Photodynamic treatment as a promising strategy applied in lichenoid tissue reaction/interface dermatitis with moderate-to-severe dysplasia: A case report.

Lichenoid tissue reaction/interface dermatitis represents a class of mucocutaneous inflammatory diseases which share common histopathological manifestations. One patient presented to our clinic whose oral lesions could not categorized into a definitely clinical or pathological diagnosis, but could be ascribed to lichenoid tissue reaction/interface dermatitis with moderate-to-severe dysplasia. Photodynamic treatment was applied in this case and a satisfactory result was eventually achieved. Signs of recurrence were not revealed at the follow-up of the tenth month.

Resultados de la conización por radiocirugía en pacientesatendidas en consulta de patología de cuello uterino / Results of Conization by Radiosurgery in patients treated in a Cervical Pathology Clinic

Introducción: La radiocirugía tiene como objetivo proporcionar una herramienta de diagnóstico y tratamiento. Objetivos: Describir los resultados de la conización por radiocirugía en pacientes atendidas en la consulta de patología de cuello uterino de la institución. Métodos: Se realizó una investigación descriptiva de corte transversal en el Hospital General Docente Mártires del 9 de Abril de Sagua la Grande, Villa Clara, Cuba. La población de estudio estuvo conformada por la totalidad de 256 pacientes atendidas en la consulta de patología de cuello uterino que fueron sometidas a conización por radiocirugía, entre enero 2013 y diciembre 2015. Para la recogida de la información se empleó la revisión de documentos y se confeccionó un modelo de recogida de datos. Resultados: El diagnóstico preoperatorio que aportó mayor cantidad de casos fue el NIC III (displasia severa) (78 casos; 30,5 por ciento). Conclusiones: Las lesiones premalignas en el presente estudio comenzaron a aparecer con marcada incidencia a partir de los 20 años y hasta los 49, sobresaliendo el grupo de 30 - 39 años. El aumento en el número de parejas sexuales, así como el comienzo temprano de las relaciones sexuales incrementan el riesgo de padecer lesiones intraepiteliales en el cuello del útero. A partir de los cinco años de iniciada las relaciones sexuales comienzan a aparecer las lesiones intraepiteliales cervicales, el diagnóstico preoperatorio que aportó mayor cantidad de casos fue el NIC III (displasia severa). En los diagnósticos histológicos por sacabocado y cono existió correspondencia en todos los casos(AU)

Introduction: Radiosurgery aims to provide a diagnostic and treatment tool. Objectives: To describe the results of conization by radiosurgery in patients treated in the cervical pathology clinic of the institution. Methods: A descriptive cross-sectional investigation was carried out at Mártires del 9 de abril General Teaching Hospital, in Sagua la Grande, Villa Clara, Cuba. The study population consisted of 256 patients attended in the cervical pathology clinic who underwent conization by radiosurgery, from January 2013 to December 2015. For the collection of the information, the document review was used and a data collection form was made. Results: The preoperative diagnosis that contributed the greatest number of cases was IAS III (severe dysplasia) (78 cases; 30.5 percent). Conclusions: The premalignant lesions in the present study began to appear with a marked incidence from the age of 20 and up to 49, with the group of 30-39 years standing out. The increase in the number of sexual partners, as well as the early sexual intercourse increase the risk of suffering intraepithelial lesions in the cervix. After five years of beginning sexual intercourse, cervical intraepithelial lesions begin to appear, the preoperative diagnosis that contributed the greatest number of cases was IAS III (severe dysplasia). In histological diagnoses by punch and cone correspondence existed in all cases(AU)

Impact of dysplastic surgical margins for patients with oral squamous cell carcinoma.

