The Journal of the Korean bone and joint tumor society
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v.6
no.2
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pp.98-105
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2000
In the case of osteosarcoma, secondary acute myeloid leukemia which occurs as the consequences of the complication of chemotherapy, is rare. We are reporting the case that we have recently experienced in the laboratory. A case of secondary acute myeloid leukemia have been occurred to among 77 patients who have been diagnosed as osteosarcoma and received chemotherapy from 1995 to 1999. This case was compared with the cases of other reports for the analysis of its cause and results. A 17-year-old man was diagnosed as a osteosarcoma in the distal part of femur, and recieved chemotherapy. Within 28months, the hematological analysis of the case indicated the severe increase in the number of the white cell (over 200,000) and the profound decrease in the number of platelets. A test of bone marrow needle aspiration and peripheral blood smear showed a tremendous increase in the number of the monocytoid immature cell, which mostly are blasts and promonocytes. Due to this clinical results, the case was diagnosed as the secondary acute myeloid leukemia after the chemotherapy. The frequency of occurrence of secondary acute myeloid leukemia after chemotherapy is quite phenomenal. But the disease could be fatal leading to a high rate of morbidity and mortality without early diagnosis and treatment. Hence, an enough recognition of the possibility of its development, the periodical observation and inspection after chemotherapy and an immediate treatment in the case of occurrence are essential.
Purpose: To report our experience of gastrointestinal operations performed in neonates including low birth weight infants and to evaluate their clinical characteristics. Methods: We retrospectively reviewed the medical records of patients who underwent neonatal gastrointestinal surgery or had necrotizing enterocolitis (NEC) or inguinal hernia from January 2008 to December 2010 at Pusan National University School of Medicine. Results: The main disease was anorectal malformation and male patients were dominant. Twenty four patients (19.2%) had one or more associated anomalies including hydronephrosis and congenital heart disease. Eighteen patients (43.9%) of anorectal malformation had other anomalies. Seventy six percent of NEC cases were very low birth weight infants. Concerning mean days of full enteral feeding after operation, NEC patients needed 30.8 days, which was the longest period. Overall mortality of operation (except NEC and inguinal hernia operation) was 1.6%. The mortality of NEC with surgical treatment was 18.8%. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC patients. Conclusion: The morbidity and mortality after neonatal gastrointestinal surgery were excellent. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC.
Peripheral arterial disease, because of it's significant and prolonged morbidity and related mortality is a major medical and surgical problem. Contrast angiogram remains the essential standard for the anatomic demonstration of disease. It does not, however, provide data suitable for quantification or any evaluation of the microcirculation. For these reasons, radionuclide studies are playing an increasingly important role by not only confirming the diagnosis and offering objective data on the physiologic significance of anatomic lesions, but by offering prognosis of healing and prediction of therapeutic results. In addition, radionuclide procedures offer means to safely and repeatedly monitor response to therapy and long term follow up. The object of this study was to evaluate the clinical availability of $^{201}T1$ perfusion scan in patients with peripheral arterial diseases. We performed $^{201}T1$ perfusion scans in patients with five Buerger' s disease (10 legs), six DM gangrenes (12 legs) and classified three perfusion pattern groups. Finally we compared treatment modalities among each groups and compaired T1-201 perfusion scan findings with angiographic findings in six patients with Buerger's disease. The results were as follows: 1) Seven legs showed increased perfusion in stress image and normal or increased perfusion in resting image (type 1). Six legs showed decreased perfusion in stress image and improved in resting image (type II). Of total 13 legs, only 1 leg needed to amputation. 2) Three legs showed decreased perfusion in stress and resting image (type III), and subsequently all cases were received surgical amputation. 3) In six Buerger's disease patients, there were disagreements in two patients (2 legs) between $^{201}T1$ scan and angiography, in which angiograms were normal but $^{201}T1$ scans showed 'type II' perfusion patterns.
