• Title/Summary/Keyword: Total excision

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Korean Medicine Treatments with Joripewon-tang for Chemotherapy-Induced Peripheral Neuropathy of Ovarian Cancer : Case Report (난소암의 항암화학요법 유발 만성 말초신경병증의 조리폐원탕 및 복합한의치료 치험 1례)

  • Ji-yoon, Yeum;Su-hyun, Kim;Seung-yun, Oh;Soo-jung, Park
    • Journal of Korean Traditional Oncology
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    • v.27 no.1
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    • pp.49-56
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    • 2022
  • Objective: This case report represented that Korean traditional medicine therapies can make effective results for chemotherapy-induced peripheral neuropathy(CIPN) patients. Methods: A 63-year-old female patient has been diagnosed with ovarian cancer(Sertoli-Leydig cell tumor). Total excision of uterus and appendages was operated, and Bleomycin, etoposide and cisplatin combination therapy was applied. After three cycles of chemotherapy, the severe side effects of neutropenia and CIPN occurred. Chemotherapy was terminated, but numbness and tingling pains in the limbs persisted for several months. We provided Korean medicine treatments including herbal medicine, pharmacopuncture, acupuncture, moxibustion and physiotherapies. Results: After treatments, the numbness and pain were reduced from 10 to 1 in hand and 6 to 0 on the numeric rating scale(NRS). Functional assessment of cancer therapy/Gynecologic oncology group neurotoxicity (FACT/GOG-NTX) score was improved from 58 to 97. Conclusion: According to these results, Korean medicine treatments could be considered effective for CIPN. Prospective studies are needed to confirm and expand these findings.

Objective quantification of the impact of blepharoplasty on the superior visual field

  • Kim, Hyodong;Lee, Sanghun;Son, Daegu;Yeo, Hyeonjung
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.19-24
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    • 2022
  • Background Blepharoplasty has both aesthetic and functional benefits in patients with pseudoptosis; however, previous studies could not demonstrate its beneficial effects quantitatively and objectively. The authors objectively analyzed the visual field before and after surgery and investigated whether measurements of the visual field can be applied as a suitable predictor of surgical outcomes. Methods In total, 18 eyelids in nine patients with pseudoptosis who had undergone simple skin excision blepharoplasty were evaluated prospectively from February to May 2016. The visual fields were analyzed preoperatively and 3 months postoperatively using the Goldmann kinetic perimetry test. The visual field test area was assessed using Adobe Photoshop. Results Blepharoplasty had an average 4.99-fold beneficial effect on the superior visual field. In particular, more improvement was seen in the superior temporal quadrant than in the nasal quadrant. No correlation was found between the preoperative margin-to-reflex distance 1 (MRD1) and the surgical outcome (P=0.119). However, there was a strong correlation between the preoperative superior visual field and the surgical outcome (P=0.001). Conclusions Using the Goldmann kinetic perimetry test, we objectively and quantitatively proved the beneficial effect of blepharoplasty on patients with pseudoptosis. Furthermore, we demonstrated that the preoperative visual field is a better preoperative surgical outcome predictive factor than the preoperative MRD1.

A Brachial Artery Pseudoaneurysm Treated with a Bifurcated Y-Shaped Artificial Vessel Graft

  • Joon seok Oh;Seokchan Eun
    • Archives of Plastic Surgery
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    • v.49 no.6
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    • pp.755-759
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    • 2022
  • Brachial artery aneurysms are rare diseases that may be caused by infection or trauma. We report a case of a 71-year-old man who presented with a mass in his right antecubital fossa that increased in size slowly over time. Three years ago, the patient underwent ascending and total-arch replacement with artificial vessel graft to treat aortic root and ascending aorta aneurysm. Preoperative physical examination of right upper extremity showed a nonpulsatile mass with normal pulse of axillary, brachial, and radial arteries. The mass was removed and brachial artery reconstruction was done initially using saphenous vein graft. Two months later, the patient revisited with recurrent pseudoaneurysm, involving the bifurcation point of brachial artery. Aneurysm was totally resected and the brachial artery was reconstructed by interposition graft using a bifurcated GORE-TEX artificial vessel graft. The patient healed without complication and no recurrence was observed. Artificial vessel graft is an available option for reconstruction, and revascularization of vessel defect after excision of brachial artery aneurysm may involve bifurcation point.

