• Title/Summary/Keyword: 재발율

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Lymph Node Failure Pattern and Treatment Results of Esophageal Cancer Patients Treated with Definitive Radiotherapy (근치목적 방사선치료를 받은 식도암 환자의 림프절 재발양상과 치료성적)

  • Lee, Sun-Young;Kwon, Hyoung-Cheol;Lee, Heui-Hwan;Kim, Jung-Soo;Kim, Soo-Geon
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.77-82
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    • 2008
  • Purpose: We evaluated the failure pattern of the celiac axis, gastric lymph node, and treatment outcome in the upper and mid-esophageal region of cancer patients treated by definitive radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, retrospectively. Materials and Methods: The study constituted the evaluation 108 patients with locally advanced esophageal cancer receiving radiotherapy or a combination of radiotherapy and chemotherapy at Chonbuk National University Hospital from January 1986 to December 2006. In total, 82 patients treated by planned radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, were analysed retrospectively. The study population consisted of 78 men and 2 women(mean age of 63.2 years). In addition, 51 patients received radiotherapy alone, whereas 31 patients received a combination of radiation therapy and chemotherapy. The primary cancer sites were located in the upper portion(17 patients), and mid portion(65 patients), respectively. Further, the patients were in various clinical stages including T1N0-1M0(7 patients), T2N0-1M0(18 patients), T3N0-1M0(44 patients) and T4N0-1M0(13 patients). The mean follow up period was 15 months. Results: The various treatment outcomes included complete response(48 patients), partial response(31 patients) and no response(3 patients). The failure patterns of the lymph node were comprised of the regional lymph node(23 patients) and the distance lymph node which included celiac axis and gastric lymph node(13 patients). However, metastasis was not observed in the regional and distant lymph node in 10 patients, whereas 36 patients were not evaluated. Furthermore, of the 13 patients who developed celiac axis and gastric lymph node metastases, 3 were in stage T1N0-1M0 and 10 were in stage T2-4N0-1M0. A complete response appeared in 12 patients, whereas a partial response appeared in 1 patient. The mean survival time of the patients who appeared for regional and distant lymph node metastasis was 14.4 and 7.0 months, respectively. Conclusion: In locally advanced esophageal cancer patients, who were treated by definitive radiotherapy without celiac axis and gastric lymph node irradiation, the distant lymph node metastasis rate was high and the overall survival rate was lower compared to the regional lymph node metastasis. The incidence of regional and distant lymph node metastasis was high in patients who appeared beyond clinical stage T2 and received radiotherapy alone.

MUCORMYCOSIS IN MAXILLA : A CASE REPORT (상악에 발생한 뮤코르 진균증의 치험례)

  • Kim, Yeo-Gab;Kim, Ju-Dong;Ryu, Dong-Mok;Lee, Baek-Soo;Oh, Jung-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.1
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    • pp.69-73
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    • 2004
  • Mucormycosis is an acute opportunistic infection caused by a saprophytic fungus found in soil, decaying fruits and vegetables. Numerous predisposing risk factors are associated with mucormycosis, although most cases have been reported in poorly controlled diabetics or in patients with hematologic malignant conditions. Throughout the history of mucormycosis, from the first case in humans reported in 1885 by Paltauf, through publication by Gregory et al of the first observation of rhino-orbital cerebral mucormycosis in 1943, to the report by Harris in 1955 of the first known survivor, little has changed in the diagnosis and outcome of this disease. Without treatment, the patient may die after an interval ranging from a few days to a few weeks. Regulation of diabetes mellitus and a decrease in the dose of immunosuppressive drugs facilitate the treatment of Mucormycosis. Extensive debridement of craniofacial lesions appears to be very important. intravenous amphotericin B is clearly of value. This is a case report of a patient with mucormycosis in maxilla. He was an uncontrolled DM patient, and for the treatment of intravenous amphotericin B and sequestrectomy were applied.

