• Title/Summary/Keyword: Inoperable

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Successful Conversion Arterial Switch Operation after Palliative Senning Operation (고식적 심방 전환술 후 시행한 전환 대혈관 치환술)

  • Kim Joon Bum;Park Jeong-Jun;Chung Sung Ho;Park In Sook;Seo Dong Man
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.140-144
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    • 2006
  • Six year-old female having TGA, VSD with severe PHT which was considered inoperable for anatomical correction, received palliative Senning procedure. During follow-up, she was given prostacyclin and at the age of 21, she received Senning takedown, arterial switch and VSD closure after a reevaluation of the hemodynamic status. Significant reduction in PHT was found and she is doing well without complication 3 months after the operation.

Comparative Study of the Effects of the Retrocrural Celiac Plexus Block Versus Splanchnic Nerve Block, C-arm Guided, for Upper Gastrointestinal Tract Tumors on Pain Relief and the Quality of Life at a Six-month Follow Up

  • Shwita, Amera H.;Amr, Yasser Mohamed.;Okab, Mohammad I.
    • The Korean Journal of Pain
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    • v.28 no.1
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    • pp.22-31
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    • 2015
  • Background: The celiac plexus and splanchnic nerves are targets for neurolytic blocks for pain relief from pain caused by upper gastrointestinal tumors. Therefore, we investigated the analgesic effect of a celiac plexus block versus a splanchnic nerve block and the effects of these blocks on the quality of life six months post-intervention for patients with upper GIT tumors. Methods: Seventy-nine patients with inoperable upper GIT tumors and with severe uncontrolled visceral pain were randomized into two groups. These were Group I, for whom a celiac plexus block was used with a bilateral needle retrocrural technique, and Group II, for whom a splanchnic nerve block with a bilateral needle technique was used. The visual analogue scale for pain (0 to 100), the quality of life via the QLQ-C30 questionnaire, and survival rates were assessed. Results: Pain scores were comparable in both groups in the first week after the block. Significantly more patients retained good analgesia with tramadol in the splanchnic group from 16 weeks onwards (P = 0.005, 0.001, 0.005, 0.001, 0.01). Social and cognitive scales improved significantly from the second week onwards in the splanchnic group. Survival of both groups was comparable. Conclusions: The results of this study demonstrate that the efficacy of the splanchnic nerve block technique appears to be clinically comparable to a celiac block. All statistically significant differences are of little clinical value.

Metastatic Cervical Lvrnphadenopathy from Uterine Leiornyosarcorna with Good Local Response to Radiotherapy and Chemotherapy (자궁 평활근육종의 경부림프절 전이와 방사선치료 및 화학요법에의 반응)

  • Oh Yoon Kyeong;Park Hee Chul;Kee Keun Hong;Jeon Ho Jong;Park You Hwan;Chung Choon Hai
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.309-313
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    • 2000
  • The metastasis of uterine leiornyosarcorna to the neck node has not been reported previously and the radiotherapy has been rarely used for the metastatic lesion of the other sites. We report a case of neck metastasis from a uterine leiornyosarcorna, which developed 10 months after surgery and postoperative pelvic radiotherapy. It also involved the parapharyngeal space, adjacent spine, and spinal canal. The metastatic neck mass was inoperable, and was treated by neck radiotherapy (6,000 cGy) and chemotherapy including taxol and carboplatin. The mass has regressed progressively to a nearly impalpable state. She has never developed spinal cord compression syndrome, and has maintained good swallowing for eight months since the neck radiotherapy and chemotherapy. Since the extensive metastatic neck mass showed good local response to high dose radiotherapy and chemotherapy, both treatments may be considered for an unresectable metastatic leiornyosarcorna.

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Curative Resection of Inoperable, Locally Advanced Gastric Cancer after Neoadjuvant Chemotherapy with Taxotere and Cisplatin (절제 불가능한 국소 진행성 위암 환자에서 Taxotere 및 Cisplatin을 이용한 선행 화학 요법제의 투여 후 근치적 절제가 가능했던 2예)

  • Lee, Han-Hong;Hur, Hoon;Chae, Byung-Joo;Kim, Wook;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.57-64
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    • 2005
  • At diagnosis, the majority of patients with gastric cancer are found to have local invasion or distant organ metastasis, even though the sole measure for a complete cure is a curative resection. A curative resection is hardly applicable for those with invasion and metastasis; thus, trials with neoadjuvant chemotherapy for downstaging the cancer should be considered. Docetaxel is a semisynthetic taxane that promotes tubulin polymerization and inhibits microtubule depolymerization. In recent studies, many metastatic gastric cancers were treated using neoadjuvant chemotherapy with docetaxel, and the response rates were reported. We report here two cases of locally advanced, non-resectable gastric cancer that were candidates for a curative resection after induction chemotherapy with docetaxel and cisplatin.

