• Title/Summary/Keyword: Anatomical resection

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An Australian Retrospective Study to Evaluate the Prognostic Role of p53 and eIF4E Cancer Markers in Patients with Head and Neck Squamous Cell Carcinoma (HNSCC): Study Protocol

  • Singh, Jagtar;Jayaraj, Rama;Baxi, Siddhartha;Mileva, Mariana;Curtin, Justin;Thomas, Mahiban
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4717-4721
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    • 2013
  • Complete surgical resection of the primary tumour is a crucial predictive step for head and neck squamous cell carcinoma (HNSCC), because incomplete resection may lead to increase in the recurrence rate. Molecular cancer markers have been investigated as potential predictors of prognosis marker, to identify patients who are at high risk of local recurrence. This retrospective study aimed to determine the prognostic correlation between p53 and eIF4E expression and clinical characteristics, recurrence and overall survival. Forty eight HNSCC patients were selected between 2006 and 2009 diagnosed at the Royal Darwin Hospital, Darwin, Northern Territory, Australia. Out of 48, only those 24 with negative surgical margins with hematoxylin and eosin (HandE) were chosedn for further analysis. A total of 77 surgical margins were obtained and subsequently analysed by immunohistochemical (IHC) staining with monoclonal p53 and polyclonal eIF4E antibodies. Contingency table and ${\chi}^2$-test were used to investigate the correlation between p53 and eIF4E expression and clinical characteristics, recurrence and overall survival of the HNSCC patients. The follow up period was 74 months (range 1-74 months). The Kaplan-Meier method was used to generate recurrence and survival curves. This is a first retrospective study of Northern Territory patients, including Indigenous and non-Indigenous Australians. Molecular study of surgical margins could help to identify patients with and without clear margins after surgery and help in choice of the most appropriate adjuvant treatment for HNSCC patients.

AN ELECTROCHEMICAL STUDY ON MICROLEAKAGE OF RETROGRADE FILLING USING DIFFERENT RETROGRANE FILLING MATERIALS, ROOT RESECTION ANGLE AND CAVITY PREPARATION INSTRUMENTS (역충전재 및 치근단 절제 각도와 와동 형성 기구에 따른 역충전물의 변연 누출에 관한 전기화학적 연구)

  • Kim, Jin-Woo;Lim, Sung-Sam
    • Restorative Dentistry and Endodontics
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    • v.19 no.2
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    • pp.499-512
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    • 1994
  • The purpose of this study was to evaluate the microleakage electrochemically using different retrograde filling materials, different root resection angle, and different cavity preparation instruments. 104 extracted single-rooted teeth were selected for this study. 100 teeth were used as experimental groups and four was used as controls. Anatomical crowns were resected, root canals were prepared, and the apical 2 mm of roots were removed. The experimental roots were randomly divided into five equal groups. Experimental groups : Group 1. no bevel, cavity preparation with ultrasonic instruments, amalgam filling Group 2. no bevel, cavity preparation with ultrasonic instruments, SuperEBA cement filling Group 3. no bevel, cavity preparation with ultrasonic instruments, desiccated ZOE filling Group 4. $45^{\circ}$ bevel, cavity preparation with ultrasonic instruments, amalgam filling Group 5. no bevel, cavity preparation with conventional bur, amalgam filling Microleakage was measured once a day for 30 days using electrochemical method and were analyzed statistically. The results were as follows : 1. The group with Super EBA cement filling showed the least marginal leakage from second to fourth day(p<0.05), there was no significant difference between the group with amalgam filling during eighth to eighteenth day(p>0.05), but after the nineteenth day here was a higher marginal leakage than the group with amalgam filling(p<0.05). 2. The group with desiccated ZOE filling demostrated that the highest marginal leakage, started on the eighth day(p<0.05). 3. The group using ultrasonic instrument showed lower marginal leakage than the group using bur until the nineteenth day(p<0.05), but there was no significant differnce with the group using bur after twentythird day(p>0.05). 4. The group without bevel showed lower marginal leakage than the group with bevel (p<0.05). 5. Whether bevel or nor had much more effect on marginal leakage than with cavity perparation instrument when the cavity was retrogrdefilled with amalgam(stepwise regression).

