• 여성건강간호학회지
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• 제12권1호
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• pp.37-46
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• 2006

Purpose: The purpose of this study was to investigate the effects of an exercise program on physical function and quality of life of mastectomy patients. Method: This study was conducted from October, 2004 to June, 2005. The subjects consisted of 60 patients with breast cancer(30 each in the experimental and control groups). The subjects in the experimental group participated in an exercise program for 16 weeks. Evaluation was performed four times in both the experimental and control group. Results: The results revealed an increase in physical function in the experimental group including wrist circumstance, function of shoulder joint, stretching, and upper endurance. Also, an increase in function scales in quality of life were significantly higher in the experimental group than the control group. In addition subjective comments on how they felt after participating in the exercise program were good in the experimental group. Conclusion: The 16-week exercise program showed a large positive effect on physical function and quality of life of breast cancer patients after a mastectomy.

• 정신신체의학
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• 제21권1호
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• pp.11-17
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• 2013

연구목적 유방암 환자에서 우울증상의 동반 빈도는 매우 높은 것으로 알려져 있으며 우울증상은 건강과 연관된 삶의 질에 영향을 미칠 수 있다. 본 연구는 일 대학병원 유방암 환자의 우울증상의 유병율을 알아보고 우울증상이 건강과 연관된 삶의 질과, 우울증상과 삶의 질에 미치는 인구 사회학적 및 임상적 변인을 알아보고자 하였다. 방 법 원광대학교병원 외과에서 2010년 11월 1일부터 2011년 5월 31일까지 유방암으로 진단 및 수술을 받고 통원치료 중인 19세 이상 75세 미만인 여성 환자 52명에서 이전에 기분장애로 진단을 받았거나 평가 설문지 및 의학적 정보가 부족한 11명을 제외한 41명을 연구대상으로 하였다. 연구 대상자의 인구통계학적 변인 및 유방암에 대한 임상적 특성은 의무기록지를 통하여 조사하였다. 우울증상은 Beck 우울척도, 불안은 성격평가질문지의 불안 하위 척도를 이용하였으며, 건강과 관련된 삶의 질은 한국판 단축형 36항목 건강 설문지(Short Form 36 health Survey-Korean Version)를 사용하였다. Beck 우울 척도에 따른 우울증상 군과 비우울증상 군의 건강과 관련된 삶의 질을 비교하였으며, 인구사회학적 변인 및 임상적 변인을 예언 변인으로 하고 우울증상과 삶의 질을 준거 변인으로 한 중다회귀분석을 시행하였다. 결 과 유방암 환자 중 우울증상의 유병율은 36.4%였다. 우울 증상을 나타내는 유방암 환자의 건강과 연관된 삶의 질에서 신체 기능(p<.01), 신체 역할(p<.001), 전반적 건강(p<.05), 사회 기능(p<.001), 정서 역할(p<.001), 정신 건강(p<.001)의 하위 척도가 우울증상을 동반하지 않은 환자군에 비하여 유의하게 낮았다. 그러나 신체 통증 및 활력의 하위척도에서는 유의한 차이가 없었다. 유방암 환자의 우울증상은 불안과 교육 정도, 항암치료 시행 여부와 유의한 것으로 나타나 전체 우울증상의 63.6%의 설명 변량을 나타냈다. 유방암 환자의 건강과 관련한 삶의 질은 우울증상, 수술형태, 연령이 유의하였으며 55.8%의 설명 변량을 나타냈다. 결 론 유방암 환자의 우울증상은 36%에서 나타났으며 우울증상은 건강과 연관된 삶의 질을 낮추었다. 우울증상은 삶의 질에 높은 설명 변량을 가지고 있으며, 불안은 우울증상을 동반한 유방암 환자에서 높은 설명 변량을 갖고 있었다. 따라서 유방암 환자의 삶의 질을 높이기 위하여 우울증상에 대한 평가 및 치료가 필요할 것으로 여겨진다.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.628-634
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• 2007

