• Title/Summary/Keyword: proximal methods

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Diabetes Mellitus and Site-specific Colorectal Cancer Risk in Korea: A Case-control Study

  • Woo, Hyeongtaek;Lee, Jeeyoo;Lee, Jeonghee;Park, Ji Won;Park, Sungchan;Kim, Jeongseon;Oh, Jae Hwan;Shin, Aesun
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.1
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    • pp.45-52
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    • 2016
  • Objectives: Previous large-scale cohort studies conducted in Korea have found a positive association between diabetes mellitus (DM) and colorectal cancer (CRC) in men only, in contrast to studies of other populations that have found significant associations in both men and women. Methods: A total of 1070 CRC cases and 2775 controls were recruited from the National Cancer Center, Korea between August 2010 and June 2013. Self-reported DM history and the duration of DM were compared between cases and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by binary and polytomous logistic regression models. Results: DM was associated with an elevated risk of CRC in both men (OR, 1.47; 95% CI, 1.13 to 1.90) and women (OR, 1.92; 95% CI, 1.24 to 2.98). This association remained when we controlled for age, body mass index, alcohol consumption, and physical activity level. In sub-site analyses, DM was associated with distal colon cancer risk in both men (multivariate OR, 2.04; 95% CI, 1.39 to 3.00) and women (multivariate ORs, 1.99; 95% CI, 1.05 to 3.79), while DM was only associated with rectal cancer risk in women (multivariate OR, 2.05; 95% CI, 1.10 to 3.82). No significant association was found between DM and proximal colon cancer risk in either men (multivariate OR, 1.45; 95% CI, 0.88 to 2.41) or women (multivariate OR, 1.79; 95% CI, 0.78 to 4.08). Conclusions: Overall, DM was associated with an increased risk of CRC in Koreans. However, potential over-estimation of the ORs should be considered due to potential biases from the case-control design.

American ginseng significantly reduced the progression of high-fat-diet-enhanced colon carcinogenesis in ApcMin/+ mice

  • Yu, Chunhao;Wen, Xiao-Dong;Zhang, Zhiyu;Zhang, Chun-Feng;Wu, Xiaohui;He, Xin;Liao, Yang;Wu, Ningning;Wang, Chong-Zhi;Du, Wei;He, Tong-Chuan;Yuan, Chun-Su
    • Journal of Ginseng Research
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    • v.39 no.3
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    • pp.230-237
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    • 2015
  • Background: Colorectal cancer (CRC) is a leading cause of death worldwide. Chronic gut inflammation is recognized as a risk factor for tumor development, including CRC. American ginseng is a very commonly used ginseng species in the West. Methods: A genetically engineered $Apc^{Min/+}$ mouse model was used in this study. We analyzed the saponin composition of American ginseng used in this project, and evaluated its effects on the progression of high-fat-diet-enhanced CRC carcinogenesis. Results: After oral ginseng administration (10-20 mg/kg/d for up to 32 wk), experimental data showed that, compared with the untreated mice, ginseng very significantly reduced tumor initiation and progression in both the small intestine (including the proximal end, middle end, and distal end) and the colon (all p < 0.01). This tumor number reduction was more obvious in those mice treated with a low dose of ginseng. The tumor multiplicity data were supported by body weight changes and gut tissue histology examinations. In addition, quantitative real-time polymerase chain reaction analysis showed that compared with the untreated group, ginseng very significantly reduced the gene expression of inflammatory cytokines, including interleukin-$1{\alpha}$ (IL-$1{\alpha}$), IL-$1{\beta}$, IL-6, tumor necrosis factor-${\alpha}$, granulocyte-colony stimulating factor, and granulocyte-macrophage colony-stimulating factor in both the small intestine and the colon (all p < 0.01). Conclusion: Further studies are needed to link our observed effects to the actions of the gut microbiome in converting the parent ginsenosides to bioactive ginseng metabolites. Our data suggest that American ginseng may have potential value in CRC chemoprevention.

