• 제목/요약/키워드: Primary Medical Center

검색결과 1,503건 처리시간 0.03초

종격동 내 발생한 활막 육종 1예 (A Case of Synovial Sarcoma in Mediastinum)

  • 윤용훈;강동욱;공은정;엄상용;이진서;류지원;김우성
    • Journal of Yeungnam Medical Science
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    • 제30권1호
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    • pp.51-54
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    • 2013
  • Synovial sarcoma is a rare malignancy in the thoracic cavity, especially in the mediastinum. In this paper, a case of primary mediastinal synovial sarcoma is reported. A 34-year-old woman was hospitalized with dyspnea. Her chest X-ray and computed tomography (CT) showed a $16{\times}13{\times}11$ cm mass in her anterior mediastinal space. Surgical resection was performed but was incomplete. The pathological and immunohistochemical analysis confirmed the diagnosis of monophasic spindle cell synovial sarcoma. The patient underwent adjuvant radiotherapy for two months, but local recurrence and metastasis occurred in her pleural cavity. She eventually underwent chemotherapy for one year and died 18 months after her operation.

Real-time monitoring of ultra-high dose rate electron beams using bremsstrahlung photons

  • Hyun Kim;Dong Hyeok Jeong;Sang Koo Kang;Manwoo Lee;Heuijin Lim;Sang Jin Lee;Kyoung Won Jang
    • Nuclear Engineering and Technology
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    • 제55권9호
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    • pp.3417-3422
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    • 2023
  • Recently, as the clinically positive biological effects of ultra-high dose rate (UHDR) radiation beams have been revealed, interest in flash radiation therapy has increased. Generally, FLASH preclinical experiments are performed using UHDR electron beams generated by linear accelerators. Real-time monitoring of UHDR beams is required to deliver the correct dose to a sample. However, it is difficult to use typical transmission-type ionization chambers for primary beam monitoring because there is no suitable electrometer capable of reading high pulsed currents, and collection efficiency is drastically reduced in pulsed radiation beams with ultra-high doses. In this study, a monitoring method using bremsstrahlung photons generated by irradiation devices and a water phantom was proposed. Charges collected in an ionization chamber located at the back of a water phantom were analyzed using the bremsstrahlung tail on electron depth dose curves obtained using radiochromic films. The dose conversion factor for converting a monitored charge into a delivered dose was determined analytically for the Advanced Markus® chamber and compared with experimentally determined values. It is anticipated that the method proposed in this study can be useful for monitoring sample doses in UHDR electron beam irradiation.

원발 중추신경계림프종의 단일 기관 현실 세계 21세기 경험 (Single-Center Real-World Experience with Primary Central Nervous System Lymphoma in the 21st Century)

