• Title/Summary/Keyword: soft margin

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Surgical Resection and Polypropylene Mesh Reconstruction for Canine Chest Wall Soft Tissue Sarcoma

  • Youngsoo Hong;Youngrok Song;Woojin Song;Myung-Chul Kim;Joo-Myoung Lee;Hyunjung Park;Jiwhan Moon;Jongtae Cheong
    • Journal of Veterinary Clinics
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    • v.41 no.1
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    • pp.24-29
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    • 2024
  • A 6-year-old spayed female French Bulldog presented with a left-sided chest wall tumor. Physical examination revealed that the tumor was firmly adhered to the chest wall. A preoperative punch biopsy of the tumor revealed a grade 2 soft tissue sarcoma (STS). On computed tomography, the tumor's dimensions were assessed as 6.5 × 5.7 × 3.5 cm, and it exhibited invasiveness near the tissue surrounding the ninth rib. The tumor size was large in comparison to the dog's chest wall area. Hence, if the traditional wide-margin resection surgery were to be performed, primary wound closure seemed impractical and could potentially result in respiratory function complications. Therefore, considering the extent of tumor invasion and grade, deep margins were established to include the removal of the eighth to tenth ribs, and a 1-cm lateral margin was designated to enable primary wound closure. To reconstruct the chest wall, polypropylene mesh was attached to the adjacent ribs and the remaining muscles were sutured and covered over the mesh. The dog exhibited a rapid recovery beginning the day after the operation. Postoperative biopsy confirmed that the tumor was a grade 2 STS, and the surgical margins were evaluated as incomplete. The owner chose to pursue follow-up observation instead of chemotherapy. In this study, the surgical approach was chosen based on the importance of functional recovery after surgery. Recent research indicates that the tumor grade is more critical for postoperative prognosis than the extent of surgical margins when removing an STS.

The Signification of Anterolateral Thigh Free Flap for Reconstruction of Soft Tissue Defect in Malignant Soft Tissue Tumor of Lower Extremity (하지에 발생한 연부 조직 종양의 광범위 절제술 후 재건술에서 전외측 대퇴부 유리 피판술의 유용성)

  • Kwon, Young Ho;Lee, Gun Woo
    • Archives of Reconstructive Microsurgery
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    • v.20 no.2
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    • pp.89-95
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    • 2011
  • Purpose: The purpose of this study was to evaluate the clinical results of anterolateral thigh free flap on soft tissue defect following wide excision in malignant soft tissue tumor of lower extremities. Methods: Between February 2005 to April 2010, we followed up 19 cases who were undergoing anterolateral thigh free flap because of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity, including 9 cases were heel, 5 cases in foot, 3 cases in ankle, 2 cases in knee and leg. We observed that of implanted area's color, peripheral circulation at 3, 5, 7 days after operation and evaluated operating time, amount of hemorrhage, implanted skin necrosis, additional operations, complications. And we also evaluated the oncologic results, including local recurrence, metastasis, and morbidity. Results: Average operation time of wide excision and anterolateral thigh free flap was 7 hour 28 minutes. 18(94.7%) of total 19 cases showed successful engraftment, on the other hand, failure of engraftment due to complete necrosis of flap in 1 case. In 18 cases with successful engraftment, reoperation was performed in 4 cases. Among them, removal of hematoma and engraftment of flap after bleeding control was performed in 3 cases, because of insufficient circulation due to the hematoma. In the remaining 1 case, graft necrosis due to flap infection was checked, and grafted after combination of wound debridement and conservative treatment such as antibiotics therapy, also skin graft was performed at debrided skin defect area. Skin color change was mainly due to congestion with hematoma, flap was not observed global congestion or necrosis except 4 cases which shows partial necrosis on margin that treated with conservative therapy. Conclusions: Anterolateral thigh free flap could be recommended for reconstruction of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity.

