• 제목/요약/키워드: new treatment modality

검색결과 88건 처리시간 0.023초

Role of fractionated radiotherapy in patients with hemangioma of the cavernous sinus

  • Park, Sunmin;Yoon, Sang Min;Lee, Sumin;Park, Jin-hong;Song, Si Yeol;Lee, Sang-wook;Ahn, Seung Do;Kim, Jong Hoon;Choi, Eun Kyung
    • Radiation Oncology Journal
    • /
    • 제35권3호
    • /
    • pp.268-273
    • /
    • 2017
  • Purpose: We performed this retrospective study to investigate the outcomes of patients with hemangioma of the cavernous sinus after fractionated radiotherapy. Materials and Methods: We analyzed 10 patients with hemangioma of the cavernous sinus who were treated with conventional radiotherapy between January 2000 and December 2016. The median patient age was 54 years (range, 31-65 years), and 8 patients (80.0%) were female. The mean hemangioma volume was $34.1cm^3$ (range, $6.8-83.2cm^3$), and fractionated radiation was administered to a total dose of 50-54 Gy with a daily dose of 2 Gy. Results: The median follow-up period was 6.8 years (range, 2.2-8.8 years). At last follow-up, the volume of the tumor had decreased in all patients. The average tumor volume reduction rate from the initial volume was 72.9% (range, 18.9-95.3%). All 10 of the cranial neuropathies observed before radiation therapy had improved, with complete symptomatic remission in 9 cases (90%) and partial remission in 1 case (10%). No new acute neurologic impairments were reported after radiotherapy. One probable compressive optic neuropathy was observed at 1 year after radiotherapy. Conclusion: Fractionated radiotherapy achieves both symptomatic and radiologic improvements. It is a well-tolerated treatment modality for hemangiomas of the cavernous sinus.

Congenital Hypoplasia of Internal Carotid Artery Accompanying with Cerebral Aneurysms

  • Baek, Geum-Seong;Koh, Eun-Jeong;Lee, Woo-Jong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
    • /
    • 제41권5호
    • /
    • pp.343-346
    • /
    • 2007
  • Hypoplasia of the internal carotid artery is a rare congenital anomaly. Agenesis, aplasia, and hypoplasia of the internal carotid artery [ICA] are frequently associated with cerebral aneurysms in the circle of Willis. Authors report two cases with congenital hypoplasia of the ICA accompanying with the aneurysms. Transfemoral cerebral angiography [TFCA] in one patient identified nonvisualization of the left ICA. Bilateral anterior cerebral artery [ACA] and middle cerebral artery [MCA] were supplied from the right ICA accompanying with two aneurysms at anterior communicating artery [AcoA] and A1 portion of the left ACA. TFCA in another patient demonstrated hypoplastic left ICA and left ACA filled from the right ICA accompanying with AcoA aneurysm. Left MCA was filled from basilar artery via posterior communicating artery [PcoA]. Skull base computed tomography [CT] in two patients showed hypoplastic carotid canal. Authors performed direct aneurysmal neck clipping. Follow up CT angiography [CTA] at one year after surgery did not show regrowth or new development of the aneurysm. In patients with hypoplastic ICA, neurosurgeons should be aware of the possibility of development of the aneurysms, presumably because of hemodynamic process. Direct aneurysmal neck clipping is a good treatment modality. After operation, regular CTA, magnetic resonance angiography [MRA] or TFCA is needed to find progressive lesion and to prevent cerebrovascular attack [CVA].

천공분지에 기저를 둔 도서형 피부피판을 이용한 천골부 욕창의 재건 (Reconstruction of Sacral Pressure Sores Using Perforator-Based Island Skin Flaps)

  • 문지현;이내호
    • Archives of Reconstructive Microsurgery
    • /
    • 제9권1호
    • /
    • pp.62-67
    • /
    • 2000
  • 저자들은 1998년 1월부터 2000년 2월까지 1 5례의 천골부 욕창 환자를 대상으로 천공분지에 기저를 둔 도서형 피부피판을 욕창 재건에 적용하였다. 피판의 공여부의 기능적 소실을 최소화하며 특별한 합병증 없이 좋은 결과를 얻었으며 현재까지 추적조사한 결과 재발은 관찰되지 않았다. 천공분지에 기저를 둔 도서형 피판은 신체 여러부위의 재건에 고려될 수 있을 것으로 사료되며 다양한 모양과 깊이의 창상재건에 유용한 방법이라고 사료된다.

