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The Role of Chest CT Scans in the Management of Empyema (농흉에서 전산화 단층촬영의 의의)

  • Heo, Jeong-Suk;Kwun, Oh-Yong;Sohn, Jeong-Ho;Choi, Won-Il;Hwang, Jae-Seok;Han, Seung-Beom;Jeon, Young-June;Kim, Jung-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.397-404
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    • 1994
  • Background: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et al retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. Method: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. Results: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in ninteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to loculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(p<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. Conclusion: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement and serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.

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DEVELOPMENT OF THREE DIMENSIONAL MEASURING PROGRAM WITH FRONTAL AND LATERAL CEPHALOMETRIC RADIOGRAPHS -PART 1. COMPUTATION OF THE THREE-DIMENSIONAL COORDINATES BY COMPENSATION OF THE ERROR OF THE HEAD POSITION IN ORDINARY NON-BIPLANAR CEPHALOSTAT- (정모 및 측모 두부 방사선 규격사진을 이용한 3차원 계측 프로그램의 개발 -1. 단일 방사선원으로 촬영된 두부 방사선사진의 두부 위치 보정을 이용한 3차원 좌표의 산출-)

  • Lee, Geun-Ho;Lee, Sang-Han;Jang, Hyon-Joong;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.214-220
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    • 2001
  • The clinical application of the three-dimensional radiographic technique had been limited to standard Broadbent-Bolton cephalometer with biplanar stereoradiography. We developed a new method for compensating the error of head position in ordinary non-biplanar cephalostat. It became to possible to use the three dimensional cephalogram commonly in clinical bases. 1. The method of methemetical compensation of head positioning error in non-biplanar condition was evaluated with dry skull. The error of the method of first and the second trial was $0.46{\pm}1.21$, $0.33{\pm}0.90mm$, which means the error of the head positioning correction in conventional cephalogram was within clinical acceptance. 2. The reproducibility of this system for clinical application was 0.54 mm ($-2.99{\sim}2.26mm$) which defines the absolute mean difference of the first and second trial. Compare to the The landmark identification error $1.2{\pm}1.6mm$, the error of the measurement was within the range of landmark identification error. The result indicates the adequate clinical accuracy of the computation of three-dimensional coordinates by compensation of the error of the head position in ordinary non-biplanar cephalostat.

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Relationship between Environmental Conditions and the Growth of Ginseng (Panax ginseng C. A. Meyer) Plant in Field III. Field Photosynthesis under Different Light Intensity (인삼포의 환경조건과 인삼(Panax ginseng C. A. Meyer) 생육과의 관계)

  • 이성식;천성기;목성균
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.32 no.3
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    • pp.256-267
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    • 1987
  • Changes of light intensity under and above shading materials were measured at different relative light intensity(R.L.I. 5% of common straw shading, 15% of polyester shading and 20% of polyester shading at 12 o'clock on clear day) and lines(lst, 3rd and 5th lines) on clear and cloudy days in 5-year -old ginseng plant populations. Rates of photosynthesis and respiration, microclimate and root yield were also measured in field. Air temperature of R.L.I. 5% were lower 2$^{\circ}C$ compared with R.L.I. 15% and lower 3$^{\circ}C$ compared with R. L. I. 20% from 12 to 14 o'clock on clear day, but there were not difference among R. L. I. on cloudy day. Relative humidity of R. L. I. 5% were higher 5% compared compared with R.L.I. 20% from 10 to 14 o'clock on clear day, R. L. I. on cloudy day. Light intensity were below 5,000 lux at R.L.I. 5%, about 15,000 lux at R.L.I. 15% and about 20,000 lux at R.L.I. 20% from 10 to 15 o'clock on clear day. But light intensity were below 3, 000 lux at R. L. I. 5% about 10, 000 lux at R. L. I. 15% and about 15, 000 lux at R. L. I. 20% from 10 to 15 o'clock on cloudy. Photosynthetic rate of R.L.I. 15% and R.L.I. 20% were higher compared with R.L.I. 5% on clear and cloudy days. Tatal photosynthesis in a day were increased by R.L.I. 5%, 20%, 15% in turn on clear and cloudy days. R. L. I. 15% and 20% were not notable difference of photosynthetic rates among lines but R. L. I. with R. L. I. 15%, and higher 8% but there were not different among 5% was notable difference of one. Root fresh weight were increased by R.L.I. 5%, 20% and 15% in turn and R.L.I. 15% and 20% were not notable difference of root yield among lines but R. L. I. 5% was notable difference of one.