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Tumor Margin Infiltration in Soft Tissue Sarcomas: Prediction Using 3T MRI Texture Analysis (연조직 육종의 종양 가장자리 침윤: 3T 자기공명영상 텍스처 분석을 통한 예측)

  • Minji Kim;Won-Hee Jee;Youngjun Lee;Ji Hyun Hong;Chan Kwon Jung;Yang-Guk Chung;So-Yeon Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.112-126
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    • 2022
  • Purpose To determine the value of 3 Tesla (T) MRI texture analysis for predicting tumor margin infiltration in soft tissue sarcomas. Materials and Methods Thirty-one patients who underwent 3T MRI and had a pathologically confirmed diagnosis of soft tissue sarcoma were included in this study. Margin infiltration on pathology was used as the gold standard. Texture analysis of soft tissue sarcomas was performed on axial T1-weighted images (WI) and T2WI, fat-suppressed contrast-enhanced (CE) T1WI, diffusion-weighted images (DWI) with b-value of 800 s/mm2, and apparent diffusion coefficient (ADC) was mapped. Quantitative parameters were compared between sarcomas with infiltrative margins and those with circumscribed margins. Results Among the 31 patients with soft tissue sarcomas, 23 showed tumor margin infiltration on pathology. There were significant differences in kurtosis with the spatial scaling factor (SSF) of 0 and 6 on T1WI, kurtosis (SSF, 0) on CE-T1WI, skewness (SSF, 0) on DWI, and skewness (SSF, 2, 4) on ADC between sarcomas with infiltrative margins and those with circumscribed margins (p ≤ 0.046). The area under the receiver operating characteristic curve based on MR texture features for identification of infiltrative tumor margins was 0.951 (p < 0.001). Conclusion MR texture analysis is reliable and accurate for the prediction of infiltrative margins of soft tissue sarcomas.

Intramuscular Myxoma of the Foot: A Case Report (족부 근육 내 점액종: 증례 보고)

  • Woo Jin Shin;Choong Sik Lee;Cheol Mog Hwang;Min Gu Jang;Jae Hwang Song
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.1
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    • pp.35-38
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    • 2023
  • Intramuscular myxoma is a rare benign myxoid tumor that is difficult to differentiate from other benign soft tissue tumors and sarcoma, and as a result, intramuscular myxoma is commonly misdiagnosed as another type of soft tissue tumor. Accordingly, awareness of the existence of this condition is a fundamental requirement for treatment decision-making. Furthermore, although intramuscular myxoma appears grossly to be well-circumscribed, it can infiltrate adjacent soft tissue microscopically. Tumor resection is the recommended treatment, but appropriate surgical margin sizes remain controversial. To the best of our knowledge, this is the first South Korean report to be issued on the treatment of intramuscular myxoma of the foot.

Prediction of bankruptcy data using machine learning techniques (기계학습 방법을 이용한 기업부도의 예측)

  • Park, Dong-Joon;Yun, Ye-Boon;Yoon, Min
    • Journal of the Korean Data and Information Science Society
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    • v.23 no.3
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    • pp.569-577
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    • 2012
  • The analysis and management of business failure has been recognized to be important in the area of financial management in the evaluation of firms' performance and the assessment of their viability. To this end, effective failure-prediction models are needed. This paper describes a new approach to prediction of business failure using the total margin algorithm which is a kind of support vector machine. It will be shown that the proposed method can evaluate the risk of failure better than existing methods through some real data.

