• 제목/요약/키워드: p-dissection

검색결과 283건 처리시간 0.026초

구강 편평세포암종의 반대측 예방적 경부치료 (Management of Contralateral Node Negative Neck in Oral Cavity Squamous Cell Carcinomas)

  • 구본석;이욱진;나경원;정의석;김유석;이진석;임영창;최은창
    • 대한두경부종양학회지
    • /
    • 제21권2호
    • /
    • pp.196-200
    • /
    • 2005
  • Objectives: The purpose of this study was to evaluate the incidence and predictive factors of contralateral occult lymph node metastasis in oral cavity squamous cell carcinomas to form a rational basis for elective contralateral neck management. Materials and Methods: We performed a retrospective analysis of 66 N0-2 oral cavity cancer patients undergoing elective neck dissection for contralateral clinically negative necks from 1991 to 2003. Results: Clinically negative but pathologically positive contralateral lymph nodes occurred in 11%(7 of 66) . Of the 11 cases with a clinically ipsilateral node positive neck, contralateral occult lymph node metastases developed in 36%(4 of 10, in contrast with 5%(3/55) in the cases with clinically ipsilateral node negative necks(p<0.05). Based on the clinical staging of the tumor, 8%(3 of 37) of the cases showed lymph node metastases in T2 tumors, 25%(2 of 8) in T3, and 18%(2 of 11) in T4. None of the T1 tumors(10 cases) had pathologically positive lymph nodes. The rate of contralateral occult neck metastasis was significantly higher in advanced stage cases and those crossing the midline, compared to early stage or unilateral lesions(p<0.05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific survival over patients with any pathologically positive nodes(5-year disease-specific survival rate was 79% vs. 43%, p<0.05). Conclusion: The risk of contralateral occult neck involvement in the oral cavity squamous cell carcinomas above the T3 stage or those crossing the midline with unilateral metastases was high. Therefore, we advocate an elective contralateral neck treatment with surgery or radiotherapy in oral cavity squamous cell carcinoma patients with ipsilateral node metastases or tumors that are greater than stage T3 or crossing the midline.

컴퓨터 단층 촬영 혈관 조영술을 이용한 심하복벽 혈관과 천공지의 박리 용이성에 따른 분류 (Classification of Deep Inferior Epigastric Perforator Courses Based on Computed Tomography Angiography: Incidences and Clinical Implications)

  • 이연훈;김성찬;엄진섭;김은기
    • Archives of Hand and Microsurgery
    • /
    • 제23권4호
    • /
    • pp.281-289
    • /
    • 2018
  • 목적: 우리는 미세혈관 유방 재건술 수술 계획에 참고하기 위하여 컴퓨터 단층 촬영(computed tomography, CT)혈관 조영술을 이용하여 심하복벽혈관과 천공지의 주행을 세부 유형으로 나누어 보고 영상 및 임상 소견의 상관성과 각 유형의 빈도를 보고하고자 한다. 방법: 하복부 조직을 이용한 유방 재건을 받은 연속한 115명의 환자를 전향적으로 분석하였다. 심하복벽동맥과 천공지를 주로 근육 내 주행의 특징에 따라 박리하기 용이한 것과 박리에 곤란한 것으로 특징짓고 각각의 빈도를 조사하였다. 결과: 확인된 425개의 천공지 중 89개(20.9%)의 천공지는 박리에 용이한 주행을 하였으며 긴 근육 아래 주행(34.8%), 긴 근막 아래 주행(15.6%), 근육 주위 주행(13.9%)이 그에 속하였다. 반면 심하복벽동맥이 없거나 적절한 천공지가 조영되지 않는 경우가 3예와 8예에서 보고되었다. 총 65명(56.5%)의 환자가 적어도 한 개 이상의 박리가 용이한 천공지를 가지고 있었다. 결론: 수술 전 CT 혈관 조영술을 통하여 심하복벽동맥과 천공지의 주행을 분석하여 박리에 용이한 유형과 곤란한 유형을 미리 파악함으로써 수술 계획의 수립에 도움을 받을 수 있다.

