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1.
Rev. colomb. psiquiatr ; 49(3): 194-198, jul.-set. 2020. graf
Article in English | LILACS, COLNAL | ID: biblio-1149826

ABSTRACT

ABSTRACT We report the case of a 60-year-old female patient with a history of hypertension and dyslipidemia, who suddenly presented with a clinical picture of emotional lability, disorientation, complex visual hallucinations and persecutory delusions. There were no associated neurological findings in her initial physical examination. At a local hospital she was initially diagnosed with late-onset bipolar disorder and a manic episode with psychotic features, then referred to the mental health unit, where nuclear magnetic resonance (NMR) imaging of the brain revealed an acute ischemic stroke in the territory of the left posterior cerebral artery (PCA) with haemorrhagic reperfusion to the occipital cortex. Complete and spontaneous resolution of her clinical condition was achieved after approximately 15 days.


RESUMEN Se presenta el reporte de caso de una mujer de 60 anos de edad con antecedente de hipertensión arterial y dislipidemia, quien presenta cuadro clínico de inicio súbito consistente en labilidad emocional, desorientación alopsíquica global, alucinaciones visuales complejas e ideación delirante de tipo persecutorio, sin hallazgos neurológicos asociados en el examen físico inicial. Se enfocó en hospital local como un trastorno bipolar de inicio tardío con episodio actual maníaco con características psicóticas y es remitida a unidad de salud mental. Posteriormente hallazgos de resonancia magnética nuclear (RMN) cerebral revelaron una lesión correspondiente a ataque cerebrovascular (ACV) isquémico agudo en territorio de la arteria cerebral posterior (ACP) izquierda con reperfusión hemorrágica a nivel de corteza occipital. Se alcanzó una resolución espontánea completa de su cuadro clínico en un curso aproximado de 15 días.


Subject(s)
Humans , Female , Middle Aged , Mental Health , Stroke , Bipolar Disorder , Passive Cutaneous Anaphylaxis , Magnetic Resonance Spectroscopy , Confusion , Posterior Cerebral Artery , Delusions , Dyslipidemias , Neuropsychiatry/trends , Hallucinations
2.
Rev. colomb. psiquiatr ; 49(2): 67-67, abr.-jun. 2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1115645

ABSTRACT

A raiz de la polemica originada por la difusión de un programa televisivo de opinion donde se denuncias maltratos a pacientes hospitalizados en instituciones nacionales de salud mental, la ACP emitió el siguiente comunicado que ponemos hoy como editorial de nuestra revista.


As a result of the controversy caused by the dissemination of an opinion television program where mistreatment of hospitalized patients in national mental health institutions is reported, the ACP issued the following statement that we put today as the editorial of our magazine.


Subject(s)
Humans , Male , Female , Television , Mental Health , Patients , Passive Cutaneous Anaphylaxis , Diffusion
4.
Pesqui. vet. bras ; 39(5): 332-341, May 2019. tab, graf
Article in English | ID: biblio-1012753

ABSTRACT

Knowledge about reproduction of white-lipped peccary is of great importance to assist with the conservation of this species and enable its rational use in captivity. This study aimed to evaluate the effect of ACP-103®, ACP-116® and BTS semen extenders on sperm viability during cooling of Tayassu pecari semen. Five ejaculates from four adult males were chilled. The animals were submitted to the protocols of sedation and anesthesia for semen collection by the electroejaculation method. After collection, the semen was macro- and microscopically assessed and diluted to reach 35x106 spermatozoa/mL in each of the three different extenders tested. The fresh-extended semen was packed in a BotuFLEX® thermal box to keep samples at 15°C for 24 hours. After cooling, the following semen parameters were analyzed: sperm motility, functional and structural integrity of sperm membranes, mitochondrial activity, chromatin condensation, and the thermoresistance test was performed. The parameters sperm motility, structural and functional integrity of sperm membranes, mitochondrial activity, and chromatin condensation were preserved after use of the extenders tested, and were similar to those of in natura semen (p>0.05). Curvilinear velocity (VCL) (p<0.05) was the only parameter with reduced values after cooling regardless of the extender used. The percentage of sperm with normal morphology was greater in samples cooled using the BTS extender (p<0.05). The ACP-103®, ACP-116® and BTS extenders can be used for the cooling and preservation of white-lipped peccary semen at 15°C for 24 hours.(AU)


