Lee, Jiyun;Moon, Seok Whan;Choi, Jung Suk;Hyun, Kwanyong;Moon, Young Kyu;Moon, Mi Hyoung
Journal of Chest Surgery
/
v.53
no.3
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pp.93-103
/
2020
Background: Risk assessment for pulmonary resection in patients with early-stage non-small-cell lung cancer (NSCLC) is important for minimizing postoperative morbidity. Depletion of skeletal muscle mass is closely associated with impaired nutritional status and limited physical ability. We evaluated the relationship between skeletal muscle depletion and early postoperative complications in patients with early-stage NSCLC. Methods: Patients who underwent curative lung resection between 2016 and 2018 and who were diagnosed with pathological stage I/II NSCLC were included, and their records were retrospectively analyzed. The psoas volume index (PVI, ㎤/㎥) was calculated based on computed tomography images from routine preoperative positron emission tomography-computed tomography. Early postoperative complications, defined as those occurring within 90 days of surgery, were compared between the lowest sex-specific quartile for PVI and the remaining quartiles. Results: A strong correlation was found between the volume and the cross-sectional area of the psoas muscle (R2=0.816). The overall rate of complications was 57.6% among patients with a low PVI and 32.8% among those with a normal-to-high PVI. The most common complication was prolonged air leak (low PVI, 16.9%; normal-to-high PVI, 9.6%), followed by pneumonia (low PVI, 13.6%; normal-to-high PVI, 7.9%) and recurrent pleural effusion (low PVI, 11.9%; normal-to-high PVI, 6.8%). The predictors of overall complications were low PVI (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.07-4.09; p=0.03), low hemoglobin level (OR, 0.686; 95% CI, 0.54-0.87; p=0.002), and smoking history (OR, 3.93; 95% CI, 2.03-7.58; p<0.001). Conclusion: Low PVI was associated with a higher rate of early postoperative complications in patients with early-stage NSCLC.
Background: Bronchiectasis is a irreversible disease, a lot of cases of which are associated with chronic bronchitis, pulmonary emphysema and bronchial asthma due to chronic recurrent pulmonary infection. Therefore, pulmonary functions in bronchiectasis may also vary with associated diseases or involved segments. Methods: For the evaluation of ventilatory dynamics in bronchiectasis with respect to the pathoanatomic types of bronchiectasis and the degree of dyspnea, a total of 93 cases comprising 45 cases of tubular, 30 saccular and 18 mixed type of bronchiectasis whose clinical diagnosis was confirmed by bronchography were analyzed retrospectively. They were also divided into two groups: those with Hugh-Jones dyspnea grade 1 & 2 (group I) and those with Hugh-Jones dyspnea grade 3 & 4 (group II). Pulmonary functions tested in this study were analyses of curves of forced expiratory volume and flow-volume, and determinations of maximal voluntary ventilation and closing volumes. Results: The results were as follows; 1) The vital capacity and parameters reflecting expiratory flow rate except PEF were significantly reduced in saccular and mixed type than that in tubular type of bronchiectasis. 2) In saccular and mixed type, the maximal voluntary ventilation tended to decrease while CV/VC tended to increase. 3) As the degree of dyspnea became serious, the involved segments were progressively increased. In contrast, ventilatory functions were significantly reduced in proportion to the severity of dyspnea. Conclusion: These findings suggest that in bronchiectasis, there be obstructive ventilatory impairment combined with mild restrictive ventilatory impairment, which becomes more prominent in saccular and mixed type and also as the degree of dyspnea progresses.
