Background: Male breast cancer (MBC) is a rare disease that accounts for less than 1% of all cancers in men and less than 1% of all diagnosed breast cancers. In this study, we retrospectively evaluated the clinicopathological features, treatment options and overall survival in Kurdish MBC cases. Materials and Methods: Seventeen MBC were referred to Department of Radiation Oncology in Imam Reza Hospital, Kermanshah, Iran, between 2010 and 2016. Immunohistochemical analysis was performed for ER, PR and Her2 biomarkers and FISH for those with Her2 2+. Median follow-up period was 30 months (2-65 months). We excluded from the study patients who did not have follow-up after initial diagnosis. Treatment methods were chemotherapy, radiotherapy, hormonal therapy, target therapy and palliative care. Survival was estimated by the Kaplan Meier method (Prism 5). Results: The mean age at diagnosis was $49.24{\pm}17$ years (range, 24-85 years). Grade II was the most grade in MBC (65%). Fourteen patients (82%) had invasive ductal carcinoma, one (6%) had ductal carcinoma in situ and 2 (12%) had invasive papillary. ER, PR and Her2 were significantly positive in 14/17, 8/17 and 2/17 cases, respectively. The treatment included modified radical mastectomy for most patients. Chemotherapy with TAC and CEF regimens was delivered to 15/17 cases. Tamoxifen therapy was delivered to 14/17 cases. Three stage IV patients received Avestin and two with Her2 3+ were given Trastuzumab (Herceptin). Patients received adjuvant radiotherapy following surgery and chemotherapy. The site of metastasis was the bone in 2 cases, lung in 1 case and liver in 1 case. Zoledronic acid (Zometa) was prescribed for patients with bone metastasis. Five-year overall survival rate was 64%. Conclusions: MBC is rare. Thus, we need larger studies are in collaboration with several research centers in the field of breast cancer. ER positive, grade II of invasive ductal carcinoma, stage II and right side happened more with MBC. Overall survival is similar to other studies.
Purpose: The aim of the study was to obtain data on the anatomic and histologic distributions, the clinical features, and the treatment results for patients with primary gastric non-Hodgkin's lymphoma. Materials and Methods: One hundred thirty-two patients who were treated at 8 university hospitals and 2 general hospitals between January 1991 and December 2000 were enrolled to evaluate clinico-pathologic features. Results: The lower one-third of the stomach was the most frequent site ($42\%$), and the most frequent chief complaint was epigastric pain ($54\%$). Gastric resection was performed in 114 cases. Pathologic findings of preoperative endoscopic biopsy specimens from the 114 patients that underwent surgery were a gastric lymphoma in 94 cases ($82\%$), a carcinoma in 15 cases ($13\%$), an ulcer in 4 cases ($4\%$), and a gastrointestinal stromal tumor in 1 case ($1\%$). The stage distributions by Musshoff's criteria were 71 cases ($54\%$) of stage IE, 36 cases ($27\%$) of stage $II_{1}E$, 8 cases ($6\%$) of stage $II_{2}E$, 2 cases ($2\%$) of stage IIIE, and 15 cases ($11\%$) of stage IVE. Histologic gradings by the Working Formulation in were 31 cases ($23\%$) of low grade, 96 cases ($73\%$) of intermediate grade, and 5 cases ($4\%$) of high grade. Chemotherapy-related complications occurred in 25 cases ($22\%$) while operation-related complications occurred in 6 cases ($5\%$). Seventeen patients ($13\%$) only underwent surgery, 19 ($14\%$) had chemotherapy (CTx) and/or radiotherapy (RTx) only, and 96 patients ($73\%$) received surgery and CTx and/or RTx. No substantial differences in survival were found in relation to the different histologic grades and different treatments. The five-year survival was $85\%$ in stage I or II and $47\%$ in stage III or IV (P=0.0000). Conclusion: Pathologic stage appears to be the single most important prognostic indicator. Survival differences according to treatment modalities were not statistically significant. However, the low number of patients treated with various approaches over a long period precludes a firm conclusion.
