• Title/Summary/Keyword: Early outcomes

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Pylorus-preserving Proximal Gastrectomy vs. Total Gastrectomy with Jejunal Interposition for Proximal Gastric Adenocarcinomas (상부 위암에서 유문보존 근위부 위아전절제술과 공장간치술을 시행한 위전절제술의 비교)

  • Noh Seung-Moo;Jeong Hyun-Yong;Lee Byong-Seok;Cho June-Sik;Shin Kyung-Sook;Song Kyu-Sang;Lee Tae-yong
    • Journal of Gastric Cancer
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    • v.2 no.3
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    • pp.145-150
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    • 2002
  • Purpose: The aim of this study was to evaluate the shortterm outcome of a pylorus-preserving proximal gastrectomy by comparing it with a jejunal interposition after a total gastrectomy in proximal gastric adenocarcinoma. Materials and Methods: For 22 patients (12 men and 10 women) who underwent a pylorus-preserving proximal gastrectomy, several clinical parameters were obtained from the medical records retrospectively. In this study, the data were collected between September 1993 and December 1999 at Chungnam National University Hospital, and the results were compared with those of 25 patients (17 men and 8 women) who underwent an isoperistaltic simple jejunal interposition. Results: The average operative time in the pylorus-preserving proximal gastrectomy group (220 minutes) was shorter than that in the jejunal interposition group (243 minutes) (P<0.05). The hemoglobin and hematocrit levels were significantly higher in the pylorus-preserving proximal gastrectomy group at 2 years after the operation. The body weight ratio (postoperative body weight/preoparative body weight) in patients who had a pylorus-preserving proximal gastrectomy was significantly higher than that in patients with a jejunal interposition at 2 years after the operation. The jejunal interposition procedure had better outcomes in anastomotic site stricture, duration of hospital stay, and number of removed lymph nodes (P<0.05). Conclusions: We think that from the viewpoint of quality of life, a pylorus-preserving proximal gastrectomy, as well as a jejunal interposition, is a useful reconstruction method for early adenocarcinomas of the proximal stomach. However, stricture of the esophagogastrostomy site in the pyloruspreserving proximal gastrectomy is a common problem to be solved in the future.

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MANAGEMENT OF ORAL COMPLICATIONS IN THE PEDIATRIC POPULATION WITH CANCER (소아의 종양성 질환에 동반된 구강합병증 관리)

  • Kim, Sung-Ki;Kim, Min-Jeong;Lee, Dong-Soo;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.1
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    • pp.157-167
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    • 2009
  • The incidence of childhood cancer is greatest in the first year of life. Early diagnosis and advances in medicine have significantly improved outcomes of treatment resulting in higher survival rate; however, this progress comes at the expense of a higher incidence of adverse side effects because of more aggressive antineoplastic treatment strategies. The oral cavity, a trauma-prone environment, is extremely sensitive to toxicities from antineoplastic agents. Oral health care specialists, including pediatric and hospital dentists can support the oncology team by providing basic oral care, implementing oral care protocols, delivering emergency dental treatment, and assisting and/or managing oral complications from cancer therapy. This article covers the considerations in the dental management of pediatric patients undergoing cancer treatment, specifically chemotherapy, radiotherapy, and hematopoietic stem cell transplantation.

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Osteosarcoma in Patients Older than 40 Years (40대 이후에 발생한 골육종)

  • Rhee, Seung-Koo;Woo, Yong-Kyun;Kang, Yong-Koo;Song, Seok-Whan;Chung, Yang-Guk;Lee, An-Hi;Yoo, Jin-Young;Chung, Do-Hyun
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.3
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    • pp.169-177
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    • 1999
  • Osteosarcoma in patients older than 40 years are rare, however they have different clinical, radiological and pathological features from those of younger patients. Sometimes accurate histologic diagnosis is not easy, which is important in determining the correct surgical treatment and appropriate chemotherapy. Since January 1995, 11 patients with osteosarcoma occurring in patients older than 40 years have been diagnosed, treated and followed up for more than 6 months. In contrast to osteosarcoma in children and adolescents, only 4 cases(36.4%) were conventional types, while the others included 2 malignant fibrous histiocytoma-like types, 2 small cell types, 2 periosteal osteosarcomas and 1 giant cell-rich type. Seven cases showed purely osteolytic or predominantly osteolytic bony lesions and 8 were in Enneking stage IIB. Performed surgical treatments included 2 amputations, 6 wide resections and reconstructions, and one curettage and autogenous bone graft. In the remaining 2 cases, definitive surgical treatments included not carried out because of old age, multifocal involvement or poor medical tolerance. Neoadjuvant and adjuvant chemotherapies were performed in 9 of 11 patients. At last follow-up, there were 6 continuously disease-free survivals, 3 alive with diseases and 2 died of diseases. The overall cumulative 4-year survival rate calculated using Kaplan-Meier's productlimit method was 59.3%. For improved oncologic outcomes and survivals, early and accurate diagnosis, surgical treatment with adequate margin and neoadjuvant and adjuvant chemotherapy will be necessary.

