• Title/Summary/Keyword: treatment approach

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Trend (in 2005) of Repair of Inguinal Hernia in Children in Korea - A National Survey by the Korean Association of Pediatric Surgeons in 2005 - (2005년도 소아 서혜부 탈장치료 경향)

  • Kim, Seong-Min;Kim, Dae-Yeon;Kim, Sang-Yoon;Kim, Seong-Chul;Kim, Woo-Ki;Kim, Jae-Eok;Kim, Jae-Chun;Park, Kwi-Won;Seo, Jeong-Meen;Song, Young-Tack;Oh, Jung-Tak;Lee, Nam-Hyuk;Lee, Doo-Sun;Chun, Yong-Soon;Chung, Sang-Young;Chung, Eul-Sam;Choi, Kum-Ja;Choi, Soon-Ok;Han, Seok-Joo;Huh, Young-Soo;Hong, Jeong;Choi, Seung-Hoon
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.155-166
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    • 2006
  • Inguinal hernia is the most common disease treated by the pediatric surgeon. There are several controversial aspects of management 1)the optimal timing of surgical repair, especially for preterm babies, 2)contralateral groin exploration during repair of a clinically unilateral hernia, 3)use of laparoscope in contralateral groin exploration, 4)timing of surgical repair of cord hydrocele, 5)perioperative pain control, 6)perioperative management of anemia. In this survey, we attempted to determine the approach of members of KAPS to these aspects of hernia treatment. A questionnaire by e-mail or FAX was sent to all members. The content of the questionnaire were adapted from the "American Academy of Pediatrics (AAP) Section on Surgery hernia survey revisited (J Pediatr Surg 40, 1009-1014, 2005)". For full-term male baby, most surgeons (85.7 %) perform an elective operation as soon as diagnosis was made. For reducible hernia found in ex-preterm infants already discharged from the neonatal intensive care unit (NICU), 76.2 % of surgeons performed an elective repair under general anesthesia (85.8 %). 42.9 % of the surgeons performed the repair just before discharge. For same-day surgery for the ex-premature baby, the opinion was evenly divided. For an inguinal hernia with a contralateral undescended testis in a preterm baby, 61.9 % of surgeons choose to 'wait and see' until 12 month of age. The most important consideration in deciding the timing of surgery of inguinal hernia in preterm baby was the existence of bronchopulmonary dysplasia (82.4 %), episode of apnea/bradycardia on home monitoring (70.6 %). Most surgeons do not explore the contralateral groin during unilateral hernia repair. Laparoscope has not been tried. Most surgeons do not give perioperative analgesics or blood transfusion.

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Effects of Oyster Shell Extract on Papain-induced Osteoarthritis in C57BL/6J Mice (굴 패각 추출물이 Papain으로 유도된 골관절염 C57BL/6J Mice에 미치는 영향)

  • Lee, Se-Young;Kim, Hak-Ju;Han, Ji-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.8
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    • pp.1183-1189
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    • 2013
  • We investigated the effects of oyster shell extract (OSE) on papain-induced osteoarthritis in C57BL/6J mice. Osteoarthritis was induced in mice by a papain injection into the knee joint. The mice were divided into a total of five groups (n=8). The normal group was untreated, whereas the papain group (negative control) was induced with osteoarthritis and treated with water daily. The papain+DS group (positive control) was treated with diclofenac sodium. Papain+OSE groups were treated with OSE concentrations of 100 and 200 mg/kg/bw for 20 days. Proteoglycan content in articular cartilage was analyzed through safranine-O fast green staining and H&E staining. The histopathological changes in cartilage were measured by the Rudolphi score approach. The contents of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin (IL)-$1{\beta}$, and IL-6 in plasma were analyzed by the ELISA method. After experiments, body weights of the treated groups were not significantly different compared with the normal group. Cartilage loss and joint instability significantly improved in a dose-dependent manner in the OSE-treated group compared with the papain group (P<0.05). Proteoglycan content was significantly higher in the OSE-treated group than the papain group (P<0.05). Osteoarthritis scores of the OSE-treated group were significantly decreased compared with the papain group (P<0.05). TNF-${\alpha}$, IL-$1{\beta}$, and IL-6 content in the plasma of the papain+OSE treated groups significantly decreased in a dose-dependent manner compared with the papain group (P<0.05). These results suggest that OSE treatment might have anti-arthritic effects on papain-induced osteoarthritis in C57BL/6J mice.

