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Clinical Features in Primary Mediastinal Tuberculous Lymphadenitis (조직학적으로 증명된 결핵성 림프절염에 대한 임상적 고찰)

  • Ahn, Chul-Min;Yoo, Kwang-Ha;Park, Kwang-Ju;Kim, Hyung-Joong;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.767-774
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    • 1999
  • Background : Tuberculous mediastinal lymphadenitis (TML) is a relatively commonly encountered in Korea. However, there were no datas available on TML without other combined tuberculous infections in Korea. We retrospectively analyzed clinical manifestations, radiologic findings, Chest CT scan findings, the duration of treatment, and follow up Chest CT scan findings of 23 cases who had only TML. Method : 23 cases from 1991 to 1997 with TML confirmed by biopsy and had no other combined tuberculous infections were studied retrospectively. Results : Of the 23 cases, 7 cases were male and 16 female. The male to female ratio was 1 : 2.4. Mean age was 31 years and the most prevalent age group was the 3rd decade(43%). The most common presenting symptoms were fever(39%) followed by no symptom, cough, swallowing difficulty, and chest discomfort. On simple chest X-ray, mediastinal enlargement were noted in 20 cases(90%). The most frequently involved site was the paratracheal node in 11 cases with the right to left side involvement ratio being 4.6 : 1. On chest CT scan, the most commonly enlarged node was the paratracheal node(33%) followed by the subcarinal(20%), hilar(13%), tracheobronchial (8%), subaortic(8%), supraclavicular(8%) and anterior. mediastinal nodes. 6 cases were dropt out due to incomplete follow up. Thirteen cases were treated with HERZ regimen and the mean duration of treatment was 14 months. Three cases were treated with second line drug regimens(Tarivid, Pyrazinamide, Streptomycin plus Ethambutol or Para-aminosalicylic acid) for 18 months. In HERZ groups, one case was recurred after 10 months later and retreatment was done by same HERZ regimen during 12 months. Follow up chest CT scan after completion of treatment were done in 13 cases and that revealed more than a 50% decrease in size in 77% of the cases and no interval change in 23% of the cases. Conclusion : In cases of TML without other combined tuberculous infection, the minimal duration of treatment was required 12 months by HERZ regimen and 18 months by a 2nd line regimen or more. Further studies will be needed to confirm the treatment duration for TML without other combined tuberculous infections.

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Analysis of the Movement of Surgical Clips Implanted in Tumor Bed during Normal Breathing for Breast Cancer Patients (유방암 환자의 정상 호흡에서 종양에 삽입된 외과적 클립의 움직임 분석)

  • Lee, Re-Na;Chung, Eun-Ah;Suh, Hyun-Suk;Lee, Kyung-Ja;Lee, Ji-Hye
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.192-200
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    • 2006
  • [ $\underline{Purpose}$ ]: To evaluate the movement of surgical clips implanted in breast tumor bed during normal breathing. $\underline{Materials\;and\;Methods}$: Seven patients receiving breast post-operative radiotherapy were selected for this study. Each patient was simulated in a common treatment position. Fluoroscopic images were recorded every 0.033 s, 30 frames per 1 second, for 10 seconds in anterior to posterior (AP), lateral, and tangential direction except one patient's images which were recorded as a rate of 15 frames per second. The movement of surgical clips was recorded and measured, thereby calculated maximal displacement of each clip in AP, lateral, tangential, and superior to inferior (SI) direction. For the comparison, we also measured the movement of diaphragm in SI direction. $\underline{Results}$: From AP direction's images, average movement of surgical clips in lateral and SI direction was $0.8{\pm}0.5\;mm$ and $0.9{\pm}0.2\;mm$ and maximal movement was 1.9 mm and 1.2 mm. Surgical clips in lateral direction's images were averagely moved $1.3{\pm}0.7\;mm$ and $1.3{\pm}0.5\;mm$ in AP and SI direction with 2.6 mm and 2.6 mm maximal movement in each direction. In tangential direction's images, average movement of surgical clips and maximal movement was $1.2{\pm}0.5\;mm$ and 2.4 mm in tangential direction and $0.9{\pm}0.4\;mm$ and 1.7 mm in SI direction. Diaphragm was averagely moved $14.0{\pm}2.4\;mm$ and 18.8 mm maximally in SI direction. $\underline{Conclusion}$: The movement of clips caused by breathing was not as significant as the movement of diaphragm. And all surgical clip movements were within 3 mm in all directions. These results suggest that for breast radiotherapy, it may not necessary to use breath-holding technique or devices to control breath.