  • PDF

기관 협착증 환자에서 기관 절제 및 단단 문합술의 성적에 대한 고찰 (Surgical Result of Tracheal Resection and Primary Anastomosis in Tracheal Stenosis)

  • 조성래
    • Journal of Chest Surgery
    • /
    • 제28권2호
    • /
    • pp.156-161
    • /
    • 1995
  • Although there are many kinds of method in treatment of tracheal stenosis, tracheal resection and primary anastomosis can be performed for management of various kinds of tracheal stenosis because it is considered the most anatomical ideal therapeutic modality. During a 10-year period we performed 18 tracheal resection on 18 patients with no operative mortality and some morbidity. 13 patients had tracheal stenosis caused by endotracheal intubation [eight patients or tracheostomy [five patients ; and five patients caused by a variety of neoplastic lesions [four primary and one secondary . The length of tracheal stenosis were various from 1.5cm to 5.5cm and site of tracheal stenosis were cervical[17patients and thoracic [one patient . Operative techniques were tracheal resection and primary anastomosis[18 patients and additional procedures were cricoid cartilage reconstruction with costal cartilage [one patient , primary repair of esophagus[one patient and suprahyoid laryngeal release technique[eight patients without any complications. We have eight complications; tracheal restenosis were developed in five patients[growth of grannulation tissue at anastomotic site in three patients, delayed restenosis in two patients , anastomotic disruption in one patient, hoarseness and pneumonia in each of two patients. We managed tracheal complications with T-tube insertion in two patients, permanent tracheostomy in three patients and insertion of Gianturco tracheal stent in one patient, but tracheal stent did not reveal good result because it caused persistent production of sputum. We concluded that it is necessary to access full length of normal trachea including suprahyoid laryngeal release technique to avoid anastomotic tension in tracheal surgery and develope new ideal techniques to manage postoperative tracheal complications, because we suppose tracheal complications are developed due to anastomotic tension.

  • PDF

노출된 영구 심박조율기의 치험례 (Clinical Experience of Exposed Pacemakers)

  • 오득영;김태형;이종원;이백권;한기택;안상태;최윤석
    • Archives of Plastic Surgery
    • /
    • 제32권6호
    • /
    • pp.753-756
    • /
    • 2005
  • In the cases of severe arrythmia and conduction failure, a permanent implanted pacemaker is considered an essential treatment modality with less complication rate, broad indications and low morbidity. However, some pacemakers needs to be removed or replaced due to infection, in need of a lead upgrade, elective replacement, conduction failure or insulation failure. The most common indication for pacemaker extraction is infection. Conservative treatments such as administration of intravenous antibiotics and limitation of debridement are not effective and the removal of the entire pacing system is considered to be the best approach to pacemaker pocket infection. Although a locking stylet, a laser sheath and other newer methods of transvenous lead extraction have been proven to be effective, all leads cannot be removed. Moreover, major complications such as, cardiac tamponade and respiratory arrest during leads extraction procedure should not be ignored. We experienced two cases of exposed pacemakers in the subclavicular region. After removing the pacemaker body, exposed proximal lead was pulled out and cut off. The end of remnant external insulation tube was tied to prevent infection propagation between external insulation tube and inner metalic coil. Wounds were covered by local flap coverage. No other problems were detected during the one-year follow-up. Since there are few reports on lead-preserving method of treating limited infection of exposed pacemakers, we would like to present our new method for treating exposed pacemakers.