  • 조형우;홍정용;이대호;김신;이경민;강은희;이순종;박정선;김정훈;류진숙;허주령;서철원
    • The Korean Journal of Medicine
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    • 제99권1호
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    • pp.37-49
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    • 2024
  • 목적: 대한민국에서 원발 중추신경계림프종(primary central nervous system lymphoma, PCNSL)의 발생이 증가하고 있고, 자가 조혈모세포 이식술(autologous stem cell transplantation, ASCT)이 젊은 환자들의 생존 성적을 호전시켜 왔다. 이에 서울아산병원(Asan Medical Center, AMC)의 PCNSL 환자 현실 세계 경험을 분석하고자 하였다. 방법: 환자 자료를 전향적으로 수집, 기록 중인 AMC 림프종 등록을 이용하였다. 2002년부터 2019년 8월까지 279명의 환자를 분석하였다. 결과: AMC의 PCNSL 발생은 점진적으로 증가하여 최근 4년 동안은 매해 전체 비호지킨림프종 신규 환자의 7.4-8.9%를 차지하였다. 중앙 연령은 60세(범위, 17-85)였고, 남자가 55%였다. 65세 미만(n = 183)은 후두엽 침범이 보다 적고, 베타-2 저분자글로불린 수치가 낮다는 것 외에는 65세 이상과 비교해 의미 있는 차이를 보이지 않았다. 리툭시맵, 메토트렉세이트, 프로카르바진, 빈크리스틴(rituximab, methotrexate, procarbazine, and vincristine, R-MPV) 복합 유도 요법의 전체 반응률이 95%로 가장 우수하였다. 전체 환자의 중앙 생존 기간은 3.8년, 5년 생존율은 41.5%, 10년 생존율은 30.2%였다. 비교 시 젊은 연령군과 ASCT 시행군의 생존이 더 우수하였다. 싸이오테파, 부설판, 사이클로포스퍼마이드(thiotepa + busulfan + cyclophosphamide, TBC) 고용량 요법이 여타 조합보다 성적이 우수하였다. 기존의 PCNSL 예후 점수 체계가 본 연구에서도 유효하였다. 연령과 수행도가 독립 예후 인자였다. 중추신경계 외에서만 실패하는 경우는 전체 107명의 실패 중 6명(5.6%)이었다. 결론: PCNSL의 발생은 증가 추세를 보이고 있다. R-MPV 유도 요법 후 TBC 고용량 요법을 동반한 ASCT 시행이 젊고 적응증에 해당하는 PCNSL 환자의 생존 성적을 향상시켜 왔다.

저위교합된 제 2유구치에 대한 치험례 (MANAGEMENT OF INFRAOCCLUDED MANDIBULAR SECOND PRIMARY MOLARS: CASE REPORT)

  • 곽소연;박기태;김지연
    • 대한소아치과학회지
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    • 제36권3호
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    • pp.475-480
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    • 2009
  • 저위교합이란 치아가 출은한 이후 유착 등의 원인으로 맹출이 정지되어 주위 인접치 보다 교합평면이 낮아지는 것을 말한다. 저위교합은 인접치들의 경사, 저위교합된 부위의 공간상실, 대합치의 정출, 해당부위 치아우식 감수성의 증가, 후속 영구치의 맹출경로 변위, 매복, 회전 등의 문제점을 유발할 수 있으므로 조기 진단 및 정기검진을 통한 적절한 치료가 필요하다. 저위교합된 유구치는 대부분 영구 계승치가 존재하며 일반적으로 정상 탈락한다. 그러나 저위교합된 유구치의 탈락이 지연되고 저위교합의 정도가 심화되어 해당부위의 공간상실이 발생하면, 공간부족으로 인하여 후속 영구치의 매복을 야기할 수 있다. 이러한 경우 교정적으로 공간확장술을 시행한 후 외과적 발치를 고려해야 한다. 본 증례는 하악 제 2유구치의 저위교합이 관찰된 3명의 환아를 대상으로 공간에 대한 평가 후 필요한 경우 공간확장술을 시행하고 발치를 시행함으로써 저위교합으로 인해 발생된 문제점을 개선하고, 추후에 발생될 합병증을 예방하였기에 이를 보고하는 바이다.

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Neuroprotective effects of L-carnitine against oxygen-glucose deprivation in rat primary cortical neurons

