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Kwak EJ, Cha IH, Nam W, Yook JI, Park YB, Kim HJ. Effects of locally administered rhBMP-2 and bisphosphonate on bone regeneration in the rat fibula. Oral Dis 2018; 24:1042-1056. [DOI: 10.1111/odi.12864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 02/23/2018] [Accepted: 03/16/2018] [Indexed: 12/25/2022]
Affiliation(s)
- E-J Kwak
- Department of Oral and Maxillofacial Surgery; College of Dentistry; Yonsei University; Seoul Korea
| | - I-H Cha
- Department of Oral and Maxillofacial Surgery; College of Dentistry; Yonsei University; Seoul Korea
| | - W Nam
- Department of Oral and Maxillofacial Surgery; College of Dentistry; Yonsei University; Seoul Korea
| | - JI Yook
- Department of Oral Pathology; College of Dentistry; Yonsei University; Seoul Korea
| | - Y-B Park
- Department of Prosthodontics; College of Dentistry; Yonsei University; Seoul Korea
| | - HJ Kim
- Department of Oral and Maxillofacial Surgery; College of Dentistry; Yonsei University; Seoul Korea
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Abstract
Although osteoradionecrosis (ORN) is a serious complication of craniofacial radiotherapy, the current management methods remain suboptimal. Teriparatide (TPTD), a recombinant human parathyroid hormone (1-34), has shown beneficial effects on osseous regeneration in medication-related osteonecrosis of the jaw or periodontitis. However, TPTD therapy in irradiated bones has not been indicated yet because of the theoretical risk of osteosarcoma seen in rat models. Hence, we first report here two patients with tongue cancer with late-emerging ORN who were successfully treated with TPTD for 4-6 months with serum calcium and vitamin D supplementation. In contrast to the usual progress of ORN, the bone defect regenerated well and bone turnover markers including serum C-terminal telopeptide of type 1 collagen and osteocalcin were restored with TPTD therapy. Our experience might suggest that TPTD therapy with careful monitoring can provide an effective treatment option for patients with ORN in select refractory cases, with the benefits outweighing the potential risks.
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Affiliation(s)
- Y H Cha
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul, 03722, Korea
| | - N Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Y Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - I-H Cha
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul, 03722, Korea.
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Kim KY, Zhang X, Kim SM, Lee BD, Cha IH. A combined prognostic factor for improved risk stratification of patients with oral cancer. Oral Dis 2016; 23:91-96. [PMID: 27588367 DOI: 10.1111/odi.12579] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 07/18/2016] [Accepted: 08/22/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE We aimed to identify a combined prognostic factor for predicting better performance in risk stratification. MATERIALS AND METHODS We reviewed the clinical and pathological variables of 316 patients with oral squamous cell carcinoma (OSCC) who underwent surgery. To identify a combined predictor, principal component analysis (PCA) was performed. RESULTS Univariate analysis showed that the independent prognostic variables for overall survival (OS) were pathologic T stage (T1 vs T4, HR = 1.99, 95% CI: = 1.083-3.675, P = 0.026) and pathologic N stage (N0 vs N2, HR=1.90, 95% CI: = 1.17-3.08, P = 0.008). In the multivariate analysis, only pathologic T stage was significant (P = 0.006 and P = 0.007); however, the multivariate model was not significant (P = 0.191). The multivariate model became significant by including lymph node ratio (LNR) instead of pathologic N stage (P = 0.0025 in numeric LNR, P = 0.0007 in categorized LNR). Also, the performance of prediction model was improved by a combined prognostic factor (P = 0.0002). CONCLUSIONS The newly identified combined prognostic factor included resection margin, differentiation, and LNR, and they were insignificant factors independently except for LNR. This combined prognostic factor showed a good performance although it did not include molecular markers; therefore, it may be used conveniently for risk stratification of patients with OSCC by combining only clinical information.
