• Title/Summary/Keyword: Acute ischemic stroke

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Impact of Lifestyle Diseases on Postoperative Complications and Survival in Elderly Patients with Stage I Non-Small Cell Lung Cancer

  • Jeong, Sang Seok;Choi, Pil Jo;Yi, Jung Hoon;Yoon, Sung Sil
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.86-93
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    • 2017
  • Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

Current Status of Systems Biology in Traditional Chinese medicine - in regards to influences to Korean Medicine (최근 중의학에서 시스템생물학의 발전 현황 - 한의학에 미치는 영향 및 시사점을 중심으로 -)

  • Lee, Seungeun;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.2
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    • pp.1-13
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    • 2017
  • Objectives : This paper serves to explore current trends of systems biology in Traditional Chinese Medicine (TCM) and examine how it may influence the Traditional Korean medicine. Methods : Literature review method was collectively used to classify Introduction to systems biology, diagnosis and syndrome classification of systems biology in TCM perspective, physiotherapy including acupuncture, herbs and formula functions, TCM systems biology, and directions of academic development. Results : The term 'Systems biology' is coined as a combination of systems science and biology. It is a field of study that tries to understand living organism by establishing a theory based on an ideal model that analyzes and predicts the desired output with understanding of interrelationships and dynamics between variables. Systems biology has an integrated and multi-dimensional nature that observes the interaction among the elements constructing the network. The current state of systems biology in TCM is categorized into 4 parts: diagnosis and syndrome, physical therapy, herbs and formulas and academic development of TCM systems biology and its technology. Diagnosis and syndrome field is focusing on developing TCM into personalized medicine by clarifying Kidney yin deficiency patterns and metabolic differences among five patterns of diabetes and analyzing plasma metabolism and biomarkers of coronary heart disease patients. In the field of physical therapy such as acupuncture and moxibustion, researchers discovered the effect of stimulating acupoint ST40 on gene expression and the effects of acupuncture on treating functional dyspepsia and acute ischemic stroke. Herbs and formulas were analyzed with TCM network pharmacology. The therapeutic mechanisms of Si Wu Tang and its series formulas are explained by identifying potential active substances, targets and mechanism of action, including metabolic pathways of amino acid and fatty acid. For the academic development of TCM systems biology and its technology, it is necessary to integrate massive database, integrate pharmacokinetics and pharmacodynamics, as well as systems biology. It is also essential to establish a platform to maximize herbal treatment through accumulation of research data and diseases-specific, or drug-specific network combined with clinical experiences, and identify functions and roles of molecules in herbs and conduct animal-based studies within TCM frame. So far, few literature reviews exist for systems biology in traditional Korean medicine and they merely re-examine known efficacies of simple substances, herbs and formulas. For the future, it is necessary to identify specific mechanisms of working agents and targets to maximize the effects of traditional medicine modalities. Conclusions : Systems biology is widely accepted and studied in TCM and already advanced into a field known as 'TCM systems biology', which calls for the study of incorporating TCM and systems biology. It is time for traditional Korean medicine to acknowledge the importance of systems biology and present scientific basis of traditional medicine and establish the principles of diagnosis, prevention and treatment of diseases. By doing so, traditional Korean medicine would be innovated and further developed into a personalized medicine.

A Study on the Mitigation of the Exposure Dose Applying Bolus Tracking in Brain Perfusion CT Scan (뇌 관류 CT검사에서 BolusTracking기법을 적용한 피폭선량 저감화에 관한 연구)

  • Kim, Ki-Jeong;Jung, Hong-Ryang;Lim, Cheong-Hwan;Hong, Dong-Hee;Shim, Jae-Goo;You, In-Gyu
    • Journal of Digital Convergence
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    • v.12 no.3
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    • pp.353-358
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    • 2014
  • This study was conducted to analyze the patient's exposed dose targeting the patients who had acute ischemic stroke symptoms and CT brain perfusion scan, by comparing fixed time technique and bolus tracking technique which was provided by the manufacturer and to identify the Time graph to implement the usability of contrast medium's tracking technique the best contrast enhancement intervals. $CTDI_{VOL}$ of PCT in patient appeared to be 431.72mGy in fixed scan delay protocol, whereas 323.61mGy in Bolus tracking technique. The value of DLP appeared to be $1243.47mGy{\cdot}cm$ in fixed scan delay protocol, whereas $932mGy{\cdot}cm$ in Bolus tracking technique. Time graph appeared to be various in fixed scan delay protocol, whereas the optimal time graph could be obtained in Bolus tracking. The exposure dose could be reduced by 25% applying Bolus tracking technique when taking brain perfusion CT scan.

