Chang Sei Kyung;Kim Gwi Eon;Lee Sang-Wook;Park Hee Chul;Pyo Hong Ryull;Kim Joo Hang;Moon Sun Rock;Lee Hyeong Sik;Choi Eun Chang;Kim Kwang Moon
Radiation Oncology Journal
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v.20
no.1
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pp.17-23
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2002
Purpose : To clarify the clinical benefit derived from the combined modality therapy (CMT) consisting of chemotherapy (CT) and involved field radiotherapy (RT) for stage I and II angiocentric lymphomas of the head and neck. Materials and Methods : Of 143 patients with angiocentric lymphoma of the head and neck treated at our hospital between 1976 and 1995, 104 patients (RT group) received involved field RT alone with a median dose of 50.4 Gy (range : 20~70 Gy), while 39 patients (CMT group) received a median 3 cycles (range : 1~6 cycles) of CT before involved field RT. The response rate, patterns of failure, complications, and survival data of the RT group were compared with those of the CMT group. Results : Despite a higher response rate, local failure was the most common pattern of failure in patients of both groups. The patterns of failure, including the systemic relapse rate were not influenced by the addition of combination CT. Although both modalities were well tolerated by the majority of patients, aberrant immunologic disorders or medical illnesses, such as a hemophagocytic syndrome, sepsis, intractable hemorrhage, or the evolution of second primary malignancies were more frequently observed in patients of the CMT group. The prognosis of patients in the RT group was relatively poor, with a 5-year overall actuarial survival rate of 38% and disease-free survival rate of 32%, respectively. However, their clinical outcome was not altered by the addition of systemic CT. Achieving complete remission was the most important prognostic factor by univariate and multivariate analyses, but treatment modality was not found to be a prognostic variable influencing survival. Conclusions : Involved field RT alone for angiocentric lymphoma of the head and neck was insufficient to achieve an improved survival rate, but the addition of CT to involved field RT failed to demonstrate any therapeutic advantage over involved field RT alone.
There is tremendous variability in the ways patients present with taste problems. Because of complex and multifactorial etiological background, it is not simple to evaluate patients with taste disorders. Accurate assessment of patients' status by prudent, thorough history taking and symptom analysis is the most essential for exact diagnosis of taste disorders. The aim of this study was to investigate the clinical characteristics of patients with taste problems as a primary complaint. Consecutive series of 50 patients (12 males and 38 females, mean age $53.6\;{\pm}\;14.7$ years) were included for the present study. All subjects were requested to complete a comprehensive questionnaire. Clinical evaluation procedures included oral examination, interview, questionnaire analysis, panoramic radiography, blood test and measurement of salivary flow rate. The obtained results were as follows: 1. Among the patients, 36 patients (72%) complained of oral mucosal pain or burning sensation. Of these patients, 18 patients (36%) were diagnosed as burning mouth syndrome. 2. Nineteen patients (38%) complained of subjective oral dryness. The flow rate of unstimulated whole saliva was less than 0.1 mL/min in 14 patients (28%) and 17 (34%) had a stimulated whole salivary flow rate of less than 0.5 mL/min. 3. Among the types of taste disorders, hypogeusia, the most frequently reported, was found in 25 patients (50%), dysgeusia in 18 patients (36%), phantogeusia in 15 patients (30%), hypergeusia in 10 patients (20%), and ageusia in 5 patients (10%). Nineteen patients (38%) reported more than one type of taste disorder and the most frequent combination was dysgeusia + hypogeusia (n=6, 12%). 4. Based on data from the medical and dental histories and examinations, the patients were assigned to 12 probable causal categories. Taste disorders due to oral mucosal diseases and idiopathic taste disorder were the most frequent (n=9; 18%, each), followed by psychogenic taste disorder (n=8; 16%), drug-induced taste disorder (n=7; 14%), and taste disorder due to dry mouth (n=6; 12%). These 5 categories of taste disorder accounted for 78% of all cases in this study.
