• Title/Summary/Keyword: 와추적

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Analysis of Octyl-2-Cyanoacrylate as a Dressing Material after Pediatric Urological Procedures (소아비뇨기과 관혈적 수술 시 피부봉합제로 사용된 Octyl-2-Cyanoacrylate (Dermabond$^{TM}$)의 효용성)

  • Lee, Hahn-Ey;Min, Sun Ho;Kim, Kwang Myung
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.115-120
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    • 2012
  • Purpose: We aimed to evaluate the efficacy of Octyl-2-cyanoacrylate (Dermabond$^{TM}$) as a topical skin adhesive for pediatric urologic open surgery. Methods: From August 2010 to August 2011, we retrospectively evaluated pediatric patients who underwent urologic open surgery at our institution. A total of 128 pediatric patients with 210 incisions used Dermabond$^{TM}$ for skin closure. Results: We divided the 128 patients into 3 groups according to type of surgery. Group 1 underwent hydrocelectomy (55 cases, 41.3%), Group 2 underwent orchiopexy (43 cases, 32.3%), Group 3 underwent penoplasty (35 cases, 26.4%). One hundred and twenty eight patients who underwent 133 surgeries in total, with a total of 210 incisions visited our outpatient department postoperatively, and a total of 5 wound complications (2.3%) occurred, but were simple inflammations and no dehiscence was observed. When analyzed according to groups, no wound problems occurred in Group 1 (0/55, 0%), one occurred in Group 2 (1/43, 2.3%) and four cases occurred in Group 3 (4/35, 11.4%) respectively. When re-analyzed according to wound locations, one occurred in an inguinal wound (1/120, 0.83%), none occurred in scrotal wounds (0/55, 0%), and four occurred in penile wounds (4/35, 11.4%). In Group 3, the incidence of penile wounds was significantly increased compared to other groups (P=0.008). All 5 wound problems were inflammatory and healed at an average of 13.8 days (13-15 days) with antibiotic ointment application only. Conclusion: Dermabond$^{TM}$ is feasible and safe topical skin adhesive alternative to standard skin suture in pediatric urologic surgery. However, further research about its efficacy and safety could be valuable in the future.

Estimating Fine Particulate Matter Concentration using GLDAS Hydrometeorological Data (GLDAS 수문기상인자를 이용한 초미세먼지 농도 추정)

  • Lee, Seulchan;Jeong, Jaehwan;Park, Jongmin;Jeon, Hyunho;Choi, Minha
    • Korean Journal of Remote Sensing
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    • v.35 no.6_1
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    • pp.919-932
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    • 2019
  • Fine particulate matter (PM2.5) is not only affected by anthropogenic emissions, but also intensifies, migrates, decreases by hydrometeorological factors. Therefore, it is essential to understand relationships between the hydrometeorological factors and PM2.5 concentration. In Korea, PM2.5 concentration is measured at the ground observatories and estimated data are given to locations where observatories are not present. In this way, the data is not suitable to represent an area, hence it is impossible to know accurate concentration at such locations. In addition, it is hard to trace migration, intensification, reduction of PM2.5. In this study, we analyzed the relationships between hydrometeorological factors, acquired from Global Land Data Assimilation System (GLDAS), and PM2.5 by means of Bayesian Model Averaging (BMA). By BMA, we also selected factors that have meaningful relationship with the variation of PM2.5 concentration. 4 PM2.5 concentration models for different seasons were developed using those selected factors, with Aerosol Optical Depth (AOD) from MODerate resolution Imaging Spectroradiometer (MODIS). Finally, we mapped the result of the model, to show spatial distribution of PM2.5. The model correlated well with the observed PM2.5 concentration (R ~0.7; IOA ~0.78; RMSE ~7.66 ㎍/㎥). When the models were compared with the observed PM2.5 concentrations at different locations, the correlation coefficients differed (R: 0.32-0.82), although there were similarities in data distribution. The developed concentration map using the models showed its capability in representing temporal, spatial variation of PM2.5 concentration. The result of this study is expected to be able to facilitate researches that aim to analyze sources and movements of PM2.5, if the study area is extended to East Asia.

