• Title/Summary/Keyword: Extent of surgery

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$^{18}F-FDG-PET/CT$ in Renal Cell Carcinoma (신세포암에서 $^{18}F-FDG-PET/CT$)

  • Jeon, Tae-Joo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.126-129
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    • 2008
  • Renal cell carcinoma is the most common histological type of renal malignancy, predominant in men and the primary treatment modality of this tumor is surgery. The role of diagnostic imaging in the management of this tumor is the evaluation of extent of disease as well as the detection and characterization of renal mass. US has long been a routine screening tool for kidney but tomographic imaging modalities such as CT and MRI begin to be also commonly used these days. On the other hand, the sensitivity of $^{18}F-FDG-PET$ in detection of renal mass is relatively low because of inherent limitation caused by FDG excretion pathway despite avid uptake of FDG to tumor cell per se. Many studies revealed FDG PET scan could play an important role in detection of metastatic lesions although the sensitivity for the detection of primary lesion is not so high. Furthermore, development of PET/CT scanner will make it possible to expand the indication of FDG PET scan in this malignancy.

Quality of Life of Long-term Survivors after a Subtotal or a Total Gastrectomy for Gastric Cancer (위암 수술 후 장기생존자에서 위 절제 범위에 따른 삶의 질)

  • Lee, Seung-Soo;Han, Sung-Won;Jeong, Hye-Yeon;Song, Jye-Won;Chung, Ho-Young;Yu, Wan-Sik
    • Journal of Gastric Cancer
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    • v.10 no.1
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    • pp.34-39
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    • 2010
  • Purpose: The aim of this study was to compare quality of life of long-term survivors after a subtotal or a total gastrectomy for gastric cancer. Materials and Methods: The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire and QLQ-STO22 questionnaire were used to assess quality of life of 166 patients on their 5th annual follow-ups after gastrectomy for gastric cancer. One hundred twenty-six patients underwent a subtotal gastrectomy and 40 patients a total gastrectomy. Results: The subtotal gastrectomy group revealed a trend to have better quality of life in functional scales (physical, role, emotional, cognitive and social), fatigue, pain, dyspnea, diarrhea and financial difficulties. The total gastrectomy group showed a trend to have better quality of life in the global health status and quality of life, nausea and vomiting, insomnia, appetite loss and constipation. In all scales of the EORTC QLQ-STO22, the subtotal gastrectomy group had a trend to have better quality of life. However these did not reach the statistical significance. Conclusion: Surgeons may not limit the extent of resection concerning long-lasting poor quality of life. Oncologically sound resection is recommended.

Recent Advances in Radioiodine Therapy for Thyroid Cancer (갑상샘암의 방사성요오드 치료의 최신 지견)

  • Bae, Sang-Kyun
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.132-140
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    • 2006
  • Well-differentiated thyroid cancer is the most common endocrine malignancy with an increasing incidence. Most patients with well-differentiated thyroid caner have a favorable prognosis with high survival rate. While surgery and radioiodine therapy is sufficient treatment for the majority of patients with differentiated thyroid cancer, a minority of these patients experiences progressive, life-threatening growth and metastatic spread of the disease. Because there is no prospective controlled study to evaluate the differences of management of thyroid cancer, it is hard to choose the best treatment option. And there are still lots of controversies about the management of this disease, such as surgical extent, proper use of radioiodine for remnant ablation and therapy, use of rhTSH instead of withdrawal of thyroid hormone, long-term follow-up strategy, thyroglobulin as a tumor marker, etc. In this review, recent data related to these conflicting issues and recent advances in diagnosis, radioiodine therapy and long-term monitoring of well-differentiated thyroid cancer are summarized.

Clinicopathologic Characteristics of Incidentally Discovered Thyroid Carcinomas (갑상선 우연암종의 임상병리적 특성)

  • Chung Woung-Youn;Cheong Jae-Ho;Chang Hang-Seok;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.64-68
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    • 2000
  • Objectives: With the recent advances and increasing use of imaging techniques in examination of the neck, the incidence of incidentally discovered thyroid carcinoma has been increasing. This study was carried out to evaluate the clinicopathologic characteristics of incidental thyroid carcinomas and to find optimal therapeutic strategies for these lesions. Materials & Methods: From Jan. 1988 to Aug. 1998, 1,053 patients were operated on for thyroid cancer, of whom 127(12.1%) had incidentally discovered thyroid cancers which were identified during routine health checkups(n=40), diagnostic procedures for unrelated medical conditions(n=39) and mass screening for thyroid cancer(n=48). The preoperative diagnosis was obtained by ultrasound-guided FNAB and the extent of surgery was determined based on frozen section examinations, as well as prognostic factors and gross findings at the time of surgery. Results: There were 6 men and 121 women with a mean age of 45.9 years. Histopathological diagnosis included papillary carcinomas(n=1l9), follicular carcinomas(n=6), poorly differentiated carcinoma(n=l) and medullary carcinoma(n=1). Thirty patients(23.6%) had multifocallesions. The mean diameter of the tumors was 1.1 cm(0.2-3.4 cm). Capsular invasions were found in 53 patients(41.7%) and nodal metastases in 41(32.3%). The surgical procedures used were: 90 less-than total thyroidectomies and 37 total thyroidectomies with central neck node dissection. Lateral neck dissection was added in 5 patients. According to TNM staging, 79 patients(63.2%) were at stage I, 15(12.0%) at stage II, 31(24.8%) at stage III and 0(0.0%) at stage IV. By AMES scoring system, 102 patients(81.6%) were in the low-risk group and 23(18.4%) in the high-risk group. And by MACIS scoring system, 103(86.6%) of 119 papillary thyroid cancer patients were less than 6. Conclusions: The clinicopathological characteristics of incidentally discovered thyroid carcinomas are similar to ordinary thyroid carcinomas. The treatment of choice should be individualized based on the particular clinical situation encountered, as in ordinary thyroid carcinomas.

