• Title/Summary/Keyword: Minimal dilatation

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REMARKS ON THE LIECHTI-STRENNER'S EXAMPLES HAVING SMALL DILATATIONS

  • Ham, Ji-Young;Lee, Joongul
    • Communications of the Korean Mathematical Society
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    • v.35 no.4
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    • pp.1299-1307
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    • 2020
  • We show that the Liechti-Strenner's example for the closed nonorientable surface in [13] minimizes the dilatation within the class of pseudo-Anosov homeomorphisms with an orientable invariant foliation and all but the first coefficient of the characteristic polynomial of the action induced on the first cohomology nonpositive. We also show that the Liechti-Strenner's example of orientation-reversing homeomorphism for the closed orientable surface in [13] minimizes the dilatation within the class of pseudo-Anosov homeomorphisms with an orientable invariant foliation and all but the first coefficient of the characteristic polynomial p(x) of the action induced on the first cohomology nonpositive or all but the first coefficient of p(x)(x ± 1)2, p(x)(x2 ± 1), or p(x)(x2 ± x + 1) nonpositive.

A case report of Successful Laparascopic Myotomy for Achalasia (식도이완불능증의 복강경 수술)

  • 황성욱;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.157-160
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    • 2002
  • Recently, video-assisted surgical approaches for achalasia have been adopted by many surgeons. Many reports showed that the minimal invasive video-assisted operations for Ihe achalasia revealed such good results as the conventional operations via thoracotomy. In some studies, among the minimal invasive video assisted surgeries for achalasia, the laparascopic assisted operations have some advantages mainly in respect to patient satisfaction over the thoracoscopic assisted surgeries. In this case, the patient had not responded to repeated balloon dilatation, and we made 5 small incisions over the abdominal wall and performed an esophageal myotomy and partial anterior fundoplication by laparascopic guide. The patient's symptoms were almost relieved, and the postoperative radiologic findings were satisfactory.

Comparison the Diagnostic Value of Dilatation and Curettage Versus Endometrial Biopsy by Pipelle - a Clinical Trial

  • Sanam, Moradan;Majid, Mir Mohammad Khani
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4971-4975
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    • 2015
  • Background: Several methods have been presented for the evaluation of the endometrium in patients with abnormal uterine bleeding, which include minimal invasive and invasive approaches such as diagnostic curettage or endometrial biopsy by Pipelle. Many studies have been performed in order to compare two methods; diagnostic curettage and outpatient endometrial biopsy. This investigation compared sampling adequacy, endometrial histopathology, failure rates, duration and costs between diagnostic curettage in a hospital and endometrial biopsy. Materials and Methods: This single blind clinical trial was performed on 130 patients older than 35 years who was referred to Amir training hospital in 2013 for elective diagnostic curettage because of abnormal uterine bleeding. For all patients eligible for the study, an endometrial sample by Pipelle was taken without anesthesia or dilatation. Then under general anesthesia diagnostic curettage was performed by sharp curette. Sampling duration was calculated and both samples were sent to the same pathologist. The diagnostic values of two methods in the diagnosis of normal endometrium, endometrial hyperplasia and carcinoma were compared. The costs of these two methods were also compared. Data analysis was performed by SPSS (version 16.0) software. Chi-Square, Fisher, and Pearson tests were used and were considered statistically significant at P values less than 0.05. Results: Two methods were agreed upon 88% of sampling adequacy and 94% of pathological results. Specificity of 100% and sensitivity of 90% for detection of proliferative endometrium, secretory endometrium, simple hyperplasia without atypia and 100% for cancer were recorded. Pipelle diagnostic accuracy in comparison with curettage, have been reported over 97%, so the failure rate in this study was below 5%. Sensitivity of Pipelle for detection of atrophic endometrium was reported below 50%. Duration and cost was lower in Pipelle versus curettage. Conclusions: It is concluded that due to high agreement and cohesion coefficient between curettage and Pipelle on the issue of sampling adequacy, histopathology finding (except atrophic endometrium), low failure rate, duration of sampling and cost, Pipelle can be introduced as a suitable alternative of diagnostic curettage.

