• 제목/요약/키워드: Primary Medical Center

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십이지장 폐쇄를 동반한 선천성 식도 폐쇄에 대한 고찰 (Clinical Experience with Esophageal Atresia Combined with Duodenal Atresia)

  • 이유미;남소현;김대연;김성철;김인구
    • Advances in pediatric surgery
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    • 제14권1호
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    • pp.21-26
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    • 2008
  • There is significant morbidity and mortality associated with the combination of esophageal atresia (EA) and duodenal atresia (DA). Nevertheless, the management protocol for the combined anomalies is not well defined. The aim of this study is to review our experience with the combined anomalies of EA and DA. From May 1989 to August 2006, seven neonates were diagnosed as EA with DA at Asan Medical Center. In all cases, the type of EA was proximal EA and distal tracheoesophageal fistula (TEF). The diagnosis of DA was made in theprenatal period in 1, at birth in 4, 4 days after birth in 1 (2 days after EA repair) and at postmortem autopsy in 1. Except the one case where DA was missed initially, primary simultaneous repair was attempted. DA repair with gastrostomy followed by EA repair in 2, EA repair followed by DA repair without gastrostomy in 2, and TEF ligation followed by DA repair with gastrostomy in 1. There were two deaths. One baby had a large posterolateral diaphragmatic hernia, and operative repair was not attempted. The other infant who had a TEF ligation and DA repair with gastrostomy expired from cardiac failure due to a large patent ductus arteriosus. Simultaneous repair of EA and DA appears to be an acceptable management approach for the combined anomalies, but more experience would be required for the selection of the primary repair of both anomalies.

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RNA Editing Enzyme ADAR1 Suppresses the Mobility of Cancer Cells via ARPIN

  • Min Ji Park;Eunji Jeong;Eun Ji Lee;Hyeon Ji Choi;Bo Hyun Moon;Keunsoo Kang;Suhwan Chang
    • Molecules and Cells
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    • 제46권6호
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    • pp.351-359
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    • 2023
  • Deamination of adenine or cytosine in RNA, called RNA editing, is a constitutively active and common modification. The primary role of RNA editing is tagging RNA right after its synthesis so that the endogenous RNA is recognized as self and distinguished from exogenous RNA, such as viral RNA. In addition to this primary function, the direct or indirect effects on gene expression can be utilized in cancer where a high level of RNA editing activity persists. This report identified actin-related protein 2/3 complex inhibitor (ARPIN) as a target of ADAR1 in breast cancer cells. Our comparative RNA sequencing analysis in MCF7 cells revealed that the expression of ARPIN was decreased upon ADAR1 depletion with altered editing on its 3'UTR. However, the expression changes of ARPIN were not dependent on 3'UTR editing but relied on three microRNAs acting on ARPIN. As a result, we found that the migration and invasion of cancer cells were profoundly increased by ADAR1 depletion, and this cellular phenotype was reversed by the exogenous ARPIN expression. Altogether, our data suggest that ADAR1 suppresses breast cancer cell mobility via the upregulation of ARPIN.

인공심장판막 실패에 대한 재치환술의 임상적 고찰 (Clinical Analysis of Reoperations on Prosthetic Valve Failur)

  • 최병철;유환국;안욱수;허용;김병열;이정호;유회성
    • Journal of Chest Surgery
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    • 제24권7호
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    • pp.663-668
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    • 1991
  • To evaluate risks, complications and mortality of reoperations on heart valve prosthesis, we reviewed clinical records of 53 patients who underwent reoperation because of prosthetic valve failure[PVF], from Jan 1959 through Jun. 1991. They had undergone 48 mitral, 10 aortic valve rereplacement Primary tissue failure was the main cause of reoperation : it occurred in 51 valves at a mean postoperative interval of 58 months. Calcification and collagen disruption of prosthesis were main causes of primary tissue failure in macro and micropathology, In 3 failing mechanical prostheses, paravalvular leak was in 2 cases, another one case had the thrombi at the hinge portion. If conditions such as emergency operation with or without endocarditis, thromboembolism and advanced NYHA functional class are prevented, we think that reoperative valve replacement has similar morbidity and mortality to initial valve replacement surgery. But our sturdy represents higher mortality [22.6%] because of late surgical intervention failing the prevention of conditions leading to myocardial damage. In conclusion if the tearing, calcification, and a new murmur were detected the early reoperation should be considered to increase late survival.

