• Title/Summary/Keyword: Invasive surgery

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Fifty Years of Innovation in Plastic Surgery

  • Kwasnicki, Richard M;Hughes-Hallett, Archie;Marcus, Hani J;Yang, Guang-Zhong;Darzi, Ara;Hettiaratchy, Shehan
    • Archives of Plastic Surgery
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    • v.43 no.2
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    • pp.145-152
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    • 2016
  • Background Innovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years. Methods Patents and publications related to plastic surgery (1960 to 2010) were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored. Results Between 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued. Conclusions The application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active.

Non-invasive different modalities of treatment for temporomandibular disorders: review of literature

  • Abouelhuda, Amira Mokhtar;khalifa, Ahmad Khalifa;Kim, Young-Kyun;Hegazy, Salah Abdelftah
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.2
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    • pp.43-51
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    • 2018
  • Temporomandibular disorders (TMDs) are diseases that affect the temporomandibular joint and supporting structures. The goal of treatment for TMDs is elimination or reduction of pain and return to normal temporomandibular joint function. Initial treatment for TMDs is non-invasive and conservative, not surgical. Oral and maxillofacial surgeons should fully understand and actively care about non-invasive treatments for TMDs. The purpose of this study is to review the validity and outcomes of non-invasive and surgical treatment modalities for TMDs.

Radiation Induced Cystitis and Proctitis - Prediction, Assessment and Management

  • Mallick, Supriya;Madan, Renu;Julka, Pramod K;Rath, Goura K
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5589-5594
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    • 2015
  • Cystitis and proctitis are defined as inflammation of bladder and rectum respectively. Haemorrhagic cystitis is the most severe clinical manifestation of radiation and chemical cystitis. Radiation proctitis and cystitis are major complications following radiotherapy. Prevention of radiation-induced haemorrhagic cystitis has been investigated using various oral agents with minimal benefit. Bladder irrigation remains the most frequently adopted modality followed by intra-vesical instillation of alum or formalin. In intractable cases, surgical intervention is required in the form of diversion ureterostomy or cystectomy. Proctitis is more common in even low dose ranges but is self-limiting and improves on treatment interruption. However, treatment of radiation proctitis is broadly non-invasive or invasive. Non-invasive treatment consists of non-steroid anti-inflammatory drugs (NSAIDs), anti-oxidants, sucralfate, short chain fatty acids and hyperbaric oxygen. Invasive treatment consists of ablative procedures like formalin application, endoscopic YAG laser coagulation or argon plasma coagulation and surgery as a last resort.

Considerations for Invasive Dental Treatment in Disabled Patients

  • Eun-Jung Kwak
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.1-8
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    • 2023
  • Dental treatment for the disabled should be a customized that considers the characteristics and degree of cooperation of each disabled patient. There are additional considerations during implant treatment and tooth extraction in disabled patients. Since some brain lesion disorder or cardiac disease patients may be taking antiplatelet or anticoagulant medications, it is necessary to evaluate whether these medications should be discontinued before an invasive procedure. Precautions should be taken for patients with heart valve disease considering the risk of infective endocarditis, especially during invasive dental procedures. Moreover, disabled patients may have difficulty in following instructions and cautions. There are specific considerations for each stage of implant treatment in disabled patients. In the case of patients who are in the pre- or post-transplant state, it is necessary to assess their general condition and oral disease due to the risk of infection. Since disabled patients with various systemic diseases may visit the dental clinic, it is important to understand their characteristics and treatment process in order to flexibly adjust the dental treatment plan accordingly.

Radiology for Ductal Carcinoma In Situ of the Breast: Updates on Invasive Cancer Progression and Active Monitoring

  • Lars J Grimm
    • Korean Journal of Radiology
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    • v.25 no.8
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    • pp.698-705
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    • 2024
  • Ductal carcinoma in situ (DCIS) accounts for approximately 30% of new breast cancer diagnoses. However, our understanding of how normal breast tissue evolves into DCIS and invasive cancers remains insufficient. Further, conclusions regarding the mechanisms of disease progression in terms of histopathology, genetics, and radiology are often conflicting and have implications for treatment planning. Moreover, the increase in DCIS diagnoses since the adoption of organized breast cancer screening programs has raised concerns about overdiagnosis and subsequent overtreatment. Active monitoring, a nonsurgical management strategy for DCIS, avoids surgery in favor of close imaging follow-up to de-escalate therapy and provides more treatment options. However, the two major challenges in active monitoring are identifying occult invasive cancer and patients at risk of invasive cancer progression. Subsequently, four prospective active monitoring trials are ongoing to determine the feasibility of active monitoring and refine the patient eligibility criteria and follow-up intervals. Radiologists play a major role in determining eligibility for active monitoring and reviewing surveillance images for disease progression. Trial results published over the next few years would support a new era of multidisciplinary DCIS care.

