• Title/Summary/Keyword: Vascular age type

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Analysis of Prognositic Factors and Long-tenn Survival According to the Pattern of Lymph Node Metastasis in Surgically Resected N2 Non-Small Cell Lung Cancer(NSCLC) (N2 병기의 비소세포성 폐암 수술 후 림프절 전이 양태에 따른 생존율 비교 및 예후 인자 분석)

  • Chung, Kyung-Young;Kim, Si-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.474-485
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    • 2000
  • Background : Current studies on multimodal strategy for N2 non-small cell lung cancer are being high interest, have drawn much attention. N2 lung cancer, however, is composed of is divided into several sub groups with that have different prognoses. The prognostic factors still remain controversial. Methods : Between January 1990 and June 1999, 180 patients with N2 lung cancer who underwent surgical resection were investigated, excluding 10 of these for surgical mortality. All patients underwent mediastinal lymph node dissection. 20 clinicopathologic factors were investigated by univariable and multivariable analyses to identify significant prognostic factors among resected N2 disease. Results : The overall 5-year survival rate was 20.6%. Multivariable analyses among overall patients revealed 3 significant prognostic factors : Age, Histologic type, Vascular invasion. Based on the result, 49 patients with both age more than 60 and pathologic Non-squamous cell showed a 5-year survival of 5.0%, whereas 37 patients with neither of the factors showed a 5-year survival of 56.6%(p<0.001). And 12 patients with both vascular invasion and pathologic Non-squamous cell showed a 5-year survival of 11.9%, whereas 67 patients with neither of the factors showed a 5-year survival of 33.6%(p=0.01). Conclusion : The prognosis of surgically resected N2 disease varies according to the 3 significant prognosis factors. Tumor size may be an additional influencing factor in the prognosis of N2 disease.

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A Study of The Correlativity in EAV(Electroacupuncture According to Voll)measurement valvues, Sasang Constitution Classfication and CVA(Cerebrovascular accident) (EAV의 측정치(測定値)와 사상체질유형(四象體質類型) 및 중풍(中風)과의 상관성(相關性)에 관한 연구(硏究))

  • Kim, Jong-Weon;Ko, Bung-Hee;Song, Il-Byung
    • Journal of Sasang Constitutional Medicine
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    • v.7 no.2
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    • pp.59-88
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    • 1995
  • Three groups have participated in this study. 1) The first group consists of 57 patients were who had been treated in the Oriental Medical Hospital at Kyung Hee Medical Center. 2) The second group consists of 37 outpatients who had been treated in the Oriental Medical Hospital at Kyung Hee Medical Center. 3) The third group consists of 76 students of the Oriental Medical School at Kyung Hee University. The following conclusions were made in comparison with EAV measurement values, SaSang Constitution Classfication and CVA. 1. The following conclusions were made in comparison with EAV measurement values and Type(SaSang Constitution Classfication). 1) The analsis of the Correlation in Normal group with EAV measurement values and Type(SaSang Constitution Classfication). 2) The analysis of the correlation in patient group with EAV measurement values showed significant differences in Right meridians(Nerval degeneration vessel, Circulation, Allergy) and in Left meridian(Liver). 3) The analysis of the correlation in Total(Normal+patient)group with EAV measurement values showed significant differences in Right meridians(Large intestine, Nerval degeneration vessel, Circulation, Allergy, Pancreas) and in Left meridians(Lymph vessel, Nerval degeneration vessel, Spleen, liver). 4) The above results showed common-significant differences in Right Allery meridian and in Left Liver meridian. 2. The analysis of the correlation in EAV measurement values and Group (Cerebrovascular accident) showed significant differences in Right meridians(Lymph vessel, Lung, Nerval degeneration vessel, Allergy, Paren & Epith. degeneration vessel, Triple warmer, Heart, Pancreas, Stomach, Fibroid degeneration vessel, Skin, Fatty degeneration vessel, Heart, Stomach, Fibroid degeneration vessel, Skin, Fatty degeneration vessel, Bile duct, Kidney). 3. The analysis of the correlation in EAV measurement values and Para(GROUPS according to PARALYSIS)showed significant differences in Left Stomatch meridian. The analysis of the correlation in EAV measurement values and Para(GROUPS according to PARALYSIS) about the differance of right measurement values and left measurement values showed significant differences in Nerval degeneration vessel, Stomatch, Gall bladder & Bile duct, Kidney and Urinary Bladder meridians. 4. The analysis of the correlation in EAV measurement values and Compl(GROUPS according to COMPLICATION with CVA)showed significant differences in Right meridians(Lymph vessel, Articular degeneration vessel, Fatty degeneration vessel) and in Left meridians(Lung, Stomatch, Fatty degeneration vessel). 5. The analysis of the correlation in Type and MORPHOROGICAL DIAGRAMING (HTOUPS according to MORPHOROGY) showed significant differences in Cranium region, Chest region, Stomatch region and Umbilicum region. 6. The analysis of the correlation in BAZ measurement values and Group(Cerebral Vascular Attack)showed significant differences, the analysis on the correlation of BAZ measurement values and Type(SaSang Constitution Classfication) didn't show any significant differences. 7. In comparison with Actual measurement vales and Voll's measurement values, BAZ measurement values agree with Voll's measurement values but CMP measurement values lower than the Voll's measurement values. Later We have to research further about classifications of race, age, sex etc. The EAV measurement values have Group(Cerebrovascular accident) more correlative than Type(SaSang Constitution Classfication). The EAV may well be that it will be used as an accessory method in SaSang Constitution Classfication and as a diagnostic method in medicine too.

