• Title/Summary/Keyword: Stage IV

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AN EFFECT OF HYALURONIC ACID ON THE TEMPOROMANDIBULAR JOINT ARTHROCENTESIS (악관절강내 천자술시 히알루산(Hyaluronic acid) 사용에 대한 임상적 연구)

  • Yeo, Hwan-Ho;Kwon, Byong-Gon;Kim, Jae-Seung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.4
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    • pp.388-394
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    • 1999
  • To compare the effect of hyaluronate and dexamethasone on the temporomandibular joint arthrocentesis the author investigated 22 temporomandibular joint disorder(TMD) patients with pain and limitation of mouth opening who visited at the Department of Oral and Maxillofacial Surgery. Chosun Dental Hospital and were made a diagnosis as Wilkes stage III or IV of TMJ internal derangement clinically and radiographically. The two groups consisted of 10 patients with injection of sodium hyaluronate 10mg$(Artz^{(R)})$(hyaluronate group) on the upper joint space of the affected temporomandibular joint 5 times at intervals of a week after arthrocentesis, and 12 patients with injection of dexamethasone$(Oradexon^{(R)})$ at a time(dexamethasone group). Maximum mouth opening, pain value and satisfaction value during mastication were assessed on a visual analog scale before arthrocentesis and after 6 months. Then the within-group and between-group differences were evaluated in the obtained data and the clinical success rate of each group was calculated according to our success criteria. The results were as follows. 1. the mean of maximum mouth opening before arthrocentesis and after 6 months in the hyaluronate group were 24.9mm and 39.0mm respectively, and those before arthrocentesis and after 6 months in the dexamethasone group were 25.7mm and 41.3mm respectively. 2. The mean of pain value on a visual analog scale in the hyaluronate group before arthrocentesis and after 6 months were 6.7 and 1.8 respectively, and those in the dexamethasone group before arthrocentesis and after 6 months were 7.0 and 1.8 respectively. 3. The mean of satisfaction value during mastication on a visual analog scale in the hyaluronate group before arthrocentesis and after 6 months were 2.8 and 7.7 respectively, and those in the dexamethasone group before arthrocentesis and after 6 months were 3.1 and 7.8 respectively. 4. There were statistically significant differences between all measurements before arthrocentesis and after 6 months(P<0.001), but no difference between all measurements in the hyaluronate group and those in the dexamethasone group. 5. The over all success rate of the hyaluronate group and the dexamethasone group were 60.0% and 63.6% respectively. In summary, there was significant difference between the effect of hyaluronate and dexamethasone on the temporomandibular joint arthrocentesis but hyaluronate is better than corticosteroid as the injection drug in consideration of the side effect related with repeated injection.

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Value Chain System and Management of Cultural Contents Industry in Daegu (대구 문화콘텐츠산업의 가치사슬 체계와 경영 특성)

  • Park, Kyung-Sook;Lee, Chul-Woo
    • Journal of the Korean association of regional geographers
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    • v.13 no.2
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    • pp.171-186
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    • 2007
  • This paper was to examine the existing foundation of cultural contents industry through analyzing the development process, the location pattern, and the value chain system and the management of cultural contents industry in Daegu. Most cultural contents industry in Daegu had less than ten employees: so, it was classified into the early stage of commercialization. The firms that dealt with on-line distribution were recently founded. The high portion of the finns was located in the center of city such as Jung-Gu and Nam-Gu in which the Center for Digital Industry Promotion of Daegu (DIP) is located. The value main system consisted of four nodes such as creation node, production node, marketing node and distribution node. The production node was played the most important role. Based on value chain system, the cultural contents industry firms in Daegu could be divided into four types: Type I is a contents production firm with a single value chain in the cultural contents industry. Type II is a contents production firm with two or three value chains. Type III is a contents production firm with comprehensive value chain. Type IV is a non contents production firm with multiple value chains.