Clinicostatistical Analysis for 53 Cases which were performed Microlaryngeal Surgery under Suspension Laryngoscope (Suspension Laryngoscope 하에 후두미세 수술을 시행한 53명에 대한 임상통계학적 고찰)

  • 전하동;최인환;추광철;김선곤
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.6.3-7
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    • 1979
  • During last two. decades, microlaryngeal surgery opened now era in the laryngeal surgery. In 1960, using Lynch's suspension laryngoscope, Seal co et al performed the first successful microsurgery in the treatment of polyp and other laryngeal diseases. In 1968, Kleinsasser reported a new technique of microlaryngeal surgery with a self retaining laryngoscope. Authors studied the statistic analysis of 53 cases (75 times) of the suspension laryngoscopic microsurgery at E.N.T. department of Han Yang University Hospital from May 1972 to April 1979 an reported this result. 1) sex distribution was male 1.3 : female 1. 2) age distribution was 3rd decade 14 cases (26.4%), 2nd decade 10 cases (18.7%) and 5th decade 9 cases (17%) in order. 3) chief compliant was hoarseness 48 cases (90.6%), dyspnea 16 cases (30.5%) and sore throat 8 cases (15.1%) in order. 4) diagnostic impression was polyp 18 cases (34%), nodule 12 cases (22.6%), papilloma 9 cases (17%), tumor 7 cases (13.2%), intubation granuloma 3 cases (5.7%) in order and other kinds were laryngeal stenosis with decannulation difficulty, laryngeal paralysis and hematoma. 5) histopathologic result of 48 cases was polyp 17 cases (35.4%), papilloma 11 cases (23%), nodule 9 cases (18.9%), malignancy 3 cases (6.3%), chronic inflammation 2 cases (4.2%) in order and others were hyperkeratosis, mucous retension cyst, nodule associated abscess, granuloma, hematoma and unconfirmed case. 6) in involved site, both sides 15 cases (60%), Lt.side 5 cases (19%), Rt side 3 cases (12%), anterior commissure 3 cases (12%) on the nodule and polyp (26 cases) and whole laryngeal involvement 7 cases (63.6%), one side cord involement 3 cases (23.7%), extralaryngeal involvement 1 cases (9.1%) on the papilloma (11 cases).

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The Effect of Hyaluronic Acid and Vitamin I Combination on Preventing Postoperative Intraperitoneal Adhesion Formation in Dogs (개에서 Hyaluronic Acid와 Vitamin E의 병용이 복강수술 후 유착방지에 미치는 효과)

