• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6755-6760
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• 2014

Background: Oral cancer is a common form of cancer in India, particularly among men. About 95% are squamous cell carcinomas. Tobacco along with alcohol are regarded as the major risk factors. Objectives: (i) To determine associations of oral squamous cell carcinoma (OSCC) with respect to gender, age group, socioeconomic status and risk habits; (ii) To observe the distribution of affected oral anatomical sites and clinico-pathological profile in OSCC patients. Materials and Methods: This is an unmatched case-control study during period January 2012 to December 2013. Total of 471 confirmed OSCC patients and 556 control subjects were enrolled. Data on socio-demography, risk habits with duration and medical history were recorded. Results: There were significant associations between OSCC with middle age (41-50years; unadjusted OR=1.63, 95%CI=1.05-2.52, p=0.02) (51-60 years; unadjusted OR=1.79, 95%CI=1.15-2.79, p=0.009) and male subjects (unadjusted OR=2.49, 95%CI=1.89-3.27, p=0.0001). Cases with both habits of tobacco chewing and smoking were at a higher risk for OSCC than tobacco chewing alone (unadjusted OR=0.52, 95%CI=0.38-0.72, p=0.0001), duration of risk habits also emerged as a responsible factor for the development of carcinoma. The majority of patients were presented in well-differentiated carcinomas (39.9%). Prevalence of advance stages (TNM stage III, IV) was 23.4% and 18.3% respectively. The buccal mucosa was the most common (35.5%) affected oral site. Conclusions: In most Asian countries, especially India, there is an important need to initiate the national level public awareness programs to control and prevent oral cancer by screening for early diagnosis and support a tobacco free environment.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9649-9654
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• 2014

Background: Polyps are common lesions in the gastrointestinal (GI) tract. Colon cancer is mostly a result of progression from polyps. The present study aimed to evaluate demographic, clinical, and histological characteristics of colorectal polyps in Iran, particularly neoplastic and advanced types. Materials and Methods: Over a period of 10 years, specimens of all colorectal polyps obtained from colonoscopy were studied. The variables subjected to statistical analysis were age, sex, and the chief clinical complaint of the patients who underwent colonoscopy, their motivation, and the site, size, and histological types of detected polyps. The level of significance was set at p value <0.05. Results: Data were obtained from a total of 352 patients. No difference was seen between male and female patients regarding histological types. Only in nine patients was screening the reason for colonoscopy. Almost two-thirds (66.2%) of the polyps were neoplastic. Familial polyposis syndrome and inflammatory bowel disease were seen in 4.3% and 3.0% of the patients with neoplastic polyps, respectively. Sites of polyps were the sigmoid, rectum, and descending colon in 40.1%, 34.5%, and 17% of the cases, respectively. The advanced type made up 58.8% of neoplastic polyps. Only 3.6% of the patients undergoing colonoscopy in the study period had biopsied polyps. Discussion: No difference was observed between male and female patients in terms of overall incidence of polyps, histological and anatomical profiles, and mean age distribution. Anatomical and histological profiles agreed with the studies performed in areas with a low risk of colon cancer. The findings show that colonoscopy was not performed when it was necessary. A meaningful increase in the number polyp biopsy cases and a corresponding decrease in polyp size in the last few years of the study can be associated with the presence of more GI specialist clinicians in hospital centers, and this holds out much hope for the further improvement of the situation in the future.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1261-1266
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• 2012

Introduction: HPV has been found repeatedly in esophageal squamous cell carcinoma (ESCC) tissues. However, reported detection rates of HPV DNA in these tumors have varied markedly. Differences in detection methods, sample types, and geographic regions of sample origin have been suggested as potential causes of variation. We have reported that infection of HPV DNA in ESCC tumors depends on anatomical sites of esophagus of the patients from Mazandaran, north of Iran. Materials and Methods: HPV DNA was examined in 46 upper, 69 middle and 62 lower third anatomical sites of esophageal squamous cell carcinoma specimens collected from Mazandaran province in north Iran, near the Caspian Littoral as a region with high incidence of ESCC. HPV L1 DNA was detected using Qualitative Real time PCR and MY09/MY11 primers. Results: 28.3% of upper, 29% of middle and 25.8% of lower third of ESCC samples were positive for HPV DNA. 13.6% for males and 14.1% for females were HPV positive in all samples. Conclusions: HPV infection is about one third of ESCC in this area. Findings in this study increase the possibility that HPV is involved in esophageal carcinogenesis. Further investigation with a larger sample size is necessary.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.1
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• pp.34-40
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• 2012

