• Title/Summary/Keyword: Re-infection

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Validation of the ACS NSQIP Surgical Risk Calculator for Patients with Early Gastric Cancer Treated with Laparoscopic Gastrectomy

  • Alzahrani, Saleh M;Ko, Chang Seok;Yoo, Moon-Won
    • Journal of Gastric Cancer
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    • v.20 no.3
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    • pp.267-276
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    • 2020
  • Purpose: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator is useful in predicting postoperative adverse events. However, its accuracy in specific disorders is unclear. We validated the ACS NSQIP risk calculator in patients with gastric cancer undergoing curative laparoscopic surgery. Materials and Methods: We included 207 consecutive early gastric cancer patients who underwent laparoscopic gastrectomy between January 2018 and January 2019. The preoperative characteristics and risks of the patients were reviewed and entered into the ACS NSQIP calculator. The estimated risks of postoperative outcomes were compared with the observed outcomes using C-statistics and Brier scores. Results: Most of the patients underwent distal gastrectomy with Roux-en-Y reconstruction (74.4%). We did not observe any cases of mortality, venous thromboembolism, urinary tract infection, renal failure, or cardiac complications. The other outcomes assessed were complications such as pneumonia, surgical site infections, any complications requiring re-operation or hospital readmission, the rates of discharge to nursing homes/rehabilitation centers, and the length of stay. All C-statistics were <0 and the highest was for pneumonia (0.65; 95% confidence interval: 0.58-0.71). Brier scores ranged from 0.01 for pneumonia to 0.155 for other complications. Overall, the risk calculator was inconsistent in predicting the outcomes. Conclusions: The ACS NSQIP surgical risk calculator showed low predictive ability for postoperative adverse events after laparoscopic gastrectomy for patients with early gastric cancer. Further research to adjust the risk calculator for these patients may improve its predictive ability.

A Case of Tracheobronchomegaly with Pneumonia (폐렴을 동반한 기관 및 주기관지의 확장 소견)

  • Joo, Kyu Re;Oak, Ju Hyun;Lee, Sung Eun;Jang, Suk Tae;Kim, Sung Kyoung;Lee, Sang Haak;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik;Lee, Bae Young;Kim, Hyeon Sook
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.4
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    • pp.403-406
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    • 2006
  • A 66-years-old man was refered to our hospital because of cough, sputum, chill and fever. Enlargement of the trachea and main bronchi on radiography and bronchoscopy is compatible with Mounier-Kuhn syndrome. Mounier-Kuhn syndrome or tracheobronchomegaly is a rare disorder of uncertain etiology, characterized by marked dilatation of the trachea and major bronchi. This syndrome is associated with tracheal diverticulosis, bronchiectasis and recurrent respiratory tract infection. We report a rare case of Mounier-Kuhn syndrome with pneumonia and literature reviews.

Thyroid and Parathyroid Surgery without Wound Drains (갑상선 및 부갑상선 수술시 배액관 삽입술에 대한 검토)

  • Chung Woung-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.2
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    • pp.119-124
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    • 1995
  • Traditionally, wound drainage after thyroid or parathyroid surgery has been widely used to prevent airway obstruction due to accumulation of hematoma or seroma within the paratracheal dead space. Recently, however, the routine use of drains after thyroid or parathyroid surgery has become a matter of controversy. To determine whether the rouine use of drains after thyroid or parathyroid surgery is warranted, a prospective study on the complications after various types of thyroid or parathyroid surgery without wound drains was conducted. Three hunded sixty-six consecutive patients underwent thyroid or parathyorid surgeries by one surgeon from January through December 1994 were included in this study. Of these, only 38 patients (10.4%) required the wound drains. Indications for drainage included the patients with a large dead space(n=9) or wet operative field at the conclusion of surgery(n=11), and patients with radical neck disection(n=18). In the remaining 328 patients(89.6%), the wounds were closed without drains after thyroid lobectomy and isthmusectomy(n=226), bilateral subtotal thyroidectomy(n=21), total or near-total thyroidectomy(n=62), isthmusectomy(n=9) and parathyroid surgery(n=l0). Histologic findings revealed benign tumors in 214(65.2%), carcinoma in 89(27.1%), Graves' disease in 15(4.7%), hyperparathyroidism in 7(2.1%) and parathyroid cyst in 3(0.9%). Among the 328 patients without drain used, wound related complications were seen in only 15 patients(4.6%); 12 patients with seroma and 3 patients with hematoma. All but one complications could be controlled by two or three aspirations, and the remaining one patient required re-exploration. There were no instances of laryngeal nerve palsy or wound infection. The mean length of hospital stay after surgery was 2.8 days with a range of 1 to 11 days. These results support the routine use of drains is not warranted in most thyroid or parathyroid surgeries.

