• Title/Summary/Keyword: aggressive response

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Clinical Analysis of Frostbite (동상의 임상적 분석)

  • Choi, Jang Kyu;Kim, Hyun Chul;Shin, Hong Kyung
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.158-169
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    • 2015
  • Purpose: Frostbite can affect still soldiers. Initial clinical manifestations are similar for superficial and deep frostbite, so early treatment is identical. It is under-estimated by physicians. We try to identify the challenges of managing these complex tissue injuries. Methods: A retrospective analysis of 84 patients hospitalized at AFCH from 2009 to 2015 was conducted. We investigated differences of epidemiological characteristics, identification of soft tissue injury, treatment and complications between superficial (SF: 43; 51.2%) and deep (DF: 41; 48.8%) frostbite. Results: The major (94.0%) developed frostbite in dry circumstances (89.3%). Wet circumstances (66.7%) were more susceptible to DF rather than dry (46.7%). The 38 (45.2%) arrived to specialist within 7days. Most prone sites were feet, followed by hands. Toes had more deep injuries. DF presented more increased levels of ALT, CPK, CKMB, CRP. The bone scan of W+S+ was 48.3%, 87.1% and W+S- was 20.7%, 12.9%, respectively. The treatment resulted in improved or normalized perfusion scan with matching clinical improvement. It was a good tool to assess treatment response. Eighteen normal and 8 stenotic type of PCR resulted in normal with matching clinical improvement. One continuous obstructive waveform led to minor amputation. Twelve underwent both PCR and MRA. Among 6 normal PCR, 5 showed normal and one stenosis in MRA. All 5 stenosis and one obstruction showed the same findings in MRA. It was a good tool to evaluate vascular compromise. They were treated with rapid rewarming (11.6%, 22.0%), hydrotherapy (16.3%, 29.3%), respectively. Six (14.6%) underwent STSG, 2 (4.9%) had digital amputation in DF. Berasil, Ibuprofen, Trental were commonly administered. PGE1 was administered selectively for 6.8, 10.8 days, respectively. Raynaud's syndrome (16.3%), CRPS (4.7%), LOM (14.6%) and toe deformity (4.9%) were specific sequelae. Conclusion: We should recommend intensive foot care education, early rewarming and evacuation to specialized units. The bone scanning and PCR should allow for a more aggressive and active approach to the management of tissue viability.

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Fine Needle Aspiration Cytology of Metastatic Small Cell Carcinoma of Lymph Nodes - Comparison to Non-Hodgkin's Lymphoma on 5 Cases - (림프절의 전이성 소세포암종의 세침흡인 세포학적 소견 - 악성 림프종과의 감별을 중심으로 5예 분석 -)

  • Kim, Yeon-Mee;Cho, Hye-Je;Ko, Ill-Hyang
    • The Korean Journal of Cytopathology
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    • v.7 no.1
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    • pp.44-50
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    • 1996
  • Small cell carcinoma of the lung is characterized by cells with finely stippled chromatin and scanty cytoplasm as well as a particularly aggressive clinical course and favorable response to the chemotherapy. Recently percutaneous fine needle aspiration (FNA) biopsy has become both widely established and highly respected for the diagnosis of lung cancer. However metastatic small cell carcinoma of lymph node should be cytologically differentiated from the small round cell tumor of particular sites, especially malignant lymphoma, because small ceil carcinoma of classic oat cell type nay simulate small cell non-Hodgkin's lymphoma. We report five cases of metastatic small cell carcinoma of in-termediate cell type diagnosed by FNA of the enlarged lymph nodes of the neck and axilla. The cytologic smears contained diffuse small neoplastic cells larger than lymphocytes with dense, pyknotic nuclei and extremely scanty cytoplasm. Apparently viable large tumor cells have vesicular nuclei with granular, sometimes very coarse chromatin. The characteristic cytologic features of small cell carcinoma as compared to malignant lymphoma were as follows.: 1) small cells with dense pyknotic nuclei are evenly distributed in the background of apparently viable larger tumor cells, admixed with mature lymphocytes and phagocytic macrophages. 2) small loose aggregates of cells with nuclear melding are indicative of small cell carcinoma rather than non-Hodgkin's lymphoma. 3) the cytoplasmic and nuclear fragments of tumor necrosis are more dominant in the smears of small cell carcinoma. 4) nuclear membrane and nucleoli are generally indistinct in small cell carcinoma due to condensation of chromatin.

