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Good Outcomes of Patients with Stage IB Endometrial Cancer with Surgery Alone

  • Rahatli, Samed;Dizdar, Omer;Kucukoztas, Nadire;Oguz, Arzu;Yalcin, Selim;Ozen, Ozlem;Reyhan, Nihan Haberal;Tarhan, Cagla;Yildiz, Ferah;Dursun, Polat;Altundag, Ozden;Ayhan, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.3891-3893
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    • 2014
  • Background: Most patients with endometrial cancer have stage I disease. Adjuvant therapy in stage IB (formerly IC) endometrial cancer is controversial, treatment options including observation or brachytherapy/radiotherapy in grade 1-3 patients with or without chemotherapy. The purpose of this study was to assess the outcomes of our patients with stage IB endometrioid endometrial cancer. Materials and Methods: Sixty two patients with stage IB endometrial cancer and endometrioid histology were retrospectively evaluated. All patients were initially treated surgically by the same surgeon with comprehensive staging, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Adjuvant radiotherapy was discussed with patients and utilized by those who accepted. Adjuvant chemotherapy was not given to any of the patients. Results: Median age was 62 (range, 42-95). Ninety percent of the patients had grade 1-2 disease. Thirteen patients (21%) received intra vaginal brachytherapy (IVBT) and one received whole pelvic radiotherapy (WPRT). Median follow-up time was 46 months (range, 9-77 months). Three patients experienced recurrence (4.8%), two of them died on follow-up and one was still alive at last visit. Two patients with recurrence had FIGO grade 2 tumors and one had a grade 3 tumor. Two patients (3.2%) died without evidence of recurrent disease. Relapse free survival at 5 years was 94.4% and overall survival was 93.1%. Conclusions: Patients with stage IB disease in our study demonstrated relatively low recurrence rates although the majority of them received no adjuvant treatment. Surgery alone may be sufficient for most patients with this stage of endometrial cancer.

Prevalence of Ruminal Lactic Acidosis and Clinical Assessments of Four Therapeutics in Goats of Bangladesh (방글라데시 염소에서 유산증의 분포 및 4가지 치료법의 임상적 적용)

  • Rahman, Md. Mahbubur;Islam, Mohammad Saiful;Adam, G.O.;Alam, Md. Rafiqul;You, Myung-Jo
    • Journal of Veterinary Clinics
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    • v.31 no.3
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    • pp.199-205
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    • 2014
  • Acidosis conditions either acute or chronic following ingestion of excessive amounts of readily fermented carbohydrate are great production problems for goat in Bangladesh. This study designed to investigate the prevalence of lactic acidosis and then response to different therapeutic agents. For this purpose, 1,128 goat were examined at outdoor District Veterinary Hospital, Faridpur, Bangladseh for treatment of which 40 goats were found positive for lactic acidosis showing 3.55% prevalence of disease. The highest occurrence found in female (4.64%) of over 3 years age (4.64%) in indigenous goat (2.7%). For therapeutic assessment the forty affected goats were divided into four groups A, B, C and D comprising of 10 animals each. Group A were given magnesium hydroxide 8% w/v at 1 g/kg body weight orally. In group B magnesium hydroxide 8% w/v at a dose as group A combination with 7.5% sodium bicarbonate at the rate of 0.9 ml/Kg body weight intravenously administered. Goat in group D were treated with mixture of ginger, nuxvomica, sodium carbonate, cobalt sulphate, dried ferrous sulphate and thiamin mononitrate at the rate of 1 g/kg body weight orally. Goat of group C treated with combination drugs of group A, B and D. The rectal temperature, pulse rate, respiration rate, was performed before and after treatment. It was found that the highest recovery in group C with an average period of $21{\pm}1.8$ hours. It was concluded that lactic acidosis is a common disease of goats and its severity can be effectively reduced by using combination drugs.

A Survey of Sedation Practices in the Korean Dentistry (치과 치료 시 진정법 시행에 대한 실태 조사 연구)

