• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.343-347
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• 2014

Background: Maspin expression is a potential prognostic factor for various malignancies but its relation with gallbladder cancer is unknown and needs to be investigated needs to be investigated. We therefore here focused on maspin mRNA expression in normal, gall stone disease and gallbladder cancer subjects, with particular attention to prognostic importance in individuals with malignancies. Materials and Methods: This study was carried out at the Department of Surgical Gastroenterology, King George's Medical University, Lucknow, India. Gallbladder samples from normal (n=25), gall stone disease (n=25) and cancer patients (n=38) were analysed for maspin mRNA expression by semi-quantitative reverse transcriptase PCR and quantitative real time PCR. Statistical analysis was carried out using the Students t test or ANOVA. Survival analysis was conducted according to the Kaplan-Meier method and correlations were assessed using the Pearson correlation method. p<0.05 was considered statistically significant. Results: Significant increase (p=0.028) in expression of maspin mRNA was observed in gallbladder cancer as compared to gall stone disease, whereas no expression was found in normal tissues. Significant correlation (Pearson's coefficient(r)=-0.798, p<0.0001) was observed between relative quantification of maspin mRNA and survival of cancer patients after surgery, with significantly shorter (p=0.002) survival in patients having relative quantification >1.5 as compared to those having relative quantification <1.5. Similarly, significant differences in patient survival for maspin mRNA expression was observed for stage II (p=0.025) and III (p=0.011) cancer. Conclusions: Higher expression of maspin mRNA in gallbladder cancer has prognostic significance for stage II and III cancer, which needs to be investigated further.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.1
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• pp.162-168
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• 2007

Impaction of the maxillary central incisor may cause social, esthetic, and functional problems in children. There are various means of treatment for the inverted maxillary central incisor, such as extraction, surgical opening followed by orthodontic traction surgical repositioning or intra-alveolar autotransplantation prior to extraction. In this case, we surgically repositioned the inverted maxillary central incisor to normal semi-erupted position in a 5-year-old boy The developmental stage of the inverted tooth was Nolla's 6.5, which indicates formation of less than one third of the root. After surgical reposition, we did follow-up for 21 months, expecting spontaneous growth Unfortunately, poor prognosis was noted further root was not observed. Such failure seems to originate from possible injury on Hertwig's epithelial root sheath by surgical trauma. We performed surgical repositioning to retain the tooth instead of extraction. However, arrest of root development occurred which is one of the critical complications. In order to increase the success rate of the surgical reposition procedure, minimal surgical trauma is required as well as selection of adequate indication and decision of proper time of treatment considering the stage of root development.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.312-316
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• 2009

Objective : The purpose of this study was to evaluate the efficacy of a transforaminal suprapedicular approach, semi-rigid flexible curved probe, and 3-dimensional reconstruction computed tomography (3D-CT) with discogram in the endoscopic treatment of non-contained lumbar disc herniations. Methods : The subjects were 153 patients with difficult, non-contained lumbar disc herniations undergoing endoscopic treatment. The types of herniation were as follows : extraforaminal, 17 patients; foraminal, 21 patients; high grade migration, 59 patients; and high canal compromise, 56 patients. To overcome the difficulties in endoscopic treatment, the anatomic structures were analyzed by 3D reconstruction CT and the high grade disc was extracted using a semi-rigid flexible curved probe and a transforaminal suprapedicular approach. Results : The mean follow-up was 18.3 months. The mean visual analogue scale (VAS) of the patients prior to surgery was 9.48, and the mean postoperative VAS was 1.63. According to Macnab's criteria, 145 patients had excellent and good results, and thus satisfactory results were obtained in 94.77% cases. Conclusion : In a posterolateral endoscopic lumbar discectomy, the difficult, non-contained disc is considered to be the most important factor impeding the success of surgery. By applying a semi-rigid flexible curved probe and using a transforaminal suprapedicular approach, good surgical results can be obtained, even in high grade, non-contained disc herniations.

