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Prevalence of Benign Diseases Mimicking Lung Cancer: Experience from a University Hospital of Southern Brazil

  • Homrich, Gustavo Kohler;Andrade, Cristiano Feijo;Marchiori, Roseane Cardoso;Dos Santos Lidtke, Grazielli;Martins, Fabio Pacheco;Dos Santos, Jose Wellington Alves
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.72-77
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    • 2015
  • Background: Lung cancer is the most lethal type of cancer in the world. Several benign lung diseases may mimic lung carcinoma in its clinical and radiological presentation, which makes the differential diagnosis for granulomatous diseases more relevant in endemic regions like Brazil. This study was designed to describe the prevalence and the diagnostic work-up of benign diseases that mimic primary lung cancer in patients hospitalized at a university hospital from south of Brazil. Methods: This was a transversal study, which evaluated the medical records of 1,056 patients hospitalized for lung cancer treatment from September 2003 to September 2013 at University Hospital of Santa Maria. Results: Eight hundred and four patients underwent invasive procedures for suspected primary lung carcinoma. Primary lung cancer was confirmed in 77.4% of the patients. Benign disease was confirmed in 8% of all patients. Tuberculosis (n=14) and paracoccidioidomycosis (n=9) were the most frequent infectious diseases. The diagnosis of benign diseases was obtained by flexible bronchoscopy in 55.6% of the cases and by thoracotomy in 33.4%. Conclusion: Infectious diseases are the most frequent benign diseases mimicking lung cancer at their initial presentation. Many of these cases could be diagnosed by minimally invasive procedures such as flexible bronchoscopy. Benign diseases should be included in the differential diagnosis during the investigation for primary lung cancer in order to avoid higher cost procedures and mortality.

Reduction of Closed Frontal Sinus Fractures through Suprabrow Approach

  • Hahn, Hyung Min;Lee, Yoo Jung;Park, Myong Chul;Lee, Il Jae;Kim, Sue Min;Park, Dong Ha
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.230-237
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    • 2017
  • Background: The traditional approach for reduction of frontal sinus fractures is coronal incision. Inherent complications of the coronal approach include long scar, hair loss, and long operation time. We describe a simple approach for the reduction of frontal sinus anterior wall fractures using a suprabrow incision that is commonly used for brow lift. Methods: From March 2007 to October 2016, the authors identified patients with anterior wall frontal sinus fractures treated by open reduction through a suprabrow incision. Only cases with photographic/radiographic documentation and a minimum follow-up of 6 months were included. The incision line was designed to be at the upper margin of the eyebrow. Medical records and radiographic data were retrospectively reviewed. Surgical outcomes, cosmetic results, and complication were assessed. The patient scale of the patient and observer scar assessment scale was used to assess patient satisfaction for incisional scar at the 6-month follow-up. Results: Thirty-one patients underwent fracture reduction through a suprabrow approach during the study period, with a mean follow-up of 41 months. No patients showed any recurrent displacement, eyebrow asymmetry, or infection during follow-up. Thirteen patients reported their forehead paresthesia postoperatively, and 12 of them had preoperative symptom. One patient complained of incisional scar and underwent scar revision. All patients were satisfied with their eyebrow and forehead contour. Conclusion: The suprabrow approach allowed for an accurate reduction of the fractures in the anterior wall frontal sinus by providing direct visualization of the fracture. This transcutaneous approach can effectively restore forehead contour with acceptable postoperative complications and patient satisfaction.