Video-assisted Thoracoscopic Surgery for Treatment of Earlystage Non-small Cell Lung Cancer

  • Fan, Xing-Long;Liu, Yu-Xia;Tian, Hui
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권5호
    • /
    • pp.2871-2877
    • /
    • 2013
  • Objectives: To evaluate the safety, efficacy, and invasiveness of lobectomy by video-assisted thoracoscopic surgery (VATS) in the treatment of stage I/II non-small cell lung cancer (NSCLC). Methods: A total of 148 patients presenting with Stage I or II NSCLC were enrolled into our study, comprising 71 who underwent VATS and 77 patients undergoing conventional thoracotomic lobectomy, in combination with systematic lymph node resection. Results: It was found that VATS was superior to conventional thoracotomy in terms of the duration of surgery, intraoperative blood loss, frequency of the need to administer postoperative analgesia, thoracic intubation indwelling time, post-operative hospital stay, and survival rate (P<0.05). We saw no obvious difference in the number of resected lymph nodes with either approach. Conclusions: VATS lobectomy is a safe and reliable surgical approach for the treatment of Stage I/II NSCLC, characterized by significantly minimal invasiveness, rapid post-operative recovery, and markedly lower loss of blood.

CONGRUENCES MODULO POWERS OF 2 FOR OVERPARTITION PAIRS INTO ODD PARTS

  • Ahmed, Zakir;Barman, Rupam;Ray, Chiranjit
    • 대한수학회지
    • /
    • 제57권2호
    • /
    • pp.471-487
    • /
    • 2020
  • We find congruences modulo 32, 64 and 128 for the partition function ${\overline{PP}_o}(n)$, the number of overpartition pairs of n into odd parts, with the aid of Ramamnujan's theta function identities and some known identities of tk(n), for k = 6, 7, where tk(n) denotes the number of representations of n as a sum of k triangular numbers. We also find two Ramanujan-like congruences for ${\overline{PP}_o}(n)$ modulo 128.

Chyle leak after head and neck surgeries: a comprehensive review of diagnosis and management strategies

  • Aparna Ganesan;Nehal C. Singh;Naren P. Khatri;Charanjeet Singh Madaan;Savreek Kaur;Amanjot Kaur
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제50권1호
    • /
    • pp.3-12
    • /
    • 2024
  • Chyle leaks are uncommon complications after head and neck surgeries. Although uncommon, such a complication is noteworthy mention due to its perplexing diagnosis and management strategies. This scoping review aims to highlight and emphasize the diagnosis and management options proposed in the literature. A comprehensive search was performed in PubMed, Google Scholar, Cochrane Library, and Scopus databases and identified 617 articles that were reduced to 40 studies and reports after applying the eligibility criteria. Although numerous treatment options ranging from simple, conservative measures to invasive surgical procedures have been mentioned for low-output, high-output, and massive leaks, there is no concrete evidence on the best method. Thus, a combination of management options must be customized by case for optimum results.

