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Clinical Analysis of Traumatic Diaphragmatic injuries Report of 28 cases (외상성 횡경막 손상 28례 분석보고)

  • 장진우;이연재
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.402-407
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    • 1997
  • The records of 28 patients with traumatic diaphragmatic injuries seen at Masan Samsung Hospital from march 1986 o March 1995 were reviewed. We treated 21 male and 7 female patients ranging in ages from 5 to 68 years. Thc diaphragimatic injuries were due to blunt trauma in'20 cases(Trawc accident 18, compression injury 1, Human trauma 1) and penetrating injuries 8 cases (all stab wound). Most common symptoms were dyspnea 27 (96%), chest pain 26 (93%), abdomianl pain 8 (29%), comatose mentality 36 (11 %). Chest X-ray were elevated diaphragm in 20 cases(71%) find hemothorax in 18 cases (64%) and 25 cascs (89%) were diagnosed or suspected as diaphragmatic inju,rims prcopcrativcly. The repair of 28 cases were performed with thoracic approach in 20 cases, abdominal approach 7, thoracoabdominal approach in 1 cases. There were 5 death (18%) and all death related to the severity of associated injury. (hypovolcmic shock 3, combined head injury 1, renal failure 1).

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Capecitabine Pattern of Usage, Rate of Febrile Neutropaenia and Treatment Related Death in Asian Cancer Patients in Clinical Practice

  • Phua, Vincent Chee Ee;Wong, Wei Quan;Tan, Pei Lin;Bustam, Anita Zarina;Saad, Marniza;Alip, Adlinda;Ishak, Wan Zamaniah Wan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1449-1453
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    • 2015
  • Background: Oral capecitabine is increasingly replacing intravenous 5-fluorouracil in many chemotherapy regimens. However, data on the risk of febrile neutropaenia (FN) and treatment related death (TRD) with the drug remain sparse outside of clinical trial settings despite its widespread usage. This study aimed to determine these rates in a large cohort of patients treated in the University of Malaya Medical Centre (UMMC). Materials and Methods: We reviewed the clinical notes of all patients prescribed with oral capecitabine chemotherapy for any tumour sites in University Malaya Medical Centre (UMMC) from $1^{st}$ January 2009 till $31^{st}$ June 2010. Information collected included patient demographics, histopathological features, treatment received including the different chemotherapy regimens and intent of treatment whether the chemotherapy was given for neoadjuvant, concurrent with radiation, adjuvant or palliative intent. The aim of this study is to establish the pattern of usage, FN and TRD rates with capecitabine in clinical practice outside of clinical trial setting. FN is defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$ (de Naurois et al., 2010). Treatment related death was defined as death occurring during or within 30 days of last chemotherapy treatment. Results: Between $1^{st}$ January 2009 and $30^{th}$ June 2010, 274 patients were treated with capecitabine chemotherapy in UMMC. The mean age was 58 years (range 22 to 82 years). Capecitabine was used in 14 different tumour sites with the colorectal site predominating with a total of 128 cases (46.7%), followed by breast cancer (35.8%). Capecitabine was most commonly used in the palliative setting accounting for 63.9% of the cases, followed by the adjuvant setting (19.7%). The most common regimen was single agent capecitabine with 129 cases (47.1%). The other common regimens were XELOX (21.5%) and ECX (10.2%). The main result of this study showed an overall FN rate of 2.2% (6/274). The overall TRD rate was 5.1% (14/274). The FN rate for the single agent capecitabine regimen was 1.6% (2/129) and the TRD rate was 5.4% (7/129). All the TRDs were with single agent capecitabine regimen were used for palliative intent. Conclusions: Oral capecitabine is used widely in clinical practice in a myriad of tumour sites and bears a low risk of febrile neutropaenia. However, capecitabine like any other intravenous chemotherapeutic agent carries a significant risk of treatment related death.

