Purpose: By reviewing literature on the subject, we compared the survival rate of implants placed in various graft materials used for maxillary sinus augmentation. Materials and Methods: The search protocol used the Pubmed electronic database, with a time limit from 1998 to 2009. Keywords such as 'sinus lift,' 'sinus augmentation,' 'sinus floor elevation,' 'sinus graft,' 'bone graft,' 'implants,' 'oral implants,' and 'dental implants' were used, alone and in combination, to search the database. We selected articles and divided them into three groups by type of graft materials: Group 1. Autogenous bone group: autogenous bone alone; Group 2. Combined bone group: autogenous bone in combination with bone substitutes; and Group 3. Substitute group: bone substitutes alone or bone substitute combinations. Results: We selected 37 articles concerning a total of 2,257 patients and 7,282 implants; 417 implants failed. The total implant survival rate (ISR, %) was 94.3%. In Group 1, 761 patients and 2,644 implants were studied; 179 implants failed and the ISR was 93.2%. In Group 2, 583 patients and 1,931 implants were studied; 126 implants failed and the ISR was 93.5%. In Group 3, 823 patients and 2,707 implants were studied; 112 implants failed and the ISR was 95.9%. Conclusion: Implants inserted in grafts composed of bone substitutes alone or in grafts composed of autogenous bone in combination with bone substitutes may achieve survival rates better than those for implants using autogenous bone alone (P<0.05).
Purpose : Patients with esophageal cancer treated with surgery plus postoperative radiotherapy or radiation alone were retrospectively analyzed. Method : From August 1980 to June 1992, 93 patients who were treated with 30 Gy or more in the Department of Therapeutic Radiology were evaluated. Median age was 59 years. Ninety one were male and remaining 2 were female. Patients with stage II, III and IV disease were 25, 62 and 6 respectively. Thirteen of the tumor were located in upper one third, 56 in middle one third and 24 in lower one third. Forty three patients had tumors 5cm or less in size and remaining 50 had greater than 5cm. Of those 93 patients, 41 were treated with surgery plus postoperative radiotherapy and 52 with radiation alone. Dose of radiation ranged from 34 to 66.6 Gy. Follow up period was 12 to 61 months. Results : Stage of the tumor was the most important prognostic factor of the evaluated factors. Median survival for entire group of patients was 12 months. Median survival for patients treated with surgery plus postoperative radiotherapy and radiation alone were 15 and 10 months, respectively. There was no difference of 2 year survival. Median survival was 21 months for Stage II and 10 months for Stage m disease. In Stage II disease, that was 21 months for postoperative group and 17.5 months for radiation alone group. Five year survival were $27.5\%$ and $9\%$, respectively. Conclusion : This study showed that the result of surgery plus postoperative radiotherapy was not different from that of radiation alone despite of slightly longer median survival in postoperative group. Also stage of the disease was the most important prognostic factor.
From June 1983 to September 1984, the pleural biopsies with Cope needle were performed at department of thoracic and cardiovascular surgery, Pusan Paik Hospital, Inje college, on 78 patients for exudative pleural effusion caused by various conditions. These results were analyzed clinically and summarized as follows: 2. The accuracy of pleural biopsy was 69.2% [54 of 78 patients]. The accuracy represented by ratio for the number of biopsy was 63.5% [54 of 85 biopsies]. 3. Among 61 patients of tuberculosis or malignancy, 37 [60.7%] were confirmed by pleural biopsy. 4. Tuberculosis was diagnosed in 48 patients, in 26[54.2%] out of these by pleural biopsy alone, in 3[6.2%] by pleural biopsy and isolation of AFB, in 2[4.2%] by pleural biopsy and operation, in 4[8.3%] by isolation of AFB, in 2[4.2%] by operation, and in 11[22.9%] clinically. 5. Among 13 patients of malignancy, 4[30.8%] were diagnosed by cytology alone, 4[30.8%] by pleural biopsy and cytology alone, 4[30.8%] by pleural biopsy and cytology, 1[7.7%] by pleural biopsy alone, 1[7.7%] by pleural biopsy and operation, and remained 3 by operation, lymph node biopsy, or bronchoscopy respectively. 6. False positive of clinical diagnosis was 12.5% for tuberculosis and 28.6% for malignancy. In pathological diagnosis there was no false positive. So specificity of pleural biopsy was very high. But false negative of pleural biopsy was 29.2% for tuberculosis and 46.2% for malignancy. 7. 4 cases[5.1%] of minimal pneumothorax were in the early series.
