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Surgical Outcomes Associated with Operable Gastric Cancer in a Tertiary Care Indian Hospital

  • Franklyn, Joshua;George, Sam V.;Yacob, Myla;Abraham, Vijay;Chandran, Sudhakar;Sebastian, Tunny;Samarasam, Inian
    • Journal of Gastric Cancer
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    • 제17권1호
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    • pp.63-73
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    • 2017
  • Purpose: Data on operable gastric cancer from India is sparse. The purpose of this study was to investigate the clinical details, histopathological demographics, and 5-year overall survival (OS) and disease free survival (DFS) associated with operable, non-metastatic gastric cancer in a dedicated upper gastrointestinal (GI) surgical unit in India. Materials and Methods: Data for patients diagnosed with operable gastric cancer between January 2006 and December 2014 were retrospectively analyzed. Data were collected from electronic hospital records in addition to mail and telephonic interviews when possible. Results: A total of 427 patients were included. The tumor was located in the pyloro-antral region in 263 patients (61.7%). Subtotal gastrectomy was performed in 291 patients and total gastrectomy in 136 patients. Tumor stage classification revealed 43 patients (10.0%) with stage I, 40 patients (9.4%) with stage IIA, 59 patients (13.9%) with stage IIB, 76 patients (17.8%) with stage IIIA, 96 patients (22.5%) with stage IIIB, and 113 patients (26.4%) with stage IIIC disease. Follow-up data were available for 71.6% of the patients with a mean duration of 32.4 months. Five-year DFS and OS were 39% and 59%, respectively. Conclusions: Despite presenting at an advanced stage, the 5-year DFS and OS of patients with operable gastric cancer treated at a dedicated upper GI unit of a tertiary care center in India was good.

장 회전이상 환자에서 연령에 따른 임상적 특성의 차이 (Age-related Differences Effect the Clinical Characteristics of Intestinal Malrotation)

  • 김종진;정규환;박태진;정성은;박귀원
    • Advances in pediatric surgery
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    • 제15권2호
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    • pp.121-131
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    • 2009
  • Intestinal malrotation presents with different clinical characteristics, depending upon the age of the patient. The medical records of 44 patients treated for intestinal malrotation with/without midgut volvuls between January 2002 and August 2009 at Seoul National University Children's Hospital were reviewed retrospectively. Patients were grouped by the age criteria of 1 and 12 months. Fourteen patients were under 1 month of age (31.8 %), 9 patients between 1 month and 12 months (20.5 %) and 21 patients over 12 months (47.7 %). Twenty patients (45.5 %) presented with volvulus. Vomiting (66 %) and abdominal pain (20 %) were the most common symptoms. UGIS (68.2 %) was the most frequent diagnostic tool. Mean postoperative hospital stay was 13.7 days. There were 7 mild postoperative complications. Volvulus was more frequent in patients under 1 month (p=0.025) than over 1 month. The interval between diagnosis and operation was shorter in patients under 1 month (p=0.003) than in patients over one month of age. In the age between under and over 12 months, volvulus was more common in those under 12 months of age, but the difference was not significant. The interval from diagnosis to operation was shorter in patients under 12 months than over 12 months of age (p=0.001). Vomiting was the most frequent symptom in patients under 12 months. On the other hand, abdominal pain was the most frequent symptom in patients over 12 months. In conclusion, patients with intestinal malrotation had age-related differences in the presence of midgut volvulus, the interval between diagnosis and operation, and clinical symptoms. The age of the patient should be considered in order to determine adequate treatment of malrotation.

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Safety and Effectiveness of Indacaterol in Chronic Obstructive Pulmonary Disease Patients in South Korea

