• Title/Summary/Keyword: 수술 후 예후

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A Case of Primary Diffuse Nodular Pulmonary Amyloidosis Localized in the Lung (원발성 결절성 폐실질형 유전분증 1예)

  • Jung, Sung-Kwoen;Oh, Joon;Roh, Yang-Won;Kong, Hee-Sang;Park, Kae-Young;Park, Jeong-Woong;Park, Jae-Kyung;Nam, Gui-Hyun;Ha, Seong-Hwen;Lee, Han-Kyung;Jeong, Seong-Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.365-371
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    • 2000
  • Nodular pulmonary amyloidosis is one of the rare manifestation of amyloid disease. It is known to be caused by amyloid L fibrils in the majority of cases. We experienced an unusual case of a forty-one year-old woman who was presented with multiple nodular lesion on the chest X-ray. CT-guided core needle biopsy, performed on the lesion, showed apple green birefringes, when stained Congo red and examined under polarized light, Ultrastructurally, there are randomly oriented, forming densed networks, and consists of fine, 7.5 to 10nm diameter, rigid, non-branching filaments of various lengths in electron-microscopic finding. We report a case of primary diffuse nodular pulmonary amyloidosis only localized in the lung, which was confirmed by CT guided core needle biopsy.

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Activity of Matrix Metalloproteinase-2 and its Significance after Resection of Stage I Non-small Cell Lung Cancer (제1기 비소세포폐암 환자의 수술적 절제 후 Matrix Metalloprotainase-2 활성도에 따른 재발 및 예후)

  • Kim Sang Hui;Hong Young-Sook;Lee Jinseon;Son Dae-Soon;Lim Yu-Sung;Song In-Seung;Lee Hye-Sook;Kim Do Hun;Kim Jingook;Choi Yong Soo
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.38-43
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    • 2005
  • Matrix metalloproteinase-2 (MMP-2) is a class of proteolytic enzymes that digest collagen type IV and other components of the basement membrane. It plays a key role in the local invasion and the formation of distant metastases by various malignant tumors. The aim of this study was to evaluate the activity of MMP-2 and its significance as a prognostic marker in resected stage I non-small cell lung cancer (NSCLC). Material and Method: In this study we obtained fresh-frozen samples of tumor and non-tumor tissues from 34 patients with stage I NSCLC who underwent resection without preoperative radiotherapy or chemotherapy. After the extraction of total protein from tissue samples, MMP-2 activities were assessed by gelatin-substrate-zymography. The activities were divided into the higher or lower groups. Result: The MMP-2 activities were higher in tumor tissues than in non-tumor tissues. The MMP-2 activity of non-tumor tissues in recurrent group was higher than in non-recurrent group (p<0.01). Also the patients with higher MMP-2 activity of non-tumor tissues showed poor 5 year survival (p<0.01). Conclusion: This result indicates that the higher level of MMP-2 activity in the non-tumor tissue is associated with the recurrence and survival after the resection of stage I NSCLC. Therefore, MMP-2 activity in the non-tumor tissue could be used as a potential prognostic marker for the resected stage I-NSCLC.

A RETROSPECTIVE CLINICAL STUDY OF PERIAPICALLY INFECTED TEETH TREATED WITH PERIAPICAL SURGERY (치근단 감염 치아의 치근단 수술 후 예후에 관한 후향적 연구)

  • Kim, Hyeon-Min;Park, Chul-Hwi;Lee, Sang-Chil;Kim, Dong-Woo;Park, Dae-Song;Jung, Jin-Hwan;Lee, Seul-Ki;Song, Min-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.3
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    • pp.236-241
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    • 2010
  • Purpose: The purpose of this retrospective clinical study was to monitor the outcomes of periapical surgery in periapically infected tooth with or without retrograde filling materials (MTA or IRM). Patients and Methods: A total of 85 teeth in 63 patients were included in the study between November 2004 and August 2008. Randomly, MTA or IRM was used as a retrograde filling material or only apical resection without retrograde filling. Teeth with advanced periodontal bone loss or presence of root fracture were excluded from the study. The patients were subjected to a minimum follow-up period of 12 months, with a mean of 17.1 months. Results: Successful healing was observed in 83.3% of the MTA-treated teeth, 80% of the IRM-treated teeth and 75% of the teeth which was not retrograde filling. Doubtful healing was seen 9.3% (MTA), 13.3% (IRM), 12.5% (no retro-filling). The success rate of upper incisors (92%) was higher than lower lincisor and molars (66.7% and 50%, respectively). Conclusion: In this study, periapical surgery including retrograde filling improves the prognosis. And, no statistically significant differences were found between retrograde filling materials (MTA or IRM).

