• 제목/요약/키워드: Radical surgery

검색결과 595건 처리시간 0.024초

기무라 병 환자에서 수술적 치료 및 술 후 스테로이드 병합요법의 치험2례 (Case report of Kimura's disease Treated by Radical resection and Post Operative Steroid therapy)

  • 김정태;김기웅;이경묵;김연환
    • Archives of Plastic Surgery
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    • 제36권2호
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    • pp.229-232
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    • 2009
  • Purpose: Kimura's disease is a relatively rare head and neck tumor that frequently occurs in young orientals accompanied with eosinophila. We shared our experience of two cases of Kimura's disease, treated by radical resection and post operative steroid therapy, so we report the correlation of eosinophil counts and disease progression. Methods: A 25 years old male came to the clinic with a mass localized to the right cheek inferior to the right auricle. We could not resect the mass totally. During the follow up period, we checked the eosinophil counts, and steroid therapy was started 7 months after the surgery. A 34 year old female came to the clinic with a mass localized inferior to the left auricle reaching from the posterior portion of the auricle to the left temporal portion. We tried to remove as much tumor as possible, save the temporal region, in regard to the impairment of blood supply to the auricle. After operation, steroid therapy was started. Results: In the first case, the tumor was easily approachable, and radical resection of the tumor with post operative steroid therapy was an effective treatment. In tumors located at difficult regions to remove, as in the second case, optimal debulking and post operative steroid therapy was also effective in treating Kimura's. There were no recurrences in both cases. Eosinophil counts were always reduced after surgery and steroid therapy, and during the period with low eosinophil counts, there was no recurrence of Kimura's disease. Conclusion: Surgery and post operative steroid therapy were effective in treatment of Kimura's disease, and we could assume eosinophil counts as a good indicator for evaluation of the prognosis of Kimura's disease during the follow up period.

Radical Surgical Excision and Use of Lateral Thoracic Flap for Intractable Axillary Hidradenitis Suppurativa

  • Teo, Wan-Lin;Ong, Yee-Siang;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • 제39권6호
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    • pp.663-666
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    • 2012
  • Current treatments for hidradenitis suppurativa (HS) include prolonged courses of antibiotics, retinoids, immunosuppressants, and biologics. Severe cases that are resistant to prolonged medical treatment pose a therapeutic challenge. We propose radical excision and lateral thoracic flap reconstruction as a treatment option for such cases. In our experience with two patients, good aesthetic and functional outcomes were achieved, with a high level of patient satisfaction. The availability of suitable flap coverage allows for wide resection of all of the hair-bearing skin, leading to a low incidence of residual disease and subsequent recurrence. Following excision of the affected tissue, the ideal reconstructive method in the axilla provides suitable coverage without unacceptable donor site morbidity and also avoids axillary contractures. A long lateral thoracic flap with delay has excellent coverage with minimal donor tissue sacrifice. With a suitable flap coverage option, the management paradigm of intractable HS should shift from prolonged medical treatment to allow decisive radical excision, which will improve the quality of life for patients.

멜라토닌이 백서의 임의형 등피판 생존에 미치는 영향 (The Effect of Melatonin on the Random Flap Survival in the Rat)