Para auxiliar na conservação da espécie e permitir o uso racional do queixada em cativeiro é de grande importância o conhecimento sobre a reprodução da espécie. Objetivou-se avaliar o efeito dos diluidores de sêmen ACP-103®, ACP-116® e BTS na viabilidade espermática durante a refrigeração do sêmen do Tayassu pecari. Foram refrigerados cinco ejaculados provenientes de quatro machos adultos. Os animais foram contidos com auxílio de puçá e submetidos ao protocolo de sedação e anestesia para realização da coleta de sêmen pelo método da eletroejaculação. Depois da coleta, o sêmen foi avaliado macro e microscopicamente e diluído para atingir 35x106 espermatozoides/mL em cada um dos três diferentes diluidores testados. O sêmen diluído foi acondicionado em caixa térmica BotuFLEX® para manter as amostras a 15°C por um período de 24 horas. Depois da refrigeração, os espermatozoides foram avaliados quanto aos parâmetros de movimento espermático, integridade funcional e estrutural das membranas espermáticas, atividade mitocondrial, condensação da cromatina e teste de termorresistência. Os diluidores testados preservaram as características cinéticas, a integridade estrutural e funcional das membranas espermáticas, a atividade mitocondrial e a condensação da cromatina semelhante ao sêmen in natura (P>0,05). O único parâmetro que reduziu com o processo de refrigeração independente do diluidor utilizado foi a Velocidade Curvilinear (VCL) (P<0,05). Foi observado aumento do percentual de espermatozoides morfologicamente normais nas amostras refrigeradas em BTS (P<0,05). Os diluidores ACP-103®, ACP-116® e BTS podem refrigerar e conservar o sêmen de queixada a 15°C por 24 horas.(AU)


Subject(s)
Animals , Artiodactyla , Semen Preservation/methods , Passive Cutaneous Anaphylaxis , Cryopreservation/veterinary
5.
Yonsei Medical Journal ; : 257-266, 2019.
Article in English | WPRIM | ID: wpr-742536

ABSTRACT

PURPOSE: Radical prostatectomy (RP) is one of main treatments for prostate cancer (Pca). The prevalence of Pca has been decreasing in recent reports. However, no study has reported trends in Pca prevalence or RP rate according to age structural changes. The objective of this study was to investigate trends in Pca prevalence and frequency of RP according to age structural change. MATERIALS AND METHODS: We evaluated trends in Pca prevalence and RP rate using National Health Insurance Data from 2005 to 2015. Relationships for Pca prevalence and RP rate with age structural change were also determined. Primary outcomes included trends in Pca prevalence and RP rates according to age groups, comparing those before and after 2011. RESULTS: Pca prevalence tended to increase before 2011 and decreased after 2011 in persons in the 60-years age group. RP rate increased pattern before 2011 and decreased after 2011 in age groups of 50s, 60s, and over 70s. Pca prevalence and age structural change showed a significantly positive relationship in all age groups, except for the age group under 40 years. RP rate and age structural change also showed a significantly positive relationship in all age groups. CONCLUSION: Age structural change can affect the decreasing trend in Pca prevalence and RP rate in South Korea. Future studies are needed to validate this result.


Subject(s)
Humans , Korea , National Health Programs , Passive Cutaneous Anaphylaxis , Prevalence , Prostate , Prostatectomy , Prostatic Neoplasms
6.
Article in English | WPRIM | ID: wpr-719629

