• Title/Summary/Keyword: Insufficient surgery

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Percutaneous Enteral Stent Placement Using a Transhepatic Access for Palliation of Malignant Bowel Obstruction after Surgery

  • Won Seok Choi;Chang Jin Yoon;Jae Hwan Lee
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.742-750
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    • 2021
  • Objective: To assess the safety and clinical efficacy of percutaneous transhepatic enteral stent placement for recurrent malignant obstruction in patients with surgically altered bowel anatomy. Materials and Methods: Between July 2009 and May 2019, 36 patients (27 men and 9 women; mean age, 62.7 ± 12.0 years) underwent percutaneous transhepatic stent placement for recurrent malignant bowel obstruction after surgery. In all patients, conventional endoscopic peroral stent placement failed due to altered bowel anatomy. The stent was placed with a transhepatic approach for an afferent loop obstruction (n = 27) with a combined transhepatic and peroral approach for simultaneous stent placement in afferent and efferent loop obstruction (n = 9). Technical and clinical success, complications, stent patency, and patient survival were retrospectively evaluated. Results: The stent placement was technically successful in all patients. Clinical success was achieved in 30 patients (83.3%). Three patients required re-intervention (balloon dilatation [n = 1] and additional stent placement [n = 2] for insufficient stent expansion). Major complications included transhepatic access-related perihepatic biloma (n = 2), hepatic artery bleeding (n = 2), bowel perforation (n = 1), and sepsis (n = 1). The 3- and 12-months stent patency and patient survival rates were 91.2%, 66.5% and 78.9%, 47.9%, respectively. Conclusion: Percutaneous enteral stent placement using transhepatic access for recurrent malignant obstruction in patients with surgically altered bowel anatomy is safe and clinically efficacious. Transhepatic access is a good alternative route for afferent loop obstruction and can be combined with a peroral approach for simultaneous afferent and efferent loop obstruction.

Novel Hydrophilic Taxane Analogues inhibit Growth of Cancer Cells

  • Fauzee, Nilufer Jasmine Selimah;Wang, Ya-Lan;Dong, Zhi;Li, Qian-Ge;Wang, Tao;Mandarry, Muhammad Tasleem;Lu, Xu;Juan, Pan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.563-567
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    • 2012
  • In our era there has been several anti-cancer drugs which have undergone both experimental and clinical trials; however, due to their poor solubilities, numerous side effects, insufficient bioavailability and poor compliance, many have resulted into poor outcomes. Therefore, our aim was to investigate the effects of novel hydrophilic taxanes analogues CQMU-0517 and CQMU-0519 on growth of A549 lung, SKVO3 ovary and MCF7 breast carcinoma cell lines. Different concentrations of original paclitaxel, CQMU-0517, original docetaxel and CQMU-0519 were utilized on three cell lines, where cell growth was assessed using cell culture kit-8 and flow cytometry analysis. The results unveiled that CQMU-0517 and CQMU-0519 suppressed cell growth in the three particular cell lines, cell cycle arrest being evident in the G2/M phase. Hence, the results showed that these new taxane analogues have potential and warrant future clinical trials.

A Case-control Study of unexpected Readmission in a University Hospital (비예정 재입원의 위험요인에 대한 환자-대조군 연구)

  • Yu, Seung-Hum;Oh, Hyohn-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.289-296
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    • 1999
  • Objectives: This study describes the risk factors affecting the unexpected readmission of 261 patients who were discharged from a university hospital in Seoul. Methods: This case-control study reviewed medical records of inpatients who had been discharged from a hospital between 1 August 1995 and 31 October 1995 after the treatment for general diseases. The cases were 68 patients who were readmitted unexpectedly within 28 days of discharge from an index stay, and the controls were 193 Patients who were discharged without readmission during the study period. Results: Logistic regression analysis results were as follows; Patients who had no operation during their hospital stay were more likely to be readmitted unexpectedly than patients who had operation. Patients who had 1 or 2 parts of their body being involved in treatment were more likely to be readmitted unexpectedly than patients who hand more than 3 parts of their body being involved in treatment. Patients who had complications after surgery were more likely to be readmitted unexpectedly than patients who had no complications. Insufficient discharge planning caused unexpected readmissions. Conclusions: Discharge planning education should be extended to health care providers. And the assessment of discharge planning should be evaluated. Readmission is often necessary for the treatment of related problems of originating from initial hospitalization, which causes cost problems. Unexpected readmission is preventable and the models for readmission can serve as a valuable clinical tool for high risk patients.