A Case of Papillary Thyroid Cancer Presenting as Pleural Effusion (흉수로 발현한 유두모양 갑상샘암)

  • Jung, Ki Hwan;Seo, Ji A;Lee, Ju-Han;Jo, Won Min;Kim, Je Hyeong;Shin, Chol
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.314-317
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    • 2008
  • We report the patient presented with a left-sided pleural effusion. Pleural fluid analysis revealed lymphocyte-dominant exudates with lower level of adenosine deaminase and negative cytologic malignancy. Thoracoscopic examination and histologic examination revealed metastatic nodules on pleurae, proven to be from the papillary thyroid cancer. There were no other sites of distant metastases. Though papillary thyroid cancer is characterized with slow progression and relatively good prognosis, metastatic pleural effusion as an initial manifestation of undiagnosed papillary thyroid cancer can be considered.

Treatment of Locally Advanced Pancreatic Cancer (국소적으로 진행된 췌장암의 치료)

  • Kim, Dae-Yong;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.331-335
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    • 1993
  • From January 1981 to December 1991, forty patients with localized advanced carcinoma of the pancreas were treated at the Department of Therapeutic Radiology, Seoul National University Hospital. The treatment protocol consisted of two split course external radiation therapy with each 2000 cGy over two weeks separated by two week rest period. Intravenous 5-fluorouracil (5-FU) was administered on the first three days of each radiotherapy course. Twenty three of these patients were treated by maintenance 5-FU or FAM (5-FU, adriamycin, mitomycin) chemotherapy. Median survival was 9 months and the 2-year survival rate was $10.0\%.$ Good prognostic indicators were good performance status, palliative bypass surgery and tumor located in the head of pancreas.

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Prognostic Factors Affecting Long Term Survival after Operation in Metastatic Lung Cancer (전이성 폐암에서 수술 후 장기 생존에 영향을 미치는 예후 인자)

  • 홍기표;정경영;김길동;박인규
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.916-923
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    • 1999
  • Background: Many institutes are interested in lung metastatectomy than before because of the improved long term survival, low mortality, and low morbidity after lung metastatectomy. However, prognostic factors affecting long term survival are controversial. We attempt to analyze the prognostic factors affecting retrospectively by comparing the results of lung metastasectomy. Material and Method: Between Jan. 1990 and Dec. 1997, 74 operations were taken in 63 patients with pulmonary metastases in various primary sites. We analyzed the postoperative long term survival according to sex, cell type, laterality, disease free interval(DFI), operation, the number of metastases, and the size of the largest metastasis. Result: There were 27 male and 36 female patients. Sex did not appeared to affect survival time(p=0.849). The primary tumor was carcinoma in 32, sarcoma in 28, and others in 3. Cell type, considering carcinoma and sarcoma, did not relate to survival time(p=0.071). DFI had no influence on the outcome(p=0.902). The type of operative procedure had no influence on the outcome(p=0.556). The laterality of metastases, 47 unilateral(74.6%) and 16 bilateral(25.4%), had no influence on the outcome(p=0.843). The number of metastases excised(one, two or three, four or more) did not appear to affect survival(p=0.263). The size of largest metastasis(<=10mm, 11mm-30mm, and >30mm) did not appear to affect survival(p=0.751). Previous factors were evaluated in both the carcinoma and sarcoma patients respectively. DFI was the only significant prognostic factor in metastatic lung sarcoma(p=0.0026). Conclusion: Survival was not related to sex, cell type, laterality, DFI, operative procedure, number of metastases, nor the size of the largest metastasis. DFI was related to the survival time in sarcoma group but further study is needed.

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Alveoloar Rhabdomyosarcoma of Tongue Base in an Infant : A Case Report (영아의 설근부에 발생한 폐포성 횡문근육종 1예)

  • Kim, Jisung;Yeon, Je Yeob;Park, Jae-Hong;Lee, Yong-Moon;Lee, Dong Wook
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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    • pp.75-78
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    • 2013
  • 영아의 설근부에 발생하는 악성 종양은 매우 드물다. 저자들은 연하곤란과 폐쇄성 수면 무호흡증으로 의뢰된 17개월 남아의 설근부에 발생한 횡문근육종을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 외래에서 실시한 이학적 검사 상 설근부 전체가 돌출되어 있었으며 단단한 종괴가 촉지 되었다. 조직검사와 기관절개술을 시행하였으며 컴퓨터단층촬영, 양전자 방출 단층 촬영 그리고 뼈 스캔과 함께 염색체 분석을 실시하였다. 조직검사 결과 폐포성 횡문근육종이 확인되었으며 전이의 증거는 없었다. 염색체 분석상 폐포성 횡문근육종에 상응하는 PAX7-FKHR 유전자 전좌가 발견되었다. 8 회의 항암화학요법과 방사선 치료 후 촉지되는 설근부의 종괴는 없었으며 환자가 호소하는 증상도 개선되었다. 추적 관찰 시 시행된 자기공명영상 결과 확연한 종괴 크기의 감소를 확인할 수 있었다. 횡문근육종은 매우 드문 악성 종양으로 수술과 함께 항암화학요법, 방사선치료 등 여러 치료 방법이 동원되지만 전이나 재발이 있을 시 예후는 매우 불량하다. 그러므로 영아에서 연하곤란, 호흡 곤란 등의 증상이 있을 시에는 설근부를 포함한 상부호흡소화관을 적극적으로 검사하여야 하며 악성 종양의 가능성을 염두에 두어야 하겠다.

