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Ultrasonographic study on the masseter muscle thickness of adult Korean (한국인 성인의 교근 두께에 관한 초음파검사적 연구)

  • Cha, Bong-Kuen;Park, In-Woo;Lee, Yeun-Hee
    • The korean journal of orthodontics
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    • v.31 no.2 s.85
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    • pp.225-236
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    • 2001
  • It is widely accepted that the shape and structure of bone are closely related to the activity of attached muscle. Numerous clinical and animal experimental studies indicated the significant effects of masticatory muscle function on maxillofacial morphology. Recently, the development of ultrasonography has spread throughout different fields of medicine. In the clinical examinations, ultrasonography is a convenient, inexpensive technique to apply with accurate and reliable results. The aim of this study is to assess the thickness of the masseter muscle and its correlation to maxillofacial skeleton by examining 35 male and 15 female dental students at Kangnung National University. The masseter muscle thickness of the subjects were measured by ultrasonographic scanning with a 7.5MHz linear probe, and their maxillofacial morphology were investigated by lateral cephalometric radiographs. The relationship between the masseter muscle thickness and maxillofacial morphology of normal adult was statistically analyzed, and the following results were obtained. 1. The average thickness of male masseter muscle was 13.8${\pm}$1.71mm in the relaxed state and 14.8${\pm}$1.77mm at maximal clenching state, while that of female was 11.6${\pm}$1.58mm and 12.4${\pm}$1.47mm, respectively. Ethnic difference in thickness of the masseter muscle and maxillofacial skeleton was found when the results of many researchers were compared with those of this study. 2. The thickness of the masseter muscle in both sexes increased significantly at maximal clenching state than in relaxed state(P<0.05). 3. The masseter muscle thickness of male was greater than that of female both in the relaxed state and maximal clenching states(P<0.05). 4. In males, the thickness of the masseter muscle was negatively correlated with the mandibular plane angle and positively correlated with the mandibular ramus height and anterior cranial base length(P<0.05). It may suggest that the male with thicker masseter muscle has smaller facial divergence. 5. No significant correlation was found between the masseter muscle thickness and maxillofacial morphology in females(P<0.05). Therefore, these data suggest that ultrasonography can add valuable information to the conventional examinations of masseter muscle function.

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Status of Water Quality in Nakdong River Districts (낙동강 수계의 수질 현황)

  • Lim, Young-Sung;Cho, Ju-Sik;Lee, Hong-Jae;Lee, Young-Han;Sohn, Bo-Kyoon;Heo, Jong-Soo
    • Korean Journal of Environmental Agriculture
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    • v.18 no.2
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    • pp.126-134
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    • 1999
  • To provide the basic information for the water improvement and control of water resource in Nakdong river districts, the physico-chemical characteristics of water in four main streams and three branch streams of the river were investigated through 36 times totally, one time per each month from January in 1995 to November in 1997. The pH values of each sites in main or branch stream of Nakdong river was pH $6.3{\sim}9.3$ range, pH range of Jukpo and Namji area at spring and fall was almost over pH 8.5, which was exceeded the water quality standard for agriculture. DO values of Nakdong river was almost $8.0{\sim}13mg/l$, except for Kangchang area in downstream of Kumho river. BOD values in Dasa area where was prior to mixing of Kumho river was $1.5{\sim}4.8mg/l$, which was under the water quality standard for agriculture(8mg/l), but BOD values followed mixing of Kumho river was over the permit standard of agricultural water as $3.8{\sim}8.9mg/l$ in Koryung, $3.4{\sim}8.4mg/l$ in Jukpo and $3.3{\sim}7.8mg/l$ in Namji according to time or season. Especially, BOD values at Gangchang area in Kumho river were $7.6{\sim}18.5mg/l$, which was over the water quality standard for agriculture and so Kumho river was a main pollutant: source of Nakdong river. COD values of main stream of Nakdong river was over the permit standard of agriculture(8mg/l) as $5.2{\sim}13.5mg/l$ in Koryvng, $5.0{\sim}12.7mg/l$ in Jukpo and $5.0{\sim}12.2mg/l$ in Namji according to time or season. And COD values was much high rather than BOD values and its gap of concentration was increased along with downstream. $NH_4-N$ of main stream of Nakdong river followed mixing of Kumho river($0.5{\sim}13.1mg/l$) was the highest affected in Koryung($0.18{\sim}5.0mg/l$) and detected much more in winter than in summer. T-N in Koryung($4.96{\sim}12.06mg/l$) followed mixing of Kumho river was significantly high rather than $2.86{\sim}4.86mg/l$ in Dasa, $4.20{\sim}8.20mg/l$ in Jukpo and $3.18{\sim}8.64mg/l$ in Namji, which was almost over the permit standard of agricultural water(1.0mg/l). T-P in Koryung($0.10{\sim}0.58mg/l$) also was significantly high rather than those $0.07{\sim}0.36mg/l$ in Jukpo and $0.08{\sim}0.4mg/l$ in Namji as over the standard of agricultural water(0.1mg/l). The concentration of T-N or T-P in Nakdong districts was trended of increasing in every year.

