• Title/Summary/Keyword: Recurrence Method

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How to Treat Chronic Subdural Hematoma? Past and Now

  • Lee, Kyeong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.144-152
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    • 2019
  • Treatment of chronic subdural hematoma (CSDH) is relatively straightforward, however, there is still some debate regarding the best strategy for treatment. The most practical recommendations of up to date were identified by a review of literature. The author reviewed the literature on CSDH management from the past to now to identify the best methods. Till 1970s, craniotomy was the most commonly used method. Burr hole (BH) became the most preferred method from 1980s. In 1977, twist drill (TD) craniostomy was introduced. Closed system drainage after a BH or a TD became the most frequently used surgical method. Although nonsurgical treatment is often successful, trephination has more advantages, such as rapid resolution of the symptoms and short period of hospitalization. Nonsurgical treatment is possible in asymptomatic patients with a small CSDH. For the symptomatic patients with CSDH, trephination is the treatment of choice, either by BH or TD. In gray zone between surgery and medical treatment, shared decision making can be an ideal approach. For the recurrent CSDHs, repeated trephination is still effective for patients with a low risk of recurrence. If the risk of recurrence is high, additional management would be helpful. For the refractory CSDHs, it is necessary to obliterate the subdural space.

Oncological and Aesthetic Outcomes of Nipple-Areolar Complex(NAC) Sparing Mastectomy and Immediate Breast Reconstruction (유둔-유륜 복합체 보존 유방절제술 및 즉시 유방 재건술 후 종양학적 미용학적 결과)

  • Park, Chan Woo;Ahn, Hee Chang;Kim, Youn Hwan;Jung, Min Sung
    • Archives of Reconstructive Microsurgery
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    • v.21 no.2
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    • pp.118-130
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    • 2012
  • Background: Women receiving mastectomy usually prefer a single-stage surgical procedure without the need for additional surgery. Hence, nipple sparing mastectomy was introduced, and the follow-up data on the aesthetic outcome and recurrence of breast cancer were investigated in this study. Materials and Methods: The study subjects comprised 22 patients who received nipple-sparing mastectomy and immediate breast reconstruction using the free transverse abdominal rectus abdominis myocutaneous flap between June of 2007 and June of 2012. The patients' aesthetic outcomes were measured with 2 methods for the objective result: Breast size measurements and breast volume calculation both at preoperative phase and postoperative 1 years phase. Also, the patients' satisfaction was evaluated at postoperative 1 year with the self-assessment questionnaire. Follow up check for assessing cancer recurrence was performed for an average period of postoperative 1063 days. Results: First, in objective aesthetic outcome, there were no significant differences between the preoperative and postoperative results on both the breast size and the volume. Second, the patient satisfaction analysis scores were graded as very good in 15 patients (68.2%), and as good in 6 patient (27.3%). Most of the patients were very satisfied with our surgery method. Last, there was no local or distant recurrence in these 22 patients during the follow-up period. Conclusion: In this study, the nipple-sparing mastectomy achieved satisfactory results for the breast scar and shape with a single-stage surgical procedure, and the cancer recurrence rate was not significantly different from that of the conventional mastectomy. Besides, the nipple-sparing mastectomy is more cost-effective than the conventional mastectomy since it reduces the need for additional procedures. However, we think that it is necessary to determine the long-term outcomes about the recurrence rate.

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Intralesional Cidofovir Therapy for Recurrent Repiratory Papillomatosis (재발성 호흡기 유두종증의 병변내 시도포비어 치료)

  • Song, Hyoung-Yong;Han, Myung-Woul;Choi, Seung-Ho;Kim, Sang-Yoon;Nam, Soon-Yuhl
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.2
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    • pp.136-140
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    • 2009
  • Background and Objectives: Recurrent respiratory papillomatosis (RRP) is difficult to treat because of its tendency to recur and spread throughout the aerodigestive tract. We aimed to estimate the effect of intralesional injections of cidofovir in patients with RRP. Materials and Method: Within the period from January 2003 to July 2007, 13 patients aged 2 to 61 years were treated with intralesional injections of cidofovir combined with surgical excision of RRP. Cidofovir was injected intralesionaly at a concentration of 5 mg/cc after complete removal of the papilloma with $CO_2$ laser or microdebrider. We evaluated the effect of intralesional cidofovir therapy by comparing pre-treatment mean interval of recurrence with post-treatment interval of recurrence. Results: Of 13 patients, two patients showed complete response during follow up period and four patients showed partial response. Seven patients did not respond to cidofovir at all. Mean pre-treatment mean interval of recurrence was 9 months and mean post-treatment interval of recurrence was 13.1 months (p=0.039). There was a statistical significance between the injected dose of cidofovir and post-treatment interval of recurrence (p=0.009). There were no local or systemic side effects caused by cidofovir. Conculsion : Intralesional injection of cidofovir seems to have a potential of a safe and effective adjuvant therapy of RRP. There was a positive correlation between the injected dose of cidofovir and patient clinical outcomes so that administration of higher doses and more frequency of injections should be needed to reduce recurrence. Further study regarding injection therapy regimen for RRP is required.

