• Title/Summary/Keyword: 완전 절제

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Prosthetic rehabilitation for a glossectomy patient - a clinical report (혀절제술을 시행한 환자의 보철적 수복 증례)

  • Yoon, Jiyoung;Lee, Siho;Lee, Jiyoen;Oh, Namsik
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.347-352
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    • 2013
  • Malignant tumours of the oral cavity that require resection of the tongue result in severe deficiencies in speech and deglutition. In such patients, improvements in mastication, swallowing, and speech may be reasonable goals for treatment. The viability of a prosthodontic approach to treatment depends on the type and extent of surgery. In a total glossectomy, a mandibular tongue prosthesis is the treatment of choice. Mandibular tongue prosthesis occupies the space in the floor of the oral cavity. It provides the patients with a platform for directing food into the esophagus and aids in speaking. This type of prosthesis can achieve that protection of the underlying fragile tissue and improvement in appearance and psychosocial adjustment. This case report describes the technical steps involved in prosthetic rehabilitation for a glossectomy patient.

The Role of Neoadjuvant Chemotherapy for Advanced Stage Wilms Tumor (진행된 Wilms 종양에서 수술 전 항암화학요법의 의의)

  • Kang, Chang Kyu;Moon, Kwang Bin;Yoo, Keon Hee;Koo, Hong Hoe;Yoon, Hye Kyung;Park, Kwan Hyun
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1534-1539
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    • 2002
  • Purpose : This study was designed to exclude radiation in advanced(stage 3, 4) Wilms tumor (WT) by increasing the chance of complete surgical removal with preceding neoadjuvant chemotherapy, thereby reducing the incidence of late effects. Methods : Between December 1998 and July 2002, we conducted neoadjuvant chemotherapy after needle aspiration biopsy on patients who had advanced WT. If needle biopsy was accessible, we conducted neoadjuvant chemotherapy(vincristine, adriamycin, dactinomycin) for 12 weeks and then performed surgical removal, excluded radiation therapy and conducted postoperative chemotherapy (vincristine, dactinomycin${\pm}$adriamycin). In other cases, we firstly conducted the operation and then performed radiation and postoperative chemotherapy. Results : Of the 17 patients diagnosed as WT, 12 patients had an advanced stage of disease. In two of the 12 patients, initial surgical removal was conducted. The median age of patients was 21 months(5-103 months). Of the 10 the patients who received neoadjuvant chemotherapy, eight patients were stage 1, one patient was stage 2, and the other was stage 3 at operation. In nine patients except one with stage 3 disease, we could perform complete surgical resection and therefore could omit radiation. In four cases we could also exclude adriamycin after operation. All but one patient was alive, disease-free, for a median follow-up of 21 months(9-43 months). Conclusion : After neoadjuvant chemotherapy, we could increase the chance of complete tumor resection, exclude radiation and decrease the intensity of postoperative chemotherapy in selected cases. Long term follow-up is needed to determine whether our method would significantly decrease late effects.

Surgical Results for Myasthenia Gravis (중증근무력증의 수술적 치료 결과)

  • 장인석;김성호
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.72-76
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    • 1997
  • Myasthenia gravis is relatively rare disease which is related autoimmune response. There are various methods of management for myasthenia gravis, but nowaday radical thymectomy is the treatment of choice in the aspect of bringing out complete remission and clinical improvement. Sixteen patients of myasthenia gratis underwent radical thymectomy during last eight years, and its result was analysed. Complete rem ssion was achieved in five patients (31 %) and pharmacological or symptomatic improvement in seven patients (44%), thus giving a total remission in 12 patients (75%). Postoperative result was not correlated with age, sex, degree of preoperative symptom, surgical approach, pathologic diagnosis.

