Repair of diaphragmatic injury and placement of tube thoracostomy during right upper quadrant peritonectomy

Nejat Ozgul,Derman Basaran,Gokhan Boyraz,M. Coskun Salman 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.1

Objective: Patients with advanced or recurrent ovarian cancer often have metastatic disease in the upper abdominal region, especially to the right hemidiaphragm, which requires diaphragmatic resection in order to achieve optimal cytoreduction. The aim of this surgical video is to demonstrate repair of a diaphragmatic injury and placement of tube thoracostomy during right upper quadrant peritonectomy in a patient with recurrent ovarian cancer. Methods: This is the case of a 45-year-old woman presented with platinum sensitive recurrent ovarian cancer. Abdomen computed tomography also confirmed peritoneal carcinomatosis and pelvic recurrent mass. HIPEC was administered after complete cytoreduction including bilateral upper quadrant peritonectomy, during which diaphragmatic injury occurred near the central tendon and pleural cavity was entered. We inserted a chest tube through the 6th intercostal space in the anterior axillary line in order to prevent postoperative massive pleural effusion. Diaphragmatic defect was closed primarily after the tube placement. The chest tube was withdrawn on the third postoperative day and the patient was discharged on postoperative day 25 without any complications. Results: The central tendon of diaphragm is the most vulnerable part for lacerations. Diaphragmatic repairs could be performed by various techniques; interrupted or continuous, locking or non-locking sutures, with either permanent or absorbable materials. In our view, all of the techniques provide similar results and surgeons can choose any of them as long as they are comfortable with the procedure. Conclusion: In most cases, these lacerations can be repaired primarily without necessitating tube thoracostomy. However, performance of HIPEC can cause massive pleural effusions which can lead to significant pulmonary morbidity. Therefore, retrograde placement of the chest tube under direct vision is quite straightforward when the diaphragm is opened.

Are patients and physicians willing to accept less-radical procedures for cervical cancer?

Kemal Gungorduk,Roman Kocian,Derman Basaran,Taner Turan,Aykut Ozdemir,David Cibula 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.4

OBJECTIVE: To evaluate the opinions of women who underwent surgery for cervical cancer (CC) and physicians who treat CC about the acceptability of increased oncological risk after less-radical surgery. METHODS: One hundred eighty-two women who underwent surgery for CC and 101 physicians participated in a structured survey in 3 tertiary cancer centers in Czech Republic and Turkey. Patients and physicians were asked whether they would accept any additional oncological risks, which would be attributable to the omission of parametrectomy (radical hysterectomy/trachelectomy vs. simple hysterectomy/trachelectomy) or pelvic lymph node dissection (systematic resection vs. sentinel lymph node sampling). RESULTS: Although 52.2% of patients reported morbidity related to their previous treatment, the majority of patients would not accept less-radical surgical treatment if it was associated with any increased risk of recurrence (50%-55%, no risk; 17%-24%, risk <0.1%). Physicians tended to accept a significantly higher risk than patients in the Czech Republic, but not in Turkey. Patients with higher education levels, more advanced-stage of disease, or adverse events related to previous cancer treatment, and patients who received adjuvant therapy were significantly more likely to accept an increased oncological risk. CONCLUSION: Patients, even if they suffered from morbidity related to previous CC treatment, do not want to choose between oncological safety and a better quality of life. Physicians tend to accept the higher oncological risk associated with less-radical surgical procedures, but attitudes differ regionally. Professionals should be aware of this tendency when counselling the patients before less-radical surgery.

Preparation and Characterization of Silver Cyclohexane Mono Carboxylate : β-Cyclodextrine Inclusion Complexes and Obtaining Wash-Resistant Antibacterial Effect on Cotton Fabrics

Riza Atav,Aylin Yildiz,Derman Vatansever Bayramol,A. Ozgur Agirgan,Mine Aydin Kurc 한국섬유공학회 2019 Fibers and polymers Vol.20 No.10

In this study, inclusion complexes were prepared according to kneading and physical mixing techniques at 1:1 and1:2 (guest:host) mass ratios of silver cyclohexane mono carboxylate:β-cyclodextrin. Prepared complexes were analyzed byusing fourier transformed infrared spectroscopy, thermogravimetric analyses and scanning electron microscope. With regardto the obtained results, inclusion complex formation was observed with silver cyclohexane mono carboxylate and β-cyclodextrin at a mass ratio of both 1:1 and 1:2. In addition to preparation and characterization of inclusion complexes, theywere applied on cotton fabrics via pad-dry method. In order to investigate the wash resistance of antibacterial effect, inclusioncomplex containing cotton fabrics were repeatedly washed and tested up to 50 washes. It was determined that cotton fabricsloaded with Ag-CC:β-CD 1:2 inclusion complexes showed antimicrobial efficiency against S. aureus, B. subtilis and P. aeruginosa even after 50 washings.