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Steroid Effect on the Brain Protection During OPen Heart Surgery Using Hypothermic Circulatory Arrest in the Rabbit Cardiopulmonary bypass Model (저체온순환정지법을 이용한 개심술시 스테로이드의 뇌보호 효과 - 토끼를 이용한 심폐바이패스 실험모델에서 -)

  • Kim, Won-Gon;Lim, Cheong;Moon, Hyun-Jong;Chun, Eui-Kyung;Chi, Je-Geun;Won, Tae-Hee;Lee, Young-Tak;Chee, Hyun-Keun;Kim, Jun-Woo
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.471-478
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    • 1997
  • Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

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Characteristics of Manure and Estimation of Nutrient and Pollutant of Holstein Dairy Cattle (홀스타인 젖소 분뇨의 특성과 비료성분 및 오염물질 부하량 추정)

  • Choi, D.Y.;Choi, H.L.;Kwag, J.H.;Kim, J.H.;Choi, H.C.;Kwon, D.J.;Kang, H.S.;Yang, C.B.;Ahn, H.K.
    • Journal of Animal Science and Technology
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    • v.49 no.1
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    • pp.137-146
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    • 2007
  • This study was conducted to determine fertilizer nutrient and pollutant production of Holstein dairy cattle by estimating manure characteristics. The moisture content of feces was 83.9% and 95.1% for urine. The pH of feces and urine were in the ranges of 7.0~7.4 and 7.5~7.8, respectively. The average BOD5, COD, SS, T-N, T-P concentrations of the dairy feces were 18,294, 52,765, 102,889, 2,575, and 457mg/ℓ, respectively. Dairy urine showed lower levels of BOD5(5,455mg/ℓ), COD(8,089mg/ℓ), SS(593mg/ℓ), T-N(3,401mg/l), and T-P(13mg/ℓ) than feces. The total daily produced pollutant amounts of a dairy cow were 924.1g(Milking cow), 538.8g(Dry cow), 284.4g(Heifer) of BOD5, 2,336.5g (Milking cow), 1,651.8g(Dry cow), 734.1g(Heifer) of COD and 4,210.1g(Milking cow), 2,417.1g(Dry cow), 1,629.1g(Heifer) of SS and 194.8g(Milking cow), 96.4g(Dry cow), 58.3g(Heifer) of T-N and 24.0g(Milking cow), 10.2g(Dry cow), 6.1g(Heifer) of T-P. The calculated amount of pollutants produced by a 450kg dairy cow for one year were 181.3kg of BOD5, 492.5kg of COD, 899.9kg of SS, 36.0kg of T-N and 4.1kg of T-P. The total yearly estimated pollutant production from all head(497,261) of dairy cattle in Korea is 90,149 tons of BOD5, 244,890 tons of COD, 447,491 tons of SS, 17,898 tons of T-N and 2,008 tons of T-P. The fertilizer nutrient concentrations of dairy feces was 0.26% N, 0.1% P2O5 and 0.14% K2O. Urine was found to contain 0.34% N, 0.003% of P2O5 and 0.31% K2O. The total daily fertilizer nutrients produced by dairy cattle were 197.4g (Milking cow), 97.4g(Dry cow), and 57.9g(Heifer) of Nitrogen, 54.2g(Milking cow), 22.2g(Dry cow), and 14.2g(Heifer) of P2O5 and 110.8g(Milking cow), 80.4g (Dry cow), and 39.5g(Heifer) of K2O. The total yearly estimated fertilizer nutrient produced by a 450kg dairy animal is 36.2kg of N, 8.8kg of P2O5, 24.6kg of K2O. The estimated yearly fertilizer nutrient production from all dairy cattle in Korea is 18,000 tons of N, 4,397 tons of P2O5, 12,206 tons of K2O. Dairy manure contains useful trace minerals for crops, such as CaO and MgO, which are contained in similar levels to commercial compost being sold in the domestic market. Concentrations of harmful trace minerals, such as As, Cd, Hg, Pb, Cr, Cu, Ni, Zn, met the Korea compost standard regulations, with some of these minerals being in undetected amounts.