ABSTRACT

PURPOSE: To evaluate changes in the expression of androgen receptor (AR) and its variants (ARVs) in human prostate cancer (PCa) tissues according to disease status, and its prognostic significance following radical prostatectomy (RP). MATERIALS AND METHODS: A total of 282 PCa cases were evaluated, which included 252 localized PCa, 8 metastatic castration resistant prostate cancer (CRPC), and 22 benign prostatic hyperplasia (BPH) cases. Samples were collected from patients who underwent RP or transurethral resection and were stored in ethically approved tissue banks. Quantitative real-time polymerase chain reaction, Western blotting, and immunohistochemistry were performed for AR and ARVs. Each tissue was confirmed as cancerous (greater than 80%) using hematoxylin and eosin staining. AR and ARVs expression was compared according to disease status. The biochemical recurrence free survival (BCRFS) rates in men with localized PCa was analyzed according to AR and ARV7 expression using the Kaplan-Meier curve. RESULTS: Only 58 of the 252 localized PCa were included in the analysis because of insufficient cancer tissue. AR and ARV7 mRNA expression was higher in the CRPC tissue than in the localized PCa tissue (p=0.025, p=0.002, respectively). In localized PCa tissue, high AR mRNA and protein level was associated with a low BCRFS rate (log-ranked, p=0.019, p < 0.001, respectively). CONCLUSIONS: Overall AR and ARV7 mRNA expression levels were increased in CRPC tissues compared to localized PCa and BPH tissues. High AR protein and mRNA expression in the tumor tissue may be considered a predictive factor of BCRFS following RP.


Subject(s)
Blotting, Western , Castration , Eosine Yellowish-(YS) , Hematoxylin , Humans , Immunohistochemistry , Male , Passive Cutaneous Anaphylaxis , Prostate , Prostatectomy , Prostatic Hyperplasia , Prostatic Neoplasms , Real-Time Polymerase Chain Reaction , Receptors, Androgen , Recurrence , RNA, Messenger , Tissue Banks
7.
Article in English | WPRIM | ID: wpr-719317

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the influence of heritability on the craniofacial soft tissue cephalometric characteristics of monozygotic (MZ) twins, dizygotic (DZ) twins, and their siblings (SIB). METHODS: The samples comprised Korean adult twins and their siblings (mean age, 39.8 years; MZ group, n = 36 pairs; DZ group, n = 13 pairs of the same gender; and SIB group, n = 26 pairs of the same gender). Thirty cephalometric variables were measured to characterize facial profile, facial height, soft-tissue thickness, and projection of nose and lip. Falconer's method was used to calculate heritability (low heritability, h2 0.9). After principal components analysis (PCA) was performed to extract the models, we calculated the intraclass correlation coefficient (ICC) value and heritability of each component. RESULTS: The MZ group exhibited higher ICC values for all cephalometric variables than DZ and SIB groups. Among cephalometric variables, the highest h2 (MZ-DZ) and h2 (MZ-SIB) values were observed for the nasolabial angle (NLA, 1.544 and 2.036), chin angle (1.342 and 1.112), soft tissue chin thickness (2.872 and 1.226), and upper lip thickness ratio (1.592 and 1.026). PCA derived eight components with 84.5% of a cumulative explanation. The components that exhibited higher values of h2 (MZ-DZ) and h2 (MZ-SIB) were PCA2, which includes facial convexity, NLA, and nose projection (1.026 and 0.972), and PCA7, which includes chin angle and soft tissue chin thickness (2.107 and 1.169). CONCLUSIONS: The nose and soft tissue chin were more influenced by genetic factors than other soft tissues.


Subject(s)
Adult , Chin , Humans , Lip , Methods , Nose , Passive Cutaneous Anaphylaxis , Siblings , Twins , Twins, Dizygotic , Twins, Monozygotic
8.
Article in English | WPRIM | ID: wpr-742310

