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Treatment Results of Hypopharyngeal Carcinoma (하인두암의 방사선치료 성적)

  • Lee Chang Gul;Loh John J.K.;Ryu Sam Youl;Park Kyung Ran;Suh Chang Ok;Kim Gew Earn;Hong Won Pyo;Kim Byung Soo
    • Radiation Oncology Journal
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    • v.6 no.1
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    • pp.23-33
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    • 1988
  • A rerospective review of fifty patients with carcinoma of hypopharynx treated with $RT{\pm}surgery$ was studied for eleven-year period from 1974 to 1984. Of the 50 patients,46 were pyriform sinus in origin, 4 were posterior pharyngeal wall. Eighty-eight percent of patients were locoregionally advanced(stage III, IV) and 78% of patients presented conical lymphadenopathy. 5-year disease-free survival rate of the pyriform sinus ca. was $25.4\%$ in RT alone group, $80\%$ in combined modality group and $30.6\%$ in overall. Local control rate with RT alone in early stage (II) was excellent $(100\%)$, however combined modality appears to be better for local control$(80\%)$ in advanced stage (III, IV) as compared with that of RT alone group $(32\%).$ On basis of this study, RT alone is effective in terms of local control and functional preservation in treatment of early stage of pyriform sinus ca. while surgery can be reserved for salvage purpose when RT fails and combined modality is recommended in patients with locally advanced stage for better local control and survival.

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Prevalene of Secondary Hypertension in Yeungnam University Hospital (영남대학교 의과대학 부속병원에서의 이차성 고혈압의 유병율)

  • Kweon, Jun-Young;Choi, Kyo-Won;Sin, Dong-Gu;Lee, Hyeung-Woo;Yoon, Kyeung-Woo;Kim, Young-Jo;Shim, Bong-Sup;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.109-114
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    • 1994
  • We studied the incidence and results of treatment of secondary hypertension in Yeungnam University Hospital. Ntneteen hundred fifty patients with hypertension were included from march 1990 to march 1994. We analysed the prevalence of secondary hypertension and results of treatment. The incidence of secondary hypertension in Yeungnam University Hospital was six percent. The most common underlying causes of secondary hypertension was renal parenchymal disease. Patients with three forms of potentially reversible secondary hypertension, namely, renovascular hypertension, endocrine disease exogenous hormone, were assed to determine whether surgery or withdrawal of the exogenous hormone had led to an improvement in blood pressure control. The incidence of secondary hypertension in Yeungnam University Hospital was low(6%), but some of these are curable. Thus it is very inportant that evaluate the secondary hypertension.

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Factors Affecting Discharge Delay in Lumbar Spinal Surgery Patients Who were Treated according to a Critical Pathway (표준진료지침을 적용한 요추 수술 환자의 퇴원 지연에 영향을 미치는 요인)

  • Kim, Jeoung Hee;Lee, Eun Ha;Kim, Su Ran;Kim, Sung Reul
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.43-52
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    • 2016
  • Purpose: The aim of this study was to identify demographic, clinical, physical, and psychosocial factors affecting discharge delay in lumbar spinal surgery patients who were treated according to a critical pathway. Methods: A sample of 170 patients with lumbar spinal surgery agreed to participate in the study, between April 1, 2014 and August 30, 2015. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test, ANCOVA, and logistic regression analysis using SPSS 22.0 program. Results: Approximately fifty-nine percent of the participants was delayed discharge. On logistic regression analysis, female gender (OR=2.63, 95% CI=1.40~4.94), age (OR=1.03, 95% CI=1.01~1.05), spondylolisthesis (OR=4.49, 95% CI=1.90~10.61), and spinal fusion operation (OR=4.14, 95% CI=1.89~9.05) were significant factors predicting discharge delay of the participants. However, discharge delay was not related with pain, physical function, depression, or family support. Conclusion: An analysis of discharge delay may assist in evaluating and revising critical pathway for optimal care. In addition, nurses need to understand the factors affecting discharge delay of the given population who were treated according to a critical pathway.