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SNS Operation Status Analysis and Improvement Plan for Facilitating of Use of Open Data Portal (공공데이터포털 이용 활성화를 위한 SNS 운용현황 및 개선방안)

  • Hwang, Sung-Wook;Jung, Yeyong;Kim, Soojung;Oh, Hyo-Jung
    • Journal of the Korean Society for information Management
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    • v.37 no.2
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    • pp.23-45
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    • 2020
  • The world is paying attention to the South Korean government's aggressive COVID-19 response, key of which is transparency and openness in sharing information. Opening up government information is essential to enhancing its social and economic value through increased awareness and accessibility. The purpose of this study is to investigate the current status of SNS operated by national open data portals in which government-collected and -disclosed data is available and to suggest improvements for the use of open data portals. To do this, the study compared 3 national open data portals, each from India, U.S.A, and Korea, by performing quantitative analysis, user feedback analysis, time-series analysis, and information type analysis. Based on the identified information types and user needs, the study suggests concrete ways to facilitate the use of open data portals.

A Study on the Design and Validation of Switching Mechanism in Hot Bench System-Switch Mechanism Computer Environment (HBS-SWMC 환경에서의 전환장치 설계 및 검증에 관한 연구)

  • Kim, Chong-Sup;Cho, In-Je;Ahn, Jong-Min;Lee, Dong-Kyu;Park, Sang-Seon;Park, Sung-Han
    • Journal of Institute of Control, Robotics and Systems
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    • v.14 no.7
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    • pp.711-719
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    • 2008
  • Although non-real time simulation and pilot based evaluations are available for the development of flight control computer prior to real flight tests, there are still many risky factors. The control law designed for prototype aircraft often leads to degraded performance from the initial design objectives, therefore, the proper evaluation methods should be applied such that flight control law designed can be verified in real flight environment. The one proposed in this paper is IFS(In-Flight Simulator). Currently, this system has been implemented into the F-18 HARV(High Angle of Attack Research Vehicle), SU-27 and F-16 VISTA(Variable stability. In flight Simulation Test Aircraft) programs. This paper addresses the concept of switching mechanism for FLCC(Flight Control Computer)-SWMC(Switching Mechanism Computer) using 1553B communication based on flight control law of advanced supersonic trainer. And, the fader logic of TFS(Transient Free Switch) and stand-by mode of reset '0' type are designed to reduce abrupt transient and minimize the integrator effect in pitch axis control law. It hans been turned out from the pilot evaluation in real time that the aircraft is controllable during the inter-conversion process through the flight control computer, and level 1 handling qualities are guaranteed. In addition, flight safety is maintained with an acceptable transient response during aggressive maneuver performed in severe flight conditions.

Antimicrobial photodynamic therapy as an adjunct to nonsurgical periodontal treatment - Systematic review and Meta-analysis (광역학요법을 이용한 치주염치료 - 체계적 문헌고찰 및 메타분석)

