• Title/Summary/Keyword: Non-surgical

Search Result 1,337, Processing Time 0.034 seconds

Aggressive Treatment of Performance Status 1 and 2 HCC Patients Significantly Improves Survival - an Egyptian Retrospective Cohort Study of 524 Cases

  • Aziz, Ashraf Omar Abdel;Omran, Dalia;Nabeel, Mohamed Mahmoud;Elbaz, Tamer Mahmoud;Abdelmaksoud, Ahmed Hosni;Attar, Inas El;Shousha, Hend Ibrahim
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.5
    • /
    • pp.2539-2543
    • /
    • 2016
  • Background: In the Barcelona Clinic Liver Cancer (BCLC) system, only sorafenib is suggested for HCC patients having performance status (PS) 1 or 2 even if they have treatable lesions. In the current study, we aimed to explore the outcome of using aggressive treatment for HCC patients with PS 1 and 2. Materials and Methods: Five hundred and twenty four patients with HCC were enrolled in this study and divided into 2 groups: 404 PS 1 and 120 PS 2. Of the included 524 patients, 136 recceived non-aggressive supportive treatment and sorafenib, while 388 patients were offered aggressive treatment in the form of surgical resection, transplantation, percutaneous ablation, trans-arterial chemoembolization and/or chemoperfusion. All the patients were followed up for a period of 2 years to determine their survival. Results: Most HCC patients were CHILD A and B grades (89.4% versus 85.0%, for PS1 and PS2, respectively). Patients with PS1 were significantly younger. Out of the enrolled 524 patients, 388 were offered aggressive treatment, 253 (65.2%) having their lesions fully ablated, 94 (24.2%) undergoing partial ablation and 41 patients with no ablation (10.6%). The median survival of the patients with PS 1 who were offered aggressive treatment was 20 months versus 9 months only for those who were offered supportive treatment and sorafenib (p<0.001). Regarding HCC patients with PS 2, the median survivals were similarly 19.7 months versus 8.7 months only (p<0.001). Conclusions: Aggressive treatment of HCC patients with PS 1 and 2 significantly improves their survival. Revising the BCLC guidelines regarding such patients is recommended.

CASE REPORT : A NASOPALATINE DUCT CYST IN 9-YEAR-OLD CHILD (9세 소아에서 나타난 비구개낭의 치험례)

  • Lee, Sang-Ho;Mo, Kyung-Hee;Park, Jong-Whi;Lee, Nan-Young;Lee, Chang-Seop;Yoon, Jung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.30 no.3
    • /
    • pp.483-488
    • /
    • 2003
  • Nasopalatine duct cyst(NPDC) is the most common non-odontogenic cyst in the oral area and is thought to be originated from the epithelial remnants of the nasopalatine duct. Many etiologic factors have been proposed for the NPDC; trauma to the region during mastication or from ill fitting dentures, bacterial infection, and spontaneous proliferation of tissue. The majority of cases are seen between the ages of 40th and 60th and it is rare in children. Surgical enucleation is the recommended treatment for NPDC, usually under general anaesthesia. A 9-year-old boy was refered to the chosun university pedodontics clinic that this child who has anterior palatal swelling is in routine check. In this case, swelling was presented at the bottom of the anterior nasal cavity as well as in the labial aspect of the upper alveolar ridge. It was so large that we treated it by marsupialization and obturator was put. This patient is on the continuous observation. We treated the child who had NPDC by marsupialization, and got the successful results such as rapid bone regeneration and the consistency of incisor vitality.

  • PDF

Development of the Greenbottle Blowfly, Lucilia sericata, under Different Temperatures (온도별 구리금파리(Lucilia sericata)의 발육)

  • Kim, Hyeon-Cheol;Kim, Soo-Jung;Yun, Ji-Eun;Jo, Tae-Ho;Choi, Byeong-Reol;Park, Chung-Gyoo
    • Korean journal of applied entomology
    • /
    • v.46 no.1 s.145
    • /
    • pp.141-145
    • /
    • 2007
  • Maggot therapy (MT) has been re-introduced for non-healing wounds such as pressure sore, diabetic and necrotic ulcers, as well as infected surgical wounds, burn, and trauma injuries since early 1990s. For the production of sterile maggot of proper developmental stage, Lucilia sericata were studied on developmental periods of immature stages on liver agar medium under six different temperatures such as 15.4, 20.6, 22.5, 26.2, 29.1, and $33.0^{\circ}C$, and adult longevity and egg Production under $29^{\circ}C$. The periods of eggs and larvae of the 1st and the 2nd instars were shortest at $33^{\circ}C$ by 9.0, 14.0 and 18.6 hours, respectively. The periods of the 3rd instar larvae and pupae were shortest at $29.1^{\circ}C$ by 285.0 and 171.0 hours, respectively. Developmental zero point and total effective temperature far the development of each stage were calculated based on the developmental periods. Adults of both female and male lived more than one month. Females laid an average of 338.5 eggs through 2.7 times of egg laying throughout her lifetime.

