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Article
Management of Retroperitoneal Soft Tissue Sarcomas

Authors: Safa M. AL-Obaidi --- Alaa A. AL-Wadees --- Mohammed Abd-Zaid Akool
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 2 Pages: 166-174
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: Hospital , Baghdad.*Department of surgery ,Kufa Teaching Hospital , Najaf. BACKGROUND:Most retroperitoneal tumors are malignant and about one third are soft tissue sarcomas. Sarcomasare uncommon malignant tumors arising from mesenchymaltissue . Retroperitoneal sarcomasaccount for approximately 10%-15% of soft tissue sarcomas and less than 1% of all malignantneoplasms. Surgery is the only curative treatment for retroperitoneal soft tissue sarcomas. OBJECTIVE:To define the best extent of surgery that would optimize the safe margins on retroperitoneal softtissue sarcomas , where the recurrence of tumor greatly depends on feasibility of completeresection and the grade of tumor.PATIENTS AND METHODS:Between June 2007 and December 2010,28 patients (female 16,male 12, mean age; 43.93 years,range18-69 years)were evaluated for survival and response to therapy by gender, age ,preoperativesymptoms ,symptoms duration , primary or recurrent tumors , the extended of surgical resection, orpalliative procedures .Complete resection was defined as removal of gross tumor withhistologically confirmed clean resection margins. RESULTS:Eighteen patients(64%) out of 28 patients under went simple surgical resection ,5patients(28%)underwent compartmental resection (systematic resection of noninvolved contiguousorgans),1 patient (3%) underwent enucleation of tumor ,while debulking done in 4 patients (15%).The surgical resection margin was involved only in one patient (due to tumor rupture duringresection) of those patients underwent compartmental resections, it’s was free in only (10/18,56%)patients underwent simple resection ,while it was involved in all tumors removed with enucleationor debulking (incomplete resection) .The recurrence of tumor greatly depends on state of surgical margin in resected sample (pvalue=0.001,significantlyassociated).Thehistopathological grade of tumor on the other hand also proved an important factor in therecurrence of tumor where it was higher with high grade tumor versus low grade tumor (Pvalue=0.001,significantlyassociated).CONCLUSION:Complete compartmental surgery without tumor rupture should be performed when possible toachieved clear margins. Wide resection lowers the local recurrence and improves survival rate.Both the state of surgical margin and grade of tumor are the most important prognostic factorswhich determine the survival rate and recurrence tumor.


Article
The early results of surgical treatment of congenital clubfoot by a modified soft tissue release
النتائج المبكرة للعلاج الجراحي للقدم المشقوقة بواسطة تحرير الأنسجة الرخوة

Authors: Mustafa Adnan Mustsfa --- Omar Ameen Saeed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2013 Volume: 17 Issue: 3 Pages: 577-581
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Talipes Equinovarus (TEV) or Congenital Clubfoot is the most common congenital anomaly of the foot. The incidence of TEV is 1-2 per 1000 life births, about 30% of these cases is bilateral with a higher incidence in males than in females (2:1). Congenital Clubfoot is a complex deformity which has four components: Heel in equinus, hind foot in varus, mid foot in cavus, forefoot in adduction and supination. The presented study aimed to evaluate the surgical treatment outcome of congenital club foot by a modified soft tissue release (i.e. division of tendons of tibialis posterior and flexor hallucis longus).Methods: This is a prospective study done on the Result of treatment of congenital Clubfoot by soft tissue release. Numbers of patients are thirty three patients, forty eight feet, fifteen patients (45.46%) had bilateral, and eighteen patients (54.55%) had unilateral deformities. Twenty one patients (63.64) were male and twelve patients (36.37) were female, male to female ratio was 1.75:1, their ages range between 4-35 months (mean ages in months = 15.43 months). The patients whom included in this study had no previous treatment because of delay in presentation.Results: All patients were assessed clinically and radiologically. The result of our study was as follow: Excellent result for 28 feet (58.3%), Good result for 16 feet (33.3%), Poor result for 4 feet (8.3%). The over all result can be sub divided to two categories; a) satisfactory which involve both the excellent result and the good result (91.67%) and b) unsatisfactory result which involve only the poor result (8.33%).Conclusion: The study revealed that the use of this surgical method is of good result and lower rate of complication.