OBJECTIVES: Dysplastic changes at the surgical margin of oral squamous cell carcinoma (OSCC) could be encountered frequently. However, the impact of a dysplastic surgical margin on patients with OSCC remains unclear. MATERIALS AND METHODS: Retrospectively, we reviewed patients with OSCC who were diagnosed and treated at the National Taiwan University Hospital between January 2010 and December 2015. Patients were divided into four groups: clear (≥5 mm), close (<5 mm), positive, and dysplastic margins. RESULTS: Of 1642 patients, 596 had clear margin, 169 had positive margin, 707 had close margin, and 170 had dysplastic margin. The mean age at diagnosis was 55 ±â€¯11 years (range, 16-97 years). Dysplastic margins were frequently present in patients with primary T1/T2 OSCC (odds ratio [OR] = 1.7, p = 0.009), tumor without perineural invasion (OR = 1.48, p = 0.04), and tumor thickness ≤10 mm (OR = 1.94, p = 0.001). In patients with clear, close, positive, and dysplastic margins, the 5-year disease-free survival rates were 63.1%, 51%, 37.2%, and 54.7%, respectively; overall survival (OS) rates were 71.1%, 61.9%, 49%, and 72%, respectively. Disease-free and overall survival were not significantly different in patients with dysplastic and clear margins (p = 0.37 and p = 0.38, respectively). Adjuvant radiotherapy had no significant benefit for patients with dysplastic margins. Finally, a multivariate analysis showed that the presence of a dysplastic margin was not an independent risk factor for disease-free (p = 0.43) and overall survival (p = 0.71). CONCLUSIONS: The survival rates of the patients with OSCC who had dysplastic margin were significantly better than those with positive margin.

Does Severity of Acetabular Dysplasia Influence Clinical Outcomes After Periacetabular Osteotomy?-A Case-Control Study.

BACKGROUND: Detailed characterization of factors influencing post-periacetabular osteotomy (PAO) outcome could guide treatment offered. METHODS: Using a prospective, multicenter database of PAOs, 61 hips/patients (51 females) with lesser dysplasia (acetabular index < 15° and lateral center-edge angle > 15°) were case-control matched for age, gender, body mass index, Tönnis grade, and joint congruency (P = .6-.9) with a "comparison group" of pronounced dysplasia (n = 183), aiming to assess whether severity of acetabular dysplasia has an effect on outcome following PAO and/or the ability to achieve desired acetabular correction. RESULTS: At 4 ± 1.5 years, no differences in complication or reoperation rates were detected between the groups (P = .29). Lesser dysplastic hips had inferior Hip Disability and Osteoarthritis Outcome Score, both preoperatively (52 vs 59) and postoperatively (73 vs 78); however, similar improvements were seen. Among the lesser dysplastic hips, those that required a femoral osteochondroplasty at PAO had significantly inferior preoperative Hip Disability and Osteoarthritis Outcome Score (48 ± 18). Increased ability to achieve optimum correction was seen (80% vs 59%, P = .4) in lesser dysplasia. CONCLUSION: A PAO is safe and efficacious in the treatment of lesser dysplasia. Further study on the identification of the optimum treatment modality for the mildly dysplastic hips with cam deformity is required.

Resultados de la conización por radiocirugía en pacientes atendidas en consulta de patología de cuello uterino / Results of conization by radiosurgery in cervical pathology patients

Introducción: la radiocirugía tiene como objetivo proporcionar una herramienta de diagnóstico y tratamiento. Objetivos: describir los resultados de la conización por radiocirugía en pacientes atendidas en la consulta de patología de cuello uterino. Método: se realizó una investigación descriptiva de corte transversal en el Hospital General Docente Mártires del 9 de abril, de Sagua la Grande, Villa Clara, Cuba. La población de estudio estuvo conformada por 256 pacientes atendidas en la consulta de patología de cuello uterino que fueron sometidas a conización por radiocirugía, desde enero de 2013 a diciembre de 2015. Para la recogida de la información se empleó la revisión de documentos mediante la confección de un modelo de recogida de datos. Resultados: el diagnóstico preoperatorio que aportó mayor cantidad de casos fue el NIC III (displasia severa) con 78 casos (30,5 por ciento). Conclusiones: en el presente estudio las lesiones premalignas comenzaron a aparecer con notada incidencia desde los 20 años y hasta los 49, con marcada ocurrencia en el grupo de 30 a 39 años. El aumento en el número de parejas, así como el comienzo temprano de las relaciones sexuales incrementan el riesgo de padecer lesiones intraepiteliales en el cuello del útero. A partir de los cinco años de iniciada las relaciones sexuales, comienzan a aparecer las lesiones intraepiteliales cervicales, el diagnóstico preoperatorio que aportó mayor cantidad de casos fue el NIC III (displasia severa). Existió correspondencia en todos los casos en los diagnósticos histológicos por sacabocado y cono(AU)

