• Title/Summary/Keyword: Orbital area

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Technical Aspects and Difficulties in the Management of Head and Neck Cutaneous Malignancies in Xeroderma Pigmentosum

  • Sibar, Serhat;Findikcioglu, Kemal;Erdal, Ayhan Isik;Barut, Ismail;Ozmen, Selahattin
    • Archives of Plastic Surgery
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    • v.43 no.4
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    • pp.344-351
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    • 2016
  • Background Xeroderma pigmentosum (XP) is an autosomal recessive disorder characterized by xerosis, ultraviolet light sensitivity, and cutaneous dyspigmentation. Due to defects in their DNA repair mechanism, genetic mutations and carcinogenesis inevitably occurs in almost all patients. In these patients, reconstruction of cutaneous malignancies in the head and neck area is associated with some challenges such as likelihood of recurrence and an aggressive clinical course. The aim of this study is to discuss the therapeutic options and challenges commonly seen during the course of treatment. Methods Between 2005 and 2015, 11 XP patients with head and neck cutaneous malignancies were included in this study. Demographic data and treatment options of the patients were evaluated. Results The mean age of the patients was 32 years (range, 10-43) (4 males, 7 females). The most common tumor type and location were squamous cell carcinoma (6 patients) and the orbital region (4 patients), respectively. Free tissue transfer was the most commonly performed surgical intervention (4 patients). The average number of surgical procedures was 5.5 (range, 1-25). Six patients were siblings with each other, 5 patients had local recurrences, and one patient was lost to follow-up. Conclusions Although genetic components of the disease have been elucidated, there is no definitive treatment algorithm. Early surgical intervention and close follow-up are the gold standard modalities due to the tendency toward rapid tumor growth and possible recurrence. Treatment must be individualized for each patient. In addition, the psychological aspect of the disease is an important issue for both patients and families.

Clinical Follow-up on Sagittal Fracture at the Temporal Root of the Zygomatic Arch: Does It Need Open Reduction?

  • Cheon, Ji Seon;Seo, Bin Na;Yang, Jeong Yeol;Son, Kyung Min
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.546-552
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    • 2013
  • Background The zygoma is a major portion of the midfacial contour. When deformity occurs in this area, a reduction should be conducted to correct it. If a sagittal fracture at the temporal root of the zygomatic arch occurs, this also requires reduction, but it is difficult to approach due to its anatomical location, and the possibility of fixation is also limited. Thus, the authors attempted the reduction of sagittal fracture by two- or three-point fixation and the Gillies approach without direct manipulation. The preoperative and postoperative results of the patients were evaluated. Follow-up was performed to establish a treatment guideline. Methods A retrospective study was done with 40 patients who had sagittal fractures at the temporal root of the zygomatic arch from March 2009 to June 2012. Only two- or three-point fixation was performed for the accompanying zygomatic-orbital-maxillary fracture. The Gillies approach was used for complex fractures of the zygomatic arch, while the temporal root of the zygomatic arch was only observed without reduction. Preoperative and postoperative computed tomography and X-ray scans were performed to examine the results. Results The result of the paired t-test on preoperative and postoperative bone gap differences, the depression level, and the degree of temporal protrusion showed a marked decrease in the mean difference at a 95% confidence interval. The results were acceptable. Conclusions In the treatment of sagittal fractures at the temporal root of the zygomatic arch, it is acceptable to use indirect reduction and non-fixation methods. This leads to a satisfactory aesthetic and functional outcome.

Lens Dose Reduction Methods and Image Quality in Orbital Computed Tomography Scan (안와 전산화단층촬영검사 시 수정체 선량감소 방법과 영상 평가)