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The Response of Parenchymal Mass and Airway Obstruction from Lung Cancer to Radiation Therapy (단순 흉부 X-선 사진상 폐암 소견에 대한 방사선 치료의 효과 -단기 추적 조사를 중심으로-)

  • Kang, Cheol-Hoon;Shin, Sei-One;Kim, Myung-Se
    • Radiation Oncology Journal
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    • v.7 no.2
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    • pp.227-233
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    • 1989
  • From April 1986 to Dec 1988, fifty one patients with carcinoma of lung were treated by radiation therapy in Department of Therapeutic Radiology, Yeungnam University Hospital Of the 51 patients, $31(61\%)$ were squamous cell ca, $8(15.7\%)$ were small cell ca, and remained $4(7.9\%)$ were other cell types. Total radiation dose was average $64Gy (60\~75 Gy)$ for group A and 45Gy $(40\~59Gy)$ for group B. The mass regression and the response of airway obstruction to radiation therapy was established on the basis of follow up chest X-ray. The mass regression above $50\%$ of total volume was noted in 23 patients $(74.2\%)$ among 31 patients and the difference between two groups was not seen. In squamous cell ca, however, the mass regression rate (above $50\%$ of total volume) was $83.3\%$ (10/12) in group A compared to $50\%$ (3/6) in group B(p<0.05). The alleviation of airway obstruction was noted as follows. In group A, CR $42.9\%$, PR $35.7\%$, no response $21.4\%$ and in group B, CR $55.6\%,\;PR\;33.3\%$, no response $11.1\%$. But, in squamous cell ca, responsiveness is higher than group B. The study indicates that the importance of higher radiation dose in the management of primary tumor mass and airway obstruction caused by lung cancer especially squamous cell ca. So, meticulous treatment planning and multimodality combination therapy without increasing si.do elect or complication is recommended in management of inoperable bronchogenic carcinoma.

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A Case of Locally Invasive and Recurred Papillary Thyroid Carcinoma Metastatizing to Cervical Lymphatic Chains and Mediastinum (광범위한 국소재발 및 경부, 종격동 전이를 동반한 유두상 갑상선암 1례)

  • Choi Hong-Shik;Lee Ju-Hyoung;Kim Jae-Won;Yang Hae-Dong
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.62-68
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    • 1997
  • The papillary carcinoma is the most common malignant neoplasm of thyroid gland and the prognosis is better than anyother type of thyroid carcinoma. However, the thyroid is closed to the important organs such as esophagus, trachea and larynx, there are some possibilities to invade these organs. In case of advanced disease, not only surrounding structures but also mediastinum and cervical lymphatic chain can be involved or distant metastasis develops frequently. Therefore in these cases the prognosis is worse and the rate of inoperable case is more than those of non-metastatic group. Generally, the treatment modality for papillary thyroid carcinoma consists of surgery, postoperative thyroid hormone and radioiodine therapy. If the tumor invades surrounding structures, cervical lymph node or mediastinum, total thyroidectomy and wide excision of tumor invaded area including mediastinal dissection and neck dissection is necessary. Recently, the authors have experienced a case of locally invasive and recurred papillary thyroid carcinoma without treatment for 7 years. The patient was performed previously thyroid lobectomy and isthmusectomy 13 years ago. We had determinded surgical therapy for this patient and performed mass excision with overlying skin, completion total thyroidectomy, right type I modified radical neck dissection, left lateral neck dissection, thoracotomy with supramediastinal dissection, shaving of diffusely involved trachea and skin defect reconstruction with pectoralis major myocutaneous flap. After operation 2 cycles of radioiodine therapy were taken. Now the patient is following up at the outpatient base and no evidence of disease state for postoperative 16 months. So we report on this case with a brief review of literature.

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Verbal Violence Type in Operating Room Nurses, Fusion Study on Emotional Response and Coping (수술실 간호사의 언어폭력유형, 정서적 반응과 대처에 대한 융합연구)

  • Oh, Suk-Hee;Sun, Jeong-Ju;Kang, Hee-Sun
    • Journal of Convergence for Information Technology
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    • v.9 no.8
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    • pp.53-62
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    • 2019
  • This study is a descriptive study to investigate the relationship between verbal violence type, emotional response and coping in the operating room nurse. The subjects of the study were 400 nurses working in 20 general hospitals and 372 nurses in the operating room. As a result of the analysis, it was found that the perpetrators of the verbal violence experienced by the subject were physicians, direct supervisors, and more than half of the subjects were considering the transition. The most frequent cases of language violence were when the equipment was inoperable or not used during surgery, There were significant differences in verbal violence experience according to marriage, clinical career, and work style. Language violence emotional response showed significant difference with gender, position and coping, age, academic background, clinical career, and position. There was a significant correlation between experience of verbal violence and emotional response, emotional response and coping. Therefore, the results of this study will contribute to the development of coping strategies and prevention education programs.

