• Title/Summary/Keyword: pathologic study

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Cervicomediastinal Anastomotic Loop between Recurrent Laryngeal Nerves (양측 반회후두신경사이의 신경문합궁에 대한 실체)

  • 홍기환;정희수
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.69-74
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    • 1995
  • The anatomic course of recurrent laryngeal nerve, its branch and its function were most significant for laryngeal, thyroid and tracheoesophageal surgery. Furthermore, the vocal cord palsy resulting from multi-etiology was serious complication and resulted in affecting the life quality. So, for the prevention of this complication, the concepts and knowledge about anatomic course and variants are very important. At now, most of anatomic courses and it's function has been identified precisely. But recently, the report about the anastomotic loops of both recurrent laryngeal nerve was published. In this study, we explored three cadevors for identifying the reality of the anastomotic loops between recurrent laryngeal nerves. Finally, we identified the cervicomediastinal anastomosis at tracheoesophageal groove in 2 of 3 cadevors that was confirmed by pathologic finding. This anatomic reliefs related to it's branch are extremely interest, although research is still in its initial phase. Our study will be extended toward histomorphometrical study and progressive electrophysiologic study, and we will be able io gather the largest amount of useful data regarding any possible use of this anatomic entity in future.

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Neuroactivation studies using Functional Brain MRI (기능적 자기공명영상을 이용한 뇌활성화 연구)

  • Chung, Kyung-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.1
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    • pp.63-72
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    • 2003
  • Functional MRI (fMRI) provides an indirect mapping of cerebral activity, based on the detection of the local blood flow and oxygenation changes following neuronal activity (Blood Oxygenation Level Dependent). fMRI allows us to study noninvasively the normal and pathological aspects of functional cortical organization. Each fMRI study compares two different states of activity. Echo-Planar Imaging is the technique that makes it possible to study the whole brain at a rapid pace. Activation maps are calculated from a statistical analysis of the local signal changes. fMRI is now becoming an essential tool in the neurofunctional evaluation of normal volunteers and many neurological patients as well as the reference method to image normal or pathologic functional brain organization.

Advantages of ypTNM Staging in Post-surgical Prognosis for Initially Unresectable or Stage IV Gastric Cancers

  • Jeong, Gyu-Seong;Lee, In-Seob;Park, Young-Soo;Kim, Beom-Su;Yoo, Moon-Won;Yook, Jeong-Hwan;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.20 no.3
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    • pp.233-244
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    • 2020
  • Purpose: For unresectable or initially metastatic gastric cancer, conversion surgery (CVS), after systemic chemotherapy, has received attention as a treatment strategy. This study evaluated the prognostic value of ypTNM stage and the oncologic outcomes in patients receiving CVS. Materials and Methods: A retrospective review of clinicopathologic findings and oncologic outcomes of 116 patients who underwent CVS with curative intent, after combination chemotherapy, between January 2000 and December 2015, has been reported here. Results: Twenty-six patients (22.4%) underwent combined resection of another organ and 12 patients received para-aortic lymphadenectomy (10.3%). Pathologic complete remission (CR) was confirmed in 11 cases (9.5%). The median overall survival (OS) and disease-free survival (DFS) times were 35.0 and 21.3 months, respectively. In multivariate analysis, ypTNM stage was the sole independent prognostic factor for DFS (P=0.042). Tumors invading an adjacent organ or involving distant lymph nodes showed better survival than those with peritoneal seeding or solid organ metastasis (P=0.084). Kaplan-Meier curves showed that the 3-year OS rate of patients with pathologic CR and those with CR of the primary tumor but residual node metastasis was 81.8% and 80.0%, respectively. OS was 65.8% for stage 1 patients, 49.8% for those at stage 2, and 36.3% for those at stage 3. Conclusions: The ypTNM staging is a significant prognostic factor in patients who underwent CVS for localized unresectable or stage IV gastric cancers. Patients with locally advanced but unresectable lesions or with tumors with distant nodal metastasis may be good candidates for CVS.

Role of Endoscopic Ultrasound in Evaluation of Pancreatic Neuroendocrine Tumors - Report of 22 Cases from a Tertiary Center in Iran

  • Haghighi, Shirin;Molaei, Mahsa;Foroughi, Forough;Foroutan, Mojgan;Dabiri, Reza;Habibi, Effat;Alizadeh, Amir Houshang Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4537-4540
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    • 2012
  • Background: The pancreatic neuroendocrine tumor (pNET) is relatively rare and generally felt to follow an indolent course. EUS has an important role in detection of pNET. This is a review of clinical and radiological presentation and pathologic reports of 22 patients with pNET. Patients and methods: In this study we analyzed clinical and radiological presentations and pathologic reports of all relevant cases who were referred to Taleghani hospital for 3 years since 2008. Results: A total of 22 patients 28-74 years old (mean=49) were enrolled between 2008 and 2011. Among the total, 13 (59%) were male, 9 (41%) were female and 16 (72.7%) had functional tumors. The results of CT were negative in 12 (54%) cases but EUS was capable of detecting the lesions in these patients, cysts being found in 4 (19%) patients. Conclusion: EUS is a highly sensitive procedure for the localization of functional pNETs and especially insulinomas. Nonfunctional tumors were detected in more advanced and late stages and cystic lesions were more common in this group.