Analysis of premature death of Sprague-Dawley rats in carcinogenicity studies

  • Son, Woo-Chan;Kim, Bae-Hwan
    • Korean Journal of Veterinary Research
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    • v.44 no.3
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    • pp.373-378
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    • 2004
  • To help the interpretation of causes of death, it is critical that the background incidence of factors contributing to death be recorded and archived. Information was gathered from the control groups of 19 rat carcinogenicity studies. All cases of death occurring within the 2-year period were reviewed. Out of 1124 males and 1084 females, 720 male (64.1%) and 689 female (63.6%) decedents were recorded. There was no difference in the probability of survival between two sexes. Analysis of factors contributing to death revealed that 400 males (48.7%) had neoplastic changes, 189 males (23.0%) had non-neoplastic lesions, and 232 males (28.3%) died from unknown causes. In females, these figures were 627 (76.4%), 62 (7.6%) and 132 (16.0%), for neoplastic, non-neoplastic and unknown findings, respectively. It could be suggested that the risk of death by non-neoplastic reasons was higher in the males than in the females, whereas females were more likely to be affected by tumours. In the neoplastic causes of death, pituitary tumours were the most common in both sexes, followed by mammary tumours in females, and haemopoietic tumours in males. In non-neoplastic cause of death, renal diseases were the most common in both sexes, followed by skin diseases and cardiovascular diseases in males, and skin diseases and poditis in males. A relatively large number of animals (28.3% in males and 16.0% in females) were found dead, without any significant clinical or histologically identifiable cause. Most of the animals with pituitary tumours were killed in extremis and the proportion of females (70.1%) being greater than males (46.8%). There were no case which died by accident, and also only minimal incidence which died by bleeding procedures.

Clinical analysis of mediastinal tumor (종격동 종양의 임상적 고찰;34례 임상경험)

  • 박재홍
    • Journal of Chest Surgery
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    • v.26 no.12
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    • pp.940-943
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    • 1993
  • Mediastinal tumors have long fascinated the thoracic surgeon of their variety and unpredictability of iagnosis prior to exploration.We report the analysis of the 34 cases of mediastinal tumors,experenced in the dept.of the Thoracic and Cardiovascular Surgery of the National Medical Center.Between the 1993.9-1992.12. The age distribution was relatively even and the mean age was 35 years old.The thymomas were 16 cases [ 47% ].the lipoma were 4 cases [12%].the germ cell tumors were 7 cases [20%].the neurogenic tumors were 3 cases [8%].Histologically analysised .The malignant tumors were 16 cases [17.6%] in classified by hisotlogical types.the tumor size,location,and the clinical manifestation are presented.The successful removal was done in 28 cases [ 100%] among 28 cases of benign mediastinal tumors. Among the 6 cases of malignancy mediastinal tumors, the surgical intervention had done in 5 cases [ 83%] and inoperatable cases were 1 case [16.6%].There was no operative death.

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Clinical Analysis of Chest Trauma; Analysis of 247 patients (흉부 손상의 임상적 고찰)

  • 김승규
    • Journal of Chest Surgery
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    • v.26 no.12
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    • pp.944-949
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    • 1993
  • Clinical analysis were performed on 247 cases of thoracic trauma, those were admitted & treated at the department of thoracic & cardiovascular surgery,Hanyang University Hospital during the period from Jan,1989 to June,1992. Age distribution of those was from 2 to 80 years old & mean age was 38 years old. The ratio of male to female patient was 186:61 [3:1].This ratio revealed high incidence in male patient. The most common cause of trauma was traffic accident in this series.The modes of injury were as follows: traffic accident 124 cases[50.2%],fall down 52 cases[21.05%], stab wound 47 cases[19.03%] and gun-shut wound 1 case.Ellapse time from accident to admission were 141 cases [57.09%] under 6 hr.Rib fracture were observed in 159 cases[64.37%], hemo or pneumothorax were observed 134 cases[54.25%] of total cases and location distributed Right:Left:Both[74:112:37], in left predominant. Conservative,non-operative treatment were performed in 128 cases and operation[open thoracotomy] 32 cases.Mortality was 1.6%[4 cases] & most common cause of death were due to irreversible shock with brain edema. Conclusively, more evaluation & co-operation of other department were expected treatment & better prognosis.

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Clinical Experience of Stenotic Anastoma of Neck after Reconstuctive Surgery for Corrosive Esophageal Stricture (재수술을 요한 식도재건술 환자의 원인분석과 임상적 고찰)

  • 안욱수
    • Journal of Chest Surgery
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    • v.25 no.2
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    • pp.183-187
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    • 1992
  • Reconstructive surgery for corrosive esophageal stricture was performed in 392 patients at National Medical Center from 1959 to 1990 Between Jan. 1971 and Dec. 1990, 23 cases were experienced stenotic anastoma of neck after reconstructive surgery for corrosive esophageal stricture. The major procedure of esophageal reconstruction was colon interposition without resection of the strictured esophagus except jejunal interposition in 1 case. There were 12 males % 11 females, and mean age was forty years. The caustic materials were 16[70%] alkali and 7[30%] acid. Half of the cases had hypopharyngeal injury. After reconstructed surgery, dysphagia was developed immediate in 65%, from 2 months to 5 months in 31%, and from years in 4%[1 case]. The complications were anastomatic leakage in 13 cases, anastomatic stenosis in 8 cases, graft gangrene in 1 case, and cancer development in 1 case. The therapeutic procedures were end-to-end anstomolis & partial resection of stenotic anastoma in 18 cases, bourgination in 2 cases, and coin interposition with graft removal in 3 cases. The therapeutic results were excellent in 16 cases, mild discomfort in 3 cases, poor in 3 cases, and death in 1 cases.

