• 제목/요약/키워드: Extent of surgery

검색결과 603건 처리시간 0.028초

Differential effects of type 1 diabetes mellitus and subsequent osteoblastic β-catenin activation on trabecular and cortical bone in a mouse mode

  • Chen, Sixu;Liu, Daocheng;He, Sihao;Yang, Lei;Bao, Quanwei;Qin, Hao;Liu, Huayu;Zhao, Yufeng;Zong, Zhaowen
    • Experimental and Molecular Medicine
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    • 제50권12호
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    • pp.3.1-3.14
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    • 2018
  • Type 1 diabetes mellitus (T1DM) is a pathological condition associated with osteopenia. $WNT/{\beta}$-catenin signaling is implicated in this process. Trabecular and cortical bone respond differently to $WNT/{\beta}$-catenin signaling in healthy mice. We investigated whether this signaling has different effects on trabecular and cortical bone in T1DM. We first established a streptozotocin-induced T1DM mouse model and then constitutively activated ${\beta}$-catenin in osteoblasts in the setting of T1DM (T1-CA). The extent of bone loss was greater in trabecular bone than that in cortical bone in T1DM mice, and this difference was consistent with the reduction in the expression of ${\beta}$-catenin signaling in the two bone compartments. Further experiments demonstrated that in T1DM mice, trabecular bone showed lower levels of insulin-like growth factor-1 receptor (IGF-1R) than the levels in cortical bone, leading to lower $WNT/{\beta}$-catenin signaling activity through the inhibition of the IGF-1R/Akt/glycogen synthase kinase $3{\beta}$ ($GSK3{\beta}$) pathway. After ${\beta}$-catenin was activated in T1-CA mice, the bone mass and bone strength increased to substantially greater extents in trabecular bone than those in cortical bone. In addition, the cortical bone of the T1-CA mice displayed an unexpected increase in bone porosity, with increased bone resorption. The downregulated expression of WNT16 might be responsible for these cortical bone changes. In conclusion, we found that although the activation of $WNT/{\beta}$-catenin signaling increased the trabecular bone mass and bone strength in T1DM mice, it also increased the cortical bone porosity, impairing the bone strength. These findings should be considered in the future treatment of T1DM-related osteopenia.

Meningiomas with Rhabdoid or Papillary Components : Prognosis and Comparison with Anaplastic Meningiomas

  • Kim, Jeong-Kwon;Jung, Tae-Young;Jung, Shin;Lee, Kyung-Hwa;Kim, Seul-Kee;Lee, Eun Jung
    • Journal of Korean Neurosurgical Society
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    • 제59권4호
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    • pp.357-362
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    • 2016
  • Papillary and rhabdoid meningiomas are pathologically World Health Organization (WHO) grade III. Any correlation between clinical prognosis and pathologic component is not clear. We analyzed the prognoses of patients with meningiomas with a rhabdoid or papillary component compared to those of patients with anaplastic meningiomas. From 1994 to June 2013, 14 anaplastic meningiomas, 6 meningiomas with a rhabdoid component, and 5 meningiomas with papillary component were pathologically diagnosed. We analyzed magnetic resonance imaging (MRI) findings, extent of removal, adjuvant treatment, progression-free survival (PFS), overall survival (OS), and pathologic features of 14 anaplastic meningiomas (group A), 5 meningiomas with a predominant (${\geq}50%$) papillary or rhabdoid component (group B1), and 6 meningiomas without a predominant (<50%) rhabdoid or papillary component (group B2). Homogeneous enhancement on MRI was associated with improved PFS compared to heterogeneous enhancement (p=0.025). Depending on pathology, the mean PFS was $134.9{\pm}31.6\;months$ for group A, $46.6{\pm}13.4\;months$ for group B1, and $118.7{\pm}19.2\;months$ for group B2. The mean OS was $138.5{\pm}24.6\;months$ for group A and $59.7{\pm}16.8\;months$ for group B1. All recurrent tumors were of the previously diagnosed pathology, except for one tumor from group B1, which recurred as an atypical meningioma without a papillary component. Group B1 tumors showed a more aggressive behavior than group B2 tumors. In group B2 cases, the pathologic findings of non-rhabdoid/papillary portion could be considered for further adjuvant treatment.