The documentary characteristics of acupuncture and moxibustion recorded in Dusagyeong(杜思敬)'s".Jesaengbalsu(濟生拔粹)" can be summarized into 3 major parts: 1. "Gyeolgo-ungichimbeop(潔古雲岐鍼法)" and "Dutaesachimbeop(竇太師鍼法)" 1) "Gyeolgo-ungichimbeop" was edited by Dusagyeong of the Won dynasty, and was recorded in "Jesaengbalsu". Du was influenced by his teacher Heohyeong(許衡) and followed Janggyeolgo(張潔古) and his son Jangbyeok(張璧), and collected his work "Chimgu-pyeon(鍼灸篇)" for Jang and named it "Gyeolgo-ungichimbeop", and took the content from the medical book of Jang and his student Wang-haejang(王海藏). (2) "Jesaengbalsu"'s original edition exists today. The "Gyeolgo-ungichimbeop" listed in "Jesaengbalsu"'s index contain two collections, the first collection being "Gyeolgo-ungichimbeop" and the second collection being "Dutaesachimbeop(竇太師鍼法)" (3) Gyeolgo(潔古)、Un-gija(雲岐子)'s acupuncture methods can be seen in Un-gija "Bomyeongjipryuyo(保命集類要)" and Wanghaejang "Chasananji(此事難知)". (4) The related acupuncture methods are 'Non-gyeong-rak-yeongsubosabeop(論經絡迎隨補瀉法)', 'Gyeong-rakchwiwonbeop(經絡取原法)', 'Jeopgyeongbeop(接經法)', and 'Sang-hanyeolbyeongjabeop(傷寒熱病刺法)' (5) Du's edition of the entire text of 'Gyeolgojajetongbeop(潔古刺諸痛法)' 'Jasimtongjehyeol(刺心痛諸穴)' and the first half of 'Jeopgyeongbeop(接經法)' is all recorded in "Somunbyeonggigi-uibomyeongjip(素問病機氣宜保命集)". The existing "Somunbyeonggigi-uibomyeongjip" is a combination of the unfinished posthumous work of Yuwanso(劉完素), "Gi-ui(氣宜)" and "Byeonggi(病機)" with works such as Jangwonso(張元素)'s '"Bomyeongseo(保命書)"'. (6) Of the titles "Gyeolgo-ungichimbeop" and "Dutaesachimbeop", the 14$\sim$19th chapters "Dutaesachimbeop" should be concentrated at the end of the chapter, and the 16th chapter that Du added was put after chapter 14 "Yujujiyobu(流注指要賦)", and chapters 20, 21 should be put in "Gyeolgoungichimbeop" after chapter 13. 2. "Chimgyeongjeok-yeongjip(鍼經摘英集)" (1) "Chimgyeongjeok-yeongjip" is a collection of the acupuncture and moxibustion contents of medical books from the Geum and Won dynasties that Dusagyeong collected and organized during the Won dynasty, which is consisted of 5 chapters : "Guchimshik(九鍼式)", "Jeolyangchwisuhyeolbeop(折量取腧穴法)", "Bosabeop(補瀉法)", "Yongchimhoheupbeop(用鍼呼吸法)", "Chibyeongjik-ralgyeol(治病直剌訣)". (2) First, the contents. The nine acupuncture needles[九鍼] listed in "Guchimshik(九鍼式)" is the first existing document recording to systematically illustrate the 'nine classical needles' in drawing and text form which reflects the forms of the needles of the era. Second, "Jeolyangchwisuhyeolbeop(折量取腧穴法)" has the same basic way of measuring points [量穴法] as Wang-yuil's "Dong-insuhyeolchimgudo-gyeong(銅人腧穴鍼灸圖經)" and the same point selection rules as "Jeonyeongbang(全嬰方)". Third, in "Bosabeop(補瀉法)", "Somun(素問)" and Janggyeolgo's "Yeongsubosabeop(迎隨補瀉法)" is put together. Fourth, in "Yongchimhoheupbeop(用鍼呼吸法)", the cold and heat supplementation and draining [寒熱補瀉] method that combines breathing with inner and outer rotation[外 內撚] is recorded. Fifth, "Chi-byeongjik-ralgyeol(治病直剌訣)" is the main part of "Chimgyeongjeok-yeongjip(鍼經摘英集)" listing 69 acupuncture treatments reflecting Du's scholastic ideas on aspects such as syndrome differentiation[辨證], needling method and type of needle[鍼具]. (3) The content of this book was quoted by "Bojebang Chimgumun(普濟方 鍼灸門)" and when Gomu compiled "Chimguchwiyeong", he put the acupuncture treatments for the main indications of the disease patterns[鍼方主治病證] of this book in the related main indications of acupuncture points[腧穴主治證], which influenced books on acupuncture points there after. 3. "Chimgyeongjeolyo(鍼經節要)" (1) Consists of 1 volume. The original title of this book is "Dong-insuhyeolchimgudo-gyeong (銅人腧穴鍼灸圖經)" and the author is Wang-yuil of the Northern Song dynasty, written in the 4th year of the Cheonseong(天聖) era of the Song dynasty(1026). (2) Dusagyeong selected the contents on pathology of the 12 meridians in volume one and two, the introduction and five transport points[五輸穴] in volume 5 of "Dong-indo-gyeong(銅人圖經)" and named it "Chimgyeongjeolyo." During the Won dynasty it was recorded in "Jesaengbalsu".
