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Limb Salvage Surgery with Intramedullary Nailing and Cementization for the Bone Tumors of the Proximal Humerus (근위 상완골 골종양에서 골수강내 금속정과 골시멘트를 이용한 사지 구제술)

  • Kim, Han-Soo;Oh, Joo-Han;Nam, Woo-Dong;Rhie, Tae-Yon;Jeong, Jin-Young;Lee, Han-Koo;Lee, Sang-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.2
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    • pp.53-60
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    • 2000
  • Purpose : The purpose of the current study is to evaluate the functional and oncologic results of the limb salvage surgery with intramedullary nailing and cementization in malignant bone tumors of the proximal humerus. Materials and Methods : We reviewed 18 cases of limb salvage surgery of resection and reconstruction with an intramedullary nail and cement-molded humeral head for the malignant bone tumors of the proximal humerus, which performed between August, 1992 through the April, 1998. The diagnoses included the osteosarcoma in 7 patients, chondrosarcoma in 3, the recurrent giant cell tumor in 3, metastatic tumor in 3, multiple myeloma in one patient and the one patient with malignant fibrous histiocytoma. The mean age at the time of surgery was 38 years(range, 15-73 years). The mean follow-up period was 26 months(range, 6-67 months). Results : Average functional score by ISOLS evaluation system was 21.1(70.3%). There were 3 local recurrences and 5 distant metastases. There were one case of shoulder instability and one case of deep infection. The seven patients are continuously disease free state and seven patients are alive with disease. Four patients died from the disease. Conclusion : The limb salvage surgery with intramedullary nailing and cementization in the bone tumors of the proximal humerus may be considered an option for the malignant bone tumors of the proximal humerus in selected patients.

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The Clinical Characteristics and Prognosis of Elderly Patients with Lung Cancer Diagnosed in Daegu and Gyeongsangbukdo (대구 경북지역에서 진단된 노령자 폐암의 임상적 특징과 예후)

  • Kim, Hyun Sook;Hyun, Dae Sung;Kim, Kyung Chan;Lee, Sang Chae;Jung, Tae Hoon;Park, Jae Yong;Kim, Chang Ho;Cha, Seung Ick;Lee, Kwan Ho;Chung, Jin Hong;Shin, Kyeong Cheol;Jeon, Young June;Han, Seong Beom;Choi, Won Il;Kim, Yeun Jae;Chung, Chi Young;Lim, Geon Il
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.1
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    • pp.15-22
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    • 2008
  • Background: Lung cancer is the leading cause of cancer death in South Korea since the year 2000 and it is more common in elderly patients, with a peak incidence at around 70~80 years of age. However, these elderly patients receive treatment less often than do the younger patients because of organ dysfunction related to their age and their comorbidities, and they show poor tolerance to chemotherapy. The aims of this study were to analyze the clinical characteristics and treatment-related survival of elderly patients with lung cancer. Methods: In this retrospective study, we analyzed the clinical data of 706 lung cancer patients who were diagnosed at hospitals in Daegu and Gyeongsangbukdo from January 2005 to December 2005. We compared the clinical characteristics and outcomes of the patients who were aged 70 years and older (elderly patients) with those clinical characteristics and outcomes of the younger individuals. Results: The median age of the patients was 68 years (from 29 to 93) and the elderly patients were 38.7% (n=273) of all the study's patients. Squamous cell carcinoma was the most common type of lung cancer in both the elderly and younger patient groups. Elderly patients had more symptoms of dyspnea and chronic obstructive pulmonary disease (COPD) than the younger patients (p<0.001 and p<0.001, respectively). A good performance status (ECOG 0-1) was less common for the elderly patients (p<0.001). The median survival of the non-small cell lung cancer (NSCLC) patients was significantly higher in the younger patient group than in the elderly patient group (962 days vs 298 days, respectively, p=0.001). However, the median survival of the NSCLC patients who received any treatment showed no significant difference between the younger patient group and the elderly patient group (1,109 days vs 708 days, respectively, p=0.14). Conclusion: Our data showed that appropriate treatment for selected elderly patients improved the survival of patients with NSCLC. Therefore, elderly NSCLC patients with a good performance status should be encouraged to receive appropriate treatment.

