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자궁내막암 환자에서 복강경하 자궁적출술과 복식 자궁적출술의 비교 연구
김종혁,이상수,김천복,김대연,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4
목적 : 자궁내막암 환자에서 시행된 복강경 수술의 임상적 결과를 평가하고 수술적 지표 및 재발률에 대하여 기존의 개복 수술과 비교하고자 하였다. 연구 방법 : 1997년 8월부터 2003년 11월까지 저자들은 임상적 병기 I기인 79명의 자궁내막암 환자에서 복강경하 자궁적출술과 골반 및 부대동맥 림프절 절제술을 시행하였다. 총 79명의 환자 중, 수술적 병기 I기와 II기로 판명된 74명의 환자를 연구 대상으로 하였다. 대조군으로는 같은 기간 동안에 개복수술을 시행한 환자중 복강경 수술군과 병기가 같은 168예를 선정하였다. 결과 : 평균 수술 기간, 수혈량은 양군에서 비슷하였으며, 평균 재원 기간은 복강경 수술군에서 유의하게 짧았다. 수술전후 및 만성 합병증의 발생은 개복 수술군에서 유의하게 증가되었으며, 획득한 림프절의 수는 복강경 수술군에서 유의하게 더 많았다. 복강경 수술군에서 1예, 개복 수술군에서는 2예에서 재발하였고, 2년 무병 생존률은 복강경 수술군과 개복 수술군에서 각각 97.5%와 98.6%으로 유의한 차이는 관찰되지 않았다. 결론 : 자궁내막암 치료로서 복강경 수술은 기존의 개복술을 대신할 수 있는 안전하고 효과적인 시술 방법이다. 개복 수술과 비교해 볼 때, 재발 및 생존율 면에서 차이가 없었지만, 향후 전향적이고 더 오랜 추적기간을 갖는 연구가 필요하다고 사료된다. Objective : To evaluate the outcomes of laparoscopic surgery and to compare surgical parameters and recurrence rate of these with those of conventional abdominal surgery in patients with endometrial cancer. Methods : From August 1997 to November 2003, we have performed 79 cases of LAVH (laparoscopically assisted vaginal hysterectomy) with or without lymph node dissection. Laparoscopic approach was adapted in patients with FIGO clinical stage I by imaging study. Of the 79 patients, 74 patients who were proved to be surgical stage I and II were enrolled in this comparative study. As a control group, We selected 168 cases for the laparotomy group of the same stages. Results : The mean duration of surgery, the amount of blood transfusion and hemoglobin chamges were similar in both the laparoscory and the convertional alparotomy group. The mean duration of hospital stay was significantly shorter in patients treated by laparoscopic surgery (10.2 vs. 15.5 days). The number of lymph node obtained was significantly higher in the laparoscopy group. Two year recurrence-free survival rates were 97.5% in laparoscopy group and 98.6% in laparotomy group (p=0.763). Conclusion : Laparoscopic surgery for the treatment of early stage endometrial cancer is safe and effective altematives in terms of perioperative complications. Overall and recurrence-free survival did not differ significantly in both groups however long term risk for recurrence and survival has yet to be defined.
박정열,조준식,김대연,이동헌,김종혁,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2002 Journal of Gynecologic Oncology Vol.13 No.3
횡문근육종은 소아와 청소년기에 가장 흔한 연부조직 육종이다. 발생 부위는 일반적으로 두부 및 경부, 그 다음으로 비뇨생식계이다 조직학적으로 배아성 횡문근육종, 국화상 육종, 폐포성 횡문근육종, 다형성 횡문근육종으로 나누어진다. 횡문근육종의 약 20%가 비뇨생식기에서 발생하고, 50% 이상이 배아성 횡문근육종이다. 여성 생식기의 배아성 횡문근육종은 드문 악성 종양으로,주로 유소아의 질에서 발생하며, 자궁경부에서 발생하는 횡문근육종은 청소년기에 흔하고, 질에서 기원하는 횡문근육종이 자궁경부에 기원하는 경우보다 5배 정도 많다. 폐경기여성에서는 자궁체부에서 가장 흔히 발생한다. 비뇨생식기의 횡문근육종의 치료는 과거에는 골반장기 적출술만으로 치료를 시도하였으나. 서서히 다중 항암화학요법, 방사선요법, 근치적 절제술을 포함한 병합요법으로 바뀌어가고 있으며, 이에 따라 생존율이 현저하게 향상되었다. 이에 저자들은 최근 본원 산부인과에서 자궁경부에 발생한 배아성 횡문근육종 2예를 경험하였기에 문헌 고찰과 아울러 보고하는 바이다. Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and young adult. Genitourinary tract is the econd most common site of rhabdomyosarcoma. Rhabdomyosarcoma can be classified into one of four major types; embryonal, alveolar, pleomorphic and undifferentiated. Embryonal rhabdomyosarcoma of the female genital tract is rare malignant tumor and usually occurs during childhood in the vagina. In rare cases, rhabdomyosarcoma can originate in the uterine cervix, with a peak incidence in the second decade. Recently we have experienced two cases of embryonal rhabdomyosarcoma of the uterine cervix. These cases are presented with a brief review of the literature.