Radiotherapy for Early Glottic Carinoma (조기 성문암 환자에서의 방사선치료)

  • Kim, Won-Taek;Nam, Ji-Ho;Kyuon, Byung-Hyun;Wang, Su-Gun;Kim, Dong-Won
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.295-302
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    • 2002
  • Purpose : The Purpose of this study was to establish general guidelines for the treatment of patients with early glottic carcinoma (T1-2N0M0), by assessing the role of primary radiotherapy and by analyzing the tumor-related and treatment-related factors that have an influence on the treatment results. Materials and Methods : This retrospective study was composed of 80 patients who suffered from early glottic carcinoma and were treated by primary radiotherapy at Pusan National University Hospital, between August 1987 and December 1996. The distribution of patients according to T-stage was 66 for stage T1 and 14 for stage T2. All of the patients were treated with conventional radical radiotherapy using a 6MV photon beams, a total tumor dose of $60\~75.6\;Gy$ (median 68.4 Gy), administered in 5 weekly fractions of $1.8\~2.0\;Gy$. The overall radiation treatment time was from 40 to 87 days, median 51 days. All patients were followed up for at least 3 years. Univariate and multivariate analysis was done to identify the prognostic factors affecting the treatment results. Results : The five-years survival rate was $89.2\%$ for all patients, $90.2\%$ for T1 and $82.5\%$ for T2. The local control rate was $81.3\%$ for all patients, $83.3\%$ for T1 and $71.4\%$ for T2. However, when salvage operations were taken into account, the ultimate local control rate was $91.3\%,\;T1\;94.5\%,\;T2\;79.4\%$, reprosenting an increase of $8\~12\%$ in the local control rate. The voice preservation rate was $89.2\%,\;T1\;94.7\%,\;T2\;81.3\%$. Fifteen patients suffered a relapse after radiotherapy, among whom 12 patients underwent salvage surgery. We included T-stage, tumor location, total radiation dose, fraction size, field size and overall radiation treatment time as potential prognostic factors. T-stage and overall treatment time were found to be statistically significant in the univariate analysis, but in the multivariate analysis, only the over-all treatment time was found to be significant. Conclusion : The high cure and voice preservation rates obtained when using a procedure, comprising a combination of radical radiotherapy and salvage surgery, may make this the treatment of choice for patients with early glottic carcinoma. However, the prognostic factors affecting the treatment results must be kept in mind, and more accurate treatment planning and further optimization of the radiation dose are necessary.

Sequential Chemotherapy and Radiation Therapy for Advanced Nasopharyngeal Carcinoma (진행된 비인강암의 화학요법 및 방사선 치료)

  • Park, In-Kyu;Kim, Song-Bo;Yun, Sang-Mo;Kim, Jae-Cheol;Park, Jun-Sik
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.259-265
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    • 1993
  • Between January 1985 and July 1992, 52 patients with locally advanced nasopharyngeal carcinoma were studied retrospectively for the effectiveness of sequential chemotherapy and radiation therapy. The male to female ratio was 3.3:1 with a median age of 41 years. Forty patients had squamous cell carcinoma and the remaining 12 had undifferentiated carcinoma. Seven patients had stage III disease and the remainder had stage IV disease at time of presentation. All patients were treated two courses of chemotherapy followed by radiation therapy. Chemotherapy consisted of either CVB (cisplatin, vincristine and bleomycin) or CF (cisplatin and 5-FU). Total radiation dose to the primary site ranged from 6000 cGy to 7500 cGy. Neck nodes were given booster treatment to maximum of 7000 cGy, depending on the extent of disease. Local control, overall survival and disease-free survival rates were analyzed. The complete response (CR) rate to chemotherapy was $15\%$ and the partial response (PR) rate was $46\%,$ for overall major response rate of $61\%.$ The CR rate was $87\%$ after radiation therapy. Median follow-up time was 51 months. The overall survival and disease-free survival rates at 36 months were $54\%\;and\;49\%,$ respectively. Median time to relapse was 15 months. The patterns of initial relapse in CR patients was as follows: locoregional failure only, 12 patients; distant metastasis only,11: both,2. Cox's multivariate regression model revealed that nodal status was the single most important independant prognostic factor influencing disease-free survival (p=0.001). Comparision of these results with other published reports with radiation therapy alone showed that a high rate of initial response to chemotherapy did not translate into local control or survival. At present time radiation therapy alone remains the standard treatment for locoregional cancer of the nasopharyngeal cancer. More controlled clinical trials must be completed before acceptance of chemotherapy as a part of treatment of advanced nasopharyngeal carcinoma.

