• Title/Summary/Keyword: 5 year survival rate

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Clinical Experiences of Congenital Aortic Stenosis (선천성 대동맥 판막협착증의 임상 경험)

  • Jeong, Dong-Seop;Ra, Yong-Joon;Lee, Jeong-Ryul;Kim, Yong-Jin;Lee, Chang-Ha;Lee, Cheul;Lim, Hong-Gook;Hwang, Seong-Wook;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.17-24
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    • 2007
  • Background: The aim of this study is to assess the clinical results of various procedures in congenital aortic stenosis. Material and Method: From August 1987 to June 2004, 53 patients of congenital aortic stenosis underwent procedures such as percutaneous balloon valvuloplasty, aortic valvuloplasty, Ross procedure, and aortic valve replacement. The mean age of initial procedures was $8.2{\pm}6.0$ years. Percutaneous balloon valvuloplasty was peformed in sixteen patients, aortic valvulopiasty in thirty two patients, Ross procedure in nineteen patients, and aortic valve replacement in fourteen patients. The mean follow duration was $80.6{\pm}60\;(0{\sim}207)$ months. Result: There was 15.1% (8/53) of early mortality and no late mortality. The six patients with critical aortic stenosis were died of left ventricular dysfunction in early series (before 1 year; 4 cases) and two patients died after the Ross procedure and aortic valve replacement respectively. After percutaneous balloon valvuloplasty, most patients needed reoperations (14/16). Thirteen patients needed reoperation, after aortic valvuloplasty. After Ross procedure, two patients needed reoperation due to aortic regurgitation caused by progressive aortic root dilatation. The actuarial survival rate after Ross procedure at 7 years was 90.5%. Conclusion: In young children before the age of one, percutaneous balloon valvuloplasty was considered as :he safe initial palliative procedure. But children over one year-old, aortic valvuloplasty were the effective procedure. Ross procedure can be preformed safely with good results.

Prediction of Changes in Habitat Distribution of the Alfalfa Weevil (Hypera postica) Using RCP Climate Change Scenarios (RCP 기후변화 시나리오 따른 알팔파바구미(Hypera postica)의 서식지 분포 변화 예측)

  • Kim, Mi-Jeong;Lee, Heejo;Ban, Yeong-Gyu;Lee, Soo-Dong;Kim, Dong Eon
    • Korean journal of applied entomology
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    • v.57 no.3
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    • pp.127-135
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    • 2018
  • Climate change can affect variables related to the life cycle of insects, including growth, development, survival, reproduction and distribution. As it encourages alien insects to rapidly spread and settle, climate change is regarded as one of the direct causes of decreased biodiversity because it disturbed ecosystems and reduces the population of native species. Hypera postica caused a great deal of damage in the southern provinces of Korea after it was first identified on Jeju lsland in the 1990s. In recent years, the number of individuals moving to estivation sites has concerned scientists due to the crop damage and national proliferation. In this study, we examine how climate change could affect inhabitation of H. postica. The MaxEnt model was applied to estimate potential distributions of H. postica using future climate change scenarios, namely, representative concentration pathway (RCP) 4.5 and RCP 8.5. As variables of the model, this study used six bio-climates (bio3, bio6, bio10, bio12, bio14, and bio16) in consideration of the ecological characteristics of 66 areas where inhabitation of H. postica was confirmed from 2015 to 2017, and in consideration of the interrelation between prediction variables. The fitness of the model was measured at a considered potentially useful level of 0.765 on average, and the warmest quarter has a high contribution rate of 60-70%. Prediction models (RCP 4.5 and RCP 8.5) results for the year 2050 and 2070 indicated that H. postica habitats are projected to expand across the Korean peninsula due to increasing temperatures.

