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It Sometimes Happens: Staging Surgery in Coexisting Graves' Disease and Thyroid Cancer
Ettore Caruso,Maria De Pasquale,Antonella Pino,Vincenzo Bartolo,Fausto Famà,Gianlorenzo Dionigi 대한갑상선-내분비외과학회 2019 The Koreran journal of Endocrine Surgery Vol.19 No.3
Thyroidectomy is a safe procedure often performed either for benign or malignant thyroid diseases. Complication rate is low and bilateral recurrent laryngeal nerve (RLN) injury associated with thyroidectomy is rarely described. The RLN may be injured bilaterally and damage is usually recognized postoperatively. With an increased use of intraoperative neural monitoring (IONM), an adaptation of the resection strategy appears to be necessary in case of an intraoperative loss of signal of the first operated side with total thyroidectomy planned. We review a case of a 21-year-old female with a history of Graves' disease who underwent a total thyroidectomy in a 2-stage procedure due to a loss of RLN function detected intraoperatively. The patient recovered uneventfully from the 2 surgeries.
P2Y1 receptor signaling is controlled by interaction with the PDZ scaffold NHERF-2
Fam, S. R.,Paquet, M.,Castleberry, A. M.,Oller, H.,Lee, C. J.,Traynelis, S. F.,Smith, Y.,Yun, C. C.,Hall, R. A. Proceedings of the National Academy of Sciences 2005 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.102 No.22
<P>P2Y(1) purinergic receptors (P2Y(1)Rs) mediate rises in intracellular Ca(2+) in response to ATP, but the duration and characteristics of this Ca(2+) response are known to vary markedly in distinct cell types. We screened the P2Y(1)R carboxyl terminus against a recently created proteomic array of PDZ (PSD-95/Drosophila Discs large/ZO-1 homology) domains and identified a previously unrecognized, specific interaction with the second PDZ domain of the scaffold NHERF-2 (Na(+)/H(+) exchanger regulatory factor type 2). Furthermore, we found that P2Y(1)R and NHERF-2 associate in cells, allowing NHERF-2-mediated tethering of P2Y(1)R to key downstream effectors such as phospholipase Cbeta. Finally, we found that coexpression of P2Y(1)R with NHERF-2 in glial cells prolongs P2Y(1)R-mediated Ca(2+) signaling, whereas disruption of the P2Y(1)R-NHERF-2 interaction by point mutations attenuates the duration of P2Y(1)R-mediated Ca(2+) responses. These findings reveal that NHERF-2 is a key regulator of the cellular activity of P2Y(1)R and may therefore determine cell-specific differences in P2Y(1)R-mediated signaling.</P>
Finite element analysis of slender HSS columns strengthened with high modulus composites
Amir Fam,Amr Shaat 국제구조공학회 2007 Steel and Composite Structures, An International J Vol.7 No.1
This paper presents results of a non-linear finite element analysis of axially loaded slender hollow structural section (HSS) columns, strengthened using high modulus carbon-fiber reinforced polymer (CFRP) longitudinal sheets. The model was developed and verified against both experimental and other analytical models. Both geometric and material nonlinearities, which are attributed to the column’s initial imperfection and plasticity of steel, respectively, are accounted for. Residual stresses have also been modeled. The axial strength in the experimental study was found to be highly dependent on the column’s imperfection. Consequently, no specific correlation was established experimentally between strength gain and amount of CFRP. The model predicted the ultimate loads and failure modes quite reasonably and was used to isolate the effects of CFRP strengthening from the columns’ imperfections. It was then used in a parametric study to examine columns of different slenderness ratios, imperfections, number of CFRP layers, and level of residual stresses. The study demonstrated the effectiveness of high modulus CFRP in increasing stiffness and strength of slender columns. While the columns’ imperfections affect their actual strengths before and after strengthening,the percentage gain in strength is highly dependent on slenderness ratio and CFRP reinforcement ratio, rather than the value of imperfection.
Ureteral stricture formation after ureteroscope treatment of impacted calculi: A prospective study
Xeng Inn Fam,Praveen Singam,Christopher Chee Kong Ho,Radhika Sridharan,Rozita Hod,Badrulhisham Bahadzor,Eng Hong Goh,Guan Hee Tan,Zulkifli Zainuddin 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.1
Purpose: Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stonesis the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases. Materials and Methods: This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteralstones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB)ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of acomputed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures. Results: Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. Ananalysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stoneimpacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the uretericstrictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration ofimpaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures. Conclusions: This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that allpatients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impactedureteral stones.
김종범 한국 지리·환경 교육학회 1998 한국지리환경교육학회지 Vol.6 No.1
This paper reviewed main subject of dialectics briefly, set forth the justice of application of dialectics in geographical study, and discussed three major subjects of geographical study from the point of view of dialectics. Dialectics is not only a theory about the law of the development of nature, social and man's thinking but also a methodology on man's cognizance. Dialectics has three law and five categories and from these viewpoint claims combining induction and deduction, analysis and synthesis, historical and reson in the practice of investigating matters. These made dialectics important method in social study and also in goegraphical study. The results discussed in this paper can be abstracted as folliwers. At the viewpoint of dialectics the process of man's cognizance is from practice to cognition (theory) and to practice last. The practice of last means not only examining of theory but also reforming the world and which is very important. But there is little of study on the practice of reforming the world in geographical study and it cannot satisfy social need. Therefor geographical study must strengthen of that. It is can be said that place and space is the most basic, important and confusing concept in geography. The cause of giving rise to the problem of the confusion in the concept comes from many kinds of view to this. But if the purpose of study in regional geography is to find the structure of the region we can achieve the aim of this by getting rid of that dispute about the concept of the region and using the principle about the law, category and methhods of dialectics' thinking. The relationship of the function of man's thought with the environment must be reconsidered in geographical study. The function of man's thought is important but we cannot evaluate it too high because man's imagination and act is subject to social and natural environment where he lived from the viewpoint of dialectics and in fact.
Prophylactic Phenylephrine for Iatrogenic Priapism: A Pilot Study With Peyronie's Patients
Pengbo Jiang,Athena Christakos,Mina Fam,Hossein Sadeghi-Nejad 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.10
Purpose: Although penile duplex Doppler ultrasonography (PDDU) is a common andintegral procedure in a Peyronie’s disease workup, the intracavernosal injection of vasoactiveagents can carry a serious risk of priapism. Risk factors include young age, goodbaseline erectile function, and no coronary artery disease. In addition, patients withPeyronie’s disease undergoing PDDU in an outpatient setting are at increased risk giventhe inability to predict optimal dosing. The present study was conducted to providesupport for a standard protocol of early administration of phenylephrine in patientswith a sustained erection after diagnostic intracavernosal injection of vasoactiveagents to prevent the deleterious effects of iatrogenic priapism. Materials and Methods: This was a retrospective review of Peyronie’s disease patientswho received phenylephrine reversal after intracavernosal alprostadil (prostaglandinE1) administration to look at the priapism rate. Safety was determined on the basisof adverse events reported by subjects and efficacy was determined on the basis of therate of priapism following intervention. Results: Patients with Peyronie’s disease only had better hemodynamic values onPDDU than did patients with Peyronie’s disease and erectile dysfunction. All of thepatients receiving prophylactic phenylephrine had complete detumescence of erectionswithout adverse events, including no priapism cases. Conclusions: The reversal of erections with phenylephrine after intracavernosal injectionsof alprostadil to prevent iatrogenic priapism can be effective without increasedadverse effects.