• The Korean Journal of Pain
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• 제34권4호
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• pp.375-393
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• 2021

Percutaneous osteoplasty (POP) is defined as the injection of bone cement into various painful bony lesions, refractory to conventional therapy, as an extended technique of percutaneous vertebroplasty (PVP). POP can be applied to benign osteochondral lesions and malignant metastatic lesions throughout the whole skeleton, whereas PVP is restricted to the vertebral body. Common spinal metastases occur in the thoracic (70%), lumbosacral (20%), and cervical (10%) vertebrae, in order of frequency. Extraspinal metastases into the ribs, scapulae, sternum, and humeral head commonly originate from lung and breast cancers; extraspinal metastases into the pelvis and femoral head come from prostate, urinary bladder, colon, and uterine cervical cancers. Pain is aggravated in the dependent (or weight bearing) position, or during movement (or respiration). The tenderness and imaging diagnosis should match. The supposed mechanism of pain relief in POP is the augmentation of damaged bones, thermal and chemical ablation of the nociceptive nerves, and local inhibition of tumor invasion. Adjacent (facet) joint injections may be needed prior to POP (PVP). The length and thickness of the applied needle should be chosen according to the targeted bone. Bone cement is also selected by its osteoconduction, osteoinduction, and osteogenesis. Needle route should be chosen as a shortcut to reach the target bony lesions, without damage to the nerves and vessels. POP is a promising minimally invasive procedure for immediate pain relief. This review provides a technical survey for POPs in painful bony lesions.

• 한방안이비인후피부과학회지
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• 제31권4호
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• pp.22-30
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• 2018

Objectives : The aim of this study is to investigate the relationship between chronic low grade inflammation theory, psoriasis, and herbal medicine. Methods : We reviewed recent studies on the relationship between chronic low-grade inflammation, psoriasis, and herbal medicine through Pubmed. Results : The pathological basis for psoriasis is the action of inflammatory mediators by the activation of the immune response, which can be a cause of various cardiovascular, metabolic and psychological symptoms of psoriasis patients, in addition to skin lesions. The herbal medicines improve these inflammatory conditions and improve local lesions through herbal medicine such as Qingdai, which have a strong inhibitory effect on IL-17,22 production. Conclusions : Herbal medicines used in psoriasis are thought to be effective not only for the improvement of local psoriasis lesions through anti-inflammatory effect but also for the improvement of systemic inflammation associated with chronic low grade inflammation.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5141-5144
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• 2013

Background: This study aimed to determine clinical outcomes of local excision for early rectal cancer from a University Hospital in Thailand. Materials and Methods: We performed a retrospective review of 22 consecutive patients undergoing local excision for early rectal cancer (clinical and radiological T1/T2) from 2005-2010 at the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok. Data were collected from patients' medical records, including demographic and clinical characteristics, pathological report and surgical outcomes. Results: This study included 10 males and 12 females, with average age of 68 years. Nineteen patients (86%) underwent transanal excision and the others had trans-sacral excision. Median operative time was 45 minutes. Postoperative complications occurred in 2 patients (9%); 1 fecal fistula and 1 wound infection following trans-sacral excision. There was no 30-day postoperative mortality. Median hospital stay was 5 days. Pathological reports revealed T1 lesion in 12 cases (55%), T2 lesion in 8 cases (36%) and T3 lesion in 2 cases (9%). Eight patients received additional treatment; one re-do transanal excision, two proctectomies, and five adjuvant chemoradiation. During the median follow-up period of 25 months, local recurrence was detected in 4 patients (18%); two cases of T2 lesions with close or positive margins, and two cases of T3 lesions. Three patients with local recurrence underwent salvage abdominoperineal resection. No local recurrence was found in T1/T2 lesions with free surgical margins. Conclusions: Local excision is a feasible and acceptable alternative to radical resection only in early rectal cancer with free resection margins and favorable histopathology.

• 대한치과의사협회지
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• 제10권8호
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• pp.523-527
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• 1972

All patients admitted to dept. of Oral Surgery, infirmary Dental Hospital, Kyung Hee University with complaints of Apical lesions of Anterior teeth. The authors have treated the inflammatory lesions by the Apicoectomies under local anesthesia.