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Mitral Valve Reconstruction (승모판 재건술)

  • 이현우
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1107-1112
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    • 1995
  • Between December 1993 and December 1994, fifty-eight percent of the mitral valve patients[33/57 had undergone mitral valve repair. Their mean age was 49[SD-16 years[range 11 - 75 and they were consisted with 15 males and 18 females. The causes of mitral disease in 33 patients were classified as follows: 19 cases[58% were degenerative, 9[27% were rheumatic, 3[9% were congenital and 2[6% were infectious. Carpentier`s functional classification was consisted with Class I 4 cases[12% , II 25 [76% and III 4 [12% . Surgical techniques included prosthetic annuloplasty in 32 cases[97% , leaflet resection in 16[48% , chorda shortening in 13[39% , chorda transfer in 9[27% , new chorda formation in 7[21% , commissurotomy in 7[21% , leaflet mobilization in 4[12% , chorda resection in 3[9% , papillary muscle splitting in 2[6% , cleft repair in 2[6% , leaflet patching in 1[3% and vegetation removal in 1[3% . Average number of mitral anatomical lesions per patient was 3.3 and We used average 3.0 procedures upon mitral valve apparatus per patient. Intraoperative transesophageal echocardiography was carried out in 27 patients[82% for providing an immediate and accurate assessment of the adequacy of the reconstruction before closure of the chest. Operative mortality was absent. The mean functional class[NYHA was 2.87 preoperative and improved to 1.03 postoperatively. Postoperative Doppler echocardiography showed much improvement from grade II MR[5 , grade III[5 , grade IV[21 to no MR[26 , only trace MR[3 , grade III MR[2 . Postoperative mean mitral valve area was 2.4$\pm$0.6cm2[range 1.5 - 4.0 . We conclude that cautiously evaluated mitral valve reconstruction is stable and predictable operation with minimal postoperative left ventricular dysfunction.

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Giant cell tumor of Cuneiform - A Case Report - (족부 설상골에 발생한 거대세포종 - 증례보고 1례 -)

  • Kim, Jin-Won;Park, Hong-Gi;Cho, Hyun-I
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.2
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    • pp.58-62
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    • 2002
  • The incidence of giant cell tumors represents only 5% to 10% of all bone tumors. Occurrence on the small bones of the hand and foot are very rare. They typically present with pain and sometimes a pathologic fracture or even soft tissue extension. The radiographic appearance is highly characteristic. An eccentric osteolytic lesion is seen, producing cortical thinning and expansion, and possessing a delicate trabecular pattern. In tarsal bones, poorly or well-defined osteolytic lesions of variable size are encountered. Surgical treatment remains the preferred therapy. Marginal or wide en bloc resection has had far better results in term of local recurrence. Several authors have suggested extended curettage and cement as an alternative to en bloc resection. Follow-up is necessary to monitor for both local recurrence and the infrequent pulmonary metastases.

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Indications for Dental Floss Clip Traction During Gastric Endoscopic Submucosal Dissection by Less-Experienced Endoscopists

  • Hirosato Tamari;Shiro Oka;Takahiro Kotachi;Hajime Teshima;Junichi Mizuno;Motomitsu Fukuhara;Hidenori Tanaka;Akiyoshi Tsuboi;Ken Yamashita;Ryo Yuge;Yuji Urabe;Yasuhiko Kitadai;Koji Arihiro;Shinji Tanaka
    • Journal of Gastric Cancer
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    • v.23 no.4
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    • pp.512-522
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    • 2023
  • Purpose: Dental floss clip (DFC) traction-assisted endoscopic submucosal dissection (ESD) is widely performed owing to its simplicity. This study aimed to clarify the appropriate indications for the DFC traction method in early gastric cancer when ESD is performed by less-experienced endoscopists. Methods and Methods: We retrospectively analyzed 1,014 consecutive patients who had undergone gastric ESD performed by less-experienced endoscopists between January 2015 and December 2020. Gastric ESD was performed without DFC in all cases before December 2017 [DFC (-) group, 376 cases], and ESD was performed with DFC in all cases after January 2018 [DFC (+) group, 436 cases]. The procedure time and rates of en bloc resection, complete resection, and adverse events of the groups were compared. Results: The procedure time did not differ significantly between the 2 groups. However, when comparing lesions >20 mm, the procedure time in the DFC (+) group was significantly shorter than that in the DFC (-) group (95±46 vs. 75±31, P<0.01). The procedure time for lesions located in the greater curvature of the upper or middle stomach and lesions >20 mm located in the lesser curvature side of the stomach in the DFC (+) group was significantly shorter than that in the DFC (-) group. Conclusions: The indications for DFC during gastric ESD by less-experienced endoscopists include lesions located in the greater curvature of the upper or middle stomach, and lesions >20 mm located in the lesser curvature of the stomach.

