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Clinical Evaulation of Reoperation for Mitral Vavular Disease (승모판막질환의 재수술에 대한 임상적 고찰)

  • Kim, Myung-In;Kim, Eung-Joong;Lee, Young
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.49-56
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    • 1992
  • Total 20 cases of reoperation for mitral vavular disease, which had been performed during the period from May 1983 till October 1991, were reviewed. This study contained 1 case of previous balloon valvuloplasty and 1 case of death with bleeding from right ventricle during sternal reenrty. The average time intervals between reoperation and previous operation was 19 years in closed mitral commissurotomy[n=4], 7 years and 2 months in mitral valve replacement[n=10], 1 year and 8 months in mitral valvuloplasty[n=4], 3 years and 10 months in open mitral commissurotomy [n=2]. The cause of reoperation in closed mitral commissurotomy was progression of the disease, and residual stenosis with progression was the cause in open mitral commissurotomy cases. Technical failure might be the cause in the cases of valvuloplasty. In prosthetic valve replacement group the causes of reoperation were primary failure. Also two cases of suggested valve thrombosis and one case of failure of tricuspid annuloplasty was noted in prosthetic valve replacement group. The used valves for reoperation were Ionescue-Shiley in 3 cases, Bjork-Shiley in 6 cases, St. Jude Medical in 2 cases and CarboMedics in 8 cases. The mortality rate was 20%[n=4] and the causes of death were low output syndrome in 1 case, multiple organ failure in 2 cases and bleeding in 1 case during sternal reentry. During follow up 1 case of sudden death was observed.

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Effect of whole Body Vibration Exercise on Intracerebral Hemorrhage in Rats (흰쥐 해마 CA1 부위의 뇌출혈 유발 시 전신진동운동의 효과)

  • Kim, Bo-Kyun;Yoon, Sung-Jin;Kim, Dong-Hyun;Ko, Il-Gyu;Kim, Chang-Ju;Jee, Yong-Seok;Shin, Mal-Soon
    • Korean Journal of Exercise Nutrition
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    • v.13 no.2
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    • pp.147-153
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    • 2009
  • Effect of whole body vibration exercise on intracerebral hemorrhage in rats. Intracerebral hemorrhage is one of the most devastating types of stroke. This disease is known to cause severe neurological damage and also has a very high mortality rate. In the present study, the effects of whole body vibration exercise on memory capability and apoptotic neuronal cell death in the hippocampal CA1 region following intracerebral hemorrhage in rats were investigated. Intracerebral hemorrhage was induced by injection of collagenase into the hippocampal CA1 region using a stereotaxic instrument. The rats were divided into 5 groups: the sham-operation group, the hemorrhage-induction group, the hemorrhage-induction and 8 Hz vibration exercise group, the hemorrhage-induction and 16 Hz vibration exercise group, and the hemorrhage-induction and 24 Hz vibration exercise group. The animals in the whole body vibration exercise groups received whole body vibration at 8 Hz, 16 Hz, and 24 Hz, respectively for 30 min once a day during 14 consecutive days. In the present results, the apoptotic neuronal cell death in the hippocampal CA1 region was significantly increased following induction of intracerebral hemorrhage, resulting in memory impairment. Whole body vibration exercise suppressed hemorrhage-induced apoptosis in the hippocampal CA1 region. This suppressive effect of whole body vibration exercise also alleviated hemorrhage-induced memory impairment. Here in this study, we have shown that whole body vibration exercise inhibited intracerebral hemorrhage-induced apoptotic neuronal cell death and thus facilitated recovery of brain function following intracerebral hemorrhage.

Physical and Psychospiritual Care Need by End-of-life Stages among Non-cancer Patient at Home: Based on the Importance and Difficulty of Care Need (재가 비암 환자의 생의 말기 단계별 신체적, 영적 간호요구도 - 간호요구의 중요도와 난이도를 중심으로 -)

  • Lee, Jong-Eun;Kim, Soon-Lae
    • Research in Community and Public Health Nursing
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    • v.23 no.2
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    • pp.127-133
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    • 2012
  • Purpose: This study was conducted to assess needs at each end-of-life care stage and to analyze importance and difficulty of care needs for home care nursing among non-cancer patients. Methods: We used a retrospective design. Total eligible patients were 117 at the ages of 40 and over, who continuously received home care nursing throughout beginning, stable, and near death stages, and finally died at home from January 1, 2006 to December 31, 2006. Descriptive statistics, Cochran's Q test, Friedman's test were used for data analysis. Results: In the area of physical care, the care need for 'assistance for activities in daily life' was significantly highest in the beginning stage. The care need for 'aggravation or adverse changes in physical symptoms' was significantly increased in the near death stage. In the area of psychospiritual care, 'family's psychological burden' was revealed as having the highest rate of care needs in the every stage. Conclusion: Future intervention should consider assessing care needs in end-of-life care for non-cancer patients who are provided with home care nursing.

