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BACKGROUND: Chemotherapy with docetaxel, cisplatin, and fluorouracil (TPF) has been studied in patients with head and neck cancer. Its impact on patients with oral cavity cancer was not specified. METHODS: We consecutively reviewed medical files of patients with untreated oral cavity cancer who received neoadjuvant TPF chemotherapy in our department from January 2017 to April 2020. Outcomes included the objective response to TPF chemotherapy, factors associated with the response, and progression and survival in different response groups. RESULTS: A total of 167 patients were included, with half of stage IV disease. Complete or partial response was observed in 51 patients. A total of 91 patients had stable disease, and 25 patients had progressive disease. The response was not associated with age, sex, anatomic subsite, and the tumor's T stage. It was related with N stage (p < 0.001) and clinical stage (p = 0.004). Most patients with bulky nodes or nodes with obvious necrosis showed low response or even progressed after neoadjuvant TPF chemotherapy. The planned surgery was conducted in 159 patients. Disease relapse mostly occurred in 2 years after treatment. The 2-year overall survival and the progression-free survival were 89.0% and 85.2% for patients with complete or partial response, 62.4% and 55.6% for patients with stable disease, and 12.5% and 4.2% for patients with progressive disease, respectively. CONCLUSIONS: The response of neoadjuvant TPF chemotherapy in patients with oral cavity cancer is related to disease stage, especially the nodal stage. Patients with complete or partial response developed less progression events and better survival.
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Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Humanos , Docetaxel , Cisplatino/uso terapêutico , Terapia Neoadjuvante , Taxoides , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Recidiva Local de Neoplasia/tratamento farmacológico , Fluoruracila , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias Bucais/tratamento farmacológico , Quimioterapia de InduçãoRESUMO
Novel neoadjuvant therapy regimens are warranted for oral squamous cell carcinoma (OSCC). In this phase I trial (NCT04393506), 20 patients with locally advanced resectable OSCC receive three cycles of camrelizumab (200 mg, q2w) and apatinib (250 mg, once daily) before surgery. The primary endpoints are safety and major pathological response (MPR, defined as ≤10% residual viable tumour cells). Secondary endpoints include 2-year survival rate and local recurrence rate (not reported due to inadequate follow-up). Exploratory endpoints are the relationships between PD-L1 combined positive score (CPS, defined as the number of PD-L1-stained cells divided by the total number of viable tumour cells, multiplied by 100) and other immunological and genomic biomarkers and response. Neoadjuvant treatment is well-tolerated, and the MPR rate is 40% (8/20), meeting the primary endpoint. All five patients with CPS Ë10 achieve MPR. Post-hoc analysis show 18-month locoregional recurrence and survival rates of 10.5% (95% CI: 0%-24.3%) and 95% (95% CI: 85.4%-100.0%), respectively. Patients achieving MPR show more CD4+ T-cell infiltration than those without MPR (P = 0.02), and decreased CD31 and É-SMA expression levels are observed after neoadjuvant therapy. In conclusion, neoadjuvant camrelizumab and apatinib is safe and yields a promising MPR rate for OSCC.
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Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Anticorpos Monoclonais Humanizados , Antígeno B7-H1/metabolismo , Carcinoma de Células Escamosas/patologia , Humanos , Neoplasias Bucais/tratamento farmacológico , Terapia Neoadjuvante , Recidiva Local de Neoplasia , Projetos Piloto , Piridinas , Carcinoma de Células Escamosas de Cabeça e PescoçoRESUMO
OBJECTIVES: The aim of this study was to retrospectively analyze the clinical characteristics, surgical treatment, and prognosis of patients with diffuse-type tenosynovial giant cell tumor (D-TGCT) involving the temporomandibular joint (TMJ) and the skull base. STUDY DESIGN: A retrospective study was performed in patients with D-TGCT involving the TMJ and the skull base at our institute from April 2009 to August 2018. Data on clinical characteristics, surgical treatment, and prognosis were collected and analyzed. A literature search on D-TGCT involving the TMJ was conducted and the data analyzed. RESULTS: The study included 22 patients (14 males and 8 females), with an average age of 44 years. The main symptoms were headache and hearing limitation, accompanied by a swelling in the TMJ area. Magnetic resonance imaging (MRI) showed low signals on T1- and T2-weighted images. All lesions were completely removed. Temporal bone flap, titanium mesh, and temporal muscle flap were used for reconstruction. The recurrence rate was 4.5%. In the literature, 115 cases were reported. Surgery alone was performed in 88 cases; postoperative radiotherapy was performed in 19 cases; the tumor recurrence rates were 9.1% and 15.8% for the 2 procedures, respectively. All patients were alive at the end of the follow-up period. CONCLUSIONS: D-TGCT involving the TMJ and the skull base is a locally aggressive but benign lesion necessitating complete resection and has a good prognosis.
