• Title/Summary/Keyword: 비수술적 치료

Search Result 993, Processing Time 0.027 seconds

The Production, Distribution, and Utilization of Rice in Japan (일본의 쌀 생산, 유통 및 이용 현용)

  • Inouchi, Naoyoshi
    • Food preservation and processing industry
    • /
    • v.1 no.1
    • /
    • pp.17-26
    • /
    • 2002
  • 일본은 기후적으로도 쌀의 생산에 적합하며 쌀은 일본의 주곡이다. 1893년 국립농업연구소가 설치된 이래로 쌀은 품질과 단보당 생산량이 꾸준히 개선되어와 116의 노동시간으로 생산량은 2.5배의 증가를 가져왔다. 이러한 진전은 재배방법의 개선, 비료, 농약, 재배기술, 기계화, 관개배수, 농지개량 등의 요인들로 볼 수 있다. 현재 일본에서 생산되고 있는 주요 쌀 품종으로는 코시히카리($35.5\%$), 히토메보레($9.7\%$), 히노히카리($9.0\%$), 아키다코마치($8.5\%$), 키라라($4.8\%$) 등 10여 품종이며 최근에는 형질전환 품종의 연구와 함께 생물공학적 연구 ,생리, 품질, 곤충과 잡초, 토양, 식품가공 등 기본적인 연구에 심혈을 기울이고 있다. 새로운 형태의 쌀 품종으로는 냉동조리쌀밥, 초밥, 레토르트룡 쌀 등 가공용으로 적합하도록 하기 위하여 아밀로오즈의 함량을 $5-15\%$로 낮춘 쌀이나 카레, 필라프, 튀김 쌀 등의 용도에 적합하도록 아밀로오스의 함량을 $30\%$이상으로 높인 쌀뿐만 아니라 곡립의 크기와 길이 등을 변형시킨 쌀, 유색미, 향미, 단백질 함량 조절 쌀, 거대 배아미, lipoxygenase 활성을 없앤 쌀, 단맛나는 쌀 등이 연구, 생산되고 있다. 일본에서의 쌀이용은 먼저 가공용 쌀을 들 수 있다. 밥, 청주, 스낵, 쌀가루, 미소발효 등 다양하게 이용이 되고 있으며 parboiled rice와 이의 색과 향을 개선한 converted rice, 현미를 이용한 가공쌀, 쌀빵, 현미가루, 세척미, 쌀국수, 쌀스낵, 당과, 죽, 쌀은 채소아 함께하는 타키코미고한, 초밥, 냉동쌀밥, 무균포장밥, 건조밥, 즉석밥 등 매우 다양하다.는 일, 쌀 재배구조 조정과 함께 높은 미질을 가지는 품종육종, 기계화를 비롯한 경작기술의 발달, 쌀과 부산물 가공기술의 개발연구, 특정기능을 함유하는 유전공학적 기술의 적용, 토지와 도시화 그리고 식량순환에 시스템의 개혁 등 과학기술을 고양하는 일 등을 들 수 있다.하는데 도움이 되리라 생각된다.=0.002)가 통계적으로 유의한 인자였다. 결론 : 본 기관에서 시행되어진 근침윤성 방광암에 대한 방광보존치료법은 기존의 근치적 방광절제술에 비하여 대등한 치료성적을 내는 동시에 $63\%$에서 장기보존이 가능하였다. 따라서 본 치료법이 방광암의 치료에 적극적으로 적용되어야 할 것으로 생각하며 향후 여러 기관이 참여하는 활발한 연구를 통해 한국인에게 가장 적절한 치료법을 개발해야 될 것으로 생각한다. B2+3, C1, C2+3군에서 수술달독군과 방사선치료 추가군의 골반종양제어율은 각각 $79\%$$75\%$ (p=0.88), $100\%$$100\%,\;44\%$$68\%$ (p=0.01)이었다. 전체 환자를 대상으로 다요인 분석을 시행한 결과 생존율과 무병생존율에 병기만이 유의하였고 두 치료 군에서도 역시 병기가 유의한 인자로 나타났다. 전체환자에서 골반종양제어율에 유의한 예후인자로 다요인분석을 시행한 결과 병기와 수술방법이 유의하였다. 수술단독군에서는 병기만이 유의하였고 방사선치료 추가군에서는 수술방법만이 유의하여 복부회음절제술군의 골반종양재발률이 높았다. 결론 : 본 후향적 연구에서 수술 후 보조적 방사선치료를 시행하여 수술단독군에 비해 병기 C2+3군에서 골반종양제어율이 향상되었음을 알 수 있었다. 그러나 병기 B2이상의 모든 환자에서 골반종양제어율 뿐만 아니라 생존율의 향상을 가져오기

