• 제목/요약/키워드: Invasiveness

검색결과 292건 처리시간 0.025초

종경동경을 이용한 요부 교감신경 절제술 (Mediastinoscopic Lumbar Sympathectomy)

  • 김동원
    • Journal of Chest Surgery
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    • 제38권3호
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    • pp.229-232
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    • 2005
  • 요부 교감 신경 절제술은 족부 다한증, 하지 혈관 질환 및 신경계 질환의 치료를 목적으로 시행되는 수술로 흉부교감 신경 절제술에 비해 수술 빈도는 많이 떨어지나, 최근의 수술 경향인 최소 침습 수술의 발달과 복강경을 이용한 요부 교감 신경 절제술이 소개되면서 관심이 증가되었다 대상 및 방법: 2003년 7월부터 2004년 12월까지 18명의 환자에서 종격동경을 이용한 요부 교감 신경 절제술을 시행하였는데 환자의 남녀비는 12:6으로 남자가 많았고 평균 연령은 24.3세였으며, 수술 부위는 12명의 족부 다한증 환자에서는 양측을 수술하였고 나머지 6명의 환자에서는 좌측 4예, 우측 2예의 수술을 시행하여 총 30예의 요부 교감 신경 절제술을 시행하였다. 결과: 평균 수술 시간은 37.2$\pm$12.5 분이었으며 수술 후 평균 재원일은 3.1$\pm$2.2일이였다. 결론: 종격동경을 이용한 요부 교감 신경 절제술은 간단하고 효과적인 수술 방법으로, 미용적인 측면과 수술 후 동통의 감소 및 수술 후 재원 기간의 단축 등의 장점이 있는 수술이라고 생각되며, 향후 더 많은 수의 환자에서 결과를 분석하여 더 나은 결과를 가져올 수 있다고 예상된다.

Indocyanine green 형광조영제의 형광발현을 위한 농도 범위 분석 (Concentration Range Analysis for Fluorescence Expression of Indocyanine Green)

  • 김용재;이다애;윤기철;김광기
    • 한국멀티미디어학회논문지
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    • 제22권12호
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    • pp.1339-1346
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    • 2019
  • In the characteristic of the brain malignant, the blood vessels and tumors have the same color and shape, and the boundary distinction is not clear, Therefore, it is difficult to observe the naked eye. Because of the high invasiveness, the risk of recurrence is high. Therefore, complete resection of the tumor is essential. The method for distinguishing the boundary between blood vessels and tumors is a fluorescence contrast method using indocyanine green (ICG), a fluorescence contrast agent. In ICG, the concentration range analysis is very important because the fluorescence expression state varies depending on the concentration. However, since the analysis result of the fluorescence expression condition is insufficient according to the current concentration, this paper proposes by analyzing the initial protocol of the concentration range. 780 nm infrared light was irradiated to the ICG sample to observe the fluorescence expression through a near infrared (NIR) camera. The wavelength is measured by using a spectrum instrument (ocean view) to observe the fluorescence expression wavelength of 811nm. As a result of analyzing the mol concentration according to each sample, the fluorescence expression range was found to be 16.15-0.16M and the optimum fluorescence concentration on the brightest part was found to be 3.23-0.81M.

The Potential Usefulness of Magnetic Resonance Guided Focused Ultrasound for Obsessive Compulsive Disorders

  • Jung, Hyun Ho;Chang, Won Seok;Kim, Se Joo;Kim, Chan-Hyung;Chang, Jin Woo
    • Journal of Korean Neurosurgical Society
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    • 제61권4호
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    • pp.427-433
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    • 2018
  • Obsessive compulsive disorder is a debilitating condition characterized by recurrent obsessive thoughts and compulsive reactions. A great portion of the obsessive compulsive disorder (OCD) patients are managed successfully with psychiatric treatment such as selective serotonin-reuptake inhibitor and cognitive behavioral psychotherapy, but more than 10% of patients are remained as non-responder who needs neurosurgical treatments. These patients are potential candidates for the neurosurgical management. There had been various kind of operation, lesioning such as leucotomy or cingulotomy or capsulotomy or limbic leucotomy, and with advent of stereotaxic approach and technical advances, deep brain stimulation was more chosen by neurosurgeon due to its characteristic of reversibility and adjustability. Gamma knife radiosurgery are also applied to make lesion targeting based on magnetic resonance (MR) imaging, but the complication of adverse radiation effect is not predictable. In the neurosurgical field, MR guided focused ultrasound has advantage of less invasiveness, real-time monitored procedure which is now growing to attempt to apply for various brain disorder. In this review, the neurosurgical treatment modalities for the treatment of OCD will be briefly reviewed and the current state of MR guided focused ultrasound for OCD will be suggested.