Song, Won Seok;Jeon, Dae-Geun;Cho, Wan Hyeong;Kong, Chang Bae;Cho, Sang Hyun;Lee, Kwang Ryul;Lee, Soo-Yong
The Journal of the Korean bone and joint tumor society
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v.19
no.1
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pp.20-27
/
2013
Purpose: The purpose of this study was to evaluate the oncologic outcomes of parosteal osteosarcoma (POS) and to ascertain the fates of patients after local recurrence (LR). Materials and Methods: The authors retrospectively reviewed 22 POS patients with an average follow-up of 114 months (range: 36-235 months). Seven of the 22 patients were referred after LR. There were 17 Stage IB and 5 Stage IIB (G2, 2; dedifferentiation, 3). Tumors were located in the femur (11) and in other locations (11). Initial surgical margins were wide in 10, marginal in 5, and intralesional in 7. Correlations between clinico-pathologic variables and LR and clinical courses after LR were evaluated. Results: The 10-year overall survival rate was 85.7%. Three (14%) patients developed distant metastasis and all of them succumbed to the disease. Nine (41%) patients developed LR. Tumor location, resection type, and surgical margin were found to be correlated with LR. At final follow-up, 7 of the 9 patients that experienced local failure achieved no evidence of disease. Conclusion: A substantial risk of misdiagnosis exists, especially for POS in other than a femoral location. Recurrent tumor re-excision is possible in most cases; however, patients with an aggressive recurrence pattern deserve special attention.
Sun, Young Ghyu;Kim, Soo Hyun;Lee, Dong Gu;Park, Sang Hoo;Sim, Issac;Hwang, Yu Min;Kim, Jin Young
Journal of IKEEE
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v.22
no.3
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pp.829-835
/
2018
Recently, studies have been actively conducted to reduce spare power that is unnecessarily generated or wasted in existing power systems and to improve energy use efficiency. In this study, smart meter, which is one of the element technologies of smart grid, is implemented to improve the efficiency of energy use by controlling power of electric devices, and predicting trends of energy usage based on deep learning. We propose and develop an algorithm that controls the power of the electric devices by comparing the predicted power consumption with the real-time power consumption. To verify the performance of the proposed smart meter based on the deep running, we constructed the actual power consumption environment and obtained the power usage data in real time, and predicted the power consumption based on the deep learning model. We confirmed that the unnecessary power consumption can be reduced and the energy use efficiency increases through the proposed deep learning-based smart meter.
Kim, Nam-Hyuk;Lee, Jae-Ho;Kim, Seong-Oh;Choi, Hyung-Jun;Song, Je-Seon
Journal of the korean academy of Pediatric Dentistry
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v.36
no.4
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pp.619-624
/
2009
Pyknodysostosis(PKND) is a rare sclerosing bone disorder that has an autosomal recessive trait, also known as Toulouse-Lautrec syndrome. Deficiency of the cathepsin enzyme K in the osteoclasts of PKND patients results in continuous endosteal bone deposits without osteoclastic resorption or remodeling. This causes a generalized increase in sclerosis and fragility of bones. Osteomyelitis in the mandible and recurrent fracture of the long bones are characteristic complicatons of PKND. The patients present typical features of PKND, such as short stature under 150 cm, open cranial suture and fontanelle, club-shaped phalanges, and underdevelopment of midface. This is a case of a 7-year-old girl with PKND, who visited our clinic with the chief complaint of anterior Open-bite and generalized crowding. The patient had been diagnosed as PKND by an orthopedist and manifested characteristic clinical and radiographic features, such as open cranial suture and fontanelle, obtuse madibular gonial angle, frontal and occipital bossing, grooved palate, club-shaped phalanges, and short stature. Orthodontic treatment was not considered because patients with PKND show abnormal bone resorption and remodeling. Instead, removal of deciduous teeth near exfoliation and TFA were performed, and periodic check-up is planned to maintain good oral hygiene.
