• Title/Summary/Keyword: 임상적 관찰

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The Role of Radiotherapy in Patients with Brain Metastasis (고형암의 뇌전이시 방사선치료 효과)

  • Lee Soon Nam;Choo Mi-Soon;Lee Kyung-Ja;Nam Eunmi
    • Radiation Oncology Journal
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    • v.17 no.4
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    • pp.281-286
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    • 1999
  • Purpose : Brain metastases are the most frequent metastatic neurologic complication of systemic cancer. Even if the prognosis of brain metastases is grave, with available treatments, most patients experience effective palliation of neurologic symptoms and meaningful extension of life. We evaluated the clinical features and prognostic factors of the patients who were diagnosed as solid tumors with brain metastasis and received radiotherapy for brain metastases. Materials and Methods: Between January 1987 and January 1998, 71 patients with brain metastases from solid malignancy were included. We reviewed neurologic symptoms and signs of patients and evaluated improvememt of neurologic symptoms and signs. Survival durations after brain metastasis were ana lysed according to several factors such as age, performance status, primary malignancies, the pre-sence of brain metastasis at initial diagnosis of primary tumor, multiplicity of brain metastass, the presence of metastases other than brain, and treatment method. Results: Frequent symptoms associated with brain metastasis were headache (47.9$\%$), motor weakness (40.8$\%$), nausea and vomiting (19.7$\%$) and mental change (19.7%). Palliation of these symptoms was accomplished in 64.9$\%$ of cases. The overall median survival time was 16 weeks and 1- and 2-year survival rates were 15.0$\%$ and 5.1$\%$ respectively. Patients without extracranial metastases (n=27) had longer median survival than patients with extracranial metastases (33 weeks vs 10 weeks, p=0.0018). In patients with single brain metastasis (n=37), the median survival time was longer in patients treated with surgery plus radiotherapy than in patients treated with radiotherapy alone (40 weeks vs 16 weeks, p=0.0438). Conclusion: Patients who has brain metastases only constitute a prognostically favorable group and they may be benefited from radiotherapy and surgery if indicated.

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Laparoscopy-assisted Total Gastrectomy for Advanced Upper Gastric Cancer - Comparison with Open Total Gastrectomy - (진행위암의 복강경 보조 위 전절제술 - 개복 위 전절제술과의 후향적 비교 -)

  • Lee, Jun Hyun;Nam, Yoo Hee;Hur, Hoon;Jeon, Hae Myung;Kim, Wook
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.141-147
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    • 2008
  • Purpose: The aim of this study was to compare the short-term operative outcomes of laparoscopy-assisted total gastrectomy (LATG) with those of open total gastrectomy (OTG) for patients suffering with advanced upper gastric cancer. Materials and Methods: Of the 47 patients who underwent LATG with $D1+{\beta}$ or D2 lymphadenectomy from July 2004 to March 2008, 29 patients with pathologically proven advanced gastric cancer were compared with 35 patients who underwent conventional OTG during the same time period. The comparison was based on the clinicopathological characteristics, the surgical outcome, the follow-up survival and tumor recurrence. Results: The patients' age, gender and body mass index were similar between the two groups. However, there were statistically differences in tumor size ($9.2{\pm}3.9$ vs $6.1{\pm}3.6cm$, P=0.002) and the proximal resected margin ($2.1{\pm}2.0$ vs $3.6{\pm}2.1cm$ P=0.004). There was no significant difference in most of the peri- and post-operative courses such as the time to first flatus, the time to starting a solid diet and the length of the hospital stay, except for a longer operating time (289.0 vs. 361.3 minutes, P<0.001) in the LATG group. The complication rate was higher in the LATG group (13.8%) than that in the OTG group (5.7%). The mean overall survival and disease free survival times were 32 and 31 months, and 24 and 28 months, respectively, with an average 18.8 months follow-up duration. The main recurrent sites were peritoneum and lymph node in both groups. Conclusion: The early results of the current study suggest that LATG for AGC is technically feasible and it does not show any inferiorities of the postoperative outcomes as compared to those of conventional open total gastrectomy.

