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1.
Article in English | WPRIM | ID: wpr-874758

ABSTRACT

Background@#A rapid response system (RRS) contributes to the safety of hospitalized patients. Clinical deterioration may occur in the general ward (GW) or in non-GW locations such as radiology or dialysis units. However, there are few studies regarding RRS activation in non-GW locations. This study aimed to compare the clinical characteristics and outcomes of patients with RRS activation in non-GW locations and in the GW. @*Methods@#From January 2016 to December 2017, all patients requiring RRS activation in nine South Korean hospitals were retrospectively enrolled and classified according to RRS activation location: GW vs non-GW RRS activations. @*Results@#In total, 12,793 patients were enrolled; 222 (1.7%) were non-GW RRS activations.There were more instances of shock (11.6% vs. 18.5%) and cardiac arrest (2.7% vs. 22.5%) in non-GW RRS activation patients. These patients also had a lower oxygen saturation (92.6% ± 8.6% vs. 88.7% ± 14.3%, P < 0.001) and a higher National Early Warning Score 2 (7.5 ± 3.4 vs. 8.9 ± 3.8,P < 0.001) than GW RRS activation patients. Although non-GW RRS activation patients received more intubation (odds ratio [OR], 3.135; P < 0.001), advanced cardiovascular life support (OR, 3.912; P < 0.001), and intensive care unit transfer (OR, 2.502;P < 0.001), their hospital mortality (hazard ratio, 0.630; P = 0.013) was lower than GW RRS activation patients upon multivariate analysis. @*Conclusion@#Considering that there were more critically ill but recoverable cases in non-GW locations, active RRS involvement should be required in such locations.

2.
Article in Korean | WPRIM | ID: wpr-920076

ABSTRACT

Angiomyolipoma is a benign tumor that is composed of adipose tissue, blood vessels and smooth muscle. The kidney is the most common site for this tumor. Although extrarenal angiomyolipoma is rarely found in areas other than the kidney, it has been observed in other organs such as liver, heart, mediastinum, spermatic cord, vaginal wall, oral cavity, and so on. Angiomyolipoma in the nasal cavity especially, has been very rarely reported in literature. Furthermore, nasal angiomyolipoma is mostly found in middle aged or old men. In this case, angiomyolipoma was found in a 29-year-old male patient who was the youngest of the reported cases. He complained of nasal obstruction and physical examination revealed a 1.5 cm sized mass in the left posterior part of the nasal septum. The mass was composed of an intimate mixture of mature fat, smooth muscle cells, and thick walled varying sized blood vessels histopathologically coinciding with angiomyolipoma. It was removed via endoscopic surgery without complications.

3.
Article in Korean | WPRIM | ID: wpr-920047

ABSTRACT

Malignant tumors rarely occur in the paranasal sinuses. Paranasal tumors, when they occur, exhibit atypical symptoms, such as nasal obstruction, rhinorrhea, facial pain, and nasal bleeding. Because of nonspecific symptoms commonly observed in the sinusitis and their infrequent occurrence, malignant tumors of the paranasal sinuses are generally diagnosed late. If there is bone destruction or invasion of the surrounding tissues in the imaging studies, malignant tumors could be suspected; however, without such findings, it is difficult to predict the existence of cancer. It is more difficult to suspect malignant tumors when they coexist with sinus diseases. In addition, since the concomitant presence of fungal balls and cancer is extremely rare, it is difficult to suspect the presence of cancer when treating fungal balls. We report a case of a fungal ball accompanied by squamous cell carcinoma without any sign of malignancy, such as bone destruction, which has not been reported in the English literature to date.

4.
Article | WPRIM | ID: wpr-831304

ABSTRACT

Objectives@#. Crosshatching incision has been considered a useful method for correcting cartilaginous septal deviation. The aim of this study was to determine the utility and limitations of this approach. @*Methods@#. This retrospective case-control study included 353 patients who underwent septoplasty performed by a senior surgeon between January 2004 and December 2010. Patients were classified into two groups according to whether crosshatching incision was performed (n=151) during septoplasty or not (n=202). All other techniques performed during septoplasty were identical. The parameters of surgical success (improvement of nasal obstruction, correction of deviation, and acoustic rhinometry results) and adverse effects were compared between the groups. @*Results@#. There were no significant differences in the parameters of surgical success between the groups (improvement of nasal obstruction, P=0.333; correction of deviation, P=0.608; acoustic rhinometry results, P=0.322 for the difference in the minimal cross-sectional area; P=0.919 for difference in volume). Relative to patients who did not undergo the cross-hatching incision, patients with whom the technique was performed showed a significantly higher incidence of saddle nose (0/202 vs. 4/151 cases, P=0.033) and overcorrection (0/202 vs. 5/151 cases, P=0.014). @*Conclusion@#. Crosshatching incision during septoplasty did not produce better surgical outcomes; however, it caused adverse effects such as saddle nose and overcorrection. Therefore, the use of crosshatching incision should be re-evaluated.

