• Title/Summary/Keyword: INVASIVE

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The Efficacy of Preincisional Surgical Site Infiltration of Ketorolac & Bupivacain in Minimally Invasive Thyroid Surgery: A Double Blind Study (최소침습 갑상선절제술에서 피부절개전 Ketororac과 Bupivacaine 국소주사에 의한 진통효과)

  • Chung Woung-Youn;Kim Tae-Jin;Lee Hae-Kyung;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.2
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    • pp.182-186
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    • 2000
  • The reduction of the postoperative wound pain has been a concern in recent surgery, especially in various types of minimally-invasive surgeries. This study was performed to evaluate the postoperative analgesic effect of the preincisional local anesthesia with the mixture of ketorolac(Tarasyn) and bupivacaine to the surgical site in minimally-invasive thyroid surgeries. Of 491 patients who were scheduled for minimally-invasive thyroid surgeries between October 1999 and July 2000, 244 were randomly assigned to receive a mixture of ketorolac tromethamine 15mg(0.5ml) and 0.25% bupivacaine 3ml via surgical site infiltration 3 minutes prior to the skin incision. The outcomes of these patients were compared to those of the 247 controls. Total number of patients in need of post-operative analgesic requirements(n=39, 16.0%), total dose of postoperative analgesics used($19.6{\pm}8.4mg$ of ketorolac) and Visual Analogue Pain Score(VAS, $2.6{\pm}1.2$) of the preincisional local anesthesia group were significantly lower than those of the control group(p<0.05). The mean postoperative hospital stay was $1.6{\pm}0.4$ days for the preincisional local anesthesia group versus $1.9{\pm}0.7$ days for the control group. The preincisional local infiltration of ketorolac and bupivacaine in the minimally invasive thyroidectomies reduces postoperative wound pain thus would be more beneficial to the patients.

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The Effect of Bromocriptine Treatment for Invasive Prolactinoma (침습성 프로락틴 분비 뇌하수체 선종에서 Bromocriptine의 치료효과)

  • Yang, Moon-Sool;Kim, Sun-Ho;Lim, Seung-Gil;Lee, Seung-Koo
    • Journal of Korean Neurosurgical Society
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    • v.37 no.4
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    • pp.275-281
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    • 2005
  • Objective: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. Methods: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1 month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. Results: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had $20{\sim}30%$ of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. Conclusion: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.

Minimally Invasive Treatment for Sacroiliac Dislocation in Dogs

  • Kim, Young-ung;Cho, Hyoung-sun;Kim, Sun-young;Lee, Ki-chang;Kim, Nam-soo;Kim, Min-su
    • Journal of Veterinary Clinics
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    • v.34 no.5
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    • pp.370-373
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    • 2017
  • Sacroiliac dislocation is the separation of the iliac wing from the pelvic bone and needs to be repaired by surgery. Corrective surgical methods include open reduction and minimally invasive techniques. In the present study, we used a minimally invasive surgical technique in seven dogs with sacroiliac dislocation. Five cases had unilateral sacroiliac joint luxation and two cases had bilateral sacroiliac joint luxation; all were referred to hospital after being hit by an automobile. All cases were treated with a fluoroscope-assisted, minimally invasive technique. Patients were evaluated by measuring surgery time, postoperative ambulatory time, and calculating pelvic canal diameter ratios. Surgery time was measured from initial incision to completion of skin closure. Mean surgery time was 30.6 minutes in unilateral sacroiliac joint luxation and 68 minutes in bilateral sacroiliac joint luxation. Mean preoperative pelvic canal diameter ratio was 1.22 (${\pm}0.27$), immediate postoperative pelvic canal diameter ratio was 1.26 (${\pm}0.10$), and at 2 weeks after surgery, the pelvic canal diameter ratio was 1.37 (${\pm}0.22$). All cases were ambulatory within 1 week and mean postoperative ambulatory time was 5 days. Based on the results, the use of a minimally invasive technique for correction of sacroiliac dislocation can decrease surgical time, lessen operative and postoperative burdens on patients, and provide owners with a good prognosis.

Invasive Pulmonary Aspergillosis after Influenza A Infection in an Immunocompetent Patient

  • Kwon, Oh Kyung;Lee, Myung Goo;Kim, Hyo Sun;Park, Min Sun;Kwak, Kyoung Min;Park, So Young
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.6
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    • pp.260-263
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    • 2013
  • Invasive aspergillosis has emerged as a major cause of life-threatening infections in immunocompromised patients. Recently, patients with chronic obstructive pulmonary disease, who have been receiving corticosteroids for a long period, and immunocompetent patients in the intensive care unit have been identified as nontraditional hosts at risk for invasive aspergillosis. Here, we report a case of invasive pulmonary aspergillosis after influenza in an immunocompetent patient. The patient's symptoms were nonspecific, and the patient was unresponsive to treatments for pulmonary bacterial infection. Bronchoscopy revealed mucosa hyperemia, and wide, raised and cream-colored plaques throughout the trachea and both the main bronchi. Histologic examination revealed aspergillosis. The patient recovered quickly when treated systemically with voriconazole, although the reported mortality rates for aspergillosis are extremely high. This study showed that invasive aspergillosis should be considered in immunocompetent patients who are unresponsive to antibiotic treatments; further, early extensive use of all available diagnostic tools, especially bronchoscopy, is mandatory.