During sleep, relatively major respiratory physiological changes occur in healthy subjects. The contributions and interactions of voluntary and metabolic breathing control systems during waking and sleep are quite different Alterations of ventilatory control occur in chemosensitivity, response to mechanical loads, and stability of ventilation. The activities of intercostal muscles and muscles involved in regulating upper airway size are decreased during sleep. These respiratory physiological changes during sleep compromise the nocturnal ventilatory function, and sleep is an important physiological cause of the nocturnal alveolar hypoventilation. There are several causes of chronic alveolar hypoventilation including cardiopulmonary, neuromuscular diseases. Obstructive sleep apnea syndrome (OSAS) is an important cause of nocturnal hypoventilation and hypoxia. Coexistent cardiopulmonary or neuromuscular disease in patients with OSAS contributes to the development of diurnal alveolar hypoventilation, diurnal hypoxia and hypercapnia. The existing data indicates that nocturnal recurrent hypoxia and fragmentation of sleep in patients with OSAS contributes to the development of systemic hypertension and cardiac bradytachyarrhythmia, and diurnal pulmonary hypertension and cor pulmonale in patients with OSAS is usually present in patients with coexisting cardiac or pulmonary disease. Recent studies reported that untreated patients with OSAS had high long-term mortality rates, cardiovascular complications of OSAS had a major effect on mortality, and effective management of OSAS significantly decreased mortality.
An ideology what a modern society seeks is lifelong employment through lifelong learning. The single word which draws the attainment is lifelong vocational competency development. This study is designed for exploring its possibility and limit of a redesign of it, and tries to propose efficiently a redesign idea of a vocational educational path. To this end, it was analyzed by a subject for a national human resource foundation plan and a lifelong bocational competency development foundation plan. In addition to that, it was covered a structure and content analysis of main laws and regulations which are a base of policy making. An educational path could be divided into an area of formal education system, an area of workplace for labors, and an area of lifelong vocational competency development. And the insights were drawn by pulling apart an operational situation of main organizations and a recurrent process of the educational path. The redesign plan of a vocational education path we did analyze to activate lifelong vocational competency development system is deduced as following. Firstly, it should be re-organized with a direction towards an effective manpower training to be linked with skills and demands required by an industry. Secondly, it should be generalized for a model of recurrence between work and learning and its alternation for lifelong vocational competency development. Thirdly, it should create a cluster in the region for lifelong vocational competency development so that it is to form an efficient network to have a division of labor and its liaison with cooperative relationship.
Objectives: To evaluate the clinicopathologic correlation and prognostic value of HPV18 DNA viral load in patients with early-stage cervical neuroendocrine carcinoma (NECA). Methods: Formalin-fixed, paraffin-embedded tissue of cervical NECA patients with known HPV18 infection and clinicopathologic data including follow-up results were collected. The HPV18 DNA load was assessed with quantitative PCR targeting the HPV18 E6E7 region. Results: Twenty-one patients with early-stage (IB-IIA) cervical NECA were identified. HPV18 DNA viral load ranged from 0.83 to 55,174 copies/cell (median 5.90). Disease progression, observed in 10 cases (48%), was not significantly associated with any clinicopathologic variables. However, the group of patients with progressive disease tended to have a higher rate of pelvic lymph node metastasis (50% versus 9%, p=0.063) and a lower median value of HPV18 DNA viral load (4.37 versus 8.17 copies/cell, p=0.198) compared to the non-recurrent group. When stratified by a cut-off viral load value of 5.00 copies/cell, the group of patients with viral load ${\leq}5.00$ copies/cell had a significantly shorter disease-free survival than the group with viral load >5.00 copies/cell (p=0.028). The group with a lower viral load also tended to have a higher rate of disease progression (75% versus 31%, p=0.080). No significant difference in the other clinicopathologic variables between the lower and higher viral load groups was identified. Conclusion: HPV18 DNA viral load may have a prognostic value in patients with early-stage NECA of the cervix. A low viral load may be predictive of shortened disease-free survival in these patients.
