Horizontal Dorsal Septal Incision for High Deviation Correction During Septoplasty / 대한이비인후과학회지

When performing septoplasty in patients with a high deviation of the nasal septum, effective correction is difficult and postoperative complications such as a saddle nose may result if the bone or cartilage is removed inordinately. Although several surgical techniques have been introduced, some are difficult to apply easily. Furthermore, the deviation may persist despite the application of surgical techniques due to the rebound memory of the remaining cartilage. This study aimed to describe a simple and safe surgical technique for crooked nasal septa with a high deviation. This method using horizontal dorsal septal incision allows easy separation of the highly deviated portion from the upper lateral cartilage. Furthermore, it is less traumatic than other methods, and predictably preserves the keystone area.

Sphenoid Sinus Fat Packing in Transsphenoidal Surgery: Long-Term Fate Assessment Using Magnetic Resonance Imaging

Background and Objectives@#Following the transsphenoidal approach (TSA), appropriate sphenoid sinus fat packing has been preferred to prevent postoperative cerebrospinal fluid leakage; however, studies on the behavior of fat tissue transplanted in the sphenoid sinus are lacking. This study aimed to determine the long-term fate of these fat grafts using magnetic resonance imaging (MRI).Subjects and Method: A total of 139 postoperative MRI scans of 41 patients who underwent sphenoid sinus fat packing using the standard TSA were evaluated. Additionally, MRI time series indicating the vital fat volumes were assessed postoperatively. @*Results@#In 82.9% of cases, the fat volumes measured in the final MRI scans declined to 60% of the initial volume. The fat tissue volume decreased significantly with time, with a median half-life of 18 months. Typically, the sphenoid sinus was eventually almost filled with air rather than transplanted fat. In the subgroup analysis, the fat clearance rate was significantly lower in patients with residual tumors than in those without such remnants (p=0.013). @*Conclusion@#Long-term MRI surveillance of fat grafts in the sphenoid sinus revealed that the transplanted fat graft had degraded and was gradually eliminated.

Social Network Analysis for Research of Cancer Patients’ Health-Related Quality of Life

Purpose@#The purpose of this study was to identify the knowledge structure of articles related to the Health-Related Quality of Life (HRQoL) of patients with five different types of cancer. @*Methods@#Author keywords from the articles related to breast (508), prostate (319), cervical (45), colorectal (123), and gastric cancer (37) on Web of Science (1990~2013) were extracted and classified into seven domains of HRQoL. Social network analysis was performed using the NetMiner program. @*Results@#Core keywords with the highest degree centrality were ‘depression’ (breast), ‘radiotherapy’ (prostate), ‘sexual dysfunction’ (cervical), ‘colorectal cancer surgery’ (colorectal), and ‘gastrectomy’ (gastric). Core keywords with the highest betweenness centrality were ‘chemotherapy’ (breast), ‘radiotherapy’ (prostate), ‘sexual dysfunction’ (cervical), ‘fatigue’ (colorectal), and ‘gastrectomy’ (gastric). In addition, the five types of roles of the core keywords in the seven domains of HRQoL, verified through brokerage analysis, are coordinator, consultant, gatekeeper, representative, and liaison. @*Conclusion@#This study examined the HRQoL trends of patients with five different types of cancer. The findings of this study can be helpful for nursing intervention development to improve patients’ HRQoL according to the five different types of cancer.

Anti-inflammatory and Immunosuppressive Effects of Panax notoginseng

Here, we designed to examine the anti-inflammatory effects on RAW264.7 cells and the immunosuppressive effects by evaluating interleukin-2 (IL-2) production in Jurkat T cells using a MeOH extract of Panax notoginseng roots. The results showed that the MeOH extract inhibited the synthesis of nitric oxide (NO) in a dose-dependent manner (IC₅₀ value of 7.08 µg/mL) and displayed effects on T cell activation at a concentration of 400 µg/mL. In efforts to identify the potent compounds, bioactivity-guided fractionation of the MeOH extract and chemical investigation of its active CH₂Cl₂-, EtOAc-, and butanol-soluble fractions led to the successful isolation and identification of eleven compounds, including two polyacetylenes (1, 2), a steroid saponin (3), seven dammarane-type ginsenosides (4 – 10), and an oleanane-type ginsenoside (11). Among them, compound 11 was isolated from this plant for the first time. Compound 2 exhibited potent inhibitory effects on NO synthesis and an immunosuppressive effect with IC₅₀ values of 2.28 and 65.57 µM, respectively.