The Protective Effects of Statins towards Vessel Wall Injury Caused by a Stent Retrieving Mechanical Thrombectomy Device : A Histological Analysis of the Rabbit Carotid Artery Model

  • Lee, Seung Hwan;Shin, Hee Sup;Oh, Inho
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.693-704
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    • 2021
  • Objective : Endovascular mechanical thrombectomy (MT) has been regarded as one of the standard treatments for acute ischemic stroke caused by large vessel occlusion. Despite the wide use of stent retrievers for MT, arterial intimal damage caused when deployed stent is pulled has been a certain disadvantage. We hypothesized that statin could protect and stabilize vessel damage after endovascular MT using a stent retriever. In this animal study, we observed the protective effects of the statins towards MT-induced vessel wall injury. Methods : Twenty-eight carotid arteries of fourteen rabbits were used in the experiments with MT using stent retriever. We divided the rabbits into four groups as follows : group 1, negative control; group 2, positive control; group 3, statin before MT; and group 4, statin after MT. After MT procedures, we harvested the carotid arteries and performed histomorphological and immunohistochemical analyses. Results : In histomorphological analysis with hematoxylin and eosin and Masson's trichrome stain, significant intimal thickening (p<0.05) was observed in the positive control (group 2), compared to in the negative control (group 1). Intimal thickening was improved in the statin-administered groups (groups 3 and 4 vs. group 2, p<0.05). We also observed that statin administration after MT (group 4) resulted in a more effective decrease in intimal thickness than statin administration before MT (group 3) (p<0.05). We performed immunohistochemical analysis with the antibodies for tumor necrosis factor-alpha (TNF-α), cluster of differentiation (CD)11b, and CD163. In contrast to the negative control (group 1), the stained percentage areas of all immunological markers were markedly increased in the positive control (group 2) (p<0.05). Based on statin administration, the percentage area of TNF-α staining was significantly reduced (p<0.05) in group 3, compared to the positive control group (group 2). However, significant differences were not observed for CD11b and CD163 staining. In group 4, no significant differences were observed for TNF-α, CD11b, and CD163 staining (p≥0.05). The differences in the percentage areas of the different markers between the statin-administered groups (groups 3 and 4) were also not revealed. Conclusion : We presented that statin administration before and after MT exerted protective effects towards vessel wall injury. The efficacy of statins was greater post-administration than pre-administration. Thus, statin administration in routine prescriptions in the peri-procedural period is strongly advised.

Comparison of Lens Dose in accordance with Bismuth shielding and Patient position in Brain perfusion CT (Brain Perfusion CT에서 Bismuth 차폐와 환자의 자세 변화에 따른 수정체 선량 비교 연구)

  • Gang, Eun Bo
    • Journal of the Korean Society of Radiology
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    • v.12 no.1
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    • pp.47-52
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    • 2018
  • Brain perfusion CT scanning is often employed usefully in clinical conditions as it accurately and promptly provides information about the perfusion state of patients having acute ischemic stroke with a lot of time constraints and allows them to receive proper treatment. Despite those strengths of it, it also has a serious weakness that Lens may be exposed to a lot of dose of radiation in it. In this study, as a way to reduce the dose of radiation to Lens in brain perfusion CT scanning, this researcher conducted an experiment with Bismuth shielding and change of patients' position. TLD (TLD-100) was placed on both lens using the phantom (PBU-50), and then, in total 4 positions, parallel to IOML, parallel to IOML (Bismuth shielding), parallel to SOML, and parallel to SOML (Bismuth shielding), brain perfusion scanning was done 5 times for each position, and dose to Lens were measured. Also, to examine how the picture quality changed in different positions, 4 areas of interest were designated in 4 spots, and then, CT number and noise changes were measured and compared. According to the results of conducting one-way ANOVA on the doses measured, as the significance probability was found to be 0.000, so there was difference found in the doses of radiation to crystalline lenses. According to the results of Duncan's post-hoc test, with the scanning of being parallel to IOML as the reference, the reduction of 89.16% and 89.66% was observed in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding) respectively, so the doses to Lens reduced significantly. Next, in the scanning of being parallel to IOML (Bismuth shielding), the reduction of 37.12% was found. According to the results, reduction in the doses of radiation was found the most significantly both in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding). With the limit of the equivalent dose to Lens as the reference, this researcher conducted comparison with the dose to occupational exposure and dose to Public exposure in the scanning of being parallel to IOML and found 39.47% and 394.73% respectively; however in the scanning of being parallel to SOML (Bismuth shielding), considerable reduction was found as 4.08% and 40.8% respectively. According to the results of evaluation on picture quality, every image was found to meet the evaluative standards of phantom scanning in terms of the measurement of CT numbers and noise. In conclusion, it would be the most useful way to reduce the dose of radiation to Lens to use shields in brain perfusion CT scanning and adjust patients' position so that their lens will not be in the field of radiation.