A Literature Review of Application of Sifeng Point (EX-UE 10) in Children (소아에서 사봉혈(四縫穴) 활용에 대한 문헌 조사)

  • Lee, Boram;Shin, Hye Jin;Lee, Jihong;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.32 no.3
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    • pp.72-89
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    • 2018
  • Objectives The objective of this study is to investigate the application of Sifeng point (EX-UE 10) in children and to make suggestions for domestic research and clinical application by reviewing relevant randomized controlled trials. Methods Eight electronic databases including English, Chinese, Korean databases were comprehensively searched for randomized controlled trials evaluating the effects of Sifeng point in children up to May 2, 2018. We extracted the year of publication, country, target diseases or symptoms, location of Sifeng, acupuncture method; such as acupuncture tool and depth of insertion, and frequency, number, and duration of the treatment. Results Fifty studies were included for analysis. All the included studies were conducted in China, and studies were published from 1962 to 2017. The most frequent target symptom was anorexia (46%). In addition, Sifeng point was used for digestive diseases or symptoms such as diarrhea, constipation, and mesenteric lymphadenitis, as well as respiratory diseases or symptoms such as cough, cold, acute bronchiolitis, recurrent respiratory tract infections, bronchopneumonia, and asthmatic bronchitis. Also, allergic diseases such as chronic urticaria, and other variety of symptoms such as malnutrition, fever, and iron-deficiency anemia were treated with the Sifeng point. The location of Sifeng points was inconsistent, and the most common location of the Sifeng point was the midpoint of transverse creases of the proximal interphalangeal joints of the index, middle, ring and little fingers (84.2%). The most commonly used acupuncture tool was three-edged needle (40.9%). All included studies have the method of squeezing out blood or mucus from the Sifeng points. The treatment was mostly conducted once per week (35.4%), mostly repeated for 4 times (32.6%). The most common treatment duration was 4 weeks (18.6%). Conclusions We could identify acupuncture method and various indications for the Sifeng points treatment. Based on this study, there is a need for the clinical application and related researches on the Sifeng points in children in Korea. In addition, the treatment location of Sifeng point should be standardized.

Hypoxia Induced Expression of Vascular Endothelial Growth Factor in Rat Pulmonary Artery Smooth Muscle Cells (쥐의 폐동맥 평활근 세포에서 저산소에 의한 Vascular Endothelial Growth Factor의 발현)

  • Nho, Un Seok;Kim, Yeo Hyang;Hyun, Myung Chul;Lee, Sang Bum
    • Clinical and Experimental Pediatrics
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    • v.46 no.2
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    • pp.167-172
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    • 2003
  • Purpose : Pulmonary vascular hypertension is a common problem in congenital heart disease, the most common cardiac condition in childhood. However, the mechanisms responsible for this pathologic change, treatment, and prevention are poorly understood. Therefore, we studied the gene expression of vascular endothelial growth factor(VEGF) by using a hypoxic model of the pulmonary artery smooth muscle cells. Methods : The main pulmonary artery and its proximal branches of a 6 wk old Fischer rat were excised. They were cut into multiple small pieces and suspended in DMEM medium supplemented with 20% fetal bovine serum and incubated in 5% $CO_2$-95% air atmosphere. The smooth muscle cells were confirmed by immunostaining with smooth muscle myosin and ${\alpha}$-smooth muscle actin antibodies. The VEGF gene expression in the hypoxic group was compared with the one in control the group as well as the one in the starved group by RT-PCR and Northern blot hybridization. Results : There was no statistically significant difference among the control, hypoxic and starved groups. Conclusion : There are few studies of pulmonary vascular hypertension at the molecular level in Korea. Therefore, we studied the expression of VEGF gene in hypoxic pulmonary vascular smooth muscle cells. Further studies will be needed to find the difference between newly born and adult rats, or human and rat pulmonary vascular smooth muscle cells in gene expression. We hope that the study will lead to a better understanding of pulmonary vascular hypertension.

