• Title/Summary/Keyword: Permanent Lesion

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Recent Perspectives on Oncoplastic Breast Surgery in Korea (우리나라의 종양성형학적 유방암 수술에 대한 최신 동향)

  • Kang, Taewoo
    • Journal of Life Science
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    • v.30 no.6
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    • pp.563-569
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    • 2020
  • Oncoplastic surgery (OPS) combines oncologically safe tumor resection with aesthetically satisfying reconstruction of defects using established plastic surgery techniques. OPS is characterized by initial excision as extensive as is beneficial for oncological safety, and, once sufficient resection is complete, displacement or replacement techniques are selected based on remnant volume. The size of the lesion and the individual patient are important factors when considering the appropriate approach, and when pre-operative imaging, including MRI, is used to determine the technique, the complete removal of cancer cells by permanent pathology is essential. A frozen section is used during the operation to reduce the reoperation rate, but it is difficult to cover the entire margin surface theoretically and even harder in practice. A recent report about adequate margins has empowered OPS in its oncological safety. Considering the patients to whom each modality could be applied, basic breast volume is an important factor, and this is influenced by ethnic differences. In Europe or the US, for example, the average breast size is 36D (600 ㎤) and reduction mammoplasty is predominantly used. However, the average size of patients in our institution is 33A (300 ㎤), and so quite different approaches are selected in most cases. New techniques involving radiofrequency and fluorescence have been proposed as safe and easily accessible ways of reducing complications.

AN INVESTIGATION OF THE FREQUENCY AND PATENCY OF ACCESSORY CANALS IN FURCATION AREAS OF PRIMARY MOLARS (유구치 치근분지부 부근관의 빈도와 개통성에 관한 연구)

  • Lee, Seung-Hyun;Kim, Sung-Ki;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.3
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    • pp.482-490
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    • 2006
  • Deep caries in primary molars without early intervention frequently induce a pulpal disease and consequent abscess lesion in surrounding tissue. Especially in many furcation radiolucent lesions of primary molars, accessory canals in furcation areas of primary molars play an important role in theses pathological progress. Although the studies of these communication canals in furcation area of human permanent molar well documented, there has been little research showing their existence in primary molar. For the purpose of understanding the morphological characteristics of accessory canals at furcation areas of primary molars and examining its frequency and patency, 52 specimen teeth were observed under the scanning electro-microscope and tested with dye penetration under vacuum pressure, and obtained the results as follows : 1. In SEM study, the frequency of accessory foramina viewed from the external and internal furcation area was 60% and 35% respectively. Likewise the diameter of the accessory canals was within the range of $11{\sim}107{\mu}m$ and $12{\sim}62{\mu}m$ respectively. 2. The frequency of patent accessory canals evidenced by the dye penetrated under the vacuum suction at furca areas in primary molars was 50% among the 20 specimen teeth tested.

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Effects of Pulsed Nd:YAG Laser Irradiation and Fluoride Compound Application on Surface Hardness of Incipient Carious Lesion in Enamel of Bovine Teeth (Pulsed Nd : YAG 레이저 조사와 불소 화합물 도포가 초기 우식 법랑질의 표면 경도에 미치는 영향)

  • Jun-Bong Kwag;Woo-Cheon Kee
    • Journal of Oral Medicine and Pain
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    • v.21 no.2
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    • pp.207-224
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    • 1996
  • This study was designed to determine the most effective concentration of fluoride and energy density of laser irradiation for the anticarious effect. For this study surface hardness in enamel was measured before and after irradiation with pulsed Nd;YAG laser and the topical application of fluoride. Of the permanent mandibular anterior hovine teeth, healthy, carious free ones were used. Three hundred specimens were made. Specimens within 25~45 Vickers hardness numbers were assigned to 20 control and experimental stoops ; each containing 15 specimens. After forming artificial carious lesions, 10 J/$\textrm{cm}^2$, 20 J/$\textrm{cm}^2$, and 30 J/$\textrm{cm}^2$ energies were irradiated on the enamel surface of each experimental group. Also NaF, NH4F, Elmex gel(amine fluoride) and APF gel fluoride compounds were applied topically. Next, all the specimens were placed into the pH circulatory procedures for eight days. Vickers hardness numbers were measured using a microhardness tester. Surface changes of the enamel were observed using an scanning electron microscope. The comparative ana1ysis yielded the following results : 1. The reduction of surface hardness of the enamel surface was less in all groups with fluoride application than in the group without fluoride application. 2. The APF gel croup with 10 J/$\textrm{cm}^2$ irradiation showed the lowest reduction of surface hardness. 3. The reduction of surface hardness of the enamel surface in the group of laser irradiation without fluoride application not showed any significant difference according to the energy density of the laser. 4. Under the scanning electron microscope, in enamel irradiated with 10J/$\textrm{cm}^2$ showed appearance similar to acid etching surface. In enamel irradiated with 20 J/$\textrm{cm}^2$, line enamel crack was detected. In enamel irradiated with 30j/$\textrm{cm}^2$, severe enamel crack and fusion of enamel were detected. These results suggest that one could obtain the best anticariogenic effects without damage to teeth in the group of application of APF gel after laser irradiation with 10 J/$\textrm{cm}^2$.

