A clinical study of 71 cases of pulmonary tuberculosis that had had surgical resection during the period of 7 years and 6months from January 1989 to June 1996 in National Masan Tuberculosis Hospital. The results were as follows. 1. The ratio of male to female was 3.7:1 and in the age incidence the fourth decade was 22%, the third decade 15%. Although medical treatment was performed for more than 3 to 6 months, preoHeratively the conversion failure rate of positive sputum to negative state was 66.2%(47 cases). Of the failure cases, multiple-drug-resistant(MDR) patients were 41 cases(87.2%), 3. In MDR group, preoperatively conversion failure rate was 71.9%. 4. From the view of indica ion for lung resection on the radiographic finding, cavitary lesions were 43 cases(60.6%), destroyed lung lesions were 24 cases(33.8%). 5. The incidence of postoperative complication was 28.2%(20 cases). All cases were MDR 6. group and the most common of complication was tuberculosis spreading. In bilateral lesion, incidence of postoperative tuberculosis spreading was 25%(7 cases). Of the 7 cases, there was the cavitary lesion in 6 cases(86.7%). Total conversion rate of AFB positive sputum to negative state related to resectional sugery was 76.6% and in MDR group conversion rate of AFB positive sputum to negative state was 73.2% Conversion rate of MDR group with bilateral lesion was the lowest(60%). Conversion rate of drug-sensitivity group was 100% regardeless of lesions Slt to. In conclusion, despite of long-standing medical treatment, it is difficult to converse sputum-positive to negative state in multiple-drug resistance patients and that increases postoperative complications su h as tuberculosis relapse as a lack of appropriate drugs postoperatively. Postoperative conversion rate of sputum-positive to negative state was decreased in multiple-drug resistance patients. Because multiple-drug resistance patients have inireased due to several factors in Korea, it is important to prevent spreading of multiple-drug resistnce patients through the aggressive operative treatment. When the first medical therapy is fail or drug-resistance is found, operative treatment should be considered with the secondary medical therapy. The operation should be aggressively attempted even though at first medical treatment if indicated.
Background : Primary adenoid cystic carcinoma arising in the bronchus is an uncommon disease that is histologically and ultrastructurally identical to the salivary gland tumor of the same name and regarded as a slow growing low-grade malignancy. We examined its clinical characteristics. Method : We collected 13 Korean cases of primary adenoid cystic carcinoma arising in the bronchus including 5 cases of our own and 8 cases from the literature. Result : The patients ages ranged from 20 to 74. Men numbered 9 and women 4. The presenting symptoms were cough, dyspnea, and hemoptysis. The fiberoptic bronchoscopic findings were primarily hypervascular polypoid mass with a smooth surface that obstructed airway totally or near totally. There were three inoperable cases including two cases with distant metastasis to bone or cervical lymph node and one case with mediastinal invasion. The remaining 10 patients underwent surgical resection. Among them, two patients received postoperative radiotherapy. The median survival was 21 months in the 8 surgical and evaluable cases. One patient lived 13 years without recurrence. The prognosis was relatively favorable in operable cases. Conclusion : It was not common for primary adenoid cystic carcinoma arising in the bronchus to have distant metastasis or invasion to the mediastinum on presentation. The prognosis was relatively favorable in operable cases. It would be important to perform flexible bronchoscopy for early diagnosis and to do surgical treatment if possible.
Purposes : This study reports the possible causes of seizure recurrence in patients underwent previous epilepsy surgery, and surgical strategy for resection of the additional epileptogenic zone locating at the distant area to the site of first resection. Methods : A total of 10 patients with previous surgery due to intractable epilepsy were studied. Five of these underwent standard temporal lobectomy, four extratemporal resection, and one corticoamygdalectomy. Seizure outcome of these were class III-IV. Evaluation methods for reoperation included MRI, 3D-surface rendering of MRI, PET, prologned video-EEG recording with surface electrodes and subdural grid electrodes. Additional resection was done in the frontal lobe in two, in the temporal lobe in three, in the parietal lobe in two, and in the supplementary sensori-motor area in two. Tumor in the superior frontal gyrus in the left hemisphere was removed in one patient. Extent of resection was decided based on the results of ictal subdural grid EEGs and MRI findings. Awake anesthesia and electrocortical stimulation were performed in the two patients for defining the eloquent area. Results : Histopathologic findings revealed extratemporal cortical dysplasia in six, hippocampal sclerosis and cortical dysplasia of the temporal neocortex in one, neuronal gliosis in two, and meningioma in one. Previous pathology of the five patients with cortical dysplasia in the second operation was hippocampal sclerosis plus cortical dysplasia of the temporal neocortex. After reoperation, seizure outcomes were class I in six, class II in three, class III in one at the mean follow-up period of 17.5 months. Characteristically, patients in class II-III after reoperation showed histopathologic findings of hippocampal sclerosis plus temporal neocortical cortical dysplasia plus extratemporal cortical dysplasia. Conclusions : Seizure recurrence after epilepsy surgery was related with the presence of an additional epileptogenic zone distant to the site of first operation, and the majority of the histopathology of the surgical specimens was cortical dysplasia. In particular, hippocampal sclerosis plus temporal neocortical cortical dysplasia was highly related with seizure recurrence in patients with previous operation. In these patients, multimodal evaluation methods were necessary in defining the additional epileptogenic zone.
