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Comparison of Two Step LEEP and Cold Conisation For Cervical Intraepithelial Lesions to Decrease Positive Surgical Margins

  • Senol, Taylan;Polat, Mesut;Ozkaya, Enis;Karateke, Ates
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3317-3320
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    • 2016
  • Purpose: To assess the success rates of two step loop electrosurgical excision procedure (LEEP) compared with conventional cold conization procedures for decreasing positive surgical margins. Materials and Methods: This study was conducted on 70 patients who underwent colposcopic evaluation in Zeynep Kamil Women and Children's Health Training and Research Hospital between 2013-2015 with indications of CIN 2/3 or persistent CIN 1 for more than 2 years. The study included age matched groups of patients with similar histopathololical lesions who underwent cold conization (n=40) or LEEP (N=30). Results: Comparison of tissue characteristics between the two groups revealed significantly higher deepest depth and lower volume of tissue removed by the two step LEEP. Ectocervical positivity rate was similar between groups (1/39 versus 0/29, P>0.05), while endocervical surgical margin positivity rate was significantly higher in the cold conization group (9/39 versus 0/29, P<0.05). Surgical margin positive cases were significantly older than the cases with negative margins (P<0.05). Conclusions: Two step LEEP made it easier to reach the squamocolumnar junction in the endocervical region with lower blood loss and applicability in office settings. Our study suggests to use two step approach in cases with high grade and glandular CIN.

TCP-ROME: A Transport-Layer Parallel Streaming Protocol for Real-Time Online Multimedia Environments

  • Park, Ju-Won;Karrer, Roger P.;Kim, Jong-Won
    • Journal of Communications and Networks
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    • v.13 no.3
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    • pp.277-285
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    • 2011
  • Real-time multimedia streaming over the Internet is rapidly increasing with the popularity of user-created contents, Web 2.0 trends, and P2P (peer-to-peer) delivery support. While many homes today are broadband-enabled, the quality of experience (QoE) of a user is still limited due to frequent interruption of media playout. The vulnerability of TCP (transmission control protocol), the popular transport-layer protocol for streaming in practice, to the packet losses, retransmissions, and timeouts makes it hard to deliver a timely and persistent flow of packets for online multimedia contents. This paper presents TCP-real-time online multimedia environment (ROME), a novel transport-layer framework that allows the establishment and coordination of multiple many-to-one TCP connections. Between one client with multiple home addresses and multiple co-located or distributed servers, TCP-ROME increases the total throughput by aggregating the resources of multiple TCP connections. It also overcomes the bandwidth fluctuations of network bottlenecks by dynamically coordinating the streams of contents from multiple servers and by adapting the streaming rate of all connections to match the bandwidth requirement of the target video.

Health Nutrition Education Program Curriculum and the Effects for Preschool Children (유아 대상 건강 영양 교육 프로그램 내용 및 효과에 대한 연구)

  • Lee, Hyun-Ok
    • The Korean Journal of Food And Nutrition
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    • v.20 no.2
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    • pp.202-208
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    • 2007
  • This study had two purposes: first, to develop various health nutrition education materials for preschool children as well as their teachers and parents, and second, to apply the health nutrition education programs systematically. The health nutrition education materials consisted of : 'Salt! I know what it is and eat it', 'Friend! Let's have breakfast.', 'I eat vegetables(rainbow)', 'I hate fat', 'I enjoy exercise', 'I am growing very fast'. 'I am curious about my body', 'My body is important', 'Cigarettes, what are they?', 'What's included in cigarettes?'. 'Smoking, it gives my family pain', 'Let's quit smoking', and 'Let's drink moderately'. During the education period, booklets, wall charts, photographs, food models, videos, animated films, and demonstrations were utilized. Based on age, there were significant differences in the effects of 'I am curious about my body'(p<0.05), 'What is included in cigarettes?'(p<0.01), and 'Smoking, it gives my family pain'(p<0.05). There were also significant differences in 'Salt! I know what it is and eat it', 'Friends! Let's have breakfast.', 'My body is important.' and 'Let's quit smoking'. As a result, to improve food habits and health nutrition knowledge, health nutrition education programs must be presented to day care center children as well as their parents, and persistent education is necessary.

