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Missing Elements in Surgical Pathology Reports: Breast, Colon and Stomach Cancers

  • Kadivar, Maryam;Rahimabad, Parnian Kheirkhah
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1469-1472
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    • 2016
  • Cancer pathology reports play an important role in choice of patient care. They provide crucial information concerning diagnosis, therapy options, and prognosis. Professional pathology institutions, such as the College of American Pathologists (CAP), have developed checklists to ensure the presence of all the required elements in reports. In this study, 438 surgical pathology reports of patients with breast (148), colon (147), and stomach cancer (143) were evaluated with respect to the presence of mandated elements according to CAP checklists. The most common missing element in all the three types of cancer was 'staging' (73.6, 53.1, and 56.6% in breast, colon, and stomach cancer reports missed 'staging', respectively). The second most missing element was 'tumor site' in breast (64.2%) and stomach cancer (30.1%), and 'procedure' in colon cancer (29.3%). 'Perineural invasion' was the third most missing element in the three types of cancer (25.7, 17.0, and 22.4% in breast, colon, and stomach cancer, respectively). Only 11.4% of reports included all key elements required by CAP. The use of checklists was associated with higher rate of completeness. This study demonstrates that the key elements requiring the information on the requisition forms from the clinicians are commonly missed, leading to ambiguity.

Case Report of Recurrent Osteoma at the Grafted Bone (이식된 뼈에서 재발한 뼈종의 치험례)

  • Joo, Chun Seung;Lee, Yoon Ho
    • Archives of Plastic Surgery
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    • v.33 no.3
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    • pp.367-370
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    • 2006
  • Surgical curettage or en bloc excision are the usual choice of treatment for osteoma. Local recurrence of osteoma after surgical treatment is not very common. We report a case of osteoma recurred at the grafted bone. A $5{\times}8cm$ sized osteoma of frontal bone was excised and then the defect was covered with calvarian bone and rib bone. Six years after reconstruction, recurrence from grafted area was noted. We completely removed the osteoma with enough normal tissue around it, after checking that the grafted bone has changed into an osteoma through a bicoronal incision. Then we covered the defect with a rib bone. The tissue was confirmed histologically as an osteoma. The recurrence of the tumor at the bone grafted site after osteoma excision is probably due to the fact that we covered grafted bone with periosteum left over osteoma. Therefore, we can learn that when we excise osteoma, galea should be carefully separated from the periphery of the tumor and that the periosteum should be completely removed, to prevent the osteoma from recurrence.

Anterolateral Thigh Flap for Reconstruction of the Oral Cavity : Anatomic Study and Clinical Application (전외측대퇴피판을 이용한 구강 재건술)

  • Choi, Sung-Weon
    • The Journal of the Korean dental association
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    • v.49 no.9
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    • pp.535-548
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    • 2011
  • The anterolateral thigh flap(ALT flap) was originally described in 1984 as a septocutaneous nap based on the descending branch of the lateral circumflex artery. This nap has some significant advantages for reconstruction of the head and neck. It can be raised as a subcutaneous flap, a fasciocutaneous nap, or a myocutaneous nap and can resurface large defects in the head and neck. In addition, it has a large and long vascular pedicle, and because of the distance of the donor site from the head and neck, it can easily be harvested with a two-team approach. However, the number and locations of cutaneous perforators vary individually, and thus, it is not widely used because nap elevation is often complicated and time-consuming owing to unexpected anatomical variations. The purposes of this study are to clarify the vascular anatomy and to assess the suitability of anterolateral thigh nap for oral cavity reconstruction in Koreans. In addition, we used anterolateral thigh free nap for oral cavity reconstruction in 20 oral cancer patients from 2006 to 2011. Through our clinical experience, we discuss a series of practical "pearls and pitfalls". Our experience has not only given us new flap choice using anterolateral thigh nap in oral cavity reconstruction, but also given us a new possibility on the applicability of chimeric naps.