  • 홍승은;김양우;범진식;강소라
    • Archives of Plastic Surgery
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    • 제35권6호
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    • pp.645-652
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    • 2008
  • Purpose: In skin flap surgery, surgeons often encounter distal ischemia of the flap. If a powerful free radical scavenger is used, it may reduce the formation of free radical and improves the survival of flap. Thus, the present study purposed to examine whether the survival of flap can be enhanced by administering melatonin, which is known to be a powerful free radical scavenger a antioxidant molecule. Methods: We divided 40 Sprague-Dawley rats into 4 groups, 10 in each group. For the control group(n=10), we intraperitoneally injected only carrier solution once 30 minutes before the operation, and once a day for 7 days from the day of operation. Among the experimental groups, a group(n=10) was administered with dimethyl sulfoxide(DMSO), in another group(n=10), melatonin was intraperitoneally injected, and in the other(n=10) melatonin was intraperitoneally injected and applied topically(2 cc of 1% melatonin) to the operation site. Caudally based skin flaps measuring $3{\times}10cm^2$ were elevated on the mid-dorsum of the rats. and then repositioned. On the seventh postoperative day, the survival area of the flap was measured and tissues were examined under the light microscope. Results: The control group, the DMSO group, the melatonin administration group and the melatonin administration and application group showed the mean survival rates of $55.26{\pm}9.2%$, $70.29{\pm}7.47%$, $81.45{\pm}4.14%$ and $86.1{\pm}1.52%$, respectively, for $30cm^2$ of flap. Compared to the control group, the experimental groups showed a significantly high increase in survival area at significance level of 95%. Conclusion: In this study, the survival rate of flap was enhanced through the administration of melatonin after flap surgery. This suggests that melatonin not only functions as a powerful free radical scavenger and oxygen radical scavenger but also stabilizes and protects cells, and by doing so, enhances the survival of moderately injured ischemic sites in the distal end of flap.

체외강력집속초음파치료 (Extracorporeal High Intensity Focused Ultrasound Therapy)

  • 한상석
    • 대한골관절종양학회지
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    • 제11권1호
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    • pp.17-24
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    • 2005
  • 의학의 발달과 더불어 종양에 대한 국소치료는 광범위근치술(extended radical surgery) 로부터 기능보존술(function preserving surgery)로 발달하고 이것은 다시 최소침습술(minimal-invasive surgery)로 발전하여 왔다. 그러나 최근 들어서는 기술의 혁신적인 진보로 비침습적수술법(non-invasive surgery)이 개발되어 감마나이프(gamma knife), 사이버나이프(cyber knife), 및 하이푸나이프(HIFU knife) 등이 출현하게 되었다. 본 논문에서는 이들 중 하이푸나이프를 이용한 체외강력집속초음파치료(extracorporeal high intensity focused ultrasound therapy)에 대하여 발달사, 치료기 구조 및 치료과정, 조직학적 변화와 기전, 임상적용, 장단점 및 전망 등을 살펴보고자 한다.

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Functional recovery after radical prostatectomy for prostate cancer

  • Ko, Young Hwii
    • Journal of Yeungnam Medical Science
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    • 제35권2호
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    • pp.141-149
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    • 2018
  • With the enthusiasm regarding robotic application in radical prostatectomy in accordance with the widespread use of serum prostate-specific antigen as a screening test, the number of surgeries performed for complete removal of the gland is increasing continuously. However, owing to the adjacent anatomical location of the prostate to the nerve and urethral sphincter complex, functional recovery, namely improvement from post-prostatectomy incontinence (PPI) and post-prostatectomy erectile dysfunction, still remains a main problem for patients who are reluctant to undergo surgery and tend to choose alternative ways instead. Since the late 1980s, the introduction of radical prostatectomy by open surgical modalities, the depth of the anatomical understanding of the structure surrounding the prostate is getting tremendous, which leads to the development of new surgical modalities and techniques that are consequently aimed at reducing the incidences of PPI and erectile dysfunction. Briefly, recent data from robotic radical prostatectomy, particularly on PPI, are quite acceptable, but by contrast, the reported potency regain rate still remains <20%, which indicates the need for advanced surgical modification to overcome it. In this review, the authors summarized the recent findings on the anatomy and surgical techniques reported up to now.

CHYLOUS FISTULA의 처치 (MANAGEMENT OF CHYLOUS FISTULA (CASE REPORT))

  • 전주홍;박기광;조경엽
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제17권2호
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    • pp.202-207
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    • 1995
  • Chylous fistula is a rare complication occurring after radical neck dissection. Previous reports on neck dissection described an incidence of about 1% to 2%. We report a case of chylous fistula that occurred after radical neck dissection for squamous cell carcinoma of left lower gingiva and mandible in a 52-year-old man. We successfully managed the fistula by the following conservative measures : bed rest with head elevation, continuation of closed suction drainage, and dietary management to decrease the rate of chyle formation.

