• Title/Summary/Keyword: Extent of surgery

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Sequential treatment from mandibulectomy to reconstruction on mandibular oral cancer - Case review II: mandibular anterior and the floor of the mouth lesion of basaloid squamous cell carcinoma and clear cell odontogenic carcinoma

  • Yang, Jae-Young;Hwang, Dae-Seok;Kim, Uk-Kyu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.3
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    • pp.216-223
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    • 2021
  • Preoperative patient analysis for oral cancer involves multiple considerations that are based on multiple factors; these include TNM stages, histopathologic findings, and adjacent anatomical structures. Once the decision is made to excise the lesion, the margin of dissection and its extent should be considered along with the best form of reconstruction and airway management. Treatment methods include surgical resection, radiotherapy, and chemotherapy. Although the combined method of treatment is controversial, surgical resection is considered predominantly, and immediate reconstruction after surgical resection follows. The choice of treatment is dictated by the anticipated functional and esthetic results of treatment and also by the availability of a surgeon with the required expertise. Segmental mandibulectomy with primary reconstruction has been shown to have advantages in both functional and esthetic results. A 52-year-old male patient with basaloid squamous cell carcinoma of the floor of the mouth, and the anterior portion of the mandible was treated with surgical procedures that included segmental mandibulectomy with both supraomohyoid neck dissection (SOHND) at Levels I-III and mandible reconstruction with a left fibula free flap. A 55-year-old male patient with clear cell odontogenic carcinoma of the oral cavity underwent segmental mandibulectomy with both SOHND at Levels I-III and mandible reconstruction with a left fibula free flap. The purpose of this study was to review the anatomic and functional results of patients after immediate reconstruction with a fibula free flap following resection of carcinoma in the anterior portion of the mandible and floor of the mouth.

Correlation between Subscapularis Tears and the Outcomes of Physical Tests and Isokinetic Muscle Strength Tests

  • Jang, Ho-Su;Kong, Doo-Hwan;Jang, Suk-Hwan
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.90-95
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    • 2016
  • Background: The aim of this study was to investigate the correlation between the type of subscapularis tendon tears diagnosed during arthroscopy and the outcomes of physical tests and of isokinetic muscle strength tests. Methods: We preoperatively evaluated physical outcomes and isokinetic muscle strength of 60 consecutive patients who underwent an arthroscopic rotator cuff repair and/or subacromial decompression. We divided the patients into five groups according to the type of subscapularis tear, which we classified using Lafosse classification system during diagnostic arthroscopic surgery. Results: When we performed a trend analysis between the outcomes of the physical tests and the severity of subscapularis tendon tear, we found that both the incidence of positive sign of the collective physical tests and that of individual physical tests increased significantly as the severity of the subscapularis tear increased (p<0.001). Similarly, the deficit in isokinetic muscle strength showed a tendency to increase as the severity of subscapularis tear increased, but this positive correlation was statistically significant in only the deficit between those with Lafosse type II tears and those with Lafosse type III tears. Conclusions: Although no single diagnostic test surpasses above others in predicting the severity of a subscapularis tear, our study implies that, as a collective unit of tests, the total incidence of the positive rate of the physical tests and the extent of isokinetic strength deficit may correlate with severity of subscapularis tears.

Development of the Prevention Guideline of Deep Vein Thrombosis in Patients with Surgery according to the Guideline Adaptation Process (수술환자의 심부정맥혈전증 예방 지침 수용개작)