Diabetes is an Important Risk Factor for Metastasis in Non-Muscle-Invasive Bladder Cancer

  • Ozer, Kutan;Horsanali, Mustafa Ozan;Gorgel, Sacit Nuri;Ozbek, Emin
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.105-108
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    • 2016
  • Background: Epidemiological evidence indicates that individuals with diabetes mellitus (DM) may have a modestly increased risk of bladder cancer. In the present study, we aimed to show any association between DM and risk of metastasis in patients with non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: We retrospectively analyzed 698 patients between January 2007 and December 2014 who were diagnosed with and underwent transurethral resection of bladder tumors (TUR-BT). Comparisons of means was conducted by independent samples t test, and relations between categorical variables were investigated by non-parametric chi-square test. A p value of 0.05 was accepted as statistically significant in comparisons. Results: We analyzed 418 patients with non muscle invasive bladder cancer. 123 of whom were diabetic and 295 non-diabetic. In diabetic patients, 13 were N1 stage and 11 M1 stage. When compared with non diabetic patients that was statistically significant (p<0.001). TNM stages were more advanced in diabetic patients (p<0.001), but concurrent CIS (p=0.1) and squamous metaplasia did not significantly differ between diabetic and non-diabetic cases (p=1). Conclusions: Diabetic patients with non-muscle-invasive bladder cancer may suffer metastases earlier than expected although they are non invasive. Therefore such patients must be followed-up carefully and early cystectomy decision may be necessary. Further prospective studies with more patients are needed to confirm these findings.

Application of Lobaplatin in Trans-catheter Arterial Chemoembolization for Primary Hepatic Carcinoma

  • Wang, Nan;Lv, Yin-Zhang;Xu, An-Hui;Huang, Yan-Rong;Peng, Ling;Li, Jia-Rui
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.647-650
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    • 2014
  • Objective: To explore the efficiency of single application of lobaplatin in tran-scatheter arterial chemoembolization (TACE) for patients with a primary hepatic carcinoma who were unable or unwilling to undergo surgery. Methods: 173 patients with primary hepatic carcinoma diagnosed by imaging or pathology were randomly divided into experimental and control groups and respectively treated with lobaplatin and pirarubicin hydrochloride as chemotherapeutic drugs for TACE. The amount of iodipin was regulated according to the tumor number and size, and then gelatin sponge or polyvinyl alcohol particles were applied for embolisms. The efficiency of treatment in the two groups was compared with reference to survival time and therapeutic response. Results: The experimental group (single lobaplatin as chemotherapy drug) was superior to control group (single pirarubicin hydrochloride as chemotherapy drug) in the aspects of survival time and therapeutic response, with statistical significance. Conclusions: Single lobaplatin can be as a chemotherapy drug in TACE and has better efficiency in the aspects of mean survival time and therapeutic response, deserving to be popularized in the clinic.

The control of invasive Candida infection in very low birth weight infants by reduction in the use of 3rd generation cephalosporin

  • Chang, Yu Jin;Choi, Il Rak;Shin, Won Sub;Lee, Jang Hoon;Kim, Yun Kyung;Park, Moon Sung
    • Clinical and Experimental Pediatrics
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    • v.56 no.2
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    • pp.68-74
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    • 2013
  • Purpose: To evaluate the effectiveness of new management policies on the incidence of invasive Candida infections Methods: This observational study involved a retrospective analysis of the patients' medical records. In total, 99 very low birth weight infants, who were admitted to the neonatal intensive care unit at Ajou University Hospital from January 2010 to December 2011, were enrolled for the study. Period I, defined as the period before the revision of management policies, comprised 57 infants; whereas, period II, defined as the period after the implementation of new management policies, comprised 42 infants. The new management policies entailed a reduction in antibiotic and histamine type 2 receptor blocker (H2 blocker) use, duration of central venous catheterization, and duration of endotracheal intubation. Results: There was a significant overall decrease in the use of antibiotics including 3rd generation cephalosporin and H2 blockers (P<0.05), and a significantly lower incidence of invasive Candida infections in period II as compared to period I (0/42 vs. 6/57, respectively; P=0.037). Comparison between infants with invasive Candida infections (n=6) and those without (n=93) showed that gestational age (odds ratio [OR], 0.909; 95% confidence interval [CI], 0.829 to 0.996; P=0.042) and the duration of 3rd generation cephalosporin use (OR, 1.093; 95% CI, 1.009 to 1.183; P=0.029) were statistically significant risk factors. Conclusion: The new management policies effectively decreased overall use of antibiotics, especially 3rd generation cephalosporin, and H2 blockers, which led to a significantly lower incidence of invasive Candida infections.

