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The impact factors on 5-year survival rate in patients operated with oral cancer

  • Geum, Dong-Ho;Roh, Young-Chea;Yoon, Sang-Yong;Kim, Hyo-Geon;Lee, Jung-Han;Song, Jae-Min;Lee, Jae-Yeol;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Chung, In-Kyo;Kim, Uk-Kyu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.5
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    • pp.207-216
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    • 2013
  • Objectives: The purpose of this study is to analyze clinical impact factors on the survival rate, and to acquire basic clinical data for the diagnosis of oral cancer, for a determination of the treatment plan with long-term survival in oral cancer patients. Materials and Methods: Through a retrospective review of the medical records, the factors for long-term survival rate were analyzed. Thirty-seven patients, among patient database with oral cancer treated in the Department of Oral and Maxillofacial Surgery at Pusan National University Hospital within a period from March 1998 to March 2008, were selected within the study criteria and were followed-up for more than 5 years. The analyzed factors were gender, age, drinking, smoking, primary tumor site, type of cancer, TNM stage, recurrence of affected region, and metastasis of cervical lymph node. The 5-year survival rate on the impact factors was calculated statistically using the Kaplan-Meier method. Results: By classification of clinical TNM at the 1st visit, there were 11 (29.7%) cases for stage I, 11 (29.7%) cases for stage II, 3 (8.1%) cases for stage III, and 12 (32.5%) cases for stage IV. The 5-year survival rate of total oral cancer patients after the operation were 75.7%, pathological TNM stage related 5-year survival rate were as follows: stage I 90.0%, stage II 81.8%, stage III 100% and stage IV 45.5%; in which the survival rate difference by each stage was significantly observed. The recurrence of cervical lymph node was the significant impact factor for the survival rate, because only 30.0% the survival rate in recurrent cases existed. During the follow-up, there were 15 (40.5%) patients with confirmed recurrence, and the 5-year survival rate of these patients was decreased as 46.7%. Conclusion: The classification of clinical and pathological TNM stage, local recurrence after surgery, and metastasis of cervical lymph node after surgery were analyzed as the 3 most significant factors.

ROOT MALFORMATION OF PERMANENT INCISORS BY ALVEOLAR BONE FRACTURE (치조골 골절을 동반한 유치열기 외상에 의한 영구절치의 치근 형성 이상)

  • Ji, Eun-Hye;Choi, Hyung-Jun;Choi, Byung-Jai;Son, Heung-Kyu;Kim, Seung-Hye;Song, Je-Seon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.3
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    • pp.290-295
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    • 2011
  • During tooth formation, tooth development can be affected by physical action or metabolic changes around dental follicle. Especially trauma to primary dentition is the most representative physical factor that can cause development disorders of succedaneous tooth. Enamel hypoplasia and crown discoloration of succedaneous tooth are common complications of trauma. And impaction, ectopic eruption, arrest of root formation and root dilaceration of succedaneous tooth are rare. In this case, a 6-year and 5-month-old female patient visited for dental evaluation after trauma. She was diagnosed with alveolar bone fracture near upper front teeth, extrusion of the upper right and left primary central incisors, intrusion of the upper right primary lateral incisor, and palatal luxation of the upper left primary lateral incisor. Upper right and left primary central incisors with severe mobility were extracted, with gingival suture on the day of the visit. During 24 months check up, root dilacerations were found near the cemento enamel junction in the upper lateral incisors and arrests of root formation were found on the coronal 1/3 of the root in the upper central incisors. Although alveolar bone fracture is rare type of trauma in children, a thorough examination of alveolar bone is essential for prognosis and following treatment in patients with trauma.

A Case of Pulmonary Alveolar Proteinosis Associated with Pulmonary Tuberculosis (폐결핵과 병발된 폐포단백증 1예)

  • Park, Min Sik;Jung, Sung Chang;Jin, Myoung In;Lee, Jin Bae;Lim, Sang Hyuk;Park, Sung Hun;Chung, Seung Hie;Shin, Tae Rim;Hyun, Dae Sung;Lee, Sang Chae;Yun, Kil Suk;Kwon, Kun Young
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.411-418
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    • 2002
  • Pulmonary alveolar proteinosis(PAP) is a disorder in which an insoluble, proteinaceous material, rich in phospholipids, is deposited in the alveoli and bronchioles. The deficiency in the clearance and degradation of the intra-alveolar phospholipoproteinaceous material in PAP most likely represents a dysfunction of the type II pneumocytes. Although the pathogenesis and causative treatment of PAP is unclear a whole lung bronchopulmonary lavage is a relatively safe and effective treatment. Here we experienced a case of pulmonary alveolar proteinosis in a 62 year old female patient who had pulmonary tuberculosis approximately 20 years ago. She complained of aggravated dyspnea and chronic cough, and presented fine inspiratory crackles at both lung fields, diffuse ground glass opacity with some area of consolidation and smooth interlobular septal thickenings in both upper, right middled lobes, and a portion of right lower lobe. Optical microscopy of the lung tissue obtained by and open lung biopsy revealed many granulomas containing acid-fast smear positive bacilli and diffuse homogeneous PAS-positive fluid in the alveolar space. Immunohistochemical stain showed surfactant. A in the alveolar space. Antituberculosis drugs with bronchoalveolar lavage were used to treat the disease. Thereafter she showed improvement in her symptoms and a partial improvement in the chest X-ray and HRCT findings. We present a case of PAP associated with pulmonary tuberculosis.

