• Title/Summary/Keyword: Extent of surgery

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A CLINICAL STUDY ON REPLANTATION OF AVULSED PERMANENT TEETH (결출치아의 재식술후 효과에 관한 임상적 연구)

  • Lee, Eui-Wung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.1
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    • pp.73-79
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    • 2000
  • A material of 48 patients with 60 avulsed and replanted permanent teeth were followed retrospectively in the period of 1996. 1 to 1998. 12 (mean observation period=1year 7months). The age of the patients at the time of replantation ranged from 9 to 63 years (mean=24 years). Clinical records of patients were reviewed to obtain valid data concerning the extent of injury and treatment provided. Pulpal and periodontal healing states were examined with periapical x-rays and clinical examination procedures (i.e. percussion test and mobility test) at their recall visit. Root ankylosis was found in fifty-two teeth(87%) and root resorption in twenty-four(40%). Only two of the replanted teeth(3%) showed partial regeneration of the periodontal ligament. Six teeth(10%) resulted in tooth loss, but the remaining fifty-four were clinically well functioning. Most of teeth have mild marginal bone loss accompanied by gingival retraction without pathological periodontal pockets. The incidence of root resorption was much higher in younger age group. However, it was not affected by the interval between avulsion and replantation, the condition of supporting tissues, the degree of root formation and the type of splinting, indicating that multiple factors involved in determining the prognosis of replanted teeth. Based on these findings, avulsed teeth in unfavorable conditions (i.e. long extra-alveolar periods, etc.) should be preserved if possible.

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Consideration of fractionation or field size prior to radiation therapy in patients with breast cancer and psoriasis: a case report

  • Jin Yi Hyun;So Hyun Park;Dae-Hyun Kim;Jinhyun Choi
    • Journal of Medicine and Life Science
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    • v.20 no.2
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    • pp.89-93
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    • 2023
  • We present three cases of patients with breast cancer and psoriasis who received radiotherapy following breast-conserving surgery. One patient developed an extensive flare-up of psoriasis during chemotherapy. After discontinuing chemotherapy, she received conventional radiotherapy to the ipsilateral whole breast, axillary, and supraclavicular lymph nodes with 50.4 Gy in 28 fractions and boosted with 10 Gy in five fractions to the tumor bed. Two patients received hypofractionated whole-breast radiotherapy at a total dose of 40.05-42.4 Gy in 15-16 fractions. In all three cases, there was no flare-up of psoriatic events at least 6 months after the completion of radiotherapy. We hypothesized that there is a close relationship between psoriatic events and the extent of trauma rather than the daily dose of the fraction. Therefore, we confirmed that the effect of radiotherapy on psoriatic events is minimal if the radiation field size does not exceed that of the whole breast.

Multidetector computed tomography in preoperative planning for temporomandibular joint ankylosis: A pictorial review and proposed structured reporting format

  • Singh, Rashmi;Bhalla, Ashu Seith;Manchanda, Smita;Roychoudhury, Ajoy
    • Imaging Science in Dentistry
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    • v.51 no.3
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    • pp.313-321
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    • 2021
  • Ankylosis of the temporomandibular joint (TMJ) is a disabling disease resulting from fibrous or bony fusion of the mandibular condyle and the glenoid fossa. Early diagnosis and surgical treatment are essential to prevent facial deformity and other complications. Conventional radiography has limitations in demonstrating the true extent of ankylosis. It is important for surgeons to be aware of the size and degree of bony ankylosis in order to perform complete resection of the ankylotic mass. In addition, a detailed evaluation of the relationship with adjacent vital structures such as the internal maxillary artery, inferior alveolar nerve canal, external auditory canal, and skull base are crucial to avoid iatrogenic injury. Multidetector computed tomography (MDCT) is the current imaging modality of choice for preoperative assessments. Herein, the authors propose a structured CT reporting template for TMJ ankylosis to strengthen the value of the preoperative imaging report and to reduce the rates of intraoperative complications and recurrence.