The Long-term Outcome of Esophageal Atresia (선천성 식도 폐쇄의 수술 후 경과 및 장기 예후)

  • Jeong, Jae-Hong;Kim, Hye-Eun;Lee, Suk-Koo;Seo, Jeong-Meen
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.117-124
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    • 2008
  • Children who underwent reparative operations for esophageal atresia (EA) with or without tracheoesophageal fistula (TEF), are confronted with many gastrointestinal or respiratory problems, especially during the early years of life. We reviewed the medical records of 50 patients who underwent repairs of EA with or without TEF at the Division of Pediatric Surgery, Samsung Medical Center, from December 1994 to December 2005. Current status of children was accessed by telephone-interview, but only 27 of them were accessible. Of 50 patients, 3 patients (6 %) were type A, 45 patients (90 %) were type C, and 2 patients (4 %) were type E. The mean interval between primary operation and interview was 5.5 years. The incidences of growth retardation (<10 percentile of height/weight) were 39 % and 21 % during the first 5 years after repairs, respectively. The incidences of dysphagia or gastroesophageal reflux and recurrent respiratory infections were 33 % and 39 %, respectively. However, these problems were likely to improve as the children grew. The incidences of growth retardations (<10 percentile of height/weight) were 11 % and 11 % for the children more than five years postoperative. The incidences of dysphagia or gastroesophageal reflux and recurrent respiratory infections were 22 % and 22 %, respectively. Children with EA with or without TEF are faced with many obstacles. Close observation and adequate treatment for delayed postoperative complications are necessary to improve the quality of life for these children.

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Study on Clinical Patient-oriented Education System for Medical Organizations (의료기관에서의 환자 중심 교육 시스템 연구)

  • Park, Hwagyoo
    • Journal of The Korean Association of Information Education
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    • v.17 no.4
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    • pp.475-486
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    • 2013
  • Recent healthcare studies evaluate the effective impacts of a patient educational information intervention in hospitals on adherence to communicating knowledge, life quality, and therapeutic response in patients treated with highly active therapy in medical organizations. Therefore, the aim of this study is to design and implement the effective and systematic frameworks by providing clinical patient-oriented education system(CPES), which enhances health promotion and medical cures. CPES initiatives accelerate positive financial returns with network-driven educational system. To validate the CPES, the author analyzes the efficiency and effectiveness using statistical survey works. With this outcome, it is compared with previous system. One of the findings is that the system can improve compliance with treatment right dietetics and give patients self-manage their conditions in S hospital. Patients' acknowledge of their condition and its treatment process can be improved through the educational systems.

RECONSTRUCTION WITH A VASCULARIZED FREE ILIAC OSTEOMUSCULAR FLAP AFTER HEMIMANDIBULECTOMY FOR OSTEOSARCOMA OF THE MANDIBULAR CONDYLE REGION : A CASE REPORT (하악과두에서 발생한 악성 골육종 환자에서 외과적 절제 후 유리장골이식을 이용한 재건)

  • Park, Hong-Ju;Yu, Min-Gi;Kook, Min-Suk;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.4
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    • pp.386-394
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    • 2008
  • Osteosarcoma of the jaw is a rare malignant bone tumor which usually leads to a poor prognosis. It commonly occurs in young patients, especially in male. The tumor can involve mandible or maxilla with same frequency. The swelling in the involved area and facial deformity are common clinical findings. The pain and sensory changes are also complained by the patients. Although radical surgery plays an important role in the management of this tumor, the adjuvant chemotherapy or radiotherapy is used to enhance local control and to prevent distant metastases. We treated a 22-year-old male patient who had osteosarcoma in the left condylar region. The radical surgery which consisted of hemimandibulectomy and total parotidectomy, was done and an immediate mandibular reconstruction was performed with a vascularized free iliac osteomuscular flap. The obtained results, both esthetic and functional, were satisfactory. The patient was received postoperative chemotherapy. This is a case with reviews of the literatures.