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1.
Article in English | WPRIM | ID: wpr-888998

ABSTRACT

Background@#Cranioplasty for the treatment of cephalhematomas in small infants with limited blood volume is challenging because of massive bleeding. This study aimed to elucidate the correlation between cephalhematoma size and intraoperative blood loss and identify criteria that can predict large intraoperative blood loss. @*Methods@#We reviewed the medical records of 120 pediatric patients aged less than 24 months who underwent cranioplasty for treatment of a cephalhematoma. The cephalhematoma sizes in preoperative brain computed tomography (CT) were measured using ImageJ. @*Results@#Pearson correlation showed that the cephalhematoma size in the pre-operative brain CT was weakly correlated with intraoperative blood loss (Pearson coefficient = 0.192, P = 0.037). In a multivariable logistic regression analysis, a cephalhematoma size greater than 113.5 cm3 was found to be a risk factor for large blood loss. The area under the curve in the receiver operating characteristic plot of the multivariable model was 0.714 (0.619–0.809). @*Conclusions@#A cephalhematoma size cutoff value of 113.5 cm3, as measured in the preoperative CT imaging, can predict intraoperative blood loss exceeding 30% of the total body blood volume. The establishment of a transfusion strategy prior to surgery based on cephalhematoma size could be useful in pediatric cranioplasty.

2.
Article in English | WPRIM | ID: wpr-899898

ABSTRACT

Background@#The impact of reflux esophagitis on the decline of lung function has been rarely reported. This study was performed to evaluate the association between erosive reflux esophagitis and lung function changes. @*Methods@#We included patients with normal lung function who underwent esophagogastroduodenoscopy for health screening from a health screening center. Patients with persistent erosive reflux esophagitis on two discrete endoscopic examinations were designated as the erosive reflux esophagitis group. We also selected patients without erosive reflux esophagitis and matched them 1:4 with patients from the erosive reflux esophagitis group. We estimated annual forced expiratory volume in 1 second (FEV1 ) and forced vital capacity (FVC) changes from baseline and compared these estimates by the linear mixed regression model. We also estimated the biannual incidence of chronic obstructive pulmonary disease (COPD). @*Results@#In total, 1,050 patients (210 patients with erosive reflux esophagitis, and 840 matched controls) were included. The median follow-up duration for spirometry was six years. In patients with erosive reflux esophagitis, mild reflux esophagitis (A grade) was most common (165 patients, 78.6%). The adjusted annual FEV1 change in patients with erosive reflux esophagitis was −51.8 mL/yr, while it decreased by 46.8 mL/yr in controls (P = 0.270).The adjusted annual FVC decline was similar between the two groups (−55.8 vs. −50.5 mL/ yr, P = 0.215). The estimated COPD incidence during the follow-up period was not different between the erosive reflux esophagitis and control groups. @*Conclusion@#In patients with normal lung function, the presence of erosive reflux esophagitis did not affect the annual declines in FEV1 or FVC.

3.
Article in English | WPRIM | ID: wpr-896702

ABSTRACT

Background@#Cranioplasty for the treatment of cephalhematomas in small infants with limited blood volume is challenging because of massive bleeding. This study aimed to elucidate the correlation between cephalhematoma size and intraoperative blood loss and identify criteria that can predict large intraoperative blood loss. @*Methods@#We reviewed the medical records of 120 pediatric patients aged less than 24 months who underwent cranioplasty for treatment of a cephalhematoma. The cephalhematoma sizes in preoperative brain computed tomography (CT) were measured using ImageJ. @*Results@#Pearson correlation showed that the cephalhematoma size in the pre-operative brain CT was weakly correlated with intraoperative blood loss (Pearson coefficient = 0.192, P = 0.037). In a multivariable logistic regression analysis, a cephalhematoma size greater than 113.5 cm3 was found to be a risk factor for large blood loss. The area under the curve in the receiver operating characteristic plot of the multivariable model was 0.714 (0.619–0.809). @*Conclusions@#A cephalhematoma size cutoff value of 113.5 cm3, as measured in the preoperative CT imaging, can predict intraoperative blood loss exceeding 30% of the total body blood volume. The establishment of a transfusion strategy prior to surgery based on cephalhematoma size could be useful in pediatric cranioplasty.