Occult Metastatic Rate of Laryngeal Cancer Predicted by Elective Neck Dissection (후두암종에서 예방적 경부청소술로 확인한 경부 잠재전이율)

  • Tae Kyung;Jeong Jin-Seok;Lee Dong-Wook;Jeong Jin-Hyeok;Lee Hyung-Seok
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.1
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    • pp.19-23
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    • 2004
  • Background and Objectives: Neck metastasis is one of the most important prognostic factor in head and neck squamous cell carcinoma. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal cancer varies widely depending upon authors. To evaluate the rate and characteristics of occult metastasis and efficacy of the elective neck dissection in clinical N0 laryngeal cancer, we performed this study. Materials and Method: Seventy two patients (supraglottic cancer: 19 cases, glottic cancer: 53 cases) who underwent surgery for laryngeal cancer as an initial treatment from 1993 to 2002 were evaluated. All was underwent elective neck dissection at the time of surgery for the primary treatment. The record of patients and pathologic report were reviewed retrospectively. Results: Occult metastasis rate of supraglottic and glottic cancer were 42.1% (8/19) and 9.4% (5/53), respectively. According to T stage, the occult meastasis of supraglottic and glottic cancer was 20%, 0% in T1, 36.4%, 0% in T2, 100%, 40% in T2, 100%, 20% in T4, respectively. Occult metastasis was mostly confined within level II (69.2%), III (76.9%), IV (23.1%). Conclusion: Based on ours results, elective neck dissection might be needed in treating of clinically N0 all supraglottic cancer and advanced T3, T4 glottic cancer.

Clinical and Pathologic Characteristics of Papillary Thyroid Carcinoma According to the Size of Primary Tumor (갑상선 유두암의 크기에 따른 임상병리학적 특징)

  • Lee, Joo Hyung;Kim, Hyung-Kyu;Kim, Seok-Mo;Chang, Ho Jin;Kim, Bup-Woo;Lee, Yong Sang;Park, Cheong Soo;Chang, Hang-Seok
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.16-20
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    • 2015
  • Background and Objectives : In papillary thyroid carcinoma (PTC), multiplicity and central or lateral lymph node metastases significantly affect the recurrence. This study was carried out to evaluate the clinical and histological characteristics of PTC according to the tumor size. Materials and Method : Between January 1, 2009 and December 31, 2014, 12,269 PTC patients underwent thyroid surgery at the Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Korea. We analyzed pathologic findings and clinical features according to the size of tumor Results : The mean size of tumor was $0.89{\pm}0.70cm$. The Central and lateral compartment metastases were observed 64.7% and 37.6% on the range that the primary tumor size is 1cm. There was a significant association between the PTC primary tumor size and multiplicity and cervical neck metastasis (p<0.001). Conclusion : The PTC primary tumor size for prediction of multiplicity and neck node metastasis can be helpful in optimization of the surgical extent for each patient.

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Clonazepam Treatment of Pathologic Aerophagia in Children with Mental Retardation

  • Lee, Ga-Hyun;Jang, Hyo-Jeong;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.4
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    • pp.209-213
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    • 2014
  • Purpose: Pathologic aerophagia (PA) may lead to bowel perforation or volvulus in mentally retarded patients. The authors investigated the effects of clonazepam on the management of PA in children with severe to profound mental retardation (MR). Methods: This study was undertaken as a retrospective case analysis of 21 PA patients with MR who were followed for over 12 months and diagnosed as having PA. Patients were assigned to two management groups, that is, to a clonazepam randomized open-labeled, treatment group or a reassurance group. The following were recorded and analyzed; age, response, remission rate to clonazepam treatment, and the side effect of clonazepam. It was defined positive response (response+) as being symptom-free for a whole week within 1 month of commencing treatment and remission(+) as being symptom-free for a whole month within 6 months of treatment. Results: The average age of the 21 PA children with MR was 10 years and 13 patients were female. Symptom duration before diagnosis of PA was 7 months. Clinical features of the clonazepam-trial group (n=11) and the reassurance group (n=10) were non-significantly different. Response(+) was achieved by 2 patients (18.2%) in the clonazepamtrial group and by no patient in the reassurance group. Remission(+) was achieved by 6 patients (54.5%) in the clonazepam-trial group and by one patient (10%) in the reassurance group (p=0.040). Conclusion: When PA children with MR with severe bowel distention are considered for surgical treatment to prevent acute abdomen, a trial of clonazepam could be recommended.

