• Title/Summary/Keyword: functional staging

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Correlation of Habits and Clinical Findings with Histopathological Diagnosis in Oral Submucosal Fibrosis Patients

  • Ara, Syeda Arshiya;Arora, Vini;Zakaullah, Syed;Raheel, Syed Ahmed;Rampure, Prakash;Ashraf, Sajna
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7075-7080
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    • 2013
  • Background: Oral submucosal fibrosis (OSMF) is one of the most prevalent premalignant conditions in India which is easy to diagnose but difficult to manage. At present it is considered as irreversible and incurable. It has also been referred to as an epidemic in India. Aims and Objectives: To correlate the frequency and duration of habits with clinical staging, functional staging and histopathological grading and to correlate the clinical and functional staging with histopathological grading. Materials and Methods: The study included a total of 90 subjects, 80 with OSMF in the experimental group and 10 patients in the control group. Patient personal history was recorded with chewing habits, including frequency and duration of chewing. The site of keeping the quid, time duration and whether he/she swallows it or spits it were also noted. Clinical staging was done on the presence of palpable fibrous bands. Functional staging was accomplished by measuring mouth opening. Incisional biopsy was done for all the patients for histopathological examination. Histopathological grading was according to Pindborg and Sirsat. Results: The experimental group comprised 71 males and 9 females, the majority of which were in the age group of 21-30 years. Correlation of habits with clinical staging, functional staging and histopathological grading were significant (p<0.05). Clinical and functional staging did not correlate with histopathological grading, but the correlation of clinical and functional staging was highly significant (p<0.01). Conclusions: The widespread habit of chewing gutkha is a major risk factor for OSMF, especially in the younger age group. In this study, it was found that with increase in the duration and frequency of the habit the severity of the disease increased.

Clinical Application of $^{18}F-FDG$ PET in Malignant Mesothelioma (악성중피종에서 $^{18}F-FDG$ PET의 임상응용)

  • Lee, Eun-Jeong
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.157-161
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    • 2008
  • Malignant pleural mesothelioma (MPM) has a poor prognosis and a strong association with exposure to asbestos. Although there are not generally accepted guidelines for treatment of MPM, recent reports suggest that multi modality therapy combining chemotherapy, radiotherapy, and surgery can improve the survival of patients with MPM. Therefore exact staging is required to decide the best treatment option. However, it is well known that there are many difficulties in determining precise preoperative stage, predicting prognosis, and monitoring response to therapy with conventional imaging modalities such as CT and MRI in MPM. Recently PET with $^{18}F-FDG$ comes into the spotlight as an important staging method. There is increasing evidence that PET is superior to other conventional imaging modalities in diagnosis and staging of MPM. Particularly PET/CT improves the diagnostic and staging accuracy over PET or CT alone in MPM because it provides anatomic imaging data as well as functional information. PET and PET/CT are also useful for monitoring response to therapy and SUV is reported as a prognostic factor in MPM.

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.

Use of DNA Methylation for Cancer Detection and Molecular Classification

  • Zhu, Jingde;Yao, Xuebiao
    • BMB Reports
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    • v.40 no.2
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    • pp.135-141
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    • 2007
  • Conjugation of the methyl group at the fifth carbon of cytosines within the palindromic dinucleotide 5'-CpG-3' sequence (DNA methylation) is the best studied epigenetic mechanism, which acts together with other epigenetic entities: histone modification, chromatin remodeling and microRNAs to shape the chromatin structure of DNA according to its functional state. The cancer genome is frequently characterized by hypermethylation of specific genes concurrently with an overall decrease in the level of 5-methyl cytosine, the pathological implication of which to the cancerous state has been well established. While the latest genome-wide technologies have been applied to classify and interpret the epigenetic layer of gene regulation in the physiological and disease states, the epigenetic testing has also been seriously explored in clinical practice for early detection, refining tumor staging and predicting disease recurrence. This critique reviews the latest research findings on the use of DNA methylation in cancer diagnosis, prognosis and staging/classification.

The Role of PET in Lung Cancer (폐암에서 PET의 역할)

  • Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.28-33
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    • 2002
  • Lung cancer has become a loading cause of cancer death in Korea. Positron emission tomography was introduced in clinical nuclear medicine in the early 1990s and many studios using this functional imaging technology were performed for evaluation of its clinical utility. I review the current role of positron emission tomography in the diagnosis, staging, and therapy monitoring of lung cancer.

Classification and surgical management of temporomandibular joint ankylosis: a review

  • Upadya, Varsha Haridas;Bhat, Hari Kishore;Rao, B.H. Sripathi;Reddy, Srinivas Gosla
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.4
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    • pp.239-248
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    • 2021
  • The paper reviews various classifications and surgical techniques for the treatment of temporomandibular joint ankylosis. PubMed, EBSCO, Web of Science, and Google Scholar were searched using a combination of keywords. Articles related to classification, resection-reconstruction of the temporomandibular joint, and management of airway obstruction were considered and categorized based on the objectives. Seventy-nine articles were selected, which included randomized clinical trials, non-randomized controlled cohort studies, and case series. Though several classifications exist, most classifications are centered on the radiographic extent of the ankylotic mass and do not include the clinical and functional parameters. Hence there is a need for a comprehensive staging system that takes into consideration the age of the patient, severity of the disease, clinical, functional, and radiographic findings. Staging the disease will help the clinician to adopt a holistic approach in treating these patients. Interpositional arthroplasty (IA) results in better maximal incisal opening compared with gap arthroplasty, with no significant difference in recurrent rates. Distraction osteogenesis (DO) is emerging as a popular technique for the restoration of symmetry and function as well as for relieving airway obstruction. IA, with a costochondral graft, is recommended in growing patients and may be combined with or preceded by DO in cases of severe airway obstruction. Alloplastic total joint replacement combined with fat grafts and simultaneous osteotomy procedures are gaining popularity. A custom-made total joint prosthesis using CAD/CAM can efficiently overcome the shortcomings of stock prostheses.