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The comparison of inflammatory mediator expression in gingival tissues from human chronic periodontitis patients with and without type 2 diabetes mellitus (단순 만성 치주염 환자 및 2형 당뇨병환자의 만성 치주염 치은조직에서 염증성 매개인자의 발현 양상 비교)

  • Joo, Sang-Don;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.37 no.sup2
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    • pp.353-369
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    • 2007
  • Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was divided into three groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2 (n=8) is inflamed gingiva from patients with chronic periodontitis. Group 3 (n=8) is inflamed gingiva from patients with chronic periodontitis associated with type 2 diabetes. Tissue samples were prepared and analyzed by Western blotting. The quantification of $IL-1{\beta}$, MMP-13 and TIMP-1 were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. 1. The expressions of MMP-13 and TIMP-1 showed increasing tendency in group 2 & 3 compared to group 1. 2. The expressions of $IL-1{\beta}$ & MMP-13 were showed increasing tendency in group 3 compared to group 2. 3. As $IL-1{\beta}$ levels were increasing, MMP-13 showed increasing tendency in group 3, and although $IL-1{\beta}$ , MMP-13 levels were increasing, TIMP-1 levels were similar expressed comparing to group 2. In conclusion, this study demonstrated that the expression levels of MMP-13 and TIMP-1 had increasing tendency in inflamed tissue. It can be assumed that $IL-1{\beta}$ and MMP-13 may be partly involved in the progression of periodontal inflammation associated to type 2 DM.

The National Survey of Breast Cancer Treatment Pattern in Korea (1998): The Use of Breast-Conserving Treatment (1998년도 우리나라 유방암 치료 현황 조사: 유방보존술 적용 실태를 중심으로)

  • Shin Hyun Soo;Lee Hyung Sik;Chang Sei Kyung;Chung Eun JE;Kim Jin Hee;Oh Yoon Kyung;Chun Mi Sun;Huh Seung Jae;Loh Jun Kyu;Suh Chang-Ok
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.184-191
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    • 2004
  • Purpose: In order to improve the proper use of radiotherapy and breast-conserving treatment (BCT) in the management of breast cancer, current status of breast cancer treatment in Korea was surveyed nationwide and the use of BCT were evaluated. Materials and Methods: Patients characteristics and treatment pattern of 1048 breast cancer patients from 27 institutions diagnosed between January, 1998 and June, 1998 were analyzed. The incidence of receiving BCT was analyzed according to the stage, age, geography, type of hospital, and the availability of radiotherapy facility. Results: Radical mastectomy was peformed in 64.8$\%$ of total patients and 26$\%$ of patients received breast- conserving surgery (BCS). The proportions of patients receiving BCT were 47.5$\%$ in stage 0, 54.4$\%$ in stage I, and 20.3$\%$ in stage II, Some of the patients (6.6$\%$ of stage I, 10.1$\%$ of stage II and 66.7$\%$ of stage III) not received radiotherapy after BCS. Only 45$\%$ of stage III patients received post-operative radiotherapy after radical mastectomy. The proportion of patients receiving BCT was different according to the geography and availability of radiotherapy facilities. Conclusion: Radiotherapy was not fully used in the management of breast cancer, even in the patients received breast-conserving surgery. The proportion of the patients who received BCT was lower than the report of western countries. To improve the application of proper management of breast cancer, every efforts such as a training of physicians, public education, and improving accessibility of radiotherapy facilities should be done. The factors predicting receipt of BCT were accessibility of radiotherapy facility and geography. Also, periodic survey like current research is warranted.

