• Title/Summary/Keyword: Early treatment

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Early Reconstruction of Orbital Roof Fractures: Clinical Features and Treatment Outcomes

  • Kim, Jin-Woo;Bae, Tae-Hui;Kim, Woo-Seob;Kim, Han-Koo
    • Archives of Plastic Surgery
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    • v.39 no.1
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    • pp.31-35
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    • 2012
  • Background : Orbital roof fractures are frequently associated with a high energy impact to the craniofacial region, and displaced orbital roof fractures can cause ophthalmic and neurologic complications and occasionally require open surgical intervention. The purpose of this article was to investigate the clinical features and treatment outcomes of orbital root fractures combined with neurologic injuries after early reconstruction. Methods : Between January 2006 and December 2008, 45 patients with orbital roof fractures were admitted; among them, 37 patients were treated conservatively and 8 patients underwent early surgical intervention for orbital roof fractures. The type of injuries that caused the fractures, patient characteristics, associated fractures, ocular and neurological injuries, patient management, and treatment outcomes were investigated. Results : The patients underwent frontal craniotomy and free bone fragment removal, their orbital roofs were reconstructed with titanium micromesh, and associated fractures were repaired. The mean follow up period was 11 months. There were no postoperative neurologic sequelae. Postoperative computed tomography scans showed anatomically reconstructed orbital roofs. Two of the five patients with traumatic optic neuropathy achieved full visual acuity recovery, one patient showed decreased visual acuity, and the other two patients completely lost their vision due to traumatic optic neuropathy. Preoperative ophthalmic symptoms, such as proptosis, diplopia, upper eyelid ptosis, and enophthalmos were corrected. Conclusions : Early recognition and treatment of orbital roof fractures can reduce intracranial and ocular complications. A coronal flap with frontal craniotomy and orbital roof reconstruction using titanium mesh provides a versatile method and provides good functional and cosmetic results.

Chronological Changes in the Clinical Features of Gastric Cancer (위암의 시대적 변화)

  • Lee Chun-Hwan;Lee Sun-Il;Ryu Keun-Won;Mok Young-Jae
    • Journal of Gastric Cancer
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    • v.1 no.3
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    • pp.161-167
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    • 2001
  • Purpose: Although gastric carcinomas occur throughout the world and the incidence is on the decrease, they remain the most common type of carcinoma in Korea. Significant advancements in the diagnostics and the surgical treatment of gastric carcinomas have been achieved during the last three decades. The present retrospective study was undertaken to investigate the chronological changes in the clinical features, including clinicopathological findings, operative treatment, and prognosis of gastric carcinomas. Materials and Methods: A total of 1973 patients with a primary gastric adenocarcinoma who had been treated surgically during the period from 1983 to 1998 at the Department of Surgery, Korea University College of Medicine, were divided into two groups to evaluate chronological changes: 1007 patients had been treated during the period from 1983 to 1992 (early period) and 966 patients during the period from 1993 to 1998 (late period). Chronological changes in age, sex, ratio of early gastric cancer (EGC), and resectability were analyzed in all 1973 cases. For the 1755 resected cases, we also studied the chronological changes in the clinicopathological and treatment factors between the early-period (n=894) and the late-period (n=867) groups. Results: There were significant differences between the two periods with regard to age and ratio of EGC: EGC was more frequent in the late period. Univariate analysis of resected cases showed that gross type, tumor size, depth of invasion, UICC stage, and histological type were statistically significant. The analysis of the treatment factors revealed that total gastrectomies and extended lymphadenectomies were more frequent during the late period. The number of lymph nodes dissected was $26.0\pm12.7$ in the early period and $33.4\pm14.1$ in the late period (p<0.01). The 5-year survival rate in all cases was $51.4\%$ in the early period and $55.9\%$ in the late period. The stage-related survival rates (UICC 4th Ed., 1987) in the early vs. the late periods were $92.9\%\;vs.\;95.5\%$ in stage IA, $82.1\%\;vs.\;91.1\%$ in stage IB, $76.5\%\;vs.\;73.1\%$ in stage II, $46.5\%\;vs.\;52.1\%$ in stage IIIA, $14.5\%\;vs.\;33.6\%$ in stage IIIB, and $2.8\%\;vs.\;8.8\%$ in stage IV. There was a statistically significant difference in survival between stage IIIB and IV. Conclusion: These results suggest that the differences in the clinicopathological findings are related primarily to the increased number of early gastric cancer cases in the late period and that the improved survival noted during the late period for in stage IIIB and IV cancers might be related to extended surgery.