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Affiliation(s)
- K-Y Kim
- BK21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Korea
| | - X Zhang
- Department of pathology, Yanbian University medical college, Yanji city, China
| | - S-M Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - B-D Lee
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - I-H Cha
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
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Kim KM, Park W, Oh SY, Kim HJ, Nam W, Lim SK, Rhee Y, Cha IH. Distinctive role of 6-month teriparatide treatment on intractable bisphosphonate-related osteonecrosis of the jaw. Osteoporos Int 2014; 25:1625-32. [PMID: 24554340 DOI: 10.1007/s00198-014-2622-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 01/09/2014] [Indexed: 12/21/2022]
Abstract
UNLABELLED The administration of teriparatide (TPTD) in conjunction with periodontal care could provide faster and more favorable clinical outcomes in previously refractory bisphosphonate-related osteonecrosis of the jaws (BRONJ) cases compared to conventional dental care, combination of surgery and antimicrobial treatment. We also found that underlying vitamin D levels might influence the response to TPTD treatment. INTRODUCTION Treatment of BRONJ is quite challenging and there are no standard treatment modalities. In this retrospective, longitudinal study, we examined whether additional TPTD administration could be beneficial for the resolution of BRONJ lesions compared to conservative management, such as antimicrobial treatment with or without surgery, and also studied the factors influencing the response to TPTD. METHODS Twenty-four cases of intractable BRONJ were included: 15 subjects were assigned to the TPTD group and the other 9 subjects, who refused TPTD administration, were assigned to the non-TPTD group. All subjects in both groups continued calcium and vitamin D supplementation and the TPTD group additionally received a daily subcutaneous injection of 20 μg TPTD for 6 months. RESULTS While 60.0% of the non-TPTD group showed one stage of improvement in BRONJ, 40.0% of the group did not show any improvement in disease status. In the TPTD group, 62.5% of the treated subjects showed one stage of improvement and the other 37.5% demonstrated a marked improvement, including two stages of improvement or complete healing, and there was not a single case that did not improve. The clinical improvement of BRONJ was statistically better in the TPTD group after the 6-month treatment (p < 0.05). Moreover, patients with higher baseline serum 25(OH)D levels showed better clinical therapeutic outcomes with TPTD. CONCLUSIONS We observed the beneficial effects of TPTD on BRONJ, and subjects with optimal serum vitamin D concentrations seemed to reap the maximum therapeutic effects of TPTD. A prospective, randomized, controlled trial should be needed to further evaluate the therapeutic efficacy of TPTD in the resolution of BRONJ.
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Affiliation(s)
- K M Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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Kim DW, Park JC, Rim TT, Jung UW, Kim CS, Donos N, Cha IH, Choi SH. Socioeconomic disparities of periodontitis in Koreans based on the KNHANES IV. Oral Dis 2013; 20:551-9. [PMID: 24033864 DOI: 10.1111/odi.12168] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Revised: 06/26/2013] [Accepted: 07/12/2013] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to identify the socioeconomic factors associated with the prevalence of periodontitis in Koreans. METHODS Cross-sectional data from 12 763 subjects, 15 years old and above, who underwent periodontal examinations were obtained from the Korean National Health and Nutrition Examination Survey IV (2007-209). Multivariate linear and logistic regression analyses were applied to estimate the association between socioeconomic indicators and prevalence of periodontitis. RESULTS A significant association was found between increasing age and periodontitis. Participants with higher income were less likely to have periodontitis (aOR = 0.9 and 95% CI = 0.78-0.98, and aOR = 0.7 and 95% CI = 0.60-0.80 in the middle and highest quintiles of monthly household income, respectively). In addition, participants living in rural areas were less likely to have periodontitis (aOR = 0.9 and 95% CI = 0.81-0.99), and current smokers were more likely to have periodontitis (aOR = 1.7 and 95% CI = 1.49-1.89). The analysis of comorbidities revealed that individuals with diabetes mellitus (DM) were significantly more likely to have periodontitis (aOR = 1.4 and 95% CI = 1.18-1.68). CONCLUSIONS In a rapidly increasing Korean population, the lower socioeconomic groups as well as individuals with DM were significantly more likely to present with periodontitis.
