• Title/Summary/Keyword: Surgical oncology

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Epidermal Growth Factor Receptor-Related DNA Repair and Radiation-Resistance Regulatory Mechanisms: A Mini-Review

  • Bai, Jing;Guo, Xiao-Guang;Bai, Xiao-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.4879-4881
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    • 2012
  • Epidermal growth factor receptor (EGFR) overexpression is associated with resistance to chemotherapy and radiotherapy. The EGFR modulates DNA repair after radiation-induced damage through an association with the catalytic subunit of DNA protein kinase. DNA double-strand breaks (DSBs) are the most lethal type of DNA damage induced by ionizing radiation, and non-homologous end joining is the predominant pathway for repair of radiation-induced DSBs. Some cell signaling pathways that respond to normal growth factors are abnormally activated in human cancer. These pathways also invoke the cell survival mechanisms that lead to resistance to radiation. The molecular connection between the EGFR and its control over DNA repair capacity appears to be mediated by one or more signaling pathways downstream of this receptor. The purpose of this mini-review was not only to highlight the relation of the EGFR signal as a regulatory mechanism to DNA repair and radiation resistance, but also to provide clues to improving existing radiation resistance through novel therapies based on the above-mentioned mechanism.

Comparison of Target Approximation Techniques for Stereotactic Radiosurgical Plan

  • Choi, Kyoung-Sik;Oh, Seong-Jong;Lee, Jeong-Woo;Choe, Bo-Young;Kim, Moon-Chan;Chung, Hyun-Tai;Suh, Tae-Su
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2005.04a
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    • pp.47-50
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    • 2005
  • The aim of radiosurgery cures a patient to deliver the lower dose at the normal organ and the higher dose at the tumor. Therefore accuracy of the dose is required to gain effect of radiosurgery in surgical planning. In this paper, we developed the methods of target approximation for a fast treatment planning. Nominally, the stereotactic radiosurgery(SRS) using Linac and Gamma knife produces spherical dose distribution through circular collimators using multiple arcs and 201 holes on semi-spherical helmet by $^{60}Co$. We developed an automatic radiosurgical plan about spherical packing arrangement. To automatically plan the SRS, new planning methods based on cylinder and cube structure for target shaping was developed. This approach using heuristic and stochastic algorithm is a useful radiosurgical plan without restrictions in the various tumor shapes and the different modalities.

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F-18 FDG Uptake in a Toxic Autonomous Thyroid Nodule

  • Lee, Myoung-Hoon;Park, Chan-H.;Kim, Hyun-Soo;Yoon, Seok-Nam;Hwang, Kyung-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.4
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    • pp.286-287
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    • 2001
  • A 44 year-old male patient was undergoing diagnosis and therapy for acute myelogenous leukemia (AML, M2). On physical examination a thyroid mass was palpated in the left lower lobe. He had palpitation and intolerance to heat. Thyroid function tests revealed hyperthyroidism; T3: 150ng/dl (N:60-90), fT4: 2.26 ng/dl (N:0.70-1.80), TSH: 0.01 ulU/ml (N:0.25-5.00). Ultrasonography demonstrated a hypoechoic mass with scattered calcifications measuring 2.55 2.03 3.64 cm in size. F-18 FDG camera-based PET scan performed as a follow-up study of AML revealed a focal increased uptake in the left neck, where an autonomous nodule was detected on Tc-99m thyroid scan. After the diagnosis of toxic autonomous nodule, Goetz disease, he underwent surgical nodulectomy. Microscopically, the nodule contained follicular proliferation with degenerative change but without evidence of thyroid carcinoma. Focal uptake in autonomous thyroid nodules is due to increased glycolysis within the nodules.

