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경부와 액와부에 동시에 발생한 소아의 국소형 Castleman 질환
노혜원(Hye Won Ro),유희선(Hee Sun Ryu),조진성(Jin Seong Cho),박민호(Min Ho Park),윤정한(Jung Han Yoon),제갈영종(Young Jong Jegal),이지신(Ji Shin Lee),임효순(Hyo Sun Lim) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.78 No.5
Castleman’s disease (CD) is an unusual benign lymphoproliferative disorder of unknown etiology and pathogenesis. It most commonly occurs in the mediastinum, but rarely in the axilla or neck. CD has been rarely reported at pediatric age in Korea. Here we report a 17-month-old male patient with histopathologically proven cervical & axillary CD of the hyline vascular type who presented with a painless axillary palpable mass and was treated with a complete excision of the neck & axilla mass without complication.
5 mm 이하의 유두 갑상선 미세암에서 림프절 전이와 관련된 예측인자
류희선,노혜원,조진성,박민호,윤정한,제갈영종,Hee-Seon Ryu,M.D.,Hye-Won Ro,M.D.,Jin-Seong Cho,M.D.,Min-Ho Park,M.D.,Jung-Han Yoon,M.D. and Young-Jong Jegal,M.D. 대한갑상선-내분비외과학회 2007 The Koreran journal of Endocrine Surgery Vol.7 No.4
Purpose: Papillary thyroid cancer is the most common histological type of malignancy that originates from the thyroid. The disease has an excellent prognosis, despite characteristically being associated with lymph node metastases. According to the World Health Organization, a papillary thyroid microcarcinoma (PTMC) is defined as papillary carcinoma measuring ≤1 cm in the greatest dimension. We present the clinico-pathological features and investigate predictive factors related with lymph node metastases in patients with papillary thyroid microcarcinomas less than 5 mm in size. Methods: Between January 2003 and June 2005, 75 patients underwent surgical treatment for thyroid papillary cancer less than 5 mm in size at the Department of Endocrine Surgery at our hospital. We analyzed the age of patients, gender, presence of symptoms, multifocality, combined thyroid disease, tumor size, capsular invasion, presence of a lymph node metastasis, tumor location, operative method and postoperative complications by use of Pearson's chi-squared test. Results: Lymph node metastases most frequently occurred in patients with a lateral neck mass at presentation (p= 0.004). Patients with capsular invasion of the thyroid showed a high rate of lymph node metastases (p=0.027). In patients with combined thyroid disease such as thyroiditis, more lymph node metastases were observed (p= 0.018). Conclusion: Preoperative symptoms at presentation (especially a lateral neck mass) and tumors with capsular invasion had a high potential to cause lymph node metastases. Factors such as a lateral neck mass, capsular invasion, and combined thyroiditis may be predictive of a lymph node metastasis and are helpful in the determination of proper treatment. (Korean J Endocrine Surg 2007;7: 242-245)
장기간의 갑상선 호르몬 술 후 대체요법 시 골밀도의 변화
김병천,노혜원,정연승,윤인상,정순주,박민호,윤정한,제갈영종,Byung Chun Kim,Hye Won Ro,Yeun Sung Jung,In Sang Yoon,Soon Ju Jeong,Min Ho Park,Jung Han Yoon and Young Jong Jegal 대한갑상선-내분비외과학회 2006 The Koreran journal of Endocrine Surgery Vol.6 No.1
Purpose: Bone turnover is increased in patients suffering with hyperthyroidism, and this results in osteoporosis. Especially after total thyroidectomy for the treatment of thyroid papillary cancer, it is necessary to pay attention to osteoporosis because we must treat these patients with suppressive thyroxine therapy. Methods: Among the patients who underwent endocrine surgery of Chonnam National University, 110 cases had taken thyroxine for more than one year. We analyzed them on the basis of their medical record. The study consisted of women between 45 and 74 years of age who were treated with thyroxine for more than one year, who had total thyroidectomy performed for thyroid papillary carcinoma and who taken thyroxine for 12∼142 months (mean: 53 months). We measured the bone mineral density at the lumbar spine and the femoral neck with using dual energy X-ray absorptiometry. Results: The bone mineral density of the lumbar spine and femur neck was significantly reduced with the increasing the duration of thyroxine medication. Yet this was not significant after adjusting by age. There was correlation between the TSH levels and bone mineral densities. Conclusion: After total thyroidectomy, it may be necessary to evaluate the bone mineral density of the patients who were treated with suppressive thyroxine and also to warn them about osteoporosis. (Korean J Endocrine Surg 2006; 6:1-5)