Clinical Observation about the Extent of Improvement of Low Back Pain Patient through Medi-acupuncture Therapy (약침치료(藥鍼治療)를 통한 요통환자(腰痛患者)의 호전도(好轉度)에 관한 임상적(臨床的) 관찰(觀察))

  • Yook, Tae-Han
    • The Journal of Korean Medicine
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    • v.16 no.1 s.29
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    • pp.184-197
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    • 1995
  • After 45 patients examined as to the result of medical treatment among the ones who came to Dept. of Pain Clinic, Oriental Medical Hospital, Chunju Woosuk University complaining low back pain chiefly from Dec/19/1994 to Feb/7/1995 for 50 days or so were observed clinically, the results were obtained as follows: 1. In duration of the case history, acute stage(37.8%) was the most predominant, and subacute stage(35.6%) and chronic stage(26.7%) were revealed in turn. 2. In opinions of radiation, Spondylosis(26.7%) was the most predominant, Scoliosis(15.6%) and HIVD(11.1%) were revealed in order, and 3 cases were revealed to be negative. 3. In the radiating pain of the lower limb, the radiating pains of the left lower limb were the most predominant and those of the right lower limb and those of both lower limbs were revealed in turn. By the way, 31.1% of patients didn't suffer from the radiating pain of the lower limb. 4. In the grade of the seriousness of subsective symptom, Grade 2(66.7%) was the most predominant, and Grade 3, Grade 4, and Grade 1 followed it in order. 5. In the period of the treatments of medi-acupuncture, 2-5 day treatments(31.1%) were major and 6-10 day treatments(26.7%), 16-20 day treatments(11.1%), 26-30 day treatments(11.1%), over 31 day treatments(11.1%), 11-15 day treatments(4.4%), and 21-25 day treatments(4.4%) followed it by turns. Thus 2-10 day treatments are 57.8% and under 30 day treatments are 57.8% of all. 6. In the frequency of use of each medi-acupuncture, V was most frequency used in 41 cases(91.1%), and 11 cases of HN(24.4%), 8 cases of MOK(17.8%), 4 cases of OK(8.9%), 2 cases of B(4.4%), and a case of I(2.2%) were revealed in turn. 7. In the effect of treatments, 10 cases(22.2%) were excellent, 25 cases(55.6%) were good, 5 cases(11.1%) were fair, and 5 cases(11.1%) were poor. As the result, 88.9% of all changed for the better and all of these were improved within the third trial. 8. The effect of the treatments per durations was 100% in acute stage, 93.8% in subacute stage, and 66.7% in chronic stage. According to that, it was reavealed that the rate of treatments decreased as it came near to the chronic stage. 9. The effect of treatments per radiating pains was 87.5% in the radiating pains of the left lower limb, 81.8% in those of the right lower limb, 100% in those of both lower limbs, and 92.9% in case that patients have no radiating pains. So in the rate of treatments on radiating pains of the lower limbs, the case of both sides or no radiating pains was higher than that of one side. 10. In the effect of treatments per the condition of patients, Grade 4 showed 100% of improvement, Grade 3 showed 90.9% of improvement, Grade 2 showed 86.7% of improvement, and Grade 1 showed 100% of improvement. 11. In the effect of treatments per contents of treatments, the group treated with medi-acupuncture therapy, herb medication therapy, acupuncture therapy, and physiothrapy at the same time(Group 1) showed 100% of improvement, the group treated with medi-acupuncture therapy, acupuncture therapy, and physiotherapy simultaneously(Group 2) showed 73.7% of improvement, and the group treated with medi-acupuncture therapy and acupuncture therapy at the same time(Group 3) showed 100% of improvement. 12. 2-5 day treatments showed 78.6% of improvement, 6-10 day treatments showed 91.7% of improvement, and over 31 day treatments showed 100% of improvement. As the result, genarally the longer the period of treatment was, the better the effect of treatment was. 13. When only V was used, the rate of treatment was 96.2%. When only HN was used, the rate of treatment was 100%. When only MOK was used, the rate of treatment was 100%. When V and HN were used at the same time, the rate of treatment was 33.3%. When V and MOK were used at the same time, the rate of treatment was 100%. When V and OK were used at the same time, the rate of treatment was 100%. When V, HN, and MOK were used at the same time, the rate of treatment was 100%. When V, OK, and MOK were used at the same time, the rate of treatment was 100%. When V, MOK, and B were used at the same time, the rate of treatment was 100%. When V, HN, OK, and I were used at the same time, the rate of treatment was 100%. When V, HN, and B were used at the same time, the rate of treatment was 100%.