Clinical findings of severe amniotic fluid aspiration pneumonia and effects of surfactant replacement therapy (중증 양수 흡인성 폐렴의 임상양상 및 폐표면 활성제 보충요법의 효과)

  • Park, Sang Woo;Kim, Chun-Soo;Lee, Sang-Lak;Kwon, Tae-Chan
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.429-434
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    • 2009
  • Purpose : Severe aspiration of the amniotic fluid is known to cause fatal respiratory distress in neonates. We conducted this study to investigate the clinical findings of severe amniotic fluid aspiration pneumonia (AFAP) in neonates and the effect of pulmonary surfactant replacement therapy (SRT). Methods : Retrospective analysis of medical records was conducted on 28 patients who received ventilator care due to severe AFAP in a neonatal intensive care unit over a 7-year period (2000-2006). Patients whose amniotic fluid was contaminated with meconium were excluded. Results : A large number of cases were term infants (82.1%) and infants born by caesarean section (85.7%), and the 1- and 5-min Apgar scores of these patients were $6.5{\pm}1.2$ and $7.5{\pm}1.3$, respectively. Soon after birth, the amount of amniotic fluid sucked out from airway below the vocal cord was $16.0{\pm}10.1$ mL. All patients received SRT with a modified bovine-derived surfactant (120 mg/kg/dose), and one dose was administered in most cases (75%). Compared with pre-SRT, the oxygenation index ($8.0{\pm}9.6$ vs. $18.9{\pm}7.3$) according to ventilator care was a significant improvement at 12 h after SRT (P<0.001). Furthermore, most cases showed radiological improvement for aeration at 12 h post-treatment. Many cases (46.4%) had cardiorespiratory complications, but their final outcomes were excellent (survival rate, 96.4%). Conclusion : AFAP may be an important cause of serious respiratory distress in near-term and term infants, and SRT seems to be an effective adjuvant therapy in mechanically ventilated neonates with severe AFAP.

Chronic Dialysis in Infants and Children Under 2 Years of Age (2세 미만 만성 신부전 환아에서의 만성 투석)

  • Sohn, Young-Bae;Nam, Sook-Hyun;Kwak, Min-Jung;Kim, Su-Jin;Jin, Dong-Kyu;Paik, Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.41-50
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    • 2007
  • Purpose : Dialysis in children with chronic renal failure presents with many difficulies. The purpose of this study is to find an improved method in chronic dialysis in infants and children less than 2 years of age by analyzing the experience with 10 cases. Methods : A retrospective review of the medical records of 10 patients(6 boys and 4 girls) was conducted. The patients had chronic renal failure and underwent chronic dialysis at Samsung medical center from March 1999 to February 2007. Results : At Initiation of dialysis, the median age was 3 months old(22 days-20 months), the median body weight was 3.75 kg(2.2-10.3 kg), and the median serum creatinine level was 4.3 mg/dL(2.0-11.4 mg/dL). The median duration of dialysis was 29.5 months(3-62 months). Dysplastic kidney disease was the most common underlying renal disease. Two patients were treated with hemodialysis, 4 patients with peritoneal dialysis, and 4 patients eventually switched dialysis modality. Nine of the 10 patients took erythropoietin and anti-hypertensive drugs. At the end of the follow up period, 1 patient received kidney transplantation, 2 patients died due to sepsis, and 5 patients were treated with peritoneal dialysis. Two patients were lost to follow up. The most common complication of dialysis was infection. Achieving vascular access and maintaining proper catheter function were the most important factors in treating patients with hemodialysis. The growth status of patients was aggravated after 6 month of dialysis but improved after 1 year of dialysis. Patients showed better growth on peritoneal dialysis than hemodialysis. Conclusion : Chronic dialysis can be performed successfully in infants and children under 2 years of age. Vascular access was the main limitation of hemodialysis, and infection was the common problem in both hemodialysis and peritoneal dialysis. To improve the patients survival rate and quality of life, major efforts should be directed toward the prevention of infection and preservation of catheter function. (J Korean Soc Pediatr Nephrol 2007;11:41-50)

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MR Imaging Findings of Uterine Cervical Adenocarcinoma (자궁경부 선암종의 자기공명영상 소견)