5.
Article in English | WPRIM | ID: wpr-759995

ABSTRACT

It is well known that the presence of arachnoid cysts (ACs) in young patients is a risk factor for developing a chronic subdural hematoma (CSDH) after a minor head injury. Although there have been controversies with the treatment, most authors recommend only draining the CSDH if the AC is asymptomatic. This judgement is based on the facts that this surgical approach has shown good clinical outcomes, and the AC usually remains unchanged after the surgery. Our case demonstrates that the AC of a young patient who developed a CSDH after a minor head injury completely disappeared after a burr hole drainage of the CSDH. Although the chances of an AC disappearing are low, this case shows that an AC might disappear after only draining a CSDH when a rupture of the AC membrane is identified. In such cases, we recommend first draining only the CSDH for the treatment of AC-associated CSDHs.


Subject(s)
Arachnoid Cysts , Arachnoid , Craniocerebral Trauma , Drainage , Hematoma, Subdural, Chronic , Humans , Membranes , Risk Factors , Rupture
6.
Article in English | WPRIM | ID: wpr-765007

ABSTRACT

BACKGROUND: The lack of medical personnel has led to the employment of hospitalists in Korean hospitals to provide high-quality medical care. However, whether hospitalists' care can improve patients' outcomes remains unclear. We aimed to analyze the outcome in patients cared for by hospitalists. METHODS: A retrospective review was conducted in 1,015 patients diagnosed with pneumonia or urinary tract infection from March 2017 to July 2018. After excluding 306 patients, 709 in the general ward who were admitted via the emergency department were enrolled, including 169 and 540 who were cared for by hospitalists (HGs) and non-hospitalists (NHGs), respectively. We compared the length of hospital stay (LOS), in-hospital mortality, readmission rate, comorbidity, and disease severity between the two groups. Comorbidities were analyzed using Charlson comorbidity index (CCI). RESULTS: HG LOS (median, interquartile range [IQR], 8 [5–12] days) was lower than NHG LOS (median [IQR], 10 [7–15] days), (P < 0.001). Of the 30 (4.2%) patients who died during their hospital stay, a lower percentage of HG patients (2.4%) than that of NHG patients (4.8%) died, but the difference between the two groups was not significant (P = 0.170). In a subgroup analysis, HG LOS was shorter than NHG LOS (median [IQR], 8 [5–12] vs. 10 [7–16] days, respectively, P < 0.001) with CCI of ≥ 5 points. CONCLUSION: Hospitalist care can improve the LOS of patients, especially those with multiple comorbidities. Further studies are warranted to evaluate the impact of hospitalist care in Korea.


Subject(s)
Comorbidity , Emergency Service, Hospital , Employment , Hospital Mortality , Hospitalists , Humans , Korea , Length of Stay , Patients' Rooms , Pneumonia , Retrospective Studies , Urinary Tract Infections
7.
Article in English | WPRIM | ID: wpr-763313

ABSTRACT

OBJECTIVES: There is a great deal of interest in the possibility that environmental factors may influence the risk of developing allergic rhinitis (AR) in early life. We investigated the simultaneous effects of mode of delivery and duration of breastfeeding on the development of AR in children. METHODS: Data from 1,374 children participating in the Allergic Rhinitis Cohort Study for kids (ARCO-kids study) was analyzed. All subjects were divided into AR or non-allergic rhinitis (NAR) groups. Data on environmental factors, mode of delivery and duration of breastfeeding were collected using a questionnaire. RESULTS: Compared with short-term breastfeeding (<6 months), long-term breastfeeding (≥12 months) was significantly associated with a lower prevalence of AR (adjusted odds ratio [aOR], 0.54; 95% confidence interval [CI], 0.34 to 0.88). Children in the AR group also had a higher cesarean delivery rate than those in the NAR group (39.1% vs. 32.8%, P=0.05). Regarding the combined effects of mode of delivery and duration of breastfeeding, long-term breastfeeding with a vaginal delivery strongly suppressed the development of AR, compared to short-term breastfeeding with a cesarean delivery (aOR, 0.47; 95% CI, 0.30 to 0.73). CONCLUSION: Long-term breastfeeding (≥12 months) and a vaginal delivery are associated with a lower risk of developing childhood AR.


