Robotic-assisted interval cytoreductive surgery in ovarian cancer: a feasibility study

( Semiramis L. Carbajal-mamani ),( David Schweer ),( Merry J. Markham ),( Ashwini K. Esnakula ),( Joseph R. Grajo ),( Jacqueline C. Castagno ),( Joel Cardenas-goicoechea ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.2

Objective The primary objective was to assess the feasibility of robotic-assisted interval cytoreductive surgery for achieving complete cytoreduction for patients with advanced-stage ovarian cancer. The secondary objective was to examine the perioperative outcomes. Methods A retrospective study of 12 patients with stage ⅢC or Ⅳ ovarian, fallopian tube, and primary peritoneal carcinoma who underwent interval cytoreductive surgery after neo-adjuvant chemotherapy. Results Optimal cytoreduction was achieved in 100% of selected patients. Complete cytoreductive surgery was achieved in 75% of patients. The estimated mean blood loss was 100 mL. The median length of hospital stay was 2 days. Perioperative complication and 30-day readmission rates were 8.3% (1 patient). The median follow-up time was 9.5 months. Conclusion Robotic-assisted interval cytoreductive surgery in ovarian cancer is safe and feasible and may be an alternative to standard laparotomy in selected patients.

Germline PALB2, ATM variants in a patient with breast and ovarian cancer at risk for familial cancer syndrome: Is there a role for risk-reducing salpingo-oophorectomy?

( Semiramis L. Carbajal-mamani ),( Merry J. Markham ),( Joaquín Santolaya-forgas ),( Jacqueline C. Castagno ),( Joel Cardenas-goicoechea ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.2

A 50-year-old non-Hispanic white Caucasian female was diagnosed with breast cancer and was subsequently found to possess the tumorigenic ataxia telangiectasia mutated (ATM) and PALB2 variants but not the BRCA1 and BRCA2 variants. She visited the gynecologic oncology office for routine counseling about risk-reducing salpingo-oophorectomy (RRSO). Although the patient was asymptomatic, an adnexal mass was discovered in the physical examination performed by palpation. Upon using pre-operative imaging techniques, an 8 cm complex adnexal mass was identified. Her CA-125 level was elevated. She underwent complete cytoreductive surgery. Pathological analysis showed a stage IC clear cell carcinoma of the left ovary; subsequently, she received 6 cycles of adjuvant chemotherapy with a combination of carboplatin and paclitaxel. The patient exhibited no signs ovarian cancer in a follow-up appointment after 32 months of treatment. However, bilateral RRSO is not recommended for patients positive for ATM and PALB2. Breast cancer patients with PALB2 and ATM mutations should extensively discuss the risks and benefits of RRSO in light of current data.

Effect of the shades of background substructures on the overall color of zirconia-based all-ceramic crowns

Suputtamongkol, Kallaya,Tulapornchai, Chantana,Mamani, Jatuphol,Kamchatphai, Wannaporn,Thongpun, Noparat The Korean Academy of Prosthodonitics 2013 The Journal of Advanced Prosthodontics Vol.5 No.3

PURPOSE. The objective of this study was to determine the effect of the color of a background substructure on the overall color of a zirconia-based all-ceramic crown. MATERIALS AND METHODS. Twenty one posterior zirconia crowns were made for twenty subjects. Seven premolar crowns and six molar crowns were cemented onto abutments with metal post and core in the first and second group. In the third group, eight molar crowns were cemented onto abutments with a prefabricated post and composite core build-up. The color measurements of all-ceramic crowns were made before try-in, before and after cementation. A repeated measure ANOVA was used for a statistical analysis of a color change of all-ceramic crowns at ${\alpha}$=.05. Twenty four zirconia specimens, with different core thicknesses (0.4-1 mm) were also prepared to obtain the contrast ratio of zirconia materials after veneering. RESULTS. $L^*$, $a^*$, and $b^*$ values of all-ceramic crowns cemented either on a metal cast post and core or on a prefabricated post did not show significant changes (P>.05). However, the slight color changes of zirconia crowns were detected and represented by ${\Delta}E{^*}_{ab}$ values, ranging from 1.2 to 3.1. The contrast ratios of zirconia specimens were 0.92-0.95 after veneering. CONCLUSION. No significant differences were observed between the $L^*$, $a^*$, and $b^*$ values of zirconia crowns cemented either on a metal cast post and core or a prefabricated post and composite core. However, the color of a background substructure could affect the overall color of posterior zirconia restorations with clinically recommended core thickness according to ${\Delta}E{^*}_{ab}$ values.

