A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. His hypoxemia failed to improve even after the application of endotracheal intubation with mechanical ventilator care, and we therefore decided to initiate venovenous extracorporeal membrane oxygenation (VV ECMO) for additional pulmonary support. On his twentieth day of hospitalization, hypotension and desaturation (arterial saturated oxygen <85%) developed, and right ventricular failure was confirmed by two-dimensional echocardiography. Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.
The establishment of DNA microarray technology has enabled high-throughput analysis and molecular profiling of various types of cancers. By using the gene expression data from microarray analysis we are able to investigate diagnostic applications at the molecular level. The most important step in the application of microarray technology to cancer diagnostics is the selection of specific markers from gene expression profiles. In order to select markers of Immortalization and transformation we used c-myc and $H-ras^{V12}$ oncogene-transfected NIH3T3 cells as our model system. We have identified 8751 differentially expressed genes in the immortalization/transformation model by multivariate permutation F-test (95% confidence, FDR<0.01). Using the support vector machine algorithm, we selected 13 discriminative genes which could be used to predict immortalization and transformation with perfect accuracy. We assayed $H-ras^{V12}$-transfected 'transformed' cells to validate our immortalization/transformation dassification system. The selected molecular markers generated valuable additional information for tumor diagnosis, prognosis and therapy development.
The homeopathic remedy Chelidonium majus 200C (Chel-200) is traditionally used by homeopathic practitioners in liver ailments arising out of hepatotoxicity. The present investigation was aimed at examining whether vitamin C (L-ascorbic acid or AA), used in both traditional and orthodox medicines, can show better effects when used in combination with Chel-200, in favorably modifying the toxicological effects induced by the chronic feeding of p-dimethylaminoazobenzene (p-DAB, initiator) and phenobarbital (PB, promoter) in mice for 7 days through 120 days to induce hepatotoxicity and liver tumors. Mice were euthanized at 7, 15, 30, 60, 90, and 120 days of carcinogen feeding to assess various cytogenetical, biochemical and histological changes occurring in them. In a placebo controlled study, Chel-200 or the respective placebo (Alcohol-200C or Alc, "vehicle" of homeopathic drug), was orally administered to toxicant-fed mice. Sub-groups of the mice receiving Chel-200 were also fed either AA or an Alc placebo and their individual and conjoint effects were studied against the respective controls, to evaluate if the combination therapy of Chel-200 with AA can be of additional help in the amelioration of the toxicities generated by the toxicants. The combined feeding of Chel-200 and AA appeared to reduce the cytotoxic and genotoxic effects significantly, when compared to either only the Chel-200 or AA fed group. A similar trend was also obtained in the results of scanning and transmission electron microscopic studies of the livers. Experiments in other mammalian models are warranted to confirm if these drugs in combination could be used in palliative care of human patients with liver diseases including cancer.
Park, Yeon Won;Moon, Han Ju;Han, Jung Suk;Han, Ji Min;Park, Jong Wook;Ku, Yun Hyi
Journal of Yeungnam Medical Science
/
v.34
no.2
/
pp.247-253
/
2017
Approximately 10-15% of pheochromocytomas are malignant. There are insufficient histologic criteria for the diagnosis of malignant pheochromocytoma. Thus, the term malignant pheochromocytoma is restricted to tumors with local invasion or distant metastases. We experienced a case of malignant pheochromocytoma recurred with spinal metastasis 4 years after the surgery for huge benign pheochromocytoma. A 68-year-old female was admitted for trunk and back pain. The patient had a history of surgery 4 years ago for a $10.0{\times}9.5{\times}7.5cm$ sized benign pheochromocytoma at the left adrenal gland. A thoracolumbar magnetic resonance imaging showed a tumor in the 7th thoracic vertebral body and a 24-hour urinary norepinephrine increased, suggesting metastatic recurrence of malignant pheochromocytoma. After metastasectomy in the 7th thoracic vertebral body, urine catecholamine was normalized and pain also disappeared. However, a metastatic lesion was found in the paraaortic area on a follow-up abdominal computed tomography scan and an additional metastasectomy was performed. The pathology confirmed the diagnosis of metastatic pheochromocytoma in the paraaortic lymph nodes. She is supposed to be treated with adjuvant iodine 131-meta-iodobenzylguanidine therapy. In our experience, a close follow-up should be considered in patients who had a huge benign pheochromocytoma due to the possibility of malignant metastases.