ABSTRACT

Trichomoniasis is the most common curable sexually-transmitted infection. Most Trichomonas vaginalis-infected men are asymptomatic and can remain undiagnosed and untreated, and this has been thought to result in chronic persistent prostatic infection. Chronic inflammation is regarded as the major factor in the pathogenesis and progression of benign prostatic hyperplasia (BPH) and prostatic cancer (PCa). The aim of this study is to identify seropositivity to T. vaginalis in men with prostate tumors (BPH or PCa) visited to Hanyang University Hospital. A total of 183 men were enrolled between October 2013 and November 2014. They consisted of 139 with BPH (mean age: 64.0±0.07) and 44 with prostate cancer (mean age: 73.3±0.18). We carried out ELISA to identify the seropositivity to T. vaginalis. Mixed lysate antigen extracted from 8 strains of T. vaginalis was used in the ELISA. Also 58 male outpatients visited to Health Promotion Center in Hanyang University Hospital were evaluated for comparing group. As a results, seropositivity to T. vaginalis in patients with prostatic diseases was 19.7% (BPH: 18.7%, PCa: 22.7%) and it was significantly higher than the 1.7% of the comparing healthy group (P=0.001). Therefore, prostatic tumor showed higher seropositivity against T. vaginalis than normal men. As far as we know, this is the first report about seroprevalence in prostatic tumor in Korea.


Subject(s)
Enzyme-Linked Immunosorbent Assay , Health Promotion , Humans , Inflammation , Korea , Male , Outpatients , Passive Cutaneous Anaphylaxis , Prostate , Prostatic Diseases , Prostatic Hyperplasia , Prostatic Neoplasms , Seroepidemiologic Studies , Trichomonas vaginalis , Trichomonas
9.
Article in English | WPRIM | ID: wpr-764925

ABSTRACT

BACKGROUND: Recently, younger prostate cancer (PCa) patients have been reported to harbour more favourable disease characteristics after radical prostatectomy (RP) than older men. We analysed young men (< 50 years) with PCa among the Korean population, paying attention to pathological characteristics on RP specimen and biochemical recurrence (BCR). METHODS: The multi-centre, Severance Urological Oncology Group registry was utilized to identify 622 patients with clinically localized or locally advanced PCa, who were treated with RP between 2001 and 2017. Patients were dichotomized into two groups according to age (< 50-year-old [n = 75] and ≥ 50-year-old [n = 547]), and clinicopathological characteristics were analysed. Propensity score matching was used when assessing BCR between the two groups. RESULTS: Although biopsy Gleason score (GS) was lower in younger patients (P = 0.033), distribution of pathologic GS was similar between the two groups (13.3% vs. 13.9% for GS ≥ 8, P = 0.191). There was no significant difference in pathologic T stage between the < 50- and ≥ 50-year-old groups (69.3% vs. 68.0% in T2 and 30.7% vs. 32.0% in ≥ T3, P = 0.203). The positive surgical margin rates were similar between the two groups (20.0% vs. 27.6%, P = 0.178). BCR-free survival rates were also similar (P = 0.644) between the two groups, after propensity matching. CONCLUSION: Contrary to prior reports, younger PCa patients did not have more favourable pathologic features on RP specimen and showed similar BCR rates compared to older men. These findings should be considered when making treatment decisions for young Korean patients with PCa.


Subject(s)
Biopsy , Humans , Korea , Male , Middle Aged , Neoplasm Grading , Passive Cutaneous Anaphylaxis , Prognosis , Propensity Score , Prostate , Prostatectomy , Prostatic Neoplasms , Recurrence , Survival Rate , Young Adult
10.
Article in English | WPRIM | ID: wpr-739994

