• Title/Summary/Keyword: Over 90 years

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Clinical Characteristics and Treatment Result of Laryngeal Cysts (후두에 발생한 낭종의 임상양상 및 치료 결과)

  • Kim, Tae-Su;Kang, Woo-Suk;Choi, Seong-Ho;Roh, Jong-Lyel;Kim, Sang-Yoon;Nam, Soon-Yuhl
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.17 no.1
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    • pp.53-55
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    • 2006
  • Background and Objectives: The purposes of this study are to find out clinical causes, clinical characteristics and treatment outcomes in relation to anatomical location of laryngeal cyst. Subjects and Method: A retrospective study of medical records was carried out for 170 patients with cysts on vocal cord, epiglottis, vallecula, arytenoid and aryepiglottic fold. Results: There were 83 cases of epiglottic cysts, 41 cases of vallecular cysts, 35 cases of intracordal cysts, 3 cases of arytenoid cysts and 2 cases of aryepiglottic cysts. Laryngeal cysts were more common in men than in women, and the ratio between men and women was 2:1. The age of patients ranged from 7 to 90 years, with their average age being 52 years. The most common symptom was voice change at intracordal cysts and globus sensation at vallecular and epiglottic cysts. The most common cause of intracordal cysts were voice abuse. But other location of laryngeal cysts doesn't have common causes. The average size of cysts was 0.3cm at vocal cord, 1.43cm at epiglottis, 1.4cm at vallecula, 0.9cm at arytenoid and 1cm at aryepiglottis. Recurrence was observed in 7 cases from 1 months to 18 months following the operation. Size of all recurred cysts was over the average. Conclusion: Physicians should be aware of changes in clinical patterns of laryngeal cysts according to location and have long follow-up period at large cysts after operation.

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Clinicopathological and p53 Gene Alteration Comparison between Young and Older Patients with Gastric Cancer

  • Karim, Sajjad
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1375-1379
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    • 2014
  • Background: Differences in clinicopathological characteristics of gastric cancer (GC) between young and older patients are controversial and a matter of debate. Determining the statistical significance of clinicopathological information with respect to age might provide clues for better management and treatment ofGC. Materials and Methods: A total ofl03 Indiao GC patients were enrolled for study and specimens were classified according to the AjCC-TNM system. Patients were grouped into two age-wise categories, young patients (<40 years; n=13) and older patients (${\geq}40$ years, n=90). The clinicopathological features of both groups were retrospectively examined and compared. p53 alterations were analyzed by polymerase chain reaction-single strand conformational polymorphism and immunohistochemistry methods at gene and protein levels respectively. The cases were considered p53 over-expressed if it was present in more than 25% of the tumor cells and p53 alterations was correlated with the clinicopathological characteristics of the patients as well as etiological factors for GC in both groups. Results: We found significant association of young patients with cancer stage (p=0.01), and very strong association with histology grade (p=0.064) and poorly differentiated (p=0.051) state of GC. However, neither young nor elderly patients showed associations with location, gender, etiological factors and p53 expression and alteration. Overall the male-to-female ratio of GC patients was 3.12 and the value was higher in the young (5.5) than in the older group (2.91). Conclusions: Clinicopathological features of GC like caocer stage, cell differentiation and histological grades were significantly different among young and old age cohorts. We observed a male predominance among the young group that decreased significantly with advancing age. More awareness of GC onset is required to detect cancer at an early stage for successful treatment.

Changes of the Plant Community Structure during the Twenty-two Years(1972~1993) in Forest of Mt. Kwanak (관악산 삼림의 22년간(1972~1993)의 식물군집구조 변화)

