• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3595-3600
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• 2016

Background: To investigate the association between preoperative pathological Ki-67 labeling index and serum tumor marker cancer antigen 15-3 (CA 15-3) with clinic-pathological parameters and treatment outcomes in early breast cancer. Materials and Methods: A retrospective study at 4 cancer centers in Saudi Arabia and Egypt was performed. Data were collected for female patients diagnosed with unilateral early breast cancer between March 2010 and October 2013. Cases treated with neoadjuvant chemotherapy (NACT) followed by surgery and radiotherapy were included. NACT included 6-8 cycles of anthracycline and taxane based regimens. Trastuzumab and hormonal treatments were added according to HER2 and hormone receptor status. Baseline serum CA15.3 and pathological Ki67 levels were evaluated and correlated with disease free survival (DFS) and overall survival (OS). Results: A total of 280 pts was included. The median age was 49 years (38-66 y) and median overall survival was 35 (20-38) months (mo). Estrogen receptors (ER), progesterone receptors (PR) and HER 2 receptors were positive in 233 (83.2%), 198 (70%) and 65 cases (23.2%), respectively. High preoperative Ki67 and CA15.3 were noted in 177 (63.2%) and 131 (46.8%). A total of 45 (16%) patients had distal or local recurrence and 24 (8.6%) died of their disease. Most of the relapsed cases had high preoperative Ki-67 (n=41, 91%) and CA15.3 (n=28, 62%) values. All of the patients who died had a high Ki-67 but CA15.3 was high in 9 (37%) only. Mean DFS/OS in patients with high preoperative Ki-67 was 32 months /32 months as compared to 37 months/35 months in those with normal Ki-67 (p<0.001). Correlation of preoperative CA15.3 and survival was statistically not significant. Conclusions:Preoperative Ki-67 can be a predictive and prognostic marker. Higher levels are associated with poor DFS and OS in patients with early BC.

• Journal of Gastric Cancer
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• 제5권3호
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• pp.146-151
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• 2005

목적: 위암환자에서 수술 전 빈혈의 빈도 및 특성과 위절제술 후 빈혈의 특성에 대해 알아보고 위절제술 전후의 적절한 빈혈 관리 방법을 모색하여 환자 진료에 도움을 얻기 위하여 이 연구를 하였다. 대상 및 방법: 2001년 1월부터 2001년 12월까지 경북대학교병원에서 위암으로 위절제술을 받은 32f명의 환자들을 대상으로 수술 전과 수술 후에 혈색소, 혈청 철, 혈청 페리틴, 혈청 비타민 $B_{12}$, 혈청 엽산을 측정하였다. 결과: 수술 전 빈혈이 있었던 환자는 94명이었다. 수술 전 혈색소, 혈청 철, 혈청 비타민 $B_{12}$는 조기위암 환자에서 진행성 위암환자보다 높았다. 수술 전 혈색소, 혈청 철, 혈청 페리틴 농도는 남자환자에서 여자환자보다 높았다. 수술 전 빈혈이 있었던 환자가 위절제술 후에도 빈혈이 있을 확률이 의미 있게 높게 나타났다(P<0.001). 또한, 수술 전 저장 철 결핍이 있던 환자들이 위절제술 후에도 빈혈에 이환되거나 지속적 저장 철 결핍이 있을 확률이 의미 있게 높게 나타났다(P<0.001). 결론: 위절제술 전 저장 철 결핍이 있던 환자들은 수술 후에도 저장 철 결핍이 지속되거나 철 결핍성 빈혈이 발생할 가능성이 많고, 수술 전 빈혈이 있던 환자가 수술 후에도 빈혈에 이환 될 가능성이 많으므로 빈혈 및 철 결핍의 관리가 중요하며, 위절제술 후 철 결핍과 함께 비타민 $B_{12}$ 및 엽산의 결핍도 관찰되므로 수술 후 빈혈 지표를 추적 관찰하여 교정하는 것이 중요하다고 생각된다

• Journal of Korean Neurosurgical Society
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• 제29권4호
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• pp.500-506
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• 2000

