• Title/Summary/Keyword: surgery-first

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MACC1 Expression Correlates with PFKFB2 and Survival in Hepatocellular Carcinoma

  • Ji, Dong;Lu, Zhong-Tang;Li, Yao-Qing;Liang, Zhe-Yong;Zhang, Peng-Fei;Li, Chao;Zhang, Jun-Li;Zheng, Xin;Yao, Ying-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.999-1003
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    • 2014
  • Objective: To validate the relationship between MACC1 and 6-phosphofructo-2-kinase/fructose 2, 6 bisphosphatase (PFKFB2) expression as well as its clinicopathological features and prognostic significance in hepatocellular carcinoma. Methods: By using immunohistochemistry, we investigated the MACC1 and PFKFB2 protein expression in 60 pairs of hepatocellular carcinoma and corresponding non-tumor tissues. Using the Mann-Whitney U test, the Chi-square test, Kaplan-Meier survival analysis, Cox proportional hazard regression analysis and Spearman analysis, we studied the relationship between MACC1 and PFKFB2 protein expression and postoperative overall survival (OS) of the HCC patients. Results: MACC1 and PFKFB2 positive staining rates were significantly higher in hepatocellular carcinoma than in the corresponding nontumor tissues (P=0.012 and 0.04, respectively). The clinicopathological features evaluation revealed that positive expression of MACC1 was associated with a high Edmondson classification (P=0.007) and advanced TNM stage (P=0.027). Similar findings were evident for PFKFB2 expression (P=0.002 and P=0.027). MACC1 and PFKFB2 positive expression was associated with a lower OS rate (P=0.004 and 0.03, respectively). Kaplan-Meier survival and Cox proportional hazard regression analyses revealed MACC1 positive expression to be a prognostic factor for postoperative OS, but PFKFB was not. Conclusion: Highly expressed MACC1 and PFKFB2 protein were associated with TNM stage, Edmondson-Steier classification and overall survival. MACC1 may affect tumor metabolism partly through expression and phophorylation of PFKFB2.

The First Web Space Free Flap of the Foot to Reconstruct the Pulp of Fingers (수지 수질부 재건을 위한 족부의 제 1물갈퀴부 유리 피판술)

  • Kong, Byeong Seon;Kim, Yun Seok;Lee, Hyeong Seok;Jung, Dae Won;Kwak, Jae Yong;Lee, Hyun Suk
    • Archives of Reconstructive Microsurgery
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    • v.21 no.2
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    • pp.153-158
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    • 2012
  • Purpose: The first web space of the foot has a similar thickness and skin texture of the pulp of the fingers. Moreover, it has a reliable blood vessel and sensory nerve. The purpose of this study was to evaluate the clinical results of the first web space free flap to reconstruct the pulp of fingers. Materials and Methods: Authors have performed 23 cases of first web space free flap to reconstruct the pulp defect of the fingers between June 2004 and May 2009. The age of the patients ranged from 20 years old to 55 years old. The size of the flap ranged from $1{\times}1.5cm$ to $8.5{\times}2.5cm$. The mean flap area was 5.4 cm2. In 4 cases, we elevated the flap including lateral aspect of the big toe and medial aspect of the second toe. And then we made an artificial syndactyly to reconstruct the pulps on two fingers at the same time. In all cases, we performed 1 digital artery and 1 dorsal vein anastomosis. Every donor site that had a small defect healed spontaneously without any additional operations to cover it. Results: Of this type of surgery 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. There was no severe complication in the donor sites. There was no walking disturbance due to the skin defect of the donor site. The static 2 point discrimination in 11 cases that we could check ranged from 3 mm to 15 mm. Conclusion: The authors believe that the first web space free flap of the foot is a good option for the reconstruction of the pulp of the fingers and it has a minimal donor site morbidity.

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Repairing Facial Soft Tissue Defects by Swelling Anesthesia after Tumor Resection with Narrow Pedicle Flaps

  • Huang, Chun-Hui;Qian, Han-Gen;Zhao, Xiao-Yu;Shen, Guo-Liang;Lin, Wei;Qi, Qiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6761-6763
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    • 2015
  • Aims: To investigate the role of swelling anesthesia in repairing facial soft tissue defects after tumor resection and temporal superficial artery frontal branch of narrow pedicle flap. Materials and Methods: From January 2008 to June 2008, 16 patients from Department of Ophthalmology with eye or eyelid tumors after eyeball removal of eye and part resection of surrounding soft tissue, undergoing postoperative swelling anesthesia with superficial temporal artery flap repair to prevent facial soft tissue defect formation and bone exposure, were recruited. Results: In all 16 patients facial soft tissue defect repair had good effects, with limited bleeding, and short operation times. Seven days after surgery, all flaps were in good repair. On postoperative follow-up after 3 months, flaps showed a similar appearance as with facial tissue. Conclusions: Swelling anesthesia for superficial temporoparietal artery frontal branch of narrow pedicle flap to repair soft tissue defect after facial tumor resection is feasible, and is linked with good analgesic effects, high postoperative survival of skin flaps, and good cosmetic effects.

