• Title/Summary/Keyword: Grading operation

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Breast Conserving Operation and Radiation Therapy in Early Breast Cancer : Interim Analysis (초기유방암에서 유방보존수술 후 방사선치료 : 중간분석)

  • Kim, Jin-Hee;Kim, Ok-Bae;Kim, You-Sah
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.27-33
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    • 2001
  • Purpose : To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. Material and Methods : From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. According to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were IIa, and nine were IIb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Results : Five year disease free survival rate (5YDFS) was $95.8\%$. According to stage, 5YDFS was $100\%,\;96.9\%,\;96\%\;and\;88.9\%$ in stage 0, I, IIa and IIb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patients of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic result questionnaire and cosmetic results were good to excellent in fifty one patients $(86\%)$. Conclusion : We considered that conservative surgery and radiation for the treatment of early stage invasive breast cancer was safe and had excellent survival and cosmetic results. We need to assess about prognostic factors with longer follow up and with large number of patients.

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Integrated Mechanization System on Polyethylene Film Mulching Culture in Sesame (참깨의 비닐피복 기계화 일관작업 체계 연구)

  • Kang, Chul-Whan;Lee, Byoung-Kyu;Ahn, Byoung-Ok;Park, Choong-Bum;Roh, Jae-Hwan;Lee, Seong-Woo;Lee, Seung-Tack;Hong, Jong-Tae;Lee, Sun-Ho;Kim, Seok-Hyeon;Lee, Sang-Chuel;Kim, Wan-Suk
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.42 no.5
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    • pp.489-496
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    • 1997
  • This study was carried out to develop and investigate integrated mechanization system on polyethylene(P.E.) film mulching culture in sesame. Field trials were carried out to develop optimum mechanics for each step of manual operation in sesame culture and demonstrated those developed mechanics of sesame dibbling vinyl mulcher, sesame binder, sesame thresher and sesame grader at the farmer, s field of Hwasong (Kyunggi-do) in 1994 and 1995. Newly developed sesame dibbling vinyl mulcher brought saving manpower 280 hrs /ha for sowing and P.E. film mulching with it's 98% of labour saving for the harvesting operation of sesame. Sesame Binder showed 93% labour saving for cutting and binding with only 22 hrs /ha compared to 330 hrs /ha that of conventional. Sesame thresher was appeared to have 85% effects of labour saving for threshing with completely dry sesame bundles at one time by 23 hrs /ha compared to 151 hrs /ha that of conventional. Sesame grader was appeared to have 72% effects for sesame grain grading with 12 hrs /ha compared to that of conventional 54 hrs /ha. Grain yield of integrated mechanization culture system showed 6% higher than that of coventional. Integrated mechanization culture system (sesame dibbling vinyl mulcher + sesame binder + sesame thresher + sasame grader) showed 62% of labour saving effects through whole steps of sesame culture by 472 hrs /ha compared to that of conventional 1, 230 hrs /ha.

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Clinical Analysis of the Results following Meniscal Suture (반월상 연골 파열환자에서 봉합술 후 결과 분석)

  • Bae, Dae-Kyung;Yoon, Kyoung-Ho;Jeong, Ki-Woong;Kwon, Chang-Hyeok;Shin, Neung-Choel
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.19-24
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    • 2000
  • Purpose : To clinically analyze 62 patients who had meniscal repair and compare the results according to methods of repair. Materials and Methods : Between May 1997 and June 1998, we repaired 68 torn menisci in 68 patients. There were 52 male and 10 female with an average age of 26.9 years(ranging from 6 to 51 years). We used Linvatec suture in 46 knees(group A)and meniscal arrow in 16 knees(B group). In six knees we used Linvatec and meniscal arrow both. These 6 knees were excluded and 62 of 68 repaired meniscus were analyzed in this study. Average follow-up period was 18.5 months(ranging 12 to 26 months). We evaluated clinical results by Tapper and Hoover's grading system and subjective symptoms of the patients. Results : There were excellent in 47 cases$(76\%)$, good in 12$(19\%)$ and fair in 3$(5\%)$. In group A, there were excellent in 35 cases$(76\%)$, good in 9$(20\%)$ and fair in 2$(4\%)$. In group B, there were excellent in 12 cases$(75\%)$, good in 3$(19\%)$ and fair in 1$(6\%)$. There was no significant differences in clinical results between two groups. But mean operative time taken for meniscus repair was 40 minutes in group A and 25 minutes in group B. Conclusion : We can obtain good clinical results with short operation time in meniscal repair by proper selection of methods of repair according to the type, location, and size of meniscal tear and associated lesions.

