• 제목/요약/키워드: Definitive

검색결과 986건 처리시간 0.029초

Platelet Indices May be Useful in Discrimination of Benign and Malign Endometrial Lesions, and Early and Advanced Stage Endometrial Cancer

  • Kurtoglu, Emel;Kokcu, Arif;Celik, Handan;Sari, Seher;Tosun, Migraci
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권13호
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    • pp.5397-5400
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    • 2015
  • Background: The aim of this study was to investigate the predictive value of white blood cells (WBC), the neutrophil to lymphocyte ratio (NLR), platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT) and platelet to lymphocyte ratio (PLR) in discrimination between benign and malign endometrial lesions, and early and advanced stage endometrial adenocarcinomas. Materials and Methods: Data for 105 patients undergoing total abdominal or vaginal hysterectomy for benign uterine diseases and 114 patients surgically staged for endometrium adenocarcinoma at Ondokuz Mayis University, Department of Gynecology and Obstetrics, between 2008 and 2014, were collected. Parameters were preoperative and postoperative complete blood counts in the week prior to surgery with differentials including WBC, platelet count, platelet indices (MPV, PCT, PDW), NLR and PLR. Pathologic evaluations for both benign and malign endometrium lesions, grade of endometrium adenocarcinoma, tumor stage, presence of lymphovascular space invasion (LVI) were retrospectively analyzed. Results: Regarding definitive factors in discriminating patients with endometrium cancer from those with benign diseases, MPV was significantly increased in the malign group whereas there was a significant decrease in the PDW value compared to the benign group. The best cut-off value in differentiation of the benign and malign groups, malign cases were found to increase over the value of 7.54 for MPV, and under 37.8 for PDW. When definitive factors in discrimination of early stage endometrium cancer from advanced stage disease and LVI in the malign group were evaluated according to the ROC analysis, no significant relation was detected between blood parameters and the stage and the LVI of the disease. Conclusions: MPV and PDW may have predictive value in the discrimination of benign and malign endometrium diseases. Nevertheless, since there have been few reports on this topic, further large-scale prospective studies are necessary.

혈역학적으로 불안정한 골반외상 환자의 치료를 통해 본 외상전문의의 필요성 (The Importance of the Trauma Surgeon: A Reflection on the Management of Hemodynamically Unstable Pelvic Trauma Patients)

  • 신성;경규혁;김지완;김정재;홍석경
    • Journal of Trauma and Injury
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    • 제22권2호
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    • pp.254-259
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    • 2009
  • Purpose: Pelvic trauma is a serious skeletal injury with high mortality. Especially in cases of severe injury trauma, treatment outcomes depend on early diagnosis and intervention. We expect trauma surgeon to play an important role in the management of severe multiple trauma patients. Methods: A retrospective study was performed on pelvic trauma patients with hemodynamic instability between March 2005 and September 2009. We divided the time period into period I (March 2005~Feburary 2009) and period II (March 2009~September 2009). The trauma surgeon and team started to work from period II. Data were collected regarding demographic characteristics, mechanism of injury, type of pelvic fracture, ISS(injury severity score), treatment modality, transfusion requirement, time to definitive treatment, and mortality. Results: During period I, among 7 hemodynamically unstable patients, 4(57.1%) patients died. However during Period II, only one of 6(16.6%) patients died. The demographic data and injury scores showed no differences between the two time periods, but the time to definitive treatment was very short with trauma team intervention(14.4 hrs vs. 3.9 hrs). Also, the amount of transfusion was less(41.1 U vs. 13.9 U). With arterial embolization, early pelvic external fixation led to less transfusion and made patients more stable. Conclusion: This study demonstrated the importance of the trauma surgeon and the trauma team in cases of hemodynamically unstable pelvic trauma. Even with the same facility and resources, an active trauma team approach can increase the survival of severely injured multiple trauma patients.

