Objective : Recently, the survival rate and prognosis of spontaneous intracerebral hemorrhage[S-ICH] has improved, and their enhanced survival has become associated with a consequent rise in the recurrence of S-ICH. The aim of this study is to improve the prevention of recurrent S-ICH. Methods : Between January 1999 and March 2004, we experienced 48 cases of recurrence. We classified the patients into the two groups; a double ICH group and a triple ICH group. We investigated their brain CTs, MRIs, cerebral angiographies, and medical records, retrospectively. Results : Majority of patients had the intervals at least 12 months, and most of patients underwent conservative treatment. The most common hemorrhage pattern of recurrence was ganglionic-ganglionic [basal ganglia - basal ganglia], and the second attack was contralateral side of the first attack in a large percentage of all patients. Prognosis of patients was worsened in recurrent attack. Nearly all patients had medical history of hypertension, and most patients have taken antihypertensive medication at the arrival of emergency room. Conclusion : In treating hypertension for S-ICH patients, we stress that blood pressure must be thoroughly controlled over a long period of time.
Kim, Eun Jung;Yoon, Sung Ho;Lee, Seung Il;Kwon, Yong Eun
Tuberculosis and Respiratory Diseases
/
v.67
no.1
/
pp.27-31
/
2009
Background: The large caliber catheter used in the treatment of pneumothorax causes great damage to the chest wall and organs. The purpose of this study was to prove that the use of a smaller caliber catheter is effective in treating pneumothorax with decreasing admission period and that the recurrence rate of spontaneous pneumothorax is low. Methods: Patients who had been admitted for treatment of first time occurrence of pneumothorax between May, 2004 and December, 2008 were included in the study. The caliber of catheter used this study is 18 Guage (1.2mm). The efficacy of treatment, admission period and recurrence rate of treating pneumothorax with small caliber catheter were compared to the control group using a tube thoracostomy for treatment. Results: The admission period for primary spontaneous pneumothorax was 10.8$\pm$3.6 days for the group (n=68) using tube thoracostomy compared to 4.5$\pm$1.3 days for the group (n=31) using the small caliber catheter (p<0.05). There was no statistically significant difference in recurrence rate between the two groups. Conclusion: The use of a smaller caliber catheter for the treatment of pneumothorax reduces the admission period without a significant increase in recurrence rates.
Song, Joon Ho;Chang, In Bok;Ahn, Jun Hyong;Kim, Ji Hee;Oh, Jae Keun;Cho, Byung Moon
Journal of Korean Neurosurgical Society
/
v.57
no.4
/
pp.250-257
/
2015
Objective : Endovascular treatment of wide-necked intracranial aneurysms is a challenge and the durability and the safety of these treated aneurysms remain unknown. The aim of this study was to evaluate the clinical and long-term angiographic results of wide-necked intracranial aneurysms treated with coil embolization. Methods : Between January 2002 and December 2012, 53 wide-necked aneurysms treated with coil embolization were selected. Forty were female, and 13 were male. Twenty eight (52.8%) were ruptured aneurysms, and 25 (47.2%) were unruptured aneurysms. The patents' medical and radiological records were reviewed retrospectively. Results : Of the 53 aneurysms, coiling alone was employed in 45 (84.9%) and stent-assisted coiling was done in 8 (15.1%). The initial angiographic results revealed Raymond class 1 (complete occlusion) in 30 (56.6%) cases, Raymond class 2 (residual neck) in 18 (34.0%) cases, and Raymond class 3 (residual sac) in 5 (9.4%) cases. The mean angiographic follow-up period was 37.9 months (12-120 months). At the last angiographies, Raymond class 1 was seen in 26 (49.1%) cases, Raymond class 2 in 16 (30.2%), and Raymond class 3 in 11 (20.8%). Angiographic recurrence occurred in 22 (41.5%) patients, with minor recurrence in 7 (13.2%) cases and major recurrence in 15 (28.3%). Retreatment was performed in 8 cases (15.1%). A suboptimal result on the initial angiography was a significant predictor of recurrence in this study (p=0.03). Conclusion : The predictor of recurrence in wide-necked aneurysms is a suboptimal result on the initial angiography. Long-term angiographic follow-up is recommended in wide-necked aneurysms.
