• Title/Summary/Keyword: Surgery alone

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Epidemiologic Study of Frostbites and Its Current Managements in Community Hospital (지역 병원에서 동상 환자에 대한 역학에 관한 연구 및 최근 치료)

  • Kim, Dong Chul;Min, Byung Duk;Kim, Ji Hoon;Chung, Chang Eun;Lee, Chong Kun;Yu, Sung Hoon
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.21-29
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    • 2021
  • Purpose: Frostbite is a hazard to people exposed to cold environments. With the progression of modern industrial development and change of leisure behavior encountering cold environments, frequent accidental exposure to frostbite injury during work and human behavior is increasing, and the predisposing factors of frostbite were greatly changed than before. The purpose of this study was to make epidemiological analysis, and to review the treatment outcomes of frostbite. Methods: From March 2010 to February 2021, this study has included 27 patients with second- to third-degree frostbite injuries in Advanced Burn Reconstruction Center, Bundang Jesaeng Hosptial. A retrospective study was made about the distribution of age, gender, predisposing factors, prevalent area, type of managements, and the length of treatment period. Results: In our institution, acute management of frostbite patients has included rewarming, anticoagulation therapy (acetylsalicylic acid), and agents to improve vascular perfusion (lipo-prostaglandin E1 [Eglandin®]). The 25 frostbite patients with second-degree frostbite (92.6%) were successfully managed by the conservative treatment alone with a mean of 20.3 days healing time. Two patients with third-degree frostbite (7.4%) also showed good outcomes after surgical reconstruction with a mean of 59 days healing time. In our clinical experiences of third-degree frostbite, definitive surgical reconstruction should be recommended to wait for more than 4~6 weeks for identification of clear demarcation of necrotic tissue caused by frostbite. In this study, 43 frostbite injuries site in 27 frostbite patients occurred. Among them, 15 patients (55.6%) had multiple-site frostbite injury. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments (40.8%), misapplying ice pack for treatment purposes (7.4%), barefoot walking on the cold ground (3.7%), and loss of consciousness in cold grounds (3.7%). The most prevalent sites of frostbite injuries revealed as the hand (58.1%), followed by the foot (32.6%), face (7.0%), and abdomen (2.3%). And in the winter season from the November to March, the incidence rate of frostbite injuries was high at 74.1%. Conclusion: This study included 27 frostbite patients with 43 frostbite sites since last decade in a single institution at the community hospital. The frostbite patients with second-degree frostbite (92.6%) were successfully healed by the conservative treatment alone with a mean of 20.3 days healing time. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments, etc. The most prevalent site of frostbite injuries was the hand (58.1%). And the most prevalent seasonal incidence of frostbite was from November to March (74.1%).

Aspirin-Triggered Resolvin D1 Inhibits TGF-β1-Induced EndMT through Increasing the Expression of Smad7 and Is Closely Related to Oxidative Stress

  • Shu, Yusheng;Liu, Yu;Li, Xinxin;Cao, Ling;Yuan, Xiaolong;Li, Wenhui;Cao, Qianqian
    • Biomolecules & Therapeutics
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    • v.24 no.2
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    • pp.132-139
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    • 2016
  • The endothelial-mesenchymal transition (EndMT) is known to be involved in the transformation of vascular endothelial cells to mesenchymal cells. EndMT has been confirmed that occur in various pathologic conditions. Transforming growth factor ${\beta}1$ (TGF-${\beta}1$) is a potent stimulator of the vascular endothelial to mesenchymal transition (EMT). Aspirin-triggered resolvin D1 (AT-RvD1) has been known to be involved in the resolution of inflammation, but whether it has effects on TGF-${\beta}1$-induced EndMT is not yet clear. Therefore, we investigated the effects of AT-RvD1 on the EndMT of human umbilical vein vascular endothelial cells line (HUVECs). Treatment with TGF-${\beta}1$ reduced the expression of Nrf2 and enhanced the level of F-actin, which is associated with paracellular permeability. The expression of endothelial marker VE-cadherin in HUVEC cells was reduced, and the expression of mesenchymal marker vimentin was enhanced. AT-RvD1 restored the expression of Nrf2 and vimentin and enhanced the expression of VE-cadherin. AT-RvD1 did also affect the migration of HUVEC cells. Inhibitory ${\kappa}B$ kinase 16 (IKK 16), which is known to inhibit the NF-${\kappa}B$ pathway, had an ability to increase the expression of Nrf2 and was associated with the inhibition effect of AT-RvD1 on TGF-${\beta}1$-induced EndMT, but it had no effect on TGF-${\beta}1$-induced EndMT alone. Smad7, which is a key regulator of TGF-${\beta}$/Smads signaling by negative feedback loops, was significantly increased with the treatment of AT-RvD1. These results suggest the possibility that AT-RvD1 suppresses the TGF-${\beta}1$-induced EndMT through increasing the expression of Smad7 and is closely related to oxidative stress.

