• Title/Summary/Keyword: Salvage

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Comparison of Clinical Outcomes in Patients Undergoing a Salvage Procedure for Thrombosed Hemodialysis Arteriovenous Grafts

  • Park, You Kyeong;Lim, Jae Woong;Choi, Chang Woo;Her, Keun;Shin, Hwa Kyun;Shinn, Sung Ho
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.500-508
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    • 2021
  • Background: The major limitation of arteriovenous graft access is the high incidence of thrombotic occlusion. This study investigated the outcomes of our salvage strategy for thrombosed hemodialysis arteriovenous grafts (including surgical thrombectomy with balloon angioplasty) and evaluated the efficacy of intragraft curettage. Methods: Salvage operations were performed for 290 thrombotic occluded arteriovenous grafts with clinical stenotic lesions from 2010 to 2018. Of these, 117 grafts received surgical thrombectomy and balloon angioplasty from 2010 to 2012 (group A), and 173 grafts received surgical thrombectomy and balloon angioplasty, with an additional salvage procedure using a curette and a graft thrombectomy catheter, from 2013 to 2018 (group B). Outcomes were described in terms of post-intervention primary patency and secondary patency rates. Results: The post-intervention primary patency rates in groups A and B were 44.2% and 66.1% at 6 months and 23.0% and 38.3% at 12 months, respectively (p=0.003). The post-intervention secondary patency rates were 87.6% and 92.6% at 6 months and 79.7% and 85.0% at 12 months, respectively (p=0.623). Multivariate Cox regression analysis demonstrated that intragraft curettage was a positive predictor of post-intervention primary patency (hazard ratio, 0.700; 95% confidence interval, 0.519-0.943; p=0.019). Conclusion: Surgical thrombectomy and balloon angioplasty showed acceptable outcomes concerning post-intervention primary and secondary patency rates. Additionally, intragraft curettage may offer better patency to salvage thrombotic occluded arteriovenous grafts with intragraft stenosis.

Clinical Characteristics of Gynecologic Cancer Patients who Respond to Salvage Treatment with Lingzhi

  • Suprasert, Prapaporn;Apichartpiyakul, Chatchawann;Sakonwasun, Choompone;Nitisuwanraksa, Pimonphan;Phuackchantuck, Rochana
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4193-4196
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    • 2014
  • Lingzhi or Ganoderma lucidum is a popular medicinal mushroom used as a health promotion herb in China and other Asian countries for thousands of years. There have many previous studies about the anti-cancer effects of lingzhi especially in vitro. The present study reports the clinical data of 5 gynecologic cancer patients who achieved stability in the disease after ingestion of lingzhi in the form of fruit body water extract and spores in a salvage setting. This report has been written to enhance the data describing the effect of lingzhi in cancer patients.

Salvage rapid maxillary expansion for the relapse of maxillary transverse expansion after Le Fort I with parasagittal osteotomy

  • Lee, Hyun-Woo;Kim, Su-Jung;Kwon, Yong-Dae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.2
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    • pp.97-101
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    • 2015
  • Maxillary transverse deficiency is one of the most common deformities among occlusal discrepancies. Typical surgical methods are segmental Le Fort I osteotomy and surgically-assisted rapid maxillary expansion (SARME). This patient underwent a parasagittal split with a Le Fort I osteotomy to correct transverse maxillary deficiency. During follow-up, early transverse relapse occurred and rapid maxillary expansion (RME) application with removal of the fixative plate on the constricted side was able to regain the dimension again. RME application may be appropriate salvage therapy for such a case.

Calculation of 4 Crane Lifting Forces for a Sunken Ship (4기 크레인에 의한 첨물 선체의 인양력 계산)

  • 이상갑
    • Journal of Ocean Engineering and Technology
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    • v.14 no.1
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    • pp.17-22
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    • 2000
  • This study focuses on a simple analytical approach to calculate crane lifting forces for a sunken ship. The method takes into account the relation of lifting forces acting in wire rope slings to the inclination of the vessel including the effect of lug positions. The importance of the sunken ship salvage is explained from the statistics of ship casualties during last 15 years. Euler angles are introduced to represent the inclination of a sunken ship in developing the static force and moment equations,. Three dimensional examples with one redundant degree of freedom for a GT1500 oil tanker are analyzed and the results show that the information obtained by the method could be useful to salvors to conduct salvage work.

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Salvage Approaches for Maintaining the Eye Globe in a Glaucomatous Patient with Severe Unilateral Exophthalmos

  • Kim, Eunjik;Yun, Sungho;Kwon, Young-Sam
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.123-125
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    • 2017
  • An eight-year-old Shih-Tzu dog was referred to Kyungpook National University Veterinary Medical Teaching Hospital because of severe glaucoma and exophthalmos. The symptoms included severe buphthalmos, conjunctival hyperemia, focal dried cornea and discomfort in the affected eye. Although enucleation was considered as a potential intervention measure in light of the severity of symptoms, it was possible to save the globe and relieve symptoms through evisceration, intraocular prosthesis implantation, and lateral canthoplasty. Our experience with this case suggests that symptomatic salvage therapy, rather than enucleation, is an appropriate approach for resolution of exopthalmos and other complications associated with glaucoma surgery.

