• Title/Summary/Keyword: PA6

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Comparative Analysis between Preoperative Radiotherapy and Postoperative Radiotherapy in Clinical Stage I and II Endometrial Carcinoma (자궁내막암 환자에서 수술 전 방사선치료와 수술 후 방사선치료의 성적 비교 분석)

  • Keum Ki Chang;Lee Chang Geol;Chung Eun Ji;Lee Sang Wook;Kim Woo Cheol;Chang Sei Kyung;Oh Young Taek;Suh Chang Ok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.377-383
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    • 1995
  • Purpose : To obtain the optimal treatement method in patients with endometrial carcinoma(clinical stage FIGO I, II) by comparative analysis between preoperative radiotherapy (pre-op RT) and postoperative radiotherapy (post-op RT). Material and Methods : A retrospective review of 62 endometrial carcinoma patients referred to the Yonsei Cancer Center for radiotherapy between 1985 and 1991 was undertaken. Of 62 patients, 19 patients(Stagel : 12 patients. Stagell;7 patients) received pre-op RT before TAH(Total Abdominal Hysterectomy) and BSO (Bilateral Salphingoophorectomy) (Group 1) and 43 patients(Stage 1;32 patients, Stage 2; 11 patients) received post-op RT after TAH and BSO (Group 2). Pre-op irradiation was given 4-6 weeks prior to surgery and post-op RT administered on 4-5 weeks following surgery. All patients except 1 patient(Group 2: ICR alone) received external irradiation. Seventy percent(13/19) of pre-op RT group and 54 percent(23/42) of post-op RT group received external pelvic irradiation and intracavitary radiation therapy(ICR). External radiation dose was 39.6-55 Gy(median 45 Gy) in 5-6. 5weeks through opposed AP/PA fields or 4-field box technique treating daily, five days per week, 180 cGy per fraction. ICR doses were prescribed to point A(20-39.6 Gy, median 39 Gy) in Group 1 and 0.5cm depth from vaginal surface (18-30 Gy,median 21 Gy) in Group 2. Results : The overall 5 year survival rate was $95{\%}$. No survival difference between pre-op and post-op RT group.($89.3{\%}$ vs $97.7{\%}$, p>0.1) There was no survival difference by stage, grade and histology between two groups. The survival rate was not affected by presence of residual tumor of surgical specimen after pre-op RT in Group 1 (p>0.1), but affected by presence of lymph node metastasis in post-op RT group(P<0.5). The complication rate of pre-op RT group was higher than post-op RT. ($16{\%}$ vs $5{\%}$) Conclusion : Post-op radiotherapy offers the advantages of accurate surgical-pathological staging and low complication rate.

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A Statistical Study of Radiolucent Foreign Bodies in Food and Air Passage (단순 흉부 방사선 검사상 발견되지 않은 식도 및 기도 이물의 임상 통계적 고찰)

  • 손영규;이창업;배광식;박문서;이선철
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.9.2-9
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    • 1983
  • We have observed 74 cases of radiolucent foreign bodies in food and air passage in E. N. T. department of Hang Gang Sacred Hospital, from Jan. 1972 to Mar. 1983. The following results were obtained. 1) Distribution of location was 56 cases(75.6 %) in food passage and 18 cases (24.4 %) in air passage. 2) In age distribution, 46 cases (82.1 %) of F. B. in food passage were found in patient over 21 years old and 12 cases (66.7 %) of F. B. in air passage were found in patient under 5 years old. 3) Female seems to be more frequently involved than male in cases of F. B. of food passage and in cases of air passage, male is more frequent. Food passage male: female - - - 25 : 31 Air passage male: female - - - 10 : 8 4) Meats was the most frequent foreign body in food passage (19 cases-33.9%), and the bony pieces was next (17 cases-30.4 %). Plastic material was the most frequent foreign body in air passage (9 cases-49.9 %), and the vegetable seed was the second (4cases-22.0 %). 5) In the location of F. B. in food passage, the first narrowing of the esophagus was the most frequent site and in air passage, the bronchus-especially right bronchus-was the most frequent site. 6) In the duration of lodgement, 44 cases(78.6 %) of F.B. in food passage were visited with - in 24 hours, and 11 cases (61 %) of F. B. in air passage were visited with - in 24 hours. 7) Simple chest PA was checked in all patient and then, esophagogram was checked in 34 cases of F.B. in food passage, among them positive finding was noticed in 23 cases. 8) Removal of F. B. in food passage by esophagoscopy was performed in 54 cases (96.4 %), but in the cases of air passage, removal of F. B. by bronchoscopy was performed in 14 cases (77.8 %). 9) Complications of food passage by the F. B. itself or esophagoscopy were esophageal mucosal laceration (1 cases-1.8 %) and esophageal perforation (1 case -1. 8 %) and complication of air passage by F. B. itself or bronchoscopy were atelectasis (2 cases -11.1 %) and pneumonia (3 cases-16.7 %).

