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1.
Korean Journal of Clinical Oncology ; (2): 37-42, 2018.
Article in English | WPRIM | ID: wpr-788026

ABSTRACT

PURPOSE: The status of tumor regression in rectal cancer after neoadjuvant concurrent chemoradiotherapy (CCRT) has significant effect on tumor recurrence and patient survival. The aim of this study was to evaluate the long-term oncologic outcomes of rectal cancer patients presenting complete response or down-staging of rectal cancer compared to patients with non-response after neoadjuvant therapy in advanced mid-to-lower rectal cancer.METHODS: We retrospectively reviewed 79 patients with stage II/III mid-to-lower rectal cancer following neoadjuvant CCRT between March 2003 and April 2012. Patients were classified into three groups according to down-staging tumor response after neoadjuvant CCRT: complete response group (CRG), partial response group (PRG), and non-response group (NRG).RESULTS: Of the 79 patients in the study, eight (10.1%), 31 (39.2%), and 40 (50.7%) were classified as CRG, PRG, and NRG, respectively. Median follow-up period was 57 months. There was significant difference in local recurrence (P=0.012) between the three groups, yet there was no significant difference in overall survival (CRG, 100%; PRG, 82.5%; NRG, 74.0%; P=0.244). There was a significant difference in disease-free survival (CRG, 100%; PRG, 90.1%; NRG, 57.7%; P=0.006).CONCLUSION: Tumor response with complete response or down-staging provided better oncologic outcomes in terms of disease-free survival and local recurrence in locally advanced rectal cancer patients.


Subject(s)
Humans , Chemoradiotherapy , Disease-Free Survival , Follow-Up Studies , Neoadjuvant Therapy , Rectal Neoplasms , Recurrence , Retrospective Studies
2.
Journal of the Korean Fracture Society ; : 132-138, 2015.
Article in Korean | WPRIM | ID: wpr-43885

ABSTRACT

PURPOSE: The purpose of this study is to determine the ideal period of brace application for thoracolumbar (T10-L2) osteoporotic vertebral compression fracture (OVCF) based on the progression of the vertebral compression with passage of time and to evaluate the factors associated with progression of thoracolumbar OVCF, when treated conservatively. MATERIALS AND METHODS: This retrospective study included a total of 46 patients who were diagnosed with thoracolumbar OVCF and could be followed-up for at least 6 months. In this study, the increase of compression rate and the mean slope of compression rate per weeks were compared between two periods (from diagnosed date to 8 weeks and from 8 weeks to 6 months), as the standard point. Age, bone mineral density (BMD), osteoporosis treatment after injury, diabetes mellitus (DM) as underlying disease were also compared between two groups (setting up 15% as standard point of increase of compression rate, or =15%). Statistical analyses were performed using the paired t-test to assess the increase of compression rate and using the linear mixed model to assess the mean slope change. The relationships between the factors and progression of compression were analyzed using t-test, chi-square test, and logistic regression analysis. RESULTS: The increase of compression rate was 13.03% and 1.97% in each period and the difference between those two periods was 11.06% (p=0.00). At 8 weeks of follow-up, the mean slope was reduced by 1.12 (p=0.00). No statistically significant difference in related factors was observed between two groups. CONCLUSION: Considering the increase of compression rate with passage of time, brace should be applied strictly for an initial 8 weeks. And age, BMD, osteoporosis treatment after injury, and DM as underlying disease are not predictors of progression of compression in vertebral fractures.