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Autogenous Osteochondral Grafts for the Osteochondritis dissecans of the Knee (슬관절 박리성 골연골염에 대한 자가 골연골 이식술)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chun Shun-Wook;Seo Ji-Hyun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.142-148
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    • 2003
  • Purpose: This study was performed to evaluate the operative results of osteochondritis dissecans treated with autogenous osteochondral grafts. Materials and Methods: From May 1990 to May 2000, this study included 13 patients, 17 cases treated with autogenous osteochondral grafts. The mean age of patients at operation was 23.4 years (range,20 to 32 years), all cases were men, and the mean follow-up was for 24.2 months (range, 12 to 110 months). Treatment was done by open or arthroscopic method using with Osteochondral Autograft Transfer System (OATS, Arthrex, USA). Results: Trauma history existed in all cases, and major trauma history in 7 cases, and minor repetitive in 10 cases. The involved sites of lesion were medial femoral condyle in 11 cases, in which extended classic site was 9 cases, inferocentral site was 2 cases, and lateral femoral condyle in 6 cases, in which all cases were inferocentral site. Magnetic resonance imaging (MRI) staging was stage II in 1 case, stage III in 11 cases, stage IV in 5 cases, and arthroscopic staging was stage III in 12 cases, stage IV in 5 cases. The mean lesion size was 3.19$cm^2$ (range, 1 to 8$cm^2$). Clinical results evaluated with grading system by Aichroth, were excellent in 3 cases (18$\%$), good in 11 cases (65$\%$), moderate in 2 cases (12V), poor in 1 case (5$\%$), which revealed satisfactory results in 83$\%$. Congruent articular surface, satisfactory articular thickness, and no loosening or subsidence was evidenced by follow-up MRI or arthroscopic finding. Conclusion: Autogenous osteochondral grafts can be an alternative treatment in lesions larger than 1$cm^2$ in size, unstable lesion, and involvement of weight-bearing articular surface. Long term follow-up will be needed for the final efficacy of autogenous osteochondral grafts.

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A Clinical Review of Mucoepidermoid Carcinoma of The Lung in Korea (점액상피암의 임상적 고찰)

  • Kim, Yeon-Jae;Park, Jae-Yong;Shin, Moo-Chul;Bae, Moon-Sup;Kim, Jeong-Seok;Chae, Sang-Cheol;Park, Tae-In;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.311-321
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    • 1998
  • Background: Mucoepidermoid carcinoma of the lung arises from submucosal gland of tracheobronchial tree. Histologically, the tumor is composed of mucin-secreting cells, squamous cells, and intermediated cells, which show no particular differentiating characteristics, in varying proportions. The tumor is divided into low grade and high grade depending on the proportion of cells, and the degree of the mitotic activity, cellular necrosis and nuclear pleomorphism. While favorable prognosis of low grade tumor, high grade tumor, which is very difficult to differentiate from adenosquamous carcinoma, has an aggressive clinical course. The tumor is rare, comprising 0.1 to 0.2% of primary lung cancers and 1 to 5% of bronchial adenomas. Method: A retrospective clinical study was done on 17 cases of mucoepidermoid carcinoma. The study investigated the clinical features, radiologic findings, bronchoscopic findings, histology and clinical courses. Results: Age ranged between second to seventh decade with a mean age of 42 years. Twelve out of 17 cases were male. Five out of 17 cases were smokers with a mean 11 pack-years. Common symptoms included dyspnea, cough, hemoptysis, and wheezing. Two out of 17 cases was asymptomatic. Atelectasis or mass was common radiologic finding. Plain chest radiography was normal in one patient whom the tumor was located in upper trachea. Bonchoscopy revealed exophytic mass in 12 cases and nodular infiltrations in 4 cases. One case having solitary pulmonary nodule in the right lower lung was normal on bronchoscopy. Histologically, ten out of 17 cases were low grade, and seven out of 17 cases were high grade. Among 10 patients with low grade tumor,9 patients were performed operation and have been alive without recurrence during a mean follow-up of 30 months. Two out of 7 patients with high grade tumor were performed pneumonectomy and have been alive during a follow-up of 3 and 8 months, respectively. Conclusion: Most of mucoepidermoid carcinoma is located at central airway and is presented symptoms by mucosal irirtation. Although atelectasis or mass is common radiologic finding. chest X -ray can be normal. The histologic grading and the extent of tumor are two most important factors for prognosis.

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Endoscopic Carpal Tunnel Release Using Single Portal Technique (단일 입구를 이용한 내시경적 수근관 감압술)

  • Cheon Sang-Jin;Kim Hui-Taek;Suh Kuen-Tak;Suh Jeung-Tak;Yoo Chong-Il
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.159-165
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    • 2000
  • Purpose : Endoscopic carpal tunnel release technique was developed and has being used to decrease postoperative morbidity and complications. The purpose of this study was to evaluate the clinical results and clinical usefulness of endoscopic carpal tunnel release using single portal technique. Methods and Materials : 18 carpal tunnel syndrome patients who were diagnosed by means of clinical symptoms, physical examination, and electrodiagnostic study had endoscopic carpal tunnel release using single portal technique with about 1 cm oblique wrist incision on 30 hands. And then they were followed-up and reviewed in the same way. Late results of operation were analysed by grading system according to patient's own assessments of relief of symptoms at the final fellow-up. The follow-up period ranged 6 to 13 months from surgery. Results : There were postoperative improvements with respect to clinical symptoms, physical examination, and electrodiagnostic study. 23 of 30 hands$(76.7\%)$ had complete resolution of symptoms. 27 hands$(90\%)$ were able to return to normal activities and work within 6 weeks, and 30 hands$(100\%)$ returned within 8 weeks. In grip strength study, 29 hands$(96.6\%)$ regained preoperative strength in 6 months. 12 of 22 hands$(55\%)$ had improvement with respect to thenar atrophy within 6 months. Late results were as follows . 23 hands$(76.7\%)$ was graded as excellent, 6 hands$(20\%)$ graded as good and 1 hand$(3.3\%)$ graded as fair, and there was no poor result. Conclusion : We think that endoscopic carpal tunnel release with single portal technique is technically safe and simple, if the surgeon takes step to stay within the safety zone based on local anatomy and selects an appropriate patient and that endoscopic carpal tunnel release does have advantages over open release. We agree that the surgeon must be prepared to perform an open technique, if technical difficulties arise, difficulty in introducing the device into the carpal tunnel is encountered, or the transverse fibers of the transverse carpal ligaments are not clearly seen.

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