Introduction : The management of chordomas and chondrosarcomas in the skull base is difficult due to the critical location, locally aggressive nature, and high recurrence rate. The authors present the effectiveness of surgical removal and radiation therapy on survival and tumor recurrence. Material and Methods : Thirty cranial base chordomas and chondrosarcomas from 23 patients(14 patients with chordomas and 9 patients with chondrosarcomas) were operated in our institution between 1985 and 1998. There were 15 men and 8 women, with a mean age of 40.7 years. The largest diameter of tumors ranged from 15 to 70mm (mean 41.5). The extent of surgical removal was subtotal or total in a half(15 operations). In nineteen operations, tumors were removed by conventional approaches and skull base approaches were applied in 11 operations. Postoperative radiation therapy was performed in 16(70%) patients. The mean duration of follow up is 50 months(1- 156 months). Results : The 3- and 5-year survival rates(YSR) of overall patient are 75% and 67%, respectively. The analysis showed that 1) skull base approach to chordomas and chondrosarcomas showed a tendency to remove more portion of the tumors(p=0.058) but leave more frequent incidence of new deficits(p=0.047) : 2) larger tumor diameter af-fected the extent of removal(p=0.028) : 3) the extent of removal seemed to be the determining factor for overall survival and recurrence-free survival(the 5-YSR and RFSR of subtotal or total removal group are 92% and 80% vs. 40% of partial removal or biopsy group) : 4) conventional radiation therapy improved patient survival(5-YSR of patients who received RT is 76% whereas 5-YSR of those who didn't receive RT is 43%) but failed to prolong long-term recurrence-free survival. Conclusion : The extent of removal and postoperative radiation therapy are determining factors of patients' survival in skull base chordomas and chondrosarcomas. However, none of these factors significantly influenced the survival in multivariate analysis. Aggressive surgical removal of more than subtotal resection combined with postoperative radiation therapy seems to be the choice of therapy in the management of these tumors.
Three Yorkshire Terriers (12-year-old, 13-year-old, and 15-year-old castrated males) with respiratory distress, coughing and anorexia were the subjects of this report. In laboratory examinations, there were no remarkable findings. However, the thoracic radiographic findings included a large mass of soft tissue density in the cardiac base region, tracheal elevation, and aortic bulging in all three Yorkshire Terriers. There were no remarkable findings in the abdominal radiographs. In echocardiography, a homogeneous hyperechoic mass around the aorta and bicuspid valve regurgitation were found in all three dogs. There were no remarkable findings in abdominal ultrasonography. Computed tomographic findings showed a large well -defined heterogeneous mass in the cranial vena cava, which was dominant in the left side in all three Yorkshire Terriers. The mass sizes were about $3{\times}4cm$. In post-contrast scanning, contrast enhancement was evident. These cases were diagnosed as heart-base tumor. Treatments provided to the three dogs were based on symptomatic medical management of cardiac failure and tracheal collapse. Case 1 (12-year-old) survived for 3 months, case 2 (13-year-old) for 5 months, and case 3 (15-year-old) for 32 months after the diagnosis. Our results show that the clinical findings, thoracic radiography, echocardiography, computed tomography (CT) and symptomatic medical management in dogs suspected to have heart base tumor.
Alessandri-Bonetti, Giulio;Ippolito, Daniela Rita;Bartolucci, Maria Lavinia;D'Anto, Vincenzo;Incerti-Parenti, Serena
The korean journal of orthodontics
/
v.45
no.6
/
pp.308-321
/
2015
Objective: The efficacy of mandibular advancement devices (MADs) in the treatment of obstructive sleep apnea (OSA) ranges between 42% and 65%. However, it is still unclear which predictive factors can be used to select suitable patients for MAD treatment. This study aimed to systematically review the literature on the predictive value of cephalometric analysis for MAD treatment outcomes in adult OSA patients. Methods: The MEDLINE, Google Scholar, Scopus, and Cochrane Library databases were searched through December 2014. Reference lists from the retrieved publications were also examined. English language studies published in international peer-reviewed journals concerning the predictive value of cephalometric analysis for MAD treatment outcome were considered for inclusion. Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results: Fifteen eligible studies were identified. Most of the skeletal, dental, and soft tissue cephalometric measurements examined were widely recognized as not prognostic for MAD treatment outcome; however, controversial and limited data were found on the predictive role of certain cephalometric measurements including cranial base angle, mandibular plane angle, hyoid to mandibular plane distance, posterior nasal spine to soft-palate tip distance, anterior nasal spine to epiglottis base distance, and tongue/oral cross sectional area ratio thus justifying additional studies on these parameters. Conclusions: Currently available evidence is inadequate for identification of cephalometric parameters capable of reliably discriminating between poor and good responders to MAD treatment. To guide further research, methodological weaknesses of the currently available studies were highlighted and possible reasons for their discordant results were analyzed.