Subject(s)
Humans , Bone Density , Braces , Diabetes Mellitus , Follow-Up Studies , Fractures, Compression , Logistic Models , Osteoporosis , Retrospective Studies
3.
Asian Pacific Journal of Tropical Medicine ; (12): 169-175, 2015.
Article in English | WPRIM | ID: wpr-820382

ABSTRACT

OBJECTIVE@#To calculate the numbers of weekly infections and prevalence of malaria, and to predict future trend of malaria incidences in South Korea.@*METHODS@#Weekly incidences of malaria for 13 years from the period 2001-2013 in South Korea were analyzed. The back-calculation equations were used with incubation period distributions. The maximum likelihood estimation for Poisson model was also used. The confidence intervals of the estimates were obtained by a bootstrap method. A regression model for time series of malaria incidences over 13 years was fitted by the non-linear least squares method, and used to predict futuretrend.@*RESULTS@#The estimated infection curve is narrower and more concentrated in the summer than in the incidence distribution. Infection started around the 19th week and was over around the 41st week. The maximum weekly infection 110 was obtained at the 29th week. The prevalence at the first week was around 496 persons, the minimum number was 366 at 22nd week, and the maximum prevalence was 648 at 34th week. Prevalence drops in late spring with people that falling ill and had had long incubation periods and rose in the summer with new infections. Our future forecast based on the regression model was that an increase at year 2014 compared to 2013 may reach a peak (at maximum about 70 weekly cases) at year 2015, with a decreasing trend after then.@*CONCLUSIONS@#This work shows that back-calculation methods could work well in estimating the infection rates and the prevalence of malaria. The obtained results can be useful in establishing an efficient preventive program for malaria infection. The method presented here can be used in other countries where incidence data and incubation period are available.

4.
Asian Pacific Journal of Tropical Medicine ; (12): 169-175, 2015.
Article in Chinese | WPRIM | ID: wpr-951516

ABSTRACT

Objective: To calculate the numbers of weekly infections and prevalence of malaria, and to predict future trend of malaria incidences in South Korea. Methods: Weekly incidences of malaria for 13 years from the period 2001-2013 in South Korea were analyzed. The back-calculation equations were used with incubation period distributions. The maximum likelihood estimation for Poisson model was also used. The confidence intervals of the estimates were obtained by a bootstrap method. A regression model for time series of malaria incidences over 13 years was fitted by the non-linear least squares method, and used to predict futuretrend. Results: The estimated infection curve is narrower and more concentrated in the summer than in the incidence distribution. Infection started around the 19th week and was over around the 41st week. The maximum weekly infection 110 was obtained at the 29th week. The prevalence at the first week was around 496 persons, the minimum number was 366 at 22nd week, and the maximum prevalence was 648 at 34th week. Prevalence drops in late spring with people that falling ill and had had long incubation periods and rose in the summer with new infections. Our future forecast based on the regression model was that an increase at year 2014 compared to 2013 may reach a peak (at maximum about 70 weekly cases) at year 2015, with a decreasing trend after then. Conclusions: This work shows that back-calculation methods could work well in estimating the infection rates and the prevalence of malaria. The obtained results can be useful in establishing an efficient preventive program for malaria infection. The method presented here can be used in other countries where incidence data and incubation period are available.

5.
Journal of Korean Neuropsychiatric Association ; : 342-352, 2013.
Article in Korean | WPRIM | ID: wpr-168405

ABSTRACT

OBJECTIVES: This study was conducted in order to determine the validity and reliability of the Korean Version of the Conners Adult ADHD Rating Scales-42 items & 26 items (K-CAARS-42 & K-CAARS-26) in nonclinical adult subjects. METHODS: The K-CAARS-42 & K-CAARS-26 was tested in non-clinical (n=270) native Korean-speakers. Internal consistency reliability was calculated using Cronbach's alpha and test-retest reliability was measured using Pearson correlations. To see validity, we performed the confirmatory factor analysis for determination of whether the four-factor model fit the data. RESULTS: The results showed that the subscales had acceptable internal consistency reliability and high test-retest reliability ; and the second-order scores showed significant correlation with the Korean version of the Barratt Impulsiveness Scale-11-Revised and Prospective and Retrospective Memory Questionnaire. The Confirmatory factor analysis revealed a four-factor structure of both K-CAARS-42 and K-CAARS-26. CONCLUSION: The K-CAARS-42 & K-CAARS-26 is reliable and has possible utility for symptom assessment of attention deficit and hyperactivity disorder in nonclinical adult subjects. Further research is needed in order to determine the cutoff score for administration of the K-CAARS-42 & K-CAARS-26 to clinical adult subjects.


