Jung, Jin Young;Chang, Jong Hee;Chang, Jin Woo;Park, Yong Gou;Chung, Sang Sup
Journal of Korean Neurosurgical Society
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v.30
no.4
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pp.456-462
/
2001
Objective : Although cingulotomy has been applied to patients with affective disorders more frequently, there are numerous reports of its use for the control of severe pain. The goal of this study was to investigate the role of stereotactic bilateral anterior cingulotomy for intractable cancer pain. Method : Between January and June, 2000, we underwent stereotactic bilateral anterior cingulotomy in 6 patients for intractable cancer pain with poor response to opioids. The patients were suffering from widespread musculoskeletal or visceral pain. We made four lesions along the two tracks on either side of the cingulate cortex. Result : In all patients, pain reliefs after cingulotomy were dramatic and immediate. Five out of six patients did not require any opioids and one patient could reduce dose of opioids. There were no deaths or serious complications related to the procedure. Conclusion : These results suggested that a bilateral anterior cingulotomy might be useful method to control intractable cancer pain associated with the widespread metastatic disease. To provide rationale of bilateral anterior cingulotomy in intractable cancer pain, the theoretical mechanisms and role of bilateral anterior cingulotomy are discussed, along with our surgical techniques and the course of our patients.
Lee, Song Am;Chee, Hyun Keun;Lee, Sung Jun;Kim, Jun Seok;Hwang, Jae Joon;Cho, Seong Joon
Journal of Chest Surgery
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v.42
no.1
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pp.127-130
/
2009
Primary leiomyosarcoma of the mediastinum is an extremely rare tumor that develops either in the mesenchymal cells of the visceral mediastinum or in the smooth muscle of the great vessels. In the literature, the most significant factor for determining survival is the ability to completely resect the tumor. But there is 30~64% recurrence rate and there is also a lack of data for the role of adjuvant therapy after complete resection. We report here on a case of recurred leiomyosarcoma of the mediastinum that was surgically removed via left thoracotomy 2 years previously and this was misdiagmosed as benign disease.
Purpose: Excess intake of sodium is a major diet-related risk factor for human diseases including hypertension and cancer as well as obesity and inflammation. However, findings are still controversial, and evidence is lacking in Koreans. Therefore, for better understanding of the role of dietary sodium intake in disease etiology, this study investigated the effects of dietary sodium intake on adiposity, inflammation, and hormones in Koreans. Methods: A total of 80 males and females joined the study. The general characteristics and dietary intake data were investigated by trained interviewers using a questionnaire and 24-h dietary recall, respectively. For the markers of adiposity, body weight, body mass index, percent of body fat, visceral fat area, and waist and hip circumference were measured. For the inflammation and hormone markers, leptin, adiponectin, insulin, tumor necrosis $factor-{\alpha}$, and interleukin-6 were also analyzed. Results: Multivariate linear regression analyses suggested that dietary sodium intake was not associated with adiposity. However, dietary sodium showed a significant association with insulin level: Plasma insulin concentration increased with sodium intake independent of other dietary intake or percent of body fat (${\beta}=0.296$, adjusted $r^2=0.276$, p < 0.01). Other markers for inflammation and hormonal responses were not associated with dietary sodium intake. Conclusion: Findings suggested that dietary sodium intake may be a critical modifying factor in the level of plasma insulin. However, it showed a limited effect on obesity and other inflammation markers and hormone levels. These findings should be confirmed in larger, well-designed investigations.
The observations on climate change show a clear increase in the temperature of the Earth's surface and the oceans, a reduction in the land snow cover, and melting of the sea ice and glaciers. The effects of climate change are likely to include more variable weather, heat waves, increased mean temperature, rains, flooding and droughts. The threat of climate change and global warming on human and animal health is now recognized as a global issue. This presentation is described an overview of the latest scientific knowledge on the impact of climate change on zoonotic diseases. Climate strongly affects agriculture and livestock production and influences animal diseases, vectors and pathogens, and their habitat. Global warming are likely to change the temporal and geographical distribution of infectious diseases, including those that are vector-borne such as West Nile fever, Rift Valley fever, Japanese encephalitis, bluetongue, malaria and visceral leishmaniasis, and other diarrheal diseases. The distribution and prevalence of vector-borne diseases may be the most significant effect of climate change. The impact of climate change on the emergence and re-emergence of animal diseases has been confirmed by a majority of countries. Emerging zoonotic diseases are increasingly recognized as a global and regional issue with potential serious human health and economic impacts and their current upward trends are likely to continue. Coordinated international responses are therefore essential across veterinary and human health sectors, regions and countries to control and prevent emerging zoonoses. A new early warning and alert systems is developing and introducing for enhancing surveillance and response to zoonotic diseases. And international networks that include public health, research, medical and veterinary laboratories working with zoonotic pathogens should be established and strengthened. Facing this challenging future, the long-term strategies for zoonotic diseases that may be affected by climate change is need for better prevention and control measures in susceptible livestock, wildlife and vectors in Korea. In conclusion, strengthening global, regional and national early warning systems is extremely important, as are coordinated research programmes and subsequent prevention and control measures, and need for the global surveillance network essential for early detection of zoonotic diseases.