Kim, Ji Hyun;Cho, Kwang Ho;Jin, Zhe Wu;Murakami, Gen;Abe, Hiroshi;Chai, Ok Hee
Anatomy and Cell Biology
/
v.51
no.4
/
pp.266-273
/
2018
The ganglion cardiacum or juxtaductal body is situated along the left recurrent laryngeal nerve in the aortic window and is an extremely large component of the cardiac nerve plexus. This study was performed to describe the morphologies of the ganglion cardiacum or juxtaductal body in human fetuses and to compare characteristics with intracardiac ganglion. Ganglia were immunostained in specimens from five fetuses of gestational age 12-16 weeks and seven fetuses of gestational age 28-34 weeks. Many ganglion cells in the ganglia were positive for tyrosine hydroxylase (TH; sympathetic nerve marker) and chromogranin A, while a few neurons were positive for neuronal nitric oxide synthase (NOS; parasympathetic nerve marker) or calretinin. Another ganglion at the base of the ascending aorta carried almost the same neuronal populations, whereas a ganglion along the left common cardinal vein contained neurons positive for chromogranin A and NOS but no or few TH-positive neurons, suggesting a site-dependent difference in composite neurons. Mixtures of sympathetic and parasympathetic neurons within a single ganglion are consistent with the morphology of the cranial base and pelvic ganglia. Most of the intracardiac neurons are likely to have a non-adrenergic non-cholinergic phenotype, whereas fewer neurons have a dual cholinergic/noradrenergic phenotype. However, there was no evidence showing that chromogranin A- and/or calretinin-positive cardiac neurons corresponded to these specific phenotypes. The present study suggested that the ganglion cardiacum was composed of a mixture of sympathetic and parasympathetic neurons, which were characterized the site-dependent differences in and near the heart.
Upon analyzing the literature, it becomes apparent that norms for orthodontic diagnosis were from normal occlusion with pleasing face, and that the form and size of craniofacial skeleton were different between racial or ethnic groups. Therefore, this study was intended to establish Korean adult norms be useful for diagnosing the cases and to compare those to other ethnic or racial groups. Lateral cephalometric radiographs were taken of ninety-one Korean adults with normal occlusion showing pleasing face consisted in forty-three males and forty-eight females. The subjects ranged in age from seventeen to twenty-six years. The tracings involved measurements that were analyzed with a digitizer. The findings of this study can be summarized as follows, 1. Norms of Korean adult males, females, and combined sexes were established. 2 It was found that in the form and shape of craniofacial skeleton, there were no significant differences between males and females, but in the size males were larger than females 3. There were a great variation between ethnic or racial groups in the measurements of craniofacial skeleton 4 The size of Korean cranial base was smaller than the American Caucasian. 5 The maxilla and mandible of Korean were less protruded than those of the other ethnic groups 6 The dental pattern of Korean were more proclined than that of the American Caucasian and less protruded than that of the American Negro and the North Indian.
This comparative study was undertaken to investigate the position of the hyoid bone in unilateral cleft lip and palate individuals. The materials for this study consisted of 35 subjects with surgically repaired unilateral cleft lip and palate (25 males, 10 females) and 40 subjects with normal facial morphology (20 males, 20 females). Cephalometric measurements of unilateral cleft and palate individuals were compared with those of non-cleft individuals. The conclusions of this study were obtained as follows: 1. To the anterior cranial base, the hyoid bone in unilateral cleft lip and palate individuals was located downward as compared with non-cleft individuals. 2. To the mandible, the hyoid bone in unilateral cleft lip and palate individuals was located backward as compared with non-cleft individuals. 3. The distance between the dorsum of the tongue and the inferior border of the hard palate in unilateral cleft lip and palate individuals was longer than that in non-cleft individuals. 4. Unilateral cleft lip and palate individuals showed no significant difference in the distance between the hyoid bone and the dorum of the tongue as compared with non-cleft individuals.