COX-2 Expression in Renal Cell Carcinoma and Correlations with Tumor Grade, Stage and Patient Prognosis

  • Tabriz, Hedieh Moradi;Mirzaalizadeh, Marzieh;Gooran, Shahram;Niki, Farzaneh;Jabri, Maryam
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.535-538
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    • 2016
  • Background: Cyclooxygenase 2 (COX-2) is important as an enzyme in the pathway leading to the production of prostaglandin E2 (PGE2) and arachidonic acid. This pathway is known to play a role in inflammation, tumor growth, invasiveness and metastasis, inhibition of apoptosis and angiogenesis. Inhibition of COX-2 has been shown to be a promising antitumor and antiangiogenic strategy in several tumor types, including renal cell carcinoma (RCC). Therefore, we decided to evaluate the immunohistochemical expression of this marker and its association with several clinicopathological characteristics in a series of cases. Materials and Methods: COX-2 expression was examined immunohistochemically in tumor tissues obtained from 96 patients who underwent radical (94 cases) or partial (2 cases) nephrectomy. Correlations between COX-2 expression and clinicopathologic findings including pathologic stage, nuclear grade and other indicator of prognosis were examined. Results: Of 96 tumors, 20.9% were positive for COX-2 expression. A correlation was found between COX-2 expression and tumor histological subtype (P=0.03).The papillary subtype showed maximum expression of this marker (43.8%) and the clear subtype minimum (14.7%). There were also possible links between COX-2 expression and pathologic stage, nuclear grade and nodal involvement but the results were not statistically significant (P=0.8, P= 0.14 and P=0.06, respectively). No correlation was found between COX2 expression and patient age, gender, tumor size, metastasis or survival. Conclusions: In our study, COX-2 expression was correlated with the histological subtype of RCC. Additional research is required to determine the link between COX-2 expression and prognosis and also evaluation of probable effectiveness of COX-2 inhibitor drugs in treatment of RCC patients.

Preferences and Acceptance of Colorectal Cancer Screening in Thailand

  • Saengow, Udomsak;Chongsuwiwatvong, Virasakdi;Geater, Alan;Birch, Stephen
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권6호
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    • pp.2269-2276
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    • 2015
  • Colorectal cancer (CRC) is now common in Thailand with an increase in incidence over time. Health authorities are planning to implement a nationwide CRC screening program using fecal immunochemical test (FIT) as a primary screening tool. This study aimed to estimate preferences and acceptance of FIT and colonoscopy, explore factors influencing the acceptance, and investigate reasons behind choosing and rejecting to screen before the program was implemented. Patients aged 50-69, visiting the primary care unit during the study period, were invited to join this study. Patients with a history of cancer or past CRC screening were excluded. Face-to-face interviews were conducted. Subjects were informed about CRC and the screening tests: FIT and colonoscopy. Then, they were asked for their opinions regarding the screening. The total number of subjects was 437 (86.7% response rate). Fifty-eight percent were females. The median age was 58 years. FIT was accepted by 74.1% of subjects compared to 55.6% for colonoscopy. The acceptance of colonoscopy was associated with perceived susceptibility to CRC and family history of cancer. No symptoms, unwilling to screen, healthy, too busy and anxious about diagnosis were reasons for refusing to screen. FIT was preferred for its simplicity and non-invasiveness compared with colonoscopy. Those rejecting FIT expressed a strong preference for colonoscopy. Subjects chose colonoscopy because of its accuracy; it was refused for the process and complications. If the screening program is implemented for the entire target population in Thailand, we estimate that 106,546 will have a positive FIT, between 8,618 and 12,749 identified with advanced adenoma and between 2,645 and 3,912 identified with CRC in the first round of the program.