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Tumor de Células Gigantes de Bainha Tendinosa , Recidiva Local de Neoplasia , Adulto , Feminino , Tumor de Células Gigantes de Bainha Tendinosa/diagnóstico por imagem , Tumor de Células Gigantes de Bainha Tendinosa/cirurgia , Humanos , Masculino , Estudos Retrospectivos , Base do Crânio/diagnóstico por imagem , Base do Crânio/cirurgia , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/cirurgiaRESUMO
OBJECTIVE: To compare and evaluate the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) values between a 15-channel phased array head coil and 6-channel dS Flex M surface coil in the MRI of temporomandibular joint. METHODS: 300 patients were randomly assigned to two groups: 150 patients were examined by using a 15-channel phased array head coil and the other 150 patients were scanned by using a 6-channel dS Flex M surface coil. All of the data were set in the same 6 regions of interest including the temporal lobe, condyle neck, lateral pterygoid muscle, parotid gland, the adipose area and an area of the background noiseï¼. SNR and CNR values were measured respectively. RESULTS: The numerical variation law of SNR and CNR values measured in regionsof interest of each group was similar, although different coils were used. There were statistically significant differences of SNR values in all of the oblique sagittal (OSag) proton density-weighted imaging, the part of OSag T 2 weighted image (T 2WI) except for SNR4 and SNR5. and oblique coronal (OCor) T 2WI sequence except for SNR2. On the contrary, SNR4 and SNR5 values in the OCor T 2WI and SNR5 values in OSag T 2WI sequences by using the surface coil were higher than those by using the head coil. There were no statistically significant intergroup differences of CNR values in OSag proton density-weighted imaging sequence except CNR1 and in OSag T 2WI sequence except CNR5. But, statistically significant differences of all the values in the OCor T 2WI sequence except for CNR1 were observed. CONCLUSION: Both the phased array head coil and dS Flex M surface coil can be used for temporomandibular joint MRI.
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Imageamento por Ressonância Magnética , Articulação Temporomandibular , Humanos , Pescoço , Músculos Pterigoides , Razão Sinal-Ruído , Articulação Temporomandibular/diagnóstico por imagemRESUMO
BACKGROUND: The clinical significance of lipid profile in gastric cancer remains unclear. The aim of the present study was to investigate the correlation between serum lipid profiles and patient clinical parameters as well as prognosis in gastric cancer. METHODS: The preoperative plasma lipid profile levels of 358 gastric cancer patients, who were operated in between 2001 and 2009, were retrospectively evaluated, and the correlation between these factors and patient clinical parameters as well as survival were analyzed. RESULTS: There was a significant association between serum high-density lipoprotein cholesterol level (HDL-C <54.2 mg/dL) and cancer progression, Logistic regression analysis revealed that lower level of serum HDL-C was an independent risk factor for deeper cancer invasion, nodal metastasis as well as late stage in patients with gastric cancer. However, no significant association was reported between other lipid markers [triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein (VLDL) and apolipoprotein A (apoA)] and lymph node involvement as well as stage of disease. In univariate analysis and multivariate analyses regarding patient's survival, there was no significant association between the groups in terms of TG, TC, HDL-C, LDL-C, VLDL and apoA. CONCLUSIONS: Low level of serum HDL-C in gastric cancer correlates with cancer progression but not patient's survival.
