• 제목/요약/키워드: Cranial base

검색결과 191건 처리시간 0.022초

두개강내 척삭종 및 연골육종 : 수술 및 방사선 치료의 효능 (Intracranial Chordomas and Chondrosarcomas : The Effectiveness of Surgery and Radiation Therapy)

  • 정영섭;곽호신;정희원;박홍준;백선하;김동규;김현집
    • Journal of Korean Neurosurgical Society
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    • 제29권7호
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    • pp.910-917
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    • 2000
  • Introduction : The management of chordomas and chondrosarcomas in the skull base is difficult due to the critical location, locally aggressive nature, and high recurrence rate. The authors present the effectiveness of surgical removal and radiation therapy on survival and tumor recurrence. Material and Methods : Thirty cranial base chordomas and chondrosarcomas from 23 patients(14 patients with chordomas and 9 patients with chondrosarcomas) were operated in our institution between 1985 and 1998. There were 15 men and 8 women, with a mean age of 40.7 years. The largest diameter of tumors ranged from 15 to 70mm (mean 41.5). The extent of surgical removal was subtotal or total in a half(15 operations). In nineteen operations, tumors were removed by conventional approaches and skull base approaches were applied in 11 operations. Postoperative radiation therapy was performed in 16(70%) patients. The mean duration of follow up is 50 months(1- 156 months). Results : The 3- and 5-year survival rates(YSR) of overall patient are 75% and 67%, respectively. The analysis showed that 1) skull base approach to chordomas and chondrosarcomas showed a tendency to remove more portion of the tumors(p=0.058) but leave more frequent incidence of new deficits(p=0.047) : 2) larger tumor diameter af-fected the extent of removal(p=0.028) : 3) the extent of removal seemed to be the determining factor for overall survival and recurrence-free survival(the 5-YSR and RFSR of subtotal or total removal group are 92% and 80% vs. 40% of partial removal or biopsy group) : 4) conventional radiation therapy improved patient survival(5-YSR of patients who received RT is 76% whereas 5-YSR of those who didn't receive RT is 43%) but failed to prolong long-term recurrence-free survival. Conclusion : The extent of removal and postoperative radiation therapy are determining factors of patients' survival in skull base chordomas and chondrosarcomas. However, none of these factors significantly influenced the survival in multivariate analysis. Aggressive surgical removal of more than subtotal resection combined with postoperative radiation therapy seems to be the choice of therapy in the management of these tumors.

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세 마리 개에서 발생한 심저부 종양 증례 (Heart-base Tumors in Three Yorkshire Terriers)

  • 권정국;정우조;장주원;김영일;정대원;정석영;정진영
    • 한국임상수의학회지
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    • 제31권4호
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    • pp.303-306
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    • 2014
  • 본 증례는 호흡곤란, 기침과 식욕결핍으로 내원한 세 마리의 요크셔테리어 개 (12년령, 13년령, 15년령)를 대상으로 하였다. 실험실적 검사 상 특이소견은 없었다. 그러나 흉부 방사선 검사상 세 마리에서 모두 심저부위의 종괴를 확인할 수 있었고, 기관지의 상승과 대동맥 융기를 확인할 수 있었다. 복부 방사선 검사 시 특이 소견은 관찰할 수 없었다. 초음파 검사상 균질한 고 에코의 종괴가 대동맥 주위에서 확인되었고 이첨판 역류를 확인할 수 있었다. 복부초음파 검사 상 특이소견은 관찰할 수 없었다. 컴퓨터 단층 촬영 결과 경계가 명확한 종괴를 좌측 앞대정맥에서 확인할 수 있었다. 종괴의 크기는 대략 $3{\times}4cm$였고 조영 증강을 확인할 수 있었다. 이상의 검사를 바탕으로 심저부 종양으로 진단하였다. 치료를 위해 심부전과 기관 허탈에 대한 대증 처치를 실시하였다. 진단 후 증례 1 (12년령)은 3 개월, 증례 2 (13년령)는 5개월, 증례 3 (15년령)은 32개월동안 생존하였다. 본 증례는 심저부 종양으로 의심되는 개에서의 임상증상, 흉부 방사선 검사, 컴퓨터 단층 촬영과 대증 처치에 대한 보고이다.

