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Metastatic Bone Disease as Seen in Our Clinical Practice - Experience at a Tertiary Care Cancer Center in Pakistan

  • Qureshi, Asim;Shams, Usman;Akhter, Azra;Riaz, Sabiha
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4369-4371
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    • 2012
  • Aim: Metastatic tumor of bone is the most common malignancy involving bone and is an important predictor of prognosis in advanced cancers. The prognosis depends upon the primary site of origin and the extent of disease. In current study, we present the pattern and distribution of metastatic bone disease seen in the leading cancer care center of Pakistan, Shaukat Khanum Cancer Hospital & Research Center (SKMCH & RC), Lahore. Materials & Methods: All cases of bony metastatic disease were included that presented in the Pathology Department, from Jan 2005 to July 2011. Patients of all ages and both sexes were included. Primary bone tumors, lymphomas, sarcomas and other malignancies were excluded. The data were recorded and analyzed with SPSS 16.0. Results: A total of 146 cases of metastatic bone disease were included in the study. Out of the total cases, 79 were male and 67 were female. Age range 25-82 years (median 52). Hip bone was the most frequent bone involved, with femur and vertebrae as second and third in the list. The commonest bone involved in males was vertebrae with 23 cases and in females was hip bone with 22 cases. Regarding primary site, cancers of breast, prostate and gastrointestinal tract were at the top of the list with prostate and breast being the most frequent primary sites of metastasis in males and females respectively. Conclusion: Bone metastasis is an important entity to consider in the differential diagnosis whenever a bony tumor especially carcinoma present in older age. Our data are comparable with international findings and the literature available regarding the site and distribution of skeletal metastatic lesions. A slight deviation noted was more common bony metastatic lesions with ovarian primaries in females and gastrointestinal tract cancers in males in our study.

Effects of various cone-beam computed tomography settings on the detection of recurrent caries under restorations in extracted primary teeth

  • Kamburoglu, Kivanc;Sonmez, Gul;Berktas, Zeynep Serap;Kurt, Hakan;Ozen, Dogukan
    • Imaging Science in Dentistry
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    • v.47 no.2
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    • pp.109-115
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    • 2017
  • Purpose: The aim of this study was to assess the ex vivo diagnostic ability of 9 different cone-beam computed tomography (CBCT) settings in the detection of recurrent caries under amalgam restorations in primary teeth. Materials and Methods: Fifty-two primary teeth were used. Twenty-six teeth had dentine caries and 26 teeth did not have dentine caries. Black class II cavities were prepared and restored with amalgam. In the 26 carious teeth, recurrent caries were left under restorations. The other 26 intact teeth that did not have caries served as controls. Teeth were imaged using a $100{\times}90-mm$ field of view and a 0.2-mm voxel size with 9 different CBCT settings. Four observers assessed the images using a 5-point scale. Kappa values were calculated to assess observer agreement. CBCT settings were compared with the gold standard using a receiver operating characteristic analysis. The area under the curve (AUC) values for each setting were compared using the chi-square test, with a significance level of ${\alpha}=.05$. Results: Intraobserver kappa values ranged from 0.366 to 0.664 for observer 1, from 0.311 to 0.447 for observer 2, from 0.597 to 1.000 for observer 3, and from 0.869 to 1 for observer 4. Furthermore, interobserver kappa values among the observers ranged from 0.133 to 0.814 for the first reading and from 0.197 to 0.805 for the second reading. The highest AUC values were found for setting 5 (0.5916) and setting 3 (0.5886), and were not found to be statistically significant(P>.05). Conclusion: Variations in tube voltage and tube current did not affect the detection of recurrent caries under amalgam restorations in primary teeth.

