• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권5호
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• pp.277-283
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• 2013

Purpose: Well vascularized pectoralis major myocutaneous flap (PMMF) had been a commonly used versatile flap in reconstructive oromaxillofacial surgery since the 1970s. However, after the advent of microvascular surgery in the 1980s, the PMMF was used less frequently. But, to date, PMMF has been useful and has some advantages such as covering wide defects, covering vital structures, back-up procedure in cases of free flap failure, and reconstruction for radiotherapy patients. The purpose of this study is to evaluate the role, indication, complications, functional, and aesthetic results of this flap in the era of free flap with a literature and chart review. Methods: A retrospective study was conducted of 16 oral cancer patients undergoing reconstructive surgery with PMMF for reconstruction of defects from 2001 to 2012 at Kyungpook National University Hospital. The male to female ratio was 10:6, with a mean age of 63 years (16~79 years). Basic demographic data, previous treatment history, indications, dimension of the flap, site of reconstruction, postoperative complications, and patients' final status were systemically analyzed from chart review. Results: The pathology of the disease included squamous cell carcinoma in the majority of cases (n=14). The remaining cases were fibrosarcoma and mucoepidermoid carcinoma. Of the 16 PMMF reconstructions, 13 flaps were applied as primary reconstructive procedures, whereas three flaps were; salvage; procedures (vascularized free flap failure). Twelve patients had complications such as wound dehiscence, infection, hematoma, fistula, flap bulkiness, and partial flap necrosis. The higher complication rates showed an association with utilization of the flap in preoperative radiotherapy cases. However, all patients were discharged without failure. Conclusion: In reconstructive oromaxillofacial surgery, the PMMF is still a useful flap for huge defects. In addition, the PMMF can be used as a salvage procedure after vascularized free flap failure and reconstruction for patients with a history of preoperative radiotherapy.

• Journal of Chest Surgery
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• 제12권4호
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• pp.324-335
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• 1979

During the period of 4 years from August 1975 to August 1979 one hundred and forty seven cases of lung cancer were seen at Paik Foundation Hospital in Seoul, Korea. Among these 147 cases, 104 patients had primary carcinoma of the lung and the remainder was metastatic carcinoma to the lung. Among these 104 primary carcinoma patients, 73 cases were proven histologically as primary carcinoma of the lung. There were three cases of alveolar cell carcinoma [Table 1 ]. This clinical observation is based on those 73 cases including three case reports of the alveolar cell carcinoma. 1. Peak incidence was observed in the 5th decade of life. Male to female ratio was 2 to 1 [Fig. 1]. 2. Pathological classifications were as follows: epidermoid carcinoma, 24 cases [32.9%]; undifferentiated carcinoma, 20 cases [27.4%]; adenocarcinoma, 15 cases [20.5%]; bronchioloalveolar carcinoma [5.5%] and positive cytology, 10 cases [13.7%] [Fig. 2]. 3. Evidence of inoperability was observed in 55 patients [75% of the 73 cases] [Table 3]. 4. Among those 73 cases, operability was evaluated in 18 patients or 25%. One patient refused operation and 17 patients [23.6%] were explored. In 11 [15%] out of 17 patients, thoracotomies were performed. Six cases were pneumonectomies and 5 cases were lobectomies or bilobectomies [Fig. 3]. 5. First case of alveolar cell carcinoma was a 46 year-old housewife complaining of cough and hemoptysis for one year. The plain chest X-ray and bronchogram showed characteristic pictures as Figures 4 and 5. A pneumonectomy was carried out. Histologically, a beautiful alveolar carcinoma consisted of the characteristic tall columnar epithelial cells, which were lining the alveolar spaces as seen in Figures 6, 7, 8, and 20. 6. In the second case of 41 year old male, predominant clinical feature was single, well defined mass in the right lower lobe [Fig. 10 and 11] on chest X-ray. Bilobectomized specimen showed fragile, soft and hard tissue containing mucoid secretions and focal yellowish necrosis with pigmentation on cut surface [Fig. 12]. Slides showed tumor cells lined up along the alveolar septa with papillary projections [Fig. 13 and 14]. 7. Third case of alveolar cell carcinoma was a 50-year-old housewife with hemoptysis. An outstanding clinical picture was a round to lobulated mass in the right upper lobe [Fig. 16]. She is living now, 2 years and 1 month post-operatively, but has arrived at terminal stage with military nodular disseminations to the contralateral lung [Fig. 19].

