• 제목/요약/키워드: Delayed

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유리 횡복직근피판술을 이용한 지연 유방재건술; 즉시 유방재건술과의 비교 (Delayed Breast Reconstruction using Free Transverse Rectus Abdominis Myocutaneous(TRAM) Flap; Comparison with Immediate Breast Reconstruction)

  • 전명곤;안희창
    • Archives of Reconstructive Microsurgery
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    • 제10권1호
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    • pp.28-33
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    • 2001
  • The numbers of breast cancer are increasing in Korea and the needs for breast reconstruction are also parallel with cancer frequency. The purpose of the study is to define the different state and condition between the delayed reconstruction and the immediate reconstruction of breasts and to suggest how to get more satisfactory outcome. The study included 22 patients who underwent delayed breast reconstruction using transverse rectus abdominis myocutaneous(TRAM) free flap from December, 1990 to January, 2001. Their ages ranged from 28 years to 58 years. We have used internal mammary artery and vein as a recipient vessel in 13 patients because of fibrosis and severe scarring in the axillary region and thoracodorsal artery and vein in 9 patients. When we used internal mammary artery with recipient vessel, we would use contralateral deep inferior epigastric artery with donor vessel. We obtained satisfactory result without any flap loss, and most patients satisfied with shape and volume of reconstructed breast. We found that delayed breast reconstruction have some differences compared with immediate breast reconstruction. First, we remove fibrotic and scar tissue as much as possible to achieve satisfactory shape of breast. Second, we plan preoperative design in standing position to obtain symmetrical recreation of inframammary fold. Third, we use internal mammary vessel in many cases with recipient vessel for microvascular anastomosis. Fourth, patients with delayed breast reconstruction feel more satisfaction than patients with immediate breast reconstruction do. Finally, economic burden is much higher in the delayed case than in the immediate case because of no coverage with insurance.

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Factors Associated with Delayed Diagnosis of Cervical Cancer in Iran - a Survey in Isfahan City

  • Behnamfar, Fariba;Azadehrah, Mahboobeh
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.635-639
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    • 2015
  • Background: In the absence of routine screening program for cervical cancer in Iran and high rate of diagnosed cancer in its advanced stage, recognition of sociodemographic factors related to delayed diagnosis of cancer in Iran could be helpful in reducing the burden of disease in our community. The aim of this study was to determine the stage of cervical cancer at diagnosis and factors related to delayed diagnosis of cervical cancer in Isfahan, Iran. Materials and Methods: In this cross sectional study women diagnosed with cervical cancer for the first time by histo-pathological examination were enrolled. According to the clinical and paraclinical findings and staging of the cancer, they were classified into early and delayed diagnosis of cervical cancer. Sociodemographic factors were compared in the two groups. Results: In this study of 55 women mean age was $48.3{\pm}12.0.$ According to our classification 6/55 (10.9%) and 49/55 (89.1%) of them had early and delayed diagnosis of cervical cancer. Delayed diagnosis of the cancer was significantly higher in patients with lower degree of education, lower socioeconomic status, having smoker and addict husband and those who did not have a history of Pap smear test (p<0.05). Conclusions: The results of this study indicated risk factors related to delayed diagnosis of cervical cancer. The affected women should be targeted for implementation of specialized educational programmes for improving knowledge and screening test.

스트레칭과 사전원심성 운동이 지연성근육통에 미치는 영향 (The Effect of Stretching and Pre-eccentric exercise on Delayed Onset Muscle Soreness)

  • 정진규;류성선;김용남;강종호;김수현;황태연
    • 대한임상전기생리학회지
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    • 제8권1호
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    • pp.15-22
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    • 2010
  • Purpose : This study examines the effects of pre-eccentric exercise and stretch ing to bicepsbrachii to prevent delayed onset muscle soreness and recovery of muscular function depending on the training intensity with 28 normal adults in their twenties. Methods : The subjects were divided into a control group, a group without any previous eccentric exercise, and a stretching group. Pre-eccentric exercise group conducted exercise with the intensity of 25% of maximal voluntary contraction. Pre-eccentric exercise and stretching was applied before to induce delayed onset muscle soreness and after, 24 hour post, 48 hour post, and 72 hour post. Measurements were conducted to examine pain and muscular function changes before, immediately after, and after inducing delayed onset muscle soreness. After inducing delayed onset muscle soreness, measurements were taken at the 24th hour, 48th hour, and 72nd hour. Results : The pre-eccentric exercise group and stretching group showed a significant difference from the control group by isometric contract ion power and mechanical pain threshold as a result of measuring delayed onset muscle soreness. Conclusion : From these results, electrical stimulation using presynaptic inhibition mechanism of transcutaneous electrical stimulation (TES) had positive effects for walking ability on inhibition of muscle tone in lower extremity. The motor level stimulation group experienced a more significant effect than the sensory level stimulation group. Therefore, the transcutaneous electrical stimulation (TES) is considered to be effective on walking ability increasing through inhibition of muscle tone in lower extremity for rehabilitation of post stroke hemiplegic patients.