Purpose : We know little about the natural course of IgA nephropathy (IgAN) in association with histologic changes especially in children. We investigated clinicopathologic features with long-term follow-up biopsy to clarify the outcomes and prognostic indicators for childhood IgAN. Methods : From our patients' medical records, we retrieved 20 patients with IgAN, to whom renal biopsies had been performed for the initial diagnosis and follow-up to find out any histologic changes. Initial and follow-up biopsies were classified by Haas classification. The changes of these parameters were compared with the evolution of clinical features. Results : Patients were treated with angiotensin-converting enzyme inhibitors in combination with angiotensin receptor blockers (in subclass II or above) and short-term cyclosporine A(in patients showing nephrotic syndrome). Histologic improvement in 7 cases and deterioration in 3 cases were observed. At the time of last biopsy, 10 cases (50%) showed clinical remission and the others showed improved clinical features. These clinical outcomes did not correlate with initial Haas classifications. Hypertension at onset observed in 5 cases (25%) revealed significant correlation with clinical outcome (P =0.01) and last Haas classification (P =0.007). None of the cases showed progression to CRF or ESRD. Conclusion : During a mean follow-up of $10.8{\pm}3.4$ years, childhood IgAN showed good clinicopathologic outcome. Hypertension at onset was only a strong predictor of clinicopathologic outcomes, but initial Haas classification cannot predict outcomes in children. Histologic change of IgAN in long term follow-up period cannot be completely predicted by clinical data and vice versa. Therefore, a renal biopsy should be considered as a part of follow-up plan.
Exercise-induced anaphylaxis (EIA) is a physical allergy, sometimes severe, triggered by exertion following specific food intake. It was defined for the first time in 1980. EIA is associated with different kinds of exercise. The clinical manifestations progress from itching, erythema and urticaria to some combination of cutaneous angioedema and vascular collapse. Mast cell participation in the pathogenesis of this syndrome has been proved by the findings of an elevated serum histamine level during exhaustive exercise. As predisposing factors of EIA, a specific or even nonspecific sensitivity to food has been reported. Food-dependent exercise-induced anaphylaxis (FDEIA) is a distinct form of food allergy induced by physical exercise. It is typified by the onset of anaphylaxis during exercise which was preceded by the ingestion of the causal food allergens. The diagnosis of FDEIA is heavily dependent on clinical history. Allergy tests may need to be performed using a broad panel of food and food additives. As with food allergies, FDEIA diagnosis is based on interview, biological test and skin test. Prophylaxis aims to prevent a recurrence; the patient should be given an emergency kit to deal with any recurrent episodes. After the food allergen has been identified, it should be avoided for at least 4 to 5 hours before any exercise. Two cases of EIA are presented (EIA to circumstances; FDEIA) in this paper, The diagnosis, pathophysiology and therapy of FDEIA are also reviewed.
