• Title/Summary/Keyword: Salvage of life

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A study on the Information Network Structure for the Marine Pollution Adminstration (해양오염관리를 위한 네트워크 정보시스템에 관한 연구)

  • 변헌수;김천석;신현식
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.5 no.1
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    • pp.227-231
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    • 2001
  • In this paper recently catastrophic oil spills from tanker casualties have polluted the marine environment. The Sea Prince casualties are analyzed and the systems to be introduced are considered. Also, the establishment of the national contingency plan and the decision-making procedure based on technical analysis are described. Based on the discussions the Rapid Response Technical Support System is derived for the support of salvage and oil spill removal operation. The System will contribute to the protection of life and assets from the marine casualties and to keeping the clean and safe ocean.

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Unusual Late Life-Threatening Arterial Bleeding after Salvage Total Laryngectomy Following Chemotherapy and Radiotherapy (항암 방사선 치료 후 시행한 구제 후두 전적출술 후에 발생한 생명을 위협하는 특이한 지연 동맥 출혈)

  • Lee, Dong-Hoon;Kim, Rok-Young;Lee, John Jae-Woon;Lee, Joon-Kyoo
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.1
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    • pp.24-26
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    • 2012
  • 본방사선 치료 후에 후두 절제술을 시행할 경우 인두피부누공, 감염, 출혈 등 상처부위 합병증의 가능성이 높다. 저자들은 최근에 항암치료와 방사선 치료 후에 재발한 성문상부암에 대해 후두 전적출술을 시행하였고, 수술 66일째 생명을 위협하는 인두의 동맥 출혈을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Study on the Health-related Quality of Life in Patients after Surgery for Malignant Bone Tumors

  • Han, Gang;Wang, Yan;Bi, Wen-Zhi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.127-130
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    • 2012
  • Aim: We conducted a study in China to assess the health-related quality of life (HRQoL) in patients treated on for malignant bone tumors after surgery, and investigate the possible determinants. Methods: The subjects were 120 patients surgically treated by amputation and limb-salvage for bone tumors during the period of June 2008 to June 2010. The Medical Outcomes Study Short Form 36 (SF-36) was employed to measure the HRQoL of all the patients before and after surgery. Results: With regard to the results of the general quality of life tool (SF-36), we observed a significant improvement of all the indexes of HRQoL after 6 months (p<0.05). PF, RP and BP scores showed significant increase between surgery after 6 and 12 months (p<0.05). The means of the HRQoL of bone tumor patients in our study were still much lower than those of general population in every domain, even 12 months after surgery. Logistic regression showed that female patients were found to have lower scores in physical component summary (PCS) than males (OR=0.64, 95% CI=0.35-0.89). Patients older than 15 years had lower scores in mental component summary (MCS) (OR=0.60, 95% CI=0.32-0.86). Ablative surgery was related to both lower MCS and PCS scores (For MCS, OR=0.54, 95% CI=0.31-0.83; for PCS, OR=0.43, 95% CI=0.25-0.73). Conclusion: Our study showed the treatment for bone tumor could greatly alter the HRQoL of patients. Age, sex and type of surgery were associated with physical or mental HRQoL after surgery.

A Case of Severe Acute Respiratory Distress Syndrome Treated with Extracorporeal Life Support (체외생명보조를 이용한 중증 급성호흡곤란증후군 치료 1예)

  • Kim, Young Mook;Lee, Jue Yong;Lee, Myung-Goo;Lee, Chang Youl;Kim, Go Woon;Sohn, Kyoung Min;Yang, Ha Na;Kim, Dae Yong;Choi, Hyun Hee;Kim, Hyoung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.6
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    • pp.526-530
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    • 2007
  • The incidence of acute respiratory distress syndrome (ARDS) has been estimated worldwide to range from 1.7 to 75 cases per 100,000. There are many treatments for ARDS, but only the low tidal volume strategy is based on strong clinical evidence from randomized clinical trials. The efficacy of extracorporeal life support (ECLS) in adults remains controversial. Ongoing clinical trials and research have shown a benefit for its use to salvage severe ARDS patients that are in failure with conventional treatment. We encountered a 41-year-old woman who developed ARDS induced by pneumococcal pneumonia. Despite conventional mechanical ventilation in the emergency room, severe hypoxia remained. We treated the patient immediately with ECLS. The patient has almost fully recovered, and was discharged from a 177-day stay at our hospital.

