• Title/Summary/Keyword: Surgery alone

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Clinical, statistical and chemical study of sialolithiasis

  • Lim, Ho-Kyung;Kim, Soung-Min;Kim, Myung-Jin;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.1
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    • pp.44-49
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    • 2012
  • Introduction: Sialolithes are initiated by localized deposition of calcified material in the salivary glands. And that may even cause various symptom especially swelling and pain. This study purposes to collect statistical data of sialolithiasis for clinical analysis. Materials and Methods: Among forty seven patients who have visited Seoul National University Dental Hospital during 2004-2009, patients' age, sex, location and size of stone, radiodensity of stone, symptom, surgical procedure were investigated. Statistical correlation between size, location, symptom was evaluated. Chemical composition was analyzed for 3 sialolithes. Results: The average age was 41.4 years. Sialolithiasis had slight female predilection (57.4%). Most cases occurred in the submandibular glands (91.5%). And most cases had radiopaque features (95.8%). The average size was 7.17 mm. The most frequent location of the stones were the duct orifice and the submandibular gland hilum (16 cases in each), followed by the middle part of the duct (n=8), the intraglandular area (n=4), and the proximal part of the duct (n=3). Eleven cases were asymptomatic. Thirty six cases had complaints of pain, swelling, hardness, and decrease in saliva flow (multiple symptoms). Various methods of surgery was performed. Two cases were self-removed. Thirty seven cases underwent procedure involving stone removal alone. Six cases underwent gland extirpation, and two cases underwent ductoplasty. Conclusion: There was no statistical correlation between size, location, and symptoms. Sialolith was composed of Ca (58.5-69.3%), P (30.7-35.7%), organic material, and trace inorganic material.

Treatment Results in Patients with Salivary Gland Malignancy (타액선 악성 종양 환자에 대한 치료성적)

  • Song Dal-Won;Ahn Jae-Hyun;Sohn Jin-Sik;Kim Tae-Jong;Ahn Byung-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.46-51
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    • 2000
  • Objectives: Primary malignant tumors in the salivary glands are relatively rare. Because of the rarity and the different histopathologic patterns, it is difficult to establish a uniform treatment strategy. The prime treatment of salivary gland malignancy is the surgery, but the role of radiotherapy has been under debate. Radiation therapy combined with conservative surgical procedures may be as successful and perhaps more rational treatment than radical surgery alone. The aim of this study is to evaluate clinical pattern, incidence, treatment modality and outcome of the salivary gland maligancy. Materials and Methods: The medical records of 32 patients with malignant neoplasm of salivary gland who treated at the Keimyung university Dongsan hospital were analyzed retrospectively. Results: The overall 5 year survival rate was 77.9% stage I : 100%, stage II : 75%, stage III : 66.7%, stage IV : 55.6%). The 5 year survival rate according to tumor grade was 100% in low grade malignancy, 71.8% in high grade malignancy. The 5 year survival rate according to treatment modalities was as follows: Surgery only group was 83.3%, combined treatment group with surgery and posoperative radiation was 74.6%. Conclusion: The factors affecting prognosis is variable, but the stage at the time of diagnosis, site of lesion, tumor grade, histologic subtype were important factors. Surgery was the prime treatment tool and postoperative radiotherapy was also imperative in higher stage patient, high grade tumor, or patients with positive surgical margin.

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Bone regenerative effect of recombinant human bone morphogenetic protein-2 after cyst enucleation

  • Hwang, Doo Yeon;On, Sung Woon;Song, Seung II
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.22.1-22.6
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    • 2016
  • Background: The aim of this study is to quantitatively evaluate the effect of rhBMP-2 for repair of bone defects after cyst enucleation using the osteogenesis index (OI). Methods: Under general anesthesia, 10 patients (12 lesions) underwent oral or maxillofacial surgery for cyst enucleation. Postoperatively, 12 lesions were divided into two groups: group A (six lesions) was treated with absorbable collagen sponge (ACS) in combination with rhBMP-2, and group B (six lesions) was treated with ACS alone. After 3 months, cone-beam computed tomographic scans were obtained to measure changes in the volume of the lesions. We then calculated the OI of each group at two different Hounsfield units to determine any statistically significant difference between these two groups (Mann-Whitney U test). Results: As tested at the level of new bone, the mean OI was 72.37 % in group A and 55.08 % in group B -a statistically significant difference (p = 0.041). As tested at the level of mature bone, the mean OI was 27.47 % in group A and 18.88 % in group B, but the difference was not statistically significant (p = 0.394). Conclusions: The application of rhBMP-2 after maxillofacial cyst enucleation accelerated new bone formation in the bone defects. Thus, the use of rhBMP-2 in combination with ACS may be considered an alternative to conventional bone grafting in some patients with postoperative bone defects.