Purpose: The study was performed to compare patients with anatomical variations in facial asymmetry with patients in the normal range using cone-beam computed tomography (CBCT) and to take the preoperative condition into consideration in the case of a sagittal split ramus osteotomy (SSRO). Methods: The study was conducted on 46 adult patients composed of 2 subdivided groups, an asymmetry group (n=26) and a symmetry group (n=20). The asymmetry group was divided between patients with hemimandibular hyperplasia (HH, n=8) and hemimandibular elongation (HE, n=18). Using cross-sectional computed tomography images, the thickness of cancelleous bone in the buccal area of the mandible, thickness of buccal cortex in the buccal aspect of the mandible, thickness of cancellous bone in the inferior aspect of the mandible, thickness of buccal cortex in the inferior aspect of the mandible, and cross-sectional surface area of the mandible were measured. Results: In the asymmetry group, the cross-sectional area of the mandible including the inferior alveolar nerve positioned on the affected side was significantly different from the symmetry group. Thickness of cancelleous bone in the buccal aspect of the mandible, thickness of cancelleous bone in the inferior aspect of the mandible, and cross-sectional surface area of the mandible in the affected site of hemimandibular hyperplasia was significantly smaller than in the symmetry group. Conclusion: The inferior alveolar nerve runs lower and in a more buccal direction and shows a smaller cross-sectional surface of the mandible in the hemimandibular hyperplasia patients with asymmetry.

• Clinics in Shoulder and Elbow
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• v.20 no.1
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• pp.37-41
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• 2017

Background: Increased frequency of comminuted clavicle mid-shaft fractures and importance of functional satisfaction through early joint exercise has resulted in higher emphasis on surgical treatments. This study aimed to evaluate the clinical radiological results of treatment of clavicle mid-shaft fractures by open reduction and internal fixation using a plate with a small incision. Methods: The subjects of this study were 80 clavicle mid-shaft fracture cases treated with internal fixation using a plate from October 2010 to July 2014. Clavicle mid-shaft fractures were internally fixated using anatomical plates or locking compression plates. Achievement of bone union, union period, and clavicle length shortening were evaluated radiologically, and clinical assessment was done by using Constant and University of California at Los Angeles (UCLA) scores. Results: All 80 cases were confirmed to have achieved bone union through radiographs with an average union period of 10.9 weeks (range: 7-18 weeks). The average clavicle length of shortening in the affected side was 1.8 mm (range: 0-17 mm). The average UCLA score and Constant score were 33.6 (range: 25-35) and 92.5 (range: 65-100), respectively. Regarding complications, four cases reported skin irritation by metal plates, and one case reported a screw insertion site fracture due to minor trauma history. Conclusions: We were able to induce successful bone union and obtain clinically satisfactory results in displaced mid-shaft fractures of the clavicle without major complications such as nonunion through treatment of internal fixation using a plate.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.3
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• pp.184-194
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• 2011

The dorsalis pedis artery (DPA) was renamed from the anterior tibialis artery after it passed under the extensor retinaculum, and DPA travels between the extensor hallucis longus and extensor digitorum longus muscle along the dorsum of the foot. After giving off the proximal and distal tarsal, arcuate and medial tarsal branches, DPA enters the proximal first intermetatarsal space via the first dorsal metatarsal artery (FDMA), which courses over the first dorsal interosseous muscle (FDIM). For detailed knowledge of the neurovascular anatomy of a dorsalis pedis artery flap (DPAF) as a routine reconstructive procedure after the resection of oral malignant tumors, the precise neurovascular anatomy of DPAF must be studied along the DPA courses as above. In this first review article in the Korean language, the anatomical basis of DPAF is summarized and discussed after a delicate investigation of more than 35 recent articles and atlas textbooks. Many advantages of DPAF, such as a consistent flap vascular anatomy, acceptable donor site morbidity, and the ability to perform simultaneous flap harvest using oral cancer ablation procedures, and additional important risks with the pitfalls of DPAF were emphasized. This article will be helpful, particularly for young doctors during the special curriculum periods for the Korean National Board of Specialists in the field of oral and maxillofacial surgery, plastic surgery, otolaryngology, orthopedic surgery, etc.

• The Korean Journal of Pain
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• v.24 no.4
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• pp.205-215
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• 2011

Background: Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. Methods: A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. Result: The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. Conclusion: All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties.

