• Title/Summary/Keyword: bone and skin

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Patterns of Cancer in Kurdistan - Results of Eight Years Cancer Registration in Sulaymaniyah Province-Kurdistan-Iraq

  • Khoshnaw, Najmaddin;Mohammed, Hazha A;Abdullah, Dana A
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8525-8531
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    • 2016
  • Background: Cancer has become a major health problem associated with high mortality worldwide, especially in developing countries. The aim of our study was to evaluate the incidence rates of different types of cancer in Sulaymaniyah from January-2006 to January-2014. The data were compared with those reported for other middle east countries. Materials and Methods: This retrospective study depended on data collected from Hiwa hospital cancer registry unit, death records and histopathology reports in all Sulaymaniyah teaching hospitals, using international classification of diseases. Results: A total of 8,031 cases were registered during the eight year period, the annual incidence rate in all age groups rose from 38 to 61.7 cases/100,000 population/year, with averages over 50 in males and 50.7 in females. The male to female ratio in all age groups were 0.98, while in the pediatric age group it was 1.33. The hematological malignancies in all age groups accounted for 20% but in the pediatric group around half of all cancer cases. Pediatric cancers were occluding 7% of total cancers with rates of 10.3 in boys and 8.7 in girls. The commonest malignancies by primary site were leukemia, lymphoma, brain, kidney and bone. In males in all age groups they were lung, leukaemia, lymphoma, colorectal, prostate, bladder, brain, stomach, carcinoma of unknown primary (CUP) and skin, while in females they were breast, leukaemia, lymphoma, colorectal, ovary, lung, brain, CUP, and stomach. Most cancers were increased with increasing age except breast cancer where decrease was noted in older ages. High mortality rates were found with leukemia, lung, lymphoma, colorectal, breast and stomach cancers. Conclusions: We here found an increase in annual cancer incidence rates across the period of study, because of increase of cancer with age and higher rates of hematological malignancies. Our study is valuable for Kurdistan and Iraq because it provides more accurate data about the exact patterns of cancer and mortality in our region.

LANGERHANS CELL HISTIOCYTOSIS IN THE JUVENILE MANDIBLE (소아의 하악골을 침범한 랑거한스세포 조직구 증식증의 임상적 고찰)

  • Kang, Yeon-Hee;Park, Se-Hyun;Seo, Dong-Jun;Cha, In-Ho;Yi, Choong-Kook;Kim, Hyun-Sil;Kim, Jin;Kim, Hyung-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.577-583
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    • 2008
  • Langerhans cell histiocytosis (LCH) is characterized by proliferation of pathological Langerhans cells within different organs. It mainly affects children, but adult cases also occur, with an incidence rate of one to two per million. LCH results from the clonal proliferation of Langerhans cells. And its etiopathogenesis is still unknown. The hypothesis that it is a neoplastic or inflammatory disease, as well as the existence or not of immunological, viral or genetic predisposing factors, has been widely discussed in the literature, but no conclusive proof has ever been provided. Although lesions may appear in tissues of various origins such as skin, hypothalamus, liver, lung, or lymphoid tissue, bone is the most common site of the disease. The head and neck are affected in almost 90% of cases. The maxillary and mandibular bones are affected in 5 to 10% of cases. In our report, we present four cases of LCH in patients aged 3, 4, 7 and 9 years respectively, with primary manifestation in maxillofacial area.

A Case Report on Oro-Facial Manifestations in Leukemia (Oral Chronic GVHD) (백혈병 환자의 구강악안면 증상 발현에 관한 증례보고 (Oral Chronic GVHD))

  • Ahn, Hyoung-Joon;Kwon, Byung-Ki;Shin, Kyoung-Jin;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.25 no.2
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    • pp.159-165
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    • 2000
  • Subsequent to an allogenic stem cell transplantation(ASCT) on patients with hematologic malignancy(AML, ALL, CML, multiple myeloma, lymphoma etc.), chronic GVHD(graft versus host disease), which is an immunological reaction, occurs. With treatment results from patients who were diagnosed with ALL(acute lymphocytic leukemia), undergone BMT(bone marrow transplantation) and showed oral and skin lesions due to GVHD, treatment of oral manifestations of leukemia and its general management were studied. 90% of patients with chronic GVHD show change in the oral mucosa causing oral manifestations such as leukoplakia, lichenoid change of the oral mucosa, mucosal atrophy, erythema, ulceration and xerostomia. In treating GVHD, extensive systemic immunosuppression cause bacterial, viral, fungal infection that are fatal, and even if the treatment is successful, the patient is already in a severe immunosuppressed state. Therefore, localized target therapy is preferred. In another words, topical application(rinse, cream, ointment etc.) of cyclosporin and steroid in treating oral chronic GVHD is highly recommended, and the use of PUVA(Psoralen Ultraviolet A) and thalidomide is reported to be effective. In treating such diseases, dental treatment to control pain and prevent secondary infection of oral manifestations is very important. To those patients with systemic diseases who show limited effect by general dental treatment, non-invasive treatment such as the dental laser, in addition to the use of drugs, may be necessary to actively treat pain and help the healing process. For greater results, new effective methods are to be developed for treatment.