  • Bae, Jae-Sung;Jang, Kwang-Ho;Kwon, Young-Sam;Jang, Hwan-Soo;Kim, Jung-Eun;Park, Se-Il;Lim, Jae-Hyun;Li, Wen-Xue;Lee, Seoung-Jin
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.42-48
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    • 2003
  • This study was performed to compare the effect of hyaluronic acid(HA), vitamin I and their combinations for the prevention of postoperative intraperitioneal adhesion in dogs. Twelve mongrel dogs were divided into four groups; HA- (HA Group), vitamin E 800IU- (E8 Group), HA + vitamin E 800IU- (HA+E8 Group) and HA + vitamin E 1600IU-treated group(HA+E16 Group) with three dogs in each group. After celiotomy, five abrasions of 1$\times$1 cm area were made on the antimesenteric serosal surface of the anterior ileocecum with a No. 10 scalpel blade. The five abrasions and peritoneal cavity were coated with 25 of 0.l% HA. Oral supplements of vitamin E were given from the fifth day before the operation to the fourteenth day after the operation. Hematologic values were evaluated before the operation and on the 1st, 4th, 7th and 14th day after the operation. The locations and scores of adhesion were assessed through the second operation on the 21st day after the first operation. The adhesions were located on serosa to mesentary(43.3%)), serosa to serosa(20%), serosa to omentum(5%) and serosa to parietal peritoneum(1.7%). The incidences of adhesion in HA, E8, HA+E8 and HA+E16 groups were 80%, 100%, 47% and 53%, respectively. The scores of adhesion in HA+E8 group(p < 0.05) were lower than those in other groups. This study showed that the combination of HA and vitamin E 800IU was significantly effective in reducing the intraperitoneal adhesion in dogs.

Anatomy of Large Intestine Meridian Muscle in human (수양명경근(手陽明經筋)의 해부학적(解剖學的) 고찰(考察))

  • Sim Young;Park Kyoung-Sik;Lee Joon-Moo
    • Korean Journal of Acupuncture
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    • v.19 no.1
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    • pp.15-23
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    • 2002
  • This study was carried to identify the component of Large Intestine Meridian Muscle in human, dividing into outer, middle, and inner part. Brachium and antebrachium were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Large Intestine Meridian Muscle. We obtained the results as follows; 1. Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows. 1) Muscle; extensor digitorum tendon(LI-1), lumbrical tendon(LI-2), 1st dosal interosseous muscle(LI-3), 1st dosal interosseous muscle and adductor pollicis muscle(LI-4), extensor pollicis longus tendon and extensor pollicis brevis tendon(LI-5), adductor pollicis longus muscle and extensor carpi radialis brevis tendon(LI-6), extensor digitorum muscle and extensor carpi radialis brevis mucsle and abductor pollicis longus muscle(LI-7), extensor carpi radialis brevis muscle and pronator teres muscle(LI-8), extensor carpi radialis brevis muscle and supinator muscle(LI-9), extensor carpi radialis longus muscle and extensor carpi radialis brevis muscle and supinator muscle(LI-10), brachioradialis muscle(LI-11), triceps brachii muscle and brachioradialis muscle(LI-12), brachioradialis muscle and brachialis muscle(LI-13), deltoid muscle(LI-14, LI-15), trapezius muscle and supraspinous muscle(LI-16), platysma muscle and sternocleidomastoid muscle and scalenous muscle(LI-17, LI-18), orbicularis oris superior muscle(LI-19, LI-20) 2) Nerve; superficial branch of radial nerve and branch of median nerve(LI-1, LI-2, LI-3), superficial branch of radial nerve and branch of median nerve and branch of ulna nerve(LI-4), superficial branch of radial nerve(LI-5), branch of radial nerve(LI-6), posterior antebrachial cutaneous nerve and branch of radial nerve(LI-7), posterior antebrachial cutaneous nerve(LI-8), posterior antebrachial cutaneous nerve and radial nerve(LI-9, LI-12), lateral antebrachial cutaneous nerve and deep branch of radial nerve(LI-10), radial nerve(LI-11), lateral antebrachial cutaneous nerve and branch of radial nerve(LI-13), superior lateral cutaneous nerve and axillary nerve(LI-14), 1st thoracic nerve and suprascapular nerve and axillary nerve(LI-15), dosal rami of C4 and 1st thoracic nerve and suprascapular nerve(LI-16), transverse cervical nerve and supraclavicular nerve and phrenic nerve(LI-17), transverse cervical nerve and 2nd, 3rd cervical nerve and accessory nerve(LI-18), infraorbital nerve(LI-19), facial nerve and infraorbital nerve(LI-20). 3) Blood vessels; proper palmar digital artery(LI-1, LI-2), dorsal metacarpal artery and common palmar digital artery(LI-3), dorsal metacarpal artery and common palmar digital artery and branch of deep palmar aterial arch(LI-4), radial artery(LI-5), branch of posterior interosseous artery(LI-6, LI-7), radial recurrent artery(LI-11), cephalic vein and radial collateral artery(LI-13), cephalic vein and posterior circumflex humeral artery(LI-14), thoracoacromial artery and suprascapular artery and posterior circumflex humeral artery and anterior circumflex humeral artery(LI-15), transverse cervical artery and suprascapular artery(LI-16), transverse cervical artery(LI-17), SCM branch of external carotid artery(LI-18), facial artery(LI-19, LI-20)

