Park, Byung-Chan;Ryu, Min-Hee;Kim, Tae-Gon;Kim, Yong-Ha
Archives of Plastic Surgery
/
v.36
no.3
/
pp.283-288
/
2009
Purpose: Frey's syndrome is a common complication after parotid surgery and characterized by gustatory sweating and flushing in the periauricular area during meals. Although a variety of methods have been proposed to prevent this postoperative problem but they have been unsatisfactory. In this article, therefore, botulinum toxin A was used to treat nine patients with Frey's syndrome and its duration effect after injection was investigated. Methods: Nine patients became the object of study about the effect of botulinum toxins as treatment of Frey's syndrome. Age of patients ranged from 25 to 78 years (mean, 43.7 years). Six of nine patients had both symptoms of gustatory sweating and flushing. And the others had only gustatory sweating symptom. Using Minor starch iodine test, the affected skin area was detected, and it was marked by $1cm^2$ sized grid appearance. After application of EMLA cream on the gustatory sweating area, botulinum toxin A was injected intracutaneously into the affected skin area ($2.5U/cm^2$). Patients were followed up from six to fifteen months (mean, about 12 months) and asked about improvement of their symptoms. Results: The treatement with botulinum toxin A took effective within two days after injection. Six months after injection, gustatory sweating disappeared completely in all patients, and five of six patients who had gustatory flushing improved in their symptom. Last follow-up, no patients complained of recurrent gustatory sweating and flushing except one. One patient, seven months after initial injection, was retreated with botulinum toxin A because of recurrence, and the result was successful. The duration of the effect after botulinum toxin A treatment was ranged from seven to thirteen months. One patient in our series experienced the upper eyelid weakness as adverse effect, but it improved spontaneously. Conclusion: Local injection of botulinum toxin A is an effective, safe and long - lasting method for treatment of Frey's syndrome. Hereafter, however, additional study will be required to evaluate the duration effect of botulinum toxin A according to frequency in use and dosage.
Objective : Balloon kyphoplasty can effectively relieve the symptomatic pain and correct the segmental deformity of osteoporotic vertebral compression fractures. While many articles have reported on the effectiveness of the procedure, there has not been any research on the factors affecting the deformity correction. Here, we evaluated both the relationship between postoperative pain relief and restoration of the vertebral height, and segmental kyphosis, as well as the various factors affecting segmental deformity correction after balloon kyphoplasty. Methods : Between January 2004 and December 2006, 137 patients (158 vertebral levels) underwent balloon kyphoplasty. We analyzed various factors such as the age and sex of the patient, preoperative compression ratio, kyphotic angle of compressed segment, injected PMMA volume, configuration of compression, preoperative bone mineral density (BMD) score, time interval between onset of symptom and the procedure, visual analogue scale (VAS) score for pain rating and surgery-related complications. Results : The mean postoperative VAS score improvement was $4.93{\pm}0.17$. The mean postoperative height restoration rate was $17.8{\pm}1.57%$ and the kyphotic angle reduction was $1.94{\pm}0.38^{\circ}$. However, there were no significant statistical correlations among VAS score improvement, height restoration rate, and kyphotic angle reduction. Among the various factors, the configuration of the compressed vertebral body (p=0.002) was related to the height restoration rate and the direction of the compression (p=0.006) was related with the kyphotic angle reduction. The preoperative compression ratio (p=0.023, p=0.006) and injected PMMA volume (p<0.001, p=0.035) affected both the height restoration and kyphotic angle reduction. Only the preoperative compression ratio was found to be as an independent affecting factor (95% CI : 1.064-5.068). Conclusion : The two major benefits of balloon kyphoplasty are immediate pain relief and local deformity correction, but segmental deformity correction achieved by balloon kyphoplasty does not result in additional pain relief. Among the factors that were shown to affect the segmental deformity correction, configuration of the compressed vertebral body, direction of the most compressed area, and preoperative compression ratio were not modifiable. However, careful preoperative consideration about the modifiable factor, the PMMA volume to inject, may contribute to the dynamic correction of the segmental deformity.