ABSTRACT

BACKGROUND: Postoperative nausea and vomiting (PONV) frequently occurs following bimaxillary orthognathic surgeries. Compared to opioids, Nefopam is associated with lower incidences of PONV, and does not induce gastrointestinal tract injury, coagulopathy, nephrotoxicity, or fracture healing dysfunction, which are common side effects of Nonsteroidal anti-inflammatory drugs. We compared nefopam- and fentanyl-induced incidence of PONV in patients with access to patient-controlled analgesia (PCA) following bimaxillary orthognathic surgeries. METHODS: Patients undergoing bimaxillary orthognathic surgeries were randomly divided into nefopam and fentanyl groups. Nefopam 120 mg or fentanyl 700 µg was mixed with normal saline to a final volume of 120 mL. Patients were given access to nefopam or fentanyl via PCA. Postoperative pain intensity and PONV were measured at 30 minutes and 1 hour after surgery in the recovery room and at 8, 24, 48, and 72 hours after surgery in the ward. The frequency of bolus delivery was compared at each time point. RESULTS: Eighty-nine patients were enrolled in this study, with 48 in the nefopam (N) group and 41 in the fentanyl (F) group. PONV occurred in 13 patients (27.7%) in the N group and 7 patients (17.1%) in the F group at 8 hours post-surgery (P = 0.568), and there were no significant differences between the two groups at any of the time points. VAS scores were 4.4 ± 2.0 and 3.7 ± 1.9 in the N and F groups, respectively, at 8 hours after surgery (P = 0.122), and cumulative bolus delivery was 10.7 ± 13.7 and 8.6 ± 8.5, respectively (P = 0.408). There were no significant differences in pain or bolus delivery at any of the remaining time points. CONCLUSION: Patients who underwent bimaxillary orthognathic surgery and were given nefopam via PCA did not experience a lower rate of PONV compared to those that received fentanyl via PCA. Furthermore, nefopam and fentanyl did not provide significantly different postoperative pain control.


Subject(s)
Analgesia, Patient-Controlled , Analgesics, Opioid , Fentanyl , Fracture Healing , Gastrointestinal Tract , Humans , Incidence , Nefopam , Orthognathic Surgery , Pain, Postoperative , Passive Cutaneous Anaphylaxis , Postoperative Nausea and Vomiting , Prospective Studies , Recovery Room
11.
Article in English | WPRIM | ID: wpr-739401

ABSTRACT

PURPOSE: Endotype in chronic rhinosinusitis (CRS) has been established in the last decade. However, the exact immunologic profile of CRS still has controversy because it has a considerable immunologic heterogeneity. Therefore, we investigated various inflammatory mediators according to different nasal tissues in chronic rhinosinusitis and compared them within the same subject. METHODS: We collected uncinate process mucosa (UP) and nasal polyp (NP) tissues from controls, CRS without NP (CRSsNP) and CRS with NP (CRSwNP). Expression levels of 28 inflammatory mediators including T helper (Th) 1, Th2, Th17, proinflammatory cytokines and remodeling markers were determined by multiplex immunoassay and were analyzed using paired tests as well as principal component analysis (PCA) to investigate endotype in each subtype of CRS. RESULTS: Signature inflammatory mediators are interleukin (IL)-5, C-C motif chemokine ligand (CCL)-24, monocyte chemoattractant protein (MCP)-4, and vascular cell adhesion molecule (VCAM)-1 in eosinophilic NP, whereas IL-17A, IL-1β, and matrix metallopeptidase (MMP)-9 were detected as signature inflammatory markers in non-eosinophilic NP. Despite differences in inflammatory cytokine profile between eosinophilic and non-eosinophilic NP, the common upregulation of IL-5, CCL-11, IL-23, IL-2Rα, VCAM-1, MMP-3 and MMP-9 were shown in NP compared to UP within the same subject. In the PCA, we observed that Th2 immune response was helpful in discriminating between nasal tissues in subtypes of CRS and that there was a partial overlap between non-eosinophilic NP and eosinophilic NP in terms of Th2 mediators. CONCLUSIONS: Commonly upregulated mediators in NP were Th2-associated, compared with UP regardless of CRS subtypes, whereas signature markers were distinct in each NP subtype. These findings imply that Th2 inflammatory responses may play a role in the development of NP regardless of CRSwNP subtypes.


Subject(s)
Cytokines , Eosinophils , Immunoassay , Interleukin-17 , Interleukin-23 , Interleukin-5 , Interleukins , Monocytes , Mucous Membrane , Nasal Polyps , Passive Cutaneous Anaphylaxis , Population Characteristics , Principal Component Analysis , Rhinitis , Sinusitis , Up-Regulation , Vascular Cell Adhesion Molecule-1
12.
Article in English | WPRIM | ID: wpr-763013