Neolignan Derivatives from the Flower of Magnolia biondii Pamp. and their Effects on IL-2 expression in T-cells

The isolation of the MeOH extract from the flower bud of Magnolia biondii Pamp. using various column chromatographies and HPLC led to eleven neoglignan derivatives (1 - 11). Their structures were mainly determined by 1D and 2D NMR spectral data analysis and physiological methods. The isolated compounds (1 - 11) were tested for anti-allergic effects using IL-2 inhibitory assay in Jurkat T cells.

Swiprosin-1 Expression Is Up-Regulated through Protein Kinase C-theta and NF-kappaB Pathway in T Cells

Swiprosin-1 exhibits the highest expression in CD8+ T cells and immature B cells and has been proposed to play a role in lymphocyte biology through actin remodeling. However, regulation of swiprosin-1 gene expression is poorly understood. Here we report that swiprosin-1 is up-regulated in T cells by PKC pathway. Targeted inhibition of the specific protein kinase C (PKC) isotypes by siRNA revealed that PKC-theta is involved in the expression of swiprosin-1 in the human T cells. In contrast, down-regulation of swiprosin-1 by A23187 or ionomycin suggests that calcium-signaling plays a negative role. Interestingly, swiprosin-1 expression is only reduced by treatment with NF-kappaB inhibitors but not by NF-AT inhibitor, suggesting that the NF-kappaB pathway is critical for regulation of swiprosin-1 expression. Collectively, these results suggest that swiprosin-1 is a PKC-theta-inducible gene and that it may modulate the late phase of T cell activation after antigen challenge.

Effect of Changes in Nursing Delivery System on Satisfaction of Nurses and Patients and Direct Nursing Time / 간호행정학회지

PURPOSE: Purpose of this research was to identify effects of application of a modified primary nursing system. METHODS: Measurement was done of direct nursing time and satisfaction of nurses and patients before and after one month of the modified primary nursing system in a surgery unit in C university hospital, Seoul. RESULTS: There was no statistically significant difference between average for patient satisfaction (4.24) before and (4.11) after application of the modified primary nursing system. Total average for nurse satisfaction with the nursing delivery system was 2.89 before application and, 3.34 after, indicating some significant differences (t=-4.06, p<.001). The KPCS-1 was 10.19 before application of the modified primary nursing system and 9.52 after application. Recalculated into direct nursing time, the average direct nursing time for one patient was 92 minutes before application, and 85.98 minutes after, indicating no significant difference. CONCLUSION: Through this research an attempt was made to build and test a modified primary nursing system. Results indicate that the most important thing is to clearly regulate office work and safely implement the new system.

Preemptive analgesic efficacy of ultrasound-guided transversus abdominis plane block in patients undergoing gynecologic surgery via a transverse lower abdominal skin incision / 대한마취과학회지

