Journal of Cerebrovascular and Endovascular Neurosurgery
/
v.26
no.3
/
pp.274-283
/
2024
Objective: The incidence of spontaneous intracerebral hemorrhage (ICH) in young people is relatively low; however, it leads to devastating lifelong neurologic deficits. We focused on spontaneous ICH occurring in young adults between 30 and 50 years of age. Methods: We retrospectively reviewed the records of 139 patients, aged 30-50 years, diagnosed with spontaneous ICH between 2011 and 2021. Cases of ICH attributable to discernible causative lesions were excluded. Demographic data, laboratory results, image findings, and clinical outcome were analyzed. Results: After exclusions, 73 patients were included in this study. Common characteristics among the study patients included male sex (83.6%), high body mass index (>25 kg/m2, 45.8%), smoking history (47.2%), heavy alcohol consumption (30.6%), previously diagnosed hypertension (41.1%), high serum triglyceride level (>150 mg/dL, 33.3%), and microbleeds or white matter changes observed on magnetic resonance images (51.3%). In the multivariate analysis, previously diagnosed hypertension was the sole significant risk factor for cerebral small vessel (OR 7.769, P=0.031). Age, brain stem location, Glasgow Coma Scale score at admission, and hematoma volume were associated with poor outcomes. Conclusions: Hypertension, obesity, smoking, and cerebral small vessel disease were important factors associated with non-lesional spontaneous intracerebral hemorrhage in young patients. Radiologic changes corresponding to cerebral small vessel disease appeared in young patients (in their 30s) and they were associated with hypertension.
Purpose: Tumor recurrence is the principal cause of poor outcomes in remnant gastric cancer (RGC) after resection. We sought to elucidate the recurrent patterns according to tumor locations in RGC. Materials and Methods: Data were collected from the Shanghai Cancer Center between January 2006 and December 2020. A total of 129 patients with RGC were included in this study, of whom 62 had carcinomas at the anastomotic site (group A) and 67 at the non-anastomotic site (group N). The clinicopathological characteristics, surgical results, recurrent diseases, and survival were investigated according to tumor location. Results: The time interval from the previous gastrectomy to the current diagnosis was 32.0±13.0 and 21.0±13.4 years in groups A and N, respectively. The previous disease was benign in 51/62 cases (82.3%) in group A and 37/67 cases (55.2%) in group N (P=0.002). Thirty-three patients had documented sites of tumor recurrence through imaging or pathological examinations. The median time to recurrence was 11.0 months (range, 1.0-35.1 months). Peritoneal recurrence occurred in 11.3% (7/62) of the patients in group A versus 1.5% (1/67) of the patients in group N (P=0.006). Hepatic recurrence occurred in 3.2% (2/62) of the patients in group A versus 13.4% (9/67) of the patients in group N (P=0.038). Patients in group A had significantly better overall survival than those in group N (P=0.046). Conclusions: The tumor location of RGC is an essential factor for predicting recurrence patterns and overall survival. When selecting an optimal postoperative follow-up program for RGC, physicians should consider recurrent features according to the tumor location.
Objective: Prospective studies on postoperative residual breast tissue (RBT) after robotic-assisted nipple-sparing mastectomy (R-NSM) for breast cancer are limited. RBT presents an unknown risk of local recurrence or the development of new cancer after curative or risk-reducing mastectomies. This study investigated the technical feasibility of using magnetic resonance imaging (MRI) to evaluate RBT after R-NSM in women with breast cancer. Materials and Methods: In this prospective pilot study, 105 patients, who underwent R-NSM for breast cancer at Changhua Christian Hospital between March 2017 and May 2022, were subjected to postoperative breast MRI to evaluate the presence and location of RBT. The postoperative MRI scans of 43 patients (age, 47.8 ± 8.5 years), with existing preoperative MRI scans, were evaluated for the presence and location of RBT. In total, 54 R-NSM procedures were performed. In parallel, we reviewed the literature on RBT after nipple-sparing mastectomy, considering its prevalence. Results: RBT was detected in 7 (13.0%) of the 54 mastectomies (6 of the 48 therapeutic mastectomies and 1 of the 6 prophylactic mastectomies). The most common location for RBT was behind the nipple-areolar complex (5 of 7 [71.4%]). Another RBT was found in the upper inner quadrant (2 of 7 [28.6%]). Among the six patients who underwent RBT after therapeutic mastectomies, one patient developed a local recurrence of the skin flap. The other five patients with RBT after therapeutic mastectomies remained disease-free. Conclusion: R-NSM, a surgical innovation, does not seem to increase the prevalence of RBT, and breast MRI showed feasibility as a noninvasive imaging tool for evaluating the presence and location of RBT.
