- [Value of supraclavicular region radiotherapy on patients with pT1-2N1M0 breast cancer after mastectomy]. [Journal Article]
- ZNZhong Nan Da Xue Xue Bao Yi Xue Ban 2019 Jun 28; 44(6):664-671
- To evaluate the potential clinical benefit on radiotherapy to supraclavicular region on patients pT1-2N1M0 breast cancer with after mastectomy. Methods: A total of 923 patients with pT1-2N1M0 treated…
To evaluate the potential clinical benefit on radiotherapy to supraclavicular region on patients pT1-2N1M0 breast cancer with after mastectomy. Methods: A total of 923 patients with pT1-2N1M0 treated by radiotherapy (RT) to chest wall plus supraclavicular region (supraclavicular RT group, SCRT) or RT to chest wall only (non-supraclavicular RT, NSCRT) were retrospectively analyzed. Supraclavicular fossae recurrence (SCFR) rate and overall survival (OS) rate were analyzed by Kaplan-Meier method. The risk factors for SCFR were evaluated by univariate and multivariate analysis. Results: In the following-up period (medium time: 108 months; range from 6 to 179 months), the 5-year and 10-year SCFR in the NSCRT group and the SCRT group were 3.5% and 1.5% (P=0.052), 7% and 2.6% (P=0.001), and the 5-year and 10-year OS were 81.5% and 87.3% (P=0.023), 67.9% and 78.4% (P=0.001), respectively. Univariate analysis showed that risk factors associated with SCFR were age <35 years (P=0.016), T2 stage (P=0.018), 3 axillary lymph nodes (P=0.006), progesterone receptor negative (P=0.038), and human epidermal growth factor receptor-2 positive (P=0.01). Multivariate analysis further demonstrated that T2 stage and age<35, with 3 positive axillary lymph nodes were SCFR-independent prognostic factors. Analysis was conducted by grouping patients with any two of the three items as a high-risk group and patients without or with only one of the three conditions as a low-risk group. RT in the supraclavicular region significantly reduced the 10-year SCFR in the high-risk group (NSCRT, 30.2%; SCRT, 4.5%, P<0.001). However, this benefit was not obvious in the low-risk group (NSCRT, 4%; SCRT, 1.8%, P=0.063). Conclusion: RT in supraclavicular region should be recommended to pT1-2N1M0 breast cancer patients with two of the three items (<35 years, T2 stage diseases, and 3 axillary lymph node metastasis). High-risk patients need SCRT; whereas the low-risk patients do not need.
- The Frontoparietal Fossa and Dorsotemporal Fenestra of Archosaurs and Their Significance for Interpretations of Vascular and Muscular Anatomy in Dinosaurs. [Journal Article]
- ARAnat Rec (Hoboken) 2019 Jul 01
- The attachments of jaw muscles are typically implicated in the evolution and shape of the dorsotemporal fenestra on the skull roof of amniotes. However, the dorsotemporal fenestrae of many archosauri…
The attachments of jaw muscles are typically implicated in the evolution and shape of the dorsotemporal fenestra on the skull roof of amniotes. However, the dorsotemporal fenestrae of many archosaurian reptiles possess smooth excavations rostral and dorsal to the dorsotemporal fossa which closely neighbors the dorsotemporal fenestra and jaw muscle attachments. Previous research has typically identified this region, here termed the frontoparietal fossa, to also have attachment surfaces for jaw-closing muscles. However, numerous observations of extant and extinct archosaurs described here suggest that other tissues are instead responsible for the size and shape of the frontoparietal fossa. This study reviewed the anatomical evidence that support soft-tissue hypotheses of the frontoparietal fossa and its phylogenetic distribution among sauropsids. Soft-tissue hypotheses (i.e., muscle, pneumatic sinus, vascular tissues) were analyzed using anatomical, imaging and in vivo thermography techniques within a phylogenetic framework using extant and extinct taxa to determine the inferential power underlying the reconstruction of the soft tissues in the skull roofs of dinosaurs, pseudosuchians, and other reptiles. Relevant anatomical features argue for rejection of the default hypothesis-that the fossa was muscular-due to a complete lack of osteological correlates reflective of muscle attachment. The most-supported inference of soft tissues is that the frontoparietal fossa contained a large vascular structure and adipose tissue. Despite the large sizes and diverse morphologies of these fossae found among dinosaur taxa, these data suggest that non-avian dinosaurs had the anatomical foundation to support physiologically significant vascular devices and/or vascular integumentary structures on their skull roofs. Anat Rec, 2019. © 2019 Wiley Periodicals, Inc.