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Fixation with Suture Material in Akin Osteotomy (봉합사 고정을 이용한 Akin 절골술)

  • Young, Ki-Won;Lee, Kyung-Tai;Kim, Jae-Young;Cha, Seung-Do;Kim, Eung-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.138-141
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    • 2004
  • Purpose: The purpose of this study was to document the results of fixation with ethibond suture in akin osteotomy and its advantages. Materials and Methods: From May 2001 to January 2004, Akin osteotomy was performed in 218 patients. We reviewed 110 patients (114 feet) who were possible radiographic evaluation more than 6 months after operation. 110 feet had hallux valgus and 4 feet had hallux valgus interphalangeus. 105 patients were female and 5 were male. The average age was 43.8 years old (18 to 68 years old). The average follow up was 9 months (6 to 23 months). After performing the Akin osteotomy at 7 mm from the proximal articular surface of the proximal phalanx, one hole is made on either side of the osteotomy site with a K-wire. The passer was passed through the both holes and the ethibond was passed. And then, the ethibond was tied tightly. 2 sutures in 66 feet and 1 suture in 48 feet were made. Radiographic bone union at 6 months follow up was regarded as success and loss of the reduction, nonunion was regarded as failed. Results: In the radiographic evaluation, bony union were made at 6 months follow up in all feet. There was no difference between 2 sutures and 1 suture, and the knots were removed in 3 feet because of skin irritation. Conclusion: The fixation of the osteotomy site using suture material was an effective method in Akin osteotomy. The advantage of this procedure was unnecessity of the material removal.

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SURGICAL MANAGEMENT OF THE TUMOR IN THE PARAPHARYNGEAL SPACE AND INFRATEMPORAL FOSSA USING ZYGOMATIC ARCH AND MANDIBULAR OSTEOTOMY (하악골 및 관골궁 절단술을 이용한 측두하와와 인두주위간극에 발생한 종양적출술 1례)

  • Lee, Bong-Seo;Nam, Jung-Soon;Koo, Myoung-Sook;Kim, Shin-Yu;Kwon, Dae-Hyun;Lee, Yong-Gyu;Kwon, Tae-Geon;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.6
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    • pp.565-569
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    • 2001
  • A new surgical approach to the area of the infratemporal fossa and parapharyngeal space is described. This approach results in a wide-field exposure of the infratemporal fossa, pterygomaxillary space and parapharyngeal space. We used two osteotomies on the patient's mandible and temporary resection of zygomatic arch for superior margin of tumor. Lower lip splitting was not needed because the incision was started in the frontal scalp, curved in front of and below the external auditary canal, and extended anteriorly to the greater horn of hyoid bone on the neck along a skin crease. We had good results without sacrifice of the facial nerve, mandibular function and sensory supply of the face and oral cavity.

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Reconstruction of Hand Using Peroneal Perforator Free Flap in High-Voltage Electrical Burn Patients (고압 전기화상에 의한 수부 손상 시 비골동맥 천공지 유리피판술을 이용한 재건)

  • Kim, Dong Hoon;Yoo, Jung Seok;Lim, Jun Kyu;Lee, Dong Lark
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.67-72
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    • 2008
  • Purpose: The hand is frequently affected area in high voltage electrical burn injury as an input or output sites. Electrical burn affecting the hand may produce full thickness necrosis of the skin and damage deep structures beneath the eschar, affecting the tendon, nerve, vessel, even bone which result in serious dysfunction of the hand. As promising methods for the reconstruction of the hand defects in electrical burn patients, we have used the peroneal perforator free flaps. Methods: From March 2005 to June 2006, we applied peroneal perforator free flap to five patients with high tension electrical burn in the hand. Vascular pedicle ranged from 4cm to 5cm and flap size was from $4{\times}2.5cm$ to $7{\times}4cm$. Donor site was closed primarily.Results: All flaps survived completely. There was no need to sacrifice any main artery in the lower leg, and there was minimal morbidity at donor site. During the follow-ups, we got satisfactory results both in hand function and in aesthetic aspects.Conclusion: The peroneal perforator flap is a very thin, pliable flap with minimal donor site morbidity and is suitable for the reconstruction of small and medium sized wound defect, especially hand with electrical burn injury.

Medial Canthopexy using Modified Hiraga's Incision for Correction of Traumatic Telecanthus (외상성 내안각격리증 환자에 있어 Hiraga 절개법을 이용한 내안각 고정술)

