Purpose: This study was performed to evaluate the disease-free survival and risk factors of recurrence in early breast cancer patients who have undergone breast conserving surgery and radiation therapy. Materials and Methods: From March 1997 to December 2002, 77 breast cancer patients who underwent breast conserving surgery and radiation therapy were reviewed retrospectively. The median follow-up time was 58.4 months (range $43.8{\sim}129.4$ months) and the mean subject age was 41 years. The frequency distribution of the different T stages, based on the tumor characteristics was 38 (49.3%) for T1, 28 (36.3%) for T2, 3 for T3, 7 for T is and 1 for an unidentified sized tumor. In addition, 52 patients (67.5%) did not have axillary lymph metastasis, whereas 14 patients (18.1%) had $1{\sim}3$ lymph node metastases and 3 (0.03%) had more than 4 lymph node metastases. The resection margin was negative in 59 patients, close (${\leq}2\;mm$) in 15, and positive in 4. All patients received radiation therapy at the intact breast using tangential fields with a subsequent electron beam boost to the tumor bed at a total dose ranging from 59.4 Gy to 66.4 Gy. Patients with more than four positive axillary lymph nodes received radiation therapy ($41.4{\sim}60.4\;Gy$) at the axillary and supraclavicular area. Chemotherapy was administered in 59 patients and tamoxifen or fareston was administered in 29 patients. Results: The 5 year overall survival and disease-free survival rates were 98.08% and 93.49%, respectively. Of the 77 patients, a total of 4 relapses (5.2%), including 1 isolated supraclavicular relapse, 1 supraclavicular relapse with synchronous multiple distant relapses, and 2 distant relapses were observed. No cases of local breast relapses were observed. Lymph node metastasis or number of metastatic lymph nodes was not found to be statistically related with a relapse (p=0.3289) nor disease-free survival (p=0.1430). Patients with positive margins had a significantly shorter disease-free survival period (p<0.0001) and higher relapse rates (p=0.0507). However, patients with close margins were at equal risk of relapse and disease-free survival as with negative margins (p=1.000). Patients younger than 40 years of age had higher relapse rates (9.3% vs. 0%) and lower disease-free survival periods, but the difference was not statistically significant (p=0.1255). The relapse rates for patients with tumors was 14% for tumor stage T2, compared to 0% for tumor stage T1 tumors (p=0.0284). A univariate analysis found that disease-free survival and relapse rates, T stage, positive resection margin and mutation of p53 were significant factors for clinical outcome. Conclusion: The results of this study have shown that breast conservation surgery and radiation therapy in early breast cancer patients has proven to be a safe treatment modality with a low relapse rate and high disease-free survival rate. The patients with a positive margin, T2 stage, and mutation of p53 are associated with statistically higher relapse rates and lower disease-free survival.
We report the radiological findings of regional enhancement of the liver adjacent to the right adrenal pheochromocytoma. CT and MRI showed focal strong enhancement of adjacent liver tissue in the arterial phase. However during the delayed phase, the lesion showed iso-attenuation with normal hepatic parenchyma and not delineated. The lesion did not show abnormal signal intensity on neither T1 nor T2 weighted images and indistinguishable from normal parenchyma. The enhancing hepatic lesion was spontaneously regressed on postoperative follow up CT which was taken several months after the adrenalectomy.
Journal of the korean academy of Pediatric Dentistry
/
v.44
no.2
/
pp.235-242
/
2017
Marsupialization and decompression constitute a well-established procedure for treating cavitary bone lesions of the jaw. The technique can be a primary treatment option, especially for pediatric patients with large cysts or lesions involving vital anatomical structures, such as a developing tooth germ. In this procedure, a decompression stent, such as a customized acrylic obturator or space-maintaining appliance, silicone tube, or nasal cannula, is inserted to maintain the patency of the cyst. However, this may cause clinical problems, such as irritation or trauma to the adjacent tissues, as well as discomfort to the patient, or failure of the stent due to cyst shrinkage. It can also be a reason for patient noncompliance. In the cases described here, a minimally invasive marsupialization technique using a metal tube made from a 16-gauge needle was used for odontogenic cysts in pediatric patients associated with unerupted teeth. Through this method, the lesions were removed, with patient cooperation, and the cyst-associated teeth erupted spontaneously.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.33
no.6
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pp.694-700
/
2007
It is a gel type high functional toothpaste containing vitamin C, E, propolis extract and the rest of herb with a nanoemulsion state. Vitamin C, E is known as the material with an eminent anti-oxidation effect. Propolis is known as the material with an antimicrobial and anti-inflammatory effect. We have been succeeding in making nanoemulsion of vitamin C, E and propolis through the high pressure homogenizer using stable oil and lecithin and the gel type high functional tooth paste were made from nanoemulsion of vitamin C, E and propolis. We observed the process of wound protecting effect and cure effect for a wound of soft tissue, gingival tissue and mucous membrane showing ulcer and inflammation in oral cavity after applying a gel type high functional toothpaste to patient. As a result, the wound were healed very fast and any side effects were not shown. We confirmed that a gel type high functional toothpaste with nanoemulsion of vitamin C, E and propolis extract has good effect not only for wound healing but also for treatment of ulcer-like lesion in oral cavity. So we report our cases with review of literatures.