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Physicochemical, Microbiological and Sensory Properties of Food Additive-Free Grilled Pork Products during Cold Storage (식품 첨가제 미함유 그릴 돈육햄의 냉장저장 중 물리화학, 미생물학 및 관능적 품질 특성)

  • Kim, Il-Seok;Jin, Sang-Geun;Park, Gi-Hun;Jeong, Gi-Jong;Kim, Dong-Hun;Yang, Mi-Ra;Ha, Gyeong-Hui;Lee, Mu-Ha
    • the MEAT Journal
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    • s.34 winter
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    • pp.14-25
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    • 2007
  • The objective of this study was to investigate the physicochemical, microbiological and sensory properties of food additive-free grilled pork products manufactured using loin (T1), tender loin (T2) and ham (T3). The samples were heated for 30 min at $60^\circC$, and then 50 min for $150^\circC$. After cooling, vacuum packaged grilled pork samples was stored at $4\pm$$1^\circC$ for 40 days. The pH values of grilled pork samples ranged from 5.92 (T1) to 6.10 (T3) at the initial storage time, and from 6.28 (T1) to 6.60 (T3) after 40 days. The water holding capacities (%) was 85.99~93.24% for T1, 85.26~93.89% for T2 and 89.11~94.67% for T3, all of which were slightly higher than those of other pork products. The shear force values of T2 were significantly higher (p<0.05) than those of the other pork products throughout the storage period. The TBARS and VBN values of T2 were significantly higher (p<0.05) than those of T1 and T3. With regard to microorganisms, all grilled pork samples was in good condition, showing 1.93~3.48 log10 CFU/g via total plate counts, and 1.74~3.48 log10 CFU/g for lactic acid bacteria throughout the storage period. Regarding sensory evaluation, the scores of overall acceptability in all products were above 5.0 points through 40 days of storage.

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A study of post-operative changes in facial height and width of mandibular prognathic patients (하악전돌증 환자의 수술후 안모길이 및 폭경의 변화에 관한 연구)

  • Kim, Eun-Joo;Moon, Cheol-Hyun
    • The korean journal of orthodontics
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    • v.30 no.3 s.80
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    • pp.367-375
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    • 2000
  • If a mandibular prognathic patient has an extremely unnatural anteroposterior and vertical maxilla or keen esthetical perception for facial profile, orthognathic surgery must be performed along with orthodontic treatment, which alone cannot provide satisfactory results in this case. Esthetical improvement becomes an important factor in the satisfaction level of the patient's treatment result, but an attempt to objectively measure beauty holds many problems. Therefore, in the end, the patient submits the final esthetical evaluation based on his/her subjective viewpoint. Because Korean people have a tendency to prefer the facial appeareance of westerners, they favor an oval shaped face over the traditional round face. This research was conducted in response to the complaints raised by patients who claim that their face had become more round from widening of facial width after the orthognathic surgery for manidibular prognathism than before the surgery. The following results were obtained on the changes in facial appearance and patient satisfaction level by analyzing the skull P-A analysis of total of 14 patients (8 male and 6 female) who underwent orthognathic surgery primarily chief complaint for manidibular prognathism and from their responses on questionnaires. These results are to be used in the research on the pre- and post- operative changes in facial height and width from orthognatic surgery. 1. Three ($21.4\%$) of 14 patients said that their face had widened. 2. The A group showed no change in mandibular width but B group showed a 0.7mm reduction. The facial width increased by 0.45mm and 0.66mm in groups A and B, respectively, after the orthognathic surgery 3. After the surgery the facial length changed by an 0.52mm increase in upper facial height , 1.19mm reduction in lower facial height, and 0.7mm reduction in mandibular height in group A. In group B group, there was a 0.67mm reduction in upper facial height, 3.66mm reduction in lower facial height, and 5mm reduction in mandibular height. 4. In reference to facial width, the facial height showed $1.5\%$ reduction in group A and $3.6\%$ reduction in group B after the surgery. 5. In reference mandibular height-to-facial width ratio, there was a $1.3\%$ reduction in group A, and $4.4\%$ reduction in group B after the surgery. 6. In reference to the mandibular height-to-width ratio, there was a $1.3\%$ reduction in group A and $4.3\%$ reduction in group B after the surgery. 7. Although the change in the facial width due to surgery can be ignored, sufficient explanation should be Provided to the patient before surgery on the fact that the face can appear to be relatively wide because of the reduced facial length as result of the surgery.

