• Title/Summary/Keyword: 평균절단수

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Clinical Outcome of Treatment for Stage IIA, IIB and III Osteosarcomas (Comparative Studies between Invasive Surgical Treatment and Non-invasive HIFU Technique) (진행된 장관골 골육종의 수술 및 비수술적 강력 집속 초음파 치료의 장기 추적 결과)

  • Wenzhi, Chen;Wei, Wang;Zhibiao, Wang;Hui, Zhu;Kequan, Li;Hao, Piao Xiang;Haibing, Su;Chengbing, Jin;Feng, Wu;Jin, Bai;Rhee, Seung-Koo;Kang, Yong-Koo;Bahk, Won-Jong;Chung, Yang-Guk;Huh, Sung-Woo;Lee, Eun-Sang
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.37-46
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    • 2006
  • Purpose: To evaluate the end results between the surgical treatment with neo-adjuvant chemotherapy in Korea and non-invasive high intensity focused ultrasound (HIFU) technique in China for osteogenic sarcomas. Materials and Methods: The surgical treatment with neoadjuvant chemotherapy for total 67 cases (4 IIA, 58 IIB, and 5 III) in Korea since 1993 and the HIFU therapy for total 71 cases (57 II and 14 III) in China since 1997 was performed. In Korea, neo-adjuvant chemotherapy in 66 cases out of total 67 patients, but the adjuvant chemotherapy in only one case was done. On the contrary, in China, full chemotherapy for more than 9 times for 37 patients with stage II out of total 71 cases, but for less than 8 times of partial chemotherapy for 23 patients (stage II) and 14 patients (stage III) was done. The surgical treatment in total 67 Korean patients was done with wide resection and reconstruction for 56 patients, but wide resection without reconstruction for 5 patients and amputation for 6 patients. In china, total 71 patients was treated with average 1.5 times (1~4 times) of HIFU, and if there are some evidences of residual tumor after HIFU with following MRI, the second HIFU therapy was given 2~4 weeks later. After then, the bony defect was in no touch, keep bracing for long time expecting regeneration. All of them were followed for average 46 Mo (12~150 Mo) in Korea, but followed for average 22 Mo (9 years~8 months) in China. Results: The 5 year survival rate (stage II), was average 92.7% (IIA 100%, IIB 85.5%) in Korea series, and average 78.7% (full chemotherapy 91.8%, part chemotherapy 56.6%) in China series. The 3 year survival rate (stage III) was 20% in Korea and 7.1% in China. So, the final overall survival rate was 65.2% in Korea and 51.8% in China. The overall functional outcome score by ISOLS was 24.3 (81%) in Korea and 19.8 (73%) in China. There are 25.4% (17/67 cases) of complications in Korea and 31% (27 complications in 22 patients out of total 71 cases) in China after each treatment. Conclusions: The end results of Korea series which was treated with neoadjuvant chemo- and surgical methods are better than that of non-invasive thermal ablation in china. But we also believe the HIFU, as one of, was also effective to decrease the local recurrence and symptomatic releaf for stage II or even in III of osteogenic sarcomas.

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The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

Secondary Chondrosarcoma Arising from Osteochondroma(tosis) (골연골종(증)에서 발생한 속발성 연골육종)

  • Cho, Hyun-Min;Rhee, Seung-Koo;Kang, Yong-Koo;Chung, Yang-Guk;Lee, An-Hi;Park, Jung-Mi;Bahk, Won-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.21-26
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    • 2010
  • Purpose: To analyze clinical, radiological and pathological features as well as clinical outcome after surgical treatment of patients with secondary chondrosarcoma arising from osteochondroma(tosis). Materials and Methods: We retrospectively reviewed clinical records, radiographs, pathologic slides of 14 patients. Nine patients were male and fi ve were female. The mean age was 34 years. The mean follow-up period was 54 months. Results: All patients had a history of previous mass since childhood or puberty. Preexisted osteochondroma was single in 3 patients and multiple in 10. Remaining 1 patient had multiple osteochondromatosis with enchondromatosis. MRI clearly provided thickness of cartilage cap, which was over 2 cm except in 2 cases. Chondrosarcoma was grade 1 in all except 1 case, which was grade 2. Wide excision was performed in 10 patients, marginal excision in 3 and amputation in 1. Twelve patients were doing very well without evidence of disease. Among 3 patients with marginal excision, 1 patient had local recurrence and 1 patient died of disease. Conclusion: Comprehensive understanding of clinical, radiological and pathological features of secondary chondro sarcoma is warranted for accurate diagnosis. The best result can be expected with early recognition of malignant change of osteohcondroma(tosis) and wide excision.

