• 제목/요약/키워드: Long-Term Follow-Up

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Extramedullary Plasmacytoma of the Sinonasal Cavity 1예 (A Case of Extramedullary Plasmacytoma of the Sinonasal Cavity)

  • 임상철;신명석
    • 대한두경부종양학회지
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    • 제22권2호
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    • pp.167-170
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    • 2006
  • Extramedullary plasmacytoma is rare tumor of plasma cell tumor, which involve soft tissue without any signs of systemic spread and occurs predominantly in the head and neck, especially the nasal cavity and the paranasal sinuses. Ten to twenty percent of extramedullary plasmacytoma have regional lymph metastasis at the time of diagnosis and approximately one third of patients with extramedullary plasmacytoma will subsequently develop multiple myeloma during long-term follow-up. Primary treatment modality is moderate-dose radiation and surgery is rarely used. Extramedullary plasmacytoma has good prognosis, but requires long-term systemic evaluation and follow-up. We report a case of extramedullary plasmacytoma of the sinonasal cavity with a review of literature.

심장 점액종의 외과적 고찰임상 경험 및 장기 성적 (Approach in the Surgical Management of Cardiac Myxoma - Clinical Experience and Long-term Result -)

  • 김응수
    • Journal of Chest Surgery
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    • 제21권3호
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    • pp.518-525
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    • 1988
  • Between 1977 and 1987, 8 patients underwent excision of cardiac myxomas at the Hanyang University Hospital. All had a left atrial myxoma. There were 4 female and 4 male patients ranging from 15 to 62 years of age. Preoperative findings consist of symptoms and signs of congestive heart failure except one. Diagnosis was confirmed by echocardiography[8 cases] and angiography[2 cases], preoperatively. A biatrial operative approach was utilized in all but 2, who were small sized. Complete excision of the tumor with a cuff of normal tissue[1 was atrial wall and 7 were atrial septum] was performed. all heart chambers were carefully explored for presence of multicentric myxomas or tumor debris. There were no operative deaths or intraoperative embolization. Follow-up has been 1/3 to 10 years. There has been 1 late death, due to recurrence and 1 patient had reoperation for mitral regurgitation due to dilatation of the annulus by a huge tumor mass. Surgical excision of the myxoma can be performed with low morbidity, and it provides excellent and sustained symptomatic relief. The recurrence rate is low, but long-term follow-up and serial echocardiography are advisable.

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수장부 다한증에 제한적 교감신경절간 절단술의 장기 고찰 (Long-term Follow-up of Limited T3 Symathicotomy in Palmar Hyperhidrosis)

  • 채진호;최봉춘;이영철
    • The Korean Journal of Pain
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    • 제14권1호
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    • pp.56-60
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    • 2001
  • Background: Conventional thoracoscopic sympathectomy or sympathicotomy is an effective method in treating localized hyperhidrosis; however, this may result in a postoperatively compensatory hyperhidrosis or facial anhidrosis in the treatment of palmar hyperhidrosis. We modified the conventional sympathicotomy by limiting the extent of nerve transection (limited T3 sympathicotomy) since May 1998. However, there are many reports of a good short-term outcome of limited T3 sympathicotomy. Therefore, we reviewed long-term follow-up of limited T3 sympathicotomy based on outcomes analysis using a questionnaire. Methods: Fifty four patients with palmar hyperhidrosis underwent a limited T3 sympathicotomy between May 1998 and March 1999 and had a complete follow-up over two years using a questionnaire (the mean follow-up was 2.6 years). The patients' postoperative satisfaction was determined by their subjective responses to the questionnaires; the degree of compensatory hyperhidrosis, the effects on foot hyperhidrosis, gustatory hyperhidrosis and facial dryness, and recurrence, and patient's satisfaction. Results: Of the total, 87% of patients had a compensatory hyperhidrosis and 3.7% of them were disabled. 31.5% of patients showed improvement in foot hyperhidrosis, while 68.5% of patients demonstrated no change or got worse. 31.5% of patients had gustatory hyperhidrosis and facial dryness and 22.2% of patients showed a mild palmar hyperhidrosis. The postoperative patients' satisfaction was significantly in 96.3% of patients. Conclusions: The limited T3 sympathicotomy is a highly effective treatment of palmar hyperhidrosis and has a low rate of postoperative compensatory hyperhidrosis, gustatory hyperhidrosis, and facial dryness.

