• Archives of Plastic Surgery
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• 제40권4호
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• pp.341-347
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• 2013

Background Intractable chronic scalp ulcers with cranial bone exposure can occur along the incision after cranioplasty, posing challenges for clinicians. They occur as a result of severe scarring, poor blood circulation of the scalp, and focal osteomyelitis. We successfully repaired these scalp ulcers using a vascularized bipedicled pericranial flap after complete debridement. Methods Six patients who underwent cranioplasty had chronic ulcers where the cranial bone, with or without the metal plate, was exposed along the incision line. After completely excising the ulcer and the adjacent scar tissue, subgaleal dissection was performed. We removed the osteomyelitic calvarial bone, the exposed metal plate, and granulation tissue. A bipedicled pericranial flap was elevated to cover the defect between the bone graft or prosthesis and the normal cranial bone. It was transposed to the defect site and fixed using an absorbable suture. Scalp flaps were bilaterally advanced after relaxation incisions on the galea, and were closed without tension. Results All the surgical wounds were completely healed with an improved aesthetic outcome, and there were no notable complications during a mean follow-up period of seven months. Conclusions A bipedicled pericranial flap is vascularized, prompting wound healing without donor site morbidity. This may be an effective modality for treating chronic scalp ulcer accompanied by the exposure of the cranial bone after cranioplasty.

• Journal of Yeungnam Medical Science
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• 제1권1호
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• pp.13-23
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• 1984

Acute renal failure refers to a rapid reduction in renal function that usually occurs in an individual with no known previous renal disease. Development of a complication of acue renal failure in critically ill surgical patients is not unusual, and it causes high morbidity and mortality. Acute renal failure can be divided as Pre-renal (functional), Renal (organic), and Post-renal (obstructive) azotemia according to their etiologies. Early recognition and proper correction of pre-renal conditions are utter most important to prevent an organic damage of kidney. These measures include correction of dehydration, treatment of sepsis, and institution of shock therapy. Prolonged exposure to ischemia or nephrotoxin may lead a kidney to permanent parenchymal damage. A differential diagnosis between functional and organic acute renal failure may not be simple in many clinical settings. Renal functional parameters, such as $FENa^+$ or renal failure index, are may be of help in these situations for the differential diagnosis. Provocative test utilyzing mannitol, loop diuretics and renovascular dilators after restoration of renal circulation will give further benefits for diagnosis or for prevention of functional failure from leading to organic renal failure. Converting enzyme blocker, dopamine, calcium channel blocker, and propranolol are also reported to have some degree of renal protection from bioenergetic renal insults. Once diagnosis of acute tubular necrosis has been made, all measures should be utilized to maintain the patient until renal tubular regeneration occurs. Careful regulation of fluid, electrolyte, and acid-base balance is primary goal. Hyperkalemia over 6.5 mEq/l is a medical emergency and it should be corrected immediately. Various dosing schedules for medicines excreting through kidney have been suggested but none was proved safe and accurate. Therefore blood level of specific medicines better be checked before each dose, especially digoxin and Aminoglycosides. Indication for application of ultrafiltration hemofilter or dialysis may be made by individual base.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6741-6747
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• 2015

Background: Smoking is one of the most preventable causes of disease and death, including cancer, and quitting at an early age can reduce smoking-related morbidity and mortality. This study aimed to estimate the prevalence and to identify factors affecting the "intention to quit" among intermediate and secondary school current cigarette smoker students in Al Madinah city, Saudi Arabia. Materials and Methods: This study cohort included 307 current smoker students in a school-based survey. The intention to quit and its related determinants were assessed using a self-administered questionnaire. Results: More than half of the participants were ${\geq}17$ years, and of male gender (54.7%, 77.9% respectively). An intention to quit smoking was reported in 71.7% of participants, and was been significantly associated with: male gender (OR=3.25, 95% CI=1.65-6.41): age at 1st trial of smoking. 10-15 years (OR=2.11, 95% CI=1.03-4.32) along with age of ${\geq}15$ years (OR=3.10, 95% CI=1.20-7.88); days of smoking in the past 30 days (days <10 (OR=2.31, 95% CI=1.23-4.35) along with days ranging from 10-19 days (OR= 3.42, 95% CI=1.18-9.91); knowing that smoking is hazardous to health (OR=3.04, 95% CI=1.42-6.47); and finally, supporting smoking bans in public places (OR=1.89, 95% CI=1.11-3.25). Conclusions: A substantial number of participants were willing to quit smoking. Effective interventions focusing on providing information about the hazards of smoking and prohibiting smoking in public places could help initiate the intention to quit among youth smokers.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7535-7540
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• 2015

