Objective : This study is performed to evaluate the procedural complications, aneurysm occlusion rate, and mid-term outcome of endovascular treatments in intracranial aneurysms. Methods : We retrospectively investigated 135 patients with 161 cerebral aneurysms who were treated by endovascular means at our institute from March 1999 to December 2004. We statistically analyzed overall outcome, occlusion rate, and occurrence of complications according to the location, size, rupture history, and neck size of aneurysms. Results : Forty-nine patients [36.3%] had experienced acute intracranial or extracranial complications related to the procedure. Among these, there were 13cases of perforation of the aneurysm, 9 of local vasospasm, 8 of thromboembolism, 4 of coil migration, 3 of occlusion of parent vessels due to coil protrusion, and 1 of seizure. Extracranial complications occurred in 14cases including alopecia [9cases], femoral artery thrombosis [2cases], acute renal failure [2cases], and hypovolemic shock [1case]. One hundred twenty-six aneurysms [78.3%] had complete occlusion of the aneurysm and 35 [21.7%] incomplete occlusion at 6months angiographic follow-up. Postembolization clinical follow-up ranged from 1 to 60months [mean, 14.2months]. Seven of the 161 aneurysms underwent additional embolization and 2 incomplete embolized aneurysms required subsequent surgery. Conclusion : The procedural complications and incomplete occlusion rates are substantial. Therefore, endovascular treatment needs close and continued neurosurgical and neuroradiological concerns for the therapy of intracranial aneurysms.
Mucopolysaccharidosis (MPS) is an inherited metabolic disorder caused by a deficiency in enzymes that participate in the degradation of glycosaminoglycans (GAGs) such as heparin sulfate and dermatan sulfate. Left untreated, patients show progressive mental and physical deterioration due to deposition of GAGs in organs. Death often occurs due to cardiac or respiratory failure before patients reach their early twenties. MPS has several oral and dental manifestations. An enlarged head, short neck, and open mouth associated with a large tongue are major characteristics of MPS patients. Dental complications can be severe, including unerupted dentition, dentigerous cyst-like follicles, malocclusions, condylar defects, and gingival hyperplasia. A 21-year-old female patient with MPS was described in this article, with special emphasis on oral manifestations and dental treatment.
Danbi Jo;Seo Yeon Ahn;Seo Yoon Choi;Yoonjoo Choi;Dong Hoon Lee;Juhyun Song
Clinical Nutrition Research
/
v.13
no.2
/
pp.121-129
/
2024
The prevalence of metabolic syndrome caused by diets containing excessive fatty acids is increasing worldwide. Patients with metabolic syndrome exhibit abnormal lipid profiles, chronic inflammation, increased levels of saturated fatty acids, impaired insulin sensitivity, excessive fat accumulation, and neuropathological issues such as memory deficits. In particular, palmitic acid (PA) in saturated fatty acids aggravates inflammation, insulin resistance, impaired glucose tolerance, and synaptic failure. Recently, adiponectin, brain-derived neurotrophic factor (BDNF), and glucose-like peptide-1 (GLP-1) have been investigated to find therapeutic solutions for metabolic syndrome, with findings suggesting that they are involved in insulin sensitivity, enhanced lipid profiles, increased neuronal survival, and improved synaptic plasticity. We investigated the effects of adiponectin, BDNF, and GLP-1 on neurite outgrowth, length, and complexity in PA-treated primary cortical neurons using Sholl analysis. Our findings demonstrate the therapeutic potential of adiponectin, BDNF, and GLP-1 in enhancing synaptic plasticity within brains affected by metabolic imbalance. We underscore the need for additional research into the mechanisms by which adiponectin, BDNF, and GLP-1 influence neural complexity in brains with metabolic imbalances.
Purpose : To determine the optimal radiation dose in a localized non-Hodgkin's lymphoma of the head and neck in the treatment setting for combined chemoradiotherapy. Materials an Methods :Fifty-three patients with stage I and II diffuse large ceil non-Hodgkin's lymphoma of the head and neck, who were treated with combined chemoradiotherapy between 1985 and 1998 were retrospectively reviewed. The median age was 49 years, and the male-to-female ratio was approximately 1.6. Twenty-seven patients had stage 1 disease and 26 had stage II. Twenty-three patients had bulky tumors $(\geq5\;cm)$ and 30 had non-bulky tumors (<5 cm). The primary tumors arose mainly from an extranodal organ $(70\%)$, most cases involving Waldeyer's ring $(90\%)$. All patients except one were initially treated with $3\~6$ cycles of chemotherapy, which was followed by radiotherapy. Radiation was delivered either to the primary tumor area alone $(9\%)$ or to the primary tumor area plus the bilateral neck nodes $(91\%)$ with a minimum dose of 30 Gy $(range\;30\~60\;Gy)$. The failure patterns according to the radiation field were analyzed, and the relationship between the dose and the in-field recurrence was evaluated. Results : The 10-year overall survival and the 10-year disease free survival rates were similar at $75\%\;and\;76\%$, respectively. A complete response (CR) after chemotherapy was achieved in 44 patients $(83\%)$. Subsequent radiotherapy showed a CR in all patients. Twelve patients $(23\%)$ had a relapse of the lymphoma after the initial treatment. Two of these patients had a recurrence inside the radiation field. No clear dose response relationship was observed and no significant prognostic factors for the in-field recurrences were identified because of the small number of in-field recurrences. However, for patients with tumors <5 cm in diameter, there were no in-field recurrences after a radiation dose 30 Gy. The 2 in-field recurrences encountered occurred in patients with a tumor $\geq5\;cm$. Conclusion .A dose of 30 Gy is sufficient for local control in patients with a non-bulky (<5 cm), localized, diffuse large cell non-Hodgkin's lymphoma when combined with chemotherapy. An additional boost dose in the primary site is recommended for patients with bulky tumors $(\geq5\;cm)$.