유년기 안구적출술 및 방사선치료로 인하여 발생된 안와 열성장에 대한 재건 치험례 (PRELIMINARY CASE REPORTS OF RECONSTRUCTION FOR ORBITAL HYPOPLASIA AFTER EYEBALL ENUCLEATION AND IRRADIATION DURING CHILDHOOD)

  • 김훈;최미숙;최성원;홍관석;김성문;임재석;권종진
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제18권1호
    • /
    • pp.17-25
    • /
    • 1996
  • There are many reports of the surgical management for the craniofacial abnormalities arising from the irradiation of the head and face for treatment of childhood cancers. Since the mordern combined-modality theraphy for childhood cancers began in the late 1960s and the early 1970s, recent reports have described the occular, dental and maxillo-facial abnormalities after irradiation in long-term survivors of cancers of the head and face. The resultant deformities may be known to be difficult to reconstruct with surgical techniques. This paper describes the late reconstructive surgery for the unilateral orbital and malar hypoplasia after eyeball enucleation and irradiation during childhood to correct the facial asymmetry and expand the contracted orbital socket into the functional dimension for the retaining eyeball prosthesis with spherical implant. We reports the satisfactory preliminary results from the midfacial osteotomy through the supero-lateral orbital rim and malar bone and the antero-lateral repositioning with the autogenous bone grafting in 26 year-old female patient who will be planned to make the new eyeball prosthesis by the department of ophthalmology.

  • PDF

Development of a Method for Improving the Electric Field Distribution in Patients Undergoing Tumor-Treating Fields Therapy

  • Sung, Jiwon;Seo, Jaehyeon;Jo, Yunhui;Yoon, Myonggeun;Hwang, Sang-Gu;Kim, Eun Ho
    • Journal of the Korean Physical Society
    • /
    • 제73권10호
    • /
    • pp.1577-1583
    • /
    • 2018
  • Tumor-treating fields therapy involves placing pads onto the patient's skin to create a low- intensity (1 - 3 V/cm), intermediate frequency (100 - 300 kHz), alternating electric field to treat cancerous tumors. This new treatment modality has been approved by the Food and Drug Administration in the USA to treat patients with both newly diagnosed and recurrent glioblastoma. To deliver the prescribed electric field intensity to the tumor while minimizing exposure of organs at risk, we developed an optimization method for the electric field distribution in the body and compared the electric field distribution in the body before and after application of this optimization algorithm. To determine the electric field distribution in the body before optimization, we applied the same electric potential to all pairs of electric pads located on opposite sides of models. We subsequently adjusted the intensity of the electric field to each pair of pads to optimize the electric field distribution in the body, resulting in the prescribed electric field intensity to the tumor while minimizing electric fields at organs at risk. A comparison of the electric field distribution within the body before and after optimization showed that application of the optimization algorithm delivered a therapeutically effective electric field to the tumor while minimizing the average and the maximum field strength applied to organs at risk. Use of this optimization algorithm when planning tumor-treating fields therapy should maintain or increase the intensity of the electric field applied to the tumor while minimizing the intensity of the electric field applied to organs at risk. This would enhance the effectiveness of tumor-treating fields therapy while reducing dangerous side effects.

A Novel Niosomal Combination of Selenium Coupled with Glucantime against Leishmania tropica

  • Mostafavi, Mahshid;Khazaeli, Payam;Sharifi, Iraj;Farajzadeh, Saeedeh;Sharifi, Hamid;Keyhani, Alireza;Parizi, Maryam Hakimi;Kakooei, Sina
    • Parasites, Hosts and Diseases
    • /
    • 제57권1호
    • /
    • pp.1-8
    • /
    • 2019
  • There is no effective treatment modality available against different forms of leishmaniasis. Therefore, the aim of this study was to improve the penetration and efficacy of selenium and glucantime coupled with niosomes and compared them with their simple forms alone on in vitro susceptibility assays. In this study, the niosomal formulations of selenium and in combination with glucantime were prepared. The size and morphology of the niosomal formulations were characterized and the effectivity of the new formulation was also evaluated using in vitro MTT assay, intra-macrophage model, and gene expression profile. From the results obtained, no cytotoxicity effect was observed for niosomal and simple forms of drugs, as alone or in combination. Niosomal formulations of the drugs significantly showed more inhibitory effects ($P{\leq}0.001$) than the simple drugs when the selectivity index was considered. The gene expression levels of Interleukin (IL-10) significantly decreased, while the level of IL-12 and metacaspase significantly increased ($P{\leq}0.001$). The results of the present study showed that selenium plus glucantime niosome possess a potent anti-leishmanial effect and enhanced their lethal activity as evidenced by the in vitro experiments.