Effect of the shades of background substructures on the overall color of zirconia-based all-ceramic crowns

Wannaporn Kamchatphai,Jatuphol Mamani,Noparat Thongpun,Chantana Tulapornchai,Kallaya Suputtamongkol 대한치과보철학회 2013 The Journal of Advanced Prosthodontics Vol.5 No.3

PURPOSE The objective of this study was to determine the effect of the color of a background substructure on the overall color of a zirconia-based all-ceramic crown. MATERIALS AND METHODS Twenty one posterior zirconia crowns were made for twenty subjects. Seven premolar crowns and six molar crowns were cemented onto abutments with metal post and core in the first and second group. In the third group, eight molar crowns were cemented onto abutments with a prefabricated post and composite core build-up. The color measurements of all-ceramic crowns were made before try-in, before and after cementation. A repeated measure ANOVA was used for a statistical analysis of a color change of all-ceramic crowns at α=.05. Twenty four zirconia specimens, with different core thicknesses (0.4-1 mm) were also prepared to obtain the contrast ratio of zirconia materials after veneering. RESULTS L*, a*, and b* values of all-ceramic crowns cemented either on a metal cast post and core or on a prefabricated post did not show significant changes (P>.05). However, the slight color changes of zirconia crowns were detected and represented by ΔE*ab values, ranging from 1.2 to 3.1. The contrast ratios of zirconia specimens were 0.92-0.95 after veneering. CONCLUSION No significant differences were observed between the L*, a*, and b* values of zirconia crowns cemented either on a metal cast post and core or a prefabricated post and composite core. However, the color of a background substructure could affect the overall color of posterior zirconia restorations with clinically recommended core thickness according to ΔE*ab values.

Cone-beam computed tomography artifacts in the presence of dental implants and associated factors: An integrative review

Terrabuio, Bianca Rodrigues,Carvalho, Caroline Gomes,Peralta-Mamani, Mariela,da Silva Santos, Paulo Sergio,Rubira-Bullen, Izabel Regina Fischer,Rubira, Cassia Maria Fischer Korean Academy of Oral and Maxillofacial Radiology 2021 Imaging Science in Dentistry Vol.51 No.2

Purpose: This study was conducted to review the literature regarding the types of cone-beam computed tomography (CBCT) artifacts around dental implants and the factors that influence their formation. Materials and Methods: A search strategy was carried out in the PubMed, Embase, and Scopus databases to identify published between 2010 and 2020, and 9 studies were selected. The implants included 306 titanium, titanium-zirconium, and zirconia implants, as well as 5 titanium cylinders. Results: The artifacts around the implants were the beam-hardening artifact, the streaking artifact, and band-like radiolucent areas. Some factors that influenced the formation of artifacts were the implant material, bone type, evaluated regions, distance, type of CBCT, field of view (FOV) size, milliamperage, peak kilovoltage (kVp), and voxel size. The beam-hardening artifact was the most widely reported, and it was minimized in protocols with a smaller FOV, larger voxels, and higher kVp. Conclusion: The risk and benefit of these protocols in individuals with dental implants must be considered, and clinical examinations and complementary radiographs play an essential role in implantology.

