• Title/Summary/Keyword: CM at Risk

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Characteristics and Treatment Outcomes of Patients with Malignant Transformation Arising from Mature Cystic Teratoma of the Ovary: Experience at a Single Institution

  • Oranratanaphan, Shina;Khemapech, Nipon
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4693-4697
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    • 2013
  • Background: Malignant transformation arising in mature cystic teratoma (MCT) is one of the most serious complications of MCT. Squamous cell carcinoma is the most common malignant change. Some clinical findings such as advanced age group and large tumor size are significant risk factors of malignant transformation. This study was conducted in order to evaluate characteristics, cell types, treatment and outcome of malignant transformation arising from dermoid cysts in our institution. Materials and Methods: A retrospective chart review was performed. General characteristics, operative data, procedure, operative finding and operative outcome were analyzed. Statistical assessment was performed with SPSS version 17.0, using mean, mode, median and percentage to describe those data. Results: During the 10 years period, 11 cases of malignant transformation from a total of 753 cases (1.46% incidence) of MCT were reviewed. Mean age of the patients was 41.2 years (SD 4.34, range 24-70). The most common presenting symptom was a palpable mass (8 cases; 72.7%). Primary surgical staging was performed in 4 patients (36.4%). Re-staging was conducted in the other 4. Complete cytoreduction was obtained in 45.5% (5 cases) and optimal surgical resection was obtained in 36.4% (4 cases). Mean tumor size was 14.1 cm. (SD 1.55, range 6-20). Squamous cell carcinoma was found in 36.4% (4 cases) and mucinous cancer in the other 4. More than half of them were stage Ia (54.5%, 6 cases). All patients whose stage more than Ia received chemotherapy (45.5%). Mean disease free survival was 5.53 years (1.32, 0.3-10). Conclusion: According to our study, the incidence of malignant transformation was consistent with previous studies. The common malignant transformation histologic types are both squamous and mucinous carcinoma which differed from previous reports. Early detection for early stage disease and optimal surgery are important for long term survival.

Transaxillary Subpectoral Placement of Cardiac Implantable Electronic Devices in Young Female Patients

  • Oh, Joo Hyun;Kim, Chae Min;Song, Seung Yong;Uhm, Jae Sun;Lew, Dae Hyun;Lee, Dong Won
    • Archives of Plastic Surgery
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    • v.44 no.1
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    • pp.34-41
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    • 2017
  • Background The current indications of cardiac implantable electronic devices (CIEDs) have expanded to include young patients with serious cardiac risk factors, but CIED placement has the disadvantage of involving unsightly scarring and bulging of the chest wall. A collaborative team of cardiologists and plastic surgeons developed a technique for the subpectoral placement of CIEDs in young female patients via a transaxillary approach. Methods From July 2012 to December 2015, subpectoral CIED placement via an axillary incision was performed in 10 young female patients, with a mean age of 25.9 years and mean body mass index of $20.1kg/m^2$. In the supine position, with the patient's shoulder abducted, an approximately 5-cm linear incision was made along one of the deepest axillary creases. The submuscular plane was identified at the lateral border of the pectoralis major, and the dissection continued over the clavipectoral fascia until the subpectoral pocket could securely receive a pulse generator. Slight upward dissection also exposed an entrance to the subclavian vein, allowing the cardiology team to gain access to the vein. One patient with dilated cardiomyopathy underwent augmentation mammoplasty and CIED insertion simultaneously. Results One case of late-onset device infection occurred. All patients were highly satisfied with the results and reported that they would recommend the procedure to others. Conclusions With superior aesthetic outcomes compared to conventional methods, the subpectoral placement of CIEDs via a transaxillary approach is an effective, single-incision method to hide operative scarring and minimize bulging of the device, and is particularly beneficial for young female or lean patients.