Background: Early initiation of smoking and chewing of diverse forms of tobacco among youth in India is a significant driver for tobacco epidemic in India. Several socio-demographic factors are predictors of tobacco use in populations, especially among youth. Interventions which address these socio-demographic factors can help policy makers to curb new initiations and avert morbidity and mortality due to tobacco use. Objective: To study the various sociodemographic variables associated with tobacco use among youth in India. Materials and Methods: Secondary analysis of data from the Global Adult Tobacco Survey-India 2009-10 for the age group of 15-24 years was performed and predictors of smoking and smokeless tobacco were analyzed using data on occupation, education, and other sociodemographic factors. Results: In India there are a total of 51.3 million (22.1%) youth (15-24 years) tobacco users. Of these 35.1 million consumes chewable tobacco (15.1%), 16.2 million smoke (7%) and 1.6 million are dual users (3.1%). Males, urban, less educated, un-employed and those belonging to middle class preferred smoking over chewing; whereas, females, rural, students and those belonging to low socio-economic class are predictors of smokeless tobacco use. The major determinants of dual users are male sex, poor socio-economic strata and student class. The overall tobacco use was higher among males, rural populations, lower socioeconomic strata and un-employed class. Conclusions: India's youth is more susceptible to the tobacco addiction, especially of smokeless tobacco. Youth from rural India especially students, girls and those from poor socio-economic strata prefer to use smokeless tobacco products whereas urban, male and those less educated prefer smoking tobacco products. More population-based and region-focused research is needed to understand initiation patterns into tobacco use among youth so as to inform policymakers to devise new policy measures to curb the growing epidemic.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1775-1781
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• 2014

Background: To assess the long term clinical outcome of preoperative radiotherapy with or without chemotherapy followed by limb sparing surgery in patients with non-metastatic soft tissue sarcomas (STS) of the extremities. Materials and Methods: Sixty patients with locally advanced STS were retrospectively analyzed. The median tumor diameter was 12 cm. All patients were treated with preoperative radiotherapy delivered with two different fractionation schedules (35Gy/10fr or 46-50Gy/23-25fr). Neoadjuvant chemotherapy was added to 44 patients with large and/or high grade tumors. Surgery was performed 2-6 weeks after radiotherapy. Chemotherapy was completed up to 6 courses after surgery in patients who had good responses. Results: Median follow-up time was 67 months (8-268 months). All of the patients had limb sparing surgery. The 5-year local control (LC), disease free (DFS) and overall survival (OSS) rates for all of the patients were 81%, 48.1% and 68.3% respectively. 5-year LC, DFS and cause specific survival (CSS) were 81.7%, 47%, 69.8%, and 80%, 60%, 60% in the chemoradiotherapy and radiotherapy groups, respectively. On univariate analysis, patients who were treated with hypofractionation experienced significantly superior LC, DFS and CSS rates with similar rates of late toxicity when compared with patients who were treated with conventional fractionation and statistical significance was retained on multivariate analysis. Conclusions: Treatment results are consistent with the literature. As neoadjuvant chemoradiotherapy provides effective LC and CSS with acceptable morbidity, it should be preferred for patients with large and borderline resectable STS.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4301-4306
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• 2016

Background: Cancer is a burden on humanity and ranks as a leading cause of morbidity and mortality in China. Shanxi province has its unique cancer patterns and the burden is increasing. In this study, we aimed to assess the pattern of dietary habits and life-style in Shanxi, a high-risk area for upper gastrointestinal cancers in China and further evaluate the trends in cancer incidence and mortality based on registered data. Materials and Methods: Data on lifestyle, diet, physical activity were obtained from the household health survey at Zhongyang from 2013 to 2015. Cancer diagnoses were reported to Shanxi Center for Disease Control and Prevention (SCDCP). Population-based cancer incidence data and mortality data of 2012 were collected from the SCDCP. All incidence and death rates were expressed per 100,000 populations. Univariate analysis was performed using the Chi-squared test or Fisher's exact test. Results: Overall, deficiencies in fresh fruits and vegetable food, and intake of hot food, salted food, or pickled food are serious problems in Shanxi, especially in rural areas. Upper gastrointestinal cancers were the most commonly diagnosed cancers, and the incidence in rural areas is higher than those in urban areas. Cervical cancer is the most common cancer for females. Moreover, the agespecific incidence exhibited an increased trend before 40 years old. Consistent with the previous literature, our epidemiological investigation results suggest that lifestyle, nutrition deficient, and infections were major risk factors for upper gastrointestinal cancers or cervical cancer in Shanxi. Facing a serious situation, we further explored defensible recommendations for the general public in order to promote changes in environments that support healthful eating and physical activity habits, to reduce cancer risk. Conclusions: Our results present the current cancer trends in Shanxi and its related etiologic risk factors and provide a theoretical basis to guide public health efforts to prevent and control cancers in the province.