Subject(s)
Breast Feeding , Cesarean Section , Child , Cohort Studies , Delivery, Obstetric , Female , Humans , Odds Ratio , Pregnancy , Prevalence , Rhinitis , Rhinitis, Allergic
8.
Cancer Research and Treatment ; : 1041-1051, 2019.
Article in English | WPRIM | ID: wpr-763175

ABSTRACT

PURPOSE: We compared the oncologic outcomes of breast-conserving surgery plus radiation therapy (BCS+RT) and modified radical mastectomy (MRM) under anthracycline plus taxane-based (AT) regimens and investigated the role of adjuvant radiation therapy (RT) in patients with pathologic N1 (pN1) breast cancer treated by mastectomy. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 2,011 patients with pN1 breast cancer who underwent BCS+RT or MRM alone at 12 institutions between January 2006 and December 2010. Two-to-one propensity score matching was performed for balances in variables between the groups. RESULTS: The median follow-up duration for the total cohort was 69 months (range, 1 to 114 months). After propensity score matching, 1,074 patients (676 in the BCS+RT group and 398 in the MRM-alone group) were analyzed finally. The overall survival, disease-free survival, locoregional failure-free survival, and regional failure-free survival (RFFS) curves of the BCS+RT group vs. MRM-alone group were not significantly different. The subgroup analysis revealed that in the group with both lymphovascular invasion (LVI) and histologic grade (HG) III, the BCS+RT showed significantly superior RFFS (p=0.008). Lymphedema (p=0.007) and radiation pneumonitis (p=0.031) occurred more frequently in the BCS+RT group than in the MRM-alone group, significantly. CONCLUSION: There are no differences in oncologic outcomes between BCS+RT and MRM-alone groups under the AT chemotherapy regimens for pN1 breast cancer. However, BCS+RT group showed superior RFFS to MRM-alone group in the patients with LVI and HG III. Adjuvant RT might be considerable for pN1 breast cancer patients with LVI and HG III.


Subject(s)
Anthracyclines , Breast Neoplasms , Breast , Cohort Studies , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Humans , Lymphedema , Mastectomy , Mastectomy, Modified Radical , Mastectomy, Segmental , Medical Records , Propensity Score , Radiation Pneumonitis , Retrospective Studies
9.
Article in English | WPRIM | ID: wpr-785923

ABSTRACT

OBJECTIVE: Selecting an appropriate guiding catheter to provide both sufficient supportability for working devices and sufficient distal navigability is essential for ensuring the success of a procedure. This study aimed to evaluate the advantages and disadvantages of using the ENVOY 6F distal access (DA) guiding catheter in coil embolization of anterior circulation cerebral aneurysms.METHODS: We included 98 patients (72 [73.5%] women, median age: 63 [range: 25–84] years) who underwent endovascular coiling with the ENVOY 6F DA guiding catheter from May to November 2016. We analyzed data on patient demographics and the number of co-axial techniques to position the guiding catheter, initial and final location of the catheter, and complications related to the catheter.RESULTS: The co-axial technique was used to position the ENVOY 6F DA guiding catheter in the internal carotid artery (ICA) in 20 cases (20.41%). The initial position of the ENVOY 6F DA guiding catheter involved the cervical ICA (79.6%), horizontal petrous ICA (17.3%), and vertical petrous ICA (3.1%). Final control angiograms after endovascular coiling showed proximal change in the final, compared to the initial, position of the ENVOY 6F DA guiding catheter in 25 cases (25.51%). Procedure-related complications were observed in nine patients (9.18%), involving vasospasm in all cases; however, there was no symptomatic case.CONCLUSION: The ENVOY 6F DA guiding catheter had relatively sufficient distal navigability without symptomatic procedural complications. However, the change in the catheter position after endovascular coiling denoted insufficient supportability.