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이오네스큐 판막의 장기 임상성 (Long-term clinical results of isolated mitral valve replacement with the Ionescu-Shiley bovine pericardial valve)

  • 김종환
    • Journal of Chest Surgery
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    • 제17권2호
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    • pp.212-222
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    • 1984
  • A total of and consecutive 291 patients underwent isolated mitral valve replacement using the Ionescu-Shiley bovine pericardial xenograft valve during the 5-year period between October 1978 and June 1983. Thirty-two patients were the children under 15 years of age. There were 15 deaths within 30 days after surgery [operative mortality, 5.2%]. All early survivors except 6 children were placed on the long-term oral anticoagulation longer than postoperative 3 months. A total follow-up period extended for 398.2 patient-years, and 12 patients died [late mortality, 4.1%, or 3.0%/patient- year]. Ten patients experienced the thromboembolic complication [2.51%/patient-year], occurring in 8 patients within the first 3 postoperative months, and 4 died. Three patients had the late prosthetic valve endocarditis [0.75%/patient-year] and 2 died. The incidence of overall valve failure according to the criteria was 3.01%/patient-year, or 12 patients, and 2 had replacement of the failed bioprostheses [primary tissue failure, 0.5%/patient-year]. The long-term survival rate was 87.8%\ulcorner2.6% at 5 years postoperatively, and 84% of the late survivors were in NYHA Class I at the end of the follow- up. The probability remaining free from thromboembolism and overall valve failure was 89.8%\ulcorner6.3% and 81.2%\ulcorner.8% at 5 years respectively. These clinical results confirm the safety of mitral valve replacement. The only remaining clinical problem is the structural and functional durability of the bovine pericardial xenograft valve, and its use in young patients may be stopped in preference to the mechanical prosthetic valves.

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Long-Term Follow-Up of the Half-Turned Truncal Switch Operation for Transposition of the Great Arteries with Ventricular Septal Defect and Pulmonary Stenosis

  • Lee, Jong Uk;Jang, Woo Sung;Lee, Young Ok;Cho, Joon Yong
    • Journal of Chest Surgery
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    • 제49권2호
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    • pp.112-114
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    • 2016
  • The half-turned truncal switch (HTTS) operation has been reported as an alternative to the Rastelli or $r{\acute{e}}paration$ $\grave{a}$ $l^{\prime}{\acute{e}}tage$ ventriculaire procedures. HTTS prevents left ventricular outflow tract (LVOT) obstruction in patients with complete transposition of the great arteries (TGA) with a ventricular septal defect (VSD) and pulmonary stenosis (PS), or in those with a Taussig-Bing anomaly with PS. The advantages of the HTTS procedure are avoidance of late LVOT or right ventricular outflow tract (RVOT) obstruction, and of overstretching of the pulmonary artery. We report the case of a patient who underwent HTTS for TGA with VSD and PS, in whom there was no LVOT obstruction and only mild aortic regurgitation and mild RVOT obstruction, including observations at 12-year follow-up. Our experience with long-term follow-up of HTTS supports a solution for late complications after the Rastelli procedure.

Longitudinal Relationships between Cigarette Smoking and Increases Risk for Incident Metabolic Syndrome: 16-year Follow-up of the Korean Genome and Epidemiology Study (KOGES)

  • Sang Shin Pyo
    • 대한의생명과학회지
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    • 제29권4호
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    • pp.355-362
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    • 2023
  • This study aimed to determine whether smoking affects the metabolic syndrome and its components through long-term follow-up. Of the 10,030 cohort subjects in the community-based Korean Genome and Epidemiology Study (KoGES) from 2001 to 2018, 2,848 people with metabolic syndrome and 4,854 people with insufficient data for analysis were excluded for this study. The study population comprised 2,328 individuals (1,123 men, 1,205 women) who were eligible for inclusion. The mean age of the participants was 49.2±7.5 years, and 21.9% were current smoker. In log rank test, current smoker had a significantly higher cumulative incidence of metabolic syndrome compared with non smoker (P<0.001). In the Cox proportional hazards model adjusted for key variables, metabolic syndrome (hazard ratio [HR] 1.57, P<0.001), high fasting glucose (HR 1.40, P<0.01), hypertriglyceridemia (HR 1.60, P<0.001), low HDL-cholesterol (HR, 1.30, P<0.01), and abdominal obesity (HR 1.32, P<0.01) in current smoker compared with non smoker were statistically significant, respectively, but not hypertension (HR 1.00, P>0.05). After adjustment for confounders, the time (P-time<0.001) and group (P-group<0.001) effects on metabolic syndrome score change were statistically significant. Furthermore, the interaction analysis of time and smoking group on the change in metabolic syndrome score was statistically significant (P-interaction<0.001). In long-term follow-up, smoking worsens metabolic syndrome.

