• Title/Summary/Keyword: Pathology, surgical

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Pancreas-preserving limited duodenal resection: Minimizing morbidity without compromising oncological adequacy

  • Ajay Sharma;Anand Nagar;Peeyush Varshney;Maunil Tomar;Shashwat Sarin;Rajendra Prasad Choubey;V. K. Kapoor
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.2
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    • pp.149-158
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    • 2022
  • Backgrounds/Aims: Pancreaticoduodenectomy is the most common procedure for the management of duodenal pathologies. However, it is associated with substantial morbidity and a low risk of mortality. Pancreas-preserving limited duodenal resection (PPLDR) can be performed under specific scenarios. We share our experience with PPLDR and its outcome. Methods: We retrospectively analyzed a prospectively maintained database of patients undergoing limited duodenal resection in the form of wedge (sleeve) resection or segmental resection of one or more duodenal segments from March 2016 to March 2021 at a tertiary care center in North India. Results: During the study period, 10 patients (including 9 males) underwent PPLDR. Five of these 10 patients showed primary duodenal or proximal jejunal pathology, while the remaining five had duodenal pathology involving an adjacent organ tumor. Four patients underwent wedge (sleeve) resection, while the remaining six underwent segmental duodenal resection of one or more duodenal segments. Mean hospital stay was 6 days (range, 3-11 days) without 30-day mortality. Morbidity occurred in 4 patients (Grade I-II, n = 3; Grade III, n = 1). All patients were alive and disease-free at the time of last follow-up. The mean follow-up duration was 23 months (range, 2-48 months). Conclusions: PPLDR is a safe and effective alternative for pancreaticoduodenectomy when selected carefully for specific tumor types and location.

Clinical interventions and speech outcomes for individuals with submucous cleft palate

  • Jung, Seung Eun;Ha, Seunghee;Koh, Kyung S.;Oh, Tae Suk
    • Archives of Plastic Surgery
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    • v.47 no.6
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    • pp.542-550
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    • 2020
  • Background This study aimed to identify the initial diagnostic characteristics and treatment status of children with submucous cleft palate (SMCP) and to examine the relationship between the timing of surgical correction and the degree of articulation and resonance improvement. Methods This retrospective study included 72 children diagnosed with SMCP between 2008 and 2016. The evaluation criteria were the age of the initial visit, total number of visits, age at the end of treatment, speech problems, resonance problems, and speech therapy. Results Children with SMCP first visited the hospital at an average age of 34.32 months, and speech problems were identified at an average age of 48.53 months. Out of 72 children, 46 underwent surgery at an average age of 49.74 months. Four of these children required secondary surgery at an average age of 83.5 months. Among the children who underwent surgery before 3 years of age, 70% exhibited articulation improvements, with mild-to-moderate hypernasality. Articulation improvements showed no statistically significant differences according to age at the time of surgery. However, children who underwent surgery before 4 years had a better hypernasality rating than those who underwent surgery after 4 years of age. Conclusions Children with SMCP tend to undergo delayed treatment because the anatomical symptoms in some children with SMCP are unclear, and surgical interventions are considered only after speech problems are clarified. Starting interventions as early as possible reduces the likelihood of receiving secondary surgery and speech therapy, while increasing expectations for positive speech function at the end.

Management of rare ectopic teeth eruption: case series

  • Olutayo, James;Ibrahim Kayode Suleiman;Mukhtar Modibbo Ahmad;Hector Oladapo Olasoji
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.2
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    • pp.86-90
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    • 2023
  • Objectives: An ectopic tooth is a rare eruption of a tooth out of the normal dental apparatus and occurs commonly with the third molar. Thus, in this study, we reported a case series of ectopic teeth in rare jaw locations and highlight the associated pathology and our experience in the surgical management. Patients and Methods: All cases of ectopic tooth managed at the Department of Oral and Maxillofacial Surgery, University of Maiduguri Teaching Hospital from January 2011 to December 2020 were reviewed. The information retrieved includes biodata, location of the ectopic tooth, signs, symptoms, type of tooth and associated pathology, surgical approach and complications. Results: Ten cases of ectopic teeth were identified over the study period. This comprised 80.0% males with a mean age was 23.3 years. The antrum and lower border of the mandible accounted for 50.0% and 40.0% of the ectopic locations, respectively. Dentigerous cyst was the most associated pathology (70%) and usually presented with pain and swelling. Surgical intervention predominantly via the intraoral route was performed if indicated. Conclusion: Ectopic teeth are rare and not always associated with pathology. A high index of suspicion and radiological investigation are necessary for diagnosis. A more extensive multi-center study is however recommended to determine the prevalence of ectopic teeth other than the third molar.