This study was carried out to evaluate the distribution and the degree of the asymmetry existed in normal persons and asymmetric patients, and to investigate the changes of asymmetric patients after orthognathic surgery. The analysis was performed with the posteroanterior cephalometric radiography of 60 normal persons and 31 facial asymmetric patients. The results were as follows : 1. The degree of normal asymmetry existed in normal persons was not significant except MF and Me measurements. 2. The degree of normal asymmetry according to sex difference was not significant except cranial base area. 3. When normal persons were compared to asymmetric patients, there were more measurements which presented significant asymmetry on mandible than on maxilla. 4. When postoperative state was compared to preoperative state, the degree of asymmetry were usually decreased except AGO and GA measurements, especially the Cd, MF, Me, and Cd-Me measurements decreased significantly. 5. When postoperative state was compared to normal persons, 4 measurements of mandible approached significantly the measurements of normal persons.
This study was undertaken to analyze the growth of mandible in surgically repaired unilateral cleft lip and palate. The subjects consisted of 63 unilateral cleft lip and palate individuals, 60 class III malocclusions and 60 normal occlusions ranging from 6 to 15 years old. Each group was divided into two age groups. (6-10 Y and 11-15 Y) The results obtained from UCLP compared with other groups were as follows: 1. The anteroposterior position of the chin was similar to that of the normal occlusions. 2. The shape of the mandible was similar to that of the class III malocclusions. 3. In mandibular size, ramus height was the smallest among three groups, but body length and overall mandibular length were similar to those of the normal occlusions. 4. The lower border of the mandible was the steepest among three groups and strong vertical or clockwise growth tendency was indicated. 5. The position of condyle in relation to the cranial base showed little difference in three groups. 6. In older age group , vertical growth tendency of the mandible decreased more or less.
The interrelationships between growth rates (and size) of the selected cranifacial dimensions and body dimensions (height and weight) were investigated in the longitudinal data of primary school children from 6 to 11 years of age. The data were obtained from serial cephalometric radiographs and health record which were taken at one year interval. Regression analyses were used to analyze the data. The main concludions might be summarized as follows; 1. Size relationships between body height (and weigh) and S-Gn, posterior facial height (s-Go), total mandibular length (Ar-Gn) showed high significant correlation, but no association between body height, weight and anterior cranial base length (S-N). 2. Correlation coefficients between facial dimensions and body height (and weight) were getting lower with age increase. 3. At all age groups, significant prediction equation for some facial dimensions with body height and weight were obtained. 4. In this sample, the growth rates of facial dimensions and body height and weight showed almostly constant during this age period and the growth rate of body height and weight of girls was exceeded that of boys. 5. A relatively high degree of variation between individuals existed in the sample. 6. A positive correlation was found for the relationship between the growth rates of facial dimensions and those of body height (and weight) in boys and girls, but was not found in total samples.
The purpose of this study was to evaluate the effects of the chincap therapy on the craniofacial structure in persons with skeletal Class III malocclusion. The patients selected for this study were treated with extra-oral chincap therapy only. Both control and treatment samples were obtained from Seoul National University Hospital where these longitudinal data were gathered. 55 treated patients and 14 control patients were studied. The mean ages at the 1st evaluation was 8 years 3 months in the treatment sample and 9 years 4 months in the control sample. The duration of chincap therapy was variable but averaged 2 years of treatment. Post-treatment observation procedeeded for 1 year 2 months. Active treatment and post treatment effects were evaluated. The results were as follows: 1. Neither significant restraint nor acceleration of growth was found in the cranial base and maxilla during treatment. 2. A distal rotation of the mandibular complex was seen. 3. Some amount of restraint of growth was found in mandibular body length, ramus height, mandibular length during treatment. 4. The genial angle was reduced. 5. After removal of the chin-cap, forward displacement of the mandible took place.
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