• Title/Summary/Keyword: recurrence rate

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Expansile keratocystic odontogenic tumor in the maxilla: immunohistochemical studies and review of literature

  • Byun, June-Ho;Kang, Young-Hoon;Choi, Mun-Jeong;Park, Bong-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.4
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    • pp.182-187
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    • 2013
  • Keratocystic odontogenic tumors (KCOT) - previously termed odontogenic keratocysts (OKC) - are characterized by aggressive behavior and a high rate of recurrence. Histopathologically, the basal layer of KCOT shows a higher cell proliferation rate and increased expression of anti-apoptosis genes. Clinically, KCOT is frequently involved in the mandibular posterior region but is not common in the posterior maxilla. However, it should be noted that due to its expansive characteristics, KCOT involved near the maxillary sinus could easily expand to an enormous size and occupy the entire maxilla. To achieve total excision of these expanded cystic tumors in the maxilla, a more aggressive approach would be needed. In this report, we describe two cases of expansile KCOT involving the entire unilateral maxilla and maxillary sinus; they were completely excised using the Weber-Ferguson approach, showing no evidence of recurrence during the follow-up period of more than two years. In immunohistochemical analyses of the tumor specimens, p53 and p63 showed strong expression, and B-cell lymphoma 2 (BCL2) and MKI67 (Ki-67) showed moderate or weak expression, however, detection of BCL2-associated X protein (BAX) was almost negative. These data indicate that expansile KCOT possesses increased anti-apoptotic activity and cell proliferation rate but decreased apoptosis. These properties of KCOT may contribute to tumor enlargement, aggressive behavior, and high recurrence rate.

Therapeutic Results of Postoperative Radiation Therapy for Early Stage Uterine Cervical Cancer (초기 자궁경부암의 수술후 방사선치료 결과)

  • Kang, Seung-Hee;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.347-354
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    • 1993
  • This is a retrospective analysis of 67 patients with histologically proven invasive carcinoma of uterine cervix treated with surgery followed by adjuvant radiotherapy at Inje University Seoul Paik Hospital between october 1983 and september 1991, Postoperative radiotherapy was carried out in patients with high risks of locoregional recurrence such as positive pelvic lymph node (38 pts), large tumor size more than 3 cm (22 pts), cervical stromal invasion more than 2/3 (46 pts), parametrial involvement (9 pts), positive resection margin (14 pts), endo/myometrial extension (10 pts), and angiolymphatic invasion (13 pts). Stage I A, I B, and IIA were 2 $(3\%),$ 39 $(58.2\%),\;and\;26\;(38.8\%),$ respectively. Median follow-up period was 48 months with ranges from 13 to 115 months. All 67 patients were treated externally with standard pelvic field with radiation dose ranging from 4080 to 6120 cGy in 4~6 weeks period of time. Of these, 45 patients received intracavitary radiotherapy. The overall survival rate and disease free survival rate at 5-year were $88.0\%\;and\;82.1\%,$ respectively. The survival rates by stage were $87.1\%$ in IB and $88.4\%$ in IIA. Local control rate was $80.6\%(58\;pts).$ The treatment failure was noted in 12 of 67 patients $(17.9\%):$ locoregional failure in $7(10.4\%),$ distant metastasis in 3 $(4.5\%),$ and locoregional and distant metastasis in $2(3\%),$ The univariate analysis of prognostic factors disclosed endo/myometrial extension as a significant factor of survival and recurrence $(70.0\%\;vs\;91.1\%\;P<0.05\;&\;30.0\%\;vs\;15.8\%,\;respectively).$ The complication of postoperative radiothrapy was not significant and all patient were well tolerated. In conclusion, postoperative radiotherapy in patients with high risks of locoreginal recurrence is relatively well tolerated and it gives significantly improved survival rate especially in patients with positive lymph nodes, bulky tumor size $(\geqq3\;cm),$ parametrial involvement, cervical stromal invasion more than 2/3, positive resection margin and angiolymphatic invasion.

