• Journal of Korean Neurosurgical Society
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• 제64권4호
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• pp.505-513
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• 2021

Objective : The adaptive immune response following subarachnoid hemorrhage (SAH) is not well understood. We evaluated and compared the T cell receptor (TCR) immune repertoire of good-grade and poor-grade SAH patients to elucidate the T cell immunology after ictus. Methods : Peripheral blood from six SAH patients was collected at two different times, admission and at the 7-day follow-up. Composition and variation of the TCR β-chain (TCRB) complimentary determining regions (CDR) 3 repertoire was examined using high-throughput sequencing; the analysis was based on sampling time and disease severity (good vs. poor-grade SAH). Results : Clonality at admission and follow-up were 0.059 (0.037-0.038) and 0.027 (0.014-0.082) (median, 25th-75th percentile). Poor-grade SAH (0.025 [0.011-0.038]) was associated with significantly lower clonality than good-grade SAH (0.095 [0.079-0.101]). Poor-grade SAH patients had higher diversity scores than good-grade SAH patients. CDR length was shorter in good-grade SAH vs. poor-grade SAH. Differences in clonotype distribution were more prominent in TCRBV gene segments than TCRBJ segments. TCRBV19-01/TCRBJ02-04 and TCRBV28-01/TCRBJ02-04 were the most increased and the most decreased V-J pairs in the 7-day follow-up compared to admission in good-grade SAH. The most increased and decreased V-J pairs in poor-grade SAH patients were TCRBV28-01/TCRBJ02-06 and TCRBV30-01/TCRBJ02-04, respectively. Conclusion : The TCRB repertoire is dynamic in nature following SAH. TCRB repertoire may facilitate our understanding of adaptive immune response according to SAH severity.

• Journal of Korean Neurosurgical Society
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• 제39권2호
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• pp.120-124
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• 2006

Objective : This study is aimed to assess the clinical outcome in early and minimally invasive surgery using incision for the patients with poor grade aneurysm. Methods : The authors retrospectively reviewed all 46 poor grade patients of Hunt and Hess[H-H] grade IV and V who suffered aneurysmal subarachnoid hemorrhage[SAH] between 1999 and 2004. All 35 patients harboring 43 aneurysms who underwent early surgery within 72 hours were included in this study. Clinical outcome was assessed by Glasgow outcome scale[GOS] and compared with that of conventional pterional approach. Results : Twenty four patients were operated with conventional pterional approach and 11 with eyebrow approach within 72 hours after SAH. Seven multiple aneurysm patients harbor 15 aneurysms, Forty one aneurysms were treated with clippings. All 11 patients of eyebrow surgery group[ESG] were in H-H grade IV, 3 in Fisher grade III and 8 in Fisher grade IV. Among 24 patients of pterional approach group[PAG]. 20 were in H-H grade IV and 4 in H-H grade V, 3 were in Fisher grade III and 21 in Fisher grade IV. Overall favorable outcome was achieved in 41.7% and 54.5% in PAG and ESG, respectively. Favorable outcome of H-H grade IV in PAG showed 45.0%. Overall mortality rate was 14.3%. Conclusion : It is concluded that the clinical outcome of early and minimally invasive aneurysmal surgery using eyebrow incision in the selected poor grade aneurysm patients can be compatible with that of conventional pterional surgery.

• Journal of Korean Neurosurgical Society
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• 제40권3호
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• pp.159-163
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• 2006

Objective : Unique Internal carotid artery angiographic findings have been found especially in very poor grade aneurysmal subarachnoid hemorrhage[SAH] patients before and during the endovascular coiling. The author investigates their patterns and classifies them into lour subtypes. Methods : Among Hunt&Hess grade IV, V SAH patients, the author could gather eight patients who showed abnormal intracranial circulation in cerebral catheter-based angiography. Results : The author introduces new term 'misery collaterals' first and has classified them into four types with the case illustrations. Type 1 is the worst condition defined as almost no intracranial circulation. Type 2 is the condition of little intracranial circulation with contrast filling just only at vessels of brain base, type 3 is of no or little cortical circulation with contrast filling at bilateral large vessels of brain base through circle of Willis channel and type 4 is of visible bilateral cortical circulation but delayed intracranial circulation time. The prognosis of these eight patients showed misery collaterals were disappointed. Conclusion : These finding can be used as the supportive information in deciding a management plan in poor grade SAH patients.