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$H\"{u}rthle$ Cell Tumor of the Thyroid (갑상선의 $H\"{u}rthle$씨 세포 종양)

  • Chung Woong-Youn;Kim Suk-Ju;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.206-212
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    • 1997
  • H$\"{u}$rthle cell neoplasm of the thyroid gland is an uncommon, but potentially malignant lesion. However, in many instances, the malignant potential of the H$\"{u}$rthle cell neoplasm is very difficult to judge histologically. For this reason, the biologic behavior of this tumor and its optimal treatment have come under considerable debate in recent years. In order to review the clinicopathologic features of the H$\"{u}$rthle cell neoplasm and to determine its optimal treatment modalities, we studied 26 patients with path logical proof of H$\"{u}$rthle cell tumor from January 1987 to September 1997. We also performed an immunohistochemical study using the monoclonal antibodies against antigen CD34 for the angiogenic activity of this tumor and evaluated the differences of microvessel density(MVD) between benign and malignant tumors. The age of the patients ranged from 1 to 71 years with a mean of 44.2 years. There were 6 males and 20 females(M : F= 1 : 3.3). The accuracies of fine needle aspiration biopsy and frozen section were very low; 6.3% and 34.8%, respectively. There were 20 benign tumors and 6 malignant tumors(23.1%). All the malignant tumors were microinvasive(intermediate) type which had minimal capsular invasion and most of them(5 cases) were diagnosed postoperatively. Any specific clinicopathologic differences were not seen between benign and intermediate groups. Most of the cases had conservative surgeries(15 ipsilateral lobectomy-isthmusectomy, 7 subtotal thyroidectomy) while total thyroidectomy was performed in 4 cases. Of the cases with malignant tumor, 2 had ipsilateral lobectomy-isthmusectomy, 3 had subtotal thyroidectomy and the remaining 1 had total thyroidectomy. Mean size of the tumors was 3.0 cm(0.1- 8.5 cm) in the greatest diameter and multiple tumors were seen in 6 cases(23.1 %). During the follow-up period, only one recurrence(3.8%) of benign tumor occurred but distant metastasis or cause-specific death was seen in the benign or intermediate groups. Mean MVDs of the benign(n=13) and intermediate(n=6) groups were $121.7{\pm}35.3$ and $114.3{\pm}31.7$, respectively and there was no statistical significance between them. In conclusion, because of the low accuracies of fine needle aspiration biopsy and frozen section for the H$\"{u}$rthle cell neoplasm, the extent of surgery could be individualized based on permanent pathologic examination; Conservative surgery would be adequate for patients with benign or intermediate H$\"{u}$rthle cell neoplasm and total or near-total thyroidectomy for those with definite malignancy.

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PULPAL AND PERIAPICAL REACT10N TO FORMOCRESOL AND DEPULPIN® IN THE RAT TEETH (백서에서 Depulpin®과 Formocresol에 대한 치수와 치근단 조직의 반응)

  • Moon, Hyung-In;Kim, Sun-Ho;Hwang, Yun-Chan;Oh, Byung-Ju;Hwang, In-Nam;Kim, Sun-Hun;Jeong, Sun-Wa;Youn, Chang;Oh, Won-Mann
    • Restorative Dentistry and Endodontics
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    • v.27 no.4
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    • pp.355-362
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    • 2002
  • One fifth dilution of formocresol is usually used for pulpotomy of the primary teeth and emergency pulpotomy of the permanent teeth. However the use of formaldehyde has been subjected to criticism because it may be absorbed into the blood stream and become distributed systemically, it nay also alter the pulp tissue rendering it immunologically active, and have carcinogenic potential. Recently Depulpin$^{\circledR}$(VoCo., Germany) gains popularity as a devitalizing agent during root canal therapy in spite of high concentration of 49 % paraformaldehyde because it facilitate devitalization of pulp and make root canal therapy easier But there have been not enough publications about the reaction of pulp and periapical tissue caused by Depulpin. This study was performed to evaluate the histological changes in pulp and periapical tissue of rats after pulpotomy using formocresol and Depulpin and to elucidate the toxic effects of these agents. Thirty six Sprague-Dawley rats were anesthetized by intraperitoneal injection of ketamine Maxillary first molar teeth were used for pulpotomy with formocresol and Depulpin. Rats were sacrificed after 2 days, 4 days, 1 week, 2 weeks, 3 weeks and 4 weeks respectively. Specimens were histologically observed by light microscope changes in pulp and periapical tissue. The obtained results were as follows. 1. Formocresol group A zone of fixed tissue. in which odontoblasts could clearly be defined, was present directly underneath the pulpotomy dressing in almost all teeth of this group. This was followed by an area of necrotic tissue which resembled dried out fibrous tissue with no cellular detail except some pyknotic nuclei. In the specimens of after 2 days, 4 days, 1 week, 2 weeks in which vital tissue was present, it was separated from the fibrous area by a zone of inflammation. In the specimens of after 3 weeks and after 4 weeks, inflammatory infiltrate was in the periodontal ligament adjacent to the apical foramina of the teeth. 2. Depulpin$^{\circledR}$ group The area of necrotic tissue which had no cells and fibers, was present adjacent to the dressing. This was followed by dried out fibrous tissue with no cellular details except some pyknotic nuclei, A short stump of vital pulp with odontoblasts was present at the end of the canal after 2 days. Inflammatory infiltrate was in the periodontal ligament after 4 days and after 1week. Severe root resolution and necrosis of periapical tissue opposite the root resorption site were defined after 2 weeks and after 3 weeks. Periapical lesion which consist of necrotic tissue surrounded by a fibrous connective wall, was found after 4 weeks. The results indicated that Depulpin can cause more adverse reaction to the dental pulp and periapical tissue than formocresol, and further studies are needed for its clinical use with safety.