Acutrak Screw Fixation for Radial Head Fracture -7 Cases Report- (Acutrak 나사를 이용한 요골두 골절의 치료 -7례 보고-)

  • Kim, Kwang-Yul;Lim, Moon-Sup;Shin, Heung-Sub;Choi, Shin-Kwon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.75-80
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    • 2006
  • Purpose: To evaluate the efficiency of Acutrak screw fixation for radial head fracture (Mason type 2) without considering the safe Bone of radial head. Materials and Methods: Consecutive seven radial head fracture of Mason type II underwent internal fixation with Acutrak screws from May 2001 to February 2003. The mean follow-up period was 1.2years (ranged, $6 months{\sim}2.5 years$). The mean age of patients was 47 years old (ranged, $36{\sim}60years$ old). The cause of injury were fall down -4 cases and traffic accident -3 cases. The results were evaluated by Mayo Clinic results scoring system. Results: Functional Rating Index of Mayo Clinic was excellent- 2 cases and good- 5 cases. There were no nonunion, loosening, heterotopic ossification, infection or degenerative changes. The postoperative range of motion in elbow joint is nearly full for flexion, extension, pronation and supination in this study Conclusion: Consideration of safe zone is not necessary when Acutrak screws are used for radial head fracture. It seems to be a useful method that Acutrak screw fixation for radial head fracture (Mason type II) could achieve good radiologic and clinical results without influencing proximal radio-ulnar joint and has powerful fixation.

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Operative Treatment of Fractures of the Midshaft Clavicle using Locking Compression Plate (Locking Compression Plate를 이용한 전위성 쇄골 간부 골절의 수술적 치료)

  • Chung, Nam-Sik;Hong, Ki-Do;Ha, Sung-Sik;Park, Sung-Joon;Kang, Jung-Ho;Sim, Jae-Cheon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.63-68
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    • 2006
  • Purpose: To assess the effectiveness of the Locking compression plate (LCP) after open reduction for the treatment of the displaced clavicular shaft fracture, the clinical and radiologic outcome of the patients who were managed with the LCP for internal fixation after open reduction has been analyzed. Materials and Methods: We reviewed 26 cases with a displaced clavicular shaft fracture treated by internal fixation using Locking compression plate after open reduction between May 2003 and November 2004. The patients were followed up for at least six months period, and final postoperative outcome was evaluated using clinical results based on Kang's criteria, radiologic signs of fusion. Results: All fractures united by an average of 9.3 weeks without delayed union and showed fast recovery of motion fraction and shoulder function. In addition,24 cases without the fractures of proximal humerus recovered to normal range of shoulder notion within 2.9 weeks. Clinically, according to Kang's criteria, the outcome was good or better in 22 patients. The complications included shoulder joint dysfunction in two cases and keloid formation in one case, and no other complications were observed. Conclusion: The internal fixation using LCP for the treatment of displaced clavicular shaft fracture is a safe, reliable method of treatment, with few complications, and offers rapid recovery of shoulder joint function and bone union.

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Analysis of the Correlation between atrophy of exocervical epithelial cell and osteoporosis (자궁경부 상피세포위축과 골다공증의 상관관계 분석)