Robotic assisted cytoreductive surgery, removal of a recurrent disease in the right pericaval lymph node in a patient with ovarian cancer with the robotic Xi platform

( Massoud Shoraka ),( Hadeer Metwally ),( Semiramis Carbajal-mamani ),( Joel Cardenas-goicoechea ) 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.6

Objective The standard approach for recurrent ovarian cancer is laparotomy. In this video, we present a cytoreductive surgery using the robotic Xi platform to remove a 2.7 cm pericaval tumor. Methods A narrative video demonstration of robotic-assisted surgery to remove recurrent ovarian cancer in a pericaval lymph node. A 62-year-old female presented with recurrent carcinoma of the pericaval lymph node. After 40 months of surveillance, the patient was asymptomatic, but a computed tomography (CT) scan showed an isolated mass (2.7×2.3 cm) in the right pericaval lymph node. Her cancer antigen (CA)-125 level increased from 26 to 46 U/mL. The robotic Xi platform was used to remove the metastatic lymph nodes. The first step was diagnostic laparoscopy. The second step was robotic port placement below the umbilicus. The third step was dissection and identification of landmarks, and the last step was removal of the tumor and closure. Results The metastatic lymph nodes were removed. The patient was discharged on postoperative day 1 and had no postoperative complications. Her CA-125 level dropped to 17 U/mL two weeks after surgery. Pathology showed metastatic high-grade serous carcinoma in one lymph node, consistent with the patient’s known primary. Two additional lymph nodes were removed and negative for carcinoma. Pelvic washings were negative for malignancy. Conclusion Robotic-assisted surgery is safe and feasible in selected patients with isolated recurrent disease.

First Isolates of OXA-48-Like Carbapenemase-Producing Enterobacteriaceae in A Specialized Cancer Center

Villanueva-Cotrina Freddy,Condori Dick Mamani,Gomez Tamin Ortiz,Yactayo Katia Mallma,Barron-Pastor Heli 대한감염학회 2022 Infection and Chemotherapy Vol.54 No.4

Background OXA-48-like carbapenemases have been found in a growing and varied number of carbapenemase-producing Enterobacteriaceae (CPE) isolates, and they are spreading to several countries. Although this oxacillinase leads to weak resistance to carbapenems without affecting broad-spectrum cephalosporin activity, when they are associated with other resistance mechanisms, the level of resistance to these antibiotics may be significantly higher. This weak resistance against carbapenems and cephalosporins, along with the absence of other resistance mechanisms, could render OXA-48-like harboring isolates undetected in the laboratory routine. In addition, the lack of a specific screening test for this enzyme complicates the detection of these isolates. This report characterizes the first isolates of OXA-48-like CPE detected in our laboratory. Materials and Methods The study was carried out at the Instituto Nacional de Enfermedades Neoplasicas, Lima - Peru, between March and December 2021. OXA-48-like CPE isolates were detected as part of the routine microbiological study, and clinical data were obtained by reviewing medical records. The automated microbiological system provides the bacterial identification and antimicrobial susceptibility profile by the dilution method. Additionally, the column chromatography test is used to detect carbapenemase enzymes, including OXA-48-like. Finally, the molecular identification of the OXA-48-like enzyme was carried out by Polymerase Chain Reaction PCR amplification for the blaOXA-48-like. Results Seven OXA-48-like CPE strains were isolated. Notably, in all cases, the automated system issued a minimum inhibitory concentration (MIC) of ≥1 ug/mL for ertapenem and a MIC of >64/4 ug/mL for piperacillin/tazobactam. In addition, resistance category to imipenem and meropenem was found (2/7), at least one indeterminate category for any of these carbapenems (5/7), and other serine β-lactamases such as Extended-spectrum beta-lactamases (3/7) and AmpC (3/7). The immunochromatographic study confirmed the presence of the OXA-48-like enzyme in all isolates, while class A and class B were ruled out for them. Finally, the multiplex PCR, for the five isolates that could be recovered, showed amplification for carbapenemase OXA-48-like, while none of the other carpabemases was amplified for class A or class B carbapenemase genes. Conclusion We confirm the emergence of OXA-48-like CPE isolates in our cancer center and highlight the need to implement surveillance and detection measures of these strains, for controlling their dissemination. We found practical and inexpensive methodologies for the detection of OXA-48-like CPE: (1) the finding of resistance to ertapenem and piperacillin/tazobactam in the antibiogram in the absence of class A and B carbapenemases, for screening and (2) immunochromatographic study, for confirmation. Background OXA-48-like carbapenemases have been found in a growing and varied number of carbapenemase-producing Enterobacteriaceae (CPE) isolates, and they are spreading to several countries. Although this oxacillinase leads to weak resistance to carbapenems without affecting broad-spectrum cephalosporin activity, when they are associated with other resistance mechanisms, the level of resistance to these antibiotics may be significantly higher. This weak resistance against carbapenems and cephalosporins, along with the absence of other resistance mechanisms, could render OXA-48-like harboring isolates undetected in the laboratory routine. In addition, the lack of a specific screening test for this enzyme complicates the detection of these isolates. This report characterizes the first isolates of OXA-48-like CPE detected in our laboratory. Materials and Methods The study was carried out at the Instituto Nacional de Enfermedades Neoplasicas, Lima - Peru, between March and December 2021. OXA-48-like CPE isolates were detected as part of the routine microbiological study, and clinical data were obtained by reviewing medical records. The automated microbiological system provides the bacterial identification and antimicrobial susceptibility profile by the dilution method. Additionally, the column chromatography test is used to detect carbapenemase enzymes, including OXA-48-like. Finally, the molecular identification of the OXA-48-like enzyme was carried out by Polymerase Chain Reaction PCR amplification for the blaOXA-48-like. Results Seven OXA-48-like CPE strains were isolated. Notably, in all cases, the automated system issued a minimum inhibitory concentration (MIC) of ≥1 ug/mL for ertapenem and a MIC of >64/4 ug/mL for piperacillin/tazobactam. In addition, resistance category to imipenem and meropenem was found (2/7), at least one indeterminate category for any of these carbapenems (5/7), and other serine β-lactamases such as Extended-spectrum beta-lactamases (3/7) and AmpC (3/7). The immunochromatographic study confirmed the presence of the OXA-48-like enzyme in all isolates, while class A and class B were ruled out for them. Finally, the multiplex PCR, for the five isolates that could be recovered, showed amplification for carbapenemase OXA-48-like, while none of the other carpabemases was amplified for class A or class B carbapenemase genes. Conclusion We confirm the emergence of OXA-48-like CPE isolates in our cancer center and highlight the need to implement surveillance and detection measures of these strains, for controlling their dissemination. We found practical and inexpensive methodologies for the detection of OXA-48-like CPE: (1) the finding of resistance to ertapenem and piperacillin/tazobactam in the antibiogram in the absence of class A and B carbapenemases, for screening and (2) immunochromatographic study, for confirmation.