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Effects of pregnancy serum and scriptaid on development in early partheno embryo

  • Oh, Min-Gee;Jung, Na-Hyeon;Kim, Dae-Seung;Yoon, Jong-Taek
    • Journal of Animal Reproduction and Biotechnology
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    • v.35 no.2
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    • pp.163-170
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    • 2020
  • Partheno Embryo's research is known to play a very important role in identifying the development of embryonic cells or analyzing the genetic mechanisms of embryonic development, but the information on apoptosis formed during the early stage of development on Partheno Embryo is very little. Therefore, this study analyzed whether the embryonic cell death of unit embryos can be inhibited by adding Scriptaid, one of HDACi, which plays a role in demethylation of histone proteins as a method of regulating the cell cycle in the early embryo development of Partheno Embryo. As a result, the differentiation rate was higher in the group that added Scriptaid and FBS, but the cellular development was higher in the group that added pregnant serum to Scriptaid. As a result of analyzing the expression of the gene through IF and PCR, the group with the addition of gestational serum increased the expression of BCL2 and PCNA, which affects the anti-Casp3 action in cell survival. In addition, it is interpreted that treatment of Scriptaid for 16 hours, rather than 24 h treatment lowers the expression of Casp-3, a representative factor of apoptosis, and also increases embryonic development, thus affecting early embryo development. Therefore, it is concluded that the 16-hour treatment of Scriptaid and the use of gestational serum will inhibit cell death in the early embryonic development and increase the development rate of the embryo.

Time to presentation and mortality outcomes among patients with diabetes and acute myocardial infarction

  • Min-A Shin;Seok Oh;Min Chul Kim;Doo Sun Sim;Young Joon Hong;Ju Han Kim;Youngkeun Ahn;Myung Ho Jeong
    • The Korean journal of internal medicine
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    • v.39 no.1
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    • pp.110-122
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    • 2024
  • Background/Aims: Due to limited real-world evidence on the association between time to presentation (T2P) and outcomes following acute myocardial infarction and diabetes (AMI-DM), we investigated the characteristics of patients with AMI-DM and their outcomes based on their T2P. Methods: 4,455 patients with AMI-DM from a Korean nationwide observational cohort (2011-2015) were divided into early and late presenters according to symptom-to-door time. The effects of T2P on three-year all-cause mortality were estimated using inverse probability of treatment weighting (IPTW) and survival analysis. Results: The incidence of all-cause mortality was consistently higher in late presenters than in early presenters (11.4 vs. 17.2%; p < 0.001). In the IPTW-adjusted dataset, the incidence of all-cause mortality was numerically higher in late presenters than in early presenters (9.1 vs. 12.4%; p = 0.072). In the survival analysis, the cumulative incidence of all-cause mortality was significantly higher in late presenters than in early presenters before and after IPTW. In the subgroup with ST-elevation myocardial infarction, late presenters had a higher incidence of cardiac death than early presenters before (4.8 vs. 10.5%; p < 0.001) and after IPTW (4.2 vs. 9.7%; p = 0.034). In the initial glycated hemoglobin (HbA1c)-stratified analysis, these effects were attenuated in patients with HbA1c ≥ 9.0% before (adjusted hazard ratio [HR]: 1.45, 95% confidence interval [CI]: 0.80-2.64) and after IPTW (adjusted HR: 0.82, 95% CI: 0.40-1.67). Conclusions: Late presentation was associated with higher mortality in patients with AMI-DM; therefore, multifaceted and systematic interventions are needed to decrease pre-hospital delays.

A Survey on Treatment Trend for Allergic Rhinitis in Korean Medicine Clinic (알레르기 비염의 한의 진료 현황 설문조사)

  • Kim, Young-Eun;Jeong, Ui-Min;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.4
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    • pp.75-96
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    • 2017
  • Objectives : The purpose of this study was to investigate the treatment trend for allergic rhinitis in Korean Medicine. Methods : We conducted an online survey for Korean Medicine Doctors who were registered in the association of Korean Medicine. The questionnaire was consisted of patient characteristics, diagnosis status, treatment status, and future research needs. Results : Data from total of 396 respondents were analyzed. More than 70% of the patient came to the Korean Medicine Clinic after visiting the Western Medicine Clinic in 43.9% of the respondents. 55.6% of the respondents performed combination therapy. History taking, nasal examination, x-ray, and Korean Medicine diagnostic test were used for diagnosis. The mean duration of treatment ranged from $4.9{\pm}2.91$ to $15.2{\pm}8.45$ for pediatric and early childhood patients and from $17.5{\pm}16.15$ to $5.3{\pm}3.85$ weeks for adolescents and adult patients. The mean number of treatment times was from $9.8{\pm}7.00$ to $33.5{\pm}24.45$ for pediatric and early childhood patients and from $10.8{\pm}11.55$ to $40.4{\pm}48.18$ times for adolescents and adult patients. 64.5%, 48.0%, and 91.2% of the respondents used herbal medication in national health insurance coverage, herbal medication uninsured in health insurance and herbal prescription filled at each medical institution, respectively for pediatric and early childhood patients and 67.6%, 42.8% and 86.1% for adolescents and adult patients. 36.9% and 36.4% of respondents answered that the study of acupuncture and herbal medicine are needed preferentially. Conclusions : The results of this survey will be used to develop clinical practice guideline that reflect actual clinical practice.