Subject(s)
Adult , Humans , Attention Deficit Disorder with Hyperactivity , Factor Analysis, Statistical , Memory , Prospective Studies , Surveys and Questionnaires , Reproducibility of Results , Retrospective Studies , Symptom Assessment
6.
Korean Journal of Anesthesiology ; : 79-82, 2012.
Article in English | WPRIM | ID: wpr-95868

ABSTRACT

Stress-induced cardiomyopathy (SICM) presenting as an acute myocardial dysfunction is characterized by transient left ventricular wall motion abnormality, which has been known to be associated with excessive catecholamine production caused due to various types of stress. Sympathetic hyperactivity is common during the perioperative period, and reports of SICM occurring during this period have actually increased. We present a case of SICM following negative pressure pulmonary edema due to upper airway obstruction during emergence from anesthesia. Excessive catecholamine release in response to respiratory difficulty could have been the underlying inciting factor.


Subject(s)
Airway Obstruction , Anesthesia , Cardiomyopathies , Perioperative Period , Pulmonary Edema
7.
Journal of Korean Neuropsychiatric Association ; : 378-386, 2012.
Article in Korean | WPRIM | ID: wpr-100448

ABSTRACT

OBJECTIVES: This study was conducted in order to determine the validity and reliability of the Korean version of the Barratt Impulsiveness Scale-11-Revised (K-BIS-11-R) in Nonclinical Adult Subjects. METHODS: The K-BIS-11-R was tested in non-clinical (n=270) native Korean-speakers. Internal consistency reliability was calculated using Cronbach's alpha and test-retest reliability was measured using Pearson correlations. To see external validity, we performed confirmatory factor analysis for determination of whether the three-factor model, proposed by the previous report, fit the data. RESULTS: According to the results, the K-BIS-11-R had an acceptable test-retest reliability and internal consistency reliability. In addition, the K-BIS-11-R total score and second-order subscale score showed significant correlation with Conners' Adult attention deficit/hyperactivity disorder Rating Scale-Korean and Buss & Durkee Hostility Inventory. In addition, no significant difference was observed between the K-BIS-11-R total score and demographic variables. Thus, the K-BIS-11-R total score was transformed to standard score. CONCLUSION: K-BIS-11-R is a reliable and valid measure and has possible utility for assessment of impulsiveness in nonclinical adult subjects. Further research is needed in order to determine the cutoff score for administration of K-BIS-11-R to clinical adult subjects.


Subject(s)
Adult , Humans , Factor Analysis, Statistical , Hostility , Reproducibility of Results
8.
The Korean Journal of Pain ; : 141-145, 2011.
Article in English | WPRIM | ID: wpr-91092

ABSTRACT

BACKGROUND: Stellate ganglion block is usually performed at the transverse process of C6, because the vertebral artery is located anterior to the transverse process of C7. The purpose of this study is to estimate the location of the transverse process of C6 using the cricoid cartilage in the performance of stellate ganglion block. METHODS: We reviewed cervical lateral neutral-flexion-extension views of 48 patients who visited our pain clinic between January and June of 2010. We drew a horizontal line at the surface of the cricoid cartilage in the neutral and extension views of cervical lateral x-rays. We then measured the change in the shortest distance from this horizontal line to the lowest point of the transverse process of C6 between the neutral and extension views. RESULTS: There was a statistically significant difference in the shortest distance from the horizontal line at the surface of the cricoid cartilage to the lowest point of transverse process of C6 between neutral position and neck extension position in both males and females, and between males and females in both neutral position and neck extension position. The cricoid cartilage level was 4.8 mm lower in males and 14.4 mm higher in females than the lowest point of transverse process of C6 in neck extension position. CONCLUSIONS: Practitioners should recognize that the cricoid cartilage has cephalad movement in neck extension. In this way, the cricoid cartilage can be still useful as a landmark for stellate ganglion block.