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Diagnosis and Arthroscopic Decompression of Impingement Syndrome of the Shoulder (견관절 충돌 증후군의 진단 및 관절경적 견봉 감압술)

  • Byun Ki-Yong;Kwon Soon-Tae;Lee Jang-Ik;Rhee, Kwang-Jin
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.19-25
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    • 1998
  • Appropriate clinical examination and imaging may lead to early diagnosis and treatment of the shoulder impingement syndrome, thus preventing progressing to a complete tear of rotator cuff. The impingement syndrome was caused by repeated entrapment and compression of supraspinatus tendon between the proximal end of humerus inferiorly, particullary its greater tuberosity. and one or m <)re component of coracoacromial arch superiorly. The purpose of this study is to critically, evaluate the result of twenty-five consecutive subacromial decompression with impingement syndrome and to assess the diagnostic accuracy of MR imaging by using oblique coronal and oblique sagittal plan. These patients were treated by arthroscopic subacromial decompression after their pains failed to improve with conservative therapy over three month. The average follow up was 25 month(range, 12 to 50). The mean age was 43 year old. The results were rated based on subjective response and the UCLA shoulder rating scale of the result. Ten patients(40%) were rated as excellent, 11patients(44%) were good. while four patients(16%) were fair. Radiologic evaluation suggested that the oblique sagittal plan of MRI can be helpful in evaluation of bony and soft-tissue structure of the coracoacromial arch and determining depth of bony resection. There were no infection or neurovascular injury. In reviewing our result, it appears that the arthroscopic subacromial decompression can be successful sugery for shoulder impingement syndrome and diagnostic accuracy of supplimentary oblique sagittal view of MRI was relatively higher than oblique coronal view alone for apprqpriate surgical plan.

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Spinal Cord Tumors : An Analysis of 654 Cases(1973-1999) (척수 종양 654예의 임상 분석(1973-1999))

  • Choe, Woo Jin;Chung, Chun-Kee;Cho, Byung-Kyu;Kim, Hyun Jib
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.1004-1012
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    • 2001
  • Objective : The spinal cord tumors(including vertebral tumors) are increasingly diagnosed and operated due to development of refined diagnostic and therapeutic tools. It is necessary to re-evaluate clinical features and surgical results of spinal cord tumors with increasing cases and developing treatment modalities. The authors reviewed the spinal cord tumor cases to evaluate their clinical characteristics. Material and Methods : The retrospective review of 654 cases of spinal cord tumors between 1973 and 1999 was done. The clinical features, pathological analysis and surgical results were analyzed and compared to the literature. The results of the study are analyzed with a more detailed consideration of each of major pathologies : neurogenic tumors, meningeal tumors, neuroepithelial tumors, and metastatic tumors. Results and Conclusion : The spinal cord tumor was most common in the 5th decade of age(145 cases, 22.1%) and 78 cases(11.9%) were found in children under 15 years of age. The ratio of male to female was 1.2 : 1. The pathologic diagnosis was neurogenic tumor in 266 cases(40.7%), neuroepithelial tumor in 131(20.0%), metastatic tumor in 118(18.0%), and meningeal tumor in 94(14.4%) in the order of frequency. The tumor was located most frequently in the thoracic area(36.5%) and in the intradural extramedullary space(38.1%). The most common initial presentation was pain(40.1%) and the mean duration for presentation to operation was 14.8 months. The total or gross total removal was possible in 404 cases(61.7%) and the surgical result on the postoperative one month was recovery or improvement in 424 cases(64.8%), stationary in 188(28.7%), progression in 42(6.4%). As a surgical complication, there was a spinal deformity(12 cases), wound infection(5 cases), aspiration pneumonia(5 cases) etc. Neurogenic tumors and menigiomas showed good surgical results, whereas neuroepithelial tumors(except ependymoma) and metastatic tumors showed relatively poor prognosis.