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BOLD Responses to Acupuncture on Each Side of ST36 (족삼리 좌우측 자침에 대한 BOLD 반응)

  • Yeo, Sujung;Bae, Seong-In;Choe, Ilwhan;Jahng, Geon-Ho;Lim, Sabina
    • Korean Journal of Acupuncture
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    • v.31 no.1
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    • pp.20-32
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    • 2014
  • Objectives : There has been some controversy about the modulatory effects on brain function during acupuncture on each side of the same acupoint. This study was designed to investigate and compare the blood oxygen level-dependent(BOLD) responses of acupuncture on each side of ST36. Methods : Fourteen healthy subjects were recruited for imaging and received acupuncture or placebo stimulations either on the left or on the right acupoint of ST36 in each scan. For the voxel-wise statistical analysis, one sample T-test and the within-subject analysis of variance(ANOVA) test were performed using SPM8 software. Results : This study showed that acupuncture on each side of ST36 showed different BOLD signal patterns. Higher BOLD responses after acupuncture stimulations at the left ST36 compared to the right were observed mainly in the parahippocampal gyrus(BA 28), dorsolateral prefrontal cortex(DLPFC, BA 44), thalamus, culmen and claustrum. We investigated the different neural responses between rest and activation periods of placebo and acupuncture stimulations on each side of ST36. Acupuncture at the right ST36 elicited activation mainly in the insula, supplementary motor area(SMA) and anterior cingulate cortex(ACC), while acupuncture at the left ST36 elicited activation mainly in the insula, primary somatosensory cortex(SI, BA 2) and DLPFC(BA 44). Conclusions : To our knowledge, this is the first reported functional MRI study directly comparing when needling at the right and at the left side of ST36. This study's preliminary results proved to be evidence of acupuncture's different effects when performed on opposite sides of an acupoint.

Prognostic Factors for Local Control in Early Glottic Cancer Treated with Radiation Therapy (방사선치료를 받은 조기 성문암 환자의 국소 종양 제어에 관한 예후 인자)

  • Chung Woong-Ki;Ahn Sung Ja;Nam Taek Keun;Nah Byung Sik;Cho Jae-Shik;Lim Sang-Chull
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.226-232
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    • 2000
  • Purpose :This study was performed to find out the prognostic factors affecting local control in early glottic cancer treated with radiation therapy alone. Materials and Methods :We analysed 37 patients of histologically confirmed early glottic cancer treated at Chonnam National University Hospital between July Im and December 1995, retrospectively. Age of patients ranged from 30 to 73 years (median; 59 years). Thirty-five (95$\%$) patients were male. Histological type was all squamous cell carcinoma. According to the staging system of 1997 American Joint Committee on Cancer, 37 patients were restaged as follows: Tla; U (73$\%$), Tlb; 3 (8$\%$), 72: 7 (19$\%$). Radiation therapy was done using 6 MV X-ray of linear accelerator The range of total radiation dose delivered to the glottic lesion was between 5,040 cGy and 7,020 cGy (median; 6,600 cGy). Median follow-up period was U months. local control rates were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of control rates between comparable groups. Multivariate analysis using Cox proportional hazard model was done to find out prognostic factors affecting local control. Results:5 year survival rate of 37 patients was 89$\%$. Local control rate of 37 patients was 74$\%$ in 5 years. We included age, 7-stage, anterior commissure involvement, fraction size, total radiation dose, treatment time of radiotherapy as potential prognostic factors in univariate and multivariate analysis. As a result, treatment time had statistical significance in local control rate in both univariate (p=0.026) and multivariate (p=0.017) analysis. Complication was not recorded except one patient with hypothyroidism. Conclusion :This study revealed that overall treatment time of radiation was a significant factor affecting local control rate.