Therapeutic Results of Radiotherapy in Nonsmall Cell Lung Cancers (비소세포성 폐암의 방사선치료 성적)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.72-81
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    • 1994
  • Total 55 patients with nonsmall cell lung cancer treated with radiation therapy at Department of Therapeutic Radiology, Yeungnam University Hospital, between May-1 1986 and April-30 1993 were retrospectively analyzed by clinical characteristics, failure patterns, follow up duration and survival ratio according to prognostic factors. Obtained results were as follows : 1. Male to female ratio was 17.3 2. Sixth and seventh decades were predominant age group. 3. The patients were 8 in stage I-II, 34 in stage IIIA, 13 in stage IIIb, respectively. 4. Forty five patients out of 55 were squamous cell carcinoma. 5. Primary tumor were originated from upper lobe bronchi predominantly. 6. The size of the primary tumor, lymph node involvement and the degree of differentiation were important in evaluation of prognosis. 7. In conclusion, for patients with poor prognostic factors systemic chemotherapy and multidisciplinary approach were recommended for better treatment outcome and improvement of survival.

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A Documentational Study on the Development of Chi-Kung-Hak (기공학(氣功學) 발달(發達)에 관한 문헌적(文獻的) 연구(硏究))

  • Kim, Woo Ho;Hong, Won Sik
    • Journal of Korean Medical classics
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    • v.4
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    • pp.19-73
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    • 1990
  • Today, many people are more interested in preventing the disease than curing it. Chi-Kung (氣功) is the way of Life-Cultivation (養生法) peculiar to the orient, it is reported in china that Chi-Kung has an excellent curative value not only in curing the disease but also in preventing it. But the full-scale study of Chi-Kung is not be made up to now in Korea, so I studied the developmental history of chinese Chi-Kung through the oriental medical books. From this study, I reached the following conclusions ; 1. Chi-Kung is naturally derived from the self-preservation instinct to adapt oneself to circumstances of the nature, but in the investigation from the documentational records, it is originated in the treatment method of the Sam-Huang-O-Jae (三皇五帝 )period to cure the abnormal circulation of the vital force and blood caused by damp (濕). 2. As the principle and the method of the Life-Cultivation of the Chun-chu-Jeon-Kook (春秋戰國) periods were recorded in Huang-Jae-Nai-Gyung (黃帝內徑) detailly and the remedy examples by ancient Chi-Kung such as Tao-Yin (導引), Haeng-Chi (行氣) were presented, we considered that theoretical basis of the development of Life-cultivation and Chi-Kung study was furnished in that period. 3. A famous doctor, Hwa-Ta (華陀) lived in Han dynasty, researched the theory and practice of Tao-Yin transmitted from the former generations, as that result, he formed a kind of medical gymnastics what is called O-Keum-Hi (五禽戱). It is considered that 'O-Keum-Hi' is a Tao-Yin method developed more practically and systemetically than the Tao-Yin appeared in the 'Jang-Ja' (莊子) or 'Hoy-Nam-Ja' (淮南子). 4. In Wui-Jin-Nambook Jo (魏晋南北朝) periods, the contents of Chi-Kung were more abundant under the influence of Buddhism (佛敎) and Taoism (道敎). Galhong (葛洪), the author of 'Po-Bak-Ja' (抱朴子) arranged the ancient Chi-Kung method systematically first of all, Tao-Goeng-Gyung (陶宏景), the author of 'Yang-Seong-Yeun-Myung-Rok' (養性延命錄) recorded the 'Yook-Ja-Geul' (六字訣) first time. 5. There is a new development of Chi-Kung therapy in Soo-Tang-Odae (隋唐五代) pefiods, especially So-Won-Bang (巢元方), the author of 'Jey-Byung-Won-Hwu-Ron' (諸病源候論) collected aimost all of the Chi-Kung method, for curing the disease formed before soo (隋) period. From that fact, we supposed that Chi-Kung was utilized more widely in curing the disease. 6. 'So-Ju-Cheon-Hwa-Hu-Peob' (小周天火候法) was adopted as the best orthodox approach under the influence of Nae-Tan-Taoist (道敎內丹學派) in Song-Keum-Won (宋金元) periods, especially in the song dynasty, 'Pal-Dan-Geum' (八段錦) was appeared and assignment of six-Chi (六氣) for bowel and viscera in the 'Yook-Ja-Geul' (六字訣) was decided firmly, that is to say Lung-Si (肺-呬), Heart-Kha (心-呵), Spleen-Hoa (脾-呼), Liver-Hoe (肝-噓), Kidneychui (賢-吹), Three-Burner-shi (三焦-嘻). 7. In Myung-Cheong (明淸) periods, The general practitioner applied the principle of 'Byun-Jeng-Ron-Chi' (辨證論治) to the Chi-Kung field, and after Myeong dynasty the style of doing 'Yook-Ja-Gyel' (六字訣) was developed to the moving style. 8. Today, in china, the study on the Chi-Kung is being progressed constantly under the positive assistance of government, Chi-Kung-Hak (氣功學) has taking its place as a branch of study step by step. It is considered that the establishment of Chi-Kung-Hak Classroom (氣功學教室) and Medical Chi-Kung Center (氣功療法室) for special and systematic research are needed, at the same time the settlement of institutional system for training the Chi-Kung technician (氣功師) is also needed.