Comparison of Clinical Outcomes of Incidental and Non-Incidental Gallbladder Cancers: A Single-Center Cross-Sectional Study

  • Cha, Byung Hyo;Bae, Jong-Myun
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권3호
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    • pp.1281-1283
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    • 2014
  • Background: Gallbladder cancer (GBC) is a rare malignancy characterized by high invasiveness and poor survival. In a nation-wide cancer survey, the age-standardized incidence rate of GBC was the highest in Jeju Island compared to 15 other provinces in Korea. The purpose of this study was to compare the clinical outcomes of GBC according to the nature of diagnosis, that is, incidental versus non-incidental. Materials and Methods: Consecutive patients who were newly diagnosed with GBC at the Digestive Disease Center and Department of Internal Medicine, Cheju Halla General Hospital, between November 2008 and November 2011, were enrolled and divided into 2 groups: incidental gallbladder cancer (IGBC) and non-incidental gallbladder cancer (NIGBC). Clinical outcomes were retrospectively compared between the two groups. Results: Seventy-nine patients were enrolled and analyzed in our study. Thirty-three (41.8%) and 46 (58.2%) were identified as IGBC and NIGBC, respectively. The proportions of patients with gallstone disease, gallbladder polyp, and cholecystectomy were significantly different between the two groups. Additionally, the median survival rate was significantly higher for patients with IGBC than for those with NIGBC (11.4, 95% confidence interval, 5.6-13.7 vs 4.0, 95% confidence interval 3.03-5.96 months; p=0.01) during a median follow-up period of 5.7 months. Conclusions: Patients with IGBC showed better clinical prognosis than those with NIGBC. Therefore, patients with gallstone disease or gallbladder polyps, major predictive risk factors for IGBC, should undergo advanced work-up for chelecystectomy.

Expression, Purification, and Biological Characterization of The Amino-Terminal Fragment of Urokinase in Pichia pastoris

  • Li, Jianping;Lin, Yuli;Zhuang, Hongqin;Hua, Zi-Chun
    • Journal of Microbiology and Biotechnology
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    • 제23권9호
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    • pp.1197-1205
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    • 2013
  • Urokinase (uPA) and its receptor (uPAR) play an important role in tumor growth and metastasis. Targeting the excessive activation of this system as well as the proliferation of the tumor vascular endothelial cell would be expected to prevent tumor neovasculature and halt the tumor development. In this regard, the amino-terminal fragment (ATF) of urokinase has been confirmed as effective to inhibit the proliferation, migration, and invasiveness of cancer cells via interrupting the interaction of uPA and uPAR. Previous studies indicated that ATF expressed in Escherichia coli was mainly contained in inclusion bodies and also lacked posttranslational modifications. In this study, the biologically active and soluble ATF was cloned and expressed in Pichia pastoris. The recombinant protein was purified to be homogenous and confirmed to be biologically active. The yield of the active ATF was about 30 mg/l of the P. pastoris culture medium. The recombinant ATF (rATF) could efficiently inhibit angiogenesis, endothelial cell migration, and tumor cell invasion in vitro. Furthermore, it could inhibit in vivo xenograft tumor growth and prolong the survival of tumor-bearing mice significantly by competing with uPA for binding to cell surfaces. Therefore, P. pastoris is a highly efficient and cost-effective expression system for large-scale production of biologically active rATFs for potential therapeutic application.

Minimally Invasive Lumbar Spinal Decompression : A Comparative Study Between Bilateral Laminotomy and Unilateral Laminotomy for Bilateral Decompression

  • Kim, Seok-Won;Ju, Chang-Il;Kim, Chong-Gue;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • 제42권3호
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    • pp.195-199
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    • 2007
  • Objective : Bilateral laminotomy and unilateral laminotomy for bilateral decompression are becoming the minimally invasive procedures for lumbar spinal stenosis (LSS). With the aim of less invasiveness and better preservation of spinal stability. these techniques have been developed. But there are no large randomized studies to show the surgical results between these two techniques. The objective of this study was to examine the safety and efficacy of these two minimally invasive techniques. Methods : A total of 80 patients were included in this study (Group I : bilateral laminotomy, Group II : Unilateral laminotomy for bilateral decompression). Perioperative parameters and complications were analyzed. Symptoms and scores such as visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, and SF-36 scores of prospectively accrued patients were assessed preoperatively and at 1 month and 12 months after surgery. Paired-t test, two-sample student-t tests, and non parametric tests were used to determine cross-sectional differences between two groups. Results : No major complications such as spinal instability or deaths occurred during follow-up periods. VAS, ODI scores and SF-36 body pain and physical function scores showed statistically significant improvements in both groups (p<0.001). The significant widening of the spinal canal diameter was also noted in both groups. But, in Group II. there were minor postoperative complications such as dural tear (2 cases 5.0%), fracture of ipsilateral inferior facet (1 case 2.5%), and 5 cases of transient leg symptoms of contralateral side. Conclusion : Both bilateral laminotomy and unilateral laminotomy for bilateral decompression allow achievement of adequate and long-lasting operative results in patients with LSS. But postoperative complications are more frequent in Group II (unilateral laminotomy and bilateral decompression). These results indicate that bilateral laminotomy is the preferred minimally invasive technique to treat symptomatic LSS.