Effect of saline irrigation used in combination with antimicrobial agents on salivary bacterial counts (생리식염수 세척이 구강 소독제의 타액 내 세균 수의 변화에 미치는 영향)

  • Kim, Dong-Joo;Yu, Kyoung-Hwan;Lim, Hyong-Sub;Lee, Sung-Kyu;Kim, Su-Gwan;Kim, Hak-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.3
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    • pp.202-205
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    • 2010
  • Introduction: The aim of the present study was to investigate the effect of mechanical irrigation in combination with mouthwash of antimicrobial agents on salivary bacterial counts. Materials and Methods: This study was performed with a randomized study employing a panel of 40 healthy volunteers (20 males and 20 females) between the age of 26 and 32 years. Volunteers were randomly put in one of four treatment groups. In the first group, 0.2 mL of non-stimulatory saliva was collected from every subjective person. Then, saliva was collected after rinsing with chlorhexidine (CHX) for 1 minute. In the second group, non-stimulatory saliva was collected, and then saliva was collected after rinsing with CHX and irrigation with saline. In the third and fourth groups, the same procedures as the first and second groups were performed with povidone iodine (PVI) instead of CHX. All of these samples were cultured for 48 hours aerobically. The reduction rates of colony-forming units (CFU) were calculated for each group. The reduction rate between each group was tested statistically using student t-test. Results: Using CHX in combination with saline irrigation showed a significant decrease of the salivary bacterial CFU when compared with only using CHX.(P<0.01) And using PVI with saline irrigation showed a little decrease of the CFU when compared with only using PVI, but there was no statistical significance.(P>0.01) Conclusion: It was concluded that the CHX or PVI used with saline irrigation made the salivary bacterial counts reduced more than when CHX or PVI was used alone as an oral antiseptic agent.

Postoperative Adjuvant Radiotherapy for Patients with Gastric Adenocarcinoma

  • Lim, Do Hoon
    • Journal of Gastric Cancer
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    • v.12 no.4
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    • pp.205-209
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    • 2012
  • In gastric adenocarcinoma, high rates of loco-regional recurrences have been reported even after complete resection, and various studies have been tried to find the role of postoperative adjuvant therapy. Among them, Intergroup 0116 trial was a landmark trial, and demonstrated the definite survival benefit in adjuvant chemoradiotherapy, compared with surgery alone. However, the INT 0116 trial had major limitation for global acceptance of the INT 0116 regimen as an adjuvant treatment modality because of the limited lymph node dissection. Lately, several randomized studies that were performed to patients with D2-dissected gastric cancer were published. This review summarizes the data about patterns of failure after surgical resection and the earlier prospective studies, including INT 0116 study. Author will introduce the latest studies, including ARTIST trial and discuss whether external beam radiotherapy should be applied to patients receiving extended lymph node dissection and adjuvant chemotherapy.

Osteochondral Lesions of the Talus: Autologous Osteochondral Transplantation (거골의 골연골병변: 자가 골연골 이식술)

  • Bae, Su-Young
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.55-60
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    • 2020
  • Among the various surgical treatment methods for osteochondral lesions of the talus, autologous osteochondral transplantation (AOT) is a useful procedure in cases of a large defect, subchondral cyst, and failed primary bone marrow stimulation procedure. Although bone marrow stimulation alone may not regenerate the damaged plate sufficiently, AOT has the advantage of being able to replace the subchondral bone plate and cartilage with a new one at a same time. Nevertheless, postoperative cyst formation or pain may persist and donor site morbidity is still a limitation of AOT.

A Cerebral Astroblastoma Mimicking an Extra-axial Neoplasm

  • Eom, Ki-Seong;Kim, Jong-Moon;Kim, Tae-Young
    • Journal of Korean Neurosurgical Society
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    • v.43 no.4
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    • pp.205-208
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    • 2008
  • Astroblastoma is a rarely diagnosed primary brain neoplasm whose histogenesis has been clarified recently. It occurs in children and young adults and presents as a well circumscribed, contrast-enhancing lesion in the cerebral hemisphere. We present a case of 20-year-old woman with an astroblastoma in the left temporal convexity that was treated with total tumor resection alone. We thought the mass was extra-axial neoplasm based on radiological findings of computed tomography and magnetic resonance imaging initially, but later, we obtained angiographic findings suggesting an intra-axial neoplasm. The patient is doing well even two years after surgery. The characteristic radiological and histopathological features of this case are described with a literature review. An astroblastoma should be included in the differential diagnosis of a superficially located tumor presenting with the findings of an extra-axial mass, especially in a young patient.

