• Title/Summary/Keyword: Early involvement

Search Result 396, Processing Time 0.037 seconds

DENTAL TREATMENT IN A PATIENT WITH FUKUYAMA TYPE MUSCULAR DYSTROPHY UNDER TOTAL INTRAVENOUS ANESTHESIA USING PROPOFOL (후쿠야마 선천성 근이영양증 환자의 프로포폴을 이용한 전정맥마취 하 치과치료)

  • Jin, Dallae;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Jang, Ki-Taeg
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.40 no.1
    • /
    • pp.66-71
    • /
    • 2013
  • Muscular dystrophy is a genetically heterogeneous group of disorders characterized by progressive muscle weakness of variable distribution and severity. Fukuyama type congenital muscular dystrophy (FCMD) is an unusual form of muscular dystrophy with autosomal recessive inheritance and is clinically characterized by an early age of onset, severe central nervous system involvement, facial muscle weakness, and multiple joint contractures. Muscular dystrophy is susceptible to perioperative respiratory, cardiac and other complications. Patients with FCMD have upper airway muscle weakness, therefore general anesthesia is preferred to sedation regarding maintaining the airway when treating these patients. The development of malignant hyperthermia in general anesthesia for patients with muscular dystrophy is a concern. Total intravenous anesthesia should be used instead of inhaled anesthetics because of the risk of malignant hyperthermia. A 3-year-9-month old, 13kg girl with Fukuyama type congenital muscular dystrophy was scheduled for dental treatment under general anesthesia. She had multiple caries and 14 primary teeth needed caries treatment. Prior to general anesthesia, oral premedication with 9 mg midazolam was given. General anesthesia was induced and maintained with target controlled infusion of propofol $3{\sim}3.5{\mu}g/mL$. The patient with progressive muscular dystrophy was successfully treated under total intravenous anesthesia with a target controlled infusion of propofol. There were no complications related to anesthesia and dental treatment during or after the operation. This case suggests that target controlled infusion of propofol is a safe and appropriate anesthetic technique in FCMD patients for dental treatment.

Primary Synchronous Lung Cancer Detected using Autofluorescence Bronchoscopy (자가 형광 기관지 내시경을 이용한 동시성 원발성 폐암의 진단)

  • Kwon, Sun Jung;Lee, Yun Seun;Joung, Mi Kyong;Lee, Yu Jin;Jang, Pil Soon;Lee, Jeung Eyun;Chung, Chae Uk;Park, Hee Sun;Jung, Sung Soo;Kim, Sun Young;Kim, Ju Ock
    • Tuberculosis and Respiratory Diseases
    • /
    • v.60 no.6
    • /
    • pp.645-652
    • /
    • 2006
  • Objective: Patients with lung cancer have a relative high risk of developing secondary primary lung cancers. This study examined the additional value of autofluorescence bronchoscopy (AFB) for diagnosing synchronous lung cancers and premalignant lesions. Methods: Patients diagnosed with lung cancer from January 2005 to December 2005 were enrolled in this study. The patients underwent a lung cancer evaluation, which included white light bronchoscopy (WLB), followed by AFB. In addition to the primary lesions, any abnormal or suspicious lesions detected during WLB and AFB were biopsied. Results: Seventy-six patients had non-small cell lung cancer (NSCLC) and 23 had small cell lung cancer (SCLC). In addition to the primary lesions, 84 endobronchial biopsies were performed in 46 patients. Five definite synchronous cancerous lesions were detected in three patients with initial unresectable NSCLC and in one with SCLC. The secondary malignant lesions found in two patients were considered metastatic because of the presence of mediastinal nodes or systemic involvement. One patient with an unresectable NSCLC, two with a resectable NSCLC, and one with SCLC had severe dysplasia. The detection rate for cancerous lesions by the clinician was 6.0% (6/99) including AFB compared with 3.0% (3/99) with WLB alone. The prevalence of definite synchronized cancer was 4.0% (4/99) after using AFB compared with 2.0% (2/99) before, and the staging-up effect was 1.0% (1/99) after AFB. Since the majority of patients were diagnosed with advanced disease, the subjects with newly detected cancerous lesions did not have their treatment plans altered, except for one patient with a stage-up IV NSCLC who did not undergo radiotherapy. Conclusions: Additional AFB is effective in detecting early secondary cancerous lesions and is a more precise tool in the staging workup of patients with primary lung cancer than with WLB alone.