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Clinical Efficacy of Radiation-Sterilized Allografts for Sellar Reconstruction after Transsphenoidal Surgery

  • Kim, Se-Jin;Jeon, Chi-Man;Kong, Doo-Sik;Park, Kwan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.503-506
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    • 2011
  • Objective : The aim of this study was to assess the safety and efficacy of radiation-sterilized allografts of iliac bone and fascia lata from cadaver specimens to repair skull base defects after transsphenoidal surgery. Methods : Between May 2009 and January 2010, 31 consecutive patients underwent endonasal transsphenoidal surgery and all patients received sellar reconstruction using allografts following tumor removal. The allografts were obtained from the local tissue bank and harvested from cadaver donors. The specimens used in our approach were tensor fascia lata and the flat area of iliac bone. For preparation, allografts were treated with gamma irradiation after routine screening by culture, and then stored at $-70^{\circ}C$. Results : The mean follow-up period after surgery was 12.6 months (range, 7.4-16 months). Overall, postoperative cerebrospinal fluid (CSF) leaks occurred in three patients (9.7%) and postoperative meningitis in one patient (3.2%). There was no definitive evidence of wound infection at the routine postoperative follow-up examination or during re-do surgery in three patients. Postoperative meningitis in one patient was improved with the use of antibiotics and prolonged CSF diversion. Conclusion : We suggest that allograft materials can be a feasible alternative to autologous tissue grafts for sellar reconstruction following transsphenoidal surgery under selected circumstances such as no or little intraoperative CSF leaks.

Establishment of Mass Propagation System of Virus-Free Sweetpotato Plants and Conservation

  • Lee, Joon-Seol;Chung, Mi-Nam;Jeong, Byeong-Choon;Ahn, Young-Sup;Kim, Hag-Sin;Park, Jong-Suk;Bang, Jin-Ki
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.52 no.2
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    • pp.220-227
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    • 2007
  • Sweetpotato fields in Korea are highly infected with virus and virus like diseases that greatly diminish both yield and quality as indicated by field observations and laboratory tests. In order to solve this problem, there is an urgent need to produce and mass propagate virus-free planting materials for distribution to the farmers. These experiments were conducted, firstly, to determine the most appropriate culture media, nutrient solution, and cutting intervals to maintain growth and vigor of tissue cultured plantleta as mother plants for propagation in insect-proof greenhouse. And as a labor saving method, the production efficiency of plug trays for rapid propagation of stem cuttings as a source of planting materials was likewise evaluated. Results showed that plants grown in medium B supplied with 0.5 and 1.0 strength of MS nutrients had high growth rate, and 20-day cutting interval was the best. 72-plug tray was better than 128-plug. Secondly, it was to develop a technique for the production of first-generation seed roots using hydroponics cultivation system. The yield of virus-free plants propagated in the non-insect proof and open-field cultivation was 2,402 kg/10a, 6% higher than those in the insect-proof cultivation, and the rate of virus re-infection was 18% higher compared to 3.3% with insect-proof cultivation. Lastly, it was to investigate the growth performance of virus free plants in farmers' field. Differences were existed in the yield depending on the variety used, but virus free plants showed an increase of $6{\sim}24%$ over virus infected plants.

The Effect that the Application of Time-Based Electrolysis Has on Acute Ischemia

  • Lee, Jung Sook;Song, Young Wha;Kim, Sung Won
    • Journal of International Academy of Physical Therapy Research
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    • v.6 no.2
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    • pp.846-851
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    • 2015
  • This neurological damage accelerates the infection reaction of cells and apoptosis at the time of reperfusion after ischemia occurs. BCL-2/BCL-2 allogeneic begeminum has a function of suppressing the apoptosis of cells, and thus it is inferred that the susceptibility of cells to apoptosis is determined by the amount of allogeneic begeminum present which is determined based on the amount of BAX. Ischemia was induced in SD mice by occluding the common carotid artery for 5 minutes, after which blood was re-perfused. NEES was applied to acupuncture points, at 12, 24, and 48 hours post-ischemia on the joksamri, Hapgok. Protein expression was investigated through BAX antibody immuno-reactive cells in the cerebral nerve cells and Western blotting. The results were as follows: In the present study as well, as a result of observation of the change in the number of the BAX reaction cells after the inducement of GI, there was the aspect of most of the BAX reaction cells being observed in the corpus striatum area of the GI group 24 hours after the inducement of ischemia. This revealed the same results as those of previous studies in which the change in the number of BAX reaction cells occurred in all areas while ischemia was in progress. The change in the expression of BAX protein after 24 hours showed that there was a very significant reduction in the NEES group compared to the GI group (p<.01). As a result, a greatest amount of change in the number of BAX immunoreactive cells related to apoptosis 24 hours after ischemia appeared in the NEES group. This study that ischemia increases the expression of BAX that induces apoptosis. Thus, it is determined that ischemia is the main cause of the apoptosis of neurons, and this study reveals that low frequency needle electrode electrical stimulation has the effect of blocking the apoptosis of neurons by reducing protein related to the apoptosis of cells that has increased after ischemia has occurred.