Osteotomies in the Cervical Spine

Venu M. Nemani,Peter B. Derman,Han Jo Kim 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.1

Rigid cervical deformities are difficult problems to treat. The goals of surgical treatment include deformity correction, achieving a rigid fusion, and performing a thorough neural decompression. In stiff and ankylosed cervical spines, osteotomies are required to restore sagittal and coronal balance. In this chapter, we describe the clinical and radiographic workup for patients with cervical deformities, and delineate the various factors that must be considered when planning surgical treatment. We also describe in detail the various types of cervical osteotomies, along with their surgical technique, advantages, and potential complications.

Saline-Coupled Bipolar Sealing in Simultaneous Bilateral Total Knee Arthroplasty

Atul F. Kamath,Daniel C. Austin,Peter B. Derman,R. Carter Clement,Jonathan P. Garino,Gwo-Chin Lee 대한정형외과학회 2014 Clinics in Orthopedic Surgery Vol.6 No.3

Background: The efficacy of saline-coupled bipolar sealing devices in joint arthroplasty is uncertain, and the utility in simultaneous bilateral total knee arthroplasty (TKA) has not been reported. Methods: This study compares the use of bipolar sealing and conventional electrocautery in 71 consecutive patients. The experimental and control groups were matched for age, sex, body mass index, American Society of Anesthesiologists (ASA) classification, and preoperative hemoglobin. Variables of interest included blood loss, transfusion requirements, and operative characteristics. Results: In comparison to patients treated with conventional electrocautery, those treated with the bipolar sealer were 35% less likely to require transfusion. The median number of transfusions per case was also significantly lower in the experimental group. Hemoglobin change, total blood loss, and length of stay were not significantly different between the groups. The experimental group had longer operative times. Conclusions: Bipolar sealing shows promise as a blood loss reduction tool in simultaneous bilateral TKA. The marginal savings attributed to reduced transfusion rates with use of the bipolar sealer did not exceed the additional per-case expense of using the device. The decision to use the device with the goal of less blood loss must come with the additional expense associated with its use.

Blood Transfusion Rates as a Primary Outcome Measure: The Use of Predetermined Triggers and Display of Clinical Indications in Providing Accurate Comparative Transfusion Rates: In Reply

Atul F. Kamath,Daniel C. Austin,Peter B. Derman,R. Carter Clement,Jonathan P. Garino,Gwo-Chin Lee 대한정형외과학회 2017 Clinics in Orthopedic Surgery Vol.9 No.1

We thank the readers for their letter to the editor, and for interest in our manuscript published in 2014. Issues surrounding blood management continue to be an important part of the global care of total joint arthroplasty patients as we move into 2017. In addition to our group’s multiple studies on the use of bipolar sealing devices in joint arthroplasty, 1,2) we continue to examine our blood management and transfusion practices. We now routinely employ the use of tranexamic acid, which has further allowed a reduction in transfusion requirements. This may account for some of the differences between contemporary rates of transfusion, and historical rates presented before the routine use of tranexamic acid. We thank the readers for inquiring about the transfusion reduction rates as presented in our manuscript. The absolute reduction in transfusion rate was 83% to 55%, a difference of 28% points. The relative reduction as a percentage of the original transfusion rate of 83% would be approximately 35%. In a simpler comparison, for example, if the transfusion rate was reduced from 10% to 5%, we would have stated that there was an absolute reduction of 5% but a 50% reduction from the baseline rate (5%/10% = 0.5). In our manuscript, we acknowledge some of the limitations discussed by the readers’ letter to the editor. This study was not a prospective randomized controlled trial, and therefore issues of blinding and randomization do not apply. Rather, our study has important applications for real-world transfusion scenarios based on clinical scenario and patient comorbid conditions. We thank the readers for sharing their own data and algorithm for management, which, like our practice, involves careful evaluation of “comorbidity and cardiorespiratory risk, ongoing blood loss, and symptoms related to anaemia.” Likewise, confounders of age and dilutional anaemia are important considerations in any study of blood management, but are not controlled for in our clinical practice review. Again, we thank the readers for their letter to the editor, as well as their own institutional efforts to examine transfusion thresholds, understand adjunctive tools in blood management, and further the perioperative care of total joint patients.