뇌동정맥기형의 치료에 있어 술 전 색전술과 미세뇌수술을 병합함으로서 얼마나 치료효과를 높일 수 있는지를 알고자 후향적조사를 시행하였다. 조사군은 수술 전 초선택적 색전술후 수술을 시행하였던 10명의 뇌동정맥기형 환자를 대상으로 하였고, 대조군은 술 전 색전술 없이 수술만으로 치료하였던 27명의 환자를 대상으로 하였으며 각각의 환자군은 Spetzler-Martin grade, 뇌동정맥기형의 크기 그리고 Glasgow Outcome Scale을 이용한 술 후 추적관찰 결과에 따라 나누어 비교하였다. 조사대상 37명의 환자중 남자가 23명, 여자가 14명이었으며 나이는 11세부터 74세(평균 36세)였다. 뇌동정맥기형의 크기는 술 전 색전술과 수술적 치료를 병합하였던 조사군에서 평균 4.45cm로 수술만 시행하였던 군의 3.83cm에 비해 크게 나타났으며, Spetzler-Martin grade도 조사군에서는 3, 4, 5등급이 80%이었으나 대조군에서는 52%로 술 전 색전술과 수술을 병합한 군에서 높은 등급의 환자가 많았다. 수술 후 일주일째 평가한 Glasgow-Outcome Scale 점수는 조사군에서는 5점인 경우가 60%로 대조군의 44%보다 높았으며, 수술 후 6개월만에 평가한 점수도 조사군에서 5점인 경우가 80%이었고 대조군은 63%로 술 전 색전술과 수술을 병합하였던 환자에서 더 좋은 예후를 보였다. 결론적으로 수술 전 N-butyl cyanoacrylate를 이용한 초선택적 색전술을 시행한 후 수술 적으로 뇌동정맥기형을 제거함으로서 비교적 등급이 높은 환자에서 치료가 용이하였으며 이전의 수술적 치료만 하였던 경우에 비해 더 좋은 예후를 보임을 알 수 있었다.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.106-113
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• 2019

Objective : The efficacy of preoperative embolization for hypervascular metastatic spine disease (MSD) such as renal cell and thyroid cancers has been reported. However, the debate on the efficacy of preoperative embolization for non-hypervascular MSD still remains unsettled. The purpose of this study is to determine whether preoperative embolization for non-hypervascular MSD decreases perioperative blood loss. Methods : A total of 79 patients (36 cases of preoperative embolization and 43 cases of non-embolization) who underwent surgery for metastatic spine lesions were included. Representative hypervascular tumors such as renal cell and thyroid cancers were excluded. Intraoperative and perioperative estimated blood losses (EBL), total number of transfusion and calibrated EBL were recorded in the embolization and non-embolization groups. The differences in EBL were also compared along with the type of surgery. In addition, the incidence of Adamkiewicz artery and complications of embolization were assessed. Results : The average age of 50 males and 29 females was $57.6{\pm}13.5$ years. Lung (30), hepatocellular (14), gastrointestinal (nine) and others (26) were the primary cancers. The demographic data was not significantly different between the embolization and the non-embolization groups. There were no significant differences in intraoperative EBL, perioperative EBL, total transfusion and calibrated EBL between two groups. However, intraoperative EBL and total transfusion in patients with preoperative embolization were significantly lower than in non-embolization in the corpectomy group (1645.5 vs. 892.6 mL, p=0.017 for intraoperative EBL and 6.1 vs. 3.9, p=0.018 for number of transfusion). In addition, the presence of Adamkiewicz artery at the index level was noted in two patients. Disruption of this major feeder artery resulted in significant changes in intraoperative neuromonitoring. Conclusion : Preoperative embolization for non-hypervascular MSD did not reduce perioperative blood loss. However, the embolization significantly reduced intraoperative bleeding and total transfusion in corpectomy group. Moreover, the procedure provided insights into the anatomy of tumor and spinal cord vasculature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권5호
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• pp.252-261
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• 2023

