• 제목/요약/키워드: Perforation Rate

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Clinical Outcomes of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients with Comorbidities

  • Natsagdorj, Enerelt;Kim, Sang Gyun;Choi, Jinju;Kang, Seungkyung;Kim, Bokyung;Lee, Eunwoo;Chung, Hyunsoo;Cho, Soo-Jeong
    • Journal of Gastric Cancer
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    • 제21권3호
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    • pp.258-267
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    • 2021
  • Purpose: As the rate of endoscopic resection for early gastric cancer (EGC) has increased in patients with comorbid diseases, it is necessary to elucidate the efficacy of endoscopic submucosal dissection (ESD) for EGC in patients with comorbidities. This study aimed to analyze the clinical outcomes of ESD for EGC in patients with comorbidities. Materials and Methods: A total of 969 patients with 1,015 lesions who underwent ESD for EGC at Seoul National University Hospital between 2010 and 2014 were analyzed. The short- and long-term clinical outcomes were evaluated according to the comorbidity status. Results: Comorbidities were observed in 558 patients (57.6%). The comorbidity group had a higher proportion of patients using antithrombotic agents (29.5% vs. 0.9%; P<0.0001). Although procedure-related complications (bleeding and perforation) were not significantly different between the two groups, the length of hospital stay was significantly longer (1.8 vs. 1.4 days, P=0.023), while survival was significantly shorter in the comorbidity group (5-year overall survival rate: 90.5% vs. 97.2%, P<0.0001; 5-year disease-specific survival rate: 97.9% vs. 100%, P=0.018; 5-year disease-free survival rate: 83.4% vs. 89.2%, P=0.007). Conclusions: Gastric ESD can be performed in patients with comorbidities without increasing the risk of complications.

심장판막 재수술: 29례 보 (Reoperations for valvular heart disease: report of 29 cases)

  • 김은기
    • Journal of Chest Surgery
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    • 제16권4호
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    • pp.498-505
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    • 1983
  • It has been over 20 years since successful operations of Cardiac valves at the Department of Thoracic and Cardiovascular surgery, college of medicine, Yonsei University. About six hundreds of patients with severely symptomatic valvular heart disease have had valve operations with complete loss or sharp decrease in their cardiac symptoms since 1956. As the number of cardiac patient increases, reoperation on valves assumes greater importance. To define the group of patients undergoing reoperations on valves and the factors influencing their survival, we have reviewed our experiences of the reoperation on valves at the Yonsei University, Severance Hospital. This is a report of 29 cases which was undergone secondary or more surgery for valvular heart disease from 1966 to 1983. The primary operations includes 159 cases of open heart surgery from 1966 to 1975 and 476 cases from 1976 to march, 1983. The secondary operations are classified into groups of secondary valvuloplasty or valvotomy [8 cases], prosthetic valve replacement following valvuloplasty or valvotomy [14 cases] and prosthetic valve rereplacement [2 case] for such as calcification, degeneration and perforation of the cusps and paravalvular leakage, of the bioprosthetic valves. The leading indication for reoperation of mitral valve was restenosis or stenoinsufficiency, The indications of aortic valve replacement was active bacterial endocarditis, medically uncontrollable prosthetic endocarditis or paravalvular leakage. Overall death rate of the reoperation was 17.4% [5 death among the 29 patients] and the leading causes of death were myocardial failure, arrhythmia, cerebral embolism, acute renal failure due to low output syndrome. And it was followed by sepsis associated with active prosthetic endocarditis. The death rate of reoperation was 4.3% in the elective cases except urgent cases and the death rate of overall cardiac valve except reoperation cases was 4.1% in the last two years. Although the general mortality of reoperation was high, both mortality rates were comparable except emergency cases due to urgent preoperative patient’s condition.

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Multicenter clinical study on the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique

  • Lee, Hyung-Ju;Moon, Jee-Won;Lee, Ju-Hyoung;Park, In-Sook;Kim, Nam-Ho;Sohn, Dong-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권2호
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    • pp.85-89
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    • 2012
  • Objectives: This study was to evaluate the effect of vertical bone gain and success rate and analyze the failure cases using the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique. Materials and Methods: Patients who had been operated in the three centers including Daegu Catholic University Medical Center were selected for this study. The mucoperiosteal flap was elevated, and the sinus floor was then broken by specially designed piezoelectric insert, with hydraulic pressure applied to the sinus membrane for even elevation. Afterward, implants were placed. Panoramic radiogram or computed tomogram was taken before and after surgery and at the second operation and prosthesis placement. Later, changes in vertical height were measured and compared. The survival rate was based on the criteria of Buser et al. and Cochran et al. Results: In this study, 8 implants failed out of a total of 169 implants, resulting a success rate of 95.3%. These failure cases were due to insufficient initial stability or sinus membrane perforation. The mean of radiographic vertical height change at prosthesis placement was 5.7 mm (0.5-10.5 mm). Conclusion: In this study, HPISE technique was found to be a predictable treatment for atrophic maxilla and an alternative technique to the lateral approach.

