• Title/Summary/Keyword: Types of surgery

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The Protective and Recovery Effects of Peucedanum Japonicum Thunberg for Vascular Dementia (식방풍의 혈관성 치매에 대한 예방과 치료효과 검증)

  • Kim, Ka-Na;Choi, Min-Ji;Lee, Younghyurk;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.1
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    • pp.123-130
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    • 2013
  • Objectives : During several thousand years, Peucedanum Japonicum Thunberg has been considered as a vegetable side dish in Korea. There is folk knowledge that Peucedanum Japonicum Thunberg prevents vascular disease such as stroke. To identify the effects Peucedanum Japonicum Thunberg, we made up its extract and named it as KH020. Then, we employed common carotid artery ligation (CCAl) surgery for vascular dementia model (VDM), and two types doses of per os (per oral: p.o) treatment. Methods : To confirm prevention and recovery effects for vascular dementia, we treated two doses (100, 400 mg/kg) KH020 in male C57BL/6 mouse during 7 days. After treatment, animals were CCAl operated, and given time to recover. Then, animal were tested in a Y-maze and passive avoidance test. Results : Y-maze results demonstrated that cognition and memory performance were decreased in the VDM group, compared to the sham group. KH020 treatment abolished these effects significantly. The results from the passive avoidance test showed the same phenomenon, but it was not statically significant. Conclusions : Therefore, KH020 prevents the onset of vascular dementia. In future studies, we will evaluate KH020 in regard to alzheimer dementia.

Practical Understanding of Gross Examination Techniques (육안검사기술의 실무적 이해)

  • Woo-Hyun JI
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.1
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    • pp.89-98
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    • 2024
  • Gross examination techniques (GETs) of specimens collected from cancer surgery or endoscopy comprise the act of recording visual information about cancer for accurate histopathological diagnosis and collecting sections of the lesion to create microscopic specimens. GETs must include concise and accurate expressions, appropriate structuring, sufficient resections, error-free standardization of important information, and photo-diagramming of complex specimens. To increase the satisfaction of pathological interpretation, it is a task that must be performed accurately and carefully to gain confidence on a theoretical and practical basis with a sufficient understanding of gross examination. Based on the experience of clinical pathologists in the field of GETs, additional specimen types should be identified as viable candidates. Also, their needs and concerns regarding treatment should be carefully considered. In addition, departments at each institution should review the national focus on clinical partnerships, continuous professional training, diagnostic errors, and value-based healthcare provision.

Analysis of electroencephalogram-derived indexes for anesthetic depth monitoring in pediatric patients with intellectual disability undergoing dental surgery

  • Silva, Aura;Amorim, Pedro;Felix, Luiza;Abelha, Fernando;Mourao, Joana
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.4
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    • pp.235-244
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    • 2018
  • Background: Patients with intellectual disability (ID) often require general anesthesia during oral procedures. Anesthetic depth monitoring in these patients can be difficult due to their already altered mental state prior to anesthesia. In this study, the utility of electroencephalographic indexes to reflect anesthetic depth was evaluated in pediatric patients with ID. Methods: Seventeen patients (mean age, $9.6{\pm}2.9years$) scheduled for dental procedures were enrolled in this study. After anesthesia induction with propofol or sevoflurane, a bilateral sensor was placed on the patient's forehead and the bispectral index (BIS) was recorded. Anesthesia was maintained with sevoflurane, which was adjusted according to the clinical signs by an anesthesiologist blinded to the BIS value. The index performance was accessed by correlation (with the end-tidal sevoflurane [EtSevo] concentration) and prediction probability (with a clinical scale of anesthesia). The asymmetry of the electroencephalogram between the left and right sides was also analyzed. Results: The BIS had good correlation and prediction probabilities (above 0.5) in the majority of patients; however, BIS was not correlated with EtSevo or the clinical scale of anesthesia in patients with Lennox-Gastaut, West syndrome, cerebral palsy, and epilepsy. BIS showed better correlations than SEF95 and TP. No significant differences were observed between the left- and right-side indexes. Conclusion: BIS may be able to reflect sevoflurane anesthetic depth in patients with some types of ID; however, more research is required to better define the neurological conditions and/or degrees of disability that may allow anesthesiologists to use the BIS.