A Study on the Recognition and Actual Condition of Korea Medical Doctors in Oriental Medical Care of Hypertension (국내 임상한의사의 고혈압 한방치료 인식 및 실태조사)

  • Shin, Mi-Suk;Han, Chang-Hyun;Kim, Bo-Young;Kim, Ki-Jin;Park, Sun-Hee;Choi, Sun-Mi
    • Journal of Acupuncture Research
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    • v.25 no.6
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    • pp.23-33
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    • 2008
  • Objectives : The study was accomplished to find out how korean medical doctor take oriental medical service for hypertension patients in clinical practice Methods : Survey questions were developed based on consensus of 2 clinician, 2 oriental internal medicine specialist and 1 acupuncture specialist. The list of the Korean oriental medical doctors is provided by the Association of the Korean Oriental Medicine. The questionnaire were distributed via E-mail to 9,465 members of Korean oriental medical doctors from 19th August 2008 to 11th September 2008. One thousand sixty three(11.24% of 9,465) members completed answer and the computerized data were analyzed by SAS statistical program Results : Fifty-one percent of Korean oriental medical doctors has experienced hypertension treatment. The most common medical diagnosis method was pattern diagnosis(64.2%). Saam and five element acupuncture were as frequent as 32.3% of acupuncture prescription principle. The most common acupuncture points were region of shoulder and back acupoints inclued $GB_{21}$, $GV_{14}$(25%). The most common herbs prescription principle were 'constitution prescription'(35.4%), 'pattern prescription'(12.6%). The most common opinion for the revitalization of oriental medical service were 'medical insurance system of herbal medicine'(28.8%) and 'research of oriental medical treatments in hypertensive patients'(26.8%). Conclusions : This survey provides unique insight into the perception, treatment method of the Korea medical doctor at oriental medical service for hypertension patient. This study provides a wealth of information and a fresh raft of questions which will inform future research and policy-making.

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Therapeutic Effects of Kyphoplasty on Osteoporotic Vertebral Fractures (골다공성 척추체 골절에서 척추 후만변형 복원술의 치료효과)

  • Park, Chun-Kun;Kim, Dong-Hyun;Ryu, Kyung-Sik;Son, Byung-Chul
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.116-123
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    • 2005
  • Objective: Percutaneous kyphoplasty using a balloon-catheter is an widely accepted method which achieves the restoration of vertebral height and the correction of kyphotic deformity with little complication in osteoporotic vertebral compression fractures. The authors assess the results of 59 patients who underwent kyphoplasty, and analyze the factors that could affect the prognosis. Methods: From December 2001 to May 2003, fifty-nine patients underwent kyphoplasty. The patients included 49 women and 10 men aged 52-85 years. Average t-score on bone marrow density was -3.58. About 7cc of polymethylmethacrylate(PMMA) was injected into the fractured vertebral body using $Kyphon^{(R)}$ under local anesthesia. The vertical height of all fractured vertebrae was measured both before and after surgery. Outcome data were obtained by comparing pre- and post-operative VAS score and by assessing postoperative satisfaction, drug dependency and activity. Various clinical factors were analyzed to assess the relationship with the outcome. Results: The VAS score improved significantly, and the mean percentage of restored vertebral height was 53%. The mean improvement in kyphosis was $3.6^{\circ}$. Eighty-nine percent of the patients gained excellent or good results. Any of the clinical factors including the interval between fracture and operation, the degree of height loss, the degree of the vertebral height restoration or the correction rate of kyphosis did not affect the clinical results. Conclusion: Kyphoplasty is associated with a statistically significant improvement in pain and function with little complication. The clinical results are not affected by any clinical parameters. Further follow-up study is needed to determine whether the restoration affects the long-term clinical results.