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Education that allows South Korean Colleges of Dentistry to teach Emergency Care

  • Kang, Jeongwan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.4
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    • pp.223-236
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    • 2016
  • As the medical environment and dental services change, the importance of educating dentists in responses to systemic emergencies is increasing. The current student-oriented education paradigm is moving towards training students in the abilities required to address the daily crises they will face, while also providing them with the ability to deliver knowledge. Before addressing a patient's situation, emergency physicians begin by diagnosing symptoms. As they must decide on the tests and treatments that are immediately required and must solve problems through interdisciplinary treatment, emergency physicians require additional skills and communication abilities besides clinical knowledge. Since dentistry colleges provide education that emphasizes the skills dentists require to treat oral diseases, they do not have sufficient time to teach emergency care. Additionally, because their professors lack expertise in pedagogy, dental students also have insufficient motivation to study the pathophysiology of systemic diseases. This review proposes a direction of teaching that can help dental students recognize problems and situations in emergency cases and that can help them develop their capability to immediately make a decision and resolve the problem. To do this, the author surveyed the educational philosophy and knowledge provided in the instructional design of clinical professors who give lectures on emergency care, and also examined the teaching methods of the learner-oriented education paradigm.

Knowledge and Practice of Patient-controlled Analgesia Use and Management among Nurses (간호사의 자가통증조절기 사용과 관리에 대한 지식 및 적용실태)

  • Park, Mi-Hyun;Kim, Tae-Im
    • The Journal of Korean Academic Society of Nursing Education
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    • v.24 no.1
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    • pp.5-15
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    • 2018
  • Purpose: The purpose of this study was to investigate the knowledge and practice of patient-controlled analgesia use and management (PCA-UM) among nurses. Methods: Data were collected from 182 nurses employed by four general hospitals having more than 300 beds in Daejeon. The data were collected using self-report questionnaires from November 4 to November 20, 2015. Collected data were analyzed using descriptive statistics, t-test, and ANOVA. Results: The average nurses' knowledge about PCA-UM was 14.8 points out of 20. PCA-UM knowledge was significantly higher for nurses with experience in PCA education (t=3.55, p<.001). Most participants (91.2%) wanted to get PCA training, 86.8% of them provided PCA education to patients after surgery. Approximately 62% of participants regularly evaluated the level of consciousness of patients with PCA. Conclusion: Findings indicate that the knowledge and practice of PCA-UM among nurses were insufficient to provide safe and effective pain management to postoperative patients with PCA. Therefore, it is concluded that it is necessary to develop standardized PCA education programs for nurses to provide safe and effective pain management to postoperative patients with PCA.

Long-term results of new deproteinized bovine bone material in a maxillary sinus graft procedure

  • Shin, Seung-Yun;Hwang, You-Jeong;Kim, Jung-Hoon;Seol, Yang-Jo
    • Journal of Periodontal and Implant Science
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    • v.44 no.5
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    • pp.259-264
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    • 2014
  • Purpose: The aim of this case report is to present the longitudinal results of sinus grafting using a new demineralized bovine bone material (DBBM) in human cases. Methods: A patient with a resorbed maxilla was treated by maxillary sinus grafting using a new deproteinized bovine bone material. After a healing period of 6.5 months, three implants were placed and restored. The patient was periodically recalled and followed up for 5 years after restoration. Results: Twelve partially edentulous patients (average age, 55.7 years) were followed up. All patients had insufficient residual height in their maxillary posterior area and underwent maxillary sinus graft surgery to increase the height of their maxilla. In all, 27 fixtures were placed in the augmented bone area. On average, 8.6 months later, implants were loaded using provisional or final restorations. The observation period ranged from 27 to 75 months (average, 43.3 months), and the patients did not show any severe resorption of the graft material or any infection during this time. Conclusions: Our results show that the new DBBM is useful for a maxillary sinus graft procedure. Good healing responses as well as reliable results were obtained for an average follow-up period of 43.3 months.

Patients' Evaluation on Foodservice in University and General Hospitals (대학병원 종합병원 입원환자의 급식에 대한 평가)

  • 이종주;최명한;이석구;이동배
    • Korean Journal of Community Nutrition
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    • v.2 no.4
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    • pp.616-623
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    • 1997
  • This study was conducted to investigate and to improve the actual condition of food service for patients in hospitals. For this purpose, questionnaires were distributed to 283 patients admitted to a university hospital and three general hospitals between January 27 and February 15, 1997. The department participated in the study included internal medicine, surgery, obstetrics, orthopedics and so forth. For meal time, 61.1$\%$ of patients wanted to eat breakfast at 8 am, 55.8$\%$ lunch at noon, and 73.5$\%$ dinner at 6 pm. The patients complained about unsatisfactory hospital food itself by 37.8$\%$, about insufficient food amount by 19.6$\%$, about menu with no choice by 41.2$\%$ and about low variety of the meals by 32.7$\%$. Sixty two point nine percent of the subjects enjoyed snacks between meals because of poor appetite at meal time(46.1$\%$), delayed food service(39.9$\%$) and others(11.2$\%$). The types of diet were mainly regular ones(58.6$\%$) with some high protein(12.4%) and diabetic sensitive ones(7.1$\%$). As eating place, the patient's prefered bed(51.9$\%$), room-table(27.2$\%$) and dining room(17.7$\%$). Fifty-five percent of them also wanted hospital foods available to their caring relatives. (Korean J Community Nutrition 2(4) : 616-623, 1997)

