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Minimally Invasive Surgery without Decompression for Hepatocellular Carcinoma Spinal Metastasis with Epidural Spinal Cord Compression Grade 2

  • Jung, Jong-myung;Chung, Chun Kee;Kim, Chi Heon;Yang, Seung Heon
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.467-475
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    • 2019
  • Objective : There is a lack of knowledge regarding whether decompression is necessary in treating patients with epidural spinal cord compression (ESCC) grade 2. The purpose of this study was to compare the outcomes of minimally invasive surgery (MIS) without decompression and conventional open surgery (palliative laminectomy) for patients with hepatocellular carcinoma (HCC) spinal metastasis of ESCC grade 2. Methods : Patients with HCC spinal metastasis requiring surgery were retrospectively reviewed. Patients with ESCC grade 2, medically intractable mechanical back pain, a Nurick grade better than 3, 3-6 months of life expectancy, Tomita score ${\geq}5$, and Spinal Instability Neoplastic Score ${\geq}7$ were included. Patients with neurological deficits, other systemic illnesses and less than 1 month of life expectancy were excluded. Thirty patients were included in the study, including 17 in the open surgery group (until 2008) and 13 in the MIS group (since 2009). Results : The MIS group had a significantly shorter operative time ($94.2{\pm}48.2minutes$ vs. $162.9{\pm}52.3minutes$, p=0.001), less blood loss ($140.0{\pm}182.9mL$ vs. $1534.4{\pm}1484.2mL$, p=0.002), and less post-operative intensive care unit transfer (one patient vs. eight patients, p=0.042) than the open surgery group. The visual analogue scale for back pain at 3 months post-operation was significantly improved in the MIS group than in the open surgery group ($3.0{\pm}1.2$ vs. $4.3{\pm}1.2$, p=0.042). The MIS group had longer ambulation time ($183{\pm}33days$ vs. $166{\pm}36days$) and survival time ($216{\pm}38days$ vs. $204{\pm}43days$) than the open surgery group without significant difference (p=0.814 and 0.959, respectively). Conclusion : MIS without decompression would be a good choice for patients with HCC spinal metastasis of ESCC grade 2, especially those with limited prognosis, mechanical instability and no neurologic deficit.

Latent Transition Analysis of the Work-Family Balance of Working Mothers with a Child in Elementary School: Focus on the Effect of Antecedents on both Work-Family Balance Typology and Transition between Typologies (초등학생 자녀를 둔 취업모의 일-가정 균형의 잠재전이분석: 일-가정 균형의 유형 및 유형 간 전이의 예측요인 검증을 중심으로)

  • Hong, Yea-Ji
    • Human Ecology Research
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    • v.59 no.2
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    • pp.199-213
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    • 2021
  • The purpose of the study was to apply latent transition analysis to the work-family balance of working mothers with a child in elementary school by focusing on the effect of antecedents on both work-family balance typology and the transition between typologies. Data from 400 working mothers who participated in the eighth and eleventh waves of the Panel Study on Korean Children were used. The results can be summarized as follows. First, the latent profile analysis of working mothers whose children were in the first grade classified the work-family balance types as 'contradictory' or 'beneficial' and of working mothers whose children were in the fourth grade as 'conflictual', 'contradictory', 'high beneficial', 'low beneficial' or 'beneficial'. Second, working mothers whose work-family balance was 'contradictory' or 'beneficial' when their children were in the first grade mostly had, respectively, a 'low beneficial' or a 'high beneficial' balance when their children were in the fourth grade. Third, the probability of being classified into each type differed according to subjective happiness and marital conflict in the first grade, and marital conflict and social support in the fourth grade. Moreover, marital conflict and social support were significant in the transition between the types of work-family balance. The study showed that the types of work-family balance differed for each time point for individual working mothers. The study also highlighted the importance of parenting-related personal, family and social factors in determining the work-family balance type and transition between types.