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OBJECTIVE: The aim of this study was to analyze myopericytoma in the oral and maxillofacial region in terms of clinical appearance, diagnosis, treatment, and outcomes. STUDY DESIGN: Data on 5 new patients with myopericytoma in the oral and maxillofacial region treated at our department were collected and analyzed. RESULTS: There were 2 males and 3 females (age range 10-62 years; mean age 43.8 years). All of the 5 patients presented with masses showing benign biologic behavior. Imaging examinations with use of computed tomography or magnetic resonance imaging showed heterogeneous regions with internal contrast-enhancement or cystic change in 3 cases. All of the patients underwent surgery. Histologic examination showed a broad morphologic spectrum characterized by concentric and perivascular growth of ovoid, plump spindled, and/or round myoid tumor cells. Immunohistochemical examination showed positive staining for vimentin and smooth muscle actin, and negative for CD34 and desmin. During the follow-up period (8-56 months), there was no tumor recurrence. CONCLUSIONS: Myopericytoma in the oral and maxillofacial region always exhibits benign biologic behavior and a heterogeneous region with internal contrast-enhancement or cystic change on imaging examinations. Surgery is the first choice of treatment and results in good clinical outcomes.
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Neoplasias Bucais , Miopericitoma , Adolescente , Adulto , Criança , Desmina , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/terapia , Miopericitoma/diagnóstico , Miopericitoma/terapia , Recidiva Local de Neoplasia , Adulto JovemRESUMO
BACKGROUND: To evaluate the computed tomographic features and create a prediction model for clinical diagnosis of adenoid cystic carcinoma (ACC) in the palate with intact mucosa. METHODS: From March 2016 to May 2018, 102 patients with palatal tumors and intact mucosa, including 28 patients with a pathological diagnosis of ACC after surgery, were enrolled in this study. The patients' clinical symptoms, computed tomographic features and pathological diagnoses were recorded and analyzed. Independent predictors of ACC were determined by using univariate analysis and multivariate logistic regression, and the discrimination and calibration of the prediction model was evaluated, and internal validation was performed. RESULTS: Univariate analysis of patients showed that ACC patients were more likely than non-ACC patients to be older (P = 0.019); to have palatine bone destruction (P<0.001) and greater palatine foramen (GPF) enlargement (P<0.001); to have involvement of the pterygopalatine fossa (P<0.001), foramen rotundum (P<0.001), nasal cavity (P<0.001) and maxillary bone (P<0.001); and to have numbness (P = 0.007) and pain (P<0.001). Multivariate logistic analysis showed that age and GPF enlargement were independent predictors of ACC in palatal tumors. The diagnostic prediction model showed good discrimination and calibration, as evaluated by the area under the receiver operating characteristic curve (0.98) and the Hosmer-Lemeshow goodness-of-fit test (P = 0.927). CONCLUSIONS: The palate ACC prediction model based on age and GPF enlargement shows excellent discrimination with no evidence of poor calibration. Older patients with palatal tumors and intact mucosa should be considered for ACC when they have GPF enlargement.
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Carcinoma Adenoide Cístico/diagnóstico por imagem , Neoplasias Palatinas/diagnóstico por imagem , Palato/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/diagnóstico por imagem , Palato Duro , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: The aim of this study was to analyze tuberculosis (TB) in the oral cavity according to clinical appearance, clinical differential diagnosis, treatment, and outcome. STUDY DESIGN: We enrolled 11 patients with TB in the oral cavity between November 2012 and November 2016. Glossal lymphoid TB was excluded. Clinical symptoms, auxiliary examinations, treatments, and outcomes were recorded and analyzed. RESULTS: The study population comprised 6 men and 5 women, with a mean age of 59 years. Five patients presented with ulcer, 5 with a mass, and 1 with osteomyelitis. Excisional biopsy was performed in 3 patients, mass resection in 7, and curettage of mandibular lesion in 1. After pathologic diagnosis of TB in the oral cavity in 8 patients; 6 of them underwent purified protein derivative examination, and 4 of them had positive results and received drug therapy. The mean follow-up period was 24.9 months, and there was no recurrence. CONCLUSIONS: TB in the oral cavity is rare and has no specific clinical features. Pathology, acid-fast staining, polymerase chain reaction, and DNA testing for Mycobacterium tuberculosis are useful for final diagnosis. Surgery is recommended as the treatment of choice to achieve good clinical outcomes.