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Treatment of Stomach Cancer Involving Esophagogastric Junction (식도-위 경계부위를 침범한 위암의 치료)

  • 이종목;백희종;박종호;임수빈;조재일
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.930-936
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    • 2001
  • Background: The origin site of carcinoma invading esophagogastric junction is variable. It may arise from squamous cell carcinoma of low esophagus, adenocarcinoma arising from Barrett's esophagus, adenocarcinoma of gastric cardia, or extension from proximal stomach cancer. In Korea, the majority of adenocarcinoma invading esophago-gastric junction seems to arise from proximal gastric carcinoma. Material and Method: We reviewed the data of surgically-resected gastric adenocarcinoma involving esophagogastric junction in KCCH between 1988 and 1999. Result: There were 212 cases. Male to female ratio was 156 to 56. Age distribution was between 22 and 78. Variable surgical approaches including median laparotomy, laparotomy with left or right thoracotomy, left thoracotomy, and thoracoabdominal approach were used. Postoperative pathologic stages were : Stage IA-7, IB-11, Ⅱ-25, ⅢA-73, ⅢB-34, and Ⅳ-57. Curative resection was performed in 199 patients, and total gastrectomy was performed in 200 patients. There were 77.4%(164 cases) with esophageal involvement, 74.1%(157 cases) with tumor involvement in the abdominal LN, and 8%(17 cases) with mediastinal LN metastasis. Operative mortality was 3.3%, and over-all 5 year survival rate was 35%. Conclusion: There are various surgical approaches and many things to consider for surgical resection, thoracic and abdominal approach may need for obtain proper resection margin and adequate lymph node dissection in stomach cancer invading esophagogastric junction.

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Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in Gastric Cancer Patients with Peritoneal Metastasis (PM): Results of a Single-Center Experience and Register Study

  • Gockel, Ines;Jansen-Winkeln, Boris;Haase, Linda;Rhode, Philipp;Mehdorn, Matthias;Niebisch, Stefan;Moulla, Yusef;Lyros, Orestis;Lordick, Florian;Schierle, Katrin;Wittekind, Christian;Thieme, Rene
    • Journal of Gastric Cancer
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    • v.18 no.4
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    • pp.379-391
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    • 2018
  • Purpose: Gastric cancer (GC) patients with peritoneal metastasis (PM) have poor prognosis. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) in combination with systemic chemotherapy is a novel treatment option for patients in stage IV of the disease. Materials and Methods: Between November 2015 and June 2018, prospective data collection was performed in 24 patients with GC and PM (median age, 57; range, 44-75 years). These patients underwent 46 PIPAC procedures with a median number of 2 interventions per patient (range, 1-6). A laparoscopic access was used and a combined therapy of cisplatin and doxorubicin aerosol was administered. Results: The median peritoneal carcinomatosis index before the 1st PIPAC was 14 (range, 2-36), and the median ascites volume in patients before the 1st PIPAC was 100 mL (range, 0-6 mL, 300 mL). Eleven patients, who received 2 or more PIPAC procedures, had decreased and stable volumes of ascites, while only 3 patients displayed increasing volume of ascites. The median overall survival was 121 days (range, 66-625 days) after the 1st PIPAC procedure, while 8 patients who received more than 3 PIPAC procedures had a median survival of 450 days (range, 206-481 days) (P=0.0376). Conclusions: Our data show that PIPAC is safe and well tolerated, and that the production of ascites can be controlled by PIPAC in GC patients. Patients, who received 2 or more PIPAC procedures, reported a stable overall quality of life. Further studies are required to document the significance of PIPAC as a palliative multimodal therapy.

Clinical Characteristics of Korean Patients with Lung Cancer Who Have Programmed Death-Ligand 1 Expression