  • Yoon, Ji Hyun;Lee, Ihn Seon;Lee, Kyeong Yoon;Jang, Mi Ja;Lee, Jung Min;Nam, Min Sun;Park, Ji Hyeon;Hwang, Ji Won;Song, Hyun Ju;Cho, Yong Ae;Kwon, In Gak;Kim, Mi Young
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.3
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    • pp.337-347
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    • 2014
  • Purpose: Deep Vein Thrombosis (DVT) is the cause of fatal diseases such as pulmonary embolism, due to a prolonged immobility, surgery, paralysis, and injuries. This study aimed to develop an evidence-based practice guideline for DVT prevention and apply it to patients with surgery in diverse nursing sites in South Korea. Methods: A 24-staged processes of adaptation was carried out on the basis of "adaptation of nursing practical guidelines" developed by Gu et al., in 2012. Results: Developed nursing guidelines of DVT prevention are composed of 79 recommendations in 8 domains. The extent and ratings of each recommendation with its evidence were addressed along with the background information. Conclusion: The developed DVT prevention guideline is necessary to be added to the evidence-based practice guidelines for the fundamentals of nursing practice. The developed guideline is needed to be disseminated to diverse nursing clinical settings in order to prevent DVT and enhance the quality nursing care.

Genetic Polymorphism of MDM2 SNP309 in Patients with Helicobacter Pylori-Associated Gastritis

  • Tongtawee, Taweesak;Dechsukhum, Chavaboon;Leeanansaksiri, Wilairat;Kaewpitoon, Soraya;Kaewpitoon, Natthawut;Loyd, Ryan A;Matrakool, Likit;Panpimanmas, Sukij
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7049-7052
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    • 2015
  • Background: Helicobacter pylori plays an important role in gastric cancer, which has a relatively low inciduence in Thailand. MDM2 is a major negative regulator of p53, the key tumor suppressor involved in tumorigenesis of the majority of human cancers. Whether its expression might explain the relative lack of gastric cancer in Thailand was assessed here. Materials and Methods: This single-center study was conducted in the northeast region of Thailand. Gastric mucosa from 100 patients with Helicobacter pylori associated gastritis was analyzed for MDM2 SNP309 using real-time PCR hybridization (light-cycler) probes. Results: In the total 100 Helicobacter pylori associated gastritis cases the incidence of SNP 309 T/T homozygous was 78 % with SNP309 G/T heterozygous found in 19% and SNP309 G/G homozygous in 3%. The result show SNP 309 T/T and SNP 309 G/T to be rather common in the Thai population. Conclusions: Our study indicates that the MDM2 SNP309 G/G homozygous genotype might be a risk factor for gastric cancer in Thailand and the fact that it is infrequent could explain to some extent the low incidence of gastric cancer in the Thai population.

Surgical Treatment of Radial Nerve Injury (요골 신경 손상의 수술적 치료)

  • Lee, Kwang-Suk;Park, Sang-Won;Wie, Dae-Gon
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.128-136
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    • 1996
  • Radial nerve injury is caused by variety of etiologies, mainly traumatic. It is primarily a motor nerve and loss of it's function leads to a significant disability. Surgical treatments of radial nerve comprise of neurolysis(internal or external), neurorrhaphy(eineural, perineural or epi-perineural), nerve graft and tendon transfer. However, there is still controversies in treatment methods and time of operation. Authors experienced 23 cases of radial nerve injuries who were treated by operative methods and followed up over 1 year's duration. The male to female ratio was 18 to 5 and mean age was 30.7 years old. The causes were 13 cases in fractures, 5 cases in crushing injury, 3 cases in laceration, 1 case in CO poisoning and 1 case in unknown cause. The summary of the study were as follows ; 1. Excellent or good results were obtained in overall 16 cases among 23 cases; 5 of 9 cases in neurolysis, 3 of 3 cases in neurorrhaphy, 2 of 3 cases in nerve graft and 6 of 8 cases in tendon transfer. 2. In cases of neurorrhaphy and nerve graft, primary or delayed repair showed excellent or good results and neurolysis performed before 6 months leads to better results. But there was no correlations between the time of injury and operation in tendon transfer. 3. The radial nerve injury associated with extensive soft tissue defect or any conditions that leads to nerve ischemia results poor prognosis. 4. The patients aged under 40 years showed better prognosis in clinical results according to the age of surgical treatment. 5. If the surgeon decide the method and the time of operation through the exact evaluation of the factors which influencing the end result such as age of the patient, level and type of injury, extent of nerve lesion and the associated tissue injury, good result could be expected.