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Doenças da Boca/diagnóstico , Doenças da Boca/microbiologia , Doenças da Boca/terapia , Boca/microbiologia , Tuberculose/diagnóstico , Tuberculose/terapia , Idoso , Antituberculosos/uso terapêutico , Terapia Combinada , DNA Bacteriano/análise , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais , Reação em Cadeia da Polimerase , Radiografia Panorâmica , Coloração e Rotulagem , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
PURPOSE: To assess the capability of monochromatic energy images of gemstone spectral imaging(GSI) by using spectral CT in reducing metal artifacts of oral and maxillofacial region. METHODS: Spectral CT imaging was applied to 46 patients with metallic implants with GSI sequence to measure CT numbers (expressed in Hounsfield units, HU) and SD (standard deviation) numbers of the soft tissues. 11 monochromatic-image groups were obtained, ranging from 40 keV(kiloelectronvolts) to 140 keV (every 10 keV as one group). The data were analyzed with SPSS19.0 software package. RESULTS: Images in 20 subjects with orthodontic appliance, the minimal average AI ranged between (23.86±10.90) to (24.42±11.54) HU. Similarly, in 12 subjects with titanium implants, the minimal average AI ranged between (26.49±9.40) to (26.95±8.97) HU. In 10 images from 14 subjects with dental fillings or fixed dentures, the minimal average AI ranged between (29.84±13.04) to (30.97±13.15) HU. The average AI values were (63.36±70.52), (70.82±105.14) and (107.35±147.57) HU from 40 keV to 140 keV in 3 groups, respectively, which was similar to the average AI values of 70keV monochromatic images (61.46±32.06, 70.18±62.86, 110.28±78.70) HU in each corresponding group. There was a significant difference about AI value among 3 energy spectrum groups (P<0.05). CONCLUSIONSï¼Spectral CT imaging could obviously reduce metal artifacts, and improve the display capabilities of the structures around the metallic implants. 70 keV is the dividing point of metal artifact subtraction. The optimal energy range is at 110-140 keV in reducing metal artifacts of oral and maxillofacial region.
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Artefatos , Implantes Dentários , Metais , Interpretação de Imagem Radiográfica Assistida por Computador , Humanos , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: The authors introduce a new method of preoperative computed tomography angiography mapping and virtual and printed located template for accurate location of perforators in the anterolateral thigh perforator flap for head and neck reconstruction. METHODS: Between April and December of 2014, a cohort study was performed with 29 patients who underwent head and neck reconstruction with anterolateral thigh perforator flaps. Computed tomography angiography images were processed for maximum intensity projection and volume rendering to obtain and evaluate the perforator information. The virtual and printed templates with grid were used to transfer the perforator information for intraoperative guidance during flap harvest. The preoperative angiography results were compared with the high-frequency color Doppler results and with the intraoperative real-time findings to evaluate the accuracy of computed tomography angiography mapping. RESULTS: The source vessel, origin, location, direction, number, and caliber of the perforators were determined by preoperative computed tomography angiography mapping. All of the perforator data were accurately mapped on a virtual template and printed on the located template to guide flap harvest. The flap was actually used and survived successfully in 20 patients. The results for perforators identified by mapping were more accurate than those for perforators identified by Doppler. There was no significant difference between the preoperative computed tomography angiography results and the intraoperative findings (p > 0.05). CONCLUSIONS: The role of preoperative computed tomography angiography mapping in guiding anterolateral thigh perforator flap harvest and reducing the unpredictable risk of surgery is acceptable. Located virtual and printed template with grid can transform preoperative computed tomography angiography information to the intraoperative setting accurately and easily. CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, II.
