• Title/Summary/Keyword: mortality function

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A Clinical Study of Management In Myasthenia Gravis (중증 근무력증 환자의 임상적 고찰)

  • Kim, Hun;Lee, Du-Yeon;Jo, Beom-Gu;Hong, Seung-Rok
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.112-127
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    • 1987
  • Myasthenia gravis is a neuromuscular transmission function disorder characterized by fatigue and weakness of voluntary muscles. This muscular weakness is intensified by activity and stress, and improved by the use of anticholinesterase compounds. It was initially described by Erb in 1879 and later named myasthenia gravis by Jolly in 1895. Although the pathogenesis is Known to be an autoimmune related reduction in the number of available acetylcholine receptors at neuromuscular junctions, the role of thymus in myasthenia gravis is still unclear and under investigation. Thymectomy in the management of myasthenia gravis has become increasingly important since Dr. Blalock observed in 1939 that some patients with thymic tumors and myasthenia gravis improved following thymectomy. A clinical study of 102 cases of myasthenia gravis was performed at Yonsei University College of Medicine. Seoul, Korea from Jan. 1976 to Jun. 1986. In order to determine which factors are of prognostic significance, attention is focused upon pre-operative patient evaluation, problems in operative and post-operative care, and long-term follow-up observations. The results were as follows: 1. The sex distribution was 67 females and 35 males, the mean age of onset was 28.95*1.69 years, and the maximal incidence occurred between 21 and 40 years of age [56 cases: 54.9%]. 2. Clinical manifestations of ocular symptoms were seen to 70 patients [68.6%] extremities weakness in 33 [32.3%], bulbar weakness in 29 [28.4%], and dyspnea in 13 [12.7%]. 3. Study cases more than two thirds were classified as mild types [MG 1 and MG 11A] and 6 cases as grave [MG 1V] based on the modified Osserman`s classification system, 4. Thymectomy was performed in 19 cases which presented in severe myasthenia symptoms and showed no improvement with cholinergic drugs. Histologic examination of the excised thymus glands revealed no abnormalities in 4 cases, thymic hyperplasia in 5, benign thymoma in 5, and malignant thymoma in 5. 5. Immediate post-operative complications included 2 cases of pneumothorax which were treated by tube thoracostomies, there was no operative mortality. 6. The response to cholinergic drugs in 36 cases younger than 20 years old and in 27 cases older than 40 years was relatively poor, while that in 35 cases between the ages of 21 and 40 years old was good. 7. Thirty of 39 cases in groups IIB, III & IV improved markedly with medical or surgical management while only 16 of 59 cases in the mild groups [I and IIA] improved, almost all surgical cases improved in all categories. 8. There were 5 deaths. occurring between 7 months and 3 years 3 months of treatment of myasthenia gravis. The causes of death were myasthenic crisis in 2 cases, respiratory failure due to candidiasis & radiation pneumonitis in one case, cerebral hemorrhage due to high blood pressure in two case.

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Versatility of Radial Forearm Free Flap on Head and Neck Cancer in Old-Aged Patient and its Donor Site Morbidity (노인 두경부 종양환자에서 노쪽아래팔유리피판술의 유용성 및 공여부 결과의 비교)

  • Lee, Ki-Eung;Koh, Sung-Hoon;Eo, Su-Rak
    • Archives of Reconstructive Microsurgery
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    • v.15 no.2
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    • pp.92-100
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    • 2006
  • Radial forearm free flap (RFFF) has been established itself as a versatile and widely used method for reconstruction of the head and neck, although it is still criticized for high mortality of donor site. Delayed wound healing, cosmetic deformity, vascular compromise and potentially reduced wrist function have many plastic surgeons hesitate to adapt it as a first choice in micro-reconstruction. To overcome these drawbacks, some techniques for donor-site repair such as V-Y advancement with full thickness skin graft (FTSG), application of artificial dermis ($Terudermis^{(R)}$) or acellular dermal matrix ($AlloDerm^{(R)}$), and double-opposing rhomboid transposition flap have been reported. Authors performed 4 cases of RFFF in old-aged patients of the head and neck cancer from April 2005 to February 2006. We compared the outcomes of donor site of RFFF which were resurfaced with split thickness skin graft (STSG) only and STSG overlying an $AlloDerm^{(R)}$. Patients were all males ranging from 59 to 74 years old (mean, 67.5). Three of them had tongue cancers, and the other showed hypopharyngeal cancer. All cases were pathologically confirmed as squamous cell carcinomas. We included the deep fascia into the flap, so called subfascially elevated RFFF in three cases, and in the other one, we dissected the RFFF suprafascially leaving the fascia intact. The donor site of the suprafascially elevated RFFF was resurfaced with STSG only. Among three of subfascially elevated RFFFs, donor-sites were covered with thin STSG only in one case, and STSG overlying $AlloDerm^{(R)}$ in two cases. All RFFFs were survived completely without any complication. The donor site of the suprafascially elevated RFFF was taken well with STSG only. But, the partial graft loss exposing brachioradialis and flexor carpi radialis muscle was unavoidable in all the subfascially elevated RFFFs irregardless of $AlloDerm^{(R)}$ application. Considering that many patients of the head and neck cancer are in old ages, we believe the RFFF is still a useful and versatile choice for resurfacing the head and neck region after cancer ablation. Its reliability and functional characteristics could override its criticism for donor site in old-aged cancer patients.