Introduction: radiosurgery aims to provide a diagnostic and treatment tool. Objectives: describe the results of radiosurgery conization in patients treated at the cervical pathology clinic. Method: adescriptive cross-sectional study was carried out at Mártires del 9 de Abril General Teaching Hospital, Sagua la Grande, Villa Clara, Cuba. The study population consisted of 256 patients treated at the cervical pathology clinic, who were submitted to radiosurgery conization, from January 2013 to December 2015. For the collection of the information, a review of documents was done by making a data collection model. Results: CIN III (severe dysplasia was) the preoperative diagnosis that contributed the most cases ( 78 cases (30.5 percent)). Conclusions: in the present study, premalignant lesions began to appear with a marked incidence from the age of 20 to 49, with a distinct occurrence in the group aged 30 to 39 years. The increase number of couples as well as the early beginning of sexual intercourse increase the risk of intraepithelial lesions in the cervix. After five years of sexual intercourse, cervical intraepithelial lesions began to appear, the preoperative diagnosis with the highest number of cases was CIN III (severe dysplasia). There was correspondence in all cases in the histological diagnoses by punch and cone(AU)

Resultados de la conización por radiocirugía en pacientes atendidas en consulta de patología de cuello uterino / Results of conization by radiosurgery in cervical pathology patients

Introducción: la radiocirugía tiene como objetivo proporcionar una herramienta de diagnóstico y tratamiento. Objetivos: describir los resultados de la conización por radiocirugía en pacientes atendidas en la consulta de patología de cuello uterino. Método: se realizó una investigación descriptiva de corte transversal en el Hospital General Docente Mártires del 9 de abril, de Sagua la Grande, Villa Clara, Cuba. La población de estudio estuvo conformada por 256 pacientes atendidas en la consulta de patología de cuello uterino que fueron sometidas a conización por radiocirugía, desde enero de 2013 a diciembre de 2015. Para la recogida de la información se empleó la revisión de documentos mediante la confección de un modelo de recogida de datos. Resultados: el diagnóstico preoperatorio que aportó mayor cantidad de casos fue el NIC III (displasia severa) con 78 casos (30,5 por ciento). Conclusiones: en el presente estudio las lesiones premalignas comenzaron a aparecer con notada incidencia desde los 20 años y hasta los 49, con marcada ocurrencia en el grupo de 30 a 39 años. El aumento en el número de parejas, así como el comienzo temprano de las relaciones sexuales incrementan el riesgo de padecer lesiones intraepiteliales en el cuello del útero. A partir de los cinco años de iniciada las relaciones sexuales, comienzan a aparecer las lesiones intraepiteliales cervicales, el diagnóstico preoperatorio que aportó mayor cantidad de casos fue el NIC III (displasia severa). Existió correspondencia en todos los casos en los diagnósticos histológicos por sacabocado y cono(AU)