개에서 Poly-L-lactic-acid 이식물의 생분해성과 생체적합성에 관한 연구 (Study of Bio-absorbability and Bio-compatibility of Poly-L-lactic-acid Implant in Dogs)

  • 박보영;김영기;박종윤;박종만;고필옥;장홍희;이희천;이효종;연성찬
    • 한국임상수의학회지
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    • 제24권2호
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    • pp.182-191
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    • 2007
  • Bioabsorbable devices have been utilized and experimented in many aspects of orthopaedic surgery. Depending upon their constituent polymers, these materials can be tailored to provide sufficient rigidity to allow bone healing, retain mechanical strength for certain period of time, and then eventually begin to undergo degradation. The objective of this study was to estimate extent in which Poly-L-latic acid (PLLA) implants had bioabsorbability and biocompatibility with bone and soft tissue in dogs and also to develop bioabsorbable, biocompatible materials with the appropriate strength and degradation characteristics to allow for regular clinical use for treating orthopedic problems in humans as well as animals. Eighteen dogs were used as experimental animals and were inserted two types of PLLA implants. PLLA rods were inserted into subcutaneous tissue of back or the abdomen wall. And the rods were tested for material properties including viscosity, molecular weight, melting point, melting temperature, crystallinity, flexural strength, and flexural modulus over time. PLLA screws were inserted through cortical bone into bone marrow in the femur of the dogs and stainless steel screw was inserted in the same femur. Radiographs were taken after surgery to observe locations of screw. Histological variations including cortical bone response, muscular response, bone marrow response were analyzed over the time for 62weeks. The physical properties of PLLA rods had delicate balances between mechanical, thermal and viscoelastic factors. PLLA screws did not induce any harmful effects and clinical complications on bone and soft tissue for degradation period. These results suggest that PLLA implants could be suitable for clinical use.

Computed Tomography Findings Associated with Treatment Failure after Antibiotic Therapy for Acute Appendicitis

  • Wonju Hong;Min-Jeong Kim;Sang Min Lee;Hong Il Ha;Hyoung-Chul Park;Seung-Gu Yeo
    • Korean Journal of Radiology
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    • 제22권1호
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    • pp.63-71
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    • 2021
  • Objective: To identify the CT findings associated with treatment failure after antibiotic therapy for acute appendicitis. Materials and Methods: Altogether, 198 patients who received antibiotic therapy for appendicitis were identified by searching the hospital's surgery database. Selection criteria for antibiotic therapy were uncomplicated appendicitis with an appendiceal diameter equal to or less than 11 mm. The 86 patients included in the study were divided into a treatment success group and a treatment failure group. Treatment failure was defined as a resistance to antibiotic therapy or recurrent appendicitis during a 1-year follow-up period. Two radiologists independently evaluated the following CT findings: appendix-location, involved extent, maximal diameter, thickness, wall enhancement, focal wall defect, periappendiceal fat infiltration, and so on. For the quantitative analysis, two readers independently measured the CT values at the least attenuated wall of the appendix by drawing a round region of interest on the enhanced CT (HUpost) and non-enhanced CT (HUpre). The degree of appendiceal wall enhancement (HUsub) was calculated as the subtracted value between HUpost and HUpre. A logistic regression analysis was used to identify the CT findings associated with treatment failure. Results: Sixty-four of 86 (74.4%) patients were successfully treated with antibiotic therapy, with treatment failure occurring in the remaining 22 (25.5%). The treatment failure group showed a higher frequency of hypoenhancement of the appendiceal wall than the success group (31.8% vs. 7.8%; p = 0.005). Upon quantitative analysis, both HUpost (46.7 ± 21.3 HU vs. 58.9 ± 22.0 HU; p = 0.027) and HUsub (26.9 ± 17.3 HU vs. 35.4 ± 16.6 HU; p = 0.042) values were significantly lower in the treatment failure group than in the success group. Conclusion: Hypoenhancement of the appendiceal wall was significantly associated with treatment failure after antibiotic therapy for acute appendicitis.

