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Imaging of Facial Nerve With 3D-DESS-WE-MRI Before Parotidectomy: Impact on Surgical Outcomes

  • Han-Sin Jeong;Yikyung Kim;Hyung-Jin Kim;Hak Jung, Kim;Eun-hye Kim;Sook-young Woo;Man Ki Chung;Young-Ik Son
    • Korean Journal of Radiology
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    • v.24 no.9
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    • pp.860-870
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    • 2023
  • Objective: The intra-parotid facial nerve (FN) can be visualized using three-dimensional double-echo steady-state water-excitation sequence magnetic resonance imaging (3D-DESS-WE-MRI). However, the clinical impact of FN imaging using 3D-DESS-WE-MRI before parotidectomy has not yet been explored. We compared the clinical outcomes of parotidectomy in patients with and without preoperative 3D-DESS-WE-MRI. Materials and Methods: This prospective, non-randomized, single-institution study included 296 adult patients who underwent parotidectomy for parotid tumors, excluding superficial and mobile tumors. Preoperative evaluation with 3D-DESS-WE-MRI was performed in 122 patients, and not performed in 174 patients. FN visibility and tumor location relative to FN on 3D-DESS-WE-MRI were evaluated in 120 patients. Rates of FN palsy (FNP) and operation times were compared between patients with and without 3D-DESS-WE-MRI; propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to adjust for surgical and tumor factors. Results: The main trunk, temporofacial branch, and cervicofacial branch of the intra-parotid FN were identified using 3D-DESS-WE-MRI in approximately 97.5% (117/120), 44.2% (53/120), and 25.0% (30/120) of cases, respectively. The tumor location relative to FN, as assessed on magnetic resonance imaging, concurred with surgical findings in 90.8% (109/120) of cases. Rates of temporary and permanent FNP did not vary between patients with and without 3D-DESS-WE-MRI according to PSM (odds ratio, 2.29 [95% confidence interval {CI} 0.64-8.25] and 2.02 [95% CI: 0.32-12.90], respectively) and IPTW (odds ratio, 1.76 [95% CI: 0.19-16.75] and 1.94 [95% CI: 0.20-18.49], respectively). Conversely, operation time for surgical identification of FN was significantly shorter with 3D-DESS-WE-MRI (median, 25 vs. 35 min for PSM and 25 vs. 30 min for IPTW, P < 0.001). Conclusion: Preoperative FN imaging with 3D-DESS-WE-MRI facilitated anatomical identification of FN and its relationship to the tumor during parotidectomy. This modality reduced operation time for FN identification, but did not significantly affect postoperative FNP rates.

The Effect of Glucocorticoid on the Change of Nitric Oxide and Cytokine Levels in Induced Sputum from Patients with Bronchial Asthma (기관지 천식 환자에서 부신피질 스테로이드 투여 전후 유도객담내 Nitric Oxide 및 Cytokine의 변화)