Bafckground: Thr role and indication of surgery in the treatment of small cell lung cancer(SCLC) is currently limited and unsettled. Material and Method: We analyzed the surgical results of 9 patients with SCLC at Yosei Medical Center from January 1990 to December 1996. There were 8 males and 1 female, and their mean age was 57.2 years (range; 35-76). Preoperatively SCLC was confirmed in 5, but the other 4 cases were diagnosed as undifferentiated squamous cell carcinoma. All patients underwent pulmoinary resection(lobectomy;5, lobectomy, segmentectomy and en-bloc resection of rib;1, bilobectomy; 2, pneumonectomy;1) and mediastinal lymph node dissection. Results: There were no operative mortality with two complications(postoperative bleeding;1, arrhythmia;1). All cases were diagnosed as SCLC histologically and their TNM staging were confirmed as follows: T1N0M0;1, T2N0M0;4, T3N0M0;1, T3N1M0;1, T2N2M0; 1, T4N0M0;1. All patients had received postoperative chemotherapy, and radiotherapy was combined in 4 patients. During follow up period(range 1-63 months; mean 33.0months), there was only one metastasis to pelvic bone among 8 patients without lymph node metastasis, and all patients were alive. On the other hand, among 3 patients who had regional and/or mediastinal lymph node metastasis or T4 lesion, all patients had recurrences(local;2, brain;1), and 2 patients died. Conclusion: We suggest that the use of TNM staging is beneficial, and surgical resection should be recommended in the patients with early staged SCLC as an important treatment modality.
The Journal of the Korean bone and joint tumor society
/
v.18
no.2
/
pp.59-65
/
2012
Purpose: Multidisciplinary approaches of surgical resection and chemotherapy have been widely used for the treatment of non-metastatic osteosarcomas. We aimed to assess the effect of neoadjuvant chemotherapy for metastasis and disease-specific survival. Materials and Methods: Authors retrospectively reviewed 225 young (<30 years old) and non-metastatic osteosarcoma patients who underwent surgical resection and postoperative chemotherapy between February 1984 and July 2010. Mean age was 14.4 years old (ranged: 4-29 years old) and average follow-up period was 9.1 years (2-28 years). The patients were divided into two groups according to the application of preoperative chemotherapy. Both groups were compared with clinical characteristics, metastasis-free survival and disease-specific survival. Results: All of 225 patients, 32 patients were treated with postoperative chemotherapy and 193 patients were performed preoperative and postoperative chemotherapy. Postoperative chemotherapy group showed significantly high rate of amputation (p<0.001). Metastasis was occurred in 101 patients. Postoperative chemotherapy group indicated significant higher rate of metastasis (69% vs 41%, p=0.004) and early development of metastasis (mean: 11.5 vs 20.3 months, p=0.045) than pre-and postoperative chemotherapy group. Fifty-seven patients were died of osteosarcoma. Postoperative chemotherapy group revealed significant lower rate of 5-year disease-specific survival than pre-and postoperative chemotherapy group (51% vs 84%, p=0.001). Adult (>15 years) and large sized tumor (>8 cm) were meaningful risk factors of metastasis and disease-specific survival. Although, local recurrences were occurred in 13 patients, there was no significant difference. Conclusion: Neoadjuvant chemotherapy offers better disease-specific survival and metastasis-free survival.
The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
/
v.1
no.2
/
pp.59-72
/
1996
The stratigraphy of the Gomso-Bay tidal flat consists of basement, preHolocene oxidized unit, and Holocene tidal sequence in ascending order. The oxidized unit is a yellowish brown stiff mud of the last stadial (or subglacial) stage before 12,000 yr B.P. This yellowish brown preHolocene unit does not contain any marine fossils, but contains plant roots, plant fragments, and also vertical and horizontal microfractures indicating soil-formation when exposed. It is regarded as interfluve deposits. The Holocene tidal sequence is composed of lower mud facies (upper-flat muds), upper sand and muddy sand facies (middle to lower-flat sands). This coarsening-upward and retrograding pattern of Holocene tidal deposits reflects a Holocene sea-level rise. The plots of $\^$14/C-age versus depth of dated samples (peats and shells) show that the sea level of 7,000 yr B.P. was located about 6.5 m below the present mean sea level, and the sea levels of 4,000 yr B.P. and 2,000 yr B.P. were also situated about 3 m and 2.5 m below the present mean sea level, respectively.