스파이랄 발란스 테이핑이 유방암 환자의 수술 후 후유증에 미치는 영향 : 사례연구 (The Effect of Spiral Balance Taping on Postoperative Sequelae in Breast Cancer : Case study)

  • 강수지;이대희;장철;임백빈
    • 대한통합의학회지
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    • 제12권3호
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    • pp.37-47
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    • 2024
  • Purpose : Cancer survivors often suffer from postoperative sequelae. the diagnosing and provision of manual therapy using spiral taping significantly improves the quality of life of cancer patients. The aim of this case study is to investigate the immediate effects of spiral taping on pain, range of motion (ROM), chemotherapy-induced peripheral neuropathy (CIPN), and lymphedema following breast cancer surgery. Methods : The taping techniques were performed as follows by spiral taping. The measurements were taken before, in the middle, and after taping using a mobile phone camera, tape measure, and a numerical rating score (NRS). The evaluation employed a single-group pre-post design based on a primitive experimental design. Results : Out of four patients, all four exhibited Reverse circle flow energy (RCFE), Passive cervical right (Rt) rotation test, anterior-posterior movement pattern, nerve type (+), cold energy (CE), sangcho acupuncture point, blood clot, hwal point. Comparing before and after treatment, almost all values were reduced to zero after treatment in terms of pain complaints. The lack of range of motion (ROM) caused by the shortened tissue after surgery did not increase. The range of motion (ROM) lost due to pain returned to normal. The circumference of lymphedema did not show a tendency. The symptoms of CIPN improved. Conclusion : There was a significant change in joint range of motion, with pain decreasing, but there were structural limitations in the tissue due to total resection, and the chemotherapy-induced peripheral neuropathy scale. It was effectively treated surgical site pain, axillary membrane syndrome-induced pain, and unexplained pain. While there was a treatment effect for lymphedema in the evaluation of circumference values, there was no significant change in circumference. There was a significant effect on chemotherapy-induced peripheral neuropathy, particularly in treating numbness in the feet, which is a side effect of TC anticancer drugs. This case study found that spiral balance taping provides a rapid therapeutic effect for most side effects in patients who have undergone total breast cancer resection. However, the generalization is limited due to the small sample size, and further research is needed to determine the extent to which the effects of one treatment are maintained.

내과계 중환자의 영양공급 현황 및 영양상태 변화 (Degree of Nutritional Support and Nutritional Status in MICU Patients)

  • 지수나;고재영;이수하;임은화;권국환;윤미선;김은숙
    • Journal of Nutrition and Health
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    • 제44권5호
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    • pp.384-393
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    • 2011
  • The objective of this study was to determine the nutritional support in patients treated in medical intensive care units (MICUs) by evaluating the extent of current nutritional support using the patient care plan and considering the association between nutritional status and the amount of nutrition supplied. From April to December 2010, 114 patients (age ${\qeq}$ 18 years) admitted to the MICU and who underwent nutritional support for > 5 days were included. Descriptive statistics showed that the 114 patients received nutritional support within 1.2 ${\pm}$ 0.7 days and for 16.2 ${\pm}$ 11.7 days in the MICUs. The total delivered/required caloric ratio was 81.08 ${\pm}$ 27.31%, and the protein ratio was 80.32 ${\pm}$ 28.93%. Patients who received > 80% of required calories and protein showed improved nutritional status (p < 0.05). The results showed that adequate nutritional support is crucial to critically ill patients. We suggest early nutritional screening using simple tools such as periodic monitoring and management to recalculate nutritional status and nutritional requirements and nutritional support using a multidisciplinary method. Systematic nutritional support teams are needed to provide adequate nutritional support for patients in the MICU.