An Experimental Study on the Heterotopic Canine Heart Transplantation: Pathologic Observation (동종 심장이식의 병리조직학적 연구)

  • 손광현;서경필;이영균
    • Journal of Chest Surgery
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    • v.2 no.2
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    • pp.155-166
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    • 1969
  • Heterotopic abdominal homograft of canine heart was carried out in 20 pairs of dogs. Of these 12 cases were subjected as a control and 8 were subjected to immunosuppressive group. The dosage of immunosuppressive agent was 5mg/kg/day of Imuran [Azathioprine] for 3 days preoperatively, 10mg/kg on operative day and 5mg/kg/day postoperatively. For reducing the metabolic demand, the donor heart was preserved in 4degree heparinized saline solution for approximately I4 minutes. In the most of the cases, transplantation was performed with the technique of end-to-side aorto-aortic anastomosis and end-to-side pulmonary artery-inferior vena cava anastomosis at the infrarenal portion. Five out of 20 grafted dogs were survived more than one day. The longest survived 18 days in the control group and survive more than 60 days in the treated group. The survival cases were 3 out of 8[37. 5%] in the group of dogs treated with lmuran and 2`out of 12 [16.6%] in the group of non-treated. A prominent gross findings of the grafted heart was a minimal to moderate degree of dilatation of the heart with or without thrombosis in the cardiac chambers and/or anastomotic site. The case number 10, 15, and 19 showed moderate hypertrophy in grossly. The microscopic findings were as follows; 1. There were early hypersensitive histologic reactions such as interstitial edema, cellular infiltrations and early degenerative changes in the myocardium in the cases of 3 hour survival. 2. In the cases of more than 6 hours survival, organizing thrombosis of myocardial vessels, vasculitis,myocardial necrosis and lymphocyte, plasma cell, round cell infiltrations were noted. In the cases of more than 12 hours survival, the degree of these histologic changes especially in the non-treated group were more intensified than in the treated. 3. In the cases which survived more than one day, so called homograft specific histologic changes were milder in the immunosuppressive group compared with the control. 4. All the host hearts showed no evidence of pathologic findings histologically. Among the homologous canine cardiac transplantation tissue reaction, was milder and suvival time longer in the group treated with immunosuppressive drug.

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Effect of the Paclitaxel and Radiation on the Gastric Mucosa of the Rat (흰쥐의 위점막에 Paclitaxel (Taxol)과 방사선조사의 효과)

  • Lee Kyung-ja;Koo Heasoo
    • Radiation Oncology Journal
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    • v.17 no.4
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    • pp.314-320
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    • 1999
  • Purpose : Paclitaxel is a chemotherapeutic agent with potent microtubule stabilizing activity that arrests cells in $G_2$-M phase. Because $G_2$ and M are the most radiosensitive phase of the cell cycle, paclitaxel has potential role as a cell-cycle specific radiosensitizer. This study was peformed to see the effects of paclitaxel on the radiation-induced damage of gastric mucosa of the rat. Materials and Methods : The rats were divided into the three groups i.e., paclitaxel alone group, radiation alone group and, a combination of paclitaxel and radiation in combined group. A single intraperitoneal infusion of paclitaxel (10 mg/kg) was done in paclitaxel alone group. In radiation alone group, a single fraction of irradiation (8 Gy, x-ray) to the whole abdomen and, a combination of a single fraction of irradiation (8 Gy, x-ray) to the whole abdomen was given 24 hrs after paclitaxel infusion In combined group of paclitaxel and radiation. The incidence of mitosis and apoptosis as well as histologic changes of the gastric mucosa were evaluated at 6 hrs, 24 hrs, 3 days and 5 days after treatment. Results : The number of the mitosis was not increased by paclitaxel infusion. The incidence of the apoptosis was similar from 6 hrs to 3 days after paclitaxel infusion and was decreased at 5 days. Paclitaxel induced minimal glandular dilatation and cellular atypia of gastric mucosa at 24 hrs and 3 days. In irradiation group, the incidence of apoptosis was $6.0\%$ in 6 hrs and $1.25\%$ in 24 hrs after irradiation and minimal glandular dilatation and cellular atypia were noted throughout the experimental period. The incidence of apoptosis in the combined group of paclitaxel and irradiation ($4.5\%$) was significantly higher than irradiation alone group ($1.25\%$) at 3 days (p<0.05). Conclusion : Paclitaxel had no mitotic on mitotic arrest in gastric mucosa of the rat. Increased number of apoptosis in combined paclitaxel and irradiation group suggested the additive effects of paclitaxel on irradiation.