Estimation of Reproduction Number for COVID-19 in Korea (국내 코로나바이러스감염증-19의 감염재생산수 추정)

  • Jeong, Jaewoong;Kwon, Hyuck Moo;Hong, Sung Hoon;Lee, Min Koo
    • Journal of Korean Society for Quality Management
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    • v.48 no.3
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    • pp.493-510
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    • 2020
  • Purpose: As of July 31, there were 14,336 confirmed cases of COVID-19 in South Korea, including 301 deaths. Since the daily confirmed number of cases hit 909 on February 29, the spread of the disease had gradually decreased due to the active implementation of preventive control interventions, and the daily confirmed number had finally recorded a single digit on April 19. Since May, however, the disease has re-emerged and retaining after June. In order to eradicate the disease, it is necessary to suggest suitable forward preventive strategies by predicting future infectivity of the disease based on the cases so far. Therefore, in this study, we aim to evaluate the transmission potential of the disease in early phases by estimating basic reproduction number and assess the preventive control measures through effective reproduction number. Methods: We used publicly available cases and deaths data regarding COVID-19 in South Korea as of July 31. Using ensemble model integrated stochastic linear birth model and deterministic linear growth model, the basic reproduction number and the effective reproduction number were estimated. Results: Estimated basic reproduction number is 3.1 (95% CI: 3.0-3.2). Effective reproduction number was the highest with 7 on February 15, decreased as of April 20. Since then, the value is gradually increased to more than unity. Conclusion: Preventive policy such as wearing a mask and physical distancing campaigns in the early phase of the outbreak was fairly implemented. However, the infection potential increased due to weakening government policy on May 6. Our results suggest that it seems necessary to implement a stronger policy than the current level.

Production of Red Ginseng Specific Ginsenosides $(Rg_2, Rg_3, Rh_1 and Rh_2)$ from Agrobacterium-transformed hairy Roots of Panax ginseng by Heat Treatment

  • Yang, Deok-Chun;Yang, Kye-Jin;Park, Yong-Eui
    • Journal of Photoscience
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    • v.8 no.1
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    • pp.19-22
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    • 2001
  • It was reported that Red ginseng contains specific ginsenoside-Rg$_2$,-Rg$_3$,-Rh$_1$and -Rh$_2$, which show various pharmacological effects. However, production of these specific ginsenosides from Red ginseng is not commercially applicable because of high cost of the raw material, roots. This work was carried out to examine the production of Red ginseng specific ginsenosides from Agrobacterium-transformed hairy roots. Hairy roots were induced from 3 year-old root segment of Korean ginseng (Panax ginseng C.A. Meyer) after infection with Agrobacterium rhizogenes A4. Among many lines of hairybroots, KGHR-8A was selected. Steam heat treatment of hairy roots was resulted in the changes of ginsenoside composition. Eleven ginsenosides were detected in heat-treated hairy roots but eight in freeze dried hairy roots. In heat treated hairy root, content of ginsenoside-Rb$_1$,Rb$_2$,Rc, Rd, Re, Rf, and Rg$_1$were decreased compared to those of freeze dried hairy roots. However, heat treatment strongly enhanced the amount of Red ginseng specific ginsenogides (ginsenoside-Rg$_2$,-Rg$_3$,-Rh$_1$and -Rh$_2$). Amounts of ginsenoside-Rg$_3$,-Rh$_1$and -Rh$_2$ in heat-treated hairy roots were 2.58, 3.62 and 1.08 mg/g dry wt, respectively, but these were detected as trace amount in hairy roots without heat treatment. Optimum condition of heat treatment for the production of Red ginseng specific ginsenoside was 2 h at 105$^{\circ}C$. This result represents that Red ginseng specific ginsenoside can be producted from hairy roots by steam heat treatment.

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