BACKGROUND: The transversus abdominis plane block is recently described peripheral block to providing analgesia to the anterior abdominal wall. The goal of this study is to evaluate the analgesic efficacy of the ultrasound-guided transversus abdominis plane block (US-TAP block) in patients undergoing gynecologic surgery via a transverse lower abdominal skin incision. METHODS: Thirty-two patients undergoing gynecologic surgery were randomized to undergo standard care such as PCA, or to receive additional US-TAP block with standard care. After general anesthesia induction, a bilateral US-TAP block was performed using 0.375% ropivacaine 20 ml on each side. Postoperative demand of rescue analgesics in PACU and ward were recorded. Each patient was assessed postoperatively by a blinded investigator in the postanesthesia care unit (PACU) and at 2, 6, 10, 24, 48 hr postoperatively to investigate pain, drowsiness, nausea and itch. RESULTS: The US-TAP block reduced pain intensity compared to standard care in the PACU (5.2 +/- 3.1 vs 8.4 +/- 1.3) and at 2, 24 postoperative hours (3.0 +/- 2.4 vs 5.2 +/- 2.4, 0.9 +/- 1.5 vs 2.2 +/- 1.9). Fentanyl requirements in PACU was reduced (20.3 +/- 20.9 vs 62.5 +/- 35.4 microg, P < 0.05). In ward, pethidine requirements was reduced (21.9 +/- 28.7 vs 56.3 +/- 34.8 mg, P < 0.05). CONCLUSIONS: The US-TAP block with standard care provide more effective analgesia after gynecologic surgery via a transverse lower abdominal skin incision.

Complications of Tonsillectomy

Sinusitis Managment Associated with Maxillary Sinus Augmentation: Case Report

Cystic metastasis of the lateral neck mass: A case of occult thyroid adenocarcinoma

A Study on Emotional State of Preoperative Patients and Postoperative Pain(patients with abdominal surgery who received IV-PCA) / 기본간호학회지

The patients with abdominal surgery usually have acute pain. It is important for a patient's quality of life and for good recovery after surgery to control the postoperative pain. The purpose of this study is to identify the relationship between emotional state of preoperative patients and postoperative pain. The participants in this study were the 100 patients receiving abdominal surgery who received Intravenous Patient Controlled Analgesia (IV-PCA) at the end of the operation. The data were collected using questionnaires and the period of the data collection was from March to August, 2001. The instruments used for this study were The State-Trait Anxiety Inventory (STAI) Developed by Spielberger (1972), The Center for Epidemeologic Studies-Depression (CESD) scale and Visual Analog scale (VAS). The data were analyzed using descriptive statistics, t-test, ANOVA and Pearson Correlation coefficient with the SPSS program. The results are as follows. 1.For general characteristics there were significant differences in the degree of trait anxiety according to gender (p= 0.0010), marital status (p=0.0122), religion (p=0.0040), education (p=0.0001), occupation (p=0.0002), monthly income (p=0.0001), diagnosis (p=0.0001), and operation title (p=0.0001). 2.For general characteristics there were significant differences in the degree of state anxiety according to gender (p= 0.0023), education (p=0.0073), monthly income (p=0.0001), diagnosis (p=0.0005), and operation title (p=0.0063). 3.For general characteristics there were significant differences in the degree of depression according to gender (p= 0.0073), occupation (p=0.0469), monthly income (p=0.0001), diagnosis (p=0.012), and operation title (p=0.0033). 4.For general characteristics there were significant differences in the degree of postoperative pain according to gender (p=0.0213), marital status (p=0.0082), education (p=0.0016), occupation (p=0.0128), monthly income (p=0.0008), diagnosis (p=0.0007), and operation title (p=0.0008). 5.The relationship between trait anxiety and postoperative pain revealed a significant positive correlation (r=0.51, p=0.0001), and the relationship between state anxiety and postoperative pain revealed a significant positive correlation (r=0.50, p=0.0001), and the relationship between Depression and pain revealed a significant positive correlation (r=0.49, p=0.0001).

A case of stent insertion into stenotic renal artery caused by Takayasu's arteritis / 대한내과학회지

Takayasu's arteritis is a common etiology of renovascular hypertension in orientals. We report a case of renovascular hypertension caused by Takayasu's arteritis in a 18 year-old male patient. The narrowed renal artery was treated by renal artery stenting and blood pressure was normalized after the procedure. Restenosis was suspected after 7 months follow-up because his blood pressure was elevated.