Kim, Jun-Hwan;Hong, Yeon-Jung;Kim, Bumseok;Kim, Yunhye;Park, Jin-Ho;Chung, Tae-Ho;Park, Chul
Journal of Veterinary Clinics
/
v.30
no.6
/
pp.482-485
/
2013
This case report describes the increment of regulatory T cells in thyroid carcinoma of a mixed breed dog compared with normal dogs. A mixed breed dog was referred for a submandibular mass and hyperthermia. Right cervical mass was detected during the physical examination and radiography identified right cervical mass suspected thyroid gland. Accurate location and size of mass was confirmed using computed tomography and 3D reconstructed images. After confirmation of mass, surgical resection was performed and evaluation of regulatory T cells in blood of this patient was performed using flow cytometric assay. The percentage of regulatory T cells was 38.28% of all CD4 (+)/CD25 (+) T cells. This result was higher than median percentage of regulatory T cells of healthy 8 beagles ($7.66{\pm}1.65%$ (p<0.01) of all CD4 (+)/CD25 (+) T cells). And masses were confirmed as giant cell thyroid carcinoma based on histopathologic examination. After surgical resection of cervical mass was performed, the owner didn't want chemotherapy. Seven days later, cervical mass came out again. And CBC showed severe leukocytosis (WBC $47.6{\times}10^3/{\mu}L$) and non-regenerative anemia (PCV 21%). Suspected pulmonic metastasis regions became more severe. Finally the dog died of severe anemia and respiratory disorder.
Journal of the Korea Academia-Industrial cooperation Society
/
v.15
no.1
/
pp.274-282
/
2014
This study aimed to investigate the general characteristics of patients with acute cerebral infarction, the characteristics of its treatment and its correlation with stroke rating scale and to analyze the factors that affect patient's quality of life. The subject of this study was 576 patients who survived more than a year after they were diagnosed with cerebral infarction that occurred within 7 days and discharged from a study center. Their quality of life was investigated through phone interview. The average age of subjects was $65.8{\pm}12.4$ years old and male subjects took up 62% among all subjects. The mean of quality of life showed $0.77{\pm}0.29$. There was statistically significant difference in factors such as gender, age, hypertension, atrial fibrillation, stroke history and smoking. The result of multiple regression analysis showed the quality of life was lower in females than in males and it was significantly low in older subjects or those with stroke history. Also high stroke scale was related to significantly low quality of life. As such, hospitalized patients due to stroke should receive appropriate intervention during the hospitalization and after their discharge and the development of program is required to prevent relapse.
The purpose of this study was to examine the perception of cyber community participants on reconciliation of divorced couple and find reasons for pros and cons concerning reconciliation after divorce. The data were collected through searching for website or Internet cafe related to 'reconciliation after divorce' on Internet. The contents of 7 cases for asking for advice on reuniting and opinions of cyber community participants on them were analyzed. Cyber community participants expressed their approval of divorced couple's reuniting for following reasons: 'strong motive for reunion', 'sexual relation with ex-partner', 'parental responsibility', 'regarding reconciliation as a better choice than remarriage', 'regarding as a good choice for child' etc. But cyber community members were opposed to divorced couple's reuniting for following reasons: 'doubt about real intention to reuniting', 'no self-reflection on previous marriage and ex-spouse', 'concern for recurrence of former marital conflict', 'reuniting only for child not for couple', 'no prior settlement of former marital conflict', 'no forgiveness and tolerance for ex-spouse', 'no reflection and change', 'no effort on ex-spouse's side' etc. Though these results were restrictive, this study identified issues surrounding reconciliation after divorce through asking and giving advices by anonymous members on cyberspace. These findings implied that we should take more interest in reconciliation as an realistic alternative marriage pattern after divorce and consider what is important to successful reuniting after divorce.
