• Title/Summary/Keyword: Early surgery

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CAVERNOUS SINUS THROMBOSIS : A CASE REPORT (해면 정맥동 혈전증(Cavernous Sinus Thrombosis) 치험례)

  • Chang, Hyun-Suk;Jang, Myung-Jin;Kim, Yong-Kwan;Kim, Kyoung-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.4
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    • pp.447-455
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    • 1995
  • Cavernous sinus thrombosis is one of the major complications of abscesses of the maxillofacial region. The initial symptoms of CST are usually pain in the eye and tenderness to pressure. this is associated with high fluctuating fever, chills, rapid pulse, and sweating. Venous obstruction subsequently causes edema of the eyelids, lacrimation, proptosis, chemosis and retinal hemorrhages. Blindness is sometimes an accompaniment of cavernous sinus thrombosis when the infection also involves the orbit. There is also cranial nerve involvement (oculomotor, troclear, abducence) and ophthalmoplegia, diminished or absent corneal reflex, ptosis, and dilation of the pupil occur. The terminal stages bring signs of advanced toxemia and meningitis. Infections of the face can cause a septic thrombosis of the cavernous sinus. Furunculosis and infected hair follicles in the nose are frequent causes. Extractions of maxillary anterior teeth in the presence of acute infection and especially curettage of the sockets under such circumstances can cause this condition. The infection is usually staphylococcal. The inflection may spread directly through the pterygoid plexus of veins and the pterygomaxillary space and then ascend into the sinus or it may spread directly from the pterygopalatine space to the orbit. This is possible because of the absence of valves in the angular, facial, and ophthalmic veins. The treatment is empirical antibiotic therapy followed by specific anbibiotic therapy based on blood or pus culture. The inflection usually involves one side, however, it may easily spread to the opposite side through the circulus sinus. Unless it is treated early, the prognosis is poor even in this doses. Occasionally the antibiotics will not adequately resolve the septic thrombus, and death ensues. the use of anticoagulants to prevent venous thrombosis has been recommended, but the efficacy of such therapy has not been substantiated. Surgical access through eye enucleation has been suggested. We report a case which demonstrates cavernous sinus thrombosis by the infection after the functional neck dissection and the intraoral reconstruction with auriculomastoid fascio-cutaneous island flap.

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Factors that influence treatment duration for patients with palatally impacted maxillary canines (구개측으로 매복된 상악견치의 교정치료기간에 영향을 미치는 요소)

  • Jeong, Song-Hwa;Jo, Bong-Hye;Kim, Seong-Sik
    • The korean journal of orthodontics
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    • v.37 no.2 s.121
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    • pp.150-158
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    • 2007
  • Objective: The aim of this study was to determine the relationship between the status of a unilateral palatally impacted maxillary canine (as seen on the panoramic radiograph) and the orthodontic treatment duration. Methods: A total of 36 subjects were chosen (8 males and 28 females, $13.7{\pm}2.5$ years). All patients had undergone orthodontic traction of the impacted canine after a closed flap surgery. The position of impacted canine on the panoramic radiograph was traced and calculated with regard to the treatment duration. Results: The canine overlap over the lateral incisor (COGr) had significant statistical difference between the short-term and the long-term treatment duration groups (divided by average treatment time of 21 months) (p<0.05). Multiple regression indicated that the variables of significance (with treatment duration as the dependent variable) were the canine vertical height from the occlusal plane $(HCV,\;r^2=0.115;\;p<0.05)$ and the mandibular anterior width $(MnDW,\;r^2=0.142;\;p<0.05)$. The treatment duration, the canine angle to the incisor midline (CA), and HCV decreased from primary dentition (under 12 yrs) to permanent dentition (15 yrs). Howerer, these increased again at the adolescent ages (over 16 yrs). Conclusion: These findings suggested that orthodontic treatment of a palatally impacted canine would show good prognosis at an age of early permanent dentition with the canine showing smaller CA and HCV.

The success rate of Mg-incorporated oxidized implants in partially edentulous patients: a prospective clinical study (부분 무치악 환자에서 마그네슘 이온주입 임플란트의 성공률에 대한 전향적 임상연구)

