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고영일,박홍석,문두건,이정구,김제종,윤덕기,강석호,천준 대한암학회 2008 Cancer Research and Treatment Vol.40 No.4
Purpose: To evaluate the feasibility and efficacy of performing laparoscopic renal cryoablation (LRC) for the treatment of RCC, as compared with open partial nephrectomy (OPN), which is the established NSS. Materials and Methods: From April 2004, among the patients who underwent LRC with a 1.47 mm cryoprobe, we enrolled 20 patients who were pathologically confirmed as having RCC with a tumor size smaller than 4 cm. These patients were matched with a group of 20 patients, who were selected based on the pre-operative characteristics of the tumor and those of the patients, from a pre-existing database of the patients who underwent OPN during the same period. Results: The mean age and tumor size were 56.3±11.5 years and 2.4±1.7 cm in the LRC group, and 57.6±10.9 years and 2.2±1.1 cm in the OPN group. The two groups were similar for their age, gender, BMI, ASA, the tumor characteristics and the indications for operation. While the pathologic results and the operation time showed similarity, the EBL (98±87 ml vs 351±147 ml, respectively, p=0.001), the transfusion rate (10% vs 40%, respectively, p=0.03) and the hospital stay (4.2±1.5 days vs 8.2±2.4 days, respectively, p=0.005) were significantly less in the LRC group. Major complications did not occur in the LRC group, but in the OPN group, one patient experienced urine leakage and one patient had a perirenal hematoma. During the mean follow up of 27.3±10.8 months and 28.7±14.9 months for each group, respectively, all the patients remained disease- free with no evidence of local recurrence or metastases. Conclusions: LRC using ultra-thin cryoprobes for the treatment of small RCC showed similar effective oncologic results with the merits of minimal invasiveness, as compared with OPN, during the intermediate term follow up.
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고영일,한기택,임진수,김민철 대한두개안면성형외과학회 2014 Archives of Craniofacial Surgery Vol.15 No.1
Leiomyosarcoma is a rare form of soft tissue neoplasm, with only 1% to 5% occurring in the head and neck region. Current recommended treatment suggests surgical excision with a wide lateral margin, but no definite guidelines regarding excisional margin have been established yet. Recently, complete excision with a narrow surgical margin has been recommended, and the authors present a case of cutaneous leiomyosarcoma on the face that was successfully managed by complete removal with a narrow excisional margin. A 74-year-old woman presented with a 3 cm sized, rapidly growing cutaneous mass on her right preauricular area. Preoperative biopsy of the skin lesion suggested a cutaneous leiomyosarcoma. The authors performed complete surgical excision with a 1 cm lateral margin, and the resulting skin defect was repaired with bilateral V-Y advancement local flaps. Histopathology and immunohistochemistry evaluation confirmed a moderately differentiated cutaneous leiomyosarcoma, with negative margin involvement. The patient refused of any additional treatment, but showed no locoregional recurrence during the 1.5 years of postoperative follow-up period. With a regular postoperative follow-up, cutaneous leiomyosarcomas may be successfully treated with a narrow surgical margin.
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Kummell 씨 병의 이해: 정의, 진단, 병태생리 및 치료
고영일,고명섭,방청원,박형열,김영훈 대한척추외과학회 2024 대한척추외과학회지 Vol.31 No.1
연구 계획: 종설목적: Kummel l씨 병의 정의, 진단 및 병리생리학, 그리고 치료에 대한 현시점의 이해를 정리하고자 한다. 선행 연구문헌의 요약: Hermann Kummell은 외상성 척추 골절 후 지연된 척추 변형 및 임상 증상 악화를 보고하였다. 이후 Kummell 씨 병은 척추 골절이후 지연된 척추 후만 변형과 신경 합병증을 유발하는 상태로 정의되고있으며 현재 Kummell씨 병에 대한 다양한 연구가 이루어지고있다. 대상 및 방법: 관련 연구 고찰결과: Kummell 씨 병의 진단시 임상 증상과 함께 추체내 틈 및 동적 가동성 등의 영상의학적 소견을 고려하여야한다. 병리생리학적으로는 혈행의 문제와불유합이 원인으로 생각되고있다. 치료는 임상 증상과 불안정성 등을 고려하여 보존적 치료 및 수술적 치료방법을 고려할 수 있다. 수술적 접근에는 추체내 시멘트 삽입술과 후방 고정술 등 다양한 수술적 방법이 시행되고 있다. 결론: Kummell 씨 병은 추체내 틈 및 동적 불안정성을 동반한 진행성의 골다공증성 골절로 정의된다. 대부분의 경우 보존적치료가 우선적으로 이루어지지만, 환자의 의학적상태 및 척추의 상태에 따라 치료의 방향이 결정된다. 약칭 제목: Kummell 씨 병의 이해 Study design: Review article Objective: To provide a comprehensive review of Kummell’s disease, focusing on its definition, diagnosis, pathophysiology, and treatment approaches. Summary of Literature Review: Hermann Kummell reported the delayed occurrence of post-traumatic vertebral deformities and worsening of clinical symptoms following minor spinal fractures. Later, Kummell’s disease was defined as a condition that causes delayed kyphotic deformity and neurological problems due to spinal fractures. Numerous research efforts and imaging advancements have been made for Kummell’s disease. Results: The diagnosis of Kummell’s disease requires considering the clinical presentation, radiographic findings, and dynamic mobility. Vascular causes and nonunion are implicated in its pathophysiology. The treatment involves conservative approaches and surgical interventions based on symptoms and instability. Various surgical methods, including vertebroplasty and posterior fixation, have been explored, but limited evidence hinders a consensus. Conclusions: Kummell’s disease presents as a progressive osteoporotic compression fracture with the intravertebral cleft, together with and dynamic instability. Conservative and medical treatments are tried first, but if they are unsuccessful or complications arise, surgery may be considered. The choice of treatment depends on analyzing the patient's overall health and spinal condition.
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