• Title/Summary/Keyword: Insufficient surgery

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Candida Infection in a Patient with Gastric Carcinoma; 1 Case Report (위선암에서 발견된 칸디다증 1예)

  • Chyung, Ju-Won;Yoo, Chang-Young;Cheung, Dae-Young;Hur, Hoon;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.31-35
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    • 2009
  • Most gastric candida infections have been reported in immune-insufficient patients with peptic ulcer, but there have been few reports on gastric candidiasis with malignant ulcer in the stomach. We experienced a case of candida infection with gastric carcinoma in a 72-year-old female with diabetic mellitus. The endoscopic view showed multiple whitish necrotic plaques with a huge ulcer in the body of the stomach. The pathologic findings showed that budding yeast and pseudohyphae had infiltrated through the ulcerated stomach wall and the stomach wall contained tubular adenocarcinoma. After treatment with Fluconazole medication for 14 days, the patient underwent total gastrectomy along with D2 lymph node dissection. For the final pathologic results, there was no evidence of any remnant candidiasis, and the patient was discharged without specific complications. Through our experience and with reviewing articles about gastric candidiasis, we recommend that the gastric candidiasis that is accompanied with gastric malignancy should be treated before administering definite treatments for the gastric cancer.

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Identification of Osteogenic Purmorphamine Derivatives

  • Lee, Sung-Jin;Lee, Hak-Kyo;Cho, Sung Yun;Choi, Joong-Kwon;Shin, Hea Kyeong;Kwak, Eun-Jung;Cho, Mi-Ran;Kim, Hye-Ryun;Kim, Seung-Ryol;Kim, Yong-Min;Park, Kyoung-Jin;Choi, Joong-Kook
    • Molecules and Cells
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    • v.26 no.4
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    • pp.380-386
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    • 2008
  • During embryonic and cancer development, the Hedgehog family of proteins, including Sonic Hedgehog, play an important role by relieving the inhibition of Smo by Ptc, thus activating the Smo signaling cascade. Recently, a purine compound, purmorphamine, has been reported to target the Hedgehog signaling pathway by interacting with Smo. Interestingly, both Sonic Hedgehog and purmorphamine were found to promote the osteogenic differentiation of mouse chondroprogenitor cells. However, there is insufficient information as to how the activation of this seemingly unrelated signaling pathway, either by Sonic Hedgehog or purmorphamine, contributes to osteogenesis. Using alkaline phosphatase assays, we screened 125 purmorphamine derivatives from the Korea Chemical Bank for effects on the differentiation of preosteoblast C2C12 cells. Here, we report that two purine derivatives modulate ALP activity as well as the expression of genes whose expression is known or suggested to be involved in osteogenesis.

Clinical Guidelines to Diagnose and Manage Dental Patients with Hyposalivation and Xerostomia

  • Jeong-Kui Ku;Pil-Young Yun;Sungil Jang;Won Jung;Kyung-Gyun Hwang
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.9-22
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    • 2023
  • Xerostomia is defined as the subjective complaint of dry mouth with or without hyposalivation, which is insufficient salivary secretion from salivary gland. Xerostomia can lead to multiple oral symptoms such as dental caries, halitosis, burning mouth syndrome, and oral candidiasis, which can significantly impact the well-being of patients, especially in geriatric patients who may already have compromised health. Clinical findings of xerostomia include decreased salivary flow and alterations in salivary composition. These changes can lead to various oral health problems such as dental caries, periodontitis, swallowing and speaking difficulties, taste disturbances, halitosis, mucosal diseases, and burning mouth syndrome. Recognizing these clinical manifestations is essential for early diagnosis and appropriate management. Although several reasons and risk factors have been suggested for xerostomia such as aging, chemo-radiation therapy, systemic disease, and Sjögren's syndrome, the polypharmacy is recently highlighted especially in elderly patients. Understanding the etiology and risk factors associated with xerostomia is crucial for effective management. To manage xerostomia patients, a multidisciplinary guideline should be established beyond dental care. Through this literature review, we summarized consideration for diagnostic, therapeutic, nursing essentials for the clinical guideline. By addressing the underlying causes and implementing appropriate treatment strategies, healthcare professionals can improve the quality of life for individuals suffering from xerostomia.

