• Title/Summary/Keyword: 임상특징

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Usefulness and Limitations of Fine Needle Aspiration Cytology in Adult Cervical Lymph Node Enlargement Patients: An analysis of 342 cases (성인 경부 림프절 비대 환자들에서 미세침 흡인 세포검사법의 유용성과 문제점: 342 증례의 분석)

  • Lee, Jaeho
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.18-28
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    • 2004
  • Background : Many diseases like lung cancer and tuberculosis can involve cervical lymph node. Fine needle aspiration cytology(FNAC) was known as a useful screening test for the evaluation of enlarged lymph node. But the usefulness and limitations of FNAC according to disease category or physical characteristics of lymph node were not yet fully established. Methods : Retrospective analysis of three hundred forty two adult patients who performed FNAC due to enlarged cervical lymph nodes at the Seoul Municipal Boramae Hospital during the period from January 1999 to December 2002 and final diagnosis could be made by surgical biopsy, microbiology or clinical observation. Results : Among the 342 cases, 176(51.5 %) were finally diagnosed as benign nature ncluding reactive hyperplasia, Kikuchi's disease and acute suppuration. Eighty eight(25.7 %) were diagnosed as tuberculous lymphadenitis, 66(19.3 %) as metastasis, and 12(3.5 %) as lymphoma. Tuberculosis, metastasis, and lymphoma all showed significantly larger diameter, longer duration of lymph node enlargement. There were higher frequency of supraclavicular involvement in the cases of tuberculosis and metastasis. The overall diagnostic sensitivity of FNAC was 88.0 %, and 88.6 % in benign nature lesion, 77.3 % in tuberculosis, 90.1% in metastasis and 58.3 % in lymphoma. The diagnosis of tuberculosis was made by FNAC in 68 cases (77.3 %) among 88 cases. Lung cancer(43.9 percent) was most frequent cause of cervical lymph node metastasis. Diagnostic sensitivity of FNAC was significantly lower in the supraclavicular than other cervical lymph node(80 % vs. 91.3 %) and not correlated with disease nature, node size or number. Conclusion : Though FNAC was a reliable screening test for enlarged cervical lymph node enlargement, the diagnostic sensitivity was low in the case of lymphoma or when the enlarged lymph node was located at the supraclavicular area.

Colon Interposition as a Gastric Substitute after Performing Gastrectomy in Patients with Gastric Cancer (위암 환자에서 위 절제술 후 결장 간치술)

  • Lee, Jun-Hyun;Hur, Hoon;Jeon, Hae-Myung;Kim, Wook
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.217-224
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    • 2008
  • Purpose: For most surgeons, colon interposition after gastrectomy remains an infrequently performed procedure because of its complexity. The aim of this study was to assess its technical feasibility and safety as a post-gastrectomy reconstruction method by reviewing our experience with colon interposition. Materials and Methods: From March 2001 to February 2002, 30 colon interpositions after-gastrectomy were done with using the ileo-ascending or transverse colon. We analyzed the clinicopathologic features and the surgical outcomes. Results: There were 16 males and 14 females in this study with a mean age of 67.5 years (range: 31 to 76 years). Twenty-five ascending colons and 5 transverse colons were used for the interposition, respectively. The mean operation time was 373 minutes (range: 204 to 600 minutes). There were 9 operative morbidities (30%) and 1 operative mortality. The restoration of bowel motility was noted at 3.8 postoperative days; a soft diet was started at 4.9 postoperative days and the duration of the hospital stay was 18.2 days. The percentage of weight loss in the patients with total, proximal and distal gastrectomy was 16.3%, 14.0% and 8.8%, respectively, at 6 months, and thereafter the weight loss gradually recovered as 8.1%, 7.5% and 5.6%, respectively, at 5 years postoperatively. Gastric stasis was the one of the most meaningful long-term complications, and especially in the patients who underwent distal gastrectomy with colon interposition. Conclusion: Colon interposition after gastrectomy was a very complex procedure with a long operating time and many anastomosis sites. The postoperative outcomes failed to achieve satisfactory weight gain and the patients displayed postprandial symptoms. This suggested that this procedure was not an appropriate procedure for conventional reconstruction after gastrectomy.