A study of Conjunctival Cellular Changes in Dry Eye Patients by Impression Cytology (Impression cytology를 이용한 건성안의 결막 세포변화에 관한 연구)

  • Kim, Jai-Min;Kho, Eun-Gyung;Chae, Soo-Chul;Kim, Soon-Ae
    • Journal of Korean Ophthalmic Optics Society
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    • v.9 no.2
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    • pp.333-343
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    • 2004
  • Impression cytology refers to application of cellulose acetate filter material to the ocular surface to remove the superficial layers of the conjunctival epithelium. The technique is non-invasive, is easy to perform, causes minimal discomfort to the patient, and can be used to follow changes in the conjunctival ocular surface over time. With this method, the morphology of the conjunctival ocular surface can be studied and the degree of squmaous metaplasia assessed. This study was performed to evaluate the conjunctival surface by impression cytology in dry eye patients. A total of 70 students with no contact lens wearing history were recruited. Subjects were required to fill in a McMonnies dry eye symptom questionnaire. The non-invasive tear thinning time(TIT) test of each subject was measured, followed by Schirmer tear test(STI), tear film break-up time(TBUT) tests and Rose-bengal staining were performed as a baseline. Conjunctival epithelial cells from the inferior bulbar conjunctiva were harvested by the impression cytology technique. The specimens collected were labelled and stained with PAS(Periodic Acid Schift)-haematoxylin. The goblet cells and conjunctival epithelial cells were observed under a light microscope of 400x magnification. The specimens were classified according to the Nelson Grading scale which was based on the degree of squamous metaplasia such as changes of goblet cells density, size/form, N:C(nucleus : cytoplasm) ratio. Dry eye patients were observed morphological changes of the epithelial cells, different nuclear alterations, decrease of the goblet cells density. The degree of cytological changes was related to severity of dry eye conditions. When the epithelial cell morphology was graded according to the system described by Nelson, specimens from the control group revealed 91.43% of the eyes to be grade 0 and 8.57% to be grade 1, whereas of the dry eye patients, 20% were grade 0, 42.86% grade 1, 34.29% grade 2 and 2,86% grade 3. Impression cytology represents a non- or minimally invasive biopsy of the ocular surface epithelium with no side effects or contraindications. It has demonstrated to be a useful diagnostic aid for a wide variety of processes involving the ocular surface. This technique is a safe, simple method and may help increase understanding of various ocular surface alterations in dry eye patients.

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A STUDY ON THE HUMAN PULPAL RESPONSE TO DENTIN BONDING DESENSITIZER (상아질 접착 지각과민 처치제에 대한 치수반응에 관한 연구)

  • You, Hee-Seung;Lee, Sung-Bok;Woo, Yi-Hyung;Park, Nam-Soo;Choi, Boo-Byung
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.3
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    • pp.483-495
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    • 1998
  • The purpose of this study was to evaluate the human pulpal response to Dentin Bonding Desensitizer. Class V cavities were prepared on the buccal surfaces of the first premolars and Dentin Bonding Desensitizer(ALL-BOND Desensitizer, Bisco, Inc. U.S.A.) was applicated in ten experimental teeth, or ZOE(PROPAC, GC Co. TOKYO, JAPAN) cement in eight control teeth and cavities were filled with light curing glass ionomer(Fuji II LC, GC Co., TOKYO, JAPAN). At 3-day and 25-day postoperative interval. pulpal response was observed and evaluated histologically with light microscope. The results were as follows. ; 1. At 3-day postoperative interval, the control teeth were grade 1 inflammatory cell response and grade 1 connective tissue response. 2. At 25-day postoperative interval, all control teeth were grade 1 inflammatory cell response and in three control teeth grade 1 connective tissue response were observed, and one teeth showed grade 2 connective tissue response. 3. At 3-day postoperative interval, the experimental teeth were grade 1 inflammatory cell response and grade 1 connective tissue response. Below the cavity, a few inflammatory cell(PMNs) in odontoblastic layer, increased blood vessels and pulpal cells were seen and this pulpal response was similar to control teeth. 4. At 25-day postoperative interval, in four experimental teeth grade 1 inflammatory cell response and grade 1 connective tissue response were observed, and one experimental teeth showed mild inflammatory response. 5. At 3-day and 25-day postoperative interval, no reparative dentin deposition was seen. 6. Both experimental and control group, pulpal response showed difference between 3 and 25-day of postoperative interval. In control teeth, increased predentin and pulpal cells were seen and in experimental teeth, congestion of blood vessels and increased pulpal cells were seen. In conclusion, the pulpal irritation due to this Dentin Bonding Desensitizer was not severe, and it was considered that the agent was not harmful to the human pulp.