• Journal of Korean Neurosurgical Society
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• 제64권4호
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• pp.592-607
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• 2021

Objective : Few studies exist on primary spinal cord tumors (PSCTs) in pediatric patients. The purpose of this study was to perform descriptive analysis and detailed survival analysis for PSCTs. Methods : Between 1985 and 2017, 126 pediatric patients (male : female, 56 : 70) with PSCTs underwent surgery in a single institution. We retrospectively analyzed data regarding demographics, tumor characteristics, outcomes, and survival statistics. Subgroup analysis was performed for the intramedullary (IM) tumors and extradural (ED) tumors separately. Results : The mean age of the participants was 6.4±5.04 years, and the mean follow-up time was 69.5±46.30 months. The most common compartment was the ED compartment (n=57, 45.2%), followed by the IM (n=43, 34.1%) and intradural extramedullary (IDEM; n=16, 12.7%) compartments. Approximately half of PSCTs were malignant (n=69, 54.8%). The most common pathologies were schwannomas (n=14) and neuroblastomas (n=14). Twenty-two patients (17.5%) died from the disease, with a mean disease duration of 15.8±15.85 months. Thirty-six patients (28.6%) suffered from progression, with a mean period of 22.6±30.81 months. The 10-year overall survival (OS) rates and progression-free survival (PFS) rates were 81% and 66%, respectively. Regarding IM tumors, the 10-year OS rates and PFS rates were 79% and 57%, respectively. In ED tumors, the 10-year OS rates and PFS rates were 80% and 81%, respectively. Pathology and the extent of resection showed beneficial effects on OS for total PSCTs, IM tumors, and ED tumors. PFS was affected by both the extent of removal and pathology in total PSCTs and ED tumors; however, pathology was a main determinant of PFS rather than the extent of removal in IM tumors. The degree of improvement in the modified McCormick scale showed a trend towards improvement in patients with IM tumors who achieved gross total removal (p=0.447). Conclusion : Approximately half of PSCTs were malignant, and ED tumors were most common. The most common pathologies were schwannomas and neuroblastomas. Both the pathology and extent of resection had a decisive effect on OS. For IM tumors, pathology was a main determinant of PFS rather than the extent of removal. Radical excision of IM tumors could be a viable option for better survival without an increased risk of worse functional outcomes.

• 대한한방내과학회지
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• 제32권1호
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• pp.129-135
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• 2011

This report documents a case in which the administration of an herbal product, an extract of the lacquer tree, Rhus verniciflua Stokes, as sequential and concurrent treatment with chemotherapy was associated with a long term survival and good quality of life in a patient with metastatic non-small cell lung cancer(NSCLC). A 51-year-old Korean female was referred to the $M{\cdot}{\mu}$ Integrative Cancer Center, East-West Neo Medical centrer, Kyung Hee University for stage IV, metastatic NSCLC. She was treated with aRVS alone for 19 months and then received 1st line paclitaxel/carboplatin combined with aRVS, 2nd line gefitinib, and 3rd line pemetrexed. The number of cycles of pemetrexed administered was seventeen. aRVS was restarted as the 13th pemetrexed was administered. Pemetrexed with aRVS is currently ongoing. This patient has been alive for 41 months, and has been keeping a good performance status so far. We suggest aRVS as sequential and concurrent treatment with chemotherapy is an effective alternative treatment strategy.