Development of a Cardiac Catheter Remote Control Robot Platform for Radiofrequency Ablation Intervention (고주파 절제술을 위한 심장전극도자 원격 제어 로봇 플랫폼의 개발)

  • Park, Jun-Woo;Song, Seung-Joon;Lee, Jung-Chan;Choi, Hyuk;Lee, Jung-Joo;Choi, Jae-Soon
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.60 no.7
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    • pp.1417-1426
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    • 2011
  • Radiofrequency ablation through cardiac catheterization is one of minimally invasive intervention procedures used in drug resistant arrhythmia treatment. To facilitate more accurate and precise catheter navigation, systems for robotic cardiac catheter navigation have been developed and commercialized. The authors have been developing a novel robotic catheter navigation system. The system is a network-based master-slave configuration 3-DOF (Degree-Of-Freedom) robotic manipulator for operation with conventional cardiac ablation catheter. The catheter manipulation motion is composed of the translation (forward/backward) and the roll movements of the catheter and knob rotation for the catheter tip articulation. The master manipulator comprises an operator handle compartment for the knob and the roll movement input, and a base platform for the translation movement input. The slave manipulator implements a robotic catheter platform in which conventional cardiac catheter is mounted and the 3-DOF motions of the catheter are controlled. The system software that runs on a realtime OS based PC, implements the master-slave motion synchronization control in the robot system. The master-slave motion synchronization performance tested with step, sinusoidal and arbitrarily varying motion commands showed satisfactory results with acceptable level of steady state error. The developed system will be further improved through evaluation of safety and performance in in vitro and in vivo tests.

Compression Fractures Diagnosed during the Treatment of Postherpetic Neuralgia - A case report - (대상포진후신경통 치료 중 발견된 척추압박골절 - 증례보고 -)

  • Choi, Yong Min;Shin, Hwa Yong;Lee, Kang Joon;Koo, Mi Suk;Nahm, Francis Sahn Gun;Suh, Jeong Hun;Jo, Ji Yon;Kim, Yong Chul;Lee, Sang Chul
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.224-229
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    • 2007
  • Vertebral compression fractures can occur due to trauma, a malignancy, or most commonly, osteoporosis. These fractures are frequently seen in elderly women; 30% of postmenopausal women are affected by vertebral compression fractures. These fragile fractures frequently result in both acute and chronic pain, but more importantly, are a source of increased morbidity and possibly, mortality. These injuries can be treated both conservatively and with surgery. The use of percutaneous vertebral augmentation offers a minimally invasive approach for the treatment of vertebral compression fractures. We experienced two cases of compression fractures diagnosed during the treatment of thoracic postherpetic neuralgia. Two patients suffering from postherpetic neuralgia with a sharp and stabbing pain in the thoracic dermatomes that was unresponsive to conservative treatment were transferred to our clinic. During the management of postherpetic neuralgia, we incidentally found thoracic compression fractures after obtaining fluoroscopic guided images. After a balloon kyphoplasty, the preoperative pain related to the postherpetic neuralgia was successfully relieved soon after the procedure, and there were no complications.

Survey of Sonoanatomic Distances For Lumbar Medial Branch Nerve Blocks in Healthy Volunteers

  • Gharaei, Helen;Imani, Farnad;Solaymani-Dodaran, Masoud
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.133-138
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    • 2014
  • Background: The precise knowledge of anatomy and the region of transverse process (TP) and superior articular processes (AP) and their distance from the skin are important in blocking and treating lumbar facet syndrome. Evaluation of these anatomic distances from 3rd and 5th lumbar vertebrae in both sides and in different body mass index (BMI) in healthy volunteers might improve knowledge of ultrasound (US) lumbar medial branch nerve blocks (LMBB). Methods: Bilateral US in the 3rd and 5th lumbar vertebrae of 64 volunteers carried out and the distance between skin to TP and skin to AP was measured. These distances were compared on both sides and in different BMI groups. The analysis was done using SPSS 11. Analysis of variance was used to compare the means at three vertebral levels (L3-L5) and different BMI groups. P values less than 0.05 were considered statistically significant. The paired t-test was used to compare the mean distance between skin to TP and skin to AP on both sides. Results: The distance between skin to TP and skin to AP of 3rd vertebrae to 5th vertebrae was increased in both right and left sides (P < 0.001) from up to down. The mean distance from skin to TP were greater on the left side compared to the right in all three vertebral levels from L3 to L5 (P values 0.014, 0.024, and 0.006 respectively). The mean distance from skin to TP and the skin to AP was statistically significant in different BMI groups (P < 0.001). Conclusions: We found many anatomic distances which may increase awareness of US guided LMBB.