Evaluation of the 7th UICC TNM Staging System of Gastric Cancer

  • Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.11 no.2
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    • pp.78-85
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    • 2011
  • Since January of 2010, the seventh edition of UICC tumor node metastasis (TNM) Classification, which has recently been revised, has been applied to almost all cases of malignant tumors. Compared to previous editions, the merits and demerits of the current revisions were analyzed. Many revisions have been made for criteria for the classification of lymph nodes. In particular, all the cases in whom the number of lymph nodes is more than 7 were classified as N3 without being differentiated. Therefore, the coverage of the N3 was broad. Owing to this, there was no consistency in predicting the prognosis of the N3 group. By determining the positive cases to a distant metastasis as TNM stage IV, the discrepancy in the TNM stage IV compared to the sixth edition was resolved. In regard to the classification system for an esophagogastric (EG) junction carcinoma, it was declared that cases of an invasion to the EG junction should follow the classification system for esophageal cancer. A review of clinical cases reported from Asian patients suggests that it would be more appropriate to follow the previous editions of the classification system for gastric cancer. In addition, in the classification of the TNM stages in the overall cases, the discrepancy in the prognosis between the different stages and the consistency in the prognosis between the same TNM stages were achieved to a lesser extent as compared to that previously. Accordingly, further revisions are needed to develop a purposive classification method where the prognosis can be predicted specifically to each variable and the mode of the overall classification can be simplified.

A Case of Posterior Hypopharyngeal Wall Cancer Reconstructed with Longus Colli Flap and Skin Graft after Failure of Radial Forearm Free Flap (요골측 전박유리 피판 실패 후 경장근 피판과 피부이식으로 재건한 하인두후벽암 1례)

  • Yang Hae-Dong;Chung Sang-Ho;Kwon Oh-Hwi;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.216-220
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    • 2001
  • There are many approaches in surgery of posterior hypopharyngeal wall cancer according to location, extent, and invasion depth of primary cancer. And many reconstruction methods have been used in reconstruction of surgical defect remaining after wide resection of primary cancer. Posterior hypopharyngeal wall cancer is relatively rare, so its surgical experiences are fewer than those of pyriform sinus cancer and there have been few reports of surgical approaches and reconstruction methods of posterior hypopharyngeal wall cancer. Recently, we experienced a case of posterior hypopharyngeal wall cancer reconstructed with longus colli flap and skin graft after failure of radial forearm free flap in a 72-year -old man and report it with the review of the literatures.

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Reirradiation of head and neck cancer in the era of intensity-modulated radiotherapy: patient selection, practical aspects, and current evidence

  • Kim, Yeon Sil
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.1-15
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    • 2017
  • Locoregional failure is the most frequent pattern of failure in locally advanced head and neck cancer patients and it leads to death in most of the patients. Second primary tumors occurring in the other head and neck region reach up to almost 40% of long-term survivors. Recommended and preferred retreatment option in operable patients is salvage surgical resection, reporting a 5-year overall survival of up to 40%. However, because of tumor location, extent, and underlying comorbidities, salvage surgery is often limited and compromised by incomplete resection. Reirradiation with or without combined chemotherapy is an appropriate option for unresectable recurrence. Reirradiation is carefully considered with a case-by-case basis. Reirradiation protocol enrollment is highly encouraged prior to committing patient to an aggressive therapy. Radiation doses greater than 60 Gy are usually recommended for successful salvage. Despite recent technical improvement in intensity-modulated radiotherapy (IMRT), the use of concurrent chemotherapy, and the emergence of molecularly targeted agents, careful patient selection remain as the most paramount factor in reirradiation. Tumors that recur or persist despite aggressive prior chemoradiation therapy imply the presence of chemoradio-resistant clonogens. Treatment protocols that combine novel targeted radiosensitizing agents with conformal high precision radiation are required to overcome the resistance while minimizing toxicity. Recent large number of data showed that IMRT may provide better locoregional control with acceptable acute or chronic morbidities. However, additional prospective studies are required before a definitive conclusion can be drawn on safety and effectiveness of IMRT.

The Change of Mitochondrial Fusion and Fission in human Skeletal Muscle with Aging

  • Cho, Hyung-Jun;Park, Soo-Yeon
    • Biomedical Science Letters
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    • v.18 no.2
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    • pp.112-122
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    • 2012
  • A gradual change of molecules that are related in fission and fusion is occurred during aging process. Although aging effects on mitochondrial fusion and fission are investigated, it is still unclear that the extent of the change in mitochondria fusion and fission periodically. In this study we investigated the changes of mitochondrial proteins involved in fusion (Mfn2, Opa1) and fission (Drp1, Fis1) in the human gracilis muscle ranging from 10 to 50 years of age (n=40). The gracilis muscle showed a significant increase in muscle apoptotic changes in the age of 50s compared with 10s by using in situ terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL). The expression levels of Drp1 and Fis1 (P<0.01, P<0.05) mRNA were significantly elevated and the Mfn2 and Opa1 (P<0.01, P<0.05) levels were decreased from older individuals. The ratio of fission and fusion was altered and the level of increment of fission gene was greater than fusion gene decrement in the age of 50s. These findings suggest that changes of mitochondrial fusion and fission proteins related with aging might contribute to aged muscle apoptosis.