  • Kim, Tae-Yon;Yoon, Hyeong-Kyu;Choi, Young-Mee;Lee, Sook-Young;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Park, Sung-Hak;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.922-931
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    • 2000
  • Background : It has been well known that bronchia1 asthma is a chronic airway inflammatory disorder. Recently, sputum induced with hypertonic saline was introduced as a simple and useful nonivasive medium to investigate airway inflammation and symptom severity in patients with asthma. We examined the eosinophil, eosinophil cationic protein (ECP), interleukin(IL)-3, IL-5, granulocyte-macrophage colony-stimulating facta (GM-CSF), and nitric oxide (NO) derivatives in induced sputum from patients with bronchia1 asthma in order to determine the role of NO and various inflammatory cytokines as a useful markers of airway inflammation or changes in pulmonary function tests and symptoms. Methods : A total 30 patients with bronchia1 asthma received oral prednisolone 30 mg daily for 2 weeks. Forced expiratory volume in one second ($FEV_1$), total blood eosinophil count and induced sputum eosinophil count, ECP, IL-3, IL-5, GM-CSF, and NO derivatives were determined before and after the administration of prednisolone. Results : Of the 30 patients, 13 (43.3%) were male and 17 (56.7%) were female. The mean age of patients was 41.8 years (range 19-64 years). Two patients could not produce sputum at the second study and 3 could not be followed up after their first visit. Two weeks after the prednisolone administration, there was a significant increase in $FEV_1$ (% of predicted value) from 78.1$\pm$20.6 % to 90.3$\pm$ 18.3 % (P<0.001). The eosinophil percentages in induced sputum were significantly decreased after treatment with prednisolone, with values of 56.1$\pm$27.2 % versus 29.6$\pm$21.3 % (P<0.001), and ECP were $134.5\pm68.1\;{\mu}g/L$ versus $41.5\pm42.4\;{\mu}g/L$ (P<0.001) respectively. After the prednisolone treatments, the eotaxin concentration also showed a decreasing tendency from 26.7$\pm$12.8 pg/ml to 21.7$\pm$8.7 pg/ml. There was a decreasing tendency but no significant differences in total blood eosinophil count (425.7$\pm$265.9 vs 287.7$\pm$294.7) and in the concentration of NO derivatives ($70.4\pm44.6{\mu}mol/L$ vs $91.5\pm48.3\;{\mu}mol/L$) after the prednisolone treatments. IL-3, IL-5, GM-CSF were undetectable in the sputum of most subjects either before the prednisolone treatments or after the treatments. Before the prednisolone treatments, a significant inverse correlation was observed between FEV1 and sputum ECP (r=-D.364, P<0.05) and there was a significant correlation between sputum eosinophils and eotaxin (r=0.369, P<0.05) Conclusion : The eotaxin and ECP concentration in induced sputum may be used as markers of airway inflammation after treatments in bronchia1 asthma. In addition, the measurement of sputum eosinophil percent ages is believed to be a simple method displaying the degree of airway inflammation and airway obstruction before and after the prednisolone treatment in bronchia1 asthma. However, unlike exhaled NO, the examination of NO derivatives with Griess reaction in induced sputum is considered an ineffective marker of changing airway inflammation and obstructing symptoms.

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Characteristics of an AZO/Ag/AZO Transparent Conducting Electrode Fabricated by Magnetron Sputtering for Application in Cu2ZnSn(S,Se)4 (CZTSSe) Solar Cells (Cu2ZnSn(S,Se)4 (CZTSSe) 박막 태양전지 적용을 위한 마그네트론 스퍼터링으로 증착된 AZO/Ag/AZO 투명전극의 특성)

  • Lee, Dong Min;Jang, Jun Sung;Kim, Jihun;Lee, InJae;Lee, Byeong Hoon;Jo, Eunae;Kim, Jin Hyeok
    • Korean Journal of Materials Research
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    • v.30 no.6
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    • pp.285-291
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    • 2020
  • Recent advances in technology using ultra-thin noble metal film in oxide/metal/oxide structures have attracted attention because this material is a promising alternative to meet the needs of transparent conduction electrodes (TCE). AZO/Ag/AZO multilayer films are prepared by magnetron sputtering for Cu2ZnSn(S,Se)4 (CZTSSe) of kesterite solar cells. It is shown that the electrical and optical properties of the AZO/Ag/AZO multilayer films can be improved by the very low resistivity and surface plasmon effects due to the deposition of different thicknesses of Ag layer between oxide layers fixed at AZO 30 nm. The AZO/Ag/AZO multilayer films of Ag 15 nm show high mobility of 26.4 ㎠/Vs and low resistivity and sheet resistance of 3.5810-5 Ωcm and 5.0 Ω/sq. Also, the AZO/Ag (15 nm)/AZO multilayer film shows relatively high transmittance of more than 65 % in the visible region. Through this, we fabricated CZTSSe thin film solar cells with 7.51 % efficiency by improving the short-circuit current density and fill factor to 27.7 mV/㎠ and 62 %, respectively.

