• Title/Summary/Keyword: Free Grade Operation

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A Study on the Thermal Characteristics of the Large Low Temperature Vacuum Dryer for Biological Drying (생체 건조용 대형 저온진공건조기의 열적 특성에 관한 연구)

  • 김경근;성부용;정한식;최순열;문수범
    • Journal of Advanced Marine Engineering and Technology
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    • v.24 no.4
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    • pp.427-434
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    • 2000
  • In tradition, there have been two kinds of drying methods, which are sun drying and artificial drying. The sun drying method which has been adopted traditionally has been replaced by the hot-air drying method which is one of the most general methods of artificial drying, with its simple drying system, low initial cost of drying plant, and easy operating method. But the hot-air drying method has some defects; (1) much energy loss happens due to the discharge of hot air during the drying process, (2) control of drying rate is not easy on account of changing relative humidity of inlet air for uniform hot air temperature, (3) high temperature of foods in drying process brings about the production of low-grade drying products. Vacuum drying takes advantage of energy saving and mass production because it reduces the drying time by increasing the drying rate under low temperature condition. The aim of this paper is to develop the low temperature vacum dryer, with low initial investments and operating costs, easy operating method and trouble-free operation.

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Reconstruction of the Shoulder using Rotational Latissimus Dorsi Flap in the Malignant Fibrous Histiocytoma (악성 섬유성 조직구종에서 광배근피판을 이용한 견관절 재건술)

  • Han, Chung-Soo;Chung, Duke-Whan;Lee, Young-Ho;Im, Yang-Jin
    • Archives of Reconstructive Microsurgery
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    • v.10 no.2
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    • pp.111-117
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    • 2001
  • Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.

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Effect of leukocyte alteration on treatment outcomes following preoperative chemoradiotherapy in patients with rectal cancer

  • Kim, Tae Gyu;Park, Won;Choi, Doo Ho;Park, Hee Chul;Kim, Seok-Hyung;Cho, Yong Beom;Yun, Seong Hyen;Kim, Hee Cheol;Lee, Woo Yong;Lee, Jeeyun;Park, Joon Oh;Park, Young Suk
    • Radiation Oncology Journal
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    • v.35 no.3
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    • pp.217-226
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    • 2017
  • Purpose: Hematotoxicity following anti-cancer treatment is known to be related to treatment efficacy in several malignancies. The purpose of this study was to examine the hematologic parameters related to the tumor response and survival in patients treated with curative surgery following preoperative chemoradiotherapy (CRT) for rectal cancer. Materials and Methods: Four hundred eighteen patients with rectal cancer who underwent preoperative CRT and curative surgery were analyzed, retrospectively. The main clinical factors and blood cell counts before and after CRT were investigated with respect to their relationships with tumor downstaging and patient survival. Results: The post-CRT leukocyte count was significantly different between the tumor downstaging group and the non-downstaging group (median, 4740/uL vs. 5130/uL; p = 0.013). Multivariate analysis showed that histological grade, circumferential extent, and post-CRT leukocyte count were related to tumor downstaging. In addition, histological grade, post-CRT leukocyte count, and tumor downstaging were related to disease-free survival. The 5-year disease-free survival and overall survival in patients with post-CRT leukocyte count ${\leq}3730/uL$, which is the cut-off value derived from the receiver operation characteristic (ROC) curve analysis, were significantly higher than those with higher counts (88.0% vs. 71.6%, p = 0.001; 94.4% vs. 84.1%, p = 0.024). Conclusion: Post-CRT leukocyte count of ${\leq}3730/uL$ could be regarded as a good prognostic factor for tumor response and survival in rectal cancer patients treated with preoperative CRT.

Prognostic Factors for Lymph Node Negative Stage I and IIA Non-small Cell Lung Cancer: Multicenter Experiences

