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Oncologic Results and Functional Assessment of Limb Salvage Surgery in Primary Bone Tumors Around the Shoulder Girdle (견관절 주위 원발성 골 종양에서 사지 구제술의 종양학적 결과 및 기능적 평가)

  • Lee, Sang-Hoon;Yoo, Jae-Ho;Oh, Joo-Han;Suh, Sung-Wook;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.3
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    • pp.96-105
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    • 2002
  • Purpose: The purpose of this study was to assess the oncologic results and functional outcomes of limb salvage surgery performed in patients of primary bone tumors of the shoulder girdle. Materials and Methods: Twenty-nine patients who underwent limb sparing resection for shoulder girdle neoplasm between 1982 and 2001 were analyzed. Follow up periods averaged 7 years and 1 month. Mean age of the patients was 35 (11~71) years. There were 14 males and 15 females. Primary malignant bone tumors of shoulder girdle (proximal humerus 21, scapula 3, both 1) were 23 cases; osteosarcomas 7, chondrosarcoma 14, parosteal osteosarcoma 1, hemangioendothelioma 1, and giant cell tumor of proximal humerus were 6 cases. Limb salvage surgery was performed by curettage and cementing in 7 patients, by cement molding arthroplasty in 10 patients, and by tumor prosthesis in 7 patients, by other method such as resection only, bone graft, arthrodesis in 5 patients. The Musculoskeletal Tumor Society functional rating system was used to assess functional outcomes. Results: One osteosarcoma and 2 chondrosarcoma patients died, and the survival of the salvaged limb was 88.6% at the final follow-up. There were 6 local recurrences, 2 lung metastases, 2 local recurrences and lung metastases. The functional outcome was 80%. There was statistically significant difference of functional results among the patients treated by cement filling (86%), cement molding arthroplasty and IM nailing (71%), and tumor prosthesis (83%). (p=0.034) There were three complications including 1 radial nerve palsy and 1 axillary nerve palsy, and 1 wound infection. Dislodgement of vascularized fibular graft in one patient was treated by internal fixation. Conclusion: Limb salvage surgery seems to be useful method to treat bone tumors of the shoulder girdle.

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Effect of Cholesterol Supplementation in Freezing Medium on the Survival and Integrity of Human Sperm after Cryopreservation (콜레스테롤이 동결-해동 후 인간정자의 생존과 기능보존에 미치는 영향)

  • Lim, Jung-Jin;Sung, Su-Ye;Kim, Kye-Seong;Song, Seung-Hon;Lee, Woo-Sik;Yoon, Tae-Ki;Lee, Dong-Ryul
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.3
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    • pp.203-212
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    • 2008
  • Objective: During cryopreservation process, cold shock and cryo-injury affect the fertilizing capacity of the sperm by damaging cell membranes with loss of functional integrity. A longstanding concept for preventing the cryo-damage is to stabilize the plasma membrane by incorporating cholesterol. This study was to determine the effects of cholesterol in freezing media on the motility and functional integrity of human sperm after cryopreservation. Methods: Control group (non-cholesterol treated) and different concentrations of cholesterol-treated sperm (14 healthy males) were frozen and thawed. After freezing and thawing of sperm, the quality of sperm was evaluated by sperm analysis, acrosome reaction test and sperm chromatin structure assay. Results: When human sperm were incubated in sperm freezing medium (SFM) containing $0.5{\mu}g$ cholesterol and then freezing/thawing, the motility of sperm have significantly improved compared to those untreated cholesterol ($33.46{\pm}1.48%$ vs. $30.10{\pm}1.07%$, p<0.05). The rate of calcium ionophore-induced acrosome reactions in post-thawed sperm was significantly higher than that ($53.60{\pm}1.60%$ vs. $47.40{\pm}1.86%$, p<0.05) in SFM containing cholesterol. Sperm chromatin structure assay revealed that DNA damage to the sperm in the cholesterol-treated group was lower than that of non-treated group. Conclusion: These results suggest that increased cholesterol content of sperm plasma membrane by supplementation of cholesterol in SFM improves sperm motility, capacitation status, and DNA integrity. Therefore, addition of cholesterol into SFM could be a useful for protecting human sperm from cold shock and cryo-injury during cryopreservation.