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Primary Traumatic Anterior Shoulder Dislocation in the Middle-aged And Elderly Patients (중장년층에서의 외상성 견관절 탈구)

  • Lee Kwang-Won;Ryu Chang-Soo;Kim Ha-Yong;An Jae-Hun;Yum Jin-Sub;Kim Whoan-Jeang;Choy Won-Sik
    • Clinics in Shoulder and Elbow
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    • v.3 no.2
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    • pp.75-78
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    • 2000
  • Purpose: The purpose of this study was to review primary traumatic anterior shoulder dislocation in the 40 years and older to determine the incidence of recurrence, rotator cuff injury and associated fractures. Materials and Methods: From May, 1991 to October, 1998, seventeen patients were available to participate in the study. The average age was 55 years(range, 40 to 75 years). Follow-up averaged 27 months(range, 12 to 48 months). There were 12 men and 5 women. 10 right and 7 left shoulders were involved. Any participant with a history of shoulder pain and limitation of motion was excluded from the study. Each shoulder was evaluated with UCLA shoulder functional assessment. Results: The overall results were excellent in 9 patients(52.9%), good in 3 patients(17 .6%), fair in 3 patients(17.6%), and poor in 2 patients(11.7%). Surgical treatment of the associated rotator cuff and greater tuberosity fracture injuries resulted in 5 patients with excellent(55.6%), 3 patients with good(33.3%) and I patient with poor(11.1 %) and Nonsurgical treatment of the associated injuries resulted in 2 patients with excellent(33.3%), 3 patients with fair(50%), 1 patient with poor(16.7%)(P=0.025). Conclusion : Our findings on small number of patients suggest that the diagnosis of a rotator cuff and other pathologies should be approached aggressively by an MRI, CT arthrogram if significant pain and weakness are still present and early surgical repair of rotator cuff and greater tuberosity can lead to restoration of shoulder function and better outcomes in selected patients.

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Clinical Results of Treatment of Distal Biceps Rupture (이두박근 원위부 파열의 임상적 치료 결과)

  • Chung, Duke-Whan;Hwang, Jung-Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.13-18
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    • 2009
  • Purpose: To report the clinical results of patients treated for a rupture of the distal tendon of biceps brachii Materials and Methods: Between February 1987 and March 2004, we treated 16 patients with a rupture of the distal tendon of biceps brachii. 9 of 16 patients underwent surgical treatment. All cases were male, median age was 26.3(range, 16-48) years. The mean interval between injury and surgery was 4.7 days (range, 1~36 days). Operative correction was performed anatomically, using the two-incision technique(3 cases) or one-incision technique(6 cases). Clinical outcomes were evaluated one year after operation by assessing the review about the physical examination finding and radiologic findings with surgical findings, range of motion, muscle strength, subjective satisfaction, activity and return to previous occupation. and via telephone interview in cases of conservative treatment. Results: In cases of surgical treatment, 85.8%, 86.3% of flexion-extension and supination-pronation motion than healthy side were measured respectively. 75% of flexion power than healthy side was measured. Eight of nine(89%) were very satisfied. Eightl of nine returned to original job. In cases of conservative treatment, 65% of flexion power than pre-injury state was reported. Four of seven were satisfied, two were dissatisfied, one was very dissatisfied. Three of seven returned to original job. Conclusion: Early anatomic reconstruction can restore more strength and endurance for supination and flexion range and power. Conservative management may be considered for partial injuries, but operative repair must be considered in complete rupture, athletes, patient with high activity.