Long-Term Wildfire Reconstruction: In Need of Focused and Dedicated Pre-Planning Efforts

  • Harris, William S.;Choi, Jin Ouk;Lim, Jaewon;Lee, Yong-Cheol
    • International conference on construction engineering and project management
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    • 2022.06a
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    • pp.923-928
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    • 2022
  • Wildfire disasters in the United States impact lives and livelihoods by destroying private homes, businesses, community facilities, and infrastructure. Disaster victims suffer from damaged houses, inadequate shelters, inoperable civil infrastructure, and homelessness coupled with long-term recovery and reconstruction processes. Cities and their neighboring communities require an enormous commitment for a full recovery for as long as disaster recovery processes last. State, county, and municipal governments inherently have the responsibility to establish and provide governance and public services for the benefit and well being of community members. Municipal governments' comprehensive and emergency response plans are the artifacts of planning efforts that guide accomplishing those duties. Typically these plans include preparation and response to natural disasters, including wildfires. The standard wildfire planning includes and outlines (1) a wildfire hazard assessment, (2) response approaches to prevent human injury and minimize damage to physical property, and (3) near- and long-term recovery and reconstruction efforts. There is often a high level of detail in the assessment section, but the level of detail and specificity significantly lessons to general approaches in the long-term recovery subsection. This paper aims to document the extent of wildfire preparedness at the county level in general, focusing on the long-term recovery subsections of municipal plans. Based on the identified challenges, the researchers provide recommendations for better longer-term recovery and reconstruction opportunities: 1) building permit requirements, 2) exploration of the use of modular construction, 3) address through relief from legislative requirements, and 4) early, simple, funding, and the aid application process.

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Current Status of the Diagnosis and Management of Pancreatic Neuroendocrine Tumors in Japan

  • Tetsuhide Ito;Masami Miki;Keijiro Ueda;Lingaku Lee;Ken Kawabe;Hisato Igarashi;Nao Fujimori;Kazuhiko Nakamura;Kohei Yasunaga;Robert T. Jensen;Takao Ohtsuka;Yoshihiro Ogawa
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.51-57
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    • 2016
  • The epidemiology of pancreatic neuroendocrine neoplasms (PNENs) in Asia has been clarified through epidemiological studies, including one conducted in Japan, and subsequently another in South Korea. As endoscopic ultrasonography (EUS) has become more widely accessible, endoscopic ultrasound-fine needle aspiration (EUS-FNA) has been performed in pancreatic tumors for which the clinical course was only monitored previously. This has enabled accurate diagnosis of pancreatic tumors based on the 2010 WHO classification; as a result, the number of patients with an accurate diagnosis has increased. Although surgery has been the standard therapy for PNENs, new treatment options have become available in Japan for the treatment of advanced or inoperable PNENs; of particular note is the recent introduction of molecular target drugs (such as everolimus and sunitinib) and streptozocin. Treatment for progressive PNENs needs to be selected for each patient with consideration of the performance status, degree of tumor differentiation, tumor mass, and proliferation rate. Somatostatin receptor (SSTR)-2 is expressed in many patients with neuroendocrine tumor. Somatostatin receptor scintigraphy (SRS), which can visualize SSTR-2 expression, has been approved in Japan. The SRS will be a useful diagnostic tool for locating neuroendocrine neoplasms, detecting distant metastasis, and evaluating therapy outcomes. In this manuscript, we review the latest diagnostic methods and treatments for PNENs.

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Application of Radiofrequency Ablation to Thyroid Cancer: Past, Present, and Future (갑상선암에 대한 고주파 절제 적용의 과거, 현재, 그리고 미래)

  • Ji-hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.999-1008
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    • 2023
  • Thyroid cancer, characterized by high incidence rates, good prognosis, and frequent recurrence, is typically treated surgically. However, since the early 2000s, radiofrequency ablation, which is commonly utilized in liver, lung, and kidney cancers, is being performed for management of primary and recurrent thyroid cancers. Many studies have focused on inoperable cases of low-risk papillary microcarcinoma (≤ 1 cm) and some have investigated its role in larger lesions (up to 4 cm). Overall, these studies have reported positive results. Radiofrequency ablation for recurrent cancer has primarily been performed for locally recurrent cervical cancer, and this therapeutic approach has been attempted for treatment of distant metastases in lungs and bones, with encouraging outcomes. A growing global trend, particularly in South Korea, the United States, and Europe supports radiofrequency ablation for thyroid cancer. However, this therapy is currently not recognized as a treatment option recommended by universally accepted clinical guidelines such as those established by the National Comprehensive Cancer Network. Based on past efforts and future research, radiofrequency ablation is expected to play a key role in thyroid cancer treatment in the near future.