유방암 환자에서 방사선 동위원소를 이용한 감시림프절 생검의 유용성

윤현조(Hyun Jo Youn),정성후(Sung Hoo Jung) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.3

Purpose: Sentinel lymph node biopsy (SLNB) is a minimally invasive procedure to avoid axillary dissection in breast cancer patients without axillary lymph node involvement, although there is no standardization of the technique. The aims of this study were to evaluate the efficacy of SLNB using radioisotopes in predicting axillary lymph node status, and to asses the clinical indications of SLNB. Methods: We conducted a prospective study of SLNB performed at Chonbuk National University Hospital between February 2000 and August 2005. All patients underwent SLNB, followed by planned completion axillary dissection regardless of the SLNB results. For identification of SLN, a radioisotope was used as a tracer with a peritumoral or subareolar injection, and SLNB using a gamma probe was performed after preoperative lymphoscintigraphy. Results: The sentinel lymph nodes were identified in 68 of the 70 patients (97.1%), with a mean of 2.84 sentinel nodes per patient. Overall, sensitivity was 83.3% (30/36), specificity 100% (32/32), accuracy 91.2% (62/68), and negative predictive value 84.2% (32/38). The false negative rate was 16.7% (6/36), and there was a significant difference in preoperative radiologic findings for axillary lymph node status (P=0.005). Conclusion: Compared with peritumoral injection, SLNB using a subareolar injection of a radioisotope was an accurate alternative to complete axillary dissection. SLNB may be indicated when there is no evidence of axillary lymph node metastasis in the preoperative radiologic examination.

암 환자의 항암화학요법 중 발생하는 탈모의 관리

윤현조 ( Hyun Jo Youn ),정성후 ( Sung Hoo Jung ) 대한임상종양학회 2011 Korean Journal of Clinical Oncology Vol.7 No.1

Chemotherapy induced alopecia (CIA) is one of the most common and emotionally traumatic side effects in cancer patient care. CIA occurs with an estimated incidence of 65% and negatively affects a patient°Øs perception of appearance, body image, attractiveness, and self-esteem. Patient who fear CIA may select regimens with less favorable outcomes or may refuse treatment. CIA is caused by certain chemotherapeutics such as anthracyclines and taxanes. The incidence and severity of CIA depends on dose, administration route, rate, schedule, and peak blood level of the drug. The keratinocytes of hair follicle are susceptible to apoptosis induced by chemotherapeutics. Fortunately, CIA is usually reversible but permanent CIA also has been reported. The major approaches to prevent or minimize CIA are by physical and pharmacological means. Several experimental studies to the development of pharmacological agents to overcome CIA are under evaluation. However, effective methods for preventing CIA are currently unavailable. The management of CIA must be individualized based on the needs of each patient. An effective CIA treatment would likely require agents that are effective for chemotherapeutics with different action mechanisms and selective to hair follicles.

촉지 되는 유방 종괴에서 세침흡인세포검사와 비교한 침생검의 유용성

윤현조(Hyun Jo Youn),정성후(Sung Hoo Jung) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.1

Purpose: Fine needle aspiration cytology (FNAC) is an established, highly accurate method for diagnosing breast lesions. However, core needle biopsy (CNB) is being increasingly used in this setting. The purpose of this study was to evaluate the accuracy of both methods and to assess which is more proper as an initial diagnostic method for palpable breast masses. Methods: The authors performed 403 FNACs and 226 CNBs in palpable breast masses between January 2002 and December 2002. The cytologic diagnoses were classified into three groups: malignant, suspicious or benign, and the histologic diagnoses were classified into three groups: malignant, atypical or benign. Histological conformation was obtained in 123 aspirated cases and 69 biopsied cases, either by open biopsy or mastectomy. Results: FNAC and CNB did equally well for the specificity (98.4% vs 100%), the false positive rate (1.6% vs 0%), and the positive predictive value (97.4% vs 100%) for malignancy. However, statistical differences are found for the sensitivity (63.8% vs 92.5%; P=0.000), the false negative rate (36.2% vs 7.5%; P=0.000), and the diagnostic accuracy (81.8% vs 92.4%; P=0.006). Conclusion: For palpable breast masses, CNB has a higher sensitivity, diagnostic accuracy and lower false negative rate than FNAC. Our study suggests that CNB is a useful initial diagnostic tool for assessing a breast mass before establishing a treatment strategy.

자궁경부암에서 전이된 전이성 유방암

윤현조(Hyun Jo Youn),정성후(Sung Hoo Jung),김재천(Jae Chun Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.5

Metastatic breast cancer from a primary cervical cancer is extremely rare with few cases reported. A diagnosis of breast metastasis can present difficulties due to various clinical, radiological, and histological manifestations. The important factors that suggest an appropriate diagnosis are the history of the cancer, specific mammographic or ultrasonographic findings and a correlation between the histology of the metastatic and primary tumor. Only an accurate diagnosis can avoid an unnecessary mastectomy and is required to institute an appropriate systemic oncological therapy. An metastatic breast cancer has a poor prognosis. We report a case of a 39-year-old woman with primary cervical cancer who developed a breast metastasis with a review of the literature.

How to refine chemotherapy for elderly patients?

Hyun Jo Youn(윤현조) 대한외과학회 2014 대한외과학회 학술대회 초록집 Vol.2014 No.11

Lymph node dissection in thyroid carcinoma ; When ? & How ?