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A Case Report of Holoprosencephaly (전전뇌증(Holoprosencephaly)의 증례보고)

  • Song, Seung Han;Kang, Nak Heon
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.528-530
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    • 2007
  • Purpose: Holoprosencephaly(HPE) is a rare developmental defect due to incomplete cleavages of the prosencephalon during the third week of fetal development. Chromosomal anomalies, genetic syndrome, teratogen, or genetic disorder of non-syndromic HPE are usually accepted as etiology. The consequences of prechordal mesoderm defect are varying degrees of deficit of midline facial development, especially the median nasal process(premaxilla), and incomplete morphogenesis of the forebrain. We experienced a case of lobar HPE with complete cleft lip and palate. Methods: A female newborn infant was born at $38^{+6}$ weeks' gestational age via NSVD. The infant's birth weight was 3.6 kg, height 52 cm, and head circumference 32.5 cm, showing microcephaly, flat nose, median complete cleft lip & palate, and hypotelorism, along with defects of midfacial development including losses of premaxilla, philtrum, nasal septum, and columella. Results: There were no specific findings noted from the head and neck X-ray and tests for endocrine and metabolic disorders, but clinical characteristics of midface and dysgenesis corpus callosum on brain MRI were seen, so that this case was diagnosed with HPE. Conclusion: HPE is divided into three categories of alobar, semilobar, and lobar prosencephaly according to the degree of cerebral hemisphere separation. Assesment of patient's brain abnormality and malformation is essential in determining the extent and benefit of surgical intervention. This case was included in the lobar type HPE which shows relatively good prognosis compared with other types and reconstruction of median complete cleft lip & palate and midfacial defects will be performed.

Improvement in periodontal healing after periodontal surgery supported by nutritional supplement drinks

  • Lee, Jaeri;Park, Jung-Chul;Jung, Ui-Won;Choi, Seong-Ho;Cho, Kyoo-Sung;Park, Yoo-Kyoung;Kim, Chang-Sung
    • Journal of Periodontal and Implant Science
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    • v.44 no.3
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    • pp.109-117
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    • 2014
  • Purpose: The aim of this study was to determine the effects of nutritional supplements on periodontal health and tooth mobility after surgery. Methods: Patients were randomly assigned to an intervention group who consumed nutritional supplement drinks for 8 weeks, while the placebo group did not receive any such supplements. The gingival index (GI) and tooth mobility were measured at baseline and at 1, 4, and 8 weeks. In addition, the oral health impact profile-14 and anthropometric measurements along with loss of appetite and dietary intake were assessed at baseline and 8 weeks. Results: At 1 week, GI values were reduced in the intervention group (P<0.05), and tooth mobility had increased, but to a lesser extent in the intervention group (P<0.05). At 8 weeks, the intakes of protein, vitamins A and B1, and niacin were increased in the intervention group. Conclusions: These results demonstrate that nutritional supplementation improves early periodontal healing after surgery.

Radiation Therapy Following Total Keloidectomy: A Retrospective Study over 11 Years

  • Kim, Kyuhee;Son, Daegu;Kim, Jinhee
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.588-595
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    • 2015
  • Background Radiotherapy treatment after keloidectomy is known to be an effective method for reducing the rate of recurrence. However, to date, the appropriate total radiation dose and fractionation have not yet been confirmed. The authors performed a retrospective analysis to identify the appropriate radiation dose and fractionation in post-keloidectomy radiotherapy. Methods From May 2000 to February 2011, postoperative radiotherapy was performed on 39 lesions in 28 patients after total keloidectomy. The keloid lesions were confined to the ear lobes. Between May 2000 and May 2004, 14 keloids were treated with surgical excision, followed by a total radiation dose of 1,200 cGy in three fractions over four to five days (group 1). Between June 2004 to February 2011, 25 keloids were treated with surgical excision, followed by a total radiation dose of 1,500 cGy in three fractions over four to five days (group 2). Patients were given a survey asking them to report their experiences regarding reoperation, recurrence of symptoms, recurrence of the lesion, and satisfaction with the operation. Results Of the 28 patients who were treated, 20 underwent follow-up. Group 2 had more cases showing elevation with erythematous changes, whereas group 1 had more cases showing progressive stages of elevation than group 2. These differences were statistically significant. Moreover, a correlation was observed between the level of keloid elevation and the extent of symptoms. Conclusions We suggest 1,500 cGy of radiation in three fractions following keloidectomy for ear lobe keloids. A further randomized study is needed to assess the recurrence of keloids after radiotherapy.