Jang Ji-Young;Cho Moon-June;Kim Ki-Hwan;Song Chang-Joon;Kim Byoung-Kook;Kim Jun-Sang;Kim Jae-Sung
Korean Journal of Head & Neck Oncology
/
v.16
no.2
/
pp.172-176
/
2000
Objectives: To improve local control and reduce toxicity, 3-D conformal radiotherapy was used as a boost the primary tumor site following fractionated radiotherapy in patients with nasopharyngeal carcinoma. Materials and Methods: Eight patients with previously untreated nasopharyngeal carcinomas were treated with 3-D conformal radiotherapy following fractionated radiotherapy from September 1998 to April 2000. All patients had biopsy confirmation of disease before radiation therapy. Stages were II in 1, III in 5, and IV in 2. Two patients received cisplatin based chemotherapy in addition to radiation therapy; induction chemotherapy in 1, concurrent chemoradiation in 1. 3-D conformal radiotherapy delivered using 6MV Linac as a boost(range 25.2-28.8Gy, median 25.7Gy) following conventionally fractionated radiotherapy(range 50.4Gy). Average total dose ranged from 75.6-79.2Gy(median 76Gy). Follow-up time was 4-21 months(median 9.6 months). Results: Seven of 8 patients were evaluated radiologically within 3 months after completion of radiation therapy. All 7 patients were seen complete remission. One of 7 patients had distant metastasis after 5 months and local failure after 7 months. The tree interval of local recurrence was ranged from 4 - 21 months(median 10.2 months). One patient without radiological evaluation got complete remission clinically. Treatment related toxicity was grade 1-3 xerostomia, dysphagia, and mucositis. During 3-D conformal radiotherapy, there was no aggravation of any toxicity. Conclusion: Although the number of patients was small and follow-up period was short, 3-D conformal radiotherapy following conventional radiotherapy improved tumor control and dose escalation without increased toxicity. Survival and late toxicity should be evaluated through long term follow-up. In addition, it is necessary to confirm the benefits of 3-D conformal radiotherapy in nasopharyngeal carcinoma with randomized trial.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.26
no.4
/
pp.363-368
/
2000
The purposes of the study was to examine changes in thickness and strength of the rat femur after administration of sodium fluoride in the drinking water. 48 female Sprague-Dawley rats were randomly divided into 4 groups, and they were supplied with 0(control), 1, 5 and 50 ppm of fluoride in the drinking water ad libitum for 6 weeks. Rats were killed and both sides of femur were dissected. Bone strength was measured as the stress of failure of femur at the middle point and femoral neck with Instron. Histologic slides were prepared from the femur shaft with routine processing of fixing, demineralizing, embedding and HE staining. Thickness and area of cortical bone and medullary cavity were measured by using Camera Lucida and Image Analyzer. All the collected data were analyzed with one-way ANOVA, Duncan's multiple range test for post-hoc tests and ANCOVA using the SAS 6.12 package at the level of 0.05. Bone strength increased significantly in the animals given 1 and 5 ppm of fluoride in the water, as compared to the control group. There were significant decreases of stress at fracture in 50 ppmF group compared to the 1 and 5 ppmF groups. The similar trends of bone strength at the femoral neck fracture test, but there were no statistical significances. Cortical bone thickness and area of the femur increased in the 1 and 5 ppmF groups compared to the control. However, the thickness of 50 ppmF group also decreased significantly as compared to 1 and 5 ppmF groups. On the other hand, medullary thickness and area increased in all fluoride groups than control group. All of the findings presented support the conclusion that, low fluoride dosage used in water fluoridation could increase the bone strength and might have preventive effect on femur fracture.
Seong J. S.;Kim S. G.;Suh C. O.;Kim G. E.;Loh J. K.