Fluorodeoxyglucose positron-emission tomography ratio in non-small cell lung cancer patients treated with definitive radiotherapy

  • Kang, Hyun-Cheol;Wu, Hong-Gyun;Yu, Tosol;Kim, Hak Jae;Paeng, Jin Chul
    • Radiation Oncology Journal
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    • 제31권3호
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    • pp.111-117
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    • 2013
  • Purpose: To determine whether the maximum standardized uptake value (SUV) of [$^{18}F$] fluorodeoxyglucose uptake by positron emission tomography (FDG PET) ratio of lymph node to primary tumor (mSUVR) could be a prognostic factor for node positive non-small cell lung cancer (NSCLC) patients treated with definitive radiotherapy (RT). Materials and Methods: A total of 68 NSCLC T1-4, N1-3, M0 patients underwent FDG PET before RT. Optimal cutoff values of mSUVR were chosen based on overall survival (OS). Independent prognosticators were identified by Cox regression analysis. Results: The most significant cutoff value for mSUVR was 0.9 with respect to OS. Two-year OS was 17% for patients with mSUVR > 0.9 and 49% for those with mSUVR ${\leq}0.9$ (p = 0.01). In a multivariate analysis, including age, performance status, stage, use of chemotherapy, and mSUVR, only performance status (p = 0.05) and mSUVR > 0.9 (p = 0.05) were significant predictors of OS. Two-year OS for patients with both good performance (Eastern Cooperative Oncology Group [ECOG] ${\leq}1$) and mSUVR ${\leq}0.9$ was significantly better than that for patients with either poor performance (ECOG > 1) or mSUVR > 0.9, 23% (71% vs. 23%, p = 0.04). Conclusion: Our results suggested that the mSUVR was a strong prognostic factor among patients with lymph node positive NSCLC following RT. Addition of mSUVR to performance status identifies a subgroup at highest risk for death after RT.

Radiotherapy in prostate cancer treatment: results of the patterns of care study in Korea

  • Chang, Ah Ram;Park, Won
    • Radiation Oncology Journal
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    • 제35권1호
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    • pp.25-31
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    • 2017
  • Purpose: The purpose of this study was to describe treatment patterns of radiotherapy (RT) for prostate cancer in Korea. Materials and Methods: A questionnaire about radiation treatment technique and principles in 2013 was sent to 83 radiation oncologists and data from 57 hospitals were collected analyzed to find patterns of RT for prostate cancer patients in Korea. Results: The number of patients with prostate cancer treated with definitive RT ranged from 1 to 72 per hospital in 2013. RT doses and target volumes increased according to risk groups but the range of radiation doses was wide (60 to 81.4 Gy) and the fraction size was diverse (1.8 to 5 Gy). Intensity-modulated radiation therapy was used for definitive treatment in 93.8% of hospitals. Hormonal therapy was integrated with radiation for intermediate (63.2%) and high risk patients (77.2%). Adjuvant RT after radical prostatectomy was performed in 46 hospitals (80.7%). Indications of adjuvant RT included positive resection margin, seminal vesicle invasion, and capsular invasion. The total dose for adjuvant RT ranged from 50 to 72 Gy in 24-39 fractions. Salvage RT was delivered with findings of consecutive elevations in prostate-specific antigen (PSA), PSA level over 0.2 ng/mL, or clinical recurrence. The total radiation doses ranged from 50 to 80 Gy with a range of 1.8 to 2.5 Gy per fraction for salvage RT. Conclusion: This nationwide patterns of care study suggests that variable radiation techniques and a diverse range of dose fractionation schemes are applied for prostate cancer treatment in Korea. Standard guidelines for RT in prostate cancer need to be developed.

흰쥐, 개 및 고양이의 이락촌폐흡충 감염 실험 (Experimental infection of Paragonimus iloktsuenensis to albino rats, dogs and cats)

  • 이순형;구경회
    • Parasites, Hosts and Diseases
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    • 제27권3호
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    • pp.197-202
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    • 1989
  • 이 연구는 흰쥐, 개 및 고양이 숙주에 대한 이락촌폐흡충(Paragonimus iloktsuenensis)의 감염력 및 충체 성장 발육을 비교함으로써 개 및 고양이의 숙주 적합성을 알아보고 나아가 이 흡충 의 인체 감염 가능성을 추정해 보고자 실시하였다. 섬진강 하구산 말똥게(Sesarma dehaani)로부터 분리, 수집한 이락촌폐흡충의 피낭유충을 흰쥐, 개 및 고양이에 경구 감염시킨 후 42일을 기준으로 충체를 회수하였으며, 감염 후 42일에 회수한 충체를 유대로 하여 성장 발육을 비교하였다. 감염 후 42일에 흰쥐, 개 및 고양이에서 충체 회수율은 각각 평균 53.4%, 21.9% 및 12.7%이었으나 회수된 충체의 크기가 각각 평균 6.3×3.2mm, 6.3×3.0mm 및 6.2×3.5mm로 차이가 없었고 충체 발육 상에 있어서도 차이가 없었다. 이 연구의 결과는 이탁촌폐흡충의 종숙주로서 개 및 고양이가 충분히 가능함을 나타내었다.