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Effects of Sabaiksan on the Compound 48/80 Induced Anaphylatic Shock and Cutaneous Reaction (사백산(瀉白散)이 Compound 48/80에 의하여 유도(誘導)된 Anaphylatic shock와 피하반응(皮下反應)에 미치는 영향(影響))

  • Kim, Min-Ho;Han, Sang-Whan;Jeon, Byeong-Deuk
    • The Journal of Internal Korean Medicine
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    • v.11 no.2
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    • pp.22-42
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    • 1990
  • Sabaiksan has been prescribed to treat various allergic diseases in herbal medicine which were induced by various vasoactive amine released from the mast cells. The constituents of Sabaiksan are Mori Cortex Radices(MCR), Lycii Cortex Radicis(LCR) and Glycyrrhizae Radix(GR). Recently, simple models of compound 48/80 induced anaphylactic shock and cutaneous reaction in vivo were developed to test various agents employed in the field of allergy and toxicology research. The purpose of this study is to evaluate the effects of Sabaiksan on compound 48/80 induced anaphylactic stock, cutaneous reaction and mesenteric mast cell degranulation rate in ICR mice, and on compound 48/80 induced peritoneal mast cell degranulation and histamine release in vitro. Groups of ICR mice were intraperitoneally pretreated with $100{\mu}{\ell}$ of saline, $MCR(2g/m{\ell}),\;LCR(2g/m{\ell}),\;GR(g/m{\ell})$ or Sabaiksan itself(MCR+LCR+GR) at 24, 12 and 1 hour before compound 48/80 solution ($10{\mu}{\ell}/gm$ B. W) were peritoneally given into them, and then mortality within 72 hours after the compound 48/80 injection, and mesenteric mast cell degranulation rate at 15 minutes after compound 48/80 injection were calculated. In vitro experiment, $400{\mu}{\ell}$ of rat peritoneal mast cell suspension$(10^6cell/m{\ell})$ were pretreated with $50{\mu}{\ell}$ of saline, $MCR(2g/m{\ell}),\;LCR(2g/m{\ell}),\;GR(g/m{\ell})$ or Sabaiksan itself at room temperature for 30 minutes, and then $50{\mu}{\ell}$ of compound 48/80 solution $(100{\mu}g/m{\ell})$ were added into it. 30 minutes after the addition of compound 48/80 solution, histamine release assay in the supernatant of peritoneal mast cell suspension were performed employing radioisotope enzymatic assay and morphologic changes of mast cells in each regular time point were photographed. Compared with controls, compound 48/80 induced anaphylactic shock was significantly inhibited by MCR and GR pretreatment into the ICR mice. Significant inhibition of compound 48/80 induced cutaneous reaction, mesenteric mast cell degranulation rate in vivo and histamine release from the rat peritoneal mast cells in vitro was observed only in MCR pretreated group. From the above results, it is suggested that MCR component of Sabaiksan may playa key role to suppress mast cell function since it has been applied to various allergic diseases.

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28-Day Oral Toxicity of Cadmium Selenide in Sprague-Dawley Rats