The Masking Effect According in Olfactory Stimulus on Horns Stimulus While Driving in Graphic Driving Simulator (화상 자동차 시뮬레이터에서 운전 중에 경적음 자극에 대한 후각자극의 마스킹 효과)

  • Min, Cheol-Kee;Ji, Doo-Hwan;Ko, Bok-Soo;Kim, Jin-Soo;Lee, Dong-Hyung;Ryu, Tae-Beum;Shin, Moon-Soo;Chung, Soon-Cheol;Min, Byung-Chan;Kang, Jin-Kyu
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.35 no.4
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    • pp.227-234
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    • 2012
  • In this study, the masking effect of olfactory stimulus on the awakening state due to sound stimuli while driving using Graphic Driving Simulator was observed through the response of autonomic nervous system. The test was conducted for 11 males in their twenties. The siren of ambulance car was presented to them as auditory stimulus for 30 secs while driving in a situation of high way in the condition of both peppermint and control, respectively, and LF/HF ratio of HRV (Heart Rate Variability), the activity index of sympathetic nerve, and GSR (Galvanic Skin Response) response were examined. The test was proceeded in the order of three stages, that is, sound stimuli (test 1), driving performance, and sound stimuli (test 2), and fragrance stimulus, driving performance, and sound stimuli (test 3), and the physiological signal of GSR, HRV was measured in the whole stages. As a result of test, comparing the results of before and after auditory stimulus test (1) (p < 0.01), test (2) (p < 0.05), and test (3) (p < 0.01), driving performance test (2) (p < 0.01), test (3) (p < 0.01), and olfactory stimulus test (3) (p < 0.05), respectively, GSR response increased, showing significant difference in all the tests. It indicates that when auditory stimulus was presented to the subjects, they were in the awakening state as sympathetic nervous system got activated. As a result of comparing auditory stimulus while driving before and after presenting olfactory stimulus, there was no significant difference in GSR response. The LF/HF ratio of HRV increased, showing a significant difference only in test (2) (p < 0.05), and in driving performance test (2) (p < 0.05) in auditory stimulus, however, it showed no significant difference in olfactory stimulus. As a result of comparing auditory stimulus while driving before and after presenting olfactory stimulus, there was a decrease, showing significant difference (p < 0.05) in LF/HF ratio of HRV. That is, it means that the activation of sympathetic nervous system decreased, and that parasympathetic nervous system got activated. From these results, it was observed that while driving, the awakening level due to auditory stimulus was settled with olfactory stimulus. In conclusion, it was drawn that while driving, olfactory stimulus could have the masking effect on auditory stimulus.

Evaluation of Result of Coronary Artery Bypass Graft Surgery by Using Pre and Postoperative Myocardial SPECT (관동맥우회술 전후의 심근 SPECT를 이용한 수술 결과의 평가)

  • 이장훈;한승세
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1083-1091
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    • 1997
  • This study was purposed to assess the result of coronary artery bypass graft surgery by analyzing and comparing the pre and postoperative myocardial perfusion state quantitatively by using myocardial SPECT. Twenty patients who received coronary artery bypass graft surgery since 1993 underwent both preoperative and postoperative myocardial SPECT and the result were analyzed. The mean age was 56.4$\pm$9.0 years, and the patients were composed of thirteen males and seven females. For quantitative analysis, we used polar maps of SPECT generated by Cedars-Sin i Medical Center program and we calculated perfusion scores, ischemic myocardial area ratios and reperfusion scores from polar maps. Preoperative mean stressfrest perfusion score was 7.3$\pm$ 1.117.7$\pm$ 1.0 and postoperative score was 8.1 $\pm$ 1 118.3$\pm$ 1.1. Preoperative mean stress ischemic myocardial area ratio was 0.32$\pm$0.2 and postoperative ratio was 0.15 $\pm$0.1. Postoperative mean perfusion score was significantly increased but, on the other hand, mean ischemic myocardial area ratio was significantly decreased as compared with preoperative values(p<0.01). Preoperative mean perfusion score of patients with postoperative roper(usion score more than 1.5 was significantly higher(p<0.01) than that of patients with postoperative reperfusion score less than 1.5. Preoperative perfusion scores of coronary artery territories that had fixed perfusion defect at myocardial SPECT were significantly low(4.3 $\pm$0.514.6$\pm$0.6, stresslrest), nevertheless it proved quantitatively that there was improvement in myocardial perfusion after surgery by showing improved perfusion scores postoperatively. In conclusion, myocardial SPECT is useful method for quantitative analysis of the myocardial perfusion state after coronary artery bypass grafting surgery.