  • Yum, Ho-Kee;Kim, Hak-Ryul;Chang, Yoon Soo;Shin, Kyeong-Cheol;Kim, Song;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • 제80권1호
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    • pp.52-59
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    • 2017
  • Background: Inhaled indacaterol (Onbrez Breezhaler), a long-acting ${\beta}_2$-agonist, is approved in over 100 countries, including South Korea, as a once-daily bronchodilator for maintenance and treatment of chronic obstructive pulmonary disease (COPD). Here, we present an interim analysis of a post-marketing surveillance study conducted to evaluate the real-world safety and effectiveness of indacaterol in the Korean population. Methods: This was an open-label, observational, prospective study in which COPD patients, who were newly prescribed with indacaterol (150 or $300{\mu}g$), were evaluated for 12 or 24 weeks. Safety was assessed based on the incidence rates of adverse events (AEs) and serious adverse events (SAEs). Effectiveness was evaluated based on physician's assessment by considering changes in symptoms and lung function, if the values of forced expiratory volume in 1 second were available. Results: Safety data were analyzed in 1,016 patients of the 1,043 enrolled COPD patients receiving indacaterol, and 784 patients were included for the effectiveness analysis. AEs were reported in 228 (22.44%) patients, while 98 (9.65%) patients reported SAEs. The COPD condition improved in 348 patients (44.4%), while the condition was maintained in 396 patients (50.5%), and only 40 patients (5.1%) exhibited worsening of ailment as compared with baseline. During the treatment period, 90 patients were hospitalized while nine patients died. All deaths were assessed to be not related to the study drug by the investigator. Conclusion: In real-life clinical practice in South Korea, indacaterol was well tolerated in COPD patients, and can be regarded as an effective option for their maintenance treatment.

Circulating Tumor Cell Number Is Associated with Primary Tumor Volume in Patients with Lung Adenocarcinoma

  • Kang, Byung Ju;Ra, Seung Won;Lee, Kyusang;Lim, Soyeoun;Son, So Hee;Ahn, Jong-Joon;Kim, Byung Chul
    • Tuberculosis and Respiratory Diseases
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    • 제83권1호
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    • pp.61-70
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    • 2020
  • Background: Circulating tumor cells (CTCs) are frequently detected in patients with advanced-stage malignant tumors and could act as a predictor of poor prognosis. However, there is a paucity of data on the relationship between CTC number and primary tumor volume in patients with lung cancer. Therefore, our study aimed to evaluate the relationship between CTC number and primary tumor volume in patients with lung adenocarcinoma. Methods: We collected blood samples from 21 patients with treatment-naive lung adenocarcinoma and 73 healthy individuals. To count CTCs, we used a CTC enrichment method based on fluid-assisted separation technology. We compared CTC numbers between lung adenocarcinoma patients and healthy individuals using propensity score matching, and performed linear regression analysis to analyze the relationship between CTC number and primary tumor volume in lung adenocarcinoma patients. Results: CTC positivity was significantly more common in lung adenocarcinoma patients than in healthy individuals (p<0.001). The median primary tumor volume in CTC-negative and CTC-positive patients was 10.0 ㎤ and 64.8 ㎤, respectively. Multiple linear regression analysis showed that the number of CTCs correlated with primary tumor volume in lung adenocarcinoma patients (β=0.903, p=0.002). Further subgroup analysis showed a correlation between CTC number and primary tumor volume in patients with distant (p=0.024) and extra-thoracic (p=0.033) metastasis (not in patients with distant metastasis). Conclusion: Our study showed that CTC numbers may be associated with primary tumor volume in lung adenocarcinomas patients, especially in those with distant metastasis.

일부 만성 중증 정신질환자의 약물 복용에 따른 구강건조증상과 자극성 타액분비율 (Subjective oral dryness and stimulated salivary flow rate in medicated patients in chronic severe psychiatric patients)

  • 문소정;서혜연;전현선;백지현;노희진;정원균
    • 한국치위생학회지
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    • 제14권3호
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    • pp.353-362
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    • 2014
  • Objectives : The purpose of the study is to investigate the xerostomia in the chronic severe psychiatric patients in Korea because there were few reports on xerostomia in the psychiatric patients. Methods : The subjects were 61 psychiatric patients in the mental hospital by convenience cluster sampling. A self-reported symptom questionnaire was filled out by the three researchers on the basis of medical records by the informed consent. The stimulated salivary flow rate of the patients was measured by saliva sampling. Results : The subjects consisted of 45.9% of male and 54.1% of female. High school graduation accounted for 40.0% and 20.0% did not attend the school. The majority of the patients were medicaid recipients. Schizophrenia accounted for 86.9% and most patients were long term care recipients. A total of 68.9% of the patients suffered from salivary dysfunction. The medication in schizophrenia seemed to decrease the stimulated salivary flow rate and made the patients difficult in chewing and swallowing due to xerostomia and low saliva secretion(p<0.05). Conclusions : Medication in schizophrenic patients caused the salivary dysfunction. So the collaboration between the psychiatry doctors and dental hygienists is very important to improve the salivary secretion in the schizophrenic patients. The continuous and long term care of the xerostomia will help the patients maintain the good oral hygiene.