S100A16 is a Prognostic Marker for Lung Adenocarcinomas

  • Saito, Keita;Kobayashi, Makoto;Nagashio, Ryo;Ryuge, Shinichiro;Katono, Ken;Nakashima, Hiroyasu;Tsuchiya, Benio;Jiang, Shi-Xu;Saegusa, Makoto;Satoh, Yukitoshi;Masuda, Noriyuki;Sato, Yuichi
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권16호
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    • pp.7039-7044
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    • 2015
  • Background: Many functional molecules controlling diverse cellular function are included in low-molecular weight proteins and peptides. Materials and Methods: To identify proteins controlling function in lung adenocarcinomas (AC), we performed two-dimensional gel electrophoresis employing tricine-SDS polyacrylamide in the second dimension (tricine 2-DE). This system was able to detect proteins under 1 kDa even with post-translational modifications. To confirm the utility of detected proteins as novel tumor markers for AC, we performed immunohistochemical analysis using 170 formalin-fixed and paraffin-embedded lung AC tissues. Results: Tricine 2-DE revealed that five proteins including S100A16 were overexpressed in lung AC-derived cells compared with lung squamous cell carcinoma, small cell carcinoma, and large cell neuroendocrine carcinoma-derived cells. Immunohistochemically, S100A16 showed various subcellular localization in lung cancer tissues and a membranous staining status was correlated with the T-factor (P=0.0008), pathological stage (P=0.0015), differentiation extent (P=0.0001), lymphatic invasion (P=0.0007), vascular invasion (P=0.0001), pleural invasion (P=0.0087), and gender (P=0.039), but not with the age or smoking history. More importantly, membranous staining of S100A16 was significantly correlated with a poorer overall survival of either stage I (P=0.0088) or stage II / III (P=0.0003) lung AC patients, and multivariate analysis confirmed that membranous expression of S100A16 was an independent adverse prognostic indicator (P=0.0001). Conclusions: The present results suggest that S100A16 protein is a novel prognostic marker for lung AC.

한국에서의 심장이식수술 - 설문조사를 중심으로 - (Brain Death and Heart Transplantation in Korea: A Questionnaire Survey)

  • 이형교;김원곤;유세영
    • Journal of Chest Surgery
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    • 제23권6호
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    • pp.1204-1212
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    • 1990
  • Recent social and medical developments have significantly changed both the concept of death and the criteria for its pronouncement. Instead of considering. the heart as central to the determination for death, it is now prevalent to use death of the brain as adequate for death regardless of cardiac function in most western countries. But the brain death theory is not yet legally accepted despite growing public interest in our country due mainly to customary and moral reasons. Subsequently heart transplantation, which necessitates the concept of brain death, still remains a possible surgical entity in the future. As a part of endeavor the evaluate social atmosphere for the legal acceptance of the concept of brain death and the availability of potential heart donors, a four-page questionnaire on brain death and cardiac transplantation was given to the sophomore students of a medical college in Seoul[n=116, group I] and their family members[n=83, group II ]. The groups were chosen under the assumptions that they lacked sophisticated medical knowledge but had general medical interest so reliable data could be obtained. The majority of respondents in both group I and II thought that they knew the concept of brain death[group I 99.1%, group II 93.3%] and the definition of heart transplantation[group I 94%, group II 67.6%] at least to some extent, but only a small proportion of them was proven to have correct knowledge: brain death[74.4%, group II 39. 8%], heart transplantation[group I 31.9%, group II 30.1%]. Most respondents answered in the affirmative for the legal approval of brain death[group I 87.8%, group Il 97.9%]. The possibility of medical usage of brain dead organs was the biggest reason for brain death[group I 52.9%, group Il 47.9%]. Ninety-one percent of group I and 89.1 percent of group II responded that they were willing to give permission for donating the heart of brain-dead family members. Fifty-nine percent of group I and 51.9 percent of group II wanted their own heart donated. These results suggest, despite some inherent sampling limitations, that favorable responses to brain death and heart transplantation can be obtained among the general public if they are properly informed.