CASE REPORTS OF TREATMENT OF ERUPTION-DISTURBED MX. FIRST MOLAR BY SURGICAL EXPOSURE (맹출 장애를 가진 상악 제1대구치의 외과적 노출을 이용한 치험례)

  • Seok, Choong-Ki;Nam, Dong-Woo;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.11-18
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    • 2004
  • The eruption of permanent teeth represents the movement in the alveolar bone before appearance in oral cavity, to the occlusal plane after appearance in oral cavity, and additive movement after reaching th the occlusal plane. Tooth eruption is mostly controlled by genetic signals. The eruption stage is divided to preeruptive alveolar stage, alveolar bone stage, mucosal stage according to the process of growth and development. If the disturbance is occured in any stage of eruption, tooth does not erupt. The cause of eruption disturbance are ectopic position of the tooth germ, obstruction of the eruption path and defects in the follicle or PDL. In the treatment of eruption disturbance, surgical procedures are commonly used. There are three kind of surgical procedure ; surgical exposure, surgical repositioning, surgical exposure and traction Surgical exposure is basic procedure. This involves removal of mucosa, bone, lesion that are surrounding the teeth, dental sac when necessary to maintain a patent channel between the crown and the normal eruptive path into the oral cavity. To ensure this patency, many techniques including cementation of a celluloid crown, packing with gutta-percha or zinc oxide-eugenol, or a surgical pack, are used. When surgical exposure is conducted, operators should not expose any part of cervical root cement and not injure periodontium or root of adjunct tooth. After surgical exposure, tooth should be surrounded by keratinized gingiva. There is direct relationship between the extent of development of pathophysiologic aberrations and the intensity of the manipulative injury inflicted on the tooth by surgical treatment, so operator should consider this thing. In these cases, surgical exposure is conducted on Maxillary 1st milars that have a eruption disturbance and improve the eruption disturbance effectively.

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Clinical Experience of LINAC-based Stereotactic Radiosurgery for Angiographically Occult Vascular Malformations (혈관조영상 잠재혈관기형에 대한 선형가속기형 정위방사선수술의 임상경험)

  • Kim Dae Yong;Ahn Yong Chan;Lee Jung Il;Nam Do-Hyun;Lim Do Hoon;Lee Jeong Eun;Yeo Inhwan;Huh Seung Jae;Noh Young Joo;Shin Seong Soo;Hong Seung-Chyul;Kim Jong Hyun
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.1-9
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    • 2001
  • Purpose : To establish the role of stereotactic radiosurgery (SRS) for the treatment of patients with angiographically occult vascular malformation (AOVM). Materials and Methods : Eleven patients (12 lesions) with AOVM were treated with linear accelerator-based SRS between February 1995 and December 1999. A magnetic resonance imaging of each patients showed well-circumscribed vascular lesion with reticulated core of heterogeneous signal intensity and peripheral rim of low signal intensity. SRS were peformed with the median peripheral dose of 16 Gy (range 13~25). A single isocenter was used with median collimator size of 14 mm (range 8~20) diameter. Results : With a median follow-up period of 42 months (range 12~56), rebleeding occurred in 3 AOVMS at 5, 6 and 12 months after SRS but no further bleeding did. Two patients experienced radiation-induced necrosis associated with permanent neurologic deficit and one patient showed transient edema of increased 72 signal intensity. Conclusion : SRS may be effective for the prevention of rebleeding in AOVM located in surgically inaccessible region of the brain. Careful consideration should be needed in the decision of case selection and dose prescription because the incidence of radiation-induced complications is too high to be accepted.

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