SIALOLITHIASIS ON THE MOUTH FLOOR IN A CHILD (소아의 구강저에 발생한 타석증)

  • Lee, Hyo-Seol;Choi, Byung-Jai;Choi, Hyung-Jun;Kim, Seong-Oh;Son, Heung-Kyu;Song, Je-Seon;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.36 no.1
    • /
    • pp.114-118
    • /
    • 2009
  • Sialolithiasis is the formation of calcific concretions within the ductal system of major or minor salivary glands. The submandibular gland is most involved because of its high viscosity of the saliva and the long, curved duct. It may occur at any age but, it is most common in middle-aged adults and rare in childhood. Clinical symptoms in sialolithiasis are variable but, swelling is the most common, followed by the pain. Clinical examination and radiographic examination(panoramic and mandibular occlusal radiographs, sialography, intraoral-, extraoral- ultrasound, CT scan, MRI and sialoendoscopy) can help to confirm a diagnosis and localize a stone. The treatment is surgical intervention, either removal of the sialolith or sialoadenectomy. However, non-invasive techniques including shock-wave lithotripsy, $CO_2$ laser and endoscopic treatment used in selected cases. A 5-Year-old girl referred from private practice for evaluation of a yellowish mass on the floor of the mouth. She complained that it had became three times bigger than four months ago when it was found for the first time and she had some pain on submandibular gland area occasionally. On physical examination, a firm and yellowish mass could be seen at the orifice of the submandibular duct. Diagnosis is the submandibular sialolithiasis in the anterior Wharton`s duct. Under local anesthesia, stone was removed.

  • PDF

Improved Hypophysectomy Technique by Sublaryngeal A, pp.oach and the Efficacy of bGH in Hypophysectomized Female Rats (흰쥐에서 후두하경로를 통한 하수체 적출술의 개량과 하수체 적출 흰쥐를 이용한 bGH 효능시험)

  • 정영채;김창근;이종완;나광빈;김광식;박선애;유영아;이세영
    • Korean Journal of Animal Reproduction
    • /
    • v.21 no.2
    • /
    • pp.197-205
    • /
    • 1997
  • Improved hypophysectomy technique and the efficacy of bGH in hypophysectomized female rats were studied as a basis for the function of endocrine gland and hormones. 1. With improved sublaryngeal a, pp.oach by hypophysectomy, 34 rats out of 40 were successfully hypophysectomized(more than 80% of success). The surgical time for hypophysectomy per rat was taken about 3.0$\pm$1.0 min. 2. For the effect of hypophysectomy and bGH on body weight gain among the 5 gruops of A, B, C, D, and E, the weight gains for A, B, C, D, and E, were 93g, 9.2g, 10.7g, 25.1g and 36.2g, respectively, which implied that hypophysectomy had a major effect on body weight. And also, the effect of bGH was paralleled with the level of bGH. There were significant difference between control and hypophysectomized groups, and between the bGH treated and bGH non-treated groups after hypophysectomy(p<0.01). 3. For the effect of hypophysectomy and bGH on the length of femur, tibia, humerus, and anterbrachi, longest was for A, shortest for B, and longer in order of C, D, and E. The A group was significantly longer than B, C, D, and E groups. The B group was shorter than C, D, and E groups(p<0.01). 4. For the effect of hypophysectomy and bGH on the weight of femur, tibia, humerus, and antebrachi, heaviest was for A, lightest for B, and heavier in order of C, D, and E. The A group was significantly heavier than B, C, D, and E groups. The B group was lighter than C, D, and E groups(p<0.01). 5. In changes of body length, and weights of liver and heart, A group was most drastically increased. Among the hypophysectomized groups, the change was increased in order of B, C, D, and E. Especially, the change of A group was significantly greater than B, C, D and E gruops. However, no significant differences were found among B, C, D, and E groups. 6. The hypophysectomy in rat had a significant effect on body growth. The effect of hormone was remarkably different depending upon the level of hormone. It was found that 300$\mu\textrm{g}$ of bGH/kg of body wt/day was slightly lower for normal growth.