ABSTRACT

Mast cells are the most prominent effector cells of Type 1 hypersensitivity immune responses. CYC116 [4-(2-amino-4-methyl-1,3-thiazol-5-yl)-N-[4-(morpholin-4-yl)phenyl] pyrimidin-2-amine] is under development to be used as an anti-cancer drug, but the inhibitory effects of CYC116 on the activation of mast cells and related allergy diseases have not reported as of yet. In this study, we demonstrated, for the first time, that CYC116 inhibited the degranulation of mast cells by antigen stimulation (IC₅₀, ∼1.42 µM). CYC116 also inhibited the secretion of pro-inflammatory cytokines including TNF-α (IC₅₀, ∼1.10 µM), and IL-6 (IC₅₀, ∼1.24 µM). CYC116 inhibited the mast cell-mediated allergic responses, passive cutaneous anaphylaxis (ED50, ∼22.5 mg/kg), and passive systemic anaphylaxis in a dose-dependent manner in laboratory experiments performed on mice. Specifically, CYC116 inhibited the activity of Fyn in mast cells and inhibited the activation of Syk and Syk-dependent signaling proteins including LAT, PLCγ, Akt, and MAP kinases. Our results suggest that CYC116 could be used as an alternative therapeutic medication for mast cell-mediated allergic disorders, such as atopic dermatitis and allergic rhinitis.


Subject(s)
Anaphylaxis , Animals , Cytokines , Dermatitis, Atopic , Hypersensitivity , Interleukin-6 , Mast Cells , Mice , Passive Cutaneous Anaphylaxis , Phosphotransferases , Rhinitis, Allergic
13.
Article in English | WPRIM | ID: wpr-762246

ABSTRACT

BACKGROUND: Thoracic interfascial plane block is useful as a component of multimodal analgesia in patients undergoing mastectomy. However, multimodal analgesia tends not to be provided during lumpectomy as it is one of the less aggressive procedures among breast cancer surgeries. Therefore, we investigated the effects of thoracic interfascial plane block as more effective analgesia after breast lumpectomy. METHODS: Forty six patients (20–80 years old, female) with breast cancer scheduled to undergo lumpectomy were randomly assigned to two groups. Postoperative pain control in the control group consisted only of intravenous patient-controlled analgesia (PCA). In the block group, intravenous PCA was used after serratus intercostal fascial plane block and pecto-intercostal fascial plane block. The primary outcome was the 24 h cumulative postoperative fentanyl consumption. Pain severity, additional rescue analgesic requirement, side effects, and patient satisfaction were also evaluated. RESULTS: Postoperative fentanyl consumption in the block group was significantly reduced compared with the control group (median, 88.8 [interquartile range, 48.0, 167.6] vs. 155.2 [88.8, 249.2], P = 0.022). The pain score was significantly lower in the block group only in the post-anesthesia care unit (2.9 ± 1.8 vs. 4.3 ± 2.3, P = 0.022). There were no differences in the incidence of postoperative nausea and vomiting and the requirement for additional analgesics between the groups. The satisfaction score was significantly higher in the block group. CONCLUSIONS: Thoracic interfascial plane block after lumpectomy reduces opioid usage and increases patient satisfaction with postoperative pain control. Thoracic interfascial plane block is useful for multimodal analgesia after lumpectomy.


Subject(s)
Analgesia , Analgesia, Patient-Controlled , Analgesics , Analgesics, Opioid , Breast Neoplasms , Breast , Fentanyl , Humans , Incidence , Mastectomy , Mastectomy, Segmental , Nerve Block , Pain, Postoperative , Passive Cutaneous Anaphylaxis , Patient Satisfaction , Postoperative Nausea and Vomiting
14.
Article in English | WPRIM | ID: wpr-741401