Kim, Sang-Hyun;Baik, You-Sang;Jeong, Chang-Hyun;Jang, Woo-Chang
Journal of Korean Medical classics
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v.25
no.4
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pp.85-94
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2012
The concept of makwon(膜原) holds great importance in the texts of Seup-yeoljobyeon(濕熱條辨). Research on the concept was based on Seolsaengbaek(薛生白)'s medical theories organized by Wang Maengyeong(王孟英). The results are as follows. Seolsaengbaek describes makwon as half-exterior half-interior(半表半裏) of yang-myeong(陽明) and half-exterior half-interior of the body. The half-exterior half-interior in these definitions each hold a different meaning. In half-exterior half-interior of yang-myeong, it refers to its mediating function, focusing on the location of makwon as yang-myeong. In half-exterior half-interior of the body, it refers to an intersection where the pathological mechanism of damp-heat disease(seup-yeoljeung 濕熱證) begins, and also where the course of the disease changes. This is why treatment of the makwon is included in treating many damp-heat disease symptoms. The conditions derived from the original damp-heat disease can follow the designated prognosis, or follow a reversed course. Because of its intersecting role, treating the makwon can help prevent aggravation. In treatment, consideration of the healthygi(jeonggi 正氣), the bodily fluids(jinaek 津液) with an understanding of the various prognosis is crucial.
Schistosoma haematobium is one of the most prevalent parasitic flatworms, infecting over 112 million people in Africa. However, little is known about the genetic diversity of natural S. haematobium populations from the human host because of the inaccessible location of adult worms in the host. We used 4 microsatellite loci to genotype individually pooled S. haematobium eggs directly from each patient sampled at 4 endemic locations in Africa. We found that the average allele number of individuals from Mali was significantly higher than that from Nigeria. In addition, no significant difference in allelic composition was detected among the populations within Nigeria; however, the allelic composition was significantly different between Mali and Nigeria populations. This study demonstrated a high level of genetic variability of S. haematobium in the populations from Mali and Nigeria, the 2 major African endemic countries, suggesting that geographical population differentiation may occur in the regions.
Purpose: The aim of this study was to investigate distribution of the admitted patients with disease of oral cavity, salivary glands and jaws, current clinical treatment condition and clinical dental practice. Methods: The subject were 4,564 patients with disease of oral cavity, salivary glands and jaws of the Korean National Hospital Discharge Injury Survey 2004-2008 data. This study was carried out using the administrative database including patients' characteristics and comorbidity. The statistical analysis for ratio, gender, age, region, primary diagnosis, comorbidity, operation, hospital location and bed size of inpatients in Korean National Hospital Discharge Injury Survey was conducted by frequency analysis. Results: Among the total discharge injury patients in 2004-2008, the trend showed decrease of ratio of patients with disease of oral cavity, salivary glands and jaws. The portion of male was higher than female, and 20~29 age group was the highest portion compared with other age groups. Seoul-Gyunggi region was the highest among the other residences. patients with Dentofacial anomalies[including malocclusion] as primary diagnosis, digestive system as comorbidity and operations on facial bones and joins showed the highest portion respectively. Seoul-Gyunggi region was the highest portion compared with other residences. 500~999 bed size showed the highest portion. Conclusion: In this study showed that distribution of patients with disease of oral cavity, salivary glands and jaws, current dental clinical treatment condition using the Korean National Hospital data.
Kim, Sung-Ho;Son, Sang-Yong;Park, Young-Suk;Ahn, Sang-Hoon;Park, Do Joong;Kim, Hyung-Ho
Journal of Gastric Cancer
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v.15
no.3
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pp.167-175
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2015
Purpose: Although several studies report risk factors for anastomotic leakage after gastrectomy for gastric cancer, they have yielded conflicting results. The present retrospective cohort study was performed to identify risk factors that are consistently associated with anastomotic leakage after gastrectomy for stomach cancer. Materials and Methods: All consecutive patients who underwent gastrectomy at a single gastric surgical unit between May 2003 and December 2012 were identified retrospectively. The associations between anastomotic leakage and 23 variables related to patient history, diagnosis, and surgery were assessed and analyzed with logistic regression. Results: In total, 3,827 patients were included. The rate of anastomotic leakage was 1.88% (72/3,827). Multiple regression analysis showed that male sex (P=0.001), preoperative/intraoperative transfusion (P<0.001), presence of cardiovascular disease (P=0.023), and tumor location (P<0.001) were predictive of anastomotic leakage. Patients with and without leakage did not differ significantly in terms of their 5-year survival: 97.6 vs. 109.5 months (P=0.076). Conclusions: Male sex, cardiovascular disease, perioperative transfusion, and tumor location in the upper third of the stomach were associated with an increased risk of anastomotic leakage. Although several studies have reported that an anastomotic complication has a negative impact on long-term survival, this association was not observed in the present study.