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The Analysis of Predictive Factors for the Identification of Patients Who Could Benefit from Respiratory-Gated Radiotherapy in Non-Small Cell Lung Cancer (비소세포성 폐암에서 호흡동기방사선치료 적용 환자군의 선택을 위한 예측인자들의 분석)

  • Jang, Seong-Soon;Park, Ji-Chan
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.228-239
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    • 2009
  • Purpose: 4DCT scans performed for radiotherapy were retrospectively analyzed to assess the possible benefits of respiratory gating in non-small cell lung cancer (NSCLC) and established the predictive factors for identifying patients who could benefit from this approach. Materials and Methods: Three treatment planning was performed for 15 patients with stage I~III NSCLC using different planning target volumes (PTVs) as follows: 1) PTVroutine, derived from the addition of conventional uniform margins to gross tumor volume (GTV) of a single bin, 2) PTVall phases (patient-specific PTV), derived from the composite GTV of all 6 bins of the 4DCT, and 3) PTVgating, derived from the composite GTV of 3 consecutive bins at end-exhalation. Results: The reductions in PTV were 43.2% and 9.5%, respectively, for the PTVall phases vs. PTVroutine and PTVgating vs. PTVall phases. Compared to PTVroutine, the use of PTVall phases and PTVgating reduced the mean lung dose (MLD) by 18.1% and 21.6%, and $V_{20}$ by 18.2% and 22.0%, respectively. Significant correlations were seen between certain predictive factors selected from the tumor mobility and volume analysis, such as the 3D mobility vector, the reduction in 3D mobility and PTV with gating, and the ratio of GTV overlap between 2 extreme bins and additional reductions in both MLD and $V_{20}$ with gating. Conclusion: The additional benefits with gating compared to the use of patient-specific PTV were modest; however, there were distinct correlations and differences according to the predictive factors. Therefore, these predictive factors might be useful for identifying patients who could benefit from respiratory-gated radiotherapy.