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Bioactive Polyglycolic Acid (PGA) or Polylactic Acid (PLA) Polymers on Extracellular Matrix Mineralization in Osteoblast-like Mc3T3-E1 Cells

  • Cho, Young-Eun;Kim, Hye-Jin;Kim, Yong-Ha;Choi, Jae-Won;Kim, Youn-Jung;Kim, Gab-Joong;Kim, Jin-Su;Choi, Sik-Young;Kwun, In-Sook
    • Nutritional Sciences
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    • 제9권4호
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    • pp.233-239
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    • 2006
  • Porous matrices of bioactive polymers such as polyglycolic acid (PGA) or polylactic acid (PLA) can be used as scaffolds in bone tissue growth during bone repair process. These polymers are highly porous and serve as a template for the growth and organization of new bone tissues. We evaluated the effect of PGA and PLA polymers on osteoblastic MC3T3-E1 cell extracellular mineralization. MC3T3-E1 cells were cultured in a time-dependent manner -1, 15, 25d as appropriate - for the period of bone formation stages in one of the five culture circumstances, such as normal osteogenic differentiation medium, PGA-plated, fetal bovine serum (FBS)-plated, PGA/FBS-coplated, and PLA-plated For the evaluation of bone formation, minerals (Ca, Mg, Mn) and alkaline phosphatase activity, a marker for osteoblast differentiation, were measured Alizarin Red staining was used for the measurement of extracellular matrix Ca deposit During the culture period, PGA-plated one was reabsorbed into the medium more easily and faster than the PLA-plated one. At day 15, at the middle stage of bone formation, cellular Ca and Mg levels showed higher tendency in PGA- or PLA-plated treatments compared to non-plated control and at day 25, at the early late stage of bone formation, all three cellular Ca, Mg or Mn levels showed higher tendency as in order of PGA-related treatments and PLA-plated treatments, compared to control even without significance. Medium Ca, Mg or Mn levels didn't show any consistent tendency. Cellular ALP activity was higher in the PGA- or PLA-plated treatments compare to normal osteogenic medium treatment PGA-plated and PGA/FBS-plated treatments showed better Ca deposits than other treatments by measurement of Alizarin Red staining, although PLA-plated treatment also showed reasonable Ca deposit. The results of the present study suggest that biodegradable material, PGA and also with less extent for PLA, can be used as a biomaterial for better extracellular matrix mineralization in osteoblastic MC3T3-E1 cells.

관절 연골 손상의 병태 생리 (Pathophysiology of Articular Cartilage Injury)

  • 박정호
    • 대한정형외과스포츠의학회지
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    • 제4권1호
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    • pp.6-11
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    • 2005
  • 관절 연골 손상은 급성 손상과 만성 손상인 퇴행성 관절염으로 구분되며, 급성 손상은 연골 손상의 깊이에 따라서 미세 손상, 연골 골절, 골연골 골절의 세 종류로 구분할 수 있고 각 손상의 종류별로 서로 다른 양상의 치유 반응과 예후를 보인다. 만성 관절 연골 손상은 다양한 원인으로 인해서 발생하며 관절 연골의 전반적인 퇴행성 관절염의 형태를 보인다. 관절 연골 손상 시 초기 손상의 정도가 예후를 결정짓는데 가장 중요하고 이외에도 손상의 크기, 부위, 나이, 활동성, 비만 정도, 하지 정렬 상태등도 예후를 결정하는 중요한 요소들이다. 본 논문에서는 관절 연골 손상 시 발생하는 관절 연골 내의 병태 생리적 변화에 대하여 기술하고 비수술적인 치료 방법을 생역학적인 측면과 생물학적인 측면으로 구분하여 그 효과를 알아보고자 한다.

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