Analysis of Postural Stability and Daily Energy Expenditure to Manage Tumor Patients' Functional Expectation

  • Caliskan, Emrah;Saygi, Evrim Karadag;Gencer, Zeynep Kardelen;Kurtel, Hizir;Erol, Bulent
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.491-499
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    • 2018
  • Background: Advances in surgical techniques, implant technology, radiotherapy, and chemotherapy have increased the recovery chances of patients with bone sarcomas. Accordingly, patients' expectations on life quality have also increased, highlighting the importance of objective evaluation of the functional results of reconstruction. Methods: Thirteen patients with distal femoral endoprosthesis, who had been followed for an average of 2.9 years were evaluated. Postural stability, daily energy expenditure, muscle power, and range of motion were the four parameters analyzed in this study. The Musculoskeletal Tumor Society (MSTS) score and Toronto Extremity Salvage Score (TESS) were used to assess postoperative function and examine correlations with other parameters. Results: Patients had sedentary activities in 84% of their daily lives. They exhibited a slower speed in the walk across test and a higher sway velocity in the sit-to-stand test (p = 0.005). MSTS scores were significantly correlated with the daily energy expenditure and walking speed. Conclusions: Objective functional results acquired from various clinics will provide significant data to compare reconstruction techniques, rehabilitation protocols, and surgical techniques. In this way, it will be possible to satisfy the expectations of patients that increase in relation to enhanced recovery.

Treatment of Primary Malignant Bone Tumors of the Scapula

  • Tomori, Yuji
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.222-222
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    • 2009
  • Primary malignant bone tumors of the scapula are very rare, and little literature is available regarding their characteristics and outcome. We studied the clinical characteristics, and outcome of patients with primary malignant bone tumors of the scapula. From 1979 to 2008, we treated 7 patients at our institute (4 men and 3 women; chondrosarcoma 3, Ewing's sarcomas 3, Osteosarcoma 1). The mean age was 45 years (range, 5~65 years). The follow-up period was 2 - 180 months. Six patients were performed operations: total scapulectomy 3, partial scapulectomy 1, forequarter resection 1, total resection of the shoulder girdle (Tikhoff-Linberg procedure) 1. No-operative treatment was chosen for one patient with a limited life expectancy. Local recurrence occurred in one patient. Distant metastasis occurred in 3 patients. Of the 7 patients, 4 patients are died because of propagation of the disease. Three patients were alive and apparently disease-free, and these patients were evaluated for functional results with the functional evaluation system of the International Society of Limb Salvage (ISOLAS). Functional result of partial scapulectomy was excellent, however, the function after total scapulectomy or Tikhoff-Linberg procedure is severely impaired. Our study indicates reconstruction procedure needs to be reconsidered following total scapulectomy or Tikhoff-Linberg procedure.

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Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients

  • Coerdt, Kathleen M.;Zolper, Elizabeth G.;Starr, Amy G.;Fan, Kenneth L.;Attinger, Christopher E.;Evans, Karen K.
    • Archives of Plastic Surgery
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    • v.48 no.2
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    • pp.231-236
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    • 2021
  • Mucormycosis is an invasive, rapidly progressive, life-threatening fungal infection, with a propensity for diabetic, immunosuppressed, and trauma patients. The classic rhinocerebral variation is most common in diabetic patients. While the cutaneous form is usually caused by direct inoculation in immunocompetent patients. Cutaneous mucormycosis manifests in soft tissue and risks involvement of underlying structures. Tibial osteomyelitis can also occur secondary to cutaneous mucormycosis but is rare. Limb salvage is typically successful after lower extremity cutaneous mucormycosis even when the bone is involved. Herein, we report two cases of lower extremity cutaneous mucormycosis in diabetic patients that presented as acute worsening of chronic pretibial ulcers. Despite aggressive antifungal therapy and surgical debridement, both ultimately required amputation. Such aggressive presentation has not been reported in the absence of major penetrating trauma, recent surgery, or burns.

Palliative and Neoadjuvant Chemotherapy for Advanced Gastric Cancer Patients (진행성 위암에서의 항암요법에 대하여)

  • Hee Seok Moon
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.45-51
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    • 2014
  • Gastric cancer is the second most common cancer and the third leading cause of cancer-related deaths in Korea. Many cases of gastric cancer are detected in the early stages on standard medical examinations; complete surgical and endoscopic resection is the most recommended treatment for early-stage gastric cancer. Nevertheless, many patients have already progressed to advanced gastric cancer (AGC) upon diagnosis, and the prognosis of such patients is very poor. Combination chemotherapy has been shown to produce a better quality of life (QOL) and to increase overall survival in AGC patients. However, approximately 50% of patients do not respond to the current first-line chemotherapy, while most patients who do respond eventually show disease progression. Accordingly, various second-line regimens have been investigated, and active salvage chemotherapy has been shown to improve the QOL and clinical outcomes in select AGS patients who can tolerate it. There is also an increasing need for neoadjuvant therapy for treating gastric cancer; therefore, various clinical trials have been set up to investigate different regimens. Neoadjuvant therapy is currently established as the standard treatment for locally AGC in Europe; it has contributed to lowering the nodal stages and has reduced overall mortality rates. Despite these benefits, many uncertainties remain. Therefore, further prospective, high quality randomized controlled trials for neoadjuvant therapies are needed to clarify their clinical benefits and to establish the most effective treatment strategies for AGC.