Strategy for Management of Giant Invasive Pituitary Adenoma

  • Yang, Hee-Seok;Kim, Oh-Lyong;Kim, Min-Soo;Kim, Sang-Woo;Chang, Chul-Hun;Cho, Soo-Ho
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.25-28
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    • 2005
  • Objective: Giant invasive pituitary adenoma looks histologically benign, but these tumors have an aggressive clinical course. The authors review 10 cases and discuss the results obtained and the strategy to use for the management of giant invasive pituitary adenoma. Methods: Out of a series of 155 pituitary adenomas treated surgically between 1994 and 2002, ten patients with giant invasive pituitary adenoma were selected and their clinical problems, radiologic findings, extent and invasiveness, hormonal and histologic findings and surgical results were analyzed retrospectively. Results: There were 4 male and 6 female patients, with an average age of 47 years and an average follow-up period of 42 months. The average size of tumor was 50.7mm. These tumors revealed severe invasions into surrounding structures. 8 patients underwent transsphenoidal approach(TSA) operations, 1 patient with transcranial operation and 1 patient with combined TSA and transcranial operation. In all cases, subtotal resection was performed. The histologic findings were 2 prolactinomas and 3 hormonal non-function adenomas. The therapies administered after surgical removal consisted of conventional fractionated radiotherapy (2 patients), treatment with dopamine agonists to control hyperprolactinemia (2 patients), and treatment with hormone replacement (2 patients). Conclusion: Giant invasive pituitary adenomas are characterized by different forms of expansion and invasiveness and variable clinical problems. Because of their aggressive expansion and invasiveness, there are many different strategies which can be considered for their management. The authors obtain good results by choosing conservative surgical removal and multidisciplinary treatments with serial radiological and hormonal follow-up.

Distribution of invasive alien plants on the islands of the Korean Peninsula based on flora data (식물상 자료에 기초한 한반도 도서 지역의 생태계 교란 외래식물 분포)

  • Kim, Hyun-Hee;Mizuno, Kazuharu;Kim, Da-Bin;Lee, Ho-Sang;Kong, Woo-Seok
    • Korean Journal of Environmental Biology
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    • v.38 no.3
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    • pp.392-403
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    • 2020
  • This study analyzed the distribution characteristics of invasive alien plants on the islands of the Korean Peninsula. Ten species, Rumex acetosella, Sicyos angulatus, Solanum carolinense, Ambrosia artemisiaefolia var. elatior, Ambrosia trifida, Aster pilosus, Eupatorium rugosum, Hypochaeris radicata, Lactuca scariola, and Paspalum distichum were present on 68 islands. These ecosystem-disturbing invasive alien plants appeared extensively on the islands of Gyeonggi province and Jeollanam province. The proportion of the plants on the inhabited islands (41 places, 2.15 species on average) was higher than that on the uninhabited islands (27 places, 1.07 species on average). This means that the distribution of invasive alien plants was closely related to human activity. The distribution of Ambrosia artemisiaefolia var. elatior(32 islands) and Rumex acetosella (31 islands) was the widest, and there were distinct distribution differences according to species. In the island area, the physical environment is poor compared to the mainland, and the native space is limited. Therefore, when invasive alien species enter and settle on the island, the native island plants can be damaged more than those on the mainland. In this regard, the discussion of the distribution of invasive alien plants in the island region can contribute to the conservation of biodiversity in the region.

Implementation of Non-Invasive Cerebral blood Increasing Platform using PI (혈류지수를 이용한 비침습적 대뇌혈류증가 장치의 구현)

  • Kwon, Seong-tae;Lee, Jean;Kim, Young-kil
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.9
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    • pp.1761-1770
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    • 2017
  • Treatment for cerebral blood flows is one of the most important treatments for cerebral infarction. There is a concern that the increasing number of cerebral blood flow treatments can cause multiple complications as it is invasive. To compensate for these problems, recently non-invasive cerebral blood flow increases have emerged. However, the current implementation of the non-invasive cerebral blood flow sensor raises the question of speed and accuracy. In this theses, the system aims to minimize the final cortical damage to the cerebrum by implementing a system in a completely different manner to complement the disadvantages of the existing non-invasive cerebral blood flow device. The system measure the PI of the limbs while simultaneously pressing limbs. Blood flow rate is carried out indirectly by increasing blood flow to peer pressure through the limbs in which the PI eips below a certain level. This can be used selectively in patients to increase blood flow.