Comparison of Protein Electrophoresis Fractions in the Leptospirosis Patient Serum

  • Kim Chong Ho;Park Seung-Taeck;Oh Geum-Ga
    • 대한의생명과학회지
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    • 제10권3호
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    • pp.253-257
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    • 2004
  • The mechanisms by which leptospires caused disease are not well understood. A number of putative virulence factors have been suggested, but with few exceptions their role in pathogenesis remains unclear. In these days, many cases of leptospirosis are diagnosed by serological immunoassay. Leptospirosis is characterized by the histopathology of liver, kidney, heart, and lung, but the electrophoresis fractions of serum protein are not compared. We analyzed total protein, albumin, aspartic aminotranferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatinine and urea nitrogen (UN) in sera of patients diagnosed leptospirosis. Total protein and albumin were decreased in 18.5% and 31.2% of patients, respectively. AST, ALT, ALP, UN and creatinine were increased in 90.4%, 66.9%, 28.0%, 15.9% and 10.8% of patients, respectively. We performed cellulose acetate membrane electrophoresis (EP) on sera of patients increased both of AST and ALT, and of patients increased both of creatinine and UN. In patients increased both of AST and ALT, and in patients increased both of AST and ALT, the relative percentage of albumin to total protein in patient serum was dcreased in 89.1 % of patients. α₁-globulin, α₂-globulin, β-globulin and γ-globulin were increased in 85.1 %, 75.2%, 33.6% and 98.0% of patients, respectively. In patients increased both of creatinine and UN, the relative percentage of albumin to total protein in patient serum was dcreased in 93.8% of patients. α₁-globulin, α₂-globulin, β-globulin and γ-globulin were increased in 87.5%, 100%, 31.2% and 93.8% of patients, respectively. These data indicate that infection of Leptospira causes severe liver damage to most of leptospirosis patients, but doesn't cause renal damage to most of them. The relative rate of serum protein electrophoresis fractions to total protein are not identical with them of typical hepatitis patient.

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이명에 대한 평가지침 수립을 위한 임상 연구 (Clinical Observation for Evaluation Protocol on Tinnitus)

  • 김윤범
    • 동의생리병리학회지
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    • 제16권2호
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    • pp.403-407
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    • 2002
  • The objective of this study is to establish the new evaluating method of tinnitus and to evaluate the effect of acupuncture therapy. Fourteen patients with tinnitus were studied. The patients answered the questionnaire designed to identify and describe the subjective symptoms of tinnitus and discomfort in daily life due to tinnitus. After acupuncture therapy, the survey was conducted again among the patients and we evaluated the difference between pre-acupuncture therapy and post-acupuncture therapy. 1. Precipitating factors of tinnitus among the patients group consisted of 14 members were stress, noise, drug, overwork, URI, and otitis media in order. 2. Significant improvements in subjective symptoms of tinnitus and discomfort in daily life after acupuncture therapy were identified among the patient group of 14 members 3. Patient group of 14 members were divided into 2 groups by digestion status: patients who have poor digestion and patients who have good digestion. The patients who have good digestion showed significant improvement both in subjective symptoms of tinnitus and in discomfort in daily life after acupuncture therapy. 4. Patient group of 14 members were divided Into 2 groups by urination and defecation status: patients who have poor urination and defecation and patients who have good urination and defecation. The patients who have good urination and defecation showed significant improvement both in subjective symptoms of tinnitus and in discomfort in daily life after acupuncture therapy. 5. Patient group of 14 members were divided into 2 groups by sleeping status: patients who sleep well and patients who don't sleep well. The patients who sleep well showed significant improvement both in subjective symptoms of tinnitus and in discomfort in daily life after acupuncture therapy. This study shows that the subjective symptoms of tinnitus and discomfort in daily life due to tinnitus are involved in urination and defecation factor, sleep factor, and digestion factor. This study also shows that acupuncture therapy is effective in improving the subjective symptoms of tinnitus and discomfort in daily life due to tinnitus.

심방중격 결손증의 외과적 완전교정 48례 보고 (Surgical Repair of Secundum Type Atrial Septal Defects Using Extracorporeal Circulation in 48 Patients)

