• Title/Summary/Keyword: 미세수술

Search Result 983, Processing Time 0.03 seconds

A Case of Lung Cancer: Postop Minimal Residual Disease at Pleura (폐암 수술 후 흉막 내 미세잔류병변 판정사례)

  • Jang, JoungSoon
    • Korean journal of aerospace and environmental medicine
    • /
    • v.31 no.2
    • /
    • pp.57-59
    • /
    • 2021
  • For nonsmall cell lung cancer (NSCLC), surgery is indicated only for stage 3 as a curative measure. Even so, there is a high risk of recurrence following stage 3 lung cancer surgery, a third (33.9%) of patients experienced a cancer recurrence mostly within 2 years after surgery. The median survival time for all stages reaches only 21.9 months. For people undergoing surgery for stage 3A NSCLC, a pre-operative course of (neoadjuvant chemotherapy) can improve survival times, by improving the resectability and lowering the risk of recurrence. Pleural metastases are frequently associated with tumors of the lung and breast. Chest radiographs and computed tomography scans of pleural metastases can present as an effusion or smooth or nodular pleural thickening. In the absence of irregular or nodular pleural thickening, it is difficult to distinguish a benign from a malignant pleural effusion. To treat lung cancer, tyrosine kinase inhibitors (TKIs) recently have been used to cope with genetic mutations, apart from cytotoxic anticancer drugs. Compared to cytotoxic drugs, they are effective, have fewer side effects, and are easy to administer. Airman must have no cancer disease to apply for Class-I medical certification. Specifically, if previously operated on cancer, the cancer should not remain in the body at present, and the disease free state should persist at least one year after all kinds of anti-cancer treatments including adjuvant chemotherapy are completed. Here, this case deals with a 41-year-old pilot who has ATP license who had stage 3A NSCLC. The pilot underwent curative lung cancer surgery (lobectomy) a year ago and showed suspicious pleural metastasis at the time of his application for certification and was still using an unauthorized TKI agent alectinib (Alecensa; Roche, Basel, Switzerland).

Current Update of Cartilage Regeneration Using Stem Cells in Osteoarthritis (골관절염에서 줄기세포를 이용한 연골 재생의 최신 지견)

  • Seon, Jong-Keun;Choi, Ik-Sun;Ko, Jee-Wook
    • Journal of the Korean Orthopaedic Association
    • /
    • v.54 no.6
    • /
    • pp.478-489
    • /
    • 2019
  • Osteoarthritis is a disease characterized by the progression of articular cartilage erosion, that increases pain during joint motion and reduces the ability to withstand mechanical stress, which in turn limits joint mobility and function. Damage to articular cartilage due to trauma or degenerative injury is considered a major cause of arthritis. Numerous studies and attempts have been made to regenerate articular cartilage. In the case of partial degenerative cartilage changes, microfracture and autologous chondrocyte implantation have been proposed as surgical treatment methods, but they have disadvantages such as insufficient mutual binding to the host cells, inaccurate cell delivery, and deterioration of healthy cartilage. Stem cell-based therapies have been developed to compensate for this. This review summarizes the drawbacks and consequences of various cartilage regeneration methods and describes the various attempts to treat cartilage damage. In addition, this review will discuss cartilage regeneration, particularly mesenchymal stem cell engineering-based therapies, and explore how to treat future cartilage regeneration using mesenchymal stem cells.

Imaging Findings of Nodular Fasciitis in Breast including Artificial Intelligence Mammography and Shear Wave Elastography: A Case Report (유방의 결절성 근막염의 인공지능 유방촬영술과 탄성초음파를 포함한 영상 소견: 증례 보고)

  • So Hyeong Park;Ji Yeon Park;Mee Joo;Jae Il Kim
    • Journal of the Korean Society of Radiology
    • /
    • v.84 no.6
    • /
    • pp.1397-1402
    • /
    • 2023
  • Nodular fasciitis is a benign fibroblastic proliferation rarely reported in the breast. We report the case of a 55-year-old woman who presented with imaging findings that resembled a malignancy. Mammography revealed an isodense nodule with partially indistinct margin in the right breast, showing the abnormality score 75% on artificial intelligence. Ultrasonography revealed an oval hypoechoic nodule with microlobulated margin, echogenic halo, increased blood flow, and soft elasticity. After core needle biopsy and excision, nodular fasciitis was diagnosed. Although nodular fasciitis of the breast is rare, it may mimic malignancy; therefore, it should be considered as a differential diagnosis to prevent unnecessary intervention.