  • Lee, Dae-Il;Nam, Ha-Gyeong;Lee, Mi-Hwa;Gwak, Min-Jeong;Lee, Hyeon-Jeong;Lee, Su-Bae;Hong, Gwang-Seon
    • Journal of Korea Association of Health Promotion
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    • v.4 no.1
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    • pp.75-84
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    • 2006
  • Background : Osteoporosis and atrophic cell pattern in Pap smear are frequent findings In postmenopausal women due to loss of ovarian function, The present study attempted to find out possible correlation between morphologic characteristics of Pap smear and osteoporosis. Material & methods: The subjects were 825 women(age from 35 to 80) who had undergone Pap smear and bone mineral density(BMD) at The Korea Association of Health Promotion, Seoul Branch, from March 8 to May 10, 2005. Pap smears from 825 women were reviewed and classified either mature cell pattern or atrophic cell pattern by their cytologic patterns, BMD were measured using LUNAR DPX MdIQ(Minster, Ohio, USA). BMD value of lumbar spine(Ll, L2,L3 and L4) were measured from 825 women and BMD value of proximal region off emur(neck NK, Wards triangle WT, and trochanter TR) were measured from 818 women and their bone status were classified as normal( T-sore:>-1.0), osteopenia (T-score: -l~<-2,5) and osteoporosis(T-score: ≤ -2.5). And age distribution of Pap smear, average T-value andfrequency ofsteoporo-sis of each region of the bone, percentage of osteoporosis of each boneregion by age group and changing pattern of percentage of osteopenia and osteoporosis in certain postmenopausal period were compared between mature and atrophic cell pattern. Results: Pap smears revealed total mature cell pattern 53,9%(445/825) and total atrophic cell pattern 46.1%(380/825), Percentage of mature cell pattern decreased from 98.2%(168/171)under 44 age group to 13,3%(17/128) over 65 age group and mature cell pattern increased from 1.8%(3/171) under 44 age group to 86.7%(111/128) oyer 65 age group. Mean T-value of each region of lumbar spine and femur of mature cell pattern were lower than that of atrophic cell pattern about -1,5. And osteoporosis has noted in atrophic cell pattern showing odds ratio Ll 13.9, L2 15.3, L3 12.0, L4 10,4, UK 6.7, WT 10.9 and TR 4.1.Atrophic cell pattern started to increase after 45 years of age and osteoporosis of a trophic cell pattern started after 55 years of age. During 50 to 64 years of age period, L3, L4 and WT revealed parallel increased of osteopenia and osteoporosis and Ll, L2 revealed decreased of osteopenia and increased of osteoporosis. nia Conclusion: Above findings suggest that atrophic cell pattern of Pap smear precedes osteoporosis about 10 years and one of predictor of osteoporosis.

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The Effect of Endoscopic Resection on Short-Term Surgical Outcomes in Patients with Additional Laparoscopic Gastrectomy after Non-Curative Resection for Gastric Cancer

  • Lee, Eun-Gyeong;Ryu, Keun-Won;Eom, Bang-Wool;Yoon, Hong-Man;Kim, Yong-Il;Cho, Soo-Jeong;Lee, Jong-Yeul;Kim, Chan-Gyoo;Choi, Il-Ju;Kim, Young-Woo
    • Journal of Gastric Cancer
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    • v.17 no.1
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    • pp.33-42
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    • 2017
  • Purpose: Endoscopic submucosal dissection (ESD) in early gastric cancer causes an artificial gastric ulcer and local inflammation that has a negative intraprocedural impact on additional laparoscopic gastrectomy in patients with noncurative ESD. In this study, we analyzed the effect of ESD on short-term surgical outcomes and evaluated the risk factors. Materials and Methods: From January 2003 to January 2013, 1,704 patients of the National Cancer Center underwent laparoscopic gastrectomy with lymph node dissection because of preoperative stage Ia or Ib gastric cancer. They were divided into 2 groups: (1) with preoperative ESD or (2) without preoperative ESD. Clinicopathologic factors and short-term surgical outcomes were retrospectively evaluated along with risk factors such as preoperative ESD. Results: Several characteristics differed between patients who underwent ESD-surgery (n=199) or surgery alone (n=1,505). The mean interval from the ESD procedure to the operation was 43.03 days. Estimated blood loss, open conversion rate, mean operation time, and length of hospital stay were not different between the 2 groups. Postoperative complications occurred in 23 patients (11.56%) in the ESD-surgery group and in 189 patients (12.56%) in the surgery-only group, and 3 deaths occurred among patients with complications (1 patient [ESD-surgery group] vs. 2 patients [surgery-only group]; P=0.688). A history of ESD was not significantly associated with postoperative complications (P=0.688). Multivariate analysis showed that male sex (P=0.008) and laparoscopic total or proximal gastrectomy (P=0.000) were independently associated with postoperative complications. Conclusions: ESD did not affect short-term surgical outcomes during and after an additional laparoscopic gastrectomy.

