• Title/Summary/Keyword: Retrospective Effects

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Bilateral retinoblastoma: Long-term follow-up results from a single institution (단일기관의 장기추적 결과)

  • Choi, Sang Yul;Kim, Dong Hwan;Lee, Kang Min;Lee, Hyun Jae;Kim, Mi-Sook;Lee, Tai-Won;Choi, Sang Wook;Kim, Dong Ho;Park, Kyung Duk;Lee, Jun Ah
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.674-679
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    • 2009
  • Purpose : The authors aimed to analyze the long-term effects of treatments, especially external beam radiotherapy (EBRT), in bilateral retinoblastoma patients. Methods : This retrospective study analyzed the medical records of 22 bilateral retinoblastoma patients who were registered between October, 1987 and October, 1998 and followed-up for more than 10 years. They were treated by enucleation, EBRT, and systemic chemotherapy. Age at diagnosis, sex, delay prior to treatment, Reese-Ellsworth (RE) classification, and the local treatment modalities were analyzed in relation to recurrence-free survival (RFS) and complications. Results : Median age at diagnosis was 7.0 months (range 1.7-31.6 months). Leukocoria was the most common presenting feature. Two patients had a familial history. The RE classifications of the 44 eyes were group II in 4, III in 14, IV in 4, and V in 22. At the end of a median follow-up period of 141 months (range 55-218 months), 20 patients were alive. The 10-year ocular survival rate of the 44 eyes was $56.8{\pm}7.5%$. The 10-year RFS and ocular survival rate of the 29 eyes treated by combined EBRT and chemotherapy were 75.9% and 86.2%, respectively. Treatment delay (>3 months) was found to be related to higher risk of recurrence. Complications after EBRT were cataract, retinal detachment, phthisis bulbi, and facial asymmetry. No patient developed a second malignancy during the follow-up period. Conclusion : Early detection and prompt treatment can increase ocular survival rates. In addition, careful attention should be paid to possible long-term sequelae in these patients.

Effects of Cryosurgery in Primary Lung Cancer (원발성 폐암에서 냉동수술의 치료 효과)

  • Jung, Won-Jae;Kim, Kwang-Taik;Yi, Eun-Jue;Lee, Sung-Ho;Kang, Moon-Chul;Chung, Jae-Ho;Ham, Soo-Yeoun;Jo, Sung-Bum
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.201-205
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    • 2009
  • Background: Cryosurgery has been used to treat primary malignant pulmonary tumors at our institute since November 2004. In this study we analyzed our treatment results and complication rates. Material and Method: A retrospective study using medical charts and imaging data was conducted involving 17 patients with a total of 17 malignant pulmonary tumors who were treated between November 2004 and March 2007. Fourteen patients were males and 3 were females. The median age of the patients was 64 years (range, $54{\sim}77$ years). The average size of the tumors was 48.8mm (range, $36{\sim}111mm$) in diameter. The patients were followed with chest CT scans 7 days, 1 month, 3 months, and 6 months postoperatively. PET scans were obtained between 6 and 9 months postoperatively. The treatment response was analyzed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Result: Six months after treatment, 6 tumors (35.3%) showed a complete response, 4 (23.5%) had a partial response, 3 (17.6%) had stable disease, and 4 (23.5%) showed disease progression. In tumors <4 cm in diameter, a complete response was reported in 50% of the tumors. A $x^2$-test showed that in tumors <4 cm in diameter, the p-value for results better than a partial response was 0.034. With respect to procedural complications, there was 1 case of blood-tinged sputum which resolved spontaneously within 1 or 2 days, a spontaneously relieved case of subcutaneous emphysema, and 1 patient with a fever. There were no mortalities and the average hospital stay was 6.3 days. Conclusion: The effects of cryosurgery on primary lung cancer is greatest in patients with small tumors. Considering the facts that cryosurgery is minimally invasive, has a low complication rate, and can be performed repetitively, we believe that it may play an important role in the treatment of high risk lung cancer patients.