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Estimation of Microclimate by Site Types in Natural Deciduous Forest and Relation between Periodic Annual Increment of Diameter and the Microclimatic Estimates - A Case Study on the National Forest in Pyungchung, Kangwon Province - (천연 활엽수림의 입지 유형별 미기후 추정과 직경생장과의 관계 - 강원도 평창 지역 국유림을 중심으로 -)

  • 신만용;정상영;이돈구
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.3 no.1
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    • pp.44-54
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    • 2001
  • This study was conducted to estimate microclimate of natural deciduous forest in national forest of Pyungchang, Kangwon province and to investigate the effects of the microclimatic conditions on the periodic annual increment of diameter by site types. In this study, site was first classified by nine types considering both elevation (higher than 1,000 m, 700∼1,000 m, and lower than 700 m) and topographical conditions (ridge, slope and valley). For each of site types, diameter growth was measured by using increment borer and periodic annual increment of diameter was then analyzed. A topoclimatological technique, for estimating microclimatic conditions, which make use of empirical relationships between the topographical factor and the climatic normals in the study area was applied to produce monthly mean, maximum and minimum temperatures, relative humidity, precipitation and hours of sunshine. From these monthly estimtes, 17 weather variables such as warmth index, coldness index, index of aridity etc. which affect the diameter growth were computed for each of site types. The periodic annual increment of diameter was then correlated with and regressed on the 17 weather variables to examine effects of microclimatic conditions on the diameter growth by site types. From the correlation analysis, it was found that the diameter growth by site types was positively correlated with all of 17 weather variables except the warmth index. Especially, the conditions such as high relative humidity and large amount of sunshine hours provide favorable environment for the growth of diameter. On the other hand, it was also found that diameter growth was negatively iufluenced by warmth index. According to the regression analysis, the periodic annual increment of diameter could be well predicted by index of aridity and mean relative humidity for the growing season.

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Automated patient set-up using intensity based image registration in proton therapy (양성자 치료 시 Intensity 기반의 영상 정합을 이용한 환자 자동화 Set up 적용 방법)

  • Jang, Hoon;Kim, Ho Sik;Choe, Seung Oh;Kim, Eun Suk;Jeong, Jong Hyi;Ahn, Sang Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.97-105
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    • 2018
  • Purpose : Proton Therapy using Bragg-peak, because it has distinct characteristics in providing maximum dosage for tumor and minimal dosage for normal tissue, a medical imaging system that can quantify changes in patient position or treatment area is of paramount importance to the treatment of protons. The purpose of this research is to evaluate the usefulness of the algorithm by comparing the image matching through the set-up and in-house code through the existing dips program by producing a Matlab-based in-house registration code to determine the error value between dips and DRR to evaluate the accuracy of the existing treatment. Materials and Methods : Thirteen patients with brain tumors and head and neck cancer who received proton therapy were included in this study and used the DIPS Program System (Version 2.4.3, IBA, Belgium) for image comparison and the Eclipse Proton Planning System (Version 13.7, Varian, USA) for patient treatment planning. For Validation of the Registration method, a test image was artificially rotated and moved to match the existing image, and the initial set up image of DIPS program of existing set up process was image-matched with plan DRR, and the error value was obtained, and the usefulness of the algorithm was evaluated. Results : When the test image was moved 0.5, 1, and 10 cm in the left and right directions, the average error was 0.018 cm. When the test image was rotated counterclockwise by 1 and $10^{\circ}$, the error was $0.0011^{\circ}$. When the initial images of four patients were imaged, the mean error was 0.056, 0.044, and 0.053 cm in the order of x, y, and z, and 0.190 and $0.206^{\circ}$ in the order of rotation and pitch. When the final images of 13 patients were imaged, the mean differences were 0.062, 0.085, and 0.074 cm in the order of x, y, and z, and 0.120 cm as the vector value. Rotation and pitch were 0.171 and $0.174^{\circ}$, respectively. Conclusion : The Matlab-based In-house Registration code produced through this study showed accurate Image matching based on Intensity as well as the simple image as well as anatomical structure. Also, the Set-up error through the DIPS program of the existing treatment method showed a very slight difference, confirming the accuracy of the proton therapy. Future development of additional programs and future Intensity-based Matlab In-house code research will be necessary for future clinical applications.

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Differential Association of History of Premenstrual Syndrome/Premenstrual Dysphoric Disorder with Vasomotor Symptoms According to Menopausal Stage (폐경 단계에 따른 월경전 증후군/월경전 불쾌장애의 과거력과 혈관운동증상의 차별적 연관성)