Park, Gwanyong;Kwon, Kyeong-Seok;Lee, In-bok;Yeo, Uk-Hyeon;Lee, Sang-Yeon;Kim, Jun-Gyu
Journal of The Korean Society of Agricultural Engineers
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v.59
no.4
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pp.75-83
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2017
Many parts of problems in livestock industry today are associated with organic dust. Endotoxin and toxic gasses on the surface of dust and dust itself can cause aesthetic displeasure and respiratory disease. It also reduces livestock productivity by suppressing immunity of animals and carrying microbes causing animal disease. However, dust level of cattle farm was rarely reported in Korea, and regulation for cattle farm worker does not exist. In this paper, dust concentration and environmental condition were regularly monitored in a commercial Korean native cattle farm. The measurement was conducted according to location and working activities. From the measurement, distribution of dust concentration was affected by wind environment, as the result of natural ventilation. TMR mixer was a major source of dust in target cattle house. The maximum inhalable dust concentration was 637.8 times higher than exposure limit as feed dropped into the TMR mixer. It was expected that dust generation could be affected by particle size and drop height of feed. This study suggests potential risk of dust in cattle farm, and necessity for latter study. Effect of aerodynamic condition and TMR processing should be investigated for dust reduction study.
Through a consideration of the contralateral collateral needling(繆刺) from "Neijing", the conclusions are as follows. The contralateral collateral needing is defined as a disordered state, and also as the pricking bloodletting method. Unlike the seasonal deficiency pathogen(虛邪), which are affected by the four seasons, the subject of the contralateral collateral needling is the extra pathogen(奇邪), which is the cause of the extra disease(奇病), therefore the treatment should be different from the general. The contralateral collateral needling is generally used when a pain is generated from the veins(絡) by an external pathogen(邪). However, it can be used as the treatment for an emotional disorder, such as flight or sorrow, or a body constituent(身形) disorder caused by internal parts of the five viscera. Although the contralateral collateral needling(繆刺) and the contralateral meridian needling(巨刺) share the left and right cross treatment(右取左, 左取右) in common, but they are different in every aspect, as the causes, transmutation, location, and feature of disease, relation of qi and blood, and location and method of needling(刺鍼). The medical procedure of the contralateral collateral needling is collateral needling(刺絡) the parts of blood collaterals(血絡) or bruising(痏) well points(井穴) of the end of the both sides of limbs, and using the left and right cross treatment when the former methods are not making any progress. The symptoms of contralateral collateral needling are head, chest, and abdomen pains, and they are treated at the end of the limbs. The bloodletting method(刺絡法), extracting a little amount of blood at well points or blood collaterals, or the collateral vessel pricking therapy(瀉血法), extracting a lot of blood by using cupping(附缸), for example, are contemporary successions of the collateral needling(絡刺), the leopard-spot needling(豹文刺), and the contralateral collateral needling.
Objective: The current study aimedto screen for possible factors which affect prognosis of chondrosarcoma. Methods: Thirty seven cases were selected and analyzed statistically. The patients received surgical treatment at our hospital between December 2005 and March 2008. All of them had complete follow-up data. The survival rates were calculated by univariate analysis using the Kaplan-Meier method and tested by Log-rank. ${\chi}^2$ or Fisher exact tests were carried out for the numeration data. The significant indexes after univariate analysis were then analyzed by multivariate analysis using COX regression model. Based on the literature, factors of gender, age, disease course, tumor location, Enneking grades, surgical approaches, distant metastasis and local recurrence were examined. Results: Univariate analysis showed that there were significant differences in Enneking grades, surgical approaches and distant metastasis related to the patients' 3-year survival rate after surgery (P<0.001). No significant difference was not found in gender, age, disease course, tumor location or local recurrence (P>0.05). Multivariate analysis showed that Enneking grade (P=0.007) and surgical approaches (P=0.010) were independent factors affecting the prognosis of chondrosarcoma, but distant metastasis was not (P=0.942). Conclusion: Enneking grades, surgical approaches and distant metastasis are risk factors for prognosis of chondrosarcoma, among which the former two are independent factors.
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