Effects of Cryosurgery in Primary Lung Cancer / 대한흉부외과학회지

BACKGROUND: Cryosurgery has been used to treat primary malignant pulmonary tumors at our institute since November 2004. In this study we analyzed our treatment results and complication rates. MATERIAL AND METHOD: A retrospective study using medical charts and imaging data was conducted involving 17 patients with a total of 17 malignant pulmonary tumors who were treated between November 2004 and March 2007. Fourteen patients were males and 3 were females. The median age of the patients was 64 years (range, 54~77 years). The average size of the tumors was 48.8 mm (range, 36~111 mm) in diameter. The patients were followed with chest CT scans 7 days, 1 month, 3 months, and 6 months postoperatively. PET scans were obtained between 6 and 9 months postoperatively. The treatment response was analyzed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. RESULT: Six months after treatment, 6 tumors (35.3%) showed a complete response, 4 (23.5%) had a partial response, 3 (17.6%) had stable disease, and 4 (23.5%) showed disease progression. In tumors <4 cm in diameter, a complete response was reported in 50% of the tumors. A chi-square-test showed that in tumors <4 cm in diameter, the p-value for results better than a partial response was 0.034. With respect to procedural complications, there was 1 case of blood-tinged sputum which resolved spontaneously within 1 or 2 days, a spontaneously relieved case of subcutaneous emphysema, and 1 patient with a fever. There were no mortalities and the average hospital stay was 6.3 days. CONCLUSION: The effects of cryosurgery on primary lung cancer is greatest in patients with small tumors. Considering the facts that cryosurgery is minimally invasive, has a low complication rate, and can be performed repetitively, we believe that it may play an important role in the treatment of high risk lung cancer patients.

Feasibility of Extracorporeal Life Support for Out-of-Hospital Cardiac Arrest Patients who are Unresponsive to Conventional Cardiopulmonary Resuscitation

PURPOSE: To determine the feasibility of using extracorporeal life support (ECLS) for out-of-hospital cardiac arrest (OHCA) patients who are unresponsive to conventional cardiopulmonary resuscitation (CPR) techniques. METHODS: This study was a case series of consecutive nontraumatic OHCA patients aged 18~75 years who received ECLS in the emergency department (ED) of a university teaching hospital. We analyzed outcomes, physiologic effects, and complications associated with ECLS. To compare outcomes of ECLS and conventional CPR, we selected a conventional CPR subgroup, those who were aged 18 to 75 years, who experienced cardiac arrest with pre-hospital CPR, who had no terminal illness, and who had CPR for more than 40 minutes. RESULTS: Of 14 attempts to initiate ECLS, 13 patients received ECLS and one patient failed catheterization. Nine patients achieved return of spontaneous circulation (ROSC) more than 20 minutes later; 4 of the 9? patients survived more than 24 hours; 2 patients were successfully weaned off ECLS; 1 patient was discharged alive without neurologic complications. Median (minimum-maximum) duration of CPR before ECLS (pre-hospital and in-hospital) was 84(41 to 167) minutes. Blood gas parameters obtained 3 hours after the start of ECLS were significantly improved compared with those obtained pre-ECLS. Four patients who arrested from acute myocardial infarction received intervention as during ECLS support to correct the causes of the arrest. Serious complications of ECLS causing mortality were catheterization failure, intracranial hemorrhage, and massive hemothorax. The ECLS group showed a higher ROSC rate than patients who received conventional CPR without ECLS (64.3% vs. 7.1%, p=0.002). CONCLUSION: ECLS in the ED is feasible for OHCA patients who are unresponsive to prolonged CPR. ECLS provides a bridge to evaluation and definitive care in refractory OHCA by improving early hemodynamic and physiologic status. Earlier application of ECLS and reduction of complications associated with ECLS may improve the survival of OHCA patients.

A Study on the Relationship of Internet Addiction and Depression in College students / 한국역학회지

OBJECTIVES: To investigate the relationship of internet addiction and depression, and evaluate other possible related factors. METHODS: Data was based on the questionnaires from 300 college students in Seoul. Gender, age, major, family income, academic performance, people they live with, location, and main use of internet were included. We used Young`s Internet Addiction Test and Beck Depression Inventory(BDI) to measure the depression and addiction degree. RESULTS: In logistic regression analysis, it was found that gender, depression degree and main use of internet were significant variables. There were 136 males, 144 females in this study, and the risk of being addicted to internet were 10.9 times(CI:2.67~44.68) higher in male than female. People with moderate depression (Beck`s Depression Inventory(BDI) Score>20) also had higher risk(11.4 times, CI:2.03~63.95) to be addicted in internet than normal group. Lastly, in case of internet use, people who use internet for games and chatting were 6.38(CI:1.38~29.63) and 4.84 times(CI:1.30~18.06) risky compare to the group with web surfing. CONCLUSION: The result of this study suggests that there is noticeable relationship of internet addiction and depression. However we do not have evidence of exact relation between them, therefore more studies should be done.