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A Study on the Estimation for the Guaranteed Strength and Construction Quality of the Combined High Flowing Concrete in Slurry Wall (지하연속벽용 병용계 고유동 콘크리트의 시공 품질 및 보증강도 평가에 관한 연구)

  • Kwon, Yeong-Ho
    • Journal of the Korea Concrete Institute
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    • v.18 no.6 s.96
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    • pp.811-817
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    • 2006
  • The primary purpose of this study is to estimate the guaranteed strength and construction quality of the combined high flowing concrete which is used in the slurry wall of underground LNG storage tank. The required compressive strength of this type of concrete become generally known as a non economical value because it is applied the high addition factor for variation coefficients and low reduction factor under water concrete. Therefore, after estimation of the construction quality and guaranteed strength in actual site work, this study is to propose a suitable equation to calculate the required compressive strength in order to improve its difference. Application results in actual site work are shown as followings. The optimum nix design proportion is selected that has water-cement ratio 51%, sand-aggregate ratio 48.8%, and replacement ratio 42.6% of lime stone powder by cement weight. Test results of slump flow as construction quality give average 616~634mm. 500mm flowing time and air content are satisfied with specifications in the rage of 6.3 seconds and 4.0% respectively. Results of strength test by standard curing mold show that average compressive strength is 49.9MPa, standard deviation and variation coefficients are low as 1.66MPa and 3.36%. Also test results by cored cylinder show that average compressive strength is 66.4MPa, standard deviation and variation coefficients are low as 3.64MPa and 5.48%. The guaranteed strength ratio between standard curing mold and cored cylinder show 1.23 and 1.32 in the flanks. It is shown that applied addition factor for variation coefficients and reduction factor under water concrete to calculate the required compressive strength is proved very conservative. Therefore, based on these results, it is proposed new equation having variation coefficients 7%, addition factor 1.13 and reduction factor 0.98 under water connote.

Clinical Features of Pulmonary Tuberculosis In The Elderly (노인 폐결핵의 임상적 특정)

  • Lee, Jae-Ho;HwangBo, Bin;Yoo, Chul-Gyu;Lee, Chun-Taek;Kim, Yeong-Hwan;Han, Sung-Koo;Shim, Young-Soo;Chung, Hee-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.4
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    • pp.334-345
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    • 2001
  • Background : Pulmonary tuberculosis(TB) is still prevalent and remains a significant clinical problem for the elderly. However, the disease presents in many ways, and there are frequent adverse drug reactions that may prevent the early diagnosis and treatment of elderly TB patients compared to the young. The purpose of this study was to determine whether or not there are any differences in the clinical feature of pulmonary tuberculosis(TB) in both the diagnosis and treatment between the young (less than 64 years) and the elderly (65 years and more). Methods : The medical records of 125 young and 70 elderly pulmonary TB patients, who were diagnosed with and treated for pulmonary TB at the Seoul Municipal Boramae Hospital from November 1991 to January 1997, were analyzed retrospectively. Results : Anorexia(12% vs. 31.4%), general weakness (20.0% vs. 54.3%), dyspnea(21.6% vs. 37.1%) and an abnormal mentality (0.8% vs. 15.7%) were more frequent presenting symptoms in elderly TB patients, whereas hemoptysis (32.8% vs. 10.0%) and fever (BT > $37^{\circ}C$, 58.4% vs. 35.7%) were more frequent in the young. The elderly had a higher number of cardiovascular and chronic obstructive pulmonary diseases as underlying illnesses. In chest PA, there were no differences in the location of the TB lesion, but the appearances were initially diagnosed more frequently as pneumonia or lung cancer (8.8% vs. 30.0%, p<0.05) in the elderly. There was no difference in the detection rate of acid fast bacilli(AFB) in the sputum between the two groups. There were no differences in the treatment response and follow-up loss. However, adverse drug reactions (13.6% vs. 45.7%, p<0.05), and changes in medication (4.9% vs. 25.7%, p<0.05) during treatment occurred more frequently in the elderly. One among the 125 young patients died from tuberculosis whereas 6 among the 70 elderly patients died from the disease. Conclusion : Because the clinical and radiological presentations were more atypical, a sputum AFB smear and culture should be done immediately in the elderly who are TB. The elderly experienced more frequent adverse drug reactions and mortality during treatment, but the response to treatment was good and rapid.

