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비정상 질확대경검사 소견을 보이는 환자에서 환상투열요법의 직접적 적용에 관한 연구
우헌탁,이철민,박교훈,조용균,최훈,김복린,이홍균 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Objective: Large Loop Excision of the Transformation Zone (LLETZ) has been widely used for evaluating cervical dysplasia/cancer. We performed this study to evaluate if colposcopically suspected cervical high-grade dysplasia or cancer could be directly evaluated and treated with LLETZ. Methods: 93 women who were scheduled for colposcopic evaluation because of an abnormal cervical cytology report were included in the study in Sanggye Paik Hospital from Jan to Dec 2001. Mean age of the study population was 38.6±9.0. colposcopy directed punch biopsy was not performed and histologic diagnosis was made by LLETZ. Sensitivity and specificity of colposcopic evaluation was calculated and compared with those of cervical cytology. Results: On histopathological examination by LLETZ, 11(11.8%) patients had invasive cancers including 3(3.2%) adenocarcinomas. The sensitivity and specificity of colposcopy for the detection of cervical dysplasia or cancer was 71.7% and 72.3% respectively, wile those of cytology was 56.5% and 74.5% respectively. Conclusion: LLETZ may be adequately performed for the diagnosis and treatment of cervical dysplasia/cancer based on the results of pap smear and colposcopy without punch biopsy. Cost benefit might be anticipated while cost-effectiveness analysis is necessary in the future.
Role of Surgical Salvage for Regional Recurrence in Laryngeal Cancer
Jeong, Woo-Jin,Jung, Young Ho,Kwon, Seong Keun,Hah, J Hun,Kwon, Tack-Kyun,Sung, Myung-Whun,Kim, Kwang Hyun The American Laryngological, Rhinological Otologic 2007 The Laryngoscope Vol.117 No.1
OBJECTIVES:: The aims of this study were to analyze the pattern of regional recurrence in laryngeal cancer, evaluate the role of surgical salvage, and identify factors affecting salvage outcome. METHODS:: Retrospective analysis was conducted on medical records from a 16-year period. Of 463 patients diagnosed with laryngeal cancer, 25 patients with regional recurrence managed with salvage neck dissection were identified and subject to study. Isolated local recurrences and all distant metastases were excluded. RESULTS:: All patients were male with a median age of 61 years. The overall rate of regional recurrence was 5.4%. Median time to regional recurrence was 13 months. Isolated regional recurrence occurred in 76% of cases, whereas locoregional recurrence occurred in 24%. A 5-year survival rate for patients undergoing neck dissection as salvage management was 61.2%. Patients with recurrence in the contralateral neck were definitely associated with poor prognosis. Although standard statistical significance was not met, trends for poorer salvage result were identified in patients with a history of local recurrence before regional recurrence, recurrence in a previously dissected neck, and recurred node size of 3 cm or above. CONCLUSIONS:: Our study shows that salvage neck dissection for regional recurrence in laryngeal cancer is an acceptable approach. Surgical eradication of disease should be warranted whenever possible. Prudent planning of management is mandatory in the presence of history of local recurrence before regional recurrence, previously dissected neck, large size of recurrent node, and contralateral neck recurrence.
이정희(Jung-Hee Lee),김기택(Ki-Tack Kim),석경수(Kyung-Soo Suk),이상훈(Sang-Hun Lee),황대우(Dae-Woo Hwang),김진수(Jin-Soo Kim),신재흥(Jae-Heung Shin),홍우성(Woo-Sung Hong),곽윤호(Yoon-Ho Kwak) 대한정형외과학회 2008 대한정형외과학회지 Vol.43 No.6
목적: 골다공증과 신경학적 결손을 동반한 외상후 후만증 환자에서 전방 및 후방 도달법을 이용한 감압술 및 재건술은 다양한 방법으로 시도되고 있다. 고령의 환자에서 후방 도달법만을 이용한 감압술, 금속 그물망의 후방 삽입 및 척추경 나사 고정술의 유용성에 대하여 분석하였다. 대상 및 방법: 후방 도달법만을 시행한 17예를 대상으로 하였다. 수술적 치료는 후궁 절제술 및 후외측 도달로 추체를 제거하여 감압술을 완성하고, 척추경 나사 고정술과 후방에서 금속 그물망을 삽입하여 전후방 유합술을 시행하였다. 수술전후 및 최종 추시 방사선 분석 및 신경학적 결손을 평가하였고, 합병증, 수술 시간 및 출혈량을 분석하였다. 결과: 수술 전 국소 후만 변형 35±9.7° (범위; 17-58°)이었고 수술 직후 3.2±1.8°(교정; 90.5%), 최종 추시시 5.5±3.2°로 교정되었다(교정; 85.5%). 최종 추시 결과 29.6°의 후만 교정과 6%의 교정 소실이 관찰되었다. Frankel 등급에 의한 신경학적 결손은 전례에서 호전되었고 부가적인 수술 또는 그물망의 탈위 등은 없었다. 수술 후 합병증은 호흡기 2예와 원위 인접 추체골절 1예가 발생하였다. 결론: 후방 도달법만을 이용한 골다공증과 신경학적 결손을 동반한 외상후 후만증 환자의 수술적 치료는 감압술이 용이하며, 금속 그물망을 이용하여 전방 지지가 가능하여 견고한 내고정을 얻을 수 있는 방법으로 사료된다. Purpose: Several treatment options have been reported for post-traumatic kyphosis (PTK) and neurologically compromised osteoporotic fractures. However, there is no ideal surgical procedure. This study evaluated the effectiveness of posterolateral decompression and anterior support with a titanium mesh in PTK by posterior surgery. Materials and Methods: Seventeen patients with PTK and neurologically compromised osteoporotic fractures underwent a single posterior approach. During posterior decompression, a titanium mesh was inserted through the posterior approach after a transpedicular intracorporeal corpectomy. Complications, operating time and blood loss were noted, and radiographic studies and neurological status were evaluated before surgery, after surgery, and at final follow-up. Results: The mean kyphosis was 35±9.7° (range; 17-58°) before surgery, 3.2±1.8° after surgery (correction; 90.5%) and 5.5±3.2° at the final follow-up (correction; 85.5%). There was 29.6° correction of the kyphosis with a 6% loss of correction. Postoperative neurological improvement using the Frankel classification was demonstrated in all patients. There was no new onset or progressive neurological deterioration, additional surgery or extrusion of mesh. Three complications were encountered: one care each of pneumonia, prolonged ventilator support and distal adjacent vertebral fracture. Conclusion: The posterior insertion of a titanium mesh for anterior support appears to maintain the length of the anterior column, stabilize the injured vertebra and facilitate spinal fusion. Posterolateral decompression allows as direct a decompression as the anterior approach.
Kwon, Jung-Hoon,Lee, Dong-Hun,Swayne, David E.,Noh, Jin-Yong,Yuk, Seong-Su,Erdene-Ochir, Tseren-Ochir,Hong, Woo-Tack,Jeong, Jei-Hyun,Jeong, Sol,Gwon, Gyeong-Bin,Song, Chang-Seon Centers for Disease Control and Prevention 2016 Emerging infectious diseases Vol.22 No.3
<P>Highly pathogenic avian influenza A(H5N8) viruses were isolated from migratory waterfowl in South Korea during fall 2014–winter 2015, a recurrence after initial introduction in winter 2014. These reappeared viruses were phylogenetically distinct from isolates circulating in poultry farms in South Korea.</P>