Radiotherapy Results of Uterine Cervix Cancer Stape IIB : Overall Survival, Prognostic factors, Patterns of Failure and Late Complications (자궁경부암 병기 IIB에서의 방사선 치료 성적: 생존율 및 예후인자, 치료 후 실패양상, 만성 합병증)

  • Kim Eun-Seog;Choi Doo-Ho;Huh Seung-Jae
    • Radiation Oncology Journal
    • /
    • v.16 no.1
    • /
    • pp.51-61
    • /
    • 1998
  • Purpose : Treatment of choice for uterine cervix cancer stage IIB is radiotherapy. We analyzed survivals, Prognostic factors, patterns of failure and complications. Materials and Methods : This is a retrospective analysis of 167 patients with stage IIB carcinoma of uterine cervix treated with curative external pelvic and high dose rate intracavitary radiotherapy at the Department of Therapeutic Radiology, Soonchunhyang University Hospital from August 1985 to August 1994. All the patients followed up from 3 to 141 months(mean 60 months) and age of patients ranged from 31 to 78 years at presentation(mean : 55 years). Results : Overall complete response rate was $84\%$. The response rate for squamous cell carcimoma and adenocarcinoma were $86\%$ and $60\%$, respectively. Overall 5-years survival rate and disease free survival rate was 62 and $59\%$, respectively Mass size and treatment response were significant Prognostic factors for survival Pathologic type and parametrial involvement were marginally significants Prognostic factors. Local failure was 43 cases, distant metastasis was 14 cases and local failure plus distant metastasis was 3 cases, and most of local failures occurred within 24 months, distant metastasis within 12 months after treatment Twenty eight($16.8\%$) patients developed late rectal and urinary complications There were tendency to increasing severity and frequency according to increased fractional dose and total(rectal and bladder) dose. Conclusions : Survival rate was significantly related to tumor size and radiotherapy response. Tumor size should be considered in the clinical s1aging. To increased survival and local control, clinical trials such as decreasing duration of radiotherapy or addition of chemotherapy is needed. To detect early recurrence, regular follow up after RT is important. Because total rectal and bladder dose affected late complications. meticulous vaginal packing is needed to optimize dose of normal tissues and to decrease late complications.

  • PDF

Factors for Survival and Complications of Malignant Bone Tumor Patients with a Total Femoral Replacement (대퇴골 전치환술 받은 악성 골종양 환자의 생존인자와 합병증)

  • Cho, Wan Hyeong;Jeon, Dae-Geun;Song, Won Seok;Park, Hwan Seong;Nam, Hee Seung;Kim, Kyung Hoon
    • Journal of the Korean Orthopaedic Association
    • /
    • v.55 no.3
    • /
    • pp.244-252
    • /
    • 2020
  • Purpose: Total femoral replacement (TFR) is an extreme form of limb salvage. Considering the rarity of this procedure, reports have focused on the complications and a proper indication is unclear. This study analyzed 36 patients with TFR who were asked the following: 1) prognostic factors related to survival in patients who underwent TFR with a tumoral cause; 2) overall implant and limb survival; 3) complications, functional outcome, and limb status for patients surviving for more than 3 years. Materials and Methods: According to the causes for TFR, 36 patients were categorized into three groups: extensive primary tumoral involvement (group 1, 15 cases), tumoral contamination by an inadvertent procedure or local recurrence (group 2, 16 cases), and salvage of a failed reconstruction (group 3, 5 cases). The factors that may affect the survival of patients included age, sex, cause of TFR, and tumor volume change after chemotherapy. Results: The overall five-year survival of the 36 patients was 31.5%±16.2%. The five-year survival of 31 patients with tumoral causes was 21.1%±15.6%. The five-year survival of 50.0%±31.0% in patients with a decreased tumor volume after chemotherapy was higher than that of increased tumor volume (p=0.02). The five-year survival of 12 cases with a wide margin was 41.7%±27.9%, whereas that of the marginal margin was 0.0%±0.0% (p=0.03). The ten-year overall implant survival of 36 patients was 85.9%±14.1%. The five-year revision-free survival was 16.6%±18.2%. At the final follow-up, 12 maintained tumor prosthesis, three underwent amputation (rotationplasty, 2; above knee amputation, 1), and the remaining one had knee fusion. Among 16 patients with a follow-up of more than three years, 14 patients underwent surgical intervention and two patients had conservative management. Complications included infection in 10 cases, local recurrences in two cases, and one case each of hip dislocation, bushing fracture, and femoral artery occlusion. Conclusion: Patients showing an increased tumor volume after chemotherapy and having an inadequate surgical margin showed a high chance of early death. In the long-term follow-up, TFR showed a high infection rate and the functional outcome was unsatisfactory. Nevertheless, this procedure is an inevitable option of limb preservation in selected patients.