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A Comparative Study on Risk Factors Related to Patient with Recurrent Stroke Between Recurrent Group and Non-recurrent Group: Single Hospital Based Cohort Study (뇌졸중 재발자와 비재발자의 뇌졸중 재발 위험 요인의 비교 분석: 일개 병원의 뇌졸중 환자 코호트를 기반으로)

  • Jeon, Mi Yang;Cho, Hyung Je;Park, Mingyeong;Jin, Mi Jeong;Ha, Youngmi
    • Journal of muscle and joint health
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    • v.27 no.3
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    • pp.219-228
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    • 2020
  • Purpose: This study was a comparative analysis of stroke-related factors between recurrent patients and non-recurrent patients. Methods: A retrospective cohort study design was used, and data were collected from March 2020 to April 2020 using electronic medical records. 244 patients (221 first-timers and 23 recurrent) were included in this study. Results: The stroke recurrence rate in 5 years was 9.4%, the readmission rate was 39.3%, and the mortality rate was 2.0%. The number of patients hospitalized for stroke was greater among men than among women. Of the patients, 60.7% had an underlying disease. With regard to daily life abilities, over 70% of participants needed more than moderate dependence and about 40% of participants had more than mild cognitive impairment. More than 50% were moved to wheelchairs or stretcher cars. The difference in the stroke readmission rate between recurrent and non-recurrent patients was statistically significant. Conclusions: Based on our findings, a program to prevent recurrence of stroke should be developed to considering age, ability of daily living, place of discharge, gait ability at discharge, and place of discharge.

Midterm Clinical Outcomes after Modified High Ligation and Segmental Stripping of Incompetent Small Saphenous Veins

  • Hong, Ki Pyo
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.398-403
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    • 2015
  • Background: The aim of this study was to evaluate the midterm clinical outcomes after modified high ligation and segmental stripping of small saphenous vein (SSV) varicosities. Methods: Between January 2010 and March 2013, 62 patients (69 legs) with isolated primary small saphenous varicose veins were enrolled in this study. The outcomes measured were reflux in the remaining distal SSV, the recurrence of varicose veins, the improvement of preoperative symptoms, and the rate of postoperative complications. Results: No major complications occurred. No instances of the recurrence of varicose veins at previous stripping sites were noted. Three legs (4.3%) showed reflux in the remaining distal small saphenous veins. The preoperative symptoms were found to have improved in 96.4% of the cases. Conclusion: In the absence of flush ligation of the saphenopopliteal junction, modified high ligation and segmental stripping of small saphenous vein varicosities with preoperative duplex marking is an effective treatment method for reducing postoperative complications and the recurrence of SSV incompetence.

Recurred Macrodystrophia Lipomatosa of the Foot: A Case Report (족부에 재발한 지방종 거대증: 증례 보고)

  • Lee, Myoung Jin;Kim, Dong Ryul
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.1
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    • pp.32-35
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    • 2016
  • We reported on a rare case of recurred macrodystrophia lipomatosa of the foot, and reviewed the literature. A 62-year-old male patient presented with right foot second toe pain; preoperative magnetic resonance imaging and radiograph examination was performed. After surgery the biopsy confirmed the diagnosis. American Orthopaedic Foot and Ankle Society score was checked before and after surgery. Wide excision of the affected area including ray amputation is an effective way to prevent recurrence and relieve the pain after surgery. The 2nd toe ray amputation was performed in the treatment of recurred macrodystrophia lipomatosa of the foot, and is thought to be an effective way to relieve pain and prevent recurrence. After minimally invasive surgery with complete excision surgery, additional data on recurrence and pain relief rate are needed.

SITE-DEPENDENT IRREGULAR RANDOM WALK ON NONNEGATIVE INTEGERS

  • Konsowa, Mokhtar-H.;Okasha, Hassan-M.
    • Journal of the Korean Statistical Society
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    • v.32 no.4
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    • pp.401-409
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    • 2003
  • We consider a particle walking on the nonnegative integers and each unit of time it makes, given it is at site k, either a jump of size m distance units to the right with probability $p_{k}$ or it goes back (falls down) to its starting point 0, a retaining barrier, with probability $v_{k}\;=\;1\;-\;p_{k}$. This is a Markov chain on the integers $mZ^{+}$. We show that if $v_{k}$ has a nonzero limit, then the Markov chain is positive recurrent. However, if $v_{k}$ speeds to 0, then we may get transient Markov chain. A critical speeding rate to zero is identified to get transience, null recurrence, and positive recurrence. Another type of random walk on $Z^{+}$ is considered in which a particle moves m distance units to the right or 1 distance unit to left with probabilities $p_{k}\;and\;q_{k}\;=\;1\;-\;p_{k}$, respectively. A necessary condition to having a stationary distribution and positive recurrence is obtained.