Long-term Outcomes of Augmentation Cystoplasty in a Pediatric Population With Refractory Bladder Dysfunction: A 12-Year Follow-up Experience at Single Center

  • Mehmood, Shahbaz;Alhazmi, Hamdan;Al-Shayie, Mohammed;Althobity, Ahmed;Alshammari, Ahmed;Altaweel, Waleed Mohamed;Almathami, Ahmed;Vallasciani, Santiago
    • International Neurourology Journal
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    • 제22권4호
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    • pp.287-294
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    • 2018
  • Purpose: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. Methods: A retrospective analysis was conducted of 42 patients (31 males; mean age, $14.2{\pm}6.2years$) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median $12.0{\pm}1.5years$ of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. Results: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. Conclusions: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.

Safety and feasibility of opening window fistulotomy as a new precutting technique for primary biliary access in endoscopic retrograde cholangiopancreatography

  • Yasuhiro Kuraishi;Kazuo Hara;Shin Haba;Takamichi Kuwahara;Nozomi Okuno;Takafumi Yanaidani;Sho Ishikawa;Tsukasa Yasuda;Masanori Yamada;Nobumasa Mizuno
    • Clinical Endoscopy
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    • 제56권4호
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    • pp.490-498
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    • 2023
  • Background/Aims: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common and serious complication of endoscopic retrograde cholangiopancreatography. To prevent this event, a unique precutting method, termed opening window fistulotomy, was performed in patients with a large infundibulum as the primary procedure for biliary cannulation, whereby a suprapapillary laid-down H-shaped incision was made without touching the orifice. This study aimed to assess the safety and feasibility of this novel technique. Methods: One hundred and ten patients were prospectively enrolled in this study. Patients with a papillary roof size ≥10 mm underwent opening window fistulotomy for primary biliary access. In addition, the incidence of complications and success rate of biliary cannulation were evaluated. Results: The median size of the papillary roof was 6 mm (range, 3-20 mm). Opening window fistulotomy was performed in 30 patients (27.3%), none of whom displayed PEP. Duodenal perforation was recorded in one patient (3.3%), which was resolved by conservative treatment. The cannulation rate was high (96.7%, 29/30 patients). The median duration of biliary access was 8 minutes (range, 3-15 minutes). Conclusions: Opening window fistulotomy demonstrated its feasibility for primary biliary access by achieving great safety with no PEP complications and a high success rate for biliary cannulation.

제조담배의 연기희석에 미치는 재료품과 궐련 물성 연구 I. 제조담배의 연기희석율과 팁 흡인저항에 미치는 팁페이파 및 필터권지 기공도의 영향 (Study on cigarette ventilation with cigarette materials and the properties of cigarettes 1. Effect of tipping paper permeability and plugwrap porosity on the cigarette pressure drop and ventilation)

  • 김성한;오영일;이영택;박태무
    • 한국연초학회지
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    • 제10권1호
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    • pp.83-91
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    • 1988
  • The effects of tipping paper permeability and plugwrap porosity on the ventilation and the pressure drop of cigarettes have been studied and the results obtained were as follows. 1. The single and the multiple regression equation to estimate tip ventilation were establised. In the equations, the observed values of the tip ventilation with the varieties the plugwrap porosity were content with them by the single regression equation. 2. As based on the statistical consideration of the above equation, the deviation of the observed tip ventilation versus the tipping paper permeability were higher than them to the plugwrap porosity. 3. The regression equations to calculate pressure drop ratio and the total ventilation rate in filter tip from the tea ventilation were obtained. According to the equation, the observed values of the pressure drop ratio were significantly similar to them calculated. 4. It was found that the equations could be applied to the calculation of the ventilation of cigarettes using the mechanical and micro laser perforation tipping paper as well as the electrically perforated tipping paper of this Study.

