• Title/Summary/Keyword: Initial data

Search Result 4,975, Processing Time 0.585 seconds

Treatment and Results of Olfactory Neuroblastoma (후각신경아세포종의 치료 및 결과)

  • Wu Hong-Gyun;Kim Il Han
    • Radiation Oncology Journal
    • /
    • v.18 no.3
    • /
    • pp.177-181
    • /
    • 2000
  • Purpose : Rarity of olfactory neuroblastoma makes it difficult for treating Physician to Practice with a consistent protocol. This study is peformed to analyze our experience with various treatment modalities for patients with olfactory neuroblastoma. Discussion includes review of some recently published literatures. Methods and Materials : Between June of 1979 and April of 1997, 20 patients were treated under the diagnosis of olfactory neuroblastoma at Seoul National University Hospital. There were 14 male and 6 female patients. Age at initial treatment ranged from l3 to 77 years with median or 24 years. fifteen or 20 patients had Kadish stage C. They were treated with various combinations of surgery, radiation therapy and chemotherapy; surgery+postoperative radiation therapy+adjuvant chemotherapy for 2 patients, surgery+postoperative radiation therapy for 6, neoadjuvant chemotherapy+surgery for 1, surgery+adjuvant chemotherapy for 1, surgery only for 2, neoadiuvant chemotherapy+ radiation therapy for 3, radiation therapy+adjuvant chemotherapy for 1, radiation therapy only for 3, and no treatment for 1 patient. Results : Follow-up ranged from 2 month to 204 months with mean of 39.6 months. The overall 5- and 10-year survival rates are 20% and 10%, respectably. Four patients are alive at the time of data analysis. One of four living patients was treated with radical surgery, postoperative radiation therapy and adjuvant chemotherapy, two patients with radical surgery and postoperative radiation therapy, and one with radical surgery only. Conclusion : Multidisciplinary approach, including radical surgery, pre- or post-operative radiation therapy and chemotherapy, should be addressed at the initial time of diagnosis. Although limited by small number of the patients, this study suggests importance of local treatment modality, especially radical surgery in the treatment of lofactory neuroblastoma.

  • PDF

Clinical Analysis of the Acute Respiratory Distress Syndrome after Thoracotomy (개흉술 후 발생하는 급성 호흡부전 증후군에 대한 임상적 고찰)

  • 이용직;박승일;제형곤;박창률;김동관;주석중;김용희;손광현
    • Journal of Chest Surgery
    • /
    • v.35 no.9
    • /
    • pp.653-658
    • /
    • 2002
  • The cause and clinical course of the postoperative ARDS is, as of yet, not very well understood. The current study is a review of our experience on patients with ARDS after thoracotomy. Material and Method: Between Jan. 1996 to Aug. 2001, a retrospective analysis was conducted on 32 post-thoracotomy ARDS patients among 4018 patients receiving thoracotomy inclusive of thoracoscopic surgery. Result: The incidence of ARDS after pneumonectomy cases was 5.3%(13/245), 1.3% after lobectomy(9/ 710), and 4.4% after esophageal surgery(10/226). Of the 32 ARDS patients, 31 had malignant disease. The remaining 1 patient had aspergillosis. In the majority, the cause of ARDS was unknown. The average onset was on the 7.4th postoperative day. In 10 cases, the initial lesion was in the right lower lung field(31.2%), in the left lower lung field in 9(28.1%), and in both lower lung fields in 12(37.5%) cases. In all, the initial lesion was in the lower lung fields in 96.9% of the cases(31/32). There was a significant relationship between the development of ARDS and intraoperative I/O balance. The overall mortality rate was 65.6%(21/32). In the earlier period of the study(1996-Jun, 1998) the mortality rate was 100%, but in the latter period(July, 1998-Aug, 2001) it was significantly reduced to 47.6%: Conclusion: The current data showed a higher incidence of postoperative ARDS in patients with malignant disease and in those receiving extensive lymph node dissection with either lobectomy or pneumonectomy, and also in patients receiving esophageal surgery. In addition, introperative fluid overload was also associated with an increased incidence of ARDS. Treatment outcome could be improved with prone positioning and NO gas inhalation.