Clinical Characteristics of False-Positive Lymph Node on Chest CT or PET-CT Confirmed by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Lung Cancer

  • Lee, Jongmin;Kim, Young Kyoon;Seo, Ye Young;Choi, Eun Kyoung;Lee, Dong Soo;Kim, Yeon Sil;Hong, Sook Hee;Kang, Jin Hyoung;Lee, Kyo Young;Park, Jae Kil;Sung, Sook Whan;Kim, Hyun Bin;Park, Mi Sun;Yim, Hyeon Woo;Kim, Seung Joon
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.4
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    • pp.339-346
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    • 2018
  • Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure to evaluate suspicious lymph node involvement of lung cancer because computed tomography (CT) and $^{18}F$-fluorodeoxyglucose positron emission tomography-CT (PET-CT) have limitations in their sensitivity and specificity. There are a number of benign causes of false positive lymph node such as anthracosis or anthracofibrosis, pneumoconiosis, old or active tuberculosis, interstitial lung disease, and other infectious conditions including pneumonia. The purpose of this study was to evaluate possible causes of false positive lymph node detected in chest CT or PET-CT. Methods: Two hundred forty-seven patients who were initially diagnosed with lung cancer between May 2009 and December 2012, and underwent EBUS-TBNA to confirm suspicious lymph node involvement by chest CT or PET-CT were analyzed for the study. Results: Of 247 cases, EBUS-TBNA confirmed malignancy in at least one lymph node in 189. The remaining 58 patients whose EBUS-TBNA results were negative were analyzed. Age ${\geq}65$, squamous cell carcinoma as the histologic type, and pneumoconiosis were related with false-positive lymph node involvement on imaging studies such as chest CT and PET-CT. Conclusion: These findings suggest that lung cancer staging should be done more carefully when a patient has clinically benign lymph node characteristics including older age, squamous cell carcinoma, and benign lung conditions.

Aneurysmal Bone Cyst of the Rib Misdiagnosed as Soft Tissue Tumor - A Case Report - (연부조직종괴로 오인된 늑골의 동맥류성 골낭종 - 증례 보고 -)

  • Lee, Ah-Won;Lee, Youn-Soo;Jo, Gun-Huyn;Lee, Jung-Dal;Kim, Byung-Kee
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.4
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    • pp.163-167
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    • 2000
  • Aneurysmal bone cyst(ABC) is a benign lesion and generally occurs in the long bones and vertebral column. ABC of the rib is an uncommon entity. We reported a case of ABC originating in the left first rib. The patient was a 19-year-old woman and presented with palpable mass on the shoulder. Chest X ray and MRI showed a large expansile mass, with multiple cystic areas, arising from the left first rib and bulging out into retroclavicular and paravertebral soft tissue, so the lesion was initially misdiagnosed as a soft tissue malignant tumor destructing adjacent rib. On histological examination, the mass, which was surrounded by a peripheral band of mature trabecular bone, consisted of multiple anastomosing cavernous blood channels separated by fibrous septa that containing osteoid, myxochondroid material and osteoclast-type giant cells.

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A Study on the Difference of Cataract Surgery Prognosis between Adult Diseases and Non-adult Diseases (성인병 여부에 따른 백내장 수술 효과의 차이 연구)

  • Cho, Seon-Ahr
    • Journal of Korean Ophthalmic Optics Society
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    • v.21 no.3
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    • pp.275-280
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    • 2016
  • Purpose: This study is intended to look into the difference in surgery effects through the analysis of risk factors on how the common adult diseases among Korean adults diseases (glaucoma, hypertension and diabetes) are affecting cataract. Methods: Cataract surgery patients' daily records at hospitals in Jeonnam were used as analysis data. Factors - which can affect the results of medical treatment before and after an operation - were classified into the input, process and outcome of medical treatment. The medical treatment and patient characteristics were reflected as the input of medical treatment, and clinical results, functional status and general status as the process of medical treatment. Results: There was a close relationship between adult diseases of glaucoma, diabetes and hypertension, and cataract. Visual acuity of adult diseases patients was 10% lower than of non-adult diseases patients. And for post-surgery it was around 16% difference in refractive error and visual acuity between two groups. Conclusions: According to a study result, the cataract has been confirmed that there is a close relationship of Adult disease patients's glaucoma, diabetes and hypertension. Depending on the type about these adult diseases, before and after cataract surgery, vision and refractive power was found to indicate a significant difference when compared with conventional low normal adult control.

