• Journal of Yeungnam Medical Science
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• 제39권3호
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• pp.235-243
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• 2022

Background: Intrahepatic cholangiocarcinoma (ICC) of the left liver often shows left-sided lymph node (LN) metastasis. If gastric lesser curvature is extensively dissected, it can induce an iatrogenic injury to the extragastric vagus nerve branches that control motility of the pyloric sphincter and lead to gastric stasis. To cope with such LN dissection-associated gastric stasis, we performed pyloroplasty preemptively. The objective of this study was to analyze our 20-year experience of preemptive pyloroplasty performed in 10 patients. Methods: We investigated clinical sequences of 10 patients with ICC who underwent preemptive pyloroplasty following left hepatectomy and extended left-sided LN dissection. Incidence of gastric stasis and oncological survival outcomes were analyzed. Results: All 10 patients were classified as stage IIIB due to T1-3N1M0 stage according to the 8th edition of American Joint Committee on Cancer staging system. The overall patient survival rate was 51.9% at 1 year, 25.9% at 2 years, and 0% at 3 years. Seven patients showed uneventful postoperative recovery after surgery. Two patients suffered from gastric stasis, which was successfully managed with supportive care. One patient suffered from overt gastric paresis, which was successfully managed with azithromycin administration for 1 month. Conclusion: We believe that preemptive pyloroplasty is an effective surgical option to prevent gastric stasis in patients undergoing extensive left-sided LN dissection. Azithromycin appears to be a potent prokinetic agent in gastroparesis.

• 상하수도학회지
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• 제24권6호
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• pp.713-722
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• 2010

This paper has assessed the flow patterns and settling efficiency in the sedimentation basin using the particle tracking method of the CFD code and has reached the following conclusions: In the original design where no baffle is installed in the sedimentation basin, a large recirculating area where the flow stagnates is created in the right side of the sedimentation basin, with most of the particles moving to the left side of the sedimentation basin following the flow. This biased flow structure in the sedimentation basin reduces the residence time of particles and thereby undermines settling efficiency. The biased flow toward the left side of the sedimentation basin is alleviated by installing a baffle in the sedimentation basin, promptly reducing the fast flow of over 0.7 m/s in the inlet of the sedimentation basin to the rate below 0.2 m/s. In this paper's simulation conditions, if a one-sided baffle is to be installed in the sedimentation basin, placing it 15 meters away from the basin's inlet leads to the best settling efficiency; it has also been analyzed that installing a two-sided baffle-rather than a one-sided one-is a better option in terms of settling efficiency. The highest settling efficiency of 96.2% is achieved when the underwater length of the two-sided baffle is set at 8 meters.

• 대한인간공학회지
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• 제13권1호
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• pp.15-25
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• 1994

Based on Fatal Accident Reporting System (FARS) data, safety belt effect- tiveness in preventing fatalities is investigated for the following five types of crashes: frontal, left, rear, right, and rollover. Passenger cars containing two occupants, a driver and a right front passenger, are included in this analysis. For each crash type, these cars containing the two occupants are classified into four categories according to the safety belt usage categories for the two front seat occupants, namely, both belted, both unbelted, and either one was belted but not both. Relative risks of driver and right front passenger fatalities are compared among these four cases. For each crash type, two independent estimates of safety belt effectiveness are obtained for drivers and for right front passengers. The weighted average of the two estimates is calculated for drivers and for right front passengers for the five crash types. Using FARS data starting 1978 throught 1983, safety belts are more effective in rollover accidents than in frontal collisions. In rollover accidents, safety belt effectiveness estimate for drivers is $68%{\pm} 6% $ and that for right front passengers is $71%{\pm}6% $ , in which the error limits indicate one standard error. Sfety belt effectiveness estimates for drivers and right front passengers involved in frontal collisions are $41%{\pm} 9% $ and $37%{\pm} 10% $ , respectively. For left and right sided collisions and for both drivers and right-front-passengers, none of the four estimates are significantly different from 0%, statistically : however, when left and right sided collisions are combined with far sided occupants(drivers involved in right sided collisions and right front passengers involved in left sided collisions) safety belt effectiveness is significant, $38%{\pm} 12% $ . For rear collisions, the estimate for drivers shows statistically significant positive effect, $60%{\pm}23% $ . while for right-front-passengers the estimate is not significantly different from 0%. These results show that a safety belt is an effective restraint system not only in frontal crashes but also in a variety of crashes.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.279-282
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• 2012

Background: Although more than two third of colorectal cancers are localized on the left side, recent studies suggest a right ward shift in anatomical distribution with increase in proximal colon cancers. The aim of the present study was to determine the anatomical distribution of colorectal cancer in a referral center over a 15 year period. Method: Records of patients who underwent colectomy in the Cancer Institute of Iran from 1994 to 2009 were retrieved. Data including anatomical localization, year of diagnosis, patient age and gender, tumor histology and differentiation, and disease stage were extracted. Tumors located from the cecum to the distal transverse colon were classified as right side and those occurring from the splenic flexure to the descending colon as left-sided. Cancer of rectum and recto-sigmoid junction were considered as rectal cancers. Results: A total of 442 patients including 220 (49/8%) men and 222 (50/2%) women with mean age 53 were included. Most patients were in stage II &III (47.1% and 33% respectively). There were 157 (35.5 %) colon cancers and 285 (64.5%) rectal cancers. 43.3% of the colon cancers were right sided and 56.7% were left sided. There was no statistically significant increase in right sided cancer during the period of the study. There were no significant differences in age at diagnosis, gender, grade and stage of tumor between the right and the left sided cancers. Conclusion: No proximal shift over time was identified in our study.