Importance of Sacrotuberous Ligament in Transgluteal Approach for Sciatic Nerve Entrapment in the Greater Sciatic Notch (Piriformis Syndrome)

  • Byung-chul Son
    • Journal of Korean Neurosurgical Society
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    • v.67 no.2
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    • pp.217-226
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    • 2024
  • Objective : The efficacy of sciatic nerve decompression via transgluteal approach for entrapment of the sciatic nerve at the greater sciatic notch, called piriformis syndrome, and factors affecting the surgical outcome were analyzed. Methods : The outcome of pain reduction was analyzed in 81 patients with sciatic nerve entrapment who underwent decompression through a transgluteal approach. The patients were followed up for at least 6 months. The degree of pain reduction was analyzed using a numerical rating scale-11 (NRS-11) score and percent pain relief before and after last follow-up following surgery. Success was defined by at least 50% reduction in pain measured via NRS-11. To assess the degree of subjective satisfaction, a 10-point Likert scale was used. In addition, demographic characteristics, anatomical variations, and variations in surgical technique involving sacrotuberous ligamentectomy were analyzed as factors that affect the surgical outcome. Results : At a follow-up of 17.5±12.5 months, sciatic nerve decompression was successful in 50 of 81 patients (61.7%), and the pain relief rate was 43.9±34.17. Subjective improvement based on a 10-point Likert scale was 4.90±3.43. Among the factors that affect the surgical outcome, only additional division of the sacrotuberous ligament during piriformis muscle resection played a significant role. The success rate was higher in the scarotuberous ligementectomy group (79.4%) than in the non-resection group (42.6%), resulting in statistically significant difference based on average NRS-11 score, percent pain relief, and subjective improvement (p<0.05, independent t-test). Conclusion : Sciatic nerve decompression is effective in pain relief in chronic sciatica due to sciatic nerve entrapment at the greater sciatic notch. Its effect was further enhanced by circumferential dissection of the sciatic nerve based on the compartment formed by the piriformis muscle and the sacrotuberous ligament in the greater sciatic notch.

Retrospective analysis of 8th edition American Joint Cancer Classification: Distal cholangiocarcinoma

  • Atish Darshan Bajracharya;Suniti Shrestha;Hyung Sun Kim;Ji Hae Nahm;Kwanhoon Park;Joon Seong Park
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.251-257
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    • 2023
  • Backgrounds/Aims: This is a retrospective analysis of whether the 8th edition American Joint Committee on Cancer (AJCC) was a significant improvement over the 7th AJCC distal extrahepatic cholangiocarcinoma classification. Methods: In total, 111 patients who underwent curative resection of mid-distal bile duct cancer from 2002 to 2019 were included. Cases were re-classified into 7th and 8th AJCC as well as clinicopathological univariate and multivariate, and Kaplan-Meier survival curve and log rank were calculated using R software. Results: In patient characteristics, pancreaticoduodenectomy/pylorus preserving pancreaticoduodenectomy had better survival than segmental resection. Only lymphovascular invasion was found to be significant (hazard ratio 2.01, p = 0.039) among all clinicopathological variables. The 8th edition AJCC Kaplan Meier survival curve showed an inability to properly segregate stage I and IIA, while there was a large difference in survival probability between IIA and IIB. Conclusions: The 8th distal AJCC classification did resolve the anatomical issue with the T stage, as T1 and T3 showed improvement over the 7th AJCC, and the N stage division of the N1 and N2 category was found to be justified, with poorer survival in N2 than N1. Meanwhile, in TMN staging, the 8th AJCC was able differentiate between early stage (I and IIA) and late stage (IIB and III) to better explain the patient prognosis.