• Journal of Korean Neurosurgical Society
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• 제39권1호
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• pp.36-39
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• 2006

Objective : The present study attempts to address the change of management results over time during the past 13 years in good-grade patients with intracranial aneurysm. Methods : Six hundred twenty five [Hunt-Hess grade I to III] out of 826 patients with ruptured intracranial aneurysms operated by the same operator within 3 days after the attack from 1990 to 2002 were selected. Since 1998, endovascular aneurysmal occlusion was done in selected cases of 21 patients. The change of management results over time, including rebleeding rate, delayed ischemic neurologic deficit[DIND] as a cause of morbidity and mortality and surgical outcome were examined. Results : The ratio of poor-grade patients in all patients tended to decrease over the years. The early rebleeding rate declined from 5.0% to 1.2% with the use of tranexamic acid and computed tomography angiogram DIND as a cause of mortality and morbidity has decreased from 12.5% in 1990 to approximately 0% currently. Surgical outcome began to improve significantly in 1994 [poor outcome : 25% in 1990, 12.2% in 1994,6.8% in 2002]. Conclusion : These results suggest that the advances in care and increased experience of the operator significantly affect the change of overall outcome, and early detection of the aneurysm is needed for reducing the ratio of poor-grade patients.

• Journal of Yeungnam Medical Science
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• 제38권2호
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• pp.169-174
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• 2021

Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary gland, but primary thyroid MEC has rarely been reported and usually has a good prognosis. Herein, I report a case of thyroidal MEC with a poor prognosis in an 82-year-old woman with an anterior neck mass. Ultrasonography and computed tomography revealed a thyroid mass. The patient initially underwent fine-needle aspiration, was diagnosed with malignancy, and underwent a right lobectomy. On gross examination, a 4.0×3.6×2.6 cm-sized ill-defined, unencapsulated, and infiltrative tan to whitish mass with necrosis was identified. Microscopically, epidermoid tumor cell nests or solid sheets were identified. Mucous cells that were positive for periodic acid-Schiff and mucicarmine stains were also identified within epidermoid cell nests. Frequent mitosis and necrosis were observed. Immunohistochemical staining for p40 and p63 was positive, and that for thyroid transcription factor-1 and paired box gene 8 was focally positive. According to the Armed Forces Institute of Pathology grading system for salivary gland MEC, the current case was classified as high-grade MEC. After surgery, the patient suffered from dyspnea due to a remnant neck mass that compressed and obstructed the trachea; therefore, the patient refused further treatment. Thyroidal MECs are considered low-grade with a favorable prognosis, but there are several reported cases of thyroidal MEC with poor prognosis. The current case is a rare presentation of high-grade thyroidal MEC with a poor prognosis.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.425-429
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• 2001

Objective : Patients with poor grade aneurysm usually present with increased intracranial pressure(ICP), even those without an intracranial clot. Based on this fact, the present study investigated a significance of intracranial pressure monitoring in those patients. Patients and Methods : A total of 60 patients with Hunt and Hess Grade IV(50 patients) or V(10 patients) were treated for aneurysmal subarachnoid hemorrhage(SAH) during a 3-year-period, and intraparenchymal ICP was measured in the majority, immediately after arrival to the emergency room. Early surgery including intraoperative ventriculostomy was undertaken within 3 days after SAH. An ultraearly surgery was performed without preceding angiogram or ICP monitoring in patients with large sylvian hematomas, highly suggestive of middle cerebral artery aneurysm. Outcomes were assessed by the Glasgow Outcome Scale(GOS) at 6 months. Results : In overall, favorable outcome(GOS scores 1-2) was seen in 27(54.0%) of admission Grade IV and 1(10.0%) of admission Grade V patients. Of the 38 surgical patients with preoperative ICP monitorings, 25 patients (80.6%) exhibiting ICP values of less than 40mmHg showed favorable outcome, however, no patients with ICP values above 40mmHg recovered(Fisher's exact test, p=0.0001). Conclusion : It is concluded that a preoperative ICP above 40mmHg before ventriculostomy indicate significant vital brain destruction as intractable intracranial hypertension, and Grade IV patients at admission with an ICP below 40mmHg can be of benefit from early surgical intervention while Grade V patients still remains unfavorable.