  • Ustaalioglu, Bala Basak Oven;Unal, Olcun Umit;Turan, Nedim;Bilici, Ahmet;Kaya, Serap;Eren, Tulay;Ulas, Arife;Inal, Ali;Berk, Veli;Demirci, Umut;Alici, Suleyman;Bal, Oznur;Benekli, Mustafa;Gumus, Mahmut
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6287-6292
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    • 2013
  • Background: Surgery is the only curative treatment for operable non-small lung cancer (NSCLC) and the importance of adjuvant chemotherapy for stage IB patients is unclear. Herein, we evaluated prognostic factors for survival and factors related with adjuvant treatment decisions for stage I and IIA NSCLC patients without lymph node metastasis. Materials and Methods: We retrospectively analyzed 302 patients who had undergone curative surgery for prognostic factors regarding survival and clinicopathological factors related to adjuvant chemotherapy. Results: Nearly 90% of the patients underwent lobectomy or pneumonectomy with mediastinal lymph node resection. For the others, wedge resection were performed. The patients were diagnosed as stage IA in 35%, IB in 49% and IIA in 17%. Histopathological type (p=0.02), tumor diameter (p=0.01) and stage (p<0.001) were found to be related to adjuvant chemotherapy decisions, while operation type, lypmhovascular invasion (LVI), grade and the presence of recurrence were important factors in predicting overall survival (OS), and operation type, tumor size greater than 4 cm, T stage, LVI, and visceral pleural invasion were related with disease free survival (DFS). Multivariate analysis showed operation type (p<0.001, hazard ratio (HR):1.91) and the presence of recurrence (p<0.001, HR:0.007) were independent prognostic factors for OS, as well visceral pleural invasion (p=0.01, HR:0.57) and LVI (p=0.004, HR:0.57) for DFS. Conclusions: Although adjuvant chemotherapy is standard for early stage lymph node positive NSCLC, it has less clear importance in stage I and IIA patients without lymph node metastasis.

Postoperative Radiation Therapy in the Soft-tissue Sarcoma (연부 조직 육종의 수술 후 방사선 치료 결과)

  • Kim Yeon Shil;Jang Hong Seok;Yoon Sei Chul;Ryu Mi Ryeong;Kay Chul Seung;Chung Su Mi;Kim Hoon Kyo;Kang Yong Koo
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.485-495
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    • 1998
  • Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 50 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patients with median follow up duration 50 months (range 6-162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58$\%$) was the most frequent site of occurrence followed by trunk (20$\%$) and head and neck (12$\%$). Histologically malignant fibrous histiocytoma (23$\%$), liposarcoma (17$\%$), malignant schwannoma (12$\%$) constitute 52$\%$ of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42$\%$) received chemotherapy with various regimen in the postoperative period. Results : Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48$\%$) of local recurrence. Four patients (7$\%$) developed simultaneous local recurrence and distant metastasis and 8 patients (13$\%$) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck Primary This feature is likely explanation for the decreased local control rate. Five of 29 Patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 $\%$, 30.6$\%$ respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

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Limb Salvage in the Treatment of the Upper Extremity Bone Tumors (상지에 발생한 악성 및 침윤성 양성골종양에 대한 사지 구제술)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Bum-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.154-163
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    • 1995
  • With the development of anticancer chemotherapy and improved radiographic imaging studies, limb salvage operation became possible in the treatment of malignant and aggressive benign tumors. High grade sarcomas of the shoulder or the upper extremity can be surgically treated with a forequarter amputation, shoulder disarticulation or limb salvage surgery such as Tikhoff-Linberg procedure, segmental resection and replacement with endoprosthesis, segmental resection and replantation, or segmental resection and free vascularized bone graft. Among them the limb salvage surgery showed not only preservation of the remained upper extremity but also the excellent functional results. When comparing amputation and limb salvage operation while performing anticancer chemotherapy in both cases, 5 year survival rate, local recurrence, and distant metastasis did not show much difference. We studied 13 cases of limb salvage for the malignant and aggressive benign bone tumor of the upper extremity from March 1986 to December 1993 at Severance hospital. The summarized results were as follows. 1. There were 21 cases of malignant bone tumors and 5 cases of benign aggressive ones. 2. Of the 26 cases of malignant and benign aggressive bone tumors, limb salvage procedures such as Tikhoff-Linberg operation(8 cases), endoprosthetic replacement(2 cases), segmental resection and replantation(2 cases), and segmental resection and free vascularized fibular graft(l case) were done in 13 cases. 3. In 13 patient on whom the limb salvage procedure was performed, there were 3 osteosarcomas, 4 chondrosarcomas, 3 giant cell tumors, 1 Ewing's sarcoma, 1 leiomyosarcoma and 1 chondroblastoma. 4. In 13 patients, there was no local recurrence nor distant metastasis except one who had a segmental resection of the entire humerus part including glenoid and then postoperative anticancer chemotherapy for the treatment of the Ewing's sarcoma of the entire shaft of the humerus with pathological fracture. Local recurrence occurred 2 years and 6 months postoperatively in this Ewing's sarcoma patient, so forequarter amputation was performed and the irradiation and the anticancer chemontherapy were performed, but multiple bony metastasis developed and died of the disease 22 months after local recurrence. 5. The patients were followed-up for I year to 7 years and 5 months(average 4 years 5 months). 6. In 8 cases in which Tikhoff-Linberg procedure was performed, the function of the hand was almost normal. 7. Segmental resection and endoprosthetic replacement was performed in 2 cases, and the function of the remained upper extremity was good with no evidence of aseptic loosening or nerve palsy. 8. In 1 case of segmental resection and free vascularized fibular graft for the patient of the chon drosarcoma in the humerus, the function of the shoulder, elbow and hand was nearly normal. 9. In I case of leiomyosarcoma which involved both forearm muscles and bone near wrist joint, segmental resection and replantation was performed, and the patient has useful hand function.