To characterize genotypic and phenotypic traits of Staphylococcus aureus isolates (n = 86) from lettuces and raw milk, major virulence-associated genes and antibiotic susceptibility were detected using PCR-based methods and disk diffusion method, respectively. All isolates possessed coagulase gene and showed five polymorphism types [500 bp (2.4%), 580 bp (17.4%), 660 bp (61.6%), 740 bp (17.4%), and 820 bp (1.2%)] due to variable numbers of tandem repeats present within the gene. Two or three different loci of hemolysin gene family were dominant in isolates, 47 of which (55%) possessed combination of hla/hld/hlg-2 genes as the most prevalent types. Among enterotoxin-encoding genes, sea was detected from 32 isolates (37%), sed from 1 isolate (1%), and sea and sed genes were co-detected from 4 isolates (5%), whereas seb, sec, and tsst-1 genes were not detected. All isolates were susceptible to ciprofloxacin, trimethoprim/sulfamethoxazole, oxacillin, and vancomycin, 85 isolates (99%) to penicillin G, 54 isolates (63%) to chloramphenicol, 51 isolates (59%) to erythromycin, and 7 isolates (8%) to clindamycin. Among resistant isolates, seven displayed multiantibiotic-resistance against two different antibiotics.
Background and Objective : Although prone positioning has been reported to improve gas exchange, prone positioning alone does not seem to be sufficient to increase systemic oxygen transport in an acute lung injury. The objective of this study was to investigate whether the combined therapy of low dose nitric oxide (NO) inhalation and prone positioning has an additive effect on the oxygenation and hemodynamics in patients with severe ARDS. Patients and Methods : Twelve patients with ARDS were included. Prone positioning alone, later combined with nitric oxide inhalation (5~10 ppm) from the supine position (baseline) were performed with serial measurement of gas exchange, respiratory mechanics and hemodynamic at sequential time points. The patient was regarded as a responder to prone positioning if an increase in $PaO_2/FiO_2$ of more than 20 mm Hg at 30 min or 120 min intervals after prone positioning was observed compared to that of the baseline. The same criterion was applied during nitric oxide inhalation. Results : Eight patients (66.5%) responded to prone positioning and ten patients (83.3%) including the eight just mentioned responded to the addition of NO inhalation. The $AaDO_2$ level also decreased promptly with the combination of prone positioning and NO inhalation compared to that of prone positioning alone ($191{\pm}109$ mm Hg vs. $256{\pm}137$ mm Hg, P<0.05). Hemodynamic parameters and lung compliance did not change significantly during prone positioning only. Following the addition of NO inhalation to prone positioning, the mean pulmonary artery pressure and pulmonary artery occlusion pressure decreased and cardiac output, stroke volume and oxygen delivery increased (P < 0.05) compared to those of prone 120 min. Conclusion : These findings indicate that NO inhalation would provide additional improvement in oxygenation and oxygen transport to mechanically ventilated patients with ARDS who are in a prone position.
Lee, Jae Seung;Chung, Joo Won;Koh, Yunsuck;Lim, Chae-Man;Jung, Young Joo;Oh, Youn Mok;Shim, Tae Sun;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Hong, Sang-Bum
Tuberculosis and Respiratory Diseases
/
v.59
no.5
/
pp.522-529
/
2005
Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.
Purpose : We evaluated retrospectively the outcomes of inoperable squamous cell lung cancer patients treated with radiotherapy to find out prognostic factors affecting survival. Materials and methods : Four hundred and eleven patients diagnosed as squamous cell lung cancer between November 1988 and December 1997 were the basis of this analyses. The planned dose to the gross tumor volume was ranged from 30 to 70.2 Gy. Chemotherapy was combined in 72 patients $(17.5\%)$ with the variable schedule and drug combination regimens. Follow-up period ranged from 1 to 113 months with the median of 8 months and survival status was identified in 381 patients $(92.7\%)$. Overall survival rate was calculated using the Kaplan-Meier method. Results : Age ranged from 23 years to 83 years with the median 63 years. The male to female ratio was about 16:1. For all 411 patients, the median overall survival was 8 months and the 1-year survival rate (YSR), 2-YSR, and 5-YSR were $35.6\%,\;12.6\%,\;and\;3.7\%$, respectively. The median and 5-YSR were 29 months and $33.3\%$ for Stage IA, 13 months and $6.3\%$ for Stage IIIA, and 9 months and $3.4\%$ for Stage IIIB, respectively(p=0.00). The median survival by treatment aim was 11 months in radical intent group and 5 months in palliative, respectively (p=0.00). Of 344 patients treated with radical intent, median survival of patients (N=247) who received planned radiotherapy completely was 12 months while that of patients (N=97) who did not was 5 months (p=0.0006). In the analyses of the various prognostic factors affecting to the survival outcomes in 247 patients who completed the planned radiotherapy, tumor location, supraclavicular LAP, SVC syndrome, pleural effusion, total lung atelectasis and hoarseness were statistically significant prognostic factors both in the univariate and multivariate analyses while the addition of chemotherapy was statistically significant only in multivariate analyses. The acute radiation esophagitis requiring analgesics was appeared in 49 patients $(11.9\%)$ and severe radiation esophagitis requiring hospitalization was shown in 2 patients $(0.5\%)$. The radiation pneumonitis requiring steroid medication was shown in 62 patients $(15.1\%)$ and severe pneumonitis requiring hospitalization was occurred in 2 patients $(0.5\%)$. During follow-up, 114 patients $(27.7\%)$ had progression of local disease with 10 months of median time to recur (range : $1\~87\;months$) and 49 patients $(11.9\%)$ had distant failure with 7 months of median value (range : $1\~52\;months$). Second malignancy before or after the diagnosis of lung cancer was appeared in 11 patients Conclusion : The conventional radiotherapy in the patients with locally advanced squamous cell lung cancer has given small survival advantage over supportive care and it is very important to select the patient group who can obtain the maximal benefit and to select the radiotherapy technique that would not compromise the life quality in these patients.