Pulsatile Blood Flows Through a Bileaflet Mechanical Heart Valve with Different Approach Methods of Numerical Analysis : Pulsatile Flows with Fixed Leaflets and Interacted with Moving Leaflets

  • Park, Choeng-Ryul;Kim, Chang-Nyung;Kwon, Young-Joo;Lee, Jae-Won
    • Journal of Mechanical Science and Technology
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    • v.17 no.7
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    • pp.1073-1082
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    • 2003
  • Many researchers have investigated the blood flow characteristics through bileaflet mechanical heart valves using computational fluid dynamics (CFD) models. Their numerical approach methods can be classified into three types; steady flow analysis, pulsatile flow analysis with fixed leaflets, and pulsatile flow analysis with moving leaflets. The first and second methods have been generally employed for two-dimensional and three-dimensional calculations. The pulsatile flow analysis interacted with moving leaflets has been recently introduced and tried only in two-dimensional analysis because this approach method has difficulty in considering simultaneously two physics of blood flow and leaflet behavior interacted with blood flow. In this publication, numerical calculation for pulsatile flow with moving leaflets using a fluid-structure interaction method has been performed in a three-dimensional geometry. Also, pulsatile flow with fixed leaflets has been analyzed for comparison with the case with moving leaflets. The calculated results using the fluid-structure interaction model have shown good agreements with results visualized by previous experiments. In peak systole. calculations with the two approach methods have predicted similar flow fields. However, the model with fixed leaflets has not been able to predict the flow fields during opening and closing phases. Therefore, the model with moving leaflets is rigorously required for advanced analysis of flow fields.

A Study on the Expression of CD44s and CD44v6 in Non-Small Cell Lung Carcinomas (비소세포성 폐암종의 CD44s 및 CD44v6의 발현에 대한 연구 -CD44의 발현에 대한 연구-)

  • Chang, Woon-Ha;Oh, Tae-Yun;Kim, Jung-Tae
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.1-11
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    • 2006
  • Background: CD44 is a glycoprotein on the cell surface which is involved in the cell-to-cell and cell-to-matrix interaction. The standard form, CD44s and multiple isoforms are determined by alternative splicing of 10 exons. Recent studies have suggested that CD44 may help invasion and metastasis of various epithelial tumors as well as activation of Iymphocytes and monocytes. The expression pattern of CD44 can be different according to tumor types. The author studied the expression pattern of CD44s and one of its variants, CD44v6 in non-small cell lung carcinomas (NSCLC) to find their implications on clinicopathologic aspects, including the survival of the patients. Material and Method: A total of 89 primary NSCLSs (48 squamous cell carcinomas, 33 adenocarcinomas, and 8 undifferentiated large cell carcinomas) were retrieved during the years between 1985 to 1994. The immunohisto chemistry was done by using monoclonal antibodies and the CD44 expression for angiogenesis was evaluated by counting the number of tumor microvessels. Result: Seventy-one (79.8$\%$) and 64 (71 .9$\%$) among 89 NSCLSs revealed the expression of CD44s and CD44v6, respectively. The expression of CD44s was well correlated with that of CD44v6 (r=0.710, p < 0.0001). The expression of CD44s and CD44v6 was associated with the histopathologic type of the NSCLCs, and squamous cell carcinoma was the type that showed the highest expression of CD44s and CD44v6 (p < 0.0001). Microvessel count was the highest in adenocarcinomas (113.6$\pm$69.7 on 200-fold magnification and 54.8$\pm$41.1 on 400-fold magnification) and correlated with the tumor size of TNM system (r=0.217, p=0.043) and CD44s expression (r=0.218, p=0.040). In adenocarcinoma, the patients with higher CD44s expression survived shorter than those with lower CD44s expression (p=0.0194) but there was no statistical significance on multivariate analysis(p=0.3298). Conclusion: The expression of both CD44s and CD44v6 may be associated with the squamous differentiation in non-small cell lung carcinomas. The relationship of CD44s expression with micro-vessel density of the tumor suggests an involvement of CD44s in tumor angiogenesis, which in turn would help tumor growth.