A STUDY OF ANALGESIC EFFECT ON PULP INDUCED BY PULSED Nd : YAG LASER (Pulsed Nd ; YGA 레이저의 치수마취효과에 관한 연구)

  • Kim, Do-Hyeong;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.1
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    • pp.301-312
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    • 1997
  • The purpose of this study was to evaluate the analgesic effect on pulp induced by pulsed Nd : YAG laser according to the power density, irradiated time and the method of application (Non-contact vs contact) in vivo. Experiments were carried out on 90 volunteers who have sound 4 canines. Each canine was grouped by the intensity and the time of irradiation of pulsed Nd : YAG laser was measured. Mean EPT response(units) was measured at 5 min, 30 min, and 60 min after irradiation with various intensity(1.5-3W, 15-30Hz), irradiated time (1.5min, 3min), and application method (Non-contact and contact). The results were as follows: 1. 5 minutes after irradiation, the mean EPT response(units) was increased by 32 % in the non-contact method and by 35% in the contact method of application. Which showed significant difference in mean EPT response(units) compared to not-lased canine in each groups(P<0.05). 2. The mean EPT response(units) with irradiating condition according to the various laser intensity, and the irradiation time stastically did not show significant difference in each groups as time elapsed. 3. There was no significant difference between the non-contact and contact method in the mean EPT response(units). 4. The mean EPT response(units) returned to the baseline value within 30 miuntes. In regard to the above results, the analgesic effect on pulp induced by pulsed Nd : YAG laser resulted a slight increase of pulpal pain threshold, but it was not as high as to replace the role of drug analgesia as whole. This technique can be used for inducing pulpal analgesia as adjunct to other pain control methods and is needed to develop better analgesic effects.

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Intravenous levetiracetam versus phenobarbital in children with status epilepticus or acute repetitive seizures

  • Lee, Yun-Jeong;Yum, Mi-Sun;Kim, Eun-Hee;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.59 no.1
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    • pp.35-39
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    • 2016
  • Purpose: This study compared the efficacy and tolerability of intravenous (i.v.) phenobarbital (PHB) and i.v. levetiracetam (LEV) in children with status epilepticus (SE) or acute repetitive seizure (ARS). Methods: The medical records of children (age range, 1 month to 15 years) treated with i.v. PHB or LEV for SE or ARS at our single tertiary center were retrospectively reviewed. Seizure termination was defined as seizure cessation within 30 minutes of infusion completion and no recurrence within 24 hours. Information on the demographic variables, electroencephalography and magnetic resonance imaging findings, previous antiepileptic medications, and adverse events after drug infusion was obtained. Results: The records of 88 patients with SE or ARS (median age, 18 months; 50 treated with PHB and 38 with LEV) were reviewed. The median initial dose of i.v. PHB was 20 mg/kg (range, 10-20 mg/kg) and that of i.v. LEV was 30 mg/kg (range, 20-30 mg/kg). Seizure termination occurred in 57.9% of patients treated with i.v. LEV (22 of 38) and 74.0% treated with i.v. PHB (37 of 50) (P=0.111). The factor associated with seizure termination was the type of event (SE vs. ARS) in each group. Adverse effects were reported in 13.2% of patients treated with i.v. LEV (5 of 38; n=4, aggressive behavior and n=1, vomiting), and 28.0% of patients treated with i.v. PHB (14 of 50). Conclusion: Intravenous LEV was efficacious and safe in children with ARS or SE. Further evaluation is needed to determine the most effective and best-tolerated loading dose of i.v. LEV.

Thrombocytopenia in Moderate- to High-Risk Sutureless Aortic Valve Replacement

  • Thitivaraporn, Puwadon;Chiramongkol, Sarun;Muntham, Dittapol;Pornpatrtanarak, Nopporn;Kittayarak, Chanapong;Namchaisiri, Jule;Singhatanadgige, Seri;Ongcharit, Pat;Benjacholamas, Vichai
    • Journal of Chest Surgery
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    • v.51 no.3
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    • pp.172-179
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    • 2018
  • Background: This study aimed to compare preliminary data on the outcomes of sutureless aortic valve replacement (SU-AVR) with those of aortic valve replacement (AVR). Methods: We conducted a retrospective study of SU-AVR in moderate- to high-risk patients from 2013 to 2016. Matching was performed at a 1:1 ratio using the Society of Thoracic Surgeons predicted risk of mortality score with sex and age. The primary outcome was 30-day mortality. The secondary outcomes were operative outcomes and complications. Results: A total of 277 patients were studied. Ten patients (50% males; median age, 81.5 years) underwent SU-AVR. Postoperative echocardiography showed impressive outcomes in the SU-AVR group. The 30-day mortality was 10% in both groups. In our study, the patients in the SU-AVR group developed postoperative thrombocytopenia. Platelet counts decreased from $225{\times}10^3/{\mu}L$ preoperatively to 94.5, 54.5, and $50.1{\times}10^3/{\mu}L$ on postoperative days 1, 2, and 3, respectively, showing significant differences compared with the AVR group (p=0.04, p=0.16, and p=0.20, respectively). The median amount of platelet transfusion was higher in the AVR group (12.5 vs. 0 units, p=0.052). Conclusion: There was no difference in the 30-day mortality of moderate-to high-risk patients depending on whether they underwent SU-AVR or AVR. Although SU-AVR is associated with favorable cardiopulmonary bypass and cross-clamp times, it may be associated with postoperative thrombocytopenia.