Subject(s)
Female , Humans , Male , Cricoid Cartilage , Neck , Pain Clinics , Stellate Ganglion , Vertebral Artery
9.
Journal of Korean Neurosurgical Society ; : 224-230, 2011.
Article in English | WPRIM | ID: wpr-69795

ABSTRACT

OBJECTIVE: This study aimed to show the possibility of neural canal enlargement and restoration of bony fragments through laminectomy and minimal facetectomy without pediculectomy or an anterior approach, and also to prove the adequacy of posterior stabilization of vertebral deformities after thoracolumbar bursting fracture. METHODS: From January 2003 to June 2009, we experienced 45 patients with thoracolumbar burst fractures. All patients enrolled were presented with either a neural canal compromise of more than 40% with a Benzel-Larson Grade of VI, or more than 30% compromise with less than a Benzel-Larson Grade of V. Most important characteristic of our surgical procedure was repositioning retropulsed bone fragments using custom-designed instruments via laminectomy and minimal facetectomy without removing the fractured bone fragments. Beneath the dural sac, these custom-designed instruments could push the retropulsed bone fragments within the neural canal after the decompression and bone fragment repositioning. RESULTS: The mean kyphotic deformities measured preoperatively and at follow-up within 12 months were 17.7 degrees (+/-6.4 degrees) and 9.6 degrees (+/-5.2 degrees), respectively. The mean midsagittal diameter improved from 8.8 mm (+/-2.8 mm) before surgery to 14.2 mm (+/-1.6 mm) at follow-up. The mean traumatic vertebral body height before surgery was 41.3% (+/-12.6%). At follow-up assessment within 12 months, this score showed a statistically significant increase to 68.3% (+/-12.8%). Neurological improvement occurred in all patients. CONCLUSION: Though controversy exists in the treatment of severe thoracolumbar burst fracture, we achieved effective radiological and clinical results in the cases of burst fractures causing severe canal compromise and spinal deformity by using this novel custom-designed instruments, via posterior approach alone.


Subject(s)
Humans , Body Height , Congenital Abnormalities , Decompression , Follow-Up Studies , Laminectomy , Neural Tube , Spinal Fractures , Spinal Fusion , Surgical Fixation Devices , Surgical Instruments
10.
Journal of Korean Neurosurgical Society ; : 264-267, 2011.
Article in English | WPRIM | ID: wpr-69786

ABSTRACT

A 50-year-old man presented bilateral hypesthesia on and below the T6 dermatome and paresthesia. Magnetic resonance imaging (MRI) showed an intraspinal extradural tumor, which located from the 6th thoracic vertebral body to the upper margin of the 7th vertebral body, continuing dumbbell-like through the intervertebral foramen into the right middle thorax suggesting a neurogenic tumor (neurofibroma or neurilemmoma). With the patient in a prone position, we exposed and excised the tumor via a one stage posterior approach through a hemi-laminictomy of T6. Histologic examination showed a grade 1 meningothelial meningioma, according to the World Health Organization classification. Initially, we assumed the mass was a schwannoma because of its location and dumbbell shape. However, the tumor was actually a meningioma. Postoperatively, hypesthesia resolved completely and motor power of the leg gradually full recovered. A postoperative MRI revealed no evidence of residual tumor.