  • Choi, Su-Jung;Yoo, Jung-Ho;Lee, Ku-Bok;Kim, Jin-Wook
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.3
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    • pp.176-183
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    • 2012
  • Purpose: This study examined the clinical success rate of Mg titanate implants (M Implant system, Shinhung, Korea), which employ a Mg coating method, by evaluating the marginal bone loss and implant stability using radiographs and Osstell$^{(R)}$, over a 1 year. Materials and methods: The locations of the implants placement were divided into 4 areas; the maxillary and mandibular premolars and molars. In the maxilla, 8 and 9 implants were inserted in the premolar and molar areas, respectively. In the mandible, 11 and 51 implants were inserted in the premolar and molar areas. Marginal bone loss and ISQ of all implants (79) were measured after insertion, mounting the prosthetic appliance, and 1, 3, 6, and 12 months after loading. The marginal bone loss was measured from the radiograph using XCP bite, which was customized, and the implant stability measured using Osstell$^{(R)}$. Fisher's exact test (${\alpha}$=.05) was used to compare the success rates of each region. Results: The mean marginal bone loss for the upper and lower jaws were 1.537 mm and 1.172 mm. The mobility showed a non-significant reduction or increase according with time. The success rates were accounted for 94.12% and 98.39% in the upper and lower jaws; the premolars and molars were accounted for 100% and 96.67%. The two cases of early failure resulted from failure of primary stability during implant insertion. The late failures were not observed for 1 year after adding a loading to the implants. Conclusion: The Mg titanate implant showed good primary stability and good clinical results in both healing and function.

DEVELOPMENTAL DISTURBANCE OF PERMANENT TEETH AFTER RADIOTHERAPY FOR TREATMENT OF MALIGNANT TUMOR : REPORT OF CASES (소아암 환자에서 방사선 치료 후 영구치 치근발육장애 : 증례보고)

  • Heo, Su-Kyung;Choi, Nam-Ki;Kim, Seon-Mi;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.144-150
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    • 2008
  • Multimodal cancer therapy including surgery, chemotherapy, and radiotherapy could not only improve the prognosis of malignancy but also reduce the dosage and toxicity of cancer drug for treatment of malignant tumor. The effects of radiotherapy are generally localized, additive, and accumulative, and depend on dosage, site and cell sensitivity. However, in growing individuals, the dental and skeletal sequelae to radiotherapy result in dental or facial abnormalities that are irreversible : arrested root development, disturbances in enamel formation, microdontia, anodontia, altered tooth eruption and mandibular or maxillary hypoplasia. Especially, the teeth which are developing is affected according to the stage. We report three cases of developmental disturbance of permanent teeth after radiotherapy. These children had received radiotherapy for malignant tumor at the age of 3 to 4 years, in which root hypoplasia, short tapered root and early apex closure were observed. For the management of radiation caries and radiotherapy-related teeth, periodic recall check and oral hygiene instruction are required.

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A Study in Bridging Sciatic Nerve Defects with Combined Skeletal Muscle and Vein Conduit in Rats (백서의 좌골신경에서 정맥 및 골격근을 이용한 결손신경 봉합술에 대한 연구)

  • Lee, Jun-Mo
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.29-38
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    • 1997
  • A peripheral nerve when approximation of the ends imparts tension at the anastomosis and with a relatively long segment defect after excision of neuroma and neurofibroma cannnot be repaired by early primary suture. The one of the optimistic reconstruction method of severed peripheral nerves is to restore tension-free continuity at the repair site putting an autogenous nerve graft into the neural gap despite of ancipating motor or sensory deficit of the donor nerve area. To overcome the deficit of the autogenous nerve graft, several other conduits supplying a metabolically active environment which is able to support axon regeneration and progression, providing protection against scar invasion, and guiding the regrowing axons to the distal stump of the nerve have been studied. An author have used ipsilateral femoral vein, ipsilateral femoral vein filled with fresh thigh muscle, and autogenous sciatic nerve for the sciatic nerve defect of around 10 mm in length to observe the regeneration pattern in rat by light and electron microscopy. The results were as follows. 1. Light microscopically regeneration pattern of nerve fibers in the autogenous graft group was more abundant than vein graft and vein filled with muscle group. 2. On ultrastructural findings, the proxial end of the graft in various groups showed similar regenerating features of the axons, myelin sheaths, and Schwann cells. The fascicular arrangement of the myelinated and unmyelinated fibers was same regardless of the type of conduits. There were more or less increasing tendency in the number and the diameter of myelinated fibers correlated with the regeneration time. 3. In the middle of the graft, myelinated nerve fibers of vein filled with muscle group were more in number and myelin sheath was thinner than in the venous graft, but the number of regenerating axons in autogenous nerve graft was superior to that in both groups of the graft. The amount of collagen fibrils and amorphous materials in the endoneurial space was increased to elapsed time. 4. There was no difference in regenerating patterns of the nerve fibers of distal end of the graft. The size and shape of the myelinated nerve fbers were more different than that of proximal and middle portion of the graft. From the above results, the degree of myelination and regenerating activity in autogenous nerve is more effective and active in other types of the graft and there were no morphological differences in either ends of the graft regardless of regeneration time.

