• Title/Summary/Keyword: Surgical therapy

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A systematic review of the keystone design perforator island flap in the reconstruction of trunk defects

  • Rini, Irena Sakura;Gunardi, Alberta Jesslyn;Marsaulina, Renate Parlene;Aryandono, Teguh;Dachlan, Ishandono;Dwiprahasto, Iwan
    • Archives of Plastic Surgery
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    • v.47 no.6
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    • pp.535-541
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    • 2020
  • The keystone design perforator island flap can be utilized in the repair of trunk defects. A systematic review was carried out to identify the complication rates of the use of this flap to treat such defects. The MEDLINE, Embase, Cochrane Library, and PubMed Central databases were searched for articles published between January 2003 and December 2018 that reported the use of keystone design perforator island flaps in the repair of trunk defects. Study selection was conducted in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Eight articles involving a total of 54 flaps satisfied the inclusion criteria. The most frequently reported cause of trunk defects was oncologic resection (64.4%). The overall complication rate was 35.2%, and complications included infection (11.1%), wound dehiscence (7.4%), delayed healing (7.4%), and partial flap loss (1.9%). The keystone design perforator island flap is associated with a high success rate and low technical complexity. Despite minor complications, keystone design flaps could be a preferred choice for trunk reconstruction.

The status of assisted reproductive technology in Korea in 2012

  • Committee for Assisted Reproductive Technology Statistics, Korean Society for Assisted Reproduction;Lee, Gyoung Hoon;Song, Hyun Jin;Choi, Young Min;Han, Hyuck Dong
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.1
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    • pp.47-51
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    • 2017
  • Objective: This study was designed to report the status of assisted reproductive technology (ART) therapy in South Korea between January 1, 2012 and December 31, 2012. Methods: A localized online survey, originally developed by the International Committee Monitoring Assisted Reproductive Technologies, was first launched and provided to all available ART centers via email in 2015. Fresh embryo transfer (FET) cases were categorized as standard in vitro fertilization, intracytoplasmic sperm injection (ICSI), or half-ICSI. Thawed embryo transfer (TET) and other related procedures, including surgical sperm retrieval, were surveyed. Results: Data from 33,956 ovum pick-up procedures were provided by 75 clinics in 2012. Of the 33,088 cycles in which ovums were retrieved, a complete transfer was performed in 90.5% (29,932 cycles). In addition, 10,079 FET cycles were confirmed to have resulted in clinical pregnancy, representing a pregnancy rate of 30.5% per ovum pick-up and 33.7% per ET. The most common number of embryos transferred in FET was 2 (41.6%), followed by 3 (34.0%), and non-elective single ETs (10.0%). Of the 10,404 TET cycles in which transfer was completed, 3,760 clinical pregnancies (36.1%) were confirmed by ultrasonography. Conclusion: The overall clinical pregnancy rate for FET and TET cycles in 2012 was higher than in 2011 (33.7% vs. 33.2% and 36.1% vs. 31.1%, respectively). The most common number of embryos transferred in FET cycles was 2, unlike in 2011.

A Case of Biliary Papillomatosis with Cystic Dilatation of Bile Duct (낭성 담도 확장을 동반한 담도 유두종증 1예)

  • Park, Yoo Mi;Rhee, Kwangwon;Yoon, Sun Och;Ha, Ji Yoon;Park, So Young;Lee, Jung Ho;Jang, Sung Ill
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.136-140
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    • 2012
  • A 61-year-old male who complained of right upper quadrant pain was referred to the authors for evaluation after his computed tomography suggested biliary adenocarcinoma. The lesion consisted of multiple cysts with papillary mass and peri-ampullay mass. The patient underwent an operation due to a clinical suspicion of biliary cystadenocarcinoma, but the pathology confirmed biliary papillomatosis (BP) after diagnosing intrahepatic papillary neoplasm with high-grade dysplasia and invasive adenocarcinoma with papillary neoplasm from the distal common bile duct to the duodenum. BP is a disease characterized by multiple papillary masses. Its cause has yet to be discovered. It commonly manifests as bile duct dilation but rarely as a ductal cystic change. Under computed tomography or magnetic resonance imaging, both the BP and the cystic neoplasm can show bile duct dilation and a papillary mass, which makes their differential diagnosis difficult. A confirmative diagnosis can be made through a pathologic examination. BP is classified as a benign disease that can become malignant and may recur, though rarely. Its treatment of choice is surgical resection. Laser ablation or photodynamic therapy can be used for unresectable lesions. In the case featured in this paper, biliary papillomatosis was difficult to differentiate from cystic adenocarcinoma due to diffusely scattered multiple large cystic lesions in the liver, and it was histologically confirmed to have become malignant with cystic duct dilation after the operation. This case is reported herein with a literature review.