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Analysis of Prognostic Factors in Patients with Carcinoma of Uterine Cervix (자궁경부암의 방사선치료시 예후인자의 재분석)

  • Kim Jae Young;Cho Chul Koo;Shim Jae Won;Yoo Seong Yul;Kim Mi Sook;Yun Hyong Geun
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.307-315
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    • 1996
  • Purpose : The authors conducted a retrospective analysis of patients with the carcinoma of uterine cervix treated with curative radiation therapy to evaluate the prognostic factors that would affect the results of the therapy and to get the critical ideas in determining more aggressive treatment schedule. Methods and Materials : From January 1987 to December 1988. Four hundreds and sixty patients with uterine cervical carcinomas treated with radiotherapy at KCCH were registered to this retrospective study. One hundred and three patients were treated with external radiation therapy alone, and 357 patients were treated with external radiation followed by low dose rate intracavitary radiation therapy. The follow-up rate was 88% and median follow-up duration was 48 months. Results : The overall 5 year survival rate of the patients was 67.7%, and when classified by FIGO stages, 5 year survival rates were 81.2%, 76.3%, 73.1%, 50%. 52.3%, 11.5% for stages Ib, IIa, IIb, IIIa, IVa respectively. Tumor size(p=0.0002), endocervical growth pattern(p=0.003), lymph node invasion(p=0.0001), mean hemoglobin level(p=0.0001), and pathologic cell type(p=0.0001) were significant prognostic factors and decrease in survival for young age patient group was marginally important (p=0.03). Conclusion : Significant prognostic factors in the radiation therapy of the uterine cervical carcinoma were tumor size, growth pattern of tumor, lymph node invasion, pathologic cell type, hemoglobin level of patients during treatment and lower survival rate in young age group was obvious, too. Patients with large size tumor(${\geq)$4cm), especially combined with endocervical growth patterns or advanced stages(III or more) need more aggressive treatment to improve the outcome of treatment. And positive feature of lymph node invasion affected the result of therapy, so improvement in the diagnostic and therapeutic trial is essential.

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Analysis of Pulmonary Metastases according to a New Staging Proposal (새로운 병기 제안에 따른 전이성 폐암의 분석)

  • 강정한;백효채;이진구;정경영
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.615-620
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    • 2001
  • The new stage of metastatic lung cancer based upon resectability, disease-free interval, and the number of pulmonary metastases was proposed in 1998 by Ginsberg, et al. We evaluated the validity of the new staging proposal for pulmonary metastases through the analysis of experiences at Severance Hospital. Material and Method: The cases of 111 patients who underwent resection of metastatic lung cancer during the eleven-year period (1990-2000) were reviewed. Of these patients, 103(92.8%) underwent compete surgical resection. The primary tumor was carcinoma in 60 cases, sarcoma in 46, and others in 5. The disease-free interval(DFI) was 0 to 35 months in 79 cases adn more than 36 months in 32 cases. Single metastasis accounted for 53 cases and multiple lesions for 58 cases. Mean follow-up was 49 months. Result: The actuarial survival after complete metastasectomy was 48.2% at 3 years and 32.6% at 5 years; the corresponding values for incomplete resection were 21.9% at 3 years. The 3-year survival rate(3-YSR) for complete resction was 40.5% and 5-year survival rate(5-YSR) was 30.4% for patients with a DFI less than 36 months, the 3-YSR, 75.8% and 5-YSR, 39.0% for those with a DFI equal or more than 36 moths; 45.8% and 30.5% for single lesions, 50.0% and 34.4% for multiple lesions. The 3-YSR and 5-YSR were 58.5% and 43.8% for stage I patients, 54.0% and 37.4% for stage II, 38.2% and 27.9% for stage III and 21.9% for stage IV. Conclusion: The result of the analysis of new stage of pulmonary metastases showed that the survival rate was different according to stage and there was no statistical significance. We need more experiences and long-term follow up to determine the prognostic factor of metastatic lung cancer surgery.