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Internal Mammary Artery Perforator Flap for Immediate Volume Replacement Following Wide Local Excision of Breast Cancer

  • van Huizum, Martine A.;Hage, J. Joris;Oldenburg, Hester A.;Hoornweg, Marije J.
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.502-508
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    • 2017
  • Background Breast-conserving therapy is defined as a breast-conserving wide local excision (WLE) of a mammary tumour combined with postoperative radiotherapy. Immediate restoration of the mammary shape by use of breast reduction techniques (volume displacement) or tissue replacement techniques (volume replacement) is gaining popularity to prevent breast malformation. Methods To date, using the internal mammary artery perforator (IMAP) flap has been suggested for immediate volume replacement after WLE, but has never been evaluated in a published study. Results We applied this flap in 12 women (mean age, 56.1 years) after WLE (mean specimen weight, 46.5 g) of the medial aspect of the breast. Over a median follow-up of 35.3 months (standard deviation, 1.2 months), 4 women needed repeated surgery for dog-ear correction of the donor site. Conclusions In our experience, the use of an IMAP flap was a reliable technique with good cosmetic outcomes after oncoplastic reconstruction. In this series, donor site revision often proved necessary initially, but we showed that this may easily be prevented.

Tumor Resection and Reconstruction in Periacetabular Single Metastases of Renal Cell Carcinoma - A Case Report - (신장 암의 비구주위 단독 전이 환자에서 종양절제 및 재건술 - 증례 보고 -)

  • Shin, Duk-Seop;Han, Dong-Sung
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.113-118
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    • 2007
  • Surgical treatment of pelvic bone tumors represent one of the most complicated problem in musculoskeletal oncology. Because of three dimensional anatomy of the pelvis, tumors reach huge sizes and the diagnosed late relatively to a similar tumors in extremity. Especially, there are limited reconstruction methods to keep the function of hip joint after resection of periacetabular tumors, and the results of reconstruction is not so promissing. We present one case of periacetabular metastatic tumor from renal cell carcinoma, which was resected with wide margin and reconstructed with composite of pasteurized autogenous bone graft and constrained total hip arthroplasty.

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Robotic Gastrectomy: The Current State of the Art

  • Marano, Alessandra;Hyung, Woo-Jin
    • Journal of Gastric Cancer
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    • v.12 no.2
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    • pp.63-72
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    • 2012
  • Since the first laparoscopic gastrectomy for cancer was reported in 1994, minimally invasive surgery is enjoying its wide acceptance. Numerous procedures of this approach have developed, and many patients have benefited from its effectiveness, which has been recently demonstrated for early gastric cancer. However, since laparoscopic surgery is not exempt from some limitations, the robotic surgery system was introduced as a solution by the late 1990's. Many experienced surgeons have embraced this new emerging method that provides undoubted technical and minimally invasive advantages. To date, several studies have concentrated to this new system, and have compared it with open and laparoscopic approach. Most of them have reported satisfactory results concerning the post-operative short-term outcomes, but almost all believe that the role of robotic gastrectomy is still out of focus, especially because long-term outcomes that can prove robotic oncologic equivalency are lacking, and operative costs and time are higher in comparison to the open and laparoscopic ones. This article is a review about the current status of robotic surgery for the treatment of gastric cancer, especially, focusing on the technical aspects, comparisons to other approaches and future prospects.

Periocular Myxoma in a Dog

  • Bae, Jae Hyun;Kim, Jury;Kwon, Seungjoo;Plummer, Caryn;Hillers, Kim;Kim, Min-Su
    • Journal of Veterinary Clinics
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    • v.37 no.1
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    • pp.34-37
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    • 2020
  • A 1-year-old castrated male Shih-Tzu dog presented with severe orbital swelling involving the right eye. Physical examination identified a painless swelling of the right periocular tissues and protrusion of the third eyelid. Radiographic examination revealed a well-delineated, spherical (3 × 3 cm) soft tissue mass. Ultrasonography confirmed a hypoechoic, multilobular, tubular cystic structure with hyperechoic foci. Fine needle aspiration was conducted and the cytologic impression revealed copious mucus, increased neutrophilic leucocytes, and foamy macrophages. Th tentative diagnosis was zygomatic sialocele, and the lesion was resected through lateral orbitotomy. Surgical exploration identified a multilobular mass adhering to the zygomatic glands. Both the zygomatic gland and the mass were removed. Histological findings were consistent with those of an inflamed myxoma. No postoperative recurrence occurred within 1 year.