Effect of Cisternal Drainage on the Shunt Dependency Following Aneurysmal Subarachnoid Hemorrhage

  • Kim, Sung Hun;Chung, Pil-Wook;Won, Yu Sam;Kwon, Young Joon;Shin, Hyun Chul;Choi, Chun Sik
    • Journal of Korean Neurosurgical Society
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    • v.52 no.5
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    • pp.441-446
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    • 2012
  • Objective : Shunt-dependent chronic hydrocephalus (SDCH) is known to be a major complication associated with aneurysmal subarachnoid hemorrhage (aSAH). Old age is known to be one of numerous factors related to the development of SDCH. This study investigated whether postoperative cisternal drainage affects the incidence of SDCH and clinical outcome in elderly patients with aSAH. Methods : Fifty-nine patients participated in this study. All patients underwent aneurysmal clipping with cisternal cerebrospinal fluid (CSF) drainage. Clinical variables relevant to the study included age, sex, location of ruptured aneurysm, CT finding and clinical state on admission, clinical outcome, and CSF drainage. We first divided patients into two groups according to age (<70 years of age and ${\geq}70$ years of age) and compared the two groups. Secondly, we analyzed variables to find factors associated with SDCH in both groups (<70 years of age and ${\geq}70$ years of age). Results : Of 59 patients, SDCH was observed in 20 patients (33.9 %), who underwent shunt placement for treatment of hydrocephalus. Forty seven percent of cases of acute hydrocephalus developed SDCH. In the elderly group (${\geq}70$ years of age), the duration and amount of CSF drainage did not affect the development of chronic hydrocephalus. Conclusion : In elderly patients, although the incidence of SDCH was significantly higher, clinical outcome was acceptable. The duration and the amount of cisternal drainage did not seem to be related to subsequent development of chronic hydrocephalus within elderly patients aged 70 or older.

Application of Sediment Yield Estimation Methods for an Urbanized Basin (도시유역에 대한 토사유출량 모의기법 적용성 검토)

  • Son, Kwang-Ik;Roh, Jin-Wook
    • Journal of Korea Water Resources Association
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    • v.42 no.9
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    • pp.737-745
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    • 2009
  • Field measured sediment yield from an experimental urbanized basin was compared with the predicted sediment yields with RUSLE (Revised Universal Soil Loss Equation), and MUSLE (Modified Universal Soil Loss Equation). The experimental basin is 3.1km2 in area and fifty six percent of the total area had been urbanized. The hydrological data have been measured with T/M at the outlet of the experimental basin. Runoff from the basin and rainfall depth of the basin were measured every minute. Bed load and suspended load were also measured for a given flow rate. Runoff rating curves and sediment rating curve were developed for the last three years. RUSLE showed scattered prediction results but the average of the prediction values was close to the measured one. Meanwhile, MUSLE showed linear correlation between the measured sediment yield and predicted one with high correlation coefficient. But MUSLE predicts high values than the real one. Therefore, adjustment is necessary to apply MUSLE in estimation of sediment yield from the experimental urbanized basin.

Analysis on Production Processes between Conventional and Commissary School Foodservice Systems in Kyunggi-do (경기도지역 학교급식시스템 유형별 생산관리 실태조사)

  • 양일선;이진미;이보숙;한경수
    • Korean Journal of Community Nutrition
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    • v.2 no.2
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    • pp.206-217
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    • 1997
  • This study was designed to analyze and compare production management practices and labor productivity between conventional and commissary school foodservices and 46 dietitians of commissary school foodservices in Kyunggi-do. The response rates were 89.7% and 91.3$\%$, respectively. The number of meals served was ranged from less than 100 to over 1, 900 in conventional school foodservices and from 200 to 1, 600 in commissary foodservices. Thirty three conventional foodservices(42.3%) produced less than 300 meals per day. Numbers of satellite school per central kitchen were ranged from 1 to 5 schools ; fifty percent of commissary foodservices have contained 3 satellite schools. Meals for satellite schools were transported between 11:00 a.m.and 12:00 a.m ; transportation time was from 10 to 90 minutes. Waiting time before service in satellite schools was between 10 minutes and 80 minutes. Part time employees supported by parents were hired in 37.3$\%$ of conventional and 50$\%$ of commissary school foodservices. Voluntary workers were supplied for 64.9$\%$ of conventional and 52.4$\%$ of commissary school foodservices. Labor productivity was calculated from work schedule. Labor productivity(labor minutes per meal)was lowest in foodservices with 101-4-- meals(8.48 min)was lower than that of foodservices with above 401 meals ; no significant differences were found among 401-700(6.02 min), 701-1, 100(4.01 min), 1, 101-1, 500(3.41 min), and 1, 501-1, 900(3.15 min)meals in conventional foodservices. Labor minutes per meal of foodservices which served less than 400 meals(6.90 min) per day was significantly lower than those of foodservices which served 401-1, 900 meal(3.41-4.92 min) in commissary foodservices(p<0.05)