Subject(s)
Humans , Middle Aged , Classification , Hypesthesia , Leg , Magnetic Resonance Imaging , Meningioma , Neoplasm, Residual , Neurilemmoma , Paresthesia , Prone Position , Spinal Neoplasms , Spine , Thorax , World Health Organization
11.
Korean Journal of Anesthesiology ; : 98-102, 2011.
Article in English | WPRIM | ID: wpr-149650

ABSTRACT

BACKGROUND: Bilateral total knee arthroplasty is generally accompanied by a significant amount of blood loss. We investigated the relationship between the intensity of pain and the amount of blood loss in the early postoperative period after bilateral total knee arthroplasty. METHODS: A prospective study was conducted on 91 patients who underwent elective sequential bilateral total knee arthroplasty for osteoarthritis. All patients received combined spinal and epidural anesthesia. Patients were divided into three groups based on their scores on the verbal numerical rating scale (VNRS) for pain at 6 hours postoperatively. The VNRS was classified as follows; mild pain (n = 34, VNRS score 0-4), moderate pain (n = 24, VNRS score 5-6), and severe pain (n = 33, VNRS score 7-10). We compared the mean arterial pressures and the amount of blood loss during the first 24 postoperative hours in the three groups. Factors influencing postoperative blood loss were analyzed. RESULTS: Postoperative mean arterial pressures and blood loss were not different among the groups. Of the factors examined, the amount of postoperative blood loss was only dependent on the amount of intraoperative blood loss (P = 0.001). CONCLUSIONS: Early postoperative pain has no effect on postoperative blood pressure and the amount of blood loss after bilateral total knee arthroplasty. For postoperative blood loss, intraoperative blood loss is the main determinant.


Subject(s)
Humans , Anesthesia, Epidural , Arterial Pressure , Arthroplasty , Blood Pressure , Knee , Osteoarthritis , Pain, Postoperative , Postoperative Hemorrhage , Postoperative Period , Prospective Studies
12.
Experimental & Molecular Medicine ; : 310-318, 2010.
Article in English | WPRIM | ID: wpr-164514

ABSTRACT

Transglutaminase 4 is a member of enzyme family that catalyzes calcium-dependent posttranslational modification of proteins. Although transglutaminase 4 has been shown to have prostate-restricted expression pattern, little is known about the biological function of transglutaminase 4 in human. To gain insight into its role in prostate, we analyzed the expression status of human transglutaminase 4 in benign prostate hyperplasia (BPH) and prostate cancer (PCa). Unexpectedly, RT-PCR and nucleotide sequence analysis showed four alternative splicing variants of transglutaminase 4: transglutaminase 4-L, -M (-M1 and -M2) and -S. The difference between transglutaminase 4-M1 and -M2 is attributed to splicing sites, but not nucleotide size. The deduced amino acid sequences showed that transglutaminase 4-L, -M1 and -M2 have correct open reading frames, whereas transglutaminase 4-S has a truncated reading frame. RT-PCR analysis of clinical samples revealed that transglutaminase 4-M and -S were detected in all tested prostate tissue (80 BPH and 48 PCa). Interestingly, transglutaminase 4-L was found in 56% of BPH (45 out of 80) and only in 15% of PCa (7 out of 48). However, transglutaminase 4-L expression did not correlate with serum prostate-specific antigen (PSA) level, prostate volumes or PSA densities. These results will provide a clue to future investigation aiming at delineating physiological and pathological roles of human transglutaminase 4.

13.
Journal of Korean Academy of Nursing ; : 204-216, 2008.
Article in Korean | WPRIM | ID: wpr-226227

ABSTRACT

PURPOSE: Meta-analysis of this study was to analyze the character of adolescent smoking cessation programs, to calculate the effect size according to variables and to compare the weighted mean effect sizes on adolescent smoking cessation programs in Korea. METHODS: Twenty two studies for meta-analysis were selected from dissertations, theses, articles and research papers that had been published from 1995 to 2003. The selected studies had a randomized or nonequivalent control group in a pretest-post test design and had reported statistical value to calculate the effect size. RESULTS: The mean number of sessions was 6.5. The education time per each session varied from 40 to 150 min and the most applied theories were Bandura's social-cognitive theory and the cognitive-behavioral theory. Smoking-knowledge, smoking-attitudes and smoking-amount showed high effects on the first post test after mediating adolescent smoking cessation programs according to the criteria of Cohen. The effect size of urine-cotinine found no homogeneity on the first post test, but it was significantly effective on the second post test. CONCLUSION: Adolescent smoking cessation programs analyzed in this study were relatively effective in smoking abstinence.