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Regional Analysis of Forest Eire Occurrence Factors in Kangwon Province (강원도 지역 산불발생인자의 지역별 유형화)

  • 이시영;한상열;안상현;오정수;조명희;김명수
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.3 no.3
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    • pp.135-142
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    • 2001
  • This study attempts to categorizes the factors of forest fire occurrences based on regional meteorologic data and general forest no characteristics of 18 cities and guns in Kangwon province. lo accomplish this goal, some statistical analyses such as analysis of variance, correspondence analysis and multidimensional scaling were adopted. To reveal the forest fires pattern of study region, a categorization process was conducted by employing the quantification approach which modified and quantified the metric-data of fire occurrence dates. Also, The fire occurrence similarity was compared by using multidimensional scaling for each study region. The major results are summarized as follows: It was found that the meteorological factors emerged as different to each region are average and maximum temperature, minimum dew point temperature and average and maximum wind speed. In the result of correspondence analysis representing relationships between fire causes and study regions, Kangrung is caused by arsonist, Chulwon, Hwachen and Yanggu caused by military factor, Sokcho and Chunchen caused by the debris burning, and Samchuk caused by general man-caused fires, respectively. Finally, the forest fire occurrence pattern of this study regions were divided into five areas such as, group I including Samchuk, Kangryung, Chunchen, Wonju, Hongchen and Hhoingsung, group II including Donghae, Taebaek, Yangyang and Pyongchang, group III including Jungsun, Chulwon and Whachen, group Ⅵ including Gosung, Injae and Yanggu, and group V including Shokcho and Youngwol.

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Clinical Result of Layered Suture Bridge Technique in Arthroscopic Repair for Delaminated Rotator Cuff Tear (회전근 개 층간 분리 파열에서 관절경을 이용한 층상 교량형 봉합술의 임상 결과)

  • Choi, Eui-Sung;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Cho, Byung-Ki;Park, Ji-Kang;Kim, Dong-Whan;Keum, Sang-Wook;Cha, Jung-Kwon
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.84-93
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    • 2013
  • Purpose: The purpose of this study was to evaluate the repair integrity and clinical outcomes of delaminated tears following arthroscopic layered suture bridge rotator cuff repair in a prospective fashion. Materials and Methods: A consecutive series of 67 patients with delaminated rotator cuff tears who underwent surgery using the arthroscopic Layered Suture Bridge Technique were followed prospectively. Of 67 shoulders, 26 patients were male and 40 patients were female (one patient had bilateral tears); the mean age was 58.8(40~76) years. The clinical evaluation was performed according to ASES, UCLA, and KSS (Korea Shoulder Scoring System) scores with an average follow up period of 33 months. Repair integrity was estimated using MRI, which was performed six months postoperatively. Results: The average clinical outcome in ASES, UCLA, and KSS scores showed significant improvement at the time of the final follow-up compared to preoperatively, from 50.2 to 92.3, 15 to 31.3, and 54.4 to 90.7, respectively (p<0.001 for all scores). Follow up by MRI showed that 16 shoulders had a type-I; 14, a type-II; five, a type-III; two, a type-IV; one, a type-V re-tear. The overall rate of re-tear (types IV and V) was 7.9%. Conclusion: Use of the Arthroscopic Layered Suture Bridge Technique can result in improved functional and structural outcome in cases of delaminated rotator cuff tear.

Comparison of Size Criteria in Mediastinal Lymph Node Involvement of Adenocarcinoma of Lungs (폐 선암의 종격동 림프절 전이에 있어서 림프절 크기 기준의 비교)

  • Gu, Ki-Seon;Kuk, Hiang;Koh, Hyeck-Jae;Yang, Sei-Hun;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.542-547
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    • 1999
  • Background: Decision in mediastinal lymph node involvement of lung cancer by CT scan is very important and valuable for the treatment planning and prognosis prediction. In general, long diameter of mediastinal lymph node more than 15mm is used as criterion of lung cancer involvement. Adenocarci-noma has a tendency of early distant metastasis and micrometastasis, so adenocarcinoma may involve lymph node earlier and cannot be detected before lymph nodes are enlarged enough. The authors tried to determine the difference between two size criteria(15mm, 10mm) in adenocarcinoma for the detection of cancer involvement. Methods: Numbers of sample are 60 cases(male 46, female 14, median age: 61.5 years). According to pathology, squamous cancer 41, large cell cancer 2, adenocarcinoma 17. According to TNM stage, I 23, III 24, IIIA 13. Results : Mean long diameter of lymph node involvement is 16.0($\pm8.0$) mm in non-adenocarcinoma group, and that of adenocarcinoma group is 12.0($\pm3.2$) mm(p<0.05). If long diameter of lymph node larger than 15mm as involvement criterion is applied, sensitivity, specificity, positive predictive index, negative predictive index, accuracy of nonadenocarcinoma group are 54%, 100%, 100%, 83%, 86%, and those of adenocarcinoma group are 43%, 90%, 75%, 69%, 71%. If long diameter of lymph node larger than 10mm as involvement criterion is applied, sensitivity, specificity, positive predictive index. negative predictive index. accuracy of nonadenocarcinoma group are 65%, 77%, 61%, 92%, 79%, and those of adenocarcinoma group are 100%, 80%, 78%, 100%, 88%. Conclusion: Long diameter of lymph node larger than 10mm is more valuable criterion as lymph node involvement in adenocarcinoma of lungs.

