gram-negative bacteria. Among them, amoxicillin/clavulanic acid (N=3) showed high error. Direct AST met the CLSI criteria and shortened the reporting time by 24 hours; however, we found that there was a need to perform an addition test via disk diffusion for antimicrobials with very large errors. These results suggest that the method of direct AST in blood culture positive medium may be very useful in efficiently treating patients.
Objectives : Electrical acupoint stimulation(EAS) has been used to treat motor dysfunction of stroke patients with reportedly effective results. The purpose of this study is to evaluate the efficacy of the EAS with different frequencies in treating motor dysfunction of ischemic stroke patients. Methods : The subject of this study were forty-two ischemic stroke patients with motor dysfunction in Kyunghee oriental medicine hospital who were hospitalized for one week to one month from onset. They were treated with 2Hz or 120Hz EAS for two weeks, and motor evoked potentials(MEP) were measured before and after EAS treatment. To compare the effect of 2Hz EAS with 120Hz, the number of patients who showed MEP responses after two weeks among those who had no previous response was checked. Also measured were latency, central motor conduction time(CMCT), amplitude of MEP before and after EAS treatment. Results : After two weeks of treatment, 4 out of 15 patients(27%) in the 2Hz EAS group and lout of 19 patients(5%) in the 120Hz group showed potential responses. Yet there was no significant difference between the two groups. When MEP data of the affected side between the 2Hz group and the 120Hz group was compared, the former showed more significant improvement than the latter in latency, CMCT and amplitude(P=0.040, 0.019,0.021). When the proportion of the affected side and unaffected side in MEP data was examined, the 2Hz group showed improvement on only latency and CMCT with significant differences(P=0.040, 0.014). Conclusions : These results show that EAS with low frequency is more helpful for motor recovery after ischemic stroke than that with high frequency. This suggests that low frequency EAS activates the central motor conduction system better than high frequency EAS.
Background: The clinical history and physical findings of the patients with spontaneous pneumothorax depend largely on the extent of the collapse of the lung and the presence of pre-existing pulmonary disease. Large primary spontaneous pneumothorax is a possible serious condition and. so more active treatment will be necessary for these patients. The therapeutic guideline for large pneumothorax remains controversial. Therefore, by assessing the clinical results of surgical treatment for large primary pneumothorax, we aim to determine the indicators of treatment. Material and Method: Among 348 patients with primary spontaneous pneumothorax and who underwent surgical treatment from August 2004 through December 2007, 58 patients who responded to treatment for a large primary pneumothorax were included in the current study. We then retrospectively evaluated the operative findings and the surgical results. The patients with a pneumothorax of 80% or more, including those patients with tension pneumothorax, were considered to have a "large pneumothorax". Most of these patients Should be treated with a 12F chest tube. Thoracoscopic wedge resection was considered for treating recurrent pneumothorax, continuous air leakage, controlateral pneumothorax and first episode pneumothorax with visible blebs (> 1cm) seen on the computed tomography. Result: There were 50 men and 8 women with a mean age of 28.2 years (range: $14\sim54$ years). The mean length of hospitalization was 5.3 days (range: $2\sim10$ days). Nine patients underwent chest tube drainage only. Forty-nine patients underwent thoracoscopic wedge resection. The mean follow up time was 27.8 months (range: $10\sim58$ months). The actual site of air leakage could be located in 35 patients (71.4%) and this was correlated with pleural adhesion (p=0.005). The initial air leakage tended to be more correlated with intra-operative air leakage, although this was not statistically significant (p=0.066). The recurrence rate was 11.1 % for the patients with chest tube drainage and 2.0% for the patients with thoracoscopic wedge resection. Conclusion: Large primary pneumothorax requires an early diagnosis and early treatment. Thoracoscopic wedge resection may help to prevent recurrence of large primary pneumothorax.
To save the labour reguired for separation of copulated moth during egg Production, some of the chemicals available at the market were on screen test for easy separation of copulated moth of silkworm. The obtained results are summarized as following. 1. In a separation ratio of copulated moth along with a treating time, TCTFE(Trichloro-trifluoroethane) completely separated the copulated moth in 10 minutes. The combinations of TCTFE plus Acetone (87.5 : 12.5 V/V) and TCTFE plus Acetic acid (50 : 50 V/V) take 25minutes for the complete separation of copulated moth. Use of Acetic acid solution only makes 100% separation of copulated moth in one hour and foully minutes and non$.$treatment shows only 47.5% of separation in three and half hours. On the other hand. There is no statistical significance between TCTFE Plus Acetone and control in the egg productivity. 2. The combination of TCTFE Plus Acetone (87.5 : 12.5 V/V) does not infuluence the egg productivity of the moth, showing 443 grains for an average number of egg per moth out of which 417 grains are for the number of fertilized eggs while control shows 452 grains for an avarage number of egg/moth and 428 grains for the number of fertilized eggs. However a sing1e use of TCTFE and Acetic acid shows less egg productivity and number of ferilized eggs per moth, respectively as compared to those of the control. In particular, a single use of acetic acid makes an increase of number of non-egg prodncible moth and it seems to be brought due to a chemical damage. 3. In a rearing test of the egg laid by the chemical treated moth, there are no differences among the treatments in all of the useful characters of the larvae; larval duration, survival rate, cocoon yield, single cocoon weight, single cocoon shell weight and cocoon shell ratio. In these regards, it is recognized that TCTFE can be practically used for the separation of copulated moth and the combination of TCTFE and Acetone promote its efiectiveness on the separation of copulated moth.