Ha, Jong-Kyoung;Jeong, Hoon;Kim, Yong-Ju;Lee, Kwan-Hee;Choi, Kyoung-Eob
The Journal of the Korean bone and joint tumor society
/
v.13
no.2
/
pp.67-74
/
2007
Purpose: To evaluate association of giant cell tumors recurrence between markers of proliferation cells (MCM3, Ki-67 and HH3) Materials and Methods: Ten case of giant cell tumor of bone were reviewed. The patients were six males and four females (mean age: 33 yrs). All patients were done operation after biopsy. The radiologic grading was determined according to Enneking grading system. The immunohistochemical stains of MCM3, HH3, and Ki-67 were done with Microarray block. Results: The three cases of 10 cases (30%) were recurred at same sites. Two case of recurrence was grade II according to radiologic features. The remaining case was grade I. The expression rate of immunohistochemical markers in radiologic grade 2 and 3 were more increased than grade 1. But there was not association between radiologic grading and proliferation of tumor cells because result data was not coherence. Mean MCM3 labeling index of non-recurred case was 11.2%, recurred case was 7.2%. Ki-67 was 12% vs. 8.9%, respectively and HH3 was 66.9 % vs. 75.4%, respectively. Thus there was no association between local recurrence and immunohistochemical Ki-67, MCM3 expression rate. But HH3 marker expression rate was increased in recurred cases compared to non-recurred cases. Conclusion: Our study suggests that HH3 immunohistochemical marker can be a useful prognostic factor.
Plain 0.5% bupivacaine and hyperbaric 0.5% tetracaine were compared for spinal anesthesia in 40 patients undergoing operation of lower extremities. Lumbar puncture was performed with a 22 gauge spinal needle with the patient in the lateral recumbent position. The third lumbar interspace was chosen for the puncture, when a free flow of clear CSF was obtained, the local anesthetic solution (2.5ml of 0.5% bupivacaine or 2.0ml of hyperbaric 0.5% tetracaine) was injected at a rate of 0.1ml/sec without barbotage. After injection of anesthetics, clinical features were observed and compared between the two groups. The results were as follows : 1. The two groups were well matched for age, sex, height and weight. 2. In both groups, sensory block to $T_{12}$ dermatome was obtained within 4 minutes, mean maximal level of analgesia was $T_{6-7}$, and the mean time for maximal level was around 20 minutes. 3. The onset times of motor block were similar in both groups and complete motor block was obtained in all cases within 20 minutes. 4. The duration of analgesia above the $T_{12}$ dermatome was 3 hours, postoperative analgesia was 7 hours. These values were significantly prolonged than those of the tetracaine group(p<0.05). 5. The changes in systolic pressure in the bupivacaine group were significantly less than those of the tetracaine group(p<0.05). 6. The complications after spinal anesthesia were headache, numbness, urinary retention and backpain, and were no significant difference in both groups. From the obtained results, we concluded that plain 0.5% bupivacaine was a relatively satisfactory agent for spinal anesthesia for operation of lower extremities. The time of onset, height of block and the complications of postoperative period were similar in both groups. The advantages of plain 0.5% bupivacaine were less hypotension and long duration of analgesia.
This study evaluated the validity of a newly developed mobility protocol examining the comfort functions and requirements of personal protective equipment (PPE) for COVID-19 healthcare workers. Eight males (age: 24.7 ± 3.0 y, height: 173.4 ± 2.3 cm, and body weight 69.9 ± 3.7 kg) participated in the following three PPE conditions: (1) Plastic gown ensemble, (2) Level D ensemble, and (3) Powered air purifying respirator (PAPR) ensemble. The mobility protocol consisted of 10 different tasks in addition to donning and doffing. The 10 tasks were repeated twice at an air temperature of 25oC with 74% RH. The results showed significant differences among the three PPE conditions in mean skin temperature, local skin temperatures (the forehead, thigh, calf, and foot), clothing microclimate (the chest and back), thermal sensation, thermal comfort, and humidity sensation, while there were no significant differences in heart rate or total sweat rate. At rest, the subjects felt less warm and more comfortable in the PAPR than in the Level D condition (P<0.05). However, subjective perceptions in the PAPR and Level D conditions became similar as the tasks progressed and mean skin and leg temperature became greater for the PAPR than the Level D condition (P<0.05). An interview was conducted just after completing the mobility test protocol, and suggestions for improving each PPE item were obtained. To sum up, the mobility test protocol was valid for evaluating the comfort functions of PPE for healthcare workers and obtaining requirements for improving the mobility of each PPE item.