Risk Factors Affecting the Graft and Patient Survival in Kidney Transplant Patients (신이식환자에서 이식과 환자의 생존에 영향을 끼치는 위험요인 분석)

  • Kim, Joo-Young;Han, Duck-Jong;Shin, Hae-Young;Shin, Whan-Gyun;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.1
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    • pp.14-22
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    • 2006
  • Purpose: To determine the short (1 year of transplant) and long-term (1-5 years of transplantation) risk factors affecting the graft and patient survival in kidney transplantation recipients. Methods: Records of 149 patients who received kidney transplantation in 1996 from Asan Medical Center were followed for 5 years retrospectively. Results: All patients initiated triple immunosuppressive therapy with cyclosporine, prednisone and azathioprine. One, two, three, four, five year patient and graft survival rates were 98.7%, 98.0%, 98.0%, 97.3%, 97.3%, and 96.6%, 95.2%, 94.6%, 92.5%, 91.8%, respectively. There were 30 cases of acute rejection (AR) and 6 cases of chronic rejection (CR) within $2.1{\pm}3.2$ months and $42.1{\pm}13.2$ months of transplantation, respectively. The risk factors for AR were donor's age older than 30 years (p=0.02) and cardiovascular disease (p=0.05). The risk factors for CR were AR (p=0.0169) and episode of complications (p=0.0330). Increasing period of dialysis (p=0.0473), episodes of AR (p<0.0001) and complication (p=0.0317) were significant factors for graft loss. Seven grafts were lost from noncompliance during 1-5 year period. The most com- mon cause of the graft loss for both periods was the graft rejection. The graft survival rate was significantly lower in patients with than without rejection episodes (77.4% vs. 90.0%, p=0.002). Conclusions: Survival rate of the graft with rejection was significantly lower. The risk factors affecting AR were donor's age older than 30years and CVD. AR and episode of complications within 1year were the risk factors for CR and graft loss.

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Medication Utilization Analysis of Basiliximab as a Maintenance Immunosuppressant in Renal Failure Patients Undergoing Lung Transplantation (폐 이식 후 신부전 발생 환자에서 유지 면역억제제로서 basiliximab의 사용 평가)

  • Seo, Yejin;Geum, Min Jung;Lee, Kyung Ah;Kim, Jae Song;Son, Eun Sun;Yu, Yun Mi
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.149-160
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    • 2020
  • Background: Basiliximab is used as an alternative to tacrolimus in patients with decreased renal function. However, studies on basiliximab as a maintenance immunosuppressant, particularly in patients with lung transplantation, are limited. Therefore, here, we investigated the efficacy and safety of basiliximab in patients with lung transplantation. Methods: Adult patients with acute kidney injury (AKI) who received lung transplantation at a single general hospital between July 1, 2014 and June 30, 2018, were selected and classified in tacrolimus and basiliximab groups. Both groups received a triple-drug regimen (tacrolimus, mycophenolate mofetil, and steroids). However, tacrolimus was discontinued in the basiliximab group when AKI occurred, and two or more repeat basiliximab doses were administered within 3 months after transplantation. The electronic medical records were analyzed retrospectively. Results: Of the 85 patients who met the selection criteria, 61 and 24 were assigned to the tacrolimus and basiliximab groups, respectively. Significant improvement in renal function was observed in the basiliximab group (p <0.001). However, there were no differences in acute and chronic rejection rates in both the groups. No difference was observed in the incidence rate of complications between the groups, except for chronic kidney disease, which showed higher incidence in the basiliximab group (25.0% vs. 4.9%; p =0.013). Conclusions: We suggest the use of basiliximab as an immunosuppressant alternative to tacrolimus in patients with acute renal failure after lung transplantation. Basiliximab demonstrated effectiveness as an immunosuppressant and improved renal function. Therefore, basiliximab can be used in patients with decreased renal function.