Purpose: Subcutaneous mastectomy has been accepted as a standard for the treatment of gynecomastia. Surgical managements including ultrasound-assisted liposuction(UAL) have had limited success and several combined approaches were tried to find the most effective method. We designed a modified subcutaneous mastectomy, which we call "pan-cake method". The purpose of this study is to evaluate the results of our method for the treatment of gynecomastia. Methods: 16 patients from 16 to 31 years of age having gynecomastia were operated using the pan-cake method. 11 patients were in grade I, and 5 patients were in grade II, no patient were in grade III or IV, according to Rod's classification. The pan-cake method started with modified periareolar incision. We executed subcutaneous dissection first and suprafascial dissection next. After dividing the breast into four equal quadrants, we removed breast tissue from each quadrant as necessary. The operation time for the resection was recorded and the weight of removed parenchyme tissues was measured. Results: All the operations were successful. There were no asymmetries, contour deformities, or irregularities. Only 6 cases needed the combined therapy with ultrasound-assisted liposuction(UAL) because of the step deformities. The average operation time was 24.1 minutes and the average weight of removed breast tissue was 98.1g. All the patients were satisfied with the aesthetic results. Conclusion: We concluded that the pan-cake method is an alternative option for the surgical treatment of gynecomastia, giving good aesthetic results and relatively short operation time.

• 여성건강간호학회지
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• 제10권4호
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• pp.301-310
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• 2004

Purpose: The purpose of this study was to develop an exercise program for postmastectomy patients. Method: This study was conducted from October, 2003 to June, 2004. The exercise program was developed based on literature review and needs assessment using focus group interviews. The subjects for the focus group interview consisted of 11 patients, 13 recovering patients, and 20 nurses from 3 hospitals. Development of the program was proceeded with analysusm design and development steps. Result: The results of the needs assessment using the focus group interview showed that the exercise program was imperative for postmastectomy patients. Based on the results, a home video tape containing 3 steps, was developed. Each step includes warming-up, stretching, the main exercise, and cool-down. Steps 2 and 3 include exercises with an elastic band, and an elastic ball. The program was modified after conducting a pre-test. A self-checklist including shoulder mobility, hand strength, arm volume and subjective comments on how they feel will be used before and after the exercise program. Conclusion: The exercise program will improve breast cancer patients' quality of life and their physical well-being. Further studies are recommended to test the effectiveness of the exercise program.

• Journal of Chest Surgery
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• 제30권4호
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• pp.462-466
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• 1997

원발성으로 종격동에서 발생한 융모막암종은 드문 질환으로 젊은 남자에서 주로 발견되었으며, 기침, 흉통, 여성형 유방 등의 증상을 보이는 것으로 알려졌다. 33세 여자로 약 3개월 전부터 가벼운 기침으로 시작하였으나 심한 호흡곤란과흉통증 등 증상이 급격히 악화되어 내원하였다. 방사선학적 검사상 후종격에서 직경 13cm크기의 종양이 발견되었고, 혈중 $\beta$-HCG가 20만 mIU 이상 증가하였으며, 적출된 종양은 $\beta$-HCG에 대한 면역조직화학적 검사상 양성반응을 보였다. 융모막암종 절제술을 받고 EMA-CO투여 받은후 약 7개월만에 뇌에 전이된 종양 때문에 뇌출혈을 일으켜 다시 뇌종양 적출술을 받았다. 환자는 그 후 약 7개월동안 두통외의 증상은 없었고 흉부단순촬영상 종격종양의 재발소견도 없었다.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.806-810
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• 2009