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Scar Wars: Preferences in Breast Surgery

  • Joyce, Cormac W;Murphy, Siun;Murphy, Stephen;Kelly, Jack L;Morrison, Colin M
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.596-600
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    • 2015
  • Background The uptake of breast reconstruction is ever increasing with procedures ranging from implant-based reconstructions to complex free tissue transfer. Little emphasis is placed on scarring when counseling patients yet they remain a significant source of morbidity and litigation. The aim of this study was to examine the scarring preferences of men and women in breast oncoplastic and reconstructive surgery. Methods Five hundred men and women were asked to fill out a four-page questionnaire in two large Irish centres. They were asked about their opinions on scarring post breast surgery and were also asked to rank the common scarring patterns in wide local excisions, oncoplastic procedures, breast reconstructions as well as donor sites. Results Fifty-eight percent of those surveyed did not feel scars were important post breast cancer surgery. 61% said that their partners' opinion of scars were important. The most preferred wide local excision scar was the lower lateral quadrant scar whilst the scars from the deep inferior epigastric artery perforator (DIEP) flap were most favoured. The superior gluteal artery perforator flap had the most preferred donor site while surprisingly, the DIEP had the least favourite donor site. Conclusions Scars are often overlooked when planning breast surgery yet the extent and position of the scar needs to be outlined to patients and it should play an important role in selecting a breast reconstruction option. This study highlights the need for further evaluation of patients' opinions regarding scar patterns.

Mitral Valve Reconstruction (승모판 재건술)

  • 이현우
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1107-1112
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    • 1995
  • Between December 1993 and December 1994, fifty-eight percent of the mitral valve patients[33/57 had undergone mitral valve repair. Their mean age was 49[SD-16 years[range 11 - 75 and they were consisted with 15 males and 18 females. The causes of mitral disease in 33 patients were classified as follows: 19 cases[58% were degenerative, 9[27% were rheumatic, 3[9% were congenital and 2[6% were infectious. Carpentier`s functional classification was consisted with Class I 4 cases[12% , II 25 [76% and III 4 [12% . Surgical techniques included prosthetic annuloplasty in 32 cases[97% , leaflet resection in 16[48% , chorda shortening in 13[39% , chorda transfer in 9[27% , new chorda formation in 7[21% , commissurotomy in 7[21% , leaflet mobilization in 4[12% , chorda resection in 3[9% , papillary muscle splitting in 2[6% , cleft repair in 2[6% , leaflet patching in 1[3% and vegetation removal in 1[3% . Average number of mitral anatomical lesions per patient was 3.3 and We used average 3.0 procedures upon mitral valve apparatus per patient. Intraoperative transesophageal echocardiography was carried out in 27 patients[82% for providing an immediate and accurate assessment of the adequacy of the reconstruction before closure of the chest. Operative mortality was absent. The mean functional class[NYHA was 2.87 preoperative and improved to 1.03 postoperatively. Postoperative Doppler echocardiography showed much improvement from grade II MR[5 , grade III[5 , grade IV[21 to no MR[26 , only trace MR[3 , grade III MR[2 . Postoperative mean mitral valve area was 2.4$\pm$0.6cm2[range 1.5 - 4.0 . We conclude that cautiously evaluated mitral valve reconstruction is stable and predictable operation with minimal postoperative left ventricular dysfunction.

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