Influenza A virus of the Orthomyxoviridae family is a contagious respiratory pathogen that continues to evolve and burden in the human public health. It is able to spread efficiently from human to human and have the potential to cause pandemics with significant morbidity and mortality. It has been estimated that every year about 500 million people are infected with this virus, causing about approximately 0.25 to 0.5 million people deaths worldwide. Influenza A viruses are classified into different subtypes by antigenicity based on their hemagglutinin (HA) and neuraminidase (NA) proteins. The sudden emergence of influenza A virus subtypes and access for epidemiological analysis of this subtypes demanded a rapid development of specific diagnostic tools. Also, rapid identification of the subtypes can help to determine the antiviral treatment, because the different subtypes have a different antiviral drug resistance patterns. In this study, our aim is to detect influenza A virus subtypes by using real-time nucleic acid sequence based amplification (NASBA) which has high sensitivity and specificity through molecular beacon. Real-time NASBA is a method that able to shorten the time compare to other molecular diagnostic tools and is performed by isothermal condition. We selected major pandemic influenza A virus subtypes, H3N2 and H5N1. Three influenza A virus gene fragments such as HA, NA and matrix protein (M) gene were targeted. M gene is distinguished influenza A virus from other influenza virus. We designed specific primers and molecular beacons for HA, NA and M gene, respectively. In brief, the results showed that the specificity of the real-time NASBA was higher than reverse transcription polymerase chain reaction (RT-PCR). In addition, time to positivity (TTP) of this method was shorter than real-time PCR. This study suggests that the rapid detection of neo-appearance pandemic influenza A virus using real-time NASBA has the potential to determine the subtypes.
Laparoscopic surgery is a well-established alternative to open surgery across disciplines. However, in veterinary medicine, laparoscopic surgery in dogs was rarely reported because of small abdominal size for multiple ports insertion. The concept of single-incision laparoscopic surgery (SILS) is to perform the entire laparoscopic operation through a single incision rather than conventional multiple small skin incisions. Indirect evidence of potential benefits of SILS, decreases operative morbidity related to reduction in port size, already exists. Therefore, this study was performed to evaluate the safety and feasibility of the modified form of SILS using flexible endoscope in Cholecystectomy before clinical adoption. A 2 cm single periumbilical incision was performed, and flexible endoscope was introduced into the abdominal cavity. A laparoscopic grasper was inserted into the abdominal cavity for the traction of gall bladder. Cystic duct and artery were ligated by 5 mm Hem-o-lok$^{(R)}$. Then, gall bladder was dissected and resected from the liver with 5 mm Autonomy Laparo-Angle Maryland dissector and endoscopic needle knife. Resected gall bladder was wrapped by using specimen pouch and was retrieved through abdominal incision from the cavity. All three gall bladders were successfully removed. Hematological changes were not observed during examination periods. No leakage sign was identified at necropsy. The flexible endoscope, as distinct from conventional rigid laparoscope, allows the visualization from various angles and the wide range of motion, result in less crowding.
Backgrouds: It is almost universally accepted that occlusive vascular diseases are best managed by anatomical reconstruction. However, the mortality and the morbidity have limited this operation for patients with high operation risks. In these patients, palliative operations such as extra-anatomic bypass and lumbar sympathectomy, are accepted as useful treatment. Material and Method: A retrospective study was conducted in 38 patients who underwent palliative operations for occlusive vascular disease at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 60.37 $\pm$ 17.65 years, and preoperative diagnoses were atherosclerosis in 32 patients, Buerger's disease in 4 patients, Raynaud's syndrome in 1 patient and SVC syndrome in 1 patient. Result: Extra-anatomic bypass(40procedures), lumbar sympathectomy(17), thromboembolectomy(7) and femoral artery graft interposition(1) were performed. Six patients were required reoperation due to graft flow failure or fistula. Three year primary patency rate of entire operations was 78.29 $\pm$ 8.81%, and the correlation between type of operation and patency rate was not statistically significant. Conclusion: Palliative operations for occlusive vascular disease are useful treatment in limited patients with high operation risks or limited life expectancy.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.30
no.5
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pp.428-433
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2004
Sinus floor augmentation has been proven an effective treatment procedure to increase bone volume in the posterior edentulous maxilla. Autogenous bone considered to be the best material for reconstructive bone surgery and has been successfully used as a graft material to augment posterior maxilla. However, the collection of autogenous bone required extra risks for morbidity and complaints. So, various bone graft materials included ${\beta}$-tricalcium phosphate(${\beta}$-TCP) has been introduced for replacing the autogenous bone. The objective of this clinical study was to determine the predictability of endosseous implant placed in a maxillary sinus with ${\beta}$-TCP grafting. We performed sinus elevation with ${\beta}$-TCP to install the implant in the 10 maxillary cases. The prosthetic procedure was performed 6-9 months after. The implant-prosthetics was checked about 1 year. We checked the implant and measured the maximum bite force to evaluate the function of the implant. There was not observed the specific problem and complication in dental implant and maxillary sinus in the grafted materials. The maximum bite force was 558N in case of natural tooth, 365N in implant without grafting, 318N in implant with ${\beta}$-TCP grafting. There was no significant difference between with and without sinus grafting on maximum bite force(p>0.05). As though the long term check-up is needed, the grafting of ${\beta}$-TCP as a osteoconductive materials can expand the volume and induce dense new bone formation in maxillary sinus. So, this short-term results support that ${\beta}$-TCP can be a suitable material for sinus augmentation.