  • Kim, Yu-Jin;Kim, Soo-Yoon;Sung, Dong-Kyung;Chang, Yun-Sil;Park, Won-Soon
    • Clinical and Experimental Pediatrics
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    • 제55권7호
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    • pp.238-248
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    • 2012
  • Purpose: Hypoxic-ischemic encephalopathy is an important cause of neonatal mortality, as this brain injury disrupts normal mitochondrial respiratory activity. Carnitine plays an essential role in mitochondrial fatty acid transport and modulates excess acyl coenzyme A levels. In this study, we investigated whether treatment of primary cultures of rat cortical neurons with L-carnitine was able to prevent neurotoxicity resulting from oxygen-glucose deprivation (OGD). Methods: Cortical neurons were prepared from Sprague-Dawley rat embryos. L-Carnitine was applied to cultures just prior to OGD and subsequent reoxygenation. The numbers of cells that stained with acridine orange (AO) and propidium iodide (PI) were counted, and lactate dehydrogenase (LDH) activity and reactive oxygen species (ROS) levels were measured. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and the terminal uridine deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling assay were performed to evaluate the effect of L-carnitine (1 ${\mu}M$, 10 ${\mu}M$, and 100 ${\mu}M$) on OGD-induced neurotoxicity. Results: Treatment of primary cultures of rat cortical neurons with L-carnitine significantly reduced cell necrosis and prevented apoptosis after OGD. L-Carnitine application significantly reduced the number of cells that died, as assessed by the PI/AO ratio, and also reduced ROS release in the OGD groups treated with 10 ${\mu}M$ and 100 ${\mu}M$ of L-carnitine compared with the untreated OGD group (P<0.05). The application of L-carnitine at 100 ${\mu}M$ significantly decreased cytotoxicity, LDH release, and inhibited apoptosis compared to the untreated OGD group (P<0.05). Conclusion: L-Carnitine has neuroprotective benefits against OGD in rat primary cortical neurons in vitro.

Surgical Treatment for Primary Lymphedema: A Systematic Review of the Literature

  • Miguel Angel Gaxiola-Garcia;Joseph M. Escandon;Oscar J. Manrique;Kristin A. Skinner;Beatriz Hatsue Kushida-Contreras
    • Archives of Plastic Surgery
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    • 제51권2호
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    • pp.212-233
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    • 2024
  • This is a retrospective review of surgical management for primary lymphedema. Data were extracted from 55 articles from PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials between the database inception and December 2022 to evaluate the outcomes of lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT), and outcomes of soft tissue extirpative procedures such as suction-assisted lipectomy (SAL) and extensive soft tissue excision. Data from 485 patients were compiled; these were treated with LVA (n = 177), VLNT (n = 82), SAL (n = 102), and excisional procedures (n = 124). Improvement of the lower extremity lymphedema index, the quality of life (QoL), and lymphedema symptoms were reported in most studies. LVA and VLNT led to symptomatic relief and improved QoL, reaching up to 90 and 61% average circumference reduction, respectively. Cellulitis reduction was reported in 25 and 40% of LVA and VLNT papers, respectively. The extirpative procedures, used mainly in patients with advanced disease, also led to clinical improvement from the volume reduction, as well as reduced incidence of cellulitis, although with poor cosmetic results; 87.5% of these reports recommended postoperative compression garments. The overall complication rates were 1% for LVA, 13% for VLNT, 11% for SAL, and 46% for extirpative procedures. Altogether, only one paper lacked some kind of improvement. Primary lymphedema is amenable to surgical treatment; the currently performed procedures have effectively improved symptoms and QoL in this population. Complication rates are related to the invasiveness of the chosen procedure.

림프종으로 오인될 수 있는 원발성 직장 매독: 증례 보고와 문헌 고찰 (Primary Rectal Syphilis Mimicking Lymphoma: A Case Report and Literature Review)

  • 배현영;조정흠;김혁중;장석기;나희영;백진호
    • 대한영상의학회지
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    • 제85권4호
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    • pp.801-806
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    • 2024
  • 원발성 직장 매독은 드문 질환으로 대장내시경이나 컴퓨터단층촬영에서 림프종이나 다른 직장암으로 오진될 수 있다. 이에 저자는 직장 병변과 다수의 림프절병증으로 발현하여 직장 종양으로 오인되었던 23세 남자 환자의 원발성 직장 매독 증례를 보고하고자 한다. 이 증례보고는 원발성 직장 매독이라는 드문 질환의 컴퓨터단층촬영과 내시경 소견에 초점을 둔다. 이와 같이 비전형적인 직장 종괴와 이에 비해 광범위한 림프절병증을 가지고 있는 젊은 환자를 진료할 때 우리는 직장 매독과 같은 감염성 질병을 감별 질환으로 고려해 볼 수 있다.