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Non-alcoholic Fatty Liver Disease (NAFLD) and Significant Hepatic Fibrosis Defined by Non-invasive Assessment in Patients with Type 2 Diabetes

  • Sobhonslidsuk, Abhasnee;Pulsombat, Akharawit;Kaewdoung, Piyaporn;Petraksa, Supanna
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1789-1794
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    • 2015
  • Background: Non-alcoholic fatty liver disease (NAFLD), the most common liver problem in diabetes, is a risk factor for liver cancer. Diabetes, high body mass index (BMI) and old age can all contribute to NAFLD progression. Transient elastography (TE) is used for non-invasive fibrosis assessment. Objectives: To identify the prevalence of NAFLD and significant hepatic fibrosis in diabetic patients and to assess associated factors. Materials and Methods: One hundred and forty-one diabetic and 60 normal subjects were screened. Fatty liver was diagnosed when increased hepatic echogenicity and vascular blunting were detected by ultrasonography. Liver stiffness measurement (LSM) representing hepatic fibrosis was assessed by TE. LSM ${\geq}7$ kPa was used to define significant hepatic fibrosis. Results: Four cases were excluded due to positive hepatitis B viral markers and failed TE. Diabetic patients had higher BMI, systolic blood pressure, waist circumference and fasting glucose levels than normal subjects. Fatty liver was diagnosed in 82 (60.7%) diabetic patients but in none of the normal group. BMI (OR: 1.31; 95%CI: 1.02-1.69; p=0.038) and alanine aminotransferase (ALT)(OR: 1.14; 95%CI: 1.05-1.23; p=0.002) were associated with NAFLD. Diabetic patients with NAFLD had higher LSM than those without [5.99 (2.4) vs 4.76 (2.7) kPa, p=0.005)]. Significant hepatic fibrosis was more common in diabetic patients than in normal subjects [22 (16.1%) vs 1 (1.7%), p=0.002]. Aspartate aminotransferase (AST)(OR: 1.24; 95%CI: 1.07-1.42; p=0.003) was associated with significant hepatic fibrosis. Conclusions: Sixty and sixteen percent of diabetic patients were found to have NAFLD and significant hepatic fibrosis. High BMI and ALT levels are the predictors of NAFLD, and elevated AST level is associated with significant hepatic fibrosis.