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Delayed Transfer of Major Trauma Patients Under the Current Emergency Medical System in Korea (현재의 국내 응급의료체계에서 중증외상환자의 이송 지연)

  • Jung, Kyoung-Won;Jang, Jeong-Moon;Kim, Ji-Young;Baek, Suk-Ja;Song, Seo-Young;Gang, Chan-Suk;Lee, Kug-Jong
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.25-30
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    • 2011
  • Purpose: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. Methods: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. Results: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. Conclusion: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.

A Study on the Analysis of College Students' Learning Process : Based on the surveys in K-College (전문대학생의 학습과정 분석에 관한 연구 : K-전문대학을 중심으로)

  • Kim, Soo hyun;Bae, Yu Na;Lee, Jin-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.6
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    • pp.547-557
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    • 2017
  • This study analyzed the differences depending on gender differences, the years for graduation, college majors, and grades by the level of students' learning process about the student engagement of college students. Subjects were 684 students who responded to a student engagement survey questionnaire among the students attending the regular curriculum at the K-college located in Geoje-si. For measurement, the college students' learning process analysis scale was modified and supplemented prior to use. Frequency analysis was adopted to search individual backgrounds of college students. One-way ANOVA and Post-hoc test were conducted in order to find differences according to gender differences, the years for graduation, college majors, and grades by the level of learning process. The study results are as follows. First, the college students' learning process on gender had significant differences in involvement in and out of instruction, teaching-learning outcomes, and college facility system and service. Second, the college students' learning process according to the years for graduation had significant differences in involvement in and out of instruction, class satisfaction, and college facility system and service. Third, the college students' learning process according to major differences had significant differences in involvement in and out of instruction, study interactions, academic achievement, and college facility system and service. Fourth, the college students' learning process according to grades had significant differences in total sub-components (involvement in and out of instruction, class satisfaction, study interactions, academic achievement, and college facility system and service). Lastly, the study discussions and implications are described.

A Study on the Level of Self-regulated Learning Ability for Students attending Tutoring Program (튜터링 프로그램에 참여한 D대학 대학생들의 자기조절 학습능력 수준에 관한 조사)

  • Jeong, Hyun-Ja;Pyo, Chang-Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.1
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    • pp.170-180
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    • 2011
  • The purposes of this study are to find out the effectiveness of the tutoring program and the level of self-regulated learning ability in tutoring program attending students. This study has been performed for team-tutoring program attending students(n=183) who are in 15 department, D college in Daegu. Following results were drawn thought correlation analyses of variables obtained during the survey period. The results were as follows; There was statistically significant difference among perception controlling ability, purpose controlling ability, and action controlling ability. In over 20 ages, organization, meta-perception stratagem, arrangement, self-effectiveness, controlling learning time ability were higher than of lower 20 ages(p<0.05). In tutors, demonstration, organization, meta-perception stratagem, arrangement, checking, purpose intentions, self- effectiveness, achievement, controlling action, help requirement ability were higher than tutees(p<0.05). As results, the tutoring program was effective for both tutors and tutees in college students. Further studies in an education program for students in all years should be implemented to examine tutoring effects. Implementation of tutoring should address the frustrations and difficulties encountered by the students to facilitate better outcomes.

Preliminary clinical outcome of novel strategy for the maximization of cumulative pregnancy rates per retrieval in normal responders