Results of Bronchial Sleeve Resection for Primary Lung Cancer (원발성 폐암에 대한 기관지 소매 절제술의 성적)

  • Kim, Dae-Hyun;Youn, Hyo-Chul;Kim, Soo-Cheol;Kim, Bum-Shik;Cho, Kyu-Seok;Kwak, Young-Tae;Hwang, En-Gu;Kim, Dong-Won;Park, Joo-Chul
    • Journal of Chest Surgery
    • /
    • v.40 no.1 s.270
    • /
    • pp.37-44
    • /
    • 2007
  • Background: It is known that long-term survival rate in patients underwent bronchial sleeve lobectomy for primary lung cancer is at least equal to that in patients underwent pneumonectomy, and bronchial sleeve lobectomy is performed in patients with suitable tumor location even in patients have adequate pulmonary function. Sleeve pneumonectomy is performed when carina was invaded by tumor or tumor location was near to the carina. We performed this study to know our results of sleeve resection for primary lung cancer. Material and Method: We analyzed retrospectively the medical records of 45 patients who underwent sleeve lobectomy or sleeve pneumonectomy for primary lung cancer by one thoracic surgeon from May 1990 to July 2003 in Department of Thoracic & Cardiovascular Surgery, College of Medicine, Kyung Hee University. Follow-up loss was absent and last follow-up was performed in April 5, 2005. Kaplan-Meyer method and log-lank test were used to know long-term survival rate and p-value. Result: Mean age was 60 years old and male to female ratio 41:1. Histologic types were squamous cell carcinoma were 39, adenocarcinoma were 4, and others were 2 patients. Pathologic stages were I 14, II 14, and III 17 patients. Nodal stages were N0 23, N1 13, and N2 9 patients. Types of operation were sleeve lobectomy 40 and sleeve pneumonectomy 5 patients. Operative mortality was 3 patients and its cause was respiratory complications. Early complications were pneumonia 4, atelectasis 8, air leakage more than 7 days 6, and atrial fibrillation 4 patients. In 19 patients tumor was recurred. Local recurrence was 10 and systemic metastasis was 9 patients. Overall 5, 10-year survival rate were 54.2%, 42.5%. The 5, 10-year survival rates according to the pathologic stage were 83.9%, 67.1% in stage I, 55%, 47.1% in II, 33.3%, 25% in III, and significance difference was present between stage I and III. The 5, 10-year survival rate according to the lymph node involvement were 63.9%, 54.6% in N0, 53,8%, 46.5% in N1, 28.5%, 14.2% in N2, and significance difference was present between N0 and N2. Conclusion: Because bronchial sleeve lobectomy for primary lung cancer could be performed safely and shows acceptable long-term survival rate, it could be considered primary in case of suitable tumor location if complete resection is possible. Although sleeve pneumonectomy for primary lung cancer shows somewhat high operative mortality rate, it could be considered in view of curative treatment.

Typology of Korean Eco-sumers: Based on Clothing Disposal Behaviors (관우한국생태학적일개예설(关于韩国生态学的一个预设): 기우복장탑배적행위(基于服装搭配的行为))

