• Title/Summary/Keyword: 재발

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Treatment Outcome and Analysis of the Prognostic Factors of Ductal Carcinoma in situ Treated with Breast Conserving Surgery and Radiotherapy (유방 관상피내암의 유방 보존술 후 방사선 치료의 성적과 예후 인자 분석)

  • Kim, Kyoung-Ju;Huh, Seung-Jae;Park, Won;Yang, Jeong-Hyeon;Nam, Seog-Jin;Kim, Jeong-Han;Lee, Sung-Kong;Lee, Jee-Hyun;Kang, Sung-Soo;Lee, Jeong-Eun;Kang, Min-Kyu;Park, Young-Je;Nam, Hee-Rim
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.11-16
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    • 2004
  • Purpose: To evaluate the survival rate, local failure rate and patterns of failure, and analyze the prognostic factors affecting local relapse of ductal carcinoma in situ treated with breast conserving surgery and radiotherapy Materials and Methods: From June 1995 to December 2001, 96 patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were retrospectively analyzed. The operations were either local or wide excision in all patients, with an axillary lymph node dissection performed in some patients. Radiation dose to the whole breast was 50.4 Gy, over 5 weeks, with 1.8 Gy daily fractions, with additional doses ($10\~14$ Gy) administered to the primary tumor bed in some patients with close ($\leq$2 mm) or positive resection margin. The median follow-up period was 43 months (range $10\~102$ months). Results: The 5-year local relapse free survival and overall survival rates were 91 and $100\%$ respectively. Local relapse occurred in 6 patients ($6.3\%$). Of the 6 recurrences, one was invasive ductal cell carcinoma. With the exception of one, all patients recurred 2 years after surgery. There was no regional recurrence or distant metastasis. Five patients with local recurrence were salvaged with total mastectomy, and are alive with no evidence of disease. One patient with recurrent invasive ductal cell carcinoma will receive salvage treatment. On analysis of the prognostic factors affecting local relapse, none of the factors among the age, status of resection margin, comedo type and nuclear grade affected local relapse. Operation extent also did not affect local control (p=0.30). In the patients with close resection margin, boost irradiation to the primary tumor bed did not affect local control (p=1.0). Conclusions: The survival rate and local control of the patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were excellent. Close resection margin and boost irradiation to the primary tumor bed did not affect local relapse, but further follow-up with much more patients is needed.

An Analysis of Prognostic Factors in the Uterine Cervical Cancer Patients (자궁경부암 환자의 예후인자에 관한 분석)

  • Yang, Dae-Sik;Yoon, Won-Sub;Kim, Tae-Hyun;Kim, Chul-Yong;Choi, Myung-Sun
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.300-308
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    • 2000
  • Purpose :The aim of this study is to analysis of suwival and recurrence rates of the uterine cervical carcinoma patients whom received the radiation therapy respectively. The prognostic factors, such as Papanicolaou (Pap) smear, carcinoembriogenic antigen (CEA) and squamous cell carcinoma (SCC) antigen has been studied. Methods and Materials : From January 1981 to December 1998, eight-hundred twenty-seven uterine carvical cancer patients were treat with radiation therapy. All of the patients were divided into two groups : the radiation therapy only (S2l patients) group and the postoperative radiation therapy (326 patients) group. The age, treatment modality, clinical stage, histopathology, recurrence, follow-up Pap smears, CEA and SCC antigen were used as parameters for the evaluation. The prognostic factors such as survival and recurrence rates were peformed with the Kaplan-Meier method and the Cox hazard model, respectively. Median rollow-up was 38.6 months. Results :On the radiation therapy only group, 314 patients (60$\%$) achieved complete response (CR), 47 patients (9$\%$) showed local recurrence (LR), 78 patients (15$\%$) developed distant metastasis (DM). On the Postoperative radiation therapy group, showed 276 Patients (85$\%$) CR, 8 Patients (2$\%$) LR, 37 Patients (11$\%$) DM. The 5-year survival and recurrence rates was evaluated for all parameters. The statistically significant factors for the survival rate in univariate analysis were clinical stage (p=0.0001), treatment modality (p=0.0010), recurrence (p=0.0001), Pap smear (p=0.0329), CEA (p=0.0001) and SCC antigen (p=0.0001). Conclusion: This study indicated that after treatment, the follow-up studies of Pap smear, CEA and SCC antigen were significant parameter and prediction factors for the survival and recurrence of the uterine cervical carcinoma.