Effect of Cytoskeletal Manual Therapy, a Novel Soft Tissue Mobilization Technique, on Axillary Web Syndrome after Axillary Lymph Node Dissection: A Case Report

  • Hyun-Joong Kim;Seong-Hyeok Song;Seungwon Lee
    • Physical Therapy Rehabilitation Science
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    • v.11 no.4
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    • pp.464-470
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    • 2022
  • Objective: Axillary web syndrome (AWS) is a condition comprising fibrous band-like cords that appear in the axilla of patients after axillary lymph node dissection (ALND) during breast cancer surgery and result in pain and reduced mobility. The cords appearing with AWS are hardened veins or lymphatic vessels. Manual therapy and stretching are recommended for pain control and mobility improvement. Therefore, this study investigated the effect of cytoskeletal manual therapy (CMT), which is a new soft tissue mobilization technique. Design: A case report Methods: A 41-year-old woman with AWS after breast cancer surgery and ALND visited a physical therapy clinic because of shoulder pain, decreased function, and decreased mobility. The cords were palpable and pain occurred 2 weeks after surgery. CMT was performed three times per week for a total of 6 weeks. Her pain intensity, range of motion (ROM), and shoulder function were measured. Results: Measurements were performed after 2 weeks and 6 weeks of CMT and evaluated using the numeric pain rating scale (NPRS). Her pain intensity largely decreased after 2 weeks (4-point score reduction) and after 6 weeks (5-point score reduction) of CMT. After CMT, her full ROM was restored and her shoulder function was improved (7-point score reduction). Conclusions: CMT is effective for pain control, mobility improvement, and functional improvement of patients with AWS.

A Case Report of Madelung's Disease

  • Bo Hyun Lee;Young Mann Lee;Seong Oh Park;Lan Sook Chang;Youn Hawn Kim
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.463-467
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    • 2023
  • Madelung's disease (MD) is a rare disease characterized by diffuse, nonencapsulated, multiple fat masses in different areas of the body. In this case report, we present a case of MD in Asia and its management. A 66-year-old man with a history of hypertension presented with massive growth of soft tissue around the neck, breasts, upper back, and lower abdomen. Preoperative magnetic resonance imaging revealed remarkably hypertrophic fat tissue around the neck and anterior chest was wall, which consistent with the diagnosis of MD. Multiple linear incisions were made on the neck and 763, 186, 635 g of posterior, right, and left fat tissues were excised, respectively. A single wide, transverse incision was done to excise 1,072 g of fat from the upper back. Masses of both breasts were excised, preserving the inferior pedicle, weighing 1,086 (right) and 1,164 g (left). The recovery was optimal and the patient was discharged without complications. In this case, we excised the adipose masses as much as possible and improved contour and symmetry. However, the fat infiltrations in the patient were diffusely distributed, making total fat excision difficult. This rare case report may help in managing patients with MD.

Mucosa-Associated Lymphoid Tissue Lymphoma of the Labial Minor Salivary Glands: Case Report

  • Jung Eun Lee;Dawool Han;Hyun Sil Kim;Chena Lee;YounJung Park;Jeong-Seung Kwon
    • Journal of Oral Medicine and Pain
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    • v.49 no.1
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    • pp.22-27
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    • 2024
  • A 74-year-old female presented with a complaint of dry mouth, continuous spontaneous burning sensation in the tongue, and asymptomatic submucosal soft tissue mass on both sides of the lower labial mucosa. She refused to undergo total excision of the mass due to concern about the possibility of complications such as nerve damage because of the large size of the mass. As her clinical features and magnetic resonance imaging indicated the possibility of Sjögren's syndrome, a biopsy of the minor salivary gland of the right lower lip was performed. Consequently, she was diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma. Although the patient had typical signs and symptoms of Sjögren's syndrome, the histopathological result of MALT lymphoma made it impossible to determine whether the patient had a history of Sjögren's syndrome. For patients with risk factors for MALT lymphoma, such as Sjögren's syndrome, a biopsy of the labial minor salivary gland with immunohistochemical staining can be helpful in the diagnosis of not only Sjögren's syndrome but also MALT lymphoma.

A Clinical Study of the Salivary Gland Tumors (타액선 종양의 임상적 고찰)

  • Son Ku-Chul;Park Chao-Heun;Park Chul-Jae;Pai Soo-Tong
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.46-52
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    • 1994
  • This review is based on the 52 cases of salivary gland tumors treated at the department of surgerym Hallym University Kangdong Sacred Heart hospital during the period from March 1987 to May 1992. There were 43 benign and 9 malignant tumors. Twenty eight(54%) of these cases were located in the parotid gland, 14(27%) in the submandibular gland, the rest of 10 cases(19%) in the minor salivary glands. Female outnumbered male by the ratio 1.6:1. Pleomorphic adenoma was the most common tumor followed by carcinoma and adenolymphoma(Warthin's tumor). The most common presenting symptom in both benign and malignant tumors was palpable mass. However, some patients with malignancy presented symptoms such as pain, facial palsy and dysphagia. Among 9 cases with malignancies 3 cases were found to have metastasis in the regional lymphnodes and two cases had distant metastasis. In majority of benign parotid tumors, superficial parotidectomy was carried out. In three cases of carcinoma of parotid gland with lymphnode metastasis, total parotidectomy with radical neck dissection was done. One case out of two cases of carcinoma of submandibular gland was treated with total excision of the gland with radical neck dissection. There were no postoperative mortalies. Two cases each of facial palsies and wound infections were observed as complication.