  • Lee, Kyong-Jae;Song, Keun-Joon;Cho, Woo
    • Journal of the Korean Institute of Landscape Architecture
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    • v.22 no.3
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    • pp.79-90
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    • 1994
  • This survey was ocnducted to investgate changes of the plant community structure from 1972 to 1993 in forest of Mt. Kwanak and thirty-five plots that the size of each plot was 10m${\times}$10m(100㎡) were set up and the vegetation analysis was caried out. By the TWINSPAN analysis, the plant community of survey area were divied into Quercus mongolica, Q. mongolica-Pinus densiflora(1), Q. mongolica-P. densiflora(2), Q. acutissima community. The successional trends of the woody species were seemed to be from P. densiflora, Sorbus alnifolia to Q. mongolica in the canopy layer. But the successional trends in the understory and shrub layer were difficult to suppose. The forest vegetation of Mt. Kwanak from 1972 to 1993 was severely decreased in species number and individuals. The sensitive species for the environmental pollution were selected, and the tolerant plants for the acid soil were increased. In comparision with the DBH class distribution from 1972 to 1993, it shows that the ecological succession has stopped. In the analysis of soil characteristics, soil acidification has taken place over last twenty-two years(from pH=5.40 to pH=4.53). The concentration of K+, Ca++ was severly decreased(from K+=0.60m.e./100g to K+=0.06m.e./100g, from Ca++=3.20m.e./100g to Ca++=0.63m.e./100g), which also could seemed to be cause of plant community decline.

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Impact of lifestyle factors on trends in lipid profiles among Korean adolescents: the Korea National Health and Nutrition Examination Surveys study, 1998 and 2010 Shin-Hye

  • Kim, Shin-Hye;Song, Young-Hwan;Park, Sangshin;Park, Mi-Jung
    • Clinical and Experimental Pediatrics
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    • v.59 no.2
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    • pp.65-73
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    • 2016
  • Purpose: Only a few studies have explored nationwide trends in lipid profiles among Asian adolescents. We aimed to assess trends in lipid profiles and the associated lifestyle factors among Korean children. Methods: We analyzed data for 2,094 adolescents who were aged 10-18 years and had participated in the Korea National Health and Nutrition Examination Surveys in 1998 and 2010. Results: During 1998-2010, the prevalence of obesity significantly increased in boys, but no changes were observed in girls. Over this period, there was a small but significant decrease in the mean lowdensity lipoprotein (LDL)-cholesterol level in boys (1998, 87.5 mg/dL; 2010, 83.6 mg/dL; P=0.019) and mean triglyceride levels in girls (1998, 90.8 mg/dL; 2010, 85.8 mg/dL; P=0.020). There were no significant changes in the prevalence of dyslipidemia in boys, but a modest decrease was noted in girls (1998, 25.1%; 2010, 18.3%; P=0.052). During the study period, the prevalence of breakfast skipping decreased, whereas that of regular exercise increased in both groups. Daily total energy intake did not change between these years. In multivariable logistic regression analyses, breakfast skipping was associated with increased risk of hyper-LDL-cholesterolemia in boys (odds ratio [OR], 5.77) and hypertriglyceridemia (OR, 2.27) in girls. Regular exercise was associated with decreased risk of hypo-HDL-cholesterolemia (OR, 0.40) in boys. Conclusion: Although the prevalence of obesity in boys increased, favorable or constant trends in lipid profiles were observed among Korean adolescents during 1998-2010. Decrease in breakfast skipping and increase in regular exercise may have contributed to these trends.

Ki-67 Labeling Indices in 'Classic' versus 'Blastoid' Mantle Cell Lymphomas - Proposed Cutoff Values for Routine Diagnostic Workup

  • Pervez, Shahid;Haroon, Saroona;Awan, Dreema
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6591-6594
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    • 2015
  • Background: Mantle-cell lymphoma (MCL) is a unique entity of peripheral B-cell lymphoma that has a discrete morphologic, immunologic, and genetic phenotype, with more common 'classic' and less frequent 'blastoid' and 'pleomorphic' variants, associated with an aggressive clinical course. The aim of this study was to analyze proliferation (Ki-67) indices of 'classic' (c-MCL) and 'blastoid' (b-MCL) variants of a cohort of MCL and to suggest cut off values for the Ki-67 proliferation index in these two subsets. Materials and Methods: MCL cases diagnosed over $4{\frac{1}{2}}$ years at Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi were retrieved and reviewed. Ki-67 labelling was scored and analysed. Results: A total of 90 of cases of MCL were scrutinized. Mean age ${\pm}SD$ was $60.2{\pm}12.5$ years and the male to female ratio was 4:1, with 67 (75%) cases of c-MCL and 23 (25%) cases of b-MCL. Most samples were lymph node biopsies (n=68), whereas the remainder were from various extranodal sites The mean Ki-67 proliferation index was $29.5%{\pm}14.4%$ in classic variants and $64.4{\pm}15.2%$ for the blastoid variant, the difference being statistically significant (p = 0.029). Conclusions: It was concluded that differential cut-off values of Ki-67 labeling may be used in more objective way to reliably classify MCL into classic or blastoid variants by diagnostic pathologists. We propose a < 40 proliferative index to be suggestive of c-MCL and one of > 50 for the blastoid variant.