The Analysis of Free Flap (유리 조직 이식의 분석)

  • Choi, Sang-Mook;Hong, Sung-Bum;Chung, Chan-Min;Suh, In-Seock
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.35-45
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    • 1996
  • After transplantation of groin free flap was sucessed by the Daniel and Taylor in 1973, the reconstruction of plastic surgery was extensive and universal due to rapidly developement of anatomic study of the donor site and technique of microvascular surgery. The free tissue transfers is possible to be early activity and rehabilitation by one stage operation. It currently available allow transfer of specific tissue quality as bone, muscle, nerve to achieve a functional and cosmetic result as well as the most favorable secondary defect. But free flaps require critical, skillful technique and lengthy operating time. Also it has disadvantage of donor site morbity at the large tissue transfer. Authors were transferred with 107 cases in 103 patients from May 1987 to June 1996, and then we analysed free tissue transfer to acquire more increased sucess rate, satisfactory functional and cosmetic results. The sexual distribution was male prominent in 79 cases(76.7%), female in 24(23.3%) and age was variable distribution from 3 to 76 years old. The cause of defects was most prevalent in trauma of traffic and industrial accident in 51 cases(49%). The common recipient site were lower extremities in 47 cases(43.9%), upper extremities in 28 cases(26.5%), head and neck in 25 cases(23.4%), and trunk in 7 cases(6.5%). The type of transfer were free skin flaps in 46 cases(43%), free muscle or musculocutaneous flaps in 31 cases(29%), free vasculized or osteocutaneous flaps in 10 cases(9.3%), and specilized free flaps in 20 cases(18.7%). The anastomosis of artery was end to end anastomosis in 94 cases(87.9%), end to side anastomosis in 13 cases(12.1%) and all vein was end to end anastomosis. The number of anastomosed vessels were one artery one vein in 62 cases(57.9%), one artery two vein in 45 cases(42.1%) and vein graft was performed only one case. The postoperative mornitoring were used with temperature, color of flap, capillary refilling time, ultrasonogram, bone scan, doppler, and endoscopy. The reexploration was performed in 9 cases(8.4%), and then flap was loss in 3 cases(2.8%). Accordingly overall success rate was 97.2%. The postoperative complication was early vascular occlusion, hematoma, partial necrosis and late bulkiness, scarring, color dismatch etc. Therefore, free tissue transfer is the preferred method of treatment, even through conventional local and distant flaps are available.

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Clinical Significance of Increased Ki-67 Protein Expression in Non-small Cell Lung Cancers (비소세포폐암 환자에시 Ki-67 단백질 발현증가의 임상적 의의)

  • Lee Gun;Lim Chang-Young;Kim Kwang-Il;Lee Hyeon-Jae
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.376-381
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    • 2006
  • Background: The Ki-67 protein is a biomarker associated with cell proliferation and a valuable negative prognostic factor in non-small cell lung cancer. We investigated the Ki-67 protein expression in resected non-small cell lung cancer to evaluate the impact on clinicopathological characteristics and postoperative prognosis. Material and Method: Using monoclonal antibody Ki-67, we immunohistochemically examined 38 surgically resected non-small ceil lung cancers to determine Ki-67 Labeling Index (LI). We analysed the differences of clinicopathological characteristics and postoperative recurrence and survival between High Ki-67 Group $(LI{\ge}20%)$ and Low Ki-67 Group (LI<20%). Result: The Ki-67 LIs were heterogenous and a mean values was $20.0{\pm}20.05%$. There were no significant differences in age, sex, smoking, TNM stage, and vascular invasion between High Ki-67 Group and Low Ki-67 Group. A High Ki-67 Group was significantly associated with squamous cell type, poor differentiation, and lymphatic invasion $(p{\le}0.05)$. High Ki-67 Group showed a trend of lower survival (median 47.2 vs. 90.5 months, p=0.312) and lower disease-free survival (median 18.2 vs. 72.3 months, p=0.327) than Low Ki-67 Group. Conclusion: These results indicate that increased Ki-67 protein expression may be a negative prognostic factor and showed a trend of shortened survival and disease-free survival. To evaluate the pivotal role of Ki-67 protein expression, a long-term follow-up and further study are required.