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Affiliation(s)
- D W Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
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Chung SW, Kim S, Choi JR, Yoo TH, Cha IH. Osteolytic mandible presenting as an initial manifestation of an adult acute lymphoblastic leukaemia. Int J Oral Maxillofac Surg 2011; 40:1438-40. [PMID: 21723711 DOI: 10.1016/j.ijom.2011.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 11/01/2010] [Accepted: 01/27/2011] [Indexed: 10/18/2022]
Abstract
A case of adult acute lymphoblastic leukaemia is reported. A 35-year-old male presented with an osteolytic lesion of the mandible. There was no definitive involvement in other craniofacial bones. A panoramic radiograph taken 4 months previously showed no bony involvement. A complete blood count showed a slightly decreased red blood cell count, but normal white blood cell count, white blood cell differential count and platelet count. Routine chemistry revealed hypercalcemia with an increased level of parathyroid hormone-related protein. Histopathological examination of bone marrow biopsy confirmed the diagnosis of acute lymphoblastic leukaemia.
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Affiliation(s)
- S-W Chung
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, South Korea
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Hong JW, Nam W, Cha IH, Chung SW, Choi HS, Kim KM, Kim KJ, Rhee Y, Lim SK. Oral bisphosphonate-related osteonecrosis of the jaw: the first report in Asia. Osteoporos Int 2010; 21:847-53. [PMID: 19633881 DOI: 10.1007/s00198-009-1024-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Accepted: 07/06/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious side effect of bisphosphonate therapy. The incidence of BRONJ is known to be low among patients treated with oral bisphosphonates. We investigated the prevalence, demographics, clinical manifestations, and treatment outcome of 24 patients with oral BRONJ in Asian populations. INTRODUCTION The long-term safety of oral bisphosphonates is clinically important considering the rare but potentially serious complications such as bisphosphonate-related osteonecrosis of the jaw (BRONJ) versus the effect of reducing and preventing osteoporotic fracture. The incidence of BRONJ is known to be low among patients treated with oral bisphosphonates around the world. However, the prevalence in those taking oral bisphosphonates for osteoporosis in Asian populations is unknown. Moreover, a recent article, showing that the majority of reported patients who received alendronate were Asian American, raised concern about the prevalence of oral BRONJ in Asian populations. The objective of this study was to investigate the estimated prevalence, clinical characteristics, and treatment outcome of oral BRONJ in Asian populations. METHODS From October 2005 to December 2008, a retrospective review of medical charts identified 24 patients receiving oral bisphosphonates diagnosed as BRONJ at the Department of Oral and Maxillofacial Surgery, Yonsei University Dental Hospital, Seoul, South Korea. RESULTS The estimated prevalence of oral BRONJ was 0.05-0.07%. The average oral bisphosphonate treatment duration was 43.1 months (range, 5-120 months). Treatment with oral antibiotics and/or surgery including sequestrectomy or alveolectomy showed relatively favorable results. CONCLUSIONS The prevalence of oral BRONJ in Korea is similar to that reported previously in Western populations. We suggest that recognition of BRONJ and appropriate management pre- and post-dental surgery might reduce the frequency of BRONJ among patients receiving oral bisphosphonates.