Subject(s)
Aneurysm , Carotid Arteries , Carotid Artery, Internal , Catheterization , Catheters , Cerebrovascular Circulation , Demography , Embolization, Therapeutic , Female , Humans , Intracranial Aneurysm
10.
Journal of Neurocritical Care ; (2): 119-123, 2018.
Article in English | WPRIM | ID: wpr-765909

ABSTRACT

BACKGROUND: Since the first report of a rapidly resolved subdural hemorrhage (SDH) in 1986, few additional case reports have been presented in the literature. CASE REPORT: An 82-year-old female patient presented with a SDH over the left convexity. The SDH was removed via catheter drainage through a burr hole trephination. Post-operative computed tomography (CT) following 300 mL drainage from the chronic SDH demonstrated a newly developed SDH along the right convexity. A follow-up CT performed 2 hours later revealed an unexpected significant resolution of the acute SDH. CONCLUSION: The spontaneous resolution of acute SDH is believed to result from redistribution by washout of the hematoma by cerebrospinal fluid dilution. However, its exact pathophysiology is not well understood. When surgical evacuation is considered in acute SDH, conservative management should also be considered because spontaneous resolution of hemorrhage remains a possibility.


Subject(s)
Aged, 80 and over , Catheters , Cerebrospinal Fluid , Drainage , Female , Follow-Up Studies , Hematoma , Hematoma, Subdural , Hematoma, Subdural, Chronic , Hemorrhage , Humans , Trephining
11.
Article in Korean | WPRIM | ID: wpr-713393

ABSTRACT

BACKGROUND AND OBJECTIVES: Various techniques have been reported for the correction of deviated nasal septum, most of them for caudal septal cartilage. For deviated posterior septal cartilage, the typical method of the day is the resection of deviated portion. However, we developed a bone anchoring technique that conservatively corrects deviated posterior septal cartilage. The aim of the current study is to determine the efficacy of this bone anchoring technique. SUBJECTS AND METHOD: The patients who had undergone septoplasty using bone anchoring technique by a single surgeon (J.S.K) between October 2015 and June 2016 were enrolled in this study. The result of the surgery was evaluated using a visual analogue scale (VAS, ranged 0– 10) for nasal obstruction, acoustic rhinometry, and assessment of surgeon. RESULTS: A total of 44 patients were included in this study. The VAS of nasal obstruction was significantly decreased after surgery from 7.5±1.7 to 2.4±1.4. In acoustic rhinometry, minimal cross-sectional area and volume were increased after surgery from 0.35±0.18 to 0.52±1.40 cm2 and from 3.6±1.1 to 5.8±1.5 cm3, respectively. Most of the deviated septum was well corrected, and complication or recurrence did not developed. CONCLUSION: Bone anchoring technique is easy to perform. It enables the preservation of septal cartilage, which is useful in revision septoplasty or rhinoplasty. We conclude that this technique is a good method for the correction of deviated posterior septal cartilage.


Subject(s)
Cartilage , Humans , Methods , Nasal Obstruction , Nasal Septum , Reconstructive Surgical Procedures , Recurrence , Rhinometry, Acoustic , Rhinoplasty , Suture Anchors
12.
Article in Korean | WPRIM | ID: wpr-714559

ABSTRACT

BACKGROUND AND OBJECTIVES: Since rhinoplasty techniques require meticulous and delicate manipulation, proper anesthesia is essential. The aim of the current study is to compare patient satisfaction and complication of rhinoplasty performed under local anesthesia against general anesthesia. SUBJECTS AND METHOD: Patients who underwent rhinoplasty by a single surgeon between March 2014 and January 2017 were enrolled in this study. Midazolam was utilized to sedate the patient during local anesthesia. Pain and memory of surgery under local anesthesia, satisfaction of anesthesia, and willingness to undergo the surgery with the same anesthesia method again were evaluated. Cardiopulmonary events, nausea, and vomiting were assessed as complications. Aesthetic satisfaction of patients and the doctor was evaluated 6 month after the surgery. The parameters were compared between local and general anesthesia. RESULTS: A total 120 patients were included in this study. The degree of pain was low during surgery under local anesthesia. Although most of patients remembered the process of surgery during local anesthesia, satisfaction of local anesthesia was high. The satisfaction of anesthesia and willingness to undergo surgery with same anesthesia were not signifcantly different between local and general anesthesia. No serious complications developed during local anesthesia and there were no signifcant differences of aesthetic satisfaction between local and general anesthesia. CONCLUSION: Patient satisfaction and aesthetic results of rhinoplasty performed under local anesthesia were comparable to general anesthesia, indicating that surgeons do not need to be afraid of applying local anesthesia in rhinoplasty.