Journal of the korean academy of Pediatric Dentistry
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v.32
no.4
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pp.628-633
/
2005
Deep caries in primary molars without early intervention frequently induce a pulpal disease and consequent furcation lesion with fistulous openings Up to now, majority of the textbooks on pediatric dentistry and literatures have described that extraction of the inflicted teeth is indicated for these cases and in reality these teeth have usually been extracted in the dental clinics. However when we recognize the excellent capacity of bone regeneration in children and the presence of numerous accessory canals at furcation areas, the removal of infection source in pulp by pulpectomy and inflammatory granulation tissues at furcation areas by furcal curettage might open the possibility of rapid healing at the furcation regions. In this report, 10 cases of primary molars in 3 to 6-year-old children with fistulous openings and furcation lesions in moderate size of 2 to 4mm in depth radiolucency at furcation lesion have been chosen. After pulpectomy and furcal curettage, evident bone regeneration was detected radiographically in all cases. Through the cases, we came to realize that all the cases previously described are not the indications of extraction and this approach could make many cases with pulp and furca combined lesions survive and remain healthy in the children's dental arches. However, in order for this approach to acquire objective appropriateness, it is thought that more scrupulous evaluation is desirable on the various factors regarding the indication such as the extent of furcation lesions, absorption status of teeth, amount of covering bone on succeeding teeth and so on.
The Journal of the Korean bone and joint tumor society
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v.19
no.1
/
pp.14-19
/
2013
Purpose: We analyzed the oncologic characteristics and outcome of patients with inflammatory myofibroblastic tumor of extremities. Materials and Methods: Among the soft tissue tumor patients who were treated between 1999 and 2012, 5 patients who were pathologically confirmed as the inflammatory myofibroblastic tumor of extremities were analyzed retrospectively. Results: There were 1 man and 4 women with mean age of 44 years (37-55 years). The average follow up was 34.6 months (8-87 months). All patients underwent surgical treatment. Only 1 patient had wide resection margin and remaining 4 had marginal (3) or intralesional (1) resection margin. All of 4 patients without wide resection margin developed local recurrence at 10.3 months (8-19 months). Malignant transformation to fibrosarcoma was occurred in 2 patients who developed local recurrence, and 1 patient developed multiple metastases to lung, liver and lymph nodes and expired at 37 months. Three of 5 patients had tumor location abutted to or invasion to major arteries and 1 patient had tumor invading sciatic nerve. Conclusion: It is observed that inflammatory myofibroblastic tumor of extremities is usually located near the major neurovascular structure. Wide resection should be considered as the initial surgical treatment because this tumor showed a high local recurrence rate and possibility of malignant transformation.
Journal of the korean academy of Pediatric Dentistry
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v.35
no.1
/
pp.136-143
/
2008
Infections involved with the oral and maxillofacial area are associated with various anatomical structures. If the proper treatment is not done in an immediate period, the infections will be quite fatal. The causes of the infections are numerous, but the most common cause of odontogenic infections in children is a dental caries. It is known to lead to some kinds of diseases such as periapical abscess, cellulitis, osteomyelitis, Ludwig's angina, toxic shock syndrome and so on. The common pathogenic sequence of fascial abscess is a necrotic pulpal inflammation in the form of dentoalvelor abscess which spreads over and gradually penetrates into the fascial membranes through the cortical bones and finally contracts the potential fascial spaces. If the infections of oral maxillofacial area were penetrated into the surrounding soft tissues, then they would diffuse into the directions of the least tissue resistance along with the connective tissues and the fascial spaces. These infections can be properly cured by tooth extraction, endodontic therapy, surgical treatment including Incision & drainage and antibiotics. The purpose of the cases is to report the satisfactory treatment results in the patients derived from the canine fascial space abscesss or buccal fascial space ones of the odontogenic origin.