Management of Diabetic Mellitus in Low-income Rural Patients (일개 농촌지역 저소득층 당뇨병환자의 관리 상태)

  • Kim, Hye-Yeon;Yun, Woo-Jun;Shin, Min-Ho;Kweon, Sun-Seong;Ahn, Hye-Ran;Choi, Seong-Woo;Lee, Young-Hoon;Cho, Dong-Hyeok;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.5
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    • pp.315-322
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    • 2009
  • Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.

The Results of the ATP Based Chemotherapy Response Assay in Gastric Cancer Tissues (ATP-CRA 방법을 이용한 위암조직의 항암제 감수성 검사결과)

  • Lee, Je-Hyung
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.160-166
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    • 2007
  • Purpose: Recently, chemosensitivity tests have become widely used for the selection of effective drugs in gastric cancer patients. In this study, a chemosensitivity test was performed to select agents to increase the effectiveness of adjuvant chemotherapy. Materials and Methods: Chemosensitivity testing was performed in 81 gastric cancer patients that received a gastrectomy at the Yeungnam University Hospital. An ATP (adenosine triphosphate) based chemotherapy response assay was used. Clinicopatholgical factors such as sex, age, expression of tumor markers (CEA and CA19-9 levels), location of the tumor, morphology of advanced cancer, histological type, cell differentiation, depth of invasion, Lauren classification, Ming classification, lymphatic invasion, vascular invasion, neural invasion, lymph node metastasis and TNM stage were used to correlate the chemosensitivity and clinicopathological factors. Results: The most effective antitumor agents in gastric cancer patients were (in order of effectiveness) 5-FU, Epirubicin, lrinotecan and Oxaliplatin in our series. The chemosensitivity test showed a significant difference in susceptibility according to clinicopathological factors. Conclusion: Further studies on multidrug therapy are needed to evaluate synergistic effects of drugs. Therefore, for effective chemotherapy, it is more efficacious to select a chemosensitive drug than continue to use the same drug regimen.

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Sudden Deafness (돌발적난청)

  • 조중환;류태현
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.85.3-86
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    • 1976
  • Sudden deafness requires immediate investigation and treat if there is to be any prospect of salvaging the hearing. It present an otological emergency and a diagnostic challenge. Sn Sudden sensorineural deafness can be caused by a wide variety of pathologies. A battery of tests and investigations must be performed forthwith if treatment is to be started without further delay. The concept that nothing can be done for the patient with sensori-neural deafness must be abandoned. Some pathologies causing sudden deafness are not amenable to therapy or can show only partial reversibility. But there are several causes, showing little or no spontaneous recovery, which do responed to appropriate treatment. It is important to identify them and concentrate on their management. The age and sex ratios and the unilaterral or bilateral nature of the lesion are related to the etiology and depend upon which type of case is included in the series. Though individually rare, collecting for about 2.5 per cent of new otoloical patients. Some 70 per cent of cases are unilateral. Viral, bacterial and treponemal infections accounted for about 30 per cent of the cases. Some 16 per cent were due to vascular lesions of the cochlea. In almost 22 per cent there was no obvious cause (idiopathic), they occurred in young adult and were either sensory or neural. About 12 per cent were traumatic and 9 per cent were ototoxic in origin. The remaining 11 per cent were due to a group of rarities. The two vital factors are the site of the lesion and the duration of the hearing loss. The earlier these are diagnosed and treated the better the response. The etiology, pathology and treatment are reviewed.

