Ascending colon cancer, preoperative diagnosed as diverticulitis

류제규 대한외과학회 2009 대한외과학회 학술대회 초록집 Vol.2009 No.11

수술 전 항암방사선 치료를 시행한 직장암 환자에서 3차원 경항문 직장초음파의 초기 경험: 2차원 경항문 직장초음파, 컴퓨터 단층촬영 및 자기공명 영상과의 영상진단 정확도 비교

류제규 ( Je Gyu Ryu ),김영완 ( Young Wan Kim ),김남규 ( Nam Kyu Kim ),허혁 ( Hyuk Huh ),민병소 ( Byung Soh Min ),이강영 ( Kang Young Lee ),손승국 ( Seung Kuk Sohn ) 대한임상종양학회 2010 Korean Journal of Clinical Oncology Vol.6 No.2

목표: 본 연구의 목적은 수술 전 항암방사선 치료를 받은 직장암의 진단에 있어서 3차원 경항문 직장초음파가 2차원 경항문 직장초음파 및 CT, MRI 와 비교하여 가지는 정확도의 차이를 확인하는 데 있다. 대상 및 방법: 99명의 직장암 환자를 대상으로 하였고 이 중 58명은 2차원 경항문 직장초음파와 CT, MRI를 통해 병기결정을 하였고, 41명의 환자는 3차원 경항문 직장초음파와 CT, MRI로 병기결정을 하였다. 종양의 침습정도(T)와 임파절 전이(N)의 진단에 있어서 각 영상 검사 방법의 정확도는 조직병리 검사 결과와의 비교를 통해 판단하였다. 결과: 종양의 침습 정도를 진단함에 있어서는 2차원 경항문 직장초음파, 3차원 경항문 직장초음파, CT, MRI는 각각 68.9%, 76%, 68.6% 그리고 84.3%의 정확도를 보였다. 병기 상향 평가율은 각각 24.1%, 20%, 21.6%, 9.6%였고, 병기 하향 평가율은 각각 6.8%, 4%, 9.6%, 6%이었다. 수술 전 항암방사선 치료를 시행받은 환자군에 있어서는 종양의 침습 정도의 진단에서 2차원 경항문 직장초음파, 3차원 경항문 직장초음파, CT, MRI는 각각 57.1%, 66.6%, 56.3%, 62.5%의 정확도를 보였고, 병기 상향 평가율은 28.5%, 33.3%, 43.7%, 37.5%였으며, 병기 하향평가율은 14.2%, 0%, 0%, 0%였다. 임파절 전이를 진단함에 있어서는 2차원 경항문직장초음파, 3차원 경항문 직장초음파, CT, MRI 의 정확도는 각각 58.62%, 64%, 67.47%, 73.49%였으며, 수술 전 항암방사선 치료를 시행받은 환자의 경우는 57.1%, 55.5%, 68.75%, 68.7%였다. 결론: 초기 경험이라는 한계가 있지만, 수술 전 항암방사선 치료를 시행받은 직장암의 진단에 있어서 전반적인 정확도는 2차원 경항문 직장초음파에 비해서 3차원 경항문 직장초음파가 높은 것으로 나타났다. 시행 경험이 축적되면 3차원 직장초음파는 MRI와 함께 직장암의 수술 전 진단에 있어서 유용한 검사 방법이 될 것이다. Purpose: This study was designed to evaluate the accuracy of three dimensional transrectal ultrasonography (3D TRUS) when compared to those of two dimensional transrectal ultrasonography, CT and MRI for preoperative chemoradiated rectal cancer. Material and methods: Ninety-nine rectal cancer patients were enrolled. Among them, 58 patients were staged by 2D TRUS, CT and MRI and 41 patients were staged by 3D TRUS, CT and MRI. Depth of tumor invasion (T) and nodal involvement (N) assessed by imaging modalities were compared with pathologic results. Results: When assessing depth of invasion, the accuracy of 2D and 3D TRUS, CT and MRI was 68.9%, 76%, 68.6%, and 84.3%, respectively. Overstaging rates were 24.1%, 20%, 21.6%, and 9.6%, and understaging rates were 6.8%, 4%, 9.6% and 6%, respectively. In patients undergoing preoperative chemoradiation, accuracy of depth of invasion was 57.1%, 66.6%, 56.3%, and 62.5%, and overstaging rates were 28.5%, 33.3%, 43.7%, and 37.5%, and understaging rates were 14.2%,0%,0%, and 0%, respectively. When assessing nodal involvement, accuracy of 2D and 3D TRUS, CT and MRI was 58.62%, 64%, 67.47%, and 73.49%, respectively. In patients undergoing preoperative chemoradiation, accuracy of nodal involvement was 57.1%, 55.5%, 68.75%, and 68.7%, respectively. Conclusion: Although early experience, overall diagnostic accuracy of 3D TRUS was superior to conventional 2D TRUS. As accumulation of experiences, 3D TRUS as well as MRI could be used as a useful tool for preoperative imaging for rectal cancer.