• 대한기관식도과학회지
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• 제17권1호
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• pp.5-8
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• 2011

The proliferation of new technologies has significantly enhanced the diagnostic capabilities of flexible bronchoscopy compared with traditional methods. Narrow band imaging (NBI), an optical technique in which filtered light enhances superficial neoplasms based on their neoangiogenic patterns, was developed to screen for central intraepithelial moderate or severe dysplasia, carcinoma in situ (CIS), and microinvasive neoplasia in patients at risk for lung cancer. Because angiogenesis occurs preferentially in dysplastic and neoplastic lesions, NBI may identify early dysplastic lesions better than white light bronchoscopy (WLB) currently in use. NBI bronchoscopy can be used not only to detect precancerous lesions, but also to screen for cancerous lesions. We prospectively evaluated 101 patients with suspected lung cancer between July 2009 and June 2010. All were previously scheduled for flexible bronchoscopy CT scans. Abnormal NBI was defined by Shibuya's descriptors (tortuous, dotted, or spiral and screw patterns). Biopsies of 132 lesions in 92 patients showed that 78 lesions (59.1%) were malignant and 54 (40.9%) were benign. The diagnostic sensitivity of bronchoscopy in detecting malignancy was 96.2% (75/78). When assorted by lesion pattern, the sensitivity and specificity of NBI bronchoscopy in detecting malignancies were 69.2% (54/78) and 96.3% (52/54), respectively, for the spiral and screw pattern and 14.1% (11/78) and 96.3% (52/54), respectively, for the dotted pattern. Unexpectedly, additional cancerous lesions were detected in five patients (2 dotted and 3 spiral and screw). As a screening tool for malignant lesions, NBI bronchoscopy should assess combinations of all three lesion. The dotted and spiral and screw patterns may be helpful in determining which lesions should be biopsied. NBI bronchoscopy may be useful not only for the diagnosis of early-stage lung cancer but also for more accurate local staging of lung cancer.

• Journal of Korean Neurosurgical Society
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• 제50권2호
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• pp.99-102
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• 2011

Objective : The purpose of this retrospective study was to evaluate the outcome of gamma knife radiosurgery (GKRS) and/or whole brain radiation therapy (WBRT) for the treatment of small cell lung carcinoma (SCLC) metastasis to the brain. Methods : From 2000 to 2010, 50 patients underwent GKRS for metastatic brain lesions originating from SCLC. Among these patients, 11 received prophylactic cranial irradiation (PCI) before the development of metastatic lesions (PCI group), and GKRS was performed as an initial treatment for newly diagnosed lesions in 12 patients who had not received PCI (primary GKRS group). In addition, GKRS was performed as a salvage treatment for progressive lesions after WBRT in 27 patients (salvage GKRS group). The medical records and imaging data of all patients were retrospectively analyzed. Results : The overall survival of the 50 patients was 20.8 months (range 1-53) after the diagnosis of primary tumor and 12.0 months (range 1-47) after the development of cerebral metastasis. Median survival after GKRS was 4.8 months (range 1-15) in the PCI group, 4.6 months (range 0-18) in the primary GKRS group, and 7.6 months (range 0-33) in the salvage GKRS group. Further treatment for progressive lesions after GKRS was necessary in 15 patients, after a mean interval of 3.8 months. Causes of death were systemic organ failure in 15 patients, deterioration of neurological state in 13 patients, and unknown or combined causes in 16 patients. The local control rate of the lesions treated with GKRS was 76.4% (decreased in 13 patients and stable in 16 patients at the final imaging follow-up (mean 5.60 months). Conclusion : GKRS is an effective local treatment for brain metastasis from SCLC both as an initial treatment for newly diagnosed lesions after PCI and as a salvage treatment for recurrent or progressive lesions. However, the survival benefit is not significant because most patients die of systemic multi-organ failure with a short life expectancy.