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The evaluation for Clinical usefulness and Safety of Sirolimus-eluting stent and Paclitaxel-Eluting Stents In Patients With Acute Myocardial Infarction (급성심근경색증 환자의 일차적 관동맥 스텐트 삽입술 시 삽입된 Sirolimus-eluting stent 와 Paclitaxel-eluting stent의 임상적 안정성 및 유용성 평가)

  • Min, Gye-Sik;Han, Man-Seok
    • Journal of the Korean Society of Radiology
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    • v.6 no.1
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    • pp.5-10
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    • 2012
  • There is a still unsettled issue about the comparison of long-term clinical effects between sirolimus-(SES) and paclitaxel-eluting stents (PES) for the patients with acute myocardial infarction (AMI). Therefore, we performed a retrospective analysis to evaluate the 4-year clinical outcome of SES as compared with PES after percutaneous coronary intervention (PCI) in patients with AMI. From January 2004 to August 2006, all consecutive patients with acute ST-segment elevation myocardial infarction (STEMI) underwent primary PCI and acute NSTEMI underwent PCI by implantation either SES or PES were enrolled. The occurrence of death, cardiac death, recurrent infarction, target vessel revascularization (TVR) and stent thrombosis were analyzed. The composite of major adverse cardiac events (MACE; death, recurrent infarction and TVR) were also analyzed. During the study period, total 668 AMI patients had visited. Of them, total 522 patients (299 with SES and 223 with PES) were enrolled. During 4-year clinical follow-up, there were similar occurrences of death ($18.3{\pm}3.0%$ vs. $14.6{\pm}2.2%$, p=0.26), cardiac death ($11.2{\pm}2.6%$ vs. $6.8{\pm}1.52%$, p=0.39), re-infarction ($6.4{\pm}1.8%$ vs. $3.3{\pm}1.1%$, p=0.31), and stent thrombosis ($5.4{\pm}1.7%$ vs. $3.2{\pm}1.1%$, p=0.53) between the two groups, consecutively. The occurrences of TVR ($10.0{\pm}3.0%$ vs. $4.0{\pm}1.2%$, p=0.008) and MACE ($29.4{\pm}3.5%$ vs. $19.4{\pm}2.5%$, p=0.003) were significantly higher in patients treated with PES than SES. In AMI patients treated with either SES or PES implantation, SES had a significantly lower risk of TVR and MACE during 4-year clinical follow-up. Rates of death, cardiac death or recurrent infarction, and stent thrombosis were similar.

Mitral Valve Repair for Active and Healed Endocarditis (급성 혹은 치유된 심내막염 환자에서의 승모판막성형술)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Sae;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Kang, Chang-Hyun;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Wook-Sung;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.820-827
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    • 2003
  • Background: Mitral valve repair rather than replacement for mitral regurgitation (MR) offers a number of well-accepted benefits. However, the surgical results of repair for mitral valve endocarditis remain largely unknown. Material and Method: Fourteen patients who underwent mitral valve repair for MR caused by mitral valve endocarditis from April 1995 through October 2001 were reviewed retrospectively. There were 9 male patients and mean age was 32$\pm$10 years. Four patients had previous embolism and 2 had active infections. The grade of MR were III in 6 patients and IV in 8. Operatively, mitral annuloplasty was performed in 12 patients and various valvuloplasty techniques were applied in all patients. One patient had immediate valve replacement due to residual MR after weaning of cardiopulmonary bypass. Result: There was no early operative death. Early postoperative transthoracic echocardiography revealed no or grade I of MR and no or mild mitral stenosis in 13 patients. After the mean follow-up of 36 months, there was no late death, and no or grade I of MR in 11 patients (84.6%) and no or mild mitral stenosis in 12 patients (92.3%). Reoperation required in one patient (7.1%). The cumulative freedom from recurrent MR and valve-related reoperation at 5 years were 91$\pm$9% and 75$\pm$22%, respectively. Conclusion: This study suggests that mitral valve repair for mitral regurgitation caused by endocarditis offers good early and intermediate survival and functional improvement without reinfection, and it is an attractive alternative to valve replacement in selective patients with bacterial endocariditis.