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Reconstruction of Congenital Absence of Vagina using Vulvoperineal Fasciocutaneous Flap: A Case Report (외음회음 근막피부피판을 이용한 선천성 질결여증의 재건례)

  • Kim, Mi-Sun;Kim, Chul-Han;Lee, Yong-Sek;Kang, Sang-Gue;Tark, Min-Sung
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.831-834
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    • 2010
  • Purpose: Congenital absence of the vagina is a rare case. It occurs as a result of Mullerian duct aplasia or complete androgen insensitivity syndrome. The reconstructive modality includes skin graft, use of intestine and various methods of flap. We report a patient who underwent vulvoperineal fasciocutaneous flap to reconstruct congenital absence of the vagina, while the external genitalia and ovaries are normal. Methods: A 26-year-old woman presented with vaginal agenesis. Under general anesthesia, a U-shaped incision was made between the urethral meatus and the anus. The new vaginal pocket was created up to the level of the peritoneal reflection between the urinary structures and the rectum. Next, the vulvoperineal fasciocutaneous flaps were designed in a rectangular fashion. Flap elevation was begun at the lateral margin which the adductor longus fascia was incised and elevated, and the superficial perineal neurovascular pedicle was invested by the fascial layer. The medial border was then elevated. A subcutaneous tunnel was created beneath the inferior of the labia to rotate the flaps. The left vulvoperineal flap was rotated counterclockwise and the right was rotated clockwise. The neovaginal pouch was formed by approximating the medial and lateral borders. The tubed neovagina was then transposed into the cavity. Results: In 3 weeks, the vaginal canal remained supple After 6 weeks, the physical examination showed normalappearing labia majora and perineum with an adequate vaginal depth. A year after the operation, the patient had a 7 cm vagina of sufficient width with no evidence of contractures nor fibrous scar formation. The patient was sexually active without difficulty. Conclusion: Although many methods were described for reconstruction of vaginal absence, there is not a method yet to be approved as a perfect solution. We used the vulvoperineal fasciocutaneous flap to reconstruct a neovagina. This method had a following merits: a single-stage procedure, excellent flap reliability, the potential for normal function, minimal donor site morbidity and no need for subsequent dilatation, stents, or obturators. We thought that this operation has a good anatomic and functional results for reconstruction of the vagina.

The Early Results of Tricuspid Valvuloplasty with Using the Edwards MC3 Annuloplasty System (Edwards MC3 Annuloplasty System을 이용한 삼첨판 성형술의 조기 성적)

  • Oh, Tak-hyuck;Cho, Joon-Yong;Lee, Jong-Tae;Kim, Gun-Jik;Kim, Dae-Hyun
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.28-33
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    • 2009
  • Background: Functional tricuspid regurgitation (TR) greater than or equal to a mild grade requires tricuspid valvuloplasty, and tricuspid valvuloplasty with ring annuloplasty has shown good outcomes. We report here on our early experience with the Edwards $MC^3$ annuloplasty system (Edwards LifeSciences, Irvine, CA). Material and Method: From November 2004 to July 2006, 72 patients with tricuspid annular dilatation and TR underwent tricuspid valvuloplasty with using the Edwards $MC^3$ annuloplasty ring. Sixty-eight patients were operated on via median sternotomy and four patients were operated on using robotic assisted minimal invasive thoracotomy. The patient population included 21 males and 51 females and their mean age was $53.9{\pm}12.3$. The mean grade of TR, as assessed by the preoperative echocardiography, was $2.2{\pm}1.0$. The mean NYHA functional class was $3.1{\pm}0.8$. The mean left ventricular ejection fraction was $57.0{\pm}9.9$%. Result: The TR and NYHA functional class, as assessed by postoperative echocardiography, was significantly reduced (mean=$0.4{\pm}0.6$ and $2.0{\pm}0.7$, respectively p<0.001). There was one case of hospital mortality. One patient required permanent pacemaker insertion for third degree atrioventricular block. Conclusion: Our study shows that the Edwards $MC^3$ remodeling ring is easy to implant and it effectively corrects functional TR with excellent clinical and echocardiographic outcomes. Further follow-up and a larger clinical series are required to establish the long-term stability of this repair technique.