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The Etiology and Clinical Features of Acute Osteoarthritis in Children; 2003-2009 (최근 6년간 소아청소년기 급성 화농성 골관절염의 원인균과 임상 양상; 2003-2009)

  • Choi, Jin Hyoung;Choe, Young June;Hong, Ki Bae;Lee, Jina;Yoo, Won Joon;Kim, Han Soo;Park, Moon Seok;Cho, Tae Joon;Chung, Chin Youb;Lee, Hoan Jong;Choi, In Ho;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.31-39
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    • 2011
  • Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.

Clinical and Epidemiologic Study of Kawasaki Disease in Children 8 Years of Age and Older (8세 이상 소아에서의 가와사끼병의 임상 역학적 연구)

  • Park, Yong Won;Han, Ji Whan;Park, In Sook;Kim, Chang Hwi;Cha, Sung Ho;Ma, Jae Sook;Kwon, Tae Chan;Lee, Sang Bum;Kim, Chul Ho;Lee, Heung Jae;Yun, Yong Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1139-1142
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    • 2005
  • Purpose : The aim of this study was to investigate the epidemiologic and clinical profiles of Kawasaki disease(KD) in children 8 years of age and older. Methods : For the epidemiologic study of KD in Korea, data of total 15,692 KD patients were collected from 1994 to 2002 on a 3 year basis, by the retrospective survey. Among them, data of 211 KD patients 8 years of age and older were analyzed and compared with those of the KD patients less than 8 years of age. Results : 211 patients 8 years of age and older(1.3% of total KD patients) with the mean age of 9.8 years, included 142 cases aged 8-10 years, 42 cases aged 10-12 years, and 27 cases aged 12 years and older. The male-to-female ratio was 1.9 : 1, the recurrence rate was 3.8%, and the prevalence of cases in sibling was zero. Coronary arterial(CA) abnormalities were detected by echocardiography in 25.4% of the cases, including 7.6% of CA aneurysm cases. There was 1 case complicated by myocardial infarction. Conclusion : Comparing with the data of the KD patients less than 8 years of age, data of 211 patients 8 years of age and older showed significantly higher incidences of CA abnormalities(25.4% : 19.8%) and CA aneurysms(7.6% : 4.0%).

Prevalence and Genotypes of Transfusion-Transmitted Virus in Children with Hepatitis and Normal Control (정상 소아와 간염 환자에서 Transfusion-Transmitted Virus의 감염상태와 유전자형)