  • Kim, Yong-Soon;Song, Moon-Yong;Kim, Jin-Sik;Rha, Dae-Sik;Jeon, Yong-Joon;Kim, Ji-Eun;Ryu, Hyeon-Yeol;Yu, Il-Je;Song, Kyung-Seuk
    • Toxicological Research
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    • v.25 no.3
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    • pp.140-146
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    • 2009
  • This study was performed to evaluate the toxicity of cadmium selenide for a period of 28 days in Sprague-Dawley rats. Each of 10 healthy male and females rats per group received daily oral administration for 28-day period at dosage levels 30, 300 and 1,000 mg/kg of body weight. Mortality and clinical signs were checked, and body weight, water intake and food consumption were also recorded weekly. There were no dose-related changes in food consumption or urine volume. All animals survived to the end of study with no clinical signs or differences in body weight gain observed when compared with the control group. At the end of study, all animals including control group, were subjected to necropsy. Blood samples were collected for hematology tests including coagulation time and biochemistry analysis. Blood coagulation time and relative organ weight were unaffected by all received doses. White Blood Cell (WBC) counts significantly increased in the 300 mg/kg administered male animal group when compared to the control. Monocyte (MO) value were also increased significantly in both 300 and 1,000 mg/kg male animal group. However, Mean Corpuscular Volume (MCV) were significantly decreased compared with the control in the 1,000 mg/kg dose groups for male and female animals. Mean Corpuscular Hemoglobin (MCH) decreased significantly for female in the 300 and 1,000 mg/kg group compared to the control. Blood biochemical values of Inorganic phosphorus (IP) were significantly increased in both the 300 and 1,000 mg/kg dose groups in male animals when compared to the control. Creatinine (CRE) levels indicated significant increase in kidney function for the female, 30 mg/kg dose group when compared with control. There was a significant decrease in thymus absolute organ weight in the female, 1,000 mg/kg dose group when compared with control. Histopathological findings revealed no evidence of injury related to cadmium selenide except for one case of focal hepatic inflammation in the high dose (1,000 mg/kg) group. One case of lung inflammation was also seen in the control group. Basis on these result, the No Observable Adverse Effect Level (NOAEL) of cadmium selenide was determined to be more than 1,000 mg/kg/day for male and female rats under conditions in this study.

Reconstruction of Mainstem Bronchus Obstructed by Endobronchial Tuberculosis (결핵성 주기관지협착에 대한 주기관지재건술)

  • Kim Su Wan;Kim Jhingook;Shim Young Mog;Kim Kwhanmien;Choi Yong Soo;I Hoseok;Kim Hojoong;Chang Jee Won
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.622-626
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    • 2005
  • Background: Non-invasive interventional therapy has been performed for main bronchial obstruction by endobronchial tuberculosis because of the risk of main bronchial reconstruction regardless of the pulmonary function. But, effects of the inteeventional therapy are attacked by arguments. This study was aimed at interpreting the risk and effectiveness of bronchoplasty for benign bronchial stenosis over the last ten years in our hospital by reviewing the results based on clinical progression. Material and Method: We retrospectively reviewed the clinical records and out-patient medical records including 2f consecutive patients who underwent main bronchial reconstruction for obstruction by endobronchial tuberculosis. All of them had past medical history of anti-tuberculosis medication. They were preoperatively evaluated by bronchoscopy and chest computed tomography. Result: There were no incidences of postoperative mortality and signifcant morbidity. There were 2 cases of retained secretions but these problems were resolved by therapeutic bronchoscopy or intubation. All of the patients are still alive without obstructive airway problem. Conclusion: Bronchoplasty should be considered as one of the primary treatment modalities, if it is anatomically feasible.

Early Outcomes of Sutureless Aortic Valves

  • Hanedan, Muhammet Onur;Mataraci, Ilker;Yuruk, Mehmet Ali;Ozer, Tanil;Sayar, Ufuk;Arslan, Ali Kemal;Ziyrek, Ugur;Yucel, Murat
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.165-170
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    • 2016
  • Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used. Results: The mean age of the patients was $71.15{\pm}8.60years$. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was $56.9{\pm}9.93$. The CPB time was $96.51{\pm}41.27minutes$ and the cross-clamping time was $60.85{\pm}27.08minutes$. The intubation time was $8.95{\pm}4.19hours$, and the intensive care unit and hospital stays were $2.89{\pm}1.42days$ and $7.86{\pm}1.42days$, respectively. The mean quantity of drainage from chest tubes was $407.69{\pm}149.28mL$. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was $687.24{\pm}24.76days$. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

Studies on the Toxicity of Benzophenone in the Developing Chick Embryo (계배 발생과정에서 benzophenone의 독성에 관한 연구)

  • Yoo, Min;Kim, Su-Won
    • Journal of Life Science
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    • v.19 no.9
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    • pp.1309-1313
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    • 2009
  • Endocrine disruptors are chemicals which can be found in our normal daily lives. Chemicals such as bisphenol A, DDT, benzophenone and phenylphenol can be easily ingested through plastic food containers and pesticides. Endocrine disruptors can be very harmful and toxic because they disrupt the normal function of the endocrine system. It has been reported that endocrine disruptions can cause fatal strikes in the cardiovascular, reproductive, and central nervous systems, and other parts of the body. Therefore we examined if benzophenone as an endocrine disruptor inhibits development in or induces malformation of chick embryos. Chick embryos which received a single injection of benzophenone ($1{\mu}g$/egg $\sim$ $500{\mu}g$/egg) via the yolk sac at designated times (6, 9, 12, 15, 18 and 21 days after incubation) were investigated. Body weight reduction was observed in middle doses ($40{\mu}g$/egg $\sim$ $60{\mu}g$/egg). High mortality rates and teratogenic signs such as abnormal wry beak and abnormal eyeballs were seen in high doses ($80{\mu}g$/egg $\sim$ $500{\mu}g$/egg). In conclusion, it is suggested that benzophenone induces malformation of chick embryos and seriously inhibits development.