A Study on Pulmonary Toxic Effect of High-Dose Cisplatin Administered by Isolated Lung Perfusion in Dogs (잡견에서 분리폐관류 방법으로 투여된 고농도 cisplatin의 페독성에 관한 연구)

  • 김관민;한정호;김주현
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.697-706
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    • 2000
  • Background: Isolated lung perfusion(ILP) was developed as a new treatment approach to non-resectable primary or metastatic lung cancer, because of its ability to reduce systemic toxicity while delivering high-dose chemotherapeutic agents to the target organs. This research was planned to evaluate the direct toxic effect of high-dose cisplatin to the lung tissue during isolated lung perfusion. Material and Method: Fifteen mongrel dogs were divided in the perfusate for 40 minutes. The second group was composed of 5 mongrel dogs which underwent ILP with cisplatin 2.5 mg/Kg added to the perfusate for 30 minutes and 10 minutes with washing solution without cisplatin. The third group underwent the same procedure as the second group except cisplatin 5.0 mg/Kg in the perfusate. Activities of serum angiotensin converting enzyme(ACE), tumor necrosis factor-$\alpha$(TNF-$\alpha$), and concentration of serum lactate dehydrogenase(LDH) and blood urea nitrogen/creatinine (BUN/Cr) were analyzed in each groups at the time of pre-perfusion, 1 hour, 1 day, 1 week, and 2 weeks after ILP. Result: Serum ACE activities before and 1 hour, 1 day, 1 week, and 2 weeks after ILP in control group were 45.1$\pm$6.3, 44.6$\pm$9.3, 46.7$\pm$9.5, 50.8$\pm$9.1, 46.1$\pm$4.3 U/L. Those in cisplatin 2.5 and 5.0 mg/Kg groups were 49.4$\pm$12.6, 39.0$\pm$8.6, 42.3$\pm$15.9, 50.0$\pm$2.6, 53.8$\pm$8.3 and 55.5$\pm$12.3, 47.0$\pm$6.3, 45.1$\pm$6.9, 74.8$\pm$19.5, 60.2$\pm$12.0 U/L, respectively. Serum TNF-$\alpha$ activities in each group before and after ILP were 5.0$\pm$1.5 / 7.7$\pm$2.2 / 6.6$\pm$2.5 / 4.3$\pm$1.3 / 5.2$\pm$1.1(control), 8.7$\pm$1.6 / 9.9$\pm$2.2 / 7.9$\pm$1.5 / 6.3$\pm$2.2 / 7.4$\pm$2.4 (cisplatin 2.5 mg/Kg), and 6.9$\pm$0.7 / 8.9$\pm$3.4 / 7.9$\pm$4.0 / 3.3$\pm$0.9 / 5.8$\pm$1.3 pg/ml(cisplatin 5.0 mg/Kg). Mean LDH levels of each group were 225.7 / 271.3 / 328.9 / 350.8 / 255.7(control), 235.7 / 265.7 / 336.0 / 379.5 / 299.2 (cisplatin 2.5 mg/Kg), and 259.6 / 285.2 / 340.6 / 433.4 / 292.4 IU/L(cisplatin 5.0 mg/Kg). So there was no significant difference in serum ACE, TNF-$\alpha$, and LDH activity changes after ILP between the 3 groups. And, there was no significant changes in BUN/Cr in each groups, which was independent of ILP and perfused concentration of cisplatin. In addition, all dogs survived the ILP and there was no significant evidence of pulmonary vascular injury after 2 weeks of ILP with cisplatin. Conclusion: There was no harmful effect of cisplatin to the lund tissue of the mongrel dog up to 5.0 mg/Kg in perfusate. Therefore, it is perceived to be safe and effective to deliver high-dose cisplatin to the lung without pulmonary toxicity and renal damage with ILP.

