- 作者列表："Kwon SH","Shin JW","Na JI","Park KC","Huh CH
:Background: Several local flaps have been introduced for the reconstruction of small-to-medium-sized nasal supratip defects.Objective: To evaluate the outcome of reconstructing supratip defects using tangential advancement flaps from the vertical alar groove tissue.Methods and materials: Medical records of 20 patients who underwent supratip reconstruction using this flap between January 2012 and July 2018 were retrospectively analyzed. The postoperative photographs were assessed by three dermatologists using a four-scale investigator's global assessment.Results: The male-to-female ratio was 9:11, with a mean age of 72.6 years (range, 56-89 years). In all 20 cases, defects were caused by a wide local excision of non-melanoma skin cancer on the nose. The mean diameter of the defects was 1.20 cm (ranging from 0.5 to 1.9 cm). The mean follow-up period was 14.0 months (ranging from 0.5 to 48 months). Excellent or good surgical outcome was reported in 95% of patients.Conclusions: Creating a tangential advancement flap using the vertical alar groove tissue is a simple, single-stage procedure with excellent surgical outcome. It may be useful in the reconstruction of supratip defects with a diameter of less than 2 cm.
背景: 已经引入了几种局部皮瓣用于小到中等大小的鼻上缺损的重建。目的: 评价应用垂直鼻翼沟组织切向推进皮瓣修复上皮瓣缺损的效果。方法和材料: 回顾性分析 2012 年 1 月至 2018 年 7 月使用该皮瓣进行supratip重建的 20 例患者的病历资料。术后照片由三名皮肤科医生使用四尺度研究者的整体评估进行评估。结果: 男女比例为 9:11，平均年龄 72.6 岁 (范围 56-89 岁)。在所有 20 例病例中，缺损是由鼻局部广泛切除非黑色素瘤皮肤癌引起的。缺损的平均直径为 1.20 cm (范围为 0.5 ~ 1.9 cm)。平均随访 14.0 个月 (0.5 ~ 48 个月)。95% 的患者报告了极好或良好的手术结果。结论: 使用垂直鼻翼沟组织创建切线推进皮瓣是一种简单、单阶段的手术，手术效果极好。它可能有助于直径小于 2 cm的supratip缺损的重建。
METHODS:OBJECTIVE:Large inoperable sacral chordomas show unsatisfactory local control rates even when treated with high dose proton therapy (PT). The aim of this study is assessing feasibility and reporting early results of patients treated with PT and concomitant hyperthermia (HT). METHODS: :Patients had histologically proven unresectable sacral chordomas and received 70 Gy (relative biological effectiveness) in 2.5 Gy fractions with concomitant weekly HT. Toxicity was assessed according to CTCAE_v4. A volumetric tumor response analysis was performed. RESULTS: :Five patients were treated with the combined approach. Median baseline tumor volume was 735 cc (range, 369-1142). All patients completed PT and received a median of 5 HT sessions (range, 2-6). Median follow-up was 18 months (range, 9-26). The volumetric analysis showed an objective response of all tumors (median shrinkage 46%; range, 9-72). All patients experienced acute Grade 2-3 local pain. One patient presented with a late Grade 3 iliac fracture. CONCLUSION:Combining PT and HT in large inoperable sacral chordomas is feasible and causes acceptable toxicity. Volumetric analysis shows promising early results, warranting confirmation in the framework of a prospective trial. ADVANCES IN KNOWLEDGE: :This is an encouraging first report of the feasibility and early results of concomitant HT and PT in treating inoperable sacral chordoma.
METHODS:BACKGROUND:National guidelines recommend screening and treatment for cancer-related bone disease and continued monitoring of bone-modifying agents. It is unclear whether a standardized screening tool is utilized to identify eligible patients and ensure appropriate supportive care is implemented. The purpose of this study was to evaluate current prescribing practices and optimize management of bone-modifying agents. METHODS:A retrospective chart review was performed to identify patients who received hormone deprivation therapy or had bone metastases through Hematology/Oncology or Urology clinics from 1 November 2016 to 31 October 2017. The primary endpoints of this study were the incidence of completed baseline dual-energy X-ray absorptiometry (DEXA) scan for patients on hormone deprivation therapy and percent of patients started on a bone-modifying agent for the prevention of skeletal-related events secondary to bone metastasis. Secondary endpoints included percent of patients with dental examinations prior to initiation, adequate calcium and vitamin D supplementation, incidence of osteonecrosis of the jaw or flu-like symptoms and education, and percent of bisphosphonate doses appropriately adjusted based on renal function. RESULTS:A total of 375 patients were assessed for baseline DEXA scans and bone-modifying therapy. Of the 226 patients on hormone deprivation therapy, 111 (49%) patients were appropriately screened with a DEXA scan prior to initiation of hormone deprivation therapy. Among the 149 patients with bone metastases, only 94 (63.1%) patients were started on a bone-modifying agent. CONCLUSIONS:Opportunities have been identified to optimize management of patients with cancer-related bone disease. Implementation of standardized tools may increase the rate of appropriate screening and initiation of bone-modifying therapy when warranted.
METHODS:PURPOSE:Low skeletal muscle mass has been associated with poor prognosis in patients with advanced lung cancer. However, little is known about the relationship between skeletal muscle mass and overall survival in patients with bone metastases from lung cancer. The objective of the present study was to evaluate the prognostic value of low trunk muscle mass in predicting overall survival in these patients. METHODS:The data from 198 patients who were diagnosed with bone metastases from lung cancer from April 2009 to May 2017 were retrospectively reviewed. The areas of the psoas and paravertebral muscles were measured at the level of the third lumbar vertebra on computed tomography scans taken at the time nearest to the diagnosis of bone metastasis. Muscle area was evaluated for male and female cohorts separately using different cutoff points. Cox proportional hazards analysis was performed to evaluate the factors independently associated with overall survival. RESULTS:The overall survival of patients in the lowest quartile for psoas muscle area or paravertebral muscle area was significantly shorter than that of patients above the 25th percentile for muscle area (p < 0.001). Multivariate analyses showed that paravertebral muscle mass (hazard ratio, 1.73; 95% confidence interval, 1.17-2.56; p = 0.006), epidermal growth factor receptor-targeted therapy, and performance status were independent prognostic factors. CONCLUSIONS:Low paravertebral muscle mass was associated with shorter survival, independently of known prognostic factors.