  • Mo, Jin-A
    • The Journal of the Korean dental association
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    • v.54 no.6
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    • pp.429-437
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    • 2016
  • Objectives: Photodynamic therapy has been proven to promote additional clinical and microbiological benefits in the treatment of chronic periodontitis and aggressive periodontitis. The purpose of this study is to assess the effectiveness of the photodynamic therapy for patient with periodontitis. Methods: We searched the eight Korean databases and Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library. Total 300 studies were searched and 13 studies were included in the final assessment. Each of the stages from literature search and extraction of data were carried out independently by 2 researchers. We used tools of Scottish Intercollegiate Guidelines Networks for assessment of the quality of studies. Results: The safety of the photodynamic therapy was assessed by bleeding. The effectiveness of the photodynamic therapy was assessed by the reduction of Probing pocket depth (PPD) and the gain of Clinical attachment level (CAL). The mean difference of PPD was 0.46(95% CI 0.09~0.82), (p=.01).). The mean difference of CAL was ?0.49(95% CI ?1.12~0.14), (p=.13). Conclusion: The additional use of $^{\circ}{\infty}$Antimicrobial Photodynamic Therapy for Periodontitis$^{\circ}{\pm}$ caused hemorrhage to similar extents to conventional treatment modalities, where scaling and root planing are solely performed, in patients with periodontitis who are expected to have a lower degree of treatment response to non-surgical or surgical periodontal therapies (implant or refractory periodontitis) and those where there is a concern for the possible occurrence of antimicrobial side effects or resistance. This indicates that there are no problems with its safety. But there were no consistent reports about the effects of the additional use of photodynamic therapy. This led to a decision that the safety and efficacy of the current technology deserve further studies (Recommendation rating of A, Classification of technology II-a).

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A Study on Futuristic Image of Fashion - Futuristic Image in 20C Fashion - (미래적 이미지 패션의 연구)

  • Ryu, Hyun-Jung
    • Journal of the Korea Fashion and Costume Design Association
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    • v.14 no.2
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    • pp.11-21
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    • 2012
  • The purpose of this study is to understand of future image in fashion for 20C, to suggest a guideline's role in the development on fashion designs study. The methods of this study are used academic literatures as well as practical study. Futuristic image in fashion is to introduce about the future period, as fashion goes ahead times. Trends and formative characteristics of future image in 20C fashion are summarized as follows. First, futuristic images in fashion for 20C had emerged strongly futurism, space look, kinetic look, glitter look, techno look, cyber look. Second, perspectives on response for future society's changes are summarized as follows. Attitude of futuristic images of fashion, futurism, space look, kinetic look and glitter look, had been favorable about future society's changes until 1980. In 1990, techno look had been defensive and cyber look had been aggressive about future society's changes. Third, formative characteristics of future image in 20C fashion are studied shape, material, color, pattern. Shape was preferred linear and geometric form in the first half of the 20C, but body conscious type had appeared often in the second half of 20C. Material maintained the luster or the metal touch. Color was based image of colorless and preferred the gold, silver or color feels like metal. Pattern was preferred clarity with geometric type in the first half of the 20C. On the other hand in the second half of 20C pattern of future image was dominated by vague and abstract chaotic type.

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Medical Treatment of Laryngopharyngeal Reflux (인후두역류의 약물치료)

  • Chu, Hyung-Ro
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.2
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    • pp.108-112
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    • 2007
  • Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms ; and the constellation of symptoms has been called laryngopharyngeal reflux (LPR). In the absence of definite diagnostic criteria, LPR disease remains a subjective entity. A diagnosis of LPR is usually based on response of symptoms to empirical treatment. Investigative modalities such as pH monitoring and, more recently, impedance studies are generally reserved for treatment failures. LPR usually requires more aggressive and prolonged treatment to achieve regression of both symptoms and laryngeal findings. The suppression of gastric acid and secretion with anti-secretary agents has been the mainstay of medical treatment for patients with acid-related disorders. The suppression of gastric acid secretion achieved with Hz-receptor antagonist $(H_2RA)$ has proved suboptimal for relief of reflux symptoms. The rapid development of tolerance and rebound acid hypersecretion after the with-drawal of $H_2RA$ limit their clinical use. Proton pump inhibitors (PPI) have been proved to be very effective for suppressing intragastric acidity, but the optimal dose and duration is unknown. Current evidence indicates that pharmacologic intervention should include, at a minimum, a 3 month trial of twice daily PPI. Symptoms of LPR improve over 2 months of therapy. The physical findings of LPR resolve more slowly than the symptoms and this continues through out at least 6 months of treatment. For most patients with LPR, twice daily dosing with a PPI is usually recommended for an initial treatment for a period of no less than 6 months treatment, and lifetime treatment may be required.