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Affiliation(s)
- J W Hong
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
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Kim JH, Yeon JE, Jong YK, Seo WK, Cha IH, Seo TS, Park JJ, Kim JS, Bak YT, Byun KS. Spinal cord injury subsequent to transcatheter arterial chemoembolization in patients with hepatocellular carcinoma. Dig Liver Dis 2010; 42:67-70. [PMID: 19546038 DOI: 10.1016/j.dld.2009.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 04/24/2009] [Accepted: 05/06/2009] [Indexed: 02/06/2023]
Abstract
Transcatheter arterial chemoembolization is one of the most common treatment modalities for hepatocellular carcinoma. Transcatheter arterial chemoembolization is considered to be a relatively safe procedure, but transcatheter arterial chemoembolization is associated with a number of disastrous complications. Among the ischaemic complications caused by transcatheter arterial chemoembolization, spinal cord injury is very rare, but can occur via the intercostal or lumbar arteries. We report two cases of extremely rare spinal cord injuries after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma. The patients had sensory loss below the T9 or T10 dermatomes and paraparesis or paraplegia within 6-8h after transcatheter arterial chemoembolization. One patient sustained paraplegia until death 2 months after transcatheter arterial chemoembolization and the other patient recovered almost completely 2 months after transcatheter arterial chemoembolization.
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Affiliation(s)
- J H Kim
- Department of Internal Medicine, Korea University College of Medicine, and Department of Internal Medicine, Guro Hospital, Seoul, South Korea
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Park SW, Hwang JJ, Yun IJ, Lee SA, Kim JS, Chang SH, Chee HK, Hong SJ, Cha IH, Kim HC. Endovenous Laser Ablation of the Incompetent Small Saphenous Vein with a 980-nm Diode Laser: Our Experience with 3Years Follow-up. Eur J Vasc Endovasc Surg 2008; 36:738-42. [PMID: 18851921 DOI: 10.1016/j.ejvs.2008.08.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 08/10/2008] [Indexed: 11/17/2022]
Affiliation(s)
- S W Park
- Department of Radiology, Konkuk University Hospital, Seoul, Republic of Korea
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Jung YS, Chung SW, Nam W, Cho IH, Cha IH, Park HS. Spontaneous bone formation on the maxillary sinus floor in association with an extraction socket. Int J Oral Maxillofac Surg 2007; 36:656-7. [PMID: 17367999 DOI: 10.1016/j.ijom.2007.01.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2006] [Revised: 11/22/2006] [Accepted: 01/22/2007] [Indexed: 11/22/2022]
Abstract
A case is reported of spontaneous bone formation on the maxillary sinus floor associated with the extraction socket of a maxillary impacted tooth. An impacted maxillary second premolar of a 20-year-old male had been pushed into the maxillary sinus during surgical extraction. The tooth was removed using the sinus elevation technique. After 5 months of healing, the space between the sinus floor and the socket was filled with new bone. Later, implant surgery was successfully carried out without any sinus augmentation. Osteogenic activity of sinus mucosa and the blood clot in the extraction socket beneath the elevated sinus would have been important factors in this spontaneous bone formation.
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Affiliation(s)
- Y-S Jung
- Department of Oral and Maxillofacial Surgery, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, South Korea.
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Kim KA, Park CM, Lee JH, Cha SH, Park SW, Hong SJ, Seol HY, Cha IH, Mok YJ, Kim YS. Inflammatory myofibroblastic tumor of the stomach with peritoneal dissemination in a young adult: imaging findings. ACTA ACUST UNITED AC 2004; 29:9-11. [PMID: 15160745 DOI: 10.1007/s00261-003-0085-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Inflammatory myofibroblastic tumors are lesions that most often affect young adults and children. These tumors have been found in numerous extrapulmonary sites but rarely in the stomach. It is unknown whether this process is reactive or neoplastic. They are infiltrative lesions and often extend through the gastric wall, sometimes reaching adjacent organs including the esophagus, duodenum, peritoneal cavity, spleen. pancreas, and liver. These features mimic malignancy on endoscopy and radiology. We report the ultrasound, color Doppler ultrasound, and helical computed tomographic findings of a gastric inflammatory myofibroblastic tumor with peritoneal dissemination in a young adult. To our knowledge, this is the first report of color Doppler ultrasound and helical computed tomographic findings of this rare disease entity.
