• Title/Summary/Keyword: preoperative stage

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MRI of Acute Septic Arthritis of the Shoulder Joint; Correlation with Arthroscopic Findings (급성 화농성 견관절염의 자기공명영상; 관절경적 소견과의 비교 연구)

  • Seo Kyung-Jin;Cheon Sang-Ho;Seo Jae-Sung;Ko Sang-Hun;Choi Chang-Hyuk;Jeon In-Ho
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.110-116
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    • 2005
  • Purpose: Urgent diagnosis and treatment of the septic arthritis is required. The purpose of this study is to review to correlate preoperative MRI findings with arthroscopic findings in septic arthritis of the glenohumeral joint. Materials and Methods: Eleven patients with acute septic arthritis of the glenohumeral joint were treated with combination of arthroscopic lavage, debridement, and systemic antibiotics. The arthroscopic staging of infection was made based on the modified criteria of $G\"{a}chter$ and five major findings of MRI were marked in each stage of septic shoulder. Results: Bone and cartilage erosion was the end stage finding and two patients with all five positive findings had failed with arthroscopic treatment. Reactive bone marrow edema was evident in the greater tuberosity. Joint effusion, synovial thickening and soft tissue edema were rather non-specific finding and presented in all stages of septic shoulder. Conclusion: Diffuse marrow edema with metaphyseal cyst formation in the preoperative MRI implied advanced stage of septic arthritis, which may fail with arthroscopic debridement.

A critical assessment of the medication-related osteonecrosis of the jaw classification in stage I patients: a retrospective analysis

  • Ristow, Oliver;Hurtgen, Lena;Moratin, Julius;Smielowski, Maximilian;Freudlsperger, Christian;Engel, Michael;Hoffmann, Jurgen;Ruckschloss, Thomas
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.2
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    • pp.99-111
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    • 2021
  • Objectives: It is unclear whether the extent of intraoral mucosa defects in patients with medication-related osteonecrosis of the jaw indicates disease severity. Therefore, this study investigated whether mucosal lesions correlate with the true extent of osseous defects in stage I patients. Materials and Methods: Retrospectively, all patients with stage I medication-related osteonecrosis of the jaw who underwent surgical treatment between April 2018 and April 2019 were enrolled. Preoperatively, the extent of their mucosal lesions was measured in clinical evaluations, and patients were assigned to either the visible or the probeable bone group. Intraoperatively, the extent of necrosis was measured manually and with fluorescence. Results: Fifty-five patients (36 female, 19 male) with 86 lesions (46 visible bone, 40 probeable bone) were enrolled. Intraoperatively, the necrotic lesions were significantly larger (P<0.001) than the preoperative mucosal lesions in both groups. A significant (P<0.05) but very weak (R2<0.2) relationship was noted between the extent of the mucosal lesions and the necrotic bone area. Conclusion: Preoperative mucosal defects (visible or probeable) in patients with medication-related osteonecrosis of the jaw do not indicate the extent of bone necrosis or disease severity.

Sleeve Lobectomy for Lung Cancer (기관지 성형술을 이용한 폐암 환자에서 폐엽 절제술)

  • 김희준
    • Journal of Chest Surgery
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    • v.24 no.9
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    • pp.918-925
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    • 1991
  • The technique of sleeve lobectomy has emerged as a relatively recent mode of excisional therapy. Acceptance of the technique has been slow because initially it has believed to be more difficult technically, to be associated with more complications, and be an inadequate operation for cancer. Sleeve lobectomy for bronchogenic carcinoma is an alternative to pneumonectomy. Four patients with bronchogenic carcinoma were treated by lobectomy with sleeve resection of the bronchus from 1986 to 1990. Three patients were male and one patient was female. Ages ranged from 43 years to 68 years. Symptoms were cough, sputum, blood tinged sputum, and dyspnea. Histopathologically, 3 cases were squamous cell carcinoma, 1 case was adenocarcinoma. Preoperative stage was stage I in 3 cases and stage II in 1 case. All of them were alive after operation.

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Preoperative Neutrophil to Lymphocyte Ratio as a Prognostic Factor in Patients with Non-metastatic Renal Cell Carcinoma

  • Wen, Ru-Min;Zhang, Yi-Jing;Ma, Sha;Xu, Ying-Li;Chen, Yan-Su;Li, Hai-Long;Bai, Jin;Zheng, Jun-Nian
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3703-3708
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    • 2015
  • Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with colorectal, lung, gastric cancer, pancreatic and metastatic renal cell carcinoma. We here evaluated whether preoperative NLR is an independent prognostic factor for non-metastatic renal cell carcinoma (RCC). Materials and Methods: Data from 327 patients who underwent curative or palliative nephrectomy were evaluated retrospectively. In preoperative blood routine examination, neutrophils and lymphocytes were obtained. The predictive value of NLR for non-metastatic RCC was analyzed. Results: The NLR of 327 patients was $2.72{\pm}2.25$. NLR <1.7 and NLR ${\geq}1.7$ were classified as low and high NLR groups, respectively. Chi-square test showed that the preoperative NLR was significantly correlated with the tumor size (P=0.025), but not with the histological subtype (P=0.095)and the pT stage (P=0.283). Overall survival (OS) and disease-free survival (DFS) were assessed using the Kaplan-Meier method. Effects of NLR on OS (P=0.007) and DFS (P=0.011) were significant. To evaluate the independent prognostic significance of NLR, multivariate COX regression models were applied and identified increased NLR as an independent prognostic factor for OS (P=0.015), and DFS (P=0.019). Conclusions: Regarding patient survival, an increased NLR represented an independent risk factor, which might reflect a higher risk for severe cardiovascular and other comorbidities. An elevated blood NLR may be a biomarker of poor OS and DFS in patients with non-metastatic RCC.