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An Australian Retrospective Study to Evaluate the Prognostic Role of p53 and eIF4E Cancer Markers in Patients with Head and Neck Squamous Cell Carcinoma (HNSCC): Study Protocol

  • Singh, Jagtar;Jayaraj, Rama;Baxi, Siddhartha;Mileva, Mariana;Curtin, Justin;Thomas, Mahiban
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4717-4721
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    • 2013
  • Complete surgical resection of the primary tumour is a crucial predictive step for head and neck squamous cell carcinoma (HNSCC), because incomplete resection may lead to increase in the recurrence rate. Molecular cancer markers have been investigated as potential predictors of prognosis marker, to identify patients who are at high risk of local recurrence. This retrospective study aimed to determine the prognostic correlation between p53 and eIF4E expression and clinical characteristics, recurrence and overall survival. Forty eight HNSCC patients were selected between 2006 and 2009 diagnosed at the Royal Darwin Hospital, Darwin, Northern Territory, Australia. Out of 48, only those 24 with negative surgical margins with hematoxylin and eosin (HandE) were chosedn for further analysis. A total of 77 surgical margins were obtained and subsequently analysed by immunohistochemical (IHC) staining with monoclonal p53 and polyclonal eIF4E antibodies. Contingency table and ${\chi}^2$-test were used to investigate the correlation between p53 and eIF4E expression and clinical characteristics, recurrence and overall survival of the HNSCC patients. The follow up period was 74 months (range 1-74 months). The Kaplan-Meier method was used to generate recurrence and survival curves. This is a first retrospective study of Northern Territory patients, including Indigenous and non-Indigenous Australians. Molecular study of surgical margins could help to identify patients with and without clear margins after surgery and help in choice of the most appropriate adjuvant treatment for HNSCC patients.

A Case of Long-term Survival with Traditional Korean Medicine Alone for Recurrent Metastases of Colorectal Cancer (한방 단독치료로 전이 대장암의 반복적인 재발을 억제한 장기 생존 치험 1례)

  • Kim, Eun-hye;Yoon, Sung-soo;Lee, Jee-young;Yoon, Seong-woo
    • The Journal of Internal Korean Medicine
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    • v.40 no.4
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    • pp.723-729
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    • 2019
  • Objective: This study was aimed at reporting on a patient with repeated recurrence of metastatic colorectal cancer treated with traditional Korean medicine (TKM) alone after operation and chemotherapy. Method: The patient with metastatic colorectal cancer received tumor resections four times and perioperative chemotherapy for repeated recurrence from February 2013 until March 2015. TKM, which included Gunchil-dan and Haeam-dan, was administered until June 2019 to prevent additional relapses. Results: After 49 months of TKM treatment, there was no tumor recurrence. A no evidence of disease (NED) state was maintained from March 2015 to June 2019. Recurrence-free survival (RFS) was shown for 49 months and overall survival (OS) for 78 months. Serious adverse events evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 were not identified. This study suggested that TKM with herbal medicine including aRVS might prolong survival and inhibit recurrence of tumors in patients with metastatic colorectal cancer.

Clinical Outcomes of Surgical Treatment for Primary Chest Wall Soft Tissue Sarcoma

  • Yoon, Seung Hwan;Jung, Joon Chul;Park, In Kyu;Park, Samina;Kang, Chang Hyun;Kim, Young Tae
    • Journal of Chest Surgery
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    • v.52 no.3
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    • pp.148-154
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    • 2019
  • Background: This study investigated the clinical outcomes of surgical treatment of primary chest wall soft tissue sarcoma (CW-STS). Methods: Thirty-one patients who underwent surgery for CW-STS between 2000 and 2015 were retrospectively reviewed. The disease-free and overall survival rates were estimated using the Kaplan-Meier method, and prognostic factors were analyzed using a Cox proportional hazards model. Results: The median follow-up duration was 65.6 months. The most common histologic type of tumor was malignant fibrous histiocytoma (29%). The resection extended to the soft tissue in 14 patients, while it reached full thickness in 17 patients. Complete resection was achieved in 27 patients (87.1%). There were 5 cases of local recurrence, 3 cases of distant metastasis, and 5 cases of combined recurrence. The 5-year disease-free rate was 49%. Univariate analysis indicated that incomplete resection (p<0.001) and stage (p=0.062) were possible risk factors for recurrence. Multivariate analysis determined that incomplete resection (p=0.013) and stage (p=0.05) were significantly associated with recurrence. The overall 5- and 10-year survival rates were 86.8% and 64.3%, respectively. No prognostic factor for survival was identified. Conclusion: Long-term primary CW-STS surgery outcomes were found to be favorable. Incomplete microscopic resection and stage were risk factors for recurrence.