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The Analysis on Causes of Areas with Public Appeals to the Ecosystem and Nature Map (생태·자연도 이의신청지역의 원인 분석)

  • Jung, Tae-Jun;Song, Il-Bae;Lee, Ji-Seon;Lee, Sung-Je;Cho, Kwang-Jin;Song, Kyo-Hong;Kim, Ki-Dong;Cha, Jin-Yeol;Cho, Jang-Sam;Leem, Hyosun;Joung, Hae-Joung
    • Journal of the Korean Society of Environmental Restoration Technology
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    • v.20 no.1
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    • pp.25-34
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    • 2017
  • The objective of this study is to seek for improvement measures to make the Ecosystem and Nature Map by analyzing causes for grade changes and distributional characteristics of areas with public objections to the Ecosystem and Nature Map notified by e-official gazette from 2014 to June 2016. The receipt of public appeals has been recently increased from average 23 cases a year(2007-2013) to average 33 cases a year(2014-June 2016) while there were 42 areas with public appeals for less than the minimum area($62,500m^2$) for the evaluation of grade of the Ecosystem and Nature Map. Most of the public appeals focused on the 1st grade zone of the Ecosystem and Nature Map. Before grade changes by public appeals, the 1st grade zone of the Ecosystem and Nature Map were 76.0% of the whole areas with public appeals. However, after grade changes by public appeals, it was rapidly decreased to 25.2%, which means that a lot of the 1st grade zone with public appeals were lowered. In the results of analyzing the distributional characteristics of areas with public appeals, they were mostly distributed in lowland(less than 250m altitude), section with $10{\sim}20^{\circ}$ slope, and areas close to or within 100m from built-up area. Regarding areas with public appeals, the biggest time difference between the period of the existing research by National Ecosystem Survey and the period of notice after completing the treatment of public appeals was 18 years while areas showing 6-15 years of time difference were about 70%. Thus, there were huge differences in time of research and notice. Also, the biggest causes for grade changes were boundary errors caused by small-scale survey, and then followed by changes in evaluation of endangered species and occurrence of built-up area and damaged land. Analyzing areas with public appeals in each evaluation item of the Ecosystem and Nature Map, vegetation part was 73.0%, and endangered species area was 23.1% while topography and wetland was less.

The Clinical Effectiveness of the Bonfils Intubation Fibrescope in Difficult Tracheal Intubation (기관내 삽관이 힘든 경우에서 Bonfils Intubation Fibrescope 사용의 임상적인 효과)

  • Lee, Deok-Hee;Kwon, Il-Chi
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.154-161
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    • 2007
  • Background : This study was undertaken to evaluate the effectiveness of the Bonfils intubation fibrescope for cases of difficult tracheal intubation. Materials and Methods : For patients with an ASA physical status 1 or 2 betwen the ages of 20-90, direct laryngoscopy was performed and the layngoscopic view graded according to the Cormack and Lehane classification. Forty patients with Cormack and Lehane grade 3 or 4 were intubated using the Bonfils intubation fibrescope. During intubation, the success rates for tracheal intubation, overall time to intubation, number of attempts and adverse effects were recorded. The Thyromental and sternomental distances were recorded after the orotracheal intubation. Results : The success rates were significantly higher in Cormack and Lehane grade 3 (96.9%) patients compared to grade 4 (50%) (P<0.01). The time to intubation was significantly faster in patients with grade 3 compared to grade 4 (20 (10-49[7-300]) sec vs. 180 (31-300[10-300]) sec, P=0.01). The number of cases with a $SpO_2$<90% was significantly lower in patients with grade 3 (3.1%) compared to grade 4 (50%) (P<0.01). Conclusion : In patients with Cormack and Lehane grade 3, tracheal intubation using the Bonfils intubation fibrescope appears to be an effective technique for the management of a difficult intubation. However, the Bonfils intubation fibrescope can not always be used for the management of a difficult intubation in grade 4 patients; for these patients other effective instruments should be considered for difficult intubations.