윤현조(Hyun Jo Youn) 대한갑상선-내분비외과학회 2015 대한갑상선-내분비외과학회 학술대회 논문집 Vol.- No.-

원발성 간 세포암의 절제 후 예후에 영향을 주는 인자에 관한 연구

윤현조(Hyun Jo Youn),유희철(Hee Chul Yu),조백환(Baik Hwan Cho) 대한외과학회 2000 Annals of Surgical Treatment and Research Vol.59 No.5

순수 유두 갑상선암과 소포 변이 유두 갑상선암: 임상병리학적 특성 비교 연구

이병길,윤현조,정성후,Byoung Kil Lee,M.D.,Hyun Jo Youn,M.D. and Sung Hoo Jung,M.D. 대한갑상선-내분비외과학회 2009 The Koreran journal of Endocrine Surgery Vol.9 No.1

Purpose: Pure papillary thyroid carcinoma (PPTC) and the follicular variant of papillary thyroid carcinoma (FVPTC) are the most common subtypes of papillary thyroid carcinoma (PTC). The aim of this study was to investigate if there are any differences in clinicopathological features of these two subgroups. Methods: We performed a retrospective chart review of patients who were treated for PPTC and FVPTC between September 2003 and April 2008. Four hundred fifty patients were shown to have PPTC (91.8%) and forty (8.2%) had FVPTC after a histologic review. The two groups were compared in terms of the clinicopathologic features and the results of preoperative ultrasonography (USG), the fine needle aspiration cytology (FNAC), the frozen section biopsy and the surgical treatment. Results: The tumor size was significantly larger in the FVPTC group than in the PPTC group (1.47 cm versus 1.08 cm, respectively P=0.024). However, both groups had similar clinicopathologic features in terms of age, gender, capsular invasion, multifocality, lymph node metastasis, the MACIS score and the TNM stage. Further, the operative method did not differ between the two groups. The sensitivities of USG and frozen section biopsy for diagnosing FVPTC were significantly lower than those for PPTC (53.85% versus 72.95%, respectively, P=0.045, 81.58% versus 97.25%, respectively, P=0.049). Conclusion: The FVPTC group presented with a larger tumor size, and the clinicopathologic features of the FVPTC group did not significantly differ from those of the PPTC group. Although further studies with longer follow-up are required, these results suggest that the patients in both groups should be treated identically. (Korean J Endocrine Surg 2009;9:19-23)

수술을 시행한 갑상선 우연종의 임상적 고찰

이창호,윤현조,정성후,Chang Ho Lee,Hyun Jo Youn and Sung Hoo Jung 대한갑상선-내분비외과학회 2006 The Koreran journal of Endocrine Surgery Vol.6 No.1

Purpose: An incidentaloma is a tumor that is found incidentally without clinical symptoms. This study was carried out to evaluate the clinicopathologic characteristics and to offer the optimal diagnostic and therapeutic strategies for surgical treated thyroid incidentaloma. Methods: We reviewed the medical records of 139 consecutive patients who were operated on for incidentally detected thyroid nodules from January 2000 to June 2005, and we retrospectively investigated the clinicopathologic characteristics, preoperative diagnostic methods, operative methods and histologic diagnosis of surgical treated thyroid incidentaloma. Results: The male-to-female ratio was 1:9.7 (13:126) and the mean age was 45.8 years. The mean tumor size was 1.27 cm and 122 cases (87.8%) were 1.5 cm or less in diameter. 138 patients underwent ultrasonography and 34 patients (24.6%) were diagnosed with malignant nodules. US-guided fine needle aspiration cytology (FNAC) was performed in 118 patients and 42 patients (35.6%) were diagnosed with papillary carcinoma. According to postoperative histologic diagnosis, 70 cases (50.3%) were adenomatous goiter, 14 cases (10.2%) were follicular adenoma and 54 cases (38.8%) were papillary carcinoma. Among the papillary carcinoma, capsular invasion were presented in 3 cases (5.6%) and lymph node metastasis were presented in 5 cases (9.3%). According to the TNM staging, 33 cases (61.1%) were stage I, 16 cases (29.6%) were stage II, and 5 cases (9.3%) were stage? By the AMES scoring system, 2 cases (3.7%) were in the high risk group.Conclusion: Although most patients with incidental thyroid carcinomas were low stage, their clinicopathologic characteristics were similar to those of general thyroid carcinoma. Therefore, high risk patients with thyroid incidentaloma should have active diagnostic methods performed such as FNAC for confirming the presence of carcinoma. (Korean J Endocrine Surg 2006;6:12-16)

소아의 유착성 장폐쇄증에 대한 임상적 고찰

이종재,윤현조,정연준,김재천,Lee, Jong-Jae,Youn, Hyun-Jo,Jeong, Yeoun-Jun,Kim, Jae-Chun 대한소아외과학회 2001 소아외과 Vol.7 No.2

The effectiveness of operative and non-operative management for postoperative adhesive ileus in children has been discussed. This study reviews the clinical characteristics and the treatment consequences of adhesive ileus in our institution. Department of Surgery of Chunbuk National University Hospital, retrospectively. A total of 62 cases of post-operative small bowel obstruction treated between January 1975 and December 1998 under the 15 years of age are included in this study. The patients were divided into two groups, operative(n=26) and non-operative(n=36) groups. The prevalent age was between 11 and 15 years(28 cases; 45.2 %), and the most common previous operation was appendectomy(28 cases; 45.2 %). The most common operative procedures were adhesiolysis(17 cases; 65.4 %). The interval between admission and operation was 1 day in 11 cases(42.3 %). The most common site of adhesion was the ileum in 13 cases(50.0 %) and band constriction was the most frequent pattern(8 cases; 30.8 %). Intestinal resection was significantly high in delayed operations of more than four days, in the patients with three or more classical signs of strangulation(fever, tachycardia, leukocytosis, abdominal pain, rebound tenderness), and in the cases of complete obstruction on plain abdomen film(p < 0.05). In conclusion, operation should be considered in cases with three or more signs of strangulation, no clinical improvement for over four days of conservative treatment, and signs of complete obstruction on plain abdomen film during the observation periods.