비만에 대한 약침의 효과: 체계적 문헌고찰과 메타분석 (Effects of Pharmacoacupuncture for Obesity: A Systematic Review and Meta-Analysis)

  • 김세윤;송미연;정원석;김형석;신우철;강준혁;서준원;서상우;유승호;임정현;지수환;조재흥
    • 한방비만학회지
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    • 제23권2호
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    • pp.112-124
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    • 2023
  • Objectives: Obesity is a chronic metabolic disease that negatively affects quality of life and health. It is associated with various disease and its prevalence is on the rise. Although various treatments for obesity are used, they have several adverse effects. Pharmacoacupuncture is a widely used method for treating various diseases and has the advantage of having fewer adverse effects. This systematic review and meta-analysis evaluate the efficacy of pharmacoacupuncture in treating obesity. Methods: Eight electronic databases were searched from their inception to August 2023. Only randomized controlled trials were included in this review. Intervention groups included pharmacoacupuncture. Control groups had no limitation. The primary outcome was body mass index (BMI), and the secondary outcomes were body weight (BW), waist circumference (WC), and adverse effects. Continuous outcome data were presented as mean differences (MD) with 95% confidence intervals (CI). Results: Four randomized controlled trials (RCTs) involving 139 participants were included in this systematic review and meta-analysis. Results revealed that BMI ((MD)=-0.98, 95% CI -1.84 to -0.11, Z=2.22, P=0.03, I2=0%), WC (MD=-4.29, 95% CI -7.51 to -1.08, Z=2.62, P=0.009, I2=38%) were significantly improved in the intervention groups compared to control groups. Adverse effects were reported in two studies. Conclusions: This systematic review and meta-analysis suggests that pharmacoacupuncture is an effective and safe therapy for simple obesity. Further detailed studies should be conducted on effects of pharmacoacupuncture for obesity to increase reliability.

부신의 원발성 평활근육종의 영상 소견: 증례 보고 (Imaging Findings of Primary Adrenal Leiomyosarcoma: A Case Report)

  • 윤혜란;박동희
    • 대한영상의학회지
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    • 제81권2호
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    • pp.459-464
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    • 2020
  • 평활근육종은 주로 자궁근육층, 후복막강에서 발생하는 악성질환으로 일차성으로 부신에서 발생하는 경우는 매우 드물다. 영상 소견이 비특이적이므로 부신에서 보일 수 있는 여러 종양과의 감별이 어렵다. 저자들은 좌상복부 통증을 주소로 촬영한 CT 상 좌측 부신 종괴가 발견되고, 2년 동안 1 cm 이상 크기가 증가하여 부신절제술을 받은 후 병리조직검사에서 평활근육종으로 진단된 증례를 영상 소견을 중심으로 보고하고자 한다.

Clinical characterization of a Korean case with 3p25 deletion

  • Lee, Hye Jin;Kim, Ja Hye;Cho, Ja Hyang;Lee, Beom Hee;Choi, Jin-Ho;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • 제11권1호
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    • pp.36-39
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    • 2014
  • Chromosome 3 (3p) deletion syndrome is a rare genomic disorder caused by a deletion at the terminal end of the short arm of chromosome 3. The primary characteristics of the syndrome are delayed development, dysmorphic features, and several other congenital anomalies. Here, we describe the case of a 2-year-old Korean girl with typical features of 3p deletion syndrome, including dysmorphic facial features, low birth weight, developmental delay, growth and cognitive retardation, and congenital heart disease. This case represents the first report of 3p deletion syndrome in Korea. Although phenotypes can be variable among patients, a clinically recognizable pattern has been described for this genetic defect, and our report helps to identify other cases with 3p deletion syndrome from a clinical and genetic perspective.