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Angiografia por Tomografia Computadorizada/métodos , Neoplasias de Cabeça e Pescoço/cirurgia , Processamento de Imagem Assistida por Computador/métodos , Tomografia Computadorizada Multidetectores/métodos , Retalho Perfurante/irrigação sanguínea , Procedimentos de Cirurgia Plástica/métodos , Cuidados Pré-Operatórios , Impressão Tridimensional , Cirurgia Assistida por Computador/métodos , Interface Usuário-Computador , Adolescente , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Ultrassonografia Doppler em Cores , Adulto JovemRESUMO
The aim of this study was to investigate the osseous characteristics of Chinese temporomandibular joint (TMJ) and detect the size clusters for total joint prostheses design.Computer tomography (CT) data from 448 Chinese adults (226 male and 222 female, aged from 20 to 83 years, mean age 39.3 years) with 896 normal TMJs were chosen from the Department of Radiology in the Shanghai 9th People's Hospital. Proplan CMF 1.4 software was used to reconstruct the skulls. Three-dimensional (3D) measurements of the TMJ fossa and condyle-ramus units with 13 parameters were performed. Size clusters for prostheses design were determined by hierarchical cluster analyses, nonhierarchical (K-means) cluster analysis, and discriminant analysis.The glenoid fossa was grouped into 3 clusters, and the condyle-ramus units were grouped into 4 clusters. Discriminant analyses were capable of correctly classifying 97.24% of the glenoid fossa and 94.98% of the condyle-ramus units. The means and standard deviations for the parameter values in each cluster were determined.Fossa depth and angles between the condyle and ramus were important parameters for Chinese TMJ prostheses design. 3D measurements and cluster analysis of the osseous morphology of the TMJ provided an anatomical reference and identified the dimensions of the minimum numbers of prosthesis sizes required for Chinese TMJ replacement.
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Imageamento Tridimensional , Prótese Articular , Desenho de Prótese , Articulação Temporomandibular/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Análise por Conglomerados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ajuste de Prótese , SoftwareRESUMO
PURPOSE: The study was aimed to determine and optimize the parameters for the MR fast imaging employing steady-state acquisition (FIESTA) sequence, which was to obtain an acceptable image to evaluate the value of the movement of the temporomandibular joint (TMJ). METHODS: In this investigation, 20 volunteers were examined to determine and optimize the parameters of the FIESTA sequence. Then, 160 TMJs from 80 patients with temporomandibular joint disorders (TMD) of clinical suspicion were consecutively performed by both static MRI and dynamic FIESTA MRI on the oblique sagittal position. The FIESTA MR images of TMJs were obtained from a slow, consecutive, free and open-closed movement. Based on the cycles of TMJ movements during the process of FIESTA MRI (90seconds), we classified all TMJs into 2 groups: cycles of open-closed mouths less than or equal to 3 (group 1) and more than 3 (group 2). Each image was marked level 1-3 by its quality. Meanwhile, the location of articular disc, mandibular condyle, motive artifact, "jumping sign" and the joint effusion in each TMJ were assessed respectively. RESULTS: By dynamic FIESTA MRI among 160 TMJs, 92 TMJs (57.50%) were in group 1, and 68 TMJs were (42.50%) in group 2. There were statistically significant differences between group 1 and group 2(p<0.05). It was shown that the number of "level 3" in group 1 was greater than group 2, and the number of "level 1" in group 1 was less than group 2. The phenomenon of motion artifact and "jumping sign" were much significantly higher in group 2 than those in group 1 (p<0.01). Furthermore, in all of the "jumping sign" cases, the phenomenon of "jumping sign" was significantly higher in group ADDwR than in group ADDw/oR (p<0.01). There was a statistically significant correlation between disc-condyle complex in "jumping sign" phenomenon and group ADDwR (r=0.621, p<0.05). The data with the false matching rate of 31.52% showed that the maximum motion range on the dynamic imaging was greater than the static imaging. Among 160 TMJs, joint effusions of 37 TMJs (23.13%) were identified by dynamic FIESTA-MRI. Among 79 TMJs with ADDw/oR(anterior disc displacement without reduction), 42 sides were operated with Maxillofacial arthroscopy surgery. The surgical result was in agreement with the MR result. CONCLUSION: Most TMJs images with a slow free open-close movement (cyclesâ¦3) could be successfully obtained by the dynamic FIESTA MRI. The FIESTA MRI might be considered as an additional method to evaluate the movement of the articular disk and the mandibular condyle.