A Study on the Management of the Indian Ocean Tuna Fishing Grounds (인도양 다랭이어업의 어장관리에 관한 연구)

  • Gong, Yeong;Park, Yeong-Chull;Yang, Won-Seok;Lee, Je-Hu
    • The Journal of Fisheries Business Administration
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    • v.18 no.1
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    • pp.59-97
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    • 1987
  • Tuna and tuna fishing extend over most of the tropical waters of the world oceans, especially, this study of the Indian Ocean and the fish and the fishing vessels are highly mobile. No country can deal in isolation with the problems of its tuna fishery and of any tuna fishery in its waters, without collaborating with other countries. This cooperation is often best established through some formal international mechanism. The essential requirements are for information-on the resources, the fishery, the trade-and to identify where management actions are needed to consore the resources or to maintain the economic or social function of the fishery. These will also usually require some form of international mechanism. With the changes in the Law of the Sea, the siuuation in respect of management of tuna-considered among the highly migratory species, requirng special treatment-has also changed. At present there are both uncertainty regarding tuna management and political arguments as to how such management can be best implemented. Bearing this in mind, together with the fact that only few tuna stocks have shown clear evidence of serious depletion through over-exploitation, present emphasis will be placed on information requirements. This study included compiling the data necessary to review the state of stoks in the Indian Ocean tuna fishing grounds. Information on the resources-where the fish are, their quantity, their movements, etc. is important, whether in planning development of new fisheries, or considering the need for collaboration with other countries (in ascertaining to what extent their catches may affect catches of the natoinal fleet) or for conservation measures. A major source of information is the statistics of for conservation measures. A major source of information is the statistics of catch and fishing effort from existing commercial vessels. These need to be assembled for all fisheries on the same stock on an oceanwide basis. The statistical data also need to be analysed and intepreted, and combined with biological data(e.g., on growth, mortality and migration rates) to provide information that is intelligible and useful for administrators and other decision-makers. This must also be undertaken on a resource-wide or ocean-wide basis. Finally, because of the world-wide similarities in the methods of datching, processing and marketing fish, there is a particular tut not exclusive need in those countries just beginning to develop their tuna fisheries-to have ready access to a syntheis of information on tuna, tuna biology and tuna fisheries and tuna fisheries economics and management on the Indian Ocean.

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The Role of Bmi1 in Pilocarpine-induced Status Epilepticus in Mice (Pilocarpine에 의해 유도된 생쥐 경련중첩증에서 Bmi1의 역할)

  • Pyeon, Hae-In;Bak, Jia;Choi, Yun-Sik
    • Journal of Life Science
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    • v.30 no.6
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    • pp.513-521
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    • 2020
  • B-cell-specific Moloney murine leukemia virus integration site 1 (Bmi1) is a polycomb group protein and a core component of polycomb repressive complex 1. Initial research into Bmi1 has focused on its role in tumorigenesis, and it is generally accepted that it is important for the proliferation and survival of cancer cells. However, more recent studies have revealed that Bmi1 is downregulated in brains with neurodegenerative disease and that it regulates the function of mitochondria and reactive oxygen species levels. In this study, we tested the therapeutic potential of Bmi1 in pilocarpine-induced seizures in Bmi1-knockout mice. Bmi1 expression transiently increased in the hippocampal CA1 and CA3 and the dentate gyrus following pilocarpine-induced status epilepticus (SE). In terms of seizure behavior, SE induction was 43.14% and 53.57% for Bmi1+/+ and Bmi1+/- mice, respectively. However, there was no significant difference in mortality or hippocampal damage between the two groups. Two months after SE induction, the frequency of epileptic seizures in the Bmi1+/- mice was 50% lower than in the control group, although the difference was not statistically significant. In addition, mossy fiber outgrowth in the Bmi1+/- mice was significantly higher than in their wild-type littermates. Taken together, these data indicate that reduced Bmi1 activity increases pilocarpine-induced seizure probability and mossy fiber outgrowth.

Current Trends and Recent Advances in Diagnosis, Therapy, and Prevention of Hepatocellular Carcinoma

  • Wang, Chun-Hsiang;Wey, Keh-Cherng;Mo, Lein-Ray;Chang, Kuo-Kwan;Lin, Ruey-Chang;Kuo, Jen-Juan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3595-3604
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    • 2015
  • Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.