• Journal of Gastric Cancer
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• v.18 no.3
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• pp.242-252
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• 2018

Purpose: Surgical resection for gastric adenocarcinoma is associated with significant post-operative morbidity and mortality. The aim of this study was to assess the prognostic significance of sarcopenia in patients undergoing resection for gastric adenocarcinoma with respect to post-operative morbidity and survival. Materials and Methods: A retrospective analysis was conducted on a cohort of consecutive patients who underwent surgical resection for gastric adenocarcinoma between 2008 and 2014. Patient demographics, radiological parameters, and pathological data were collected. OsiriX software (Pixmeo) was used to measure skeletal muscle area, which was normalized for height to calculate skeletal muscle index. Results: A total of 56 patients (41 male, 15 female; mean age, $68.4{\pm}11.9years$) met the inclusion criteria. Of these, 36% (20 of 56) of the patients were sarcopenic pre-operatively. Both sarcopenic and non-sarcopenic patient groups were equally matched with the exception of weight and body mass index (P=0.036 and 0.001, respectively). Sarcopenia was associated with a decreased overall survival (log-rank P=0.003) and was an adverse prognostic predictor of overall survival in multivariate analysis (hazard ratio, 10.915; P=0.001). Sarcopenia was a predictor of serious in-hospital complications in multivariate analysis (odds ratio, 3.508; P=0.042). Conclusions: In patients undergoing curative resection for gastric cancer, there was a statistically significant association between sarcopenia and both decreased overall survival and serious post-operative complications. The measurement and reporting of skeletal muscle index on pre-operative computed tomography should be considered.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.1-6
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• 2004

Purpose: We studied the diagnostic value of ultrasonography to confirm the presence of the syndesmosis injuries in the ankle. Materials and Methods: Pre-operative ultrasonography were taken in 42 cases of ankle fractures to determine injury of syndesmosis between February 2000 and August 2003. Tear of syndesmosis was confirmed when they met the following criteria; widening of distal tibiofibular clear space greater than 7 mm on pre-operative AP X-rays, leakage of contrast dye during intra-operative arthrography, and operative findings revealing syndesmosis rupture. We compared these diagnoses with those made by pre-operative ultrasonography. Results: Syndesmosis injuries were confirmed in 23 cases among the total 42 cases. Ultrasonography revealed syndesmosis tear in 25 cases, with 20 cases corresponding with confirmed tear and 5 cases without tear in confirm. Syndesmoses were found to be intact in 17 cases of ultrasonograph, but 3 cases were actually confirmed tear. In ankle ultrasonography, the sensitivity was 90.9%, the specificity was 75.0%. Conclusion: Preoperative ultrasonography is a non-invasive and useful study to determine the syndesmosis injury in ankle fractures.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.1-7
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• 1999

Purpose : There has been considerable controversy as to the method of the treatment of acute acromioclavicular joint dislocation classified to type III injury. The purpose of this study is to compare the conservative and operative treatment of the type III acute acromioclavicular joint dislocation in terms of clinical and radiological results. Materials and Methods: We treated 31 cases of acute, type III acromioclavicular joint dislocation, 17 cases were treated by operative methods and 14 patients by conservative treatment, and 1 year minimum follow-up was done from January 1990 to January 1996. We used UCLA Shoulder Rating Scale for clinical results. And for the radiological results coracoclaviclar distance were measured. We used Fisher's exact test for statistical analysis of results between the two treatment methods. Results: Fifteen(88.2%) of seventeen patients in operative treatment and eleven(78.6%) of fourteen patients in nonoperative treatment were rated excellent or good on the UCLA rating scale. In radiographic evaluation, the average coracoclavicular distances of preoperative state, immediate postoperation(or postreduction) and last follow-up were as follows. In operative cases, it was 1.75±0.21mm, 1.14±0.24mm and 1.33± 0.22mm respectively. In nonoperative cases, it was 1.65±0.14mm, 1.26±0.26mm, and 1.42±0.27mm respectively. Conclusion : This study demonstrated that there was no significant difference in clinical and radiological results between the operative and nonoperative treatment groups. So, nonoperative treatment is recommended for acute type III acromioclavicular dislocation as general rule.