Differences in Grip Strength by Living Conditions and Living Area among Men and Women in Middle and Later Life (독거여부와 거주지역에 따른 중년기와 노년기 남성과 여성의 악력 차이)

  • Joo, Susanna;Jun, Hey Jung;Park, Hayoung
    • 한국노년학
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    • v.38 no.3
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    • pp.551-567
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    • 2018
  • Demographic and socio-structural information is useful to identify potential welfare recipients who are in need of disease-prevention and intervention services. Thus, the present study aims to explore the differences in grip strength among middle and old-aged adults by living conditions and by living area. The 5th wave data of Korean Longitudinal Study of Aging was utilized. The dependent variable was grip strength, and the independent variables were living alone (living alone or not) and living area (city or non-city). Covariates were age, education, log-transformed household income, spouse existence, body mass index, self-rated health conditions, depressive symptoms, cognitive function, smoking, regular exercise, frequency of meeting with friends, and the number of social participation. Regression analysis was performed for middle-aged men, middle-aged women, old-aged men, and old-aged women, respectively. ANOVA and Chi-test were additionally used to specifically discuss significant results. Cross-sectional weight was applied to all analyses. According to the results, living alone and living area did not have significant effects on grip strength among middle-aged men, old-aged men, and old-aged women. In middle-aged women, however, living alone and living area were significantly associated with grip strength. To be specific, middle-aged women who lived alone in rural areas had the lowest grip strength compared to other middle-aged women. Additional analysis showed that middle-aged women who lived alone in rural areas had risk factors, such as low education level, low income, or high depressive symptoms. It implies that middle-aged women living alone in rural areas may have physical health risks, so they might be in need of disease prevention. This study is meaningful in that it can provide reliable information on the latent welfare recipients by using representative panel data and applying weight values.

Removal of Dissolved Organic Matter by Ozone-biological Activated Carbon process (오존처리와 생물활성탄 공정에 의한 상수원수 중의 용존유기물 제거)

  • 이상훈;문순식;신종철;최광근;심상준;박대원;이진원
    • KSBB Journal
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    • v.18 no.3
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    • pp.211-216
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    • 2003
  • The removal yield of dissolved organic matter in drinking water by biological activated carbon (BAC) process was investigated. The tested processes wer raw water-AC process (BAC1), raw water-ozonation-BAC process (BAC2), and raw water-ozonation-coagulation/sedimentation-BAC process (BAC3). The amounts of organic matter was measured as dissolved organic carbon (DOC), ulta-violet radiation at 254 nm wavelength ($UV_{254}$), total nitrogen (T-N), ammonia nitrogen (NH_3$-N), and total phosphate (T-P). As a results, 30.7% DOC was removed by BAC2 process, which showed higher removal efficiency than BAC1 or BAC3 processes. The removal yield of $UV_{254}$ in BAC1, BAC2, and BAC3 processes were observed as 45.3%, 44.6%, 58.4%, respectively. And the removal yield of ammonia nitrogen were 66%, 81%, 29% in each BAC processes. The optimal empty bed contact time (EBCT) of BAC processes was estimated as 10 minute. This study has shown that BAC process combined with ozone treatment was efficient for removing dissolved organic matter in water.

EVALUATION OF THE INFLUENCE OF APICAL SIZES ON THE APICAL SEALING ABILITY OF THE MODIFIED CONTINUOUS WAVE TECHNIQUE (Modified Continuous Wave Technique을 이용한 근관충전시 형성된 치근단 크기가 치근단 폐쇄에 미치는 영향)

  • Ryu, Mu-Hyun;Jung, Il-Young;Lee, Seung-Jong;Shin, Su-Jung;Kim, Eui-Seong
    • Restorative Dentistry and Endodontics
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    • v.33 no.1
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    • pp.66-75
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    • 2008
  • This study examined the influence of the apical sizes on the sealing ability of a root canal filling. Thirty-six single rooted teeth with a single canal were divided into 3 groups (n = 12) and instrumented with either the $Profile^{(R)}$ or $LightSpeed^{(R)}$ system to achieve three different apical sizes (master apical file [MAF] of #25, #40, or #60). The teeth were filled with gutta perch a using a modified continuous wave technique. The level of microleakage was determined by immersing ten teeth from each group into India ink for 1 week followed by clearing with nitric acid, ethyl-alcohol, and methylsalicylate. The microleakage was measured using vernier calipers. The data was analyzed statistically using Kruskal-Wallis one-way ANOVA and a Student-Newman-Keuls Method. Two teeth from each group were sectioned horizontally at 1, 2, 3 and 4 mm from the apex in order to observe a cross section. The apical size was significantly (p < .05) influenced the level of microleakage. In the Student-Newman-Deuls Method, MAF sizes of #25 and #40; and MAF sizes of #25 and #60, respectively showed a statistically significant difference. There was no significant difference between #40 and #60. In most cross sections, oval-shaped canals were observed, and the irregularity of the internal surface increased with decreasing apical size. There was also an increase in the area of recess, which is the area where the canal space is not filled with either gutta-percha or sealer. When the root canals are filled using a modified continuous wave technique, canal filling with more consistent and predictable outcome may be expected as the apical preparation size is increased.