Celik, Orcun;Akand, Murat;Keskin, Mehmet Zeynel;Ekin, Rahmi Gokhan;Yoldas, Mehmet;Ilbey, Yusuf Ozlem
Asian Pacific Journal of Cancer Prevention
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v.17
no.4
/
pp.1755-1758
/
2016
Background: Anemia is the most common hematologic abnormality in bladder cancer (BC) patients. We evaluated the impact of preoperative anemia on oncologic outcomes in BC undergoing transurethral resection of a bladder tumor (TURBT) for the first time diagnosis. Materials and Methods: We retrospectively evaluated the data collected from 639 patients who underwent TURBT between January 2006 and September 2014 in our department. Of these patients, 320 qualified for inclusion in the study. The primary efficacy endpoint was the effect of preoperative anemia status on cancer-specific and overall survival. Independent t-test and chi-square analyses were performed to assess the effects of anemia on oncologic outcomes. Survival was estimated by using the Kaplan-Meier test. Results: There were 118 (36.9%) and 202 (63.1%) patients in the anemia (Group-1) and non-anemia groups (Group-2), respectively. The median follow-up duration was 68 months. Anemia was associated with decreased overall survival (p<0.001). Comparison between cancer-specific survival of two groups did not show any statistically significant difference (p=0.17). Conclusions: Preoperative anemia status of BC patients according to World Health Organization classification is associated with decreased overall survival, but not with cancer-specific survival. We think that preoperative hemoglobin levels should be considered in patient counseling and decision-making for additional therapy.
The purpose of this study was to evaluate the effects of horseback riding simulation training(HRST) on gross motor function of children with cerebral palsy. Twenty-four children with cerebral palsy participated were divided into two groups randomly. Control group and experimental group both received 30 minutes of regular neuro-rehab exercises for three times a week per twelve weeks, but experimental group received additional 15 minutes of the HRST. Gross Motor Function Measure(GMFM) was used to evaluate the changes before and after HRST. Normalized GMFM scores were compared using Mann-Whitney U test, statistical significance was set at a=.05. The results were as followings: First, in each compared before and after the experiment, the control group showed significantly increased GMFM score in dimensions A and B. The experimental group showed significant increasing in all dimensions of GMFM test. Second, the experimental group showed significant differences comparing to control group in dimensions C, D and E of GMFM test. Consequently, HRST should be considered as a therapeutic method for physical therapy for the children with cerebral palsy to improve the functional movements.
Oh, Seo Young;Lee, Hyun;Yun, Gee Won;Kang, Jae Hui
Journal of Acupuncture Research
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v.34
no.2
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pp.49-59
/
2017
Objectives : This study evaluated the efficacy of electroacupuncture therapy using an insulated needle in adults with abdominal obesity. Methods : This study was a randomized, double-blind, parallel-designed pilot trial. Sixteen participants eligible according to the inclusion and exclusion criteria were randomly divided into an insulated needle group and a control group. Insulated or common needles were inserted at acupoints located on the abdomen (CV12, CV6, ST25, ST27, SP15) and were electrically stimulated for 30 minutes (16 Hz, within tolerable strength). A total of 10 sessions of treatment were performed twice per week for 5 weeks. All participants were requested to maintain their usual diet and lifestyle. The outcome measures were waist circumference (WC), waist-to-hip ratio (WHR), and abdominal computed tomography (CT) of the total fat area (TFA), subcutaneous fat area (SFA), and visceral fat area (VFA). Results : A total of 12 participants divided into the insulated needle group (n = 5) and the control group (n = 7; common needle) were treated for 10 sessions and analyzed per-protocol (PP). WC decreased significantly after 10 sessions in both groups. The WC, TFA, SFA, and VFA of abdominal CT in the insulated needle group decreased more than in the control group; however, there were no significant differences in any parameter between the insulated needle group and the control group. Patients in the insulated needle group were more strongly stimulated with electrical stimulation than patients in the control group. Conclusion : Electroacupuncture using insulated needles in adults with abdominal obesity might be a more effective treatment than common needles. Additional studies are required to compensate for the limitations of this pilot study and to verify the results and efficacy.