Subject(s)
Adolescent , Female , Humans , Male , Adolescent Behavior , Bibliometrics , Cognitive Behavioral Therapy , Health Education , Health Knowledge, Attitudes, Practice , Korea , Smoking/prevention & control , Smoking Cessation , Treatment Outcome
14.
Journal of the Korean Continence Society ; : 106-115, 2006.
Article in Korean | WPRIM | ID: wpr-219144

ABSTRACT

PURPOSE: When the bladder outlet is partially obstructed, The expression of iNOS and collagen type III is caused by ischemia of bladder. This study aimed to evaluate the hemodynamic changes and the expression of inducible nitric oxide synthase(iNOS) and collagen type III of bladder during acute stages of partial bladder outlet obstruction in female rats and conducted a research on the effect of alpha-adrenergic blocker. MATERIALS AND METHODS: Thirty mature Sprague-Dawley rats were randomly divided into three groups; 3 days(Group I), 7 days(Group II), 14 days(Group III), depending on the term of partial bladder outlet obstruction. After obstruction, each group was subdivided into the experimental groups and the control groups; terazosin(0.4 mg/kg) was administered to the experimental groups and normal saline was administered to the control groups for a week. The degree of expression of iNOS and collagen type III in bladder was investigated by immunohistochemical stain and Western blot. RESULTS: The blood flow of experimental groups showed significant increase compared to control groups(p<0.05). The expression of iNOS and collagen type III of exerimental groups was significantly decreased compared to the controls(p<0.05). CONCLUSION: This study suggests that alpha-adrenergic blocker makes increase in blood flows to bladder and may have a role of prevention from functional damage of bladder.


Subject(s)
Animals , Female , Humans , Rats , Blotting, Western , Collagen Type III , Hemodynamics , Ischemia , Nitric Oxide , Rats, Sprague-Dawley , Urinary Bladder Neck Obstruction , Urinary Bladder
15.
Experimental & Molecular Medicine ; : 582-587, 2004.
Article in English | WPRIM | ID: wpr-145920

ABSTRACT

p21-activated kinase (PAK)-interacting exchange factor (PIX) is known to be involved in regulation of Cdc42/Rac GTPases and PAK activity. PIX binds to the proline-rich region of PAK, and regulates biological events through activation of Cdc42/Rac GTPase. To further investigate the role of PIX we produced monoclonal antibodies (Mab) against beta PAK. Three clones; N-C6 against N-terminal half and C-A3 and C-B7 against C- terminal half of beta PAK were generated and characterized. N-C6 Mab detected beta PAK as a major band in most cell lines. C-A3 Mab recognizes GIT-binding domain (GBD), but it does not interfere with GIT binding to beta PAK. Using C-A3 Mab possible beta PAK interaction with actin in PC12 cells was examined. beta PAK Mab (C-A3) specifically precipitated actin of the PC12 cell lysates whereas actin Mab failed to immunoprecpitate beta PAK. Co-sedimentation of PC12 cell lysates with the polymerized F-actin resulted in the recovery of most of beta PAK in the cell lysates. These results suggest that beta PAK may not interact with soluble actin but with polymerized F-actin and revealed that beta PAK constitutes a functional complex with actin. These data indicate real usefulness of the beta PAK Mab in the study of beta PAK role(s) in regulation of actin cyoskeleton.


Subject(s)
Animals , Mice , Rats , Actins/metabolism , Antibodies, Monoclonal/immunology , Cell Cycle Proteins/immunology , Cell Line, Tumor , Cytoskeletal Proteins/metabolism , Epitope Mapping , Guanine Nucleotide Exchange Factors/immunology , Immunoprecipitation , Actin Cytoskeleton/physiology , Protein Structure, Tertiary
16.
Journal of the Korean Geriatrics Society ; : 1-7, 2004.
Article in Korean | WPRIM | ID: wpr-179863

ABSTRACT

No abstract available.