ABSTRACT

OBJECTIVE: To retrospectively determine whether the use of the Prostate Imaging Reporting and Data System (PI-RADS) version 2 (v2) helps predict long-term outcomes for prostate cancer (PCa) patients following radical prostatectomy (RP). MATERIALS AND METHODS: A total of 166 patients with localized PCa evaluated with multiparametric magnetic resonance imaging (mpMRI) at 3T before RP were enrolled. Three groups were created based on PI-RADS v2 score used to predict clinical outcomes: group A, ≥ 3; group B, ≥ 4; group C, 5. We calculated biochemical recurrence-free survival (RFS) and progression-free survival (PFS). Cox proportion hazards models were used to identify variables predictive of biochemical recurrence and disease progression. RESULTS: During a median follow-up of 9.1 years, biochemical recurrence occurred in 67 patients (40.4%) and disease progression occurred in 55 patients (33.1%). In all groups, 10-year RFS and 10-year PFS were significantly lower for PI-RADS scores ≥ 3, ≥ 4 and 5 than for score < 3, < 4 and < 5 (p <0.05), respectively. In multivariate analysis, PI-RADS score ≥ 3 and score 5 were significant independent risk marker for biochemical recurrence (hazard ratio [HR] = 5.58, p = 0.018; HR = 1.75, p = 0.033) and disease progression (HR = 3.99, p = 0.047; HR = 2.31, p = 0.040). Moderate inter-observer agreement was seen for PI-RADS scoring. CONCLUSION: PI-RADS v2 may be used to predict long-term outcomes following RP in PCa.


Subject(s)
Disease Progression , Disease-Free Survival , Follow-Up Studies , Humans , Information Systems , Magnetic Resonance Imaging , Male , Multivariate Analysis , Passive Cutaneous Anaphylaxis , Prognosis , Proportional Hazards Models , Prostate , Prostatectomy , Prostatic Neoplasms , Recurrence , Retrospective Studies
15.
Article in English | WPRIM | ID: wpr-761397

ABSTRACT

OBJECTIVE: Oxycodone, a semi-synthetic thebaine derivative opioid, is commonly used for treating moderate to severe pain. The aim of this study was to compare the efficacy and side effects of oxycodone and fentanyl used for treating postoperative pain with intravenous patient-controlled analgesia (IV-PCA) after laparoscopic gynecologic surgery. METHODS: A total of 122 patients were randomized to receive postoperative pain treatment with either oxycodone (n=62, group O) or fentanyl (n=60, group F). Patients received 7.5 mg oxycodone and 150 mcg fentanyl with ketorolac 30 mg at the end of anesthesia, and then continued with IV-PCA (conversion dose ratio, 50:1) for 48 hours postoperatively. A blinded observer assessed postoperative pain based on a numerical rating scale, postoperative nausea and vomiting and other side effects, infused PCA dose, patient satisfaction, and sedation level. RESULTS: No significant differences were observed in patient satisfaction according to the analgesic used during the 48 hours postoperative period. CONCLUSION: Oxycodone showed similar efficacy for pain relief compared to fentanyl when used at a conversion dose ratio of 50:1. Therefore, oxycodone may be useful as an alternative to fentanyl for IV-PCA after laparoscopic gynecologic surgery.


Subject(s)
Analgesia, Patient-Controlled , Anesthesia , Female , Fentanyl , Gynecologic Surgical Procedures , Humans , Ketorolac , Oxycodone , Pain, Postoperative , Passive Cutaneous Anaphylaxis , Patient Satisfaction , Postoperative Nausea and Vomiting , Postoperative Period , Thebaine
16.
Article in Korean | WPRIM | ID: wpr-760324

ABSTRACT

PURPOSE: To compare biopsy performance of 2 approaches for multiparametric magnetic resonance imaging (MRI) guided biopsy and transrectal ultrasonography (TRUS)-guided biopsy with 2nd and 3rd repeat biopsy patients in prostate cancer detection. MATERIALS AND METHODS: This retrospective study reviewed 2,868 patients who was performed prostate biopsy between September 2013 to March 2017 at Samsung Medical Center, Seoul, Korea with TRUS-guided random biopsy and MRI fusion, MRI cognitive, and MRI-guided biopsy as 2nd and 3rd repeat biopsy and propensity matching was applied to reduce bias. Detection rate of each study was compared with 1:1 matching. RESULTS: Among 265 patients who performed TRUS 2nd biopsy, positivity rate for prostate cancer (PCa) was 18.49% (n=49/265) while 54.72% (n=145/265) for MRI-guided biopsy. In 3rd biopsy, positivity rate for PCa of TRUS biopsy was 17.74% (n=11/62) while 56.45% (n=35/62) for MRI guided biopsy. There was no significant difference in the detection rate for the patient with Gleason score 8 or more. CONCLUSIONS: MRI-guided biopsy was associated with a higher detection rate of prostate cancer with especially in patients with prior negative biopsy.