Dual Left Anterior Descending Coronary Artery: Incidence, Angiographic Features and Clinical Significance in the Era of Revascularization

BACKGROUND AND OBJECTIVES: An anatomic variant of left anterior descending coronary artery (LAD), termed "dual LAD", consists of early bifurcation of the proximal LAD into one early terminating branch (short LAD) which remains in the anterior interventricular sulcus (AIVS) and doesn't reach the apex, and the second (long LAD), which has a variable course outside the AIVS but returns to the distal sulcus and continues to the apex. Its incidence, angiographic features and clinical significance are investigated. MATERIALS AND METHOD: Consecutive 696 coronary angiograms during October 1997 through August 1998 were analyzed. RESULTS: A dual LAD variant was noted in 45 patients (6%) of the 696 patients. Type I, in which the long LAD descends on the left ventricular side of the AIVS before reentering the AIVS, was noted in 24 patients (53%) and type II, in which the long LAD descends on the right ventricular side of the AIVS before reentering the AIVS, in 21(47%). First septal branch was commonly originated from LAD proper in both type (54% vs 52%), but first diagonal branch from LAD proper (63%) in type I, from short LAD (71%) in type II. Presence of dual LAD was recognized before percutaneous coronary intervention (10) or bypass surgery (2) in 12 (63%) of 19 patients. Regional wall motion abnormalities (RWMA) were localized in distal septum or anterolateral wall in 2 patients with short or long LAD obstruction, respectively. CONCLUSION: Recognition of dual LAD is essential to prevent errors of interpretation of the coronary angiogram, to plan optimal strategy for percutaneous coronary intervention or bypass surgery, especially in case of total occlusion, and to understand localized septal or anterolateral RWMA.

Relation between Perfusion Status of Dysfunctional Myocardium and Coronary Flow Reserve in Acute Myocardial Infarction

BACKGROUND: Dydfunction of microvasculature was frequently observed despite of successful revascularization with alteration of coronary flow dynamics flow dynamics in acute myocardial infarction (AMI). Reduction of coronary vasodilatory reserve was found in poorly perfused infarcted myocardium. The objectives of this study was to evaluate the vasodilatory reserve in infarcted myocardium and determind its relationship to perfusion status of myocardium in early recovery phase of acute myocardial infarction. METHODS: The study subjects consisted of 14 patients with anterior AMI&and 6 controls with atypical chest pain and have normal coronary artery. The coronary flow pattern was assessed using intracoronary Doppler wire and vasodilatory reserve was measured after injection of 18ug of adenosine to infarct-related artery after successful revascularization by percutaneous angioplasty at average 11 days post-AMI After measurement of coronary blood flow pattern, myocardial perfusion status was evaluated by myocardial contrast echocardiography (MCE). Perfusion status by MCE was analysed semiquantitatively and compared to various parameters of coronary flow and vasodilatory reserve of infarct-related artery. RESULTS: After successful revascularization, perfusion defect by MCE was observed in 50% (n=7) of patients. The vasodilatory reserve was lower in patients with perfusion defect by MCE than those of patients without perfusion defect (p<0.05) and control (p<0.05). There was no difference in coronary flow reserve between patients with no perfusion defect and controls (p=0.54). Coronary flow reserve was more than 2.0 in patients with no perfusion defect and was below 2.0 in patients with perfusion defect except one patients. Coronary flow reserve correlated well with the degree of contrast opacification of left anterior descending artery territory (r=0.80, p=0.005). The increments of peak distolic velocity (r=0.63, p=0.016 vs r=0.3, p=0.29). CONCLUSIONS: These data showed a good correlation of coronary flow reserve with the degree of myocardial perfusion in patients of reperfused acute myocardial infarction. The increments of peak diastolic velocity was important to maintain the coronary flow than that of systolic peak velocity. This suggest that the measurement of vasodilatory reserve by intracoronary Doppler wire is a good method to assess the perfusion status of infarcted myocardium in early recovery phase of AMI.