Subject(s)
Apoptosis , Carcinogenesis
17.
Korean Journal of Hepato-Biliary-Pancreatic Surgery ; : 214-219, 2003.
Article in Korean | WPRIM | ID: wpr-163926

ABSTRACT

PURPOSE: A pancreaticoduodenectomy (PD) and pylorus-preserving pancreaticoduodenectomy (PPPD) are the two methods commonly used to treat periampullary neoplasms. This study was designed to compare these two methods in terms of the post-operative complications, the recurrence rate, and the post-operative weight change. METHODS: The medical records of 110 patients who underwent PD or PPPD from February 1986 through to June 2002 were retrospectively reviewed. The PD was performed on 54 patients and PPPD was performed on 56 patients, respectively. The mean follow-up periods were 25.33 months in the PD group and 25.39 months in the PPPD group, respectively. RESULTS: Diabetes mellitus occurred in 9 patients (16.7%) in the PD group and 8 patients (14.3%) in the PPPD group, and gastric emptying was delayed in 14 (25.9%) and 15 (26.8%) patients of each group after surgery. Procedure related deaths occurred in 2 (3.7%) and 4 (7.1%) patients from each group. There were no statistically significant differences in the post-operative complications between the two groups. The disease recurrence rate was significantly lower in the PPPD group than in the PD group (60.5% vs. 22.9%, p=0.001). Post-operative weight loss just after surgery at 3 months and 6 months after surgery was 3.56 kg, 3.68 kg, and 3.97 kg in the PD group and 2.78 kg, 1.77 kg, and 1.8 kg in the PPPD group, respectively, without showing a statistically significant difference. CONCLUSION: The clinical outcomes of the PPPD was not different from those of the PD in terms of the post-operative complications and weight loss. The disease recurrence rate was lower in the PPPD group. These results suggest that PPPD could be the treatment choice periampullary neoplasms.


Subject(s)
Humans , Diabetes Mellitus , Follow-Up Studies , Gastric Emptying , Medical Records , Pancreaticoduodenectomy , Pylorus , Recurrence , Retrospective Studies , Weight Loss
18.
Korean Journal of Nephrology ; : 108-116, 2002.
Article in Korean | WPRIM | ID: wpr-126471

ABSTRACT

BACKGROUND: Medical treatments such as restriction of phosphate, phosphate binder use, and active vitamine D therapy have been widely used for hyperparathyroidism in ESRD patients, and surgical parathyroidectomy should be considered in patients with uncontrolled hyperparathyroidism. METHODS: A retrospective study was performed in 24 ESRD patients with severe and uncontrolled hyperparathyroidism despite of medical treatment who undertook surgical parathyroidectomy in Severance hospital from 1990 to 1999. RESULTS: Sixteen patients had total parathyroidectomy with immediate autotransplant, 7 patients had subtotal parathyroidectomy and only 1 patient had minimally invasive parathyroidectomy. An excellent short-term control of hyperparathyroidism was achieved in all patients after parathyroidectomy. Preoperative bone and joint pain improved in 16 of 19 patients. Muscle weakness and pain improved in 11 of 17 patiens, malaise improved in 8 of 10 patients and pruritus improved in 10 of 13 patients. In addition, clinical laboratory finding improved after parathyroidectomy. No clinical differences were seen between 16 patients who undertook total parathyroidectomy with immediate autotransplant and 7 patients who undertook subtotal parathyroidectomy. Recurrence of hyperparathyroidism ocurred in 5 of 24 patients with 4 nodular hyperplasia and 1 diffuse hyperplasia in pathologic finding. The less degree of attenuated response of intact PTH levels immediately after operation was observed in 5 recurrent cases. CONCLUSION: Good results were obtained after parathyroidectomy. We believe that histologic subtype and the attenuated response of intact PTH after surgical parathyroidectomy could be possible predictors of the recurrent hyperparathyroidism.