Current Update of Cartilage Regeneration Using Stem Cells in Osteoarthritis (골관절염에서 줄기세포를 이용한 연골 재생의 최신 지견)

  • Seon, Jong-Keun;Choi, Ik-Sun;Ko, Jee-Wook
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.478-489
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    • 2019
  • Osteoarthritis is a disease characterized by the progression of articular cartilage erosion, that increases pain during joint motion and reduces the ability to withstand mechanical stress, which in turn limits joint mobility and function. Damage to articular cartilage due to trauma or degenerative injury is considered a major cause of arthritis. Numerous studies and attempts have been made to regenerate articular cartilage. In the case of partial degenerative cartilage changes, microfracture and autologous chondrocyte implantation have been proposed as surgical treatment methods, but they have disadvantages such as insufficient mutual binding to the host cells, inaccurate cell delivery, and deterioration of healthy cartilage. Stem cell-based therapies have been developed to compensate for this. This review summarizes the drawbacks and consequences of various cartilage regeneration methods and describes the various attempts to treat cartilage damage. In addition, this review will discuss cartilage regeneration, particularly mesenchymal stem cell engineering-based therapies, and explore how to treat future cartilage regeneration using mesenchymal stem cells.

Integrin 𝛼4 Positive Subpopulation in Adipose Derived Stem Cells Effectively Reduces Infarct Size through Enhanced Engraftment into Myocardial Infarction

  • Zihui Yuan;Juan Tan;Jian Wang
    • International Journal of Stem Cells
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    • v.17 no.1
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    • pp.70-79
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    • 2024
  • The efficacy of adipose-derived stem cells (ASCs) on myocardial infarction is limited due to poor survival and engraftment. Integrin-mediated cell adhesion is a prerequisite for its survival and homing. ASCs expressed insufficient integrin 𝛼4, limiting their homing capacity. This study aims to characterize integrin 𝛼4+ ASC subpopulation and investigate their therapeutic efficacy in myocardial infarction. We used fluorescence-activated cell sorting to harvest integrin 𝛼4+ ASCs subpopulation, which were characterized in vitro and transplanted into myocardial infarction model. Positron emission tomography imaging were performed to measure infarction size. Cardiac cine magnetic resonance imaging was used to evaluate heart contractile function. Compared with the unfractionated ASCs, integrin 𝛼4+ ASCs subpopulation secreted a higher level of angiogenic growth factors, migrated more rapidly, and exhibited a stronger anti-apoptotic capacity. Vascular cell adhesion molecule-1 was obviously up-regulated at 3 days after myocardial infarction, which interacted with integrin α4 receptor on the surface of ASCs to enhance the survival and adhesion. Thus, we implanted unfractionated ASCs or integrin α4+ ASCs subpopulation into the 3-day infarcted myocardium. Integrin α4+ ASCs subpopulation exhibited more robust engraftment into the infarcted myocardium. Integrin α4+ ASCs subpopulation more effectively decreased infarct size and strengthen cardiac function recovery than did the unfractionated ASCs. Integrin α4+ ASCs subpopulation is superior to unfractionated ASCs in ameliorating ischemic myocardial damage in animal model. Mechanistically, their more robust engraftment into the infarct area, higher migratory capacity and their increased release of paracrine factors contribute to enhanced tissue repair.

Enhancing ketamine anesthesia with midazolam and fentanyl for children's ear surgery: a prospective randomized study

  • Seong Min Han;So Young Kwon;Jang Hyeok In;Jin Deok Joo
    • Journal of Yeungnam Medical Science
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    • v.41 no.3
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    • pp.207-212
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    • 2024
  • Background: Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery. Methods: This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 ㎍/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores. Results: The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group. Conclusion: Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

Evidence-based Treatment of Acute Lateral Ankle Sprain (근거에 기반한 급성 발목관절 외측 염좌의 치료)

  • Cho, Byung-Ki
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.4
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    • pp.135-144
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    • 2018
  • Acute lateral ankle sprain, which is the most common musculoskeletal injury, can be treated effectively with appropriate evidence-based initial care using PRICE (protection, rest, ice, compression, and elevation) and functional rehabilitation. Many systemic reviews reporting a high-level of evidence supporting the clinical usefulness and necessity of primary surgical repair for acute lateral ankle sprain have been insufficient. Regardless of the severity of ligament complex injuries, the surgical treatment for acute lateral ankle sprain without concomitant pathologies is not recommended and should be considered only in young professional athletes with complete ligament rupture (grade III) and severe instability.

Radiology for Ductal Carcinoma In Situ of the Breast: Updates on Invasive Cancer Progression and Active Monitoring

  • Lars J Grimm
    • Korean Journal of Radiology
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    • v.25 no.8
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    • pp.698-705
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    • 2024
  • Ductal carcinoma in situ (DCIS) accounts for approximately 30% of new breast cancer diagnoses. However, our understanding of how normal breast tissue evolves into DCIS and invasive cancers remains insufficient. Further, conclusions regarding the mechanisms of disease progression in terms of histopathology, genetics, and radiology are often conflicting and have implications for treatment planning. Moreover, the increase in DCIS diagnoses since the adoption of organized breast cancer screening programs has raised concerns about overdiagnosis and subsequent overtreatment. Active monitoring, a nonsurgical management strategy for DCIS, avoids surgery in favor of close imaging follow-up to de-escalate therapy and provides more treatment options. However, the two major challenges in active monitoring are identifying occult invasive cancer and patients at risk of invasive cancer progression. Subsequently, four prospective active monitoring trials are ongoing to determine the feasibility of active monitoring and refine the patient eligibility criteria and follow-up intervals. Radiologists play a major role in determining eligibility for active monitoring and reviewing surveillance images for disease progression. Trial results published over the next few years would support a new era of multidisciplinary DCIS care.