Processing of Intermediate Product(Krill Paste) Derived from Krill (크릴을 원료로 한 식품가공용 중간소재(크릴페이스트) 가공에 관한 연구)

  • LEE Eung-Ho;CHA Yong-Jun;OH Kwang-Soo;Koo Jae-Keun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.18 no.3
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    • pp.195-205
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    • 1985
  • As a part of investigation to use the Anatrctic krill, Euphausia superba, more effectively as a food source, processing conditions, utilizations and storage stability of krill paste (intermediate product of krill) were examined and also chemical compositions of krill paste were analyzed. Frozen raw krill was chopped, agitated with $25\%$ of water to the minced krill and then centrifuged to separate the liquid fraction from the residue. This liquid fraction was heated at $98^{\circ}C$ for 20 min. to coagulate the proteins of krill, and it was filtered to separate the protein fraction. Krill paste was prepared with grinding the protein fraction, adding $0.2\%$ of polyphosphate and $0.3\%$ of sodium erythorbate to the krill paste for enhancing of functional properties and quality stability. The krill paste was packed in a carton box, and then stored at $-30^{\circ}C$. Chemical compositions of krill paste were as follows : moisture $78\%$, crude protein $12.9\%$, crude lipid $5.9\%$, and the contents of hazardous elements of krill paste as Hg 0.001 ppm, Cd 1.15 ppm, Zn 9.1 ppm, Pb 0.63 ppm and Cu 11.38ppm were safe for food. The amino acid compositions of krill paste showed relatively high amount of taurine, glutamic acid, aspartic acid, leucine, lysine and arginine, which occupied $55\%$ of total amino acid and also taurine, lysine, glycine, arginine and proline were occupied $65\%$ of total free amino acid. Fatty acid compositions of krill paste consist of $32.4\%$ of saturated fatty acid, $29.6\%$ of monoenoic acid and $38.0\%$ of polyenoic acid, and major fatty acids of product were eicosapentaenoic acid ($17.8\%$), oleic acid ($16.9\%$), palmitic acid ($15.3\%$), myristic acid ($8.7\%$) and docosahexaenoic acid ($8.4\%$). In case of procssing of fish sausage as one of experiment for krill paste use, Alaska pollack fish meat paste could be substituted with the krill paste up to $30\%$ without any significant defect in taste and texture of fish sausage, and the color of fish sausage could be maintained by the color of krill paste. Judging from the results of chemical and microbial experiments during frozen storage, the quality of krill paste could be preserved in good condition for 100 days at $-39^{\circ}C$.

