• Title/Summary/Keyword: Surgical diagnosis

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Gallbladder Carcinoma: Analysis of Prognostic Factors in 132 Cases

  • Wang, Rui-Tao;Xu, Xin-Sen;Liu, Jun;Liu, Chang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2511-2514
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    • 2012
  • Objective: To evaluate the prognostic factors of gallbladder carcinoma. Methods: Presentation, operative data, complications, and survival outcome were examined for 132 gallbladder carcinoma patients who underwent gallbladder surgery in our unit during 2002-2007, and follow-up results were obtained from every patient for univariate and multivariate survival analysis. Results: The univariate analysis showed that gallbladder lesion history, tumor cell differentiation, Nevin staging, preoperative lymph node metastasis and the surgical approach significantly correlated with the prognosis of the patients (p<0.05). The results of the multivariate analysis (Cox regression) showed that gallbladder lesion history, Nevin staging and the surgical approach were independent predicators with relative risks of 6.9, 4.4, 2.8, respectively (p=0.002, 0.003, 0.008). Conclusion: Gallbladder lesion history, Nevin staging and the surgical approach are independent prognostic factors for gallbladder carcinoma, a rapidly fatal disease. Therefore, early diagnosis, anti-infective therapy and radical surgery are greatly needed to improve the prognosis of gallbladder carcinoma.

Comparision of Imaging Features with Surgical Findings in the Patients with Craniosynostosis (두개골조기유합증 환자에서 영상소견과 수술소견의 비교)

  • Kim, Hyung Soo;Park, Se-Hyuck;Cho, Byung Moon;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1417-1421
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    • 2001
  • Objective : The purposes of this study are to compare imaging features with operative findings and to determine significance of imaging studies for early detection of craniosynostosis(CS). Methods : Plain radiograph of skull and three-dimensional(3D) CT reconstruction were analyzed in 10 consecutive patients with CS to assess the presence and the extent of synostosis. The radiological findings were investigated and compared with operative findings. Results : The locations of lesion were coronal suture in 6, sagittal suture in 3 and multiple sutures in one patient, and the age ranged 1 to 53 months(mean age : 17.4 months). Reconstructive procedures with or without advancement of supraorbital rim were performed in coronal CS patients and ${\pi}$-procedures or synostectomy were done in sagittal CS patients. Radi-ological abnormalities such as sutural indistinctness or sclerosis, bony ridge, bossing and other bony deformities were nearly consistent with surgical findings. Conclusion : The interpretation of imaging study are very important for early detection of craniosynostosis, especially, the plain radiographs of skull. Also 3D CT imaging is helpful in diagnosis and surgical planing of craniosynostosis. There are no significant differences between imaging features and operative findings in CS patients.

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Simultaneous Paraspinal and Midline Approach for Upper Lumbar Disc Herniation : Technique to Prevent Lamina Fracture

  • Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.111-115
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    • 2005
  • Objective : Upper lumbar disc herniation is rare disease, compared with lower. The lamina of this high level lumbar vertebra is narrower than that of low level, and this have taken surgeon into important consideration for surgical methods because partial removal of lamina for discectomy weakens the base of the articular process and may result in fracture. The authors an accurate preoperative diagnosis that enables the surgeon to operative approach for preserving the facet joint. Methods : Thirteen patients with upper lumbar disc herniation have underone surgical procedure by midline approach for removal of ruptured disc fragment and paraspinal approach for removal of residual disc materials simultaneously without instrumentation. All patients who underwent surgery were analyzed and long-term follow-up was conducted. Results : At a mean follow-up of 24months, there were complete resolution of presenting radiating leg pain in 85% of the patients, 7.5% were left with minimal residual discomfort, and 7.5% derived little or no benefit from surgery. The follow-up radiologic findings of all patients shows that lamina and facet joint have preserved safely and no instability. Conclusion : Simultaneously, paraspinal with midline approach provides highly satisfactory operating methods by simplifying exposure and greatly limiting the risk of complications. This provides the basis for a planned surgical approach in which destruction of the facet joint can be avoided.