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Treatment and Prognosis of Chondroblastoma (연골모세포종의 치료 결과)

  • Lee, Young-Kyun;Han, Il-kyu;Oh, Joo-Han;Lee, Sang-Hoon;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.81-87
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    • 2007
  • Purpose: Chondroblastoma of bone is rare with the potential for local recurrence and metastasis. A retrospective review of 30 patients with chondroblastoma of bone treated at a single institution during a 24-year period was conducted to determine the clinical outcome and relevant prognostic factors. Materials and Methods: Thirty patients with biopsy-proven chondroblastoma of bone, treated between September of 1981 and September of 2005, were retrospectively reviewed. There were 16 men and 14 women with an average follow-up period of 7.2 years (range, 1.6~21.2). The most common sites were the distal femur (n=7), proximal humerus (n=6), proximal tibia (n=6) and proximal femur (n=4). The average age of the patients was 20 years (range, 12~47) with closed physes in 20 patients(67%.) Twenty-seven patients(90%) were treated by curettage of the tumor with or without bone grafting or cementing. Three patients(10%) were treated with en bloc resection. Clinical and pathological factors reported to be associated with poor outcome were analyzed. Results: Four local recurrences(13%) developed in postoperative 4, 6, 7 and 16 months. These patients underwent further curettage (once in 2 patients and twice 2) and had no further recurrence. All patients showed no evidence of disease at the final follow-up. Local recurrence developed in the two cases which removal of the tumor was incomplete. Curettage and bone-grafting (1) and cementing (1) were performed in the two other cases with local recurrences. In contrast, no local recurrences were observed in the 3 cases treated with en-bloc resection. The status of physes or the histologic presence of aneurysmal bone cyst, the anatomic location of the tumor did not affect local recurrence. Conclusion: Adequate removal of the tumor with aggressive curettage or en bloc resection seems to be necessary to prevent local recurrence in chondroblastoma. The status of physes, the histologic presence of aneurysmal bone cyst or the anatomic location of the tumor was not related with local recurrence.

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Analysis of Recurred Mitral Regurgitation after Mitral Repair according to Procedure or Valve Related Causes (승모판막 성형술 후 재발의 원인에 대해 술기와 판막 요인에 대한 분석)

  • Shin Hong Ju;Yoo Dong Gon;Lee Yong Jik;Park Soon Ik;Choo Suk Jung;Song Hyun;Chung Cheol Hyun;Song Meong Gun;Lee Jae Won
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.132-138
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    • 2005
  • Background: Mitral valve repair (MVP) is the optimal procedure for mitral regurgitation (MR), however, failure and subsequent reoperations are the limitations. The current study assessed the procedure in relation to the primary valve related causes of recurrent MR. Material and Method: MR was treated in 493 patients undergoing MVP from January of 1994 to January of 2002. The causes of MR were degenerative $(n=252,\;51.5\%),$ rheumatic $(n=156,\; 31.6\%),$ and others $(n=85,\; 16.9\%).$ Surgery comprised 446 ring annuloplasties $(90.5\%),$ 227 new chordae formations $(46\%),$ 125 quadriangular resections $(25.3\%),$ 28 chordae transfers $(5.7\%),$ and 8 Alfieri's stitches $(1.6\%).$ The mean follow up was $29.04\pm22.81$ months. Result: There were 5 early $(1.01\%)$, and 5 late deaths $(1.01\%).$ The reoperation rate was $1.42\%$. There were 45 $(9.1\%)$ recurrent MR (grade III or IV). Of these, 24 were procedure related including incomplete repair (n=14), discordant new chordae length (n=8) and others (n=2). In 21 patients, the cause was valve related including rheumatic disease progression (n=10), recurrent chordae elongation or prolapse (n=5) and others (n=6). Severe MR was higher after incomplete repair (p < 0.001), and valve related failure strongly correlated with rheumatic progression (p < 0.05). Conclusion: Since completeness of operation is the prime risk factor that determine the repair durability, intra-operative assessment of the initial repair with trans-esophageal echocardiography is essential.

Follow up and Salvage Treatment for Early Laryngeal Cancer (초기후두암의 추적관찰 및 재발암의 구제치료)

  • 이강대
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.50-60
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    • 1997
  • 조기후두암은 치료 목표는 생명을 구하면서 동시에 후두기능을 최대한으로 보존하는 것이라고 할 수 있는데, 치료자의 철학과 환자의 선호도에 따라 방사선 치료, 레이저 수술 그리고 후두부분적출술 등의 방법이 적용되고 있다. 어떤 치료 방법이던 재발암에 대한 구제치료를 포함하면, 궁극적인 생존율은 거의 비슷하다. 그러므로 일차 치료후 얼마나 적극적으로 환자를 추적관찰하고, 적절한 구제수술을 시행하느냐에 따라 생명의 보존 그리고 재발암에서의 기능의 보존 여부가 좌우된다고 할 수 있다. 향후 보다 체계적인 추적 관찰법과 최소의 환자 부담으로 최대의 성과를 거둘 수 있는 치료방법 이 연구되어져야겠다.

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Etiology and Pathogenesis of Recurrent Aphthous Stomatitis (재발성 아프타성 궤양의 원인과 기전)

  • Suh, Bong-Jik;Lee, Kyung-Eun
    • Journal of Oral Medicine and Pain
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    • v.33 no.2
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    • pp.187-194
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    • 2008
  • Recurrent aphthous stomatitis is common oral disease in the world. It is characterized by multiple, recurrent, painful ulcer with circumscribed margins, erythematous haloes and yellow or grey floors. Patients with recurrent aphthous stomatitis suffer from its painful ulcer. But unfortunately, its etiology and pathogenesis is not clear and still unknown. So we review etiology and pathogenesis of recurrent aphthous ulcer and wish to propose direction of the future study.