Among the 63 patients with histopathologically proven primary squamous cell anal cancer who were managed in Presbyterian Medical Center and Yonsei University Cancer from Jan. 1971 to Dec. 1991, 34 patients, who were managed with surgery alone(abdominoperineal resection) or post-operative radiotherapy and concurrent chemoradiotherapy were analysed. With mean follow up time of 81.3 months, 30 Patients(88$ \% $) were followed up from 17 to 243 months. In methods, 10 patients were treated with surgery alone. 9 Patients were treated with combined surgery and postoperative radiotherapy(50$\∼$60 Gy in 28$\∼$30 fractions). 15 patients were treated with concurrent chemoradiotherapy. Chemotherapy (Mitomycin C 15 mg/squ, bolus injection day 1;5-FU, 750 mg/squ, 24hr infusion, day 1 to 5) and radiotherapy started the same day. A dose of 30 Gy was given to the tumor and to the pelvis including inguinal nodes, in 15 fractions. After 2 weeks a boost of radiotherapy(20 Gy) to the ano-perineal area and second cycle of chemotherapy completed the treatment. The overall 5-year survival rate was 56.2$ \% $. Concurrent chemoradiotherapy group was 70$ \% $ and surgery alone group was 16.7$ \% $. According to the cox proportional harzard model, there was significant difference between survival with concurrent chemoradiotherapy and surgery alone(p=0.0129), but post-operative radiotherapy was 64.8$ \% $, which was not stastically significant(p=0.1412). In concurrent chemoradiotherapy group, the anal funtion Preservation rate was 87$ \% $ and the severe complication rate(grade 3 stenosis and incontinence) was 13.3$ \% $. In conclusion, we conclude that the concurrent chemoradiotherapy may be effective treatment modality in patients with anal cancer.
Purpose: Peritoneal carcinomatosis (PC) presents a major challenge in the treatment of late-stage, solid tumors, with traditional therapies limited by poor drug penetration. We evaluated a novel hyperthermic pressurized intraperitoneal aerosol chemotherapy (HPIPAC) system using a human abdominal cavity model for its efficacy against AGS gastric cancer cells. Materials and Methods: A model simulating the human abdominal cavity and AGS gastric cancer cell line cultured dishes were used to assess the efficacy of the HPIPAC system. Cell viability was measured to evaluate the impact of HPIPAC under 6 different conditions: heat alone, PIPAC with paclitaxel (PTX), PTX alone, normal saline (NS) alone, heat with NS, and HPIPAC with PTX. Results: Results showed a significant reduction in cell viability with HPIPAC combined with PTX, indicating enhanced cytotoxic effects. Immediately after treatment, the average cell viability was 66.6%, which decreased to 49.2% after 48 hours and to a further 19.6% after 120 hours of incubation, demonstrating the sustained efficacy of the treatment. In contrast, control groups exhibited a recovery in cell viability; heat alone showed cell viability increasing from 90.8% to 94.4%, PIPAC with PTX from 82.7% to 89.7%, PTX only from 73.3% to 74.8%, NS only from 90.9% to 98.3%, and heat with NS from 74.4% to 84.7%. Conclusions: The HPIPAC system with PTX exhibits a promising approach in the treatment of PC in gastric cancer, significantly reducing cell viability. Despite certain limitations, this study highlights the system's potential to enhance treatment outcomes. Future efforts should focus on refining HPIPAC and validating its effectiveness in clinical settings.
Purpose: To date, there are no promising treatments for gastric carcinoma with peritoneal metastasis. Some researchers have suggested a survival benefit of gastrectomy in select patients. This study investigated the survival of gastric carcinoma patients with stand-alone peritoneal metastasis according to the type of treatment modality. Materials and Methods: We reviewed the data of 132 patients with gastric carcinoma and stand-alone peritoneal metastasis. We performed gastrectomy when the primary tumor was deemed resectable and systemic chemotherapy was administered. We analyzed patient survival according to the type of treatment, and the prognostic value of gastrectomy was evaluated in univariate and multivariate models. Results: Among all patients, 70 underwent gastrectomy plus chemotherapy, 20 underwent gastrectomy alone, 36 underwent chemotherapy alone, and 6 received supportive care. The median patient survival was 13 months. Patients who underwent gastrectomy had significantly longer survival than those who did not undergo gastrectomy (14 vs. 8 months, P<0.001). Patients who received chemotherapy showed significantly longer survival than those who did not (13 vs. 7 months, P=0.032). Patients who underwent gastrectomy plus chemotherapy showed better survival than those who underwent other treatments. In multivariate analysis, gastrectomy was found to be an independent prognostic factor (hazard ratio, 0.52; 95% confidence interval, 0.33-0.82) in addition to chemotherapy. Conclusions: Our study showed that patients who underwent gastrectomy plus chemotherapy had the best survival. Although the survival benefit of gastrectomy remains uncertain, it is a favorable prognostic indicator in patients with stand-alone peritoneal metastasis.