  • Moon, Se-Young;Hong, Sang-Woo;Seo, Ji-Sook;Kim, Yeong-Beom;Kwak, Wan-Sin;Lee, Seong-Yeong;Kim, Jung-Soo
    • Journal of radiological science and technology
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    • v.43 no.5
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    • pp.343-351
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    • 2020
  • This study analyzed dose reduction and quality of images through dose reduction tools and shielding board to protect sensitive eye lens in radiation during orbit CT examinations for clinical data use. During CT scans of the phantom, surface dose (CT scanner dosimetry phantom, ion chamber-3 times) and quality of image (radiosurgery head phantom, visual assessment-2 times, HU standard deviation) were evaluated using X-care which is dose reduction tools and bismuth shielding board. The results of experiments of eight conditions showed a relatively reduced dose in all other conditions compared to when no conditions were set. In particular, the area corresponding to the ophthalmic part reduced the surface dose by up to 45.7 %. The visual evaluation of images by specialists and the quality evaluation of images analyzed by HU standard deviation were clinically closest to the use of X-care and shielding board (1 cm in height). Therefore, it is believed that the use of shielding board in a suitable location with dose reduction tools while investigating the optimal radiation dose will reduce the exposure dose of sensitive lens at radiation while maintaining the quality of the images with high diagnostic value.

Mission-based Operational Orbit Design for Sun-synchronous Spacecraft (임무기반 태양동기궤도 운영궤도 설계에 관한 연구)

  • Lee, Ji-Marn;No, Tae-Soo;Jung, Ok-Chul;Chung, Dae-Won
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.40 no.9
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    • pp.752-759
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    • 2012
  • This paper presents a mission orbit design method for spacecraft which use the sun-synchronous and ground repeat orbits. In this work, we have proposed a new design procedure, "Nonlinear simulation-based numerical optimization technique" using the commercial S/W's such as STK (Satellite Tool kit) and Matlab, which are widely adopted S/W's in the area of orbital mechanics and engineering analysis. Inclusion of all the perturbation effects on the spacecraft not only can more precisely satisfy the mission requirements for sun-synchronicity and repeated ground track, and also operational requirements such as minimum change in the S/C local time, maximization of the contact time with a specified ground station, etc. can be appropriately considered. Design examples for LEO sun-synchronous mission are presented to demonstrate the usefulness of the proposed method in this paper.

TWO CASES OF MASSIVE CRANIOFACIAL FIBROUS DYSPLASIA (광범위한 두개안면부 섬유성골이형성증의 치험 2례)

  • Kim, Jong-Ryoul;Chung, Gi-Deon;Kim, Hong-Sik;Kim, Ki-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.1
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    • pp.61-68
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    • 1996
  • In Fibrous dysplasia(FD) of the jaws, the majority of cases can await the cessation of growth before surgical intervention, and it seems prudent to delay surgery whenever possible until growth has ceased. In craniofacial FD, however, the dangers of dystopia, dystopia and loss of vision may require early surgery to prevent or control cranio-orbital complications. Delaying surgery in those circumstances may be significantly detrimental to such patients. Conservative surgical management of FD is widely practised and we advocate an extension to this conservative treatment by combining surgical recontouring with appropriate osteotomies if indicated, to achieve an optimal esthetic and functional results in craniofacial FD. One case will be presented to illustrate the feasiblility of such combined treatment, to report the uneventful healing of osteotomies in the FD of the jaws, and to demonstrate the use of titanium miniplate fixation in dysplastic bone. The other case had expansile disease of the left facial and fronto-temporal bones and osteolytic change left mandible. This patient complained of severe spontaneous bleeding of left mandibular premolar area and it was suspected as central hemangioma of the left mandible and craniofacial FD. Angiogram disclosed generalized dilation of the external carotid artery and its branches, especially terminal branches of the left facial and inferior alveolar arteries. But no specific abnormalities, such as A-V shunt, venous lake, or early venous drainage, was seen. So it was diagnosed craniofacial FD with hypercellularity and generalized bony recontouring was performed via coronal and transoral approaches.