Reconstruction of the Soft Tissue Defect on Anteromedial Surface of the Leg Using Medial Hemisoleus Flap

  • Park, Il-Jung;Sur, Yoo-Joon;You, Sung-Lim
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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    • pp.76-81
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    • 2014
  • Purpose: Anteromedial surface of the leg is susceptible to trauma, which frequently induces soft tissue defect. When the size of a soft tissue defect is small to moderate, a local muscle flap is an easy and reliable alternative to a free flap. The authors performed medial hemisoleus flaps for reconstruction of soft tissue defects on the anteromedial surface of legs. The aim of this study was to evaluate clinical outcomes and effectiveness of the medial hemisoleus flap. Materials and Methods: Twelve patients underwent the medial hemisoleus flap for reconstruction of a soft tissue defect on the anteromedial surface of the leg from February 2009 to December 2013. There were eight males and four females with a mean age of 47.8 years (15 to 69 years). The mean size of defects was $4.7{\times}4.2cm$ ($2{\times}2$ to $9{\times}6cm$). Flap survival and postoperative complications were evaluated. Results: Mean follow-up period was 39.6 months (7 to 64 months) and all flaps survived. There were two cases of negligible necrosis of distal margin of the flap, which were healed after debridement. All patients were capable of full weight bearing ambulation at the last follow-up. Conclusion: The medial hemisoleus flap is a simple, reliable procedure for treatment of a small to moderate sized soft tissue defect on the anteromedial surface of the leg.

Postoperative Radiation for Soft Tissue Sarcoma (연부조직 육종의 수술후 방사선치료)

  • Bahk, Won-Jong;Chang, Ju-Hai;Kang, Yong-Koo;Song, Seok-Whan;Moon, Myung-Sang;Kim, Jung-Man;Woo, Young-Kyun;Lee, Seung-Koo;Kim, Hyoung-Min;Kim, Yun-Sil;Chang, Jee-Young;Yoon, Se-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.84-90
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    • 1995
  • To evaluate the role of radiation and chemotherapy after limb-saving operation in the management of soft tissue sarcoma, the authors analysed retrospectively 33 patients treated in department of Orthoaepdic Surgery and Radiation Therapy, Catholic University Medical College, in terms of survival rate, local recurrence rate and prognostic factors. There were 16 males and 17 females. The age distribution ranged from 16 to 81 years with mean age of 48. The follow-up period ranged from 2 to 10 years with average of 5.5 years. The histologic diagnoses were 9 liposarcoma(27.2%), 8 malignant fibrohistiocytoma(24.2%), 7 unclassifiable(21.2%), 3 rhabdomyosarcoma(9.1%), 2 malignant schwannoma, 2 synovral sarcoma, and 2 fibrosarcoma(6.1%) in orders. While marginal and intralesional margins were gained in 24 patients(72.7%), wide and radical margins were obtained only in 9 patients(27.3%). On postoperative 3 weeks, local irradiation of 5000-7000 cGy was delivered to all patients by shrinking field technique for 5-8 weeks. Of 33 patients, 16(45.5%) patients were received adjuvant chemotherapy in combination of adriamycin, cyclophosphamide & vicristine, or VP16 & ifosfamide based on histologic type and obtained surgical margin. The survival rates by direct method at 2 years and 5 years were 58% and 37% respectively. Local recurrences occured in 15 patients(45.5%) at average 16 months after operation. Survival rates at 2 years and 5 years were 37% and 22% in case of intralesional and manginal excision, 75% and 47% in case of wide and radical excision respectively with statistical significance(p<0.05). They were 25% and 17% in the presence of local recurrence, 67% and 42% in the absence of local recurrence respectively with statistical significance(p<0.05). Even though there was no statistical correlation between survival rate and tumor size(p>0.05), the authors considered tumor size as a significant prognostic factors as well as surgical margin and the presence of local recurrence.