Non-Practice of Breast Self Examination and Marital Status are Associated with Delayed Presentation with Breast Cancer

  • Ghazali, Sumarni Mohd;Othman, Zabedah;Cheong, Kee Chee;Lim, Kuang Hock;Wan Mahiyuddin, Wan Rozita;Kamaluddin, Muhammad Amir;Yusoff, Ahmad Faudzi;Mustafa, Amal Nasir
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권2호
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    • pp.1141-1145
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    • 2013
  • Delay in seeking treatment for breast cancer is a barrier to the early diagnosis and management of the disease, resulting in a poorer prognosis. We here estimated the prevalence of delayed presentation for breast cancer and identified possible influential sociodemographic factors in a cross-sectional study of 250 patients diagnosed with primary breast cancer at the Radiotherapy and Oncology Clinic in Kuala Lumpur Hospital. Data were collected by face-to-face interview using a structured questionnaire and from medical records. We examined associations between delayed presentation (presenting to a physician more than 3 months after self-discovery of a symptom) and sociodemographic characteristics, practice of breast self examination (BSE), history of benign breast disease, family history of breast cancer and type of symptom, symptom disclosure and advice from others to seek treatment using multiple logistic regression. Time from self-discovery of symptom to presentation ranged from tghe same day to 5 years. Prevalence of delayed presentation was 33.1% (95%CI: 27.4, 39.3). A significantly higher proportion of delayers presented with late stages (stage III/IV) (58.3% vs. 26.9%, p<0.001). Divorced or widowed women (OR: 2.23, 95% CI: 1.11, 4.47) had a higher risk of delayed presentation than married women and women who never performed breast self examination were more likely to delay presentation compared to those who regularly performed BSE (OR: 2.74, 95% CI: 1.33, 5.64). Our findings indicate that delayed presentation for breast cancer symptoms among Malaysian women is high and that marital status and breast self examination play major roles in treatment-seeking for breast cancer symptoms.

Imipramine Inhibits A-type Delayed Rectifier and ATP-Sensitive $K^{+}$ Currents Independent of G-Protein and Protein Kinase C in Murine Proximal Colonic Myocytes

  • Choi, Seok;Parajuli, Shankar Prasad;Lim, Geon-Han;Kim, Jin-Ho;Yeum, Cheol-Ho;Yoon, Pyung-Jin;Jun, Jae-Yeoul
    • Archives of Pharmacal Research
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    • 제29권11호
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    • pp.998-1005
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    • 2006
  • The effects of imipramine on A-type delayed rectifier $K^{+}$ currents and ATP-sensitive $K^{+}\;(K_{ATP)$ currents were studied in isolated murine proximal colonic myocytes using the whole-cell patch-clamp technique. Depolarizing test pulses between-80 mV and +30 mV with 10 mV increments from the holding potential of-80 mV activated voltage-dependent outward $K^{+}$ currents that peaked within 50 ms followed by slow decreasing sustained currents. Early peak currents were inhibited by the application of 4-aminopyridine, whereas sustained currents were inhibited by the application of TEA. The peak amplitude of A-type delayed rectifier $K^{+}$ currents was reduced by external application of imipramine. The half-inactivation potential and the half-recovery time of A-type delayed rectifier $K^{+}$ currents were not changed by imipramine. With 0.1 mM ATP and 140 mM $K^{+}$ in the pipette and 90 mM $K^{+}$ in the bath solution and a holding potential of -80 mV, pinacidil activated inward currents; this effect was blocked by glibenclamide. Imipramine also inhibited $K_{ATP}$ currents. The inhibitory effects of imipramine in A-type delayed rectifier $K^{+}$ currents and $K_{ATP}$ currents were not changed by guanosine 5-O-(2-thiodiphosphate) ($GDP{\beta}S$) and chelerythrine, a protein kinase C inhibitor. These results suggest that imipramine inhibits A-type delayed rectifier $K^{+}$ currents and $K_{ATP}$ currents in a manner independent of G-protein and protein kinase C.