Modeling the Occurence of High-frequency Reignition Oscillation by Closing the Vacuum Circuit Braker on the Electric Railway Vehicle (전기철도차량용 진공차단기의 투입에 따른 고주파 재발호 진동발생 모의분석)

  • Jeong, Ki-Seok;Jang, Uk-Dong;Chung, Jong-Duk
    • Proceedings of the KIEE Conference
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    • 2015.07a
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    • pp.1593-1594
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    • 2015
  • 본 논문에서는 진공 차단기의 투입 시 발생하는 고주파 재발호 진동현상을 모의하여 계통의 전압-주파수 특성을 분석한다. 우선 시간영역에서 차단기 투입에 따른 개폐 서지 현상을 모의하여 다중 재발호에 의한 진행파의 주파수 특성을 검토한다. 모의 결과를 통해 추정된 고주파 회로저항과 기존 전원, 고압케이블, 변압기로 구성된 고주파 재발호 진동해석용 등가 회로를 구현하고 주파수 스캔 기능을 이용하여 인가되는 전압의 주파수 변화에 따른 계통의 임피던스 크기변화를 확인한다. 끝으로, 시간 영역 및 주파수 영역에서 도출된 계통의 공진 주파수와 철도차량용 주 변압기의 공진주파수를 비교하여 내부 공진 여부에 따른 권선간 전압 확대 가능성을 논하고자 한다.

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Surgery for Primary Pulmonary Liposarcoma (원발성폐지방육종(Primary Pulmonary Liposarcoma)에 관한 수술치험 1예)

  • 김수완;김진국;김관민;최용수;안긍환;심영목
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.942-945
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    • 2004
  • Primary pulmonary liposarcoma is extremely rare disease. It has poor prognosis with early multiple metastases and frequent local recurrences. Surgery is the choice of treatment for liposarcoma. Incomplete resection would result in rapid and aggressive growing of the tumor. We report a case of primary pulmonary liposarcoma which was successfully treated with complete resection without local recurrence and distant metastasis for 10 months.

Cryotherapy for Two Cases of Recurrent Laryngeal Papillomas (재발성 성문부 유두종 환자의 냉동치료)

  • Lee, Joon-Kyoo;Lee, Dong-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.1
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    • pp.19-23
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    • 2012
  • 목 적 : 액체 질소를 이용한 냉동 치료는 피부 사마귀 치료에 널리 사용되어왔다. 본 연구에서는 재발성 성문부 유두종 환자에 대해 냉동 치료를 시행하여 그 치료 결과를 알아보고자 하였다. 방 법 : 냉동치료 전에 재발성 유두종으로 확진 되었고, 다른 호흡기에는 병변이 없었던 환자를 대상으로 하였다. 결 과 : 냉동 치료의 국소적, 전신적 합병증 및 부작용은 없었다. 그러나, 성문부 유두종은 냉동 치료 후 각각 3개월과 2년 후에 재발하였다. 결 론 : 냉동치료는 초기에는 성문부 유두종 병변의 치료에 효과가 있으나, 장기적인 효과는 떨어졌다. 향후 더 많은 증례와 추적관찰이 필요할 것으로 생각된다.

A Study on the XKMS-Based Key Management for Key Reissue in Web Services Environment (웹 서비스 환경에서 키 재발행을 위한 XKMS 기반 키 관리 기술에 대한 연구)

  • Kim, Dae-Hyun;Lee, Jae-Sung;Lee, Kyoung-Hwa;Shin, Yong-Tae
    • Proceedings of the Korea Information Processing Society Conference
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    • 2010.04a
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    • pp.831-834
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    • 2010
  • 최근 웹 기반의 XML이 인터넷 전자거래 및 데이터 전송에 이용되고 있다. 인터넷을 통해 비즈니스 거래가 신뢰성 있게 수행되기 위해서 XML 키 관리의 중요성이 높아지고 있다. XKMS는 XML 문서를 교환하기 위해 보안을 목적으로 사용되는 암호화키의 안전한 관리를 위한 명세이다. 그러나 키의 분실 및 키 재발행 시 키의 변경에 따른 키 관리 방법에 대해서는 정의하지 않고 있다. 따라서 본 논문에서는 XKMS 표준 명세를 준수하는 키 변경에 따른 확장된 키 재발행(Extended-Reissue) 서비스를 제안한다. 제안하는 방식은 서버에 이전 사용자의 개인키를 저장하고, 키 분실 및 변경에 따른 키 재발행 시 분실키와 신규 키를 동시에 사용함으로써 효율적인 보안 서비스를 제공할 수 있다.