Effectiveness of intradiscal injection of radiopaque gelified ethanol (DiscoGel®) versus percutaneous laser disc decompression in patients with chronic radicular low back pain

  • Hashemi, Masoud;Dadkhah, Payman;Taheri, Mehrdad;Katibeh, Pegah;Asadi, Saman
    • The Korean Journal of Pain
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    • v.33 no.1
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    • pp.66-72
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    • 2020
  • Background: Low back pain secondary to discopathy is a common pain disorder. Multiple minimally invasive therapeutic modalities have been proposed; however, to date no study has compared percutaneous laser disc decompression (PLDD) with intradiscal injection of radiopaque gelified ethanol (DiscoGel®). We are introducing the first study on patient-reported outcomes of DiscoGel® vs. PLDD for radiculopathy. Methods: Seventy-two patients were randomly selected from either a previous strategy of PLDD or DiscoGel®, which had been performed in our center during 2016-2017. Participants were asked about their numeric rating scale (NRS) scores, Oswestry disability index (ODI) scores, and progression to secondary treatment. Results: The mean NRS scores in the total cohort before intervention was 8.0, and was reduced to 4.3 in the DiscoGel® group and 4.2 in the PLDD group after 12 months, which was statistically significant. The mean ODI score before intervention was 81.25% which was reduced to 41.14% in the DiscoGel® group and 52.86% in the PLDD group after 12 months, which was statistically significant. Between-group comparison of NRS scores after two follow-ups were not statistically different (P = 0.62) but the ODI score in DiscoGel® was statistically lower (P = 0.001). Six cases (16.67%) from each group reported undergoing surgery after the follow-up period which was not statistically different. Conclusions: Both techniques were equivalent in pain reduction but DiscoGel® had a greater effect on decreasing disability after 12 months, although the rate of progression to secondary treatments and/or surgery was almost equal in the two groups.

Subclavian Portal Approach for Isolated Subscapularis Tendon Tear - Technical Note - (견갑하 건 단독 파열에 대한 쇄골하 삽입구를 이용한 봉합술 - 술기보고 -)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Chang, Il-Woong;Kim, Se-Sik
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.221-225
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    • 2009
  • Purpose: For an isolated tear of the subscapularis tendon, the presented technique using a subclavian portal provides both a good angle for anchor placement and sufficient space for managing the upper portion of a subscapularis tendon tear. Materials and Methods: The conventional method needs 2 additional portals for traction, debriding the footprint and anchor fixation for repair. The presented technique requires only an anterior portal for suture management and a subclavian portal without cannula for suture anchoring and placement of suture hooks. Results: The two suture limbs of the anchor can be placed on the subscapularis tendon by the switching technique and these limbs are repaired sequentially. Conclusion: This technique is simple and reproducible and it can be applied to partial tears and minimally retracted subscapularis tears.

Effects of Antibiotics on Suppression of Agrobacterium tumefaciens and Plant Regeneration from Wheat Embryo