Cephalometric predictors of treatment outcome with mandibular advancement devices in adult patients with obstructive sleep apnea: a systematic review

  • Alessandri-Bonetti, Giulio;Ippolito, Daniela Rita;Bartolucci, Maria Lavinia;D'Anto, Vincenzo;Incerti-Parenti, Serena
    • 대한치과교정학회지
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    • 제45권6호
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    • pp.308-321
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    • 2015
  • Objective: The efficacy of mandibular advancement devices (MADs) in the treatment of obstructive sleep apnea (OSA) ranges between 42% and 65%. However, it is still unclear which predictive factors can be used to select suitable patients for MAD treatment. This study aimed to systematically review the literature on the predictive value of cephalometric analysis for MAD treatment outcomes in adult OSA patients. Methods: The MEDLINE, Google Scholar, Scopus, and Cochrane Library databases were searched through December 2014. Reference lists from the retrieved publications were also examined. English language studies published in international peer-reviewed journals concerning the predictive value of cephalometric analysis for MAD treatment outcome were considered for inclusion. Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results: Fifteen eligible studies were identified. Most of the skeletal, dental, and soft tissue cephalometric measurements examined were widely recognized as not prognostic for MAD treatment outcome; however, controversial and limited data were found on the predictive role of certain cephalometric measurements including cranial base angle, mandibular plane angle, hyoid to mandibular plane distance, posterior nasal spine to soft-palate tip distance, anterior nasal spine to epiglottis base distance, and tongue/oral cross sectional area ratio thus justifying additional studies on these parameters. Conclusions: Currently available evidence is inadequate for identification of cephalometric parameters capable of reliably discriminating between poor and good responders to MAD treatment. To guide further research, methodological weaknesses of the currently available studies were highlighted and possible reasons for their discordant results were analyzed.

Ganglion cardiacum or juxtaductal body of human fetuses

  • Kim, Ji Hyun;Cho, Kwang Ho;Jin, Zhe Wu;Murakami, Gen;Abe, Hiroshi;Chai, Ok Hee
    • Anatomy and Cell Biology
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    • 제51권4호
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    • pp.266-273
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    • 2018
  • The ganglion cardiacum or juxtaductal body is situated along the left recurrent laryngeal nerve in the aortic window and is an extremely large component of the cardiac nerve plexus. This study was performed to describe the morphologies of the ganglion cardiacum or juxtaductal body in human fetuses and to compare characteristics with intracardiac ganglion. Ganglia were immunostained in specimens from five fetuses of gestational age 12-16 weeks and seven fetuses of gestational age 28-34 weeks. Many ganglion cells in the ganglia were positive for tyrosine hydroxylase (TH; sympathetic nerve marker) and chromogranin A, while a few neurons were positive for neuronal nitric oxide synthase (NOS; parasympathetic nerve marker) or calretinin. Another ganglion at the base of the ascending aorta carried almost the same neuronal populations, whereas a ganglion along the left common cardinal vein contained neurons positive for chromogranin A and NOS but no or few TH-positive neurons, suggesting a site-dependent difference in composite neurons. Mixtures of sympathetic and parasympathetic neurons within a single ganglion are consistent with the morphology of the cranial base and pelvic ganglia. Most of the intracardiac neurons are likely to have a non-adrenergic non-cholinergic phenotype, whereas fewer neurons have a dual cholinergic/noradrenergic phenotype. However, there was no evidence showing that chromogranin A- and/or calretinin-positive cardiac neurons corresponded to these specific phenotypes. The present study suggested that the ganglion cardiacum was composed of a mixture of sympathetic and parasympathetic neurons, which were characterized the site-dependent differences in and near the heart.