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Impact of Lifestyle Diseases on Postoperative Complications and Survival in Elderly Patients with Stage I Non-Small Cell Lung Cancer

  • Jeong, Sang Seok;Choi, Pil Jo;Yi, Jung Hoon;Yoon, Sung Sil
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.86-93
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    • 2017
  • Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

Alveolar ridge expansion-assisted orthodontic space closure in the mandibular posterior region

  • Ozer, Mete;Akdeniz, Berat Serdar;Sumer, Mahmut
    • The korean journal of orthodontics
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    • v.43 no.6
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    • pp.302-310
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    • 2013
  • Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region.

Diagnostic Imaging of Recurred Mandibular Ameloblastoma with Large Soft Tissue Involvement

  • Park Kwan-Soo;Lee Sam-Sun;Jeon In-Seong;Choi Soon-Chul
    • Imaging Science in Dentistry
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    • v.30 no.4
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    • pp.281-285
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    • 2000
  • An uncommon case of a patient with recurrent mandibular ameloblastoma involving various adjacent soft tissues is presented with plain film radiography, computed tomography and magnetic resonance imaging (MRI) and bone scan. The tumor involved mandible and eroded several bones including foramen ovale. This case shows that although an ameloblastoma primarily affect mandible, exact radiographic evaluation of tumor extent will assist the surgeon in the progress of rational approaches to the management of ameloblastoma.

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The Advent of Laser Therapies in Dermatology and Urology: Underlying Mechanisms, Recent Trends and Future Directions

  • Lee, Ho;Jeong, Yeon-Uk;Chan, Kin F.
    • Journal of the Optical Society of Korea
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    • v.13 no.3
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    • pp.321-329
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    • 2009
  • Following their applications in cardiology, ophthalmology and dentistry among others, the advent of lasers in dermatology and urology had become the success story of the past decade. Laser-assisted treatments in dermatology and urology are mainly based on the laser-induced tissue injury/coagulation and/or ablation, depending upon the desirable clinical endpoint. In this review, we discussed the underlying mechanisms of the laser induced tissue ablation. In any medical laser application, the controlled thermal injury and coagulation, and the extent of ablation, if required, are critical. The laser thermal mechanism of injury is intricately related to the selective absorption of light and its exposure duration, similarly to the laser induced ablation. The laser ablation mechanisms were categorized into four different categories (the photo-thermally induced ablation, the photo-mechanically induced ablation, the plasma induced ablation and the photoablation) and their fundamentals are herein described. The brief history of laser treatment modality in dermatology and urology are summarized.

A Study of a Biodegradale Inorganic-Organic Composite Artificial Bone Substitute -Part 1. Synthesis of an Apatite with Similar Crystallinity to Bone-

  • Choon Ki Lee;Hwal Suh
    • Journal of Biomedical Engineering Research
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    • v.15 no.2
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    • pp.195-200
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    • 1994
  • To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed a composite that consists consisted of calcium phosphate and collagen according to the natural bone's main composition. The crystallinity of the synthesized apatite was shown to depend on the synthesis temperature. Carbonate apatite synthesized at $58{\circ}C$ demonstrated crystallinity very similar to that of the natural bone. By sintering the apatite over $700{\circ}C$ in vacuum, porous carbonate apatite could be obtained, and the pore extent was controllable according to the additive hydrogenperoxide volume.

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Traumatic Posterior Fossa Subdural Hematoma in a Neonate: A Case Report

  • Eom, Ki Seong
    • Journal of Trauma and Injury
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    • v.33 no.4
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    • pp.256-259
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    • 2020
  • Although traumatic posterior fossa subdural hematoma (TPFSH) in neonates immediately after birth is extremely rare, it can pose a serious clinical problem in the neonatal period. Here, the author presents the case of a 3-day-old male infant who underwent emergency surgical treatment of TPFSH with a favorable outcome. Debate continues about surgical versus conservative treatment of TPFSH in neonates. The clinical symptoms, extent of hemorrhage, early diagnosis, and prompt and appropriate surgery are the most important factors in the treatment of TPFSH in neonates. Therefore, neurosurgeons should establish treatment strategies based on the newborn's clinical condition, the size and location of the TPFSH, and the potential of the hematoma to cause long-term complications.