  • Chung, Ju Young;Han, Tae Hee;Hwang, Eung Soo;Ko, Jae Sung;Seo, Jeong Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.202-212
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    • 2005
  • Purpose: Transfusion transmitted virus (TTV) is a newly discovered virus and to date the contribution of TTV to liver disease remains unclear. Little is known about the frequency of TTV infection in children in Korea. The purpose of this study was to investigate the prevalence and genotypic distribution of TTV carried by healthy children and patients with hepatitis in Korea. Methods: Eighty eight of healthy children and three groups of patients with hepatitis-14 patients with chronic hepatitis B, 12 patients with chronic hepatitis C and 25 patients with hepatitis of unknown etiology-were tested. TTV DNA was detected by semi-nested PCR using primer sets generated from N-22 region and from 5' noncoding region (NCR) of the viral genome. PCR products derived from 8 patients with hepatitis and from 11 healthy children were sequenced and a phylogenetic tree was constructed. Results: TTV was found by PCR with N22 primer in 11.3% of healthy children, 28.5% of children with hepatitis B, 25% of children with hepatitis C, 24% of children with hepatitis of unknown etiology. TTV DNA was found by PCR with 5'NCR primer in 32.9% of healthy children, 71.4% of patients with chronic hepatitis B, in 50% of patients with hepatitis C and in 48% of patients with hepatitis of unknown etiology. TLMV DNA was found in 48.9% of healthy children, 21.4% of patients with hepatitis B, 16.6% of patients with hepatitis C, 40% of patients with hepatitis of unknown etiology. Among the sequenced isolates, 10(52%) belonged to genotype 1 (G1) and others belonged to genotype 2 (G2) or genotype 3 (G3). Among the G1 sequences, 7 were grouped as G1a. Conclusion: TTV infection was common in healthy children and in patients with hepatitis. But, the prevalence of TTV DNA by 5'NCR primer was relatively high in patients with hepatitis B and there may be some association between TTV and hepatitis B virus infection. G1 was the major genotype of the studied population.

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Evaluate Utility of Thyroid Cancer Discrimination by 18F-FDG PET/CT Delay Scan Images (18F-FDG PET/CT검사에서 지연영상을 이용한 갑상선암 진단의 유용성 평가)

  • Lee, Hyeon-Guck;Han, Man-Seok;Kim, Yong-Kyun;Seo, Sun-Youl;Jeon, Min-Cheol;Kim, Tae-Hyung;Hong, Seong-Jong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.6
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    • pp.2958-2965
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    • 2013
  • Purpose : To evaluate the degree of malignancy of incident thyroid lesion found in 18F-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods : A retrograde study was conducted of 25 patients(1 exception) who were admitted in E hospital to receive 18F-FDG PET/CT examination until Janaary and April of 2008. 18F-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal 18F-FDG PET/CT image(1hr) and then 1hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid 18F-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1hr later, we took a 1 bed-delayed image and then made a comparative study between measured maxSUV of 1hr-abnormal uptake image and that of 2hr-delayed image. Results : In this 18F-FDG PET/CT study among the patients who showed incidental 18F-FDG thyroidal uptake the number of thyroid cancer was 5(20.8%), all of then showed benign findings. a comparison of results for 18F-FDG PET/CT. the benign patient measured maxSUV in the PET/CT. image(1hr) mean value 5.06maxSUV and delay image(2hr) mean value 5.23maxSUV differences of two value is 0.19maxSUV and the malignantIt patient measured maxSUV in the PET/CT. image(1hr) mean value 9.63maxSUV and delay image(2hr) mean value 10.65maxSUV differences of two value is 10.65maxSUV in Thyroid abnormal uptake patients. Conclusion : in the case of incidental 18F-FDG uptake in thyroid, max SUV of focal thyroid lesion is above 5.0 if 18F-FDG PET/CT examine the delayed images to add, You could see that reasonable diagnostic method useful. to differentiate whether lesions of malignant.

Effects of Emulsion Containing the Specific Antibodies against staphylococcus aureus and Staphylococcal Toxins on Atopic Dermatitis (아토피 피부염에서 황색포도상구균과 독소에 대한 특이항체를 함유한 Emulsion의 피부개선효과)