Minimally Invasive Lumbar Spinal Decompression : A Comparative Study Between Bilateral Laminotomy and Unilateral Laminotomy for Bilateral Decompression

  • Kim, Seok-Won;Ju, Chang-Il;Kim, Chong-Gue;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.42 no.3
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    • pp.195-199
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    • 2007
  • Objective : Bilateral laminotomy and unilateral laminotomy for bilateral decompression are becoming the minimally invasive procedures for lumbar spinal stenosis (LSS). With the aim of less invasiveness and better preservation of spinal stability. these techniques have been developed. But there are no large randomized studies to show the surgical results between these two techniques. The objective of this study was to examine the safety and efficacy of these two minimally invasive techniques. Methods : A total of 80 patients were included in this study (Group I : bilateral laminotomy, Group II : Unilateral laminotomy for bilateral decompression). Perioperative parameters and complications were analyzed. Symptoms and scores such as visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, and SF-36 scores of prospectively accrued patients were assessed preoperatively and at 1 month and 12 months after surgery. Paired-t test, two-sample student-t tests, and non parametric tests were used to determine cross-sectional differences between two groups. Results : No major complications such as spinal instability or deaths occurred during follow-up periods. VAS, ODI scores and SF-36 body pain and physical function scores showed statistically significant improvements in both groups (p<0.001). The significant widening of the spinal canal diameter was also noted in both groups. But, in Group II. there were minor postoperative complications such as dural tear (2 cases 5.0%), fracture of ipsilateral inferior facet (1 case 2.5%), and 5 cases of transient leg symptoms of contralateral side. Conclusion : Both bilateral laminotomy and unilateral laminotomy for bilateral decompression allow achievement of adequate and long-lasting operative results in patients with LSS. But postoperative complications are more frequent in Group II (unilateral laminotomy and bilateral decompression). These results indicate that bilateral laminotomy is the preferred minimally invasive technique to treat symptomatic LSS.

Relation between Ki-67, ER, PR, Her2/neu, p21, EGFR, and TOP II-α Expression in Invasive Ductal Breast Cancer Patients and Correlations with Prognosis

  • Yan, Jian;Liu, Xiao-Long;Han, Lu-Zhe;Xiao, Gang;Li, Ning-Lei;Deng, Yi-Nan;Yin, Liang-Chun;Ling, Li-Juan;Yu, Xiao-Yuan;Tan, Can-Liang;Huang, Xiao-Ping;Liu, Li-Xin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.823-829
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    • 2015
  • The aim of the present study was to investigate the expression of the transcription factor Ki-67, ER, PR, Her2/neu, p21, EGFR, and TOP II-${\alpha}$ in the tumor tissue of patients with invasive ductal carcinoma(IDC); in addition, we examined correlations between these markers. Two hundred and sixteen IDC patients, who were not previously been treated with chemo- or radiotherapy, were included in the study. All tumors were grade I-III. Expression of molecular markers was determined by immunohistochemical analysis on paraffin-embedded tissue sections. Follow-up data were collected for 3 months to 10 years and analyzed for tumor recurrence, survival time, and prognostic risk factors. We determined Ki-67 expression correlates with the expression of ER, PR, HER-2, EGFR, and TOP-${\alpha}$, as well as lymph node involvement, high tumor grade, lymphovascular invasion, high tumor stage, and high TNM stage in IDC. Positive Ki-67 expression was a risk factor for rapid tumor recurrence and may help tumor progression, leading to poor prognosis in IDC. Ki-67 was directly correlated with EGFR, TOP II-${\alpha}$, lymph node involvement, high tumor grade, lymphovascular invasion, high tumor stage, and high TNM stage in the hormone receptor subtypes of breast cancer. In triple negative breast cancer, Ki-67 correlated with TOP II-${\alpha}$. Expression of Ki-67 correlated with that of ER, PR, HER-2, EGFR, TOP II-${\alpha}$, and p21. In addition, the biomarker Ki-67 has a role as a prognostic factor and indicates a poor prognosis in IDC.