Do Blebs or Bullae on High-Resolution Computed Tomography Predict Ipsilateral Recurrence in Young Patients at the First Episode of Primary Spontaneous Pneumothorax?

  • Park, Sungjoon;Jang, Hyo Jun;Song, Ju Hoon;Bae, So Young;Kim, Hyuck;Nam, Seung Hyuk;Lee, Jun Ho
    • Journal of Chest Surgery
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    • v.52 no.2
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    • pp.91-99
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    • 2019
  • Background: The relationship between the size of bullae and pneumothorax recurrence is controversial. The aim of this study was to retrospectively evaluate the role of blebs or bullae in predicting ipsilateral recurrence in young patients experiencing their first episode of primary spontaneous pneumothorax (PSP) who underwent conservative treatment. Methods: A total of 299 cases of first-episode PSP were analyzed. The status of blebs or bullae was reviewed on high-resolution computed tomography (HRCT). The dystrophic severity score (DSS; range, 0 to 6 points) was calculated based on HRCT. Results: The 5-year recurrence rate was 38.2%. In univariate analysis, age (<20 years), body mass index (<$20kg/m^2$), a unilateral lesion, and intermediate risk (DSS 4 and 5) were associated with recurrence. Sex; smoking history; and the presence, number, and maximal size of blebs or bullae were not related to recurrence. In Cox regression, age and intermediate risk were independent risk factors for recurrence. High risk (DDS 6) was not an independent risk factor. Conclusion: The presence, number, and size of blebs or bullae did not affect ipsilateral recurrence. DSS failed to show a positive correlation between severity and recurrence. The decision to perform surgery in patients experiencing their first episode of PSP should not be determined by the severity of blebs and bullae.

Unexpected Complications and Safe Management in Laparoscopic Pancreaticoduodenectomy

  • Yuichi Nagakawa;Yatsuka Sahara;Yuichi Hosokawa;Chie Takishita;Tetsushi Nakajima;Yousuke Hijikata;Kazuhiko Kasuya;Kenji Katsumata;Akihiko Tsuchida
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.23-27
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    • 2017
  • Although laparoscopic pancreaticoduodenectomy (LPD) is considered as minimally invasive surgery, an advanced level of laparoscopic skill is still required. LPD comprises various procedures including reconstruction. Therefore, establishment of a safe approach at each step is needed. Prevention of intraoperative bleeding is the most important factor in safe completion of LPD. The establishment of effective retraction methods is also important at each site to prevent vascular injury. I also recommend the "uncinate process first" approach during initial cases of LPD, in which the branches of the inferior pancreaticoduodenal artery are dissected first, at points where they enter the uncinate process. This approach is performed at the left side of the superior mesenteric artery (SMA) before isolating the pancreatic head from the right aspect of the SMA, which allows safe dissection without bleeding. Safe and reliable reconstruction is also important to prevent postoperative complications. Laparoscopic pancreatojejunostomy requires highly skilled suturing technique. Pancreatojejunostomy through a small abdominal incision, as in hybrid-LPD, facilitates reconstruction. In LPD, the surgical view is limited. Therefore, we must carefully verify the position of the pancreaticobiliary limb. A twisted mesentery may cause severe congestion of the pancreaticobiliary limb following reconstruction, resulting in severe complications. We must secure the appropriate position of the pancreaticobiliary limb before starting reconstruction. We describe the incidence of intraoperative and postoperative complications and appropriate technique for safe performance of LPD.

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Gallbladder Carcinoma: Analysis of Prognostic Factors in 132 Cases

  • Wang, Rui-Tao;Xu, Xin-Sen;Liu, Jun;Liu, Chang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2511-2514
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    • 2012
  • Objective: To evaluate the prognostic factors of gallbladder carcinoma. Methods: Presentation, operative data, complications, and survival outcome were examined for 132 gallbladder carcinoma patients who underwent gallbladder surgery in our unit during 2002-2007, and follow-up results were obtained from every patient for univariate and multivariate survival analysis. Results: The univariate analysis showed that gallbladder lesion history, tumor cell differentiation, Nevin staging, preoperative lymph node metastasis and the surgical approach significantly correlated with the prognosis of the patients (p<0.05). The results of the multivariate analysis (Cox regression) showed that gallbladder lesion history, Nevin staging and the surgical approach were independent predicators with relative risks of 6.9, 4.4, 2.8, respectively (p=0.002, 0.003, 0.008). Conclusion: Gallbladder lesion history, Nevin staging and the surgical approach are independent prognostic factors for gallbladder carcinoma, a rapidly fatal disease. Therefore, early diagnosis, anti-infective therapy and radical surgery are greatly needed to improve the prognosis of gallbladder carcinoma.