Imaging of Herpes Simplex Virus Type 1 Thymidine Kinase Gene Expression with Radiolabeled 5-(2-iodovinyl)-2'-deoxyuridine (IVDU) in liver by Hydrodynamic-based Procedure (Hydrodynamic-based Procedure를 이용한 간에서의 HSV1-tk 발현 확인을 위한 방사표지 5-(2-iodovinyl)-2'-deoxyuridine (IVDU)의 영상연구)

  • Song, In-Ho;Lee, Tae-Sup;Kang, Joo-Hyun;Lee, Yong-Jin;Kim, Kwang-Il;An, Gwang-Il;Chung, Wee-Sup;Cheon, Gi-Jeong;Choi, Chang-Woon;Lim, Sang-Moo
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.5
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    • pp.468-477
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    • 2009
  • Purpose: Hydrodynamic-based procedure is a simple and effective gene delivery method to lead a high gene expression in liver tissue. Non-invasive imaging reporter gene system has been used widely with herpes simplex virus type 1 thymidine kinase (HSV1-tk) and its various substrates. In the present study, we investigated to image the expression of HSV1-tk gene with 5-(2-iodovinyD-2'-deoxyuridine (IVDU) in mouse liver by the hydrodynamicbased procedure. Materials and Methods: HSV1-tk or enhanced green fluorescence protein (EGFP) encoded plasmid DNA was transferred into the mouse liver by hydrodynaminc injection. At 24 h post-injection, RT-PCR, biodistribution, fluorescence imaging, nuclear imaging and digital wholebody autoradiography (DWBA) were performed to confirm transferred gene expression. Results: In RT-PCR assay using mRNA from the mouse liver, specific bands of HSV1-tk and EGFP gene were observed in HSV1-tk and EGFP expressing plasmid injected mouse, respectively. Higher uptake of radiolabeled IVDU was exhibited in liver of HSV1-tk gene transferred mouse by biodistribution study. In fluorescence imaging, the liver showed specific fluorescence signal in EGFP gene transferred mouse. Gamma-camera image and DWBA results showed that radiolabeled IVDU was accumulated in the liver of HSV1-tk gene transferred mouse. Conclusion: In this study, hydrodynamic-based procedure was effective in liver-specific gene delivery and it could be quantified with molecular imaging methods. Therefore, co-expression of HSV1-tk reporter gene and target gene by hydrodynamic-based procedure is expected to be a useful method for the evaluation of the target gene expression level with radiolabeled IVDU.

A Study on distribution of Dry Eye and Diagnosis Methods (건성안의 분포와 진단 방법에 대한 연구)

  • Ryu, Geun Chang;Park, Hyun Ju;Kim, Jae Min;Lee, Seung A;Ra, Myung Suk
    • Journal of Korean Ophthalmic Optics Society
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    • v.5 no.2
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    • pp.91-98
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    • 2000
  • To investigate the distribution of dry eye and to accept diagnosis methods of dry eye in ophthalmic shop, this study was performed on 81 persons(male : 49, female : 32). 1. We divided two group for diagnosing dry eye by dry eye screening questionnaire : one was dry eye symptom group(49.3%) and the other was non-dry eye symptom group(50.7%). 2. Non-invasive break-up time(NIBUT) which was measured by using Tear $scope^{(R)}$ (Killer. co)was longer than invasive break-up time(IBUT). 3. A blink rate in dry eye symptom group(10%) was measured lesser than 10 cycle/min, in non-dry eye symptom group(14.9%). 4. In shirmer test there were lesser than 10mm/5min in dry eye symptom group(67.5%), in non-dry eye symptom group(39%). 5. Cornea and conjunctival staining by rose bengal represented Mild 25%, medium 36.25%, extreme 38.75% in dry eye symptom group. Non-dry eye symptom group was showed Mild 19.51%, medium 14.63%, extreme 12.19%. 6. These results showed that the patient showed dry eye symptom in 3 items of eye examination was 22.5%, 4 items 25%, 5 items 30%, 6 items 15%.