Treatment of Hip Microinstability with Arthroscopic Capsular Plication: A Retrospective Case Series

  • Tatiana Charles;Marc Jayankura;Frederic Laude
    • Hip & pelvis
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    • v.35 no.1
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    • pp.15-23
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    • 2023
  • Purpose: Hip microinstability is defined as hip pain with a snapping and/or blocking sensation accompanied by fine anatomical anomalies. Arthroscopic capsular plication has been proposed as a treatment modality for patients without major anatomic anomalies and after failure of properly administered conservative treatment. The purpose of this study was to determine the efficacy of this procedure and to evaluate potential predictors of poor outcome. Materials and Methods: A review of 26 capsular plications in 25 patients was conducted. The mean postoperative follow-up period for the remaining patients was 29 months. Analysis of data included demographic, radiological, and interventional data. Calculation of pre- and postoperative WOMAC (Western Ontario and McMaster Universities Osteoarthritis) index was performed. Pre- and postoperative sports activities and satisfaction were also documented. A P<0.05 was considered significant. Results: No major complications were identified in this series. The mean pre- and postoperative WOMAC scores were 62.6 and 24.2, respectively. The WOMAC index showed statistically significant postoperative improvement (P=0.0009). The mean satisfaction rate was 7.7/10. Four patients with persistent pain underwent a periacetabular osteotomy. A lateral center edge angle ≤21° was detected in all hips at presentation. We were not able to demonstrate any difference in postoperative evolution with regard to the presence of hip dysplasia (P>0.05), probably because the sample size was too small. Conclusion: Capsular plication can result in significant clinical and functional improvement in carefully selected cases of hip microinstability.

Influencing Factors of Plasma Levels of Total Peroxide and Oxidative Stress Index in Retired Miners with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환을 동반한 이직광부에서 혈장 총 Peroxide 및 산화스트레스 지수 수준에 미치는 영향요인)

  • Lee, Jong Seong;Shin, Jae Hoon;Baek, Jin Ee;Jeong, Ji Yeong;Choi, Byung-Soon
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.30 no.2
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    • pp.196-204
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    • 2020
  • Objective: Chronic obstructive pulmonary disease(COPD) is characterized by persistent airflow limitations associated with chronic inflammatory response due to noxious particles or gases in the lung. Increasing oxidative stress associated with COPD. The aim of this study was to evaluate the influencing factors of biomarkers for oxidative stress in retired miners with COPD. Methods: The levels of total peroxide(TPx), total antioxidant capacity(TAC), and oxidative stress index(TPx/TAC ratio, OSI) in plasma as biomarkers for oxidative stress, serum C-reactive protein(CRP) as a biomarker for inflammation, and general characteristics were measured in 93 male subjects with COPD. COPD was defined as post bronchodilator FEV1/FVC<0.7 by spirometry. Results: Mean levels of TPx(p=0.013), TAC(p=0.010), OSI(p=0.040), and CRP(p=0.024) were higher in current smokers. Levels of TPx(β=0.445, p<0.001), TAC(β=0.490, p<0.001), and OSI(β=0.351, p<0.001) were related to CRP levels, and CRP levels were related to %FEV1 predicted(β=-0.295, p=0.003) and current smoking(β=0.214, p=0.032). Conclusions: These results suggest that oxidative stress was related to inflammation, and inflammation were related to decreasing %FEV1 predicted and current smoking in retired miners with COPD.

Poor nutrition and alcohol consumption are related to high serum homocysteine level at post-stroke

