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RISS 인기검색어
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- 저자 : Byung Kyun Ko and Yon Seon Kim (검색결과 4 건)
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Spindle epithelial tumor with thymus-like differentiation of the thyroid in a 70-year-old man
Sunhye Lee,Yon Seon Kim,Jeong Hyeon Lee,Sung Ho Hwang,Yu-Hwan Oh,Byung Kyun Ko,Soo-Youn Ham 대한외과학회 2018 Annals of Surgical Treatment and Research(ASRT) Vol.94 No.6
Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a very rare tumor of the thyroid gland mostly occurring in young patients. The imaging findings of SETTLE tumors are yet to be defined. However, they are usually described as well-defined heterogeneously enhanced masses on CT scan. The current case has the potential growth as compared with a 2009 chest radiography. We took into account the possibility of SETTLE in the case of a bulky mass in patients over 70 years old, particularly in the lower neck. Herein, we report a case of the oldest patient so far. The patient underwent a right lobectomy of the thyroid and mass excision. Follow-up CT scans after 6 months revealed no local recurrence. Surgery is the gold standard treatment for SETTLE. Chemotherapy and radiotherapy could be another possible option for patients with advanced stage SETTLE.
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유방암 환자에서 내시경을 이용한 유륜부절개 부분 유방절제술에 대한 경험 및 5년 추적 관찰의 결과
강동우 ( Dong Woo Kang ),김연선 ( Yon Seon Kim ),조홍래 ( Hong Rae Jo ),고병균 ( Byung Kyun Ko ) 대한임상종양학회 2010 Korean Journal of Clinical Oncology Vol.6 No.2
목적: 유방보존술은 유방암 치료의 표준 술식으로 확립되어져 왔다. 그러나 유방보존술이 유방의 전체적인 모양을 유지시킬 수는 있으나, 수술 후 발생하는 피부 반흔은 미용적으로 해결해야 하는 문제였고 더 나은 미용 효과를 위해 내시경을 이용한 수술이 시도되었다. 저자들은 내시경을 이용한 유륜부절개 부분 유방절제술(transareolar endoscopic partial mastectomy)에 대한 임상 경험을 보고하고, 향후 유방암 수술에 대한 새로운 술식으로서의 이용 가능성에 대하여 알아 보았다. 대상 및 방법: 2005년 2월부터 2005년 6월까지 15명의 유방암 환자가 내시경을 이용한 유륜부절개 부분 유방절제술을 시행 받았다. 반달 모양의 절개창을 유륜 주위에 넣은 후 VisiportTM를 이용하여 유선조직을 피부로부터 박리하였고 preperitoneal distention balloon system (PDB)을 이용하여 유선조직을 후유방조직으로부터 박리하였다. 유선조직 상부와 하부의 충분한 박리 후에 안전한 절단면을 가진 종양조직을 제거하였다. 수술 후 경과 관찰을 위해 6개월 간격으로 5년 동안의 추적관찰을 시행하였다. 결과: 환자의 평균 나이는 47.5세였고, 종양의 평균 크기는 2.0 cm (1.3-3.0) 이었다. 유두로부터 종양까지의 거리는 평균 4.0 cm (2.5-5.0) 이었다. 15명의 환자 모두에서 안전한 절단면을 얻을 수 있었으며 수술 5년 경과 후 추적관찰에서도 국소재발은 없었다. 1명에서 흉막으로의 원격전이가 발생하였으나 국소재발은 없었다. 수술 후 미용적 만족도 평가를 위해 설문 조사를 시행하였으며 추적이 소실된 1명과 원격전이가 발생한 1명을 제외한 13명 모두에서 만족도가 높은 것으로 평가되었다. 결론: 내시경을 이용한 유륜부절개 부분 유방절제술은 미용적 측면에서 매우 효과적이고 유용한 술식으로 생각되나 향후 더 많은 환자군을 대상으로 하는 연구가 필요할 것이다. Purpose: Breast conserving surgery has been a standard surgery for breast cancers. This operation has a great cosmetic advantage over total mastectomy. Although breast conserving surgery can retain a good shape of the breast, an operation scar would be a disadvantage. Endoscopic surgery can be performed via a small and remote incision that becomes inconspicuous after surgery. We therefore designed transareolar endoscopic partial mastectomy in breast conserving surgery for breast cancer. Materials and Methods: Fifteen patients with breast cancer underwent transareolar endoscopic partial mastectomy. A semicircular incision was made around areolar and skin flap was made by using VisiportTM and deepened to the lateral edge of the mammary gland. For mobilization of the mammary gland from pectoralis muscle, we used a preperitoneal distention balloon system (PDB). The PDB allowed us to mobilize sufficiently mammary gland from the pectoralis muscle. After freeing half of the mammary gland, tumor was excised without difficulty with negative margins. Results: The mean age of patients was 47.5 years. The mean tumor size was 2.0 cm (range: 1.3-3.0 cm) and the mean tumor distance from nipple was 4.0 cm (range: 2.5-5.0 cm). In all patients, the tumor was excised with negative margins. After a mean follow up of 5 years, no patient had local recurrence, but one patient experienced distant metastasis. A patient satisfaction survey showed that all of patients evaluated the surgery as “Good”. Conclusion: Transareolar endoscopic partial mastectomy is an effective technique and feasible with a good cosmetic results. However, further study with more patients and long-term follow-up is needed.
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갑상선 유두암 T1, T2 병기 환자에서 중앙경부 림프절 전이의 빈도와 예측인자
배강호,태순영,고병균,김연선,Kang Ho Bae,Soon Young Tae,Byung Kyun Ko,Yon Seon Kim 대한갑상선-내분비외과학회 2015 The Koreran journal of Endocrine Surgery Vol.15 No.1
Purpose: Thyroidectomy without prophylactic central neck dissection may be recom-mended for small (T1 or T2) papillary thyroid carcinoma (PTC). The aim of this study was to determine the incidence and predictive factors of central cervical lymph node metastasis in T1/2 papillary thyroid carcinoma.Methods: A retrospective review of 877 patients with T1/2 PTC who underwent thyroidectomy and central lymph node dissection with or without lateral lymph node dissection from March 2007 to February 2014 was performed. The clinicopathologic results were reviewed and the incidence and predictive factors of central cervical lymph node metastasis (LNM) were analyzed.Results: The overall frequency of central LNM was 29.8%. In univariate analysis, male, younger age, bilaterality, multifocality, larger tumor size, lymphovascular invasion, and lateral lymph node metastasis were associated with central LNM. In multivariate analysis, younger age, larger tumor size, lymphovascular invasion, and lateral lymph node metastasis were independent variables of central LNM.Conclusion: Central LNM is associated with younger age, larger tumor, lymphovascular invasion, and lateral lymph node metastasis in small (T1/2) PTC patients. Prophylactic central lymph node dissection should be considered in patients with risk factors.
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