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Laparoscopic Versus Open Radical Cystectomy for Patients Older than 75 Years: a Single-Center Comparative Analysis

  • Yasui, Takahiro;Tozawa, Keiichi;Ando, Ryosuke;Hamakawa, Takashi;Iwatsuki, Shoichiro;Taguchi, Kazumi;Kobayashi, Daichi;Naiki, Taku;Mizuno, Kentaro;Okada, Atsushi;Umemoto, Yukihiro;Kawai, Noriyasu;Sasaki, Shoichi;Hayashi, Yutaro;Kohri, Kenjiro
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6353-6358
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    • 2015
  • Background: To explore the safety, efficacy, and oncological outcome of 3-port laparoscopic radical cystectomy (LRC) compared to open radical cystectomy (ORC) in patients older than 75 years. Materials and Methods: From June 2010 to July 2014, we analyzed 16 radical cystectomies in patients older than 75 years (LRC group=8; ORC group=8). Demographic parameters, operative variables, and perioperative outcome in the 2 groups were retrospectively collected, analyzed, and compared. Results: Patients in both groups had comparable preoperative characteristics. A significantly longer operating time (476 vs. 303 min, P=0.0002) and less estimated blood loss (627 vs. 2,106 mL, P=0.021) were observed in the LRC group compared to the ORC group. Infection and ileus were the most common early complications after surgery. Patients who underwent ORC suffered from more postoperative infection (22.2% vs. 0.0%, P=0.054) and ileus (25.0% vs. 12.5%, P=0.521) than the LRC group, but the difference was not significant. Conclusions: Judging from this initial trial, 3-port LRC can be safely carried out in elderly patients. We suggest 3-port LRC as the primary intervention to treat muscle-invasive or high-risk nonmuscle-invasive bladder cancer in elderly patients with an otherwise relatively long life expectancy.

Breast Radiotherapy with Mixed Energy Photons; a Model for Optimal Beam Weighting

  • Birgani, Mohammadjavad Tahmasebi;Fatahiasl, Jafar;Hosseini, Seyed Mohammad;Bagheri, Ali;Behrooz, Mohammad Ali;Zabiehzadeh, Mansour;meskani, Reza;Gomari, Maryam Talaei
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7785-7788
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    • 2015
  • Utilization of high energy photons (>10MV) with an optimal weight using a mixed energy technique is a practical way to generate a homogenous dose distribution while maintaining adequate target coverage in intact breast radiotherapy. This study represents a model for estimation of this optimal weight for day to day clinical usage. For this purpose, treatment planning computed tomography scans of thirty-three consecutive early stage breast cancer patients following breast conservation surgery were analyzed. After delineation of the breast clinical target volume (CTV) and placing opposed wedge paired isocenteric tangential portals, dosimeteric calculations were conducted and dose volume histograms (DVHs) were generated, first with pure 6MV photons and then these calculations were repeated ten times with incorporating 18MV photons (ten percent increase in weight per step) in each individual patient. For each calculation two indexes including maximum dose in the breast CTV ($D_{max}$) and the volume of CTV which covered with 95% Isodose line ($V_{CTV,95%IDL}$) were measured according to the DVH data and then normalized values were plotted in a graph. The optimal weight of 18MV photons was defined as the intersection point of $D_{max}$ and $V_{CTV,95%IDL}$ graphs. For creating a model to predict this optimal weight multiple linear regression analysis was used based on some of the breast and tangential field parameters. The best fitting model for prediction of 18MV photons optimal weight in breast radiotherapy using mixed energy technique, incorporated chest wall separation plus central lung distance (Adjusted R2=0.776). In conclusion, this study represents a model for the estimation of optimal beam weighting in breast radiotherapy using mixed photon energy technique for routine day to day clinical usage.

Association Between Single Nucleotide Polymorphisms in miRNA196a-2 and miRNA146a and Susceptibility to Hepatocellular Carcinoma in a Chinese Population