Subject(s)
Humans , Arthralgia , Autografts , Hyperparathyroidism , Hyperparathyroidism, Secondary , Hyperplasia , Kidney Failure, Chronic , Muscle Weakness , Parathyroidectomy , Pruritus , Recurrence , Retrospective Studies , Vitamins
19.
Journal of the Korean Surgical Society ; : 338-343, 2002.
Article in Korean | WPRIM | ID: wpr-101739

ABSTRACT

PURPOSE: To evaluate the efficacy of surgical treatment for multilevel aortoiliac occlusive diseases, we retrospectively analyzed 89 recent cases surgical treatment was used. METHODS: From March 1992 to July 2001, we performed 62 aortobifemoral bypasses and 27 other bypasses as primary procedures. We analyzed surgical indications, combined diseases, cardiac risk assessment, type of occlusion, treatment modalities and cumulative patency rate. RESULTS: In 59 aortobifemoral bypasses, 8 end-to-end and 51 end-to-side proximal anastomoses were performed. Adjuvant PTA, with or without stent before bypass operation, was performed in 13 cases. Types of occlusions were Rutherford type I in 18.0%, type II in 20.2% and type III in 61.8%, respectively. Associated diseases were hypertension, diabetes, cerebrovascular accidents, and myocardial infarction in order of frequency. Mean follow-up duration was 36.4 months. Cumulative patency rate by life table analysis was 77.5%. Leg or foot amputations were performed in 13 cases (14.6%) after bypass operations. Two cases of amputation were performed after 13 simultaneous infrainguinal bypasses, and in 4 cases after staged infrainguinal bypasses. Operative mortality occured in 4 cases (4.5%). CONCLUSION: Aortobifemoral bypass remains one of the most durable and effective arterial reconstructions, for extensive aortoiliac occlusive diseases in young patients with low operative risk. Simultaneous infrainguinal bypass is preferred in patients with poor distal run-off.


Subject(s)
Humans , Amputation, Surgical , Follow-Up Studies , Foot , Heart Diseases , Hypertension , Leg , Life Tables , Mortality , Myocardial Infarction , Retrospective Studies , Risk Assessment , Stents , Stroke
20.
Korean Journal of Urology ; : 427-434, 2001.
Article in Korean | WPRIM | ID: wpr-163532

ABSTRACT

PURPOSE: The pathogenesis of infertility in unilateral cryptorchidism remains unclear. We studied prospectively to evaluate the cause concerning potential infertility in unilateral inguinal cryptorchidism.Materials and Methods: Between Feb 1998 and July 2000, 30 specimens were taken by ipsilateral undescended and contralateral descened testicular biopsies in 15 unilateral inguinal cryptorchid boys (age range: 1-11 years, mean: 4.7 years). Control testicular biopsies were performed in 5 hydrocele boys (age range: 1-9 years, mean: 5.1 years). We performed histomorphologic analysis including spermatogonia per tubule (S/T) value, Sertoli cell index (SCI), tubular degeneration phase V-VII (TDP V-VII), mean tubular diameter (MTD), and changes of peritubular interstitial tissue (thickened tubular basement membrane and peritubular fibrosis). RESULTS: Testis volume, S/T value, and MTD were significantly different between ipsilateral cryptorchid and contralateral testes. However, there was no significant difference between ipsilateral cryptorchid and contralateral testis in SCI, TDP V-VII, and changes of peritubular interstitial tissue. We found significant difference between contralateral and control testis in testis volume, S/T value, MTD, TDP V-VII, and changes of peritubular interstitial tissue except SCI.Conclusions: Decreased testis volume, S/T value, MTD and increased TDP V-VII of contralateral testis are associated with germinal hypoplasia. These findings may explain the pathogenesis of infertility in unilateral inguinal cryptorchidism.


Subject(s)
Male , Basement Membrane , Biopsy , Cryptorchidism , Infertility , Prospective Studies , Spermatogonia , Testis
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