4.
Article in English | WPRIM | ID: wpr-892194

ABSTRACT

Background@#The impact of reflux esophagitis on the decline of lung function has been rarely reported. This study was performed to evaluate the association between erosive reflux esophagitis and lung function changes. @*Methods@#We included patients with normal lung function who underwent esophagogastroduodenoscopy for health screening from a health screening center. Patients with persistent erosive reflux esophagitis on two discrete endoscopic examinations were designated as the erosive reflux esophagitis group. We also selected patients without erosive reflux esophagitis and matched them 1:4 with patients from the erosive reflux esophagitis group. We estimated annual forced expiratory volume in 1 second (FEV1 ) and forced vital capacity (FVC) changes from baseline and compared these estimates by the linear mixed regression model. We also estimated the biannual incidence of chronic obstructive pulmonary disease (COPD). @*Results@#In total, 1,050 patients (210 patients with erosive reflux esophagitis, and 840 matched controls) were included. The median follow-up duration for spirometry was six years. In patients with erosive reflux esophagitis, mild reflux esophagitis (A grade) was most common (165 patients, 78.6%). The adjusted annual FEV1 change in patients with erosive reflux esophagitis was −51.8 mL/yr, while it decreased by 46.8 mL/yr in controls (P = 0.270).The adjusted annual FVC decline was similar between the two groups (−55.8 vs. −50.5 mL/ yr, P = 0.215). The estimated COPD incidence during the follow-up period was not different between the erosive reflux esophagitis and control groups. @*Conclusion@#In patients with normal lung function, the presence of erosive reflux esophagitis did not affect the annual declines in FEV1 or FVC.

5.
Article in Korean | WPRIM | ID: wpr-920263

ABSTRACT

Background and Objectives@#Scalp angiosarcoma is a rare but aggressive vascular malignancy. It is often found in the advanced state and tends to cause distant metastasis at an early stage. There is no consensus on a treatment modality, although wide excision followed by adjuvant therapy is currently used. The purpose of this study was to analyze the treatment results and disease progress pattern of scalp angiosarcoma in a single institution.Subjects and Method We enrolled patients who diagnosed with scalp angiosarcoma at Asan Medical Center from March 2011 to September 2019. Disease course and prognostic factors were analyzed by estimating overall survival rate and disease free survival. @*Results@#A total 12 patients were enrolled in this study. The median overall survival was 16.0 months. The 3-year-survival rate was 10.6%, and the median disease free survival was 5.0 months. On the average, it took 11.4 months till death after recurrence. @*Conclusion@#Although wide surgical excision and multiple adjuvant therapies are employed, scalp angiosarcoma showed frequent recurrences and metastasis which led to poor outcomes. Further investigations for scalp angiosarcoma are necessary to improve treatment outcomes.

6.
Article in English | WPRIM | ID: wpr-919309

ABSTRACT

The prevalence and intensity of Opisthorchis viverrini metacercariae (OvMc) were investigated in fish from 3 southern administrative regions along the Mekong River in Cambodia, i.e., Phnom Penh, Takeo, and Kandal Provinces from 2017 to 2020. A total of 295 freshwater fish (24 species) were transported to our laboratory with ice and examined using the artificial digestion method. In Phnom Penh, among 4 fish species positive for OvMc, 9 (23.7%) of 38 specimens examined were infected, and their intensity of infection averaged 4.3 metacercariae per infected fish. In Takeo Province, among 10 fish species positive for OvMc, 24 (38.1%) out of 63 fish examined were infected, and their intensity of infection was av. 14.4 metacercariae per infected fish. In particular, all of 3 Osteochilus schlegelii fish examined were infected, and their infection intensity was high, 34.7 metacercariae per fish. In Kandal Province, among 6 fish species positive for OvMc, 46 (90.2%) out of 51 specimens examined were infected, and their infection intensity was 24.0 metacercaraie per infected fish. All fish of Systomus orphoides (n=17), Barbonymus altus (n=14), and Rasbora aurotaenia (n=2) were infected, and their intensity of infection averaged 37.7, 21.6, and 18.5 metacercariae per fish, respectively. Metacercariae of Haplochis yokogawai, Haplorchis taichui, and Centrocestus formosanus were detected in fish from Takeo and Kandal Provinces. From these results, it has been confirmed that a variety of fish species from Phnom Penh, Takeo, and Kandal Provinces are commonly infected with OvMc, and preventive measures to avoid human O. viverrini infection should be performed in Cambodia.