Background: Docetaxel and cisplatin in combination with fluorouracil (DCF) regimen is accepted to be one of the standard regimens in the treatment of advanced gastric cancer. However, substantial toxicity has limited its use in daily clinical practice. Therefore, modification of DCF regimens, including introduction of capecitabine has been investigated to improve the safety profiles. In the present study, the efficacy and toxicity of a regimen with a modified dose of docetaxel and cisplatin in combination with oral capecitabine (DCX) was evaluated in untreated patients with HER2-negative advanced gastric cancer. Materials and Methods: Fifty-four patients with HER2-negative locally advanced or metastatic gastric cancer were included in this cohort. Patients received docetaxel $60mg/m^2$ plus cisplatin $60mg/m^2$ (day 1) combined with capecitabine $1650mg/m^2$ (days 1-14) every 3 weeks. Treatment response, survival, and toxicity were retrospectively analyzed. Results: The median age was 54 years (range: 24-76). The majority of patients (70%) had metastatic disease, while 11 patients (21%) had recurrent disease and underwent curative gastrectomy, and 5 patients (9%) had locally advanced disease (LAD). The median number of DCX cycles was 4. There were 28 partial responses and 11 complete responses, with an overall response rate of 72%. Curative surgery could be performed in four patients among five with LAD. At the median follow-up of 10 months, the median progression-free survival (PFS) and overall survival (OS) of the entire cohort of patients were 7.4 and 12.1 months, respectively. Dose modification was done in 12 patients due to toxicity in 8 and noncompliance in 4 patients. The most common hematological toxicity was neutropenia, which occurred at grade 3-4 intensity in 10 of 54 patients (27.7%). Febrile neutropenia was diagnosed only in two cases. Conclusions: DCX regimen offers prominent anti-tumor activity and considered to be effective first-line treatment with manageable toxicity for patients with HER2-negative advanced gastric cancer.
de Camargo, Elaine Aparecida;da Silva, Glenda Nicioli;Gobette, Camila Pereira;de Castro Marcondes, Joao Paulo;Salvadori, Daisy Maria Favero
Asian Pacific Journal of Cancer Prevention
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v.14
no.10
/
pp.5941-5948
/
2013
Tumor response to antineoplastic drugs is not always predictable. This is also true for bladder carcinoma, a highly recurrent neoplasia. Currently, the combination of cisplatin and gemcitabine is well accepted as a standard protocol for treating bladder carcinoma. However, in some cases, this treatment protocol causes harmful side effects. Therefore, we investigated the roles of the genes TP53, RASSF1A (a tumor suppressor gene) and hMLH1 (a gene involved in the mismatch repair pathway) in cell susceptibility to cisplatin/gemcitabine treatment. Two bladder transitional carcinoma cell (TCC) lines, RT4 (wild-type TP53) and 5637 (mutated TP53), were used in this study. First, we evaluated whether the genotoxic potential of cisplatin/gemcitabine was dependent on TP53 status. Then, we evaluated whether the two antineoplastic drugs modulated RASSF1A and hMLH1 expression in the two cell lines. Increased DNA damage was observed in both cell lines after treatment with cisplatin or gemcitabine and with the two drugs simultaneously, as depicted by the comet assay. A lack of RASSF1A expression and hypermethylation of its promoter were observed before and after treatment in both cell lines. On the other hand, hMLH1 downregulation, unrelated to methylation status, was observed in RT4 cells after treatment with cisplatin or with cisplatin and gemcitabine simultaneously (wild-type TP53); in 5637 cells, hMLH1 was upregulated only after treatment with gemcitabine. In conclusion, the three treatment protocols were genotoxic, independent of TP53 status. However, cisplatin was the most effective, causing the highest level of DNA damage in both wild-type and mutated TP53 cells. Gemcitabine was the least genotoxic agent in both cell lines. Furthermore, no relationship was observed between the amount of DNA damage and the level of hMLH1 and RASSF1A expression. Therefore, other alternative pathways might be involved in cisplatin and gemcitabine genotoxicity in these two bladder cancer cell lines.
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