뇌정위적 정신수술의 장기 추적 결과 (Long-term Results of Stereotactic Psychosurgery)

  • 손병철;김문찬;이철;강준기
    • Journal of Korean Neurosurgical Society
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    • 제29권4호
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    • pp.514-520
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    • 2000
  • Objective : Stereotactic psychosurgery is known as one of effective means of treating in some medically intractable psychiatric illness. However, it is unfamiliar and it's long-term clinical result has not reported in our country. The authors evaluated its long-term results of pscychosurgery and discussed its neuroanatomical basis. Methods : Since 1993, eight patients underwent stereotactic psychosurgery for medically intractable psychiatric illnesses. All were referred from psychiatrist of these disorders, one was aggressive behavior, five were obsessive-compulsive disorders(OCD), and two were depression with anxiety disorders. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior, and limbic leukotomy was done for OCD and depression with anxiety. The results of OCD were evaluated with with YBOCS(Yale-Brown obsessive compulsive scale) and VAS (visual analogue scale), CGI(clinical global impairment) in OCD, and OAS(overt aggression scale), MMS, WAIS were checked for the evaluation of aggressive behavior. Hamilton depression scale(HAMD) was used for evaluation of depression. Ventriculography was used in the first five patients and MR-guided stereotaxy was used in recent three cases for localization of target. The lesions were made with radiofrequency lesion generator. Results : With long-term follow up(mean 45 months) in five OCDs, mean YBOCS declined from 34 to 3(n=5). All returned to previous social life. In OAS scores of aggressive behavior during six-year follow up, scores declined from 8 to 2 with clinical improvement. In two patients with depression with anxiety, HAMD declined from 28.5 to 16.5(n=2). There was no operative mortality and no significant morbidity except one case of mild transient urinary incontinence. Conclusion : With these long-term results, authors assumed that stereotactic psychosurgery could be one of safe and effective mtherapeutic methods in several medically intractable psychiatric illness.

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The efficacy of selective nerve root block for the long-term outcome of postherpetic neuralgia

  • Doo, A Ram;Choi, Jin-Wook;Lee, Ju-Hyung;Kim, Ye Sull;Ki, Min-Jong;Han, Young Jin;Son, Ji-Seon
    • The Korean Journal of Pain
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    • 제32권3호
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    • pp.215-222
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    • 2019
  • Background: Several nerve blocks can reduce the incidence of postherpetic neuralgia (PHN) as well as relieve acute zoster-related pain, but the long-term outcome of PHN has not been clearly determined. This study investigated the efficacy of selective nerve root block (SNRB) for herpes zoster (HZ) on the long-term outcome of PHN. Methods: We prospectively conducted an interview of patients who had undergone an SNRB for HZ from January 2006 to December 2016 to evaluate their long-term PHN status. The relationship between the time from HZ onset to the first SNRB and the long-term outcome of PHN was investigated. Results: The data of 67 patients were collected. The patients were allocated to acute ($SNRB{\leq}14days$, n = 16) or subacute (SNRB > 14 days, n = 51) groups. The proportions of cured patients were 62.5% and 25.5% in the acute and subacute groups (P = 0.007), respectively. In logistic regression, an SNRB >14 days was the significant predictor of PHN (adjusted odd ratio, 3.89; 95% confidence interval, 1.02-14.93; P = 0.047). Kaplan-Meier analysis revealed that time from the SNRB to the cure of PHN was significantly shorter in the acute group ($2.4{\pm}0.7yr$) than in the subacute group ($5.0{\pm}0.4yr$; P = 0.003). Conclusions: An early SNRB during the acute stage of HZ (within 14 days) appears to decrease the incidence and shorten the duration of PHN, with a median of 5.0 years of follow-up.

상피하결합조직 이식술을 이용한 치근면 피개 (Root coverage with subeptithelial connective tissue grafts)

  • 송현종;장현선;김병옥
    • Journal of Periodontal and Implant Science
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    • 제37권3호
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    • pp.625-636
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    • 2007
  • Marginal tissue recession makes problems like esthetics, root caries, hypersensitivity and plaque accumulation. Request for root coverage is higer than ever, especially esthetic problems involved. So techniques for root coverage hav been developed. There are some kinds of surgical techniques using soft tissue for root coverage. For example, free gingival graft, kinds of pedicle flap, subepithelial connective tissue graft(SCTG), and so on. Subepithelial connective tissue graft has many advantage for root coverage, that is less pain on donor site, good blood supply for graft, and more esthetic result. For this reaseon, this case report was performed to evaluate the effect of root coverage using subepithelial connective tissue graft. Three patients has Miller's class I marginal tissue recession and one patients has Miller's class III marginal tissue recession. The following period is 36.5 month on average. The results are as follows: 1. Root coverage of 100% was obtained in 5 of 6 defects, and 80% was obtained in 1 of 6 defects, The mean root coverage was 96,6% in six cases on 4 patients. 2. The mean root coverage was 3.83mm and mean recession depth decreased from 4mm to 0.16mm. 3. The mean width of clinical attached gingiva increased from 1.5mm to 4mm. The mean width of gained attached gingiva after surgery was 2.5mm. 4. The mean follow up period was 36.5 months. The longest follow up period was 50 months and the shortest follow up period was 22 months. 5. The result that obtained by surgery was stable during follow up period. Within the above results, root coverage with SCTG is an effective procedure to cover marginal tissue recession defect with long term stability.