Jo, Kyung Il;Yang, Na-Rae;Jeon, Pyoung;Kim, Keon Ha;Hong, Seung-Chyul;Kim, Jong Soo
Journal of Korean Neurosurgical Society
/
v.61
no.1
/
pp.19-27
/
2018
Objective : The objectives of this study were to evaluate the immediate and long-term efficacy and safety of coil embolization for large or giant aneurysms. Methods : One hundred and fifty large or giant aneurysm cases treated with endovascular coil embolization between January 2005 and February 2014 at a single institute were included in this study. Medical records and imaging findings were reviewed. Statistical analysis was performed to evaluate prognostic factors associated with major recurrence (major recanalization or rupture) and delayed thromboembolism after selective coil embolization. Results : Procedure-related symptomatic complications occurred in five (3.3%) patients. The mean clinical and radiological follow-up periods were 38 months (range, 2-110) and 26 months (range, 6-108), respectively. During the follow-up period, the estimated recurrence rate was 4.6% per year. Multivariate analysis using Cox regression showed the degree of occlusion to be the only factor associated with recurrence (p=0.008, hazard ratio 3.15, 95% confidence interval 1.34-7.41). The patient's history of rupture in addition to the size and location of the aneurysm were not associated with recurrence in this study. Delayed infarction occurred in eight cases, and all were incompletely occluded. Conclusion : Although immediate postprocedural safety profiles were reasonable, longterm results showed recanalization and thromboembolic events to occur continuously, especially in patients with incomplete occlusion. In addition, incomplete occlusion was associated with delayed thromboembolic complications. Patients with incomplete occlusions should be followed carefully for delayed recurrence or delayed thromboembolic events.
Complete surgical resection of the primary tumour is a crucial predictive step for head and neck squamous cell carcinoma (HNSCC), because incomplete resection may lead to increase in the recurrence rate. Molecular cancer markers have been investigated as potential predictors of prognosis marker, to identify patients who are at high risk of local recurrence. This retrospective study aimed to determine the prognostic correlation between p53 and eIF4E expression and clinical characteristics, recurrence and overall survival. Forty eight HNSCC patients were selected between 2006 and 2009 diagnosed at the Royal Darwin Hospital, Darwin, Northern Territory, Australia. Out of 48, only those 24 with negative surgical margins with hematoxylin and eosin (HandE) were chosedn for further analysis. A total of 77 surgical margins were obtained and subsequently analysed by immunohistochemical (IHC) staining with monoclonal p53 and polyclonal eIF4E antibodies. Contingency table and ${\chi}^2$-test were used to investigate the correlation between p53 and eIF4E expression and clinical characteristics, recurrence and overall survival of the HNSCC patients. The follow up period was 74 months (range 1-74 months). The Kaplan-Meier method was used to generate recurrence and survival curves. This is a first retrospective study of Northern Territory patients, including Indigenous and non-Indigenous Australians. Molecular study of surgical margins could help to identify patients with and without clear margins after surgery and help in choice of the most appropriate adjuvant treatment for HNSCC patients.
Purpose: This was a nationwide population-based study conducted to investigate the epidemiology, treatment, disease outcomes, and associated factors of childhood intussusception in South Korea. Methods: Data from the Korean National Health Insurance Service database on all patients <18 years old diagnosed with intussusception from 2007 to 2017 were analyzed. Results: A total of 34,688 cases were identified among 30,444 patients. The overall incidence was 28.3/100,000 person-years with a male predominance. Most cases (83.1%) occurred in children <3 years old, with an annual incidence of 195.2, 200.1, and 118.6 cases per 100,000 children in their first, second, and third year of life, respectively. The median age at the first occurrence was 18.7 months, and it was higher in boys than in girls. The post-discharge recurrence rate was 10.6% (3,226/30,444) and the in-hospital recurrence rate was 6.1% (1,842/30,444). The total recurrence rate (post-discharge recurrence and/or in-hospital recurrence) was 15.0% (4,580/30,444). Enema reduction was successful in 90.0% of cases. Enema reduction was more successful in girls than in boys. A total of 3,296 (10.8%) patients underwent 3,481 surgeries, including 735 (21.1%) laparoscopic surgeries. Post-discharge recurrence and surgery were significantly affected by age, sex, and hospital type. Mortality was noted in nine cases (0.03%). Conclusion: Our study provides accurate epidemiologic data on the treatment and outcomes of intussusception through complete enumeration during an 11-year-period.
Park, Shin-Hyung;Lee, Jeeyeon;Lee, Jeong Eun;Kang, Min Kyu;Kim, Mi Young;Park, Ho Yong;Jung, Jin Hyang;Chae, Yee Soo;Lee, Soo Jung;Kim, Jae-Chul
Radiation Oncology Journal
/
v.36
no.4
/
pp.285-294
/
2018
Purpose: To determine the necessity of postmastectomy radiotherapy (PMRT) and which regions would be at risk for recurrence, we evaluated local and regional recurrence in breast cancer patients with 1-3 positive nodes and a tumor size of <5 cm. Materials and Methods: We retrospectively analyzed data of 133 female breast cancer patients with 1-3 positive nodes, and a tumor size of <5 cm who were treated with mastectomy followed by adjuvant systemic therapy between 2007 and 2016. The median follow-up period was 57 months (range, 12 to 115 months). Most patients (82.7%) were treated with axillary lymph node dissection. Adjuvant chemotherapy, endocrine therapy, and trastuzumab therapy were administered to 124 patients (93.2%), 112 (84.2%), and 33 (24.8%), respectively. The most common chemotherapy regimen was anthracycline and cyclophosphamide followed by taxane (71.4%). Results: Three patients (2.3%), 8 (6.0%), and 12 (9.0%) experienced local, regional, and distant failures, respectively. The 5-year cumulative risk of local recurrence, regional recurrence, distant metastasis, and disease-free survival was 3.1%, 8.0%, 11.7%, and 83.4%, respectively. There were no statistically significant clinicopathologic factors associated with local recurrence. Lymphovascular invasion (univariate p = 0.015 and multivariate p = 0.054) was associated with an increased risk of regional recurrence. Conclusion: Our study showed a very low local recurrence in patients with 1-3 positive nodes and tumor size of <5 cm who were treated with mastectomy and modern adjuvant systemic treatment. The PMRT volume need to be tailored for each patient's given risk for local and regional recurrence, and possible radiation-related toxicities.