The Prevalence of Obesity by Percentage of Body Fat, Waist Circumference, and Body Mass Index and Their Association with Prevalence of Chronic Diseases of Elderly in Seoul Area (서울 일부 지역 노인의 체지방률, 허리둘레와 체질량지수에 의한 비만 분류 및 만성질환 유병율과의 연관성)

  • Kang, Min Jeong;Park, Jung Young;Kim, Jung Yun;Lee, Yeon Joo;Do, Min Hee;Lee, Sang Sun
    • The Korean Journal of Food And Nutrition
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    • v.27 no.3
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    • pp.358-368
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    • 2014
  • The purpose of this study was to compare the validity of obesity indices among the body mass index (BMI), waist circumference (WC), and body fat percentage (BF%), and to determine which is the most useful index to predict the risk of chronic diseases of elderly people. This study was conducted as a cross-sectional study at welfare centers in Seoul. The total number of subjects was 261 (68 men and 193 women) with age ${\geq}60$ years. The distribution of obesity using 3 obesity indices in the subjects with hypertension, diabetes, or arthritis was BF%>WC>BMI in elderly men and WC>BF%>BMI in elderly women. In elderly women, odds ratios (ORs) for hypertension in BMI and WC quartiles were significantly increased in quartile 2 and 3 (p<0.05). The ORs for hypertension, hyperlipidemia, and arthritis in BF% quartiles were significantly increased in quartile 3 and 4 (p<0.05). The BF% was sensitive obesity index for predicting the occurrence of chronic disease in men, and the WC was sensitive index in women. Our results suggested maintaining BMI less than $23.5kg/m^2$, WC less than 82 cm, and BF less than 35% in order to prevent chronic diseases in elderly women.

Liver Abscess Associated with Maternal Perinatal Infection in a Premature Infant (주산기 모체 감염과 미숙아 간농양 1례)

  • Lee, Ju-Hee;Seo, Bong-Ok;Seo, Eun-Sun;Kim, Sung-Mi;Kim, June-Hyoung
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.105-110
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    • 2008
  • Neonatal liver abscesses are rare, carry a high mortality rate, and are difficult to diagnose. The diagnosis of liver abscesses in the neonate cannot be established from the clinical presentation alone. Risk factors for liver abscesses in neonates are maternal infection, sepsis, umbilical venous catheterization, omphalitis, and necrotizing enterocolitis. In this report, we describe a preterm infant (32 weeks, 1,580 g) who presented with abdominal distension, respiratory difficulties, and a persistent inflammatory response in spite of broad spectrum antibiotic treatment; a large (6${\times}$5 cm) solitary pyogenic liver abscess was identified at 9 days of age. It appeared that the liver abscess had originated in the uterus and umbilical venous catheterization facilitated its spread. Percutaneous drainage under abdominal ultrasound guidance was performed and prolonged antibiotics were treated for 5 weeks, effecting a cure.

Is Completion Thyroidectomy Necessary in Patients with Papillary Thyroid Carcinoma who Underwent Lobectomy? (엽절제술을 시행한 갑상선 유두암 환자에서 완결 갑상선 절제술이 필요한지에 대한 연구)

  • Kang, Il Ku;Kim, Kwangsoon;Bae, Ja Seong;Kim, Jeong Soo
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.25-31
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    • 2021
  • Background/Objectives: Although thyroid lobectomy recently is considered as sufficient for low-risk papillary thyroid carcinoma (PTC), completion thyroidectomy is required due to the insufficiency of the preoperative evaluation. The aim of this study was to investigate recurrence rate and disease free survival depending on the gross extrathyroidal extension (gETE) or the number of metastatic lymph node identified in patients with PTC. Materials & Methods: We assessed 3373 patients with PTC who underwent lobectomy at Seoul St. Mary's Hospital (Seoul, Korea) between January 2009 and December 2014. Clinicopathological characteristics and long-term surgical outcomes were retrospectively analyzed through complete chart reviews. The mean follow-up duration was 97.1 ± 21.4 months. Results: The rate of recurrence was higher in gETE group (1.8% vs. 6.0%, p=0.004), leading to decreased disease free survival in Kaplan-Meier analysis (log-rank p<0.001). N1 group (n=1389) was analyzed into two groups whether the number of positive nodes is more than 5 or less. For the group of the more metastatic nodes, the recurrence rate higher compared to the other group (3.0% vs. 9.3%, p<0.001). DFS was longer in the group that had lesser metastatic nodes (log-rank p<0.001). However, in terms of N1 group over 1cm (n=492), No statistical difference was observed according to the number of positive lymph nodes (4.5% vs. 9.1%, p=0.092) Conclusion: When it comes to node positive PTC, Despite the number of positive lymph nodes was over 5, follow-up with no further surgery can be an option.