• Radiation Oncology Journal
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• 제29권1호
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• pp.28-35
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• 2011

목 적: 초기 비소세포성 폐암 환자에서 수술적 절제 이외의 국소 치료로 최근 방사선 수술의 사용이 늘고 있다. 이에 저자들은 초기 혹은 재발한 비소세포성 폐암 환자를 대상으로 시행한 체부 방사선 수술의 치료 결과를 분석하여 그 유용성을 알아 보고하고자 한다. 대상 및 방법: 비소세포성 폐 종양에 대하여 방사선 수술이 시행되었던 24명의 환자, 28 lesion에 대하여 후향적 분석을 시행하였다. 이 중 원발성 종양은 19명 재발한 환자는 5명이었고 재발한 환자 5명 중 3명이 이전 치료 부위에서 재발한 환자 이었다. 원발성 종양 19명 중에서 4명은 외부 방사선 치료 후 추가로 방사선 수술을 시행 받았다. 24명의 초기 병기는 IA, IB, IIA, IIB, IIIA, IIIB, IV가 각각 7, 3, 2, 2, 3, 1, 6명이었고, 방사선 수술 당시의 T 병기는 T1 lesion이 13곳, T2가 12곳, T3가 3곳이었다. 방사선 수술은 6 MV X-ray를 이용하였고 planning target volume 1 (PTV1)에 총 방사선량 15~60 Gy(median, 50 Gy)를 3회 혹은 5회에 걸쳐 처방하여 시행하였다. 중앙 추적관찰기간은 469일이었다. 결 과: 28곳의 GTV는 0.7~108.7 mL (median, 22.9 m L)이었고, PTV1 은 5.3~184.8 mL (median, 65.4 m L)이었다. 3개월 반응률은 complete response (CR) 14곳, partial response (PR) 11곳, stable disease (SD) 3곳이었고, 마지막 추적에서의 치료반응은 CR 13곳, PR 9곳, SD 2곳, progressive disease (PD) 4곳이었다. 원발종양으로 초기 병기 IA, IB 10명에서는 50일만에 1명이 폐렴으로 사망하였고 1명이 국소재발 하였으나 나머지 환자는 6개월에서 2년간 국소재발 없이 추적관찰 되고 있으며, IIA-IIB 환자는 4명으로 환자 수가 적어서 뚜렷한 결론을 내리기 어려웠고, 재발성 폐암 환자 5명을 포함하는 10명의 IIIA-IV 병기에서는 사망 3명, 국소재발 1명, loco-regional failure 1명, regional failure 2명으로 좋지 않은 치료 결과를 보였다. 이 중에서 방사선 수술을 시행한 장소에서 재발한 경우는 총 28 1esion 중 4곳으로 85.8%의 국소제어율을 보였다. 방사선치료 양은 biologically equivalent dose (BEd) 100 $Gy_{10}$ 이하인 8 lesion 중에서 3 lesion에서 국소 재발하여 100 $Gy_{10}$ 이상인 20 lesion 중에서는 1 lesion에서만 재발한 경우보다 나빴다. 또한 중앙부의 종양과 방사선수술 당시의 병기가 T2 이상인 경우가 재발이 많았다. 결 론: 비소세포성 폐암환자에서 사이버나이프를 이용한 체부 방사선 수술은 부작용이 적으면서 높은 국소제어율을 얻을 수 있는 치료이며, 주변부의 T1 병기의 폐암에 대해서 BED 100 $Gy_{10}$ 이상의 방사선 치료가 국소제어율을 높이는데 도움이 된다고생각된다.