• Korean Journal of Radiology
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• v.23 no.1
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• pp.112-123
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• 2022

Objective: To investigate the relationship between ¹⁸F-FDG PET/CT semi-quantitative parameters and the International Association for the Study of Lung Cancer, American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) histopathologic classification, including histological subtypes, proliferation activity, and somatic mutations. Materials and Methods: This retrospective study included 419 patients (150 males, 269 females; median age, 59.0 years; age range, 23.0-84.0 years) who had undergone surgical removal of stage IA-IIIA lung adenocarcinoma and had preoperative PET/CT data of lung tumors. The maximum standardized uptake values (SUVmax), background-subtracted volume (BSV), and background-subtracted lesion activity (BSL) derived from PET/CT were measured. The IASLC/ATS/ERS subtypes, Ki67 score, and epidermal growth factor/anaplastic lymphoma kinase (EGFR/ALK) mutation status were evaluated. The PET/CT semi-quantitative parameters were compared between the tumor subtypes using the Mann-Whitney U test or the Kruskal-Wallis test. The optimum cutoff values of the PET/CT semi-quantitative parameters for distinguishing the IASLC/ATS/ERS subtypes were calculated using receiver operating characteristic curve analysis. The correlation between the PET/CT semi-quantitative parameters and pathological parameters was analyzed using Spearman's correlation. Statistical significance was set at p < 0.05. Results: SUVmax, BSV, and BSL values were significantly higher in invasive adenocarcinoma (IA) than in minimally IA (MIA), and the values were higher in MIA than in adenocarcinoma in situ (AIS) (all p < 0.05). Remarkably, an SUVmax of 0.90 and a BSL of 3.62 were shown to be the optimal cutoff values for differentiating MIA from AIS, manifesting as pure ground-glass nodules with 100% sensitivity and specificity. Metabolic-volumetric parameters (BSV and BSL) were better potential independent factors than metabolic parameters (SUVmax) in differentiating growth patterns. SUVmax and BSL, rather than BSV, were strongly or moderately correlated with Ki67 in most subtypes, except for the micropapillary and solid predominant groups. PET/CT parameters were not correlated with EGFR/ALK mutation status. Conclusion: As noninvasive surrogates, preoperative PET/CT semi-quantitative parameters could imply IASLC/ATS/ERS subtypes and Ki67 index and thus may contribute to improved management of precise surgery and postoperative adjuvant therapy.

• Korean Journal of Computational Design and Engineering
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• v.13 no.1
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• pp.58-66
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• 2008

The artificial discs have recently used to preserve the motion of the treated segment in lumbar spine surgery. However, there have been lack of biomechanical information of the artificial discs to explain current clinical controversies such as long-term results of implant wear and excessive facet contact forces. In this study, we investigated the biomechanical effects of three artificial implants on the lumbar spinal segments by finite element analysis. The finite element model of intact lumbar spine(L1-S) was developed and the three implants were inserted in L4-L5 segment of the spine model. 5 Nm of flexion and extension moments were applied on the superior plate of L1 with 400 N of compressive load. Excessive motions and high facet contact forces at the surgical level were generated in the all three implanted models. In the flexion, the peak von-Mises stresses in the semi-constrained type implant was higher than those in the un-constrained type implant which would cause wear on the polyethylene core. The results of the study would provide a biomechanical guideline for selecting optimal surgical approach or evaluating the current design of the implants, or developing a new implant.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.33 no.7
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• pp.637-644
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• 2009

We have analyzed the biomechanical characteristics of cervical spine after total disc replacement using finite element analysis. A finite element model of C2-C7 spinal motion segment was developed and validated by other experimental studies. Two types of artificial discs, semi-constraint and un-constraint, were inserted at C6-C7 segments. Inferior plane of C7 vertebra was fixed and 1Nm of moment were applied on superior plane of C2 vertebra with 50N of compressive load along follower load direction. Mobility of the cervical spine in which each artificial disc inserted was higher than that of intact one in all loading conditions. Also, high mobility at the surgical level after total disc replacement could lead higher facet joint force and ligaments axial stresses. The results of present study could be used to evaluate surgical option and validate the biomechanical characteristics of the implant in total disc replacement in cervical spine.

• Journal of Korean Academy of Nursing
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• v.49 no.1
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• pp.36-45
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• 2019

Purpose: The purpose of this study was to identify the characteristics of and risk factors for medical-device-related pressure ulcer (MDRPU) development in intensive care units. Methods: A prospective cohort study design was used, and the participants were 253 adult patients who had stayed in medical and surgical intensive care units. Data were collected regarding the application of medical devices and MDRPU-related characteristics over a period of six months from June to November, 2017. Data were analyzed using independent t-test, ${\chi}^2-test$, Fisher's exact test, and binary logistic regression analysis with the SPSS 21.0 program. Results: Among the 253 participants, MDRPUs occurred in 51 (19.8%) participants. The results of the logistic regression analysis showed that the risk factors for MDRPUs were the use of endotracheal tubes (OR=5.79, 95% CI: 1.66~20.20), having had surgery (OR=2.95, 95% CI: 1.11~7.77), being in a semi-coma/coma (OR=5.79, 95% CI: 1.04~32.05), and sedation (OR=5.54, 95% CI: 1.39~22.19). Conclusion: On the basis of the study results, it is effectively facilitated by nurses when they care for patients with MDRPUs in intensive care units and the results are expected to be of help in preventive education for MDRPU development as well as preparing the base data for intervention studies.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.170-177
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• 2013