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Affiliation(s)
- K A Kim
- Department of Diagnostic Radiology, Korea University Guro Hospital, 97, Gurodong-Gil, Guro-Ku, Seoul, 152-703, Republic of Korea
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Abstract
To clarify the clinical utility of the parietal bone graft in maxillofacial reconstruction, we performed an anatomical study by measuring the regional thickness of the parietal bone in 47 Korean adult dry skulls. Before sectioning of the calvaria, the appropriate anatomical landmarks were marked on each specimen. We measured the total thickness of the parietal bone, and the thickness of the outer and inner cortical plates at various points in each section of parietal bones using a digital caliper under the stereomicroscope. The total thickness of the parietal bone ranged from 5.04mm to 7.17mm, and there was no statistical difference in the total thickness of the parietal bone on the same points bilaterally. The parietal bone tended to be thicker toward the lambda point than at the coronal suture area. On the other hand, the outer plate of parietal bone was thickest at the point nearest to the coronal suture, and the inner plate proved thickest at the posteromedial area. In conclusion, this study showed that the better donor site of the parietal bone for maxillofacial reconstruction is located at its more posterior and medial area.
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Affiliation(s)
- Y-S Jung
- Department of Oral and Maxillofacial Surgery, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
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Abstract
A solitary plasmacytoma occurring in the mandible of a 15-year-old Korean male 6 years after renal transplantation is reported. The tumour presented as a hyperplastic gingival overgrowth in the right madibular molar area. Histology and immunohistochemistry revealed plasmacytoma and monoclonality of the kappa chain and IgG. In situ hybridization for Epstein-Barr virus encoded RNA (EBER) showed positive signals in the tumour cells. The tumour regressed after reducing the immunosuppressive agents with concurrent radiotherapy. The patient remains in a stable condition with normal renal functions after 7 years without recurrence. This case confirms that Epstein-Barr virus associated B-lymphoproliferative disorders are still a major complication of immunosuppression.
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Affiliation(s)
- J H Yoon
- Department of Oral Pathology, College of Dentistry, Chosun University, Gwangju, Korea
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Abstract
Vascularized fibula flaps have many advantages in the restoration of the contour and function of the mandible. Potential disadvantages include, unreliable skin paddle and the limited volume of the fibula. This study was designed, to clarify the anatomy of the peroneal artery to the fibula and lateral leg skin, and to measure the dimensions of the fibula available for dental implant placement in Korean. Through the dissection of 63 legs of Korean cadavers, we demonstrated that in most cases the musculoperiosteal (mp) and septocutaneous (sc) branches of the peroneal artery were distributed at the middle and lower thirds of the fibula. There were double the number of mp perforators to the skin compared to sc branches. This indicates the inclusion of a generous > 1 cm cuff of Peroneous longus and flexor hallucis longus (FHL) in the distal and middle third of the fibula. The location of the nutrient foramen was just proximal to the midpoint. Thus, a 15-20 cm length of the fibula is available in Koreans and an 8 12 mm length of implant can be placed to the fibula, which provides sufficient bone to reconstruct a large mandibular defect.