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Quality Changes during Storage of Kochujang Treated with Heat and High Hydrostatic Pressure (열과 초고압으로 처리한 고추장의 저장 중 품질 변화)

  • 임상빈;김봉오;김수현;목철균;박영서
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.30 no.4
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    • pp.611-616
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    • 2001
  • Effects of high pressure and thermal pasteurization on the survival of microorganisms and quality changes of kochujang during 120 days of storage at 37$^{\circ}C$ were investigated. Viable cell counts were 1.43$\times$10$^{6}$ CFU/g in heat-treated, and 1.56$\times$10$^3$ CFU/g in pressure-treated, and decreased up to 3 log cycle, compared with 3.78$\times$10$^{6}$ CFU/g in the untreated kochujang. Viable cell counts decreased by the storage period at 37$^{\circ}C$. Viable cell counts decreased up to 2 log cycle from 3.78$\times$10$^{6}$ to 5.43$\times$10$^4$ CFU/g in the untreated kochujang, 4 log cycle from 1.43$\times$10$^{6}$ to 3.10$\times$10$^2$ CFU/g in heat-treated after 120 days of storage, while those in pressure-treated were not detected after 90 days from the initial stage of 1.56$\times$10$^3$ CFU/g. pH decreased significantly by the storage time. Titratable acidity increased significantly during storage, and pressure-treated kochujang showed lower values than heat-treated. Amino nitrogen content decreased significantly during storage, and pressure-treated kochujang showed higher values than heat-treated and lower values than the untreated. There were no significant changes in reducing sugar and ethanol content regardless of the treatment condition and the storage period. Hunter L, a and b values decreased significantly during storage. In the untreated kochujang, the changes in color accelerated compared with heat and pressure-treated.

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The Combined Therapy of Inhaled Nitric Oxide and Prone Positioning Has an Additive Effect on Gas Exchange and Oxygen Transport in Patients with Acute Respiratory Distress Syndrome (급성호흡곤란증후군 환자에서 복와위(prone position)와 산화질소흡입(nitric oxide inhalation) 병용 치료의 효과)

  • Koh, Youn-Suck;Lim, Chae-Man;Lee, Ki-Man;Chin, Jae-Yong;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1223-1235
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    • 1998
  • Background and Objective : Although prone positioning has been reported to improve gas exchange, prone positioning alone does not seem to be sufficient to increase systemic oxygen transport in an acute lung injury. The objective of this study was to investigate whether the combined therapy of low dose nitric oxide (NO) inhalation and prone positioning has an additive effect on the oxygenation and hemodynamics in patients with severe ARDS. Patients and Methods : Twelve patients with ARDS were included. Prone positioning alone, later combined with nitric oxide inhalation (5~10 ppm) from the supine position (baseline) were performed with serial measurement of gas exchange, respiratory mechanics and hemodynamic at sequential time points. The patient was regarded as a responder to prone positioning if an increase in $PaO_2/FiO_2$ of more than 20 mm Hg at 30 min or 120 min intervals after prone positioning was observed compared to that of the baseline. The same criterion was applied during nitric oxide inhalation. Results : Eight patients (66.5%) responded to prone positioning and ten patients (83.3%) including the eight just mentioned responded to the addition of NO inhalation. The $AaDO_2$ level also decreased promptly with the combination of prone positioning and NO inhalation compared to that of prone positioning alone ($191{\pm}109$ mm Hg vs. $256{\pm}137$ mm Hg, P<0.05). Hemodynamic parameters and lung compliance did not change significantly during prone positioning only. Following the addition of NO inhalation to prone positioning, the mean pulmonary artery pressure and pulmonary artery occlusion pressure decreased and cardiac output, stroke volume and oxygen delivery increased (P < 0.05) compared to those of prone 120 min. Conclusion : These findings indicate that NO inhalation would provide additional improvement in oxygenation and oxygen transport to mechanically ventilated patients with ARDS who are in a prone position.

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Results of Surgical Treatment of Patella Dislocation (슬개골 탈구의 수술적 치료 결과)