Impact of Non-Calcified Specimen Pathology on the Underestimation of Malignancy for the Incomplete Retrieval of Suspicious Calcifications Diagnosed as Flat Epithelial Atypia or Atypical Ductal Hyperplasia by Stereotactic Vacuum-Assisted Breast Biopsy

  • Chi-Chang Yu;Yun-Chung Cheung;hir-Hwa Ueng;Shin-Cheh Chen
    • Korean Journal of Radiology
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    • v.21 no.11
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    • pp.1220-1229
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    • 2020
  • Objective: Stereotactic vacuum-assisted breast biopsy (VABB) is considered a reliable alternative to surgical biopsy for suspicious calcifications. In most cases, the management of flat epithelial atypia (FEA) and atypical ductal hyperplasia (ADH) after VABB with residual calcifications requires surgical excision. This study aimed to evaluate the impact of pathology of non-calcified specimens on the underestimation of malignancy. Materials and Methods: We retrospectively reviewed 1147 consecutive cases of stereotactic VABB of suspicious calcifications without mass from January 2010 to December 2016 and identified 46 (4.0%) FEA and 52 (4.5%) ADH cases that were surgically excised for the retrieval of residual calcifications. Mammographic features and pathology of the calcified and non-calcified specimens were reviewed. Results: Seventeen specimens (17.3%) were upgraded to malignancy. Mammographic features associated with the underestimation of malignancy were calcification extent (> 34.5 mm: odds ratio = 6.059, p = 0.026). According to the pathology of calcified versus non-calcified specimens, four risk groups were identified: Group A (ADH vs. high-risk lesions), Group B (ADH vs. non-high-risk lesions), Group C (FEA vs. high-risk lesions), and Group D (FEA vs. non-high-risk lesions). The lowest underestimation rate was observed in Group D (Group A vs. Group B vs. Group C vs. Group D: 35.0% vs. 20.0% vs. 15.0% vs. 3.6%, p = 0.041, respectively). Conclusion: Considering that the calcification extent and pathology of non-calcified specimens may be beneficial in determining the likelihood of malignancy underestimation, excision after FEA or ADH diagnosis by VABB is required, except for the diagnoses of FEA coexisting without atypia lesions in non-calcified specimens.

Residual Disease Following Conization of Women with Stage IA-IB1 Cervical Carcinoma in a High Incidence Region

  • Chatchotikawong, Usanee;Ruengkhachorn, Irene;Leelaphatanadit, Chairat
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7383-7387
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    • 2014
  • Background: To determine rates of residual disease along with influencing factors in women with stage IA to IB1 cervical carcinoma after conization. Materials and Methods: A retrospective study was conducted of medical records of 198 stage IA to IB1 cervical carcinoma patients who had undergoing cervical conization followed by primary surgical treatment during 2006-2013. Independent factors correlating with residual carcinoma in subsequent surgical specimens were analyzed by stepwise regression analysis. Results: Mean age was 48.9 years. Cone specimens demonstrated free margins in 36 women (18.8%). In case of having disease at margin, high-grade cervical intraepithelial neoplasia (CIN) and carcinoma were evidenced in 58 and 97 women, respectively. Pathology of subsequent specimens revealed residual carcinoma in 78 women (39.4%), high-grade CIN or adenocarcinoma in situ (AIS) in 45 (22.7%), and no residual pathology in 75 (37.9%). Age more than 35 years, postmenopausal status, having symptoms, diseases or invasive lesions at conization margins or disease on endocervical aspect, and higher stage were significantly correlated with residual cancer in surgical treatment specimens. On regression analysis, postmenopause and stage were independent factors associated with residual carcinoma.Conclusions: Patient and tumor characteristics are predictive factors for residual cancer in the studied group of women.

TRAUMATIC NEUROMA : FOUR CASES REPORT (외상성신경종 4례)

  • Jang, Hyun-Seon;Kim, Su-Gwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.4
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    • pp.357-360
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    • 2001
  • The traumatic neuroma is uncommon in the mouth. Clinically, the majority of traumatic neuromas are painless, but may give rise to neuralgic pain. The traumatic neuroma is most often diagnosed in the adult of life. They are found as small nodules in the tissues and surgical excision is curative. Four cases of traumatic neuroma was found from the files of the Department of Oral Pathology at Chosun University School of Dentistry by a 20-year retrospective study. 3 cases were male and one was female. The chief complaint of the four patients was facial asymmetry, numbness, sharp pain, and masticatory difficulty, respectively. Of the our patients, 3 cases were 55, 56, and 65 years old, respectively and one was 7 years old. Our patients were treated by surgical excision. No recurrences have been found.

