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성인에서 발생한 소장 지방종에 의한 공장-공장 중첩증 1예
김병철 ( Byung Chul Kim ),정석원 ( Seok Won Jung ),권성호 ( Sung Ho Kwon ),박재석 ( Jae Serk Park ),고병균 ( Byung Kyun Ko ),김영민 ( Young Min Kim ),김도하 ( Do Ha Kim ) 대한내과학회 2008 대한내과학회지 Vol.75 No.3
성인에 있어서의 장중첩증은 소아와 달리 대부분 원인질환을 동반하며 임상증상도 지속적이기보다는 단속적인 경우가 많고, 오히려 급성보다는 만성의 경과를 취하는 경우가 더 흔하다. 특히 그 원인이 소장의 지방종에 의한 것은 매우 드물며, 대부분 원위측 회장에서 발생한 지방종에 의한 장중첩증이 보고되었다. 저자들은 복부 수술의 병력이 없는 성인에서 정형외과적 수술 후 발생한 공장의 지방종에 의한 공장-공장 중첩증 1예를 경험하였기에 문헌고찰과 함께 보고한다. Intussusception is a prolapse of a segment of the intestine into the lumen of the adjacent intestine. The majority of intussusceptions occur in infancy and early childhood. Intussusception arising in adulthood represents only about 5% of all intussusceptions and is usually caused by a malignant small bowel lesion acting as an apex for intussusception. Lipoma is not a common tumor in the gastrointestinal tract, and gastrointestinal lipomas may be submucosal or subserosal. Most of them are asymptomatic, although they may cause abdominal pain, bowel obstruction, and gastrointestinal bleeding. Intestinal intussusception caused by lipoma is uncommon and is particularly rare when the lipoma is located in the small intestine. We report an unusual case of intussusception in an adult male patient, which was caused by a lipomatous lesion located in the proximal jejunum acting as a lead point. (Korean J Med 75:333-336, 2008)
갑상선 유두암 T1, T2 병기 환자에서 중앙경부 림프절 전이의 빈도와 예측인자
배강호,태순영,고병균,김연선,Kang Ho Bae,Soon Young Tae,Byung Kyun Ko,Yon Seon Kim 대한갑상선-내분비외과학회 2015 The Koreran journal of Endocrine Surgery Vol.15 No.1
Purpose: Thyroidectomy without prophylactic central neck dissection may be recom-mended for small (T1 or T2) papillary thyroid carcinoma (PTC). The aim of this study was to determine the incidence and predictive factors of central cervical lymph node metastasis in T1/2 papillary thyroid carcinoma.Methods: A retrospective review of 877 patients with T1/2 PTC who underwent thyroidectomy and central lymph node dissection with or without lateral lymph node dissection from March 2007 to February 2014 was performed. The clinicopathologic results were reviewed and the incidence and predictive factors of central cervical lymph node metastasis (LNM) were analyzed.Results: The overall frequency of central LNM was 29.8%. In univariate analysis, male, younger age, bilaterality, multifocality, larger tumor size, lymphovascular invasion, and lateral lymph node metastasis were associated with central LNM. In multivariate analysis, younger age, larger tumor size, lymphovascular invasion, and lateral lymph node metastasis were independent variables of central LNM.Conclusion: Central LNM is associated with younger age, larger tumor, lymphovascular invasion, and lateral lymph node metastasis in small (T1/2) PTC patients. Prophylactic central lymph node dissection should be considered in patients with risk factors.
Retroperitoneal Mucinous Cystadenoma
Gyu Yeol Kim(김규열),Dae Hwa Choi(최대화),Young Chul Lim(임영철),Byung Kyun Ko(고병균),Sang June Park(박상준),Yang Won Nah(나양원),Hong Rae Cho(조홍래),Chang Woo Nam(남창우) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.1
일차성 후복막 점액성 낭선종은 흔치 않은 종양으로 여성에게만 발생하며, 수술 전에 정확한 진단을 하기 매우 어렵다. 하지만, 이러한 낭성 종양의 낭액에서의 증가된 암태아성항원의 수치가 일차성 후복막 점액성 낭선종의 유용한 진단 지표가 될 수 도 있다. 완전 절제가 이 종양의 적절한 치료이다. 또한, 수술 중 복강 내 타 장기들을 누르거나 할 필요가 없으며, 소장 및 대장이 손상될 위험을 줄일 수 있다는 측면에서 후복막 접근이 복강 내 접근 보다 유용한 방법일 수 있다. 저자들은 후복막 접근을 통해 성공적으로 절제한 일차성 후복막 점액성 낭선종의 경험을 보고한다. We present a case of a primary retroperitoneal mucinous cystadenoma, which is a relatively rare tumor found exclusively in women. This tumor is difficult to correctly diagnose preoperatively. Although there is little published information regarding the CEA levels in the cystic fluid of cystic tumors arising in the retroperitoneum, a high CEA level in the cystic fluid is a useful diagnostic marker for a primary retroperitoneal mucinous tumor. The appropriate management of retroperitoneal mucinous cystadenomas is the total removal of the cyst. The retroperitoneal approach for retroperitoneal cystic tumors is useful, has a lower risk of traumatizing the bowel than the intra-abdominal approach, and does not require compression of the other organs. We report the successful resection of a retroperitoneal mucinous cystadenoma through the retroperitoneal approach.