Effects of Preoperative Combined Antiplatelet Agents on the Postoperative Bleeding that Occurs during Off-pump Coronary Artery Bypass Surgery (무심폐기하 관상동맥우회수술에서 아스피린과 Clopidogrel의 수술 전 병합투여가 수술 후 출혈에 미치는 영향)

  • Choi, Kang-Joo;Seong, Hoo-Sik;Kae, Yoe-Kon
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.605-609
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    • 2008
  • Background: It is well known that preoperative administration of combined antiplatelet agents can have an impact on the postoperative bleeding, the requirement for transfusion and the need for reexploration during on-pump coronary artery bypass surgery. Yet its effects have not been well evaluated in the case of off-pump coronary artery bypass surgery. Material and Method: We performed a retrospective study of nineteen patients who underwent OPCAB from March 2003 to December 2004. All the patients had taken antiplatelet agents until 12 hours before operation. The patients were divided into bo groups as an aspirin group and a combined (aspirin+clopidogrel) group. The perioperative platelet count, the hemoglobin level, the hematocrit, the prothrombin time and the aPTT were compared between both groups. The amount of postoperative bleeding, the transfusion requirement and the need for re-exploration to control bleeding were also compared between both groups. Result: There was no difference of operation time and the intraoperative ACT between the aspirin group and the combined group. The amount of blood loss through the chest tube for 24 hours was not different between the aspirin group $(697{\pm}271mL)$ and the combined group $(944{\pm}432mL)$. The number of patients who received blood transfusion was also not different between both groups. There was no patient who required reexploration for bleeding control in both groups. The perioperative hemoglobin level and hematocrit were also not different between both groups, but the postoperative hemoglobin level and hematocrit were decreased significantly in the group. Conclusion: The Preoperative combined antiplatelet (aspirin+clopidogrel) therapy group was not different from the aspirin group for the amount of postoperative bleeding, the amount of blood transfusion and the need for reexploration during off-pump coronary artery bypass grafting. This subject needs further evaluation because of small population in our study.

Effects of Artistic and Technological Context on Physics Problem Solving for High School Students (예술적 상황과 기술적 상황이 고등학생들의 물리 문제해결에 미치는 효과)

  • Lee, Sua;Park, Yunebae
    • Journal of The Korean Association For Science Education
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    • v.35 no.6
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    • pp.985-995
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    • 2015
  • This study examines the effects of the introduction of artistic and technological factors on science problems for the activation of creative and integrated thinking. We developed problems consisting of STA(problems that introduced technological and artistic factors on the College Scholastic Ability Test) and TA(problems that introduced artistic factors in a technological context). Subjects of the study included 60 high school senior students in Daegu. Their problem solving processes for STA were examined. Four students were interviewed using the retrospective interview method. Also, after finishing TA, the problem solving processes of four students were examined. The results of the study are as follows. First, students selected scientific context more than artistic and technological contexts. It was found that students preferred short length problem in order to solve problems in a short time. Second, students were more interested in artistic and technological contexts of STA than scientific context, but felt that they were more difficult. Moreover, students were more interested about the context of TA than scientific context. Third, irrespective of the given contexts in STA, students have a tendency to solve problems through relatively brief ways by using core scientific knowledge. This can seem to mean that there is a possibility to stereotype the problem solving process through repeated learning. Logical thinking and elaboration were observed, but creativity was not conspicuous. In addition, integrated thinking was not observed in all contexts of STA. Fourth, science related problems of TA showed similar results. However, in problems related to everyday life, students made original descriptions that they based on their daily lives. Particularly, in creative design, original ideas and integrated thinking were observed.

The Prognostic Indicies of Pneumocystis Carinii Pneumonia in Immunocompromised Patients other than Acquired Immune Deficiency Syndrome (비 AIDS 면역 결핍 환자들에서 발생한 주폐포자충 폐렴의 예후인자)