The management of coincident glaucoma and cataract is not only a common clinical challenge but also an important research topic in the ophthalmic surgical field. The purpose of this article is to compare the different surgical options on the basis of their achievable postoperative intraocular pressure (IOP) control, success rates, and complication rates reported in the related literature, and to give advice on how to manage typical situations of patients with both glaucoma and cataract. Main topics were focused on indications and rationale of 3 surgical options (only cataract surgery first and later trabeculectomy, only trabeculectomy first and later cataract surgery, or simultaneous combined surgery). Modern clear corneal cataract extraction techniques resulted in a modest intermediate-term reduction of IOP and has considerably improved the success rates of combined glaucoma and cataract surgery. It also enabled future trabeculectomy to be successfully performed at a later date if necessary. Trabeculectomy alone achieved better IOP regulation than phacotrabeculectomy (combined surgery), but subsequent cataract surgery may compromise preexisting filtering bleb. Combined surgery augmented with mitomycin C achieved a lower IOP than combined surgery alone but had a higher complication rate. In conclusion, the choice of the preferred surgical method should be determined according to the target pressure, the amount of glaucomatous damage, and the grade of visual disturbance caused by the cataract. Phacotrabeculectomy with adjunctive mitomycin C offers visual improvement and achieves the best IOP lowering of all types of combined glaucoma and cataract surgery currently used but is associated with potentially sight-threatening complications.
Patent ductus arteriosus is not uncommon congenital heart disease. Patent ductus arteriosus associated with mitral regurgitation is very rare, however especially nonrheumatic in character. In such a case, a ligation of ductus arteriosus alone makes it regress the symptoms and signs of mitral regurgitation. Till recent days, we have experienced 10 cases of patent ductus arteriosus with mitral regurgitation who had been undergone a ligation of ductus arteriosus alone with good clinical benefits. In 5 cases among above patients, we have followed up the patients from 4 months to 6 years. Herewith, we report these cases with review of some literatures.
Kim, Dong Sung;Kim, Jae-Young;Jeong, Chan-Woo;Park, Kwang-Ho;Huh, Jong-Ki
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
제41권5호
/
pp.259-264
/
2015
We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma.
Xu, Xiao-Hua;Peng, Xue-Hong;Yu, Ping;Xu, Xiao-Yuan;Cai, Er-Hui;Guo, Pi;Li, Ke
Asian Pacific Journal of Cancer Prevention
/
제13권1호
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pp.103-110
/
2012
Neoadjuvant chemotherapy for resectable esophageal carcinoma has been a focus of study, but no agreement has been reached on clinical randomized controlled trials and relevant systematic evaluation. The purpose of this study was to perform a meta-analysis on published randomized controlled trials (RCTs) that compared neoadjuvant chemotherapy and surgery with surgery alone for resectable esophageal carcinoma. Medline and manual searches was conducted in PubMed, ASCO (American Society of Clinical Oncology) meeting summary, Embase, the Cochrane Library (up to October 2010), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database, Wanfang Database. The selection contents were to identify all published and unpublished RCTs that compared neoadjuvant chemotherapy and surgery with surgery alone for resectable esophageal carcinoma. Sixteen RCTs which included 2,594 patients were selected. The risk ratio (RR) (95% confidence interval [CI]; P value), expressed as neoadjuvant chemotherapy and surgery versus surgery alone (treatment versus control), was 1.02 (0.95, 1.10; P=0.54) for 1-year survival, 1.29 (1.13, 1.47; P=0.0001) for 3-year survival, 1.31 (1.13, 1.51; P=0.0003) for 5-year survival, 1.00 (0.95, 1.04; P= 0.85) for rate of resection and 0.89 (0.64, 1.23; P=0.48) for operative mortality. The results showed that neoadjuvant chemotherapy for resectable esophageal carcinoma can raise the overall survival rate of patients with esophageal carcinoma, but it does not affect treatment-related mortality.
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