Subject(s)
Anesthesia , Anesthesia, General , Anesthesia, Local , Humans , Memory , Methods , Midazolam , Nausea , Patient Satisfaction , Rhinoplasty , Surgeons , Vomiting
13.
Journal of Rhinology ; : 43-46, 2018.
Article in Korean | WPRIM | ID: wpr-714404

ABSTRACT

Solitary fibrous tumor is a rare spindle cell neoplasm of mesenchymal origin that occurs most commonly in the pleura. This tumor can be found in various extrathoracic sites that contain soft tissue. There are few reports of solitary fibrous tumors in the head & neck and only 5 cases of solitary fibrous tumors of the cheek have been reported. A 53-year-old man visited our department complaining of a firm mass in the left cheek. We suspected a schwannoma originating from the infraorbital nerve. The mass was removed via a gingivobuccal approach and was diagnosed as a solitary fibrous tumor.


Subject(s)
Cheek , Head , Humans , Middle Aged , Neck , Neurilemmoma , Pleura , Solitary Fibrous Tumors
14.
Article in Korean | WPRIM | ID: wpr-717348

ABSTRACT

BACKGROUND AND OBJECTIVES: Dizziness has been known as a prognostic factor in sudden sensorineural hearing loss (SSHL), but it is difficult to describe and quantify its subjective symptoms. Also, dizziness itself cannot imply vestibular dysfunction in SSHL. Comprehensive evaluation of vestibular function may help us understand the extent of lesions in sudden deafness. The purpose of this study is to determine whether an impaired caloric response is associated with disease severity and hearing outcome. SUBJECTS AND METHOD: A retrospective chart review was conducted of 488 patients diagnosed as unilateral SSHL. The patients were divided into two, an abnormal caloric group (canal paresis >20%) and normal caloric group (canal paresis ≤20%). Initial demographic and audiologic findings and final hearing outcomes were compared between the two groups. RESULTS: The initial pure tone averages of SSHL patients of abnormal caloric group and normal caloric group were 75.4±28.4 dB HL and 68.2±25.4 dB HL (p=0.004), respectively. Patients of abnormal caloric test group showed worse hearing outcome across all frequencies compared to those of the normal caloric group. Also, a significant correlation was noted between the magnitude of hearing recovery and canal paresis (r=-0.223, p < 0.001). CONCLUSION: SSHL patients of abnormal caloric test showed worse initial hearing level and poorer hearing outcome. Evaluation of vestibular function in SSHL patients is important because subjective symptoms alone cannot account for vestibular hypofunction patients, and the caloric test can help in the counseling of patients and prediction of hearing outcome in SSHL patients.


Subject(s)
Caloric Tests , Counseling , Dizziness , Hearing , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Humans , Methods , Paresis , Retrospective Studies
15.
Article in Korean | WPRIM | ID: wpr-715853

ABSTRACT

BACKGROUND AND OBJECTIVES: The effectiveness of turbinate surgery has been well demonstrated in allergic rhinitis refractory to medication. On the contrary, the efficacy of surgery in allergic rhinitis that responds to medication has not been assessed. The aim of this study was to determine the surgical outcomes in patients with allergic rhinitis responsive to medication. SUBJECTS AND METHOD: Patients with allergic rhinitis responsive to medication and those who had undergone coblation turbinate reduction were enrolled in this study. The visual analog scale was used to assess the allergic symptoms before treatment, during medication treatment as well as postoperatively at 6 and 12 months. In addition, the degree of patient satisfaction regarding the surgery was investigated postoperatively at 12 months. RESULTS: Twenty-four patients (mean age=33.6±14.9 years; men-to-women ratio=1:1) were included in this study. During the pretreatment period, all allergic symptoms significantly improved after treatment with both medication and surgery. At 6 months postoperatively, the degree of patients' allergic symptoms was lower than in those treated with medication. However, when compared at 12 months postoperatively, all the symptoms, excluding nasal obstruction, were not significantly different from those who received medication. Surveyed postoperatively at 12 months 54.2% of patients advocated for surgical treatment. CONCLUSION: Although surgery yielded better outcome than did medication during the early postoperative period, there was little difference in the outcome at 12 months postoperatively. Therefore, we need to be careful when choosing surgical intervention for patients with allergic rhinitis responsive to medication.