Poster Presentations : Nutritional Assessment ; Assessment of Nutritional Status of Adolescent Girls of Jorhat District, ASSAM

( Mridula Saikia Barooah ),( Madhurima Chaliha Kalita ),( Mamani Das ) 한국정맥경장영양학회 2005 The 11th PENSA Congress Vol.2005 No.-

Development of a Web Database System for a Comprehensive Hypertension Management Program in the Primary Health Care Setting of Urban Areas of Peru

조혜연,Jorge A. Estrada Vidal,Oscar O. Giraldo Castillo,Luis A. Mayta Mamani,남은우 대한의료정보학회 2019 Healthcare Informatics Research Vol.25 No.1

Objectives: The objective of this case report is to introduce the development process, structure, characteristics, and effectiveness of the web database (DB) system developed for the hypertension management program in the primary health care setting in the low-income urban areas of Peru. Methods: A Korean research team cooperated with a Peruvian IT startup company to develop a web DB system to improve the data management of the hypertension management program. The entire web application infrastructure was hosted using the Amazon Web Service. Two different web platforms were established for the user groups of health workers and researchers (program managers). Results: A total of 2,827 program participants were registered in the web DB system until December 2017. Health professionals can input the participant data while providing consultation to the program participants, and the data is accumulated in the web DB in real time. Input errors or data loss is prevented by setting restrictions in the data entry system. During the 4-year project period, 7,696 hours of working time and USD 39,536.48 for data management were saved as the result of web DB system utilization. Conclusions: The developed web DB system contributed to improve the health condition of the health program participants by providing necessary information to the health professionals at the right time. This case report could be a reference for other researcher to develop web databases for their own context, especially in developing countries.