• Archives of Craniofacial Surgery
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• v.15 no.2
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• pp.53-58
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• 2014

Background: Maxillomandibular fixation (MMF) is usually used to treat double mandibular fractures. However, advancements in reduction and fixation techniques may allow recovery of the premorbid dental arch and occlusion without the use of MMF. We investigated whether anatomical reduction and microplate fixation without MMF could provide secure immobilization and correct occlusion in double mandibular fractures. Methods: Thirty-four patients with double mandibular fractures were treated with open reduction and internal fixation without MMF. Both fracture sites were surgically treated. For bony fixations, we used microplates with or without wire. After reduction, each fracture site was fixed at two or three points to maintain anatomical alignment of the mandible. Interdental wiring was used to reduce the fracture at the superior border and to enhance stability for 6 weeks. Mouth opening was permitted immediately. Results: No major complications were observed, including infection, plate exposure, non-union, or significant malocclusion. Five patients experienced minor complications, among whom the only one patient experienced a persistant but mild malocclusion with no need for additional management. Conclusion: This study showed that double mandibular fractures correction with two-or three-point fixation without MMF simplified the surgical procedure, increased patient comfort, and reduced complications, due to good stability and excellent adaptation.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.15 no.1
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• pp.75-83
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• 1985

Bitewing and periapical radiographic techniques are used in clinical and epidemiological studies to assess crestal alveolar bone levels. The purpose of the present study investigated relationships between these techniques by assessing alveolar crest location at the same site. Bitewing and periapical radiographs were available from posterior quadrants of 120 subjects. The distance from cemento-enamel junction to the alveolar crest (CEJ -CR) was measured for each proximal surface from the distal of the cuspid to the distal of the second molar. Data were arranged according to the proximal surface examined, and bitewing and periapical measurements were compared using paired tests. The obtained results were as follows; 1. In maxilla, a significant t ratio with a P value of 0.05 or less was reached for 78% and in mandible reached for 39%. 2. Pearson correlations were calculated 32 surfaces (89%) had values below 0.70 and so, data obtained by these techniques can not be used interchangeably on an individual or group basis. 3. In situations where the periapical measure was greater than the bitewing, it ranged up to 20.7% greater with a mean 9.8%. Where the bitewing was greater than periapical, it ranged up to 51. 9% greater, with a mean 18.2%. 4. The percentage difference was greater in maxillary posterior areas than in mandibular molar, premolar areas. A lower prevalence of significant differences was attributed to relatively more simple root and favorable radiographic conditions in mandibular molar and premolar areas. 5. The anatomical limitations imposed on periapical radiographic technique, most often result in somewhat foreshortened radiographic images. This situation would tend to be accentuated by the anatomical restrictions of the hard palate. 6. Consequently, since the significant differences frequently exist between measurements obtained from bitewing and periapical techniques, it is important to define which technique is used.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.20-27
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• 1998

Among many kinds of introduced free flaps, scapular freeflap is one of the most popularly using modalities in fasciocutaneous defect coverage with minimal donor defect and easier procedure and constant vascular patterns of the donor. Many surgeons who had experience of this flap pointed out deficit of the reliable sensation of the transplanted flap is the main shortcoming of the scapular free flap. If we can subjugate that point, scapular free flap is the most excellent procedure in such a cases as heel pad reconstruction and hand reconstruction which are relatively important to have skin with protective sensation. Author performed anatomical literature review, 10 cadaveric dissections and 12 clinical dissections. In surgical anatomical aspect, the upper six dorsal rami of the thoracic nerves have medial branches which pierce Longissimus thoracis and Multifidus muscle with small cutaneous twigs which pierce Latissimus dorsi and Trapezius muscle. Among that cutaneous twigs, several twigs distribute to the skin of the back from midline to lateral aspect which territory is identical to scapular free flap. We analysed clinical experiences of that sensory bearing scapular free flap surgical anatomy and one year follow-up studies with several results. 1) Two to three cutaneous twigs which pierced from the Trapezius muscle over the scapular free flap region. 2) Each twigs has two to four nerve fascicles with small artery. 3) The nerve distributed to the ordinary scapular free flap and large enough size and pedicle length to neurorrhapy with various recipient site nerves. 4) The inconvenience of this procedure is the vascular pedicle and nerve pedicle have opposite directions, vascular pedicle of that comes from lateral direction from subscapular vessels, but nerve pedicle comes from medial direction from trapezius muscle. Author can found constant cutaneous nerve branches which come from piercing the Trapezius. This nerves are helpful for protective sensation in transplanted scapular free flap. We can't had enough follow-up and evaluation of the nerve function of this procedure, we need continuous research works to application of this procedure. The in conveniences come from directional differences of pedicle can solve with longer harvest neural pedicle and change direction of the neural pedicle.