Differential Diagnosis of Metastatic Bone Disease and Benign Bone Disease on Spine SPECT in Patients with Low Back Pain (요통 환자의 척추골 SPECT에서 골전이 병변과 양성골질환의 섭취 양상 분석을 통한 감별진단이 가능한가)

  • Lee, Seung-Hun;Choi, Yun-Young;Cho, Suk-Shin
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.371-377
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    • 2001
  • Purpose: One or more abnormal vertebrae detected on bone scintigraphy is a common finding in clinical practice, and it could pose a diagnostic dilemma especially in cancer patients. as either metastasis or benign disease may cause scintigraphic abnormality. The purpose of this study was to determine whether additional spine SPECT has a role in differentiating malignant from benign lesions in patients with back pain. Materials and Methods: We reviewed spine SPECT studios obtained over a three-year period in 108 patients. Among them, forty-five patients with abnormal SPECT and clinically followed records were evaluated (20 cancer patients were included). Uptake patterns were classified as follows: 1. Body: diffusely increased uptake, linear increased uptake of end plate, segmental increased uptake, and cold defect, 2. Posterior element: posterior to body (pedicle), posterior to Intervertebral disc space (facet joint), and spinous process. Lesions were correlated with radiological findings and with final diagnosis. Results: Sixty-nine bone lesions were detected on SFECT images, including 18 metastases, 28 degenerative diseases and 21 compression fractures. Cold defect (6) and segmental increased uptake (5) were dominant findings in metastasis; linear increased uptake (12), and facet joint uptake (15) were in degenerative change; and diffuse increased uptake (9), and linear increased uptake (9) were in compression fracture. Conclusion: Cold defect and segmental increased uptake of body were characteristic findings of metastasis, but care should be taken because compression fracture also shows segmental increased uptake in some cases. Degenerative disease was easily diagnosed because of the typical finding of linear increased uptake of end plate and facet joint. Therefore, additional bone SPECT after planar bone scan would be helpful for differentiating metastasis from benign condition in cancer patients.

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Chromosomal Aberrations Induced by in Vitro Irradiation of $^{131}I$ ($^{131}I$의 체외 방사선조사에 의한 염색체이상)

  • Kim, Eun-Sil;Kim, Myung-Seon;Seo, Doo-Seon;Jeong, Nae-In;Rho, Seung-Ik;Lee, Jae-Yong;Kim, Chong-Soon;Han, Seung-Soo;Kim, Hee-Geun;Kang, Duck-Won;Song, Myung-Jae
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.133-140
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    • 1994
  • Recently, there are many considerations and studies on biological effects of radiations in radiation workers, as well as in accidentally or therapeutically irradiated persons. The most practical and reliable method of dosimetry for radiation accidents is the scoring of gross chromosomal aberrations in human lymphocytes (Ydr) as a biological dosimetry. By the way, although usual doses of $^{131}I$ administered therapeutically for thyroid cancer are ranging from 100 mCi to 200 mCi, there are differences of absorbed doses and Ydr, ranging from 0.004 to 0.04, on equally administered $^{131}I$ due to variations in metabolic characteristics, stage of tumors and physical status of subjects. In this study, We exert to obtain the dose-response relationships of $^{131}I$, as a good guide to evaluating acute effects of accidental irradiations and radiation induced leukemia or solid tumor, by in vitro induction of chromosomal aberrations. we studied the relationship between radiation dose (D) and the frequency of chromosomal aberrations (Ydr) obserbed in peripheral lymphocytes that were irradiated in vitro with $^{131}I$ at doses ranging from 0.05 to 6.00 Gy. By scoring cells with unstable chromosomal aberrations (dicentric chromosomes and ring chromosomes) we obtained this linear-quadratic dose response equation Ydr=0.064351 $D^2$-0.13143 D+0.045684 This dose-response relationship may be useful for evaluating acute and chronic $^{131}I$ induced biological effects.