• Journal of Korean Neurosurgical Society
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• v.45 no.4
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• pp.209-212
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• 2009

Objective : Avascular necrosis (AVN) of the vertebral body is known as a relatively uncommon phenomenon in a vertebral compression fracture (VCF). The outstanding radiologic findings of AVN are intravertebral vacuum phenomenon with or without fluid collection. Several reports revealed that PVP or balloon kyphoplasty might be the effective treatment modalities for AVN. We also experienced excellent results when using PVP for the treatment of AVN of the vertebral body, and intend to describe the treatment's efficacy in this report. Methods : Thirty-two patients diagnosed with AVN of the vertebral body were treated with PVP. We measured the pre- and post-operative anterior body height and kyphotic angulation. The visual analogue scale (VAS) was used to determine the relief of back pain. Results : The anterior body height (pre-operative : 1.49 cm, post-operative : 2.22 cm) and kyphotic angulation (pre-operative : 14.47 degrees, post-operative : 6.57 degrees) were significantly restored (p<0.001). VAS was improved from 8.9 to 3.7. Pseudoarthrosis was corrected in all cases, which was confirmed by dynamic radiographs. Fluid collection was found in sixteen cases and was aspirated with serous nature. No organism and tumor cell were noted. Conclusion : PVP proved to be an effective procedure for the treatment of AVN of the vertebral body, which corrected dynamic instability and significantly restored the anterior body height and kyphotic angulation.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7551-7554
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• 2013

Tumor-associated microRNAs have been detected in serum or plasma, but whether plasma microRNA-21 (miR-21) could be a potential circulating biomarker for gastric cancer (GC) prognosis in Chinese is still uncertain. Real-time quantitative reverse transcription PCR (qRT-PCR) was employed in this study to compare the relative expression of miR-21 between pre-operative and post-operative paired plasmas from 42 patients with primary GCs. The results showed that the expression levels of miR-21 in the post-operative plasmas were significantly reduced by an average of 18.2 times in all patients when compared to the pre-operative plasmas, and by 22.1 times in the subgroup of patients without family history, while only 1.76 times in the subgroup of patients with a family history. With respect of clinicopathological characteristics, the plasma miR-21 expression was highly associated with differentiation degree and lymph node metastasis rate. The results suggested plasma miR-21 could be a novel potential biomarker for GC prognosis and evaluation of surgery outcomes, especially in patients without a family history.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.363-369
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• 2011

Objective : We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. Methods : We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. Results : In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. Conclusion : Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.267-274
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• 2013

The impact of income and education level on the clinical and pathologic characteristics, implementation of clinical breast examination (CBE), and treatment patterns of a small population of Chinese female breast cancer patients was studeied in order to provide a theoretical basis and statistical reference for further nationwide research. We included 484 pathologically confirmed female primary breast cancer inpatients of the First Affiliated Hospital of Medical College of Xi'an Jiaotong University from February 2003 to January 2004. All cases were reviewed and relevant information was collected using a designed case report form (CRF). Chisquare tests, rank-sum tests, and Fisher's exact tests were used in the analysis. Our analysis showed that: (1) women in different occupation groups had significant differences in tumor size, pre-operative mammography, surgical options, post-operative estrogen receptor (ER), progestin receptor (PR) and human epidermal growth factor receptor 2 (Her2) status, and post-operative radiotherapy and chemotherapy (P < 0.05); and (2) women with different education levels had statistically significant differences in tumor size, post-operative ER, PR and Her2 status, and post-operative chemotherapy, radiotherapy, and endocrine therapy (P < 0.05). In Xi'an, China, women in low-income occupations or with low education levels are more likely to have advanced tumor stages at presentation, lower implementation rate of clinical breast examination, and less treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.49-57
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• 2006