Background: Mitral valve abnormalities in the pediatric population are rare. Mitral valve replacement or pediatric mitral lesions can cause problems such as a lack of growth potential. There re only limited experiences with mitral valve repair at any institution, so the purpose of his study is to evaluate the outcomes of mitral valve repair n pediatric patients. Material and Method: Sixty-four consecutive children (28 males and 36 females) with a mean age of $5.5{\pm}4.7$ years underwent mitral valve repair for treating their congenital mitral valve disease between January 1996 and December 2005. The patients were divided into two groups: group 1 (34 patients (53.1%)) had isolated disease (mitral anomaly with or without trial septal defect or patent ductus arteriosus) and group 2 (30 patients (46.9%)) had complex disease (mitral anomaly with concurrent intracardiac disease, except atrioventricular septal defect). Result: The overall in-hospital mortality was 6.3%; group 1 had 5.9% mortality and group 2 had 10.0% mortality. The postoperative morbidity was 18.8%; group 1 and 2 had 14.7% and 23.3% postoperative morbidity, respectively, and there as no significant difference among the groups. The median follow-up was 4.6 years range: $0.5{\sim}12.2$ years). The 10-year survival rate was 95.3%. The 10-year freedom from re-operation rate was 76.1% with 10 re-operations. The majority of the functional classifications were annular dilatation and leaflet prolapse. A mean of $2.1{\pm}1.1$ procedures per patient were performed. The echocardiography that was done at the immediate postoperative period showed a significant improvement in the mitral valve function. The follow-up echocardiographic results were significantly improved. However, mitral stenosis newly developed over time, and there ere significant differences according to the repair strategies. Conclusion: The patients who underwent mitral valve repair for congenital mitral anomalies showed good results. The follow-up echocardiography revealed satisfactory short-term and long-term results. Close follow-up is necessary to detect the development of postoperative mitral stenosis or regurgitation.
Background: The principal surgical technique for treating an abdominal aortic aneurysm since the 1960s has been the transperitoneal approach, yet there have been some recent studies that have reported improved surgical results with using the retroperitoneal approach. However, there are only limited clinical Korean studies that have, compared between the transperitoneal and retroperitoneal approaches. Material and Method: This study included 36 patients who had been diagnosed as having an aneurysm of the abdominal aorta and they were surgically treated between January 2001 and July 2007. The patients were subdivided into the retroperitoneal approach group (n=17) and the transperitoneal approach group (n=19), and they were compared in terms of the preoperative risk factors, the postoperative complications and the operative mortality. The risk factors of operative mortality risk and long-term survival for the 36 patients were assessed by the Kaplan-Meier method. Result: There were no significant differences between the groups in terms of gender, age, the underlying disease, a history of smoking, rupture of aneurysm, the preoperative symptoms, the operation time and the incidence of postoperative complications. However, the duration of postoperative fasting, the number of days of having an indwelling nasogastric tube and the length of the stay in the intensive care unit were significantly short for the retroperitoneal approach group (p<0.05). There was a 16.7% rate of operative mortality (6/36) and five of the deaths were attributed to preoperative ruptured aneurysm. On univariate analysis, a higher preoperative serum creatinine level (SCr ${\geq}$1.8 mg/dL, p=0.016) and ruptured aneurysm (p<0.001) were the significant risk factors of operative mortality. As assessed by the Kaplan-Meier method, the long-term survival was comparable between the groups and the five-year survival rate of all the patients was 57.5%. Conclusion: In the present study, a retroperitoneal approach has several advantages such as a shorter intensive care unit stay, a shorter duration of postoperative fasting and a shorter duration of an indwelling nasogastric tube. Therefore, unless there is any contraindication for a retroperitoneal approach, it could be considered as a primary surgical access for repairing an abdominal aortic aneurysm.