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Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Ahn, Hyuk;Kim, Jun-Seok
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.177-184
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    • 1996
  • Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

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Physicochemical, Microbiological and Sensory Properties of Food Additive-Free Grilled Fork Products during Cold Storage (식품 첨가제 미함유 그릴 돈육햄의 냉장저장 중 물리화학, 미생물학 및 관능적 품질 특성)

  • Kim, Il-Suk;Jin, Sang-Keun;Park, Ki-Hoon;Jung, Gi-Jong;Kim, Dong-Hun;Yang, Mi-Ra;Hah, Kyung-Hee;Lee, M.
    • Food Science of Animal Resources
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    • v.26 no.3
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    • pp.269-275
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    • 2006
  • The objective of this study was to investigate the physicochemical, microbiological and sensory properties of food additive-free grilled pork products manufactured using loin (T1), tender loin (T2) and ham (T3). The samples were heated for 30 min at $60^{\circ}C$, and then 50 min for $150^{\circ}C$. After cooling, vacuum packaged grilled pork samples was stored at $4{\pm}1^{\circ}C$ for 40 days. The pH values of grilled pork samples ranged from 5.92 (T1) to 6.10 (T3) at the initial storage time, and from 6.28 (T1) to 6.60 (T3) after 40 days. The water holding capacities(%) was $85.99{\sim}93.24%$ for T1, $95.26{\sim}93.89%$ for T2 and $89.11{\sim}94.67%$ for T3, all of which were slightly higher than those of other pork products. The shear force values of T2 were significantly higher(p<0.05) than those of the other pork products throughout the storage period. The TBARS and VBN values of T2 were significantly higher(p<0.05) than those of T1 and T3. With regard to microorganisms, all grilled pork samples was in good condition, showing $1.93{\sim}3.48\;log_{10}$ CFU/g via total plate counts, and $1.74{\sim}3.48\;log_{10}$ CFU/g far lactic acid bacteria throughout the storage period. Regarding sensory evaluation, the scores of overall acceptability in all products were above 5.0 points through 40 days of storage.

The Respiratory and Hemodynamic Effects of Prone Position According to the Level of PEEP in a Dog Acute Lung Injury Model (잡종견 급성폐손상 모델에서 Prone position 시행시 PEEP 수준에 따른 호흡 및 혈류역학적 효과)