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Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Transtornos da Articulação Temporomandibular/patologia , Articulação Temporomandibular/patologia , Adulto , Feminino , Humanos , Masculino , Mandíbula/patologia , Côndilo Mandibular/patologia , Transtornos da Articulação Temporomandibular/diagnóstico , Adulto JovemRESUMO
BACKGROUND: To identify whether a stem cell biomarker, KLF4, may predict the pathologic tumor response to neoadjuvant chemotherapy for patients with locally advanced breast cancer. METHODS: Twelve locally advanced breast cancer patients who achieved pathologic complete remission (pCR) after neoadjuvant chemotherapy were identified and for each, three non-pCR breast cancer patients - matched for age, clinical tumor-node-metastasis stage, and neoadjuvant chemotherapy cycles - were selected. The relationship between KLF4 expression in the core needle biopsied cancer tissue and patient pCR rate was assessed using univariate and multivariate analysis. RESULTS: Receiver operating characteristic curve analysis showed that the patients with a histoscore of KLF4 expression >0.18 had a lower pCR rate. Multivariable analysis showed that higher KLF4 expression (odds ratio 0.013; 95% confidence interval 0.013-0.444; P=0.004) was independently correlated with a lower pCR rate after neoadjuvant chemotherapy. CONCLUSION: KLF4 overexpression was associated with lower pCR in locally advanced breast cancer patients undergoing neoadjuvant chemotherapy. This study suggests that KLF4 may serve as a predictor for pCR in patients with breast cancer after neoadjuvant chemotherapy.
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PURPOSE: The aim of this study was to introduce our classification of the neurovascular compression (NVC) in trigeminal neuralgia and the radiologic indications for microvascular decompression (MVD) based on magnetic resonance tomographic angiography. METHODS: From 2003 to 2011, 322 patients with primary trigeminal neuralgia were treated with MVD. The score of NVC was from 0 to 3. Three scores, separately from axial, oblique sagittal, and coronal images, were added together. The degree of NVC was classified as follows: grade 0 (0-1), grade 1 (2-3), grade 2 (4-6), and grade 3 (7-9). RESULTS: In summary, 88.3% (182/206) patients with absolute indication, 78.3% (65/83) patients with relative indication, and 90.9% (30/33) without indication showed excellent results. Among the 27 patients with good result, 13 patients (48.1%) were in grade 1, and 3 (11.1%) were in grade 0. Among the 18 patients with poor result, 5 patients (27.8%) were in grade 1 preoperatively. Five patients with severe complications were all in grade 0 with vague NVC. CONCLUSION: The patients with grades 2 and 3 (absolute indications) NVC were recommended with MVD.
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Angiografia por Ressonância Magnética/métodos , Cirurgia de Descompressão Microvascular/métodos , Neuralgia do Trigêmeo/classificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/classificação , Síndromes de Compressão Nervosa/cirurgia , Neuroendoscopia/métodos , Medição da Dor/métodos , Dor Pós-Operatória/etiologia , Cuidados Pré-Operatórios , Recidiva , Resultado do Tratamento , Nervo Trigêmeo/patologia , Nervo Trigêmeo/cirurgia , Neuralgia do Trigêmeo/cirurgia , Adulto JovemRESUMO
The purpose of this study was to evaluate the guiding effect of computer-assisted design technique in local resection of exostosis osteochondroma (EOC) from the mandibular condyle. Eight patients diagnosed with EOC through computed tomographic scan were selected from January 2011 to March 2012. SurgiCase CMF 5.0.0.32 software was used for preoperative design. The osteotomy angle, depth, and tumor shape were measured to guide the surgery. The tumors were resected from the stalk 2 mm within the normal tissue to restore the unaffected condyle as much as possible. Postoperative computed tomographic scans showed that the tumors had been resected completely in all patients. The mean (SD) error between the design and the result was 1.82 (1.25) mm. Five patients had more than 1-year follow-up without recurrence. Computer-assisted design is a good way to help local resection of EOC. It can improve the accuracy of tumor resection and keep the unaffected condyle as much as possible for function.