  • Bae, Chi-Hoon;Kim, Hyuk;Cho, Kyoung-Ah;Kim, Mi-Seon;Seo, Kwang-Suk;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.1
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    • pp.29-39
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    • 2014
  • Background: Dental phobia or anxiety of patients is the serious impediment to appropriate and effective dental treatment. Sedative technique helps to mitigate patients' fear and anxiety thus make them more cooperative and familiar to dental practices. With increasing attention to sedative dentistry in dentists, educational requirements and technical qualification also become stricter but actual survey on recent sedative dentistry has not been reported yet. Especially there is insufficient study reporting the survey of sedative dentistry subjected to Korean adults. In this paper, we conducted a survey study on the actual condition and practice related to sedation with a questionnaire to dentists in South Korea. Methods: The survey was done for members of The Korean Dental Society of Anesthesiology (KDSA), who had great interest in sedation and for whom survey-by-mail was convenient. 472 members of The KDSA having dental license and solid address and contact information were subjected to the survey by sending them survey questions about their sedative techniques and knowledge. In order to increase the response rate, small gifts were presented to those who accurately responded to the survey questions and text messages and phone calls were made to encourage their participation. We collected their responses over two months and examined the returned surveys. Statistical analysis was performed using IBM SPSS Statistics 21 for each question. Results: Out of 472 dentists, 181 responded (38.4% response rate). 63.0% (114 dentists; 77 male and 37 female) of respondents had experience on sedative technique and their average age was $39.8{\pm}7.6$ year. 74 of them were private practitioners, 17 of them were professors (14.9%), 11 of them were dentists-in-service (9.6%), 11 of them were residents (specialist training) (9.6%) and 1 of them was military doctors (0.9%). There were 89 dentists (78.1%) who were specialists or receiving trainings to be specialist, most of whom were pediatric dentists (55, 48.2%) and oral surgeon (31, 27.2%). The most popular route for drug medications was orderly oral, inhalational, intravenous medication. Combination of oral and inhalational medications or single use of intravenous medication was the most common. The most preferred sedative drug was pocral in oral sedation and midazolam in intravenous sedation. 48.2% of practitioners responded that they experienced side effects and emergency situations. Airway obstruction was the most frequent. Conclusions: Results from the survey show that the protocol and system for sedative dentistry have been improved compared to the past. Nevertheless, quality of emergency protocol, monitoring devices and preparation of sedative drugs was still insufficient to achieve safe sedative procedure. This study acquires novelty since actual survey on recent sedative dentistry for adult patients has not been reported yet.

Aorta-esophageal Fistula That Developed after Endovascular Stent-grafting of a Mycotic Aneurysm - A case report- (감염성 대동맥류에 혈관 내 스텐트 삽입 시행 후 발생한 대동맥-식도루 - 1예 보고 -)

  • Nam, Jin-Hae;Park, Kay-Hyun;Yoo, Jae-Suk;Lee, Jae-Hang;Lim, Cheong;Jheon, Sang-Hoon
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.781-784
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    • 2010
  • A 74-year-old woman presented at our hospital with hemoptysis. Three months ago, she had endovascular stent-grafting done by a general surgeon for a saccular thoracic aneurysm that was found accidentally following an episode of fever and chills. Despite a lasting fever after the procedure, she was discharged without further treatment and follow-up. She was subsequently admitted to the hospital for evaluation and several exams were performed. Chest CT scans and an esophagoscopy identified an aorto-esophageal fistula at the level of the aorta that was covered by a previous stent-graft. After extensive administration of antibiotics, surgery was done - esophagectomy, cervical esophago-gastrostomy and replacement of the thoracic aorta. She was later discharged uneventfully.

Concise Bedside Surgical Management of Profound Reperfusion Injury after Vascular Reconstruction in Severe Trauma Patient: Case Report

  • Chung, Hoe Jeong;Kim, Seong-yup;Byun, Chun Sung;Kwon, Ki-Youn;Jung, Pil Young
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.204-208
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    • 2016
  • For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.

A Case of Lethal Neonatal Type Carbamoyl Phosphate Synthetase 1 Deficiency with Novel Mutation of CPS1 (새로운 CPS1 유전자 돌연변이에 의한 신생아형 carbamoyl phosphate synthetase 1 결핍 1례)

  • Suh, Seung-hyun;Kim, Yoo-Mi;Byun, Shin Yun;Son, Seung Kook;Kim, Seong Heon;Kim, Hyung Tae;Kim, Gu-Hwan;Yoo, Han-Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.2
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    • pp.109-114
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    • 2016
  • Carbamoyl phosphate synthetase 1 (CPS1) deficiency is an autosomal recessive urea cycle disorder which causes hyperammonemia. CPS1 is the first enzyme step in the urea cycle and almost patients present their symptoms during neonatal period. We report a case of CPS1 deficiency in a boy who developed symptoms including lethargy and seizure at 3 days of age. The ammonia level was up to $2,325{\mu}mol/L$, sodium benzoate (250 mg/kg/d) and high calories of both dextrose and lipid was promptly administered. Central access by experienced pediatric surgeon and emergent continuous hemodialysis by pediatric nephrologist was performed within 3 hours and ammonia was less than $100{\mu}mol/L$ at 5 days of age. Currently, he has showed excellent response to treatments including scavenging drugs and a low-protein diet. Despite of diffuse increasing signal intensity on cerebral white matters and basal ganglia on brain MRI, his development and weight gain were good at the last follow-up at 11 months of age. Molecular assay of the CPS1 gene demonstrated that patient had compound heterozygous for c.1529del ($p.Gly510Alafs^*5$) in exon 14 and c.3142-1G>C (IVS25(-1)G>C) in intron 25 and exon 26 boundary. The splicing mutation was novel mutation and inherited from patient's mother. Here, we report a neonatal lethal type CPS1 deficiency patient having novel mutation.