  • PDF

Treatment of Pectus Carinatum with a Compressive Brace (압박 교정기를 이용한 새가슴의 치료)

  • Son, Jin-Sung;Jeon, Cheol-Woo;Lee, Seong-Jin;Lee, Chol-Sae;Lee, Kihl-Rho;Lee, Seock-Yeol
    • Journal of Chest Surgery
    • /
    • v.40 no.5 s.274
    • /
    • pp.369-375
    • /
    • 2007
  • Background: Patients suffering with pectus carinatum complain of cosmetic problems when they stand and this in spite of wearing cloths. The standard surgical treatment of pectus carinatum is resection of the deformed cartilages, but the wide operative scar, post-operative pain and complications related with such an operation can occur. Therefore, we have peformed compressive brace therapy as a non-operative treatment for pectus carinatum and we observed the effects and the efficiency of this treatment. Material and Method: From January, 2001 to December, 2006, 109 patients wore the compressive brace for all day. The degree of satisfaction was evaluated after $6\sim9$ months of wearing the compressive brace. The degree of satisfaction was evaluated by a score of from $1\sim4$. A score of 1 was assigned when the status was worse, 2 when it was the same, 3 when there was partial improvement and 4 when remarkable improvement was observed. The degree of satisfaction was assessed subjectively by the parent if the patient was a child younger than middle school age, and the patients older than middle school age assessed the score themselves. Result: The mean score of the overall degree of satisfaction was $3.93{\pm}0.33$. Recurrence of pectus carinatum after removal of compressive brace occurred in 6 patients (5.5%) of the total 109 patients. But 4 patients of the total 6 recurred patients stopped wearing of compressive brace against our advice. The 6 recurred patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed the compressive brace. The complications were discomfort with initially wearing the compressive brace, which occurred in all patients, skin rash due to the compressive brace for 76 patients (69.7%) and skin discolorization with excessive compression for f6 patients (5.5%). The skin rash and discolorization returned to normal within a few months after removal of the compressive brace. Conclusion: This study demonstrated that non-surgical treatment with using the compressive brace for patients with pectus carinatum was effective, and especially for children and teenagers. Non-surgical treatment with using a compressive brace would be helpful for the patients suffering with pectus carinatum and who dislike surgical operations because of their fear about general anesthesia and operation-related complications. Yet long-term follow up is necessary to accurately evaluate the effectiveness of this compressive brace and the recurrences after removal of the compressive brace.

CLINICAL STUDY ON TRANSSEPTAL TRANSSPHENOIDAL APPROACH TO PITUITARY GLAND (경비중격 경접형동 뇌하수체 수술에 관한 임상적 고찰 -수술적인 접근 방법에 관하여-)