Natural History of Early Gastric Cancer: a Case Report and Literature Review

  • Iwai, Tomohiro;Yoshida, Masao;Ono, Hiroyuki;Kakushima, Naomi;Takizawa, Kohei;Tanaka, Masaki;Kawata, Noboru;Ito, Sayo;Imai, Kenichiro;Hotta, Kinichi;Ishiwatari, Hirotoshi;Matsubayashi, Hiroyuki
    • Journal of Gastric Cancer
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    • v.17 no.1
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    • pp.88-92
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    • 2017
  • Early detection and treatment decrease the mortality rate associated with gastric cancer (GC). However, the natural history of GC remains unclear. An 85-year-old woman was referred to our hospital for evaluation of a gastric tumor. Esophagogastroduodenoscopy identified a 6 mm, flat-elevated lesion at the lesser curvature of the antrum. A biopsy specimen showed a well-differentiated tubular adenocarcinoma. The depth of the lesion was estimated to be intramucosal. Although the lesion met the indications for endoscopic resection, periodic endoscopic follow-up was performed due to the patient's advanced age and comorbidities. The mucosal GC invaded into the submucosa 3 years later, and finally progressed to advanced cancer 5 years after the initial examination. The patient died of tumor hemorrhage 6.4 years after the initial examination. In this case, mucosal GC progressed to advanced GC, eventually leading to the patient's death from GC. Early and appropriate treatment is required to prevent GC-related death.

A Review of Total Correction in 48 Cases of Tetralogy of Fallot (Fallot 사징증(四徵症) 외과적(外科的) 완전교정(完全矯正)에 대한 임상적(臨床的) 고찰(考察))

  • Suh, Kyung Phill
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.198-206
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    • 1976
  • A Total of Forty eight patients underwent open-heart surgery for correction of tetralogy of Fallot at the Seoul National University Hospital from January 1974 to October 1976, with an overall survival rate of 77 per cent. Operative mortality varied according to severity of the lesion, age of the patient, nature of previous surgical treatment and presence or absence of an outflow tract patch across the pulmonary valve ring. Eleven patients died in the early postoperative period and thirty seven patients were discharged from the hospital alive. A patch of the right ventricular outflow tract and pulmonary annulus was required to relieve pulmonic stenosis in 24 patients. There were 10 deaths in this group (42%) as compared to 1 death in the group of 24 patients who were corrected without a patch. Operative mortality was especially higher when an inlay patch was placed across the pulmonary valve ring. This may be related to the possibly greater anatomic severity of these cases and to the longer operating time when a patch was used. The electrocardiogram showed right ventricular hypertrophy in 35 cyanotic patients. Intraventricular conduction was normal in 34 patients before operation. It was normal postoperatively in only 5 of 34 patients in this group who survived surgery. Complete right bundle branch block appeared at operation in 21 patients, and 8 patients developed incomplete right bundle branch block. Major causes of death were progressive cardiac failure (4), Complete atrioventricular dissociation (3), bleeding (2), cardiac tamponade (1), and sudden cardiac arrest (1)

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A Clinical Analysis of Atherosclerosis Obliterance in the Lower Extremity (폐쇄성 하지 동맥 경화증의 임상적 고찰)

  • 김종만
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.333-341
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    • 1990
  • aortoiliac pattern, Group II; femoropopliteal pattern and Group g; tibioperoneal pattern. A majority of patients belonged to group I [27 cases], 8 patients came under group II .and none in group g. Thirty patients underwent bypass operation with autogenous saphenous vein or synthetic graft with or without concomitant lumbar sympathectomy. Remaining 5 patients were operated on with sympathectomy only, Bypass procedures were anatomic bypass in 22 cases: aortoiliac artery bypass in 11 cases, femoropopliteal artery bypass in 10 cases, sequential femoropopliteal artery bypass in one case and extra-anatomic bypass in 8 cases, axillary-bifemoral artery bypass in one case and femorofemoral artery bypass in 7 cases. Postoperative complications which mainly composed of superficial wound infection[5 cases] which were treated without any significant sequel in all cases and thrombosis[2 cases]. Three patients died whose causes of death were acute renal failure in 2 cases and myocardial infarction in other, The overall patency, rate was 70Zo in 5 years. In conclusion, the clinical pattern and operative outcome were similar to he western pattern and all cases of death did not related to operative procedures and ischemic symptoms were relieved by bypass operations except several cases. I think and recommend that all patients suffering chronic arterial insufficiency by atherosclerosis obliterans ought to be managed with urgent and adequate operative procedure.