Primary Cutaneous Mucinous Carcinoma Treated with Narrow Surgical Margin

  • Choi, Jin-Hee;Kim, Seung Chan;Kim, Jiye;Chung, Yoon Kyu
    • Archives of Craniofacial Surgery
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    • v.17 no.3
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    • pp.158-161
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    • 2016
  • Primary cutaneous mucinous carcinoma (PCMC) is a rare malignant tumor of eccrine origin. Clinically, the carcinoma presents as a solitary, slow growing, and painless nodule. For this reason, this tumor is often considered to be a benign mass in the preoperative setting. The lesion is, however, malignant in nature and has a tendency for local recurrence and infrequent metastasis. Wide local excision is the treatment of choice. However, few reports exist with information regarding surgical margins and clinical outcomes. Herein, we report a case of PCMC excised with a narrow surgical margin and review the relevant literature. A 49-year-old man presented with a small cutaneous nodule of the right cheek. The mass was excised without any margin, but pathologic examination revealed histology of mucinous carcinoma. Because of this, the operative site was re-excised with a 5-mm margin, and the wound was closed using a V-Y advancement flap. Systemic work-up did not reveal other potential metastatic primary, for a final diagnosis of PCMC. We report this case of PCMC, treated with relatively narrow margin in a patient with good prognostic factors.

Perigastric Lymph Node Metastasis from Papillary Thyroid Carcinoma in a Patient with Early Gastric Cancer: The First Case Report

  • Jeong, Gui-Ae;Kim, Hyung-Chul;Kim, Hee-Kyung;Cho, Gyu-Seok
    • Journal of Gastric Cancer
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    • v.14 no.3
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    • pp.215-219
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    • 2014
  • Distant metastasis from papillary thyroid carcinoma (PTC), particularly from papillary thyroid microcarcinoma, is rare. We present a case of perigastric lymph node metastasis from PTC in a patient with early gastric cancer and breast cancer. During post-surgical follow-up for breast cancer, a 56-year-old woman was diagnosed incidentally with early gastric cancer and synchronous left thyroid cancer. Therefore, laparoscopic distal gastrectomy with lymph node dissection and left thyroidectomy were performed. On the basis of the pathologic findings of the surgical specimens, the patient was diagnosed to have papillary thyroid microcarcinoma with perigastric lymph node metastasis and early gastric cancer with mucosal invasion. Finally, on the basis of immunohistochemical staining with galectin-3, the diagnosis of perigastric lymph node metastasis from PTC was made. When a patient has multiple primary malignancies with lymph node metastasis, careful pathologic examination of the surgical specimen is necessary; immunohistochemical staining may be helpful in determining the primary origin of lymph node metastasis.

Surgery-first approach using a three-dimensional virtual setup and surgical simulation for skeletal Class III correction

  • Im, Joon;Kang, Sang Hoon;Lee, Ji Yeon;Kim, Moon Key;Kim, Jung Hoon
    • The korean journal of orthodontics
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    • v.44 no.6
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    • pp.330-341
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    • 2014
  • A 19-year-old woman presented to our dental clinic with anterior crossbite and mandibular prognathism. She had a concave profile, long face, and Angle Class III molar relationship. She showed disharmony in the crowding of the maxillomandibular dentition and midline deviation. The diagnosis and treatment plan were established by a three-dimensional (3D) virtual setup and 3D surgical simulation, and a surgical wafer was produced using the stereolithography technique. No presurgical orthodontic treatment was performed. Using the surgery-first approach, Le Fort I maxillary osteotomy and mandibular bilateral intraoral vertical ramus osteotomy setback were carried out. Treatment was completed with postorthodontic treatment. Thus, symmetrical and balanced facial soft tissue and facial form as well as stabilized and well-balanced occlusion were achieved.

Accuracy of Maxillary Segmental Osteotomy using 3D Simulation: A Case Report

  • Lee, Yong Bin;Yeo, Gisung;Jung, Young-Soo;Jung, Hwi-Dong
    • Journal of International Society for Simulation Surgery
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    • v.2 no.2
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    • pp.71-75
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    • 2015
  • To overcome limitations of conventional diagnosis and planning for orthognathic surgery, surgeons have begun to use 3-dimensional (3D) virtual simulation to plan complex orthognathic surgery. In many literatures, it has shown that better surgical outcome achieved with 3D virtual simulation than that with conventional methods. But, there is still lack of data about accuracy of maxillary segmental surgery with 3D virtual simulation. The purpose of this paper was to report the case of maxillary segmental orthognathic surgery with 3D virtual simulation and to assess the actual surgical outcome. Though the result was clinically acceptable, discrepancy between 3D simulation and actual surgery was not superior compared with conventional method. The accuracy of 3D simulation surgery and intermediate wafer fabrication for maxillary segmental surgery needs to be improved. Advancement in 3D software program and careful surgical technique will make it more precise and reliable method.