Hemodynamic changes and pain perception-related anxiety after experiencing an impacted-tooth removal: clinical practice outcome

  • Raocharernporn, Somchart;Boonsiriseth, Kiatanant;Khanijou, Manop;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.2
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    • pp.105-111
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    • 2017
  • Background: Dental fear is usually associated with hemodynamic changes. Fear of pain during the surgical removal of a lower impacted third molar might cause patients anxiety, thereby leading to avoidance of any future dental therapy. This study aimed to determine the effect of experiencing a surgical impacted-tooth removal on the pain perception-related anxiety and hemodynamic status. Method: Twenty-seven healthy patients aged 15-30 years (mean age, 24 years), for whom surgical removal of bilateral lower third molars was advised, were included. This prospective, randomized, controlled, split-mouth study involved operations on both sides of the mandibular arch, with a 1-month washout period in between. Blood pressure and heart rate were measured before the surgical procedure, during and after the injection, preoperatively, and postoperatively. Pain perception was evaluated using a 100-mm visual analog scale during the injection, preoperatively, and postoperatively after the numbness disappeared. Differences in the blood pressure, heart rate, and pain perception between the two appointments were analyzed using the paired t-test. For all statistical analyses, SPSS version 11.5 was used. Results: The mean pain perception values during the injection and preoperatively showed no significant differences between the two appointments (P > 0.05); however, significant differences in the blood pressure and heart rate were noted before the surgical procedure; preoperatively, the blood pressure alone showed a significant difference (P < 0.05). Conclusion: There was a significant decrease in the blood pressure and heart rate preoperatively; hence, experiencing a surgical impacted-tooth removal can reduce the subsequent preoperative anxiety in healthy patients.

Recurrent T-cell lymphoma occurred in the vocal fold: a case report (성대에서 발견된 재발성 T세포 림프종에 대한 증례 보고)

  • Kang, Karam;Choi, In Hak;Lee, Doh Young;Baek, Seung-Kuk;Jung, Kwang Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.55-58
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    • 2017
  • Background. Lymphoma of the vocal fold is extremely rare due to low lymphoid content in the larynx. To date, fewer than 100 cases of laryngeal lymphoma have been reported; however, none of these literatures are concerned about exclusive laryngeal involvement of recurred lymphoma which initially appeared in other body sites. Specific consensus about management for these patients yet to exist, due to its rare occurrence; however, the main modality of treatment is chemotherapy alone or in combination with radiation therapy. Case. Herein, we report a case of a 51-year-old female patient who had recurrent T-cell lymphoma developing in bilateral vocal folds. The patient was originally diagnosed of T-cell lymphoma in right colic flexure 10 years ago, and was cured by chemotherapy. Immunohistochemical stain revealed the histologic type of recurred tumor in the vocal folds that are identical to the previously cured lymphoma. Conclusion. To the best of our knowledge, this was the first case that recurrent lymphoma occurred solely in the vocal folds. Despite its rarity, lymphoma should be put in the index of suspicion among those patients with decreased vocal fold mucosal wave without definite vocal fold mass who had a history of cured lymphoma.

RADIX AUGMENTATION USING TEMPORALIS FASCIA GRAFT (측두근막 이식을 이용한 비근증대술)

  • Ryu, Sun-Youl;Ryu, Jae-Young;Kim, Hyun-Syeob
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.2
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    • pp.167-173
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    • 2007
  • The temporalis fascia graft has been widely used in the correction of nasal deformities. The fascia can be used alone or combined for augmentation rhinoplasty. The fascia graft provides adequate coverage, contour, and bulk on the profile of the nose, as well as an inconspicuous donor site. A depressed radix area can be successfully corrected by the fascia graft. We present two cases of nasal radix augmentation by using temporalis fascia graft. Two male patients presented with the skeletal class III malocclusion and the depressed radix. A planned orthognathic surgery and the temporalis fascia graft to the radix were performed. The malocclusion and the profile of the patients were markedly improved after the operation. Not only the radix but also the nose was improved in its size and length. There was no noticeable resorption or displacement of the radix area at follow-up. The temporalis fascia graft could be an appropriate surgical technique in radix augmentation and nose lengthening.