Multimodality and Application Software (다중영상기기의 응용 소프트웨어)

  • Im, Ki-Chun
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.2
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    • pp.153-163
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    • 2008
  • Medical imaging modalities to image either anatomical structure or functional processes have developed along somewhat independent paths. Functional images with single photon emission computed tomography (SPECT) and positron emission tomography (PET) are playing an increasingly important role in the diagnosis and staging of malignant disease, image-guided therapy planning, and treatment monitoring. SPECT and PET complement the more conventional anatomic imaging modalities of computed tomography (CT) and magnetic resonance (MR) imaging. When the functional imaging modality was combined with the anatomic imaging modality, the multimodality can help both identify and localize functional abnormalities. Combining PET with a high-resolution anatomical imaging modality such as CT can resolve the localization issue as long as the images from the two modalities are accurately coregistered. Software-based registration techniques have difficulty accounting for differences in patient positioning and involuntary movement of internal organs, often necessitating labor-intensive nonlinear mapping that may not converge to a satisfactory result. These challenges have recently been addressed by the introduction of the combined PET/CT scanner and SPECT/CT scanner, a hardware-oriented approach to image fusion. Combined PET/CT and SPECT/CT devices are playing an increasingly important role in the diagnosis and staging of human disease. The paper will review the development of multi modality instrumentations for clinical use from conception to present-day technology and the application software.

Hybrid Imaging in Oncology

  • Fatima, Nosheen;uz Zaman, Maseeh;Gnanasegaran, Gopinath;Zaman, Unaiza;Shahid, Wajeeha;Zaman, Areeba;Tahseen, Rabia
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5599-5605
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    • 2015
  • In oncology various imaging modalities play a crucial role in diagnosis, staging, restaging, treatment monitoring and follow up of various cancers. Stand-alone morphological imaging like computerized tomography (CT) and magnetic resonance imaging (MRI) provide a high magnitude of anatomical details about the tumor but are relatively dumb about tumor physiology. Stand-alone functional imaging like positron emission tomography (PET) and single photon emission tomography (SPECT) are rich in functional information but provide little insight into tumor morphology. Introduction of first hybrid modality PET/CT is the one of the most successful stories of current century which has revolutionized patient care in oncology due to its high diagnostic accuracy. Spurred on by this success, more hybrid imaging modalities like SPECT/CT and PET/MR were introduced. It is the time to explore the potential applications of the existing hybrid modalities, developing and implementing standardized imaging protocols and train users in nuclear medicine and radiology. In this review we discuss three existing hybrid modalities with emphasis on their technical aspects and clinical applications in oncology.

Complex facial degloving injury: a case report of a complication and its management

  • Sarkar, Dibya Falgoon;Dutta, Debanwita
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.3
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    • pp.174-177
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    • 2022
  • Facial degloving injuries are due to separation between the skin and subcutaneous tissues from the underlying muscles, bones, and fascia. These injuries often create a reconstructive challenge for surgeons especially when there are associated complications like wound infection or necrosis of the avulsed flap. This case report presents management of a case of facial degloving injury with full thickness necrosis of the avulsed flap. The authors concluded that treatment of such complex wounds requires a multi-disciplinary approach along with proper planning and staging of the surgical procedures for optimum aesthetic and functional outcomes.

Chronic persistent post-surgical pain following staging laparotomy for carcinoma of ovary and its relationship to signal transduction genes

  • Saxena, Ashok Kumar;Chilkoti, Geetanjali T;Chopra, Anand K;Banerjee, Basu Dev;Sharma, Tusha
    • The Korean Journal of Pain
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    • v.29 no.4
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    • pp.239-248
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    • 2016
  • Background: The present study was undertaken to evaluate the incidence of chronic persistent post-surgical pain (CPPP) and the role of signal transduction genes in patients undergoing staging laparotomy for carcinoma ovary. Methods: The present observational study was undertaken following institutional ethical committee approval and informed consent from all the participants. A total 21 patients of ASA grade I to III with age 20-70 years, scheduled for elective staging laparotomy for carcinoma ovary were included. Patients were excluded if had other causes of pain, cognitive dysfunction or chronic neurological disorders. Statistical analysis of pool data was done using SPSS version-17. For various scales like GPE, PDQ, NPSI, the visual analogue scale (VAS), global perceived effect (GPE), the pain DETECT questionnaire (PDQ), and neuropathic pain symptoms inventory (NPSI), one factor repaeted measure ANOVA applied with simple contrast with baseline as on post-operative day 1 (considered as reference and compared with subsequent time-interval), and the P values were adjusted according to "Bonferroni adjustments". In patients with CPPP, the ${\Delta}ct$ values of mRNA expressions of genes at the end of postoperative day 90 were compared with the baseline control values by one factor repeated ANOVA. P value < 0.005 significant. Results: The present study demonstrates 38.1% (8 out of 21 patients) incidence of CPPP. The functional status and quality of life as were observed to be significantly diminished in all patients with chronic pain. An up-regulation in the mRNA expression of signal transduction and a positive correlation was noted between the mRNA expression of signal transduction genes and VAS score in all patients with CPPP at the end of postoperative day 90. Conclusions: The reported incidence of CPPP in patients with carcinoma ovary was 38.1%. An up-regulation and positive correlation between mRNA expression of signal transduction genes and VAS score depicts its potential role in the pathogenesis of CPPP.