• Advances in pediatric surgery
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• 제12권2호
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• pp.257-261
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• 2006

Appendicitis is a common disease in children. But left lower abdominal pain in acute appendicitis is a rare clinical feature. A 6 year-old-girl complained of left sided abdominal pain for 2 days. Past medical history was not contributory. Abdominal tenderness and guarding in left lower quadrant were noticed. Abdominal sonography and abdominal computed tomography scan demonstrated reversed position between superior mesenteric artery and vein, and a mass in the left lower quadrant abdomen suggesting appendicitis. Acute appendicitis in left lower quadrant, associated with intestinal malrotation, was found at laparatomy.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2319-2321
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• 2014

Our aim was to determine GSTT1 expression levels in left colon tumors and paired normal tissue in order to identify specific alterations in GSTT1 mRNA levels. Alterations in GSTT1 expression in twenty-four left-sided colon tumors and paired cancer free tissue were determined by qRT-PCR. Significant fold changes were determined with t-test. When compared with cancer free tissue, left colon cancers showed a significant decrease in GSTT1 expression. However, GSTT1 mRNA levels among different grades increased gradually in correlation with tumor grade. Our results suggest that downregulation of GSTT1 in left-sided colon cancers is an early event and is reversed with cancer progression, probably due to cellular defense mechanisms as a response to changes in the microenvironment.

• Radiation Oncology Journal
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• 제32권2호
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• pp.84-94
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• 2014

Purpose: To quantify the cardiac dose reduction during breathing adapted radiotherapy using Real-time Position Management (RPM) system in the treatment of left-sided breast cancer. Materials and Methods: Twenty-two patients with left-sided breast cancer underwent CT scans during breathing maneuvers including free breathing (FB), deep inspiration breath-hold (DIBH), and end inspiration breath-hold (EIBH). The RPM system was used to monitor respiratory motion, and the in-house self respiration monitoring (SRM) system was used for visual feedback. For each scan, treatment plans were generated and dosimetric parameters from DIBH and EIBH plans were compared to those of FB plans. Results: All patients completed CT scans with different breathing maneuvers. When compared with FB plans, DIBH plans demonstrated significant reductions in irradiated heart volume and the heart $V_{25}$, with the relative reduction of 71% and 70%, respectively (p < 0.001). EIBH plans also resulted in significantly smaller irradiated heart volume and lower heart $V_{25}$ than FB plans, with the relative reduction of 39% and 37%, respectively (p = 0.002). Despite of significant expansion of lung volume using inspiration breath-hold, there were no significant differences in left lung $V_{25}$ among the three plans. Conclusion: In comparison with FB, both DIBH and EIBH plans demonstrated a significant reduction of radiation dose to the heart. In the training course, SRM system was useful and effective in terms of positional reproducibility and patient compliance.

• Journal of Chest Surgery
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• 제23권6호
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• pp.1280-1287
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• 1990

A seven month old female infant with isolated ventricular inversion and anatomically corrected malposition of the great arteries in situs solitus, associated with ventricular septal defect, patent ductus arteriosus, right-sided juxtaposition of left atrial appendage, is reported. The patient showed usual atrial arrangement with somewhat superoinferior relation, a discordant atrioventricular connection, and a concordant ventriculoarterial connection with aorta in the right-sided position. A normal sized left atrium was connected to the left superiorly positioned morphologic right ventricle through a tricuspid valve, which crossed the left ventricular outflow tract anteriorly. Well developed bilateral[subaortic and sub-pulmonary]conus was documented at operative field. successful surgical repair was done by performing the Senning procedure and by closing the ventricular sepal defect with a patch through the right ventriculotomy. The infant’s postoperative course was uneventful with normal sinus rhythm. Postoperative cardiac catheterization revealed no hemodynamic obstruction or residual shunt.

• 대한물리치료과학회지
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• 제1권1호
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• pp.129-134
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• 1994

The purpose of this study is to conduct a retrospective chart audit of initial physical therapy evaluation to determine the incidence of sitting imbalance and its relationship to the side of weakness in hemiparetic patients. A review of the records of 36 patients revealed that the left side was predominantly affected in 17 patients and the right side in 19 patients. Ages, time since onset, and proportion of men and women did not difer between the left and right hemiparetic patients. About half patients(52.8%) could sit independently, but 64.7% of those with left-sided weak-ness and 31.6% of those with right-sided weakness could not. A chi-sequare analysis revealed a significant relationship between the side of weakness and independent sitting balance(p<0.1). Patients with left hemiplegia are more likely to have difficulty with independent sitting balance(p<0.1). Patient with left hemiplegia are more likely to have difficulty with independent sitting than patients with right hemiplegia, which may affect their progress in rehabilitation.

• Journal of applied mathematics & informatics
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• 제20권1_2호
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• pp.455-464
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• 2006

In this paper, we introduce the concept of an interval-valued fuzzy left (right, two-sided, interior, bi-) ideal generated by an interval-valued fuzzy subset in semigroups. Some characterizations of such generated interval-valued fuzzy ideals are also discussed.