  • Sung, Hee-Won;Kincade, Doris H.
    • Journal of Global Scholars of Marketing Science
    • /
    • v.20 no.1
    • /
    • pp.59-69
    • /
    • 2010
  • Green or an environmental consciousness has been a major issue for businesses and government offices, as well as consumers, worldwide. In response to this movement, the Korean government announced, in the early 2000s, the era of "Green Growth" as a way to encourage green-related business activities. The Korean fashion industry, in various levels of involvement, presents diverse eco-friendly products as a part of the green movement. These apparel products include organic products and recycled clothing. For these companies to be successful, they need information about who are the consumers who consider green issues (e.g., environmental sustainability) as part of their personal values when making a decision for product purchase, use, and disposal. These consumers can be considered as eco-sumers. Previous studies have examined consumers' purchase intention for or with eco-friendly products. In addition, studies have examined influential factors used to identify the eco-sumers or green consumers. However, limited attention was paid to eco-sumers' disposal or recycling behavior of clothes in comparison with their green product purchases. Clothing disposal behaviors are ways that consumer can get rid of unused clothing and in clue temporarily lending the item or permanently eliminating the item by "handing down" (e.g., giving it to a younger sibling), donating, exchanging, selling, or simply throwing it away. Accordingly, examining purchasing behaviors of eco-friendly fashion items in conjunction with clothing disposal behaviors should improve understanding of a consumer's clothing consumption behavior from the environmental perspective. The purpose of this exploratory study is to provide descriptive information about Korean eco-sumers who have ecologically-favorable lifestyles and behaviors when buying and disposing of clothes. The objectives of this study are to (a) categorize Koreans on the basis of clothing disposal behaviors; (b) investigate the differences in demographics, lifestyles, and clothing consumption values among segments; and (c) compare the purchase intention of eco-friendly fashion items and influential factors among segments. A self-administered questionnaire was developed based on previous studies. The questionnaire included 10 items of clothing disposal behavior, 22 items of LOHAS (Lifestyles of Health and Sustainability) characteristics, and 19 items of consumption values, measured by five-point Likert-type scales. In addition, the purchase intention of two eco-friendly fashion items and 11 attributes of each item were measured by seven-point Likert type scales. Two polyester fleece pullovers, made from fabric created from recycled bottles with the PET identification code, were selected from one Korean brand and one US imported brand among outdoor sportswear brands. A brief description of each product with a color picture was provided in the survey. Demographic variables (i.e., gender, age, marital status, education level, income, occupation) were also included. The data were collected through a professional web survey agency during May 2009. A total of 600 final usable questionnaires were analyzed. The age of respondents ranged from 20 to 49 years old with a mean age of 34 years. Fifty percent of the respondents were males and about 58% were married, and 62% reported having earned university degrees. Principal components factor analysis with varimax rotation was used to identify the underlying dimensions of the clothing disposal behavior scale, and three factors were generated (i.e., reselling behavior, donating behavior, non-recycling behavior). To categorize the respondents on the basis of clothing disposal behaviors, k-mean cluster analysis was used, and three segments were obtained. These consumer segments were labeled as 'Resale Group', 'Donation Group', and 'Non-Recycling Group.' The classification results indicated approximately 98 percent of the original cases were correctly classified. With respect to demographic characteristics among the three segments, significant differences were found in gender, marital status, occupation, and age. LOHAS characteristics were reduced into the following five factors: self-satisfaction, family orientation, health concern, environmental concern, and voluntary service. Significant differences were found in the LOHAS factors among the three clusters. Resale Group and Donation Group showed a similar predisposition to LOHAS issues while the Non-Recycling Group presented the lowest mean scores on the LOHAS factors compared to the other segments. The Resale and Donation Groups described themselves as enjoying or being satisfied with their lives and spending spare-time with family. In addition, these two groups cared about health and organic foods, and tried to conserve energy and resources. Principal components factor analysis generated clothing consumption values into the following three factors: personal values, social value, and practical value. The ANOVA test with the factors showed differences primarily between the Resale Group and the other two groups. The Resale Group was more concerned about personal value and social value than the other segments. In contrast, the Non-Recycling Group presented the higher level of social value than did Donation Group. In a comparison of the intention to purchase eco-friendly products, the Resale Group showed the highest mean score on intent to purchase Product A. On the other hand, the Donation Group presented the highest intention to purchase for Product B among segments. In addition, the mean scores indicated that the Korean product (Product B) was more preferable for purchase than the U.S. product (Product A). Stepwise regression analysis was used to identify the influence of product attributes on the purchase intention of eco product. With respect to Product A, design, price and contribution to environmental preservation were significant to predict purchase intention for the Resale Group, while price and compatibility with my image factors were significant for the Donation Group. For the Non-Recycling Group, design, price compatibility with the factors of my image, participation to eco campaign, and contribution to environmental preservation were significant. Price appropriateness was significant for each of the three clusters. With respect to Product B, design, price and compatibility with my image factors were important, but different attributes were associated significantly with purchase intention for each of the three groups. The influence of LOHAS characteristics and clothing consumption values on intention to purchase Products A and B were also examined. The LOHAS factor of health concern and the personal value factor were significant in the relationships with the purchase intention; however, the explanatory powers were low in the three segments. Findings showed that each group as classified by clothing disposal behaviors showed differences in the attributes of a product, personal values, and the LOHAS characteristics that influenced their purchase intention of eco-friendly products. Findings would enable organizations to understand eco-friendly behavior and to design appropriate strategic decisions to appeal eco-sumers.