Subject(s)
Bias , Biopsy , Cohort Studies , Humans , Korea , Magnetic Resonance Imaging , Neoplasm Grading , Passive Cutaneous Anaphylaxis , Propensity Score , Prostate , Prostatic Neoplasms , Retrospective Studies , Seoul , Ultrasonography
18.
Article in Korean | WPRIM | ID: wpr-770086

ABSTRACT

PURPOSE: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). MATERIALS AND METHODS: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 µg/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. RESULTS: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. CONCLUSION: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.


Subject(s)
Analgesia, Patient-Controlled , Arthroplasty, Replacement, Knee , Buprenorphine , Catheters , Hand , Humans , Incidence , Knee Joint , Length of Stay , Methods , Nausea , Pain, Postoperative , Passive Cutaneous Anaphylaxis , Vomiting , Walking
19.
Article in English | WPRIM | ID: wpr-714282

ABSTRACT

BACKGROUND: To analyze clinical outcome of CyberKnife (CK) tumor-tracking stereotactic body radiotherapy (SBRT) for prostate cancer (Pca) according to the magnitude of intra-fractional prostate motion. METHODS: Medical records and daily treatment logs for 71 patients who received CK tumor-tracking SBRT were retrospectively analyzed. Statistical relationships between prostate motion and various outcome results, including local recurrence (LR), biochemical failure (BF), and treatment-related toxicity, were investigated in order to evaluate motion-dependent efficacy of tumor-tracking SBRT for Pca. RESULTS: In a total 71 patients, 3 (4.2%) patients with LR, 12 (16.9%) patients with BF, and 22 (31%) patients with grade-II or worse toxicities to rectal or bladder (22 to rectal, 22 to bladder and 8 patients to both) were observed in a median follow-up of 47 months. Magnitudes of intra-fractional tumor motion along superior-inferior, right-left, and anterior-posterior (AP) axes were 0.15 ± 0.31, 0.12 ± 0.19, and 0.73 ± 0.32 mm, respectively. Radial magnitude was estimated to be 1.0 ± 0.35 mm. Intra-fractional movement was not significantly correlated with tumor control. However, it was significant correlated with the incidence of grade-II or worse toxicity to rectum or bladder particularly when tumor motion was in the AP axis. CONCLUSION: Our quantitative results revealed that toxicity related to SBRT treatment was highly sensitive to intra-fractional prostate movements, although local-tumor control was not affected by such movements. Our results demonstrate that precise motion correction is essential in prostate SBRT, even if it seems to be small.


Subject(s)
Follow-Up Studies , Humans , Incidence , Medical Records , Passive Cutaneous Anaphylaxis , Prostate , Prostatic Neoplasms , Radiosurgery , Rectum , Recurrence , Retrospective Studies , Urinary Bladder
20.
Article in English | WPRIM | ID: wpr-714015

ABSTRACT

The main purpose of Prostate Imaging-Reporting and Data System Version 2 (PI-RADSv2) is to effectively detect clinically significant prostate cancers (csPCa) using multiparametric magnetic resonance imaging. Since the first introduction of PI-RADSv2, researchers have validated its diagnostic performance in identifying csPCa, and these promising data have influenced biopsy and treatment schemes. However, in this article, we focused on the potential of PI-RADSv2 in relation to various aspects of PCa such as Gleason score, tumor volume, extraprostatic extension, lymph node metastasis, and postoperative biochemical recurrence, beyond prostate cancer detection.


Subject(s)
Biopsy , Information Systems , Lymph Nodes , Magnetic Resonance Imaging , Neoplasm Grading , Neoplasm Metastasis , Passive Cutaneous Anaphylaxis , Prognosis , Prostate , Prostatic Neoplasms , Recurrence , Tumor Burden
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