Objectives: Patients undergoing oral surgery exhibit high anxiety, which may elevate their cortisol levels and affect postoperative recovery. Overweight patients are often encountered in the dental clinic due to the increasing prevalence of overweight. We aimed to investigate the relationships between preoperatively assessed body mass index (BMI), serum cortisol and high-sensitivity C-reactive protein (hs-CRP) levels, and visual analog scale (VAS) scores and preoperative anxiety in patients undergoing mandibular third molar (MM3) extraction and to identify predictors of postoperative complications. Patients and Methods: We analyzed 43 patients (age, 20-42 years) undergoing MM3 extraction. At the first visit, patients completed the Modified Dental Anxiety Scale (MDAS) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaires. Their BMI and VAS scores were also calculated. The participants underwent blood tests 1 hour before MM3 extraction. On the first postoperative day, the participants' VAS scores and serum hs-CRP levels were reevaluated. Results: We found that BMI was significantly correlated with preoperative VAS scores. Further, BMI and preoperative hs-CRP levels were significantly correlated among women and patients undergoing extractions of fully impacted MM3s. No correlations were found between serum cortisol and other variables. The preoperative MDAS and VAS scores were significantly positively correlated, especially among patients undergoing extractions of fully impacted MM3s. Multiple linear regression showed that BMI and the eruption status of the MM3 were significant predictors of postoperative hsCRP levels and VAS scores, respectively. Conclusion: In MM3 removals, patients with higher BMI showed elevated hs-CRP and higher VAS scores before surgery. Patients with higher anxiety among those undergoing extractions of fully impacted MM3s showed higher preoperative VAS scores. The two main predictors of postoperative complications were BMI and MM3 eruption status.

• Korean Journal of Radiology
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• 제21권4호
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• pp.402-412
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• 2020

Objective: To evaluate the performance of predicting early recurrence using preoperative factors only in comparison with using both pre-/postoperative factors. Materials and Methods: We retrospectively reviewed 549 patients who had undergone curative resection for single hepatcellular carcinoma (HCC) within Milan criteria. Multivariable analysis was performed to identify pre-/postoperative high-risk factors of early recurrence after hepatic resection for HCC. Two prediction models for early HCC recurrence determined by stepwise variable selection methods based on Akaike information criterion were built, either based on preoperative factors alone or both pre-/postoperative factors. Area under the curve (AUC) for each receiver operating characteristic curve of the two models was calculated, and the two curves were compared for non-inferiority testing. The predictive models of early HCC recurrence were internally validated by bootstrap resampling method. Results: Multivariable analysis on preoperative factors alone identified aspartate aminotransferase/platelet ratio index (OR, 1.632; 95% CI, 1.056-2.522; p = 0.027), tumor size (OR, 1.025; 95% CI, 0.002-1.049; p = 0.031), arterial rim enhancement of the tumor (OR, 2.350; 95% CI, 1.297-4.260; p = 0.005), and presence of nonhypervascular hepatobiliary hypointense nodules (OR, 1.983; 95% CI, 1.049-3.750; p = 0.035) on gadoxetic acid-enhanced magnetic resonance imaging as significant factors. After adding postoperative histopathologic factors, presence of microvascular invasion (OR, 1.868; 95% CI, 1.155-3.022; p = 0.011) became an additional significant factor, while tumor size became insignificant (p = 0.119). Comparison of the AUCs of the two models showed that the prediction model built on preoperative factors alone was not inferior to that including both pre-/postoperative factors {AUC for preoperative factors only, 0.673 (95% confidence interval [CI], 0.623-0.723) vs. AUC after adding postoperative factors, 0.691 (95% CI, 0.639-0.744); p = 0.0013}. Bootstrap resampling method showed that both the models were valid. Conclusion: Risk stratification solely based on preoperative imaging and laboratory factors was not inferior to that based on postoperative histopathologic risk factors in predicting early recurrence after curative resection in within Milan criteria single HCC patients.

