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임라주,김해솔,김태석,이철구,서정민,이석구,Im, Ra-Joo,Kim, Hae-Sol,Kim, Tae-Seok,Lee, Cheol-Gu,Seo, Jeong-Meen,Lee, Suk-Koo 대한소아외과학회 2007 소아외과 Vol.13 No.2
Pancreatic tumors in children are very rare but have a better prognosis compared with that in adult. Pediatric pancreatic tumors are more often benign and easier to resect. To evaluate the characteristics and prognosis, the records of 13 patients who underwent pancreatic resection, from June 1997 to May 2005, at Samsung Medical Center were reviewed. The mean follow up period was 48 months. The male to female ratio was 1: 1.6. Mean age was 10.3 years. Signs and symptoms included abdominal pain (7), abdominal palpable mass (5), jaundice (1), hypoglycemic (1), and non-specific GI symptoms (4). The commonly used diagnostic tools were CT and abdominal sonography. In addition, MRI, ERCP, EEG, and hormone test were also done when indicated. Surgical procedures included distal pancreatectomy (5), pylorus preserving pancreaticoduodenectomy (4), tumor excision (3), and subtotal pancreatectomy (1). Locations of lesions in pancreas were head (4), tail (5), and body and tail (4). Postoperative complications developed in 3 cases; postoperative ileus (1), wound problem (1), and pancreatitis (1). The pathologic diagnosis included solid-pseudopapillary tumor (6), congenital simple cyst (1), pancreatic duplication cyst (1), serous oligocystic adenoma (1), mucinous cystadenocarcinoma (1), rhabdomyosarcoma (1), insulinoma (1), and pancreatoblastoma (1). Three cases received adjuvant chemotherapy and radiotherapy. Overall survival rate was 81 %. One patient with a mucinous cystadenocarcinoma died. In this study, pancreatic tumors in children were resectable in all patients and had good survival. Surgery of pancreatic tumors should be regarded as the gold standard of treatment and a good prognosis can be anticipated in most cases of benign and malignant tumors.
임라주,이숙현,윤찬석,고승상,허민희,강성수,이해경,Ra Joo Lim,Sook Hyun Lee,Chan Seok Yoon,Ph.D.,Seung Sang Ko,Ph.D.,Min Hee Hur,Ph.D.,Sung Soo Kang,Ph.D. and Hae Kyung Lee,Ph.D. 대한갑상선-내분비외과학회 2009 The Koreran journal of Endocrine Surgery Vol.9 No.2
Purpose: There has been a rapid rise in the incidence of thyroid cancer, particularly papillary thyroid microcarcinoma (PTMC). However, there is a lack of consensus of treatment guidelines or follow-up strategies. Methods: A retrospective analysis of 606 patients who underwent operation due to thyroid cancer from March 2000 to December 2008 was conducted. Of these patients, 587 with pure papillary carcinomas were studied, of whom 392 (67%) presented with PTMC. Results: Only 23% of patients were symptomatic, but 75% of patients were positive using the imaging techniques ultrasonography or positron emission tomography. When the microcarcinoma patient group (G1) was compared with the group of remaining patients (G2), less aggressive operations were chosen for G1. A lobectomy was performed in 63.8% of G1 versus in 14% of G2, and the central compartment neck dissection was omitted in 30% of G1 versus 16% of G2. During the follow-up period (mean 37.9±25.2 months), there were 11 recurrences. Two patients developed contralateral cancers 42 and 49 months after lobectomy. One patient had recurrences on central compartment lymph nodes 34 months post-operatively. Eight patients had lateral neck lymph nodes metastases 13∼52 months post- operatively. Three of these eight patients had concomitant central neck lymph node metastases. Conclusion: Less aggressive treatments can be chosen for PTMC patients compared to non-PTMC patients. To clarify these results, longer follow up and larger and multi-institutional data are needed. (Korean J Endocrine Surg 2009; 9:74-78)
임라주(Ra Joo Lim),이경상(Kyung Sang Lee),이숙현(Suok Hyun Lee),윤찬석(Chan Seok Yoon),고승상(Seung Sang Ko),허민희(Min Hee Hur),이해경(Hae Kyung Lee),홍성란(Sung Ran Hong),이지현(Ji Hyun Lee),강성수(Sung Soo Kang) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.4
Purpose: This study was conducted to evaluate the outcome of central lumpectomy for breast conservation including nipple-areolar resection and postoperative radiation therapy in patients with central breast cancers. Methods: 19 patients with central breast cancers, aged 39 to 72 years, operated on from May 2004 to March 2010 were identified. Recurrence, survival, and cosmesis were analyzed. Treatment was undertaken as complete excision of the nipple-areolar complex (NAC), followed by external radiation to the whole breast and tumor bed. The mean follow-up period was 37.9 (1 to 71) months. Results: At pathology, 13 had invasive ductal carcinoma; 5 had ductal carcinoma in situ. 1 had neuroendocrine cancer. Only 1 had atypical ductal hyperplasia at resection margin; the remaining 18 were free margins. The mean tumor size was 1.6 ㎝ (range, 0.8∼4 ㎝) and the distance from the nipple was 0∼1 ㎝. 37.5% had positive axillary nodes. Adjuvant chemotherapy was given for 12 patients, followed by radiation therapy. All 15 patients, who were hormone receptor positive, were given tamoxifen or aromatase inhibitors. With a mean follow up of 37.9 months, all 19 patients are alive and free of disease. Cosmetic results ranged from good to excellent in 18 (94.7%) patients, as judged by both the patients and the surgeons. Conclusion: Although this study needs further evaluation and long-term follow up, subareolar or central breast cancers can be successfully treated with breast conserving therapy using nipple-areolar resection and postoperative radiation therapy, along with acceptable cosmesis.
김해솔,임라주,김혜은,이철구,서정민,이석구,Kim, Hae-Sol,Im, Ra-Joo,Kim, Hye-Eun,Lee, Chul-Gu,Seo, Jeong-Meen,Lee, Suk-Koo 대한소아외과학회 2007 소아외과 Vol.13 No.2
Liver tumors in children are rare, relatively complex, and encompass a broad spectrum of disease processes. This study reviews our experience of liver tumors during the last 10 years. Medical records of 36 cases of liver tumors in children, treated at Samsung Medical Centers, from October 1994 to December 2005, were reviewed in this study. We analyzed disease characters and survival rates as a whole and by specific disease. The median age was 3.6 years. Male and female ratio was 1:1. The most common symptom was the palpable mass in 15 cases. Others were abdominal distension in 9 cases, jaundice in 2, vomiting in 2, weight loss in 2, and pubic hair growth in 1. CT or US and liver biopsy were performed for diagnosis. There were 28 malignant tumors: malignant rhabdoid tumor (1 case), hepatocellular carcinoma (3 cases), hemangioendothelioma type II (3 cases), angiosarcoma (1 case), and hepatoblastoma (20 cases). Eight tumors were benign; hepatic adenoma (1 case), focal nodular hyperplasia (2 cases), hemangioendothelioma type I (2 cases), mesenchymal hamartoma (3 cases). In this study the clinical characteristics were not different from the other reports. Liver transplantation was performed in 3 cases-1 with hepatoblastoma and 2 with hepatocelleular carcinoma. Accurate and early diagnosis, and individualized multimodality therapeutic approaches might be important for better outcome.