Video-assisted First Rib Resection (흉강경을 이용한 1번 늑골 절제술)

  • Kim, Dong-Jin;Kim, Young-Tae;Kim, Joo-Hyun;Kang, Chang-Hyun
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.463-466
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    • 2007
  • A 21 year old male patient was admitted for pain, edema and a tingling sensation in his right arm. He underwent venography and an MRI scan, and he was diagnosed with Paget-Schroetter syndrome. Thoracoscopic first rib re-section was performed after failure of thrombolytic therapy, The symptoms were relieved after the operation and he was discharged with warfarin medication. First rib resection is generally performed through the standard transaxillary or supraclavicular route. We report here on a successful thoracoscopic first rib resection.

Malignant Skin Tumor Misdiagnosed as a Benign Skin Lesion

  • Hwang, So-Min;Pan, Hao-Ching;Hwang, Min-Kyu;Kim, Min-Wook;Lee, Jong-Seo
    • Archives of Craniofacial Surgery
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    • v.17 no.2
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    • pp.86-89
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    • 2016
  • Despite the fact that benign skin lesions can undergo malignant transformation, the necessity and timing of the surgical resection have yet to be established. In this study, we analyse three cases of benign-appearing skin lesions, which were found to be carcinomatous on histologic examination and review the literature regarding the importance of prophylactic removal of benign-appearing skin lesion. The first and second cases were female patients wishing for cosmetic surgery. The first patient had a benign-appearing lesion on dorsum nasi, and the second patient had an inconspicuous lesion right along the right nasolabial fold. The third patient was a middle-aged male with a pigmented lesion on the left cheek, who presented to the clinic only after having met the operating surgeon through an acquaintance outside the hospital setting. All of the lesions were suspected to be of benign nature and were excised for cosmesis only. However, histologic examination of these lesions showed that the first two tumors were basal cell carcinoma with the last tumor being squamouse cell carcinoma. Thus, it is considered that removal of benign like skin lesion will result in good prognosis of patients scheduled to undergo other surgery.

CLINICAL OBSERVATIONS ON MANDIBULAR CHRONIC OSTEOMYELITIS - COMBINATION THERAPY OF DECORTICATION AND INTRA-ARTERIAL INFUSION CHEMOTHERAPY - (만성경화성 하악골골수염의 임상적검토 - 외측피질골제거술 및 동주요법(국소화학요법) 병용의 증례에 관하여 -)

  • Yuichiro, Kuroiwa;Hiroaki, Matsuura;Atsushi, Abe;Mugio, Kato;Yoshiko, Ariji;Kenichi, Kurita
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.350-354
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    • 2008
  • Mandibular chronic osteomyelitis with diffuse osteosclerosis is recognized as an intractable infectious disease. We emplyed decortication and intraarterial infusion of antibiotics in 6 cases. Decortication on the affected mandible was performed with retrocatherization to the superficial temporal artery of affected side under general anesthesia. Antibiotics, IPM/CS or FOMX was used through the artery for 4-11 days. In addition, we administered FOMX, PIPC intravenously for 8-17 days. CT and MRI were taken postoperatively. The postoperative follow-up period ranged from 1 year and 6 months to 2 years and 5 months. Postoperative MR showed that bone marrow signal was recovered to approximately normal in 4 cases. High signal area of bone marrow and osteosclerosis image remained in 2 cases, but showed improvement. The results were satisfactory without recurrence in all of 6 cases.

Proteomic Profiling of Serum from Stage I Lung Squamous Cell Carcinoma Patients

  • Li, Xin-Ju;Wu, Qi-Fei;He, Da-Lin;Fu, Jun-Ke;Jin, Xin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2273-2276
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    • 2013
  • Objectives: This study employed proteomic profiling to identify specific tumor markers that might improve early diagnosis of lung squamous cell carcinoma. Methods: Serum samples were isolated from 30 patients with stage I lung squamous cell carcinoma and 30 age-and gender-matched healthy controls, and proteomic profiles were obtained by matrix-assisted laser desorption ionization time of flight mass spectrometry. Results: Three highly expressed potential tumor markers were identified in the sera of stage I lung squamous cell carcinoma patients, with molecular weights of 3261.69, 3192.07, and 2556.92 Da. One protein peak with molecular weight 3261.69 Da was chosen as the candidate biomarker and identified as a fibrinogen alpha chain through a search of the IPI, NCBI or SWISS-PROT protein databases. Conclusion: As a potential tumor biomarker, fibrinogen alpha chain may be applicable for the early diagnosis and prognosis of lung squamous cell carcinoma patients.