The release of hazardous waste materials into the environment poses serious risks in humans and ecosystems. The risk assessment of environmental pollutants including hazardous chemicals requires a comprehensive measurement of hazard and exposure of the chemicals that can be achieved by toxicity evaluation using a biological system such as biomarkers. In this report we have tried to develop a biomarker used to elucidate a molecular basis of, and to monitor abnormal behaviors caused by diazinon in Japanese medaka (Oryzias latipes) as a model organism. First, an attempt was made to clone tyrosine hydroxylase gene from Japanese medaka that would be a candidate for a biomarker for neuronal modulations and behaviors. For monitoring experiments at behavioral and molecular biological levels, the fish were treated under different sublethal conditions of diazinon and their behavioral responses were observed . In this study we have successfully cloned a partial TH gene from the medaka fish through PCR screening of an ovary cDNA library. DNA sequencing analysis revealed that the amplified fragment was 327 bp encoding 109 amino acids. Comparing the DNA sequence of medaka TH with other species, TH gene revealed the DNA sequence was completely identical to that of rat TH. In the RT-PCR, 330 Up of mRNA was consistently amplified in all the treated samples including control There were no significant differences in the TH expression level regardless of treating concentrations (1∼5,000 ppb) and time (0∼48 hr) The reason appeared to be that RT-PCR was not performed using through a quantitative analysis normalized against an actin gene expression. Organ or tissue - specific detection of TH activity and mRNA as biomarkers will be a useful monitoring tool for neurobehavioral changes in fish influenced by toxic chemicals. Furthermore, quantitative analysis of locomotive patterns and its correlation with the neurochemical and molecular data would be highly useful in measuring toxicity and hazard ofvarious environmental pollutants.
Purpose: Evaluate the clinical results of humerus neck nonunion treated with Polarus intramedullary nail. Materials and Methods: 8 patients who underwent surgery for nonunion of humerus surgical neck fracture were included. All patients were female, the average age was 65 years. 5 out the total 8 cases initially received surgery, open reduction and internal fixation with metal plate in 1 case, Ender nail insertion in 2 cases, external fixator in 1 case and closed reduction and percutaneous pinning in 1 case. The other 3 non union cases initial received conservative managemnent. The average period of nonunion was 9 months in the operated group and 6.2 months in the conservative group. All 8 cases received closed reduction with intrameedullary Polarus nail and auto iliac bone graft. Union was confirmed radiologically, and functional evaluation was done with the UCLA functional criteria. Results: All 8 cases showed union on radiologic evaluation. Average time to union was 3.5 months, average follow up period was 27 months. Average UCLA shoulder evaluation score was 7.6 points preoperatively which improved to 26.3 points after surgery. Active shoulder flexion was 40.7 degrees preoperatiely which increased to 104 degrees after surgery. Shoulder abduction improved from 32.9 degrees preoperatively to 96.3 degrees after surgery. UCLA functional criteria was good in 5 cases and fair in 3 cases, which no poor cases. Conclusion: Polarus IM nailing and AIBG is a useful method for treating nonunion of humerus neck fracture with improvement in union and function.
Purpose : Bacteremia in immunocompromised pediatric cancer patients can lead to high morbidity and mortality, if not treated early and properly. The incidence and antibiotic sensitivities to common pathogens of bacteremia in pediatric cancer patients are liable to change, according to region and time. We investigated the causative organisms and antibiotic sensitivities of bacteremia in pediatric cancer patients to assess the adequacy of empiric antimicrobial therapy. Methods : From September 1995 to August 2003, we retrospectively evaluated 58 episodes in 39 pediatric cancer patients with bacteremia treated at the Pediatric Department of Yeungnam University Hospital. We investigated and analyzed the causative organisms and the antibiotic sensitivity test results by reviewing the records of the microbiologically proven positive blood culture results. Results : The incidence of bacteremia in pediatric cancer patients in this study was 5.7 percent (58 episodes out of 1,022 occasions of blood cultures). Gram-positive organisms were isolated more often than gram-negative organisms (63.8 percent vs 36.2 percent) in the following order : Staphylococcus epidermidis (37.9 percent), Staphylococcus aureus (17.3 percent), Escherichia coli (12 percent), Streptococcus (8.6 percent), Enterobacter (6.9 percent), Klesiella (6.9 percent), Serratia (3.5 percent), Acinetobacter (3.5 percent), Proteus (1.7 percent) and Morganella morganii (1.7 percent). In antibiotic sensitivity tests, only six of 37 isolates (16 percent) of gram positive bacteria were sensitive to penicillin and 15 of 37 isolates (40 percent) were sensitive to oxacillin. All except one Staphylococcus aureus were sensitive to vancomycin and all except one Staphylococcus epidermidis were sensitive to teicoplanin among 37 isolates of gram positive bacteria. In the case of gram negative bacteria, two of 21 isolates (10 percent) and four of 21 isolates (19 percent) were sensitive to cefotaxime and ceftazidime, respectively. Only six of 21 isolates (29 percent) were sensitive to aminoglycoside, but all 21 isolates (100 percent) were sensitive to imipenem. All seven isolates tested after the year 2000 were sensitive to meropenem. Conclusion : In conclusion, we should choose the proper antimicrobials in treating pediatric cancer patients with suspected bacteremia, reflecting the increasing episodes of gram positive bacteremia and polymicrobial resistance of gram positive and negative organisms.
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