  • 민양기;정하원;오승하;정종우
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1991.06a
    • /
    • pp.39-39
    • /
    • 1991
  • 뇌하수체 종양에 대한 경비중격 경접형동 수술은 1907년 Schloffer가 비절개수술에 의한 방법을 보고한 이래 1914년 Cushing이 sublabial approach를 정립하였으나, 이후 약 반세기 동안 경비중격 경접형동 수술이 개두술에 비해 종양의 재발율이 높다는 이유로 기피되어왔다. 1968년에 이르러 Cottle의 maxilla-premaxilla approach로 비중격에 대한 수기가 축적되고 수술현미경의 발달로 미세수술이 도입되면서 경비중격 경접형동수술이 다시 각광을 받게 되었다. 이후 sublabial approach, alotomy approach, columellar approach, external rhinoplasty approach 등이 개발되어 보고되었으며 접형동의 함기화가 불완전한conchal 형이나 터어키안 상측부로의 종양의 확장이 심한 예를 제외하고는 모두 이 방법으로 수술을 시행하는 것이 보편화되어 있으며 문헌고찰에 의하면 개두술시의 술후 사망율이 17%인데 비해 경비중격 경접형동술의 경우 1.8%라고 보고되고 있다. 서울대학교병원 이비인후과에서는 sublabial approach로 터어키안까지 종양을 노출시킨 후 신경외과의와 공동으로 뇌하수체 종양을 치료한 예를1977년부터 1988년까지 135례를 보고한 바 있다. 최근에는 sublabial approach의 단점을 보완하면서 외비의 해부학적인 구조에 익숙해질 수 있는external rhinoplasty approach를 이용하여 경비중격 경접형동 수술을 시행하고 있으며 1977년부터의 치험례를 임상분석하여 특히 external rhinoplasty approach의 수술성적을 보고하는 바이다.

  • PDF

Surgical Treatment of Metastatic Tumor in Pelvis (골반부 전이성 종양의 수술적 치료)

  • Kim, Jae-Do;Park, Woong;Jo, Myung-Rae;Son, Jung-Whan;Lee, Young-Gu
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.10 no.2
    • /
    • pp.61-70
    • /
    • 2004
  • Purpose: We studied to decide the operative indication of the metastatic tumor in pelvis according to the oncologic results, the Eastern Cooperative Oncologic Group (ECOG) performance status and complication. Materials and methods: From May 1994 to May 2003, 9 patients who were performed on palliative treatment and 10 paitents on operative treatment due to metastatic tumor of pelvic bone were investigated. On palliative/operative group, the mean age of patients was 57.6/48.0 years old and the ratio of male to female was 5:4/7:3. Primary origins were 3 cases from kidney, 3 from cervix and 2 of lung, 2 of myeloma, 2 of Non-Hodgkin's Lymphoma, and 1 from breast, bladder, testis, prostate, stomach, liver and retroperitoneal leimyosarcoma respectively. The palliative treatment was performed in 5 cases with radiotherapy, 1 with chemotherapy, 2 with combined chemo-radiotherapy and 1 with percutaneous cementation. The operative methods were 1 case of bone cement insertion after curettage, 2 of Girdlestone with internal hemipelvectomy and 7 of reconstruction after wide excision. Reconstructions were done.: 1 case of bone cementation, 5 of autograft prosthesis composite with irradiation or pastuerization and 1 of saddle prosthesis. We have observed the oncologic results, the ECOG performance status and complication. Results: The oncologic results of palliative/operative groups are NED 0/1, AWD 2/6, DOC 1/2 and DOD 6/1. The ECOG performance status was changed from 1.5 into 4.3 in palliative group and from 2.6 into 2.2 in operative group. The complications were 3 cases of the prosthesis failure and 2 of infection. Conclusion: The indication of operation of metastatic pelvic tumor is decided in consideration of the patient's condition, the grade of malignancy in primary tumor and the life expectancy.

  • PDF

Salvage with Reverse Total Shoulder Arthroplasty after the Failure of Proximal Humeral Tumor Treatment (근위 상완골 종양 치료 실패 후 역 견관절 전치환물을 이용한 구제술)