Outcome of Patch Angioplasty for Left Main Coronary Ostial Stenosis (좌주관상동맥 개구부 협착에서의 혈관성형술의 결과)

  • Kang, Chang-Hyun;Na, Chan-Young;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Baek, Man-Jong;Oh, Sam-Se;Kim, Woong-Han;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.56-63
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    • 2004
  • Background: Patch angioplasty is an alternative surgical procedure to coronary artery bypass grafting (CABG) for left main coronary ostial stenosis. The purpose of this study is to evaluate the outcome of patch angioplasty by analyzing the short-term and long-term results. Material and Method: Twenty nine patients who had undergone patch angioplasty due to left main coronary ostial stenosis between July 1991 and May 2003 were enrolled in the study. The mean age of the patients was 53.1 $\pm$12.5 years. There were 8 males and 21 females, and there were 12 female patients who had no risk factor for atherosclerosis. Twenty six (89.7%) patients showed isolated coronary ostial stenosis without any distal coronary lesion. Result: Anterior approach was used in 28 patients and superior approach was used in one patient. Transsection of the main pulmonary artery was used in one patient. Concomitant CABG was performed in 4 patients because of left anterior descending artery lesions in 3 patients and unstable postoperative hemodynamic status in one patient. Hospital mortality had occurred in one patient (3.4%) and late mortality also in one patient, therefore the overall 5 year survival rate was 91.2$\pm$6.1%. Seventeen coronary angiographies were done in 13 patients (44.8%) postoperatively. Two distal patch stenoses, 1 proximal patch stenosis, and 1 new right coronary ostial lesion were identified and 3 percutaneous interventions and 1 CABG were performed during the follow-up period. The overall 5 year freedom from reintervention rate was 82.4 $\pm$ 8.5%. Aortic regurgitation less than grade 1 had developed postoperatively in 4 patients and one patient showed progression of preexisting aortic regurgitation from grade II to III. Conclusion: Patch angioplasty in left main coronary ostial lesion showed acceptable short-term and long-term results in this study. However, restenosis at the patch anastomosis site and aortic regurgitation should be carefully investigated during the follow-up period.

Study of Value Estimation of Environmental Education of Gyeongnam Forest Museum using CVM (CVM을 이용한 경상남도산림박물관의 환경교육 가치추정 연구)

  • Kang, Kee-Rae;Ha, Sung-Gyone;Kim, Hee-Chae;Lim, Yeon-Jin;Kim, Dong-Pil;Park, Chang-Kun
    • Journal of Korean Society of Forest Science
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    • v.105 no.1
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    • pp.149-156
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    • 2016
  • Forest museums can be defined as facilities for the collection, exhibition, and education of the forest or forest related artifacts or data. This study was performed to measure the educational value of Gyeongnam state forest museum's forest and its environment. The tool used was the Contingent Valuation Methods (CVM) which is well known as a value estimation tool of environmental goods. The study for the value estimation is performed from April, 2014 to October of the same year through selection of the subject, decision of proposed price, and orientation of the survey staffs and total of 386 surveys were used in analysis. The value estimation tool used the DBDC logit model and the input parameters were number of visit (time), degree of environmental education (contri), the environment conservation effort of the respondent (execu), the education level of the respondent (edu), and income of the respondent (inc) and trimmed mean (WTPtruncated) was used. The estimated value of flora and environment education per each person per visit is 23,338 won. When applied to the average annual visitors deducted from 2010 to 2014, which is 430,000 per year, the environmental value that Gyeongnam state forest museum is providing to visitors each year is about 10 billion won. The result of this study is significant to propose the value of forest education and environment that the forest museum is offering to the visitors in the current currency. This is an evidence to directly determine the value of the forest museum and therefore proposing an opportunity change the recognition toward the forest and environment education.