  • 김종철
    • Investigative Magnetic Resonance Imaging
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    • v.2 no.1
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    • pp.113-119
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    • 1998
  • Purpose : Because adenocarcinomas of the uterine cervix have lower 5-year survival rate than squamous cell carcinomas due to early lymph node metastasis and local extension, scrutiny of lymph node metastasis and local extension by radiologic examination is necessary in case of clinically diagnosed or suspected adenocarcinomas. The purpose of this study is to evaluate whether there are specific findings of these tumors, compared with squamous cell carcinomas, through the analysis of magnetic resonance (MR) imaging findings. Materials and Methods : Of 21 pathologically proven cervical adenocarcinomas, MR imaging findings of 18 tumors (histologic staging : two Ib, four IIa, two IIb, one IIIa, and one IIIb) were retrospectively analyzed and compared with those of 40 wquamous cell carcinoma in consecutive patients as a control group. T1-wetighted and fast spin echo T2-weighted images were obtained on the axial and sagittal planes, using a 1.5-T MR scanner. The largest diameter, location, signal intensity and degree of contrast enhancement contour, shape and longitudinal extent of the tumor and associated findings on MR image were analyzed. Results : The largest diameters of cervical adenocarcinomas ranged from 0.8 to 4.1 cm(mean, 2.2 cm). Of 18 adenocarcinomas, nine were of endocervical type. All adenocarcinomas were isointense to surrounding cervical stroma on T1-weighted images and hyperintense(homogeneous in ten, inhomogeneous in eight) on fast spin echo T2-weighted images. Adenocarcinomas enhanced on contrast study in all patients (homogeneous in six, inhomogeneous in 12 with hyperintese enhnacing rim in two). Eight adenocarcinomas had smooth contours and ten had irregular ones. The shape of adenocarcinoma was irregular in eight patients, barrel shape in six, papillary/polypod in three, and nodular in one. All adenocarcinomas involved lower half of the uterine cervix and six tumors extended up to the upper half. Pelvic lymph nodes of more than 1.5cm in diameter in two adenocarcinomas pateints and no detectable small pelvic lymph nodes on MR imaging in one patient were pathologically positive. Hydrometra was associated in two adenocarcinomas patients, and hematometra in one patient. Compared with squamous cell carcinomas, more frequent MR findings of endocervical type and barrel shape in cervical adenocarcinomas were statistically significant. Conclusion : Cervical adenocarcinomas had more frequent MR findings of endocervical type and barrel shape, compared with wquamous cell carcinomas. Adenocarcinoma of the uterine cervix may be suspected on MR imaging, when a cervical carcinoma is of barrel shape along the endocervical canal and tends to involve lymth nodes in earlier stages.

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Safety and Efficacy of Gemcitabine Based Chemotherapy in Elderly Patients with Advanced Pancreatic Cancer - Safety of Gemcitabine in Elderly (진행성 췌장암을 가진 노인환자에서 Gemcitabine 항암화학요법의 안정성과 효과 - 노인에서 Gemcitabine의 안정성 -)

  • You Ie Choi;Dong Uk Kim;Jae Hoon Cheong;Bong Eun Lee;Gwang Ha Kim;Geun Am Song
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.36-42
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    • 2013
  • Background/Aims: Gemcitabine is regarded as a reference regimen for advanced pancreatic cancer and shows relatively safe toxicity profiles compared with other cytotoxic agents. However, many oncologists are appeared to be still reluctant to treat elderly pancreatic cancer patients with cytotoxic chemotherapy because of predicted low response rate and potential adverse events. Methods: All patients who were received gemcitabine based chemotherapy between 2007 and 2010 were identified and clinical, laboratory, radiographic data were retrospectively reviewed. Patients were divided into two groups based on their ages: less than 65, and equal or more than 65 years old. Gemcitabine, at a dose of 1,000 mg per square meter of body surface area, was administered by intravenously over 30 minutes weekly for 3 weeks followed by 1 week rest, alone or along with other chemotherapeutic agents including cisplatin, capecitabine and erlotinib. Results: A total of 61 patients were identified and all patients were not eligible to receive operation because of advanced stage at diagnosis. Twenty three patients (37.7%) were equal or more than 65 year of age. Mean age was 56 years old and 71 years old in each group. Laboratory data including CA 19-9 were not significantly different. More gemcitabine monotherapy was delivered (56.5% vs. 26.3%, p=0.029) and less second or third line therapy was adminis- tered (17.4% vs. 50.0%, p=0.014) in elderly group. Cholangitis occurred and stent placement were performed similarly in both groups. Conclusion: Gemcitabine based chemotherapy can be administered safely to elderly pancreatic cancer patients and comparable response rate and progression free survival can be expected as young patients.