The Clinical Characteristics, Diagnosis, Treatment, and Outcomes of Patients with Tuberculosis at a Private University Hospital in Korea (국내 한 민간종합병원에서 결핵 환자의 진료 실태)

  • Jung, Young Ju;Park, I-Nae;Hong, Sang Bum;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
    • /
    • v.60 no.2
    • /
    • pp.194-204
    • /
    • 2006
  • Background : Even though tuberculosis (TB) is still a major public concern in Korea, there is little data on the management of TB patients and its outcomes in the private sector. This study evaluated the status of TB treatment in the private sector. Methods : Sixteen-hundred-sixty-six TB patients who were notified in a private university hospital from 2001 to 2002 were enrolled in this study. The patients were divided into pulmonary ($TB_P$), extrapulmonary ($TB_E$), and combined ($TB_{P+E}$) groups, and were also divided into initial and retreatment groups. The clinical characteristics, diagnostic methods, treatment regimens, and outcomes were analyzed and compared. Results : The mean age of the 1,666 patients was 48.9 years and the male-to-female ratio was 1.3:1. The number of patients in the initial and retreatment groups of $TB_P$, and those of ($TB_E+TB_{P+E}$) were 809, 276, 480, 101, respectively. A bacteriological study was performed in 92.0% of cases, and a positive culture was confirmed in 58.1% and 31.7% of patients with TBP and ($TB_E+TB_{P+E}$), respectively (p<0.05). The AFB smear was positive in 45.4 % of the $TB_P$ patients. PCR was carried out in 60.4% of the ($TB_E+TB_{P+E}$) group. The MDR was detected in 14.0% of isolates. Overall, the treatment completion, default, and death rates were 70.2%, 13.5% and 1.9%, respectively. Conclusion : Even though the management of TB patients in a private hospital was satisfactory in terms of the national guidelines, the high default rate was is still a problem. Efforts to decrease the default rate either independently or in cooperation with the public sector will be needed.

Comparison of Respiratory Mechanics and Gas Exchange Between Pressure-controlled and Volume-controlled Ventilation (압력조절환기법과 용적조절환기법의 호흡역학 몇 가스교환의 비교)

  • Jeong, Seong-Han;Choi, Won-Jun;Lee, Jung-A;Kim, Jin-A;Lee, Mun-Woo;Shin, Hyoung-Shik;Kim, Mi-Kyeong;Choe, Kang-Hyeon
    • Tuberculosis and Respiratory Diseases
    • /
    • v.46 no.5
    • /
    • pp.662-673
    • /
    • 1999
  • Background : Pressure-controlled ventilation (PCV) is frequently used recently as the initial mode of mechanical ventilation in the patients with respiratory failure. Theoretically, because of its high initial inspiratory flow, pressure-controlled ventilation has lower peak inspiratory pressure and improved gas exchange than volume-controlled ventilation (VCV). But the data from previous studies showed controversial results about the gas exchange. Moreover, the comparison study between PCV and VCV with various inspiration : expiration time ratios (I : E ratios) is rare. So this study was performed to compare the respiratory mechanics and gas exchange between PCV and VCV with various I : E raitos. Methods : Nine patients receiving mechanical ventilation for respiratory failure were enrolled. They were ventilated by both PCV and VCV with various I : E ratios (1 : 2, 1 : 1.3 and 1.7 : 1). $FiO_2$, tidal volume, respiratory rate and external positive end-expiratory pressure (PEEP) were kept constant throughout the study. After 20 minutes of each ventilation mode, arterial blood gas, airway pressures, expired $CO_2$ were measured. Results : In both PCV and VCV, as the I : E ratio increased, the mean airway pressure was increased, and $PaCO_2$ and physiologic dead space fraction were decreased. But P(A-a)$O_2$ was not changed. In all three different I : E ratios, peak inspiratory pressure was lower during PCV, and mean airway pressure was higher during PCV. But $PaCO_2$ level, physiologic dead space fraction and P(A-a)$O_2$ were not different between PCV and VCV with three different I : E ratios. Conclusion : There was no difference in gas exchange between PCV and VCV under the same tidal volume, frequency and I : E ratio.