From January 2020 to October 2021, more than 500,000 academic studies related to COVID-19 (Coronavirus-2, a fatal respiratory syndrome) have been published. The rapid increase in the number of papers related to COVID-19 is putting time and technical constraints on healthcare professionals and policy makers to quickly find important research. Therefore, in this study, we propose a method of extracting useful information from text data of extensive literature using LDA and Word2vec algorithm. Papers related to keywords to be searched were extracted from papers related to COVID-19, and detailed topics were identified. The data used the CORD-19 data set on Kaggle, a free academic resource prepared by major research groups and the White House to respond to the COVID-19 pandemic, updated weekly. The research methods are divided into two main categories. First, 41,062 articles were collected through data filtering and pre-processing of the abstracts of 47,110 academic papers including full text. For this purpose, the number of publications related to COVID-19 by year was analyzed through exploratory data analysis using a Python program, and the top 10 journals under active research were identified. LDA and Word2vec algorithm were used to derive research topics related to COVID-19, and after analyzing related words, similarity was measured. Second, papers containing 'vaccine' and 'treatment' were extracted from among the topics derived from all papers, and a total of 4,555 papers related to 'vaccine' and 5,971 papers related to 'treatment' were extracted. did For each collected paper, detailed topics were analyzed using LDA and Word2vec algorithms, and a clustering method through PCA dimension reduction was applied to visualize groups of papers with similar themes using the t-SNE algorithm. A noteworthy point from the results of this study is that the topics that were not derived from the topics derived for all papers being researched in relation to COVID-19 (
) were the topic modeling results for each research topic (
) was found to be derived from For example, as a result of topic modeling for papers related to 'vaccine', a new topic titled Topic 05 'neutralizing antibodies' was extracted. A neutralizing antibody is an antibody that protects cells from infection when a virus enters the body, and is said to play an important role in the production of therapeutic agents and vaccine development. In addition, as a result of extracting topics from papers related to 'treatment', a new topic called Topic 05 'cytokine' was discovered. A cytokine storm is when the immune cells of our body do not defend against attacks, but attack normal cells. Hidden topics that could not be found for the entire thesis were classified according to keywords, and topic modeling was performed to find detailed topics. In this study, we proposed a method of extracting topics from a large amount of literature using the LDA algorithm and extracting similar words using the Skip-gram method that predicts the similar words as the central word among the Word2vec models. The combination of the LDA model and the Word2vec model tried to show better performance by identifying the relationship between the document and the LDA subject and the relationship between the Word2vec document. In addition, as a clustering method through PCA dimension reduction, a method for intuitively classifying documents by using the t-SNE technique to classify documents with similar themes and forming groups into a structured organization of documents was presented. In a situation where the efforts of many researchers to overcome COVID-19 cannot keep up with the rapid publication of academic papers related to COVID-19, it will reduce the precious time and effort of healthcare professionals and policy makers, and rapidly gain new insights. We hope to help you get It is also expected to be used as basic data for researchers to explore new research directions.
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