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Intestinal Helminth Infections in Feral Cats and a Raccoon Dog on Aphaedo Island, Shinan-gun, with a Special Note on Gymnophalloides seoi Infection in Cats

  • Shin, Eun-Hee;Park, Jae-Hwan;Guk, Sang-Mee;Kim, Jae-Lip;Chai, Jong-Yil
    • Parasites, Hosts and Diseases
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    • 제47권2호
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    • pp.189-191
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    • 2009
  • Four feral cats and a raccoon dog purchased from a local collector on Aphaedo Island, Shinan-gun, where human Gymnophalloides seoi infections are known to be prevalent, were examined for their intestinal helminth parasites. From 2 of 4 cats, a total of 310 adult G. seoi specimens were recovered, Other helminths detected in cats included Heterophyes nocens (1,527 specimens), Pygidiopsis summa (131), Stictodora fuscata (4), Acanthotrema felis (2), Spirometra erinacei (15), toxocarids (4), and a hookworm (1). A raccoon dog was found to be infected with a species of echinostome (55), hook-worms (7), toxocarids (3), P. summa (3), and S. erinacei (1). No G. seoi was found in the raccoon dog. The results indicate that feral cats and raccoon dogs on Aphaedo are natural definitive hosts for intestinal trematodes and cestodes, including G. seoi, H. nocens, and S. erinacei, It has been first confirmed that cats, a mammalian species other than humans, play the role of a natural definitive host for G. seoi on Aphaedo Island.

최근 5년간의 흉부손상 경험 -481 예- (five year experience of thoracic civilian injuries -481 cases-)

  • 손광현;구본일;김태영
    • Journal of Chest Surgery
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    • 제19권3호
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    • pp.421-428
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    • 1986
  • From January 1981 through December 1985, 481 thoracic civilian injuries were reviewed in the Department of Thoracic Surgery, Paik Hospital in Seoul. Sixty two percent of the injuries were caused by traffic accident, 18% fall down, 15% blunt trauma, 2% crushing injury, 2% stab wound, and 0.4% gunshot wound. Peak incidence of the trauma victim was fourth and fifth decades revealing 22% and 27% respectively. Sex ratio was 3.5:1 with male predominance. Elapsed time before admission was less than one hour in 36% and one to six hour in 30%. The types of the injuries were as follows: Non-penetrating injuries were the most part of the wounded, 97.6%. Rib fracture was the most common lesion occupying 292 patient out of 481 [61%]. Of these 292 patients, 72% was multiple rib fracture. The incidence of hemothorax or hemopneumothorax was 19% [102 patients] [Table 4]. Most common associated condition was head injuries, 98 patients [14%]. Thoracoabdominal injuries were seen in 31 patients [0.6%]. Tube thoracostomy was the definitive measures in the 20% of the wounded. Open thoractomy was performed in 5%. Additional procedures for the associated condition were done in the 16% of the cases, for example, reduction of long bone fracture and trephination for the head injury. Among 481 wounded, fatal complication occurred in 13 patients [2.7%]. This paper has also compared two series of patients according to period; one from 1970 to 1980 and the present series [Table 8]. Conclusively, the fatal complications or trauma death may be reduced by the effort 1] rapid transport of the victim, 2] initial correction or resuscitative measures of the circulatory and ventilatory deficit 3] early decision of definitive thoracostomy or thoracotomy and 4] proper prioritizing for the care of the multiple critically injured patient.