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Selective Predatory Effect of River Puffer on WSSV-infected Shrimp in Culture of Shrimp with River Puffer under Laboratory Scale (황복과 새우의 복합사육시 황복에 의한 흰반점바이러스(WSSV) 감염 새우의 선택적 포식 효과)

  • Jang, In-Kwon;Cho, Yeong-Rok;Lee, Jae-Yong;Seo, Hyung-Chul;Kim, Bong-Lae;Kim, Jong-Sheek;Kang, Hee-Woong
    • Journal of Aquaculture
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    • v.20 no.4
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    • pp.270-277
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    • 2007
  • White spot syndrome virus (WSSV) which is the most serious threat to cultured shrimp around the world has given enormous economic damages to shrimp culture industry every year since it was found from the shrimp ponds in the west coast of the South Korea in 1993. WSSV has strong infectivity as well as virulence and it can be rapidly transmitted among shrimps in ponds by cannibalism of infected ones. Polyculture of shrimps with carnivorous fish has been applied in commercial shrimp farms to suppress or delay the viral outbreak because the fish may selectively eat the moribund shrimps infected by virus. To determine the selective predatory effect of a carnivorous fish, river puffer Takifugu obscurus on white shrimp Litopenaeus vannamei, polyculture trials in laboratory scale of WSSV-infected and non-infected shrimps with river puffer were conducted in concrete round tanks of $28.26\;m^2$ in surface area as followings: 1) juvenile shrimps (B. W. 0.62 g) with 5 months old puffer (B. W. 11.60 g) cultured for 8 days, and 2) sub-adult shrimps (B. W. 6.84 g) with 16 months old puffer (B. W. 85.82 g) cultured for 5 days in order to know the effects according to size difference of cultured animals. In polyculture of juvenile shrimp with 5 months old puffer, survival rates of infected and non-infected shrimps were 46.0% and 89.1% respectively and in that of sub-adult shrimp with 16 months old puffer those were4% and 48% respectively. The results showed that puffer tends to selectively prey on virus infected shrimps among infected and non-infected ones in a limited space with although there is difference in predatory rate with age and density of animals. Regardless of different densities and ages of animals as well as health condition of shrimps, however, there were low differences in daily biomass of shrimp consumed per kg body weight of puffer. This finding suggests that puffer preys on healthy shrimps when moribund shrimps were not sufficient. Therefore, farmers should consider the total biomass of puffer as well as density and stocking time when they stock puffer into shrimp ponds for polyculture.

p53 Gene Mutation in Gastric Cancer Tissue (위암조직에서 p53 유전자의 돌연변이)

  • Ku, Ki-Beom;Park, Seong-Hoon;Cheong, Ho-Young;Lee, Myung-Hoon;Yu, Wan-Sik
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.214-220
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    • 2006
  • Purpose: p53 is one of the most commonly mutated genes in human tumors. The aim of this study was to analyze p53 mutation in gastric cancer and its correlations with the clinicopathologic variables to clarify the usefulness of p53 mutation as a prognostic factor. Materials and Methods: Specimens from 331 patients with gastric cancer who underwent a gastrectomy between March 1999 and April 2001 at the Kyungpook National University Hospital were used. p53 gene mutations were assessed by using a polymerase chain-reaction single-strand conformation polymorphism (PCR-SSCP) analysis. The correlations between p53 gene mutation and clinocopathologic parameters were analyzed. Results: p53 mutations were found in 66 (19.9%) tumors. Among those 66 cases, mutations were seen in 23 tumors at axon 5, in 8 at exon 6, in 21 at exon 7, and in 17 at exon 8. Two mutations were shown in 3 tumors. Thiriy-six (23.1%) of 156 intestinal-type tumors and 19 (13.1%) of 145 diffuse-type tumors showed p53 gene mutation (P=0.007). The frequency of p53 gene mutation didn't show any significant differences according to age, sex, stage, location, or gross type. Exon 5 mutations showed more frequently in intestinal-type tumors than in diffuse-type tumors (9.7% vs. 2.8%, P=0.024), and p53 mutation were more frequent in lymph nodes metastasis group than lymph nodes non-metastasis group with statistical significance (25.0% vs 15.6%, P=0.034). The five-year survival rate showed no statistically significant difference with p53 mutation (P=0.704). Conclusion: p53 mutations assessed by PCR-SSCP had little value as a prognostic factor after gastrectomy in patients with gastric cancer.