Sternoclavicular Joint Infection: Classification of Resection Defects and Reconstructive Algorithm

  • Joethy, Janna;Lim, Chong Hee;Koong, Heng Nung;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • v.39 no.6
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    • pp.643-648
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    • 2012
  • Background Aggressive treatment of sternoclavicular joint (SCJ) infection involves systemic antibiotics, surgical drainage and resection if indicated. The purpose of this paper is to describe a classification of post resectional SCJ defects and highlight our reconstructive algorithm. Defects were classified into A, where closure was possible often with the aid of topical negative pressure dressing; B, where parts of the manubrium, calvicular head, and first rib were excised; and C, where both clavicular, first ribs and most of the manubrium were resected. Methods Twelve patients (age range, 42 to 72 years) over the last 8 years underwent reconstruction after SCJ infection. There was 1 case of a type A defect, 10 type B defects, and 1 type C defect. Reconstruction was performed using the pectoralis major flap in 6 cases (50%), the latissimus dorsi flap in 4 cases (33%), secondary closure in 1 case and; the latissimus and the rectus flap in 1 case. Results All wounds healed uneventfully with no flap failure. Nine patients had good shoulder motion. Three patients with extensive clavicular resection had restricted shoulder abduction and were unable to abduct their arm past $90^{\circ}$. Internal and external rotation were not affected. Conclusions We highlight our reconstructive algorithm which is summarised as follows: for an isolated type B SCJ defect we recommend the ipsilateral pectoralis major muscle for closure. For a type C bilateral defect, we suggest the latissimum dorsi flap. In cases of extensive infection where the thoracoacromial and internal mammary vessels are thrombosed, the pectoralis major and rectus abdominus cannot be used; and the latissimus dorsi flap is chosen.

Surgical Experience of Left Main Coronary Disease (좌주간 관상동맥질환의 외과적 치료)

  • Hong, J.M.;Chae, H.;Rho, J.R.
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1362-1368
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    • 1992
  • Between March 1986 and November 1992, thirty-one patients with left main coronary artery stenosis[LMCAS, over 50% of cross sectional area] were revascularized at Seoul National University Hospital. The incidence of LMCAS was 20.8%[31/149]. The male:female ratio was 15:16. Age ranged from 39 to 70 years, with a mean age of 51 years. The anginal syndrome was composed of 23 unstable, 6 stable and 2 post-infarction angina preoperatively. There were sixteen isolated LMCAS, four ostial stenosis and eleven combined distal and /or right coronary artery stenosis. The degree of LMCAS was 50-74% in 21 patients[67.7%], 75-89% in one[3.6%] and 90-99% in 9[29.1%]. There was no case with 100% obstruction. Of the total patients with LMCAS, 11 patients received 4 distal anastomoses, another 11 patients had 3 distal anastomoses, and 8 patients needed 2 distal anastomoses. The overall operative mortality was 12.9%[4 /31], and the incidence of which was higher than the remaing group [6.8%, 8/118]. The causes of death were myocardial infarction[2 patients], ventricular arrhythmia[1 patient] and brain damage[1 patient]. All patients have been followed-up for average 28.9 months[1-76 months]. There was no late death. But one patients experinced anginal recurrence. In conclusion, making allowance for its notorious clinical results and relatively higher incidence in Korea, aggressive surgical techniques such as retrograce myocardial perfusion may be mandatory while we are in a learning phase.