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변형적 경부청소술 후 내경정맥의 유지 (Internal Jugular Vein Patency after Modified Radical Neck Dissection)

  • 조정일;김영모;김철호;김형진
    • 대한두경부종양학회지
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    • 제14권2호
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    • pp.169-174
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    • 1998
  • 저자들은 변형적 경부청소술을 시행받은 두경부암환자 23례를 대상으로 술 후 내경정맥의 유지여부을 후향적으로 연구한 결과 총 34측 경부청소술 중 28측(82.4%)에서 내경정맥이 유지됨을 알 수 있었다. 이는 기존의 연구결과와 비슷한 개존율임을 알 수 있었다. 내경정맥의 폐쇄요인으로 술중 정맥의 손상과 혈류정체, 장기간 수술로 인한 정맥벽의 건조, 수술시 제거되는 근막의 소실이 정맥의 유착과 압박을 초래하는 것으로 알려져 있다. 또한 다양한 치료방법과 술 후 발생하는 여러 요인들에 의해 내경정맥이 영향을 받는데 본 연구에서는 국소재발과 창상합병증등이 주된 영향을 준 것으로 판단된다. 방사선치료는 다른 복합적인 요소가 결부되어 단독적인 영향으로 판단하기엔 충분치 않으며 양측 경부청소술은 내경정맥의 폐색과는 무관한 것으로 생각된다. 본 연구는 증례수가 작고 추적기간이 짧은 한계점이 있으므로 향후 좀 더 많은 증례와 충분한 추적기간을 통한 연구가 필요하리라 판단된다.

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혀에 발생한 선편평세포암의 증례보고 (A CASE REPORT OF ADENOSQUAMOUS CELL CARCINOMA INVOLVING SUBMUCOSAL GLAND AND TONGUE)

  • 방만혁;이동근;엄인웅;민승기;권혁도;김은철
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제16권2호
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    • pp.196-201
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    • 1994
  • One case of an unusual form of carcinoma involving the submucosal gland and duct of tongue was reported and reviewed. According to Gerughty et al(1968) four distinct component parts were classified : ductal carcinoma in situ(involvement of the ductal epithelium by in situ carcinomatous changes), squamous cell carcinoma, and a mixed carcinoma(combination of glandular and squamous characteristics and occasionally consisted of large nests composed of "glassy" cell). This tumor was fond to be extremely aggressive and highly malignant. The histopathologic features and the clinical behavior of this tumor were sufficiently distinctive to warrant the designation adenosquamous carcinoma : exhibit concomitant glandular and squamous neoplasm. The mode of therapy was evaluated and the treatment of choice appears to be radical surgery. So, we has done the radical neck dissection and partial glossectomy. However, the limited number of cases indicated that collection and subsequent analysis of additional cases must be performed before any definitive conclusion can be drawn.

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Enhancement of Methylene Blue-induced Cytotoxicity in Human Brain Tumor Cells by an Iron Chelator, Deferoxamine

  • Lee, Yong-Soo;Han, Suk-Kyu;Wurster, Robert D.
    • Archives of Pharmacal Research
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    • 제18권3호
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    • pp.159-163
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    • 1995
  • Previously, we have reported that methylene blue (MB) induces cytotoxicity in human brain tumor cells through the generation of free radicals. In this study the effect of deferoxamine (DFO), an iron chelator, on MB-induced cytotoxicity was investigated using SK-N-MC human neuroblastoma and U-373 MG human astrocytoma cells as model cellular systems. The cytotoxic effect of MB was potentiated by DFO. The potentiation effect of DFO was significantly blocked by either stoichiometric amounts of ferric ion, various antioxidants, hydroxyl radical scavengers or intracellular $Ca^{2+}$ release blockers. These results suggest that hydroxyl radical and intracellular $Ca^{2+}$ may act as important mediators of the enhanced cytotoxicity by MB and DFO. These results further suggest that the combined treatment with MB and DFO may be useful for the therapeutical applications of human brain tumors.

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