Surgical Treatment of Esophageal Cancer (식도종양의 외과적 치료)

  • 육을수
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.170-176
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    • 1995
  • Fourty nine patients out of 127 esophageal cancer were managed surgically from January 1986 to December 1991, at the Department of Thoracic and Cardiovascular Surgery, Jeonbuk National University Hospital. Most frequent preoperative symptom was dysphagia and its mean duration was 3.1 months. In histopathologic examination, squamous cell carcinomas were 44 cases [89.8% , and adenocarcinomas 5 [10.2% . The tumor location were the upper esophagus in 6.1%, middle esophagus in 57.2%, lower and cardiac portion of stomach in 36.7%. Involved and metastatic organs, which were detected perioperatively, were celiac lymph nodes in 6 cases, aorta 2, stomach 2, pericardium 2, cervical lymph node 1. The esophagus was resected radically, and the procedures for esophageal replacement were performed with esophagogastrostomy in 45 cases, esophagocologastrostomy 3, and esophagojejunostomy 1. Postoperative complications occurred in 16 cases [hospital morbidity = 32.6% ,anastomotic leak 3, anastomotic stricture 2, respiratory insufficiency 2, hemoperitoneum 1, chylothorax 1, intussusception 1, empyema 1, non-A,non-B hepatitis 1, and mediastinitis 1. Hospital deaths were experienced 3 cases [ hospital mortality = 6.1% . The 6 month, one, two, and five year actuarial survival rates were 85.7%, 71.4%, 57.1%, and 27.9%, respectively. One year survival rates of stages were 100% in stage I, 90.9% in stage IIa, 63.6% in stage IIb, 25.0% in stage III, and 7.2% in stage IV.

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Effects of Allogeneic Blood Transfusion in Patients with Stage II Colon Cancer

  • Meng, Jin;Lu, Xiao-Bo;Tang, Yuan-Xin;Sun, Gong-Ping;Li, Xin;Yan, Yi-Fei;Liang, Gao-Feng;Ma, Si-Ping;Li, Xiao-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.347-350
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    • 2013
  • The aim of the present study was to determine whether allogeneic red blood cell transfusions showed a deleterious effect and what might be preoperative risk factors for blood transfusion in patients with TNM stage II colon cancer. Total 470 patients who fulfilled inclusion criteria were selected for a further 10-year follow-up study. We found that there were statistical significance between non-transfused and transfused group in mortality (P=0.018), local recurrence (P=0.000) and distant metastasis (P=0.040). Local recurrence and distant metastasis between 1 to 3 units and more than 3 units group did not show any significant differences. There was no difference in survival rate between non-transfused and 1 to 3 units group (log rank=0.031, P=0.860). The difference between different blood transfusion volume in transfused patients was found (78.77% vs 63.83%, P=0.006). Meanwhile, the significant difference of survival rate was existed between non-transfused group and more than 3 units group (84.83% vs 63.83%, P=0.002 ). Univariate analysis showed the following 3 variables to be associated with an increased risk of allogeneic blood transfusions: preoperative CEA level (P<0.05), location of tumor (P<0.01) and diameter of tumor (P<0.01). Multivariate analysis revealed that location of tumor and diameter of tumor are two independent factors for requirement of perioperative transfusions. Therefore, allogeneic transfusion increase the postoperative tumor mortality, local recurrence and distant metastasis in patients with stage II colon cancer. The postoperative tumor mortality, local recurrence and distant metastasis were not associated with the blood transfusion volume. The blood transfusion volume was associated with the survival rate. Location of tumor and diameter of tumor were the independent preoperative risk factors for blood transfusion.