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The Effect of Lidocaine Dose and Pretreated Diazepam on Cardiovascular System and Plasma Concentration of Lidocaine in Dogs Ansthetized with Halothane-Nitrous Oxide (Diazepam 전투여와 Lidocaine 투여용량이 혈중농도 및 심혈역학적 변화에 미치는 영향)

  • Lee, Kyeong-Sook;Kim, Sae-Yeon;Park, Dae-Pal;Kim, Jin-Mo;Chung, Chung-Gil
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.451-474
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    • 1993
  • Lidocaline if frequently administered as a component of an anesthetic : for local or regional nerve blocks, to mitigate the autonomic response to laryngoscopy and tracheal intubation, to suppress the cough reflex, and for antiarrythmic therapy. Diazepam dectease the potential central nervous system (CNS) toxicity of local anesthetic agents but may modify the sitmulant action of lidocaine in addition to their own cardiovascular depressant. The potential cardiovascular toxicity of local anesthetics may be enhanced by the concomitant administration of diazepam. This study was designed to investigate the effects of lidocaine dose and pretreated diazepam to cardiovascular system and plasma concentration of lidocaine. Lidocaine in 100 mcg/kg/min, 200 mcg/kg/min, and 300 mcg/kg/min was given by sequential infusion to dogs anesthetized with halothane-nitrous oxide (Group I). And in group II, after diazepam pretreatment, lidocaine was infused by same way when lidocaine was administered in 100 mcg/kg/min, the low plasma levels ($3.97{\pm}0.22-4.48{\pm}0.36$ mcg/ml) caused a little reduction in cardiovascular hemodynamics. As administered in 200 mcg/kg/min, 300 mcg/kg/min, the higher plasma levels ($7.50{\pm}0.66-11.83{\pm}0.59$ mcg/ml) reduced mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), left ventricular stroke work index (LVSWI), and right ventricular stroke work index (PVSWI) and increased pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), systemic vascular resistance index (SVRI), but was associated with little changes of heart rate (HR), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance index (PVRI). When lidocaine with pretreated diazepam was administered in 100 mcg/kg/min, the low plasma level, the lower level than when only lidocaine administered, reduced MAP, but was not changed other cardiovascular hemodynamics. While lidocaine was infused in 200 mcg/kg/min, 300 mcg/kg/min in dogs pretreated diazepam, the higher plasma level ($7.64{\pm}0.79-13.79{\pm}0.82$ mcg/ml) was maintained and was associated with reduced CI, SI, LVSWI and incresed PAWP, CVP, SVRI but was a little changes of HR, MPAP, PVRI. After $CaCl_2$ administeration, CI, SI, SVRI, LVSWI was recovered but PAWP, CVP was rather increased than recovered. The foregoing results demonstrate that pretreated diazepam imposes no additional burden on cardiovascular system when a infusion of large dose of lidocaine is given to dogs anesthetized with halothanenitrous oxide. But caution may be advised if the addition of lidocaine is indicated in subjects who have impared autonomic nervous system and who are in hypercarbic, hypoxic, or acidotic states.

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Nutritional Status and Health Risks of Low Income Elderly Women in Gwangju Area (광주지역 저소득층 여자노인의 영양상태와 건강위험요인에 관한 연구)