Seroma prevention with topical Abnobaviscum sclerotherapy following excision of giant cervical lipoma

  • Jun Ho Choi;Seung Yeon Choi;Jae Ha Hwang;Kwang Seog Kim;Sam Yong Lee
    • Archives of Craniofacial Surgery
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    • v.24 no.1
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    • pp.10-17
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    • 2023
  • Background: Lipomas are common benign tumors of mesenchymal origin that are composed of mature adipocytes. Giant lipomas have a diameter ≥ 10 cm in one or more dimensions or weigh at least 1,000 g. The surgical excision of a giant lipoma requires extensive dissection, increasing the risk of a seroma, which can cause surgical site complications such as wound infection and necrosis. Sclerotherapy with Abnobaviscum (Viscum album extract) is a relatively new technique used to reduce malignant pleural effusion. In this study, we evaluated the effectiveness of prophylactic sclerotherapy using Abnobaviscum to decrease seroma after giant lipoma excision. Methods: We conducted a retrospective medical record review of patients who underwent surgical excision for giant lipoma of the neck from January 2019 to December 2022. Sclerotherapy was performed on the first postoperative day in patients who consented to the procedure, and Abnobaviscum was instilled through the existing Hemovac drain. We compared the clinical course between those who underwent postoperative sclerotherapy and those who did not. Results: Among the 30 patients who underwent giant lipoma excision, we applied sclerotherapy with Abnobaviscum to 15 patients. The average time from surgery to Hemovac removal was statistically shorter in patients who underwent sclerotherapy (p= 0.004). Furthermore, seroma formation was significantly reduced in patients receiving sclerotherapy (p= 0.003). Conclusion: In patients undergoing giant lipoma excision, sclerotherapy using Abnobaviscum helps reduce postoperative seroma formation during the initial postoperative period. It can be an excellent method to reduce complications related to seroma and attenuate patients' postoperative burden.

Characteristics of heavy metals's exposure from playground flooring (놀이터 바닥재로부터 용출되는 중금속 노출 특성)

  • Cho, Yoon A;Kim, Woo Il;Shin, Sun Kyoung;Kang, Young Yeul;Kim, Min Sun;Jeong, Seong Kyoung;Yeon, Jin Mo;Jin, Na;Lee, Ji Young
    • Analytical Science and Technology
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    • v.25 no.6
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    • pp.416-420
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    • 2012
  • The increasing use of recycling products results in the need for assessing the risk to human health. In this study heavy metals's contents of playground flooring were compared with rubber powder which is row material. And it is reviewed characteristics of heavy metals's exposure from absorption of skin, checking amount of dermal uptake for each heavy metal. Despite its high content, Zn had a very low migration rate with 0.1 $mg/cm^2$. This indicates that Zn is not easily released by surface contact. However, the contents of Fe and Al in flooring were 12 times higher than that of Zn and Fe, and Al showed migration rate 5 times higher than that of Zn. This implies that Fe and Al were derived from pigment in flooring. The measurement of dermal exposure to heavy metals at 6 playgrounds found higher level of exposure in Ba than in other heavy metals. It is assumed that despite high content of Zn, Ba had a higher exposure rate because five times as much Ba as Zn was darmal absorptionactor ($AF_{darmal}$).

Superior Gluteal Artery Perforator Turn-Over Flap Coverage for Lumboscaral Soft Tissue Defect in Ambulatory Patient (보행 환자에서의 위볼기동맥천공지뒤집기피판을 이용한 허리엉치 부위 연부조직 결손의 치료)

  • Moon, Suk-Ho;Kim, Dong-Seok;Oh, Deuk-Young;Lee, Jung-Ho;Rhie, Jong-Won;Seo, Je-Won;Ahn, Sang-Tae
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.712-716
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    • 2010
  • Purpose: Extensive lumbosacral defects after removal of spinal tumors have a high risk of wound healing problems. Therefore it is an effective reconstructive strategy to provide preemptive soft tissue coverage at the time of initial spinal surgery, especially when there is an instrument exposure. For soft tissue reconstruction of a lumbosacral defect, a variation of the gluteal flap is the first-line choice. However, the musculocutaneous flap or muscle flap that is conventionally used, has many disadvantages. It damages gluteus muscle and causes functional disturbance in ambulation, has a short pedicle which limits areas of coverage, and can damage perforators, limiting further surgery that is usually necessary in spinal tumor patients. In this article, we present the superior gluteal artery perforator turn-over flap that reconstructs complex lumbosacral defects successfully, especially one that has instrument exposure, without damaging the ambulatory function of the patient. Methods: A 67 year old man presented with sacral sarcoma. Sacralectomy with L5 corpectomy was performed and resulted in a $15{\times}8\;cm$ sized complex soft tissue defect in the lumbosacral area. There was no defect in the skin. Sacral stabilization with alloplastic fibular bone graft and reconstruction plate was done and the instruments were exposed through the wound. A $18{\times}8\;cm$ sized superior gluteal artery perforator flap was designed based on the superior gluteal artery perforator and deepithelized. It was turned over 180 degrees into the lumbosacral dead space. Soft tissue from both sides of the wound was approximated over the flap and this provided in double padding over the instrument. Results: No complications such as hematoma, flap necrosis, or infection occurred. Until three months after the resection, functional disturbances in walking were not observed. The postoperative magnetic resonance imaging scan shows the flap volume was well maintained over the instrument. Conclusion: This superior gluteal artery perforator turn-over flap, a modification of the conventional superior gluteal artery perforator flap, is a simple method that enabled the successful reconstruction of a lumbosacral defect with instrument exposure without affecting ambulatory function.