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4 Cases of Traditional Korean Medicine Treatment for Patients with Surgical Margin Positive after LEEP in Cervical Intraepithelial Neoplasia (LEEP시술 절단면에 병변이 잔존하는 자궁경부상피내종양(CIN) 한의학적 치험 4례)

  • Lee, Eun;Lee, Kyung-yeob;Yu, Byung-kook
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.3
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    • pp.149-158
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    • 2020
  • The positive margins after LEEP(loop electrosurgical excision procedure) in cervical intraepithelial neoplasia are generally considered to be a risk factor for the recurrence or persistence of CIN currently. When positive margin exists, secondary LEEP or hysterectomy is performed. The aim of this study was to observe effects of Traditional Korean Medicine treatment for patients with surgical margin positive after LEEP. It was conducted retrospective chart review for 4 patients with the surgical margin positive after LEEP, who were scheduled to have secondary LEEP 3 months later. Patients were treated with herbal medicine, pharmacopuncture and herbal liquid vaginal treatment. They were followed up by cytology, colposcopy, human papillomavirus DNA test and punch-biopsy at 1, 3 and 6 months. After 3 month of treatment, three patients did not need secondary LEEP because of normal cytology, negative HPV status and normal colposcopy, while the other patient underwent secondary LEEP because of ASCUS cytology and positive high-risk HPV. After 6 month of treatment, the other patient also had normal cytology, negative HPV status and normal colposcopy and had been in fifth week of pregnancy. This study suggest that Traditional Korean Medicine treatment may be an effective to the patients with surgical margin positive after LEEP in cervical intraepithelial neoplasia.

Angioleiomyoma of the oral cavity: a case report and brief review of the literature

  • Matiakis, Apostolos;Karakostas, Panagiotis;Pavlou, Achilleia-Maria;Anagnostou, Eleftherios;Poulopoulos, Athanasios
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.3
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    • pp.136-139
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    • 2018
  • This study presents a case of an oral angioleiomyoma along with its clinical diagnostic approach and laboratory confirmation. The differential diagnosis, especially from angioleiomyosarcoma, is also included. A 51-year-old patient presented with a tumor-like lesion on his upper labial mucosa. The clinical examination revealed a benign lesion that was surgically removed. Histopathological and immunohistochemical examinations confirmed the diagnosis of an oral angioleiomyoma. The post-surgical period was uneventful. No recurrence had occurred after a year of follow-up surveillance. Oral angioleiomyoma is a very rarely occurring oral lesion. Clinically, it may mimic some benign lesions, including fibroma, pyogenic granuloma or minor salivary gland tumor. Surgical excision is the treatment of choice. Histological and immunohistochemical examination can confirm the diagnosis. The differential diagnosis is crucial to rule out angioleiomyosarcoma.

Ganglion Cysts in Three Dogs (개의 결절종(ganglion cyst) 3 예)

  • Cho, Ho-Seong;Cho, Kyoung-Oh;Park, Nam-Yong
    • Korean Journal of Veterinary Pathology
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    • v.5 no.2
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    • pp.67-70
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    • 2001
  • Spontaneous subcutaneous cysts were detected from three dogs, being a 4-year-old male shih tzu, an 11-month-old female britany spaniel and a 9-month-old male mongrel. All the cysts were occurred around the joints (one elbow's and two shoulderes', respectively). After surgical removal, the lesions did not recur for 6 months follow-up. Neither cyst communicated with the joint cavity. Grossly, the subcutaneous ovoid cysts had moderate to abundant mucinous fluid. Histologically, the cyst wall consisted of inner myxomatous and outer immature connective tissue. Some parts of the cyst wall had various stages of myxoid metaplasia of collagen tissue leading to new cyst formation. The true lining cells of the inner cyst wall were not observed in all the cysts. From these results, these cases were diagnosed as subcutaneous ganglion cysts. This is the first report of canine subcutaneous ganglion cysts in Korea.

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Peripheral Giant Cell Granuloma in a Dog (개의 말초성 거대세포 육아종(peripheral giant cell granuloma) 증례 보고)

  • Cho, Ho-Seong;Cho, Kyoung-Oh;Park, Nam-Yong
    • Korean Journal of Veterinary Pathology
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    • v.5 no.2
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    • pp.79-80
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    • 2001
  • A gingival mass was detected from a 1-year-old female Great Dane dog. After surgical removal, the lesions recurred in 2 weeks and died of septicemia. Characteristic histologic features were large numbers of multinucleated giant cells which were connected with capillary vessels. Neovascularization was prominent with mononuclear and polynuclear cell infiltration. Overall features of these lesions except for giant cell infiltration were similar to granuloma. From these results, a gingival mass excised from a dog was diagnosed to be a peripheral giant cell granuloma (PGCG). This is the first report of canine subcutaneous PGCG in Korea.

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