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Influence of Band and Loop Type Space Maintainer on Intraoral Scanning Accuracy of an Adjacent Tooth

  • Ju Ri Ye;Yong Kwon Chae;Ko Eun Lee;Hyo-Seol Lee;Sung Chul Choi;Ok Hyung Nam
    • Journal of Korean Dental Science
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    • 제16권2호
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    • pp.149-155
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    • 2023
  • Purpose: The purpose of this study was to evaluate whether the presence of a space maintainer affects the accuracy of an intraoral scanner. Materials and Methods: The maxillary primary first molar typodont tooth was removed from the primary dentition typodont model and a band and loop type space maintainer was delivered. After the model was connected to a dental phantom, intraoral scan was performed using TRIOS 4 (3Shape A/S, Copenhagen, Denmark). The scan was repeated with the same technique without the space maintainer. Each scan was performed 10 times. All scan files into a GOM inspect 2018 software and evaluated the accuracy. The accuracy was evaluated on trueness and precision, and calculated using the root mean square value. Result: When there was a space maintainer in the oral cavity, the trueness value was 0.10±0.02 mm and the precision value was 0.15±0.03 mm. In the absence of the space maintainer, the trueness value was 0.12±0.03 mm and the precision value was 0.16±0.04 mm. There were no significant differences depending on the presence of a space maintainer (P>0.05). Conclusion: Within the limits of this study, the accuracy of the intraoral scanner was not influenced by the presence of space maintainer.

Aggressive clinical course of extramammary Paget disease after radiotherapy

  • Choi, Yunseon;Park, Won;Lee, Jeeyun;Cho, Eun Yoon;Moon, Goo-Hyun
    • Radiation Oncology Journal
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    • 제32권2호
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    • pp.95-98
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    • 2014
  • Extramammary Paget disease (EMPD) is a rare disease, especially in Asian populations. Surgical resection is considered the primary treatment option. Recently, radiotherapy has been suggested as an EMPD treatment, either as an alternative to surgical resection or in combination with surgical resection. This report reviewed a patient with EMPD who was treated with wide excision of the EMPD site followed by radiotherapy for remaining gross lymph node metastases. The aim of this report was to determine the optimal treatment for advanced EMPD.

Surgical outcomes of sternal rigid plate fixation from 2005 to 2016 using the American College of Surgeons-National Surgical Quality Improvement Program database

  • Tran, Bao Ngoc N.;Chen, Austin D.;Granoff, Melisa D.;Johnson, Anna Rose;Kamali, Parisa;Singhal, Dhruv;Lee, Bernard T.;Fukudome, Eugene Y.
    • Archives of Plastic Surgery
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    • 제46권4호
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    • pp.336-343
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    • 2019
  • Background Sternal rigid plate fixation (RPF) has been adopted in recent years in high-risk cases to reduce complications associated with steel wire cerclage, the traditional approach to sternal closure. While sternal RPF has been associated with lower complication rates than wire cerclage, it has its own complication profile that requires evaluation, necessitating a critical examination from a national perspective. This study will report the outcomes and associated risk factors of sternal RPF using a national database. Methods Patients undergoing sternal RPF from 2005 to 2016 in the American College of Surgeons-National Surgical Quality Improvement Program were identified. Demographics, perioperative information, and complication rates were reviewed. Logistic regression analysis was performed to identify risk factors for postoperative complications. Results There were 381 patient cases of RPF identified. The most common complications included bleeding (28.9%), mechanical ventilation >48 hours (16.5%), and reoperation/readmission (15.2%). Top risk factors for complications included dyspnea (odds ratio [OR], 2.672; P<0.001), nonelective procedure (OR, 2.164; P=0.010), congestive heart failure (OR, 2.152; P=0.048), open wound (OR, 1.977; P=0.024), and operating time (OR, 1.005; P<0.001). Conclusions Sternal RPF is associated with increased rates of three primary complications: blood loss requiring transfusion, ventilation >48 hours, and reoperation/readmission, each of which affected over 15% of the study population. Smokers remain at an increased risk for surgical site infection and sternal dehiscence despite RPF's purported benefit to minimize these outcomes. Complications of primary versus delayed sternal RPF are roughly equivalent, but individual patients may perform better with one versus the other based on identified risk factors.

One Stage Reconstruction of Skull Exposed by Burn Injury Using a Tissue Expansion Technique

  • Cho, Jae-Young;Jang, Young-Chul;Hur, Gi-Yeun;Koh, Jang-Hyu;Seo, Dong-Kook;Lee, Jong-Wook;Choi, Jai-Koo
    • Archives of Plastic Surgery
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    • 제39권2호
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    • pp.118-123
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    • 2012
  • Background : An area of the skull exposed by burn injury has been covered by various methods including local flap, skin graft, or free flap surgery. Each method has disadvantages, such as postoperative alopecia or donor site morbidities. Due to the risk of osteomyelitis in the injured skull during the expansion period, tissue expansion was excluded from primary reconstruction. However, successful primary reconstruction was possible in burned skull by tissue expansion. Methods : From January 2000 to 2011, tissue expansion surgery was performed on 10 patients who had sustained electrical burn injuries. In the 3 initial cases, removal of the injured part of the skull and a bone graft was performed. In the latter 7 cases, the injured skull tissue was preserved and covered with a scalp flap directly to obtain natural bone healing and bone remodeling. Results : The mean age of patients was $49.9{\pm}12.2$ years, with 8 male and 2 female. The size of the burn wound was an average of $119.6{\pm}36.7cm^2$. The mean expansion duration was $65.5{\pm}5.6$ days, and the inflation volume was an average of $615{\pm}197.6mL$. Mean defect size was $122.2{\pm}34.9cm^2$. The complications including infection, hematoma, and the exposure of the expander were observed in 4 cases. Nonetheless, only 1 case required revision. Conclusions : Successful coverage was performed by tissue expansion surgery in burned skull primarily and no secondary reconstruction was needed. Although the risks of osteomyelitis during the expansion period were present, constant coverage of the injured skull and active wound treatment helped successful primary reconstruction of burned skull by tissue expansion.

