136. 조기위암에서의 유문보존 위절제술

신연명,최경현,이승도 대한외과학회 1999 대한외과학회 학술대회 초록집 Vol.1999 No.11

고신의료원에서의 위암의 술전 병기 결정

신연명,심인수,이상호,최경현,이승도,김종민,조영덕 고신대학교(의대) 고신대학교 의과대학 학술지 1995 고신대학교 의과대학 학술지 Vol.10 No.2

-Abstract- Determination of the extent of gastric cancer may assist in making decisions regarding therapeutic intervention. Several diagnostic tools were used for preoperative staging in Kosin medical center. Authors retrospectively analyzed the preoperative checked tumor markers, endoscopic findings and abdominal CT findings in 449 cases of pathologically stage-made gastric adenocarcinoma after surgery for 12 months from January to December 1993 at department of surgery, Kosin medical center. The purpose of this report is assessment of commonly used preoperative studies for staging of gastric cancer. The results were as follows : 1. The preoperative serum CEA, CA 19-9 levels were not correlated with stage except stage Ⅳ. In case of aFP, there were no positive correlation with staging. 2. 74 (63.2%) of 117 cases diagnosed endoscopically were T1 cancer histologically, whereas among 332 cases, which diagnosed advanced gastric cancer endoscopically, 28 cases (8.4%) were T1 cancer. 3. 188 of 275 cases showed wall thickness greater than 1츠 on abdominal CT scan. 167 of 188 cases were advanced gastric cancer (89%) and 21 cases were T1 gastric cancer (11%). 4. In a comparison of enlargement of regional lymph node by CT scan to tumor infiltration of regional lymph node by histology, sensitivity was 52.7%, specificity was 73.3% and accuracy was 63.6%. 5. CT images of distant metastasis had a sensitivity of 22.2%, specificity of 98%, accuracy of 93.1%, false-negative of 77.8% and false-positive of 1.9%. 6. 125 patients (45%) were correctly staged with CT scan, 77 patients (29%) overstaged and 72 patients (26%) understaged comparing to pathologic staging. These results showed that conventional diagnostic tools alone does not accurately displayed the true extent of disease in patients with gastric carcinoma. The results of multiple studies each other must be combined and it can provide valuable information in management of gastric cancer.

조기위암에서의 유문보존 위절제술

신연명 釜山外科學會 1999 釜山外科學會誌 Vol.15 No.12

고신의료원에서의 위암의 술전 병기 결정

신연명,심인수,이상호,최경현,이승도,김종민,조영덕 고신대학교 의학부 1995 高神大學校 醫學部 論文集 Vol.10 No.2

Determination of the extent of gastric cancer may assist in making decisions regarding therapeutic intervention. Several diagnostic tools were used for preoperative staging in Kosin medical center. Authors retrospectively analysed the preoperative checked tumor markers, endoscopic findings and abdominal CT findings in 449 cases of pathologically stage-maked gastric adenocarcinoma after surgery for 12 months from january to december 1993 at department of surgery, Kosin medical center. The purpose of this report is assessment of commonly used preoperative studies for staging of gastric cancer. The results were as follows; 1. The preoperative serum CEA, CA19-9 levels were not correlated with stage except stage Ⅳ. In case of aFP, there were no positive correlation with staging. 2. 74(63.2%) of 117 cases diagnosed endoscopically were T1 cancer histologically, whereas among 332 cases, which diagnosed advanced gastric cancer endoscopically, 28 cases(8.4%) were T1 cancer. 3. 188 of 275 cases showed wall thickness greater than 1Cm on abdominal CT scan. 167 of 188 cases were advanced gastric cancer(89%) and 21 cases were T1 gastric cancer(11%). 4. In a comparision of enlargement of regional lymph node by CT scan to tumor infiltration of regional lymph node by histology, sensitivity was 52.7%, specificity was 73.3% and accuracy was 63.6%. 5. CT images of distant metastasis had a sensitivity of 22.2%, specificity of 98%, accuracy of 93.1%, false-negative of 77.8% and false-positive of 1.9%. 6. 125 patients(45%) were correctly staged with CT scan, 77 patients(29%) overstaged and 72 patient(26%) understaged comparing to pathologic staging. These results showed that conventional diagnostic tools alone does not accurately displayed the true extent of disease in patients with gastric carcinoma. The results of multiple studies each other must be combined and it can provide valuable information in management of gastric cancer.