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Survival of Colorectal Cancer Patients in the Presence of Competing-Risk

  • Baghestani, Ahmad Reza;Daneshvar, Tahoura;Pourhoseingholi, Mohamad Amin;Asadzade, Hamid
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6253-6255
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    • 2014
  • Background: Colorectal cancer (CRC) is considered to be a main cause of malignancy-related death in the world, being commonly diagnosed in both men and women. It is the third leading cause of cancer dependent death in the world and there are one million new cases diagnosed per year. In Iran the incidence of colorectal cancer has increased during the last 25 years and it is the fifth cause of cancer in men and the third in women. Materials and Methods: In this article we analyzed the survival of 475 colorectal patients of Taleghani hospital in Tehran with the semi-parametric competing-risks model. Results: There were 55% male cases and at the time of the diagnosis most of the patients were between 48 and 67years old. The probability of a patient death from colorectal cancer with survival of more than 25 years was about 0.4. Body mass index, height, tumour site and gender had no influence. Conclusions: According to these data and by using semi-parametric competing-risks method, we found out that only age at diagnosis has a significant effect on these patient survival time.

The Incidence and Mortality for Hip Fracture in the Elderly in Jeju-do (제주도 노인에서 고관절 골절 발생률과 사망률)

  • Kim, Ho-Bong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.2
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    • pp.44-49
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    • 2009
  • Purpose : The purpose of this study was to evaluate the incidence and mortality for hip fracture in the elderly in Jeju-do. Methods : We enrolled 254 cases among 318 patients older than 50 years of age with a hip fracture during two years period(2003-2004). We investigated the incidence and mortality during follow up 3~4 years period until December 31, 2007. Results : The crude incidences of hip fracture the age group ${\geq}50$ years were 141(11.2/10,000) in 2003, 177(13.6/10,000) in 2004, and 249(17.0/10,000), 69(6.3/10,000) for women and men, respectively. The mean age of them was 78.3 years, male was 69(21.7%), female was 249(78.3%) among 318 patients. Survivor was in the 146(57.5%), death was in the 108(42.5%) among 254 cases period for follow up. In the death group, activity was significantly lower at the time of post-fracture 3(p=0.013), 6(p=0.000), and 12 months(p=0.000). The mortality of hip fracture and crude death rate(CDR) were 108(42.5%, n=254), 11,884(1.7%, n=675,889) in 2003~2007 in Jeju. Conclusion : Developing and applying a variety of activity programs that increase activity in post-fracture may improve activities of daily living, reduce burden of family and society, be useful in improving the quality of life and ultimately lower the mortality.

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Primary Malignant Cardiac Tumor (심장에 발생한 원발성 악성종양)

  • 여승동
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1265-1268
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    • 1992
  • Primary tumors of the heart are extremely rare, and about 25 per cent of all primary cardiac tumors are malignant. Recently We experinced three cases of primary malignant tumor; malignant fibrous histiwytoma, carcinosarcoma, and synovial sarcoma, These three cases involved 2 men and 1 woman. There was one operative death, and two operative survivors died of metastatic disease at 12 months postoperatively in spite of chemotherapy and radiotherapy. We report these three cases of primary malignant cardiac tumors with review of the literatures.

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A clinical evaluation of 76 chest injuries (흉부손상 76례에 대한 임상적 관찰)

  • 윤갑진
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.110-117
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    • 1984
  • A clinical evaluation was performed on 76 cases of chest injury experienced at department of Chest Surgery, Capital Armed Forces General Hospital during the past 3 years period from January 1981 to August 1983. 1.The most common cause of the chest trauma was gun shot by which 26 cases were injured among 44 cases [57.9%] of penetrating injury. Remaining 32 cases [42.1%] were injured by non-penetrating blunt trauma. 2.Hemopneumothorax was observed in 60 cases [78.9%], those were caused by both penetrating [65%] and non-penetrating [35%] injuries. 3.Rib fracture was found in 58.7% of total cases and with rib fracture, clavicle fracture was combined at 19.6% and sternal fracture, at 8.7%. 4.Most common symptoms were chest pain and dyspnea, and most common signs were breath sound diminution and subcutaneous emphysema. 5.Common site of rib fracture was from 4th rib to 8th rib [69.4%]. 6.In 58 cases [76.3%], patients were treated with operation including open thoracotomy [25 cases]. 7.Overall mortality was 5.3%[4 cases] and causes of death were septic shock and respiratory failure.

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