Multi-dimentional Correction of the Scarf Osteotomy for the Treatment of Hallux Valgus (무지 외반증에 시행한 Scarf 절골술의 3차원적 변형 교정력에 관한 연구)

  • Moon, Gi-Hyuk;Ahn, Gil-Yeong;Yun, Ho-Hyun;Lee, Yeong-Hyun;Lee, Jung-Ick;Nam, Il-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.23-27
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    • 2007
  • Purpose: Scarf osteotomy can provide the simultaneous correction of the hallux valgus angle (HVA), 1-2 intermetatarsal angle ($IMA_{1-2}$), DMAA and the plantar displacement of the fragment. The study was conducted to understand the multi-dimensional correction of the hallux valgus. Materials and Methods: Fourty eight patients who had undergone Scarf osteotomy with hallux valgus at more than $30^{\circ}$ of HVA and more than $15^{\circ}$ of $IMA_{1-2}$ were studied. Before an osteotomy, a reference K-wire was inserted to the 1st metatarsal head. After the osteotomy, the plantar fragment was moved laterally and the proximal end of the fragment was forced beyond the distal end which resulted in an internal rotation of the head fragment to correct the DMAA. Results: The HVA improved an average of $33.3^{\circ}$ to $7.7^{\circ}$ with the IMA1-2 respectively from $15.4^{\circ}$ to $6.5^{\circ}$. The DMAA improved an average of $19.5^{\circ}$ ($5.2-30.9^{\circ}$) to $4.5^{\circ}$ ($0.4-13.8^{\circ}$). By checking the angle, which was at an average of $25^{\circ}$ between the plantar surface of the foot and the osteotomy plane, the average distance of 1.9 mm (1.18-3.1 mm) of plantar displacement was measured using the value of sine (sin 25 = 0.422). Conclusions: It is possible to correct the HVA, IMA1-2 and DMAA simultaneously with one osteotomy making the lateral shift, the internal rotation and the plantar displacement of the plantar head fragment as desired. Despite the technicality and difficulty of the Scarf osteotomy, once familiarized through myriad procedures, all disadvantages are outweighed by the success and satisfaction of both patient and surgeon.

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The Role of Angled Blade Plate in Treatment of Bone Tumor Occurred in Femur (대퇴골 골종양의 치료에 있어서의 Angled Blade Plate의 역할)

  • Kim, Tai-Seung;Kang, Chang-Nam;Chung, Ung-Seo
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.175-182
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    • 2005
  • Purpose: Bone tumor occurred in femur frequently involve proximal intertrochanteric region or distal metaphyseal region. Sometimes, the pathologic fracture can happen according to the size of tumor due to the substantial biomechanical stresses. Therefore, the prognosis can be improved biomechanically by the angled blade plate considering the anatomic configuration after the excision of tumor. Materials and Methods: Between October 1991 and April 2005, there were a total of 16 patients(17 cases) who were treated by the excision of tumor and internal fixation with the angled blade plate for bone tumor occurred in femur. After the excision of tumor, we filled the cavity by bone graft in 11 cases and bone cement in 6 cases. The internal fixation was used by angled blade plate in all cases. Result: The average follow-up time was 55.5 months(6-144 months) in 16 patients(17 cases). No metal failure occurred after the operation. Reoperation was performed in 4 cases due to tumor recurrence, and the internal fixation was firm until that. Conclusion: The angled blade plate can prevent the fracture until grafted bone incorporated to host bone, and protect fragile connection between cement and host bone.

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