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Anatomical Features Affecting Safranine Solution Permeability in Anthocephalus chinensis (Lam.) Rich. ex Walp

  • Ahmed, Sheikh Ali;Chun, Su-Kyoung
    • 한국가구학회지
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    • 제18권4호
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    • pp.261-267
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    • 2007
  • This report describes the wood anatomy and 1% safranine solution penetration depth in radial and longitudinal directions of Anthocephalus chinensis belonging to the family Rubiaceae native to Bangladesh. The wood of this species was mostly characterized by diffuse porous, vessel with simple perforation plate, vestured alternate intervessel pittings, relatively medium vessel elements and fiber, and nonseptate fiber with distinctly bordered pits at radial wall. The body ray cell was procumbent with 2 to over 4 rows of upright and square marginal cells. Sometimes, the rays with procumbent, square and upright cells were mixed. Latewood fiber was thin to thick walled while it was very thin walled in earlywood. Axial parenchyma was diffuse, vasicentric, 5-8 cells per parenchyma strand dominantly present. Liquid penetration depth was observed in radial and longitudinal directions at moisture level of 7.42%. Longitudinal penetration was found 6.3 times higher than radial penetration. The initial penetration rate of safranine solution was high, but gradually decreased during the course of time. Different anatomical features were found to be responsible for the variation of safranine solution penetration depth compared to Gmelina arborea.

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대형 스플리터 소음기 성능에 대한 3차원 수치해석적 연구 (Three-dimensional Numerical Study on Acoustic Performance of Large Splitter Silencers)

  • 백성현;이창헌;권대훈;이일재
    • 한국소음진동공학회논문집
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    • 제27권2호
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    • pp.139-147
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    • 2017
  • Acoustic performance of splitter silencers was investigated by using 3-dimensional commercial software and experiments. Flow resistivity of sound absorbing material was indirectly estimated by using an impedance tube setup and a curve fitting method. In addition the acoustic impedance of perforated plate was determined by an empirical formulation. Such properties have been used as input parameters in the commercial software. The prediction for a splitter silencer with 1000 mm length was compared with the experimental result. The numerical method is then applied to identify the effects of number of splitters, length of splitters, absorptive material density, and porosity of a perforated plate on the performance of the splitter silencers. As the number and length of splitter increases, the acoustic performance significantly increases. Although the increase of density of absorptive material also increase the acoustic performance, a change in the density over a certain level hardly affect it. The increase of porosity will enhance the performance especially at higher frequencies.

Resorption of bone graft after maxillary sinus grafting and simultaneous implant placement

  • Kim, Young-Kyun;Kim, Su-Gwan;Kim, Bum-Su;Jeong, Kyung-In
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제40권3호
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    • pp.117-122
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    • 2014
  • Objectives: The purpose of this study was to evaluate the sinus bone graft resorption over 3 years after two-stage implant placement. Materials and Methods: The subjects for this study included 30 patients whose maxillary posterior ridges were too atrophic for implants. Bone-added osteotome sinus floor elevation was used in 15 maxillary sinuses, while the bone graft by lateral approach technique was used in 25 maxillary sinuses. The height from the top of the fixture to the sinus floor was estimated immediately after implant placement and the follow-up period was over 3 years. The surgery was classified with two groups: sinus bone grafting with and without autogenous bone. All implants were placed simultaneously. Results: The mean vertical bone loss was $3.15{\pm}2.95mm$. The survival rate of implants was 94.7%. Conclusion: The amount of bone resorption was not significantly associated with the surgical methods, the type of bone graft materials used, or sinus perforation during surgery.

Non-Surgical Management of Gastroduodenal Fistula Caused by Ingested Neodymium Magnets

  • Phen, Claudia;Wilsey, Alexander;Swan, Emily;Falconer, Victoria;Summers, Lisa;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권4호
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    • pp.336-340
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    • 2018
  • Foreign body ingestions pose a significant health risk in children. Neodymium magnets are high-powered, rare-earth magnets that is a serious issue in the pediatric population due to their strong magnetic force and high rate of complications. When multiple magnets are ingested, there is potential for morbidity and mortality, including gastrointestinal fistula formation, obstruction, bleeding, perforation, and death. Many cases require surgical intervention for removal of the magnets and management of subsequent complications. However, we report a case of multiple magnet ingestion in a 19-month-old child complicated by gastroduodenal fistula that was successfully treated by endoscopic removal and supportive care avoiding the need for surgical intervention. At two-week follow-up, the child was asymptomatic and upper gastrointestinal series obtained six months later demonstrated resolution of the fistula.