7.
Article in Korean | WPRIM | ID: wpr-917695

ABSTRACT

Background/Objectives@#Shoulder function is an important aspect of health related quality of life (QOL). Neck dissection impairment index (NDII) is a simple shoulder-specific questionnaire. This study aimed to evaluate the association between QOL and NDII in patients who underwent neck dissection to validate the Korean version of NDII.Materials & Methods: This study enrolled 74 patients with head and neck cancer who underwent neck dissection from December 2013 to April 2014. Patients completed questionnaires on QOL including the European Organization of Research and Treatment of Cancer 30-item Core QOL questionnaire (EORTC QLQ-C30) and NDII which was translated into Korean. Validity was evaluated by calculating the Pearson correlation coefficient between NDII and EORTC QLQ-C30. @*Results@#We compared preoperative, postoperative within a week, 1st and 3rd months NDII scores. The total NDII scores were 14.7, 47.4, 33.7 and 34.3 each. Clinical variables including gender, site of primary tumor, performing revision neck dissection, radiotherapy and flap reconstruction were not significantly associated with NDII. However NDII mean score of patients who underwent unilateral neck dissection over 3 levels is most increased after operation. During all periods NDII scores were significantly associated with functioning score. Although other scores are lower correlation than function scores, global health status scores and symptom scores are also correlation with NDII. @*Conclusion@#NDII was valid instrument and can be used not only in the clinical practice to assess shoulder dysfunction but also in the simple instrument to evaluate global QOL in Korea patients with having neck dissection.

8.
Article in Korean | WPRIM | ID: wpr-901216

ABSTRACT

Inverted papilloma is a rare benign tumor which usually arises from sinonasal mucosa. We experienced a case of 62-year-old male who presented with foreign body sensation in throat. A round mass was found at right false vocal cord in laryngoscopic examination. It was excised in laryngeal microsurgery. The pathologic diagnosis was inverted papilloma of false vocal cord. Recurrence or complication did not occur during the follow up period of three months.

9.
Article in English | WPRIM | ID: wpr-900477

ABSTRACT

Background@#Primary squamous cell carcinoma (SCC) of the salivary gland is a rare disease, and distinguishing primary SCC from metastatic SCC is difficult. This study investigated the histological and immunohistochemical differences between primary and metastatic salivary gland SCC to improve the accuracy of diagnosis and to explore the pathogenesis of this disease. @*Methods@#Data of 16 patients who underwent surgery for SCC of salivary glands between 2000 and 2018 at Asan Medical Center were retrieved. Eight patients had a history of SCC at other sites, and eight patients had only salivary gland SCC. Immunostaining for p16, p53, androgen receptor (AR), gross cystic disease fluid protein 15 (GCDFP-15), and c-erbB2, as well as mucicarmine staining, were compared between the two groups. @*Results@#Most tumors were located in the center of the salivary glands with extraparenchymal extension. The histology of primary SCC of the salivary gland was consistent with moderately differentiated SCC with extensive desmoplastic reaction and peritumoral inflammation. Involvement of the salivary gland ducts and transition into the ductal epithelium were observed in two cases. Metastatic SCC resembled the primary tumor histologically and was associated with central necrosis. Both groups exhibited negative mucin staining. Two, one, and one primary SCC case exhibited AR, GCDFP-15, and c-erbB2 positivity, respectively. @*Conclusions@#A subset of primary SCCs originated in salivary ducts or was related to salivary duct carcinoma. Distinguishing primary from metastatic SCC of the salivary gland is difficult using histologic features and immunoprofiles. A comprehensive review of the medical history is essential.