Clinical Outcome after Early Rehabilitation according to Injury Type in Ankle Fracture (족관절 골절 형태에 따른 조기 재활의 임상결과)

  • Song, Joong Won;Lee, Ho Seong;Seo, Sang Gyo;Ryu, Chang Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.21-26
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    • 2017
  • Purpose: To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type. Materials and Methods: A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the OlerudMolander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising. Results: Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking. Conclusion: In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.

Intraoperative Radiation Therapy of locally Advanced Gastric Cancers - Case report - (국소진행 위암의 술중조사 2례)

  • Kim, Kyeung-Ae;Kim, Sung-Kyu;Shin, Sei-One;Kim, Myung-Se;Kim, Hong-Jin;Kwun, Koing-Bo;Kim, Hung-Dae
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.153-158
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    • 1988
  • Stomach cancer is the most popular tumor in Korea but the prognosis following extensive surgery and chemotherapy has not improved for many years. Conventional external radiotherapy also has some limitation, namely, a cancerocidal dose can not be delivered to tumors because of low radiation tolerance of adjacent critical sensitive organs. In order to overcome these limitations of curative surgery and external radiotherapy, intraoperative radiotherapy was proposed in many centers and the results were excellent. We treated two cases of locally advanced gastric cancers with IORT by using NEC 18 MeV Linear Accelerator after standard subtotal resection of the stomach. After treatment, the patients are in good conditions so far, but in order to evaluate the effectiveness of IORT, a study will be performed on the survival rates between patients treated by IORT and those treated by surgery alone.

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Evaluation of an Alveolar Bone Graft for Cleft Patients (구개열 환자의 치조열 골이식의 평가)

  • Noh, Lyang-Seok;Kim, Jong-Bae;Chin, Byung-Rho;Kwon, Tae-Geon;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.4
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    • pp.314-318
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    • 2011
  • Purpose: The purpose of this study is to evaluate the results of alveolar bone grafting in patients with various types of cleft lip and to compare the success rates according to the lateral incisors and canines. Methods: The postoperative radiographs of 20 patient with a cleft lip and alveolar process alone (CLAP), complete unilateral cleft lip and palate (UCLP) and complete bilateral cleft lip and palate (BCLP) were retrospectively analyzed. The alveolar bone height was classified according to ${\AA}$byholm (1981) and Bergland (1986) and we evaluated the dentition at the time of surgery and the existence of a lateral incisor and impacted canines. Results: 16 (80%) of the 20 patients were assigned to Type I & II and they were considered successful. In the UCLP group, the success rate was significantly better than that of the UCLP and BCLP groups. The success rate was significantly better than when the cleft was grafted with the existence of a lateral incisor and before the eruption of the canines. Conclusion: The severity of the deformity influenced the success rate. The timing of the operation was a critical variable that affected the outcome in patients with cleft lip and palate.

Genistein Reinforces the Inhibitory Effect of Cisplatin on Liver Cancer Recurrence and Metastasis after Curative Hepatectomy

  • Chen, Peng;Hu, Ming-Dao;Deng, Xiao-Fan;Li, Bo
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.759-764
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    • 2013
  • Background: The high recurrence rate after hepatic resection in hepatocellular carcinoma (HCC) is a major obstacle to improving prognosis. The objective of the present study was to explore the function of genistein, a soy-derived isoflavone, in enhancing the inhibitory effect of cisplatin on HCC cell proliferation and on tumor recurrence and metastasis in nude mice after curative hepatectomy. Methods: Proliferation of human HCC cells (HCCLM3) was detected by 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay. Synergistic effects of genistein and cisplatin were evaluated with the median-effect formula. Nude mice bearing human HCC xenografts underwent tumour resection (hepatectomy) 10 days post implantation, then received intraperitoneal administration of genistein or cisplatin alone or the combination of the two drugs. 33 days after surgery, recurrent tumours and pulmonary metastasis were evaluated individually. MMP-2 level in recurrent tumours was detected by immunohistochemistry and real-time PCR; MMP-2 expression in HCCLM3 was detected by immunocytochemistry. Results: Genistein and cisplatin both suppressed the growth and proliferation of HCCLM3 cells. The two drugs exhibited synergistic effects even at relatively low concentrations. In vivo, mice in the combined genistein and cisplatin group had a smaller volume of liver recurrent tumors and fewer pulmonary metastatic foci compared with single drug treated groups. Cisplatin upregulated the expression of MMP-2 in both recurrent tumours and HCCLM3, while genistein abolished cisplatin-induced MMP-2 expression. Conclusions: Genistein reinforced the inhibitory effect of cisplatin on HCC cell proliferation and tumour recurrence and metastasis after curative hepatectomy in nude mice, possibly through mitigation of cisplatin-induced MMP-2 upregulation.