  • Lim, Chae-Man;Chin, Jae-Yong;Koh, Youn-Suck;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.140-152
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    • 1998
  • Background: Prone position improves oxygenation in patients with ARDS probably by reducing shunt Reduction of shunt in prone position is thought to be effected by lowering of the critical opening pressure (COP) of the dorsal lung because the pleural pressure becomes less positive in prone position compared to supine position. It can then be assumed that prone position would bring about greater improvement in oxygenation when PEEP applied in supine position is just beneath COP than when PEEP is above COP. Hemodynamically, prone position is expected to attenuate the lifting of cardiac fossa induced by PEEP. Based on these backgrounds, we investigated whether the effect of prone position on oxygenation differs in magnitude according to the level of PEEP applied in supine position, and whether impaired cardiac output in supine position by PEEP can be restored in prone position. Methods: In seven mongrel dogs, $PaO_2/F_1O_2$(P/F) was measured in supine position and at prone position 30 min. Cardiac output (CO), stroke volume (SV), pulse rate (PR), and pulmonary artery occlusion pressure (PAOP) were measured in supine position, at prone position 5 min, and at prone position 30 min. After ARDS was established with warmed saline lavage(P/F ratio $134{\pm}72$ mm Hg), inflection point was measured by constant flow method($6.6{\pm}1.4cm$ $H_2O$), and the above variables were measured in supine and prone positions under the application of Low PEEP($5.0{\pm}1.2cm$ $H_2O$), and Optimal PEEP($9.0{\pm}1.2cm$ $H_2O$)(2 cm $H_2O$ below and above the inflection point, respectively) consecutively. Results : P/F ratio in supine position was $195{\pm}112$ mm Hg at Low PEEP and $466{\pm}63$ mm Hg at Optimal PEEP(p=0.003). Net increase of P/F ratio at prone position 30 min, however, was far greater at Low PEEP($205{\pm}90$ mm Hg) than at Optimal PEEP($33{\pm}33$ mm Hg)(p=0.009). Compared to CO in supine position at Optimal PEEP($2.4{\pm}0.5$ L/min), CO in prone improved to $3.4{\pm}0.6$ L/min at prone position 5 min (p=0.0180) and $3.6{\pm}0.7$ L/min at prone position 30 min (p=0.0180). Improvement in CO was attributable to the increase in SV: $14{\pm}2$ ml in supine position, $20{\pm}2$ ml at prone position 5 min (p=0.0180), and $21{\pm}2$ ml at prone position 30 min (p=0.0180), but not to change in PR or PAOP. When the dogs were turned to supine position again, MAP ($92{\pm}23$ mm Hg, p=0.009), CO ($2.4{\pm}0.5$ L/min, p=0.0277) and SV ($14{\pm}1$ ml, p=0.0277) were all decreased compared to prone position 30 min. Conclusion: Prone position in a dog with saline-lavaged acute lung injury appeared to augment the effect of relatively low PEEP on oxygenation, and also attenuate the adverse hemodynamic effect of relatively high PEEP. These findings suggest that a PEEP lower than Optimal PEEP can be adopted in prone position to achieve the goal of alveolar recruitment in ARDS avoiding the hemodynamic complications of a higher PEEP at the same time.

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Video-Assisted Thoracoscopic Surgery for Fibrinopurulent Empyema (섬유농성 농흉의 비디오 흉강경을 이용한 치료)

  • 손정환;모은경;지현근;김응중;신호승;신윤철
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.404-410
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    • 2003
  • Different treatment options are available according to the stage and duration of the empyema. Stage I empyema (exudate stage) is treated concurrently by the administration of appropriate antibiotics and chest tube drainage. Stage III empyema (organized stage) is considered for decortication through an open thoracotomy. However, the treatment of fibrinopurulent, stage II empyema remains controversial. Recently, debridement with the use of Video-Assisted Thoracoscopic Surgery (VATS) has been proposed for the treatment of stage II empyema. We analyzed and report our initial experience of 5 cases of stage II empyema, treated with the use of VATS. Material and Method: Between June 2001 and February 2002, 5 patients with fibrinopurulent empyema that did not respond to antibiotics, chest tube drainage or Percutaneous Catheter drainage (PCD), and instillation of fibrinolytic agent were treated by debridement and irrigation with the use of VATS. A CT scan was performed in all patients before the operation to confirm the diagnosis of loculated empyema and to detect additional lung parenchymal diseases. Result: All 5 patients underwent successful debridement and irrigation with the use of VATS and the chest tube was inserted properly. And no patients needed conversion to open thoracotomy. The ratio of sex was 4 : 1 (male : female), the mean age was 53 years old (range, 26~73 years), the mean operative time was 73.4 minutes (range, 52~95 minutes), the mean duration of postoperative chest tube placement was 12.4 days (range, 6~19 days), and the mean duration of postoperative hospital stay was 20.8 days (range, 10~36 days). In all patients, clinical symptoms such as pain and fever subsided and simple chest PA view revealed satisfactory lung expansion. No major postoperative complication was observed during the hospital course and no patient suffered from the recurrence of empyema in the follow-up period. Conclusion: We think that early operation with the use of VATS is safe and efficient for stage II empyema which did not respond to medical treatment(antibiotics and chest tube drainage), therefore, it can prevent stage II empyema from advancing to stage III, organized empyema.