Surgical Treatment of Metastatic Bone Tumor in Extremity (사지에서 전이성 골종양의 수술적 치료)

  • Lee, Han-Koo;Lee, Sang-Hoon;Baek, Goo-Hyun;Lee, Chang-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.45-51
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    • 1995
  • The incidence of metastatic bony lesion has been increased recently, with the advanced therapeutic modalities of malignant tumors. The purpose of this study was to evaluate the effectiveness of surgical treatment in impending or established pathologic fractures due to metastasis in extremity. From 1981 to 1992, thirty two patients who had established or impending pathologic fractures in extremity had been treated surgically. The locations of metastasis, were lower extremity in 24 cases(femsral head and neck;5, intertrochanteric;7, subtrochanteric;8, femoral shaft;4) and upper extremity in 8 cases(proximal humerus;2, humoral shaft;6). The method of surgery was excision of tumor mass and rigid internal fixation to allow immediate mobilization, except 2 cases of amputation. The results were analysed by two criteria. The first was the grade of performance status that was made by modification of Functional Classification of New York Heart Association. The second was the degree of pain relief. The performance status was improved at least one grade in all patients and the mean improvement was 1.7 grades. The satisfactory pain relief was achieved in 81% of patients. Postoperatively, most of the patients had only slight to moderate limitation of physical activities and they became comfortable at rest and ordinary activities. The solitary metastatic lesions showed better pain relief(92%) than multiple metastasis(75%). The curative surgery was done in 3 cases, and they showed more than 24 months of disease-free survival.

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Subungual Exostosis of the Foot (족부의 조갑하 외골종)

  • Ahn, Jong-Chul;Shin, Duk-Seop;Shon, Oog-Jin;Choi, Joon-Hyuk
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.56-62
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    • 1999
  • Purpose : This study was conducted to analyze the clinical materials and treatment results of 13 cases of subungual exostosis. Materials and Methods : Thirteen subungual exostoses of the foot treated from January 1991 to December 1997 were studied. We analyzed the clinical data and results of treatment to identify the clinical characteristics of this disease. We investigated the location, shape and relation of exostosis to phalanx with simple x-ray of the foot to identify the radiological characteristics. All the cases were sent to pathologic examination after resection to determine the pathological characteristics. Results : The results of physical examination on presentation were various. Most cases were located at the dorsomedial side of the distal phalanx and were involved in the toe nail. Eleven cases were located at great toes and one each at the 2nd and 3rd toe. Causes of exostosis were not clear, but 2 cases were related to trauma. For the type of exostosis, 7 cases were sessile and 6 were stalk type. On histologic examination, 9 cases showed a cartilaginous portion with overlying proliferating fibrous tissue and underlying bone formation. There was a gradual maturation of spindle cell proliferation from cartilage to cancellous bone. The cartilage was moderately cellular with some pleomorphism, but true anaplasia was not present. Conclusion : The clinical presentation and findings of simple x-rays were most helpful in diagnosing subungual exostosis. Complete excision of the mass achieved complete relief of symptoms and recovery without recurrence in all cases.

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Open Lung Biopsy for Diffuse Infiltrative Lung Disease (미만성 폐질환에 대한 개흉적 폐생검)

  • 김남혁
    • Journal of Chest Surgery
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    • v.28 no.11
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    • pp.1014-1018
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    • 1995
  • To confirm diagnosis and to set proper therapeutic strategy, open lung biopsies were done in 57 patients who were suspected for diffuse interstitial lung disease from January 1985 to December 1994. Among them, 35 were male and 22 were female[M:F=l.6: 1 and mean age of the patients is 53.5$\pm$ 2.3[24-81 years. Tissue for histologic studies were obtained from left lung in 33, from right lung in 24according to the distributions of the pathology. Preoperative diagnostic work-up`s were chest X-ray, CT[HRCT scan, sputum study, bronchoscopy[BAL, TBLB and PTNA and all of them were unsuccessful to confirm diagnosis. In comparison of pulmonary function tests between preoperative and postoperative values, there were no significant differences in FVC, FEV1, FEV1/FVC[p 0.05 but in AaDO2[p[0.05 . Postoperative complications including atelectasis, wound infection, pulmonary edema and respiratory insnfficiency, were shown in 5 cases[8.8% , and two of them were died of respiratory failure and sepsis[mortality rate 3.5% . Pathologic diagnosis was confirmed in 53 cases postoperatively but it was undetermined in 4[diagnostic yield rate 93.0% . In comparison between preoperative clinical diagnosis and postoperative pathologic diagnosis, new diagnosis were made in 17 cases[29.8% and preoperative tentative diagnosis were confirmed histologically in 36 cases[63.2% . In 4 cases[7.0% , however, diagnoses were not confirmed after biopsies. Therapeutic plans were reset in 46 cases[80.7% in accordance with the final diagnosis.In conclusion, open lung biopsy is recommended for a specific diagnosis and proper therapeutic plan in diffuse interstitial lung diseases because of its high diagnostic yield Irate and it`s relatively low morbidity and mortality rate in these tompromised patents.

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