- Bone Surface Micro-Topography at Craniofacial Entheses: Insights on Osteogenic Adaptation at Muscle Insertions. [Journal Article]
- ARAnat Rec (Hoboken) 2019 Jun 28
- Macroscopic details of the bone-muscle interface are represented by a mosaic of calcified features inclusive of fossae, tuberosities, crests, and ridges. These features are in part of an adaptive ost…
Macroscopic details of the bone-muscle interface are represented by a mosaic of calcified features inclusive of fossae, tuberosities, crests, and ridges. These features are in part of an adaptive osteogenic response to dissipate forces of localized mechanical loading. In an osteoarchaeological or paleontological context, these features are interpreted as "musculoskeletal stress markers" to infer habitual behaviors. Microscopic surveys of bone surface topography of the enthesis can reveal localized osteogenic topologies. These features illustrate the developmental mechanisms that produce these bony forms and contribute to an evidential basis to read these structures. Microscopic osteogenic topographies at sites of gnathic muscle attachments located in the craniofacial skeleton were explored in reference to extrapolated loading vectors in an ontogenetic series of craniofacial skeletons of the primate (Procolobus verus). Epoxy resin replicas of bone surfaces were made, and micro-topographical detail viewed with Scanning Electron Microscope. Osteoclastic bone remodeling was found at entheses associated with presumptive net tensile loading. Mineralized fibrocartilage was present at entheses, associated with presumptive net compressive loading. Collectively, these outcomes suggest that entheses develop through adaptive osteogenic activity in response to differential vectors of local mechanical loading. However, the presence of mineralized fibrocartilage also suggests that proliferative cartilage has a role in the development of bone eminences providing functional processes. This study concludes that the vector of muscle loading at entheses as well as proliferative fibrocartilage is influencing the form of bony eminences in the primate craniofacial skeleton defining functional and species defining morphologies. Anat Rec, 2019. © 2019 Wiley Periodicals, Inc.
- Endoscopic transorbital and endonasal approach for trigeminal schwannomas: a retrospective multicenter analysis (KOSEN-005). [Journal Article]
- JNJ Neurosurg 2019 Jun 21; :1-10
- CONCLUSIONS: ETOA provides adequate access and resectability for trigeminal schwannomas limited in the middle fossa or dumbbell-shaped tumors located in the middle and posterior fossae, as does EEA for extracranial tumors. Tumors predominantly involving the posterior fossa still remain a challenge in endoscopic surgery.
- An unusual case of complicated rhinosinusitis of the sphenoid sinus involving the cavernous sinus and skull base: Endoscopic sinus surgery and medical therapy. [Case Reports]
- SOSAGE Open Med Case Rep 2019; 7:2050313X19852885
- Isolated sphenoid sinus diseases are generally asymptomatic and relatively uncommon with the potential for serious complications. Patients with this condition should be monitored closely and treated …
Isolated sphenoid sinus diseases are generally asymptomatic and relatively uncommon with the potential for serious complications. Patients with this condition should be monitored closely and treated aggressively and either diagnostic or therapeutic intent is often indicated. In the management of a complex, life-threatening condition that involves many different fields of expertise, the otolaryngologist plays a key role in orchestrating different specialists and gaining direct access to the affected area, thus taking the first and essential step towards diagnosis and therapy. Because of the superiority of computed tomography in defining the bony margins and the superior soft tissue resolution of magnetic resonance imaging, these two techniques should be used in a complementary manner in the evaluation of isolated sphenoid sinus disease in addition to mapping the lesion better and identifying intracranial and intraorbital extent. We report an unusual case of isolated rhinosinusitis of the sphenoid sinus involving the cavernous sinus, pterygoid fossae and masticatory space in an immunocompetent patient.
