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이경근,정풍만,Lee, Kyeong-Geun,Jung, Poong-Man 대한소아외과학회 2001 소아외과 Vol.7 No.1
Congenital anomalies of the head and neck region such as preauricular sinus and skin tag, thyroglossal duct cyst, branchial anomaly, cystic hygroma and dermoid cyst are common in pediatric population. It is important for pediatricians and pediatric surgeons to be familiar with the embryology and the anatomical characteristic of these lesions in order to diagnose and treat them properly. Three hundred and nineteen patients with congenital head and neck anomalies treated at Hanyang University Hospital between 1980 and 1999 were reviewed to determine the relative frequency of the anomalies and to analyze the method of management. Eight-four (25.1 %) of 335 lesions were preauricular sinus and skin tag, 81 (24.2 %) were thyroglossal duct cyst, 81 (24.2 %) branchial anomaly, 58 (17.3 %) cystic hygroma and 31 were (9.2 %) dermoid cyst. The male-to-female ratio was 1.4:1. Thyroglossal duct cyst most commonly present at 3-5years, however branchial anomalies commonly are diagnosed in children younger than 1 year. Preauricular sinus showed familial tendency in three patients and was bilateral is 33.8 %. Most head and neck anomalies in children have specific clinical and anatomical characterics. A careful history and physical examination is very useful for diagnosis and proper management. Experienced pediatric surgeons should do the initial surgery since the recurrence rate after incomplete surgical excision can be high.
전이동 78예 및 전이 피부 부속기 28예에 대한 임상 경험
이경근,김민수,정풍만,Lee, Kyeong-Geun,Kim, Min-Soo,Jung, Poong-Man 대한소아외과학회 2003 소아외과 Vol.9 No.1
Preauricular sinus and preauricular skin tag are common childhood congenital anomalies. It is important for the pediatric surgeon to be familiar with the embryology and differentiation of head and neck structure to accurately diagnose and treat these lesions. Seventy eight patients with preauricular sinus and twenty-eight with preauricular skin tag treated in the Department of Pediatric Surgery at Hanyang University Hospital from January 1981 to May 2002 were reviewed to determine relative frequency, clinical classification and appropriate treatment. The male to female ratio of preauricular sinus was 1:1.2, and preauricular skin tag was 1:1. The most commonly presenting age of sinus and skin tag was before 5 year (62.8%) and before 1 year (53.6%). Twenty nine of 78 cases of preauricular sinuses were on the left, 25 on the right and 24 bilateral. Signs of infection were seen in 73.0% of patients with preauricular sinus at operation. Only 31.3% of lesions were infected in patients less than one year of age, but 89.5% between 3-5 years and 100% between 5-8 years. Cartilage was present in five patients with preauricular skin tag. Although re-operation due to wound infection was necessary in four cases, no recurrences were found. The preauricular sinus is a common anomaly in childhood, and has had a relatively high recurrence rate. But most of the recurrences were due to incomplete resection because of combined infection. Initial proper diagnosis and early operation are very important. Identification of the exact anatomical location of sinus tract is necessary because total excision of the lesions including those tracts is the only way to prevent recurrence.
소아에서 변형 Sistrunk술식을 적용한 갑상성 설관낭종의 치료성적
이경근,정풍만,Lee, Kyeong-Geun,Jung, Poong-Man 대한소아외과학회 2001 소아외과 Vol.7 No.2
Thyroglossal duct cyst is ectodermal remnant, which may develop along the line of descent of the thyroid gland from the foramen cecum of the tongue to the pyramidal lobe of the thyroid gland. Meticulous dissection of the cyst and duct, along with the body of the hyoid bone is necessary to avoid recurrence. Eighty-one patients with thyroglossal duct cyst treated at Hanyang University Hospital between January 1980 and December 2000 were reviewed to determine the incidence and to analyze the result of management. The male-to-female ratio was 1.4:1(47:34) with a male preponderance. They are most commonly present at 3-8years(54.2 %) of age, but rarely present at infancy. The most common symptom was a painless midline neck mass(76.5 %, 62cases). Eighty-one patients underwent modified Sistrunk operation without evidence of recurrence. Eight-nine percent(72 cases) of these lesions were located between thyroid substance and hyoid bone, and 11 %(9 cases) were above the hyoid bone. There were 22 infected cysts(27.2 %). The Sistrunk operation is a gold standard for treating the thyroglossal duct cysts. For best results in thyroglossal duct cyst surgery, one should make every effort to remove the cyst intact in continuity with the body of the hyoid bone. In our institute, Sistrunk operation modified by the authors showed a good result.