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Outcomes of Non-Metastatic Gestational Trophoblastic Neoplasia: Twelve Year Experience from a Northern Thailand Tertiary Care Center

  • Suprasert, Prapaporn;Manopunya, Manatsawee
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5913-5916
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    • 2015
  • Gestational trophoblastic neoplasia (GTN) is the malignant form of gestational trophoblastic disease. In non-metastatic GTN, the outcomes of treatment are impressive with methotrexate (MTX) or actinomycin D. We retrospectively reviewed the outcomes of non-metastatic GTN treated at our center from January, 1999 to December, 2013. One hundred and nine patients were recruited to the study. The median age was 33.1 years and over 90% were referral cases. Abnormal vaginal symptoms developed in 37.6% while 56.4% were asymptomatic. The most common antecedent pregnancy was a complete mole (92.7%) with the median interval time from antecedent pregnancy to GTN development being 2.0 months. The median pretreatment B-hCG was 5,624 mIu/ml. The most common first line treatment was methotrexate (MTX) and folinic acid (91.7%) followed by weekly MTX (4.6%), etoposide+ MTX+actinomycin D (EMA) (2.8%), and actinomycin D (0.9%), with the median number of cycles at 5.0. The positive response to first line chemotherapy was 73.8%. The patients were given subsequent chemotherapeutic regimens after resistance to the first line therapy and showed a final remission rate of 89.9%.The significant factor that was frequently found in patients who were non-responders to the first line treatment was a hysterectomy procedure. Two patients developed lung metastasis and brain metastasis at one and four years after the first treatment, respectively. In conclusion, the outcomes of non-metastatic GTN were excellent. However, the patients need long term follow up due to the possibility of developing multiple organ metastases.

Epidemiology of severe trauma patients treated by plastic surgeons: A 7-year study at a single regional trauma center in South Korea

  • Jung, Joo Sung;Kang, Dong Hee;Lim, Nam Kyu
    • Archives of Plastic Surgery
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    • v.47 no.3
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    • pp.223-227
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    • 2020
  • Background After the laws regulating emergency medicine were amended in 2012, regional trauma centers were established in South Korea. Plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds. The objective of this study was to evaluate the role of the plastic surgery department in treating severe trauma patients. Methods From January 2012 to December 2018, we enrolled 366 severe trauma patients with an Injury Severity Score (ISS) over 15 who received treatment by specialists in the plastic surgery department. Of these patients, 298 (81.4%) were male, and their mean age was 51.35 years (range, 6-91 years). The average ISS was 22.01 points (range, 16-75 points). Results The most common diagnosis was facial trauma (95.1%), and facial bone fracture (65.9%) was most common injury within this subgroup. Patients were referred to 1.8 departments on average, with the neurosurgery department accounting for a high proportion of collaborations (37.0%). The most common cause of trauma was traffic accidents (62.3%), and the average length of stay in the general ward and intensive care unit was 36.90 and 8.01 days, respectively. Most patients were discharged home (62.0%) without additional transfer or readmission. Conclusions Through this study, we scoped out the role of the specialty of plastic surgery in the multidisciplinary team at regional trauma centers. These results may have implications for trauma system planning.

Long-term evaluation of autotransplanted third molars (제 3대구치를 이용한 자가치아이식술의 장기적 예후 관찰)

  • Shin, Dong-Seok;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.39 no.4
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    • pp.431-435
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    • 2009
  • Purpose: The purpose of this study is to evaluate the long term clinical and radiographic outcome and stability after transplantation of third molar with complete root formation. Methods: The subjects were 31 teeth (male 17, female 14, aged 22-55, average 39.9 yr old) of 31 patients who visited the department of periodontics and passed more than two years after autotransplantation procedure and still under regular check up. Modified success criteria of Chamberlin and Goerig was applied to determine the success of autotransplantation. Results: Three out of 31 teeth failed and resulted 90.3% of success rate. When compared according to sex, 15 out of 17 teeth had succeeded in male, 13 out of 14 succeeded in female. When compared the success rate according to cause of extraction, tooth loss due to caries and root fracture had all succeeded but 3 out of 24 had failed in tooth loss due to periodontal disease. When compared according to donor teeth, 12 out of 14 maxillary third molars and 16 out of 17 mandibular third molars had succeeded. Conclusions: In long term evaluation over two years, if appropriate surgical procedure and proper case selection is made, autotransplantation of the third molar with complete root formation can be the alternative choice that substitutes prosthetic or implant treatment and it is a functionally acceptable procedure.