Subject(s)
Humans , Methods , Nasal Obstruction , Patient Satisfaction , Postoperative Period , Pulsed Radiofrequency Treatment , Rhinitis, Allergic , Treatment Outcome , Turbinates , Visual Analog Scale
16.
Annals of Dermatology ; : 322-330, 2018.
Article in English | WPRIM | ID: wpr-715492

ABSTRACT

BACKGROUND: Empirical evidences for efficacy of hot spring (HS) water in inflammatory skin disorders have not been substantiated with sufficient, immunological “hard evidence”. Mageumsan HS water, characterized by its weakly-alkaline properties and low total dissolved solids content, has been known to alleviate various immune-inflammatory skin diseases, including atopic dermatitis (AD). OBJECTIVE: The trial attempted to quantitatively analyze in vitro expression levels of chemical mediators in cutaneous inflammation from HaCaT cell line treated with Mageumsan HS, and suggest the likely mode of action through which it exerts the apparent anti-inflammatory effects in AD. METHODS: Using membrane-based human antibody array kit, customized to include 30 different, keratinocyte-derived mediator proteins, their expression levels (including interleukin [IL]-1, IL-6, IL-8, thymic stromal lymphopoietin, thymus and activation-regulated chemokine, and granulocyte macrophage colony-stimulating factor) were assessed in vitro. Selected key proteins were further quantified with enzyme-linked immunosorbent assay. RESULTS: There was a clear pattern of overall suppression of the mediators, especially those noted for their pro-inflammatory role in AD (monocyte chemoattractant protein [MCP]-1, regulated on activation, normal T cell expressed and secreted, cutaneous T-cell-attracting chemokine, Eotaxin, and macrophage inflammatory protein-1α, etc.). Also, reduced expression of involucrin and cytokeratin 1 was also reduced in the HS-treated group. CONCLUSION: The present study has shown that Mageumsan HS water may exert its effects on inflammatory skin disorders through regulation of proinflammatory cytokines. These evidences are to be supported with further future investigations to elucidate immunological mechanism behind these beneficial effects of HS water in the chronically inflamed skin of AD.


Subject(s)
Cell Line , Chemokine CCL17 , Chemokine CCL27 , Cytokines , Dermatitis, Atopic , Enzyme-Linked Immunosorbent Assay , Granulocytes , Hot Springs , Humans , In Vitro Techniques , Inflammation , Interleukin-6 , Interleukin-8 , Interleukins , Keratins , Macrophages , Protein Array Analysis , Skin , Skin Diseases , Water
17.
Article in English | WPRIM | ID: wpr-715280

ABSTRACT

OBJECTIVE: In our series, endovascular coiling with Target® Nano™ coils (Stryker Neurovascular, Fremont, CA, USA) with diameters of 1 or 1.5 mm exhibited favorable technical feasibility in the treatment of small cerebral aneurysms (< 4 mm). However, little is known about the recurrence of small cerebral aneurysms treated using Target® Nano™ coils. We investigated recurrence following the treatment of small cerebral aneurysms using Target® Nano™ coils. MATERIALS AND METHODS: Between January 2012 and November 2013, 143 patients with 148 small cerebral aneurysms (< 4 mm) were included our study. A total of 135 cerebral aneurysms (91.2%) were unruptured; 45 cerebral aneurysms (30.4%) were treated by endovascular coiling using Target® Nano™ coils. Follow-up radiological images were obtained for 132 cerebral aneurysms (89.2%) over a range of 3 to 58 months (mean, 34.3 months; standard deviation, 14.2). RESULTS: In the group treated with Target® Nano™ coils, radiological outcomes revealed complete occlusion in 33 (73.3%), residual necks in eight (17.8%), and residual sacs in four (8.9%) cases. Follow-up radiological outcomes revealed complete occlusion in 35 (77.8%) and residual necks in four (8.9%) cases that exhibited stable coil masses. In the group that was not treated with Target® Nano™ coils, radiological outcomes revealed complete occlusion in 69 (67%), residual necks in 18 (17.5%), and residual sacs in 16 (15.5%) cases. Follow-up radiological outcomes revealed complete occlusion in 87 (84.5%) and residual necks (5.8%) in six cases that exhibited stable coil masses. No significant differences were observed in the radiological outcomes or follow-up radiological outcomes between the two groups. No recurrences or retreatments occurred in our series. CONCLUSION: Endovascular treatment using Target® Nano™ coils may be a robust treatment option for small cerebral aneurysms (< 4 mm).