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Long-Term Treatment Results in Soft Tissue Sarcomas of the Thoracic Wall Treated with Pre-or-Postoperative Radiotherapy - a Single Institution Experience

  • Oksuz, Didem Colpan;Ozdemir, Sevim;Kaydihan, Nuri;Dervisoglu, Sergulen;Hiz, Murat;Tuzun, Hasan;Mandel, Nil Molinas;Koca, Sedat;Dincbas, Fazilet Oner
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9949-9953
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    • 2014
  • Objective: To evaluate the long term results among patients with soft tissue sarcoma of the thoracic wall. Materials and Methods: Twenty-six patients who were treated with pre-or postoperative radiotherapy between December 1980-December 2007, with a diagnosis of soft tissue sarcoma of the thoracic wall were retrospectively evaluated. Results: The median age was 44 years (14-85 years) and 15 of them were male. A total of 50% of patients were grade 3. The most common histologic type of tumor was undifferentiated pleomorphic sarcoma (26.9%). Tumor size varied between 2-25 cm (median 6.5 cm). Seventeen of the cases had marginal and 9 had wide local resection. Four cases received preoperative radiotherapy and 22 postoperative radiotherapy. Six of the patients with large and high grade tumors received chemotherapy. Median follow-up time was 82 months (9-309 months). Local recurrence and metastasis was detected in 34.6% and 42.3% of patients, respectively. Five-year local control (LC), disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS) were 62%, 38%, 69%, and 76% respectively. On univariate analysis, the patients with positive surgical margins had a markedly lower 5-year LC rate than patients with negative surgical margin, but the difference was not significant (43% vs 78%, p=0.1). Five-year DFS (66% vs 17%) and DSS (92% vs 60%) rates were significantly worse for the patients who had high grade tumors (p=0.01, p=0.008 respectively). Conclusions: Tumor grade and surgical margin are essential parameters for determining the prognosis of thoracic wall soft tissue sarcoma both in our series and the literature.

Erlang Capacity and Cell Coverage Based on Handoff Techniques in the Reverse Link of a CDMA System of 14.4 kbps/1.9 GHz Band (1.9 GHz 대역/14.4 kbps CDMA 시스템의 역방향 링크에서 핸드오프 유형별 얼랑용량과 셀커버리지)

  • Kwon, Young-Soo;Kim, Nam
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.28 no.1A
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    • pp.25-33
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    • 2003
  • We derive the outage probabilities for the Erlang capacity and link margin based on handoffs in the reverse link of a CDMA system of 14.4 kbps/1.9 GHz band, calculate them with the same parameters, and then with the maximum realizable Erlang capacity analyze newly the cell coverage in different areas by the COST-231 model If it decreases from 5 % to 2 % in case of $E_b/N_0$=5 dB under a soft handoff, the result shows a very reliable link with additional increment of 0.88 dB in the margin and a high quality of service within the coverage decrease of 0.12 km, 0.25 km, and 1 km in a city, suburban, and open areas respectively on the decrease of 2 Erlang in the capacity. When the $E_b/N_0$ decreases from 7 dB to 5 dB within the outage probability of 5 %, it shows the increase of 9 Erlang and of 0.2 km in a city on the same margin of 2.8 dB. Then, comparing it with a single cell, it shows the decrease of more than 10 Erlang in the capacity, but the enlargement of 0.17 km, 0.3 km, and 1 km in them on the margin decrease of 1.31 dB, also, with a hard handoff, the soft handoff gain of the increase of 10 Erlang and of 0.22 km, 0.5 km, and 2 km on the decrease of 2.16 dB.

Low-Grade Fibromyxoid Sarcoma Arising in Posterior Nasal Cavity: Case Report and Review of the Literature (후비강에서 발생한 저등급의 섬유점액성 육종: 증례 보고 및 문헌 고찰)

  • Sohn, Jung Heob;Lee, Kijin;Cho, Kyoung Rai
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.11
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    • pp.624-629
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    • 2018
  • Low-grade fibromyxoid sarcoma (LGFMS), a soft tissue tumor that has high recurrence and metastasizing potential, rarely occurs in the head and neck region. Therefore, the treatment for LGFMS in the facial area is challenging in terms of cosmetic and functional maintenance. The authors report a case of LGFMS in the posterior nasal cavity. It was completely removed in parallel with the nasal endoscopic and oral approach, but the lower margin was closed by preserving the soft palate. The patient is well without any recurrence or metastasis after 5 years of follow-up.