Descending Necrotizing Mediastinitis Secondary to Peritonsillar Abscess -A Case Report- (편도주위농양에 합병된 하행 괴사성 종격동염 -치험 1례-)

  • 최필조;이용훈;우종수;이기남;손춘희;박헌수;이인규
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.686-689
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    • 1999
  • Descending necrotizing mediastinitis(DNM) is a rare complication of the oropharyngeal and cervical infection. Descending necrotizing mediastinitis requires an early and aggressive surgical approach to reduce the high morbidity and mortality associated with this disease. A 39-year-old man complained of odynophagia, neck swelling, and disturbance of swallowing with dyspnea. CT scans of the neck suggested a peritonsillar abscess and retropharyngeal and peripharyngeal abscess. He underwent cervical drainage. He remained febrile and complained of severe both pain in both shoulders. On postoperative day 5, a follow-up CT scan confirmed a mediastinal abscess. Reexploration of the neck and right thoracotomy for debridement and drainage of the mediastinal abscess were performed.. A large amount of pus was drained from the anterior and posterior mediastinum and its necrotic tissue was debrided. The patient's condition and radiologic findings gradually improved. Cultures of the drain fluid revealed Klebsiella pneumoniae. He was discharged on the 85th hospital day. In our experience, both transcervical drainage and aggressive mediastinal exploration via thoracotomy can lead to an improvement in the survival of the patient with descending necrotizing mediastinitis. CT scanning is useful for early diagnosis of mediastinitis and for follow up.

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Well-differentiated Fetal Adenocarcinoma of the Lung - 3 cases report - (폐의 태아성 선암종 - 3예 보고 -)

  • Kang, Chul-Ung;Cho, Deog-Gon;Jo, Min-Seop;Cho, Kyu-Do;Moon, Young-Kyu;Park, Jae-Kil
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.388-391
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    • 2009
  • Well-differentiated fetal adenocarcinoma (WDFA) of the lung is a rare lung tumor that's composed of glycogen rich neoplastic glands and tubules that resemble the fetal lung at 10 to 15 weeks of gestation. Although WDFA is classified as a subtype of pulmonary blastoma or pulmonary adenocarcinoma, its prognosis is better than conventional pulmonary blastoma (biphasic blastoma) or pulmonary adenocarcinoma. It is important to identify this low grade malignancy tumor in younger patients because it is associated with low mortality. We report here on 3 cases of WDFA and the patients are all currently alive without tumor recurrence.

Surgical Treatment and Assessment of Prognostic Factors of Thymoma (흉선종의 수술적 치료 및 예후인자의 평가)

  • 정경영;김길동
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.734-740
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    • 1996
  • The relative importance of various factors influencing the prognosis and survival in the treatment of thymoma is still controversial. Sixty ave patients operated on for thymoma from Jan. 1981 to Dec. 1994 were evaluated, 28 patients (43.1 %) with myasthenia gravis and 37 patients (56.9%) without. Masaoka staging revealed stage I disease in 28 patie ts(4).1%) , stage ll in 1) patients(20.0%), stage 111 In 22 patients(33.8%), stage IVa in 1 patients(1.5%), and stage IVb in 1 patient(1.5%). There was no operative mortality. A complete resection was performed in 48 patients (73.8%) patients, associated in 10 patients (15.4%) with postoperative adjuvant treatment(radiotherapy 5; chemotherapy 1: radio- and chemotherapy 4). Thymomas were found to be predominantly of the epithelial type in 16 patients(24.6%), predominantly Iymphocytic type in 18 patients(27.7%), and mlxed in 22 patients (33.9%). The overall 5- and 10-year survival rates were 87% and 82%, respectively, Factors indicating a poor prognosis included local invasion, incomplete excision, thymic carcinoma, advanced staging and myasthenia gravis. The de- gree of tumor invasion turned out to be the main prognostic factor, and treatment should be planned ac- cordingly. The prognosis is best predicted by the stage of the tumor as determined intraoperatively and is poorer in patie ts with incomplete resection than in those with complete resection of the thynoma. No recurrence developed In patients with stage I disease.

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Long Term Monitoring of Deterioration Condition for the Rock-carved Buddha Triad in Seosan, Korea (서산 용현리 마애여래삼존상의 장기 모니터링과 훼손상태 변화)

  • Chun, Yu Gun;Lee, Jae Man;Lee, Mi Hye;Park, Sung Mi;Lee, Sun Myung;Lee, Myeong Seong
    • Journal of Conservation Science
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    • v.30 no.4
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    • pp.439-446
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    • 2014
  • We carried out monitoring of deterioration condition for the Rock-carved Buddha Triad in Seosan after dismantlement of protective facilities and conservation treatment. As the results of ultrasonic velocity measurement, physical properties of rock were evaluated to maintain similar the past. Result of digital image analysis, white discoloration was reoccured after four years of conservation treatments. And biodeterioration of unknown in the past was generated left side on the Rock-carved Buddha. Phenomenon of biodeterioration on the surface rocks was estimated by variation of sunshine and water contents according to topography condition.