Objective: To investigate the feasibility of cine three-dimensional (3D) balanced steady-state free precession (b-SSFP) imaging combined with a non-local means (NLM) algorithm for image denoising in evaluating cardiac function in children with repaired tetralogy of Fallot (rTOF). Materials and Methods: Thirty-five patients with rTOF (mean age, 12 years; range, 7-18 years) were enrolled to undergo cardiac cine image acquisition, including two-dimensional (2D) b-SSFP, 3D b-SSFP, and 3D b-SSFP combined with NLM. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) of the two ventricles were measured and indexed by body surface index. Acquisition time and image quality were recorded and compared among the three imaging sequences. Results: 3D b-SSFP with denoising vs. 2D b-SSFP had high correlation coefficients for EDV, ESV, SV, and EF of the left (0.959-0.991; p < 0.001) as well as right (0.755-0.965; p < 0.001) ventricular metrics. The image acquisition time ± standard deviation (SD) was 25.1 ± 2.4 seconds for 3D b-SSFP compared with 277.6 ± 0.7 seconds for 2D b-SSFP, indicating a significantly shorter time with the 3D than the 2D sequence (p < 0.001). Image quality score was better with 3D b-SSFP combined with denoising than with 3D b-SSFP (mean ± SD, 3.8 ± 0.6 vs. 3.5 ± 0.6; p = 0.005). Signal-to-noise ratios for blood and myocardium as well as contrast between blood and myocardium were higher for 3D b-SSFP combined with denoising than for 3D b-SSFP (p < 0.05 for all but septal myocardium). Conclusion: The 3D b-SSFP sequence can significantly reduce acquisition time compared to the 2D b-SSFP sequence for cine imaging in the evaluation of ventricular function in children with rTOF, and its quality can be further improved by combining it with an NLM denoising method.
Lee, Seung Jun;Kim, Hyeon Sik;Ma, Jung Eun;Lee, Sang Min;Ham, HyunSeok;Cho, Yu Ji;Jeong, Yi Yeong;Kim, Ho Cheol;Lee, Jong Deok;Kim, Sun-Joo;Hwang, Young Sil
Tuberculosis and Respiratory Diseases
/
v.62
no.4
/
pp.270-275
/
2007
The QuantiFERON-TB Gold assay and tuberculin skin test (TST) have been useful test for diagnosing latent tuberculosis infections (LTBI). However, there are few reports on the efficacy of the QuantiFERON-TB Gold assay and TST in evaluating the response after the treatment of LTBI. This study examined the changes in the TST and QuantiFERON-TB Gold assay before and after a treatment for latent tuberculosis in health care workers (HCWs) at a local tertiary hospital. Methods: A cohort of volunteers working as nurses and doctors who underwent a TST and QuantiFERON-TB Gold assay was established. The volunteers positive for the QuantiFERON-TB Gold assay had been treated with 3 months of isoniazid (INH) and rifampin (RFP). After completing treatment, the TST and QuantiFERON-TB Gold assay were repeated. Results: Of the 48 participants (14 doctors, 34 nurses, M: F=11:37, mean $age=29.9{\pm}5.5$ years, mean employment $period=74.9{\pm}64.3$ months), 19 (39.6%) tested positive to the TST (mean induration=$19.1{\pm}9.7mm$) and 8 (16.7%) were QuantiFERON-TB Gold assay. Among them, one had active pulmonary tuberculosis. Seven volunteers were consistently positive to both the TST and QuantiFERON-TB Gold assay after being medicated with INH and RFP for 3 months. Conclusion: TST and QuantiFERON-TB Gold assay are unsuitable for evaluating the treatment response of LTBI because they were consistently positive both before and after the anti-tuberculosis medication.
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