Surgical therapy of keratocystic odontogenic tumors

  • Oh, Ji-Su;Kim, Su-Gwan
    • Journal of Korean society of Dental Hygiene
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    • v.15 no.6
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    • pp.941-946
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    • 2015
  • Objectives: Since World Health Organization reclassified the odontogenic keratocyst as a keratocystic odontogenic tumor(KCOT) in 2005, management of KCOT remains controversial. The purpose of the this study is to present a current concept of the treatment of the KCOT. Methods: Recent articles were focused on the method of the surgical therapy and the recurrence rate of KCOT. Results: The treatment modality is divided into conservative treatment-such as simple enucleation with or without curettage or marsupialization-and aggressive treatment including peripheral ostectomy, chemical curettage with Carnoy's solution, and resection. Conclusions: Keratocystic odontogenic tumors have higher recurrence rates than other odontogenic lesions; thus, the selected type of treatment is very important.

Conservative surgical approach to aggressive benign odontogenic neoplasm: a report of three cases

  • Kumar, Vijay
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.1
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    • pp.37-42
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    • 2015
  • Aggressive benign odontogenic neoplasms have substantial potential to grow to an enormous size with resulting bone deformities, and they often invade adjacent tissues and spread beyond their normal clinical and radiographic margins; as such, they have a high rate of recurrence. Historically, management (conservative versus aggressive) on the basis of clinical, radiographic and/or histopathologic characteristics has been controversial. However, recent advances in the understanding of the biological features of these lesions may provide greater evidence of the benefits of conservative management. Three patients with different complaints and final histopathologic diagnoses were enrolled in the study. All three cases were treated by a single operator with similar conservative surgical procedures. During follow-up, the patients had uneventful secondary healing and bone regeneration, less packing time than previously reported, no clinical or radiographic evidence of recurrence and no apparent deformity. The aggressive behavior of these lesions requires long clinical and radiographic follow-up. Conservative surgical management may be an option to reduce recurrence and morbidity and increase the probability of uneventful secondary healing and bone regeneration.

Renal Cell Carcinoma: Case Report and Aeromedical Consideration (신장암: 증례보고 및 항공의학적 고찰)

  • Song, Joon Ho
    • Korean journal of aerospace and environmental medicine
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    • v.31 no.3
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    • pp.84-85
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    • 2021
  • Renal cell carcinoma (RCC) is common primary tumor of kidney. In the past, it had been considered a difficult tumor to manage since the detection was usually delayed until paraneoplastic syndrome and/or distant metastasis appeared due to its slow progression. However, the recent popularization of ultrasound and computed tomography has made RCC one of the easily curable cancers. Eighty percent are found early, mostly with tumor size less than 5 cm. Five-year survival rate after successful nephrectomy is exceeded 80-90 percent. Curative nephrectomy can be tried in stage 1 and 2, and some cases of stage 3. In these cases, return to flight can be considered after 6 to 12 months' observation. It should be monitored any occurrence of cancer recurrence, need for systemic treatment, metastasis, and paraneoplastic syndrome, etc. If any signs of recurrence are found or new treatment needs to be initiated, the flight should be suspended. If there is no recurrence for more than 5 to 10 years, the patient doesn't have to be followed anymore.

Clinical Characteristics of Pediatric & Adolescent Thyroid Cancer: A Single Institution Experience of 20 Years (소아청소년 갑상선암의 임상적 특징들: 단일 기관에서의 20년간의 연구)

  • Moon, Ki Yoon;Kim, Kwangsoon;Bae, Ja Seong;Kim, Jeong Soo
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.2
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    • pp.1-7
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    • 2020
  • Background/Objectives: Pediatric & Adolescent thyroid cancer is a steadily increasing malignancy. We aimed to report our experience at a single tertiary institution and to evaluate the risk factors for recurrence in pediatric & adolescent patients with differentiated thyroid carcinoma (DTC). Materials & Methods: The data of 42 pediatric & adolescent patients (aged ≤19 years) with DTC who underwent thyroidectomy at Seoul St. Mary's Hospital (Seoul, Korea) between December 1997 and February 2019 were retrospectively reviewed. Clinicopathologic features and surgical outcomes were retrospectively analyzed through complete chart reviews. Results: The mean age was 16.6 years. A total of 6 (14.3%) patients experienced recurrence after initial treatment. The recurrence rate was significantly different between total thyroidectomy (TT) and lobectomy groups (23.1% vs. 0%, p=0.038). However, no statistically significant differences were found in the recurrence rate according to lymph node ratio (LNR) of 0.4 (10.7% vs 21.4%; P=0.383). Multivariate analysis confirmed age (hazard ratio [HR], 0.443; P=0.008) and bilaterality (HR, 11.477; P=0.022) as significant risk factors for DFS. Conclusion: Pediatric & Adolescent thyroid cancer is a rare malignancy and TT is recommended as the treatment of choice. However, lobectomy may be considered for Pediatric & Adolescent patients with age >16 years, tumor size <1 cm, and no bilateral disease.