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MEASUREMENT OF PULPAL BLOOD FLOW USING A LASER DOPPLER FLOWMETER (Laser Doppler flowmeter를 이용한 치수혈류 측정)

  • Ban, Tae-Whan;Lee, Jae-Sang;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.24 no.4
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    • pp.560-569
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    • 1999
  • Blood supply rather than nerve supply implies pulp vitality. To evaluate pulp vitality clinically, electric pulp test and thermal test which are based on sensory nerve response have been used in addition to many auxiliary data such as past dental history, visual inspection, radiographic examination, percussion, palpation and transillumination test. However, reactivity of the nerves to the stimulation is not synonymous with normalcy. Therefore measurement of pulpal blood flow using a laser Doppler flowmeter became a new trial to test the pulp vitality. The purpose of the present study was to evaluate normal pulpal blood flow level of maxillary teeth in adult to provide a guideline in determining the vitality of dental pulp. Pulpal blood flow was measured in maxillary central and lateral incisors, canines, first and second premolars and first molars of seventy nine adults of 22 - 30 years old using a laser Doppler flowmeter (PeriFlux 4001, Perimed Co., Stockholm, Sweden, 780 nm infrared laser, 1mW). For directly-made splints, silicone rubber impressions were taken directly from the mouth. For indirectly-made splints, alginate impressions were taken from the mouth and stone cast were made. After making depressions on the buccal surfaces of the cast teeth to indicate the hole positions, second impressions with vinyl polysyloxane putty were taken from the cast. Holes for the laser probes were made at the putty impressions 4mm above the gingival level. Laser probe (PF416 dental probe, 1.5mm) was inserted in the prepared hole and the splint was set in the mouth. After 10 minutes of patient relaxing, pulpal blood flow was recorded for 5 minutes on each tooth. The recorded flow was saved in the computer and calculated with a software 'Perisoft' version 5.1. Pulpal blood flow was also recorded in six teeth of five individuals with no response to electric pulp test and cold test, with periapical radiolucency, or with history of root canal treatment to compare with nonvital teeth. The difference between the mean flow values of each group of teeth were analyzed using one-way ANOVA and Duncan's Multiple Range test. The results were as follows: 1. The average pulpal blood flow values of all the tested teeth of each location were between 9 - 16 Perfusion Unit. Pulpal blood flow value was highest in maxillary lateral incisors, followed by first premolars, second premolars, canines, central incisors, and then first molars (p<0.01). 2. In six anterior teeth, indirectly-made splint group showed higher pulpal blood flow values than directly-made splint group (p<0.01). In posterior teeth, however, there was no significant flow value difference between directly-made splint group and indirectly-made splint one (p>0.05). 3. Teeth with vital pulps showed higher signal values than teeth with nonvital pulps (p<0.01), and the flow photographs showed heartbeat-synchronous fluctuations and vasomotions, while those were absent in non vital tooth.

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The Measurement of Normal Talus in Korean Cadaver (한국인 사체에서의 정상 거골의 실측)