• Journal of Yeungnam Medical Science
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• 제5권2호
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• pp.221-230
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• 1988

최근 저자들은 1987년부터 1988년까지 2년간 영남의대 부속병원 외과에서 수술 및 병리 조직학적으로 확진된 다발성 원발성 악성 종양 6예를 경험하였기에 이를 연령, 발생 빈도, 호발 장기, 유발 인자, 가족력 등을 분석함으로서 외과의에게 다발성 원발성 악성 종양에 대한 관심을 고조시키고자 문헌고찰과 함께 보고하는 바이다. 1. 평균연령은 54.1세였으며 최저 38세부터 최고 67세였다. 2. 남자 3예, 여자 3예로 남녀비는 1:1이었으며 발생 빈도는 0.31%였다. 3. 호발 부위는 위암, 유방암, 대장암 순이었으며 이 중 1예는 초기 위암 및 초기 대장암이었으며 위암과 다발성 골수종을 동반한 예도 1예 있었다. 4. 면역 검사는 DNCB, CMI, T4/T8 ratio를 측정하였으나 현저하게 면역 저하된 경우는 없었다. 5. 가족력은 1예로서 17%였으며 위암이었다.

• Journal of Gastric Cancer
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• 제3권4호
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• pp.191-194
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• 2003

Purpose: Neuroendocrine carcinomas of the stomach account for only about $0.3\%$ of all gastric tumors. The prognosis of this disease is very poor compared with the common type of gastric adenocarcinoma. The purpose of this retrospective study was to review the clinicopathologic features of 18 cases of this unusual gastric tumor and to establish a treatment strategy for this tumor. Materials and Methods: Excluding 2 cases of non-curative resection and 1 case of operative mortality, 18 cases of typical neuroendocrine carcinoma who had curative resection from January 1991 to December 2000 at Asan Medical Center were analyzed; 6841 gastric cancer patient were treated surgically during the same period. Results: The mean age at the time of diagnosis was 58.6 years (range: $35\∼75$ yr). Sixteen patients were male, and two were female. Eleven tumors ($61.1\%$) developed in the lower part of the stomach, three ($16.7\%$) in the middle part, and three ($16.7\%$) in the upper part. One tumor involved the entire stomach. Eight cases ($44.4\%$) were Borrmann type 2, and six case ($33.3\%$) were Borrmann type 3. The mean tumor size was 6.94 cm (range: $0.6\∼15$ cm). Nine cases ($50\%$) showed recurrence of the disease, and eight of them died within 20 months. Of the nine recurred cases, 7 cases ($77.8\%$) showed liver metastasis. The mean disease-free interval was 6.8 months (range: $2.5\∼11$ months) after surgical resection, and the mean survival was 17.9 months (range: $8\∼40$ months) for recurrence cases. One patient with liver metastasis was treated with a liver-wedge resection just after diagnosis and was still alive for 37.5 months postoperatively. There were 9 deaths after the median follow- up period of 40 months (range: $8\∼72$ months). Conclusion: Gastric neuroendocrine carcinomas frequently recur at the liver, even in early stage cancer, and have a poor prognosis. We experienced a case of successful control of hepatic metastasis by surgical resection and a case of a small cell carcinoma which was successfully controlled with systemic chemotherapy.

• 대한두경부종양학회지
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• 제16권2호
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• pp.196-200
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• 2000

Objectives: Submandibular gland tumors is rare. The aim of this study is to get a clinical feature of submandibular gland tumors and to apply a treatment of submandibular gland tumors of future patients. Methods: We analyzed retrospectively the 18 patients with submandibular gland tumors who were treated surgically at Presbyterian Medical Center(PMC), during the period of 8 years from 1992 to 1999. Analysis was performed regarding the incidence, classification, surgical treatment, surgical complication, recurrence and prognosis. Result : 1) Male to female sex ratio was 1:1.25, the most prevalent age group was the 5th decade. 2) Benign tumors were 12 cases(66.7%) and malignant tumors were 6 cases(33.3%). 3) Histopathologically, the most common benign submandibular gland tumor was pleomorphic adenoma, and the most malignant submandibular gland tumor was adenoid cystic carcinoma. 4) In pleomorphic adenoma, excision of submandibular gland was performed in all case(8case). In malignant tumors, excision and supraomohyoid node dissection was performed in 3cases, and modified-radical neck dissection(RND) was performed in 2cases, and than standard RND was performed in 1case. 5) In the malignant tumor, we choose a radiation therapy as adjuvant therapy. 6) In a surgical complication of submandibular gland tumor, we had a facial nerve injury(1case). 7) Recurrence rate of submandibular gland tumor was 22.2%, and than all case were malignant tumor. Overall 5-year survival rate of submandibular gland cancer was 50%. Conclusion: In above results, postoperative recurrence rate is low in benign, but high in malignant tumor of submandibular gland. Surgical procedure should not be aggressive in benign tumor, but should be aggressive in malignant tumor of submandibular gland and an adjuvant radiation therapy should be considered.