  • PDF

Embryo Recovery by Direct Embryo Collection (DEC) in Korean Native Cattle (Hanwoo) (Direct Embryo Collection(DEC)에 의한 한우의 수정란 채란)

  • Yoo, Han-Jun;Lee, Yong-Seung;Park, Joung-Jun;Kim, Ki-Won;Park, Choon-Keun
    • Journal of Embryo Transfer
    • /
    • v.26 no.3
    • /
    • pp.153-158
    • /
    • 2011
  • This study was performed in order to simplify the operation and minimize stress of donor and be readily available in the field with low cost and high quality embryos using the Direct Embryo Collection (DEC). Donors, at random stages of the estrous cycle, received a CIDR. 7 days later, 200 mg FSH was treated with 40, 30, 20, 10 mg FSH levels in declining doses twice daily by intramuscular injection for 4 days. On the 3rd day administration of FSH, 25 mg $PGF_2{\alpha}$ was administered and CIDR was withdrawn. After FSH injections were complete, donors were artificially inseminated twice at 12 hr intervals. The donor cattle received 250 ${\mu}g$ GnRH at time of 1 st insemination and embryos were recovered 8 days after the 1st insemination. Embryo collection from superovulated donors was performed to flushing by non-surgical methods of 3-way, 2-way and DEC (l-way). The average number of recovered embryos were 11.25${\pm}$0.63, 12.5${\pm}$0.65 and 11.75${\pm}$0.48 from operations of 3-way, 2-way and DEC methods, respectively. There were no significant differences among the embryo collection methods. Also, The average number of transferable embryos were 6.25${\pm}$0.48, 7.25${\pm}$0.48 and 7.25${\pm}$0.63 from each embryo collection procedures. The number of transferable embryos was no differences among the 3-way, 2-way and DEC methods, respectively. Meanwhile, the ratio of transferable embryos for all recovered embryos from DEC methods was higher as 61.7 % than 55.6 %, 58 % from methods of 3-way, 2-way. And the flushing solution required for recovering embryos by DEC method was significantly lower as 0.28${\pm}$0.32 1 than 1.8${\pm}$0.12 1, 1.75${\pm}$0.10 1 from 3-way, 2-way methods (p<0.05). Also, the time required for recovering embryos by DEC methods was significantly lower as 27${\pm}$2 min than 51${\pm}$3, 45${\pm}$2 min, respectively (p<0.05). In conclusion, these results suggest that DEC method for embryo collection may be effectively used for production of in vivo embryos using less flushing solution and, it might be effectively available in the field compared to conventional embryo recovery methods using 3-way or 2-way balloon catheter.

Arthroscopic Removal of Large Cartilage Fragment in a Dog with Osteochondritis Dissecans of Shoulder Joint

  • Park, Se-Jin;Lee, Seung-Yong;Kim, Jung-Hoon;Seok, Seong-Hoon;Park, Tae-Yeong;Kim, Hyun-Jin;Kim, Jun-Min;Lee, Hee-Chun;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
    • /
    • v.33 no.3
    • /
    • pp.172-175
    • /
    • 2016
  • An 11-month-old, 19.5 kg, intact male Border collie was referred with intermittent left forelimb lameness to the Gyeongsang Animal Medical Center. The symptom was first discovered about 6 months ago, and it has gotten worse for the last 10 days with non-weight bearing on the left forelimb. During the physical examination, the patient showed painful reaction when the left shoulder was abducted. On radiographic assessment, a radiolucent line and some osteophytes were found in both humeral heads. Based on patient's clinical signs and radiographic findings, osteochondritis dissecans (OCD) was very suspicious. So, we decided to perform an arthroscopic surgery on left shoulder for definitive diagnosis and treatment because the right forelimb revealed no clinical signs. During arthroscopic technique, we found a large OCD flap on the caudo-central area of humeral head, and observed severe synovitis over a wide range on posterior area of the articular capsule. The large OCD flap was removed by a grasping forceps, and many joint mice were removed either. Curettage was performed using a curette on the articular surface until hemorrhage occurred, and articular capsule flushed with a lactated-ringer's solution. The patient was discharged on the same day without any specific abnormal status. Antibiotic, anti-inflammatory and analgesic drugs were administered. Mild lameness on left forelimb was observed in 2 weeks after surgery, but after 4 weeks, the patient showed complete normal gait without any lameness. Although surgical removal of OCD flap with arthroscopic was previously reported, We would like note that a large OCD flap can also be removed by arthroscopic surgery in this report.