  • Yang, Eun-Ju;Bang, Hee-Myung
    • Journal of Nutrition and Health
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    • v.41 no.1
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    • pp.65-76
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    • 2008
  • This study was performed to identify association between nutritional status and health risks of the elderly. This was a cross-sectional study involving low income elderly women in Gwangju, Korea (${\geq}$65y, n = 92). Socio-demographics, life style characteristics, health conditions, dietary intakes based on 24h-recall method, anthropometric measures, and clinical biochemistry parameters were examined. Anthropometric and clinical parameters included wt, ht, waist, hip, body protein, body fat, abdominal fat, total cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, hemoglobin, hematocrit, fasting blood glucose, ferritin, IL-2, IL-6, TNF-${\alpha}$, CRP, TAS, TBARS, systolic blood pressure, and diastolic blood pressure. The subjects were divided into three groups based on age (65-74y, 75-84y, 85y${\leq}$) and were divided into two groups according to the sum of the Nutrition Screening Initiative (NSI) checklist score (adequate nutritional status, NSI score ${\leq}$3; at risk of malnutrition, NSI score >3). Mean and frequency of variables were estimated. Analysis of Variance, Tukey test, Chi-square test, and Multiple linear regression analyses were performed. Mean BMI and body fat were 25.1 $kg/m^2$ and 40.0%, respectively. However, for over 80% of subjects, the intakes of energy, fiber, thiamin, riboflavin, niacin, folate, Ca, K, and Zn were less than the Korean DRI (EAR or AI). The subjects who had lower NSI score tended to have better health status, eat meals frequently, have less depression, and exercise regularly. The subjects who had higher NSI score tended to have tooth problems, to eat alone most of time, and to be physically unable to cook or feed. Serum IL-6 and TNF-${\alpha}$ were significantly related with nutritional status which suggested higher tendency of inflammatory response. Serum IL-2, TAS, and glucose were significantly correlated with body fat (%) or abdominal fat (%). These results suggest that improving the nutritional status, increasing regular exercise, maintaining normal weight are beneficial to health care of low income elderly women.

The Absorption and Purification of Air Pollutants and Heavy Metals by Selected Trees in Kwangju (광주지역(光州地域)에서 주요(主要) 수목(樹木)의 대기오염물질(大氣汚染物質)과 중금속(重金屬) 흡수(吸收) 정화기능(淨化機能)에 관(關)한 연구(硏究))

  • Cho, Hi Doo
    • Journal of Korean Society of Forest Science
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    • v.88 no.4
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    • pp.510-522
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    • 1999
  • The air pollutants ; $SO_2$, $SO{_4}^{-2}$, $NO{_3}^-$, $Cl^-$ are absorbed into soils through falling with dusts and rain from the atmosphere. The sources of heavy metal contaminants in the environments are agricultural and horticultural materials, sewage sludges, fossil fuel combustion, metallurgical industries, electronics and waste disposal etc.. The soils and hydrosphere can be polluted on the way of the circulation of these heavy metals. Studied pollutant anions are $SO{_4}^{-2}$, $NO{_3}^-$ and $Cl^-$ and heavy metals are Se, Mo, Zn, Cd, Pb, Mn, Cr, Co, V, As, Cu and Ni which are the elements to be concerned with the essentials for plants, with animal and human health. This study is with the aim of selecting the species of roadside trees and green space trees which have excellent absorption of air pollutants and heavy metals from the atmosphere and the soils in the urban area. Two areas are designated to carry out this study : urban area ; Kwangju city and rural area ; the yard of Forest Environment Institute of Chollanam-do, at Sanje-ri, Sampo-myum, Naju city, Chollanam-do (23km away from Kwangju). This study is carried out to understand the movement of anions and heavy metals from the soils to the trees in both areas, the absorption of anions and heavy metals from atmosphere into leaves and the amounts of anions and heavy metals in leaves and fine roots(< 1mm dia.) of roadside trees and green space trees in Kwangju and trees in the yard of Forest Environment Institute of Chollanam-do. The tree species selected for this study in both areas are Ginkgo biloba, Quercus acutissima, Cedrus deodara, Platanus occidentalis, Robinia pseudoacacia, Alnus japonica. Metasequoia glyptostroboides. Zekova serrata. Prunus serrulata var. spontanea, and Pinus densiflora. The results of the study are as follows : 1. $SO{_4}^{-2}$, $NO{_3}^-$ and $Cl^-$ concentrations are higher in the soils of the urban area than in those of the rural area, and $NO{_3}^-$ and $SO{_4}^{-2}$ are higher in the leaves than in the roots due to the absorption of the these pollutants through the stomata. 2. Ginkgo biloba, Robinia pseudoacacia. Zekova serrata, Quercus acutissima, and Platanus occidentalis can be adequated to the roadside trees and the environmental trees due to their good absorption of $NO{_3}^-$ and $SO{_4}^{-2}$. 3. Heavy metals in the soils of both areas are in the order of Mn > Zn > V > Cr > Pb > Ni > Cu > Mo> Cd, and in the leaves and roots of the trees in the both areas are in the order of Mn>Zn>Cr>Cu>V>Ni. Both orders are similar ones except V. There are more in the urban soils than in the rural soils in amount of Mn, Zn, Pb, V, Cu. 4. It is supposed that there is no antagonism between Mn and Zn in this study. 5. Se, Co and As are not detected in the soils, the leaves and the roots in both areas. Sn, Mo, Cd and Pb are also not detected in the leaves and roots in spite of considerable amount in the soils of both areas.