Expression and Activity of the Na-K ATPase in Ischemic Injury of Primary Cultured Astrocytes

  • Kim, Mi Jung;Hur, Jinyoung;Ham, In-Hye;Yang, Hye Jin;Kim, Younghoon;Park, Seungjoon;Cho, Young-Wuk
    • The Korean Journal of Physiology and Pharmacology
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    • 제17권4호
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    • pp.275-281
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    • 2013
  • Astrocytes are reported to have critical functions in ischemic brain injury including protective effects against ischemia-induced neuronal dysfunction. Na-K ATPase maintains ionic gradients in astrocytes and is suggested as an indicator of ischemic injury in glial cells. Here, we examined the role of the Na-K ATPase in the pathologic process of ischemic injury of primary cultured astrocytes. Chemical ischemia was induced by sodium azide and glucose deprivation. Lactate dehydrogenase assays showed that the cytotoxic effect of chemical ischemia on astrocytes began to appear at 2 h of ischemia. The expression of Na-K ATPase ${\alpha}1$ subunit protein was increased at 2 h of chemical ischemia and was decreased at 6 h of ischemia, whereas the expression of ${\alpha}1$ subunit mRNA was not changed by chemical ischemia. Na-K ATPase activity was time-dependently decreased at 1, 3, and 6 h of chemical ischemia, whereas the enzyme activity was temporarily recovered to the control value at 2 h of chemical ischemia. Cytotoxicity at 2 h of chemical ischemia was significantly blocked by reoxygenation for 24 h following ischemia. Reoxygenation following chemical ischemia for 1 h significantly increased the activity of the Na-K ATPase, while reoxygenation following ischemia for 2 h slightly decreased the enzyme activity. These results suggest that the critical time for ischemia-induced cytotoxicity of astrocytes might be 2 h after the initiation of ischemic insult and that the increase in the expression and activity of the Na-K ATPase might play a protective role during ischemic injury of astrocytes.

A rare case of primary ovarian mesenchymal chondrosarcoma in pregnancy

  • Sepideh Azizi;Elena Ghotbi;Setare Nassiri
    • Clinical and Experimental Reproductive Medicine
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    • 제49권4호
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    • pp.285-288
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    • 2022
  • Mesenchymal chondrosarcoma is a rare tumor that is more common in young people; it is an uncommon type of chondrosarcoma with a poor prognosis. In two-thirds of cases, it affects the bone, especially the spine. However, parts of the body other than the skeletal system are occasionally involved. These rarer types have a worse prognosis, with a high likelihood of metastasis and death. Due to the possible misdiagnosis of mesenchymal chondrosarcoma, the integrated use of imaging, immunohistochemistry, and pathology can be helpful.

Primary Extra Nodal Non Hodgkin Lymphoma: A 5 Year Retrospective Analysis

  • Padhi, Somanath;Paul, Tara Roshni;Challa, Sundaram;Prayaga, Aruna K.;Rajappa, Senthil;Raghunadharao, D.;Sarangi, Rajlaxmi
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권10호
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    • pp.4889-4895
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    • 2012
  • Background and Aim: The incidence of extra nodal non Hodgkin lymphoma (ENL) is rising throughout the world. However, data regarding ENL as a group is limited. The aim was to study the epidemiological and histomorphological trends of primary ENL (pENL) in India. Material and Methods: The biopsy materials from sixty eight patients with pENL (45 male, 23 female, M:F= 1.9:1), diagnosed over a five year period (2005-2009), were analysed and pathologically reclassified according to the World Health Organization (WHO) classification, 2008 criteria. Results: Primary extra nodal non Hodgkin lymphomas constituted 22.0% (68/308) of all non Hodgkin lymphomas (NHL). The mean age at presentation for pENL and primary nodal NHL was 43 years and 58 years, respectively with a male predilection (M: F=2:1). Central nervous system (CNS) constituted the most common extranodal site (20/68, 29.5%) followed by gastrointestinal tract (17/68, 25%), and nose/nasopharynx (8/68, 11.8%). Diffuse large B-cell lymphoma (DLBCL, not otherwise specified), extranodal marginal lymphoma of mucosa associated lymphoid tissue (MALT) type, and B cell NHL unclassified (U) were the three most common histological types observed. T-cell phenotype was rarely noted (4%). Follicular lymphomas and anaplastic large cell lymphoma, seen among nodal NHL, were absent at extra nodal sites. Majority (41/68, 60%) of the patients with pENL were immunocompetent and 55% were in stage I-II with favorable prognosis. Conclusion: Central nervous system was the most common site of ENL, followed by gastrointestinal tract. Majority of pENL occurred in immunocompetent hosts with a favorable prognosis.