  • Han, Si-Nae;Oh, Poo-Reum;Kim, Hong-Sig;Heo, Hwa-Young;Moon, Jun-Cheol;Lee, Sang-Kyu;Kim, Kyung-Hee;Seo, Yong-Weon;Lee, Byung-Moo
    • Journal of Crop Science and Biotechnology
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    • v.10 no.2
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    • pp.92-97
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    • 2007
  • Antibiotics used for suppressing Agrobacterium in plant transformation procedure might have negligible effects on plant tissues and regeneration. The effects of antibiotics on growth suppression of Agrobacterium and plant regeneration were investigated for enhancing Agrobacterium-mediated transformation using wheat mature embryos. Antibiotics tested, except carbenicillin, were able to suppress that embryos were coated with a layer of Agrobacterium cells in callus induction medium. Agrobacterium growth was suppressed minimally at 50 mg/l of timentin, while cefotaxime and clavamox were completely suppressed at relative high concentration of 250 mg/l. In the treatment of carbenicillin, initiation of growth suppression of Agrobacterium occurred at 750 mg/l of concentration because Agrobacterium KYRT1 contains the carbenicillin resistant gene. In Agrobacterium inoculation, effects of antibiotics were significantly different on the rate of callus induction and shoot formation. Almost embryos were induced calli at 50 mg/l of timentin whereas callus induction rate was achieved above 90% at 100 mg/l and 250 mg/l of cefotaxime and clavamox, respectively. Shoot formation rate was higher in the treatment of timentin than that of cefotaxime and clavamox at 500 mg/l of concentration, respectively. Timentin can be used as a good antibiotics in Agrobacterium-mediated wheat transformation.

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Optimal Location of Mail Distribution Center using Steiner Tree (Steiner Tree 이론을 이용한 우편물 교환센터인 최적 워치선정)

  • Yang, Seong-Deog;Lyu, Woong-Gyu;Lee, Sang-Joong
    • Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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    • v.22 no.9
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    • pp.82-87
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    • 2008
  • Faster, safer and cheaper mailing of the postal matter is essential for surviving in the competitive market of home-delivery service. In the past, the domestic delivery business has been nu by only a few number of companies. But more and more number of companies including medium size ones are participating in the business, and the competition is getting severe. This paper proposes a method to select the optimal location of mail distribution centers that minimally connect the local mail centers of some major cities in Korea using the Steiner Tree theory, which is about connecting a finite number of points with a minimal length of paths and has been used in the distribution system optimization and optimal routing of the transmission lines of the electric power system. By using Steiner Tree theory in finding the best location of the postal delivery hub, we may expect the reduction of transportation cost and the increase of profit, resulting in acquiring the superior position in the competitive delivery business. It is expected that we may use the Steiner Tree theory in finding the best location of the electric power substation for the nott higher EHV(extreme high voltage) transmission network.

Clinical application of cryolipolysis in Asian patients for subcutaneous fat reduction and body contouring

  • Oh, Chang Hyun;Shim, Jeong Su;Bae, Kwang Il;Chang, Jae Hoon
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.62-69
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    • 2020
  • Background Cryolipolysis, a preferred method for minimally invasive body contouring, involves the noninvasive cooling of adipocytes to induce lipolysis without damaging other tissues. This study aimed to evaluate the safety and efficacy of cryolipolysis for the treatment of excessive fat tissue. Methods Between May 2014 and December 2017, 231 patients with 448 areas of interest were enrolled and their records were retrospectively reviewed. We used five different vacuum applicators, and the best-fitting applicator was used for each area. One cycle of cryolipolysis was applied at a cooling intensity factor of 41.6. The efficacy was evaluated 12 weeks after treatment via review of clinical photographs, the pinch test, and ultrasonographic measurements of fat thickness. The occurrence of any complications was also assessed. Results The volume was reduced in all of the areas to which cryolipolysis was applied. The rate of reduction of the fat layer as measured via the pinch test was 19.2%, and the rate of the decrease in fat layer thickness as measured via ultrasonography was 22.8%. Fat reduction of the upper arm differed significantly from that of the abdomen and flank, but no significant difference was found between sexes. The side effects were limited to erythema, edema, bruising, and numbness at the treatment site and resolved without treatment. Conclusions Cryolipolysis, with new and better-fitting applicators, is safe, fast, and effective for the reduction of excessive fat tissue on the abdomen, back, flank, and extremities. It is a good option for treating excess adipose tissue in Asian patients.