2010년 안면도 기후변화감시센터의 온실가스 변화 추이와 특성

민들레,류제규,김상훈,임병숙 한국대기환경학회 2012 한국대기환경학회 학술대회논문집 Vol.2012 No.5

짧은창자증후군 영아의 이차 serial transverse enteroplasty(STEP) 술식

오정탁,박종태,류제규,장혜경,한석주,최승훈 대한외과학회 2009 대한외과학회 학술대회 초록집 Vol.2009 No.11

2005년 11월 7일 경기서해안 돌풍 분석

김태수,신호,류제규 한국기상학회 2006 한국기상학회 학술대회 논문집 Vol.2006 No.-

기후변화감시센터에서 관측한 1999년부터 2009년까지 온실가스 농도변화

유희정,김상훈,류제규,임한철,이일용,김성진,김종호 한국대기환경학회 2010 한국대기환경학회 학술대회논문집 Vol.2010 No.10월

특발성 육아종성 유방염의 임상병리학적 특징, 경과 및 치료 결과

최서희,박형석,류제규,김지예,김상화,박세호,김승일 한국유방암학회 2015 Journal of Breast Disease Vol.3 No.1

Purpose: Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory breast disease that mimics breast cancer in terms of clinical and radiological finding. The treatment of IGM remains controversial. We aim to evaluate the clinicopathological feature and outcomes of IGM. Methods: Fifty five pathologically confirmed IGM patients who were treated between 2005 and 2013 were enrolled. All patients were categorized into three groups according to treatment methods: conservative care including observation, aspiration, and antibiotics; steroid; surgical intervention groups. Results: The median age at time of diagnosis was 35.8 years (range, 20–49 years). The most common chief complaints were a palpable mass (40.0%) followed by painful mass (32.7%) and pain (21.8%). Thirty-one patients were treated with antibiotics for their initial treatment. Steroid treatment was initially performed in eighteen cases. The initial steroid treatment was changed to methotrexate treatment in six patients who developed side effects, such as steroid-induced diabetes mellitus and Cushing’s syndrome or showed no response to treatment. Surgical interventions were performed in six patients as the first-line treatment. Mean time to remission was 7.2±6.9 months and 1-year recurrence-free interval was 89%. Mean time to remission in conservative care group and steroid group was 5.3±5.6 months and 11.4±7.9 months, respectively, and it was significantly different (p=0.008). Conclusion: A multidisciplinary approach including close observation, antibiotics treatment, systemic steroid, methotrexate, and surgical intervention is the currently available treatment option for IGM. IGM should be closely followed up due to the frequency of disease recurrence.

췌장의 선방세포악성종양

김혜운(Hye Un Kim),류제규(Je Kyu Ryu),최새별(Sae Byeol Choi),황호경(Ho Kyoung Hwang),김경식(Kyung Sik Kim),윤동섭(Dong Sup Yoon),이우정(Woo Jung Lee) 한국간담췌외과학회 2009 한국간담췌외과학회지 Vol.13 No.1