10.
Article in English | WPRIM | ID: wpr-899233

ABSTRACT

The aim of this study was to investigate the change of microbial contamination levels in the different areas and at the different time points after application of a quaternary ammonium compound (QAC) that has mechanical antimicrobial effect. The microbial contamination levels were measured in three different areas; unit chair handle, spit sink area and hand piece holder at different time points using adenosine triphosphate (ATP) monitoring system and ATP surface test kit. Hand piece holder showed the highest level of microbial contamination. In most of the clinics, QAC significantly reduced the levels of microbial contamination, and maintained antimicrobial activity for 4 to 6 months. QAC may be used effectively in dental clinics due to the duration of antimicrobial effect and the minimal exposure of chemicals and further studies are needed with large sample size.

11.
Article in Korean | WPRIM | ID: wpr-893512

ABSTRACT

Inverted papilloma is a rare benign tumor which usually arises from sinonasal mucosa. We experienced a case of 62-year-old male who presented with foreign body sensation in throat. A round mass was found at right false vocal cord in laryngoscopic examination. It was excised in laryngeal microsurgery. The pathologic diagnosis was inverted papilloma of false vocal cord. Recurrence or complication did not occur during the follow up period of three months.

12.
Article in English | WPRIM | ID: wpr-892773

ABSTRACT

Background@#Primary squamous cell carcinoma (SCC) of the salivary gland is a rare disease, and distinguishing primary SCC from metastatic SCC is difficult. This study investigated the histological and immunohistochemical differences between primary and metastatic salivary gland SCC to improve the accuracy of diagnosis and to explore the pathogenesis of this disease. @*Methods@#Data of 16 patients who underwent surgery for SCC of salivary glands between 2000 and 2018 at Asan Medical Center were retrieved. Eight patients had a history of SCC at other sites, and eight patients had only salivary gland SCC. Immunostaining for p16, p53, androgen receptor (AR), gross cystic disease fluid protein 15 (GCDFP-15), and c-erbB2, as well as mucicarmine staining, were compared between the two groups. @*Results@#Most tumors were located in the center of the salivary glands with extraparenchymal extension. The histology of primary SCC of the salivary gland was consistent with moderately differentiated SCC with extensive desmoplastic reaction and peritumoral inflammation. Involvement of the salivary gland ducts and transition into the ductal epithelium were observed in two cases. Metastatic SCC resembled the primary tumor histologically and was associated with central necrosis. Both groups exhibited negative mucin staining. Two, one, and one primary SCC case exhibited AR, GCDFP-15, and c-erbB2 positivity, respectively. @*Conclusions@#A subset of primary SCCs originated in salivary ducts or was related to salivary duct carcinoma. Distinguishing primary from metastatic SCC of the salivary gland is difficult using histologic features and immunoprofiles. A comprehensive review of the medical history is essential.

13.
Article in English | WPRIM | ID: wpr-891529

ABSTRACT

The aim of this study was to investigate the change of microbial contamination levels in the different areas and at the different time points after application of a quaternary ammonium compound (QAC) that has mechanical antimicrobial effect. The microbial contamination levels were measured in three different areas; unit chair handle, spit sink area and hand piece holder at different time points using adenosine triphosphate (ATP) monitoring system and ATP surface test kit. Hand piece holder showed the highest level of microbial contamination. In most of the clinics, QAC significantly reduced the levels of microbial contamination, and maintained antimicrobial activity for 4 to 6 months. QAC may be used effectively in dental clinics due to the duration of antimicrobial effect and the minimal exposure of chemicals and further studies are needed with large sample size.

14.
Article | WPRIM | ID: wpr-833797

ABSTRACT

A small survey was performed to investigate the recent infection status of Clonorchis sinensis and other zoonotic trematode metacercariae in freshwater fish from a local market of Yen Bai city, Yen Bai province, northern Vietnam. A total of 118 fish in 7 species were examined by the artificial digestion method on March 2016. The metacercariae of 4 species of zoonotic trematodes, i.e., C. sinensis, Haplorchis pumilio, Haplorchis taichui, and Centrocestus formosanus, were detected. The metacercariae of C. sinensis were found in 62 (69.7%) out of 89 fish (5 species), and their intensity of infection was very high, 81.2 per fish infected. Prevalences of 3 intestinal flukes, H. pumilio, H. taichui and C. formosanus, were 75.0%, 47.6%, and 31.7% in positive fish species, respectively, with the metacercarial intensities of 15.5, 10.3, and 2.2 per fish infected. From the above results, it has been confirmed that various species of freshwater fish continue to play the role of the infection source of C. sinensis and other zoonotic trematodes in Yen Bai city, Yen Bai province, northern Vietnam. It is of particular note that the prevalence and intensity of C. sinensis metacercariae are much higher than those reported in previous studies in fish in northern Vietnam.