  • Choi, Seung-Hye;Choi-Kwon, Smi;Kim, Min-Sun;Kim, Jong-Sung
    • Nutrition Research and Practice
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    • v.9 no.5
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    • pp.503-510
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    • 2015
  • BACKGROUND/OBJECTIVES: Increased serum homocysteine (Hcy) levels have been reported to be related to the occurrence of cardio- and cerebrovascular diseases. High serum Hcy levels are also related to the development of secondary stroke and all-cause mortality. The purpose of this study was to investigate the prevalence of high serum homocysteine level and relating factors, and the change over the 10 month period post-stroke. SUBJECTS/METHODS: Consecutive stroke patients who were admitted to the Asan Medical Center were enrolled. Ten months after the onset of stroke, an interview with a structured questionnaire was performed and blood samples were obtained for the biochemical parameters. Nutritional status was determined using the mini nutritional assessment (MNA) score and dietary nutrient intakes were also obtained using a 24 hour recall method. RESULTS: Out of 203 patients, 84% were malnourished or at risk of malnutrition, and 26% had high homocysteine levels at 10 months post-stroke. Using logistic regression, the factors related with high homocysteine levels at 10 months post-stroke included heavy alcohol consumption (P = 0.020), low MNA scores (P = 0.026), low serum vitamin $B_{12}$ (P = 0.021) and low serum folate levels (P = 0.003). Of the 156 patients who had normal homocysteine levels at admission, 36 patients developed hyperhomocysteinemia 10 months post-stroke, which was related to heavy alcohol consumption (P = 0.013). Persistent hyperhomocysteinemia, observed in 22 patients (11%), was related to male sex (P = 0.031), old age (P = 0.042), low vitamin $B_6$ intake (P = 0.029), and heavy alcohol consumption (P = 0.013). CONCLUSION: Hyperhomocysteinemia is common in post-stroke, and is related to malnutrition, heavy alcohol drinking and low serum level of folate and vitamin $B_{12}$. Strategies to prevent or manage high homocysteine levels should consider these factors.

Midterm Results of Aortic Valve Replacement Using Tissue Valve (조직판막을 이용한 대동맥판막치환술의 중기성적)

  • Moon, Duk-Hwan;Lee, Jae-Won;Kim, Yun-Seok;Cho, Won-Chul;Jung, Sung-Ho;Choo, Suk-Jung;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.627-634
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    • 2010
  • Background: The durability of the tissue valve is important in choice between a mechanical valve and a tissue valve in cardiac surgery. We studied the mid-term results of tissue valve in the aortic position. Material and Method: The subjects were 380 patients who had undergone aortic prosthesis replacement between May 1990 and March 2009. We retrospectively analyzed hospital and outpatient records: the mean age was $69{\pm}9$ years; the male to female ratio was 227 : 162; and the mean follow-up duration was $46.7{\pm}40.8$ months (range 0~196 months). Result: 389 surgical cases in total had been taken with 380 patients. Early death occurred in 15 patients (3.9%). Overall survival rate at 1, 5 and 10 years were 92.3%, 78.1% and 54.2% respectively. Freedom from reoperation at 1, 5 and 10 years were 98.4%, 97.1% and 91.7% respectively. Freedom from structural valvular deterioration at 1, 5 and 10 years were 96.1%, 92.3% and 88.0% respectively. In the multivariate analysis of preoperative risk factors, young age (p<0.001) was significant risk factor for reoperation. High peak velocity in the postoperative period (p=0.034) and young age (p=0.029) were significant risk factors for structural valvular deterioration. Old age (p=0.001), long bypass time (p=0.035), concomitant coronary artery bypass graft surgery (p=0.003) and preoperative low left ventricular ejection fraction (p=0.003) were significant factors for early mortality. Preoperative estimated glomerular filtration rate (< 60 mL/min) (p=0.025) and persistent left ventricular hypertrophy (p=0.032) were the risk factors for late mortality. Conclusion: This study showed that the freedom from reoperation and the freedom from structural valvular deterioration in aortic tissue valve replacement were acceptable. It will be necessary to conduct further studies with long-term follow-up and more patients.

Efficacy of Poly-Gamma-Glutamic Acid in Women with High-Risk Human Papillomavirus-Positive Vaginal Intraepithelial Neoplasia: an Observational Pilot Study