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Affiliation(s)
- S W Choi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
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Hong SX, Cha IH, Lee EW, Kim J. Mandibular invasion of lower gingival carcinoma in the molar region: its clinical implications on the surgical management. Int J Oral Maxillofac Surg 2001; 30:130-8. [PMID: 11405448 DOI: 10.1054/ijom.2000.0030] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The spread pattern of a tumour and its extent in the mandible are important in the management of gingival cancer. Sixteen patients with gingival squamous cell carcinoma (SCC) involving the mandible in the molar region were included in this study. Resection specimens of the mandibular bone and adjacent cancer were histologically analysed to identify the type and characteristics of invasion and were compared with the radiological features. Our results showed that the actual width of invasion was underestimated to a greater extent than the actual depth of invasion. For horizontal aspects, four dentate cases had horizontal intramedullary spread underneath intact mucosa or cortical bone extended from the main foci of tumour that infiltrated through the occlusal surface. For vertical aspects, nerve invasion took place in only one of 16 specimens, while five cases showed downward infiltration beyond the inferior alveolar canal without nerve involvement, so that the pattern of tumour spread was mostly transmedullary rather than perineural in previously non-irradiated cases. These cases with deep infiltration showed the infiltrative type of invasion in the dentate mandible. And when the tumour was related with previous dental extractions or curettage, it tended to be more extensive than what was predicted from an imaging point of view. These pathological and clinical features affecting the tumour spread should be considered in the management of gingival SCC in the molar region.
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Affiliation(s)
- S X Hong
- Department of Oral and Maxillofacial Surgery, Yonsei University, College of Dentistry, Seoul, Korea
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16
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Kim HS, Han HY, Choi JA, Park CM, Cha IH, Chung KB, Mok YJ. Preoperative evaluation of gastric cancer: value of spiral CT during gastric arteriography (CTGA). Abdom Imaging 2001; 26:123-30. [PMID: 11178686 DOI: 10.1007/s002610000167] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND To evaluate the utility of dual-phase spiral computed tomography during gastric arteriography (CTGA) in the preoperative staging of gastric cancers. METHODS We performed CTGA in 21 patients with pathologically proven gastric cancers. CTGA findings were prospectively analyzed and correlated with surgical and pathologic findings. Dual-phase scans were performed at 10 s (early) and 60-100 s (delayed) after injection of 120 mL of contrast medium at an injection rate of 6 mL/s through a preset 5-Fr catheter positioned in the celiac trunk. Spiral CT scans were assessed for enhancing pattern of the normal gastric wall, tumor detectability, and accuracy of tumor staging. RESULTS Normal gastric mucosa was clearly visible as two or three layers in all patients on early-phase scans and in eight patients on delayed-phase scans. The primary tumors were correctly detected with CTGA in seven (88%) of the eight early gastric cancers and in all 13 (100%) advanced gastric cancers. The accuracy of CTGA for T staging was 50% and 77% in early and advanced gastric cancers, respectively. The overall accuracy for tumor detection and T staging was 95% and 67%, respectively. The accuracy of CTGA for the degree of serosal invasion and regional lymph node metastasis was 77% and 76%, respectively. CONCLUSION The CTGA technique improved tumor detection rate and accuracy of tumor staging, especially in early gastric cancer, and may be very useful in the preoperative staging of gastric cancer.
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Affiliation(s)
- H S Kim
- Department of Diagnostic Radiology, Ilsan Paik Hospital, Inje University, 2240 Daewha-Dong, Ilsan-Gu, Koyang-Si Kyounggi-Do, Korea
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Park CM, Cha SH, Kim DH, Choi JA, Cha IH, Kim YH, Chung KB, Suh WH. Hepatic arterioportal shunts not directly related to hepatocellular carcinoma: findings on CT during hepatic arteriography, CT arterial portography and dual phase spiral CT. Clin Radiol 2000; 55:465-70. [PMID: 10873693 DOI: 10.1053/crad.2000.0477] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AIM To evaluate findings of arterioportal shunts not directly related to hepatocellular carcinoma (HCC) which were seen within third-order portal branches on computed tomography (CT) during hepatic arteriography (CTHA), arterial portography (CTAP), and dual phase spiral CT. MATERIALS AND METHODS At CTHA in 112 patients, we examined third-order portal vein branches to find arterioportal shunts not directly related to HCC. Six cases were found. We evaluated the findings of these shunts on CTHA and investigated whether CTAP (n = 6) and dual phase spiral CT (n = 5) showed perfusion defects in the corresponding areas on arterioportal shunts. RESULTS Five of six cases showed abrupt visualization of portal branches without visualization of the proximal portion of CTHA. Five of six cases showed no perfusion defect on CTAP and no hyperattenuating area on CTHA. Four of five cases showed no hyperattenuating area on hepatic arterial phase spiral CT. CONCLUSION Arterioportal shunts not directly related to HCC and occuring within third-order portal branches mainly showed abrupt visualization of portal branches on CTHA. These occurred frequently without perfusion defects on CTAP and without a hyperattenuating area on CTHA and hepatic arterial phase spiral CT.Park, C. M. (2000). Clinical Radiology55, 465-470.