In Vivo Enhanced Indocyanine Green-Photothermal Therapy for a Subconjunctival Tumor

  • Kim, Chang Zoo;Lee, Sang Joon;Hwang, Sang Seok;Chae, Yu-Gyeong;Kwon, Daa Young;Ko, Taek Yong;Kim, Jun Hyeong;Jung, Min Jung;Masanganise, Rangarirai;Oak, Chulho;Ahn, Yeh-Chan
    • Current Optics and Photonics
    • /
    • 제5권3호
    • /
    • pp.311-321
    • /
    • 2021
  • Indocyanine green (ICG) is a dye approved for use in clinical diagnostics. ICG remains in the intravascular space following intravenous administration, due to its ability to rapidly bind to the plasma proteins, and its therapeutic potential has been studied in well-vascularized cutaneous tumors. Here we have evaluated the clinical response of a subconjunctival tumor to photothermal therapy (PTT) using an ICG-enhanced near-infrared diode laser and its adverse effects, in a rabbit. 22 male New Zealand white rabbits with subconjunctival tumors were enrolled (control group 6, laser-only group 8, laser-with-ICG group 8). Rabbits in the laser-with-ICG group received ICG (twice, 2 mg/kg each time, intravenously) directly followed by irradiation with a diode laser (λ = 810 nm). Rabbits in the laser-only group were irradiated with the diode laser. ICG angiography, ultrasonography, and pathologic examination were performed to evaluate PTT response at specific time points (0, 2, and 4 weeks after PTT). Two weeks after initial treatment, the eight rabbits treated by laser with ICG showed a 100% response rate. There was no clinical response in both laser-only and control groups. ICG-PTT is a potential and effective palliative therapeutic modality for subconjunctival tumors.

An Evaluation of a New Quantitative Point-of Care Diagnostic to Measure Glucose-6-phosphate Dehydrogenase Activity

  • Bahk, Young Yil;Ahn, Seong Kyu;Jeon, Heung Jin;Na, Byoung-Kuk;Lee, Sung-Keun;Shin, Ho-Joon
    • Parasites, Hosts and Diseases
    • /
    • 제60권4호
    • /
    • pp.281-288
    • /
    • 2022
  • Malaria continues to be one of the most crucial infectious burdens in endemic areas worldwide, as well as for travelers visiting malaria transmission regions. It has been reported that 8-aminoquinolines are effective against the Plasmodium species, particularly primaquine, for anti-hypnozoite therapy in P. vivax malaria. However, primaquine causes acute hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Therefore, G6PD deficiency testing should precede hypnozoite elimination with 8-aminoquinoline. Several point-of-care devices have been developed to detect G6PD deficiency. The aim of the present study was to evaluate the performance of a novel, quantitative G6PD diagnostics based on a metagenomic blue fluorescent protein (mBFP). We comparatively evaluated the sensitivity and specificity of the G6PD diagnostic modality with standard methods using 120 human whole blood samples. The G6PD deficiency was spectrophotometrically confirmed. The performance of the G6PD quantitative test kit was compared with that of a licensed control medical device, the G6PD strip. The G6PD quantitative test kit had a sensitivity of 95% (95% confidence interval (CI): 89.3-100%) and a specificity of 100% (95% CI: 94.3-100%). This study shows that the novel diagnostic G6PD quantitative test kit could be a cost-effective and time-efficient, and universally mandated screening tool for G6PD deficiency.