  • 서경필
    • Journal of Chest Surgery
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    • 제10권2호
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    • pp.268-273
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    • 1977
  • During the period from March, 1963, to November, 1977, forty-eight patients with secundum type atrial septal defects have undergone surgical repair using cardiopulmonary bypass with a pump oxygenator at the Seoul National University Hospital. Twenty-six [55 percent] of the patients were females and Twenty-two [45 percent] were males. The patients varied in age from 3 years to 51 years. We have divided secundum defects into three types. These are: 1] the high defect; 2] Ovale type defect; and 3] low defect including the defect in the area of the coronary sinus. An ovale type defect was present in forty-one cases [85 percent]. Partial anomalous pulmonary venous connections were present in two patients in the high defect group. All of the forty-eight patients had had right heart catheterization before operation. The pulmonary to systemic flow ratio [Qp/Qs] was determined in our 38 patients. The Qp/Qs was less than 1.5/1 in only five of the 38 patients. Among the 33 patients with moderate and severe left-to-right shunts [Qp/Qs 1.6-3.5/1], the systolic pulmonary artery pressures. ranged from 30 to 80 mm Hg. Large left-to-right shunts [Qp/Qs>3.6/1] were present in 13 patients. The postoperative complications occurred in 13 patients [27. 1 percent]. Postoperative wound infections were the most frequent complications being present in 6 patients [12.5%]. Forty-six of the patients with secundum atrial septal defects survived surgical repair of their defects. Thus the hospital mortality of surgery was 4.2 percent. The causes of death in the early postoperative period were: 1] low cardiac output syndrome related to severe pulmonary hypertension in one case; and 2] postoperative several bleeding in one case.

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하지정맥류의 임상양상 - 227 수술예의 분석 - (Clinical Analysis of Varicose Veins in the Lower Extremities - an analysis of 227 operative cases -)

  • 최수승
    • Journal of Chest Surgery
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    • 제32권11호
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    • pp.1036-1041
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    • 1999
  • Background: To know the clinical aspects of varicose vein and the effectiveness of operative treatment, the patients who had been operated during the five and a half years were reviewed. Material and Method: From September 1993 to February 1999, 227 patients with varicose vein were operated upon. These patients were reviewed with history taking, physical examination, laboratory tests, operation and follow up visits at an out patient department. Result: The ages of the patients were from 20 to 69 years, mean 40.2 years. varicose veins. Occupations of the patients include housewives, store or factory owners, cooks, waiter or waitresses in a restaurant, salary men(women), teachers, hair stylists, professional athletes, in sequence, most of them require standing all day long. The 126 women had experienced child birth, among them 116 patients delivered more than 2 babies. All patients had protruding leg veins as the symptom. Most of them(61%) had pain. Other additional symptoms were heaviness, heatness, tingling, cramp, fatigue, etc. 68.3% of the patients had the symptoms for more than 10 years. Anatomical location of varicose vein was in long saphenous vein in 157 patients, in small saphenous vein in 27, and in other regions(combined or perforating vein) in 43 patients. There was no operative mortality. There were 2 patients who underwent reoperation due to recurrence during this study period. In one patient, it recurred in the distal perforating vein in small saphenous vein. The other patient had recurrence at the saphenofemoral junction in groin. The patients are doing well after the reoperation, but a long term observation is needed. Conclusion: Clinical aspects of varicose vein were reviewed. For the patients with varicose vein who had saphenofemoral regurgitation, operative treatment seemed to bea safe and effective modality of treatment.

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악교정 수술 후 감각소실에 관한연구 (NEUROSENSORY DEFICIT AFTER ORTHOGNATHIC SURGERY)

  • 류성호;조영철;손장호;성일용;장현호;김재승
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권6호
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    • pp.482-487
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    • 2004
  • Aims: This study was designed to determine the incidence of altered sensation in patients undergoing orthognathic surgery. Method: Seventy two patients who underwent orthognathic surgery between January, 1999 and December, 1999 constituted the study group. Seven patients were excluded because of lack of follow up. Sixty five patients were followed using objective and subjective neurologic testing during the period immediately following operation, 1 month, 2 months, 6 months, and 1 year postoperatively. Age ranged from 17 to 38 years, with a mean of 24.5 years. Male patients were 21, female 44. Twenty eight bilateral sagittal splitting ramus osteotomy(BSSRO) of mandible were performed, 35 BSSRO with genioplasty, 2 genioplasties. Information on the degree of intraoperative nerve encounter was obtained from the surgical reports in 47 patients and was divided into the following three categories: (1) the nerve was not encountered in 23 patients; (2) the nerve was exposed in 11 patients; (3) the nerve was exposed and repositioned from the proximal segment in 13 patients. Results: Four patients reported altered nerve sensation of lower lip and/or chin(6.2%) at final follow up. Two patients underwent BSSRO and the other two patients BSSRO with genioplasty. Three of the patients underwent nerve exposure during the operation. Conclusion: We suggest that the nerve exposure during the operation might be partly responsible for nerve dysfunction after orthognathic surgery.