Vertical Distribution of Heavy Metal Concentrations in Sediment Cores and Sedimentation Rate Using $^{210}Pb$ Dating Technique in the Juam Reservoir (주암댐 호저 퇴적물에서의 수직적 중금속 분산과 $^{210}Pb$를 이용한 퇴적속도산정)

  • Lee Pyeong-Koo;Youm Seung-Jun;Yeon Gyu Hun;Chi Se-Jung;Kim Ji-Wook;Oh Chang-Whan;Kim Sun-Ok
    • Journal of Soil and Groundwater Environment
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    • v.10 no.1
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    • pp.43-57
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    • 2005
  • Twelve bottom sediments and three cores were collected in Juam reservoir for a study on transportation, which was controlled by particle grain size (2mm-200{\mu}m,\;200-100{\mu}m,\;100-50{\mu}m,\;50-20{\mu}m,\;<20{\mu}m), and vertical distribution of heavy metals. Sediment cores were sliced into 2 to 5 cm intervals to measure heavy metal concentrations in interstitial water and sediments with depth. Pb isotopic compositions of core samples were determined to calculate sedimentation rate. Regardless of sampling sites, levels of heavy metals and trace elements in bottom sediments are nearly constant with mean values of $14.9\;{\mu}g/g\;for\;As,\;0.81{\mu}g/g\;for\;Cd,\;30.7{\mu}g/g\;for\;Cu,\;34.7{\mu}g/g\;for\;Ni,\;63.3{\mu}g/g\;for\;Pb\;and\;87.9{\mu}g/g\;for\;Zn$. In general, Cu, Pb, Zn, Wi, and Cr in fraction of $<20{\mu}m$ exhibit the highest concentration, but content of As is the highest in grain size of $2\;mm-200\;{\mu}m$ and $200-100\;{\mu}m$. Fe and Mn occur as the dissolved compositions of the highest concentrations in interstitial waters and increase in their concentrations toward lower part of cores. On the contrary, concentrations of Zn and Cu show the highest value in the uppermost part in cores, suggesting these elements are released from reductive dissolution of hydroxides and oxidation of organic matters under different redox conditions. The highest accumulations of Cu, Ni, Pb, and Zn contents in the sediment cores are observed at 0-4 cm layers, and concentrations of Cu and Pb are especially high, implying these heavy metals are originated from anthropogenic sources. The apparent sedimentation rate estimated using unsupported $^{210}Pb$ is 0.91 cm $year^{-1}$, corresponding about 10 cm sedimentation in total depth since construction of Juam dam. These results will provide available information for management of bottom sediment in Juam reservoir.

The Role of Intra-Aortic Balloon Pump in Coronary Artery Bypass Surgery (관상동맥 우회술에서의 대동맥내 풍선 펌프의 역할)

  • 박성식;김기봉
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.282-286
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    • 1997
  • In the era of coronary artery bypass grafting, the intraaortic balloon pump (IABP) is more widely used and its indication has been ex anded. We perf'orbed retrospective clinical analysis on the patients who have received IABP pre andfor postoperatively during the course of CABG. From January 1981 to June 1995, total 322 patients have received CABG at the Seoul National University Hospital and among them 50 patients (15.5%) were supported by IABP during the course of the operation. The mean age at the time. of the operation was 57.2 years (39∼ 75 years) and the male to female ratio was 33 : 17. The preoperative diagnosis was unstable angina in 33 (66%), stable angina in 7 (14%) and postinfarct angina in 8 patients(16%). As for the indications of the IABP, there were 13 cases(26%) with left main disease, 13 (26%) with class IV angina, 12 (24%) with difficulty in CPB weaning, 6 (12%) with postinfarct angina and 3 (6%) with severe LV dysfunction. In the remaining 3 cases, one patient was operated on after PTCA failure in emergency basis, another was a patient with AMI, and the other was one who had postoperative low c rdiac output syndrome. All IABPS were introduced via femoral artery and among them 45 cases (90%) percutaneously. The mean postoperative assist time was 22.3 hours (0.5 ∼ 168 hours) and IABP could be removed within 48 hours in most of them (44150). The operative mortality was 6.1% (3 cases) and postoperative morbidity was only one with lower extremity ischemia. The more general application of the IABP during the course of the CABG ,especially in patients with high preoperative risk factors or difficulty in CPB weaning is a good measure of protecting and recovering myocardial function with minimal risk.

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