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All-trans-retinoic Acid Promotes Iodine Uptake Via Up-regulating the Sodium Iodide Symporter in Medullary Thyroid Cancer Stem Cells

  • Tang, Min;Hou, Yan-Li;Kang, Qiang-Qiang;Chen, Xing-Yue;Duan, Li-Qun;Shu, Jin;Li, Shao-Lin;Hu, Xiao-Li;Peng, Zhi-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1859-1862
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    • 2014
  • Recently, the main therapy of medullary thyroid cancer (MTC) is surgical, but by which way there is a poor prognosis with a mean survival of only 5 years. In some cases, some researchers found that it is the medullary thyroid cancer stem cells (MTCSCs) that cause metastasis and recurrence. This study aimed to eradicate MTCSCs through administration of all-trans-retinoic acid (ATRA). Here we demonstrate that MTCSCs possess stemlike properties in serum-free medium. The ABCG2, OCT4 and sodium iodide symporter (NIS) were changed by ATRA. Additionally, we found that ATRA can increase the expression of NIS in vivo. All the data suggested that ATRA could increase the iodine uptake of MTCSCs through NIS.

Distinct Postsurgical Management in Young and Elderly Breast Cancer Patients Results in Equal Survival Rates

  • Oran, Ebru Sen;Yankol, Yucel;Soybir, Gursel Remzi;Karsidag, Tamer;Sakalli, Onur;Gecgel, Umit;Soybir, Onur Can;Soran, Atilla
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7843-7847
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    • 2014
  • Background: Although breast cancer (BC) is one of the most common malignant diseases in women, the majority of the studies describing the characteristics of BC in elderly patients have been limited to survival assessments or tumor features, without using younger BC patients as a reference group. The aim of our study was to describe and compare tumor characteristics and management patterns in elderly versus younger breast cancer patients in Turkey. Materials and Methods: We retrospectively analyzed 152 patients with invasive breast cancer who underwent surgery in our institution between 2002 and 2012. Patients were divided into 2 groups according to age at the time of diagnosis. Results: There were 62 patients in the elderly group (${\geq}65$ years) and 90 patients in the younger group (<65 years). Compared to the younger group, tumors in the elderly group were more likely to be larger (p=0.018), of lower grade (p=0.005), and hormone receptor-positive (p>0.001). There were no significant differences regarding histology, localization, lymph node involvement, or types of surgical procedures between the 2 groups. Comorbidities were more common in elderly patients (p<0.001). In addition, elderly patients were more likely to receive hormonal therapy (p<0.001) and less likely to receive radiotherapy (p=0.08) and chemotherapy (p=0.003). There was no difference in survival and locoregional recurrence rates between the groups. Conclusions: The results of this study demonstrate that breast cancer in elderly patients has more favorable tumor features, warranting less aggressive treatment regimens after surgery.

Papillary Thyroid Microcarcinoma Presenting as Neck Masses (경부 종물로 발현된 유두 미세 갑상선암)

  • Kim Young-Mo;Park Sun-Ki;Shin Jun-Sun;Jeon Yong-Sun;Han Chang-Jun;Cho Jung-Il
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.1
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    • pp.65-70
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    • 2002
  • Background and Objectives: Recently the tenn 'papillary microcarcinoma' has been proposed to designate carcinoma of 10 mm or less in diameter. In some cases, cervical lymph node metastasis preceding the occurrence of the primary tumor may be the first and sole manifestation of the disease. The objective of this study is to assess the clinical features of cervical metastasis in papillary microcarcinoma of thyroid glands. Materials and Methods: 9 cases with papillary microcarcinoma with neck metastasis were analyzed retrospectively. 5 cases are men and 4 are women. All patients complained of painless, movable neck mass. The symptom had been present from 1 month to 36 months. We reviewed clinical history, imaging studies, the results of fine needle aspiration, the surgical method, the pathologic results. Results: In 9 cases, no abnormalities of the thyroid gland were shown by imaging studies and thyroid scan. 3 cases were diagnosed by fine needle aspiration cytology. the others were not. Total thyroidectomy and neck dissection were performed in 9 cases and then pathology reports showed 2 case of multiple, 2 case of contralateral single and 5 cases of unilateral single thyroid microcarcinoma. They have no recurrence during follow-up period. Conclusions: Cervical metastasis from papillary microcarcinoma is variable clinical manifestation. The diagnosis of cervical metastasis from papillary microcarcinoma should be considered in patient with neck mass. We recommend total thyroidectomy with neck dissection and postoperative radioactive iodine ablation therapy in neck metastasis from papillary thyroid microcarcinoma.

Survey of Clothing Behavior for Breast Cancer Women After Surgery: Comparison Between a Breast-Conserving Surgery Group and a Mastectomy Group (유방암 수술 후 유방 암 여성 환자의 의생활 조사: 유방 보존술과 유방 전절제술을 받은 대상자간의 비교)

  • Oh, Hee-Kyoung
    • Science of Emotion and Sensibility
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    • v.19 no.1
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    • pp.49-60
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    • 2016
  • This study examines the similarities and differences in the clothing habits between a breast-conserving surgery group (68 patients) and a mastectomy group (45 patients). In common, both parties expressed that they did not want to conspicuously display their altered body shape from the surgical procedure, and they also confirmed that they did not want to be treated as breast cancer patients by others. On the other hand, a mastectomy group significantly preferred clothes, bras and breast prostheses which enhance the body silhouette in comparison to the patients who received breast-conserving surgery. However, the patients who received breast mastectomies reported that the bras and breast prostheses available have been expensive with low emotional satisfaction, calling for particular need in specialized clothing for female patients who undergo breast surgery. Hence, this research to further the development of clothes, bras and breast prostheses for Korean women who must undergo breast surgery would be effective in helping to improve body image and quality of life in these women.