  • Park, Wann;Kim, Yoo-Kyum;Lee, Jin-Seong;Ahn, Jong-Jun;Hong, Sang-Bum;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.805-812
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    • 1998
  • Background: Among the variety of opportunistic infections, pneumonia comprises the major morbidity in immunocompromised patients. Pneumocystis carnii pneumonia (PCP) and cytomegalovirus (CMV) pneumonia are common infectious illness of immunocompromised hosts. Although there are many reports regarding to the co-infection of PCP and CMV diagnosed by bronchoalveolar lavage (BAL) fluid examination, the effects of CMV co-infection on the outcome of PCP is still controversial. The purpose of this investigation is to evaluate the effects of CMV detected by BAL fluid examination on the clinical course of PCP in the immunocompromised patients other than human immunodeficiency virus infection. Method: Ten patients with PCP were enrolled and retrospective analysis of their medical records were done. HIV infected persons were excluded. The PCP was diagnosed by BAL fluid examination with Calcofluor-White staining. CMV was detected in BAL fluid by Shell-vial culture system. Chest radiographic findings were reviewed. We used Fisher's exact test and Mann-Whitney U test for statistical analysis of data. Results: The underlying disorders of patients were idiopathic pulmonary fibrosis (n=1), renal transplantation (n=4), necrotizing vasculitis (n=l), systemic lupus erythematosus (n=1), brain tumor (n=1), chronic myelogenous leukemia (n=1), unidentified (n=1). There were no difference in clinical course, APACHE III score, arterial blood gas analysis, white blood cell count, lymphocyte count, serum albumin concentration, chest radiographic findings and mortality between patients with PCP alone (n=4) and those with CMV co-infection (n=6). Univariate analysis regarding to the factors that associated with mortality of PCP were revealed that the application of mechanical ventilation (p=0.028), the level of APACHE III score (p=0.018) and serum albumin concentration (p=0.048) were related to the mortality of patients with PCP. Conclusion: The clinical course of PCP patients co-infected by CMV were not different from PCP only patients. Instead, accompanied respiratory failure, high APACHE III score and poor nutritional status were associated with poor outcome of PCP.

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Severe Pneumonia Caused by 2009 Pandemic Influenza A (H1N1) Virus in Children and Corticosteroid Treatment (소아에서 2009 신종 인플루엔자 A (H1N1) 중증 폐렴과 스테로이드 치료)

  • Sohn, Yu Rak;Kim, Jong Hee;Ma, Sang Hyuk;Lee, Kyung Yil;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.193-200
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    • 2011
  • Purpose : The effect of corticosteroid on severe pneumonia caused by 2009 pandemic influenza (H1N1) A virus is controversial. This study was aimed to present the effects of early, short-term corticosteroid treatment for severe pneumonia with this virus infection. Methods : A retrospective analysis was performed on severe pneumonia patients (37 patients) who had severe respiratory distress at presentation requiring oxygen therapy and received intravenous methylprednisolone (MP, 8-10 mg/kg, divided in 4 doses/day for 2-3 days) with oseltamivir. The clinical and laboratory characteristics of the patients were evaluated through the medical records and chest radiographic findings. Results : The mean age and male-to-female ratio of the patients were 6.5${\pm}$2.9 years of age, and 3.4:1 (male 29 patients), respectively. The 5-9 aged group was predominant among the age groups (25 patients, 67.6%). Duration of fever prior to admission was 1.4${\pm}$0.6 days and dyspnea developed within 24 h after beginning of respiratory symptoms in all patients. All patients were previously healthy and received oseltamivir within 48 h. Thirteen patients (35.1%) developed dyspnea during oseltamivir treatment. Following MP infusion, all 37 patients including 13 progressive pneumonia patients during oseltamivir treatment showed an immediate halt in the progression of pneumonic infiltration with rapid clinical improvement. There were no side-effects following steroid use. Conclusion : For severe pneumonia patients, early corticosteroid treatment halted clinical exacerbation, and possibly prevented progression to acute respiratory distress syndrome. Further controlled clinical studies are needed for the role of corticosteroids and antivirals on severely affected patients with influenza virus infections.