Article
Soft Tissue Profile Analysis for Iraqi Patients with β-Thalassemia Major

Author: Dr. Reem Ata AL-Ani , B.D.S. ,M. Sc. د. ريم عطا العاني
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2008 Volume: 5 Issue: 2 Pages: 187-193
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

The facial appearance of patients with β-thalassemia major is readily recognizable so that soft tissue profile analysis is presented in this study.The aim of the study is concerned about the analysis of soft tissue profile morphology in a group of patients having β-thalassemia major and to record the possible differences between both thalassemic genders and to investigate the differences in the soft tissue morphology between thalassemic patients and non thalassemic normal subjectsThe material of this study consisted from lateral cephalometric radiographs for (40) thalassemic patients aged 15-17 years and (40) cephalometric radiographs for non thalassemic normal subjects were obtained for analyzing soft tissue profile morphologyThe results showed that there were no significant differences between thalassemic males and females but the soft tissue profile morphology for thalassemic patients mostly different from normal subjects which characterized by convex profile.Thalassemic patients have a soft tissue profile morphology mostly different from normal's that characterized by smaller nasal dimensions, short and everted upper lip and thicker lower lip which giving them the appearance of convex profile.


Article
Soft Tissue Sarcomas: A review of 40 cases

Author: Nada S. Al-Rubai’ee
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2006 Volume: 5 Issue: 1 Pages: 87-93
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Soft tissue sarcoma (STS) represents a heterogeneous group of rare malignant tumors. Many diagnostic problems and difficulties are often encountered in the differential diagnosis of these tumors. The variety of appearance gives a wide range of tumor types and subtypes with a high discrepancy rate in tumor typing among pathologists. METHODS: This study was conducted at the Military Medical Academy (EGYPT) during the period from (1989-1990). The study aimed to reexamine a routinely processed H and E stained slides of cases previously diagnosed as STS by a group of pathologist and match the old and new diagnoses, with the application of some special stains; histochemical and immunohistochemical, then evaluate the results. Forty cases previously diagnosed as STS were reexamined and classified according to the criteria of Enzinger and Weiss. A descriptive or morphological classification was also used; as spindle, round, myxoid and pleomorphic STS. The results were compared to, and matched with the previous diagnoses. Histochemical stains used are, Picro Sirius red (PSR), Masson trichrome (MT), and Periodic-acid schiff stain (PAS). Myoglobin was used as immunohistochemical marker for the detection of cross-striated muscle cell differentiation by peroxidase antiperoxidase method (PAP). RESULTS: Agreement in diagnosis between the previous and the recent diagnosed STS was found to be 47.5%. For spindle cell malignant tumors the agreement was 58.8%, while for round cell malignant tumors was 33.3%. Agreement in diagnosis in mixed malignant soft tissue tumors was 62.5%. PSR and MT demonstrate the amount and distribution of collagen. MT also demonstrates muscle fibers. Using Myoglobin immunohistochemical marker in the previously diagnosed STS: one out of four cases diagnosed as Rhabdomyosarcomas gave a positive result, while two cases from the unsuspected group gave positive results. In the recently diagnosed tumors: all cases diagnosed as Rhabdomyosarcoma gave positive results, while from the unsuspected group one gave positive result. CONCLUSION: While the ordinary H and E stain will suffice to permit recognition of many of STS, it will not do so for all. Limitation of diagnosis of these tumors, especially the rare ones, to specialized centers or highly qualified pathologists is recommended. Histochemical stains are supportive rather than exclusive for the diagnosis of STS. Myoglobin immunohistochemical marker could be used to aid in the diagnosis of rhabdomyosarcomas. Definite diagnosis of many STS needs further special stains and/or electron microscopy and other sophisticated procedures


Article
Clinical Comparison between Diode Laser and Scalpel Incisions in Oral Soft Tissue Biopsy

Authors: Wael S Shalawe --- Zaid A Ibrahim --- Ali D Sulaiman
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2012 Volume: 12 Issue: 2 Pages: 337-343
Publisher: Mosul University جامعة الموصل