The Changes in the Electrical Properties of $\textrm{BaTiO}_3$-based PTCR Materials due to the addition of (Ca, Sr)$\textrm{TiO}_3$ ($\textrm{TiO}_3$첨가에 의한 $\textrm{BaTiO}_3$계 PTCR 물질의 전기적 특성변화에 대한 연구)

  • Joo, Ji-Won;Kim, Jong-Hwan;Kim, Hwan;Park, Soon-Ja
    • Korean Journal of Materials Research
    • /
    • v.7 no.4
    • /
    • pp.347-353
    • /
    • 1997
  • BaTiO$_{3}$물질은 뛰어난 유전체로 널리 알려져 왔으며 특히 Heywang등이 제안한 PTCR특성은 이 물질의 응용범위를 세라믹 필터, 회로보호소자, 온도감지소자 및 저항가열장치 등으로 확대시켰다. 이러한 특성의 발현기구는 아직까지 밝혀지지 않은 상태이지만 제 특성을 향상시키기 위한 노력은 계속되어왔다. 특히 개발목적에 맞게 온도에 따른 정저항 특성(PTCR; Positive temperature constnat of resistivity phenomena)을 설계하려는 시도가 계속되어 왔으며 그 중에서도 페로브스카아트계의 2가와 4가의 양이온 자리를 등가나 원자가가 다른 양이온으로 치환하여 특성을 개선하려는 시도가 계속되어 왔다. 특히 $Ca^{2+}$나 Sr$^{2+}$$Ba^{2+}$자리를 치환할 수 있는 물질로 개별적인 첨가에 대한 연구는 많은 연구자들에 의해 진행된 상태이지만 최종적인 영향이나 해석에 대해서는 연구자들간에 이견이 많은 상태이다. 이번 실험에서는 BaTiO$_{3}$계에 합성한 (Ca, Sr)TiO$_{3}$를 Ca와 Sr의 상대적인 비를 변화시키면서 전체적인 첨가량을 변화시켜 그에 따른 전기적 특성 및 미세구조를 살펴보았다. (Ca, Sr)TiO$_{3}$의 첨가로 상온저항 및 PTCR특성을 변화시킬 수 있었으며 이를 통해 PTCR물질의 활용범위를 넓힐 수 있는 발판을 마련할 계기가 되었다. 특히 기존의 연구가 주로 개별적인 Ca나 Sr의 첨가에 의한 미세구조와 전기적 특성변화의 연구에 치중해 있었던 것과는 달리 Sr과 Ca을 함께 치환하여 상대적인 비가 특성에 더 중요한 영향을 끼치는 것을 확인하였으며 적절한 합성비를 선택하면 퀴리온도에서의 저항변화폭을 유지하면서 상온저항을 낮출 수 있음을 확인하였다.문했던 연구소인 Shanghai Research Center of Biotechnology, Shanghai Institute of Industrial Microbiology 및 Scientific Research Institute of Food and Fermentation Industry을 소개하고저 한다. 짧은 기간의 방문이라 주로 해당연구소의 자체소개 자료를 중심으로 방문하면서 느낀점을 기술하고저 한다.초염기성암 기원의 사문암이 열수변질작용을 받아 생성되었음을 명확하게 지시하며, 따라서 활석 광석내에 존재하는 녹니석은 활석의 근원 광물로서 녹니석편암 및 녹니석 편마암 매의 녹니석이 활석화되고 남은 잔존광물이 아니라, 주변암에 의해 성분상의 영향을 받은 열수와 사문암과의 변질교대작용에 의한 활석화과정 중에 주로 생성된 것으로 추정된다. 이러한 결과는 연구지역의 활석광상이 초염기성암의 사문암화 작용과 활석화 작용의 두 가지 변질작용에 의해 형성되어졌음을 알려준다.농도 증가 없이 폐 조직에 약 50배 정도의 고농도 cisplatin을 투여할 수 있었으며, 또한 분리 폐 관류 시 cisplatin에 의한 직접적 폐 독성은 발견되지 않았다이 낮았으나 통계학적 의의는 없었다[10.0%(4/40) : 8.2%(20/244), p>0.05]. 결론: 비디오흉강경술에서 재발을 낮추기 위해 수술시 폐야 전체를 관찰하여 존재하는 폐기포를 놓치지 않는 것이 중요하며, 폐기포를 확인하지 못한 경우와 이차성 자연기흉에 대해서는 흉막유착술에 더 세심한 주의가 필요하다는 것을 확인하였다. 비디오흉강경수술은 통증이 적고, 입원기간이 짧고, 사회로의 복귀가 빠르며, 고위험군에 적용할 수 있고, 무엇보다도 미용상의 이점이 크다는 면에서 자연기흉에 대해 유용한 치료방법임에는 틀림이 없으나 개흉술에 비해 재발율이 높고 비용이 비싸다는 문제가 제기되고 있는 만큼 더 세심한 주의와 장기 추적관찰이 필요하리라 사료된다.

