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근치적 수술 후 재발한 1, 2 병기 비소세포폐암의 임상양상 및 조직학적 유형의 차이 비교
송성헌 ( Sung Heon Song ),손장원 ( Jang Won Sohn ),곽현정 ( Hyun Jung Kwak ),김사일 ( Sa Il Kim ),이승호 ( Seung Ho Lee ),김상헌 ( Sang Heon Kim ),김태형 ( Tae Hyung Kim ),윤호주 ( Ho Joo Yoon ),신동호 ( Dong Ho Shin ),박성수 ( Su 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.4
Background: The clinicopathologic characteristics of patients with non-small cell lung cancer (NSCLC) have been changing. Recently, Positron emission tomography-computed tomography (PET-CT) has usually been used for diagnosis, follow-up to treatment and surveillance of NSCLC. We studied the pattern of recurrence and prognosis in patients who underwent complete resection for NSCLC according to histologic subtype. Methods: All patients who underwent complete resection for pathological stage I or II NSCLC between January 2005 and June 2009 were identified and clinical records were reviewed retrospectively, especially the histologic subtype. Results: Recurrences were identified in 50 of 112 patients who had complete resection of an NSCLC. Sites of recurrence were locoregional in 15 (30%), locoregional and distant in 20 (40%), and distant in 15 (30%). Also, sites of recurrence were intra-thoracic in 29 (58%), extrathoracic and intra-thoracic recurrence in 15 (30%), and extrathoracic in 6 (12%). In locoregional recurrence, there was 37% recurrence for non-squamous cell carcinoma (non-SQC) and 25% for squamous cell carcinoma (SQC). In distant recurrence, there was 39% recurrence for non-SQC and 18% for SQC. Locoregional recurrence in the bronchial stump was more common in SQC than non-SQC (14% vs. 45%, p=0.025). Prognosis of recurrence was not influenced by histologic subtype and the recurrence-free survival curve showed that the non-SQC group did not differ from the SQC group according to stage. Conclusion: The prognosis for recurrence does not seem to be influenced by histologic types, but locoregional recurrence in the bronchial stump seems to be more common in SQC than non-SQC in completely resected stage I and II NSCLC.
1, 2병기 비소세포폐암의 예후에 대한 수술 전 양전자방출 컴퓨터 단층촬영기의 임상적 의의
송성헌 ( Sung Heon Song ),손장원 ( Jang Won Sohn ),곽현정 ( Hyun Jung Kwak ),김사일 ( Sa Il Kim ),김상헌 ( Sang Heon Kim ),김태형 ( Tae Hyung Kim ),윤호주 ( Ho Joo Yoon ),신동호 ( Dong Ho Shin ),최윤영 ( Yoon Young Choi ),박성수 ( 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.71 No.6
Background: High 2-[18F] fluoro-2-deoxy-D-glucose (FDG) uptake on positron emission tomography-computed tomography (PET-CT) is a prognostic factor for poor survival in non-small cell lung cancer (NSCLC), especially in Stage I. We determined whether the high FDG uptake value of a primary tumor was associated with recurrence and death in patients with resected Stage I and Stage II NSCLC. Methods: We identified consecutive patients who underwent complete surgical resection for Stage I and II NSCLC between 2006 and 2009, who had preoperative PET-CT, and reviewed clinical records retrospectively. FDG uptake was measured as the maximal standardized uptake value (SUVmax) for body weight. Patients were divided into two groups based on SUVmax: (i) above or (ii) below the cut-off value (SUVmax=5.9) determined by a receiver operating characteristic (ROC) curve. Results: Of 57 patients who were enrolled consecutively, 32 (56%) had Stage I NSCLC and 25 (44%) had Stage II. The 5-year recurrence-free survival (RFS) for patients with high (≥5.9) and low (<5.9) SUVmax were 31% and 57%, respectively (p=0.014). The 5-year overall survival (OS) rates were 39% and 60%, respectively (p=0.029). In univariate analyses, SUVmax (p=0.014), T staging (p=0.025), and differentiation of tumor tissue (p=0.034) were significantly associated with RFS. But, multivariate analyses did not show that SUVmax was an independently significant factor for RFS (p=0.180). Conclusion: High FDG uptake on PET-CT is not an independent prognostic factor for poor outcomes (disease recurrence in patients with resected Stage I and II NSCLC).
Tacrolimus로 효과적으로 치료된 저항성 다발근육염
안용우 ( Yong Woo Ahn ),송성헌 ( Sung Heon Song ),황규식 ( Kyu Sig Hwang ),유대현 ( Dae Hyun Yoo ),김나래 ( Na Rae Kim ),김태환 ( Tae Hwan Kim ) 대한류마티스학회 2009 대한류마티스학회지 Vol.16 No.4
Polymyositis is one form of inflammatory myopathy. In some patients, this disease does not entirely respond to conventional initial therapy with glucocorticoid, methotrexate and azathioprine. Multiple options exist for treating these patients, but only intravenous immune globulin has been subjected to a randomized clinical trial. We report here on a case of polymyositis that did not respond to multiple drug therapy, but it did respond to tacrolimus. After treatment with tacrolimus, the patient`s disease has been well controlled for many years.
윤경현 ( Kyung Hyun Yun ),송성헌 ( Sung Heon Song ),김충현 ( Chung Hyoun Kim ),황찬희 ( Chan Hee Hwang ),이준호 ( Jun Ho Lee ),최재형 ( Je Hyoung Choi ),김선영 ( Sun Young Kim ) 영남대학교 의과대학 2017 Yeungnam University Journal of Medicine Vol.34 No.2
Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-yearold man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.
황규식 ( Kyu Sig Hwang ),노영욱 ( Young Wook Roh ),송성헌 ( Sung Heon Song ),김상헌 ( Sang Heon Kim ),손장원 ( Jang Won Sohn ),윤호주 ( Ho Joo Yoon ),신동호 ( Dong Ho Shin ),박성수 ( Sung Soo Park ),오영하 ( Young Ha Oh ),김태형 ( 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.1
Lymphocytic interstitial pneumonia (LIP) is a rare disorder characterized by a diffuse infiltration of the alveolar space, interstitium by lymphocytes, plasma cells, and reticuloendothelial cells. Although its etiology is unknown, LIP has been associated with autoimmune disorders and with viral infections. Because it`s clinical and radiographic features are nonspecific, a confirmatory diagnosis is performed by open lung biopsy. A 59-year-old female presented dry cough, which had been present for 1 month. On initial findings of multifocal consolidation at the right middle lobe on both lower lobes in chest radiography, the first diagnosis of cryptogenic organizing pneumonia was suggested. On open lung biopsy, LIP was diagnosed. The patient had no autoimmune disease, viral infection or monoclonal gammopathy. After 3 months of corticosteroid treatment, the patient experienced improved symptoms, reduced abnormalities on chest radiography, and improved pulmonary function testing.