Affective Polarization, Policy versus Party: The 2020 US Presidential Election (정서적 양극화, 정책인가 아니면 정당인가: 2020 미대선 사례)

  • Kang, Miongsei
    • Analyses & Alternatives
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    • v.6 no.2
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    • pp.79-115
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    • 2022
  • This study aims to account for electoral choice in the 2020 presidential election by focusing on social identity which forms the basis for core partisan groups. Two views compete to explain the origins of polarization, policy versus party. One emphasizes policy as more influential in choosing presidential candidates. This follows the tradition of retrospective voting theory in which voters' choice rely on government performance. Incumbent president whose performance proves well are rewarded to be reelected. Policy performance is based on measures around distinctive preferences for government spending. Republican Individuals prefer individual responsibility to government support, while Democratic counterparts support government support. Another perspective put an emphasis on the role partisanship which favors in-party members and disfavors partisan out-groups. Interparty animosity plays the key role in determining electoral behavior. This study relies on the Views of the Electorate Research (VOTER) Survey which provides a panel data of several waves from 2011 to 2020. A comparative evaluation of two views highlights three findings. First, policy matters. Policy preferences of voters are the primary drives of political behavior. Electoral outcomes in 2020 turned out to be the results of policy considerations of voters. 53.7 percent of voters tilted toward individual responsibility voted for Trump, whereas 70.4 percent of those favorable views of government support than individual responsibility voted for Biden. Thus effects of policy correspond to a positive difference of 26.4 percent points. Second, partisanship effects are of similar extent in influencing electoral choice of candidates: Democrats are less likely to vote for Trump by 42.4 percent points, while Republicans are less likely to vote for Biden by 48.7 percent points. Third, animosity of Republicans toward Democrat core groups creates 26.5 percent points of favoring Trump over Biden. Democrat animosity toward Republican core groups creates a positive difference of 13.7 percent points of favoring Biden.

Clinical findings of severe amniotic fluid aspiration pneumonia and effects of surfactant replacement therapy (중증 양수 흡인성 폐렴의 임상양상 및 폐표면 활성제 보충요법의 효과)

  • Park, Sang Woo;Kim, Chun-Soo;Lee, Sang-Lak;Kwon, Tae-Chan
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.429-434
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    • 2009
  • Purpose : Severe aspiration of the amniotic fluid is known to cause fatal respiratory distress in neonates. We conducted this study to investigate the clinical findings of severe amniotic fluid aspiration pneumonia (AFAP) in neonates and the effect of pulmonary surfactant replacement therapy (SRT). Methods : Retrospective analysis of medical records was conducted on 28 patients who received ventilator care due to severe AFAP in a neonatal intensive care unit over a 7-year period (2000-2006). Patients whose amniotic fluid was contaminated with meconium were excluded. Results : A large number of cases were term infants (82.1%) and infants born by caesarean section (85.7%), and the 1- and 5-min Apgar scores of these patients were $6.5{\pm}1.2$ and $7.5{\pm}1.3$, respectively. Soon after birth, the amount of amniotic fluid sucked out from airway below the vocal cord was $16.0{\pm}10.1$ mL. All patients received SRT with a modified bovine-derived surfactant (120 mg/kg/dose), and one dose was administered in most cases (75%). Compared with pre-SRT, the oxygenation index ($8.0{\pm}9.6$ vs. $18.9{\pm}7.3$) according to ventilator care was a significant improvement at 12 h after SRT (P<0.001). Furthermore, most cases showed radiological improvement for aeration at 12 h post-treatment. Many cases (46.4%) had cardiorespiratory complications, but their final outcomes were excellent (survival rate, 96.4%). Conclusion : AFAP may be an important cause of serious respiratory distress in near-term and term infants, and SRT seems to be an effective adjuvant therapy in mechanically ventilated neonates with severe AFAP.

Effect of the Interval from Calving to First Insemination and Days Open on the Subsequent Reproductive Performance in Dairy Cows (젖소에서 분만 후 첫 수정 간격 및 임신 간격이 이후의 번식능력에 미치는 영향)