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Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Ahn, Hyuk;Kim, Jun-Seok
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.177-184
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    • 1996
  • Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

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Reproductive Cycle of a Rockfish, Sebastes schlegeli (조피볼락의 생식주기)

  • BAEK Jae-Min;HAN Chang-Hee;KIM Dae-Jung;PARK Chul-Won;Aida Katsumi
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.33 no.5
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    • pp.431-438
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    • 2000
  • To clarify the annual reproductive cycle in a rockfish, Sebastes schlegeli, monthly changes in gonadosomatic index (GSI), hepatosomatic index (HSI) and histological feature of gonads and plasma levels of sex steroid hormones ($estradiol-l7{\beta},\;17{\alpha},\;20{\beta}-dihydroxy-4-pregnen-3-one,\;testosterone\;and\;11-ketotestosterone$) were investigated. The annual reproductive cycle in females could be divided into 5 periods as follows: 1) recovery period (June to September): serum level of $estradiol-l7{\beta}$ increased gradually; 2) vitellogenesis period (Septemer to february) : vitellogenic oocytes were obsewed, GSI sustained high value, and serum level of $estradiol-l7{\beta}$ increased; 3) gestation period (February-April): developing larva showed in the ovary, and serum levels of $17{\alpha},\;20{\beta}-dihydroxy-4-pregnen-3-one$ and testosterone increased; 4) partrition period (April to May) : larva were delivered, and value of GSI and serum levels of hormones decreased rapidly; 5) resting period (May to June) : value of GSI and serum levels of $estradiol-l7{\beta}$ and testosterone remained low. The annual reproductive cycle in males could be divided into 6 periods; 1) early maturation period (April to June): value of GSI and serum levels of hormones incresed gradually, cyst of spermatogonia incresed in number, and a small number of cyst of spermatocyte was observed; 2) mid-maturation perid (June to September); value of GSI and serum levels of hormones increased, and germ cells in many cysts were undergoing active sperrnatogenesis; 3) late maturation period (September to November) : value of GSI and serum levels of hormones remained high and spermatozoa were released into the lumina of the seminal lobules; 3) spermatozoa dischaging period (Nobember to December) : the lumina of the seminal lobules were enlarged and filled with mature spermatozoa; 4) degeneration period (December to Februauy)i value of GSI decresed and cyst of spermatocyte were decresed in number; 5) resting period (December to April) : no histological changes of testes were observed, and value of GSI and serum levels of hormones remained low. In November, the lumina of the seminal lobules were filled with mature spermatozoa and sperm masses were present in the ovarian cavity. Thus, copulation in this species occurred in November and December.

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Radiotherapy of Supratentorial Primitive Neuroectodermal Tumor (천막상부 원시신경외배엽 종양의 방사선요법)

