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우상욱,김상욱,김정한,남석진,양정현,Sang-Uk Woo,Sang-Wook Kim,Jeong-Han Kim,Seok-Jin Nam,and Jung-Hyun Yang,F,A,C,S 대한갑상선-내분비외과학회 2004 The Koreran journal of Endocrine Surgery Vol.4 No.1
Purpose: Most patients with thyroid cancer have a good prognosis. However, it has been difficult to study a large number of patients succumbing to thyroid carcinoma due to the low mortality rate and the long follow-up period associated with differentiated thyroid cancer. Therefore, we evaluated characteristics of metastasis and deaths, sites of metastasis, difference of survival from pathologic classification and treatments and the cause of deaths. Methods: From June 1995 to December 2003, fifty-four patients who died due to distant metastasis and recurrence of thyroid cancer in Samsung Seoul Medical Center were analyzed. Results: We analyzed cause of death in 55 fatal cases. Single fatal conditions could not be specified in 13 patients. In the remaining 42 patients, respiratory failure (57.1%) was the most common specific fatal condition, followed by airway obstruction (26.2%), renal failure (7.1%) and sepsis (7.1%). According to histologic subtype, overall survival and relapse survival were statistically significant (P<0.005). However, No significant difference in disease free survival was observed (P=0.09).Conclusion: Early diagnosis and suitable treatment were also important factors for thyroid cancer. There was shorter relapse survival length in papillary cancers than that of follicular cancers. Anaplastic cancers had a poorer survival. We couldn't find difference of relapse survival result from the treatments of metastatic thyroid cancer. (Korean J Endocrine Surg 2004;4:21-25)
초음파유도 중심부바늘생검 결과 유두종양 환자에서의 유방암의 예측요소
이성훈(Sung Hoon Lee),우상욱(Sang Uk Woo),이혜정(Hye Jung Lee),김우영(Woo Young Kim),이재복(Jae Bok Lee) 대한종양외과학회 2012 Korean Journal of Clinical Oncology Vol.8 No.2
목적 : 유방의 유두상 병변은 양성 종양의 10%미만이며, 모든 악성종양의 0.5~0.2%를 차지한다. 중심부바늘생검에서 유방의 유두종양으로 진단된 경우 외과적 절제의 필요성에 있어서는 현재까지 논란이 있다. 이에 중심부바늘생검 결과 유두종양으로 진단되고 절제생검을 시행한 환자에서 유방암의 예측인자를 연구하였다. 대상과 방법 : 2009년 6월부터 2012년 6월까지 고려대학교 구로병원 외과에서 초음파유도하 중심부바늘생검 결과 유두종양과 비정형 유두종으로 진단되고 절제생검을 시행한 97예를 대상으로 하였다. 수술 전 중심부바늘생검과 수술 후 조직병리 소견에서 종양의 특성 및 크기를 분석하였다. 결과 : 97에 모두 여성이었으며 평균 연령은 45.1(16~68)세였다. 최종 조직검사결과 유두종양과 악성종양 환자의 평균 연령의 차이는 없었다. 중심부바늘생검에서 유두종양이였던 71예 중 절제생검의 최종조직검사 결과는 64(90.1%)예는 유두종양, 7(9.9%)예, 4(22.2%)예 및 7(38.9%)예로 유의한 차이가 있었다(P=0.001). 증상에서는 중심부바늘생검에서 유두종양인 경우에는 촉지성 종괴에서 유의하게 악성 종양이 많았다(P=0.03). 초음파 측정 종양의 크기가 1.5cm이상일 때 유의하게 악성 종양이 많았다(P=0.005). 중심부 바늘생검에서 유두종인 경우는 최종조직검사 결과 양성과 악성종양에서 초음파 측정 종양의 크기에서는 유의한 차이가 없었으나, 절제 후 최종조직 검사에서는 유의한 크기의 차이가 있었다(P=0.19, 0.002). 중심부바늘생검에서 비정형 유두종양인 경우에서는 초음파 측정 종양의 크기와 최종조직 크기에서 모두 유의한 차이가 있었다. (P=0.003, 0.019). 중심부바늘생검에서 유두종양인 경우 BIRAD 분류에 의한 분석결과 유의한 차이가 보였으나 (P=0.023), 비정형 유두종양에서는 유의한 차이가 없었다. 다변량 분석에서는 초음파 측정 종양크기가 1.5cm 을 초과한 경우에서만 유의한 결과를 보였으며 (P=0.45, OR=2.4 95% CI 0.16-0.95). 결론 : 중심부바늘생검 결과 비정형 유두종양의 절제생검의 필요성을 본 연구에서 다시 한번 확인할 수 있었다. 중심부바늘생검에서 조직병리 결과가 유두종양이라도 1.5cm이상이거나 촉지성 병변이거나, 영상의학적 소견과 중심부바늘생검의 결과에 불일치가 있는 경우에는 외과적 절제생검이 필요하다고 생각된다. Purpose : The breast papillary neoplasm was constituted approximately less than 10% of benign breast tumor and 0.5-20% of breast malignancy. The role of excisional biopsy for papillary neoplasm was diagnosed by core biopsy has been debated yet. The aims of this study were to evaluate the predictive factors of breast cancer after the pathologic result of core biopsy revealed papillary neoplasm. Materials and Methods : We analyzed the clinical and pathologic data of 97 patients who underwent breast excisional biopsy after the pathologic result of core biopsy revealed papillary neoplasm between June 2009 and June 2012 at the Guro Hospital of the Korea University Medical Center. Results : We found statistically significant differences of excisional biopsy results for malignancy between papillary neoplasm and atypical papillary neoplasm diagnosed by core biopsy (P=0.001). Malignancy was found to be significantly related to be palpable mass, Breast Imaging Reporting and Data System (BIRADs) when papillary neoplasm without atypia was present in the core biopsy (P=0.03, 0.023). There were no significant differences of tumor size between benign and malignancy which was measured by ultrasonogram in the papillary neoplasm without atypia. However, there were statistically significant differences of pathologic tumor size in the papillary neoplasm without atypia (P=002). All of pathologic and ultrasonogram tumor size were larger than in the malignancy with atypical papillary neoplasm diagnosed core biopsy. In the multivariate analysis, There was significantly higher in the case of ultrasonogram measured tumor size more than 1.5cm (P=0.45, OR+2.4 95% Cl 0.16~0.95). Conclusion : The excisional biopsy should be considered if the core biopsy had revealed atypical papillary neoplasm. We might suggest that excisional biopsy underwent in the papillary neoplasm without atypia with the case of the ultrasonogram measured tumor size more than 1.5cm and the existence of dis-concordance between radiologic findings and core biopsy pathologic result.