Acinar cell carcinoma (ACC) is a very rare type of pancreatic cancer that makes up less than 1% of all pancreatic cancers. The prognosis of ACC is very poor and the mean survival interval is only 18-19 months. The only effective treatment is currently early radical resection. Materials and methods: To determine ACC`s clinical characteristics and the treatment efficacy, we conducted a retrospective chart review to study the clinical characteristics, laboratory findings, pathology and treatment responses of 10 ACC patients among 3042 pancreatic cancer patients who were diagnosed in Severance Hospital and Kangnam Severance Hospital of Yonsei University, College of Medicine from 1988.01.01 to 2008.12.31. Results: The 10 ACC patients were 6 males and 4 females. The mean age of the 10 ACC patients was 53.2 years. The most of the patients (7/10) complained the pain on the epigastric area and there was no jaundice in 8 patients (80%). Unfortunately, regional or distant metastases were founded in 8 patients (80%) at the time of the first diagnosis. The initial mean CA19-9 level was increased to 73.5 U/ml (range: 0.1~350.0 U/ml). Six of 10 patients underwent radical surgery and 4 of 10, including 1 with open and closure, were treated with conservative treatment. The median survival interval was 22.4 months with operative treatment and 1.5 months with conservative treatment. The median overall survival interval was 19.4 months. The median disease free survival was 17 months. The liver was the most common recurrent site (3 cases). Conclusions: An early radical resection is currently the best and only treatment for ACC, but in rare cases, post-operative adjuvant chemotherapy shows hopeful results and so this requires more study.

Comparisons of Oncologic Outcomes between Triple-Negative Breast Cancer (TNBC) and Non-TNBC among Patients Treated with Breast-Conserving Therapy

김승일,김상화,박형석,김지예,류제규,박세호 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.5

Purpose: The optimum local surgical strategy regarding breast-conserving therapy (BCT) for triple-negative breast cancer (TNBC) is controversial. To investigate whether BCT is appropriate for patients with TNBC, we evaluated the clinical outcomes of BCT in women with TNBC compared to those of women without TNBC, using a large, single-center cohort. Materials and Methods: We performed a retrospective analysis of 1533 women (TNBC n=321; non-TNBC n=1212) who underwentBCT for primary breast cancer between 2000 and 2010. Clinicopathological characteristics, locoregional recurrence-free survival (LRFS), and overall survival (OS) were analyzed. Results: Tumors from the TNBC group had a higher T stage (T2 37.4% vs. 21.0%, p<0.001), a lower N stage (N0 86.9% vs. 75.5%, p<0.001), and a higher histologic grade (Grade III 66.8% vs. 15.4%, p<0.001) than the non-TNBC group. There were no differences in 5-year LRFS rates between the TNBC and non-TNBC groups (98.7% vs. 97.8%, p=0.63). The non-TNBC group showed a slightly better 5-year OS than the TNBC group; however, the difference was not significant (96.2% vs. 97.3%, p=0.72). In multivariate analyses,TNBC was not associated with poor clinical outcomes in terms of LRFS and OS [hazard ratio (HR) for LRFS=0.37, 95% confidenceinterval (CI): 0.10–1.31; HR for OS=1.03, 95% CI: 0.31–3.39]. Conclusion: TNBC patients who underwent BCT showed non-inferior locoregional recurrence compared to non-TNBC patients with BCT. Thus, BCT is an acceptable surgical approach in patients with TNBC.

Characteristics and Survival of Breast Cancer Patients with Multiple Synchronous or Metachronous Primary Cancers

이장희,박세호,김상화,김지예,류제규,박형석,김승일,박병우 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.5

Purpose: Newly developed extra-mammary multiple primary cancers (MPCs) are an issue of concern when considering the managementof breast cancer survivors. This study aimed to investigate the prevalence of MPCs and to evaluate the implications of MPCs on the survival of breast cancer patients. Materials and Methods: A total of 8204 patients who underwent surgery at Severance Hospital between 1990 and 2012 were retrospectivelyselected. Clinicopathologic features and survival over follow-up periods of ≤5 and >5 years were investigated using univariateand multivariate analyses. Results: During a mean follow-up of 67.3 months, 962 MPCs in 858 patients (10.5%) were detected. Synchronous and metachronousMPCs were identified in 23.8% and 79.0% of patients, respectively. Thyroid cancer was the most prevalent, and the second most common was gynecologic cancer. At ≤5 years, patients with MPCs were older and demonstrated significantly worse survival despite a higher proportion of patients with lower-stage MPCs. Nevertheless, an increased risk of death in patients with MPCs did not reach statistical significance at >5 years. The causes of death in many of the patients with MPCs were not related to breast cancer. Stage-matched analysis revealed that the implications of MPCs on survival were more evident in the early stages of breast disease. Conclusion: Breast cancer patients with MPCs showed worse survival, especially when early-stage disease was identified. Therefore,it is necessary to follow screening programs in breast cancer survivors and to establish guidelines for improving prognosis and quality of life.