Late reconstruction of oncological maxillary defect with microvascular free flap (상악결손부의 2차적 재건에 있어 유리 혈관화 피판의 적용)

  • Kwon, Tae-Geon;Kim, Chin-Soo
    • The Journal of the Korean dental association
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    • v.49 no.9
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    • pp.527-534
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    • 2011
  • Microvascular reconstruction of maxillary composite defect after oncologic resection has improved both esthetic and functional aspect of quality of life of the cancer patients. However, a lot of patients had prior surgery with radiation and/or chemotherapy as a part of comprehensive cancer treatment. Sometimes it is nearly impossible to find out adequate recipient vessel for maxillary reconstruction with microvascular anastomosis. Therefore long pedicle of the flap is needed to use distant neck vessels located far from the reconstruction site such as ipsilateral transverse cervical artery or a branch of contralateral external carotid artery. For this reason, although we know the treatment of the choice is osteocutaneous flap, it is difficult to use this flap when we need long pedicle with complex three dimensional osseous defect. Vascular option for these vessel-depleted neck patients can be managed by a soft tissue reconstruction with long vascular pedicle and additional free non-vascularized flap that is rigidly fixed to remaining skeletal structures. For this reason, maxillofacial reconstruction by vascularized soft tissue flap with or without the secondary restoration of maxillary bone with non-vascularized iliac bone can be regarded as one of options for reconstruction of profound maxillofacial composite defect resulted from previous oncological resection with chemo-radiotherapy.

A Study on Interrelation between Toegye′s ‘Piety’ Notion and Space of the Dosan Saudang from an Behavioral point of view (공간행태적 측면에서 본 퇴계의 ‘경’사상과 도산서당 공간의 상관성에 관한 연군)

  • 안민선;권영걸
    • Korean Institute of Interior Design Journal
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    • v.13 no.5
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    • pp.3-10
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    • 2004
  • A built space reflects its society's philosophy, culture and technology of its time period. The study explores interrelation between Toey-Gae's 'Kyung' (Piety) philosophy and architectural designs of the 'Do-San' Sau-Dang (School). Toey-Gae is a leading scholar during Chosun Dynasty who built the Do-San School to teach and showcase Sung Confucianism. He is known for his teachings and practice of 'Kyung' philosophy in all aspects of his life including his work and designs. It is also known that he personally picked and purchased the land best suited to display spirit of 'kyung' philosophy while directing the base design and construction of the building. His attentions to details are evident in his choice of city, building site, and way he arrange his designs within the natural environment. Thus, we can safely presuppose the design of Do-San Sau-Dang was created following Toey-Gae's ideology in its buildings and environment. By examining Toey-Gae's philosophy of 'Kyung' through his writings, physical location and actual designs of Do-San Sau-Dang, we can understand how this ancient philosophical ideology and thoughts were translated to a physical form and its space. The study will also explore the importance of such ideology in the society at the time and how it influenced physical and mental activities of its people.

CYSTIC HYGROMA IN THE ADULT (성인에 발생한 낭포성활액종)

  • Oh, Seong-Seob;Kim, Il-Gyu;Chun, Hye-Kyung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.3
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    • pp.283-288
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    • 1995
  • Cystic hygroma is the benign proliferation of lymphatic tissue and has been categorized as a part of a larger spectrum that includes lymphangiomas recently. The majority of lymphangiomas occur in the head and neck as cystic hygromas with the posterior cervical region as the most common site. Cystic hygromas present in infancy or early childhood as compressible masses that may rapidly and intermittently enlarge. Cystic hygromas of the head and neck are especially difficult to manage since enlargement cause serious sequela such as airway obstruction, feeding difficulties, and speech pathology. Surgical exision remains the treatment of choice. But complete extirpation of these lesions is often impossible, and recurrence rates are accordingly different respectively ; these are high in suprahyoid lesions compared with infrahyoid involvement. This is a case report about 22 year old male patient with cystic hygrom. We obtained the successful, functional and esthetic results by surgical excision of the mass. Therefore, we report the case with literatural reviews.

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A DOUBLE LAYERS TECHNIQUE FOR MAXILLARY SINUS AUGMENTATION WITH DEMINERALIZED AND MINERALIZED BONE GRAFT MATERIALS (탈회골과 비탈회골을 이용하여 2층 구조로 이식한 상악동골이식술)

  • Lee, Eun-Young;Kim, Kyoung-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.1
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    • pp.46-52
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    • 2009
  • The maxillary posterior edentulous region presents unique and challenging conditions in implant dentistry. The height of the posterior maxilla is reduced greatly as a result of dual resorption from the crest of the ridge and pneumatization of the maxillary sinus after the loss of teeth. Materials previously used for sinus floor grafting include autogenous bone, allogeneic bone, xenogenic bone and alloplastic materials. Autogenous bone is the material of choice, but its use is limited by donor-site morbidity, complications, sparse availability, uncontrolled resorption and marked volume loss. One way to overcome this problem would be to use bone substitutes alone as a osteoconductive scaffold for bone regeneration from the residual bone or in combination with allogeneic bone, which also has osteoinductive properties. The purpose of this article is to describe a double layers technique of demineralized and mineralized bone graft materials instead of autogenous bone in sinus floor augmentation of deficient posterior maxillary alveolar process and to report our experience with this technique. Our results show that maxillary sinus augmentation using mineralized and demineralized bone materials, when installed simultaneously with the implant or not, is good results for bone healing.