The purpose of this study is to analyze elementary school students' pre-concept of electromagnet and to investigate effects of instruction through social interactions on conceptual changes of the electromagnet. For the purpose, 108 elementary school students of 3 classes were selected from the 6th grade. They were divided into the control group I, control group II and experimental group. The control group I was treated through traditional instruction on the basis of text book. The control group II was instructed with a modified version of the textbook to help them better understand the concept of electromagnet. The experimental group was treated through instruction on the basis of the above modified version of the text book and social interactions. Conceptual changes on electromagnet before and after the treatment were quantitatively and qualitatively analyzed using the identical test. The students' styles of social interaction were qualitatively analyzed with tape records of their discussions and work sheets. Effects of instruction through social interactions based on radical constructivism on the 6th-grade elementary school students' concept of electromagnet were examined here. The results were described as follows. Firstly, after the treatment, the experimental group was statistically significantly higher in mean values of conceptual understanding and academic achievement than both the control group I and II. Secondly, styles of social interaction in the three sub-groups of the experimental group were qualitatively analyzed, among the threes, high- and medium-level sub-groups were higher in the frequency of linguistic social interaction than the low-level sub-group. Those students who were excellent in communication skills actively participated in linguistic social interactions. In discussions among the three sub-groups, students of the high- and medium-level sub-groups provided explanations or information while those of the other sub-group sometimes were passive by just listening, but in large actively participated in communication. In conclusion, instruction through social interactions was effectively changed in the 6th-grade elementary school students' concept of electromagnet.
There are concepts in calculus which are difficult to teach and learn. One of these concepts is integration. However, problem posing has not yet received the attention it deserves from the mathematics education community. There is no systematic study that deals with teaching of calculus concepts by problem posing oriented teaching strategy. In this respect this study investigated the effect of problem posing on students' (prospective teachers') academic success when problem posing oriented approach is used to teach the integral concept in Calculus-II (Mathematics-II) course to first grade prospective teachers who are enrolled to the Primary Science Teaching Program of Education Faculty. The study used intervention-posttest experimental design. Quantitative research techniques were employed to gather, analyze and interpret the data. The sample comprised 79 elementary prospective science teachers. The results indicate that problem posing approach effects academic success in a positive way and at significant level.
Many different factors which may affect the prognosis of the soft tissue sarcomas have been reported by many authors ; Generally, tumor size, histologic type, surgical margin, and multi modality therapy therapy as the prognostic factors were reported. The objectives of this retrospective study of soft tissue sarcomas are : 1) to define more clearly prognostic variables that have significant predictive value for disease-free and overall survival ; and 2) to evaluate tumor histologic grade based upon extent of tumor necrosis as a means of stratifying more aggressive soft tissue sarcomas(grade II & III) of the extremities. We treated 94 patients who had soft tissue sarcoma of the extremities and trunk from May 1984 to September 1994(average duration of follow-up was 5 years ranging from 2 months to 10 years) and evaluated the prognostic factors of the soft tissue sarcomas; age, sex, depth, size, location, histologic type and grade, stage, therapy modality, surgical margin, local recurrence and distant metastasis. The results were as follows. 1. The patients with poorer prognosis were over the age of fifty, whose mass was deeply located, size of the mass was over 10cm in diameter, grade III in histology, who had local recurrence, metastasis, and received only surgery. 2. Among these prognostic factors, the most significant prognostic factor was histologic grade base upon extent of tumor necrosis.