Subject(s)
Follow-Up Studies , Humans , Intracranial Aneurysm , Neck , Recurrence , Retreatment
18.
Article in Korean | WPRIM | ID: wpr-649701

ABSTRACT

Actinomycosis is a rare anaerobic, gram-positive bacterial infection caused by Actinomyces, which is a normal flora in the gastrointestinal and female genitourinary tracts. The cervicofacial area is a common infection site for actinomycosis, while nasal cavity is rare. Generally, standard treatment of the disease is a long term antibiotics therapy. However, a treatment strategy for nasal actinomycosis has not been established due to its rarity. We present a case of nasal actinomycosis that was managed by surgical removal. A 49-year-old woman visited our clinic with epistaxis and foul odor and nasoendoscopy showed a mass in patient's right nasal cavity. The mass comprised of Actinomyces was easily removed by endoscopic surgery. Further histopathologic examination revealed that the surrounding tissues did not contain Actinomyces, so we stopped applying antibiotics to the patients. No recurrence has been observed for 26 months. We report this rare case of nasal actinomycosis with a literature review regarding treatment.


Subject(s)
Actinomyces , Actinomycosis , Anti-Bacterial Agents , Epistaxis , Female , Gram-Positive Bacterial Infections , Humans , Middle Aged , Nasal Cavity , Odorants , Patient Rights , Recurrence
19.
Article in English | WPRIM | ID: wpr-160279

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the impact of postmastectomy radiotherapy (PMRT) on loco-regional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) in pT1-2N1 patients treated with taxane-based chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed the medical data of pathological N1 patients who were treated with modified radical mastectomy and adjuvant taxane-based chemotherapy in 12 hospitals between January 2006 and December 2010. RESULTS: We identified 714 consecutive patients. The median follow-up duration was 69 months (range, 1 to 114 months) and the 5-year LRRFS, DFS, and OS rates were 97%, 94%, and 98%, respectively, in patients who received PMRT (PMRT [+]). The corresponding figures were 96%, 90%, and 96%, respectively, in patients who did not receive PMRT (PMRT [–]). PMRT had no significant impact on survival. Upon multivariable analysis, only the histological grade (HG) was statistically significant as a prognostic factor for LRRFS and DFS. In a subgroup analysis of HG 3 patients, PMRT (+) showed better DFS (p=0.081). CONCLUSION: PMRT had no significant impact on LRRFS, DFS, or OS in pT1-2N1 patients treated with taxane-based chemotherapy. PMRT showed a marginal benefit for DFS in HG 3 patients. Randomized studies are needed to confirm the benefit of PMRT in high risk patients, such as those with HG 3.


Subject(s)
Breast Neoplasms , Breast , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Humans , Mastectomy, Modified Radical , Radiotherapy , Recurrence , Retrospective Studies
20.
Article in English | WPRIM | ID: wpr-160275

ABSTRACT

PURPOSE: This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy. MATERIALS AND METHODS: We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching. Patterns of failure, disease-free survival (DFS), distant metastasis-free survival (DMFS), and treatment-related toxicity were compared between groups. RESULTS: A total of 41 patients (7.6%) were found to have recurrence. Supraclavicular lymph node (SCN) failure was detected in three patients, two in WBI and one in WBI+SCNRT. All SCN failures were found simultaneously with distant metastasis. There was no significant difference in patterns of failure or survival between groups. The 5-year DFS and DMFS for patients with WBI and WBI+SCNRT were 94.4% versus 92.6% (p=0.50) and 95.1% versus 94.5% (p=0.99), respectively. The rates of lymphedema and radiation pneumonitis were significantly higher in the WBI+SCNRT than in the WBI. CONCLUSION: We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.


Subject(s)
Breast Neoplasms , Breast , Case-Control Studies , Disease-Free Survival , Drug Therapy , Humans , Lymph Nodes , Lymphatic Irradiation , Lymphedema , Mastectomy, Segmental , Neoplasm Metastasis , Propensity Score , Radiation Pneumonitis , Radiotherapy , Radiotherapy, Adjuvant , Recurrence
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