  • Joo, Jong-Kil;Choi, Jong-Ryeol;Son, Jung-Bin;Ko, Gyoung-Rae;Lee, Kyu-Sup
    • Clinical and Experimental Reproductive Medicine
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    • v.39 no.1
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    • pp.33-39
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    • 2012
  • Objective: We devised a novel strategy, a GnRH antagonist protocol with a GnRH agonist trigger followed by frozen-thawed blastocyst transfers with long zona dissection (LZD). The purpose of this study was to investigate the clinical outcomes of this new strategy according to age. Methods: Ninety women aged less than 35 (group A) and 32 women aged 35 to 39 (group B) underwent the GnRH antagonist protocol with a GnRH agonist trigger in order to obtain many oocytes and prevent early-onset ovarian hyperstimulation syndrome (OHSS). All oocytes were cultured to the blastocyst stage and all blastocysts grade 3BB or better were cryopreserved. Embryo transfers were only performed in freeze-thaw cycles to prevent late-onset OHSS and to overcome embryo-endometrium dyssynchrony. LZD was performed just after thawing to improve hatching and implantation rates. Results: The average numbers of retrieved oocytes and blastocysts grade 3BB or better were $12.8{\pm}5.5$ and $4.4{\pm}2.6$ in group A and $10.9{\pm}7.4$ and $2.5{\pm}2.2$ in group B, respectively, and OHSS did not occur in any of the women. Implantation rates were 46.7% in group A and 39.3% in group B. Cumulative clinical pregnancy rates per retrieval were 77.8% in group A and 62.5% in group B. Cumulative ongoing pregnancy rates per retrieval were 71.1% in group A and 53.1% in group B. Conclusion: GnRH antagonist protocol with GnRH agonist trigger followed by frozen-thawed blastocyst transfers with LZD can generate many blastocysts without OHSS and maximize cumulative pregnancy rates per retrieval. This strategy is more effective in young women aged less than 35 than in women aged 35 to 39.

Lumbar Spinal Instability and Its Radiologic Findings (요추부 불안정증의 방사선학적 소견)

  • Yang, Kyoung Hoon;Kim, Nam Kyu;Kim, Young Soo;Ko, Yong;Oh, Seong Hoon;Oh, Suck Jun;Kim, Kwang Myung
    • Journal of Korean Neurosurgical Society
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    • v.29 no.1
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    • pp.78-86
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    • 2000
  • Objective : Lumbar spinal instability occurs when normal biomechanics support in lumbar vertebrae interrupted. Despite the recent enthusiastic studies, the precise radiological assessment has not been fully established, yet. Therefore, we carefully studied our cases to analyze the radiologic findings in lumbar spinal instability. Patients and Methods : We have put together radiological analysis and assessment based on 38 patients who have been diagnosed and treated for lumbar spinal instabilities from June 1994 to December 1998, Patients who have been diagnosed and treated for trauma were excluded from study. Results : The outcomes are as follows : 1) Lumbar lordotic curve was statistically significant in unstable group by 23.7, compared to the control group ($17.0^{\circ}$). 2) According to the resting x-ray, sagittal plane angulation measured on unstable group was $21.1^{\circ}$, control group $18.0^{\circ}$. Therefore unstable group was noticeably higher(p<0.01). 3) According to the resting x-ray sagittal plane displacement, unstable group had 4.3mm, the comparison had 1.2mm. Therefore measurement from the unstable group were significantly higher(p<0.01). 4) According to stress view, sagittal plane translation was 4.1mm for the unstables and 2.7mm for the comparisons. Therefore unstables were noticeably higher(p<0.01). 5) According to stress view, sagittal plane rotation was $15.1^{\circ}$ at L3-4, $22.0^{\circ}$ at L4-5, $27.9^{\circ}$ at L5S1 for the unstable group and $11.3^{\circ}$, $18.1^{\circ}$, $21.0^{\circ}$ each for the comparison. 6) Facet angle for unstable group, left $29.3^{\circ}-61.5^{\circ}$, right $24.4^{\circ}-63.2^{\circ}$ and the mean for each are $43.1^{\circ}$, $47.2^{\circ}$. The difference between left and right facet angle was $3.5^{\circ}-20.7^{\circ}$ and the mean value $15.3^{\circ}$. Facet angle for the comparisons for the left was $29.3^{\circ}-59.5^{\circ}$, right was in between $25.7^{\circ}-64.5^{\circ}$ range and the each mean are $44.9^{\circ}$ and $47.6^{\circ}$. Also, the difference between left and right facet angle was $4.1^{\circ}-9.3^{\circ}$ and the average was $17.1^{\circ}$. The average and the difference between the left and right angle are found not to have statistic necessity for both unstable and stable measurements(p>0.01). 7) 19 patients were found to have vacuum facet phenomenon among unstable group etc. results were collected. Conclusion : According to above results, we attempted to prepare the application to the patient of radiological analysis and assessment for lumbar spinal instability early checkup.

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