• 치과방사선
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• 제22권2호
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• pp.203-213
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• 1992

The purpose of this study was to aid in the evaluation of prognosis of temporomandibular joint following orthognathic surgery. For this study, 20 patients (40 TMJ) who undergone orthognathic surgery were examined. Preoperative and postoperative tomograms of TMJ were taken. And the subjects were divided into 3 groups according to postoperative periods. The obtained results were as follows; 1. There were no significant differences between preoperative and postoperative changes in joint spaces in each group and between groups(P<0.05). 2. There were no significant differences between preoperative and postoperative ratio of joint space(P<0.05). 3. There were no significant differences between preoperative and postoperative changes in the range of motion of condylar head(P<0.05). 4. The bony changes of condylar head were observed in 14(35%) condyles (6 erosion, 2 flattening, 5 double contour, 1 osteophyte).

• Archives of Plastic Surgery
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• 제41권2호
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• pp.171-173
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• 2014

Preoperative perforator marking for deep inferior epigastric artery perforator flaps is vital to the success of the procedure in breast reconstruction. Advances in imaging have facilitated accurate identification and preselection of potentially useful perforators. However, the reported imaging accuracy may be lost when preoperatively marking the patient, due to 'mapping errors', as this relies on the use of 2 reported vectors from a landmark such as the umbilicus. Observation errors have been encountered where inaccurate perforator vector measurements have been reported in relation to the umbilicus. Transcription errors have been noted where confusing and wordy reports have been typed or where incorrect units have been given (millimetres vs. centimetres). Interpretation errors have also occurred when using the report for preoperative marking. Furthermore, the marking process may be unnecessarily time-consuming. We describe a bespoke template, created using an individual computed tomography angiography image, that increases the efficiency and accuracy of preoperative marking. The template is created to scale, is individually tailored to the patient, and is particularly useful in cases where multiple potential suitable perforators exist.

• 기본간호학회지
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• 제12권2호
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• pp.240-246
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• 2005

Purpose: This study was done to examine the effects of foot massage as a nursing intervention on preoperative anxiety, depression and sleep satisfaction in patients with breast surgery. Method: Research design was a nonequivalent control group non-synchronized design. Forty-one patients were assigned to the control group (21) and the experimental group (20). The patients answered a questionnaire containing measures of anxiety, depression and sleep satisfaction before and after the intervention. The collected data were analyzed by means of descriptive statistics, Cronbach's ${\alpha}$, Chi-square test, and t test using the SPSS WIN 11.0 program. Result: Anxiety and depression for the experimental group were significantly lower than those for the control group(t=2.556, p=0.008, t=2.932, p=0.006). Sleep pattern of the experimental group was significantly higher than that of the control group (t=2.313, p=0.013). Conclusion: Judging from these results, it is suggested that foot massage might have beneficial effects on reducing preoperative anxiety, depression, and increasing sleep satisfaction.

• 성인간호학회지
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• 제25권4호
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• pp.473-482
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• 2013

Purpose: The purpose of this study was to investigate the effects of a structured preoperative instruction upon anxiety and postoperative self-care compliance. Methods: A randomized control group pre-post design was used. Sixty subjects undergoing cataract surgery were randomly assigned to one of two groups. The instruction consisted of cataract surgery procedure, sensory information, deep breathing, use of eye drop, and post op self-care regimen and was provided to the experimental group with control group receiving an usual treatment. State anxiety NRS, pulse, BP, and self-care compliance scale developed by Cho & Rho were used. Data were collected at two time periods: on the day of surgery in the clinic and prior to anesthesia in the operating room. The postoperative self-care compliance scores were measured at their second visits to the hospital after surgery. Data were analyzed using Kolmogorov Smirnov test, t-test, and Mann-Whitney U test. Results: There were significant differences between the two groups in the postoperative state anxiety (t=-3.57, p=.001) and the postoperative self-care compliance score (t=3.92, p<.001). There were no significant difference between the two groups in the postoperative blood pressure and pulse rate. Conclusion: The results of this study suggest that the structured preoperative instruction could be a nursing intervention for cataract surgery patients.