  • Jeon, Dae-Geun;Cho, Wan Hyeong;Kim, Bum Suk;Park, Hwanseong
    • Journal of the Korean Orthopaedic Association
    • /
    • v.53 no.6
    • /
    • pp.505-512
    • /
    • 2018
  • Purpose: Many reconstruction methods have been attempted after an en-bloc resection of the proximal humerus. In particular, the introduction of reverse shoulder arthroplasty (RSA) has made a breakthrough in the functional recovery of the shoulder. Nevertheless, RSA has limitations when the humeral bone stock loss is significant. In addition, it is unclear if RSA is effective in patients showing failure with non-operative treatment of a proximal humeral tumor. Materials and Methods: A reconstruction was performed using an overlapping allograft-RSA composite for 11 patients with a failed proximal humeral construct. Delayed RSA was performed on 6 patients with failed non-operative treatment. The pre- and postoperative Musculoskeletal Tumor Society (MSTS) score and the complications were addressed. Results: Overlapping allograft-RSA composite afforded a stable construct in 11 failed proximal humeral reconstructions and the patient's chief complaints were resolved. The mean time to the union of overlapped allograft-host junction was 5.5 months. Average preoperative MSTS score of 20.3 point increased to 25.7 point, postoperatively. Four of the six patients who had RSA within 4 years from the index operation showed arm elevation of more than $90^{\circ}$ whereas the remaining 5 patients showed some disability. The complications include one case each of dislocation and aseptic infection, which were resolved by changing the polyethylene liner and scar revision, respectively. None of the 6 patients who underwent delayed RSA after the failure of non-operative treatment showed arm elevation more than $90^{\circ}$. Conclusion: An overlapping allograft-RSA composite is a simple and reliable reconstructive modality in patients with massive bone loss. In patients with metastatic cancer necessitating a surgical resection at presentation, early conversion to RSA is recommended to secure functional recovery.

Surgical Treatment of Multivalvular Endocarditis with Ventricular Septal Defect (심실중격결손과 동반한 다중판막 감염성 심내막염의 수술적 치료)

  • Kim, Seon-Hee;Je, Hyoung-Gon;Lee, Sang-Kwon;Kim, Sang-Pil
    • Journal of Chest Surgery
    • /
    • v.43 no.4
    • /
    • pp.417-420
    • /
    • 2010
  • As higher mortality rate and frequent incidence of morbidity, early surgical treatment is generally recommended for the multivalvular endocarditis. A 46-year-old female presented with high fever. Echocardiography showed the vegetation on pulmonic valve, tricuspid valve and mitral valve with a ventricular septal defect. Emergency operation was conducted due to uncontrolled infection. We present a clinical success of this rare case with review of the medical literature.

Effects of Postoperative Radiation Therapy for Prevention of Keloids and Hypertrophic Scars (켈로이드와 비후성 반혼에서 재발을 방지하기 위한 수술후 방사선치료의 효과)

  • Kang, Ki-Mun;Choi, Ihl-Bohng;Kim, In-Ah;Jang, Jee-Young;Shinn, Kyung-Sub
    • Radiation Oncology Journal
    • /
    • v.15 no.3
    • /
    • pp.269-276
    • /
    • 1997
  • Purpose : To evaluate the effects of surgical excision followed by radiation therapy for Prevention of keloids and hypertrophic scars. Materials and Methods : From October 1987 to April 1995, radiation therapy was applied to 167 sites in 106 patients with surgical excision in an attempt to prevention of recurrence against keloids and hypertrophic scars. The main etiology of the keloids and hypertrophic scars were surgery in $49.2\%,\;trauma\;in\;25.0\%,\;ear-piercing\;in\;5.4\%,\;and\;burn\;in\;5.4\%$, The Patients' ages ranged from 3 to 70 years with a median of 32 years. Radiation therapy used ranged from 6 to 8MeV electron beam. Radiation therapy was delivered within 24 hours of surgical excision. Several dose schedules were used, varing from 400cGy in 1 daily fraction to 1900cGy in 4 daily fractions. The average total dose was 1059cGy, and the average dose per fraction was 433cGy. All patients were followed up from 24 to 114 months with a median follow up of 49 months. Results : The overall recurrence rate was $12.6\%$ (21/167) The overall 1-year and 2-year recurrence rates were $10.2\%\;and\;11.4\%$, respectively Among 21 recurrent sites, seventeen sites $(81\%)$ were confirmed within 12 months after surgical excision. Period to recurrence ranged from 1 month to 47 months with a median recurrence time of 9.6 months, The history of previous therapy was only a significant factor in recurrence. Twenty-four patients had history of previous therapy recurrence rates was significantly higher in this group than those without history of Previous therapy $(22.6\%\;vs.\;11.0\%,\;p=0.04)$. There was no serious complication related to radiation therapy. Conclusion : This study suggests that surgical excision followed by radiation therapy is an effective method of preventing keloids and hypertrophic scars.