Risk Factors for Gallstone Formation after Surgery for Gastric Cancer

  • Park, Dong Jin;Kim, Ki Hyun;Park, Young Suk;Ahn, Sang-Hoon;Park, Do Joong;Kim, Hyung-Ho
    • Journal of Gastric Cancer
    • /
    • 제16권2호
    • /
    • pp.98-104
    • /
    • 2016
  • Purpose: The incidence of gallstones after gastrectomy for gastric cancer is higher than in the general population. However, the causes and mechanisms of post-gastrectomy gallstones are unclear. The aim of this study was to evaluate the incidence of gallstone formation and the risk factors for their development after gastrectomy for gastric cancer. Materials and Methods: Of 1,744 gastric cancer patients who underwent gastrectomy at Seoul National University Bundang Hospital between January 2010 and December 2012, 1,284 were included in this study and retrospectively reviewed. Patients' age, sex, body mass index (BMI), tumor location, stage, type of gastrectomy, type of reconstruction, and extent of node dissection were evaluated. Results: The incidence of gallstones after gastrectomy for gastric cancer was significantly higher in men than in women (P=0.019). Exclusion of the duodenum during reconstruction was associated with a significantly higher incidence of gallstones (P=0.003). Overweight and obese patients with BMI ${\geq}23kg/m^2$ had significantly higher incidence of gallstones than those with a lower BMI (P=0.006). Multivariate analysis showed that obesity (hazard ratio, HR=1.614; 95% confidence interval, CI: 1.135~2.296; P=0.008), male sex (HR=1.515, 95% CI: 1.029~2.231, P=0.033), and exclusion of the duodenum (HR=1.648, 95% CI: 1.192~2.280, P=0.003) were significant, independent risk factors for gallstones after gastrectomy. Conclusions: The cumulative incidence of gallstones for 5 years after gastrectomy was 15.3%. Male sex, obesity, and exclusion of the duodenum were risk factors for gallstone formation after gastrectomy. Careful surveillance will be required for these patient groups after gastrectomy.

순행성 관관류법과 역행성 관관류법의 임상적 비교연구 (A Comparative Study of Antegrade Cardioplegia Versus Retrograde Cardioplegia for Myocardial Protection during the Open Heart Surgery)

  • 조완재
    • Journal of Chest Surgery
    • /
    • 제22권4호
    • /
    • pp.609-619
    • /
    • 1989
  • During aortic valve surgery, cardioplegic solution is delivered through direct cannulation of both coronary ostia. Since this approach may cause an intimal injury leading to acute dissection or late ostial stenosis, this study was undertaken to evaluate myocardial protective effect of retrograde perfusion of cardioplegia [RCSP <% RRAP] in 18 clinical cases, which were compared with antegrade perfusion of cardioplegia in 27 clinical cases. This study were investigated 1] cease and return of electromechanical activity after cardioplegia infusion 2] the myocardial temperature during operation 3] the aortic cross clamping time and total bypass time 4] frequency of DC shock for defibrillation 5] need for inotropic drugs after operation 6] electrocardiographic evidence of myocardial infarction or ventricular arrhythmia after operation 7] the enzymes activity during preoperative and postoperative period as an evaluation of myocardial ischemic injury and 8] operative mortality rate The combination of retrograde cardioplegia and topical cooling with ice slush yielded promptly hypothermia of myocardium and shorter aortic cross-clamping time compared with antegrade cardioplegia [P < 0.05]. The temperature of the interventricular septum was maintained below 20oC by continuous perfusion or intermittent perfusion of cold blood cardioplegia and other results were no statistically significant difference between the two methods [P >0.05]. This technique provides clear operative field and avoids some serious complications which are caused by coronary ostial cannulation. These results suggested that the retrograde perfusion of cardioplegia is a simple, safe, and effective means of myocardial protection during open heart surgery.

  • PDF

Determination of Sexual Problems of Turkish Patients Receiving Gynecologic Cancer Treatment: a Cross-sectional Study