두부X-선 규격사진의 계측에 의한 한국인 성인 정상교합자의 악안면두개골격의 분석 (A Cephalometric Analysis of Korean Adult Normal Occlusion)

  • 이기수;정규림
    • 대한치과교정학회지
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    • 제17권2호
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    • pp.199-213
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    • 1987
  • Upon analyzing the literature, it becomes apparent that norms for orthodontic diagnosis were from normal occlusion with pleasing face, and that the form and size of craniofacial skeleton were different between racial or ethnic groups. Therefore, this study was intended to establish Korean adult norms be useful for diagnosing the cases and to compare those to other ethnic or racial groups. Lateral cephalometric radiographs were taken of ninety-one Korean adults with normal occlusion showing pleasing face consisted in forty-three males and forty-eight females. The subjects ranged in age from seventeen to twenty-six years. The tracings involved measurements that were analyzed with a digitizer. The findings of this study can be summarized as follows, 1. Norms of Korean adult males, females, and combined sexes were established. 2 It was found that in the form and shape of craniofacial skeleton, there were no significant differences between males and females, but in the size males were larger than females 3. There were a great variation between ethnic or racial groups in the measurements of craniofacial skeleton 4 The size of Korean cranial base was smaller than the American Caucasian. 5 The maxilla and mandible of Korean were less protruded than those of the other ethnic groups 6 The dental pattern of Korean were more proclined than that of the American Caucasian and less protruded than that of the American Negro and the North Indian.

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순구개열자의 설골 위치에 관한 두부방사선 계측학적 연구 (A CEPHALOMETRIC STUDY ON THE POSITION OF THE HYOID BONE IN CLEFT LIP AND PALATE INDIVIDUALS)

  • 조일제;이병태
    • 대한치과교정학회지
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    • 제20권1호
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    • pp.197-207
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    • 1990
  • This comparative study was undertaken to investigate the position of the hyoid bone in unilateral cleft lip and palate individuals. The materials for this study consisted of 35 subjects with surgically repaired unilateral cleft lip and palate (25 males, 10 females) and 40 subjects with normal facial morphology (20 males, 20 females). Cephalometric measurements of unilateral cleft and palate individuals were compared with those of non-cleft individuals. The conclusions of this study were obtained as follows: 1. To the anterior cranial base, the hyoid bone in unilateral cleft lip and palate individuals was located downward as compared with non-cleft individuals. 2. To the mandible, the hyoid bone in unilateral cleft lip and palate individuals was located backward as compared with non-cleft individuals. 3. The distance between the dorsum of the tongue and the inferior border of the hard palate in unilateral cleft lip and palate individuals was longer than that in non-cleft individuals. 4. Unilateral cleft lip and palate individuals showed no significant difference in the distance between the hyoid bone and the dorum of the tongue as compared with non-cleft individuals.

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안모비대칭환자의 임상적 특성 및 악교정수술후 변화에 관한 연구;정모두부방사선 규격사진의 계측을 중심으로 (POSTEROANTERIOR CEPHALOMETRIC STUDY OF FACIAL ASYMMETRY ABOUT CLINICAL CHARACTERISTICS AND CHANGES AFTER ORTHOGNATHIC SURGERY)

  • 최유성;이상철
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권3호
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    • pp.396-410
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    • 1996
  • This study was carried out to evaluate the distribution and the degree of the asymmetry existed in normal persons and asymmetric patients, and to investigate the changes of asymmetric patients after orthognathic surgery. The analysis was performed with the posteroanterior cephalometric radiography of 60 normal persons and 31 facial asymmetric patients. The results were as follows : 1. The degree of normal asymmetry existed in normal persons was not significant except MF and Me measurements. 2. The degree of normal asymmetry according to sex difference was not significant except cranial base area. 3. When normal persons were compared to asymmetric patients, there were more measurements which presented significant asymmetry on mandible than on maxilla. 4. When postoperative state was compared to preoperative state, the degree of asymmetry were usually decreased except AGO and GA measurements, especially the Cd, MF, Me, and Cd-Me measurements decreased significantly. 5. When postoperative state was compared to normal persons, 4 measurements of mandible approached significantly the measurements of normal persons.