The Role of Artificial Intelligence in Gastric Cancer: Surgical and Therapeutic Perspectives: A Comprehensive Review

  • JunHo Lee;Hanna Lee ;Jun-won Chung
    • Journal of Gastric Cancer
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    • v.23 no.3
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    • pp.375-387
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    • 2023
  • Stomach cancer has a high annual mortality rate worldwide necessitating early detection and accurate treatment. Even experienced specialists can make erroneous judgments based on several factors. Artificial intelligence (AI) technologies are being developed rapidly to assist in this field. Here, we aimed to determine how AI technology is used in gastric cancer diagnosis and analyze how it helps patients and surgeons. Early detection and correct treatment of early gastric cancer (EGC) can greatly increase survival rates. To determine this, it is important to accurately determine the diagnosis and depth of the lesion and the presence or absence of metastasis to the lymph nodes, and suggest an appropriate treatment method. The deep learning algorithm, which has learned gastric lesion endoscopyimages, morphological characteristics, and patient clinical information, detects gastric lesions with high accuracy, sensitivity, and specificity, and predicts morphological characteristics. Through this, AI assists the judgment of specialists to help select the correct treatment method among endoscopic procedures and radical resections and helps to predict the resection margins of lesions. Additionally, AI technology has increased the diagnostic rate of both relatively inexperienced and skilled endoscopic diagnosticians. However, there were limitations in the data used for learning, such as the amount of quantitatively insufficient data, retrospective study design, single-center design, and cases of non-various lesions. Nevertheless, this assisted endoscopic diagnosis technology that incorporates deep learning technology is sufficiently practical and future-oriented and can play an important role in suggesting accurate treatment plans to surgeons for resection of lesions in the treatment of EGC.

Deep Brain Stimulation of the Globus Pallidus in a 7-Year-Old Girl with DYT1 Generalized Dystonia

  • Jin, Seon Tak;Lee, Myung Ki;Ghang, Ju Young;Jeon, Seong Man
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.261-263
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    • 2012
  • The experience of pediatric deep brain stimulation (DBS) of the globus pallidus internus (GPi) in the treatment of early-onset DYT1 generalized dystonia is still limited. Here, we report the surgical experience of bilateral GPi-DBS under general anesthesia by using microelectrode recording in a 7-year-old girl with early-onset DYT1 generalized dystonia. Excellent improvement of her dystonia without neurological complications was achieved. This case report demonstrates that GPi-DBS is an effective and safe method for the treatment of medically refractory early-onset DYT1 generalized dystonia in children.

Using a Genetic-Fuzzy Algorithm as a Computer Aided Breast Cancer Diagnostic Tool

  • Alharbi, Abir;Tchier, F;Rashidi, MM
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3651-3658
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    • 2016
  • Computer-aided diagnosis of breast cancer is an important medical approach. In this research paper, we focus on combining two major methodologies, namely fuzzy base systems and the evolutionary genetic algorithms and on applying them to the Saudi Arabian breast cancer diagnosis database, to aid physicians in obtaining an early-computerized diagnosis and hence prevent the development of cancer through identification and removal or treatment of premalignant abnormalities; early detection can also improve survival and decrease mortality by detecting cancer at an early stage when treatment is more effective. Our hybrid algorithm, the genetic-fuzzy algorithm, has produced optimized systems that attain high classification performance, with simple and readily interpreted rules and with a good degree of confidence.

Oral signs of acute leukemia for early detection

  • Lim, Hyun-Chang;Kim, Chang-Sung
    • Journal of Periodontal and Implant Science
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    • v.44 no.6
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    • pp.293-299
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    • 2014
  • Purpose: Systemic disease can manifest oral signs at an early phase, which may be crucial for the diagnosis and timing of treatment. This report describes two patients who presented with gingival enlargement as an early sign of acute leukemia. Methods: Two patients presented with oral symptoms including severe gingival enlargement. The progress of their symptoms was associated with underlying systemic disease. Results: The patients were transferred to the Department of Hematology and diagnosed with acute myelomonocytic leukemia. They received appropriate treatment and survived. Conclusions: Gingival enlargement can be caused by underlying systemic diseases. Accurate diagnosis and timely referral are important for preventing a fatal situation. It must be emphasized that some oral signs and symptoms may be closely correlated with systemic diseases.

Endoscopic Resection of Undifferentiated-type Early Gastric Cancer

  • Lee, Ayoung;Chung, Hyunsoo
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.345-354
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    • 2020
  • Early detection of gastric cancer is crucial because the survival rate can be improved through curative treatment. Although surgery and gastrectomy with lymph node dissection remain as the gold standard for curative treatment, early gastric cancer (EGC) with negligible risk of lymph node metastasis can be treated with endoscopic resection (ER), such as endoscopic submucosal dissection. Among gastric cancers, undifferentiated-type cancer is distinguished from differentiated-type cancer in various aspects in terms of clinical features and pathophysiology. The undifferentiated-type cancer is also known to be associated with an aggressive behavior and a poor prognosis. Therefore, the indication of ER for undifferentiated EGC is limited compared with differentiated-type. Recent studies have reported that ER for undifferentiated EGC is safe and shows favorable short- and long-term outcomes. However, it is necessary to understand the details of the research results and to selectively accept them. In this review, we aimed to evaluate the current practice guidelines and the short-term and long-term outcomes of ER for undifferentiated type EGC.