15.
Article in English | WPRIM | ID: wpr-831338

ABSTRACT

The Korean Society of Laryngology, Phoniatrics and Logopedics appointed a task force to establish clinical practice guidelines for the management of unilateral vocal fold paralysis (UVFP). These guidelines cover a comprehensive range of management-related factors, including the diagnosis and treatment of UVFP, and provide in-depth information based on current, up-to-date knowledge. Detailed evidence profiles are provided for each recommendation. The CORE databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers, using a predefined search strategy. When insufficient evidence existed, expert opinions and Delphi questionnaires were used to fill the evidence gap. The committee developed 16 evidence-based recommendations in six categories: initial evaluation (R1–4), spontaneous recovery (R5), medical treatment (R6), surgical treatment (R7–14), voice therapy (R15), and aspiration prevention (R16). The goal of these guidelines is to assist general otolaryngologists and speech-language pathologists who are primarily responsible for treating patients with UVFP. These guidelines are also intended to facilitate understanding of the condition among other health-care providers, including primary care physicians, nurses, and policy-makers.

16.
Article | WPRIM | ID: wpr-830327

ABSTRACT

Awake craniotomy is a gold standard of care for resection of brain tumors located within or close to the eloquent areas. Both asleep-awake-asleep technique and monitored anesthesia care have been used effectively for awake craniotomy and the choice of optimal anesthetic approach is primarily based on the preferences of the anesthesiologist and surgical team. Propofol, remifentanil, dexmedetomidine, and scalp nerve block provide the reliable conditions for intraoperative brain mapping. Appropriate patient selection, adequate perioperative psychological support, and proper anesthetic management for individual patients in each stage of surgery are crucial for procedural safety, success, and patient satisfaction.

17.
Yonsei Medical Journal ; : 235-242, 2019.
Article in English | WPRIM | ID: wpr-742538

ABSTRACT

As radical gastrectomy with lymph node dissection is currently the best strategy to cure gastric cancer, the role of the surgeon remains quite important in conquering it. Dr. Sung Hoon Noh, a surgeon and surgical oncologist specializing in gastric cancer, has treated gastric cancer for 30 years and has conducted over 10000 cases of gastrectomy for gastric cancer. He first adapted an electrocautery device into gastric cancer surgery and has led standardization of surgical procedures, including spleen preserving gastrectomy. His procedures based on patient-oriented insights have become the basis of the concept of enhanced recovery after surgery. He has also contributed to improving patient's survival through adoption of a multidisciplinary approach: he proved the benefit of adjuvant chemotherapy after radical D2 gastrectomy for stage II/III gastric cancer in clinical trials, updating treatment guidelines throughout the world. Dr. Noh also opened the era of precision medicine for treating gastric cancer, as he developed and validated a mRNA expression based algorithm to predict prognosis and response to chemotherapy. This article reviews his contribution and long history of service in the field of gastric cancer. The perspectives of this master surgeon, based on his profound experience and insights, will outline directions for integrative multidisciplinary health care and how can surgeons prepare for the future.