전방 경추 미세 추간공 확대술 : 경추증에 대한 최소침습적 전측방 접근법 (Anterior Cervical Microforaminotomy : A Minimally Invasive Anterolateral Approach for Spondylotic Lesions)

  • 박성진;하호균;정호;이상걸;박문선
    • Journal of Korean Neurosurgical Society
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    • 제29권1호
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    • pp.87-94
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    • 2000
  • Objective : Various surgical approaches have been implemented to fulfill the ideal goals of treatment for cervical spondylotic lesions. Conventional approaches are represented by anterior approach with or without fusion and posterior approach. The authors has applied newly developed anterior cervical microforaminotomy for these lesions on minimally invasive basis. Materials and Method : Twenty-one patients, with cervical HIVD, or stenosis, or both, underwent anterior cervical microforaminotomy between March, 1998 and April, 1999. Fifteen patients underwent unilateral decompression, and 6 bilateral decompression via unilateral foraminotomy. Operation of one level was performed in 16 patients, 2 levels in 4 patients, and 3 in 1 patient. The foraminotomy was accomplished by resecting the uncovertebral joint. Through this hole, compressed nerve root was decompressed by removing the spondylotic spur or disc fragment, and diagonal removing of posterior osteophyte from foraminotomy site to begining of contralateral nerve root made spinal cord decompression. Results : The outcome was excellent in 17 patients(81%) and good in 4 patients(19%) based on Odom's criteria. No complication was encounterd, and average post-operation hospital stay was 3.7 days. Conclusions : These results indicate that anterior cervical microforaminotomy provide adequate neural decompression, minimum postoperative discomfort and fast recovery.

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정상견 무릎의 관절경 검사소견 (Arthroscopic Findings of the Canine Stifle Joint)

  • 정순욱;정월순
    • 한국임상수의학회지
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    • 제16권2호
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    • pp.300-308
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    • 1999
  • Arthroscopy is a valuable diagnostic and operative tool in equine and human orthopedics. The arthroscope is a difficult instrument to use and requires patience, practice, and persistence in order to obtain good results. This technique was found to be less traumatic than arthrotomy, invasiveness, rapid recovery and the feasibility of surgically correcting many arthropathies. The use of the arthroscope in the dog provides a new dimension in the study and diagnosis of joint derangements. The purpose of this report is to introduce the use of the arthroscope in the dog-more specifically, in the stifle of the dog. A diameter 2.7 mm fore-oblique viewing arthroscope, cold light source, video and video printer are used. With the fore-oblique viewing type it is possible to view directly as well as slightly to the side and the range of viewing can be increased by rotating the arthroscope around the object The scope is connected with a cold light source by means of a fiber-optic light guide. The stifle joint was flexed to 20~30$^{\circ}$. The joint were lavaged with lactated Ringer's solution during arthroscopic examination. Arthroscopy of the stifle was performed prior to arthrotomy in 1 dead dog and 4 healthy dogs, and other 3 dogs was performed only arthroscopic examination. In this study only the conventional approaches were used and in most cases it was possible to view all the intra-articular structures via the lateral infrapatellar approach. In the stifle joint, endoscopic observation was performed to find lateral femoral condyle, patella, medial femoral condyle, trochlear groove, tibia, fat, cranial cruciate ligament, caudal cruciate ligament lateral meniscus, tendon of long digital extensor muscle, medial meniscus, and medial collateral ligament Post-arthroscopic examination, the lameness had disappeared within 12~24 hours. Pain and swelling in the stifle joint had disappeared within 24~36 hours. Post-arthroscopic secondary infection was never encountered in the dogs. In conclusion, arthroscopic insertion technique in canine stifle joint using a diameter 2.7 mm 30$^{\circ}$ arthroscope was established and arthroscopical views of all anatomical structures in the normal stilfe joint were obtained through lateral infrapatellar portal.

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