Importance of immediate surgical intervention and antifungal treatment for rhinocerebral mucormycosis: a case report

  • Kim, Jin-Geun;Park, Hye Jeong;Park, Jung Hyun;Baek, Jiwoong;Kim, Hyung Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.5
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    • pp.246-250
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    • 2013
  • Rhinocerebral mucormycosis (RCM) is an opportunistic, potentially life-threatening fungal disease. This infective disease invades not only the facial sinuses, but also the maxilla, zygoma, and rhino-cerebral structures with a massive destruction of the facial skeletons and soft tissue. This disease progresses within various underlying diseases, such as diabetes mellitus, hematologic malignancy, renal failure, and systemic immunodepression. The relationship between mucormycosis and these underlying conditions have been discussed extensively in the literature. The authors studied 6 cases of RCM diagnosed by a tissue biopsy and treated at the department of oral and maxillofacial surgery, from 1997 to 2012. Patients were treated with several kinds of surgical interventions and antifungal agents, and their clinical & radiological signs, underlying conditions, surgical methods, and outcomes were analyzed.

Evaluation of dental panoramic radiographic findings in edentulous jaws: A retrospective study of 743 patients "Radiographic features in edentulous jaws"

  • Kose, Taha Emre;Demirtas, Nihat;Karabas, Hulya Cakir;Ozcan, Ilknur
    • The Journal of Advanced Prosthodontics
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    • v.7 no.5
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    • pp.380-385
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    • 2015
  • PURPOSE. The aim of this study was to determine the frequency of significant panoramic radiographic findings and eventual treatment requirements before conventional or implant supported prosthetic treatment in asymptomatic edentulous patients. MATERIALS AND METHODS. A total of 743 asymptomatic edentulous patients were retrospectively evaluated using a digital panoramic system. We analyzed the radiographic findings, including impacted teeth, retained root fragments, foreign bodies, severe atrophy of the posterior maxillary alveolar bone, mucous retention cysts, soft tissue calcifications and radiopaque-radiolucent conditions. RESULTS. Four-hundred-eighty-seven (65.6%) patients had no radiographic finding. A total of 331 radiographic findings were detected in 256 (34%) patients. In 52.9% (n=175) of these conditions, surgical treatment was required before application of implant-supported fixed prosthesis. However, before application of conventional removable prosthesis surgical treatment was required for 6% (n=20) of these conditions. CONCLUSION. The edentulous patients who will have implant placement for implant-supported fixed prosthesis can frequently require additional surgical procedures to eliminate pathological conditions.

Surgery of Benign Laryngeal Mucosal Lesions (후두 양성점막 병변의 수술적 치료)

  • Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.24 no.2
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    • pp.83-87
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    • 2013
  • The term "phonosurgery," coined in the early 1960s, refers to surgical procedures that maintain, restore, or enhance the human voice. Phonosurgery includes phonomicrosurgery (endoscopic microsurgery of the vocal folds), laryngoplastic phonosurgery (open-neck surgery that restructures the cartilaginous framework of the larynx and the soft tissues), laryngeal injection (injection of medications as well as synthetic and organic biologic substances), and reinnervation of the larynx. Phonomicrosurgery is a means of maximally preserving the layered microstructure of the vocal fold, that is, the epithelium and lamina propria. The purpose of the surgery is usually to improve the vibratory characteristics of the layered microstructure of the vocal folds. Phonomicrosurgery has developed from convergence of microlaryngoscopic surgical technique theory and the mucosal wave theory of laryngeal sound production. Improvements in technology (i.e., laryngoscopes, handled instruments, and lasers), which in part arise from developments in more frequently performed minimally invasive surgical procedures, will probably facilitate the next generation of procedural innovations. The best methods of optimizing phonosurgical outcomes include making an accurate diagnosis, completing a comprehensive voice evaluation, providing sufficient preoperative therapy, carefully selecting patients to undergo phonomicrosurgical procedures, and requiring sufficient postoperative rest and therapy. Phonomicrosurgery will continue to evolve as a result of the interdependent collaboration of surgeons with voice scientists, speech pathologist, and other voice professionals.

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