IMPROVING THE POCKLINGTON AND PADRÓ-SÁEZ CUBE ROOT ALGORITHM

  • Cho, Gook Hwa;Lee, Hyang-Sook
    • Bulletin of the Korean Mathematical Society
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    • v.56 no.2
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    • pp.277-283
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    • 2019
  • In this paper, we present a cube root algorithm using a recurrence relation. Additionally, we compare the implementations of the Pocklington and $Padr{\acute{o}}-S{\acute{a}}ez$ algorithm with the Adleman-Manders-Miller algorithm. With the recurrence relations, we improve the Pocklington and $Padr{\acute{o}}-S{\acute{a}}ez$ algorithm by using a smaller base for exponentiation. Our method can reduce the average number of ${\mathbb{F}}_q$ multiplications.

A Study on the inhibition of metastasis and recurrence of neoplasm (종양(腫瘍)의 전이(轉移) 및 재발(再發) 억제(抑制)에 관(關)한 고찰(考察))

  • Kim, Jong-Dae;Cho, Chong-Kwan
    • The Journal of Internal Korean Medicine
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    • v.18 no.2
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    • pp.53-64
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    • 1997
  • Many types of cancer, current therapy other than surgery and/or radiotherapy was of only limited efficacy. At the basic chinese traditional medicine(TCM) there was increased understanding of the additional basic and clinical neoplasm treatment research. The metastasis and recurrence of neoplasm was the basis of yudu(餘毒) on remained neoplasm cell and stagnation of blood, thermotoxo, phlegm, asthenia of healthy enerngy, stagnation of vital energy. The principles therapy of neoplasm on metastasis and recurrence was based on knowledge of the method of support the healthy energy and strengthen the body resistance, promote blood circulation to remove blood stasis, clear away heat and toxic materials, dissipate phlegm and disperse the accumulation of evils, regulate vital energy and disperse the depressed vital energy. But the major clinical features of neoplasm was to be considered in developing a treatment plan include (1) distinguish between clinical and pathologic staging - acute and chronic, (2) classification of pathologic pattern, and (3) distinction of body situation : for examples asthenia - sthenia etc. It was most important to distinguish between supporting the healthy and eliminating the evil factors and to treat differently at the root and the branch cause of a neoplasm. This paper's results indicate that identification and effective use of TCM medicines inhibited netastasis and decreased recurrence and then we were able to expect increasing survival rate.

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Application for Prediction of Crown Settlements Using RMR in Weathering Rock Tunnels (RMR을 이용한 풍화암 터널의 천단침하량 예측 평가)

  • Kim, Young-Su;Kim, Dae-Man
    • Journal of the Korean Geotechnical Society
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    • v.25 no.10
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    • pp.67-76
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    • 2009
  • Statistical analysis was performed using a series of data on RMR, RMR* and crown settlements collected from sites of weathering rock tunnels in Korea. The crown settlements were predicted by recurrence analysis, exponential function, and artificial neural network (ANN) using collected in-situ data. The result of the prediction fitted well compared to the measured settlement in the order of ANN, exponential function, and recurrence analysis. The range of crown settlement predicted by recurrence analysis widely scattered and promised larger settlement than the measured. Also in all method, the predicted value by RMR well matched compared to the measured settlement predicted by RMR*.

Midterm Clinical Outcomes after Modified High Ligation and Segmental Stripping of Incompetent Small Saphenous Veins

  • Hong, Ki Pyo
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.398-403
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    • 2015
  • Background: The aim of this study was to evaluate the midterm clinical outcomes after modified high ligation and segmental stripping of small saphenous vein (SSV) varicosities. Methods: Between January 2010 and March 2013, 62 patients (69 legs) with isolated primary small saphenous varicose veins were enrolled in this study. The outcomes measured were reflux in the remaining distal SSV, the recurrence of varicose veins, the improvement of preoperative symptoms, and the rate of postoperative complications. Results: No major complications occurred. No instances of the recurrence of varicose veins at previous stripping sites were noted. Three legs (4.3%) showed reflux in the remaining distal small saphenous veins. The preoperative symptoms were found to have improved in 96.4% of the cases. Conclusion: In the absence of flush ligation of the saphenopopliteal junction, modified high ligation and segmental stripping of small saphenous vein varicosities with preoperative duplex marking is an effective treatment method for reducing postoperative complications and the recurrence of SSV incompetence.