Peroneal Tendon Repair in Sports Injury (스포츠 손상 후 비골건 봉합술)

  • Young, Ki Won;Park, Ki Chol;Hwang, Ji Sun;Lee, Hong Seop
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.3
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    • pp.100-104
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    • 2019
  • Purpose: This study examined the clinical outcomes and assessed the average time to return to play following a peroneal tendon repair in Korean athletes. Materials and Methods: Between March 2004 and February 2017, a total of 30 athletes underwent peroneal tendon repair for a peroneal tendon tear. The indications of surgical treatment were chronic pain or intractable symptoms after a previous ankle sprain affecting sports activity refractory to conservative treatment for at least six months. The patient underwent tubulization for a longitudinal tendon rupture. Peroneus longus to peroneus brevis tenodesis was performed when tendon repair was impossible due to total rupture or multiple longitudinal rupture. Results: Twenty patients not included in this study were as follows: insufficient follow-up, previous surgery, and additional bone surgery. All 10 patients had a previous ankle sprain history, tenderness and swelling on the retromalleolar area. In the 10 patient population, there were five peroneus brevis tendon tears, three peroneus longus tendon tears, one peroneus longus and brevis tendon tear, and one peroneus brevis and superior peroneal retinaculum tear. In the 10 patients, six cases of peroneal brevis tendon repair and four cases of peroneal longus to brevis tenodesis were performed. The preoperative American Orthopaedic Foot and Ankle Society score was improved from a mean of 60.6 (standard deviation [SD], 8.64) to a mean of 90.2, postoperatively (SD, 4.4; p<0.012). The preoperative visual analogue scale was improved from a mean of 5.43 (SD, 1.2) to 0.5 (SD, 0.16), postoperatively (p<0.023). The mean length of time to return to play was 12.2 weeks (range, 8~16 weeks). Conclusion: Peroneal tendon tear can occur due to sports injuries. If there is tenderness at the retromalleolar area, the surgeon should consider a peroneal tendon lesion. Surgical repair of the peroneal tendon can be an effective treatment to help athletes to return to play.

Single and Double-row Repair in Rotator Cuff Tears (회전근 개 파열의 일열 봉합술과 이열 봉합술)

  • Park, Jin-Young;Choi, Jin-Hyung;Park, Hong-Keun;Yu, Je-Wook;Seo, Joong-Bae
    • Clinics in Shoulder and Elbow
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    • v.9 no.1
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    • pp.89-95
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    • 2006
  • Purpose: Arthroscopic repair of rotator cuff tears are many techniques that have been developed to improve the initial postoperative strength of the repair. There was a doubt that current arthroscopic cuff repairs using a single row of suture anchors reproduce insufficient area of the anatomic cuff insertion, and concerns about failure of fixation often lead surgeons to limit early motion. Newer technique of double-row repair in arthroscopic treatment may provide initial stronger fixation and more contact with bone at the repair site than single-row repair did. We studied the comparison between clinical outcomes of arthroscopic single- and double-row repair in cuff tears at 1year postoperatively. Materials and methods: We retrospectively analyzed 40 shoulders with single-row repair and 38 shoulders with double-row repair of full-thickness rotator cuff tears between May 2002 and October 2004. Out of total 78 shoulders, 42 (54%) were male patients and 36 (46%) were female patients and the mean age at surgery was 56 years. All patients were diagnosed by physical examination and MRI. At 1year' follow-up after operation, we evaluated with the ASES and the Constant scoring system, and measured muscle power of abduction, internal and external rotation of the affected shoulder then compared with each other. Results: Mean ASES scores and Constant scores in double-row repair group improved more than single-row repair group significantly at 1year postoperatively. Muscle power of abduction and internal rotation, especially abduction power, improved more significantly in double-row repair group than in single-row repair. Conclusion: Arthroscopic double-row repair for the full thickness rotator cuff tear may be a superior technique, which showed better clinical outcomes and restoration of muscle power compared with single-row repair at relatively short period of postoperative follow-up. Restoration of footprint close to normal anatomy by double-row repair seems to play an important role in the recovery of muscle strength.