  • Ha, Dong-Jun;Gwak, Heui-Chul;Kim, Jeon-Gyo;Kim, Jung-Han;Lee, Chang-Rak;Kim, Young-Jun;Lee, Jeong-Han;Ha, Byung-Ho;Kim, Ui-Cheol
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.163-169
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    • 2016
  • Purpose: To investigate the measured values of the talus in Koreans. Materials and Methods: We measured 88 tali from 44 cadavers that have been donated between December 2012 and December 2015. Of the cadavers, 27 were male and 17 were female. Their mean age was 73 years. The length and width of the talus were measured using a digital goniometer and vernier caliper. Results: The values of cadaveric measurement, mean maximal width and length, width and length of the dome anterior, width and length of the posterior facet, height and length of the trochlear medial facet, and height and length of the trochlear lateral facet were $43.6{\pm}2.6mm$, $56.5{\pm}3.3mm$, $32.5{\pm}2.0mm$, $42.2{\pm}2.7mm$, $22.2{\pm}2.2mm$, $34.7{\pm}2.0mm$, $15.3{\pm}1.3mm$, $33.3{\pm}2.9mm$, $25.3{\pm}3.3mm$, and $30.8{\pm}2.4mm$ for men and $38.9{\pm}1.6mm$, $53.6{\pm}2.4mm$, $27.9{\pm}2.1mm$, $37.4{\pm}3.2mm$, $20.6{\pm}0.8mm$, $31.9{\pm}1.2mm$, $13.6{\pm}2.6mm$, $28.4{\pm}2.5mm$, $24.9{\pm}2.1mm$, and $28.9{\pm}1.4mm$ for women, respectively. The size of the talus showed an accuracy of 86% when anteroposterior diameter was greater than 59 mm. A difference in the size of the right and left talus was not observed. The mean inclination and declination angles were $24.4^{\circ}{\pm}4.2^{\circ}$ and $28.2^{\circ}{\pm}5.4^{\circ}$ for men, and $24.6^{\circ}{\pm}3.6^{\circ}$ and $24.7^{\circ}{\pm}6.7^{\circ}$ for women (p=0.980, p=0.018), respectively, at least $15^{\circ}$, which showed a big difference for every object up to $37^{\circ}$. Conclusion: This paper, to the best of our knowledge, is the first study to measure the talus in Koreans. There were differences by gender and ethnicity in the in measured talus values. The measurements were smaller than European-Americans and greater than Japanese.

A study on the change of head posture and hyoid bone position before and after rapid maxillary expansions (상악골 급속확장술식 전후 두경부 자세와 설골위치의 변화에 관한 연구)

  • Bae, Hyeon-Cheol;Lee, Jin-Woo;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.569-584
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    • 1997
  • The present study assessed the effects of Rapid Maxillary Expansion on head posture and hyoid bone position. For this study, 32 Angle's class III patients - hellman 3c $\~$ adult stage, mean age 12y9m - were selected and divided into two groups, A,B according to craniocervical angulation. Craniocervical angulation Increased in Group A and decreased in Group B after the therapy. And 23 Angle's class I persons $\~$ same hellman stage, mean age 12y7m $\~$ were selected (or the control group. Cephalometric analysis of skeletal pattern, pharyngeal space, head posture, hyoid bone position was performed. The results were as follows, 1. Comparison of skeletal pattern and pharyngeal space 1) All two groups(A,B) had Mandibular plane inclined inferiorly and no pharyngeal space change was obseved after RME therapy 2) Skeletal pattern and pharyngeal space of Group A, B were normal before and after treatment. 2. Comparison of head posture 1) Craniocervical angulation of Group A was increased after treatment. That of Group B was decreased and mandibular plane was inclined inferiorly after treatment. 2) Before treatment, craniocervical inclination was normal in Group A but larger than normal in Group B. After treatment, all two groups(A, B) had normal craniocervical angulation. 3. Comparison of hyoid bone position 1) After treatment, long axis of hyoid in Group A, B was not changed. Antero- posteriorly, hyoid position was changed posteriorly in Group A but no change was founded in Group B after treatment. Vertically, hyoid bone position were not changed in two groups except increase in APHFH in Group A after treatment 2) Long axis of hyoid bone was normal in Group A, B before and after treatment. Anteroposteriorly, hyoid bone position was more anterior than Group B, C before treatment but all the position of two groups had normal position after treatment. Vertical position of hyoid bone was normal in all two groups before and after treatment.

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