Subject(s)
Chemotherapy, Adjuvant , Delivery of Health Care , Drug Therapy , Electrocoagulation , Gastrectomy , Lymph Node Excision , Precision Medicine , Prognosis , RNA, Messenger , Spleen , Stomach Neoplasms , Surgeons
18.
Article in English | WPRIM | ID: wpr-786128

ABSTRACT

BACKGROUND: The worldwide incidence of squamous cell carcinoma of the tongue (SCCOT) in young patients has been increasing. We investigated clinicopathologic features of this unique population and compared them with those of SCCOT in the elderly to delineate its pathogenesis.METHODS: We compared clinicopathological parameters between patients under and over 45 years old. Immunohistochemical assays of estrogen receptor, progesterone receptor, androgen receptor, p53, p16, mdm2, cyclin D1, and glutathione S-transferase P1 were also compared between them.RESULTS: Among 189 cases, 51 patients (27.0%) were under 45 years of age. A higher proportion of women was seen in the young group, but was not statistically significant. Smoking and drinking behaviors between age groups were similar. Histopathological and immunohistochemical analysis showed no significant difference by age and sex other than higher histologic grades observed in young patients.CONCLUSIONS: SCCOT in young adults has similar clinicopathological features to that in the elderly, suggesting that both progress via similar pathogenetic pathways.


Subject(s)
Aged , Carcinoma, Squamous Cell , Cyclin D1 , Drinking , Drinking Behavior , Epithelial Cells , Estrogens , Female , Glutathione Transferase , Humans , Immunohistochemistry , Incidence , Mouth Neoplasms , Receptors, Androgen , Receptors, Progesterone , Smoke , Smoking , Tongue , Young Adult
19.
Article in English | WPRIM | ID: wpr-719565

ABSTRACT

OBJECTIVE: To evaluate the swallowing problems after a primary resection in patients with tongue cancer. METHODS: Thirty-eight patients with primary tongue cancer, who underwent a glossectomy and had undergone a Video Fluoroscopic Swallowing Study (VFSS) prior to surgery in a university hospital between January 2010 and May 2015, were included retrospectively. The clinical and swallowing features, including the VFSS parameters before and after surgery, were analyzed. RESULTS: Among the 38 patients, 33 patients were T1 and T2 stage. Thirty-one, six and one patient underwent a partial glossectomy, hemiglossectomy, and total glossectomy, respectively. More than ninety percent of the patients had a selective neck dissection. All the patients were on a regular diet before surgery and showed no penetration or aspiration on the VFSS. Immediately after surgery, 33 patients (87%) had to change to non-oral feeding. At discharge, 8 patients (21%) maintained non-oral feeding, and 30 patients ate a limited diet. In a telephone survey (mean 19 months after surgery), among the 25 survey participants, 24 patients (96%) reported no problems with their regular diet. CONCLUSION: In tongue cancer patients with low Tumor-Node-Metastasis (TNM), American Joint Committee on Cancer (AJCC) stages, a primary resection of tongue cancer did not cause statistically significant dysphagia after surgery. Although many patients had to change their diet to limited or non-oral feeding immediately after surgery, almost all patients improved and could eat a regular diet after the long term follow up.


Subject(s)
Deglutition , Deglutition Disorders , Diet , Follow-Up Studies , Glossectomy , Head and Neck Neoplasms , Humans , Joints , Neck Dissection , Retrospective Studies , Telephone , Tongue Neoplasms , Tongue
20.
Article in English | WPRIM | ID: wpr-718414

ABSTRACT

A 34-year-old man who previously underwent a craniotomy due to oligodendroglioma was admitted with a diagnosis of recurrent brain tumor. An awake craniotomy was planned. Approximately 15 minutes after completing the scalp nerve block, his upper torso suddenly moved and trembled for 10 seconds, suggesting a generalized clonic seizure. He recovered gradually and fully in 55 minutes without any neurological sequelae. The emergency computed tomography scan revealed a localized fluid collection and small intracerebral hemorrhage nearby in the temporoparietal cortex beneath the skull defect. He underwent surgery under general anesthesia at 8 hours after the seizure and was discharged from the hospital after 10 days. This report documents the first case of generalized seizure that was caused by the accidental intracerebral injection of local anesthetics. Although the patient recovered completely, the clinical implications regarding the scalp infiltration technique in a patient with skull defects are discussed.


Subject(s)
Adult , Anesthesia, General , Anesthetics, Local , Brain Neoplasms , Cerebral Hemorrhage , Craniotomy , Diagnosis , Emergencies , Humans , Nerve Block , Oligodendroglioma , Scalp , Seizures , Skull , Torso
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