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용용과 모델 구성을 중시하는 수학과 교육 과정 개발 방안 탐색

  • Jeong Eun Sil
    • The Mathematical Education
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    • v.30 no.1
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    • pp.1-19
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    • 1991
  • This study intends to provide some desirable suggestions for the development of application oriented mathematics curriculum. More specific objects of this study is: 1. To identify the meaning of application and modelling in mathematics curriculm. 2. To illuminate the historical background of and trends in application and modelling in the mathematics curricula. 3. To consider the reasons for including application and modelling in the mathematics curriculum. 4. To find out some implication for developing application oriented mathematics curriculum. The meaning of application and modelling is clarified as follows: If an arbitrary area of extra-mathematical reality is submitted to any kind of treatment which invovles mathematical concepts, methods, results, topics, we shall speak of the process of applying mathemtaics to that area. For the result of the process we shall use the term an application of mathematics. Certain objects, relations between them, and structures belonging to the area under consideration are selected and translated into mathemtaical objects, relation and structures, which are said to represent the original ones. Now, the concept of mathematical model is defined as the collection of mathematical objcets, . relations, structures, and so on, irrespective of what area is being represented by the model and how. And the full process of constructing a mathematical model of a given area is called as modelling, or model-building. During the last few decades an enormous extension of the use of mathemtaics in other disciplines has occurred. Nowadays the concept of a mathematical model is often used and interest has turned to the dynamic interaction between the real world and mathematics, to the process translating a real situation into a mathematical model and vice versa. The continued growing importance of mathematics in everyday practice has not been reflected to the same extent in the teaching and learning of mathematics in school. In particular the world-wide 'New Maths Movement' of the 19608 actually caused a reduction of the importance of application and modelling in mathematics teaching. Eventually, in the 1970s, there was a reaction to the excessive formallism of 'New Maths', and a return in many countries to the importance of application and connections to the reality in mathematics teaching. However, the main emphasis was put on mathematical models. Applicaton and modelling should be part of the mathematics curriculum in order to: 1. Convince students, who lacks visible relevance to their present and future lives, that mathematical activities are worthwhile, and motivate their studies. 2. Assist the acqusition and understanding of mathematical ideas, concepts, methods, theories and provide illustrations and interpretations of them. 3. Prepare students for being able to practice application and modelling as private individuals or as citizens, at present or in the future. 4. Foster in students the ability to utilise mathematics in complex situations. Of these four reasons the first is rather defensive, serving to protect or strengthen the position of mathematics, whereas the last three imply a positive interest in application and modelling for their own sake or for their capacity to improve mathematics teaching. Suggestions, recomendations and implications for developing application oriented mathematics curriculum were made as follows: 1. Many applications and modelling case studies suitable for various levels should be investigated and published for the teacher. 2. Mathematics education both for general and vocational students should encompass application and modelling activities, of a constructive as well as analytical and critical nature. 3. Application and modelling activities should. be introduced in mathematics curriculum through the interdisciplinary integrated approach. 4. What are the central ideas of, and what are less-important topics of application-oriented curriculum should be studied and selected. 5. For any mathematics teacher, application and modelling should form part of pre- and in-service education.

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Characterization of a Mucolipidosis Type II Mouse Model and Therapeutic Implication of Lysosomal Enzyme Enriched Fraction Derived from Placenta (뮤코지방증 2형 마우스 모델의 특징과 태반에서 추출한 리소좀 효소 투여의 결과)