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Health Assessment of the Fish-cage Farms using BHI(Benthic Health Index) (저서동물지수를 활용한 어류가두리 양식장의 건강도 평가)

  • Park, Sohyun;Kim, Sunyoung;Park, Se-jin;Jung, Rae-Hong;Yoon, Sang-Pil
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.5
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    • pp.735-745
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    • 2022
  • In this study, a health assessment was conducted using the Benthic Health Index (BHI) to assess fish cage farms, where a fishery environment assessment was also performed. A total of 43 farms were evaluated located in the East Sea, West Sea, and South Sea in Korea. The results of the BHI health evaluation included 8 grade 1 farms, 4 grade 2, 12 grade 3, and 19 grade 4. The grade 1 farms included sandy sediment farms and those with low intensity aquaculture, while the grade 2 farms included those located in areas with active seawater circulation. The fish cage farms belonging to grade 3 and 4 included the majority of farms with high-intensity aquaculture activities. There was no significant difference in total organic carbon between grade 3 and 4 farms, but the results of polychaete community analysis show that organic matter concentration was significantly higher in grade 4 farms.

The Study on Correlation between the KL-Grade and Improvement of Knee Pain Treated by Korean Medicine Therapy (KL-Grade의 정도와 슬관절 통증의 한의학적 치료 효과의 상관성 연구)

  • Lee, Gi-eon;Huh, Suk-won;Lee, Hyun-ho;Jeong, Seong-hyun;Jo, Kyeong-sang;Han, Si-hoon;Choi, Ji-hoon;Roh, Ji-ae
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.3
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    • pp.137-146
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    • 2017
  • Objectives The purpose of this study is to compare the effects between the KL-Grade and improvement of knee pain treated by Korean Medicine therapy. Methods 114 patients who received inpatient treatment from July 2014 to May 2017 in the Daejeon Jaseng of Korean Medicine Hospital were divided into 5 groups by the KL-Grade. All patients received a combination of treatment including acupunture, pharmacopunture, herbal medication. They were compared and analyzed on the basis of improvement between measuring Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index) as they were hospitalized and as they were discharged. The statistically significance was evaluated by SPSS 23.0 for windows. Results After treatment, KL-Grade 0 group's Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index) improvement was $2.02{\pm}1.69$, $7.50{\pm}9.67$ and $0.11{\pm}0.15$ respectively. KL-Grade 1 group's improvement was $2.09{\pm}1.23$, $11.75{\pm}13.99$ and $0.12{\pm}0.13$ respectively. KL-Grade 2 group's improvement was $1.60{\pm}1.07$ and $14.70{\pm}14.19$ respectively. But In this group, EQ-5D Index has decreased by $0.01{\pm}0.10$. KL-Grade 3 group's improvement was $1.88{\pm}1.31$, $7.81{\pm}13.35$ and $0.13{\pm}0.20$ respectively (p<0.034). In the case of KL-Grade 4, the population was not statistically significant (N=2) and therefore excluded from statistical significance. And there was no statistically significance between 4 group's improvement after treatment (p>0.05). Conclusions The above study showed that Korean medicine treatments showed significant therapeutic effects on knee pain and degenerative knee joints, but there was no significant difference in the effectiveness of degenerative arthritis (KL-Grade).