A Development of the electronic controlled vaporizer for low flow anesthesia (저유량 마취를 위한 전자제어식 기화기 개발)

  • Oh, Yeong-Taek;Park, Jae-Hoon;Chang, In-Bae
    • Journal of Industrial Technology
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    • v.29 no.B
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    • pp.107-113
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    • 2009
  • For the environmental safety of the operating room and patient healthcare, the closed type rebreathing system is widely adopted. In order to reduce the anesthesia gas during surgery, the mixing ratio of anesthesia gas with breathing air should be precisely controlled. Generally, the breathing air passes through the vaporizer to mix the anesthesia gas, but there is a difficulty in controlling the mixing ratio precisely. In this paper, the stand-alone style vaporizer is designed and the operating characteristics are investigated. The vaporizer measures the temperature and pressure in the vaporizing chamber and chamber temperature is precisely controlled by proportional controlled heater. Exact quantity of anesthesia media is feeded by PID controlled peristaltic pump and vaporized gas is mixed with breathing air flow by PWM controlled solenoid valve. The experimental result shows that the vaporizer has an excellent command following performances that it can be applied to the low flow anesthesia system.

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Clinical Application of $^{18}F-FDG$ PET in Malignant Mesothelioma (악성중피종에서 $^{18}F-FDG$ PET의 임상응용)

  • Lee, Eun-Jeong
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.157-161
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    • 2008
  • Malignant pleural mesothelioma (MPM) has a poor prognosis and a strong association with exposure to asbestos. Although there are not generally accepted guidelines for treatment of MPM, recent reports suggest that multi modality therapy combining chemotherapy, radiotherapy, and surgery can improve the survival of patients with MPM. Therefore exact staging is required to decide the best treatment option. However, it is well known that there are many difficulties in determining precise preoperative stage, predicting prognosis, and monitoring response to therapy with conventional imaging modalities such as CT and MRI in MPM. Recently PET with $^{18}F-FDG$ comes into the spotlight as an important staging method. There is increasing evidence that PET is superior to other conventional imaging modalities in diagnosis and staging of MPM. Particularly PET/CT improves the diagnostic and staging accuracy over PET or CT alone in MPM because it provides anatomic imaging data as well as functional information. PET and PET/CT are also useful for monitoring response to therapy and SUV is reported as a prognostic factor in MPM.

Radiotherapy of Non-Small Cell Lung Cancer (비소세포 폐암의 방사선 치료)

  • Seong J. S.;Oh W. Y.;Suh C. O.;Kim G. E.
    • Radiation Oncology Journal
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    • v.2 no.2
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    • pp.213-219
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    • 1984
  • 131 Patients of non·small cell lung cancer treated with irradiation at Yonsei Canter Center from Jan. 1971 to Dec. 1980 were retrospectively analysed. Overall 5 year survival rate was $7\%$ in 117 cases, treated with radiotherapy alone and $33\%$ in 14 Cases, treated with surgery & postoperative ratiotherapy. Their median survival was 9.6 months in the former, while 11.1 months in the latter. The patients treated with radical aim achieved $10\%$ in 5 YSR and with palliative aim, $0\%$. Also, survival according to histolocial classification and staging was obtained. Treatment failure was mostly distant failure (40 cases/49 cases), and within 6 months (34cases/49cases).

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Characteristics of electroencephalogram signatures in sedated patients induced by various anesthetic agents

  • Choi, Byung-Moon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.4
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    • pp.241-251
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    • 2017
  • Devices that monitor the depth of hypnosis based on the electroencephalogram (EEG) have long been commercialized, and clinicians use these to titrate the dosage of hypnotic agents. However, these have not yet been accepted as standard monitoring devices for anesthesiology. The primary reason is that the use of these monitoring devices does not completely prevent awareness during surgery, and the development of these devices has not taken into account the neurophysiological mechanisms of hypnotic agents, thus making it possible to show different levels of unconsciousness in the same brain status. An alternative is to monitor EEGs that are not signal processed with numerical values presented by these monitoring devices. Several studies have reported that power spectral analysis alone can distinguish the effects of different hypnotic agents on consciousness changes. This paper introduces the basic concept of power spectral analysis and introduces the EEG characteristics of various hypnotic agents that are used in sedation.