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Hard and soft tissue profile changes following anterior subapical osteotomy in bimaxillary dentoalveolar protrusion patients (양악성 치조 전돌 환자의 근첨하 분절 골절단술 후 경조직 및 연조직 측모 변화)

  • Han, Un-Ae;Kim, Jeong-Hwan;Yoon, Tae-Ho;Park, Je-Uk;Kook, Yoon-Ah
    • The korean journal of orthodontics
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    • v.33 no.6 s.101
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    • pp.475-483
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    • 2003
  • The purpose of this study is to evaluate hard and soft tissue changes following the subapical osteotomy in bimaxillary dentoalveolar protrusion patients requiring maximal retraction adult female patients was selected. Surgical procedures were performed by the same surgeon, anterior subapical osteotomy techniques were employed on the maxilla and cephalometric radiograms were traced and superimposed using the best-fit method and two reference The results were as follows 1. The bodily movement of the maxillary anterior segment was achieved in a posterior moved posteriorly with a slight correction of the lower incisors. 2. The horizontal soft tissue measurements changed significantly after treatment, but Nt and Sn vertical soft tissue measurements indicated that Ls moved inferiorly and Li superiorly. 3. The correlation between hard and soft tissue changes indicated that ${\Delta}HId/{\Delta}HLi,\;{\Delta}HId/{\Delta}LL-Eline,\;{\Delta}Hpt.B/{\Delta}HILS,\;and\;{\Delta}UI-FH/{\Delta}NL$ were significant. 4. More lower lip relative to upper lip retraction was demonstrated in relation to Rickett's E-line. The ratio between upper lip displacement was $50\%$, and between the lower incisor and lower lip displacement was $60\%$. We conclude from the results that the anterior subapical osteotomy is an efficient treatment severe dentoalveolar protrusion and desire rapid results.

An Evaluation of Initial Stability after Maxillary Posterior Impaction (상악의 후상방 회전이동을 시행한 환자에서의 초기 안정성 평가)

  • Ahn, Sang-Wook;Kwon, Taek-Kyun;Lee, Sung-Tak;Song, Jae-Min;Kim, Tae-Hoon;Hwang, Dae-Seok;Shin, Sang-Hoon;Chung, In-Kyo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.3
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    • pp.225-232
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    • 2011
  • Purpose: This study was designed to retrospectively evaluate the postsurgical initial stability of the Le Fort I osteotomy with posterior impaction and rigid internal fixation for the correction of mandibular prognathism with midface deficiency. Particular attention was paid to the magnitude and direction of the initial postsurgical change. Methods: 20 healthy patients with mandibular prognathism and midface deficiency participated in this study. All patients underwent Le Fort I osteotomy with posterior impaction and mandibular setback BSSO by one surgeon. Preoperative (T0), immediate postoperative (T1) and follow-up period (T2) cephalograms were taken and analyzed. Change between T0~T1 and T1~T2 was measured and analyzed. Results: Between T0~T1, significant differences were observed in all measurements except the ANS point and mandibular plane angle. Between T1~T2, only the occlusal plane angle was significantly changed. No significant changes were found in all other measurements. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions.

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 effect of conservative neck dissection in the patients with oral cancer (구강암 환자에서 보존적 경부청소술의 효과)

  • Kim, Bang-Sin;Hur, Daniel;Kim, Kyung-Rak;Yang, Ji-Woong;Jeoung, Youn-Wook;Kook, Min-Suk;Oh, Hee-Kyun;Ryu, Sun-Youl;Park, Hong-Ju
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.6
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    • pp.490-496
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    • 2010
  • Introduction: This study examined the effect of a conservative neck dissection in patients with head and neck cancer. Materials and Methods: A total of 24 patients, who underwent a conservative neck dissection for the treatment of oral cancer from January 2002 to December 2007, were included. All procedures were performed by one oral and maxillofacial surgeon. The mean age was 58.2 years (range, 19 to 79 years). The medical recordings, pathologic findings, and radiographic findings were evaluated. The mean follow up period was 41.1 months (range, 4 to 88 months). Results: 1. Oral cancer was more common in men than women with a 3:1 ratio. 2. Histopathologically, squamous cell carcinoma(83%) was the most prevalent oral cancer in this study. 3. The most common primary site was the tongue(6 cases, 25%) followed by the mouth floor (5 cases, 21%), buccal mucosa (3 cases, 13%), lower lip, mandible, palate (2 cases, respectively) and salivary gland, retromolar area, oropharynx, alveolus (1 case, each). 4. Three out of the 24 (13%) subjects had a recurrence at the primary sites. 5. Two out of 24 (8%) subjects had a distant metastasis. 6. All 24 patients survived and there were eleven patients who passed 5 years postoperatively. Conclusion: A conservative neck dissection is a reliable and effective method for controlling neck node metastases in patients with oral cancer of the N0 or N1 neck node without serious complications.