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A role for endocannabinoids in acute stress-induced suppression of the hypothalamic-pituitary-gonadal axis in male rats

  • Karamikheirabad, Maryam;Behzadi, Gila;Faghihi, Mahdieh;Raoofian, Reza;Mehr, Shahram Ejtemaei;Zuure, Wieteke Ameliek;Sadeghipour, Hamid Reza
    • Clinical and Experimental Reproductive Medicine
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    • v.40 no.4
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    • pp.155-162
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    • 2013
  • Objective: Stress is known to be an inhibitor of the reproductive hypothalamic-pituitary-gonadal (HPG) axis. However, the neural and molecular connections between stress and reproduction are not yet understood. It is well established that in both humans and rodents, kisspeptin (encoded by the kiss1 gene) is a strong stimulator of the HPG axis. In the present study we hypothesized that endocannabinoids, an important neuromodulatory system in the brain, can act on the HPG axis at the level of kiss1 expression to inhibit reproductive function under stress. Methods: Adult male Wistar rats were unilaterally implanted with an intracerebroventricular cannula. Afterwards, the animals were exposed to immobilization stress, with or without the presence of the cannabinoid CB1 receptor antagonist AM251 (1 ${\mu}g/rat$). Blood samples were collected through a retro-orbital plexus puncture before and after stress. Five hours after the stress, brain tissue was collected for reverse transcriptase-quantitative polymerase chain reaction measurements of kiss1 mRNA. Results: Immobilization stress (1 hour) resulted in a decrease in the serum luteinizing hormone concentration. Additionally, kiss1 gene expression was decreased in key hypothalamic nuclei that regulate gonadotrophin secretion, the medial preoptic area (mPOA), and to some extent the arcuate nucleus (ARC). A single central administration of AM251 was effective in blocking these inhibitory responses. Conclusion: These findings suggest that endocannabinoids mediate, at least in part, immobilization stress-induced inhibition of the reproductive system. Our data suggest that the connection between immobilization stress and the HPG axis is kiss1 expression in the mPOA rather than the ARC.

Direct Aspergillosis Invasion to the Anterior Wall of the Maxillary Sinus: A Case Report (협부 연부조직을 직접 침습한 상악동 아스페르길루스증)

  • Lee, Jung-Ho;Lee, So-Young;Oh, Deuk-Young;Kim, Sang-Wha;Rhie, Jong-Won;Ahn, Sang-Tae
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.691-694
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    • 2011
  • Purpose: With an increase in the population of immunocompromised patients, the incidence of maxillary sinus aspergillus infection has also escalated. Maxillary sinus aspergillosis is generally extended to the sinus antrum, base or thin orbital wall and ethmoid air cell region. We experienced a case of maxillary sinus aspergillosis which was extended directly to the soft tissue of the cheek. Methods: A 46-year-old man with acute myelogenous leukemia was consulted for the defect of the anterior wall of the maxillary sinus, and cheek. Radiologic and histologic findings were consistent with invasive maxillary sinus aspergillosis. The otolaryngology department performed debridement via endoscopic sinus surgery first. Coverage of the resulting defect in the anterior wall of the maxillary sinus and its inner layer was undergone by the plastic and reconstructive surgery department, using a pedicled superficial temporal fascia flap and a split thickness skin graft. The remaining skin defect of the cheek was covered with a local skin flap. Results: The patient went through an uneventful recovery. There was no recurrence during 6 months of follow-up. Conclusion: Maxillary sinus aspergillosis usually involves the orbit or the gingiva but in some cases it may directly invade soft tissues of the cheek. Such an atypical infection extending into the cheek may lead to a large soft tissue defect requiring coverage. Thus, any undiagnosed soft tissue defect involving the cheek or maxillofacial area, especially in immunocompromised patients, should be evaluated for aspergillosis. We present this rare case, with a review of the related literature.

