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Sarthak Tandon,Munish Gairola,Parveen Ahlawat,Kanika Sharma,Soumitra Barik,Nishtha Sachdeva,Sunil Pasricha,Apeksha Shenoy 대한방사선종양학회 2018 Radiation Oncology Journal Vol.36 No.4
Surgical excision along with use of postoperative radiotherapy forms an integral management of sinonasal teratocarcinosarcoma (SNTCS). However, given the rarity of the tumor, no standardised guidelines, dose, technique and target delineation exist especially in the era of modern radiation delivery techniques. This is a case of 55-year-old male diagnosed as SNTCS treated with radical ethmoidectomy followed by volumetric modulated radiotherapy, showing good local control and acceptable toxicity profile.
Tantry Thrivikrama P,BG Muralishankar,Karanth Harish,Shetty Pramal K,Shenoy Sunil P,Kadam Dinesh,Tantry Gururraj,Shetty Rithesh 대한마취통증의학회 2021 Korean Journal of Anesthesiology Vol.74 No.5
Background: Prophylaxis for cerebral desaturation events (CDEs) during anesthesia in the beach chair position (BCP) for shoulder surgeries has not been evaluated. We systematically analyzed the effectiveness of various prophylactic measures used in this clinical setting. Methods: We performed a meta-analysis (PROSPERO; no. CRD42020167285) of trials reporting CDEs and regional cerebral oxygen saturation (rSO2) and jugular venous oxygen saturation (SjvO2) values in anesthetized patients undergoing shoulder surgery in BCP. Considering the type of prophylactic measures used (pharmacological or non-pharmacological), a subgroup analysis was planned. Outcomes included (1) rSO2 and SjvO2 data with and without prophylactic measures for CDEs, recorded for different time intervals, and (2) the number of patients experiencing CDEs and hypotension. Results: Twelve studies (786 patients) were included in the analysis. We observed lower absolute rSO2 values for early and all-time periods for vasoactive agent prophylaxis. The lowest achieved rSO2 values were also lower for vasoactive agent prophylaxis. Risk of CDEs was higher with vasoactive agent prophylaxis. Subgroup analysis identified targeted mild hypercarbia as effective in preserving cerebral oxygenation. Similarly, targeted mild hypercarbia prevented the fall in rSO2 with position change. Meta-regressions revealed statistically significant highest estimates for vasoactive agent prophylaxis in contrast to targeted mild hypercarbia. Likelihood of not developing CDEs was higher for targeted mild hypercarbia. In contrast to rSO2, most prophylactic methods reduced hypotensive episodes. Conclusions: Targeted mild hypercarbia can reduce BCP-related CDEs. Evidence does not favor prophylactic use of vasoactive agents for the prevention of cerebral desaturations irrespective of whether their use interferes with cerebral oximetry readings.
Tandon, Sarthak,Gairola, Munish,Ahlawat, Parveen,Sharma, Kanika,Barik, Soumitra,Sachdeva, Nishtha,Pasricha, Sunil,Shenoy, Apeksha The Korean Society for Radiation Oncology 2018 Radiation Oncology Journal Vol.36 No.4
Surgical excision along with use of postoperative radiotherapy forms an integral management of sinonasal teratocarcinosarcoma (SNTCS). However, given the rarity of the tumor, no standardised guidelines, dose, technique and target delineation exist especially in the era of modern radiation delivery techniques. This is a case of 55-year-old male diagnosed as SNTCS treated with radical ethmoidectomy followed by volumetric modulated radiotherapy, showing good local control and acceptable toxicity profile.