  • PDF

Streptococcal Toxic Shock Syndrome Occurred during Postoperative Radiotherapy in a Cancer Patient with Preexisting Lymphedema and Chronic Illness -Case Report- (수술 후 림프부종과 만성질환을 동반한 종양 환자에서 방사선치료 기간 동안 발생한 연쇄구균독소충격증후군 예)

  • Jang, Ji-Young;Oh, Yoon-Kyeong;Kim, Dong-Min
    • Radiation Oncology Journal
    • /
    • v.24 no.4
    • /
    • pp.317-321
    • /
    • 2006
  • A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

Effect of Suboptimal Chemotherapy on Preoperative Chemoradiation in Rectal Cancer (직장암 환자의 수술 전 항암화학방사선치료에서 비적정 항암화학요법의 영향)

  • Lee, Ji-Hye;Kang, Hyun-Cheol;Chie, Eui-Kyu;Kang, Gyeong-Hoon;Park, Jae-Gahb;Oh, Do-Youn;Im, Seock-Ah;Kim, Tae-You;Bang, Yung-Jue;Ha, Sung-Whan
    • Radiation Oncology Journal
    • /
    • v.27 no.2
    • /
    • pp.78-83
    • /
    • 2009
  • Purpose: To examine the effect of suboptimal chemotherapy in patients undergoing preoperative chemoradiotherapy for the treatment of rectal cancer. Materials and Methods: The medical records of 43 patients who received preoperative concurrent chemoradiotherapy, followed by radical surgery for the treatment of pathologically proven adenocarcinoma of the rectum from April 2003 to April 2006 were retrospectively reviewed. The delivered radiation dose ranged from 41.4 to 50.4 Gy. The standard group consisted of patients receiving two cycles of a 5-FU bolus injection for three days on the first and fifth week of radiotherapy or twice daily with capecitabine. The standard group included six patients for each regimen. The non-standard group consisted of patients receiving one cycle of 5-FU bolus injection for three days on the first week of radiotherapy. The non-standard group included 31 patients. Radical surgery was performed at a median of 58 days after the end of radiotherapy. A low anterior resection was performed in 36 patients, whereas an abdominoperineal resection was performed in 7 patients. Results: No significant difference was observed between the groups with respect to pathologic responses ranging from grades 3 to 5 (83.3% vs. 67.7%, p=0.456), downstaging (75.0% vs. 67.7%, p=0.727), and a radial resection margin greater than 2 mm (66.7% vs. 83.9%, p=0.237). The sphincter-saving surgery rate in low-lying rectal cancers was lower in the non-standard group (100% vs. 75%, p=0.068). There was no grade 3 or higher toxicity observed in all patients. Conclusion: Considering that the sphincter-saving surgery rate in low-lying rectal cancer was marginally lower for patients treated with non-standard, suboptimal chemotherapy, and that toxicity higher than grade 2 was not observed in the both groups, suboptimal chemotherapy should be avoided in this setting.

Surgical Closure of Patent Ductus Arteriosus in Premature Infant -A report of two cases - (미숙아에서 동맥관 개존증 수술 2례)

  • 김삼현;서필원
    • Journal of Chest Surgery
    • /
    • v.29 no.7
    • /
    • pp.777-779
    • /
    • 1996
  • Recently we operated on two cases of PDA in premature infant. In both cases, indomethacin therapy had failed to close the PDA. The extremely small baby(body weight 540gm) died 28hrs postoperatively by unexpe ted intrathoracic bleeding probably due to coagulopathy related to septic condition and thrombocytopenia. The clinical course of the second case(body weight 1395gm) was complicated by ileal perforation sec- ondary to necrotizing enterocolitis. The baby underwent segmental resection of ileum with ileostomy on the 8th hospital day. On the 34th hospital day surgical closure of the PDA was done and the ile'ostomy was repaired simultaneously. Ventilator weaning was possible on the postoperative 6th day. The baby discharged on the postoperative 33th day with the body weight of 2050gm.

  • PDF