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편측성순구개열자의 하악골성장에 관한 연구 (A STUDY ON THE MANDIBULAR GROWTH IN SURGICALLY REPAIRED UNILATERAL CLEFT LIP AND PALATE)

  • 박춘근;양원식
    • 대한치과교정학회지
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    • 제19권1호
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    • pp.153-167
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    • 1989
  • This study was undertaken to analyze the growth of mandible in surgically repaired unilateral cleft lip and palate. The subjects consisted of 63 unilateral cleft lip and palate individuals, 60 class III malocclusions and 60 normal occlusions ranging from 6 to 15 years old. Each group was divided into two age groups. (6-10 Y and 11-15 Y) The results obtained from UCLP compared with other groups were as follows: 1. The anteroposterior position of the chin was similar to that of the normal occlusions. 2. The shape of the mandible was similar to that of the class III malocclusions. 3. In mandibular size, ramus height was the smallest among three groups, but body length and overall mandibular length were similar to those of the normal occlusions. 4. The lower border of the mandible was the steepest among three groups and strong vertical or clockwise growth tendency was indicated. 5. The position of condyle in relation to the cranial base showed little difference in three groups. 6. In older age group , vertical growth tendency of the mandible decreased more or less.

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혼합치열기 학동에서 신장 및 체중과 두개안면부사이의 상호관계에 관한 연구 (SERIAL INVESTIGATION ON THE INTERRELATIONSHIP BETWEEN BODY HEIGHT, WEIGHT AND SELECTED CRANIOFACIAL DIMENSIONS DURING MIXED DENTITION PERIOD)

  • 성재현
    • 대한치과교정학회지
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    • 제10권1호
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    • pp.81-93
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    • 1980
  • The interrelationships between growth rates (and size) of the selected cranifacial dimensions and body dimensions (height and weight) were investigated in the longitudinal data of primary school children from 6 to 11 years of age. The data were obtained from serial cephalometric radiographs and health record which were taken at one year interval. Regression analyses were used to analyze the data. The main concludions might be summarized as follows; 1. Size relationships between body height (and weigh) and S-Gn, posterior facial height (s-Go), total mandibular length (Ar-Gn) showed high significant correlation, but no association between body height, weight and anterior cranial base length (S-N). 2. Correlation coefficients between facial dimensions and body height (and weight) were getting lower with age increase. 3. At all age groups, significant prediction equation for some facial dimensions with body height and weight were obtained. 4. In this sample, the growth rates of facial dimensions and body height and weight showed almostly constant during this age period and the growth rate of body height and weight of girls was exceeded that of boys. 5. A relatively high degree of variation between individuals existed in the sample. 6. A positive correlation was found for the relationship between the growth rates of facial dimensions and those of body height (and weight) in boys and girls, but was not found in total samples.

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이모장치를 사용한 골격성 III급부정교합 아동의 두개악안면 형태변화에 대한 두부방사선계측학적 연구 (A ROENTGENOCEPHALOMETRIC STUDY ON THE EFFECTS OF THE CHINCAP IN THE SKELETAL CLASS III MALOCCLUSION)

  • 황치일;서정훈
    • 대한치과교정학회지
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    • 제19권1호
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    • pp.219-243
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    • 1989
  • The purpose of this study was to evaluate the effects of the chincap therapy on the craniofacial structure in persons with skeletal Class III malocclusion. The patients selected for this study were treated with extra-oral chincap therapy only. Both control and treatment samples were obtained from Seoul National University Hospital where these longitudinal data were gathered. 55 treated patients and 14 control patients were studied. The mean ages at the 1st evaluation was 8 years 3 months in the treatment sample and 9 years 4 months in the control sample. The duration of chincap therapy was variable but averaged 2 years of treatment. Post-treatment observation procedeeded for 1 year 2 months. Active treatment and post treatment effects were evaluated. The results were as follows: 1. Neither significant restraint nor acceleration of growth was found in the cranial base and maxilla during treatment. 2. A distal rotation of the mandibular complex was seen. 3. Some amount of restraint of growth was found in mandibular body length, ramus height, mandibular length during treatment. 4. The genial angle was reduced. 5. After removal of the chin-cap, forward displacement of the mandible took place.

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