Phase II Study on Pemetrexed-based Chemotherapy in Treating Patients with Metastatic Gastric Cancer not Responding to Prior Palliative Chemotherapy

  • Wei, Guo-Li;Huang, Xin-En;Huo, Jie-Ge;Wang, Xiao-Ning;Tang, Jin-Hai
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2703-2706
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    • 2013
  • Purpose: This study was to determine the efficacy and safety of pemetrexed based chemotherapy in treating patients with metastatic gastric cancer who failed to respond to first and (or) second line chemotherapy. Patients and Methods: Metastatic gastric cancer patients who failed first and (or) second line chemotherapy, were enrolled. All patients were recruited from Jiangsu Cancer Hospital & Research Institute, and were treated with pemetrexed $500mg/m2$ (intravenous; on day 1), and a platinum (or irinotecan) every 3 weeks until disease progression, or intolerable toxicity. Evaluation on efficacy was conducted after two cycles of chemotherapy using the Response Evaluation Criteria for Solid Tumors. Toxicity was recorded according to National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. Results: From Jun 2011 to May 2013, 23 patients were enrolled. All eligible 23 patients completed at least 2 cycles of chemotherapy with pemetrexed based chemotherapy, and were evaluable. Their median age was 55 years (range 40 to 78 years). Seventeen patients were male and 6 female. Three patients (13%) achieved partial response, five patients (22%) stable, 15 patients (65%) with disease progression, and none with complete response. Grade 2 neutrophil suppression occurred in 4.3%, grade 3 in 13% of patients, and no grade 4 was reported. Thrombocytopenia was encountered as follows: 4.3% grade 2, 4.3% grade 3 and 4.3% grade 4. Incidence of anemia was 34.8% in grade 2, 8.7% grade 3 and 0% grade 4. Only 4.3% of patients required packed red blood cell infusion. Elevated transaminase were 4.3% in grade 2 and 0% in grade 3 or 4. Other toxicity included oral mucositis. Conclusions: Pemetrexed based chemotherapy is mildly effective in treating patients with metastatic gastric cancer with tolerable toxicity.

The Study on Dietary Behaviors of Elementary School Student in Chungnam Area According to the School Food Service Type, Gender and Grade (학교급식 유형, 성별 및 학년에 따른 충남 일부지역 초등학생의 식행동에 관한 연구)

  • Chang, Hye-Soon;Kim, Myung-Ja
    • Korean Journal of Community Nutrition
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    • v.11 no.5
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    • pp.608-617
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    • 2006
  • This study compared the food habits and attitudes towards dietary life culture in types of feeding management, gender and grade. The subjects were 352 elementary school students who lived in Seocheon, Chungnam. The independently managed school students were better than jointly managed school students in food habits (p<0.05). In skipping school meals, upper grade students were skipped more than lower grade students (p<0.05). In rate of eating school meals, boys were faster than girls (p<0.001). The independently managed school students and the jointly managed school students were different on distasteful food. Boys disliked vegetables and girls disliked cereals and beans (p<0.05). Upper grade students ate more well-balanced meals than lower grade students (p<0.05). As for the question 'what you will do if the distasteful foods are provided through school meals', they responded. the highest percent of students, 'I will try once or twice'. And the response 'I have them for health' was higher independently in managed school students than the jointly managed school students (p<0.05), girls than boy (p<0.05), and the lower grades than the upper grades (p<0.05). As for the question 'what you will do if the distasteful foods are provided, after the guide for school meals was performed', the response, 'I will make an effort to have it' accounted for the highest percents, and there were differences in lower grade students who were high percents than upper grade students (p<0.01). As for the recognition for unbalanced diets, most of the students recognized that it is a 'bad habit'; the girl students accounted for more percentage than boys (p<0.05). The criterion of food choice were different in gender and grade (p<0.01). As for the factor of influences for the food habits formation, lower grade students were 'school education' and upper grade students were 'parents' (p<0.05). Thus, the systematic guide for proper intakes of nutrition should be performed. Also, the time when students can be educated by an expert of nutritional education, which is connected with school meals and students can grow healthily.