  • Zhang, Jun;Wang, Rui;Ma, Yan-Yun;Chen, Lin-Qi;Jin, Bo-Han;Yu, Hua;Wang, Jiu-Cun;Gao, Chun-Fang;Liu, Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6427-6431
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    • 2013
  • Hepatocellular carcinoma (HCC) is one of the most prevalent cancers in the world and deeply threatens people's health, especially in China. Techniques of early diagnosis, prevention and prediction are still being discovered, among which the approaches based on single nucleotide polymorphisms in microRNA genes (miRNA SNPs) are newly proposed and show prospective potential. In particular, the association between SNPs in miRNA196a-2 (rs11614913) and miRNA146a (rs2910164) and HCC has been investigated. However, the conclusions made were conflicting, possibly due to insufficient sample size or population stratification. Further confirmations in well-designed large samples are still required. In this study, we verified the association between these two SNPs and the susceptibility to HCC by MassARRAY assay in a 2,000 large Chinese case-control sample. Significant association between rs11614913 and HCC was confirmed. Subjects with the genotype of CT+TT or T allele in rs11614913 were more resistant to HCC (CT+TT: OR (95% CI)=0.73 (0.57-0.92), P=0.01; T allele: OR (95% CI)=0.85 (0.75-0.97), P=0.02) and HBV-related HCC (CT+TT: OR (95% CI)=0.69 (0.53-0.90), P=0.01; T allele: OR (95% CI)=0.82 (0.71-0.95), P=0.01). The affected carriers of CT or TT also tended to have lower levels of serum AFP (P=0.01). This study demonstrated a role of rs11614913 in the etiology of HCC. Further research should focus on the clinical use of this miRNA SNP, so as to facilitate conquering HCC.

A Clinical Analysis of Major Salivary Gland Tumors-104 Cases (주타액선종양 104례에 대한 분석)

  • Kim Myung-Sang;Kim Young-Ho;Hong Jung-Pyoe;Choi Eun-Chang;Kim Kwang-Moon;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.40-45
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    • 1998
  • Backgroud and Objectives: Major salivary gland tumor is a rare disease with a largely unknown origin. And also corresponding to the diversity of histopathologic characteristics is an equally wide distribution of clinical behavior that makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guidline of management. Materials and Methods : We studied clinical manifestations and treatment results of 104 patients who were diagnosed as major salivary gland tumors. Tumor site, patient age and sex of the patients were analysed. Histopathologic diagnosis, treatment modality, lymph nodes metastasis, recurrence rate and 5-year survival rate were studied on malignant tumors. Results: 1) 48 patients were male and 56 patients were female. 2) Benign tumors were 79 cases. They consisted of 57 cases(72%) of parotid tumor, 22 cases(27%) of submandibular tumor. And pleomorphic adenoma was the most common benign tumor. 3) Malignant tumors were 25 cases and were consisted of 19 cases(76%) of parotid tumor, 4 cases(l6%) of submandibular tumor and 2 cases(8%) of sublingual gland tumor with high-grade mucoepidermoid carcinoma as the most common cause. 4) In the malignant tumors, the number of stage I, II tumors was 14 and that of stage III, IV tumors was 11. Neck node metastasis was noted in 8 cases. 5) 8 cases of malignant tumor were died and all of them had high-grade malignancy. And they were dead before 17 months from the time of diagnosis. 6) Mean survival duration in the malignant salivary gland tumor was 56 months. 7) High-grade malignancy had a 5-year survival rate of 57.9%. A 5-year survival rate of TI, T2 patients was 92.9% and that of T3, T4 patients was 36.4%. That of patients who had neck node metastasis was 37.5% and that of those who had tree neck was 82.4%. Conclusion: The results of this study suggest that the survival rate is dependent on the tumor size, lymph node matastasis and histologic grade. And also the early diagnosis and radical surgery result in the increased survival rate and are effective for prevention of the tumor recurrance.

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SURGICAL EXTRACTION OF MULTIPLE SUPERNUMERARY TEETH BY TWO-STAGE PROCEDURE (상악 절치부에 매복된 다수 과잉치의 외과적 발거)

  • Hong, Eun-Hye;Kim, Seong-Oh;Lee, Jae-Ho;Choi, Hyung-Jun;Son, Heung-Kyu;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.333-338
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    • 2008
  • Supernumerary teeth are characterized by an excess number of teeth, which can be responsible for a variety of irregularities in the primary and transitional dentition. Supernumerary teeth, especially in the maxillary anterior region, may prevent the eruption of adjacent permanent teeth and cause their ectopic eruption, diastema, root resorption, or formation of dentigerous cyst. Therefore, early diagnosis of supernumerary teeth is important for prevention of such complications, and adequate treatment should be given according to their location, number, and morphologic features. In this case, four supernumerary teeth in the maxillary anterior region were disturbing the eruption of adjacent permanent incisors. Two of them were located in proximity to the central incisor tooth germs that their immediate removal may injure the permanent tooth germs. In order to minimize such complications, surgical extraction of the four supernumerary teeth was performed in two stages. At first, only two inverted conical supernumerary teeth were extracted. The other two tuberculous supernumerary teeth, close to the permanent tooth germs, were extracted later after their natural dislocation. In that way, we could minimize affects on the neighboring permanent tooth germs and also the amount of alveolar bone removed during surgery.

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