Transfacial Surgical Approaches to Secure Wide Exposure of the Skull Base

  • Kim, Sin Rak;Lee, Jung Woo;Han, Yea Sik;Kim, Han Kyu
    • Archives of Craniofacial Surgery
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    • v.16 no.1
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    • pp.17-23
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    • 2015
  • Background: Treatment of skull base tumors is challenging due to limited access and presence of important neurovascular structures nearby. The success of a complete tumor resection depends on the extent of tumor exposure and secure field of view. While these tumors are often removed by transcranial endoscopic access, transfacial approach is sometimes required depending on the location and size of the tumor. This study describes various transfacial approaches in patients undergoing skull base tumor resection. Methods: From March to November 2013, 15 patients underwent skull base tumor resection via transfacial accesses at a tertiary institution. Data were reviewed for patient demographics, type of access used, completeness of tumor resection, surgical outcome, and postoperative complications. Results: Two clivus tumor patients underwent transmaxillary approach; three tuberculum-sellae and suprasellar-hypothalamus tumor patients underwent transbasal approach; three clinoid and retrobulbar intraconal orbital tumor patients underwent orbitozygomatic approach; and seven petroclival-area, pons, cavernous sinus, and lateral-sphenoid-wing tumor patients underwent zygomatic approach. In all cases, the upper and lower margins of the tumor were visible. Complete tumor removal consisted of 10 cases, and partial tumor removal in 5. There were no immediate major complications observed for the transfacial portion of the operations. The overall cosmetic results were satisfactory. Conclusion: Plastic surgeons can use various transfacial approaches according to the location and size of skull base tumors to secure a sufficient field of view for neurosurgeons.

Circulating Tumor Cell Detection in Lung Cancer Animal Model

  • Chong, Yooyoung;Jung, Yong Chae;Hwang, Euidoo;Cho, Hyun Jin;Kang, Min-Woong;Na, Myung Hoon
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.460-465
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    • 2021
  • Background: Metastasis and recurrence of primary cancer are the main causes of cancer mortality. Disseminated tumor cells refer to cancer cells that cause metastasis from primary cancer to other organs. Several recent studies have suggested that circulating tumor cells (CTCs) are associated with the clinical stage, cancer recurrence, cancer metastasis, and prognosis. There are several methods of isolating CTCs from whole blood; in particular, using a membrane filtration system is advantageous due to its cost-effectiveness and availability in clinical settings. In this study, an animal model of lung cancer was established in nude mice using the human large cell lung cancer cell line H460. Methods: Six-week-old nude mice were used. The H460 lung cancer cell line was injected subcutaneously into the nude mice. Blood samples were obtained from the orbital area before cell line injection, 2 weeks after injection, and 2 weeks after tumor excision. Blood samples were filtered using a polycarbonate 12-well Transwell membrane (Corning Inc., Corning, NY, USA). An indirect immunofluorescence assay was performed with the epithelial cell adhesion molecule antibody. The number of stained cells was counted using fluorescence microscopy. Results: The average size of the tumor masses was 35.83 mm. The stained cells were counted before inoculation, 2 weeks after inoculation, and 2 weeks after tumor excision. Cancer cells generally increased after inoculation and decreased after tumor resection. Conclusion: The CTC detection method using the commercial polycarbonate 12-well Transwell (Corning Inc.) membrane is advantageous in terms of cost-effectiveness and convenience.

Synergistically Enhanced Oxygen Evolution Catalysis with Surface Modified Halloysite Nanotube

  • Hyeongwon Jeong;Bharat Sharma;Jae-ha Myung
    • Journal of Electrochemical Science and Technology
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    • v.14 no.1
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    • pp.96-104
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    • 2023
  • Synergistically increased oxygen evolution reaction (OER) of manganese oxide (MnO2) catalyst is introduced with surface-modified halloysite nanotube (Fe3O4-HNTs) structure. The flake shaped MnO2 catalyst is attached on the nanotube template (Fe3O4-HNTs) by series of wet chemical and hydrothermal method. The strong interaction between MnO2 and Fe3O4-HNTs maximized active surface area and inter-connectivity for festinate charge transfer reaction for OER. The synergistical effect between Fe3O4 layer and MnO2 catalyst enhance the Mn3+/Mn4+ ratio by partial replacement of Mn ions with Fe. The relatively increased Mn3+/Mn4+ ratio on MnO2@FHNTs induced 𝜎* orbital (eg) occupation close to single electron, improving the OER performances. The MnO2@FHNTs catalyst exhibited the reduced overpotential of 0.42 V (E vs. RHE) at 10 mA/cm2 and Tafel slope of (99 mV/dec), compared with that of MnO2 with unmodified HNTs (0.65 V, 219 mV/dec) and pristine MnO2 (0.53 V, 205 mV/dec). The present study provides simple and innovative method to fabricate nano fiberized OER catalyst for a broad application of energy conversion and storage systems.