  • Lim, Jong-Hyo;Kim, Yong-Ha;Kim, Tae-Gon;Lee, Jun-Ho
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.504-508
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    • 2010
  • Purpose: Traumatic telecanthus can result from nasoethmoid-orbital fractures. Repair of the medial canthal tendon (MCT) using transnasal wiring is regarded as a choice of method to treat telecanthus, however, is often complicated by incomplete anchoring and drift of canthus, extrusion of wire, in-fracture of orbital bone, and eye damage. The authors introduced oblique transnasal wiring method through the Hiraga's epicanthopalsty incision instead of well-known classical bicoronal approach. Methods: Five patients with traumatic telecanthus were treated with this method. Though the Hiraga's epicanthoplasty incision, we could approach the operative field; the medial orbital wall and detached MCT. Oblique transnasal wiring was performed as following steps. After slit skin incision on the contralateral nasal recession area, drill holes were made from this point to the superior and posterior point of lacrimal sac of deformed eye. A 2-0 wire was double-passed through the holes and MCT. Traction was applied to ensure pulling the MCT and the wires were twisted in the contralateral nose, securing the MCT in the correct position. Results: All patients except 1 person showed improvement and rapid recovery. On average each canthus was moved 5.6 mm medially. In all cases, there were no eyelashes disappear, lacrimal canaliculitis, lacrimal duct injury, or infections. Conclusion: The Hiraga's epicanthoplasty incision could give sufficient operative field to reattach the MCT in traumatic telecanthus patients. And the oblique transnasal wiring technique is effective for the Asians who have flat nose and exophthalmic eye. The authors conclude that this technique could be a simple, safe and scarless method to correct traumatic telecanthus.

Diffuse Large B Cell Lymphoma in Submandibular Gland (악하선에 발생한 미만성 대형 B세포 림프종 1례)

  • Lee Chang-Haeng;Choi Jee-Hoon;Baek Seung-Kuk;Woo Jeong-Su;Jung Kwang-Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.1
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    • pp.67-70
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    • 2003
  • Out of entire salivary tumor, 1.7% are malignant lymphoma developed in salivary gland and it is usually mucosa associated lymphoid tissue (MALT) lymphoma developed in salivary gland. In the case of Non-Hodgkin lymphoma, the most frequently involved extanodal sites of diffuse large B cell lymphoma are bone, skin, thyroid, gastrointestinal tract, and lung. Development in salivary gland is very rare. A 69 years old male patient who have found Lt. submandibular gland (SMG) mass a month ago is suspected of malignancy from his FNA result, so histologic exam by SMG resection was operated. According to histopathologic exam, large B cell lymphocyte infiltratration were generally shown as diffuse and lymphoepitheliallesion were not found. In immunostaining, CD79a showed positive and CD3, CAM5.2 showed negative which diagnosed as diffuse large B cell lymphoma. As Ann Arbor stage I, CEOP-B chemotherapy was used 3 times as treatment without any recurrence. In the case of malignant lymphoma in salivary gland, it develops as painless mass in ipsilateral side. If found in parotid gland, it is rare to have facial nerve falsy and pathologically diagnosed as lymphocytes of abnormal type of monoclonal immunostaining must be provided as evidence. Combined therapy is known as most effective treatment for intermediate grade.

Reconstruction of Midface Defect with Latissimus Dorsi Myocutaneous Free Flap (광배근 근피 유리피판술(Latissimus dorsi myoctaneous free flap)을 이용한 상악부 복합조직결손의 치험례)

  • Kim, Jeang-Cheal;Woo, Sang-Hyun;Lee, Tae-Hoon;Choi, See-Ho;Seul, Jung-Hyun
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.173-179
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    • 1990
  • We report 2 cases of midface defect reconstructed with latissimus dorsi myocutaneous free flap. In these cases, the main points to cover the defects were as follows ; 1. For the contour of zygoma and maxilla, it was well preserved without bone graft which was not used for second stage reconstruction. In first case, for application of artificial eye and in second case, for, operation after full development. 2. For the drainage of paranasal sinuses, we made the nostril with skin graft, and it was well preserved without any complications during follow up. 3. It was sufficient to cover the defect with latissimus dorsi muscle well designed before surgery and thick enough to fill the defect. 4. In second case, the remained defect of palate and maxilla was not covered for the appropriate reconstructions after full development. In conclusions, we experienced two cases of midface defect reconstructed with latissimus dorsi myocutaneous free flap without any complication and with good results.

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Residual foreign body inflammation caused by a lumber beam penetrating the facial region: a case report

  • Jun Ho Choi;Sang Seong Oh;Jae Ha Hwang;Kwang Seog Kim;Sam Yong Lee
    • Archives of Craniofacial Surgery
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    • v.24 no.1
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    • pp.37-40
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    • 2023
  • Penetrating wounds to the face are cosmetically devastating and can be life-threatening. If the foreign body causing the penetrating wound is a piece of wood, small remnants might be left behind after the initial treatment. A 33-year-old male patient presented to the emergency center after a piece of lumber pierced his face as a passenger in a traffic accident. The patient's vital signs were stable, and emergency surgery was performed to remove the foreign body and repair the soft tissue. No noteworthy complications were seen after open reduction and internal fixation of the facial bone fractures. Seven months after the accident, the patient underwent scar revision along with full-thickness skin grafting for post-traumatic scars. After the surgery, pus-like discharge which was not previously present was observed, and the graft did not take well. A residual foreign body, which was the cause of graft failure, was found on computed tomography and the remaining foreign body was removed through revision surgery. The patient is receiving outpatient follow-up without any complications 6 months after surgery. This case demonstrates the importance of performing a careful evaluation to avoid missing a residual foreign body, especially if it is of wooden nature.