Radiation Oncology Journal
/
v.4
no.1
/
pp.29-34
/
1986
Thirty-six patients with carcinoma of the tonsillar region treated with radical radiotherapy at Yonsei Cancer Center between Jan. 1971 and Dec. 1980 were retrospectively reviewed. The purpose of this study is to evaluate the clinical characteristics and the treatment results. Seventy-five per cent of patients were in advanced stage when they were first seen. Incidence of nodal involvement at the time of initial presentation was $64\%$. Bilateral nodal involvement was found in $19\%$ of cases. Three-year local control rates for T1, T2, T3, and T4 were $88\%,\;46\%,\;25\%,\;and\;11\%$, respectively. Advanced neck nodes were poorly controlled $(N1\;70\%,\;N2\;20\%,\;N3\;12\%)$. The prognosis is mainly affected by the status of the primary and neck nodes Overall three-year local control rate was $42\%$.
Kim, Dong-Wook;Kim, Chong-Kwan;Jung, Sung-Won;Kim, Hyeon-Soo
Clinics in Shoulder and Elbow
/
v.14
no.1
/
pp.27-34
/
2011
Purpose: We examined the clinical and radiological outcomes for displaced proximal humerus fractures that were treated with a PHILOS angular stable plate. Materials and Method: Forty four patients who underwent surgery between March 2007 and February 2010 were included in this study. All the cases were followed up for an average of 12 months. All the patients were examined and interviewed using the Visual Analog Scale (VAS) score, the Constant score and standardized X-rays to check the neck-shaft angle (NSA) and the presence of medial support. Results: The average Visual Analog Scale score was 2.8 points and the average Constant score was 70.5 points. The average neck shaft angle was $122.5^{\circ}$ and this was statistically significant between the good result group and the poor result group. There were 36 cases of the presence of medial support and 8 cases of the absence of medial support and the difference was statistically significant. Complications such as fixation failure happened in 12 cases. Conclusion: PHILOS angular stable plate fixation as an operative treatment for displaced proximal humerus fractures is a good and reliable treatment option.
The clinical and pathological features of 35 cases of anaplastic thyroid cancer were studied. These tumors occurred in 12 men and 23 women ranging in age from 19 to 83 years(mean age; 61.7 years). A rapidly enlarging thyroid mass was the most common presentation. The duration of the presence of mass varied from 20 days to 12 months with an average of 2.7 months. Systemic metastasis at the time of initial examination was found in 14 patients(40.0%) and the lung was the most common site of involvement. The overall rate of distant metastasis was about 65.7%. The tumors were subdivided morphologically into giant cell type of 10 cases, spindle cell type of 7 cases, epidermoid cell type of 1 cases, and mixed giant cell and spindle cell type of 5 cases. The mean survival period of 6 among 35 patients who had biopsy alone was 1.4 months. The 22 patients underwent the incomplete combined treatment modalities (palliative surgery with or without chemotherpy or radiation therapy) survived for a mean period of 3.0 months, among them, 7 patients who had surgery combined with chemotherapy and radiation therapy showed mean survival period of 3.7 months. The mean survival of 7 patients who had complete combined treatment modality(curative surgery combined with chemotherapy and hyperfractionated radiation therapy) was 6.6 months, only one patient survived for 21 months and one patient has been alive for 1 month after operation, and the others survived for a mean period of 4.8 months. So far, as of July 31, 1998, 34 patients among 35 were died(one has been survived for 1 month) despite the various treatment modalities, and the main cause of death were failure of local control and systemic metastasis. None of the various treatment modalities gave consistently favourable results. However, a combination of surgery, radiation therapy and chemotherapy seemed to have a slight positive effect on survival. Furthermore, the aggressive treatment modalities will be indicated only in the early diagnosed and minimal cases.
Purpose:To know the results after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer Methods and Materials:From August 1990 to December 2003, forty patients who were treated with induction chemotherapy and curative radiation therapy were analyzed retrospectively. Median age of patients was 60 years(range:40-78 years) and clinical stage was wholly stage 3 or 4. Induction chemotherapy used cisplatin with 5-FU or docetaxel, and its interval was 3 weeks. Irradiated radiation dose was 70 to 78Gy (median:70.8Gy). Results:Median follow-up time was 39.4 months(range:8-115 months). Treatment failures were observed in 52.5% patients, and main failure pattern was local recurrence in 16 patients. 3 and 5 year disease free survival were 52.6%, 48.2% respectively and values of overall survival were 60.0, 43.9% and median survival time was 44.7 months. Treatment response was only a prognostic factor for survival. Laryngeal preservation was observed in twenty-four(60.0%) patients. Conclusion:Initial primary tumor stage was a significant prognostic factor for laryngeal preservation, and response after radiation therapy was a prognostic factor for long-term survival after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer.
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