Purpose: Gynecomastia is an abnormal increase in the volume of the male breast. Subcutaneous mastectomy was the first surgical treatment for gynecomastia. But because of the complications such as nerve injury and scar formation, subcutaneous mastectomy has been substituted with liposuction. Recently various techniques including ultrasound - assisted liposuction has been used for treatment of gynecomastia. The purpose of this study is to evaluate the results of XPS$^{(R)}$ microresector(Shaver) for treatment of gynecomastia. Methods: 17 patients, 33 breasts of gynecomastia, Simon grade I or II have been treated with XPS$^{(R)}$ microresector(Shaver). The mean age was 24.5. The subcutaneous tissue and glandular tissue were removed with XPS$^{(R)}$ microresector(Shaver). The operation time, the weight of removed tissue and patients' satisfaction score were accessed. Results: The mean operation time was 78.2 minutes. The mean weight of removed tissue was 113.8 g. There was no significant complications such as necrosis, hematoma, infection or scar contracture. Patients' satisfactory score of scar, shape and confidence were 8.4, 8.2 and 8.4 respectively. As the average score was 8.3, almost patients were satisfied with their breasts. Conclusion: The authors have treated 17 patients suffering from gynecomastia with XPS$^{(R)}$ microresector(Shaver). We obtained short operation time, early recovery, minimal operative scar and less complications with XPS$^{(R)}$ microresector(Shaver) for the treatment of gynecomastia, and patients were satisfied with the results of our method. We concluded XPS$^{(R)}$ microresector(Shaver) is an alternative option for the treatment of gynecomastia.

• Archives of Plastic Surgery
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• 제34권2호
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• pp.237-242
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• 2007

Purpose: Gynecomastia is an abnormal increase in the volume of the male breast. Patients affected by gynecomastia with significant glandular enlargement may respond to suction alone and/or sharp dissection and excision. The purpose of this report is to introduce the indications and results of authors' two techniques. Methods: The diameter of parenchyme was determined by a pinch test after liposuction. For the parenchymal diameter less than 4 cm, ultrasound-assisted liposuction was performed, in conjunction with the "pull-out technique" to effectively remove the fibrofatty tissue of the male breast through a single 5-7 mm incision. For the parenchymal diameter more than 4 cm, ultrasound-assisted liposuction and excision were applied through 2.5 cm periareolar approach. Results: A total of 94 patients (185 breasts) underwent the operation from October 2000 to October 2003 and mean follow-up period was 12 months. The volume of aspirates ranged from 50 to 450 cc per breast. There were no major complications such as skin flap necrosis. Five reoperations were performed for 1 hypertrophic scar, 2 under-resected and 2 hematoma cases. The patient's satisfaction was high and most of them were pleased with the shape of the breasts and scars. Conclusion: These procedures can minimize scars and reduce the incidence of contour problem such as saucer deformity, and provides consistent results. Patients can return to full activities in 48 hours. It can be offered as an option for the treatment of gynecomastia.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.773-778
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• 2009

Purpose: The authors propose the new classification of fatty - type gynecomastia(lipomastia) which can serve as a guide for modifying the periareolar technique. Methods: A retrospective analysis was made of 1000 cases of lipomastia operated on in the last 17 months. The extent of the clinical result, the technique employed, and the complications were observed. On the basis of this review the authors observed that at grade I(fat component < 50 ml, fibroglandular component < 3 g each breast), flattening of the thorax can be achieved by means of stab incision, ultrasound - assisted lipectomy(UAL), scavenging suction - assisted lipectomy(SAL) and tissue shaving. At grade II(50 < < 150 ml, 3 < < 5 g), stab incision, UAL, SAL and pull - out method(POM) using small curved scissors. At grade III(150 < < 300 ml, 5 < < 15 g and prominent inframammary fold(IMF)), minimal incision (5 - 6 mm), UAL, SAL and POM using small angulated scissors, and blunting IMF. At grade IV (300 < < 500 ml, 15 < < 30 g, and glandular ptosis), minimal incision (5 - 6 mm), UAL, SAL, fibroglandular excision using small angulated scissors, cutting IMF and fixation of nipple - areola complex(NAC) becomes necessary. At grade V (> 500 ml, > 30 g and ptosis), small incision (7 - 8 mm), UAL, SAL, fibroglandular excision using large angulated scissors, cutting IMF, upper repositioning of NAC and delayed circumareolar skin reduction or chest lifting becomes necessary. Results: The complications were minimal but there were hematoma (n = 7), infection (n = 3) and hypertrophic scar (n =13). Almost patients were satisfied with the outcome. Conclusion: This simple classification may help in choosing the most suitable treatment, thus avoiding insufficient or invasive treatments and undesirable scars.