• 한국도로학회논문집
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• 제16권3호
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• pp.9-20
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• 2014

PURPOSES : This study is to compare load transfer efficiency of key joint and dowel joint for airport concrete pavement. METHODS : As AC150/5320-6D of FAA's [Advisory Circular] was changed into AC150/5320-6E, Key joint type of rigid pavement were excluded from Construction Joints. LTE(Load Transfer Efficiency) of dowel joint and key joint were compared by times and seasons through pavement temperature measurement, ocular investigation and HWD measurement. RESULTS : For the joint performance grade of No. 2(The second) runway of airport, 12% of poor rate was observed in key joint and 2% of poor rate in dowel joint. Poor rate of key joint was increased to 17%, if only No. 3~No. 6 slabs, which are mostly loaded from the airplanes, were applied for the study. In apron area, LTE poor rate of key joint was high in winter, and LTE poor rate of dowel joint was at least above 'Fair' grade. In summer, 'Fair' for key joint, 'Acceptable' for dowel joint appeared. CONCLUSIONS : As results, dowel joint was superior than key joint for LTE. Deviations of seasons and times were smaller in dowel joint's result. And LTE in winter was lower than LTE in summer.

• Journal of Chest Surgery
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• 제55권2호
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• pp.101-107
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• 2022

Background: Spread through air spaces (STAS) has recently emerged as a prognostic factor in lung adenocarcinoma, but little is known about the association of STAS and its grade with recurrence in neuroendocrine tumors (NETs). This study investigated the prognostic effect of STAS grade in NETs after curative resection. Methods: Seventy-seven patients were retrospectively reviewed, including 9 with typical carcinoid (TC), 6 with atypical carcinoid (AC), 26 with large cell neuroendocrine carcinoma (LCNEC), and 36 with small cell carcinoma (SCC). STAS was defined as the presence of floating tumor cells within air spaces in the lung parenchyma beyond the edge of the main tumor. STAS was classified as grade 1 or 2 depending on whether it was found within or beyond one ×10 objective lens field away from the main tumor margin, respectively. Results: Fifty-four patients (70%) had STAS, including 22% with TC, 50% with AC, 69% with LCNEC, and 86% with SCC. Patients with STAS had more nodal metastasis, lymphatic and vascular invasion, tumor necrosis, and tumor subtypes other than TC. Among STAS cases, grade 2 STAS was present in 33% of AC, 78% of LCNEC, and 87% of SCC. The 5-year recurrence-free survival (RFS) rate was 81%, 63%, and 35% in patients with no STAS, grade 1, and grade 2 STAS, respectively. Multivariate analysis found that grade 2 STAS was an independent negative prognostic factor for RFS. Conclusion: Although STAS itself was not associated with a poor prognosis, grade 2 STAS was an independent negative prognostic factor for RFS.

• 환경영향평가
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• 제14권4호
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• pp.237-245
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• 2005

We investigated the water environmental assessment by the species biotic index (SBI) of freshwater fish at the Namdaecheon in Gangneung city, Gangweon-do during June and July in 2004 and June in 2005. In fish fauna, 29 species and 10 families were collected. Dominant species was Zacco platypus (relative abundance 15.33%) and subdominant species was Rhynchocypris steindachneri (13.13%). Species biotic index (SBI) in station 1, 2, 3, 4 was 1.70, 2.85, 1.00 and 3.39 respectively and water environmental grade by SBI was all very good. Station 5 was 4.13 in SBI and good grade. Station 6 was 4.47 and fairly good. Station 7 was 7.25 and poor. And station 8 was 8.10 and very poor grade. Results of water environmental grade by SBI and water quality grade were very similar in this stream.

• Journal of Digestive Cancer Research
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• 제10권1호
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• pp.1-8
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• 2022

The incidence of gastric neuroendocrine tumors (NET) has been increased with the improvement of endoscopy accessibility. The World Health Organization classified NET of low (G1), intermediate (G2), high (G3) grade and neuroendocrine carcinoma with poor differentiation by mitotic count and Ki-67 labeling index. Gastric NET are divided into three subtypes based on the pathophysiology, and treatment is determined according to the subtype and prognostic factors of tumor. For diagnosis, endoscopy with biopsy, endoscopic ultrasonography, abdominal pelvis computed tomography, and serum gastrin level measure are required. In general, type 3, size > 2 cm, deep submucosal infiltration, high histological grade, lymphovascular invasion and metastasis are poor prognostic factors. Type 1 or 2 without these factors are treated by endoscopic resection, and other tumors needs surgery. Endoscopic resection of early type 3 or type 1 and 2 tumors with poor prognostic factors still remains a challenge.