  • Cho, Sung Yoon;Kim, Ki-Yong;Kim, Su Jin;Sohn, Young Bae;Maeng, Se Hyun;Kim, Chi Hwa;Ko, Ah-Ra;Song, Junghan;Yeau, Sung-Hee;Kim, Kyung-Hyo;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.12 no.1
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    • pp.5-13
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    • 2012
  • I-cell disease (mucolipidosis type II; MIM 252500) and pseudo-Hurler polydystrophy (mucolipidosis type III; MIM 252600) are disorders caused by abnormal lysosomal transport in cells. The presence of numerous inclusion bodies in the cytoplasm of fibroblasts, a lack of mucopolysacchariduria, increased lysosomal enzyme activity in serum, and decreased GlcNAc-phosphotransferase activity are hallmark. Here, we attempted to investigate phenotypical and biochemical characteristics of the knockoutmouse of GlcNAc-phosphotransferase ${\alpha}/{\beta}$ subunits; in addition, we also attempted to determine whether the lysosome enriched fraction derived from placenta can be beneficial to phenotype and biochemistry of the knockout mouse.We found that the knockout mouse failed to thrive and had low bone density, as is the case in human. In addition, skin fibroblasts from the animal had the same biochemical characteristics, including increased lysosomal enzyme activity in the culture media, in contrast to the relatively low enzyme activity within the cells. Intravenous injection of the lysosome rich fraction derived from placenta into the tail vein of the animal resulted in a gain of weight, while saline injected animals didn't.In conclusion, our study demonstrated the phenotypical and biochemical similarities of the knockout mouse to a mucolipidosis type II patient and showed the therapeutic potential of the lysosome enriched fraction. We admit that a larger scale animal study will be needed; however, the disease model and the therapeutic potential of the lysosome enriched fraction will highlight the hope for a novel treatment approach to mucopolipidosis type II, for which no therapeutic modality is available.

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Clinical Characteristics of the Intracordal Cysts (성대낭종의 임상적 특성)

  • Cho, Young-Ju;Yang, Yoon-Su;Yoon, Yong-Joo;Kwon, Sam-Hyun;Hong, Ki-Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.1
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    • pp.47-51
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    • 2009
  • Background and Objectives: Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They may occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. With the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Methods: In the present study, 212 cases of the intracordal cysts were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 212 cases in the 4,20 I patients who underwent laryngeal microsurgery (5.04%). Ductal cysts were 156 cases and epidermoid cysts were 56 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the preoperative laryngoscopic examination, the intracordal cysts were mostly misdiagnosed as other disease of the vocal cord such as vocal polyps or nodules. And main cause of intracordal cysts was thought of vocal abuse. From view of the surgical approach, Ductal cysts was difficult to remove completely than epidermoid cyst without cystic wall rupture. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without rupture of the cystic wall or injury of the lamina propria. And marsupialization is meaningful to ductal cyst that cannot be enucleated completely.

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Assessment of the Effectiveness of Biofeedback Therapy in Children with Pelvic Floor Dyssynergia (소아 골반저 근실조에서 바이오피드백 치료의 유용성)

  • Park, Kie-Young;Chang, Soo-Hee;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.51-59
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    • 2007
  • Purpose: Recently well-developed anorectal function tests have revealed that there is an obvious pelvic floor dyssynergia (PFD) pattern in pediatric patients with constipation, as well as in adult's. The use of biofeedback therapy (BT) has been widely implemented in adult PFD patients; however, this approach has only rarely been considered for pediatric PFD patients. Therefore, we assessed the effectiveness of BT in children with PFD. Methods: We studied 70 children with PFD, who were referred to the department of pediatrics at the Asan Medical Center for the management of soiling or chronic constipation from September 2002 to February 2005. Diagnosis of PFD and assessment of the efficacy of BT for PFD treatment were carried out along with several ano-rectal function tests (cine-defecography, ano-rectal manometry, balloon expulsion test and intra-anal EMG); in addition, a questionnaire was administered. The BT based intra-anal EMG was performed. A follow-up telephone interview was performed more than 6 months later. Results: Most of the symptoms and results of the ano-rectal function tests were statistically improved after BT. In comparisons between the BT and control groups (BT refusal group due to poor compliance), the symptoms were statistically improved at follow-up. Therefore, for the shortterm improvement of symptoms, BT was better than conservative therapy alone. The negative feelings associated with ano-rectal function testing and BT were directly associated with failure or success of therapy. Conclusion: Pediatric patients with constipation or soiling that presented with an obvious PFD pattern showed that BT was a useful therapeutic tool for rapid improvement of symptoms.

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