Historical Overview of Taenia asiatica in Taiwan

  • Ooi, Hong Kean;Ho, Chau-Mei;Chung, Wen-Cheng
    • Parasites, Hosts and Diseases
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    • v.51 no.1
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    • pp.31-36
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    • 2013
  • An overview of the epidemiological, biological, and clinical studies of Taenia and taeniasis in Taiwan for the past century is presented. The phenomenal observations that led to the discovery of Taenia asiatica as a new species, which differ from Taenia solium and Taenia saginata, are described. Parasitological surveys of the aborigines in Taiwan revealed a high prevalence of taeniasis, which might be due to the culture of eating raw liver of hunted wild boars. Chemotherapeutic deworming trials involving many patients with taeniasis were discussed. Praziquantel was found to be very effective, but sometimes complete worms could not be recovered from the feces after treatment, probably due to the dissolution of the proglottids. Atabrine, despite some side effects, can still be used, in properly controlled dosages, as the drug of choice for human T. asiatica infection if we need to recover the expelled worms for morphological examinations. Research results on the infection of T. asiatica eggs from Taiwan aborigines in experimental animals were also noted. Since the pig serve as the natural intermediate host of T. asiatica and the predilection site is the liver, a differential comparison of other parasitic pathogens that might cause apparently similar lesions is also presented.

Therapeutic radionuclides (치료용 방사성동위원소)

  • Choi, Sun-Ju;Hong, Young-Don;Lee, So-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.58-65
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    • 2006
  • Since the development of sophisticated molecular carriers such as octereotides for peptide receptor targeting and monoclonal antibodies against various antigens associated with specific tumor types, radionuclide therapy (RNT) employing open sources of therapeutic agents is promising modality for treatment of tumors. furthermore, the emerging of new therapeutic regimes and new approaches for tumor treatment using radionuclide are anticipated in near future. In targeted radiotherapy using peptides and other receptor based tarrier molecules, the use of radionuclide with high specific activity in formulating the radiopharmaceutical is essential in order to deliver sufficient number of radionuclides to the target site without saturating the target. In order to develop effective radiopharmaceuticals for therapeutic applications, it is crucial to carefully consider the choice of appropriate radionuclides as well as the tarrier moiety with suitable pharmacokinetic properties that could result in good in vivo localization and desired excretion. Up to date, only a limited number of radionuclides have been applied in radiopharmaceutical development due to the constraints in compliance with their physical half-life, decay characteristics, cost and availability in therapeutic applications. In this review article, we intend to provide with the improved understanding of the factors of importance of appropriate radionuclide for therapy with respect to their physical properties and therapeutic applications.

Pedicled sural flaps versus free anterolateral thigh flaps in reconstruction of dorsal foot and ankle defects in children: a systematic review

  • Beecher, Suzanne M.;Cahill, Kevin C.;Theopold, Christoph
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.410-416
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    • 2021
  • Background This systematic review compared free anterolateral thigh (ALT) flaps versus pedicled distally based sural artery (DBSA) flaps for reconstruction of soft tissue defects of dorsal foot and ankle in children. Methods A systematic literature search was performed to identify cases where an ALT or DBSA was used to reconstruct the dorsal foot in children. A total of 19 articles were included in the systematic review. Results Eighty-three patients underwent an ALT reconstruction and 138 patients underwent a DBSA reconstruction. Patients who had a DBSA were more likely to require grafting of the donor site (P<0.001). The size of ALT flaps was significantly larger than DBSA flaps (P=0.002). Subsequent flap thinning was required in 30% of patients after ALT and 12% of patients after DBSA reconstruction (P<0.001). Complications occurred in 11.6% of DBSA and 8.4% of ALT flaps (8.4%). Conclusions Both flaps are valid options in reconstructing pediatric foot and ankle defects. Each flap has advantages and disadvantages as discussed in this review article. In general for larger defects, an ALT flap was used. Flap choice should be based on the size of the defect.