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The Effect of Overexpression of Rat Clusterin in L929 Fibroblasts

  • PARK , JUNG-HYUN;JU, SUNG-KYU;PARK, JEE-SUN;PARK, YOO-KYOUNG;KANG, MYUNG-HEE;YOU, KWAN-HEE
    • Journal of Microbiology and Biotechnology
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    • v.14 no.6
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    • pp.1333-1337
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    • 2004
  • Oxidants such as hydrogen peroxide are powerful inducers of cell damage, ageing, and apoptosis. Since clusterin, a 75-80 kDa mammalian glycoprotein, is frequently found to be inducible in apoptotic cells and tissues, this study inquired into whether this would be a protective mechanism against further cell death. The aim was to find out whether overexpression of clusterin could protect cells from oxidant­induced stress and apoptosis. To clarify this issue, we generated and analyzed stable cell lines expressing fusion proteins of a rat clusterin with an enhanced green fluorescent protein (EGFP). When treated with varying concentrations of hydrogen peroxides, clusterin transfectants indeed showed increased resistance to apoptosis and exhibited a much higher survival rate than mock-transfected cells. On the other hand, neither intracellular re-distribution nor local concentration of clusterin-EGFP was observed, which leaves the question open about its anti-apoptotic mechanism. In conclusion, the overexpression of clusterin provides a means for protecting cells against oxidative stress and subsequent cell death.

The effect of Leonurus sibiricus on the proliferation inhibition of human uterine leiomyoma cell and expression of gene related cell apoptosis (익모초(益母草)가 자궁근종세포의 증식억제와 Apoptosis 관련 유전자 발현에 미치는 영향)

  • Lee, Soo-Jin;Beak, Seung-Hee;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.3
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    • pp.1-12
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    • 2006
  • Purpose : This study was aimed to investigate the inhibitory effect of Leonurus sibiricus on the proliferation of human uterine leiomyoma cells and the expression of gene related the mechanism of cell apoptosis. Methods : We counted the number of death cells treated with indicated concentration of Leonurus sibiricus and investigated cell death rate by MTS assay. Furthermore, flow cytometry analysis and DNA fragmentation assay were used to dissect between necrosis and apoptosis and then we observed the differential gene expression by western blot analysis. Results : Leonurus sibiricus significantly inhibited the proliferation of uterine leiomyoma cell in a dose-dependent and time dependent manner. Fluorescence activated cell sorter (FACS) analysis indicated that Leonurus sibiricus induced G1 cell cycle arrest. Leonurus sibiricus enhanced the expression of p27 and p53 with cell cycle arrest. Conclusion : These findings suggest that Leonurus sibiricus is a candidate agent for the treatment of uterine leiomyoma. p27, $p53^{1}$ may play an important role in Leonurus sibiricus-induced cell cycle arrest and cell growth inhibition.

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Gemcitabine in Treating Patients with Refractory or Relapsed Multiple Myeloma

  • Zheng, Hua;Yang, Fan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9291-9293
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    • 2014
  • Background: Patients with refractory or relapsed multiple myeloma are considered to have a very poor prognosis, and new regimens are needed to improve the outcome. Gemcitabine, a nucleoside antimetabolite, is an analog of deoxycytidine which mainly inhibits DNA synthesis through interfering with DNA chain elongation and depleting deoxynucleotide stores, resulting in gemcitabine-induced cell death. Here we performed a systemic analysis to evaluate gemcitabine based chemotherapy as salvage treatment for patients with refractory and relapsed multiple myeloma. Methods: Clinical studies evaluating the impact of gemcitabine based regimens on response and safety for patients with refractory and relapsed multiple myeloma were identified by using a predefined search strategy. Pooled response rate (RR) of treatment were calculated. Results: In gemcitabine based regimens, 3 clinical studies which including 57 patients with refractory and relapsed multiple myeloma were considered eligible for inclusion. Systemic analysis suggested that, in all patients, pooled RR was 15.7% (9/57) in gemcitabine based regimens. Major adverse effects were hematologic toxicity, including grade 3 or 4 anemia, leucopenia and thrombocytopenia i. No treatment related death occurred with gemcitabine based treatment. Conclusion: This systemic analysis suggests that gemcitabine based regimens are associated with mild activity with good tolerability in treating patients with refractory or relapsed multiple myeloma.

Factors Affecting Survival Time of Cholangiocarcinoma Patients: A Prospective Study in Northeast Thailand

  • Woradet, Somkiattiyos;Promthet, Supannee;Songserm, Nopparat;Parkin, Donald Maxwell
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1623-1627
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    • 2013
  • Cholangiocarcinoma (CCA) is a major health problem and cause of death among people in Northeastern Thailand. In this prospective study 171 patients newly diagnosed with CCA by physicians in 5 tertiary hospitals in four provinces of northeastern of Thailand between February and July 2011 were followed up to January 2012. The outcome was survival time from diagnosis to death. A total of 758.4 person-months of follow-up were available. The mortality rate was 16.9 per 100 person-months (95%CI: 14.1-20.1). The median survival time among CCA patients was 4.3 months (95%CI: 3.3-5.1). Cox's proportional hazard model was used to study the independent effects of factors affecting survival time among patients. Statistically significant factors included advanced stage at diagnosis (HR: 2.5, 95%CI: 1.7-3.8), presentation with jaundice (HR: 1.7, 95%CI: 1.1-2.4) or ascites (HR: 2.8, 95%CI: 1.8-4.4), and positive serum carcinoembryonic antigen (HR: 2.3, 95%CI: 1.2-4.3). Patients who had received standard treatment had a better prognosis that those who did not (HR: 0.5, 95%CI: 0.3-0.7).