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Evaluate Utility of Thyroid Incidentaloma Discrimination by $^{18}F$-FDG PET/CT Delay Scan Images ($^{18}F$-FDG PET/CT검사에서 지연영상을 이용한 갑상선 우연종 감별의 유용성 평가)

  • Lee, Hyun-Kuk;Yang, Seoung-Oh;Song, Gi-Deok;Song, Chi-Ock;Lee, Gi-Heun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.184-191
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    • 2008
  • Purpose: To evaluate the degree of malignancy of incident thyroid lesion found in $^{18}F$-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods: A retrograde study was conducted of 800 patients who were admitted in E hospital to receive $^{18}F$-FDG PET/CT examination. One patient who was diagnosed as primary thyroid cancer and received $^{18}F$-FDG PET/CT examination was excluded. The number of final patients of this study was 799, the reasons of $^{18}F$-FDG PET/CT examination of these patients were follow-up of old cancer or suspicious tumorous lesion in 696 and disease screening in 103. $^{18}F$-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal $^{18}F$-FDG PET/CT image (1 hr) and then 1 hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid $^{18}F$-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1 hr later, we took a 1 bed-delayed image and then made a comparative study between measured $SUV_{max}$ of 1 hr-abnormal uptake image and that of 2 hr-delayed image. Results and Conclusion: In this $^{18}F$-FDG PET/CT study among the patients who showed incidental $^{18}F$-FDG thyroidal uptake the number of thyroid incidentaloma was 5 (0.63%), all of then showed benign findings. And in the case of incidental $^{18}F$-FDG uptake in thyroid, $SUV_{max}$ variance obtained from 2 hr delayed image can be a indirect criteria in differentiating benign tumor from malignancy and decrease finding error. In the cases found thyroid incidentaloma when 1) $SUV_{max}$ of focal thyroid lesion is above 5.0 and 2) $SUV_{max}$ variance between normal $^{18}F$-FDG PET/CT exam and 2 hr delayed is $1.0{\pm}0.5$, they are suspected as malignancy and confirming biopsy is to be followed. Otherwise, I also think that distinct follow-up PET or CT image study is a reasonable diagnostic method.

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Clinical Analysis of Pulmonary Hamartoma: 37 Cases (폐과오종 37예에 대한 임상 고찰)

  • Choi, Si-Young;Yoon, Jeong-Seob;Wang, Young-Pil;Park, Jae-Kil;Park, Chan-Beom;Sa, Young-Jo;Jeon, Hyun-Woo;Kang, Chul-Ung;Kim, Yong-Hwan
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.564-568
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    • 2007
  • Background: Pulmonary hamartomas are the most common form of pulmonary benign tumors, and they occur in approximately $2{\sim}5%$ of all pulmonary neoplasm. However, only a few reports have been published on the clinical characteristics of pulmonary hamartoma in Korea. Material and Method: The charts, X-rays and pathological specimens of 37 pulmonary hamartoma patients who were diagnosed by a pathological examination from January of 2000 to May of 2005 at the Catholic Medical Center were retrospectively reviewed. Result: The peak incidence of the tumor occurred in the seventh decade of life (32.4%), There were 23 men (62.6%) and 14 women (37.8%), with mean age of 55.6 years. Twenty-six patients (70.3%) were asymptomatic and 11 patients (29.7%) had symptoms. A total of 29 tumors (78.4%) were parenchymal, and 8 (21.6%) were endobronchial. Twenty cases (54.1%) were in the right lung and 17 cases (45.9%) were in the left lung. The right lower lobe was most commonly involved. Thirty-two (86.5%) hamartomas were diagnosed by surgical resection, 4 cases (10.8%) were diagnosed by bronchoscopic biopsy and 1 case (2.7%) was diagnosed by a fine needle aspiration biopsy. Thirty-four hamartomas (91.9%) were managed by surgical resection without complication. No recurrence or malignant changes were seen during the follow up period. Conclusion: Pulmonary hamartomas are most common in males during their fifth to seventh decade and they more commonly involve the right lung. No recurrence or malignant changes were seen during the follow up period.