R&D Scoreboard에 의한 연구개발투자와 성과의 연관성 분석

  • 조성표;이연희;박선영;배정희
    • Journal of Technology Innovation
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    • v.10 no.1
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    • pp.98-123
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    • 2002
  • This study develops a Korean R&D Scoreboard which has originated from the R&D Scoreboard in United Kingdom. The Scoreboard contains details of the R&D investment, sales, growth, profits and employee numbers for Korean companies which are extracted from company annual reports and key ratios calculated, with some movements over time. Companies are classified by the Korea Standard Industrial Classification. The Scoreboard contains 190 companies which consist of 100 largest companies and 30 middle-or small-sized firms listed in Korea Stock Exchange (KSE), and 30 ventures and 30 other firms listed in KOSDAQ. The overall company R&D intensity (R&D as a percentage of sales) is 2.1% compared to the international average of 4.2%. Korea has an unusually large R&D percentage of sales in IT hardware (4.9%) and telecommunication (3.7%). R&D intensity is positively correlated with company performance measures such as profitability, sales growth, productivity and market value. For largest companies listed in KSE and ventures listed in KOSDAQ, the ratio of operating profit to sales is greater for high R&D intensity companies. Sales growth is in proportion to R&D intensity for all companies. Plots of value added per employee or sales per employee vs R&D per employee rise together for the sectors studied, especially for the chemical sectors and automobile sectors, demonstrating a correlation with productivity. The average market value of high R&D companies in the KSE has risen more than 1.6 times that of the KOSPI 200 index. Given the correlation between R&D intensity and company performance and given that R&D is a smaller percentage of surplus (profits plus R&D) than international level (both overall and in several sectors), the challenges facing Korean companies are to maintain the leading position in IT hardware and telecommunication, and to increase the intensity of R&D in many medium-intensive R&D sectors where Korea has an average intensity well below international or US levels.

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Greater Lymph Node Retrieval Improves Survival in Node-Negative Resected Gastric Cancer in the United States

  • Mirkin, Katelin A.;Hollenbeak, Christopher S.;Wong, Joyce
    • Journal of Gastric Cancer
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    • v.17 no.4
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    • pp.306-318
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    • 2017
  • Purpose: Guidelines in Western countries recommend retrieving ${\geq}15$ lymph nodes (LNs) during gastric cancer resection. This study sought to determine whether the number of examined lymph nodes (eLNs), a proxy for lymphadenectomy, effects survival in node-negative disease. Materials and Methods: The US National Cancer Database (2003-2011) was reviewed for node-negative gastric adenocarcinoma. Treatment was categorized by neoadjuvant therapy (NAT) vs. initial resection, and further stratified by eLN. Kaplan-Meier and Weibull models were used to analyze overall survival. Results: Of the 1,036 patients who received NAT, 40.5% had ${\leq}10eLN$, and most underwent proximal gastrectomy (67.8%). In multivariate analysis, greater eLN was associated with improved survival (eLN 16-20: HR, 0.71; P=0.039, eLN 21-30: HR, 0.55; P=0.001). Of the 2,795 patients who underwent initial surgery, 42.5% had ${\leq}10eLN$, and the majority underwent proximal gastrectomy (57.2%). In multivariate analysis, greater eLN was associated with improved survival (eLN 11-15: HR, 0.81; P=0.021, eLN 16-20: HR, 0.73; P=0.004, eLN 21-30: HR, 0.62; P<0.001, and eLN >30: HR, 0.58; P<0.001). Conclusions: In the United States, the majority of node-negative gastrectomies include suboptimal eLN. In node-negative gastric cancer, greater LN retrieval appears to have therapeutic and prognostic value, irrespective of initial treatment, suggesting a survival benefit to meticulous lymphadenectomy.