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Risk Factor for Recurrence in Completely Resected Stage IB Non-small Cell Lung Cancer (완전 절제된 IB기 비소세포폐암에서 수술 후 재발의 위험 인자)

  • Seok, Yang-Ki;Lee, Eung-Bae
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.680-684
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    • 2007
  • Background: Complete surgical resection is the most effective treatment for stage IB non-small cell lung cancer (NSCLC). Recurrence accounts for the disappointing survival rates after resection. There has been renewed interest in adjuvant therapy after complete resection. Appropriate selection of effective adjuvant therapy will depend on the prognostic factors for recurrence. Material and Method: The study included 114 patients with completely resected stage IB NSCLC. The variables selected for the study were gender, age, the type of resection, cell type, the degree of differentiation, the tumor size and the presence of visceral pleura invasion. The Kaplan-Meier method was used to estimate the survival and disease-free survival rate. The results were compared using the log rank test. Multivariate analysis was performed by Cox's proportional hazard model. Two-sided p-valves < 0.05 were considered to be statistically significant. Result: The 3-year overall survival and the disease-free survival rates were 87.0% and 79.4%, respectively. The degree of differentiation showed a significant influence on disease-free survival according to the univariate analysis. According to the multivariate analysis, a poor grade of differentiation was a significant poor prognostic factor. Conclusion: These results demonstrate that poor differentiation may be a poor prognostic factor for patients with completely resected IB NSCLC. Therefore, the patients with a poor grade of differentiation may require adjuvant therapies.

A Case of Advanced Gastric Cancer with Virchow's Node and Lung Metastasis Successfully Resected after Combined Chemotherapy of Taxotere, CDDP, and 5-FU (선행화학요법으로 원격전이의 관해 후 위절제를 시행한 원격전이를 동반한 위암 1예)

  • Kim Doo-Won;Suh Byoung-Jo;Yu Hang-Jong;Kim Jun-Hee;Lee Hye-Kyung;Kim Jin-Pok
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.282-285
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    • 2004
  • We report a case of advanced gastric cancer with Virchow's node and lung metastasis that responded remarkably to preoperative chemotherapy. A 47-year-old female patient was diagnosed as having incurable advanced gastric cancer with Virchow's node and multiple lung metastasis. Preoperative chemotherapy with Taxotere, CDDP and 5FU was carried out. After four courses of the regimen, the Virchow's node and the lung metastasis had disappeared, and a marked reduction of the gastric lesion was observed on the CT scan. Consequently, the patient underwent a total gastrectomy with D2 lymph node dissection. On histopathological examination, cancer cells were found to have infiltrated up to the muscle layer of the gastric wall, and 42 out of 60 resected lymph nodes were found to be metastatic. The patient received another two courses of chemotherapy after the operation. (J Korean Gastric Cancer Assoc 2004;4:282-285)

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Surgical Resection of Solitary Fibrous Tumors of the Pleura (고립성 섬유성 흉막 종양의 수술적 절제)

  • 장지원;김관민;심영목;한정호;이경수;김진국
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.432-437
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    • 2004
  • Background : Solitary fibrous tumors of the pleura (SFTP) is one of rare neoplasms that originated from submesothelial mesenchyme. Clinical course or extent of surgical resection is not well known. Material and Method: We retrospectively reviewed all the clinical records of the patients who had undergone surgical resection of benign and malignant SFTP, Result: Twenty two (male female 14 : 8) patients were enrolled and mean age was 50.2(range 25∼83). Number of symptomatic patients at the time of diagnosis was 13 (59%) and the most common symptom was dyspnea. Operative approach was carried out through thoracotomy (n=14) or video-assisted thoracic surgery (n=8). Mass excision was performed in 12 cases and en bloc resection including adjacent structure in 10 cases. In all cases complete resection was performed. There was no operative mortality. Malignant SFTP were 11 cases and benign SFTP 11 cases. Local recurrences (n=2) or distant metastasis (n=6) occurred only in malignant SFTP. Conclusion: Number of symptomatic patients, on bloc resection, and recurrence was more in malignant SFTP. Although complete surgical resection is known as treatment of choice for SFTP, further study should be performed about systemic therapeutic modalities pre- or postoperatively to control recurrence and metastasis.