ATHB12, an ABA-lnducible Homeodomain-Leucine Zipper (HD-Zip) Protein of Arabidopsis, Negatively Regulates the Growth of the Inflorescence Stem by Decreasing the Expression of a Gibberellin 20-Oxidase Gene

Ora Son,허윤선,김윤경,이현정,김성한,김미란,남경희,이명석,김부용,박종범,박정안,이석찬,Atsushi Hanada,Shinjiro Yamaguchi,이인정,김승기,윤대진,Eva So¨derman,천충일 Sookmyung Women's University Research Institute of 2010 여성과 건강 Vol.6 No.1

ATHB12, an ABA-lnducible Homeodomain-Leucine Zipper (HD-Zip) Protein of Arabidopsis, Negatively Regulates the Growth of the Inflorescence Stem by Decreasing the Expression of a Gibberellin 20-Oxidase Gene

Ora Son,허윤선,김윤경,이현정,김성한,김미란,남경희,이명석,김부용,박종범,박정안,이석찬,Atsushi Hanada,Shinjiro Yamaguchi,이인정,김승기,윤대진,Eva So¨derman,천충일 Sookmyung Women's University Research Institute of 2010 여성과 건강 Vol.6 No.1

STORYTELLING, ELECTRONIC WORD OF MOUTH AND SOCIAL MEDIA— ON THE CHANGING COMMUNICATION LANDSCAPE

Christofer Laurell,Sten Söderman 글로벌지식마케팅경영학회 2016 Global Marketing Conference Vol.2016 No.7

This paper aims to explain how storytelling becomes interlinked with social media and the conceptual consequences this development implies. In recent years the interest in storytelling has increased within the marketing discipline. Parallel to this development, the traditional media landscape has been subjected to change as a result of digitization and particularly the expansion of social media. Even though the social nature of these media and its associated electronic word of mouth seem to be well aligned with storytelling, extant literature exhibits few attempts to review the storytelling concept in relation to social media. Based on such a review, the contribution of this paper is condensed into six theoretical propositions that point out how storytelling is expected to become increasingly common and dynamic in social media. Therefore, storytelling is suggested to represent a managerial challenge with regard to professional organizations’ marketing approaches but simultaneously allow for increased customer intimacy for those actors who develop successful ways of attracting the interest and engagement of social media users.

Swedish Universities Scales of Personality: Relation to Other Personality Instruments

Tomas Fagerberg,Erik Söderman,J Petter Gustavsson,Ingrid Agartz,Erik G Jönsson 대한신경정신의학회 2021 PSYCHIATRY INVESTIGATION Vol.18 No.5

Objective To investigate associations between Swedish universities Scales of Personality (SSP) and scales of the following personality instruments: Structured Clinical Interview for DSM-III-R axis II screening questionnaire (SCID-II screen), revised NEO personality inventory (NEO-PI-R), revised Chapman scales (Chapman) and the psychotic traits questionnaire (STQ).Methods Healthy individuals (n=406) completed self-report personality questionnaires including SSP and at least one more personality inventory. Correlations were calculated between the 13 different SSP subscales as well as SSP’s three factors and factors and scales/subscales in SCID-II screen, NEO-PI-R, Chapman and STQ. The main factors of the various instruments were factor analysed. ICC were calculated.Results SSP Neuroticism factor correlated with SCID-II cluster C (r=0.71), NEO Neuroticism (r=0.80) and Chapman Social anhedonia (r=0.62). SSP Extraversion factor correlated with NEO Extraversion (r=0.63) and SSP Aggressiveness factor with NEO Agreeableness (r=-0.62). Strong correlations between SSP factors and scales and scales of the other instruments were sparse, although weaker correlations were common.Conclusion SSP is a useful investigation tool when measuring personality traits related to temperament-like features. SSP partly correlates well to especially three of the NEO-PI-R factors. The different personality inventories are not completely comparable to each other. Instead, they measure personality aspects in partly different ways.