Review of Rehabilitation Programs for Cancer survivors (암생존자의 재활을 위한 국내 프로그램 고찰)

  • Han, Jong Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.307-315
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    • 2016
  • With advances in health care, the cancer survival rate has significantly increased. Even though cancer treatment has finished, cancer survivors may continuously suffer from physical and psychosocial problems. In order to investigate the problems cancer survivors have experienced, a comprehensive rehabilitation program must be developed. This study sought to determine the content and structure of rehabilitation programs for cancer survivors, analyze the effectiveness of such programs, and develop a basis for future comprehensive rehabilitation program development. Through this review, thirteen programs were selected and classified according to exercise, psychosocial, and integrated or comprehensive aspects. Exercise programs improve physical function, fatigue, and hormone-related cancer effects. Psychosocial programs improve quality of life, mood changes such as depression, anxiety, and post traumatic factors. Comprehensive programs improve both physical and psychosocial aspects.

Case report: Treatment of Facial Nerve Palsy Following Bilateral Sagittal Split Ramus Osteotomy (증례보고 : 양측 하악지 시상골 절단술 후 발생한 안면신경 마비)

  • Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.255-260
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    • 2013
  • Bilateral sagittal split ramus osteotomy(BSSRO) of the mandible is an essential and commonly used procedure to correct dentofacial deformities and malocclusion. The possible complications associated with BSSRO include inferior alveolar nerve injury, bleeding, temporomandibular disorder, unfavorable fractures, and clinical relapse. The incidence of facial nerve palsy after orthognathic surgery recently reported is 0.1%. The probable etiologies have included facial nerve compression, complete or incomplete nerve transection, nerve traction, and nerve ischemia from anesthetic injection. Postoperative facial palsy is one of the most serious complications because it reduces the quality of life and significantly reduces social interaction. The case of a 24-year-old patient who underwent bilateral sagittal split ramus osteotomy is described. The medical records and postoperative photographs were reviewed in detail to collect information on the clinical course, treatment, and outcomes.

A Case with Abrupt Progression of Renal Scarring or Abrupt Deterioration of Renal Function Associated with Vesicoureteral Reflux (고등급의 방광요관역류가 있는 환아에서 급격히 진행된 신반흔)

  • Kim, Moon-Kyu;Park, Sung-Eun;Lee, Jun-Ho
    • Childhood Kidney Diseases
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    • v.15 no.2
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    • pp.179-183
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    • 2011
  • Abrupt progression of renal scarring associated with vesicoureteral reflux (VUR) is rare in males over 2 years old of age. We report a 5 year old boy with sustained unilateral high grade VUR who experienced abrupt progression of renal scarring; he had a relative renal radionuclide uptake of 38% at 2 years of age that dropped to 8% after three years. Per his parent's wishes, he took prophylactic antibiotics for 25 months after his first febrile urinary tract infection (UTI) at 4 months old without surgical management. One episode of recurrent breakthrough infection occurred at the age of 2 years. This observation reminds us that a recommending surgical management for sustained high grade VUR associated with renal scarring might be needed. Close follow up of DMSA for renal scanning, and long term follow up of patients after the first febrile UTI are important.

Design of a New Applicator for High-Dose Rate Vaginal Brachytherapy (고선량율 질강 근접조사를 위한 새로운 적용구의 제작)

  • Shin, Sei One
    • Journal of Yeungnam Medical Science
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    • v.17 no.2
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    • pp.123-128
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    • 2000
  • Purpose: This study was aimed to develop a new vaginal applicator(Shin's Applicator) for 2-channel high-dose rate vaginal brachytherapy to evaluate uniformity of surface dose, and to present 3-dimensional dose distribution of the applicator. Methods: Shin's Applicator was inexpensively constructed using human soft tissue equivalent acrylic bar. We evaluated dose uniformity along the applicator surface using film densitometer and performed vaginal intracavitary brachytherapy after insertion of the applicator using HDR brachytherapy planning software and brachytherapy unit(Ralstron-20B). Results: Shin's Applicator allows improved dose distribution than the existing 1-channel cylinder and achieves diminished urinary bladder and rectal dose by 20%. Conclusions: From the above results, it can be concluded that Shin's Applicator may be an improved form of a vaginal applicator. Furthermore, it can be suggested that this applicator has an advantage, for it prevents vaginal stenosis after radiation therapy and can be used as a disposable vaginal dilator. Further follow up examination with radiological study may be helpful to evaluate the therapeutic efficacy of this applicator.

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