  • Kim, Hui Taek;Cho, Yoon Jae
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.134-141
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    • 2021
  • Purpose: Patellar dislocations have a range of causes. This study examined the results of treatment aimed at balancing soft tissues around the patella. Materials and Methods: Thirty-two patellar dislocations in 28 patients (21 females and seven males) were examined. The mean patient age at the time of surgery was 11.5 years, and the mean follow-up period was 4.6 years. Dislocations were 19 chronic, six habitual, six congenital, and one acute. Soft tissue balancing surgery included lateral capsular release, medial capsular plication, and inferolateral transfer of the vastus medialis obliquus. Medial transfer of the patellar tendon, partial strip of the rectus femoris and patella tendon, and distal femoral osteotomy were also performed selectively. The preoperative Q angle, femoral anteversion angle, tibial external rotation angle, tibial tubercle-trochlear groove distance (TT-TG distance), mechanical femoral-tibial angle, and femoral trochlear dysplasia according to Dejour were measured, and the pre- and postoperative Lysholm-Tegner scores were used to analyze the clinical results. Results: The mean preoperative Q angle, TT-TG distance, femoral anteversion angle, tibial external rotation angle, mechanical femoraltibia angle, and Lysholm-Tegner score were 9.3°, 15.5 mm, 25.6°, 30.4°, 3.0°, and 75.8, respectively. Eleven patients had systemic ligament laxity with a Beighton score of five or more. Twenty-two patients had femoral trochlear dysplasia: four type A (3 patients), 16 type B (15 patients), one type C (1 patient), and four type D (3 patients). Of the 32 cases, 28 were corrected successfully by the first operation. Of four cases of postoperative subluxation, three were corrected by the second operation, and one of them was corrected after a third operation. The last patient is currently being followed-up. The mean Lysholm-Tegner score improved to 85.6 after the operation. Conclusion: Correcting all the causes of patella dislocation simultaneously is difficult. Nevertheless, satisfactory outcomes were obtained with soft tissue balancing surgery around the patella and a corrective osteotomy for an abnormal mechanical axis of the femur-tibia and torsion.

The Changes of Plasma Catecholamines Concentration during Waking and Sleep in Obstructive Sleep Apnea Syndrome Patients with Systemic Hypertension (전신성 고혈압을 동반한 폐쇄성 수면 무호흡증후군 환자에서 각성시와 수면중의 혈장 Catecholamines 농도 변화)

  • Moon, Hwa Sik;Lo, Dae Guen;Choi, Young Mee;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.600-612
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    • 1996
  • Background : Recent studies deported that untreated patients with obstructive sleep apnea syndrome had high long-term mortality rates, and cardiovascular complications of these patients clad a major effect on mortality. Several data indicates that obstructive sheep apnea syndrome contributes to the development of diurnal systemic hypertension. But the pathophysiological mechanism of the development of systemic hypertension in these patients is still uncertain. This study was performed to evaluate the possible role of sympathetic nervous system activity for the development of systemic hypertension in patients with obstructive sleep apnea syndrome. Method : 35 patients with obstructive sleep apnea syndrome(OSAS) and 13 Control subjects(control) were included in this study. 21 patients of OSAS were normotensives(OSAS-NBP), and 14 patients of OSAS were hypertensives(OSAS-HBP). Full night polysomnography was undertaken to all subjects. We measured plasma norepinephrine(NE) and epinephrine(EP) concentrations during waking and sleep, using high performance liquid chromatography, in all patients and control subjects. Results : In OSAS, OSAS-NBP and control, plasma NE and EP concentrations during sleep were lowed than during waking(p<0.01). But, in OSAS-HBP, these was no difference between during waking and sleep. Plasma NE concentrations during sleep of OSAS, OSAS-NBP and OSAS-HBP were higher than Control(p<0.05). In OSAS-HBP, daytime systolic blood pressure correlated with plasma NE concentration during sleep(r=0.7415, p<0.01), arid correlated inversely with mean arterial oxygen saturation(r=-0.6465, p<0.05) or arterial oxygen saturation nadir(r=-0.6) 14, p<0.05) during sleep. Conclusion : The sympathetic activity during sleep of obstructive sleep apnea syndrome patients was higher than control subjects. In obstructive sleep apnea syndrome patients with systemic hypertension, there was no diurnal variation of sympathetic activity, and there was correlation between daytime systolic blood pressure and sympathetic activity during sleep. These data suggests that chronic hyperactivity of sympathetic nervous system may contribute to the development of diurnal systemic hypertension in patients with obstructive sleep apnea syndrome.

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