  • Demirtas, Basak;Pinar, Gul
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권16호
    • /
    • pp.6657-6663
    • /
    • 2014
  • Background: The present study aimed to determine the prevalence and types of sexual problems of Turkish patients receiving gynecologic cancer treatment. Materials and Methods: A cross-sectional convenience sample of 168 women completed the Index of Female Sexual Function (IFSF) and a Patient Identification Form in a hospital in Ankara, Turkey. Mean IFSF scores of the patients were low ($15.7{\pm}5.72$, out of a possible 45), indicating high rates of sexual problems. Results: Women frequently reported problems with dyspareunia (97.1%), vaginal dryness (97.6%), decreased sexual desire (91.1%), and difficulties of sexual arousal (92.9%) related with the cancer treatment process. They reported increased sexual problems following the period of treatment as compared to before treatment (p<0.05). Sexual dysfunction was associated with low educational and income levels, advanced age, TAH-BSO-LND surgery (total abdominal hysterectomy-bilateral salphingoopherectomylymph node dissection), experiencing side effects of chemotherapy, receiving chemotherapy in addition to surgery and radiotherapy (CT+RT+Surgery), and having a large number of chemotherapy cycles (p<0.05). Conclusions: Patients hoped for and expected counseling from healthcare professionals about their sexual functioning in relation to cancer treatments. Nurses and physicians can help to improve the overall quality of life for gynecologic cancer patients through sexual counseling.

진행된 후두암과 하인두암의 환자에서 유도화학 요법 후 방사선 치료와 수술 후 방사선 치료의 성적 비교 및 고찰 (Induction Chemotherapy Plus Radiation Compared with Surgery Plus Radiation in Patients with Advanced Laryngeal and Hypopharyngeal Cancer)

  • 금기창;이창걸;김귀언;이경희
    • Radiation Oncology Journal
    • /
    • 제11권2호
    • /
    • pp.277-283
    • /
    • 1993
  • Background: We peformed a retroslective study in patients with previously untreated advanced (Stage III or IV) laryngeal and hypopharyngeal cancer to compare the results of induction chemotherapy followed by definitive radiation therapy (CT+ RT) with those of conventional laryngectomy and postoperative radiation therapy (OP + RT). Method: Between 1985 and 1990, twenty-four patients were treated with two or three courses of chemotherapy and radiation therapy (66-75 Gy). Twenty-five patients were received laryngectomy and radical neck dissection (except 3 patients) and postoperative radiation therapy (55~64 Gy). Result: After a median fellow-up of 20 months, the actusrial 5-year overall survival rate was $24\%$ (chemotherapy group) and $36\%,$ (op group). (P>0.1). The local control rate was the $65\%,$ (13/20) and $68.2\%,$ (15/22). (p>0.1). The rate of laryngeal preservation was $65\%$ (13/20) in chemotherapy group. Conclusion: Induction chemotherapy and definitive radiation therapy can be effective in preserving the larynx in a high percentage of patients with advanced laryngeal and hypopharyngeal cancer.

  • PDF

Aminolysis of Y-Substituted Phenyl 2-Thiophenecarboxylates and 2-Furoates: Effect of Modification of Nonleaving Group from 2-Furoyl to 2-Thiophenecarbonyl on Reactivity and Mechanism

  • Um, Ik-Hwan;Min, Se-Won
    • Bulletin of the Korean Chemical Society
    • /
    • 제29권3호
    • /
    • pp.585-589
    • /
    • 2008
  • Second-order rate constants (kN) have been measured for reactions of Y-substituted phenyl 2-thiophenecarboxylates (6a-h) with morpholine and piperidine in 80 mol % H2O/20 mol % DMSO at 25.0 0.1 oC. The Brnsted-type plot for the reactions of 6a-h with morpholine is linear with b lg = 1.29, indicating that the reactions proceed through a tetrahedral zwitterionic intermediate (T?). On the other hand, the Brnsted-type plot for the reactions of 6a-h with piperidine exhibits a downward curvature, implying that a change in the rate-determining step occurs on changing the substituent Y in the leaving group. Dissection of kN into microscopic rate constants (i.e., k1 and k2/k1 ratio) has revealed that k1 is smaller for the reactions of 6a-h than for those of Y-substituted phenyl 2-furoates (5a-h), while the k2/k1 ratio is almost the same for the reactions of 5a-h and 6a-h. It is also reported that modification of the nonleaving group from the furoyl (5a-h) to the thiophenecarbonyl (6a-h) does not influence pKao (defined as the pKa at the center of the Brnsted curvature) as well as the k2/k1 ratio.