A Case Report of an Advanced Gastric Cancer Patient Who Was Able to Undergo Conversion Surgery Treated with Chemotherapy and Korean Medicine (항암화학요법과 한방치료를 병행하여 전환수술이 가능하게 호전된 진행성 위암 환자 1례)

  • Jang, Kwon-jun;Ko, Eun-bi;Hwang, Woo-seok;Kim, Kwan-il;Lee, Beom-joon;Jung, Hee-jae;Shin, Kwang-soon
    • The Journal of Internal Korean Medicine
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    • v.41 no.5
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    • pp.911-925
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    • 2020
  • Objectives: The purpose of this study was to report a case of a patient with advanced gastric cancer with peritoneal metastasis treated with chemotherapy and Korean medicine Methods: A patient with advanced gastric cancer with peritoneal metastasis was treated with Xeloda/cisplatin since April 2019. The cycle was repeated every three weeks for a total of 11 times. At the same time, the patient was treated with Korean medicine. The tumor size was measured by computed tomography (CT) and esophagogastroduodenoscopy (EGD). Adverse events were evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After treatment with Xeloda/cisplatin and Korean medicine for nine months, the extent of the proximal portion of the primary tumor and the size and number of multiple nodules around the stomach decreased and the cancer cells with peritoneal metastasis disappeared. The symptoms of discomfort and physical activity were gradually improved. As a result, the patient underwent conversion surgery. Conclusions: This case study suggests that the combination of chemotherapy and Korean medicine may contribute to the reduction in tumor size as well as the improvement in the quality of life.

Attitude of Male University Students and High School Boys toward Cross-Sexual Fashion (남자대학생과 고등학생의 크로스섹슈얼에 대한 태도)

  • Yoo, Jung-Ja;Kweon, Soo-Ae
    • Korean Journal of Human Ecology
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    • v.17 no.2
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    • pp.335-344
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    • 2008
  • The purpose of this study was to examine male students' awareness and receptivity of cross-sexual fashion. The subjects in this study were 480 male university students and 320 high school boys. After a survey was conducted in August 2007, the following findings were given: 1. How much the students were interested in fashion was investigated, and they thought of fashion often, Even though nothing any fashion shopping plan they were interested display of fashion market and logged onto online fashion shopping malls frequently. 2. As for awareness of cross-sexual, they got a mean of 2.79(1.10), which indicated their awareness level was below the average. Those who were more intrigued by fashion, who were university students and who had a girl friend were better cognizant of cross-sexual. 3. To what extent they were receptive to cross-sexual fashion was checked in terms of clothes, haircare, skin care, accessories and perfume/cosmetic surgery and they were most receptive to cross-sexual haircare(3.49). Those who cared more about fashion were more receptive to cross-sexual. The Value of clothes and perfume/cosmetic surgery for university students was higher than the high school students. 4. They were most receptive to other's cross-sexual haircare(3.51) and to other's cross-sexual clothes(2.77) the least. Those who were more intrigued by fashion were more receptive to others seeking after cross-sexual. The Value of clothes sand perfume/cosmetic surgery for university students was higher than the high school students. 5. There was a strong correlational relationship among their interest in fashion, awareness of cross-sexual, receptivity to their own being a cross-sexual man and receptivity to others who are cross-sexual. The findings of the study illustrated that those who were more intrigued by fashion and who were better aware of cross-sexual were more receptive to cross-sexual fashion.