  • Park, Ha-Young;Oh, In-Jae;Kho, Bo Gun;Kim, Tae-Ok;Shin, Hong-Joon;Park, Cheol Kyu;Kwon, Yong-Soo;Kim, Yu-Il;Lim, Sung-Chul;Kim, Young-Chul;Choi, Yoo-Duk
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.3
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    • pp.227-233
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    • 2019
  • Background: Programmed death-ligand 1 (PD-L1), a transmembrane protein, binds to the programmed death-1 (PD-1) receptor, and anti-PD-1 therapy enables immune responses against tumors. This study aimed to assess clinical characteristics of PD-L1 expression using immunohistochemistry among Korean patients with lung cancer. Methods: We retrospectively reviewed the data of patients with pathologically proven lung cancer from a single institution. PD-L1 expression determined by Tumor Proportion Score (TPS) was detected using 22C3 pharmDx (Agilent Technologies) and SP263 (Ventana Medical Systems) assays. Results: From July 2016 to July 2017, 267 patients were enrolled. The main histologic type was adenocarcinoma (69.3%). Most participants were smokers (67.4%) and had clinical stage IV disease (60.7%). In total, 116 (42%) and 58 (21%) patients had TPS ${\geq}1%$ and ${\geq}50%$, respectively. The patients were significantly older in TPS ${\geq}1%$ group than in TPS <1% group ($64.83{\pm}9.38years$ vs. $61.73{\pm}10.78years$, p=0.014), not in TPS ${\geq}50%$ cutoff value ($64.69{\pm}9.39$ vs. $62.36{\pm}10.51$, p=0.178). Regarding histologic grade, higher proportions of poorly differentiated tumor were observed in the TPS ${\geq}1%$ (40.8% vs. 25.8%, p=0.020) and TPS ${\geq}50%$ groups (53.2% vs. 27.2%, p=0.004). Among 34 patients examined with 22C3 and SP263 assays, 27 had positive results in both assays, with a cutoff of TPS ${\geq}1%$ (r=0.826; 95% confidence interval, 0.736-0.916). Conclusion: PD-L1 expression, defined as TPS ${\geq}1%$, was related to older age and poorly differentiated histology. There was a similar distribution of PD-L1 expression in both 22C3 and SP263 results.

Revisiting Archical Appraisal Theories for their Application to Community Archives (공동체 아카이브를 위한 기록평가론의 재조명)

  • Seol, Moon-Won;Kim, Young
    • The Korean Journal of Archival Studies
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    • no.48
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    • pp.210-252
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    • 2016
  • Community creates, receives and preserves the records, which made the community members and the entire society remember their history. As for community archives, archival appraisal is very political activity because appraisal of community records means whose memory remain alive in history. This study aims to analyze archival appraisal theories from the perspective of community and community archives, and suggest appraisal model for community archives. This study begins with examining the meaning of community archives and appraisal related issues including; i) community identity and independence of archives, ii) struggle of memory and multiple narratives, iii) uniqueness of each community and its archives, and iv) community archives as memory process and social inclusion. At the next stage, it deals with the archival theories from Schellenberg's archival values theory to macro-appraisal, to investigate possible application of theories for community records appraisal. It finds that the societal approach of macro-appraisal have advantage to appraise the community records. This study finally suggests the appraisal model for community archives by modifying the macro-appraisal components as well as by complying the principles of community archives. The model consists of the purpose and object of appraisal, principle and basis of valuation, and cooperation model between mainstream repository and community.

A Delphi Study for Constructing a Suicide Prevention Protocol for Male Baby Boomers (베이비붐세대 남성의 자살 예방 프로토콜 구성을 위한 델파이 연구)

  • Kim, Hee-SooK;Shin, Eun-Jeong;Kim, Gab-Yeon
    • Journal of Internet of Things and Convergence
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    • v.7 no.1
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    • pp.43-54
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    • 2021
  • Purpose: The purpose of this study was to construct a protocol for the prevention of suicide in male baby boomers. Methods: In order to construct the protocol, a three-step expert consensus process was carried out. The first step was to compose questions based on various research data. For this purpose, two professors of psychiatric mental health nursing and two advanced practitioner nurse of psychiatric mental health in the composition. The second step was to conduct the first Delphi survey on expert panelists. The survey period was from October 13, 2015 to November 1, 2015. The third stage, the second Delphi investigation was conducted from November 10 to December 4, 2015. Results: As a result of the survey, a total of 7 areas of protocol configuration items were derived. The derived items include the characteristics of male baby boomers, suicidal signs, suicide risk factors, suicide protection factors, suicide measurement tools, related organizations, and mental health promotion programs. Conclusion: This study can be used as a guideline when intervening suicide prevention of male baby boomers in community mental health centers.