CEA and CA 19-9 are Still Valuable Markers for the Prognosis of Colorectal and Gastric Cancer Patients

  • Sisik, Abdullah;Kaya, Mustafa;Bas, Gurhan;Basak, Fatih;Alimoglu, Orhan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4289-4294
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    • 2013
  • Background: The purpose of this study was to assess the predictive effect of preoperative CEA and CA 19-9 levels on the prognosis of colorectal and gastric cancer patients. Materials and Methods: CEA and CA 19-9 were evaluated preoperatively in patients undergoing surgery for colorectal cancer (n=116) and gastric cancer (n=49). Patients with CEA levels <5 ng/mL were classified as CEA Group 1, 5-30 ng/mL as CEA Group 2 and >30 ng/mL were classified as CEA Group 3. Similarly the patients with a CA 19-9 level <35 U/mL were classified as CA 19-9 Group 1, with 35-100 U/mL as Group 2 and with >100 U/mL as Group and 3. TNM stages and histologic grades were noted according to histopathological reports. Patients with a TNM grade 0 or 1 were classified as Group A, TNM grade 2 patients constituted Group B and TNM grade 3 and 4 patients constituted Group C. Demographic characteristics, tumor locations and blood types of the patients were all recorded and these data were compared with the preoperative CEA and CA19-9 values. Results: A significant correlation between CA 19-9 levels (>100 U/mL) and TNM stage (in advanced stages) was determined. We also determined a significant correlation between TNM stages and positive vlaues for both CEA and CA 19-9 in colorectal and gastric cancer patients. In comparison between CEA and CA 19-9 levels and age, gender, tumor location, ABO blood group, and tumor histologic grade, no significant correlation was found. Conclusions: Positive levels of both CEA and CA 19-9 can be considered to indicate an advanced stage in colorectal and gastric cancer patients.

Treatment outcome in patients with triple negative early stage breast cancers compared with other molecular subtypes

  • Kim, Ja Young;Chang, Sei-Kyung;Park, Heily;Lee, Bo-Mi;Shin, Hyun Soo
    • Radiation Oncology Journal
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    • v.30 no.3
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    • pp.124-131
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    • 2012
  • Purpose: To determine whether triple negative (TN) early stage breast cancers have poorer survival rates compared with other molecular types. Materials and Methods: Between August 2000 and July 2006, patients diagnosed with stage I, II early stage breast cancers, in whom all three markers (estrogen receptor, progesterone receptor, and human epidermal growth factor receptor [HER]-2) were available and treated with modified radical mastectomy or breast conserving surgery followed by radiotherapy, were retrospectively reviewed. Results: Of 446 patients, 94 (21.1%) were classified as TN, 57 (12.8%) as HER-2 type, and 295 (66.1%) as luminal. TN was more frequently associated with young patients younger than 35 years old (p = 0.002), higher histologic grade (p < 0.0001), and nuclear (p < 0.0001). The median follow-up period was 78 months (range, 4 to 130 months). There were 9 local relapses (2.0%), 15 nodal (3.4%), 40 distant metastases (9.0%), and 33 deaths (7.4%) for all patients. The rates of 5-year OS, DFS, LFS, and DMFS for all patients were 95.5%, 89.9%, 95.4%, and 91.7%, respectively. There were no significant differences in OS, DFS, LFS, and DMFS between triple negative and other subtypes (p > 0.05). Conclusion: We found that patients with TN early stage breast cancers had no difference in survival rates compared with other molecular subtypes. Prospective study in homogeneous treatment group will need for a prognosis of TN early stage breast cancer.

The Role of Postoperative External Irradiation for the Incompletely Resected Meningiomas (불완전절제된 수막종에서 수술 후 방사선치료의 역할)

  • Kim Tae-Hyun;Yang Dae-Sik;Kim Chul-Young;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.85-91
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    • 2000
  • Purpose : The aim of this study is to look for the possible efficacy of postoperative external irradiation for incompletely resected meningiomas. Methods and Materials : From August 198: to January 1997, forty-four patients with intracranial meningioma were treated by postoperative external irradiation. Of the 44 meningiomas, 18 transitional, 13 meningotheliomatous, 6 hemangiopericytic, 4 atypical, 2 fibroblastic and 1 malignant meningioma were identified. We classified all patients into two groups by the histology. The benign group was consisted of the meningotheliomatous, transitional and fibroblastic types. The malignant group was consisted of the atypical, hemangiopericytic and malignat types. In the means of surgery, 37 patients were resected incompletely and 7 patients were managed by biopsy only. After surgery, all patients were received postoperative external irradiation. Radiotherapy was deliverd using Co-60 or 4 MV photon beam to a total dose of 50 to 65 Gy (mean dose 57.4 Gy) with a 1.8 to 2 Gy per fraction. The median follow-up was 48 months (range : 21 $\~$ 101 months). Multivariate analysis of the Influence by age, sex, location, histology and radiation dose on local control has been done using Cox's proportional hazard model. Results : 5-year local control rate was 93.8$\%$ for the benign histology and 51.8$\%$ for the malignant histology (p=0.0110) and overall local control rate at 5 years was 87.4$\%$. The analysis of the prognostic factors, such as age, sex, location, and radiation dose were not significant except for the histology. Conclusion : Adjuvant postoperative external irradiation appears to be significantly improved local control in the patients with incompletely resected meningiomas.