All-arthroscopic, Guideless Single Suture-button Fixation of Acute Acromioclavicular Joint Dislocation: A Description of the Technique and Early Treatment Results

  • Altintas, Burak;Yildiz, Fatih;Uzer, Gokcer;Kapicioglu, Mehmet;Bilsel, Kerem
    • Clinics in Shoulder and Elbow
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    • v.20 no.2
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    • pp.59-67
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    • 2017
  • Background: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations. Methods: All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally. Results: Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2-20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84-96). The mean external rotation, forward flexion, and abduction were $75.8^{\circ}$ (range, $50^{\circ}-90^{\circ}$), $170^{\circ}$ (range, $150^{\circ}-180^{\circ}$), and $163.8^{\circ}$ (range, $140^{\circ}-180^{\circ}$), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results. Conclusions: The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results.

A Case Report on a Patient with Osteonecrosis of the Femoral Head Treated with Korean Medicine Treatment Including Hwaeo-jeon (대퇴골두 골 괴사증 환자에 대한 화어전을 포함한 한의학적 치료에 대한 증례보고)

  • Bong, Sung Min;Jang, Woo Seok;Kim, Kyung Ho
    • The Journal of Internal Korean Medicine
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    • v.41 no.1
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    • pp.88-96
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    • 2020
  • Objectives: Osteonecrosis of the femoral head (ONFH) is caused by a circulatory disorder. If symptoms are not present, the patient's progress is observed, but if symptoms are present, non-surgical methods or total hip replacement are performed. Several case reports have described the effects of Korean Medicine treatment on ONFH, but the number of cases is still small, and few studies have used blood stasis-based herbal medicines like Hwaeo-jeon (HEJ). This study reports the effectiveness of Korean Medicine treatments, including HEJ, on a case of ONFH. Methods: A patient diagnosed with ONFH by CT and MRI was treated with Korean Medicine treatments consisting of herbal medicine including HEJ, bee venom pharmacopuncture, acupuncture, cupping, and physical therapy. The improvement of pain was assessed using a numerical rating scale. Inflammation levels were determined by blood tests conducted during hospitalization. Results: Korean Medicine treatment, including herbal medicine, resulted in good clinical improvement responses, including reduced pain, improved mobility, and reduced inflammatory levels in the blood tests. Conclusions: Korean Medicine treatments, including HEJ, may be effective for ONFH patients. Further studies are needed to determine the recovery of osteonecrosis and the improvement of post-operative aftereffects using Korean Medicine treatments, as well as the reduction of pre-operative pain.

Management of Pediatric Patients Presenting with Acute Abdomen Accompanying Dilatation of the Common Bile Duct

  • Kim, Young A;Kim, Gyung Min;Chun, Peter;Hwang, Eun Ha;Mun, Sang Wook;Lee, Yeoun Joo;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.3
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    • pp.203-208
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    • 2018
  • Purpose: The aim of this study was to describe our treatment experiences with patients who had acute abdomen (AA) with common bile duct (CBD) dilatation. Methods: The treatment outcomes in children with AA and CBD dilatation were retrospectively reviewed. According to the shape of the intrahepatic bile ducts on ultrasonography (US), the origin of the pain was estimated as choledochal cyst (CC) complication or choledocholithiasis in normal CBD. Patients with complicated CC underwent surgery, and patients with choledocholithiasis in a normal appearing CBD underwent symptomatic treatment initially. Results: Of the 34 patients, 30 (88.2%) were female. The mean age of the patients was $6.4{\pm}4.9$ (range, 0.8-17) years. Seventeen (50.0%) patients had CBD stones and 17 (50.0%) did not. Surgical treatment was performed in 20 (58.8%) patients, 2 of whom underwent preoperative stone removal with endoscopic retrograde cholangiopancreatography and an operation. Conservative treatment was applied in 12 (35.3%) patients (8 with and 4 without stones), 1 of whom developed symptom relapse and underwent an operation. Among the 8 patients with CBD stones, 4 (4/17, 23.5%) had complete resolution of the stones and recovery of the CBD diameter after conservative treatment. US findings of patients with stone showed a fusiform or cylindrical shape of the CBD in 14 (82.4%) patients. Conclusion: The presence of stones in the distal CBD and the US features of CBD dilatation may be helpful to diagnose and treat the causes of biliary dilatation. Conservative treatment can be considered as initial therapy in patients with uncomplicated CBD dilatation with stone.