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Exostose/cirurgia , Côndilo Mandibular/cirurgia , Neoplasias Mandibulares/cirurgia , Osteocondroma/cirurgia , Cirurgia Assistida por Computador , Adulto , Idoso , Exostose/diagnóstico por imagem , Exostose/patologia , Feminino , Humanos , Masculino , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia , Neoplasias Mandibulares/patologia , Pessoa de Meia-Idade , Osteocondroma/diagnóstico por imagem , Osteocondroma/patologia , Osteotomia , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To introduce our device and procedure of electromagnetic navigation (EMN)-guided radiofrequency thermocoagulation (RFT) in patients with trigeminal neuralgia (TN). METHODS: The EMN system mainly consists of an electromagnetic localizer, a thermoplastic facial mask with fiducial markers, and navigation software. A new surgical interface in which the foramen ovale (FO) and the trigeminal ganglion (TG) were integrated was used. It was applied in three patients with TN. RESULTS: FO was successfully and accurately cannulated on the first attempt by using EMN guidance. During the follow-up period, pain did not reoccur, and appropriate trigeminal sensory paresthesia was elicited. There were no surgery-related complications. CONCLUSION: The EMN system is effective and highly accurate for RFT in patients with primary TN. Our modification of the registration system and surgical interface could make the RFT process more simple and accurate.
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Eletrocoagulação/métodos , Neuronavegação/métodos , Neuralgia do Trigêmeo/cirurgia , Analgésicos não Narcóticos/efeitos adversos , Analgésicos não Narcóticos/uso terapêutico , Carbamazepina/efeitos adversos , Carbamazepina/uso terapêutico , Sistemas Computacionais , Resistência a Medicamentos , Campos Eletromagnéticos , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Máscaras , Pessoa de Meia-Idade , Ondas de Rádio , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND AND OBJECTIVES: To identify clinicopathologic variables that could predict pathologic tumor response to neoadjuvant chemotherapy for patients with locally advanced gastric cancer. METHODS: The study enrolled 108 patients who underwent neoadjuvant chemotherapy followed by surgery between July 2004 and December 2010. Tumor responses to neoadjuvant chemotherapy were assessed in terms of tumor regression. Statistical analyses were performed to identify factors associated with pathologic tumor response. RESULTS: Tumor regression was found in 22.2% (24/108) patients, patients with tumor regression observed better overall survival as compared to that of patients without tumor regression. Univariate and multivariate analyses observed that both tumor differentiation and tumor size were independent predictors of tumor regression. CONCLUSIONS: This study suggests that both tumor differentiation and tumor size is the most important clinical predicator of pathologic tumor response, it may be of benefit in the selection of treatment options in locally advanced gastric cancer.
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Adenocarcinoma/mortalidade , Adenocarcinoma/terapia , Terapia Neoadjuvante , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/terapia , Adenocarcinoma/patologia , Adulto , Idoso , Feminino , Gastrectomia , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Prognóstico , Distribuição por Sexo , Neoplasias Gástricas/patologiaRESUMO
PURPOSE: To analyze and evaluate the MR diffusion-weighted imaging (MR-DWI) features of head and neck hemangioma and venous malformation in children. METHODS: We retrospectively observed 10 head and neck hemangiomas and 40 head and neck venous malformations in children, which underwent both conventional MR imaging and MR-DWI. In the MR-DW images, the apparent diffusion coefficient(ADC) mean value was taken from b=500 s/mm² and 1000 s/mm², The data was analyzed using SPSS13.0 software package for t test. RESULTS: The mean ADC obtained from b value of 500 s/mm² was (1.227±0.324)x10⻳mm²/s in hemangioma and (1.851±0.364)x10⻳mm²/s in venous malformation, and from b value of 1000 s/mm² was (0.728±0.256)x10⻳mm²/s in hemangioma and (1.200±0.228)x10⻳mm²/s in vein malformation. There was significant difference between both lesions (P<0.01). CONCLUSION: There are different features in MR-DWI between head and neck hemangioma and venous malformation in children, which may be helpful for radiological differential diagnosis.
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Imagem de Difusão por Ressonância Magnética , Neoplasias de Cabeça e Pescoço , Hemangioma , Criança , Humanos , Estudos Retrospectivos , Malformações VascularesRESUMO
Hemangioma is the most commonly benign tumor of soft tissue tumors in infants. Most of them locate in the oral and maxillofacial region. The imaging examinations mainly contain ultrasonography, X-ray plain film, CT, MRI and X-ray angiography. In this article, the current situation of application with all imaging examinations used in diagnosis of hemangioma is reviewed.