  • PDF

Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
    • /
    • v.21 no.3
    • /
    • pp.71-96
    • /
    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

20-Year Experience of Surgical Treatment for Postpneumonectomy Empyema (전폐절제술 후 사강에 발생한 농흉의 치료)

  • 김형렬;김영태;성숙환;김주현
    • Journal of Chest Surgery
    • /
    • v.35 no.7
    • /
    • pp.542-547
    • /
    • 2002
  • Background: Postpneumonectomy empyema(PPE) is an infrequent but potentially life-threatening complication. To date, various surgical efforts have been made to manage this complication. We reviewed our 20-year surgical experience of PPE and long-term follow-up data. Material and Method: Total of 37 patients who were treated for PPE between fan, 1980 and Jun, 2000 were included. Various clinical factors such as micro-organism, operative method and timing, presence of bronchopleural fistula(BPF), underlying disease and fate of empyema cavity were retrospectively reviewed and analyzed. Result: Majority of patients(34) underwent Eloesser operation for effective drainage. There was only one operative mortality. The causative organisms were Staphylococcus species and Pseudomonas species in 46% BPF was found in 20 cases, among which spontaneous closures took place in 4 cases. The chest wall was closed in 40%(8/20) of patients with BPF, compared to 59%(10/17) without BPF. The closure rate was statistically better in patients without BPF(p=0.006). Even though the patients with benign disease showed higher closure rate(50%) than those with lung cancer (31%), the difference was not significant(p=0.25). Conclusion: Eloesser procedure was an effective method for initial drainage of PPE cavity with low operative mortality. Given the findings of low spontaneous closure rate of BPF, aggressive approach to close the BPF is mandatory to achieve the final goal of chest wall closure. It was found that majority of patients still left their chest cavity opened, even after controlling the active inflammation of the empyema cavity. More aggnessive approach for chest wall closure is recommended in all patents with benign disease and in selective patients with lung cancer if there is no evidence of recurrence at several years after the initial operation.

Analysis of growth environment for precision cultivation management of the oyster mushroom 'Suhan' (병재배 느타리버섯 '수한'의 정밀재배관리를 위한 생육환경 분석)

  • Lee, Chan-Jung;Lee, Sung-Hyeon;Lee, Eun-Ji;Park, Hae-sung;Kong, Won-Sik
    • Journal of Mushroom
    • /
    • v.16 no.3
    • /
    • pp.155-161
    • /
    • 2018
  • In this study, we analyze the growth environment using smart farm technology in order to develop the optimal growth model for the precision cultivation of the bottle-grown oyster mushroom 'Suhan'. Experimental farmers used $88m^2$ of bed area, 2 rows and 5 columns of shelf shape, 5 hp refrigerator, 100T of sandwich panel for insulation, 2 ultrasonic humidifiers, 12 kW of heating, and 5,000 bottles for cultivation. Data on parameters such as temperature, humidity, carbon dioxide concentration, and illumination, which directly affect mushroom growth, were collected from the environmental sensor part installed at the oyster mushroom cultivator and analyzed. It was found that the initial temperature at the time of granulation was $22^{\circ}C$ after the scraping, and the mushroom was produced and maintained at about $25^{\circ}C$ until the bottle was flipped. On fruiting body formation, mushrooms were harvested while maintaining the temperature between $13^{\circ}C$ and $15^{\circ}C$. Humidity was approximately 100% throughout the growth stage. Carbon dioxide concentration gradually increased until 3 days after the beginning of cultivation, and then increased rapidly to approximately 2,600 ppm. From the 6th day, $CO_2$ concentration was gradually decreased through ventilation and maintained at 1,000 ppm during the harvest. Light was not provided at the initial stage of oyster mushroom cultivation. On the $3^{rd}$ and $4^{th}$ day, mushrooms were irradiated by 17 lux light. Subsequently, the light intensity was increased to 115-120 lux as the growth progressed. Fruiting body characteristics of 'Suhan' cultivated in a farmhouse were as follows: Pileus diameter was 30.9 mm and thickness was 4.5 mm; stipe thickness was 11.0 mm and length was 76.0 mm; stipe and pileus hardness was 0.8 g/mm and 2.8 g/mm, respectively; L values of the stipe and pileus were 79.9 and 52.3, respectively. The fruiting body yield was 160.2 g/850 ml, and the individual weight was 12.8 g/10 unit.

