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.

National Trends and Correlates of Dysphagia After Anterior Cervical Discectomy and Fusion Surgery

Roberto J. Perez-Roman,Evan M. Luther,David McCarthy,Julian G. Lugo-Pico,Roberto Leon-Correa,Steven Vanni,Michael Y. Wang 대한척추신경외과학회 2021 Neurospine Vol.18 No.1

Objective: Anterior cervical discectomy and fusion (ACDF) is the most common performed surgery in the cervical spine. Dysphagia is one of the most frequent complications following ACDF. Several studies have identified certain demographic and perioperative risk factors associated with increased dysphagia rates, but few have reported recent trends. Our study aims to report current trends and factors associated with the development of inpatient postoperative dysphagia after ACDF. Methods: The National Inpatient Sample was evaluated from 2004 to 2014 and discharges with International Classification of Diseases procedure codes indicating ACDF were selected. Time trend series plots were created for the yearly treatment trends for each fusion level by dysphagia outcome. Separate univariable followed by multivariable logistic regression analyses were performed to evaluate predictors of dysphagia. Results: A total of 1,212,475 ACDFs were identified in which 3.3% experienced postoperative dysphagia. A significant increase in annual dysphagia rates was observed from 2004–2014. Frailty, intraoperative neuromonitoring, 4 or more level fusions, African American race, fluid/electrolyte disorders, blood loss, and coagulopathy were all identified as significant independent risk factors for the development of postoperative dysphagia following ACDF. Conclusion: Postoperative dysphagia is a well-known postsurgical complication associated with ACDF. Our cohort showed a significant increase in the annual dysphagia rates independent of levels fused. We identified several risk factors associated with the development of postoperative dysphagia after ACDF.

Effects of Body Mass Index on Perioperative Outcomes in Patients Undergoing Anterior Cervical Discectomy and Fusion Surgery

Roberto J. Perez-Roman,David McCarthy,Evan M. Luther,Julian G. Lugo-Pico,Roberto Leon-Correa,Wendy Gaztanaga,Karthik Madhavan,Steven Vanni 대한척추신경외과학회 2021 Neurospine Vol.18 No.1

Objective: Obesity has become a public health crisis and continues to be on the rise. An elevated body mass index has been linked to higher rates of spinal degenerative disease requiring surgical intervention. Limited studies exist that evaluate the effects of obesity on perioperative complications in patients undergoing anterior cervical discectomy and fusion (ACDF). Our study aims to determine the incidence of obesity in the ACDF population and the effects it may have on postoperative inpatient complications. Methods: The National Inpatient Sample was evaluated from 2004 to 2014 and discharges with International Classification of Diseases procedure codes indicating ACDF were identified. This cohort was stratified into patients with diagnosis codes indicating obesity. Separate univariable followed by multivariable logistic regression analysis were performed for the likelihood of perioperative inpatient outcomes among the patients with obesity. Results: From 2004 to 2014, estimated 1,212,475 ACDFs were identified in which 9.2% of the patients were obese. The incidence of obesity amongst ACDF patients has risen dramatically during those years from 5.8% to 13.4%. Obese ACDF patients had higher inpatient likelihood of dysphagia, neurological, respiratory, and hematologic complications as well as pulmonary emboli, and intraoperative durotomy. Conclusion: Obesity is a well-established modifiable comorbidity that leads to increased perioperative complications in various surgical specialties. We present one of the largest retrospective analyses evaluating the effects of obesity on inpatient complications following ACDF. Our data suggest that the number of obese patients undergoing ACDF is steadily increasing and had a higher inpatient likelihood of developing perioperative complications.

One-Stop Management to Initiate Thrombolytic Treatment on the Computed Tomography Table: Adoption and Results

Michal Haršány,Michal Bar,David Černík,Roman Herzig,René Jura,Lubomír Jurák,Jiří Neumann,Daniel Šaňák,Svatopluk Ostrý,Petr Ševčík,Ondřej Škoda,David Školoudík,Daniel Václavík,Aleš Tomek,Robert Mikulík 대한뇌졸중학회 2021 Journal of stroke Vol.23 No.3

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포플러와 버드나무에서 분리한 내생균의 잠재적 역할에 관한 연구

강준원 ( Jun Won Kang ),( Zareen Khan ),( Jenny Knoth ),( David Roman ),( Sharon Doty ) 한국임학회 2014 산림과학 공동학술대회 논문집 Vol.2014 No.-

식물체의 뿌리 주변이나 내부 조직에는 다양한 미생물들이 식물체와 상호작용을 하며 살고 있다. 내생균 (Endophyte)은 숙주식물의 내부 조직에 서식하며 병원성을 나타내지 않는 세균, 곰팡이를 의미한다. 이러한 내생균은 오염된 토양과 지하수를 정화할 수 있는 식물체의 정화능을 향상 시켜줄 뿐만 아니라, 질소고정, 식물 성장호르몬 분비, 환경 스트레스에 대한 식물의 저항성을 증가시키면서, 숙주식물을 보호하는 역할을 한다. 본 연구에서는 포플러와 버드나무 조직 내에 공생하는 다양한 내생균의 잠재적 기능에 대하여 알아보았으며. 이러한 내생균의 활용은 형질전환체 개발의 대안이 될 수 있을 것으로 기대된다. Most plants associate with various microbes that live around the plant`s root or intercellular space of the plant. The term endophyte refers to microorganisms, bacteria, or fungi, which live within plant tissues without causing any disease. Natural endophytes have a capacity for assisting the phytoremediation of contaminated soil and groundwater in addition to providing other benefits to the plants. We isolated a variety of microbial endosymbionts from poplar and willow trees with properties including plant growth promotion, pollutant degradation, and nitrogen fixation. With the range of beneficial traits provided, these natural endophytes provide an alternative to plant or microbial genetic engineering.

CsPbX3/SiOx (X = Cl, Br, I) monoliths prepared via a novel sol-gel route starting from Cs4PbX6 nanocrystals

Park, Sungwook,An, Mai Ngoc,Almeida, Guilherme,Palazon, Francisco,Spirito, Davide,Krahne, Roman,Dang, Zhiya,De Trizio, Luca,Manna, Liberato The Royal Society of Chemistry 2019 Nanoscale Vol.11 No.40

<P>We developed a facile synthesis of nanocomposite powders of CsPbX3 nanocrystals (NCs) embedded in silica. The synthesis starts from colloidal Cs4PbX6 NCs that are mixed with tetraethyl orthosilicate in the presence of nitric acid, which triggers the sol-gel reaction yielding the formation of SiOx and the conversion of starting NCs into CsPbX3 ones. The overall reaction delivers CsPbX3 NCs encased in a silica matrix. The resulting CsPbX3/SiOx nano-composite powders exhibited enhanced moisture and thermal stability in air. Also, when mixing different CsPbX3/SiOx samples having diverse anion compositions, no interparticle anion exchange processes were observed, which is a further indication that the silica matrix acts as a robust barrier surrounding the NCs. Finallly, we used these composites as down-converter phosphors on top of a blue light-emitting diode (LED), delivering nearly ideal white light emission with the Commission Internationale de l'Eclairage (CIE) color coordinates (0.32, 0.33).</P>