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Clinical Analysis of Arteriovenous Fistulas for Hemodialysis (혈액 투석을 위한 동정맥루 조성술의 임상적 고찰)

  • 손영상;조원민;류세민;황재준;조성준;최영호;김학제;허영숙
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.369-374
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    • 2002
  • Background: Proper construction of vascular access and adequate maintenance are essential for the prognosis of the hemodialysis patients. Though arteriovenous fistula using autogenous vessel is the first of choice, the incidence of arteriovenous fistula using artificial graft is gradually increasing. The aim of this study was to analyse the patency rates between autogenous and artificial fistula, among artificial graft types, according to the accompanied disease. Material and Method: A retrospective study was conducted on 186 patients who underwent 292 arteriovenous fistula operations for hemodialysis at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 54.37 $\pm$ 12.79years, and the male: female ratio 99:87. Result: Among 292 operations, there were 156 autogenous fistula and 116 graft fistula. The other 20 operations were thrombectomy, takedown of graft, revision, and balloon dilatation. Patency rates of autogenous fistula were 92.78 $\pm$ 2.35% at 1 year and 39.03$\pm$9.08% at 5 years, and those of graft fistula were 96.09 $\pm$ 2.22% at 1 year and 16.45 $\pm$ 10.15% at 5 scars. However, there was no statistical significance between the two operations. The patients who had hypertension, diabetes or both had no statistical significance in the patency rate compared to that of patients without underlying disease. In addition, the type of graft used did not affect the patency rate. Second operation was needed in 62 patients and third operation in 31 patients, but their patency rate again had no statistical significance compared to that of the first operation. Conclusion: The patency of the artificial graft fistula was comparable to the autogenous fistula, but the patency according to types of graft need to be studied further. Furthermore, the underlying diseases did not affect the fistula patency.

Analysis of Exploratory Thoracotomy in Non-Small Cell Lung Cancer (원발성 폐암에서의 시험적 개흉술의 분석)

  • 허재학;성숙환;김영태
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.536-542
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    • 1999
  • Background: The purpose of this study is to improve the quality of the diagnostic procedures in the preoperative evaluation so as to reduce the unnecessary thoracotomy and to ensure resectability in non-small cell lung cancer. Material and Method: Of 616 patients who underwent thoracotomy for primary lung cancer from January 1990 to December 1996, 59 patients(9.6%) turned out to have inoperable lesions after the thoracotomy. We reprospectively reviewed the bronchoscopic findings, methods of tissue diagnosis, CT scans, pulmonary function test and lung perfusion scan, reasons for nonresectability, and adjuvant therapy, and then followed up on the survival rate after exploratory thoracotomy. Result: The cell types were squamous cell carcinoma in 38, adenocarcinoma in 15, large cell carcinoma in 3 and others in 3. Primary loci were RUL in 20, RML in 6, RLL in 8, LUL in 13, LLL in 4 and others in 8. The reasons for non-resectability were various; direct tumor invaison to mediastinal structures(n=41), seeding on pleural cavity(n=8), poor pulmonary function(n=2), invasions to extranodal mediastinal lymph node(n=2), technical non- resectability due to extensive chest wall invasion (n=3), small cell carcinoma (n=1), malignant lymphoma(n=1), and multiple rib metastases(n=1). In the follow-up of 58 patients, 1-year survival rate was 55.2% and 2-year survival rate was 17.2% and the mean survival time was 14 months. When compared according to cell types or postoperative adjuvant therapeutic modalities, no significant difference in the survival rates were found. The squamous cell carcinoma was frequently accompanied by local extension to contiguous structures and was the main cause of non-resectability. In adenocarcinoma, pleural seeding with malignant effusion was frequently encountered, and was the major reason for non-resectability. Conclusion: These data revealed that if appropriate preoperative diagnostic tools had been available, many unnecessary thoracotomies could have been avoided. Both the use of thoracoscopy in selected cases of adenocarcinoma and the more aggressive surgical approach to the locally advanced tumor could reduce the incidence of unnecessary thoracotomies for non-small cell lung cancers.

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