  • Lee, Soo-Chan;Lee, Tae-Ho;Jeong, Jae-Kwan;Kang, Hyun-Gu;Kim, Ill-Hwa
    • Journal of Veterinary Clinics
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    • v.30 no.6
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    • pp.435-441
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    • 2013
  • This retrospective study evaluated the effects of the interval from calving to first insemination (ICFI) and days open (DO) on the reproductive performance in dairy cows. In the first analysis, data from 705 cows were grouped based on the ICFI: short (30-60 days, n=217), medium (61-90 days, n=309), and long (91-150 days, n=179). The occurrence of endometritis was greater in the long group than in short and medium groups (p<0.05). The occurrence of ovarian cysts increased with increasing ICFI (p<0.05), while body condition score (BCS) during the 5 month postpartum period was lower with increasing ICFI (p<0.01). The hazard of pregnancy by 365 days in milk (DIM) was lower (hazard ratio [HR]=0.70, p<0.0001) in the long group, but higher (HR=1.41, p<0.0001) in the short group compared with the medium group. In the second analysis, data from 436 cows were grouped based on the DO: short (30-90 days, n=154), medium (91-180 days, n=183), and long (181-360 days, n=99). The occurrence of a retained placenta was greater in the long group than in the medium group (p < 0.05). Ovarian cysts occurred more frequently in medium and long groups than in the short group (p=0.08). BCS was lower in the short group compared with medium and long groups at month 1 postpartum (p<0.05). Milk yield (kg/day) was greater in the medium group compared with the short group at months 2 to 5 postpartum (p<0.05). The hazard of first insemination by 150 DIM was lower in the long group than in the short group (HR=0.73; p<0.02). The hazard of pregnancy by 365 DIM was lower (HR=0.64, p<0.0001) in the long group than in the medium group, while the hazard did not differ between short and medium groups (p>0.05). Moreover, the culling rate was greater in the long group than in the short group (p<0.05). In conclusion, a longer ICFI and DO resulted in reduced reproductive performance in dairy cows, which was attributable to an increase in postpartum diseases, a lower BCS and a greater milk yield.

A Clinical Effect of Ofloxacin, Prothionamide, Cycloserine Streptomycin(Kanamycin or Tuberactinomycin) in Retreatment of Pulmonary Tuberculosis (폐결핵 재치료에서 Ofloxacin, Prothionamide, Cycloserine, Streptomycin(Kanamycin or Tuberactinomycin) 4제요법의 임상 효과)

  • Song, Ju-Young;Yoo, Min-Kyu;Hong, Jae-Rack;Jeong, Jae-Man;Kim, Young-Jun;Kim, Moon-Shik
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.295-301
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    • 1995
  • Background: The serious problems in retreatment of pulmonary tuberculosis are a significant proportion of drug resistance. Preferably retreatment should contain the drugs which has never used before, so drug retreatment is limited in selection. A new antibacterial substance, ofloxacin(OFX) is the activity against mycobacterium tuberculosis and it has been used in the treatment of pulmonary tuberculosis. The present report concerns the result of retreatment of pulmonary tuberculosis patients containing OFX treated at National Kongju Tuberculosis Hospital. Method: A retrospective study was made through the regular follow up of 92 smear positive cases, who were treated by four drugs regimen between Mar 1991 and June 1994 at National Kongju Tuberculosis Hospital. Four drugs were, namely prothionamide, cycloserine, ofloxacin and streptomycin(kanamycin or tuberactinomycin). The duration of follow up was over one year. Results: 1) Out of 92 cases with positive sputum AFB smear, 67(73%) achieved the negative conversion. 2) Considering the negative sputum conversion in all the groups, the vast majority(85%) of sputum conversion occurred within the first 4 months. 3) The roentgenological improvement occurred in 49 percent on the whole and when the extent of disease was minimal, moderately, far advanced pulmonary tuberculosis, sputum AFB smear negative response to retreatment was 100%, 93%, 68%, respectively. 4) When the duration of patient's illness was less than 1 year, 1 to 3 years, 3 to 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 87%, 76%, 65% and 55%, respectively. 5) Adverse reaction to prothionamide, with complaints of gastrointestinal troubles was common and hepatic dysfunction without jaundice was observed in 7 percent, convulsion in 1 percent, that to cycloserine occurred renal dysfunction & psycosis & convulsion, 2%, 1%, 1%, respectively. Tinnitus with KM occurred in 1% and dirrhea with OFX in 4%. Conclusion: The duration of patient's illness was shorter, sputum AFB smear negative response rate was better. Radiologic responses were not remarkable, but extent of disease by national tuberculosis association was smaller, the result of retreatment was better. Adverse reaction of the secondary antituberculosis agent was mainly observed gastrointestinal troubles, as regard to tolerance to the secondary drugs the role of the physician is of very important value and toxic effects can be overcome by the strong confidence.

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