RETENTIVE FORCES OF CLASPS OF REMOVABLE ORTHODONTIC APPLIANCES FOR CHILDREN (어린이에게 사용되는 가철식 교정장치용 clasp의 유지력비교)

  • Han, Jeong-Jae;Lee, Kwang-Hee;Kim, Dae-Eop
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.2
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    • pp.207-217
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    • 1999
  • The purpose of this study was to compare the retentive forces of various types of clasps for removable orthodontic appliances for primary and mixed dentition. Seven metal models of a single tooth and two teeth were made, including maxillary left primary canine, first primary molar, second primary molar and first molar. Retentive forces of Adams clasp, circumferential clasp(C clasp), Jackson clasp, Duyzing clasp, arrowhead clasp, ball clasp, eyelet clasp, and triangular clasp were measured by Universal Testing Machine(Zwick Z020, Germany). The obtained results were as follows. 1. Jackson clasp and Adams clasp showed the highest retentive force among single tooth clasps. 2. C clasp showed the lowest retentive force, and there was no statistically significant difference in retentive force between mesial end C clasp and distal end C clasp. 3. Eyelet clasp showed the highest, and ball clasp showed the lowest retentive farce among clasps for interdental undercut. 4. Triangular clasp showed higher retentive force than ball clasp.

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Numerical Investigation on Soot Primary Particle Size Using Time Resolved Laser Induced Incandescence (TIRE-LII) (시분해 레이저 유도 백열법을 이용한 매연 입자 크기에 관한 수치적 연구)

  • Lee, Jong-Ho;Kim, Jeong-Yong;Jeong, Dong-Soo;Chang, Young-June;Jeon, Chung-Hwan
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.29 no.9 s.240
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    • pp.1022-1031
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    • 2005
  • Temporal behavior of the laser induced incandescence (LII) signal is often used for soot particle sizing, which is possible because the cooling behavior of a laser heated particle is dependent on the particle size. In present study, LII signals of soot particles are modeled using two non-linear coupled differential equations deduced from the energy- and mass-balance of the process. The objective of this study is to obtain an appropriate calibration curve for determining primary particle size by comparing the gated signal ratio and double-exponential curve fitting methods. Not only the effects of laser fluence and gas temperature on the cooling behavior but also heat transfer mechanisms of heated soot particle have been investigated. The second-order exponential curve fitting showed better agreements with the LII signals than the gated signal ratio method which was based on the lust-order exponential curve fit. And the temporal decay rate of the LII signal and primary particle size showed nearly linear relationship, which was little dependent on the laser fluence. And it also could be reconfirmed that vaporization was dominant process of heat loss during first loons after laser pulse, then heat conduction played most important role while thermal radiation had little influence all the time.

A Study on the Health Status, Burnout, and Burden of Primary Family Caregivers of the Elderly In-Patients (입원노인 주 부양자의 건강상태, 소진감 및 부양부담감에 관한 연구)

  • Kim, Kwuy-Bun;Sung, Jung-Min;Sok, So-Hyune R.
    • Research in Community and Public Health Nursing
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    • v.19 no.2
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    • pp.216-225
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    • 2008
  • Purpose: This study was to explore the level of health status, burnout, and burden of primary family caregivers of the elderly in-patients, and to identify the relations among the factors. Method: The subjects were a total of 232 primary family caregivers of elderly in-patients at K and E Medical Center, and were surveyed from March 1 to April 10, 2007. Measures were a health status measuring tool based on CMI developed by Brodman et al. (1945), the burnout measuring tool developed by Pines et al. (1981), and the burden measuring tool revised by Jung, Soo-Jin (1998). Data were analyzed by SPSS-WIN 12.0. Results: Firstly, the mean of health status was 1.69, which means that they were mostly healthy, and the mean of burnout was 2.66, which means that they were a little burned out. The mean of burden was 2.71, which means that they were a little burdened. Second, there were high correlations between health status and burnout, between health status and burden, and between burnout and burden. Third, there were significant difference in health status and burnout according to sex and relationship, and in burden according to sex, education level and relationship. Conclusions: Nurses need to consider the characteristics, health status, burnout, and burden of primary family caregivers.