Park, Jong-Hoon;Lee, Soo-Yong;Jeon, Dae-Geun;Cho, Wan-Hyung;Song, Won-Seok;Kim, Jin-Wook;Koh, Han-Sang
The Journal of the Korean bone and joint tumor society
/
v.11
no.2
/
pp.160-167
/
2005
Purpose : Distal femur and proximal tibia are the common sites affected by giant cell tumor of bone. There are a variety of treatment modality including wide excision and intralesional curettage. We evaluated the local recurrence rates and the post-operative functional scores of giant cell tumors around knee joint and investigated the identification of possible prognostic factors for recurrence. Materials and Methods: We reviewed 41 patients pathologically confirmed as giant cell tumors around knee joint that have undergone intralesional curettage using high-speed burr and methylmethacrylate. We evaluated the recurrence rate and post-surgical functional score and possible prognostic factors for recurrence, such as, gender, age, tumor location, size, subchondral invasion, intra-articular invasion and the Campanacci Grades. Mean follow up period was 50 (12-122) months. Results: The recurrence rate was 17% and mean recurrence onset was 10 months postoperatively. According to Musculoskeletal Tumor Society (MSTS) functional evaluation system, the average score was 27.8(93%) and 78% had excellent function. According to our study, suspected prognostic factors revealed not significant for recurrence. Conclusion: We found no significant recurrence related factors. Intralesional excision with high-sped burring and PMMA provides a low recurrence rate, similar to others in the literature, and good functional scores.
Background: The prognosis of patients with hepatocellular carcinoma (HCC) after curative resection varies greatly. Few studies had investigated the risk factors for early recurrence (recurrence-free time ${\leq}$ 1 year) of hepatitis B virus (HBV)-related HCCs meeting Milan criteria. Methods: A retrospective analysis was performed on the 224 patients with HCC meeting Milan criteria who underwent curative liver resection in our center between February 2007 and March 2012. The overall survival (OS) rate, recurrence-free survival (RFS) rate and risk factors for early recurrence were analyzed. Results: After a median follow-up of 33.3 months, HCC reoccurred in 105 of 224 patients and 32 died during the period. The 1-, 3- and 5-year OS rates were 97.3%, 81.6% and 75.6% respectively, and the 1-, 3- and 5-year RFS rates were 73.2%, 53.7% and 41.6%. Cox regression showed alpha-fetoprotein (AFP) > 800 ng/ml (HR 2.538, 95% CI 1.464-4.401, P=0.001), multiple tumors (HR 2.286, 95% CI 1.123-4.246, P=0.009) and microvascular invasion (HR 2.518, 95% CI 1.475-4.298, P=0.001) to be associated with early recurrence (recurrence-free time ${\leq}$ 1-year) of HCC meeting Milan criteria. Conclusions: AFP > 800 ng/ml, multiple tumors and microvascular invasion are independent risk factors affecting early postoperative recurrence of HCC. In addition resection appears capable of replacing liver transplantation in some situations with safety and a better outcome.
Kim, Young-Sin;Choi, Hee-Lack;Lee, Jun-Mo;Lee, Hyung-Seok;Kim, Jung-Ryul
The Journal of the Korean bone and joint tumor society
/
v.16
no.2
/
pp.74-79
/
2010
Purpose: To analyse the risk factors for recurrence of hemangiomas in extremities after surgical treatment and to compare with those of trunk. Materials and Methods: 120 cases of hemangioma with surgical treatments from June 1998 to September 2009 were analysed. 53 cases with surgical treatment on trunk in the same period were set to be the control group. We analyze several factors: age, location, site, size, histologic types and correlation between recurrence and each risk factor using logistic regression analysis. Results: Recurrence rate was 11.7% in extremities and 9.4% in trunk. There were no correlation between recurrence and age, site, size, histologic type. But, there was stastically significant correlation between recurrence rate and location, especially hand, forearm, feet in extremities and head and neck in trunk. Conclusion: Recurrence after surgical treatment of hemangioma is highly prevalent in anatomical location such as, hand, foot and forearm those are difficult to achieve complete resection because of close to neurovascular structures. Careful observation should be needed owing to incomplete resection can occurs recurrence.
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