  • Kim Il Han;Yoo Hyung Jun;Cho Young Kan;Kim Dae Yong
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.11-18
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    • 1997
  • Purpose : To evaluate the efficacy of combined treatment of surgery and chemoradiotherapy for supratentorial primitive neuroectodermal tumors (SPNET) and obtain the Prognostic factors and complications Materials and Methods .The a9e of 18 patients ranged from 1 to 27 years (median=5 years). There were 12 males and 6 females The extents of surgery were gross total (n:9), subtotal (n:8), biopsy only (n: 1). Craniospinal radiotherapy was delivered to all the patients except 2 patients who were treated only with the whole brain and primary lesion. Radiation dose were 3120-5800cGy (median=5460) to primary mass, 1500-4200cGy (median=3600cGy) to the whole brain and 1320-3600cGy (median= 2400 cGy) to the spinal axis. Chemotherapy was done in 13 patients. Median follow-up period was 45 months ranged from 1 to 89 months. Results : Patterns of failure were as follows; local recurrence (1), multiple intracranial recurrence (2), spinal seeding (3), craniospinal seeding (2) and multiple bone metastasis (1). Two of two patients who did not received craniospinal radiotherapy failed at spinal area. All the relapsed cases died at 1 to 13 months after diagnosis of progression. The 2- and 5-rear overall survival rates were $61\%\;and\;49\%$, respectively The a9e, sex, tumor location did not influence the survival but aggressive resection with combined chemotherapy showed better outcome. Among 9 survivors, complications were detected as radiation necrosis (n=1), hypopituitarism (n=2), cognitive defect(n=1), memory deficit (n=1), growth retardation (n=1). Conclusion : To improve the results of treatment of SPNET, maximal surgical resection followed by radiation therapy and chemotherapy is necessary. The extended radiation field including craniospinal axis may reduce the recurrence in spinal axis.

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Correlation of Ultrasonographic Findings and Cytologic or Histopathologic Diagnoses of Splenic Lesions in Dogs : 124 cases (개에서 비장 병변의 초음파 소견과 세포학 및 조직병리 진단과의 상관관계 : 124 마리)

  • Kim, Jun-Young;Lee, Nam-Soon;Choi, Mi-Hyun;Kim, Wan-Hee;Youn, Hwa-Young;Hwang, Cheol-Yong;Kim, Dae-Yong;Lee, In-Hyung;Choi, Min-Cheol;Yoon, Jung-Hee
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.134-140
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    • 2012
  • This retrospective study was performed to describe and evaluate ultrasonographic characteristics of splenic disorders and to pursue any relationship with cytologic or histopathologic diagnoses. Medical records were reviewed for patients that had undergone both abdominal ultrasonographic procedures and ultrasound-guided fine-needle aspiration (FNA) or surgical biopsy of splenic lesions or necropsy from January 2002 to July 2011 at Seoul National University Hospital for Animals. Total 124 dogs, 76 cases with FNA and 48 cases with biopsy, were available for this investigation. The age of dogs ranged from 2 to 17 years ($mean{\pm}SD$ = $9.54{\pm}3.34$ years), with the gender distribution of 61 females (26 spayed) and 63 males (40 neutered). In breed distribution, 114 were purebred dogs and 10 were mixed breed dogs. The dogs represented 26 breeds, with 113 dogs categorized into small-sized breeds. The ultrasonographic appearances of splenic disorders could be classified into 10 types including normal appearance, depending on the distribution and echogenicity of splenic lesions as well as the increase in spleen size and diffuse parenchymal changes. Among 124 cases, 44 (35.4%) had hypoechoic nodules/masses with the highest frequency, followed by 23 (18.5%) with multiple small hypoechoic nodules. Of 124 cases, 70 (56.5%) were benign and 54 (43.5%) were malignant lesions at cytologic or histopathologic results. Each ultrasonographic appearance had variable cytologic or histopathologic diagnoses. However, diffuse heterogenicity and diffuse hypoechogenicity were significantly associated with malignancy (p < 0.05), whereas hyperechoic nodules/masses were more often associated with benignity (p < 0.05). Based on our results, it may be considered that the ultrasonographic examination for spleen could be able to provide the least information necessary for benign and malignant lesions in prioritizing differential diagnoses.