  • Koo, Yu-Jin;Min, Kyung-Jin;Hong, Jin-Hwa;Lee, Jae-Kwan
    • Journal of Microbiology and Biotechnology
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    • v.25 no.7
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    • pp.1163-1169
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    • 2015
  • Poly-gamma-glutamic acid (γ-PGA) is a natural polymer that is synthesized by Bacillus species and has been reported to have antitumor activity. The aim of this study was to investigate the effect of γ-PGA on the treatment of vaginal intraepithelial neoplasia (VAIN). A retrospective observational study on γ-PGA therapy for biopsy-proven VAIN was conducted. The efficacy was assessed by evaluating the results of Pap cytology and the viral load of high-risk HPV at three time points: at enrollment, and at the first and second post-treatment visits. Of 17 patients treated with γ-PGA, only 12 patients who had a high-risk HPV infection were included in the analysis. Histology was VAIN1 in seven patients, VAIN2 in two patients, and VAIN3 in three patients. γ-PGA was administered for newly diagnosed VAIN in five (41.7%) patients and persistent VAIN in seven (58.3%) patients for the mean time of 4.5 months. At the first and second post-treatment visits, cytological regression was observed in five (41.7%) and six (50%) patients, respectively. Regarding the HPV load, the overall response rate was 66.7%, and the mean level was 670.6 ± 292.5 RLU at the first follow-up, which was lower than the initial viral load of 1,494.8 ± 434.5 RLU (p = 0.084). At the second follow-up, the overall response rate was 58.3%, and the mean viral load level was 924.2 ± 493.7 RLU. γ-PGA may be helpful for the cytological regression and reduction of viral load in patients with high-risk HPV-positive VAIN, suggesting that γ-PGA is a promising treatment option for primary or persistent VAIN.

Mechanical Thrombectomy with Solitaire Stent Retrieval for Acute Cardioembolic Stroke

  • Han, Hokyun;Choi, Hyunho;Cho, Keun-Tae;Kim, Byong-Cheol
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.627-634
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    • 2017
  • Objective : Few studies have reported the outcome of mechanical thrombectomy with Solitaire stent retrival (MTSR) in subtypes of acute ischemic stroke. The purpose of this study was to evaluate the efficacy and result of MTSR in acute cardioembolic stroke. Methods : Twenty consecutive patients with acute cardioembolic stroke were treated by MTSR. The angiographic outcome was assessed by thrombolysis in cerebral infarction (TICI) grade. TICI grade 2a, 2b, or 3 with a measurable thrombus that was retrieved was considered as a success when MTSR was performed in the site of primary vessel occlusion, and TICI grade 2b or 3 was considered as a success when final result was reported. Clinical and radiological results were compared between two groups divided on the basis of final results of MTSR. Persistent thrombus compression sign on angiogram was defined as a stenotic, tapered arterial lumen whenever temporary stenting was performed. The clinical outcomes were assessed by the modified Rankin Scale (mRS) at 3 months. Results : The failure rate of MTSR was 20% (4/20) and other modalities, such as permanent stenting, were needed. Final successful recanalization (TICI grade 2b or 3) was 80% when other treatments were included. The rate of good outcome ($mRS{\leq}2$) was 35% at the 3-month follow-up. Failure of MTSR was significantly correlated with persistent thrombus compression sign (p=0.001). Conclusion : Some cases of cardioembolic stroke are resistant to MTSR and may need other treatment modalities. Careful interpretation of angiogram may be helpful to the decision.

Mutation Detection of E6 and LCR Genes from HPV 16 Associated with Carcinogenesis

  • Mosmann, Jessica P.;Monetti, Marina S.;Frutos, Maria C.;Kiguen, Ana X.;Venezuela, Raul F.;Cuffini, Cecilia G.
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1151-1157
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    • 2015
  • Human papillomavirus (HPV) is responsible for one of the most frequent sexually transmitted infections. The first phylogenetic analysis was based on a LCR region fragment. Nowadays, 4 variants are known: African (Af-1, Af-2), Asian-American (AA) and European (E). However the existence of sub-lineages of the European variant havs been proposed, specific mutations in the E6 and LCR sequences being possibly related to persistent viral infections. The aim of this study was a phylogenetic study of HPV16 sequences of endocervical samples from C${\acute{o}}$rdoba, in order to detect the circulating lineages and analyze the presence of mutations that could be correlated with malignant disease. The phylogenetic analysis determined that 86% of the samples belonged to the E variant, 7% to AF-1 and the remaining 7% to AF-2. The most frequent mutation in LCR sequences was G7521A, in 80% of the analyzed samples; it affects the binding site of a transcription factor that could contribute to carcinogenesis. In the E6 sequences, the most common mutation was T350G (L83V), detected in 67% of the samples, associated with increased risk of persistent infection. The high detection rate of the European lineage correlated with patterns of human migration. This study emphasizes the importance of recognizing circulating lineages, as well as the detection of mutations associated with high-grade neoplastic lesions that could be correlated to the development of carcinogenic lesions.