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Epidemiologic Profile of Patients With Valvular Heart Disease in Korea: A Nationwide Hospital-Based Registry Study

  • You-Jung Choi;Jung-Woo Son;Eun Kyoung Kim;In-Cheol Kim;Hyung Yoon Kim;Jeong-Sook Seo;Byung Joo Sun;Chi Young Shim;Se-Jung Yoon;Sahmin Lee;Sun Hwa Lee;Jun-Bean Park;Duk-Hyun Kang
    • Journal of Cardiovascular Imaging
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    • v.31 no.1
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    • pp.51-61
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    • 2023
  • BACKGROUND: Valvular heart disease (VHD) is a common cause of cardiovascular morbidity and mortality worldwide; however, its epidemiological profile in Korea requires elucidation. METHODS: In this nationwide retrospective cohort study from the Korean valve survey, which collected clinical and echocardiographic data on VHD from 45 medical centers, we identified 4,089 patients with VHD between September and October 2019. RESULTS: The aortic valve was the most commonly affected valve (n = 1,956 [47.8%]), followed by the mitral valve (n = 1,598 [39.1%]) and tricuspid valve (n = 1,172 [28.6%]). There were 1,188 cases of aortic stenosis (AS) and 926 cases of aortic regurgitation. The most common etiology of AS was degenerative disease (78.9%). The proportion of AS increased with age and accounted for the largest proportion of VHD in patients aged 80-89 years. There were 1,384 cases of mitral regurgitation (MR) and 244 cases of mitral stenosis (MS). The most common etiologies for primary and secondary MR were degenerative disease (44.3%) and non-ischemic heart disease (63.0%), respectively, whereas rheumatic disease (74.6%) was the predominant cause of MS. There were 1,172 tricuspid regurgitation (TR) cases, of which 46.9% were isolated and 53.1% were associated with other valvular diseases, most commonly with MR. The most common type of TR was secondary (90.2%), while primary accounted for 6.1%. CONCLUSIONS: This report demonstrates the current epidemiological status of VHD in Korea. The results of this study can be used as fundamental data for developing Korean guidelines for VHD.

Occlusive Complications after Lower Limb Arterial Bypass Surgery (하지동맥 재건술 후 폐쇄성 합병증에 대한 임상적 고찰)

  • Kim Jong Won;Chung Sung Woon
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.152-156
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    • 2005
  • Background: Occlusive complications after arterial revascularization are difficult to treat and have high recurrence rate. This study was performed to establish an effective treatment modality and to evaluate the factors affecting the occlusive complications by analysis of clinical data. Material and Method: During the period of 5 years. 33 patients (55 reoperations) were studied at the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital following 173 arterial revascularization surgeries. The clinical characteristics, operating methods, the time intervals of reoperation, used graft, and the results of treatment were evaluated retrospectively. Result: All the patients were men except one and the mean age was 63.5 years old. The mean time internal from first operation to reoperation was 11.9 months. The cause of arterial occlusive diseases were 28 atherosclerosis and 5 Burger's diseases, Associated diseases were Hypertension $(57.6\%)$, Diabetes mellitus $(33.3\%)$, heart failure $(18.2\%)$, and so on. The mean rate of reoperation was 1.67 times and the most common type of first operation was femoro-popliteal bypass grafting $(57.6\%)$. The graft that used revascularization surgery were 25 cases of PTFE and 6 case were Dacron. There was no statistical difference between two groups. The kinds of reoperations were thrombectomy in 20 cases, angioplasty 18 cases, re-bypass surgery in 13 cases, and lumbar sympathectomy in 4 cases. The results of reoperation were 15 cases of functional recovery, 7 cases of limb salvage, 5 cases of above-knee amputation. 3 cases of below-knee amputation and 3 deaths. Conclusion: The main cause of occlusive complications are occlusion of inflow or outflow artery. Treatments were different according to the first operation methods and graft used. The most frequent time of reoperation was within one year after the first operation. We believe that graft surveillance especially during the first year is very important factor in observing the patient. We can look forward to improving limb salvage rate to perform additional treatment such as radiological interventions and lumbar sympathectomy.