Prognosis of Patients with Non-Small Cell Lung Cancer after Surgery (비소세포 폐암 환자의 수술 후 예후)

  • Kang, Min-Jong;Park, Gye-Young;Yoo, Chul-Gyu;Chung, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.331-338
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    • 1996
  • Background : Lung cancer continues to be the leading cause of cancer death in the United States and it's incidence has been rapidly increasing in Korea, too. The overall cure rate for non-small cell lung cancer(NSCLC) is approximately 10%, and the cure is generally achieved by surgery. Unfortunately, however, less than 15% of all patients and less than 25% of those who present with localized disease are candidates for curative surgical resection. So preoperative staging evaluation followed by curative resection has a major role in determining the long tenn prognosis of NSCLC patients. Therefore, we have conducted this study to compare pre-operative and post-operative staging and the long-tenn relapse-free survival rates in NSCLC patients according to its stage. Methods : We analyzed the medical records of 217 NSCLC patients who were operated on for curative resection in Seoul National University Hospital, retrospectively. Among them, 170 patients who were completely resected were selected to determine the long term relapse-free survival rates. Results : Among 217 NSCLC patients, men were 157 and women were 30. The median age was 58 and the difference between men and women was not found. The discrepancy rate between preoperative and postoperative staging was 40.1%. Its major cause was due to the difference of nodal staging. The 3-year relapse-free survival rates were 73%, 53% and 48% in stage I, II and IIIa, respectively. There was no difference of relapse-free duration in recurred patients according to the stage or histologic types. Conclusion : The postoperative pathologic staging determines the long tenn prognosis of patients with NSCLC after surgery, but current preoperative clinical staging can not predict the postoperative pathologic staging correctly. So the improved modality of staging system is required to predict the pathologic staging more correctly.

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Pharyngoesophageal Diverticulum - 2 cases - (인두식도부 게실 2)

  • Kim, Ju-Hyeon;Choe, Jun-Yeong
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.379-383
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    • 1987
  • Pharyngoesophageal diverticulum is a well-known disease entity but is seldomly reported in Korean literature. Recently the authors experienced two cases of pharyngoesophageal diverticulum. A 46 year old female and a 51 year old female patients were admitted due to foreign body sensation in esophagus and dysphagia. Preoperative esophagography and esophagoscopy confirmed the diagnosis of pharyngoesophageal diverticulum in each patient. The authors performed one-stage pharyngoesophageal diverticulectomy and myotomy. Postoperative esophagography revealed no diverticulum or stenosis and symptoms were markedly relieved.

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Neuroblastoma of Mediastinum Diagnosed by Fine Needle Aspiration - A Case Report - (세침흡인 세포검사로 진단된 종격동 신경아세포종 - 1예 보고 -)

  • Seo, Eun-Joo;Lee, An-Hee
    • The Korean Journal of Cytopathology
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    • v.6 no.2
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    • pp.183-186
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    • 1995
  • Fine needle aspiration has been effectively being applided to pediatric tumors since it renders a rapid diagnosis with minimal intervention. This measure is especially required for the large pediatric mass, which needs preoperative chemotherapy or radiotherapy to shrink the tumor to an operable size. A case of neuroblastoma of mediastinum, stage IV diagnosed by CT-guided FNA is described.

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Analysis of Diagnostic Performance of CT and EUS for Clinical TN Staging of Gastric Cancer (위암의 임상적 병기 설정을 위한 전산화단층촬영 및 초음파 내시경의 진단력 평가)

  • Shin, Ru-Mi;Lee, Ju-Hee;Lee, Moon-Soo;Park, Do-Joong;Kim, Hyung-Ho;Yang, Han-Kwang;Lee, Kuhn-Uk
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.177-185
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    • 2009
  • Purpose: Preoperative clinical staging of gastric cancer is very important for determining the treatment plans and predicting the prognosis. The previous reports regarding the accuracy of computed tomography or endoscopic ultrasound for the preoperative staging of gastric cancer have shown various outcomes. We analyzed the diagnostic performance of CT and EUS, which are important staging tools for the staging of TN gastric cancer. Materials and Methods: We retrospectively analyzed 1,174 patients who underwent gastrectomy for gastric cancer at Seoul National University Bundang Hostpital from May, 2003 to December, 2007. We derived the Kappa value to examine the agreement of the preoperative staging obtained from CT and EUS with the pathological staging. Results: The mean age of the 1,174 patients was $59.31{\pm}11.98$ years. Six hundred thirty seven patients had early gastric cancer and 536 had advanced gastric cancer. The diagnostic performance between CT and EUS for the T staging showed no significant difference between CT and EUS for the kappa values. The kappa values showed moderate agreement at 0.4039 (P=0.021) and 0.4201 (P=0.026), respectively. This suggests that there is no difference between the two examinations for the overall T staging. Analysis of the discrimination of mucosal and submucosal lesions with EUS showed an accuracy of 58.92% and a Kappa value of 0.206 (P<0.001), suggesting fair agreement and a lower diagnostic performance than expected. To differentiate lesions with stages higher than or equal to T2 or T3 from the lesion with stages lower than T2 or T3, respectively, adoption of the higher stage from the CT staging or the EUS staging showed a larger AUC of 0.84 than that from either stage alone. The CT-derived node stage had the higher diagnostic performance (68.55%) than that of the EUS-derived node stage (60.82%) for the node staging. Conclusion: The CT-derived stage and EUS-derived stage showed comparable results for determining the T stage of gastric cancer. Yet the higher stage of the two stages from CT and EUS most accurately discriminated between those lesions with stages higher than T2 and those lesions with stages lower than T2.

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