김민수,이경근,정풍만,Kim, Min-Soo,Lee, Kyeong-Geun,Jung, Poong-Man 대한소아외과학회 2002 소아외과 Vol.8 No.2
Branchial anomaly is a frequently occurring congenital abnormality in childhood. It is important for the pediatric surgeon alike to be familiar with the embryology and differentiation of head and neck structure to accurately diagnose and treat these lesions. Eighty-five patients with branchial anomaly treated at Hanyang University Hospital between 1980 and 2001 were reviewed to determine relative frequency, clinical classification and appropriate treatment. The male to female ratio of branchial anomaly was 1.2:1. The most commonly presenting age was before 1 year (32%) and the age group between 1 and 3 year (22%) followed it. According to the classification of branchial anomalies, 73 of 85 cases were second branchial anomaly, 9 had the first type and 3 did fourth type. One patient showed combined anomalies of the first and the second type. Infection sign were seen in 70% of patients at the time of the first visit to our hospital and also patients' symptoms were frequently related with the infection. Forty-one cases (48%) were fistula, 21 (25%) were cysts, 21 (25%) were sinuses, and two were only cartilage remnants. The most common type of the branchial anomalies is the second branchial fistula and the most common symptoms of the anomalies are related with infection. Initial proper diagnosis and anatomical classification of the anomalies are very important in managing the lesions. The efforts to find the exact anatomical location of the fistula or sinus tract are necessary because total excision of the lesions including those tracts is the only way to prevent recurrence.
한국의 췌장 선방 세포암 -국내 문헌 발표된 27예와 본원의 2예의 임상병리학적 고찰-
이재훈 ( Jae Hoon Lee ),이경근 ( Kyeong Geun Lee ),박훤겸 ( Hwon Kyum Park ),이광수 ( Kwang Soo Lee ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.4
목적: 췌장의 선방 세포암은 외분비선에서 발생하는 종양으로 1-2%를 차지하는 매우 드문 악성종양이다. 국내의 선방 세포암에 대한 연구는 미흡한 실정이다. 이번 연구는 국내에서 보고된 선방 세포암에 대해 임상양상, 병리학적 특징, 치료와 예후를 알아보고자 시작되었다. 대상 및 방법: 2009년 10월까지 국내에 보고된 논문을 검색하여 병리학적으로 췌장 선방 세포암으로 확인된 총 27예의 환자와 본원에서 경험한 2예를 포함하여 총 29예에 대해 임상양상, 방사선 소견, 면역조직염색검사를 포함한 병리학적 특징, 수술과 재발 유무, 보조요법과 생존여부를 조사하였다. 이와 함께 외국의 연구와 비교하여 국내 선방 세포암의 특징을 고찰하였다. 결과: 선방 세포암은 50대의 남자에서 호발하며, 증상으로는 복부 동통과 종괴가 흔하다. 췌장 미부(41.4%)의 발생 빈도가 높았으며, 크기도 평균 7 cm으로 큰 양상을 보였다. 진단 당시 간 전이가 흔하고, 술 후 재발은 대부분 18개월 이내에 발생하였고 해당 장기로는 간이 가장 많았다. 29예 중 22예(75.9%)에서 근치적 절제술을 시행하였으며, 수술받은 환자의 생존기간은 22.4개월로 비수술적 치료의 1.5개월보다 큰 차이를 보였다. 5년 이상 생존한 예는 3예에 불과하였다. 결론: 국내의 선방 세포암의 특징은 평균 연령이 50대초반으로 더 젊었고, 크기는 평균 7 cm으로 더 크고, 췌장 미부의 발생빈도가 높았다. 예후는 비교적 나쁘지만 근치적 절제술을 시행한 경우 췌관 세포암보다 좋은 생존율을 보인다. 따라서 췌장 미부에 비교적 큰 종괴가 보일 경우 드물지만 선방 세포암을 감별해야 하고, 근치적 절제술을 위해 크기에 관계없이 적극적인 절제가 필요하다. Background/Aims: Acinar cell carcinoma (ACC) of the pancreas is a rare malignancy. ACC has been considered a cancer with poor prognosis due to frequent metastasis, a high recurrence rate, and low resectability. The aim of this study was to examine the clinical, radiologic and pathologic features of ACC in Korean patients, and surgical outcome was also investigated. Methods: We reviewed the clinical records of two patients with ACC who had undergone operation in January 1996 and December 2005 at Hanyang University Medical Center. Through searching of medical journal from 1983 to 2009, 27 patients reported on literatures as Korean ACC patients were reviewed together. The clinical, pathohistologic, and radiologic features, treatment, and prognosis were investigated for all 29 patients. Results: ACC was more common in male, and age at diagnosis ranged from 25 to 68 years (median 54). Symptoms were, mostly abdominal pain and mass. Liver was most common organ of metastasis at diagnosis and recurrence after operation. The mean tumor size was 7.0 cm, and most common location was tail. Of the 29 patients, 22 underwent surgical resection. Excluding 7 cases of not-reported survival, the median survival with operation was 22.4 months compared to 1.5 months with non-operation. Conclusions: In Korea, the clinical features of ACC include young age, large size, tail location, and nonspecific tumor markers. Surgery should be actively performed in the treatment of ACC regardless of size. (Korean J Gastroenterol 2010;55:245-251)