Proceedings of the Korean Society of Embryo Transfer Conference
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2002.11a
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pp.110-110
/
2002
Rapidly progressive interstitial renal fibrosis has recently been reported in young women who have been on a slimming regimen including chinese herbs. Aristolochic acid, suspected as the causal factor of this renal disease, is a well known carcinogen. It has been known that Madouling (Aristolochiae fructus) contains aristolochic acid. The objective of this study was to investigate the effects of Madouling, Madouling-tang, which are the extract mixture from 10 different chinese herbs including Madouling, and aristolochic acid on reproductive and developmental toxicity. Female rats were administered orally with the extracts of Madouling, madouling-tang, and aristolochic acid from 14 days before mating to day 17 of gestation. Madouling (8mg/kg) decreased fertility in the 8mg/kg group, but Madouling-tang and aristolochic acids did not. Significant decrease of mean fetal body weights were observed in the 16mg/kg group of aristolochic acids. External, visceral and skeletal malformation of fetuses were not observed with treatment. Histopathological examination showed the discrete damage of kidney in the 8mg/kg group of Madouling and 16mg/kg groups of aristolochic acid. In whole embryo culture, Madouling and Madouling-tang caused the retardation of growth and development of embryo in the dose of 1 $\mu$g/ml and 0.02 $\mu\textrm{g}$/kg, respectively while aristolochic acids showed the similar effect in the dose of 300 $\mu\textrm{g}$/kg. These results indicate that Madouling, up to 0.05mg/kg (prescription dose to human) has no adverse effects on the fertility, reproduction and development of Sprague-Dawley rats.
By examining the relationship between physiological character of stomach and true viscera pulse(眞臟脈) with "Huangdinejing(黃帝內經)", the study shows these fallowing results. Stomach is not only one of the six bowels(六腑), it represents them. It is called as yang brightness of foot(足陽明) because it has relation with function of earth among five phases(五行), great storage(倉廩) and root of five visceras and six bowels(五臟六腑), has close relationship with triple energizers(三焦). Stomach is an important organ that feeds acquired qi(後天之氣) based on food and stomach qi (胃氣) which is a transformed form by going through digestion, is significant for life conservation. In human body, the activation of stomach qi can be known by pulse. The true viscera pulse is a pulse which predicts the period of death. If stomach qi exsits, viscera qi can be led to greater yin of hand(手太陰), however, when it does not exist, five viscera qi can not be led to greater yin of hand and this kind of situation appears the true viscera pulse. Hence, by knowing the relation between stomach qi and five viscera qi, the condition of normality, disease, and death can be known. In "Hwangdineijing" it says, stomach qi, shortly string like pulse(微弦), shortly surging pulse(微鉤), shortly floating pulse(微毛), and shortly sunken pulse(微毛) shown in four seasons are normal pulse. And also it emphasizes, normal pulse is made when four seasons, five viscera pulse, and stomach qi are in harmony. In conclusion, stomach qi is based on food for well being, and a standard of judging people whether they are living in a healthy life or not.
Benign lung tumors compose a heterogeneous group of solid growths that present variations in clinical features, depending on whether the origin is within the bronchus on lung parenchyma or from visceral pleura. Benign tumors of the lung are relatively uncommon, and series are to be found in the literature and the classification of benign tumors of the lung continues to be controversial because of disagreement concerning the origin and prognosis of many common lesions. We adopt Liebows original classification but excluded bronchial adenoma which no longer considered as benign tumor and added pulmonary A-V fistula and congenital cystic adenomatoid malformation. We analyzed 61 cases of benign tumors which were composed of 16 original Korean cases and 45 cases which were reported on journal of Thoracic & Cardiovascular Surgery. The results were. [1] Incidence; Of 61 cases, chondromatous hamartoma was 2 cases [41 %], congenital cystic adenomatoid malformation 10 cases [16.4 %], pulmonary A-V fistula 5 cases [8.1 %], sclerosing hemangioma 4 cases [6.5 %], teratoma, plasma cell granuloma & mesothelioma were 3 cases [4.9%], Castlemans disease 2 cases [3.3%], and mucous gland adenoma, paraganglioma, and leiomyoma 1 case [1.6 %]. [2] Age & Sex distribution; Male 30 cases and female 31 cases. Mean age was 31.4 years old. [3] Main symptom; was coughing, 32.8%, and no symptom, 24.6%. [4] Sixty eight percentage of chest film showed mass density, and 4 cases showed calcification, 2 cases had lobulation. [5] Size of mass was large and multiple mass was 2 cases. Endobronchial tumors were 9 cases, 14.9 %. [6] Three cases of endobronchial tumor were preoperatively diagnosed by bronchoscopy and 2 cases of pulmonary A-V fistula were diagnosed by pulmonary arteriography. [7] Seven cases, 11.5%, had associating diseases such as bronchogenic cyst, thymic cyst, Schwannoma, situs inversus, bronchiectasis and bronchogenic carcinoma. [8] Minor resection such as excision 8i: wedge resection were 15 cases, 26.2 %, and 6 cases, 75.4 %, of lobectomy were performed including 5 cases of pneumonectomy 5 cases had. [9] Postoperative complications; One case, 1.6 %, expired due to respiratory insufficiency. Two cases had re-operation due to bleeding and hemoptysis.