- Acquisition of Volumetric Models of Skull Base Anatomy Using Endoscopic Endonasal Approaches: 3D Scanning of Deep Corridors Via Photogrammetry. [Journal Article]
- WNWorld Neurosurg 2019 Jun 07
- CONCLUSIONS: Endoscopic VM's represent a new way to depict the anatomy of the skull base; their use with 3D technologies could potentially improve the visuospatial understanding of narrow surgical corridors for education and surgical planning purposes.
- Pure Endoscopic Lateral Orbitotomy Approach to the Cavernous Sinus, Posterior, and Infratemporal Fossae: Anatomic Study. [Journal Article]
- JNJ Neurol Surg B Skull Base 2019; 80(3):295-305
- Objective The aim of this anatomic study is to describe a fully endoscopic lateral orbitotomy extradural approach to the cavernous sinus, posterior, and infratemporal fossae. Material and Methods Thr…
Objective The aim of this anatomic study is to describe a fully endoscopic lateral orbitotomy extradural approach to the cavernous sinus, posterior, and infratemporal fossae. Material and Methods Three prefixed latex-injected head specimens (six orbital exposures) were used in the study. Before and after dissection, a computed tomography scan was performed on each cadaver head and a neuronavigation system was used to guide the approach. The extent of bone removal and the area of exposure of the targeted corridor were evaluated with the aid of OsiriX software (Pixmeo, Bernex, Switzerland). Results The lateral orbital approach offers four main endoscopic extradural routes: the anteromedial, posteromedial, posterior, and inferior. The anteromedial route allows a direct route to the optic canal by removal of the anterior clinoid process, whereas the posteromedial route allows for exposure of the lateral wall of the cavernous sinus. The posterior route is targeted to Meckel's cave and provides access to the posterior cranial fossa by exposure and drilling of the petrous apex, whereas the inferior route gives access to the pterygopalatine and infratemporal fossae by drilling the floor of the middle cranial fossa and the bone between the second and third branches of the trigeminal nerve. Conclusion The lateral orbitotomy endoscopic approach provides direct access to the cavernous sinus, posterior, and infratemporal fossae. Advantages of the approach include a favorable angle of attack, minimal brain retraction, and the possibility of dissection within the two dural layers of the cavernous sinus without entering its neurovascular compartment.
- A Rare Case of Posterior Horseshoe Abscess Extending to Anterolateral Extraperitoneal Compartment: Anatomical and Technical Considerations. [Journal Article]
- ACAnn Coloproctol 2019 May 31
- Perianal abscess and fistula are 2 distinct entities that share a common pathology. A horseshoe fistulous abscess, a complex type of these conditions, occurs when the suppurative inflammation spreads…
Perianal abscess and fistula are 2 distinct entities that share a common pathology. A horseshoe fistulous abscess, a complex type of these conditions, occurs when the suppurative inflammation spreads through the deep anal space to the bilateral ischiorectal fossae. Following the intersphincteric plane, this infection may extend to the pararectal space, forming a supralevator abscess. We present a very rare case involving a 52-year-old male patient who was admitted to our surgical department with an extraperitoneal purulent inflammation as a complication following multiple drainage procedures for a posterior horseshoe abscess. Emphasis is given to the anatomical and technical considerations of eradication of anorectal sepsis and the management of complex fistula-in-ano along with a concise review of the literature.
- Oxytetracycline concentrations in interstitial fluid from tissue chambers inoculated with Corynebacterium pseudotuberculosis after intramuscular or intrachamber administration in sheep. [Journal Article]
- AJAm J Vet Res 2019; 80(6):586-594
- CONCLUSIONS: Intralesional administration of oxytetracycline may eliminate growth of CPT locally, but complete elimination of the organism remains difficult.
New Search Next
- Gianotti-Crosti syndrome (papular acrodermatitis of childhood) in the era of a viral recrudescence and vaccine opposition. [Review]
- WJWorld J Pediatr 2019 May 27
- CONCLUSIONS: Gianotti-Crosti syndrome is mainly a disease of early childhood, characterized by an acute onset of a papular or papulovesicular eruption with a symmetrical distribution. With the advent of more universal vaccination against hepatitis B virus, Epstein-Barr virus has become the most common etiologic agent of Gianotti-Crosti syndrome. Few cases of post-vaccination Gianotti-Crosti syndrome have been reported. Currently, the emphasis should be placed on its self-limiting attribution.