• Journal of Animal Science and Technology
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• 제64권6호
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• pp.1215-1225
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• 2022

The epidemiology of parasite infection in local and imported breeds is quite an essential topic in the meat industry and human health. This study aims to determine the prevalence of Dicrocoelium dendriticum in local sheep breeds (Naemi, Najdi, and Harri) and imported breeds from Romania (Romani breed) and the epidemiology of the infection in Saudi Arabia. Morphological description, the relationship between dicrocoeliasis and sex, age, and histological changes were also presented. A total of 6845 slaughtered sheep at Riyadh Automated slaughterhouse were investigated and followed up for 4 months between 2020-2021. It included 4,680 local breeds and 2,165 imported Romanian breeds. Fecal samples and livers and gallbladders from slaughtered animals were examined for apparent pathological lesions. The results indicated that the infection rate in slaughtered animals was 10.6% in imported Romani sheep and 0.9% in the local Naeimi breed. After identifying the parasite morphologically, negative results were obtained from examining feces, gallbladders, and livers of Najdi and Harry sheep breeds. The mean number of eggs per 20 µL/gallbladder was low (72.78 ± 17.8: 76.11 ± 5.07), medium (334.59 ± 90.6: 292.91 ± 26.63), and high (1113.2 ± 22.3: 1004 ± 143.4) in imported and Naeime sheep, respectively. Significant differences were found between gender and age (males and females were 3.67% and 6.31%; > 2 years 4.39%, 1-2 years 4.22%, and 1 year 3.53%) respectively. Histopathological lesions in the liver were more pronounced. Our survey confirmed the presence of D. dendriticum in imported Romani and local Naeimi sheep, and the potential role of imported sheep in the epidemiology of dicrocoeliasis in Saudi Arabia.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1803-1806
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• 2014

Endoscopic submucosal dissection (ESD) was originally developed for en bloc resection of large, flat gastrointestinal lesions. Compared with endoscopic mucosal resection (EMR), ESD is considered to be more time consuming and have more complications for treatment of early esophageal carcinoma, such as bleeding, stenosis and perforation. The objective of this study was to compare the efficacy and safety of ESD and EMR for such lesions. We searched databases, such as PubMed, EMBASE, Cochrane Library and Science Citation Index updated to 2013 for related trials. In the meta-analysis, the main outcome measurements were the en bloc resection rate, the histologically resection rate and the local recurrence rate. We also compared the operation time and the incidences of procedure-related complications. Five trials were identified, and a total of 710 patients and 795 lesions were included. The en bloc and histologically complete resection rates were higher in the ESD group compared with the EMR group (odds ratio (OR) 27.3; 95% CI, 11.5-64.8; OR 18.4; 95% CI, 8.82-38.59). The local recurrence rate was lower in the ESD group (OR 0.13, 95 % CI 0.04-0.43). The meta-analysis also showed ESD was more time consuming, but did not increase the complication rate (P=0.76). The results implied that compared with EMR, ESD showed better en bloc and histologically resection rates, and lower local recurrence, without increasing the incidence of procedure-related complications in the treatment of early esophageal carcinoma.

• Journal of Korean Neurosurgical Society
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• 제39권2호
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• pp.102-108
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• 2006

Objective : The management of diffuse astrocytomas is one of the most controversial areas in clinical neurooncology. There are numerous reviews and editorials outlining the difficulties in the management of these lesions. In this study, we assess the role of Gamma Knife radiosurgery[GKS] for diffuse astrocytomas. Methods : Twenty-three patients with a diffuse astrocytoma were treated with GKS as a primary or adjuvant method from February 1995 to October 2003. The mean marginal dose was $13.6\;[8.5{\sim}17.5]Gy$ and the mean maximal dose was $27.3\;[17.0{\sim}35.0]Gy$. Local control and the pattern of radiologic response were evaluated. The probable factors affecting local control, such as tumor volume, margin dose, previous history of craniotomy or stereotactic biopsy, and the presence or absence of previous radiotherapy were statistically analyzed. The average duration of follow-up was 39.7 [$11.3{\sim}101.5$] months after GKS. Results : Of the 23 lesions treated, 16 lesions [69.6%] were controlled during the follow-up period. The mean progression-free interval was 57.4 months and the 5-year progression-free rate was 68%. Only tumor volume was found to be a statistically significant factor for local control. Smaller tumors were better controlled by GKS; it was significantly effective in tumors with less than $10cm^3$ volume. Conclusion : GKS could be a valuable therapeutic modality both as a primary treatment and as a postoperative adjuvant therapy in some selected cases.