Bilateral Ureteral Obstruction Related to Pelvic Rhabdomyosarcoma Presenting with Acute Kidney Injury: A Case Report

  • Han, Sanghoon;Han, Kyoung Hee
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.116-120
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    • 2019
  • Bilateral renal obstruction is a rare critical condition, requiring a prompt diagnostic approach and treatment to restore the renal function. The most commonly observed obstructive uropathy in children is congenital malformation, such as posterior urethral valves and bilateral ureteropelvic junction obstruction. Malignant pelvic masses obstructing the ureter are widely reported in adults but are rarely observed in children. The treatment of ureteral obstruction related to pelvic malignancy is a therapeutic challenge with a median survival duration of 3-7 months in adults; however, pediatric patients with pelvic malignancy leading to ureteral obstruction had better outcomes, with a reported 5-year mortality rate of 20%, than the adult patients. Here, we report a rare case of bilateral ureteral obstruction associated with pelvic rhabdomyosarcoma presenting with acute kidney injury treated by ureteral diversion with double J stent, and concommittent emergency hemodialysis, leading to restoration of good renal function. We suggest that bilateral ureteral obstruction should be released as soon as possible using surgical or interventional approach to minimize the obstruction period, and subsequential chemotherapy may contribute to improvement of survival and recovery of renal function.

Successful Outcome of Breast Cancer Patient Refusing Conventional Treatments: A Case Report

  • Lee, Sanghun;Sohn, Kicheul;Chon, Songha
    • The Journal of Korean Medicine
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    • v.39 no.4
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    • pp.177-182
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    • 2018
  • Background: Breast cancer is a treatable disease, but some women reject conventional treatment in favor of unproven "alternative therapies," which may have serious implications for their survival. Therefore, a process is needed to lead them to more appropriate treatment choices. Case presentation: Here, we present the case of a 51-year-old Korean female diagnosed with early-stage breast cancer (stage IIB, T2N1M0) in Nov. 2015. She refused a standard surgical resection together with chemotherapy and opted instead for moxibustion by nonmedical personnel. Consequently, her preference for alternative therapy without conventional treatment exacerbated her disease. Just a little over a year later, integrative cancer treatment, including chemotherapy based on histological founding, and complementary treatment, comprised of acupuncture, moxibustion, and herbal medicine, were administered for 5 months. Finally, she successfully underwent modified radical mastectomy showing a pathological complete response. She received only adjuvant chemotherapy without any alternative medicine afterwards, and she maintained a good status without recurrence. Conclusion: In the case of breast cancer patients who are resistant to surgery and chemotherapy, integrative therapy considering adverse effects from conventional treatment should be preferred to bitter opposition to alternative medicine.

Gamma Knife Radiosurgery for Trigeminal Neuralgia : Review and Update

  • Lee, Seunghoon;Lee, Jung-Il
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.633-639
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    • 2022
  • Accurate diagnosis of trigeminal neuralgia (TN) is the starting point for optimal treatment. Gamma knife radiosurgery (GKRS) is currently regarded as one of the first-line treatment options for medically refractory TN. GKRS is a less invasive treatment with a low risk of complications than other surgical procedures that provides a favorable pain control Barrow Neurological Institute (BNI) I-IIIb rate of >75% at short-term follow-up. Drawbacks of GKRS include the latency period before pain relief and higher recurrence rate compared with microvascular decompression. Therefore, repeat treatment is necessary if the initial GKRS was effective but followed by recurrence. The concept of dose rate and the biologically effective dose of radiation has been actively studied in radiation oncology and is also applied in GKRS for TN to achieve high safety and efficacy by prescribing the optimal dose. Recent progress in functional imaging, such as diffusion tensor imaging, enables us to understand the pathophysiology of TN and predict the clinical outcome after GKRS. Here, we review TN, GKRS, and recent updates, especially in the concepts of radiation dose, diffusion tensor imaging studies, and repeat treatment in GKRS for TN.