Turning points in the practice of liver surgery: A historical review

  • Giovanni Domenico Tebala;Stefano Avenia;Roberto Cirocchi;Antonella Delvecchio;Jacopo Desiderio;Domenico Di Nardo;Francesca Duro;Alessandro Gemini;Felice Giuliante;Riccardo Memeo;Gennaro Nuzzo
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.3
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    • pp.271-282
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    • 2024
  • The history of liver surgery is a tale of progressive resolution of issues presenting one after another from ancient times to the present days when dealing with liver ailments. The perfect knowledge of human liver anatomy and physiology and the development of a proper liver resective surgery require time and huge efforts and, mostly, the study and research of giants of their own times, whose names are forever associated with anatomical landmarks, thorough descriptions, and surgical approaches. The control of parenchymal bleeding after trauma and during resection is the second issue that surgeons have to resolve. A good knowledge of intra and extrahepatic vascular anatomy is a necessary condition to develop techniques of vascular control, paving the way to liver transplantation. Last but not least, the issue of residual liver function after resection requires advanced techniques of volume redistribution through redirection of blood inflow. These are the same problems any young surgeon would face when approaching liver surgery for the first time. Therefore, obtaining a wide picture of historical evolution of liver surgery could be a great starting point to serve as an example and a guide.

A case of unexpected adjacent tooth extrusion after implant fixed prosthetic treatment, who had undergone mandibular resection and reconstruction due to ameloblastoma (법랑모세포종으로 하악골 절제 및 재건술 시행한 환자에서 임플란트 고정성 보철물 수복 후 원인 미상의 인접 치아 정출이 발생한 증례 및 고찰)

  • Kim, Su-Jin;Ha, Tae-Wook;Kim, Hyung Jun;Kim, Jee Hwan
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.448-455
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    • 2019
  • Ameloblastoma is a benign odontogenic epithelial tumor with high recurrence rate and requires extensive resection of the surrounding tissue and reconstruction of defect site. Because of the anatomical limitation of the reconstruction site, prosthetic treatment with implants is the first recommendation. This is a case of prosthetic restoration of the reconstruction site with implant fixed prosthesis in patient who underwent mandibular resection and iliac bone reconstruction due to ameloblastoma. However 14 months after completion of implant prosthesis, adjacent natural tooth erupted unexpectedly, resulting in 1mm infra-occlusion occurred including posterior implant prosthesis and anterior natural teeth. In adults, implant infra-occlusion may occur due to residual growth after placement of the maxillary anterior implant. But this case, hypo-occlusion of molar implant and open bite of anterior natural teeth is occurred due to extrusion of adjacent tooth, is rare. Thus we report the treatment process including orthodontic treatment with intrusion of the posterior tooth, and investigate the causes of sudden, unexpected tooth extrusion.

Management of Carotid Body Paraganglioma: Review of the literature with report of three cases (경동맥체 부신경절종)

  • Park Cheong-Soo;Kim Jun-Sik;Hong Won-Pyo;Choi Eun-Chang;Kim Dong-Ik
    • Korean Journal of Head & Neck Oncology
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    • v.5 no.1
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    • pp.5-13
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    • 1989
  • Carotid body paraganglioma is uncommon, with appoximately 900 reports of it in the world literature, and with only 7 documented cases in the Korean literature. The classic carotid body paraganglioma develops in the bifurcation of common carotid artery and involves both the internal and external carotid arteries at it expands. The diagnosis may almost always be established preoperatively by selective angiography which shows a widening of the carotid bifurcation with a well defined vascular mass. Differential consideration of a single, lateral cervical mass in this location include branchial cleft cyst, neurogenic tumor, metastatic thyroid cancer, carotid body aneurysm and salivary gland tumor. Surgical therapy is the preferred method of treatment as these tumors are regarded as radioresistant. Because of their high vascularity and anatomical location, surgical removal of these tumors reguires a considerable degree of caution and a high degree of surgical expertise. With improved diagnostic and surgical technique, the morbidity and mortality has been reduced lately. This report details the management of 3 patients with carotid body paraganglioma who underwent safe resection by subadventitial dissection or using an internal vascular shunt.

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