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Analysis of Factors for Satisfying Functional Outcomes in Tongue Reconstruction (설결손의 재건 후 기능적 예측 인자의 분석)

  • Hong, Hyun Joon;Lee, Won Jai;Lew, Dae Hyun;Rah, Dong Kyoon;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.35 no.3
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    • pp.255-260
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    • 2008
  • Purpose: Tongue cancer is the most common malignant tumor of the oral cavity and the ultimate goal in treatment of the cancer is not only complete excision and meticulous closure of the wound, but also, reconstruction of a demensional and functional tongue. Our study focuses on various factors, such as defect size, extent of tumor, age, application of mandibulectomy or radiotherapy, and their influences on postoperative speech and swallowing function. Methods: Our study was based on 59 patients who underwent tongue cancer operation and reconstruction of the tongue. Speech and swallowing were evaluated according to categories documented by Sultan and Teichgraeber. Patients were classified into 3 groups as partial glossectomy, hemiglossectomy and total glossectomy groups for evaluation. The average age of the patients were 51, and the mean follow-up period was 4 years 2 months. Results: The partial glossectomy group showed statistically relevant results for speech articulation and swallowing abilities compared to the total glossectomy group. In cases of defects involving the mouth floor, the group showed decreased results compared to the group without mouth floor involvement. Increased age showed decreased postoperative results with statistical significance, while mandibulectomy and radiotherapy revealed no statistically significant data. Analysis according to TNM staging resulted in decreased functional result with advanced staging without statistical significance. Conclusion: To summarize the factors influencing the functional outcome in tongue reconstruction, younger patients and early stage cancer with minimal surgical extent revealed more satisfying results while mandibulectomy and radiation did not have influence on our analysis. Addition of various influencing factors and studies with longer follow up periods on our patient groups may provide effective data for more satisfying functional outcomes in the future.

Treatment-failure tularemia in children

  • Karli, Arzu;Sensoy, Gulnar;Paksu, Sule;Korkmaz, Muhammet Furkan;Ertugrul, Omer;Karli, Rifat
    • Clinical and Experimental Pediatrics
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    • v.61 no.2
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    • pp.49-52
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    • 2018
  • Purpose: Tularemia is an infection caused by Francisella tularensis. Its diagnosis and treatment may be difficult in many cases. The aim of this study was to evaluate treatment modalities for pediatric tularemia patients who do not respond to medical treatment. Methods: A single-center, retrospective study was performed. A total of 19 children with oropharyngeal tularemia were included. Results: Before diagnosis, the duration of symptoms in patients was $32.15{\pm}17.8days$. The most common lymph node localization was the cervical chain. All patients received medical treatment (e.g., streptomycin, gentamicin, ciprofloxacin, and doxycycline). Patients who had been given streptomycin, gentamicin, or doxycycline as initial therapy for 10-14 days showed no response to treatment, and recovery was only achieved after administration of oral ciprofloxacin. Response to treatment was delayed in 5 patients who had been given ciprofloxacin as initial therapy. Surgical incision and drainage were performed in 9 patients (47.5%) who were unresponsive to medical treatment and were experiencing abcess formation and suppuration. Five patients (26.3%) underwent total mass excision, and 2 patients (10.5%) underwent fine-needle aspiration to reach a conclusive differential diagnosis and inform treatment. Conclusion: The causes of treatment failure in tularemia include delay in effective treatment and the development of suppurating lymph nodes.

Novalis Shaped Beam Radiation Treatment for Craniopharyngiomas

  • Yee, Gi-Taek;Han, Seong-Rok;Yoon, Sang-Won;Choi, Chan-Young;Lee, Dong-Joon;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • v.40 no.4
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    • pp.245-248
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    • 2006
  • Objective : To evaluate the effectiveness of Novalis shaped beam radiation treatment as an adjuvant treatment in patients with craniopharyngiomas. Methods : We reviewed 8 patients with craniopharyngiomas who had recurring tumors during follow-up or had residual lesions after primary surgery. Three of 8 patients were found to have recurrence after gross total excision of the tumor and 5 patents had residual lesions after subtotal resection. All patients were treated with fractionated stereotactic radiation treatment[FSRT] using Novalis system. The mean age of patients was 28 years [range $16{\sim}52$]. The median irradiation dose per fraction was 17Gy [range $1.7{\sim}2.0$]. The median fraction number was 23 [range $15{\sim}25$], and the median total dose was 39.1 Gy [range $25.5{\sim}42.5$]. Follow-up included MR imaging, and ophthalmologic and endocrine examinations. Results : The median follow-up period was 23 months [range $12{\sim}43$]. The local tumor control rate was 87.5%. One patient had a recurring tumor, in which cystic change developed 2 months after FSRT. Four patients showed a decrease in size of their tumor, while 3 patients remained stable. Seven out of 8 patients had hormonal dysfunction that remained unchanged after initial surgery. No further progression of visual impairment was observed. Conclusion : FSRT using Novais system is effective and safe for the treatment of recurring or residual craniopharyngiomas without toxicity like optic neuropathy.