Morbidity after surgical management of cervical cancer in low and middle income countries: A systematic review and meta-analysis

Objective: To investigate morbidity for patients after the primary surgical management of cervical cancer in low and middle-income countries (LMIC). Methods: The Pubmed, Cochrane, the Cochrane Central Register of Controlled Trials, Embase, LILACS and CINAHL were searched for published studies from 1st Jan 2000 to 30th June 2017 reporting outcomes of surgical management of cervical cancer in LMIC. Randomeffects meta-analytical models were used to calculate pooled estimates of surgical complications including blood transfusions, ureteric, bladder, bowel, vascular and nerve injury, fistulae and thromboembolic events. Secondary outcomes included five-year progression free (PFS) and overall survival (OS). Findings: Data were available for 46 studies, including 10,847 patients from 11 middle income countries. Pooled estimates were: blood transfusion 29% (95%CI 0.19–0.41, P = 0.00, I 2 = 97.81), nerve injury 1% (95%CI 0.00–0.03, I 2 77.80, P = 0.00), bowel injury, 0.5% (95%CI 0.01–0.01, I 2 = 0.00, P = 0.77), bladder injury 1% (95%CI 0.01–0.02, P = 0.10, I 2 = 32.2), ureteric injury 1% (95%CI 0.01–0.01, I 2 0.00, P = 0.64), vascular injury 2% (95% CI 0.01– 0.03, I 2 60.22, P = 0.00), fistula 2% (95%CI 0.01–0.03, I 2 = 77.32, P = 0.00,), pulmonary embolism 0.4% (95%CI 0.00–0.01, I 2 26.69, P = 0.25), and infection 8% (95%CI 0.04–0.12, 2 95.72, P = 0.00). 5-year PFS was 83% for laparotomy, 84% for laparoscopy and OS was 85% for laparotomy cases and 80% for laparoscopy. Conclusion: This is the first systematic review and meta-analysis of surgical morbidity in cervical cancer in LMIC, which highlights the limitations of the current data and provides a benchmark for future health services research and policy implementation

Revised Subjects of the Current Korean Oriental Pharmacists' Licensing Examination

This study is designed to draw out new integrated subjects of the Korean Oriental Pharmacists' Licensing Examination (KOPLE). In 2004, for the revision of subjects, we have analyzed the curriculums of the Oriental Pharmacy department, the oriental pharmacist's (OP's) job description book, and the elementary items of KOPLE. We also examined the system of the Chinese Herb Pharmacists' Examination and other health personnel licensing examinations and studied the data of items and compared them with KOPLE. We heard the public opinion on the present KOPLE. We developed a subfield of 18 subjects, a middle category of 188 items, and a small category of 1,026 items. We proposed a new KOPLE that consists of three subjects: basic oriental pharmacy, applied oriental pharmacy, and laws and regulations

Forest Decline Under Progress in the Urban Forest of Seoul, Central Korea

Vegetation in the urban area showed not only a difference in species composition but also lower diversity compared with that of the natural area. Successional trend was normal in natural area, but that in urban areas showed a retrogressive pattern. Korean mountain ash (Sorbus alnifolia (Siebold & Zucc.) K.Koch), a shade intolerant species, dominated such a retrogressive succession. The vegetation decline is due to changes of mesoclimate and soil properties that imbalanced distribution of green space induced as the result of urbanization. In recent years, new environmental stress due to climate change is imposed additively to this forest decline. Drought is the very environmental stress. Drought-induced plant damage started from withering of leaves of plants introduced for landscaping in the urban area. Over time, branches died and death of the whole plant body followed. In particular, damage of Korean mountain ash, the product of retrogressive succession, was remarkable. As retrogressive succession has already progressed much, thus such phenomenon could be recognized as crisis of urban forest

Hypersensitive Reaction to Praziquantel in a Clonorchiasis Patient

Praziquantel is the drug of choice for clonorchiasis. Since clonorchiasis is endemic in most river basins, praziquantel has been widely used for 30 years in Korea. A 54-year-old Korean woman suffered from hypersensitive reactions, such as nausea, dyspnea, rash, and urticaria after taking the first dose of praziquantel to treat clonorchiasis. She ingested one dose again and the same symptoms appeared, and she was treated at a clinic with anti-histamines. She tried one more dose with anti-histamines but found the same symptoms. Later, she was found to pass eggs of Clonorchis sinensis and medicated with flubendazole. The hypersensitive reaction to praziquantel is rare but occurs. This is the 5th case report in the world

Laparoscopic Assisted Fusion of the Lumbosacral Spine: A Biomechanical and Histologic Analysis of the Open Versus Laparoscopic Technique in an Animal Model

Study Design. An animal model for laparoscopic lumbosacral fusion. Objectives. To compare the biomechanical and histologic results of open to laparoscopic lumbosacral discectomy and fusion in an animal model. Background Data. Early clinical reports of laparoscopic lumbosacral fusions are encouraging, but animal experiments have not been reported. Methods. Ten pigs (50-80 kg) were divided into two groups. Group 1 underwent an open anterior lumbosacral discectomy and fusion at L7-S1 using autologous bone graft and a titanium MOSS (DePuy Motech) cage. Group 2 was identical to Group 1 except that a laparoscopic technique was used. The animals were killed at 3 months, and the lumbosacral spines were harvested for biomechanical and histologic testing. Results. Estimated blood loss and average length of operation, respectively, for the two groups were: Group 1, 50 mL, 2 hours 50 minutes; and Group 2, 40 mL, 3 hours 40 minutes. There were no perioperative or postoperative complications in either group. Motion analysis results showed less motion in lateral bending, flexion, and extension than in the intact specimen in both groups. Tensile testing showed that the stiffness was significantly greater in the open group than in the laparoscopic group (P \u3c 0.004). Histologic examination showed a less extensive discectomy and less bone growth in the implant in the laparoscopic group. Inadequate decortication of end-plates occurred in two animals who underwent laparoscopy. Conclusions. Although lumbosacral discectomy and implant insertion can be performed using the laparoscopic technique, the construct may not have the same biomechanical strength as that attained with the open procedure. Laparoscopic-assisted lumbosacral fusion surgery requires additional investigation before it is widely used in clinical situations

Growth of Carbon Nanotubes on Carbon Fiber by Thermal CVD Using Ni Nanoparticles as Catalysts

AbstractNickel nanoparticles and thin film on carbon fiber have been prepared through electroless deposition. Moreover, carbon nanotubes were grown on carbon fiber covered by nickel nanoparticles using thermal chemical vapor deposition. The effects of changes in the thickness of the nickel catalyst layer and the growth temperature of carbon nanotubes were studied systemically, and the results are discussed in the present work