Effect of Whole Body Vibration Training in Drop Landing Jump (전신진동운동이 드랍랜딩점프 동작에 미치는 영향)

  • Hong, Su-Yeon;Jang, Young-Kwan;Kim, Jin-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.3
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    • pp.423-429
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    • 2018
  • Objective: This study was conducted to investigate the effects of WBVE on biomechanical factor analysis of drop landing jumps before and after a four week training program. Methods: Participants were divided into two group: VEG (n=5, age: $25.7{\pm}2.3yrs$, height: $170{\pm}7.6cm$, weight: $69.3{\pm}8.3kg$) and OEG (n=5, age: $24.6{\pm}3.4yrs$, height: $164{\pm}4.9cm$, weight: $58.8{\pm}9.2kg$). Ten infrared cameras (Vicon, UK) with a sampling rate of 100 Hz were used in two GRF measurement systems (AMTI, USA). Results: The variability of the center of mass was largest at the falling phase, and there was a great risk of injury when landing after the jump. Second, the jumping heights of the VEG (vibration exercise group) were higher than those of the OEG (only exercise group), regardless of training period. Third, there were significant differences in the hip joint P1 (flexion) and knee joint P2 (extension) between the exercise groups after 4 weeks of training. However, there were no significant differences among training periods or phases. Conclusion: regardless of training periods, the VEG showed increased jump height compared with the OEG, but the consistency between the jump height and the lower joint power could not be determined.

A Microbiological Analysis and Hazard Factor Evaluation of Food Utensils and Fixtures of Food Service Operations in Schools (학교 집단급식소 내 식기류 및 집기류의 미생물학적 분석 및 위해요인 평가)

  • Park, Sung-Jun;Hong, Sung-Ho;Lee, Anne Ha-Young;Kim, Cheol-Ju;Kim, Su-Jin;Kim, Sung-Kyoon;Ko, Gwang-Pyo
    • Journal of Environmental Health Sciences
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    • v.37 no.5
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    • pp.376-386
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    • 2011
  • Objectives: The aim of this study was to evaluate the microbial hazards posed by food utensils and fixtures in food service operations at selected middle and high schools located in Seoul, Korea. Methods: We collected 200 samples of utensils and fixtures including cups, spoons/chopsticks, food trays and tables from five different schools in Seoul. Target microorganisms of this study were divided into two groups: total bacterial count and total coliform as indicators of microbial contamination and Bacillus cereus and Staphylococcus aureus as pathogens of food poisoning. We used selective media to quantify microbial concentration and 16S rRNA PCR assay for qualitative analysis. In addition, intensive interviews with nutritionists were conducted and observations were made to identify factors that may affect microbial contamination. Logistic regression analysis was employed to examine the relationship between the microbial concentration and operation characteristics of each operation. Results: The level of microbial concentration in school B and C were significantly lower than in school A, D and E (p<0.05). Some samples from school A, D and E showed over 3.4 log CFU/100 $cm^2$ (total bacterial count) and 1.0 log CFU/100 $cm^2$ (total coliform), which requires immediate hygienic action. The number of customers per staff member, periodicity of hygiene education for staff and daily operation time of sterilizers were also found to be important factors related with the microbial contamination of food service operations. Conclusions: These results suggested that not only a HACCP (Hazard Analysis and Critical Control Point) approach, but also efforts to assess internal risk factors within operations be needed to reduce the microbial contamination of food utensils and fixtures. This study is expected to provide preliminary data for assessing microbial hazards in food service operations.