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Treatment of Salivary Duct Carcinoma: A Case Report (타액선관 상피암의 치험례)

  • Moon, Suk Ho;Yoo, Gyeol;Choi, Yun Seok;Lim, Jin Soo;Han, Ki Taik
    • Archives of Craniofacial Surgery
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    • v.9 no.1
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    • pp.23-26
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    • 2008
  • Salivary duct carcinoma is a high-grade adenocarcinoma arising from the ductal epithelium and has very low prevalence. We report a case of salivary duct carcinoma in high risk group with satisfactory result. A 65-year-old male was referred to our clinic complaining of mass on Rt. cheek. Preoperative CT and MRI shows $2.0{\times}1.9cm$ sized multilobulated, cystic mass on the superficial lobe of Rt. parotid gland and multiple lymph node enlargement thorough the Rt. internal jugular chain. Total parotidectomy and modified radical neck dissection with adjuvant radiation therapy was performed. Pathologic result was salivary duct carcinoma and resection margin was free. Postoperative radiation therapy with 6400 cGy($200cGy{\times}12fx$) was performed. During the 24-months of follow up periods, recurrence or complications associated with operation and radiation therapy was not observed. Salivary duct carcinoma is rare disease with very poor prognosis. Lymph node metastasis is commonly accompanied at the time of diagnosis. Distant metastasis is the most common cause of death. Total parotidectomy, radical neck disssection and adjuvant radiation therapy can be the appropriate modality for the control of the salivary duct carcinoma especially in high risk group.

Nursing students' Perception of Blended Learning - Based on Focus Group Interview - (간호학과 학생들의 블렌디드 러닝에 대한 인식 -포커스 그룹 인터뷰를 중심으로-)

  • Kim, Soo-Jin
    • Journal of Convergence for Information Technology
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    • v.10 no.6
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    • pp.59-69
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    • 2020
  • This study is a qualitative study in which a focus group interview is applied to explore nursing students' perception of blended learning. 21 students in the 4th grade of nursing department were divided into 4 groups to collect data through interviews and content analysis was conducted. As a result of the study, it was categorized into four topics: 'Application and operation that are not thoroughly prepared', 'Loss of direction and departure from learning', 'One-way listening', and 'Convenience'. Students were satisfied with blended learning which is free from time and space constraints and repetitive, but felt inadequacy and unsatisfactoriness about quality of online contents, system, and preparation for applying blended learning. In order to apply blended learning in the future nursing classes, high-quality online content should be developed based on the effective design of online and offline classes considering the curriculum, and a systematic, administrative, financial, and institutional foundation to support online course should be prepared. In addition, a support system should be created to guide students' self-directed learning activities in online classes of blended learning.

Differences in Career Education and Experience of Middle and High School Students on Career Plan Recognition (중·고등학생의 진로교육 및 체험이 진로계획 인식에 미치는 차이)

  • Jeong, Ji-ae
    • Journal of Practical Engineering Education
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    • v.12 no.1
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    • pp.243-254
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    • 2020
  • This study focused on the perception of career plans(life goals, self-standards, future prospects) based on the experience and satisfaction of career education and experiences of adolescents. To this end, 2,998 adolescents aged 13 to 18 are divided into middle and high school students groups(Inexperienced group, Dissatisfied group, experienced satisfaction group) by utilizing the 'career, career and vocational field' of the Youth Comprehensive Survey. The main results of this study are as follows. Differences by group of career plans were higher in the majority of experienced satisfaction groups than in the inexperienced and dissatisfied groups, and the more experienced and satisfied the career education and experience, the more confident they were in life goals, self-standards, and future prospects. In addition, in the case of self-standards and future prospects, the satisfaction of the inexperienced group was higher than that of the dissatisfied group, and when satisfied with the experience, the average value of the middle school group was higher than that of the high school group. Finally, based on the results, implications and limitations for follow-up studies were discussed.