조기 위암에서의 유문보존 위 절제술

신연명(Yeon Myung Shin),최경현(Kyung Hyun Choi),이승도(Sung Do Lee) 대한외과학회 2000 Annals of Surgical Treatment and Research Vol.58 No.2

TC-99M-DISIDA Hepatobiliary Scintigraphy를 이용한 선천성 담도폐쇄증의 진단

신연명(Yeon-Myung Shin),최순옥(Soon-Ok Choi),박우현(Woo-Hyun Park) 대한외과학회 1989 Annals of Surgical Treatment and Research Vol.37 No.4

회장 천공을 동반한 Behcet씨 증후군 1예

김건균,신연명,최경현 고신대학교(의대) 고신대학교 의과대학 학술지 1993 고신대학교 의과대학 학술지 Vol.9 No.2

-Abstract- Behcet’s syndrome, reported by Behcet in 1937, is characterized by a triad of recurrent oral and genital ulceration and ocular inflammation. The syndrome has been recognized as a multisystemic disease with oral, ocular, genital, skin, articular, vascular, neurological and intestinal involvement. Recently we experienced a 23-year old male patient who had Behcet’s syndrome associated with ileal ulceration and perforation.

대음순에 발생한 거대한 공격성 혈관점액종

이철민,신연명,장희경 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.1

Aggressive angiomyxoma is a rare pathological condition which affects mainly the soft tissue of the pelvis and perineum in women. It grows solwly and lacks metastatic potential but recurrence is common. Although surgical excision with wide tumor-free margins is performed in this tumor, some patients experience local recurrence because of the infiltrative nature of this tumor. We report a 48-year-old woman who presented with a soft and painless mass from labia majora

위암환자에서 근치적 위절제술후 시행한 보조적 PMF 항암 화학요법에 대한 무작위 전향적 연구

최우식,신연명,최경현 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

연구 목적: 위암 수술 후 보조 항암 치료의 효과에 대하여서는 아직 논란이 있다. 전향적으로 무작위표본 추출법으로근치 절제 수술한 위암 환자에서 수술 후 cisplatin, mitomycin C 그리고 5-FU(PMF)의 주사가 5년 생존율이나 무병생존율을 증가할 수 있는지를 연구하였다. 연구 방법: 1995년 5월부터 2002년 5월까지 147명의 근치 수술된 위암 환자들 중에 병기 IB, II, IIIA, IIIB 및 IV를 대상으로 하였으나 65세 미만을 대상으로 하여 무작위적으로 2군으로 나누어, 경구 5-FU제를 투여하는 군(대조군)과, PMF 항암 주사 치료군(치료군)으로 나누어 치료하였다. 경구 5-FU항암제는 수술 후 퇴원할 시기부터 투여하였다. PMF 주사치료는 수술 후 8주 이내에 시작하며 2코스 이상 완료한 사람들을 치료군에 포함하였다. 항암 주사는 다음과 같이 진행하였다; cisplatin 30mg 정맥 주사를 제 1-5일에, mitomycin C 4mg과 5-FU 250mg정맥 주사를 주 2회 4 주간 주사하였다. 이런 주사치료를 매 4주마다 시행하였다. 이 후 5년 생존율과 무병 생존율을 Kaplan-Meier 분석과 log-rank 검정으로 구하였다. 결과: 중앙 추적기간은 36개월이었다. 전체 5년 생존율은 치료군과 대조군에서 각각 68.8%와 65.2%(p=0.26), 무병 생존율은 각각 72%와 64%(p=0.24)로 치료군에서 다소 나았으나 유의성은 없었다. 치료에 동의한 환자의 수가 적어 각 병기별 생존율보다 비교적 조기인 병기 IB와 병기 II를 A군으로, 병기 IIIA을 B군, 그리고 진행된 병기인 병기 IIIB 와 병기 IV를 C군으로 나누어 생존율 비교하여 보았다. A군과 C군은 5년 생존률이나 무병생존율의 차이가 없었으나, B군에서는 5년 생존율이 치료군에서 100%, 대조군은 40.8%(P=0.0019)로 유의한 차이가 있었고, 무병 생존율도 치료군 100%, 대조군 52.94%(p=0.005)으로 의미 있게 차이가 있었다. 항암 주사치료에 의한 부작용은 심하지 않았으며, 사망자는 없었다. 결론: 위암 수술 후 PMF에 의한 항암 보조치료는 경구 5-FU에 비하여 병기 IB, II, IIIB와 IV에서는 5년 생존율이나 무병 생존율에 차이가 없었으나 병기 IIIA에서는 5년 및 무병 생존율에 의미있게 좋았다. 앞으로 C군에 대한 수술 후 보조 항암치료법의 연구가 요망된다.

S 결장의 천공을 동반한 저위 쇄항 1예

윤기영,신연명,최경현 고신대학교 의학부 2000 高神大學校 醫學部 論文集 Vol.15 No.1

The rectum and anal canal are the most distal part of the gastrointestinal tract, and it is known to have developed and formed in the embryonic period. Congenital anomalies in these regions known as the inperforate anus or anorectal malformation are not uncommon disease with various clinical presentations. This describes a newborn of an imperforate anus having a fistulous track extended along the scrotal raphe and opening at the scrotal base associated with sigmoiod colon perforation. This variant appears to be a lower type anomaly. The treatment of this pathology is discussed.