  • PDF

Expression of Hypoxia-inducible Factor-1 $\alpha$ in Esophageal Squamous Cell Carcinoma: Relationship to Prognosis and Tumor Biomarkers (식도 편평세포암에시 Hypoxia-inducible Factor-1 $\alpha$의 발현: 예후와 종양표지자와의 상관성)

  • 양일종;김종인;이해영;천봉권;조성래
    • Journal of Chest Surgery
    • /
    • v.37 no.8
    • /
    • pp.691-701
    • /
    • 2004
  • Background: Tissue hypoxia is a characteristic of many human malignant neoplasms, and hypoxia inducible factor-1 (HIF-1) plays a pivotal role in essential adaptive response to hypoxia, and activates a signal pathway for the expression of the hypoxia-regulated genes, resulting in increased oxygen delivery or facilitating metabolic adaptation to hypoxia. Increased level of HIF-1 a has been reported in many human malignancies, but in esophageal squamous cell carcinoma, the influence of HIF-1 a on tumor biology, including neovascularization, is not still defined. Material and Method: The influence of HIF-1 a expression on angiogenic factors, correlation between the tumor proliferation and HIF-1 a expression, interaction of HIF-1 a expression and p53, and correlation between HIF-1 a expression and clinicopathological prognostic parameters were investigated, using immunohistochemical stains for HIF-1 a, VEGF, CD34, p53, and Ki-67 on 77 cases of resected esophageal squamous cell carcinoma. Result: HIF-1 a expression in cancer cells was found in 33 of 77 esophageal squamous cell carcinoma cases. The 33 cases (42.9%) showed positive stain for HIF-1 a. High HIF-1 a expression was significantly associated with several pathological parameters, such as histologic grade (p=0.032), pathological TMN stage (p=0.002), the depth of tumor invasion (p=0.022), regional lymph node metastasis (p=0.002), distant metastasis (p=0.049), and lymphatic invasion (p=0.004). High HIF-1 a expression had significant VEGF immunoreactivity (p=0.008) and Ki-67 labeling index (p<0.001), but was not correlated with microvascular density within tumors (p=0.088). The high HIF-1 a expression was correlated with aberrant p53 accumulation with a marginal significance (p=0.056). The overall 5-year survival rate was 34.9%. The survival rate of patients with a high HIF-1 a expression was worse than that of patients with low-expression tumors (log-rank test, p=0.0001). High HIF-1 a expression was independent unfavorable factors although statistical significance is marginal in multivariate analysis. Conclusion: It is suggested that (1) high HIF-1 a expression in esophageal squamous cell carcinoma is associated with tumor hypoxia, or with genetic alteration in early carcinogenesis and progressive stages, (2) high HIF-1 a expression may be associated with intratumoral neovascularization through HIF-VEGF pathway, and (3) high HIF-1 a expression is associated with poor prognosis in patients with esophageal squamous cell carcinoma and may playa role as biomarker for regional lymph node metastasis.

Effect of Fragment Removal on Development of Human Fragmented Embryos in IVF-ET Program (IVF-ET 시술 시 파편제거가 파편화된 인간배아의 발달에 미치는 효과)

  • Chi, Hee-Jun;Koo, Jung-Jin;Lee, Ju-Ok;Ryu, Hyoung-Eun;Kim, Kwang-Rae;Park, Chan;Roh, Sung-Il
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.37 no.4
    • /
    • pp.339-348
    • /
    • 2010
  • Objective: To investigate the beneficial effect of fragment removal on the subsequent cell division and clinical outcome of the fragmented human embryos. Methods: A prospective study was performed in Hanna Women's Clinic and Mizmedi Hospital. Sixty couples undergoing In vitro fertilization-embryo transfer (IVF-ET) program were participated in the present study. The microsurgical fragment removal was performed in 106 fragmented embryos of 29 patients before the transfer. As a control group, 122 fragmented embryos of 31 patients were transferred without the fragment removal. Effects of fragment removal on morphological changes and clinical outcomes of fragmented embryos were investigated. Results: Mean morphological grade (G2.79) of fragmented embryos was significantly improved after the fragment removal(G1.63, p<0.001). Most of the fragmented embryos did not show a regeneration of fragments after the fragment removal during the subsequent development, and a beneficial effect of fragment removal on the development of the fragment removed embryos was observed. Implantation and pregnancy rates of fragment removed embryos were 12.3% and 31.3%, whereas the rates of control group embryos were 6.6% and 22.5%, respectively. There was no statistical significance in the rates between the two groups because of the low number of trials. Conclusion: Microsurgical fragment removal improved the subsequent development as well as the morphological grade of fragmented embryos. The fragment removal may be beneficial for neighboring blastomeres by repairing the intercellular communication and removing the secretion of the potential toxic materials by fragments.