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Surgical Treatment of Primary Lung Cancer (원발성 폐암의 외과치료)

  • Youm, Wook;Sung, Sang-Hyun;Park, Sung-Hyuk
    • Journal of Chest Surgery
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    • v.26 no.5
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    • pp.373-379
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    • 1993
  • Primary lung cancer has increased markedly in its incidence and prevalence rate recently in Korea. In frequency, it occupies the second rank cancer preceded by stomach cancer in korean male. From February 1986 to December 1992, we have operated on 55 cases of primary lung cancer in Korea Veterans Hospital and followed them. The results are as follows; 1. The peak incidence of age of primary lung cancer was 6th decade and 5th decade and those were 87.3% of study group, mainly in male. 2. Symptoms were cough [63.6%], dyspnea [41.8%], chest pain and discomfort [38.2%], blood tinged sputum and hemoptysis [21.8%]. Symptoms were frequently encountered before hospitalization and asymptomatic cases were 9.1% of study group. 3. Methods of diagnostic confirmation were bronchoscopic biopsy [52.7%], percutaneous needle aspiration[PCNA][21.8%], sputum cytolgy [12.7%], open biopsy [12.7%]. 4. Histopathologically, squamous cell carcinoma [76.4%] was the most frequent cancer and adenocarcinoma [10.9%], giant cell cancer [7.3%], and the others in order. 5. Methods of operation were pneumonectomy [32.7%], bilobectomy [18.2%], lobectomy [27.3%], lobectomy and segmenectomy [1.8%], exploration [20%], and overall resectability was 80%. 6. Operative mortality was 5.5% [3 cases] and there were 5 cases of complication. 7. Postoperative long-term follow up reveals that the cumulative survival rates in 6 months, 12 months, 26 months, 34 months, 43 months, 64 months were 89.5%, 71.7%, 66.7%, 57.2%, 50.8%, 42.3% respecively.

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Inducing re-epithelialization in skin wound through cultured oral mucosal keratinocytes

  • Kim, Hyun Sil;Kim, Nam Hee;Kim, Jin;Cha, In Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.2
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    • pp.63-70
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    • 2013
  • Objectives: The purpose of this study was to investigate the wound healing effect of primary cultured oral mucosal keratinocytes (OMKs) and to assess their roles in skin wounds. Materials and Methods: OMK labeled with BromodeoxyUridine were scattered onto $1.5{\times}1.5$ cm skin defects of adult female nude mice (OMK group, n=15). For the control, culture media were placed on the wound (control group, n=15). Mice in both groups were sacrificed at three days (n=5), one week (n=5), and two weeks (n=5), and histomorphometric and immunoblot analyses with keratinocyte growth factor (KGF), interleukin (IL)-6, and IL-$1{\alpha}$ antibody were performed for the biopsied wound specimen. To verify the effect of the cytokine, rhIL-$1{\alpha}$ was applied instead of OMK transplantation, and the OMK and control groups were compared with regard to re-epithelialization. Results: Histomorphometric analyses demonstrated faster re-epithelialization in the graft group than in the control group at the third day, first week, and second week. Newly forming epithelium showed maintenance of the histological character of the skin epithelium. The graft group showed superior expression of KGF, IL-6, and IL-$1{\alpha}$ protein, compared with the control group. Similar faster re-epithelialization was observed after treatment with rhIL-$1{\alpha}$ instead of OMK transplantation. Conclusion: We successfully confirmed that the graft of primary cultured OMKs promoted regeneration of skin defects. The mechanism of accelerated wound healing by primary cultured OMKs was attributed to inducement of cytokine expression as required for re-epithelialization.