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Coordination Under Price Protection, Mid/End Life Returns, and Quantity Discount for a Three-Level Supply Chain (가격보호 정책, 반품 정책과 물량할인 정책을 사용한 3단계 공급사슬의 협력방안)

  • Lee, Chang-Hwan
    • Journal of the Korean Operations Research and Management Science Society
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    • v.30 no.3
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    • pp.17-39
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    • 2005
  • The coordination of a three-level supply chain consisting of a supplier, a retailer, and a discount outlet (DCO) is studied here. We assume that the product is sold in two consecutive periods a Normal Sales Period (NSP) and a subsequent Clearance Salvage Period (CSP). A benchmark case is studied Initially in which the supply chain is coordinated by a s1n91e agent. Thus, the supplier the retailer, and the discount outlet design a common system that allows centralized decision making about stocking quantities, markdown time schedules, and policies on disposing of leftovers to deliver the greatest possible expected supply chain profit. Next, we consider a decentralized supply chain. Here, decisions are made without coordination. The objective is to maximize an individual party's expected profits. The focus of the study is on the following questions: what factors make the coordination an effective approach for the supply chain? How do we coordinate the supply chain so as to maximize the supply chain Joint expected profit? These and other related study issues are explored in this paper.

Role of Concomitant Chemoradiation in Locally Advanced Head and Neck Cancers

  • Lasrado, Savita;Moras, Kuldeep;Pinto, George Jawahar Oliver;Bhat, Mahesh;Hegde, Sanath;Sathian, Brijesh;Luis, Neil Aaron
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4147-4152
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    • 2014
  • Standard therapy for advanced head and neck cancer consists of a combination of surgery and radiation. However, survival of this patient population has not improved during the past 20 years. Many different multimodality treatment schedules have been proposed, and chemotherapy is often used with the intent of organ preservation. The present study was intended to establish the efficacy of concomitant chemoradiation with a single agent carboplatin in advanced head and neck cancers.The objectives were to investigate the feasibility of concomitant administration of carboplatin, monitor acute toxicity during radiotherapy, and determine subacute side effects, such as wound healing following surgery after chemoradiotherapy. A prospective study was conducted wherein a total of 40 patients with stage III and IV squamous cell carcinomas of oral cavity, oropharynx, hypopharynx and larynx were enrolled. All patients were treated with external beam radiotherapy and weekly carboplatin area under curve (AUC of 5). Radiotherapy was given in single daily fractions of 1.8-2 grays (Gy) to a total dose of 66-72 Gy. Salvage surgery was performed for any residual or recurrent locoregional disease. Neck dissection was recommended for all patients with neck disease showing less than a complete response after chemoradiation. A total of 40 patients were enrolled of whom 32 were males and 8 were females. Highest incidence of cancer was seen in the 5th-6th decades of life with a median age of 47.7 years. Oropharyngeal tumours constituted a maximum of 21 patients followed by hypopharynx in 10, larynx in 7 and oral cavity in 2. 80% of the patients had a neck node on presentation of which 40% had N2-N3 nodal status. TNM staging revealed that 58% of patients were in stage III and 43% in stage IV. Evaluation of acute toxicity revealed that 50% had grade II mucositis, 25% grade III mucositis, 2.5% grade IV mucositis. 50% of patients had grade I skin reactions, 65% of patients had grade I thrombocytopenia, and 24% of patients had grade I anaemia. After completion of treatment 65% of patients had complete response at the primary and regional sites, and 35% of patients had a partial response of whom 23% underwent neck dissection and 5% of them underwent salvage surgery at the primary site. At the end of one year there were six deaths and four recurrences and 70% were free of disease. Concurrent chemoradiation with carboplatin provided good locoregional control for locally advanced head and neck cancers. This regimen, although toxic, is tolerable with appropriate supportive intervention. Primary site conservation is possible in many patients. Chemoradiotherapy appears to have an emerging role in the primary management of head and neck cancers.