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The Results of Curative Radiotherapy for the Uterine Cervical Cancer (자궁경부암의 근치적 방사선치료 성적)

  • Kim, Hyoung-Jin;Kim, Jung-Soo;Kwon, Hyoung-Cheol;Kim, Jin-Kee;Oh, Byung-Chan
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.191-199
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    • 1996
  • Purpose : To evaluate 5-year survival rate, patterns of failure and complications of cervical cancer treatment, fifty nine patients treated by curative radiotherapy for the uterine cervical cancer were analyzed retrospectively. Materials and Methods : From March 1986 to May 1990, fifty nine patients with histologically proven uterine cervical cancer were analyzed. According to FIGO stage, there were 2 patients ($3.4\%$) in stage Ib, 2 patients ($3.4\%$) in stage IIa, 31 patients ($52.5\%$) in stage IIb, 15 patients ($25.4\%$) in stage IIIb, 9 patients ($15.3\%$) in stage IV. External RT was per formed by 6 MVLINAC with daily 1.8 Gy, 5 times per week and followed by ICR. A point dose of ICR was calculated to 30-43.66 Gy (median: 34.6 Gy). These techniques delivered total A Point dose of 80.4 to 109.8 Gy (median: 85 Gy). Patients had been followed up from 2 to 110 months (median: 61 months) Results : The overall 5-year survival rate & disease free survival rate were $55.9\%$ and $55.0\%$ respectively. According to FIGO stage, the 5-year survival rate for less than IIa, IIb, IIIb, IV were $75.0\%$, $74.8\%$, $26.7\%$, $33.3\%$, respectively. In univariate analysis, the 5-year survival rate for stage IIb and below versus stage IIIa and above revealed $74.8\%$, $29.2\%$ respectively (P<0.005). According to the hemoglobin level during RT, the 5-rear survival rate of was $73.3\%$ for patients with Hg 10 gm/dL or higher, in contrast to $0\%$ for those with lower than 10 gm/dL (p<0.005). In 18 patients with nonbulky tumor (<5cm), the 5-year survival rates were $71.8\%$. The 5-rear survival rates for 18 patients with 5 cm or greater in tumor diameter were $22.2\%$ (p<0.005). The 5-year survival rate for Patient age of above 50 years and below were $65.3\%$ $34.2\%$ respectively (p<0.05). ECOG performance status. pathologic finding, total dose, total treatment time were not statistically significant factors. The significant prognostic factors affecting overall 5-year survival rate by multivariate analysis showed the hemoglobin level during RT (P=0.0001), tumor size (p=0.0390), FIGO stage (p=0.0468). Total recurrence rate was $23.7\%$ local failure $15.2\%$ (9/59), distant metastasis $6.8\%$ (4/59), local and distant metastasis $1.7\%$ (1/59). According to the RTOG/EORTC Soma Scales, the late complication rate was $23.8\%$ (14/59) The late complication rate of colorectum and genitourinary tract were $15.3\%$ (9/59), $8.5\%$ (5/59), respectively: 10 patients ($17.0\%$) were grade 2, 3 Patients ($5.1\%$) were grade 3 and one patient ($1.7\%$) was grade 4. The late complications were radiation proctitis, rectal bleeding, radiation colitis, diarrhea and radiation cystitis in decreasing order. Conclusion : For improvement of therapeutic results, prospective randomized trials are recomended to discover new prognostic factors and more aggressive radiation therapeutic methods are needed for poor prognostic patients. The adjuvant chemotherapy or radiation-sensitizing agents must be considered to inhibit regional and distant metastasis.