Mandibular fractures have higher incidence rate compared to facial bone fractures because of relatively prominent form. Specially, mandibular angle fractures were known as common fracture site because of morphological anatomic structure. The mandibular third molar appears to be the most frequent impacted tooth. The mandibular third molar have influence on mandibular angle fractures according to it's eruption state. Also, the mandibular angle fracture including the third molar may influence on post operative infection whether the third molar is in impacted or extracted state when reduction of fracture site is operated. The presence or absence and degree of impaction of the mandibular third molar were assessed for each patient and were related to the occurrence of the mandibular angle fracture. The extraction or non extraction of the mandibular third molar were related to the occurrence of the post operative infection in the reduction of mandibular angle fractures. In the presence of mandibular third molar, the possibility of mandibular angle fractures were relatively common. When viewing the mandibular third molar at occlusal plane, the possibility of mandibular angle fractures were high in the class C group. The possibility of mandibular angle fractures were high in the mesial angulation and partial impaction. There was a statistically significant difference(P<0.05). In complete erupted mandibular third molar, the possibility of post operative infection occurs quite often, but there was no statistical significant difference(P>0.05). In the extracted or non extracted of mandibular third molar, the post operative infection showed no statistical significant difference(P>0.05). With the results mentioned above, mandibular third molar was significantly more susceptible to mandibular angle fracture. In the reduction of mandibular angle fracture, it was recommended that mandibular third molar should be extracted especially in case of pericoronitis, periodontitis and other infections.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.157-160
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• 2002

The dosage of intra-operative BNCT using near-threshold $^{7}$ Li(p,n)$^{7}$ Be direct neutrons was evaluated with the calculation method validated with the phantom experiment. The production of both neutrons by near-threshold $^{7}$ Li(p,n)$^{7}$ Be and gamma rays by $^{7}$ Li(p,p'gamma)$^{7}$ Li in a Li target was calculated using Lee's method and their transport in the phantom was calculated with MCNP-4B. As a result, the region satisfying the requirements of the protocol in intra-operative BNCT for brain tumors in Japan was acknowledged to be comparable to present BNCT, for the proton energy of 1.900 MeV for example. A boron-dose enhancer (BDE) introduced in this study to increase $^{10}$ (n,$\alpha$)$^{7}$ Li dose in a living body was effective. The void used to increase doses in deep regions was also valid with the BDE. It was found that intra-operative BNCT using near-threshold $^{7}$ Li(p,n)$^{7}$ Be direct neutrons is feasible.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1649-1654
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• 2014

Background: Clinically significant portal hypertension (PHT) is considered as a contraindication for hepatectomy according to the guidelines of the European Association for Study of Liver and the American Association for Study of Liver Diseases. However, this issue remains controversial. Here we performed a metaanalysis to evaluate the impact of PHT on the results of hepatectomy for hepatocellular carcinoma (HCC). Methods: Cohort studies evaluating the impact of clinically significant PHT, defined as oesophageal varices and/or splenomegaly associated with thrombocytopenia, on the results of hepatectomy for HCC were identified using a predefined search strategy. Summary risk ratios (RRs) and 95% confidence intervals (95% CIs) for PHT and outcomes after hepatectomy for HCC were calculated. Results: Seven cohort studies which including 574 cases with PHT and 1,354 cases without PHT were considered eligible for inclusion. The meta-analysis showed that, in all patients, pooled RRs of post-operative liver failure, post-operative ascites, peri-operative blood transfusion, operative mortality, 3- and 5-year overall survival associated with PHT were 2.23 (95% CI: 1.48-3.34, P=0.0001), 1.77 (95% CI: 1.19-2.64, P=0.005), 1.23 (95% CI: 1.03-1.49, P=0.03), 2.58 (95% CI: 1.12-5.96, P=0.03), 0.82 (95% CI: 0.75-0.88, P<0.00001) and 0.76 (95% CI: 0.69-0.85, P<0.00001), respectively. In subgroup analysis, similar results were found in Child-Pugh class A patients. Conclusion: This meta-analysis suggests that presence of oesophageal varices and/or splenomegaly associated with thrombocytopenia is associated with higher rates of post-operative complications and poor long-term survival after hepatectomy for HCC.