BACKGROUND: Squamous cell carcinoma of the supraglottic larynx have a propensity to metastasize earlier to the regional lymph nodes compared to their glottic counterpart owing to their unique embryological origin and abundant lymphatic tissues. However, reliable biological markers for predicting lymph node metastasis with its associated poor outcome is lacking. OBJECTIVES: As a search for biologic markers related to nodal metastasis in supraglottic cancer, the authors have performed immunohistochemical staining of various gene products and tissue factors. The results were analysed to see if these markers influenced the metastatic capability of supraglottic cancers. MATERIALS AND METHODS: Twenty-nine cases of supraglottic cancers were subdivided into node negative group(group I, N=13) and node positive group(group II, N=16). Tumor angiogenesis was assessed by counting the peritumoral microvessels in which the endothelial cells are selectively stained by von Willebrand factor. PCNA-proliferation index(PI) was obtained, and the positivity of nm23 protein, a metastasis suppressor gene product and p53 protein, a tumor suppressor gene product were assessed. RESULTS: The mean vessel counts per high power fields(X 200) were 16.6 and 27.3 for node negative and node positive groups respectively(p=0.001). The mean PCNA-PI was 8.1 in node negative group and 18.4 in the node positive group(p=0.001). The expression of nm23 was 30.8% in the node negative group and 50.0% in the node positive group. p53 expression rate was higher in the node positive group; 50.0% compared to the node negative group; 38.5%, however there was no statistical significance. CONCLUSION: We conclude that the number of new vessels and PCNA-proliferation index, but not the nm23 and p53 expression rate, may be related to the lymph node metastasis in squamous cell carcinoma of the supraglottic larynx.
Biomarkers ; Carcinoma, Squamous Cell ; Cell Proliferation* ; Endothelial Cells ; Genes, Tumor Suppressor ; Larynx ; Lymph Nodes* ; Lymphoid Tissue ; Microvessels ; Neoplasm Metastasis* ; Proliferating Cell Nuclear Antigen ; Thromboplastin ; von Willebrand Factor

PURPOSE: Laparoscopic surgery has become the mainstream surgical operation due to its stability and feasibility. Even for liver surgery, the laparoscopic approach has become an integral procedure. According to the recent international consensus meeting on laparoscopic liver surgery, laparoscopic left lateral sectionectomy (LLS) might be a new standard of care for left lateral surgical lesions. This study was designed to compare open LLS to laparoscopic LLS. METHODS: In total, 82 patients who had undergone LLS at Chonnam National University Hwasun Hospital between 2008 and 2015 were enrolled in this study. Among them, 59 patients underwent open LLS and 23 underwent laparoscopic LLS. These two groups were compared according to general characteristics and operative outcomes. RESULTS: The data analysis results showed that laparoscopic liver resection is superior to open liver resection in terms of the amount of bleeding during the operation and the duration of hospital stay. There was no statistical difference between the two groups in terms of operation time (p value=0.747). The amount of bleeding during the operation was 145.5±149.4 ml on average for the laparoscopic group and 320±243.8 ml on average for the open group (p value=0.005). The mean duration of hospital stay was 10.7±5.8 days for the laparoscopic surgery group and 12.2±5.1 days for the open surgery group (p value=0.003). CONCLUSION: This study showed that laparoscopic LLS is safe and feasible, because it involves less blood loss and a shorter hospital stay. For left lateral lesions, laparoscopic LLS might be the first option to be considered.
Consensus ; Hemorrhage ; Humans ; Jeollanam-do ; Laparoscopy ; Length of Stay ; Liver ; Standard of Care ; Statistics as Topic

PURPOSE: This study was conducted to determine the correlation between the incidence of chronic lung disease and the combined use of gentle ventilation and high-frequency ventilation. METHODS: The subject group consisted of 63 very low birthweight infants of less than 1500gm who were born and survived through ventilator treatment in the Fatima neonatal intensive care unit for four years from January 1995 to December 1998. The analysis was performed retrospectively with medical records. Ventilator treatment was based on the combined use of gentle ventilation and high-frequency ventilation by means of the flow interruptor type of Infant star. High- frequency ventilation was carried out for 24 hours after surfactant replacement, when PaCO2 exceeded 60mmHg, or if the period of gentle ventilation exceeded one week. When the results of arterial blood gas analysis and the state of the body became stable, the aggressive weaning was performed. RESULTS: For 49(77.8%) of 63 infants, the weaning was possible within seven days. The other 14 infants(22.2%) needed ventilator treatment for more than seven days. The mean duration of ventilator treatment was 12.3 days. The causes of weaning failure included sepsis, patent ductus arteriosus, chronic lung disease, and intraventricular hemorrhage. Two infants who had received ventialtor treatment for more than two weeks were found to have incidence of chronic lung disease. CONCLUSION: It is suggested that the combined use of gentle ventilation and high-frequency ventilation can help reduce pulmonary damage, and it will be important to shorten the period of ventilator treatment.
Blood Gas Analysis ; Ductus Arteriosus, Patent ; Hemorrhage ; High-Frequency Ventilation ; Humans ; Incidence* ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Lung Diseases* ; Lung* ; Medical Records ; Retrospective Studies ; Sepsis ; Ventilation* ; Ventilators, Mechanical ; Weaning

PURPOSE: The aim of this study is to compare the quality of chest compressions between cardiopulmonary resuscitation (CPR) performed by a single trained rescuer and two rescuer CPR performed by a trained rescuer and an untrained rescuer in a prolonged out-of-hospital CPR scenario. METHODS: For the phase I experiment, thirty-six emergency medical technician students (trained rescuers) were asked to perform 10 minutes of lone rescuer CPR on an instrumented manikin. For the phase II experiment, thirty-six volunteers with no previous CPR training (untrained rescuers) were recruited. Each untrained rescuer was randomly assigned to one trained rescuer. They were asked to perform 10 minutes of two rescuer CPR during the phase II experiment. RESULTS: During phase I, the percent of correct compressions diminished over time. The number of total compressions attempted for 10 minutes was increased significantly in phase II (786+/-50 versus 689+/-50 in phase I, p<0.01). However, the mean percentage of correct compressions for 10 minutes did not show a significant difference between phases (66+/-34% in phase I versus 64+/-22% in phase II). The duration of chest compression interruption was significantly reduced in phase II (3.0+/-0.4 versus 3.5+/-0.5 min in phase I, p<0.01). CONCLUSION: The quality of two rescuer CPR performed by a trained rescuer and an untrained rescuer was comparable to that of lone rescuer CPR performed by a single trained rescuer in a 10-min CPR scenario. When CPR goes on for a prolonged period, changing the person doing the chest compressions to an untrained rescuer may improve the quality of CPR.
Cardiopulmonary Resuscitation ; Emergency Medical Technicians ; Fatigue ; Humans ; Manikins ; Thorax