Ji, Eun-Hye;Lee, Hyo-seol;Choi, Hyung-Jun;Kim, Seong-Oh;Choi, Byung-Jai;Son, Heung-Kyu;Lee, Jae-Ho
The Journal of Korea Assosiation for Disability and Oral Health
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v.8
no.1
/
pp.10-14
/
2012
Self-injurious behavior (SIB) has been defined as the deliberate destruction or alteration of body tissue without conscious suicidal intent. It occurs in conjunction with a variety of psychiatric disorders as well as various developmental disabilities and some syndromes. The behavior is destructive and causes concern and distress to all involved in the care and treatment of the affected individual. A 13-year-old girl with autism, mental retardation and delayed development was reffered from her pediatrician because of severe and painful lower lip biting. An intraoral examination revealed a diffuse swelling of lower lip. It was covered with necrotic slough and the ulcer and scarring of the lower lip was observed. We chose to use an oral removable prosthesis for Conservative treatment. It was decided to use a soft silicone mouthguard in the maxillary arch. Initially, she could not tolerate the appliance inside her mouth but soon adapted with the appliance. After one month, she lost the mouth guard and started lip biting. So we made mouth guard again. There are no standard methods for preventing self-injurious behavior in a patient who is developmentally disabled. Appropriate preventive methods must be developed for each individual patient based on close observation and clinical findings. Behavior modification techniques, pharmacological treatment, extraction of teeth, orthognathic surgery and intra/extra oral appliances can be performed for adjust self-injurious behavior. A suitable oral guard could be tried initially before employing more invasive approaches.
Lee, Chan Hee;Choi, Suck Won;Suh, Mancheol;Chae, Sang Jeong
Journal of Conservation Science
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v.9
no.1
/
pp.21-32
/
2000
Rock composition of the Hwangsang-dong Granite Standing Sculptured Buddha (Treasure No. 1122) in the Kumi City is biotite-hornblende granodiorite which consists of about 30 pieces of individual rock blocks of same compositions. However, the cap rocks is pebble-bearing coarse sandstone. Rock blocks of the Standing Buddha and surrounding out crops occur well developed several joint systems of $N25^{\circ}$ to $45^{\circ}W$ strike and nearly vertical (70 to $85^{\circ}SE$) dipping. Rock blocks of the Standing Buddha showed vertical, horizontal and oblique joints, and those blocks are well supported by individual blocks. However, the junction part of the blocks are under dangerous situation due 10 seriously mechanical and chemical weathering. Host rock of the Standing Buddha belongs to the HW grade, therefore mostly rock-forming minerals of the granodiorite Standing Buddha altered with clay and iron hydroxide minerals by mineralogical and chemical weathering. Near surface of the Standing Buddha show spore and mycelium of green algaes, and a joint plane alive with weeds. We suggest that if structural stability for the Standing Buddha remove essentially a unstable rock blocks from the main body, and the main body necessitate supporting by rock bolting method because of repeated unstability and minimizing stress to the rock blocks. For the opened joint planes, fractured surface and alive weeds will attempt to fill in a petro-epoxy, petro-filler and biochemical treatments for the algaes, and ground water curtain and wall seems to be necessary for water flow and diminishing humidity of the Standing Buddha.
Journal of the korean academy of Pediatric Dentistry
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v.39
no.3
/
pp.301-305
/
2012
The odontoma is a hamartoma of odontogenic origin and consists of enamel, dentin, cementum and pulp tissue. Two types of odonotma are histologically recognized: complex and compound. Odontoma may be the cause of noneruptoin or impaction of teeth, formation of cyst and resorption of adjacent bone. The recommended treatment for an odontoma is conservative surgical excision. No propensity for recurrence has been noted. Peripheral odontoma is relatively rare lesion and shows the histological characteristics of an intraosseous odontoma. This report described a 3-year-old Korean girl with a firm gingival mass in the posterior mandibular area, which had been gradually enlarging over 18months. Radiographic examination showed a radiopaque mass but no evidence of underlying intraosseous lesion. Excisional biopsy was performed for the mass removal and histopathological examination. The result of histopathological study was identified as hamartous supernumerary tooth germ. Based on the clinical presentation, radiographic and histopathologic findings, we concluded that the final diagnosis was peripheral odontoma. For three years after surgery, there is no clinical sign of recurrence.
Numb chin syndrome is a rare clinical manifestation, characterized by focal sensory loss and paresthesia of the chin. It is more often associated with cancer than with benign disorders, and can be the first manifestation of a cancer. A 60-year-old man presented with focal numbness of right chin and gingiva for 10 days. Chest computed tomograghy showed a 3 cm sized mass on the distal left main- stem bronchus. Squamous cell carcinoma was diagnosed on bronchoscopic biopsy. However, bony metastasis of mandible was not evident on reontgenogram, CT scan, bone scintigram and positron emission tomography. Despite the chemotherapy with three cycles of paclitaxel and cisplatinum, the cancer was progressed and pain on the right chin was developed 4 months later. Bone scintigram showed multiple bony metastasis including mandible. Here we report this case with a brief review of the appropriate literature.
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