Comparison of Spontaneous Recovery and Nerve Surgery in Brachial Plexus Injury (상완 신경총 손상에서 자연 회복과 신경 재건술간의 비교)

  • Baek, Goo-Hyun;Chung, Moon-Sang;Seo, Joong-Bae;Park, Jin-Soo;Park, Yong-Bum;Jun, Deuk-Soo
    • Archives of Reconstructive Microsurgery
    • /
    • v.5 no.1
    • /
    • pp.137-146
    • /
    • 1996
  • There has been no general agreement about optimal time for nerve surgery in the closed brachial plexus injury(BPI). From our early experiences, we knew by chance that spontaneous recovery in BPI patients may begin even later than 8 months after injury. Authors' strategy, which was based on our early experiences, for the treatment of closed fresh injury was 'wait and see' unlit 8 months after injury. From 1985 to 1994, we observed 103 patients with BPI. All of them did not have any operation until 8 months after injury. There were 95 men and 8 women with a mean age of 29 years. Motorcycle injury(31%) and vehicle accident(28%) were main causes of injury. Whole plexus types were observed in 56 patients(54%), upper plexus types in 29(28%), lower plexus types in 3(3%), and infraclavicular types in 15(15%). Electromyography was performed in all patients. This was repeated every three months to detect the recovery. Results were evaluated by authors' criteria, in which AMA system of brachial plexus impairment was modified. Duration of follow up was average 25 months. 47 patients(46%) showed spontaneous improvement, which was initially detected at average 7.8 months(range,3 months-16 months) after trauma by electromyography. The average score of these 47 patients improved from 14.8 points to 39.8 points.31 patients(30%) had nerve surgery such as nerve graft, neurotization or neurolysis. Average duration from injury to nerve surgery, was 10 months. Among 31 patients who had nerve surgery, 16 patients improved from preoperative 21.5 points to postoperative 36.3 points in average. Because spontaneous recovery began in average 7.8 months after injury, we think that it would be better to 'wait and see' for at least one year in patients with closed BPI expecting spontaneous recovery.

  • PDF

Analysis on the association between EEG and 2-deoxy-2-[18F]-D-glucose (FDG)-PET findings in children with epilepsy (소아 간질 환아에서 뇌파와 PET과의 연관성에 대한 분석)

  • Hur, Yun Jung;Lee, Joon Soo;Lee, Jong Doo;Kim, Heung Dong
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.3
    • /
    • pp.286-292
    • /
    • 2008
  • Purpose : We performed EEG and PET on children with epilepsy concomitantly in order to evaluate the effects of epileptiform and non-epileptiform discharge of EEG on glucose metabolism. Methods : Seventy three children with epilepsy who had PET and EEG simultaneously were included in our study. The subjects were classified in two ways: (1) based on the frequency of epileptiform discharge and (2) the severity of non-epileptiform discharge. We evaluated the clinical aspects of their seizures, the severity of focal slow waves during the interictal period with the frequency of spikes or sharp waves in order to compare with the PET results. Results : The subjects were divided by the frequency of epileptiform discharge, with 13 in the no/rare group, 7 in the occasional group, and 53 children in the frequent group. The concordant rates with PET in each group were 0%, 42.9%, and 67.9%, respectively, showing high correlations with the frequency of epileptiform discharge (P<0.05, r=0.491). The subjects as divided by the severity of non-epileptiform discharge were 15 in the no group, 25 in the infrequent group, 17 in the intermediate group, and 16 in the continuous group. The concurrence rates with PET for each group were 13.3%, 52.0%, 64.7%, and 68.8%, respectively, also showing a high correlation with the severity of non-epileptiform discharge (P<0.05, r= 0.365). Conclusion : Epileptiform discharge and non-epileptiform discharge in EEG showed a certain association with hypometabolism in PET. We recommend EEG to reduce false lateralization and to localize lesions in cases of high frequency and severity.