Park Myung-Won;Lee Sung-Bok;Kwon Kung-Rock;Choi Dae-Gyun
The Journal of Korean Academy of Prosthodontics
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v.43
no.4
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pp.519-527
/
2005
Statement of problem : There are many articles that showed that the magnetism affected the bone formation around titanium implant. It means that a proper magnetism made the osseointegration improved around the implant. So after additional research on the other effect of magnetism on bone formation in implant therapy, we can conclude its possibility of clinical application on implant treatment. Purpose: The purposes of this study were to find out the intensity of magnetic field where magnetism in the titanium implant specimen inserted into the bone could affect the bone formation, and to discover the possibility of clinical application in the areas of dental implants and bone grafts. Material and method: Ten adult male rabbits(mean BW 2Kg) were used in this study. Titanium implant specimens were surgically implanted on the mesial side of the tibia of rabbits. Neodymium magnets(Magnedisc 500, Aichi Steel Corp. Japan) were placed into the implants of experimental group except control group, just after placement of the titanium implants. At 2, 4 and 8 weeks after the surgery, the animals were sacrificed, specimens were obtained and stained with Hematoxylin-Eosin for light microscopic evaluation and histomorphometric analysis. Conclusion : The results were as follows: 1. In radiographic findings, increased radiopacity downward from crestal bone was observed along the titanium implant specimen at experimental period passed by 2, 4, and 8 weeks in both control and experimental group. 2. In histoiogic findings, increased new bone formation was shown in both control and experimental group through the experiment performed for 2, 4, and 8 weeks. More new bone formation and bone remodeling were shown in experimental group. 3. In histomorphometric analysis, the bone contact ratios were 11.9% for control group and 38.5% for experimental group (p<0.05).
Background Autologous or implant-based breast reconstruction after nipple-sparing mastectomy is increasingly preferred worldwide as a breast cancer treatment option. However, postoperative nipple-areola complex (NAC) necrosis is the most significant complication of nipple-sparing mastectomy. The purpose of our study was to identify the risk factors for NAC necrosis, and to describe the use of our skin-banking technique as a solution. Methods We reviewed cases of immediate autologous breast reconstruction after nipple-sparing mastectomy at our institution between June 2005 and January 2014. The patients' data were reviewed and the risk of NAC necrosis was analyzed based on correlations between patient variables and NAC necrosis. Moreover, data pertaining to five high-risk patients who underwent the donor skin-banking procedure were included in the analysis. Results Eighty-five patients underwent immediate autologous breast reconstruction after nipple-sparing mastectomy during the study period. Partial or total NAC necrosis occurred in 36 patients (43.4%). Univariate analysis and binary regression modeling found that body mass index, smoking history, radiation therapy, and mastectomy volume were significantly associated with NAC necrosis. Of the 36 cases of NAC necrosis, 31 were resolved with dressing changes, debridement, or skin grafting. The other five high-risk patients underwent our prophylactic skin-banking technique during breast reconstruction surgery. Conclusions NAC necrosis is common in patients with multiple risk factors. The use of the skin-banking technique in immediate autologous breast reconstruction is an attractive option for high-risk patients. Banked skin can be used in such cases without requiring additional donor tissue, with good results in terms of aesthetic and reconstructive outcomes.
Objectives : Sleep Disorders are very common in clinical stages and there are many reports and papers regarding this subject. I try to understand the present state of sleep research in JON (The Journal of Oriental Neuropsychiatry) for the benefits of clinical practice. Methods : We searched and read every article on JON from 1990 to 2012 and selected ones that are related to Sleep Disorder; then analyzed the data to 5 categories, like literature study, case study, Clinical Data-Analysis study, experimental study, and clinical trial. Results : 1. We Found 41 articles relating to sleep disorder in JON form 1999 to 2012, and there were 9 literature studies, 13 case studies, 13 Clinical Data-Analysis studies, 4 experimental studies, and 2 clinical trials. 2. There were Sa-Am Acupuncture Method, Pharmacopuncture, electroacupuncture, and Auricular acupuncture to treat Sleep Disorder. 3. There were many additional treatments like Purgative Therapy, etc. 4. They reported the ordinary sleep pattern of Soeumin and Soyangin, too. 5. In the experimental study, they reported several herbs, herbal prescription on the expression of melatonin receptors, and Punsimgeimgamibang on insomnia, anxiety, emotionality in rats. 6. There were 2 clinical trials, one for Hwabyung-patient with insomnia by acupuncture treatment and another for insomnia in the elderly by ETF-I program. 7. There were 2 case of other sleep disorder (enuresis, sleepwalking) and 2 literature study of dream. Conclusions : In JON regarding sleep disorder, the majority was due to insomnia. Therefore, we also have to expand our sight into other sleep diseases. We need more clinical trials and experimental researches for the construction of EBM Sleep Disorder in Oriental Neuropsychiatry.
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