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The Prognostic Value of the First Day and Daily Updated Scores of the APACHE III System in Sepsis (패혈증환자에서 APACHE III Scoring System의 예후적 가치)

  • Lim, Chae-Man;Lee, Jae-Kyun;Lee, Sung-Soon;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Park, Pyung-Hwan;Choi, Jong-Moo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.871-877
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    • 1995
  • Background: The index which could predict the prognosis of critically ill patients is needed to find out high risk patients and to individualize their treatment. The APACHE III scoring system was established in 1991, but there has been only a few studies concerning its prognostic value. We wanted to know whether the APACHE III scores have prognostic value in discriminating survivors from nonsurvivors in sepsis. Methods: In 48 patients meeting the Bones criteria for sepsis, we retrospectively surveyed the day 1(D1), day 2(D2) and day 3(D3) scores of patients who were admitted to intensive care unit. The scores of the sepsis survivors and nonsurvivors were compared in respect to the D1 score, and also in respect to the changes of the updated D2 and D3 scores. Results: 1) Of the 48 sepsis patients, 21(43.5%) survived and 27(56.5%) died. The nonsurvivors were older($62.7{\pm}12.6$ vs $51.1{\pm}18.1$ yrs), presented with lower mean arterial pressure($56.9{\pm}26.2$ vs $67.7{\pm}14.2\;mmHg$) and showed greater number of multisystem organ failure($1.2{\pm}0.8$ vs $0.2{\pm}0.4$) than the survivors(p<0.05, respectively). There were no significant differences in sex and initial body temperature between the two groups. 2) The D1 score was lower in the survivors (n=21) than in the nonsurvivors ($44.1{\pm}14.6$, $78.5{\pm}18.6$, p=0.0001). The D2 and D3 scores significantly decreased in the survivors (D1 vs D2, $44.1{\pm}14.6$ : $37.9{\pm}15.0$, p=0.035; D2 vs D3, $37.9{\pm}15.0$ : $30.1{\pm}9.3$, p=0.0001) but showed a tendency to increase in the nonsurvivors (D1 vs D2 (n=21), $78.5{\pm}18.6$ : $81.3{\pm}23.0$, p=0.1337; D2 vs D3 (n=11), $68.2{\pm}19.3$ : $75.3{\pm}18.8$, p=0.0078). 3) The D1 scores of 12 survivors and 6 nonsurvivors were in the same range of 42~67 (mean D1 score, $53.8{\pm}10.0$ in the survivors, $55.3{\pm}10.3$ in the nonsurvivors). The age, sex, initial body temperature, and mean arterial pressure were not different between the two groups. In this group, however, D2 and D3 was significantly decreased in the survivors(D1 vs D2, $53.3{\pm}10.0$ : $43.6{\pm}16.4$, p=0.0278; D2 vs D3, $43.6{\pm}16.4$ : $31.2{\pm}10.3$, p=0.0005), but showed a tendency to increase in the nonsurvivors(D1 vs D2 (n=6), $55.3{\pm}10.3:66.7{\pm}13.9$, p=0.1562; D2 vs D3 (n=4), $64.0{\pm}16.4:74.3{\pm}18.6$, p=0.1250). Among the individual items of the first day APACHE III score, only the score of respiratory rate was capable of discriminating the nonsurvivors from the survivors ($5.5{\pm}2.9$ vs $1.9{\pm}3.7$, p=0.046) in this group. Conclusion: In sepsis, nonsurvivors had higher first day APACHE III score and their updated scores on the following days failed to decline but showed a tendency to increase. Survivors, on the other hand, had lower first day score and showed decline in the updated APACHE scores. These results suggest that the first day and daily updated APACHE III scores are useful in predicting the outcome and assessing the response to management in patients with sepsis.

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