  • Hyun, Hong-Dae;Joe, Sook-Haeng;Jeong, Hyun-Ghang;Ko, Young-Hoon;Kwon, Eunjoo;Kim, Hyekyeong;Ko, Seung-Duk
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.57-65
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    • 2015
  • Objectives:Within the normal reproductive cycles of women, dramatic fluctuations of sexual hormones occur in the premenstrual and menopausal periods. In both periods, women are vulnerable to mood disturbances and show several somatic complaints. Based on these common clinical profiles and physiological changes, a relationship between vasomotor symptoms and the premenstrual syndrome has been suggested. However, attempts to establish such a link have yielded inconclusive results. The purpose of this study was to investigate the association between histories of premenstrual syndrome and menopausal vasomotor symptoms within different menopausal stages. Methods:This cross-sectional study recruited Korean women aged 45-64 years who were perimenopausal and postmenopausal from 16 branch offices of the Korean Association of Health Promotion. All subjects completed self-report questionnaires that asked about a history of premenstrual syndromes, vasomotor symptoms, and several other variables. Results:A total of 1054 participants(361 perimenopausal women and 693 postmenopausal women) completed the study. Severity of premenstrual symptoms significantly correlated with postmenopausal vasomotor symptoms, only in late perimenopausal(r=0.213, p=0.010) and early postmenopausal women(r=0.246, p<0.001). After adjusting for several factors related to vasomotor symptoms, a history of premenstrual syndrome was a significant predictor of moderate to very severe vasomotor symptoms in late perimenopausal(OR=5.197, p=0.005) and early postmenopausal women(OR=3.017, p=0.010). Conclusions:This study suggests that a history of premenstrual syndrome/premenstrual dysphoric disorder is differentially associated with vasomotor symptoms in the menopausal stage. Prospective studies with larger population are needed to confirm these findings

Clinical Characteristics in Panic Disorder Patients in Emergency Department (공황발작으로 응급실에 내원한 공황장애 환자들의 임상 특징)

  • Lee, Chang-Ju;Nam, Beom-Woo;Sohn, In-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.26-33
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    • 2021
  • Objectives : This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack. Methods : A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher's exact test was used. Collected data was analyzed using R 4.03. Results : Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (𝛘2=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (𝛘2=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%. Conclusions : The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

A Study of Waterproofing Evaluation and Effect of UV Protection (UVB/UVA) of Multiple Emulsion Sunblock Cream using Sensory Engeeneering Science (감성공학을 적용한 다중에멀젼 선블록크림의 자외선차단(UVA/B) 효과와 내수성 평가 연구)

  • Kim, In-Young
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.6
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    • pp.1517-1527
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    • 2020
  • This study is about the UV protection effect and water resistance of a multiple emulsion (W/O/W) sunblock cream applied with emotional engineering and reports an actual industrial case. Multiple emulsion system of sunblock cream has the characteristics of changing to a W/O type that is soft and moist when applied, and has excellent water resistance after absorption. Multiple emulsion cream is a highly functional sunblock cream that has both moisture and water resistance. It is a stable milky white cream with a viscosity of 36,000 cps. The organic sunscreen used for the sunscreen was ethylhexylmethoxycinnamate and bisethylhexyloxyphenolmethoxyphenyltriazine. Hexagonal zinc oxide and titanium dioxide that block both UVB and UVA were used. As a result of measuring the UV protection effect by the in-vitro method, the UV protection effect (SPF) is 78.9 for multiple emulsion cream, 76.7 for W/O cream, and 71.3 for O/W cream. It was found that the blocking effect was different. This obtained the highest effect value in the multiple emulsion. As a clinical (in-vivo) result of the UV protection effect, the SPF value representing the UV protection effect of the sunblock cream developed with a multiple emulsion system was 85.7, and the PA-value that blocks the UVA area was 26.5, and ++++. It was found that it has a corresponding high blocking effect. As a result of the water resistance test, the W/O/W formulation had a high waterproofing resistance of 93.8% even after 4 hours, W/O had 75.4%, and O/W had a low water resistance of 25.3%. In the results of the HUT test, it was found in the order of multiple emulsion sun block cream > hydrophilic cream > lipophilic cream. Based on the research results of this multiple emulsion, it is expected to be highly active as a sunblock cream dedicated to outdoor activities by improving the feeling of use, UV protection index, and water resistance. Therefore, in this study, a multiple emulsion system of sunblock cream is developed and has a characteristic that changes to a W/O type that has a soft and moist feeling when applied, and has excellent water resistance after absorption.

A Study on the Radiographic Diagnosis of Caroli's Disease (카롤리병의 방사선학적 진단에 대한 고찰)

  • Yeo-jin Hong;Min-a Kim;Soo-bin Kim;Jin-joo Song;Kyoung-hoon Jang;Min-cheol Jeon;Man-Seok Han
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.385-392
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    • 2023
  • Caroli's disease is a fibrocystic liver disease. Autosomal recessive disorder is characterized by congenital multiple dilatation of the bile duct. Computerized tomography, magnetic resonance imaging, cholangiography and ultrasound are among the methods for diagnosing caroli disease. Computerized tomography is essential for detecting and distinguishing fibroplastic liver disease and is useful for determining intrahepatic bile duct dilatation. However, awareness of the possible side effects of using contrast mediums is necessary. A typical method of magnetic resonance cholangiography is used for magnetic resonance imaging. A non-invasive examination can reduce the pain of the patient, and the anatomical structure of the bile pancreatic duct and the presence or absence of lesions can be easily and quickly observed. Biliary contrast is an effective diagnostic method that can directly visualize various cystic dilatations throughout the enlarged bile duct. However, since this procedure is also an invasive procedure, it is recommended not for diagnosis but for treatment purposes. Ultrasonography can confirm similar findings to computerized tomography. The hepatic artery root is difficult to prove with conventional grayscale ultrasound. However, it is of clinical value in that it can not only describe dilated bile ducts with vascular roots in the tube but also easily identify color Doppler signals in the tube. With the development of video diagnostics, early diagnosis has become possible through computerized tomography, magnetic resonance imaging, cholangiography, and ultrasound. In order to further contribute to the development of video diagnostics so that long-term prognosis can be improved after treatment through early diagnosis, we examined what aspects of each test's caroli disease appear.