안와하벽재건술 후 발생한 지연성 눈뒤출혈: 증례보고 (Delayed Retrobulbar Hemorrhage after Orbital Floor Reconstruction)

  • 이승우;최영웅;남상현;김훈
    • Archives of Plastic Surgery
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    • 제37권4호
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    • pp.489-491
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    • 2010
  • Purpose: Retrobulbar hemorrhage is a rare complication followed by blepharoplasty, trauma, orbital reconstruction, and so on. Most of the cases occur within 24 hours, half of them in the first 6 hours. Some authors have reported delayed retrobulbar hemorrhage after blepharoplasty and trauma within 1 day to 9 days. However, there have been few reports of delayed retrobulbar hemorrhage resulting from the complication of orbital reconstruction. Methods: A 22-year-old male underwent orbital floor reconstruction due to the orbital floor fracture. In 84 hours after the surgery, he complained sudden onset orbital pain and decreased visual acuity immediately after defecation. Intraocular pressure was unmeasurable due to the swelling at that time. Emergency computed tomography was performed. Results: Computed tomography revealed subperiosteal hematoma on inferior orbital wall extended to the apex. Emergency decompressive surgery was performed within 1 hour. After evacuation of hematoma, orbital symptom was improved and visual acuity was restored. Conclusion: Delayed retrobulbar hemorrhage is rare but vision-threatening. Therefore early diagnosis and treatment of delayed retrobulbar hemorrhage is thought to be crucial. The cause of delayed hemorrhage was not clear, however, valsalva maneuver might be the cause of hemorrhage.

두개인두종의 적출후 발현된 지연성 뇌경색 (Delayed Cerebral Infarction after Resection of Craniopharyngioma)

  • 박균철;정진명;김준수;김재형;이현석;황수현;박인성;김은상;한종우
    • Journal of Korean Neurosurgical Society
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    • 제30권7호
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    • pp.849-854
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    • 2001
  • Delayed cerebral infarction after resection of craniopharyngioma is a uncommon entity, but leads to high morbidity and mortality. We present 3 such cases and discuss the etiology and pathogenesis with review of pertinent literatures. In our cases, delayed deterioration of consciousness was observed in all cases. All of them expired. The cause may be multifactorial and the surgical approach may contribute to the pathogenesis of delayed cerebral infarction. We suspect vasospasm might be the major mechanism of pathogenesis. Vessels were primed to spasm during operation due to blood in the cistern or mechanical injury. Vasoactive materials may have been liberated from the pituitary stalk or injured hypothalamus, either at the time of surgery, or later, after portions of tumor have undergone necrosis. The high degree of suspicion to detect vasospasm should be done in the case of the delayed deterioration of mental status at an early stage of craniopharyngioma surgery. Possible mechanism underlying this delayed cerebral infarction are discussed.

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Comparison of postoperative outcomes between early and delayed surgery for pediatric nasal fractures