• Archives of Plastic Surgery
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• 제44권4호
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• pp.313-318
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• 2017

Background Jeju Island is geographically and socioeconomically distinct from the mainland of South Korea. Thus, the presentation and management of non-melanocytic skin cancers (NMSC) of the head and neck may differ from those in other regions of the country. We compared the clinical characteristics and treatment modalities of NMSC on Jeju Island with the findings of similar regional studies. Methods Patient data, including age, sex, diagnosis, tumor site, treatment, and recurrence, were obtained from the medical and pathology records of patients diagnosed with NMSC between January 2010 and June 2015. Results In total, 190 patients (57 men) with a mean age of 75 years (range, 42-97) were assessed. Overall, 203 NMSCs were diagnosed, including 123 basal cell carcinomas and 80 squamous cell carcinomas. The tumor sites included the nose, cheeks, periorbital area, and lips (n=55, 54, 25, and 20, respectively). We identified 92 T1-stage and 60 T2-stage tumors, and 120 cases were treated with wide surgical resection and 17 cases were treated with radiation therapy at the medical center. Of the 120 cases treated surgically, 69 required reconstructive surgery using a local skin flap, 22 required full-thickness skin grafting, and 12 underwent primary closure. Basal and squamous cell carcinomas recurred in 2 and 1 cases, respectively. Conclusions Compared to the reports from other regions, the average patient age was 10 years higher, with a marked female preponderance. While the proportion of squamous cell carcinoma was higher than in other regions, the tumor distribution and surgical management profiles were similar.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권6호
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• pp.327-331
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• 2015

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) occurs mainly in female patients. In males the occurrence rate is low, which seems to be related to the low incidence of osteoporosis in men. Unfortunately, BRONJ tends to be ignored in general dental clinics in male patients with a history of osteoporosis treatment. BRONJ occurred in a male patient due to the clinician's lack of interest in the patient's history. In this case, the male patient was on bisphosphonate therapy because of a orchiectomy, and a dental treatment was performed without consideration of his medical history, resulting in BRONJ. We performed careful examinations and treatment with antibiotics and surgical operations. The postoperative healing was successful. In light of this particular case, we concluded that careful listening to the patient's history is very important.

• 대한치과보철학회지
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• 제58권3호
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• pp.268-274
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• 2020

구강암 등의 병소로 인해 하악골의 절제를 시행한 환자는 구강악안면계의 재건을 통한 기능적, 심미적 회복이 중요하다. 하악골의 재건에 많이 사용되는 비골유리피판은 임플란트 식립을 동반한 보철적 수복에 있어 용이하다. 그러나 성장기 환자는 비골의 크기가 작고 잔여 성장이 남아있을 수 있어 임플란트를 이용한 치료 시 어려움이 존재한다. 본 증례는 골육종으로 하악골 절제술 및 비골유리피판을 이용해 하악골의 재건을 시행한 11세 여성 환자로, 임플란트 지지 고정성 보철물을 이용한 보철적 수복을 통해 기능적, 심미적 회복을 도모하였다. 임플란트의 식립 부위 및 개수, 보철물의 형태적 고려를 하였으며, 성장기인 13세에 임플란트 지지 고정성 보철 수복을 완료하였고, 추가로 1년간의 경과 관찰을 시행한 바 안정적인 결과를 얻었기에 보고하고자 한다. 그러나, 이후의 추가적인 검진을 통해 악안면계의 변화를 관찰하는 것이 필요하겠다.