Analysis of Algal Response Effects Using Nutrient Enrichment Bioassays in Shingu Reservoir (신구저수지 식물플랑크톤성장에 대한 제한 영양염 분석)

  • Lee, Jae-Yon;Lee, Sang-Jae;Lee, Jae-Hoon;Bae, Dae-Yeul;Choi, Ji-Woong;Hwang, Soon-Jin;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
    • /
    • v.41 no.spc
    • /
    • pp.35-41
    • /
    • 2008
  • Nutrient Enrichment Bioassays (NEBs) were conducted in the laboratory during June $22{\sim}28$, 2006 in order to determine primary limiting factor on the phytoplankton growth. For the NEBs, the water was sampled using a 10L polyethylene-lined container and dispensed into 2.5L container in the laboratory. The algal growths response in the control (C) and three treatments of phosphorus (P), 2-fold phosphorus (2P), and nitrate nitrogen $(NO_3-N)$ were monitored during 7 days. In the cubitainers which were spiked as P (T1) and 2P (T2) Chl-${\alpha}$ concentrations were decreased during the test period and the final concentrations was low than initial values. However, Chl-${\alpha}$ in the cubitainers which were spiked as $NO_3$(T3) and $P+NO_3$(T4) showed significant increases compared to the initial values, indicating that in the short-term experiments, nitrogen seemed to be a primary limiting nutrient during the periods of NEBs experiment. Long-term ambient nutrient data of TP and TN, and TN:TP mass ratios, however, showed a potential phosphorus limitation on phytoplankton growth and previous other researchers showed a variations of limiting nutrients by nitrogen or phosphorus depending on the seasons sampled and locations. In this study nitrogen as primary limiting nutrient in the NEBs seem to be an seasonal effect rather than the consistent nitrogen limitation.

Exploring Small Group Features of the Social-Construction Process of Scientific Model in a Combustion Class (연소 모델의 사회적 구성과정에서 나타나는 소집단 활동 특징 탐색)

  • Shim, Youngsook;Kim, Chan-Jong;Choe, Seung-Urn;Kim, Heui-Baik;Yoo, Junehee;Park, HyunJu;Kim, HyeYeong;Park, Kyung-Mee;Jang, Shinho
    • Journal of The Korean Association For Science Education
    • /
    • v.35 no.2
    • /
    • pp.217-229
    • /
    • 2015
  • In this study, we explored the development of scientific model through the social-construction process on "combustion." Students were 8th graders from one middle school class. Each student engaged in small group discussions three times and made a group model on combustion. Discourses between peers and teacher were videotaped, audiotaped, and transcribed. The results show that the small groups constructed an initial concept: 'Conditions of combustion', which they then evaluated and revised the initial concept through combustion experiment. Following the discussions, some small groups evaluated their model and made a revised model. Then, the small groups compared various models and constructed a scientific model through consensus within the small group and as a whole class. Finally, students kept revising their model to 'Burning needs oxygen.' This tells us that the social construction process of scientific model made a meaningful role to build scientific model through diverse discussion between the students and their teacher, although they have had some difficult process to reach the final consensus. The data also showed some group features: the members were open to other's ideas. They analyzed the differences between their own ideas from others and revised their model after the whole class discussion. Lastly, they showed the tendency to make a good use of teacher's guidance. This study implies the importance of having social interaction process for students to understand the scientific model and learn the nature of scientific inquiry in class.

Effect of seasonal cabbage cultivar (Brassica rapa L. ssp. Pekinesis) on the quality characteristics of salted-Kimchi cabbages during storage period (계절별 배추 품종에 따른 절임배추의 저장중 품질 특성)

  • Choi, Eun Jeong;Jeong, Moon Cheol;Ku, Kyung Hyung
    • Food Science and Preservation
    • /
    • v.22 no.3
    • /
    • pp.303-313
    • /
    • 2015
  • This study investigates the physicochemical, microbiological and sensory characteristics of seasonal salted-Kimchi cabbages to provide basic data on its uniform quality. Generally, seasonal salted-Kimchi samples had different pH values at initial storage periods, but there was no difference in pH between the seasonal samples when stored for longer periods. The samples from the fall and winter seasons were relatively low in acid and high in solid soluble content compared to samples from other seasons. Salted-Kimchi cabbages in the summer showed the highest microbiological number compared to samples from other seasons. In the sensory evaluation, there were differences in the appearance, aroma, and taste, depending on seasonal samples at different storage periods. The correlation coefficient between the quality characteristics in the seasonal samples showed a positive or negative correlation between the quality characteristics at 1% significant level. In the principal component analysis, F1 and F2 were shown the 51.81% and 14.23% of the total variance (66.21%), respectively. In the PCA pattern of seasonal salted-Kimchi cabbages during storage periods, winter samples were distributed on the top of F2, spring samples were in the middle of F2, while the rest of the samples were distributed on the bottom of F2. According to increasing storage periods, initial storage samples were distributed at the left of F1, while other samples were located at the right of F2.