Martin Morales-Olivera;Erik Hanson-Viana;Armando Rodriguez-Segura;Marco A. Rendon-Medina
Archives of Plastic Surgery
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제50권6호
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pp.535-540
/
2023
Background Abdominoplasty with abdominal plication increases intra-abdominal pressure (IAP) and has been previously associated with limited diaphragmatic excursion and respiratory dysfunctions. Many factors found in abdominoplasties and among postbariatric patients predispose them to a higher occurrence. This study aims to evaluate the impact of abdominal plication among postbariatric patients, assess whether the plication increases their IAP, and analyze how these IAP correlate to their postoperative outcome. Methods This prospective study was performed on all patients who underwent circumferential Fleur-De-Lis abdominoplasty. For this intended study, the IAP was measured by an intravesical minimally invasive approach in three stages: after the initiation of general anesthesia, after a 10-cm abdominal wall plication and skin closure, and 24 hours after the procedure. Results We included 46 patients, of which 41 were female and 5 were male. Before the bariatric procedure, these patients had an average maximum weight of 121.4 kg and an average maximum body mass index of 45.78 kg/m2; 7 were grade I obese patients, 10 were grade II, and 29 were grade III. Only three patients were operated on with a gastric sleeve and 43 with gastric bypass. We presented six patients with transitory intra-abdominal hypertension in the first 24 hours, all of them from the grade I obesity group, the highest presented was 14.3 mm Hg. We presented 15% (7/46) of complication rates, which were only four seroma and five dehiscence; two patients presented both seroma and wound dehiscence. Conclusion Performing a 10-cm abdominal wall plication or greater represents a higher risk for intra-abdominal hypertension, slower general recovery, and possibly higher complication rate in patients who presented a lower degree of obesity (grade I) at the moment of the bariatric surgery.
Fathalla, Hussein;Tawab, Mohamed Gaber Abdel;El-Fiki, Ahmed
Journal of Korean Neurosurgical Society
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제63권6호
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pp.821-826
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2020
Objective : Hyperostosis in meningiomas can be present in 4.5% to 44% of cases. Radical resection should include aggressive removal of invaded bone. It is not clear however to what extent bone removal should be carried to achieve pathologically free margins, especially that in many cases, there is a T2 hyperintense signal that extends beyond the hyperostotic bone. In this study we try to investigate the perimeter of tumour cells outside the visible nidus of hyperostotic bone and to what extent they are present outside this nidus. This would serve as an initial step for setting guidelines on dealing with hyperostosis in meningioma surgery. Methods : This is a prospective case series that included 14 patients with convexity meningiomas and hyperostosis during the period from March 2017 to August 2018 in two university hospitals. Patients demographics, clinical, imaging characteristics, intraoperative and postoperative data were collected and analysed. In all cases, all visible abnormal bone was excised bearing in mind to also include the hyperintense diploe in magnetic resonance imaging (MRI) T2 weighted images after careful preoperative assessment. To examine bony tumour invasion, five marked bone biopsies were taken from the craniotomy flap for histopathological examinations. These include one from the centre of hyperostotic nidus and the other four from the corners at a 2-cm distance from the margin of the nidus. Results : Our study included five males (35.7%) and nine females (64.3%) with a mean age of 43.75 years (33-55). Tumor site was parietal in seven cases (50%), fronto-parietal in three cases (21.4%), parieto-occipital in two cases (14.2%), frontal region in one case and bicoronal (midline) in one case. Tumour pathology revealed a World Health Organization (WHO) grade I in seven cases (50%), atypical meningioma (WHO II) in five cases (35.7%) and anaplastic meningioma (WHO III) in two cases (14.2%). In all grade I and II meningiomas, bone biopsies harvested from the nidus revealed infiltration with tumour cells while all other bone biopsies from the four corners (2 cm from nidus) were free. In cases of anaplastic meningiomas, all five biopsies were positive for tumour cells. Conclusion : Removal of the gross epicentre of hyperostotic bone with the surrounding 2 cm is adequate to ensure radical excision and free bone margins in grade I and II meningiomas. Hyperintense signal change in MRI T2 weighted images, even beyond visible hypersototic areas, doesn't necessarily represent tumour invasion.