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Affiliation(s)
- C M Park
- Department of Radiology, Korean University College of Medicine, Guro
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Abstract
We are reporting two cases of pancreatic adenocarcinoma that showed dense contrast enhancement on the early phase spiral CT scan and isodensity on the delayed phase scan. Both lesions were located in the head portion of the pancreas, with diameters of 2 cm and 5 cm, respectively. Despite its extremely rare incidence, adenocarcinoma may be included in the differential diagnosis of enhanced pancreatic tumor on early-phase spiral CT scan.
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Affiliation(s)
- C M Park
- Department of Diagnostic Radiology, Korea University Guro Hospital, Seoul, Korea.
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Cha SH, Park CM, Cha IH, Kim HJ, Lee DH, Baek SY, Kim PN, Ha HK. Hepatic involvement in hypereosinophilic syndrome: value of portal venous phase imaging. Abdom Imaging 1998; 23:154-7. [PMID: 9516504 DOI: 10.1007/s002619900310] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
US, portal venous phase CT, and MRI-CSE (MRI with conventional spin-echo sequence) findings in three cases of hepatic involvement in hypereosinophilic syndrome are presented. These showed varied imaging findings, but portal venous phase CT showed multiple, poorly marginated, and hypodense hepatic lesions in all three cases. The result suggested that portal venous phase CT is the optimal method for depicting hepatic involvement.
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Affiliation(s)
- S H Cha
- Department of Radiology, An San Hospital, Korea University College of Medicine, An San City, Kyung Ki Do
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Jung GM, Bak YT, Know OS, Oh JH, Kim JS, Kim JH, Keum JH, Park CM, Cha IH, Kim KI, Kim HK. Massive bleeding from left colonic arteriovenous malformation in a young patient with ventricular septal defect. Korean J Intern Med 1998; 13:56-9. [PMID: 9538633 PMCID: PMC4531932 DOI: 10.3904/kjim.1998.13.1.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Arteriovenous malformation of the gut is well known to have been an important bleeding focus in past ages. We report a young Korean male patient, who had been known to have ventricular septal defect, presenting massive lower gastrointestinal bleeding from an arteriovenous malformation involving a long segment of the left colon. Angiographic, gross and histologic findings are presented and the literature is reviewed.
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Affiliation(s)
- G M Jung
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
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Kim SH, Cha IH, Kim KS, Kim YH, Lee YC. Cloning and sequence analysis of another Shiga-like toxin IIe variant gene (slt-IIera) from an Escherichia coli R107 strain isolated from rabbit. Microbiol Immunol 1997; 41:805-8. [PMID: 9403506 DOI: 10.1111/j.1348-0421.1997.tb01931.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
An Escherichia coli R107 strain (O26 serotype) producing a Shiga-like toxin IIe variant (SLT-IIera) was isolated from the mesenteric lymph node of a freshly dead rabbit carcass. The entire structural gene for this SLT-IIera was cloned from chromosomal DNA by PCR using primers based on previously published slt-IIe sequences. Nucleotide sequence analysis indicated that the slt-IIera gene was very similar to slt-IIe (formerly called slt-IIv) from E. coli strains S1191 and 412; five and one nucleotide changes were detected in A and B subunits, respectively, which resulted in changes in amino acid sequences of the corresponding subunits by three and one residues. Recombinant SLT-IIera and SLT-IIe produced using an E. coli host-vector system showed similar cytotoxicity, suggesting that the variations in the structural gene of SLT-IIera have no significant effect on cytotoxic level.