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Current Status of Liver Transplantation (간이식의 현재)

  • Kim, Hong-Jin
    • Journal of Yeungnam Medical Science
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    • v.18 no.1
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    • pp.1-12
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    • 2001
  • Liver transplantation is widely accepted as an effective therapeutic modality for a variety of irreversible acute and chronic liver diseases for which no satisfactory therapy is available. Following the first unsuccessful efforts at human liver transplantation in 1963, development of the procedure evolved at first slowly and steadily for 20 years and then rapidly over the past two decades. The growth of liver transplantation was facilitated by the conclusion of the national institutes of health consensus development conference in 1983 that liver transplantation is not an experimental procedure but an effective therapy that deserves broader application. The number of liver transplantations increased 2.4-fold(from 1.713 to 4.058) from 1988 to 1996. but the number of patients on the UNOS(united network of organ sharing) liver list increased 12.1-fold(from 616 to 7,467); as would be expected, the number of deaths of listed patients increased 4.9-fold(from 195 to 954), The current supply of donor livers is insufficient to meet this need, and organ donation has been stagnant or increased by only a few percent in recent years. These facts underscore the importance of the appropriate selection of candidates for liver transplantation and the development of operative procedures, such as living donor liver transplant, split liver transplant and auxiliary partial liver transplant.

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Diagnosis of Persistent Right Aortic Arch with an Aberrant Left Subclavian Artery using CT in a Poodle Dog

  • Ryu, Chan-Young;Lee, Sang-Gwan;Lee, Kija
    • Journal of Veterinary Clinics
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    • v.35 no.1
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    • pp.26-29
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    • 2018
  • A 6-month-old, female poodle presented with a three-month history of persistent regurgitation immediately after eating. On physical examination, the patient was emaciated and dehydrated. Thoracic radiography showed ventral displacement of the trachea and increased radiopacity in the mediastinum, cranial to the heart base. A severely dilated esophagus was identified cranial to the heart on esophagram. Computed tomography (CT) revealed the esophagus was filled with gas, fluid and a little of contrast and dilated from caudo-cervical to cranio-thoracic part. The esophageal diameter was markedly decreased at the heart base. In addition, the trachea was displaced to the left-ventral side of the right aortic trunk and an aberrant left subclavian artery originating from the aorta was identified. There was no evidence of abdominal vascular anomaly. Based on diagnostic imaging, persistent right aortic arch (PRAA) with an aberrant left subclavian artery was diagnosed. The patient did not undergo surgery and died at 15 days after diagnosis. This report describes imaging diagnosis, including CT and radiography in a weaned dog with regurgitation due to esophageal obstruction by PRAA. When PRAA is suspected and conventional radiography or contrast study is insufficient for diagnosis, CT may be helpful for diagnosing PRAA.

The Nevus Lipomatosus Superficialis of Face: A Case Report and Literature Review

  • Jae-Won Yang;Mi-Ok Park
    • Archives of Plastic Surgery
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    • v.51 no.2
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    • pp.196-201
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    • 2024
  • Nevus lipomatosus superficialis (NLS) is a hamartoma of adipose tissue, rarely reported in the past 100 years. We treated one case, and we conducted a systematic review of the literature. A 41-year-old man presented with a cutaneous multinodular lesion in the posterior region near the right auricle. The lesion was excised and examined histopathologically. To review the literature, we searched PubMed with the keyword "NLS." The search was limited to articles written in English and whose full text was available. We analyzed the following data: year of report, nation of corresponding author, sex of patient, age at onset, duration of disease, location of lesion, type of lesion, associated symptoms, pathological findings, and treatment. Of 158 relevant articles in PubMed, 112 fulfilled our inclusion criteria; these referred to a total of 149 cases (cases with insufficient clinical information were excluded). In rare cases, the diagnosis of NLS was confirmed when the lesion coexisted with sebaceous trichofolliculoma and Demodex infestation. Clinical awareness for NLS has increased recently. NLS is an indolent and asymptomatic benign neoplasm that may exhibit malignant behavior in terms of huge lesion size and specific anatomical location. Early detection and curative treatment should be promoted.