Introduction: radiosurgery aims to provide a diagnostic and treatment tool. Objectives: describe the results of radiosurgery conization in patients treated at the cervical pathology clinic. Method: adescriptive cross-sectional study was carried out at Mártires del 9 de Abril General Teaching Hospital, Sagua la Grande, Villa Clara, Cuba. The study population consisted of 256 patients treated at the cervical pathology clinic, who were submitted to radiosurgery conization, from January 2013 to December 2015. For the collection of the information, a review of documents was done by making a data collection model. Results: CIN III (severe dysplasia was) the preoperative diagnosis that contributed the most cases ( 78 cases (30.5 percent)). Conclusions: in the present study, premalignant lesions began to appear with a marked incidence from the age of 20 to 49, with a distinct occurrence in the group aged 30 to 39 years. The increase number of couples as well as the early beginning of sexual intercourse increase the risk of intraepithelial lesions in the cervix. After five years of sexual intercourse, cervical intraepithelial lesions began to appear, the preoperative diagnosis with the highest number of cases was CIN III (severe dysplasia). There was correspondence in all cases in the histological diagnoses by punch and cone(AU)

Toxicities and early outcomes in a phase 1 trial of photodynamic therapy for premalignant and early stage head and neck tumors.

OBJECTIVES: Management of early superficial lesions in the head and neck remains complex. We performed a phase 1 trial for high-grade premalignant and early superficial lesions of the head and neck using photodynamic therapy (PDT) with Levulan (ALA). MATERIALS AND METHODS: Thirty-five subjects with high grade dysplasia, carcinoma in situ, or microinvasive (⩽1.5mm depth) squamous cell carcinoma were enrolled. Cohorts of 3-6 patients were given escalating intraoperative light doses of 50-200J/cm(2) 4-6h after oral administration of 60mg/kg ALA. Light at 629-635nm was delivered in a continuous (unfractionated) or fractionated (two-part) schema. RESULTS: PDT was delivered to 30/35 subjects, with 29 evaluable. There was one death possibly due to the treatment. The regimen was otherwise tolerable, with a 52% rate of grade 3 mucositis which healed within several weeks. Other toxicities were generally grade 1 or 2, including odynophagia (one grade 4), voice alteration (one grade 3), and photosensitivity reactions. One patient developed grade 5 sepsis. With a median follow-up of 42months, 10 patients (34%) developed local recurrence; 4 of these received 50J/cm(2) and two each received 100, 150, and 200J/cm(2). Ten (34%) patients developed recurrence adjacent to the treated field. There was a 69% complete response rate at 3months. CONCLUSIONS: ALA-PDT is well tolerated. Maximum Tolerated Dose appears to be higher than the highest dose used in this study. Longer followup is required to analyze effect of light dose on local recurrence. High marginal recurrence rates suggest use of larger treatment fields.

Short Term Results of Cementless Total Hip Arthroplasty with Subtrochanteric Shortening Osteotomy in Severe Dysplasia of Hip

PURPOSE: This study examined the clinical, functional and radiological results of total hip arthroplasty with subtrochanteric shortening osteotomy in severe dysplasia of hip. MATERIALS AND METHODS: Seventeen cases of severe dysplasia of the hip, which were treated with total hip arthroplasty with subtrochanteric shortening osteotomy from August 1997 to September 2004, were evaluated. The mean follow-up duration was 52.9 months (range: 26~106). Harris hip score (HHS), leg length discrepancy (LLD) and complication were assessed clinically. Gait analysis (7 cases) and Cybex study (8 cases) for the abductor muscle power were assessed functionally. Bony union and stability around the osteotomy site of the femoral and acetabular components was assessed radiologically. RESULTS: The mean HHS improved from 65.1 (range: 23~87) points preoperatively to 88.2 (range: 72~100) points at the last follow-up. The mean LLD improved from 3.7 (range: 1~7) cm preoperatively to 1.6 (range: 0.5~3.3) cm postoperatively. All cases showed complete bony union of the allograft in the acetabulum and osteotomy site at a mean time of 6 months postoperatively. Gait analysis improved in all cases but there was some limping gait remaining. On the Cybex study, 6 out of 8 cases showed improved abductor muscle peak toque, postoperatively. CONCLUSION: A cementless total hip arthroplasty with subtrochanteric shortening osteotomy is believed to be a useful treatment for severe dysplasia of hip. Despite the improving HHS, the abductor power can be decreased. In these points, gait analysis and the Cybex study are helpful on the follow-up.