  • Kang, Won Ki;Han, Dong Gil;Kim, Sung-Eun;Lee, Yong Jig;Shim, Jeong Su
    • 대한두개안면성형외과학회지
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    • 제22권2호
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    • pp.93-98
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    • 2021
  • Background: Pediatric nasal fractures, unlike adult nasal fractures, are treated surgically as early as 7 days after the initial trauma. However, in some cases, a week or more elapses before surgery, and few studies have investigated the consequences of delayed surgery for pediatric nasal fractures. The purpose of this study was to evaluate the postoperative outcomes of pediatric nasal fractures according to the time interval between the initial trauma and surgery. Methods: The records of pediatric patients under 12 years old who underwent closed reduction of nasal bone fracture from March 2012 to February 2020 were reviewed. The interval between trauma and surgery was divided into within 7 days (early reduction) and more than 7 days (delayed reduction). Postoperative results were classified into five grades (excellent, good, moderate, poor, and very poor) based on the degree of reduction shown on computed tomography. Results: Ninety-eight patients were analyzed, of whom 51 underwent early reduction and 47 underwent delayed reduction. Forty-two (82.4%) of the 51 patients in the early reduction group showed excellent results, and nine (17.6%) showed good results. Thirty-nine (83.0%) of the 47 patients in the delayed reduction group showed excellent results and eight (17.0%) showed good results. No statistically significant difference in outcomes was found between the two groups (chi-square test p= 0.937). However, patients without septal injury were significantly more likely to have excellent postoperative outcomes (chi-square test p< 0.01). Conclusion: No statistically significant difference was found in the outcomes of pediatric nasal fractures between the early and delayed reduction groups. Successful surgical results were found even in patients who received delayed reduction (more than 7 days after trauma).

지연성근육통 유발 후 수동적 스트레칭이 혈중피로물질 및 VAS에 미치는 융합연구 (Convergence Study on Effects of Passive Stretching on Blood Fatigue and VAS after Delayed Onset Muscle Soreness)

  • 김종혁;김도진
    • 융합정보논문지
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    • 제8권6호
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    • pp.93-99
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    • 2018
  • 본 연구는 대학생을 대상으로 지연성근육통 유발 후 수동적 스트레칭의 효과를 확인하고 부상 시 효과적인 통증완화 및 예방을 위한 재활 운동프로그램을 제안하고자 한다. 연구대상자는 20대 남자 대학생을 대상으로 수동적 스트레칭그룹과 통제그룹으로 구분하였다. 수동적 스트레칭 그룹은 지연성근육통 유발 후 수동적 스트레칭을 실시하였으며 통제그룹은 지연성근육통 유발 후 어떠한 처치도 실시하지 않았다. 지연성근육통 유발 방법은 벤치 스텝 운동을 통하여 유발하였으며, 스텝박스의 높이는 50cm이며, 착지 시 왼쪽 하지 쪽으로 착지하도록 하였다. 측정변인은 혈중피로물질과 주관적 통증척도를 알아보았으며 자료처리는 수동적 스트레칭 그룹과 통제그룹의 비교를 위하여 2-way RGRM ANOVA를 실시하였다. 결론적으로 지연성근육통 유발 후 수동적 스트레칭이 혈중피로물질(CRP, LDH)과 주관적 통증척도(VAS)에 긍정적 효과가 있는 것으로 나타났다.

Al 첨가 TWIP강에서의 지연파괴에 대한 변형유기 마르텐사이트 변태의 영향 (Effects of the Strain Induced Martensite Transformation on the Delayed Fracture for Al-added TWIP Steel)

  • 김영우;강남현;박영도;최일동;김교성;김성규;조경목
    • 대한금속재료학회지
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    • 제46권12호
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    • pp.780-787
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    • 2008
  • For the advanced high strength steels (AHSS), high-manganese TWIP (twinning induced plasticity) steels exhibit high tensile strength (800-1000 MPa) and high elongation (50-60%). However, the TWIP steels need to be understood of delayed fracture following the cup drawing test. Among the factors to cause delayed fracture, i.e, martensite transformation, hydrogen embrittlement and residual stress, the effects of martensite transformation (${\gamma}{\rightarrow}{\varepsilon}$ or ${\gamma}{\rightarrow}{\alpha}^{\prime}$) were investigated on the delayed fracture phenomenon. Microstructural phase analysis was conducted for cold rolled (20, 60, 80% reduction ratio) steels and tensile deformed (20, 40, 60% strain) steels. For the Al-added TWIP steels, no martensite phase was found in the cold rolled and tensile deformed specimen. But, the TWIP steels with no Al addition indicated the martensite transformation. The cup drawing specimens showed the martensite transformation irrespective of the Al-addition to the TWIP steel. However, the TWIP steel with no Al exhibited the larger amount of martensite than the case of the TWIP steel with Al addition. For the reason, it was possible to conclude that the Al addition suppressed the martensite transformation in TWIP steels, therefore preventing the delayed fracture effectively. However, it was interesting to note that the mechanism of delayed fracture should be incorporated with hydrogen embrittlement and/or residual stress as well as the martensite transformation.