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Abstract

Aims of the study: To compare the new diode laser (1064nm) incision with conventional blade inci-sion wounds after oral soft tissue biopsy in terms of haemostasis, local anesthetic required, duration of incision and post operative pain. Materials and Methods: This study was conducted in the Oral and Maxillofacial Surgery Department at College of Dentistry/University of Mosul and Oral and Maxil-lofacial Surgery Department in Al-Salam Teaching Hospital between February 2010 and May 2010. Thirty patients were enrolled and divided into two groups, each consisted of fifteen patients. The first group included fifteen patients requiring biopsy (based on their indications for biopsy) in the oral cavi-ty, where the incision was done using surgical blade no.15. The second one included fifteen patients who needed biopsy in the oral cavity (based on their indications for biopsy), here the incision was made by using diode laser (FOXTM, A.R.C. laser, Germany) wavelength 1064nm with output power (3.5Watt) CW in contact with the tip of bare fiber (200micron). All biopsies in the two groups were excisional and done under local anesthesia using infiltration technique. Results: In comparison be-tween the two groups: the amount of local anesthetic required in the second group (diode laser wound group 0.73 ml) was less than that required by the first group (blade incision wound group 1.6 ml) and showed statistically high significance at p value < 0.05. The mean of the difference in the weight of the gauze before and after the operation in the second group(0.16 gm) was less than the difference in the weight of the gauze in the first group(0.96 gm) which showed statistically high significance at p value <0.05. The mean of the duration for incision was statistically not significant between the two groups and the mean of pain score at the first post-operative day was statistically significant in the second group in comparison to the first group but there was no statistical difference in the pain score level at the third postoperative day between the two groups. Conclusion: The use of Diode (1064nm) laser to perform oral biopsy has several advantages over the blade incisions wound including less amount of local anesthesia required, enhanced haemostasis (suturing after surgery was not necessary) , minimal postoperative pain.


Article
Assessment of sagittal lip position and some affecting factors in a sample of Iraqi adults

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Abstract

This study aimed to determine the sagittal lip position and some of the factorsaffecting it regarding the gender differences, and their correlations in a sample of Iraqiadults.Sixty two participants (37 females and 25 males) collected among dental studentshaving Cl I skeletal and occlusal relations and full permanent dentition regardless thethird molars were chosen for this study. Each person was subjected to clinicalexamination and digital true lateral cephalometric radiograph. The radiographs wereanalyzed by using AutoCAD 2007 computer program to measure the sagittal lipposition using the soft tissue analyses of Steiner, Burstone, Ricketts, Sushner,Holdaway, and Merrifield. Descriptive statistics were obtained from themeasurements of both genders; independent samples t-test was performed to evaluatethe gender differences and Pearson’s correlation coefficient test was used to find thecontributing factors to the sagittal lip position.Sagittal jaw angles were significantly higher in males than females, while verticaljaw angle was higher in females. Lower incisors showed slight proclination in bothgenders. The mean values of H-angle and revised H-angle in males were nonsignificantlyhigher than that of females, while the mean value of Z-angle was nonsignificantlyhigher in females. Upper and lower lips thickness mean values weresignificantly higher in males. Females had non-significantly more projected nosecompared to males. Regarding the sagittal lip position, upper and lower lipmeasurements were non-significantly higher in males than females in Ricketts,Steiner, Burstone, and Holdaway analyses, but it was significant in Sushner analysis,while Z-angle of Merrilfield was non-significantly higher in female sample. Pearson’scorrelation coefficient test revealed that upper and lower lip thickness wassignificantly positively correlated with sagittal lip position, while nose projection wassignificantly negatively correlated.Sagittal position values of the upper and lower lips in a sample of Iraqi adults areclose to the norms of Ricketts, Steiner, Sushner, Burstone, and Holdaway analyseswith a slight tendency of upper lip toward retrusion and lower lip toward protrusionwith the exception of that when compared with Sushner norms. In addition to the chinposition, lips thickness and nose projection are the most important factors thatinfluence the sagittal lip position and compensate for the variations in the jaw basesbetween genders.


Article
THE OUTCOME OF 810 NM SURGICAL DIODE LASER IN THE MANAGEMENT OF ORAL SOFT TISSUE LESIONS

Author: Ammar S Al-Alawi عمار صالح رضا العلوي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2013 Volume: 11 Issue: 2 Pages: 109-112
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Surgical diode lasers have been used in oral surgical procedures with beneficial effects as compared to the conventional techniques.Objective:To evaluate the efficacy and safety of 810 nm surgical diode laser in the field of oral and maxillofacial surgery.Methods:Forty patients who had different oral lesions were attending consultation clinic of the Maxillofacial Surgery Department in the Al-Kadhimyia Teaching Hospital. The patients have been treated by 810 nm diode laser. The power of the diode laser was 2-5 Watts in continuous mode. Excisional biopsies were sent for histopathological examination. Intraoperative and postoperative clinical examinations were done.Results:The clinical observations revealed no bleeding intraoperatively and postoperatively, no infection and minimal swelling was seen postoperatively.Conclusion:The benefits of 810 nm diode laser application in oral and maxillofacial surgery have been justified based on its efficacy and safety. There is a good acceptance for this new modality of treatment by the patients.Keywords:Surgical diode laser, soft tissue lesion, oral surgery