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Two Cases of Systemic Lupus Erythematosus with Cerebrovascular Involvement (뇌 혈관계를 침범한 전신성 홍반성 루푸스 2례)

  • Kim, Bong-Jun;Lee, Eun-Young;Hong, Young-Hoon;Park, Ki-Do;Song, Young-Doo;Lee, Choong-Ki;Shim, Young-Ran
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.371-380
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    • 1998
  • Systemic lupus erythematosus(SLE) is an autoimmune disease which may affect many different organs and disclose various clinical manifestations. Recently central nervous system(CNS) involvement has been recognized as an increasingly significant contributor to morbidity and mortality of SLE. The clinical manifestations of CNS-lupus are highly variable and range from mild cognitive dysfunction, movement disorder, headache, psychosis to life-threatening stroke and coma. Among the neuropsychiatric disorders encountered in patients with SLE, cerebrovascular disease has been a relatively rare complication. The diagnosis and management of CNS-lupus is difficult because of the lack of useful diagnostic methods. If cerebrovascular involvement is suspected, aggressive treatment such as high dose steroid, immunosuppressive therapy, plasma exchange may be required to reduce high mortality rate. We experienced 2 cases cerebrovascular dis eases occurring in SLE patients which presented with various neuropsychiatric manifestations. They were diagnosed as CNS-lupus by neuropsychiatric symptoms, brain MRI, and BEG, and showed good response to high dose steroid pulse therapy.

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Partial spontaneous remission of small cell lung carcinoma with neurologic symptom (신경계 증상을 동반한 부분적으로 자연완화된 소세포폐암)

  • Yun, Kyung Hyun;Song, Sung Heon;Kim, Chung Hyoun;Hwang, Chan Hee;Lee, Jun Ho;Choi, Je Hyoung;Kim, Sun Young
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.275-278
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    • 2017
  • Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-year-old man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.

Local ablative radiotherapy for oligometastatic non-small cell lung cancer

  • Suh, Yang-Gun;Cho, Jaeho
    • Radiation Oncology Journal
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    • v.37 no.3
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    • pp.149-155
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    • 2019
  • In metastatic non-small cell lung cancer (NSCLC), the role of radiotherapy (RT) has been limited to palliation to alleviate the symptoms. However, with the development of advanced RT techniques, recent advances in immuno-oncology therapy targeting programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) and targeted agents for epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) translocation allowed new roles of RT in these patients. Within this metastatic population, there is a subset of patients with a limited number of sites of metastatic disease, termed as oligometastasis that can achieve long-term survival from aggressive local management. There is no consensus on the definition of oligometastasis; however, most clinical trials define oligometastasis as having 3 to 5 metastatic lesions. Recent phase II randomized clinical trials have shown that ablative RT, including stereotactic ablative body radiotherapy (SABR) and hypofractionated RT, to primary and metastatic sites improved progression-free survival (PFS) and overall survival (OS) in patients with oligometastatic NSCLC. The PEMBRO-RT study, a randomized phase II study comparing SABR prior to pembrolizumab therapy and pembrolizumab therapy alone, revealed that the addition of SABR improved the overall response, PFS, and OS in patients with advanced NSCLC. The efficacy of RT in oligometastatic lung cancer has only been studied in phase II studies; therefore, large-scale phase III studies are needed to confirm the benefit of local ablative RT in patients with oligometastatic NSCLC. Local intensified RT to primary and metastatic lesions is expected to become an important treatment paradigm in the near future in patients with metastatic lung cancer.