Objective : The purpose of this study was to investigate the prognostic factors in patients who suffered an intracerebral hemorrhage(ICH) due to a ruptured middle cerebral artery(MCA) aneurysm. Methods : Among 148 case of ruptured MCA aneurysm, ruptured MCA aneurysm with ICH was compared with ruptured MCA aneurysm alone. According to factors, the prognosis in these two groups was analyzed. Prognosis was evaluated postoperatively by applying Glasgow Outcome Scale(GOS) at discharge. Prognostic factors were evaluated with Chi square test, Mann-Whitney test and ANOVA test with differences being considered significant for value less than 0.05. Results : Ruptured MCA aneurysm alone revealed better consciousness on admission and final outcome than those combined with ICH. Ruptured MCA aneurysm alone showed 74% in H-H grade I, II and 82% in GOS I, II. But ruptured MCA aneurysm with ICH showed 63% in H-H grade IV, V and 52% in GOS IV, V. Age, sex, lesion site, aneurysmal size, temoporary clipping time, interval to operation, operative approach were statistically not significant in prognosis(p>0.05). But H-H grade on admission(p<0.05), complication(esp. cerebral infarction)(p<0.05), preoperative ICH volume and site(p<0.01), preoperative midline shifting(p<0.01), remained ICH volume(p<0.05) showed significance statistically. Conclusion : Prognostic factors are helpful to neurosurgeon to estimate clinical and neurological outcome postoperatively. We suggest that the good prognostic factors in ruptured MCA aneurysm with ICH were good H-H grade on admission, cerebral infarction(-), preoperative ICH volume <25cc, temporal and intrasylvian ICH, preoperative midline shifting <5mm, remained ICH volume <10cc.
The purposes of this study investigated the effects of placement of analogy on the conceptual changes of air of elementary students, while learning the air conceptions. The subjects consisted of 108 students who are in the sixth grade classes in an elementary school in Busan city. For this study, comparative group(37 members), experimental group I(37 members), and experimental group II(34 memgers) were selected. A pre-test and a post-test on the air conception were done both for the comparative group and the experimental groups. The results are as follows. First, the averages of experiment group I and II are statistically higher than comparative group's. By the way, it just has a small gap between the comparative group and the experimental II. In other words, activity of analogy does not keep always constant to change of air conceptions of elementary students. Therefore, it has a different reason that only before or after during the analogy. Second, it shows that experimental group I has effected on a more change of air conceptions as compared with experimental group II. Then, the first group's result shows better than the other group's result. From this result, six grade students showed a change of air conceptions very well by analogy. It means if the analogy is given to students at the beginning state of chapter, they can understand scientific concepts easily.
This survey was conducted to investigate the relation of children's obesity index to their mothers' food habit during the October in 1995. The survey covered a total of 492 mothers whose children were in the fifth grade of elementary schools in Cheju City area. The results are summarized as follows: 1.The surveyed children's average WLI(Weight-Length Index) is 107.08. WLI shows that 16.1% of them are overweight, 16.1% obese and 49.8% ideally weighted. The mothers' average BMI(Body Mass Index) is 22.4. 21.8% of them are underweight and 69.4% normal. The children's obesity index is significantly correlated to their fathers', but not significant to their mothers'. 2.As to the food habit I (balance of nutrients intake), 58.4% of the mothers have 'excellent' or 'good' food habit and the mean score is 14.95 out of maximum possible score 24.0. Concerning to the food habit II (intake of sugar, fat and salt etc.), 87.4% of mothers have 'good' or 'fair' food habit and the mean score of is 13.34 out of maximum (possible score) 20.0. The mothers' food habit I and II, as a whole, have no significant effect on the children's obesity index, but in some items the significant relations are founded. The children's chesty index is significantly related to the intake of eggs (P<0.05) and pan-broiled or fried foods (P<0.05). The amount of mothers' food intake is significantly relevant to their obesity index (P<0.001), but not significantly to their children's. The food habit of mothers who have taken midnight snack almost every day are significantly related to their children's chesty index (P<0.05). The findings of the study emphasize the importance of the nutrition education to ensure health and better physical fitness for children and their mothers.
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