Clinicopathologic Characteristics of and Prognosis for Patients with a Borrmann Type IV Gastric Carcinoma (Borrmann 4형 위암의 임상병리학적 특성과 예후)

  • Kim, Taeg-Hyun;Song, Kyo-Young;Kim, Seung-Nam;Park, Cho-Hyun
    • Journal of Gastric Cancer
    • /
    • v.6 no.2
    • /
    • pp.97-102
    • /
    • 2006
  • Purpose: The prognosis for patients with a Borrmann type IV gastric cancer is extremely poor despite an aggressive surgical approach. We evaluated the clinicopathological features for Borrmann type IV cancers to find treatment strategy. Materials and Methods: The 1098 patients with advanced gastric cancer who underwent surgical resection between 1990 and 2001 were analyzed. These patients were divided into two groups: 81 patients with a Borrmann type IV carcinoma, and 1017 patients with all other types of gastric carcinomas. Results: Patients with a Borrmann type IV carcinoma were younger than those with other types, and female was prevalent (p=0.000). Of the patients with a Borrmann type IV gastric carcinoma, 68 patients (84%) were classified as stage III or IV at the initial diagnosis. The histologic type was commonly undifferentiated and serosal infiltration; nodal involvement and lymphatic invasion were more frequent in patients with a Borrmann type IV than in those with other types of cancer. Multivariate analysis confirmed that the extent of lymph node metastasis was a negative prognostic factor for Borrmann type IV gastric carcinomas. The curability for a Borrmann type IV carcinoma was only 53.1%, and peritoneal dissemination rate was 25.9%. The predominant pattern of recurrence for a Borrmann type IV gastric carcinoma was peritoneal dissemination, and it was significantly different with other types (93.1% vs 55.8%, P<0.05). The 5-year survival rate of patients with a Borrmann type IV gastric carcinoma was significantly lower than those of patients with other types of cancer, even though a curative resection had been accomplished (26% vs 63%, p<0.005). The 5-year survival rates of patients with a Borrmann type IV carcinoma following a curative resection were 44.9%, 24%, and 0% for stages II, III and IV, respectively (p<0.05). Conclusion: Because the prognosis for patients of a Borrmann type IV gastric cancer is extremely poor despite a curative resection, preoperative and/or intraperitoneal chemotherapy should be considered. And diagnostic laparoscopy and peritoneal cytology may be used to play an important role in accurate staging workup. (J Korean Gastric Cancer Assoc 2006;6:97-102)

  • PDF

The Result of Radiotherapy for Pituitary Adenoma (뇌하수체 선종의 방사선치료 결과)

  • Lee, Hyun-Joo;Yang, Kwang-Mo;Cho, Heung-Lae;Shon, Seung-Chang;Suh, Hyun-Suk
    • Radiation Oncology Journal
    • /
    • v.15 no.4
    • /
    • pp.297-303
    • /
    • 1997
  • Purpose : To evaluate the prognostic factors for disease-free survival and long-term results of radiotherapy for pituitary adenoma. Methods and Materials : The study involved a retrospective review of out-come in a series of 27 patients with pituitary adenoma, between 1984 and 1995 at Paik hospital. The study included 20 patients treated with surgery and postoperative radiotherapy and 7 with radiotherapy alone. The patients were followed for 12-146 months (median : 97 months). Seventeen were men and 10 were women. The numbers of functioning and nonfunctioning pituitary adenorna were 22 and 5 respectively and those of microadenoma and macroadenoma were 4 and 23 respectively. The radiation doses of 5040-5580cGy (median : 5040cGy) were deliverd over 5-7 weeks, using 4MV LINAC. The prognostic factors were analyzed by log-rank test. Results: For radiation therapy alone, the 5YSR was 100% and progression free survival rate was 85.8%, The tumor was controlled in 6/7 (85.8%). For surgery and postoperative radiotherapy. the 5YSR, progression free survival rate and local control rate were 95%, 84.8%, and 89.5% respectively. The parameters of tumor size, hormone secretion, radiation dose. radiotherapy field size were evaluated in a uni- and multivariate analysis and all the factors were not statisticaIty significant (P>0.05). Eleven of 12 (92%) with visual field defect experienced normalization or improvement, and 5 for 7 evaluabie patients with hyperprolactinoma achived normalization in 4 and decrement in S patients. Only 2 patients developed mild degree of Panhypopituitarism. Conclusion: The radiotherapy appears to be effective in controiling clinical symptoms and signs resulting from pituitary adenoma. Local control rate with radiotherapy alone or with surgery and postoperative radiotherauy was comparable. There was a trend toward high recurrence rate in Patients with nonfunctioning or prolactin secretion tumor and larger radiation field sizes.

  • PDF