Article
Photogrammetric analysis of facial soft tissue profile of Iraqi adults sample with Class I normal occlusion: (A cross sectional study)

Authors: Suhaib M. Al-Janabi صهيب الجنابي --- Fakhri A. Ali فخري عبد علي
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2013 Volume: 25 Issue: 2 Pages: 164-172
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The purposes of this study were to determine the photogrammetric soft tissue facial profile measurementsfor Iraqi adults sample with class I normal occlusion using Standardized photographic techniques and to verify theexistence of possible gender differences.Materials and methods: Eighty Iraqi adult subjects (40 males and 40 females) with an age ranged between 18-25 yearshaving class I normal occlusion were chosen for this study. Each individual was subjected to clinical examination anddigital standardized right side photographic records were taken in the natural head position which is mirror positionwhich the patient looking straight into his eyes into the mirror mounted on the stand. The photographs were analyzedusing AutoCAD program 2011 to measure the distances and angles used in the Soft Tissue Photogrammetric Analysis.Descriptive statistics was obtained for the measured variables for both genders and independent- samples t-test wasperformed to evaluate the genders difference.Results and conclusions: The results indicated that: males had greater facial heights and lengths as well as greaterprominences. The mean values of all angular variables were higher in males than females except in the followingangular measurements: nasofrontal, mentolabial, angle of the middle facial third; and angle of the head position, withlarger male dimensions in all linear measurements of the facial, labial, nasal, and chin areas except Canut’s nasalprominence in nasal area. The nasofrontal, vertical nasal, nasal dorsum, cervicomental, middle facial third and facialconvexity angles showed statistically significant gender differences, in which the male dimensions were larger thanfemales while the nasolabial, the mentolabial, nasal, the inferior facial third, the head position and total facial convexityangles showed statistically non significant gender differences


Article
Soft tissue facial profile analysis of adult Iraqis with different classes of malocclusion

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Abstract

Background: Complete analysis of facial profile should also include an evaluation of soft tissue morphology.Materials and Method:The sample consisted of 90 Iraqi adults (45 males and 45 females) aged 18-25 years fromBaghdad city divided into 3 groups according to the ANB angle with 30 subjects in each group (15 males and 15females) for class I, II and III. Lateral cephalometric radiograph was taken for each subject and 8 angular and 5linear measurements were identified and determined, t-test, ANOVA and LSD test were used to compare betweenboth genders and between different classes.Results:Showed that females had greater angular measurements and smaller linear measurements with more lipprominence than males in all classes, there was more convex facial profile with more prominent forehead, moreprominent tip of the nose with increased facial heights and more prominent lips in class II subjects than in class I andIIIsubjects.Conclusion: There is wide variation in soft tissue facial profile among different classes of malocclusion and carefuldetermination of the components of soft tissue facial profile is very important in the diagnosis and treatmentplanning


Article
Reliability of Soft Tissue Analysis in Conventional and Digital Cephalographs

Author: Ruba J Mohammed
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2013 Volume: 13 Issue: 1 Pages: 108-115
Publisher: Mosul University جامعة الموصل

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Aims: This study compared the reliability of measurements of soft tissue cephalometric analysis be-tween the direct digital and conventional cephalometric images using computerized cephalometric pro-gram and hand tracing. Materials and Methods: The adult sample consisted of (30) Iraqi subjects (females and males) with age ranged 18 – 25 years old, the samples satisfied the criteria of this study. Nine soft tissue measurements were recorded from lateral cephalometric radiographs using either hand tracing or digitally directly on the monitor. The data were analyzed using descriptive statistic and stu-dent’s t–test. Results: No significant differences were found between the conventional or hand tracing and digital cephalometric analysis. Conclusions: The analysis of soft tissue profile using digital cepha-lometric analysis is reliable as using the conventional method. Yet, the digital method had more benefit than the conventional method, such as reduction of the radiation dose and the image enhancement.

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