Two Cases of Primary Small Cell Carcinomas of the Stomach (원발성 위 소세포암 2예)

  • Seo Yun-Seock;Park Do Joong;Lee Hyuk-Joon;Cho Soo Youn;Kim Woo Ho;Park Seong Hoe;Yang Han-Kwang;Lee Kuhn Uk;Choe Kuk Jin
    • Journal of Gastric Cancer
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    • v.4 no.3
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    • pp.186-191
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    • 2004
  • Primary small-cell carcinomas of the stomach are rare and aggressive malignancies with poor survival rates. Preoperative diagnosis is difficult and a standard treatment is not yet established. We have recently experienced two cases of a primary small-cell carcinoma of the stomach. The first case was a 65-year-old man with epigastric soreness. Endoscopic biopsy showed an adenocarcinoma. He underwent a radical subtotal gastrectomy with D2 lymph-node dissection. Pathology revealed a collision tumor of a smallcell carcinoma and an adenocarcinoma with submucosal invasion and with metastasis in 20 out of 48 lymph nodes (T1N3M0). The second case was a 64-year-old man with epigastric soreness. Endoscopic biopsy revealed a small-cell carcinoma. There was no evidence of a primary tumor in the lung. A radical subtotal gastrectomy with D2 lymph-node dissection was performed. Pathology showed a pure smallcell carcinoma with proper muscle invasion and with metastasis in 1 out of 36 lymph nodes (T2aN1M0).

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Comparison of Cortical Activation between Concentric and Eccentric Exercise: A Pilot fMRI Study (기능적 자기공명영상을 이용한 구심성 및 원심성 근 수축에 따른 뇌 활성도 분석)

  • Kim, Chung-Sun;Kim, Joong-Hwi;Park, Min-Kyu;Park, Ji-Won
    • The Journal of Korean Physical Therapy
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    • v.22 no.2
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    • pp.25-30
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    • 2010
  • Purpose: Behavior and movement are accomplished by voluntary contractions of skeletal muscles. There are three types of muscle contractions: concentric, isometric and eccentric. The aim of our study was to determine whether there is a difference in the cortical activation pattern between concentric contraction and eccentric contraction of the wrist extensor muscle. Methods: Four healthy right-handed volunteers without any previous history of physical or neurological illness were recruited. fMRI scanning was done during 4 repeated blocks of concentric and eccentric exercise of the wrist joint. Subjects exercised for 12 seconds and then rested for 12 seconds before beginning the second set of exercises. To determine the excitability of cortical neurons during exercise, voxel count and intensity index were analyzed. Results: For right hand movements, when concentric contractions of the right wrist were done, only the left primary motor area was activated. In contrast, during eccentric contraction, both the primary motor area and secondary motor area were activated. For left hand movements, both concentric and eccentric contractions induced only the supplementary motor cortex and the contralateral primary motor cortex. Conclusion: During eccentric contractions, both the primary motor area and secondary motor area are activated in ipsilateral and contralateral brain areas. Thus, eccentric contractions require more complex and difficult movements than concentric contractions do.

Connectivity Analysis of Cognitive Radio Ad-hoc Networks with Shadow Fading

  • Dung, Le The;An, Beongku
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.9 no.9
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    • pp.3335-3356
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    • 2015
  • In this paper, we analyze the connectivity of cognitive radio ad-hoc networks in a log-normal shadow fading environment. Considering secondary user and primary user's locations and primary user's active state are randomly distributed according to a homogeneous Poisson process and taking into account the spectrum sensing efficiency of secondary user, we derive mathematical models to investigate the connectivity of cognitive radio ad-hoc networks in three aspects and compare with the connectivity of ad-hoc networks. First, from the viewpoint of a secondary user, we study the communication probability of that secondary user. Second, we examine the possibility that two secondary users can establish a direct communication link between them. Finally, we extend to the case of finding the probability that two arbitrary secondary users can communicate via multi-hop path. We verify the correctness of our analytical approach by comparing with simulations. The numerical results show that in cognitive radio ad-hoc networks, high fading variance helps to remarkably improve connectivity behavior in the same condition of secondary user's density and primary user's average active rate. Furthermore, the impact of shadowing on wireless connection probability dominates that of primary user's average active rate. Finally, the spectrum sensing efficiency of secondary user significantly impacts the connectivity features. The analysis in this paper provides an efficient way for system designers to characterize and optimize the connectivity of cognitive radio ad-hoc networks in practical wireless environment.