유방암에서 유두침범을 예측할 수 있는 인자들에 대한 분석
윤상권(Sang-Kwon Yun),노혜원(Hye-Won Ro),조진성(Jin-Seong Cho),박민호(Min-Ho Park),윤정한(Jung-Han Yoon),제갈영종(Young-Jong Jegal) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.4
Purpose: After the first subcutaneous mastectomy with nipple preservation in 1974 at the Nottingham Breast Clinic in United Kingdom, many studies have shown that skin-sparing mastectomy (SSM) with the preservation of the nipple-areola complex (NAC) is an oncologically safe procedure with good cosmetic outcomes in selected mastectomy patients. However, the clinical indications for NAC preservation have not yet been precisely defined. This study was performed to investigate the predictive factors for NAC-based neoplastic involvement to determine the indications for NAC preservation. Methods: A retrospective study of 198 patients with invasive breast cancer who underwent modified radical mastectomy (MRM) at the Department of Surgery at Chonnam University Hospital from April of 2004 to April of 2006 was performed. Patients with bilateral breast cancer were excluded from the study. The predictive factors analyzed for NAC involvement were the hormone receptor status, tumor size, tumor localization, multiplicity, axillary lymph node status, nuclear grade, tumor-nipple distance (TND), and lymphovascular invasion (LVI). Results: The overall frequency of malignant NAC involvement was 19 out of the 198 patients (9.5%) as determined by definitive histology. Significant differences were found for tumor size (P=0.015), axillary lymph node status (P=0.008), TND (P=0.044), and LVI (P=0.014). There were no significant differences for the hormone receptor status, multiplicity, nuclear grade, and localization. Conclusion: Although the sample size in this study was small, the findings suggest that the clinical contraindications for NAC preservation should include tumors >2.4 cm, a positive axillary lymph node status, TND <4 cm, and positive LVI. NAC preservation can be offered in selected patients after preoperative or intraoperative evaluation of the tumor size, axillary node status, TND, and LVI.
최은진(Eun Jin Choi),노혜원(Hye Won Ro),조진성(Jin Seong Cho),박민호(Min Ho Park),윤정한(Jung Han Yoon),제갈영종(Young Jong Jegal) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.2
Purpose: This study was performed to evaluate the feasibility of the Gamma Knife Surgery on the symptomatic control of brain metastasis from breast carcinoma. Methods: We retrospectively reviewed patients with brain metastases from breast cancer who underwent Gamma Knife Surgery at our hospital, between May 2004 and November 2007. Total 82 metastases were treated with 26 cycles of Leksell gamma knife. Freedom from local recurrence and survival time were analyzed by the Kaplan-Meier method. Results: 17 patients with 82 metastases were treated over 26 Gamma Knife Surgery sessions. The mean time to brain metastases was 41.7 months (8∼84), median number was 2.0 (1∼10), and median volume was 7.4 ㎤ (0.6∼25.4). Radiologic response occurred in 84.6%, and the rate of symptom relief was 73.1%. Local brain tumor recurrences were observed in 15.3% and intracranial distant recurrence occurred in 57.7% that occurred within 3.2 months. The median length of survival for all patients was 9.3 months (95% confidence interval, 4.23∼9.37 months). Conclusion: Gamma Knife Surgery is an effective and feasible treatment for symptomatic control of brain metastases from breast cancer patients who have severe extracranial metastases and short life expectancy.