CT Follow-Up of Postoperative Bronchopleural Fistula: Risk Factors for Progression to Chronic Complicated Infection (수술 후 기관지 흉막루의 전산화단층촬영 추적 검사: 만성 복합성 감염 진행의 위험인자 분석)

  • Ji-Yeon Han;Ki-Nam Lee;Yoo Sang Yoon;Jihyun Lee;Hongyeul Lee;Seok Jin Choi;Hye Jung Choo;Jin Wook Baek;Young Jin Heo;Gi Won Shin;Jinyoung Park;Dasom Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.128-138
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    • 2021
  • Purpose We evaluated the risk factors for progression to chronic complicated bronchopleural fistula (BPF) after pulmonary resection using follow-up CT. Materials and Methods We retrospectively reviewed 45 cases with BPF that had undergone pulmonary resection during 2010-2018. We compared the clinical and radiological characteristics of those with complicated BPF (n = 24) and those without complicated (sterilized) BPF (n = 21). The clinical and radiological risk factors for progression to chronic complicated BPF were examined by logistic regression analysis. Results The thickness of the pleural cavity wall (p = 0.022), the size of the pleural cavity (p = 0.029), and the size increase of BPF on follow-up (p = 0.012) were significantly different between the two groups. The risk factors for progression to chronic complicated BPF were age > 70 years (odds ratio, 6.43; 95% confidence interval, 1.2-33.7), the thickness of the cavity wall > 5 mm (odds ratio, 52.5; 95% confidence interval, 5.1-545.4), and an increase in the size of the pleural cavity on follow-up CT (odds ratio, 12.5; 95% confidence interval, 2.1-73.5), only in the univariate analysis. Conclusion The risk factors for progression to chronic complicated BPF can be evaluated using follow-up CT.

CT Evaluation of Long-Term Changes in Common Bile Duct Diameter after Cholecystectomy (담낭 절제술 후 총담관 직경의 장기 변화에 대한 CT 평가)

  • Sung Hee Ahn;Chansik An;Seung-seob Kim;Sumi Park
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.581-595
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    • 2024
  • Purpose The present study aimed to investigate the frequency and extent of compensatory common bile duct (CBD) dilatation after cholecystectomy, assess the time between cholecystectomy and CBD dilatation, and identify potentially useful CT findings suggestive of obstructive CBD dilatation. Materials and Methods This retrospective study included 121 patients without biliary obstruction who underwent multiple CT scans before and after cholecystectomy at a single center between 2009 and 2011. The maximum short-axis diameters of the CBD and intrahepatic duct (IHD) were measured on each CT scan. In addition, the clinical and CT findings of 11 patients who were initially excluded from the study because of CBD stones or periampullary tumors were examined to identify distinguishing features between obstructive and non-obstructive CBD dilatation after cholecystectomy. Results The mean (standard deviation) short-axis maximum CBD diameter of 121 patients was 5.6 (± 1.9) mm in the axial plane before cholecystectomy but increased to 7.9 (± 2.6) mm after cholecystectomy (p < 0.001). Of the 106 patients with a pre-cholecystectomy axial CBD diameter of < 8 mm, 39 (36.8%) showed CBD dilatation of ≥ 8 mm after cholecystectomy. Six of the 17 patients with long-term (> 2 years) serial follow-up CT scans (35.3%) eventually showed a significant (> 1.5-fold) increase in the axial CBD diameter, all within two years after cholecystectomy. Of the 121 patients without obstruction or related symptoms, only one patient (0.1%) showed IHD dilatation > 3 mm after cholecystectomy. In contrast, all 11 patients with CBD obstruction had abdominal pain and abnormal laboratory indices, and 81.8% (9/11) had significant dilatation of the IHD and CBD. Conclusion Compensatory non-obstructive CBD dilatation commonly occurs after cholecystectomy to a similar extent as obstructive dilatation. However, the presence of relevant symptoms, significant IHD dilatation, or further CBD dilatation 2-3 years after cholecystectomy should raise suspicion of CBD obstruction.