Effect of gender on the pharmacokinetics and metabolite formation of sulfamethazine in the rabbit (토끼의 성차가 sulfamethazine의 약동학 및 대사산물 생성에 미치는 영향)

  • Yun, Hyo-in;Park, Il-hyun
    • Korean Journal of Veterinary Research
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    • v.32 no.1
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    • pp.35-39
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    • 1992
  • SMZ is one of the most widely used antibacterial agents in veterinary medicine. It is also used as a growth promotant in many species of domestic animals There are marked species differences in its metabolism and pharmacokinetics. However, its pharmacokinetic and metabolism in rabbits. which are ragarded not only as good laboratorty animals hut also as good economical animals in its own, are lacking. Sex-differences in drug metabolism are well recognized in wide range of animal species including rats. Males are known to he more active than females. It is also know that there are Significant differences in the direction of metabolic pathways. But recently, female goats are reported to be more active in the metabolie capacity of SMZ than the other sex by Dutch researchers at Utrecht. Therefore, it is not easy to make general conclusicn of having higher SMZ metal-die capacity in the male compared to the opposite sex in every animal species. In this regard, the study on metabolic pattern of SMZ in rabbits, which are regarded as hervivorous, is of interest because the dietary habbits of rabbit are comparable to thai of goal, NEW Zealand White rabbits of each sex were given SMZ(35mg/kg) as a bolus injection into the marginalean, vein in order to study its pharmacokinetic profiles(using plasma) anc metabolic pattem(24h urine) as specified in the methods anc materials. 1. In the rabbit, the major metabolic pathway of SMZ was the acetylation(the formation of $N_4AcSMZ$). There were hydroxylation pathways(50HSMZ, $6CH_2OHSMZ$) as well, in the metabolism of SMZ in the rabbit, but minor pathways. 2. No sex differences in the metabolic direction of SMZ and its metabolites formation were found from the urinary excreted metabolites of SMZ out of 24h collected urine. 3. The concentration-time curves of SMZ(35mg/kg, iv) in the plasma compartment were fitted to a one-compartment open model when using a computer program(NONLIN). There was also no difference in the pharmacokinetic pattem of SMZ between two sexes. 4. The emergence of $N_4AcSMZ$ metabolized from SMZ was very fast in the plasma of the rabbit The elimination of $N_4AcSMZ$ was prolonged as compared to that of the parent drug Vie found no sex difference in the elimination pattern of $N_4AcSMZ$ in the rabbit.

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Alterations of Heart Rate Variability upon β3-Adrenergic Receptor Polymorphism and Combined Capsaicin, Sesamin, and L-Carnitine in Humans (복합 캡사이신, 세사인, 그리고 카르니틴과 베타3 유전자 다형에 대한 심박수 변이성의 영향)

  • Shin, Ki-Ok;Kim, Hyun-Jun;Kang, Sung-Hwun
    • Journal of Life Science
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    • v.18 no.3
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    • pp.291-297
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    • 2008
  • We investigated whether 1) the combined capsaicin (75 mg), sesamin (30 mg), and L-carnitine (900 mg) (CCSC) ingestion enhances autonomic nervous system (ANS) activities including thermogenic sympathetic activity as energy metabolic modulator, 2) ${\beta}_3-AR$ polymorphism of each subject influences with ANS activity. Seven healthy males $(22.0{\pm}0.5\;yr)$ volunteered for this study. The cardiac autonomic nervous activities evaluated by means of heart rate variability of power spectral analysis were continuously measured during 5 min every 30 min for total 120 min resting condition with CCSC or placebo oral administration chosen at random. The results indicated that, there are not $Arp/Arg^{64}$ variants of the ${\beta}_3-AR$ genotypes in our subjects. There were not also significant differences in heart rate during rest between both trials. The difference of ANS activity did not reach the statistical significance between both trials. However, the significant improvement showed TOTAL power, HF component, and the indices of SNS and PNS activities before and at 30 min after CCSC ingestion (p<0.05, respectively). In conclusions, although each component of combined CCSC is associated with lipolysis and/or fat oxidation, the combined CCSC consumption is not influenced in stimulation of thermogenic sympathetic activity as modulator of energy metabolism. In rather, our results suggested that CCSC ingestion improves the balance of both SNS and PNS activities. Therefore, it will be considered many combined nutrient components for ergogenic and/or lipolysis effects as well as genetic variants affecting ANS activity in further studies.