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Morphological Study on the Dorsal Lingual Papillae of Myotis macrodactylus (큰발윗수염박쥐(Myotis macrodactylus)의 혀 유두의 형태학적 연구)

  • Hwang, Hyun-Suk;Lee, Jung-Hun
    • Applied Microscopy
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    • v.37 no.3
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    • pp.147-156
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    • 2007
  • The dorsal lingual papillae of Myotis macrodactylus were investigated morphologically using scanning electron microscopy. Three types of lingual papillae from Myotis macrodactylus were recognized. The filiform(Fi) papillae were distributed over the entire dorsal surface of the tongue, and they could be classified into 5 types of papillae by the shape, size and number of the protrusion. Type I was distributed on dorsal surface of the apex in the anterior region of the tongue, has a crow-like shape with ten to fifteen formed projections. Type II was located in the medial portion of the anterior region of the tongue, has an eight to ten spin-like protrusion. Type III was distributed on the medial portion of the tongue, has a scale-like papille with five to seven protrusion. Type IV was distributed on the both lateral portion of the posterior region of the tongue, has a small conical papillae, does not have needle projection. Type V have not needle projection, a large of conical papillae, on the both lateral portion of the posterior region of the tongue. Most Fu(Fungiform) papillae were distributed the both lateral region or medial portion of the posterior region of the tongue, has a round or oval shape with $40{\sim}45$ papillae. The small $(65{\mu}m)$, meddle $(75{\mu}m)$ and large $(120{\mu}m)$ fungiform papillae were distributed on dorsal surface of the apex in the anterior, the both lateral portions and medial portion of the posterior region of the tongue, respectively. Two large oval vallate (V) papillae are located in the medial portion of the posterior region of the tongue. In conclusion, the morphology of lingual papillae is useful to determine species relationship among Myotis species. It suggests that the difference of types and number of lingual papillae caused by the difference of food habit.

Modeling Paddlewheel-Driven Circulation in a Culture Pond (축제식 양식장에서 수차에 의한 순환 모델링)

  • KANG Yun Ho
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.34 no.6
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    • pp.643-651
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    • 2001
  • Paddlewheel-driven circulation in a culture pond has been simulated based on the depth integrated 2 dimensional hydrodynamic model. Acceleration by paddlewheel is expressed as shaft force divided by water mass discharged by paddlewheel blades. The model has been calibrated and applied to culture ponds as following steps:- i) The model predicted velocities at every 10 m along longitudinal direction from the paddlewheel. The model was calibrated comparing the results with the measured values at mass correction factor $\alpha$ and dimensionless eddy viscosity constant $\gamma$, respectively, in a range $15\~20$ and 6. ii) Wind shear stress was simulated under conditions of direction $0^{\circ}C,\;90^{\circ}C\;and\;180^{\circ}C$ and speed 0.0, 2.5, 5.0 and 7.5 m/s. Change rate of current speed was <$1\%$ at wind in parallel or opposite direction to the paddlewheel-driven jet flow, while $4\%$ at orthogonal angle. iii) The model was then applied to 2 culture ponds located at the Western coast of Korea. The measured and predicted currents for the ponds were compared using the regression analysis. Analysis of flow direction and speed showed correlation coefficients 0.8928 and 0.6782 in pond A, 0.8539 and 0.7071 in pond B, respectively. Hence, the model is concluded to accurately predict circulation driven by paddlewheel such that it can be a useful tool to provide pond management strategy relating to paddlewheel operation and water quality.

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