조현이,정종철,김호성,최재욱,성대경,서지훈,김성범,이계혁 大韓顎顔面成形再建外科學會 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.1
Osteosarcoma is a primary malignant tumor arising most often in the long bone, but rare in jaw bone. Especially osteogenic sarcoma of the mandible is a rare tumor, comprising less than 0.5% of all head and neck tumors. Osteosarcoma occurs cheifly in young persons, and presenting very survival rates. Histopathologically this tumor can be classified three types, osteoblastic, fibroblastic, chondroblastic and classified from low grade to high grade by anaplasia or mitosis of the tumor cells. Sometimes, the exact diagnosis of osteosarcoma is difficult especially in low grade osteosarcoma, even if clinical or radiographical findings suggest to osteosarcoma. So suspcious to malignant bone tumor in clinical or radiological findings, biopsy should be taked from deep portion and multiple area, and sharing the patient history and radiographs with pathologist will assist in the development of the diagnosis. We report a case of low grade osteosarcoma on the mandible initially difficulty in accurate diagnosis. The patient visited our hospital for routine dental treatment but radiographic findings displayed ill-defined radiolucency with osteoid formation on the mandible. Final diagnosis was difficulty in initial biopsy but subsequent biopsy taked from deep portion presented infiltrative growth and mitosis of the tumor cell in some area with small osteoid bone formation, so we could reach final diagnosis as low grade sarcoma. We treated this patient with bloc resection of the mandible and immediate reconstruction with iliac corticocancellous block.
자궁내막에 발생한 점막 연관 림프조직 (MALT) 림프종 1예
전균호,조현진,박성균,김천복,김대연,김종혁,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4
Non-Hodgkin's 림프종의 약 40%는 결절외(extranodal) 림프종으로 대개 위장관에서 발생하며 이들 중 점막 연관 림프조직(mucosa-associated lymphoid tissue: MALT)에서 기원한 림프종은 MALT 림프종으로 분류된다. 위 외의 부위에서 원발성으로 발생하는 MALT 림프종은 매우 드물지만 실제 거의 모든 신체 장기에 발생하는 것으로 알려져 있는데, 가장 흔한 부위인 위 외에도 폐, 갑상선, 침샘, 눈물샘에 발생하고, 드물게 안구, 유방, 방광, 신장, 흉선 등에도 보고된 바 있다. MALT 림프종은 오랜 기간동안 원격 전이하지 않고 국소 병변으로 남아 있는 특징이 있어 치료 방향 또한 국소 병변의 치료에 집중되며, 예후도 림프절 기원의 림프종에 비해 양호한 것으로 알려져 있다. 본 저자 등은 자궁 내막에 원발성으로 발생한 MALT 림프종 1예를 경험하였기에 문헌 고찰과 함께 이를 보고하고자 한다. Mucosa associated lymphoid tissue (MALT) lymphoma can rarely develop primarily in extranodal sites other than stomach which is the most common site for it. Other rare primary sites are small intestine, colorectum, esophagus, lung, thyroid, salivary gland, lacrymal gland, breast and skin. MALT lymphoma represents a distinct clinicopathologic features: it is usually localized to their original site for a long time and shows much more favorable prognosis than lymphoma at other site, but some MALT lymphoma can arise simultaneously or successively in different organ or give rise to another MALT lymphoma of other organ and can be multifocally disseminated or recurred. We report a very rare case of high grade B-cell lymphoma of mucosa associated lymphoid tissue (MALT) of the uterine endometrium, which was confirmed by immunohistochemical assay.
( Dae Hyeok Yang ),( Min Suk Lee ),( Jong Tae Ko ),( Yong Sik Kim ),( Moon Suk Kim ),( John M. Rhee ),( Gil Son Khang ),( Hai Bang Lee ) 한국조직공학과 재생의학회 2006 조직공학과 재생의학 Vol.3 No.3
Ultra high molecular weight polyethylene(UHMWPE) powders were impregnated into poly(methylmethacrylate)( PMMA) bone cement to improve the poor mechanical and thermal properties of the bone cement. But, the surface inertness of UHMWPE powder generated the poor bonding force with PMMA bone cement. The surface modification after pretreating UHMWPE powder with the three kinds of acid such as acetic, hydrochloric, and sulfuric acid has been carried out to advance the interfacial adhesion between UHMWPE powder and PMMA bone cement. The tensile strengths of reinforced PMMA bone cements with 3 wt% of surface-precoated UHMWPE powder with polyMMA after acids treatment were much higher than that(33.8 MPa) of 3 wt% of intact UHMWPE powder impregnated PMMA bone cement as well as were almost same as that(44.5 MPa) of conventional PMMA bone cement. Also, it was found that the curing temperatures of the composite PMMA bone cements were much lower than that(~103oC) of conventional PMMA bone cement. From these results, it was confirmed that acids treatment effectively modified the surface of UHMWPE powder. A possible mechanism for the surface modification of UHMWPE powder by acids treatment was proposed.
Case Reports : Superior Vena Cava Syndrome Caused by Encircling Soft Tissue
Dae Hyeok Kim,Yong Sun Jeon,Gi Chang Kim,In Sun Ahn,Jun Kwan,Keum Soo Park,Woo Hyung Lee 대한내과학회 2007 The Korean Journal of Internal Medicine Vol.22 No.2
Superior vena cava syndrome can occur from benign conditions that might not alter life expectancy. Here we present a case of a superior vena cava (SVC) obstruction caused by soft tissue encircling the SVC, which was strongly suspected of being an unusual focal type of fibrosing mediastinitis. A 39-year-old man with no prior medical history presented with a four-week history of facial plethora, headache and dilated veins of the neck with a dark purple color change on the anterior chest wall. Radiology examinations, including venography, and computed tomography with a 3-dimensional volume-rendering image of the chest, had revealed severe narrowing of the SVC due to tiny encircling soft tissue and collateral vessels. A total occlusion of the SVC occurred as a result of a thrombus that developed within 1 day after the diagnostic SVC angiogram. The patient underwent stent deployment three days after the administration of thrombolytic therapy.