Conventional Posterior Approach without Far Lateral Approach for Ventral Foramen Magnum Meningiomas

  • Sohn, Seil;Chung, Chun Kee
    • Journal of Korean Neurosurgical Society
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    • v.54 no.5
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    • pp.373-378
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    • 2013
  • Objective : We present our experience of conventional posterior approach without fat lateral approach for ventral foramen magnum (FM) meningioma (FM meningioma) and tried to evaluate the approach is applicable to ventral FM meningioma. Methods : From January 1999 to March 2011, 11 patients with a ventral FM meningioma underwent a conventional posterior approach without further extension of lateral bony window. The tumor was removed through a working space between the dura and arachnoid membrane at the cervicomedullary junction with minimal retraction of medulla, spinal cord or cerebellum. Care should be taken not to violate arachnoid membrane. Results : Preoperatively, six patients were of Nurick grade 1, three were of grade 2, and two were of grade 3. Median follow-up period was 55 months (range, 20-163 months). The extent of resection was Simpson grade I in one case and Simpson grade II in remaining 10 cases. Clinical symptoms improved in eight patients and stable in three patients. There were no recurrences during the follow-up period. Postoperative morbidities included one pseudomeningocele and one transient dysphagia with dysarthria. Conclusion : Ventral FM meningiomas can be removed gross totally using a posterior approach without fat lateral approach. The arachnoid membrane can then be exploited as an anatomical barrier. However, this approach should be taken with a thorough understanding of its anatomical limitation.

A Clinical Study of Serum Thyroglobulin Levels in Patients with Thyroid Tumor (갑상선종양환자(甲狀腺腫瘍患者)에서의 혈청(血淸) Thyroglobulin치(値)에 관(關)한 임상적(臨床的) 고찰(考察))

  • Lee, Choong-Kyu;Yu, Byung-Hee;Lee, Woo-Hyung;Yoo, Hyung-Joon;Lee, Chong-Suk
    • The Korean Journal of Nuclear Medicine
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    • v.17 no.1
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    • pp.25-31
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    • 1983
  • Serum thyroglobulin(Tg) was measured by radioimmunoassay in 81 patients with thyroid tumor who were treated in the department of Internal medicine of National Medical Center from January, 1981 to June, 1982. The results were as follows: 1) The mean serum thyroglobulin level in thyroid tumor was significantly higher than normal subjects (p<0.001). 2) The mean serum thyroglobulin level in benign tumor was lower than malignant tumor (p<0.05). 3) The thyroid carcinoma with metastasis had significant high level of serum thyroglobulin than without metastasis (p<0.001). 4) The mean postoperative serum thyroglobulin level was significantly lower than preoperative level (p<0.001). Data from our study show that serum thyroglobulin determination is useful for assessing the presence of malignant thyroid tumor, metastasis and the extent of residual or recurrent thyroid cancer after surgery.

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The Deep Dry Needling Techniques, and Interventional Muscle & Nerve Stimulation (IMS) for the Treatment of Chronic Pain (만성통증 치료에서 Deep Dry Needling의 모델들과 중재적 근육 및 신경자극 요법)

  • Lee, Young Jin;Ahn, Kang;Lee, Sang Chul
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.1-7
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    • 2006
  • Chronic pain can cause disability, mild to severe suffering and high medical costs. Some unfortunate patient do not improve despite administering conservative treatment and then the various interventional therapies, including oriental medical treatment and/or surgery, and they find themselves in search of a more effective pain relief. Deep dry needling is one of the newer treatment modalities for these patients. The last 10 years have seen a lot of progress in understanding the neural pathways and the type and extent of tissue involvement during chronic pain. This in turn has stimulated the development of new treatment techniques, and deep dry needling is one of them. So, the authors of this paper discuss the individual theories, the characteristics and future directions of several deep dry needling techniques, and we examine the new dry needling technique that has been recently developed in Korea.