Purpose Streptococcus pneumoniae is a major pathogen in both adults and children, causing significant morbidity and mortality In patients with nephrotic syndrome, Streptococcus pneumoniae is a major cause of spontaneous peritonitis, and the increasing incidence of penicillin-resistance strain facilitates the development of effective vaccine. The limitation of current pneumococcal polysaccharide vaccine prompted development of polysaccharide- protein conjugate vaccine. Methods: We reviewed the medical record of total 225 steroid responsive nephrotic patients to ascertain the effectiveness of 23- valent pneumococcal polysaccharide vaccine. Results. Twenty- eight patients have developed peritonitis during the courses, and 7 of those have recurrent peritonitis. Fifty- five patients were vaccinated and followed- up for 1- 108 months (mean 38.5 months), and during the follow- up period, pneumococcus related peritonitis was not detected. Vaccine- related relapse of nephrotic syndrome w as absent. Conclusion: In spite of the non- consensus about the efficacy of PPV23, clinically it benefits, and until the clinical trial of PCV7 is completed, PPV23 will be recommended. (J Korean Soc Pediatr Nephrol 2002;6: 56-60)
Lee Sang Hun;Lee Seung Eon;Lee Si Hyeong;Shin Jo Young
Journal of Physiology & Pathology in Korean Medicine
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v.18
no.2
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pp.528-533
/
2004
The immune system acts to protect the host from infectious agents that exist in the environment and from other noxious insults. The immune system has two functional divisions: the innate and the acquired. Both components involve various factors such as cytokines. A number of methodologies exist to assess aspects of immune function. There are large inter-individual variations in many immune functions even among the healthy. Genetics, age, gender, smoking habits, habitual levels of exercise, alcohol consumption, diet, stage in the female menstrual cycle, stress, history of infections and vaccinations, and early life experiences are likely to be important contributors to the observed variation. While it is clear that individuals with immune responses significantly below 'normal' are more susceptible to infectious agents and exhibit increased infectious morbidity and mortality, it is not clear how the variation in immune function among healthy individuals relates to variation in susceptibility to infection. Oriental medicine is an important factor contributing to immune competence. The author investigated the immune enhancement effects of Bojungikkitanggami-bang (BITB). The forced swimming test (FST) has been used as a screening model for new immune enhancement agents. In the present study, the author investigated the effects of BITB on FST and blood biochemical parameters related to fatigue, glucose (Glc); blood urea nitrogen (BUN); lactate dehydrogenase (LDH); creatinine; and total protein (TP). The author found that BITB (1 g/kg) significantly reduced the immobility time in the FST compared to the control. In addition, the contents of Glc, LDH, BUN, TP in the blood serum were increased in BITB (1g/kg)-fed group. Also, the author investigated the effects of BITB on the production of cytokines in human T-cell line, MOLT-4 cells. BITB (1 mg/ml) significantly increased the interferon (IFN)-vproduction compared with media control (about 2.2-fold for IFN-γ) at 24 h. However, BITB has not affect the production of IL-2 and IL-4. In addition, BITB increased the protein expression level of IFN-γ in MOLT-4 cells. Thus, BITB may have therapeutic value in generating or enhancing immune function in a clinical setting.
From August 1992 to July 1996, 63 consecutive patients underwent coronary artery bypass surgery. The mean age of these patient was 57 years(range form 30 to 71years). There were 44 men and 19 women. Preoperative 12 patients had stable angina pectoris and 23 patients were unstable angina pectoris. 8 patients had previous myocardial infarctation history and emergency or urgent myocardial revascularization were performed in 9 cases. In the risk factors of coronary atherosclerosis, 25 patients(40%) were hypercholesterolemia, 38 patients(60%) have smoking history and 19 patients(30%) have hypertension history. In the patterns of disease, 9 patients were single vessel disease, 18 patients were two vessele disease and 33 patients were three vessel disease. We performed total 284 distal anastomosis(mean 3.5 anastomosis per patient) and performed one case of ascending aorta graft interposition, two cases of mitral valve replacement, one case of aortic valve replacement, one case of ventricular septal defect repair and one case of atrial septal defect repair and the mean aortic cross clamp time was 115.3 minutes. The common complications were arrhythmia(7cases), wound infection(5cases), perioperative myocardial infarction(4cases), reoperation for bleeding control(4cases) and stroke(4cases). There were six hospital deaths due to low cardiac output syndrome, ventricular arrhythmia and respiratory failure. In the evaluation of operative risk factors, preoperative intravenous nitroglycerin requirement and prolonged aortic cross clamp tirne(>2hours) were found to be predective factor of morbidity and old age(>65years) was found to be predective factor of mortality.
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