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Affiliation(s)
- S H Kim
- College of Veterinary Medicine, Gyeongsang National University, Chin-Ju, South Korea
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Abstract
Sagittal split ramus osteotomy (SSRO) is one of the surgical techniques used to correct mandibular deformities. In order to prevent many surgical anatomical problems, we observed the anatomical structures related to SSRO. In dry mandibles of Koreans, lingular tips were located somewhat posteriorly and superiorly on the mandibular ramus. On the coronal sections of mandible, the mean cortical width of facial cortex was increased toward the ramus region while the lingual cortex was thinnest in the ramus region. On the same sections, all the fusion points of the buccal and lingual cortical plate were located above the mandibular lingula and beneath the mandibular notch. So, performing the SSRO on Koreans, medial horizontal osteotomy should be done through the superior aspect of the mandibular lingula. The cut line is extended 5-8 mm posterior to the mandibular lingula to preserve sufficient cortical width to strengthen the involved osseous segments and reduce possible surgical complications.
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Affiliation(s)
- H J Kim
- Department of Oral Biology, College of Dentistry, Yonsei University, Seodaemoon-Ku, Seoul, Korea
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Cha SH, Kim SH, Lee ES, Park CM, Cha IH, Kim JH, Chung KB, Suh WH. Saline-filled appendiceal ultrasonography in clinically equivocal acute appendicitis. Abdom Imaging 1996; 21:525-9. [PMID: 8875877 DOI: 10.1007/s002619900119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND To establish the value of saline-filled appendiceal ultrasonography in the the diagnosis of clinically equivocal acute appendicitis. METHODS Saline-filled ultrasonography was performed in 43 patients with an equivocal clinical diagnosis of acute appendicitis. RESULTS Sonography diagnosed 31 of 32 patients without acute appendicitis (97%). A normal appendix was visualized in 15 patients (47%), and we identified a normal appendix in 15 of 22 patients (68%) in whom the colon was cleansed with Golytely(R). Sonography diagnosed 10 of 11 patients with acute appendicitis (91%). In three of 10 patients, the findings corresponded to sonographic pitfalls. CONCLUSION Saline-filled appendiceal ultrasonography enables the detection of a normal appendix and may overcome sonographic pitfalls in acute appendicitis.
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Affiliation(s)
- S H Cha
- Department of Radiology, An San Hospital, Korea University College of Medicine, #516 Ko Jan Dong, An San City, Kyung Ki Do 425-020, Korea
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Abstract
An elongated solid lesion observed on ultrasonography and CT in the biliary tree causing a smooth filling defect on cholangiography was observed in 2 patients. No tumor was observed in the liver parenchyma either on radiography or at operation. Histopathology showed hepatocellular carcinoma. After removal of the intraductal tumors, recurrence was observed in 2 and 6 months, respectively.
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Affiliation(s)
- C M Park
- Department of Radiology, Korea University Guro Hospital, Seoul
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Cha IH, Ritzl F. [Functional scintigraphy of salivary glands of the head during telecobalt radiotherapy]. Strahlentherapie 1983; 159:690-694. [PMID: 6658857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
In order to find out radiogenic lesions to the large salivary glands of the head, the function of parotid and submandibular glands was examined by scintigraphy with 99m-Tc Pertechnetate before, during, and five to eight months after a telecobalt therapy for malignomas of the neck. It was shown that the parotid glands did not function at all immediately after an irradiation with 60 Gy. Five to eight months later, a recovery of about 50% of the secretory function was registered. The function of the submandibular glands was reduced to about 60% of their normal secretion after 30 and 60 Gy. This corresponds to the modification of xerostomia reported by the patients some time after an irradiation of the salivary glands.
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