양정현,우상욱<SUP>1<.SUP>,Jung-Hyun Yang,and Sang-Uk Woo,<SUP>1<.SUP> 대한갑상선-내분비외과학회 2005 The Koreran journal of Endocrine Surgery Vol.5 No.1
Purpose: Multiple Endocrine Neoplasm (MEN) is a rare, complex and familial disease. There are MEN syndromes are inherited in an autosomal dominant fashion with high penetrance. The variations in the RET gene play an important role in the MEN syndromes. Recent advances in diagnosis, treatment and genetic study of patients with MEN in Korean are reviewed. Methods: There were 79 cases and 20 families with MEN syndromes in Korea which based on my experiences and 27 published papers. According to subtypes, there were classified and analyzed. Results: Mean age was 37.9⁑11.5 years old. Sex ratio was 1:2.6. There were 7 families and 23 cases with MEN type I in Korean. The clinical characteristics of MEN I in Korean are mostly not different from the previous reports except older age (mean=43.2 old-year) at diagnosis. The frequency of the MEN I germ-line mutation in Korean MEN I (80%) families was similar to those reported previously. There were 13 families and 52 cases with MEN type II A in Korean. Three-quarters (9/12) of the Korean patients with MEN IIa had RET mutations on codon 634 of exon 11 (4 patients, C634; 4 patients, C634Y; 1 patient, C634W), but a quarter (3/12) had mutations on codon 618 of exon 10 (2 patients, C618R; 1 patient, C618S). A small medullary carcinoma in a patient of MEN type II A family was detected by genetic mutation screening in SMC. MEN IIb was reported only 4 cases. A case showed a codon 918 mutation (M918T) at exon 16 of RET proto-oncogene. Conclusion: Multiple endocrine neoplasia is rare hereditary cancer syndromes expressing a variety of tumors. Withunderstanding of the molecular and clinical pathology of MEN syndromes, genetic screening is now feasible, and treatments have become more individualized based on genetic information of Korean. (Korean J Endocrine Surg 2005;5:1-6)
갑상선 유두암에서의 bcl-2와 P53 단백질 발현의 의의
지웅배,배정원,우상욱,손길수,이재복,구범환,채양석<SUP>1<,SUP>,Woong Bae Ji,M,D,Jeoung Won Bae,M,D,Sang Uk Woo,M,D,Gil Soo Son,M,D,Jae Bok Lee,M,D,Bum Whan Koo,M,D,and Yang-Seok Chae,M,D,<SUP>1<,SUP> 대한갑상선-내분비외과학회 2007 The Koreran journal of Endocrine Surgery Vol.7 No.4
Purpose: Papillary thyroid cancer (PTC) has a good prognosis, and it's known to be related to the apoptosis of papillary thyroid cancer. The expression of bcl-2 is thought to be associated with the inhibition of apoptosis. We evaluated the differences of bcl-2 and P53 between PTC and the control (normal tissue and benign lesion). We then analyzed the correlation between the bcl-2 and P53 expressions and the classic prognostic factors. Methods: Between January 2001 and December 2005, 30 patients who underwent total thyroidectomy for the PTC were included in this study and immunohistochemical staining was performed on the tumors. Results: bcl-2 was expressed in 18 cases (60%) in their PTC (P<0.05). The expression of P53 was not significantly related with the clinicopathological factors, but P53 was expressed in 9 cases (30%) of PTC (P<0.05). The positive staining for was noted in 18 cases (62.1%) of the PTC tissue among the 30 patients, and as the TNM stage progresses, the expression rate of was significantly decrease for 7 stage I cases (100%), for 4 stage ll cases (80%) and for 7 stage ll cases (38.9%). Conclusion: bcl-2 was expressed more as the TNM stage of PTC decreases. So bcl-2 is possibly useful as a prognostic factor for PTC, but further studies are needed for confirming its significance. (Korean J Endocrine Surg 2007; 7:231-236)