• 핵의학기술
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• 제18권1호
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• pp.140-144
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• 2014

최근 유방암 환자의 급증은 여러 가지 통계로 보고되고 있다. 유방암의 발병부위는 크게는 유관, 소엽등으로 분류하고 그 중 85% 이상이 유관에서 발병되고 있다. 본 연구는 유관에서 발병되는 암의 종류를 분별하여 시간의 경과에 따라 변화되는 $SUV_{max}$의 차이를 알아보고자 하였다. 2012년 7월 1일부터 2013년 7월 22일까지 유방암 진단을 받고 본원 PET-CT센터를 방문한 여성 환자 291명을 대상으로 하였다. 병리학적 결과를 기준으로 IDC (invasive ductal carcinoma) 환자 248명과 DCIS (ductal carcinoma in situ) 환자 43명을 선별하였다. 일반 PET-CT 검사와 동일한 방법(3.7 MBq/kg)으로 $F^{18}-FDG$를 주사 후 1시간 경과 후 1차 검사(routine 검사)를 진행하였고 또 한 번의 1HR 경과 후 2차 검사 (Delay검사)를 진행하였다. 2회 진행된 검사 Data를 토대로 하여 병소부위에 ROI를 설정하여 $SUV_{max}$를 측정하였다. IDC와 DCIS의 두집단의 병소 $SUV_{max}$의 변화를 비교 확인한 결과 IDC의 경우 $SUV_{max}$값이 1차 검사에서는 M=7.11, SD=5.405이고 2차 검사에서는 M=8.363, SD=6.624으로 상승(P<0.05)하였으며, DCIS의 경우 $SUV_{max}$는 1차 검사에서는M=2.739, SD=1.229이고 2차 검사에서는 M=2.614, SD=1.470으로 감소(P<0.05)하였다. 결 론: IDC와 DCIS의 시간에 따른 $SUV_{max}$의 결과를 비교해본 결과 IDC에서는 1차 검사(routine검사)보다 2차 검사(Delay검사)에서 $SUV_{max}$가 상승(P=0.000)함을 확인하였고 DCIS에서는 1차 검사(roution검사)보다 2차 검사(Delay검사)에서 $SUV_{max}$값이 감소(P=0.039)함을 확인하였다. 본 연구를 통해 유관에서 발병되는 유방암의 종류(IDC와 DCIS)별 시간경과에 따라 $SUV_{max}$의 변화가 발생함을 확인하였다.

• Archives of Plastic Surgery
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• 제37권6호
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• pp.742-748
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• 2010

Purpose: The method of using ultrasound-assisted liposuction and excision of the remaining glandular tissue is the preferred method for treating gynecomastia and is currently used worldwide. Herein, this article described the role of ultrasound-assisted liposuction before a surgical excision in the treatment of gynecomastia. The cosmetic results were objectively evaluated. Methods: 11 patients (22 breasts) underwent ultrasoundassisted liposuction and suction-assisted lipectomy between April 2007 and January 2009. At the end of the liposuction, the remaining glandular tissue was removed through the incision used for liposuction. We evaluated the cosmetic results using ordinary scale methods on the basis of four categories (recurrence, symmetry, contour irregularity, and scar). Results: The volume of aspirates ranged between 50 and 200 cc per breast and the average weight of tissue removed by excision was 65g per breast. No complications were recorded. Regarding the cosmetic evaluation, the recurrence, contour irregularity, and scar were excellent, the symmetry was good, and the overall results represented all those cases were mostly excellent. Conclusion: Ultrasound-assisted liposuction has many advantages in the treatment of gynecomastia. When excising the remaining glandular tissue, bleeding is decreased by the use of a tumescent technique. The glandular tissue is easily mobilized and excised after being "morselized" with ultrasound-assisted liposuction. The glandular tissue is simply dissected via the suction surface. Compared the residual mound of glandular tissue beneath the nipple and areola to the periphery, it facilitates precise control of the excision.