A Tenosynovial Giant Cell Tumor Arising from Posterior Cruciate Ligament of Knee Joint: A Case Report (슬관절 후방 십자 인대에서 기원한 건막 거대 세포종: 1예 보고)

  • Kim, Hong Kyun;Choi, Chang Hyun;Chung, Kook Jin;Lee, Young Min;Shin, Mi Kyung;Hwang, Ji Hyo
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.85-88
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    • 2014
  • Localized forms of giant cell tumor are known to arise commonly in the synovial membrane of the finger joints. Multinucleated giant cells are its characteristic pathology finding, giant cell tumor shows a low rate of recurrence after complete excision. When occurring at the knee joints, giant cell tumor manifests a wide form of symptoms, from no symptom at all, to intermittent locking. Complete excision is possible by arthroscopy, but if done incompletely, it is reported to recur in 45% of cases. We present here a case of giant cell tumor that has arisen from the anterior portion of the posterior cruciate ligament, excised by arthroscopy and followed by pathologic confirmation.

Treatment Outcome of Thymic Epithelial Tumor: Prognostic Factors and Optimal Postoperative Radiation Therapy (흉선상피종의 치료 성적: 예후 인자 및 방사선치료 방법에 대한 연구)

  • Oh Dong Ryul;Ahn Yong Chan;Kim Kwan Min;Kim Jhingook;Shim Young Mog;Han Jung Ho
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.85-91
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    • 2005
  • Purpose : This study was conducted to analyze treatment outcome and prognostic significance of World Health Organization (WHO)-defined thymic epithelial tumor (TET) subtype and to assess optimal radiation target volume in patients receiving surgery and adjuvant radiation therapy with TET. Materials and Methods: The record of 160 patients with TET, who received surgical resection at the Samsung medical Center, from December 1994 to June 2004, were reviewed. 99 patients were treated with postoperative radiation therapy (PORT). PORT was recommended when patients had more than one findings among suspicious Incomplete resection or positive resection margin or Wasaoka stage $II\~IV$ or WHO type $B2\~C$. PORT peformed to primary tumor bed only with a mean dose of 54 Gy. The prognostic factor and pattern of failure were analyzed retrospectively. Results : The overall survival rate at 5 years was $87.3\%$. Age (more than 60 years $77.8\%$, less than 60 years $91.1\%$; p=0.03), Wasaoka stage (I $92.2\%$, II $95.4\%$, III $82.1\%$, IV $57.5\%$; p=0.001), WHO tumor type (A-Bl $96.0\%$, B2-C $82.3\%$; p=0.001), Extent of resection (R0 resection $92.3\%$, R1 or 2 resection $72.6\%$, p=0.001) were the prognostic factors according to univariate analysis. But WHO tumor type was the only significant prognostic factor according to multivariate analysis. Recurrence was observed in 5 patients of 71 Masoka stage I-III patients who received grossly complete tumor removal (R0, R1 resection) and PORT to primary tumor bed. Mediastinal recurrence was observed In only one patients. There were no recurrence within irradiation field. Conclusion : WHO tumor type was the important prognostic factor to predict survival of patients with TET. This study suggest that PORT to only primary tumor bed was optimal. To avoid pleura- or pericardium-based recurrence, further study of effective chemotherapy should be investigated.

Surgical Treatment of the Wolff-Parkinson-White Syndrome (Wolff-Parkinson-White 증후군의 외과적 치료)

  • 박남희;이광숙
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1373-1376
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    • 1996
  • From October 1993 to February 1996, 9 patients with Wolfr-Parkinson-White syndrome underwent surgical ablation of the accessory atrioventricular conduction pathways. The indications for surgical ablation we e radiofrequency ablation failure in 6 cases, multiple accessory pathways in 1 case, catheter tip fracture ducting catheter ablation in 1 case and additional procedure(redo mitral valve replacement due to valve thrombosis) in 1 case. There was no operative mortality. The postoperative complications were noted In 2 cases pericardial effusion and wound Infection. All patients had accessory atrioventricular connections ablated which were proven by surface ECG and follow-up electrophysiologic study and have remained free of symptomatic tachycardia. The indications for surgical treatment of Wolff-Parkinson-White syndrome are radiofrequency ablation failure, multiple pathways, or when additional procedures are required The present results were satisfactory.

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