• 대한두경부종양학회지
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• 제18권1호
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• pp.56-59
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• 2002

Background and Objective: Even though major salivary gland tumor is a rare disease, the diversity of histopathologic characteristics makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guideline of treatment. Materials and Method: Sixty-eight major salivary gland tumors and tumor-like glandular enlargements treated at Sanggye Paik Hospital during the past seven years between June, 1995 and January, 2002 are analyzed for histopathologic diagnosis, treatment modality, clinical manifestation, local control, and treatment-related morbidity, recurrence rate, retrospectively. Results: In twenty-eight patients the swellings were diagnosed as non-tumorous condition. The clinical features, diagnostic and surgical management of fourty salivary neoplasms involving the parotid and submandibular glands are correlated with their histological features. Conclusion: We have concluded that salivary gland neoplasms are needed multimodal treatment, because of their highly variable biologic behavior in each tumor type. Thirty-four cases were benign and six cases were malignant. Most of benign cases were pleomorphic adenoma and they showed wide age-distribution. In six malignant cases, there were acinic cell carcinoma, adenocarcinoma, carcinoma ex-plemorphic adenoma, myoepithelioma, and adenoid cystic carcinoma.

• 동의생리병리학회지
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• 제20권2호
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• pp.436-441
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• 2006

Rheumatoid arthritis is a chronic, systemic, and inflammatory autoimmune disorder that affects 1% of the adult population worldwide. Osteoarthritis is a multifactorial disease with high morbidity that is characterized by degradation of the matrix and destruction of articular cartilage. In this study, we examined the inhibition effect of Trachelospermi Caulis on the inflammation($TNF-{\alpha}$, $IL-1{\beta}$, NO), cartilage protection(MMP-13), and cell death in arthritis. RAW 264.7 and SW 1353 cells were cultivated in DMAE(GibcoBRL, USA) with 5% FBS and Fungizone in $37^{\circ}C$, 5% CO2. THP-1 cells were cultivated in RPMI(GibcoBRL, USA) with 5% FBS and Fungizone in $37^{\circ}C$, 5% CO2. Activity of caspase-3, XIAP, Cytochrome C in the cell was examined by using western blot. The results obtained were as Follows; Concentration of nitric oxide in Trachelospermi Caulis treatment group significantly decreased compared with that of non-treatment group (P<0.05). In treated group, Concentration of Trachelospermi Caulis was not significantly associated with cell death. Concentration of $TNF-{\alpha}$ and $IL-1{\beta}$ in Trachelospermi Caulis treatment group decreased significantly compared with that of none treatment group (P<0.05). Relative density of MMP-13 in Trachelospermi Caulis treatment group decreased significantly compared with that of none treatment group and dose-response relationship was observed. After treatment of staurosporin in SW1353 which increases cell death, in Trachelospermi Caulis treated group, the cell death was effectively decreased. In conclusion, these results suggest that Trachelospermi Caulis inhibit inflammation and cell death in arthritis. More researches about effect of Trachelospermi Caulis are considered to need.

• Parasites, Hosts and Diseases
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• 제55권5호
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• pp.533-540
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• 2017

Schistosoma mansoni is highly endemic in Tanzania and affects all age groups at different degrees. However, its control approach does not include adult individuals who are equally at risk and infected. To justify the inclusion of adult individuals in MDA programs in Tanzania, the present study focused on determining the prevalence of S. mansoni infection and its related morbidities among adult individuals. This was a cross sectional study conducted among 412 adult individuals aged 18-89 years living in selected villages of Rorya and Butiama districts located along the shoreline of the Lake Victoria. A pretested questionnaire was used to collect socio-demographic and socio-economic information of participants. Ultrasonographic examinations were conducted for all study participants using the Niamey protocol. A single stool sample was obtained from all study participants and examined for S. mansoni using the Kato-Katz technique. The study revealed a high prevalence of S. mansoni (56.3%), and the majority of infected individuals had a light intensity of infection. Ultrasonographic findings revealed that 22.4% of adult individuals had periportal fibrosis (PPF) (grade C-F), with 18.4% having grade C and D and 4% having grade E and F. Males had the highest prevalence of PPF (31.7% vs 10.8%, P<0.001). Organomegaly was common with 28.5% and 29.6% having splenomegaly and hepatomegaly, respectively. S. mansoni infection and its related morbidities included PPF, hepatomegaly, and splenomegaly were common among adult individuals. To reduce the level of transmission of S. mansoni infection, planned mass drug administration campaigns should include adult individuals living in these villages.

• Journal of Chest Surgery
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• 제39권6호
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• pp.490-494
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• 2006

말기 폐질환 환자에서 폐이식은 가장 효과적인 치료이나 원발성 이식부전은 아직도 이식 후 합병증과 사망률 증가의 주 요인이 된다. 폐기종으로 진단된 52세 남자 환자가 지속적 호흡기 치료 및 기관절개 상태에서 좌측 폐이식 수술을 시행 받았다. 본 환자는 이식술 후 발생한 원발성 이식부전으로 호흡기 발관이 불가하여 재이식이 결정되었다. 환자는 인공심폐기 하에 순차적으로 양측 폐이식 수술을 시행 받았으며 현재 퇴원하여 건강하게 일상생활을 하고 있다. 폐이식 수술 후에 발생하는 이식부전이 있으면 가급적 빠른 시일 내에 재이식 수술을 시행하는 것이 예후에 중요하다.