Complex lesions of the thoracic aorta are traditionally treated in 2 surgical steps with the elephant trunk technique. A relatively new approach is the frozen elephant trunk (FET) technique, which potentially allows combined lesions of the thoracic aorta to be treated in a 1-stage procedure combining endovascular treatment with conventional surgery using a hybrid prosthesis. These are very complex and time-consuming operations, and good results can be obtained only if appropriate strategies for myocardial, cerebral, and visceral protection are adopted. However, the FET technique is associated with a non-negligible incidence of spinal cord injury, due to the extensive coverage of the descending aorta with the excessive sacrifice of intercostal arteries. The indications for the FET technique include chronic thoracic aortic dissection, acute or chronic type B dissection when endovascular treatment is contraindicated, chronic aneurysm of the thoracic aorta, and chronic aneurysm of the distal arch. The F ET technique is also indicated in acute type A aortic dissection, especially when the tear is localized in the aortic arch; in cases of distal malperfusion; and in young patients. In light of the great interest in the FET technique, the Vascular Domain of the European Association for cardio-thoracic Surgery published a position paper reporting the current knowledge and the state of the art of the FET technique. Herein, we describe the surgical techniques involved in the FET technique and we report our experience with the F ET technique for the treatment of complex aortic disease of the thoracic aorta.
Lee, Young Ho;Sim, Jae Jeong;Kang, Kyung Ho;Song, Gwan Gyu
Tuberculosis and Respiratory Diseases
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v.43
no.5
/
pp.786-791
/
1996
Systemic sclerosis is a multisystemic disease of unknown origin charicterized by degenerative fibrotic and inflammatory changes in the skin, vessels, joints, muscles, and visceral organs. Involvement of the lung in systemic sclerosis is common, but pleural effusion is rare. Although vasculitis commonly accompanies many connective tissue disorders, it has been rarely reported in systemic sclerosis. A 43-year-old woman, with a 10-year history of Raynaud's phenomenon, was admitted due to right chest pain. Her hands showed diffuse thickening and swelling of skin. Chest X-ray showed pleural effusions and esophageal manometry showed hypotonic peristalsis and low lower esophageal sphincter tone compatible with scleroderma esophagus. Antinuclear antibodies were present (titer>1 : 160) with a speckled pattern. She was positive for rheumatoid factor, anti scl-70 and RNP antibodies, but negative for anti-Ro, La, and Sm antibodies. Histology of the pleura revealed the presence of leukocytoclastic vasculiti. After adminisrration of prednisolone 30 mg/day, her chest symptom was improved. We report a case of systemic sclerosis with pleural effusions due to leukocytoclastic vasculitis with review of the literatures.
Objectives: Metabolic syndrome has received attention as a risk factor for cardiovascular disease, with particular importance attached to visceral fat accumulation, which is associated with lifestyle-related diseases and is strongly correlated with waist circumference. In this study, our aim is to propose waist circumference cut-off values that can be used as a marker for fatty liver based on a sample of workers receiving health checkups in Japan. Methods: This study was conducted in a total of 21,866 workers who underwent periodic health checkups between January 2007 and December 2007. The mean age of the subjects was 47.4 years for men (standard deviation [SD]: 8.0) and 44.7 years for women (SD: 6.9). Evaluation included abdominal ultrasound and measurement of waist circumference, body mass index, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure. Results: Based on receiver operating characteristic curve analysis, the optimal waist circumference cut-off values were shown as 85.0 cm (sensitivity 0.72, specificity 0.69) for men and 80.0 cm (sensitivity 0.75, specificity 0.78) for women. Conclusion: Abdominal ultrasound is the most efficient means of diagnosing fatty liver, but this examination seldom occurs because the test is not routinely performed at workers' health checkups. In people found to have a high risk of fatty liver, recommendations can be made for abdominal ultrasound based on the waist circumference cut-off values obtained in this study. That is, waist circumference can be used in high risk individuals as an effective marker for early detection of fatty liver.
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