Nucleomodulin BspJ as an effector promotes the colonization of Brucella abortus in the host

  • Ma, Zhongchen;Yu, Shuifa;Cheng, Kejian;Miao, Yuhe;Xu, Yimei;Hu, Ruirui;Zheng, Wei;Yi, Jihai;Zhang, Huan;Li, Ruirui;Li, Zhiqiang;Wang, Yong;Chen, Chuangfu
    • Journal of Veterinary Science
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    • v.23 no.1
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    • pp.8.1-8.15
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    • 2022
  • Background: Brucella infection induces brucellosis, a zoonotic disease. The intracellular circulation process and virulence of Brucella mainly depend on its type IV secretion system (T4SS) expressing secretory effectors. Secreted protein BspJ is a nucleomodulin of Brucella that invades the host cell nucleus. BspJ mediates host energy synthesis and apoptosis through interaction with proteins. However, the mechanism of BspJ as it affects the intracellular survival of Brucella remains to be clarified. Objectives: To verify the functions of nucleomodulin BspJ in Brucella's intracellular infection cycles. Methods: Constructed Brucella abortus BspJ gene deletion strain (B. abortus ∆BspJ) and complement strain (B. abortus pBspJ) and studied their roles in the proliferation of Brucella both in vivo and in vitro. Results: BspJ gene deletion reduced the survival and intracellular proliferation of Brucella at the replicating Brucella-containing vacuoles (rBCV) stage. Compared with the parent strain, the colonization ability of the bacteria in mice was significantly reduced, causing less inflammatory infiltration and pathological damage. We also found that the knockout of BspJ altered the secretion of cytokines (interleukin [IL]-6, IL-1β, IL-10, tumor necrosis factor-α, interferon-γ) in host cells and in mice to affect the intracellular survival of Brucella. Conclusions: BspJ is extremely important for the circulatory proliferation of Brucella in the host, and it may be involved in a previously unknown mechanism of Brucella's intracellular survival.

A Case of Partial Response with Trastuzumab Based Treatment in Advanced Gastric Cancer with Multiple Metastasis (다발성 전이가 동반된 위암 환자에서 Trastuzumab 치료로 부분 관해를 보인 1례)

  • Seo Hee Lee;Hyun Yong Jeong;Hee Seok Moon;Jae Kyu Sung;Sun Hyun Kang;Ju Seok Kim
    • Journal of Digestive Cancer Research
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    • v.5 no.2
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    • pp.125-129
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    • 2017
  • A 38-year-old man presented with abdominal discomfort and was diagnosed as type 3 advanced gastric cancer with multiple liver and lung metastases (Stage IV). Endoscopic forcep biopsy revealed moderately differentiated adenocarcinoma, which stained positive HER2 (Human epidermal growth factor receptor) on immunohistochemistry. We started chemotherapy with FP (5-Fluorouracil plus Cisplatin) plus trastuzumab. After 6 cycles of FP plus trastuzumab chemotherapy, there were partial response in the liver, lung and lymph nodes metastasis. Especially, metastatic lung lesions showed remarkable improvement. Chemotherapy with FP plus trastuzamab was effective for HER2 positive advanced cancer with multiple liver and lung metastases. Through active research on target therapy about advanced gastric cancer, we expect to improve the survival rate and quality of life of patients with advanced gastric cancer who can not undergo curative resection.

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Full mouth rehabilitation using 3D printed crowns and implant assisted removable partial denture for a crossed occlusion: a case report (3D 프린팅 금관과 임플란트 보조 국소의치를 이용한 엇갈린 교합의 전악 수복 증례)

  • Sung-Hoon Lee;Seong-Kyun Kim;Seong-Joo Heo;Jai-Young Koak;Ji-Man Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.367-378
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    • 2023
  • With the recent development of computer-aided design-computer-aided manufacturing technology and 3D printing technology, and the introduction of various digital techniques, the accuracy and efficiency of top-down definitive prosthetic restoration are increasing. In this clinical case, stable occlusion support was obtained through the placement of a total of 9 maxillary and mandibular posterior implants in patient with anterior-posterior crossed occlusion. The edentulous area of the maxillary anterior teeth, which showed a tendency of high resorption of the residual alveolar bone, was restored with a Kennedy Class IV implant assisted removable partial denture to restore soft tissue esthetics. Computed tomography guided surgery was used to place implants in the planned position, double scan technique was used to reflect the stabilized occlusion in the interim restoration stage to the definitive prostheses, and metal 3D printing was used to manufacture the coping and framework. This clinical case reports that efficient and predictable top-down full mouth rehabilitation was achieved using various digital technologies and techniques.