Detection of HHV6 and EBV in histiocytic necrotizing lymphadenitis (Histiocytic necrotizing lymphadenitis에서 HHV6과 EBV의 검출)

  • Park, Kyung Hee;Park, Sung Shik;Kim, Ji Yeon;Park, Su Eun
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.987-991
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    • 2008
  • Purpose : Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis (HNL), is a self-limited disease characterized by cervical lymphadenopathy and fever. The etiology of KFD remains unknown; however, the self-limiting nature of HNL suggests the cause of this disease could be viral infection. For this reason, several viruses have been evaluated as possible etiologies of HNL, including Epstein-Barr virus (EBV), human herpesvirus 6 (HHV6), human herpesvirus 8 (HHV8), and cytomegalovirus (CMV). The aim of this study was to examine the relationship of EBV and HHV6 to HNL. Methods : Data pertaining to 51 cases with biopsy-confirmed HNL were collected between January 1999 and December 2005, from the Department of Pathology, College of Medicine, Pusan National University, Busan, Korea. The clinical records-including data regarding age, gender, duration of fever, and lymph node involvementwere reviewed retrospectively. The in situ hybridization (ISH) assay was performed by EBER PNA probe (Dako, Capinteria, CA, USA), and immunohistochemistry testing was performed with anti-HHV type 6 monoclonal antibodies (Chemicon, Temecula, CA, USA). Results : The HNL patients in this study were 24 males and 27 females, ranging in age from seven to 61 years (median: 25.9). ISH for EBV was positive in 8/51 (15.7%) biopsies, and immunohistochemistry for HHV6 was positive in 15/51 (29.4%) biopsies. Serologic analysis of EBV IgM was performed in 23 cases; only one patient was positive for EBV IgM and EBV ISH. Conclusion : Our study could not provide supportive evidence of a viral pathogenesis for HNL; therefore, cases of HNL may not have a dominant viral cause. However, some rare exceptional cases may have been caused by viral infection.

A Clinical Analysis of Intussusception by Non-operative Management (비수술적 처치가 시행된 장중첩증의 임상적 고찰)

  • Han, Dong-Hyun;Jeong, Gi-Lyang
    • Journal of the Korean Society of Radiology
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    • v.1 no.2
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    • pp.5-11
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    • 2007
  • Intussusception is one of the most common cause of bowel obstruction in infant under the two years old, especially in male. Clinical analysis was enrolled on 54 intussusception cases who were diagnosed by ultrasound and treated by non-operative reduction at the Presbyterian Medical Center from June 2005 to May 2007. The results were as follow. 1) There was the most common(40.7%)between thirteen and twenty four months on the distribution of age. Male(72.2%) and female(27.8%) were in the ratio of 2.6:1 on the distribution of gender 2) The frequent symptoms were abdominal pain with grizzle(100.0%), vomiting(66.7%) and diarrhea(33.3%). There was a significant difference among them(p<0.05). There was the most common(46.3%) between 10,000/$mm^3$ and 15,000/$mm^3$ in the result of WBC. 3) 42.6% of patient at a private hospital performed primary care. The treatment after initiating the symptom of intussusception was performed between 6 hrs and 12hrs (37.0%). 4) The most common type and portion of intussusception were ileo-colon(98.1%) and hepatic flexure (68.5%). 5) 88.0% at air reduction and 86.2% at barium reduction were successful. The reduction rate were similar to both techniques. There was no significant difference between them(p>0.05).

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Cost-Benefit Analysis of Back School Program for Occupational Low Back Pain Patients (직업성 요통환자에서 재활 프로그램(Back School Program) 도입의 비용-편익분석)

  • Ju, Yeong-Su;Ha, Mi-Na;Han, Sang-Hwan;Kwon, Ho-Jang;Cho, Soo-Hun;Kim, Chang-Yup;Kim, Sun-Min
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.347-357
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    • 1996
  • Although occupational low back pain accounts for $20\sim40%$ of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and funcional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. We estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson (1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of $30\sim45%$, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.

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Discharge Assessment Tool in Stroke and Elderly Patients: A Systematic Review (뇌졸중 및 노인 환자의 퇴원 평가도구에 대한 체계적 고찰)

  • Hwang, Na-Kyoung;Yoo, Eun-Young
    • Therapeutic Science for Rehabilitation
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    • v.9 no.3
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    • pp.7-21
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    • 2020
  • Objective : The aim of this systematic review is to analyze the assessment items and tools used for the discharge of stroke and elderly patients and to help select appropriate assessment tools for discharge planning. Methods : The studies included in this review were collected from the PubMed, Medline Complete (EBSCOhost), and Scopus databases from January 2009 to December 2018. A total 22 studies were selected. The research types, the areas and sub-areas of assessment, as well as the assessment tools according to the areas were analyzed. Results : Descriptive research (59.2%) was the most frequent type of research. The 12 main areas of assessment were medical condition, activities of daily living, swallowing function, sensation, mobility, cognition and perception, communication, emotion, home environment, patient knowledge and readiness for discharge, social support, and well-being. Among the assessment tools, the most frequently used tools were Bathel Index; Functional Independence Measure, to assess activities of daily living; Short-Form Health Survey, to assess well-being, and Timed Up and Go test, to assess mobility. Conclusion : This study will help select the assessment areas and tools to be considered at discharge of stroke patients and serve a basis for the development of comprehensive assessment tools for discharge planning.