Total elbow arthroplasty is still in its infancy compared with other arthroplasties, such as knee or hip arthroplasties. Implant design has been evolving with clinical experiences; however, there are only limited data on the long-term clinical outcome of elbow arthroplasty in the literature. The design of total elbow prostheses can be divided into three categories: linked (constrained or semi-constrained), unlinked (unconstrained), and convertible types. The choice between an unlinked (unconstrained) implant and a linked (semi-constrained) implant depends on joint stability and adequacy of the bone stock. Linked elbow arthroplasty has provided high patient satisfaction, and pain relief thanks to proper patient selection, advancement of implant design, improvement in cement techniques, meticulous surgical technique, and appropriate postoperative rehabilitation. Concerns remain about the use of this implant in young or high-demand patients. This article focuses on the linked (semi-constrained) prostheses, which provides an overview of the current state of linked total elbow arthroplasty.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.220-225
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• 1998

Background: The patients of facial hyperhidrosis have been known that they had much difficulties in interpersonal relationships and social activities due to excessive hidrosis when they were in stress, hot weather, or having meals. Previous drug therapy and stellate ganglion block have only temporary effects. The surgical method, $T_1$ sympathetomy has the risk of Hornor's syndrome. For that reasons, the sympathicotomy of proximal and distal portions of $T_2$ sympathetic ganglion with electroresectoscope used in transurethral resection seemed to be appropriate procedure, and we would like to report the results of our procedure. Method: Under the general anesthesia with semi-sitting position, and the portal was made through the small incision along the upper border of the 4th rib at the crossing point of mid-axillary line. After the partial collapse of lung by insufflation of 300 to 500 ml of $CO_2$, $T_2$ sympathetic ganglion was identified and resected proximally and distally with electro-cauterization. Finally the lung was expanded by limiting flow until the airway pressure reached 30 to 40 cm$H_2O$, and the wound was closed after removal of electroresectoscope. Result: There was no postoperative complication requiring surgical interventions. The facial sweating was stopped immediately after the operation and all the patients appeared to be satisfied. Conclusion: $T_2$ sympathicotomy with TUR electroresectoscope is thought be the minimal invasive and highly successful method in the treatment of facial hyperhidrosis. But longer terms follow-up will be needed to prove this result.

• Journal of Korean Neurosurgical Society
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• v.65 no.2
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• pp.186-195
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• 2022

Objective : To explore the histological feature of the cervical disc degeneration in patients with degenerative ossification (DO) and its potential mechanisms. Methods : A total of 96 surgical segments, from cervical disc degenerative disease patients with surgical treatment, were divided into ossification group (group O, n=46) and non-ossification group (group NO, n=50) based on preoperative radiological exams. Samples of disc tissues and osteophytes were harvested during the decompression operation. The hematoxylin-eosin staining, Masson trichrome staining and Safranin O-fast green staining were used to compare the histological differences between the two groups. And the distribution and content of transforming growth factor (TGF)-β1, p-Smad2 and p-Smad3 between the two groups were compared by a semi-quantitative immunohistochemistry (IHC) method. Results : For all the disc tissues, the content of disc cells and collagen fibers decreased gradually from the outer annulus fibrosus (OAF) to the central nucleus pulposus (NP). Compared with group NO, the number of disc cells in group O increased significantly. But for proteoglycan in the inner annulus fibrosus (IAF) and NP, the content in group O decreased significantly. IHC analysis showed that TGF-β1, p-Smad2, and p-Smad3 were detected in all tissues. For group O, the content of TGF-β1 in the OAF and NP was significantly higher than that in group NO. For p-Smad2 in IAF and p-Smad3 in OAF, the content in group O were significantly higher than group NO. Conclusion : Histologically, cervical disc degeneration in patients with DO is more severe than that without DO. Local higher content of TGF-β1, p-Smad2, and p-Smad3 are involved in the disc degeneration with DO. Further studies with multi-approach analyses are needed to better understand the role of TGF-β/Smads signaling pathway in the disc degeneration with DO.