Limb Salvage in the Treatment of the Upper Extremity Bone Tumors (상지에 발생한 악성 및 침윤성 양성골종양에 대한 사지 구제술)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Bum-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.154-163
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    • 1995
  • With the development of anticancer chemotherapy and improved radiographic imaging studies, limb salvage operation became possible in the treatment of malignant and aggressive benign tumors. High grade sarcomas of the shoulder or the upper extremity can be surgically treated with a forequarter amputation, shoulder disarticulation or limb salvage surgery such as Tikhoff-Linberg procedure, segmental resection and replacement with endoprosthesis, segmental resection and replantation, or segmental resection and free vascularized bone graft. Among them the limb salvage surgery showed not only preservation of the remained upper extremity but also the excellent functional results. When comparing amputation and limb salvage operation while performing anticancer chemotherapy in both cases, 5 year survival rate, local recurrence, and distant metastasis did not show much difference. We studied 13 cases of limb salvage for the malignant and aggressive benign bone tumor of the upper extremity from March 1986 to December 1993 at Severance hospital. The summarized results were as follows. 1. There were 21 cases of malignant bone tumors and 5 cases of benign aggressive ones. 2. Of the 26 cases of malignant and benign aggressive bone tumors, limb salvage procedures such as Tikhoff-Linberg operation(8 cases), endoprosthetic replacement(2 cases), segmental resection and replantation(2 cases), and segmental resection and free vascularized fibular graft(l case) were done in 13 cases. 3. In 13 patient on whom the limb salvage procedure was performed, there were 3 osteosarcomas, 4 chondrosarcomas, 3 giant cell tumors, 1 Ewing's sarcoma, 1 leiomyosarcoma and 1 chondroblastoma. 4. In 13 patients, there was no local recurrence nor distant metastasis except one who had a segmental resection of the entire humerus part including glenoid and then postoperative anticancer chemotherapy for the treatment of the Ewing's sarcoma of the entire shaft of the humerus with pathological fracture. Local recurrence occurred 2 years and 6 months postoperatively in this Ewing's sarcoma patient, so forequarter amputation was performed and the irradiation and the anticancer chemontherapy were performed, but multiple bony metastasis developed and died of the disease 22 months after local recurrence. 5. The patients were followed-up for I year to 7 years and 5 months(average 4 years 5 months). 6. In 8 cases in which Tikhoff-Linberg procedure was performed, the function of the hand was almost normal. 7. Segmental resection and endoprosthetic replacement was performed in 2 cases, and the function of the remained upper extremity was good with no evidence of aseptic loosening or nerve palsy. 8. In 1 case of segmental resection and free vascularized fibular graft for the patient of the chon drosarcoma in the humerus, the function of the shoulder, elbow and hand was nearly normal. 9. In I case of leiomyosarcoma which involved both forearm muscles and bone near wrist joint, segmental resection and replantation was performed, and the patient has useful hand function.

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Radiotherapy as an effective treatment modality for follicular lymphoma: a single institution experience

  • Choi, Seo Hee;Cho, Jaeho;Kim, Jin Seok;Cheong, June-Won;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.33 no.4
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    • pp.310-319
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    • 2015
  • Purpose: Follicular lymphoma (FL) is an indolent non-Hodgkin's lymphoma that is highly sensitive to radiotherapy (RT). However, the effectiveness of RT has not been well established. We reviewed our experiences to assess the role of RT for FL and analyze treatment results. Materials and Methods: Retrospective analysis was done on 29 patients who received first RT between January 2003 and August 2013. Of 23 early stage (stage I, II) patients, 16 received RT alone, four received chemotherapy followed by RT, two received RT postoperatively, and one received salvage RT for relapse after resection. Six advanced-stage (stage III, IV) patients received RT after chemotherapy: two received consolidation RT, three received salvage RT for residual lesions, and one received RT for progressive sites. Median RT dose was 30.6 Gy (range, 21.6 to 48.6 Gy). Median follow-up duration was 62 months (range, 6 to 141 months). Results: All patients showed complete response in the radiation field. Eight outfield relapses were reported. Seven patients received salvage treatment (three chemotherapy, four RT). Four patients showed excellent responses, especially to RT. Estimated 5-year and 10-year relapse-free survivals were 72% and 60%. In the RT-alone group, 5-year relapse-free survival was 74.5%. All advanced-stage patients were disease-free with 100% 5-year overall survival. Disease-specific death was noted in only one patient; four others died of other unrelated causes. No significant toxicity was reported. Conclusion: RT resulted in excellent treatment outcomes for all FL stages when used as a primary treatment modality for early stage or salvage-treatment modality for advanced-stage disease.