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Stoichiometry of $Ns^+/Ca^{2+}$ Exchange Quantified with Ion-selective Microelectrodes in Giant Excised Cardiac Membrane Patches

  • kang, Tong Mook;Hilgemann, Donald W.
    • 한국생물물리학회:학술대회논문집
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    • 한국생물물리학회 2003년도 정기총회 및 학술발표회
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    • pp.30-30
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    • 2003
  • Without a definitive resolution of stoichiometry of cardiac Na$^{+}$-Ca$^{2+}$exchange (NCX), we cannot proceed to any quantitative analysis of exchange function as well as cardiac excitation-contraction coupling. The stoichiometry of cardiac NCX, however, is presently in doubt because reversal potentials determined by various groups range between those expected for a 3-to-1 and a 4-to-1 flux coupling. For a new perspective on this problem, we have used ion-selective microelectrodes to quantify directly exchanger-mediated fluxes of $Ca^{2+}$and Na$^{+}$in giant membrane patches. $Ca^{2+}$- and Na$^{+}$-selective microelectrodes, fabricated from quartz capillaries, are placed inside of the patch pipettes to detect extracellular ion transients associated with exchange activity. Ion changes are monitored at various distances from the membrane, and the absolute ion fluxes through NCX are determined via simulations of ion diffusion and compared with standard ion fluxes (Ca$^{2+}$ fluxes mediated by $Ca^{2+}$ ionophore, and Na$^{+}$ fluxes through gramicidin channels and Na$^{+}$/K$^{+}$pumps). Both guinea pig myocytes and NCX1-expressing BHK cells were employed, and for both systems the calculated stoichiometries for inward and outward exchange currents range between 3.2- and 3.4-to-1. The coupling ratios do not change significantly when currents are varied by changing cytoplasmic [Ca$^{2+}$] or by adding cytoplasmic Na$^{+}$. The exchanger reversal potentials, measured in both systems under several ionic conditions, range from 3.1- to 3.3-to-1. Taken together, a clear discrepancy from a NCX stoichiometry of 3-to-1 was obtained. Further definitive experiments are required to acquire a fixed number, and the present working hypothesis is that NCX current has an extra current via ‘conduction mode’.ent via ‘conduction mode’.

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3차원 디지털 영상과 CAD/CAM 시스템을 활용한 전악 임플란트 수복 증례 (Full mouth rehabilitation with dental implant utilizing 3D digital image and CAD/CAM system: case report)

  • 강세하;정승미;신재옥;방정환;김대환;최병호
    • 구강회복응용과학지
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    • 제31권2호
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    • pp.158-168
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    • 2015
  • 본 증례는 상 하악 완전 무치악 환자에서 진단, 식립 그리고 보철물 제작에 디지털 방식을 활용하는 방법에 대해 제시하였다. 상악은 구개 부위, 하악은 기존 의치에 방사선 불투과성 마커를 부착한 후 구강스캔 및 CBCT 촬영을 시행하였다. 구강스캔 이미지와 CBCT 이미지를 중첩시켜 진단 및 수술가이드와 임시보철물을 제작하였다. 골유착 후에는 스캔바디를 이용한 구강스캔을 통해 최종보철물을 제작하였다. 임플란트를 이용한 전악수복에서 디지털 방식을 다양하게 활용하였으며 정확성과 환자의 불편감 최소화라는 목적에 만족할만한 결과를 얻었기에 이 증례를 보고하고자 한다.

동영상 촬영방식의 구강스캐너로 채득된 전악치열 디지털모형의 정확도 분석 : CS-3600 시스템을 중심으로 (Accuracy of full arch digital model obtained from rendering-based intraoral scanner(IOS) : An example of CS-3600 system)

  • 김재홍
    • 대한치과기공학회지
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    • 제42권1호
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    • pp.17-25
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    • 2020
  • Purpose: The purpose of this study was to evaluate and compare the accuracy of definitive casts that are fabricated from digital intraoral impression and conventional impression technique. Methods: A master model(ANNA-4, Frasaco GmbH, Tettnang, Germany) with the prepared upper full arch tooth was used. Conventional impression and then stone model(n=10) were produced from this master model, and on the other hands, digital impressions were made with the CS-3600 intraoral scanner(n=10). Six linear measurements were recorded between landmarks, directly on each of the stone models on two occasions by a single examiner. Measurements were made with a digital caliper to the nearest 0.01mm from manual models and with the software(Delcam PowerSHAPE) from the virtual models. The t-student test for paired samples and intraclass correlation coefficient(ICC) were used for statistical analysis. Results: The measurement of two methods showed good reliability. The ICC of the two models were 0.88~0.91(stone model) and 0.94~0.99(digital model). The mean differences to master model for stone model and digital model were 0.10~0.14mm, and 0.14~0.20mm, respectively. Conclusion: The definitive casts obtained with digital intraoral technique model had significantly larger dimensions as compared to those of the stone model. However, the differences to the master model detected appear to provide enough accuracy and reliability for clinical application.