Kim, Sung-Ki;Kim, Min-Jeong;Lee, Dong-Soo;Kim, Shin;Jeong, Tae-Sung
Journal of the korean academy of Pediatric Dentistry
/
v.36
no.1
/
pp.157-167
/
2009
The incidence of childhood cancer is greatest in the first year of life. Early diagnosis and advances in medicine have significantly improved outcomes of treatment resulting in higher survival rate; however, this progress comes at the expense of a higher incidence of adverse side effects because of more aggressive antineoplastic treatment strategies. The oral cavity, a trauma-prone environment, is extremely sensitive to toxicities from antineoplastic agents. Oral health care specialists, including pediatric and hospital dentists can support the oncology team by providing basic oral care, implementing oral care protocols, delivering emergency dental treatment, and assisting and/or managing oral complications from cancer therapy. This article covers the considerations in the dental management of pediatric patients undergoing cancer treatment, specifically chemotherapy, radiotherapy, and hematopoietic stem cell transplantation.
New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration alre basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet-derived growth factor (PDGF) is one of polypeptide growth factor. PDGF have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purposes of this study is to evaluate the possibility of using the PDGF as a regeneration promoting agent for furcation involvement defect. Eight adult mongrel dogs were used in this experiment. The dogs were anesthetized with Pentobarbital Sodium (25-30 mg/kg of body weight, Tokyo chemical Co., Japan) and conventional periodontal prophylaxis were performed with ultrasonic scaler. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree III furcation defect was made on mandibular second(P2) and fourth(P4) premolar. For the basic treatment of root surface, fully saturated citric acid was applied on the exposed root surface for 3 minutes. On the right P4 20ug of human recombinant PDGF-BB dissolved in acetic acid was applied with polypropylene autopipette. On the left P2 and right P2 PDGF-BB was applied after insertion of ${\beta}-Tricalcium$ phosphate(TCP) and collagen (Collatape) respectively. Left mandibular P4 was used as control. Systemic antibiotics (Penicillin-G benzathine and penicillin-G procaine, 1 ml per 10-25 1bs body weight) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operated sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 2, 4, 8, 12 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. At 2 weeks after surgery, therer were rapid osteogenesis phenomenon on the defected area of the PDGF only treated group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. New cementum fromation was observed from 2 weeks after surgery, and the thickness was increased until 8 weeks with typical Sharpey’s fibers reembedded into new bone and cementum. In both PDGF-BB with TCP group and PDGF-BB with Collagen group, regeneration process including new bone and new cementum formation and the group especially in the early weeks. It might be thought that the migration of actively proliferating cells was prohibited by the graft materials. In conclusion, platelet-derived growth factor can promote rapid osteogenesis during early stage of periodontal tissue regeneration.
Kim, Hyun-Joo;Kim, Seong-Jo;Choi, Jeom-Il;Lee, Ju-Youn
Journal of Periodontal and Implant Science
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v.39
no.1
/
pp.17-26
/
2009
Purpose: The non-carious cervical lesion(NCCL) is a loss of tooth structure at the neck of affected teeth that is unrelated to tooth caries. The reported prevalence of NCCL varies from 5% to 85%. Prevalence and severity of lesions have been found to increase with age. They are becoming more significant as people live longer and become more aware of the importance of oral health. The purposes of this study were first, to examine the periodontal conditions associated with NCCL, and second, to investigate the clinical effects of class V restorations of NCCL on periodontal tissues. Materials and methods: The sample size was 982 teeth of 50 subjects(25 male, mean age $52{\pm}7$) who were seen at the Department of Periodontology, Pusan National University Hospital. At the baseline examination, clinical periodontal parameters were measured. After the initial examination, 24 patients who were absent from hypersensitivity were selected. The teeth with NCCL were randomly divided into the test and control groups. The teeth in the test group were restored with flowable resin; the control teeth were not restored. Six months later, the clinical examinations were repeated. The data were analyzed using the SPSS program. Results: The results were as follows: 1) NCCL occurred on 45.8% of examined teeth. The percentage of affected teeth was higher in maxillary and premolar teeth. 2) The shallow saucer type was the most common. 3) Teeth with NCCL had more gingival recession, lower attachment level, and higher incidences of bleeding on probing(BOP) and plaque than NCCL-free teeth. 4) Six months later, gingival recession, attachment level, the percentages of BOP and plaque in the test group were lower than in the control group(p<0.05). Conclusion: NCCLs were more found in maxillary teeth, especially in premolar teeth. The results suggest that the restoration of NCCL could affect some periodontal parameters favorably.
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