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Clinical Experience of Long-term Home Oxygen Therapy (재택산소요법을 받고 있는 환자들에 대한 임상 관찰)

  • Lee, Young-Suk;Cha, Seung-Ick;Han, Chun-Duk;Kim, Chang-Ho;Kim, Yeun-Jae;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.283-291
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    • 1993
  • Background: Long-term low flow oxygen therapy not only increases survival, but also improves the quality of life in patients with chronic obstructive pulmonary disease (COPD) with chronic hypoxemia. For the assessment and improvement of the status of home oxygen therapy, we analyzed clinical experience of 26 patients who have been administered low flow oxygen at home. Method: Twenty-six patients (18 men and 8 women) who have been received long-term oxygen therapy (LTOT) at home were examined. We reviewed physical characteristics, clinical history, pulmonary function test, ECG, arterial blood gas analysis, hemoglobin and hematocrit, types of oxygen devices, inhalation time per day, concentration of administered $O_2$, duration of $O_2$ therapy, and problems in the home oxygen therapy. Results: The underlying diseases of patients were COPD 14 cases, far advanced old pulmonary tuberculosis 9 cases, bronchiectasis 2 cases, and idiopathic pulmonary fibrosis 1 case. The reasons for LTOT at home were noted for cor pulmonale 21 cases, for dyspnea on exertion and severe ventilatory impairment 4 cases, and for oxygen desaturation during sleep 1 case. The mean values of aterial blood gas analysis before home oxygen therapy were $PaO_2$ 57.7 mmHg, $PaCO_2$ 48.2 mmHg, and $SaO_2$ 87.7%. And the mean values of each parameters in the pulmonary function test were VC 2.05 L, $FEV_1$ 0.92 L, and $FEV_1$/FVC% 51.9%. Nineteen patients have used oxygen tanks as oxygen devices, 1 patient oxygen concentrator, 2 patients oxygen tank and liquid oxygen, and other 4 patients oxygen tank together with portable oxygen. The duration of oxygen therapy was below 1 year in 3 cases, 1~2 years in 15 cases, 3~5 years in 6 cases, 9 years in 1 case, and 10 years in 1 case. All patients have inhalated oxygen with flow rate less than 2.5 L/min. And only 10 patients have inhalated oxygen more than 15 hours per day, but most of them short time per day. Conclusion: For the effective oxygen administration, it is necessary that education for long-term low flow oxygen therapy to patients, their family and neighbor should be done, and also the institutional backup for getting convenient oxygen devices is required.

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Prognostic Usefulness of Maximum Standardized Uptake Value on FDG-PET in Surgically Resected Non-small-cell Lung Cancer (수술로 제거된 비소세포폐암의 예후 예측에 있어 FDG-PET 최대 표준화 섭취계수의 유용성)

  • Nguyen Xuan Canh;Lee Won-Woo;Sung Sook-Whan;Jheon Sang-Hoon;Kim Yu-Kyeong;Lee Dong-Soo;Chung June-Key;Lee Myung-Chul;Kim Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.4
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    • pp.205-210
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    • 2006
  • Purpose: FDG uptake on positron omission tomography (PET) has been considered a prognostic indicator in non-small cell lung cancer (NSCLC). The aim of this study was to assess the clinical significance of maximum value of SUV (maxSUV) in recurrence prediction in patients with surgically resected NSCLC. Materials & methods: NSCLC patients (n=42, F:M =14:28, age $62.3{\pm}12.3$ y) who underwent curative resection after FDG-PET were enrolled. Twenty-nine patients had pathologic stage 1, and 13 had pathologic stage II. Thirty-one patients were additionally treated with adjuvant oral chemotherapy. MaxSUVs of primary tumors were analyzed for correlation with tumor recurrence and compared with pathologic or clinical prognostic indicators. The median follow-up duration was 16 mo (range, 3-26 mo). Results: Ten (23.8%) of the 42 patients experienced recurrence during a median follow-up of 7.5 mo (range, 3-13 mo). Univariate analysis revealed that disease-free survival (DFS) was significantly correlated with maxSUV (<7 vs. $\geq7$, p=0.006), tumor size (<3 cm vs. $\geq3$ cm, p=0.024), and tumor tell differentiation (well/moderate vs. poor, p=0.044). However, multivariate Cox proportional analysis identified maxSUV as the single determinant for DFS (p=0.014). Patients with a maxSUV of $\geq7$(n=10) had a significantly lower 1-year DFS rate (50.0%) than those with a maxSUV of <7 (n=32, 87.5%). Conclusion: MaxSUV is a significant independent predictor for recurrence in surgically resected NSCLC. FDG uptake can be added to other well-known factors in prognosis prediction of NSCLC.