  • Kim, Mi-Rye;Yang, Si-Yong;Han, Tae-Young;Seo, Seong-Jun
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.32 no.4 s.59
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    • pp.233-239
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    • 2006
  • This study was carried out for the evaluation of the effects of emulsion containing the specific antibodies against S. aureus that secreted staphylococcal toxins in atopy dermatitis (AD). The emulsion was formulated to have basic moisturizing effect and the function to inhibit S. aureus colonization and Staphylococcal toxins. The results were as follows; 1. In 19 subjects, 14 subjects (73.7%) showed improvement in SCORAD the mean SCORAD score was improved by 21.87% at week 4 compared to pre-application (p < 0.05). 2. In 17 subjects with severe lesions, 14 subjects(82.35%) showed improvement in SCORAD; the mean SCORAD score was improved by 25.11% at week 4 compared to pre-application (p < 0.05). 3. In 19 subjects, 15 subjects (79%) showed improvement in TEWL; the mean TEWL was improved by 24.32% at week 4 compared to pre-application (p < 0.05). 4. In 17 subjects with severe lesions, 14 subjects (82.35%) showed improvement in TEWL; the mean TEWL was improved by 25.47% at week 4 compared to pre-application (p < 0.05). 5. In 19 subjects, 15 subjects (79%) showed improvement in keratin capacitance; the mean keratin capacitance was improved by 25.01% at week 4 compared to pre-application (P < 0.05). 6. In 17 subjects with severe lesions, 13 subjects (76.47%) showed improvement in keratin capacitance; the mean keratin capacitance was improved by 20.82% at week 4 compared to pre-application (p < 0.05). Based on above-described results, emulsion containing the specific antibodies against S. aureus that secreted staphylococcal toxins is considered to be helpful in the improvement of atopic dermatitis.

Prognostic Significance of Supraclavicular Lymph Nodes and Pleural Effusion in Small Cell Lung Cancer (소세포암 병기판정시 예후인자로서 쇄골상관절종 침범과 흉막삼출의 의의)

  • Kim, Mi-Jeong;Han, Seung-Beom;Kwak, Jin-Ho;Kwon, Doo-Young;Kim, Min-Su;Choi, Won-Il;Jeon, Young-June;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.1
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    • pp.84-93
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    • 2001
  • Backgrounds : In the absence of distant metastasis, small cell lung cancer (SCLC) patients presenting with supraclavicular lymph node (SCLN) involvement and pleural effusion can benefit from thoracic radiotherapy. But there are some debate as to the prognostic significance of both SCLN involvement and pleural effusion. The purpose of this study was to determine the prognostic significance of SCLN involvement and pleural effusion in SCLC. Methods : Two Hundred and fifteen patients with histologically confirmed small cell lung cancer, who were treated either at the Keimyung university Dongsan hospital and Kyungpook national university hospital from January 1994 to June 1998, were evaluated retrospectively. The patients were classified as having either limited or extensive stage using the Veterans Administration staging system. Results : SCLN was presented in 10.5% of patients(n=21). The median survival was 247 days for patients with SCLN(n=21) and 264 days for patients without(n=194) (p=0.52). After treatment, the median survival was 298 days for patients with SCLN(n=13) and 348 days for patients without(n=115) (p=0.52). SCLN involvement was not correlated with the presence of distant metastases. Median survival was 459 days for patients with a limited stage without SCLN(n=66), 650 days for those with a limited stage with SCLN (n=7) (p=0.96). Pleural effusion was presented in 24.7% of patients(n=52). The median survival was 198 days for patients with pleural effusion(n=52) and 275 days for patients without(n=163) (p<0.05). After treatment, the median survival was 294 days for patients with a pleural effusion(n=25) and 286 days for patients without(n=103) (p=0.39). The presence of pleural effusion was not correlated with that of distant metastases. The median survival was 395 days for patients with a limited stage without a pleural effusion(n=63), 451 days for those with a limited stage with pleural effusion(n=10) (p=0.92). Conclusionsa : In this study, SCLN involvement does not explain the poor survival rate and the relevance to extensive staged disease. Furthermore, the existence of a pleural effusion did not correlated with the presence of distant metastases. However, the presence of a pleural effusion appears to be a minor prognostic factor in our study. Therefore supraclavicular lymph node involvement and the presence of a pleural effusion in SCLC are not poor prognostic factors, which does not justify any amendment to the staging system currently used.

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Does Home Oxygen Therapy Slow Down the Progression of Chronic Obstructive Pulmonary Diseases?

  • Han, Kyu-Tae;Kim, Sun Jung;Park, Eun-Cheol;Yoo, Ki-Bong;Kwon, Jeoung A;Kim, Tae Hyun
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.128-135
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    • 2015
  • Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.