Comparison of Two Techniques on Titanium Clip Application for Ovariohysterectomy in Bitches (개의 난소자궁적출술에 있어서 티타늄클립의 두 가지 적용방법에 대한 비교)

  • Park, Jin-Seok;Kang, Hyun-Gu;Kim, Ill-Hwa
    • Journal of Veterinary Clinics
    • /
    • v.28 no.6
    • /
    • pp.566-570
    • /
    • 2011
  • The objective of this study was to assess the complications of titanium clip application after ovariohysterectomy (OHE) and find the proper surgical technique to minimize the complications by comparing the ligation method of ovarian pedicle. Six female beagle dogs were used for this study and they were divided randomly into two groups by ligation techniques: ligation and non-ligation of the suspensory ligament of ovary including ovarian pedicle. To evaluate the difference between two techniques, the location and embedded pattern of applied clips in the abdominal cavity were identified through radiographic tests and autopsy. Hematology tests were also performed to check the existence of inflammation by applied clips and all tests were carried out monthly for 1 year. There were few changes in location of clips of both groups on X-ray views without any migration. Almost all values in hematology of two groups were within the normal range and there were no inflammatory symptoms. All of applied clips in two groups were found near the kidney, but the embedded forms of them showed slight differences. The clips ligating suspensory ligament and ovarian pedicle were located in deep place and thickly surrounded with thin layers of peritoneum. But the clips ligating only ovarian pedicle were found with ease on surface of layer and located in lower place compared with the clips ligating suspensory ligament. These results indicate that the suspensory ligament holds applied clips and minimizes the movement of them. Therefore, ligation of suspensory ligament would be the preferred technique in titanium clip application for OHE.

Surgical Repair of Coxofemoral Joint Luxation in a Wild Black-Crowned Night Heron (Nycticorax nycticorax) (야생 검은댕기해오라기에서 대퇴관절 탈골의 수술적 교정)

  • Kim, Eun-Ju;Lee, Jong-Hyun;Kim, Min-Su;Lee, Ki-Chang;Kim, Nam-Soo;Shin, Gee-Wook;Lee, Hae-Beom
    • Journal of Veterinary Clinics
    • /
    • v.30 no.1
    • /
    • pp.49-52
    • /
    • 2013
  • A wild black-crowned night heron (Nycticorax nycticorax) with dehydration and a non-weight bearing lameness of the left leg was rescued. On physical examination, the left knee was displaced laterally at almost a $90^{\circ}$ angle with firm swelling and crepitus in the area of the coxofemoral joint. Radiographs confirmed cranio-dorsal coxofemoral luxation. A closed reduction attempt failed. The coxofemoral joint luxation was reduced surgically by placement of the femoral neck next to the pelvis with a suture. Ten days after surgery, radiographs and computed tomography showed the femoral neck and head were positioned well within the acetabulum. At 20 days, the bird was using the affected limb normally, and could hunt and forage for food in a rehabilitation housing unit with a small pond. The bird was successfully released into the wild. The placement of the femoral neck adjacent to the pelvis with a suture can be successfully performed for cases of avian coxofemoral joint luxation. Furthermore, this procedure can provide sufficient stabilization of the coxofemoral joint and acceptable limb function.

Needle Thoracoscopic Sympathectomy for Essential Hyperhidrosis (2 mm 흉강내시경을 이용한 흉부교감신경 절제술)

  • 이두연;윤용한;홍윤주;문동석
    • Journal of Chest Surgery
    • /
    • v.31 no.6
    • /
    • pp.598-603
    • /
    • 1998
  • Excessive sweating of the palms, axillae, and face has a strong negative impact on the quality of life for many people. The existing non-operative therapeutic options seldom give sufficient relief and have a transient effect. But a definitive cure can be obtained by upper thoracic sympathectomy. From June 1997 to October 1997, 117 cases of the needle (2 mm) thoracoscopic thoracic sympathectomies were performed in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center Yong-dong Severance Hospital in Seoul, Korea. We have followed up on 94 cases which include palmar hyperhidrosis (n=85), facial hyperhidrosis(n=5) and axillary hyperhidrosis(n=4). There were 42 males and 52 females whose ages ranged from 14 to 63 years(median:23 years). The T2 ganglia and T3-4 ganglia were excised by electrocuting with a hook and endoscissors and were removed for histologic examination. There have been no mortalities or life-threatening complications. The surgical results were classified as excellent(much improvement,very dry) in 93.6%, good(some improvement, minimally wet) in 2.1%, and fair(slight improvement, still wet) in 4.2%. Five patients(5.3%) required closed thoracostomy drainage because of pneumothorax in the immediate postoperative day. Horner's syndrome occurred in one case. The compensatory sweating occurred in 67 cases(71.2%) and was embarrassing in 21 cases(22.3%) and disabling in 9 cases(9.6%) of these cases. Primary failure occurred in one case. The patient with primary failure underwent successful operation. Fifty-one patients had concomitant hyperhidrosis. Our experiences indicate needle thoracoscopic sympathectomy is a very effective, safe, and time- saving procedure for essential hyperhidrosis.

  • PDF