• Advances in pediatric surgery
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• v.16 no.2
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• pp.134-142
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• 2010

Malignant ovarian tumors in children are very rare, and consist of about 1 % of all childhood malignant tumors. The purpose of this study is to examine the clinical characteristics, treatment, and prognosis for children with malignant ovarian tumors. We retrospectively reviewed the medical records of children under 15 years of age with malignant ovarian tumors who had been treated surgically at Asan Medical Center between 1989 and March 2009. There were 32 patients, ranged in age at surgery from 2 to 15 years (mean; 10.4 years). The median follow-up period was 64.7 months (from 1 month to 188 months). Pathologic diagnosis were; immature teratoma (n=10), mixed germ cell tumor (n=10), and dysgerminoma (n=6). Tumor stage was classified by the staging system of the International Federation of Gynecology and Obstetrics (FIGO). The number of patients in stage I, II, III, and IV were 24 (75 %), 2 (6.2 %), 4 (12.5 %), and 2 (6.1 %), respectively. The tumor recurred in 4 patients. Seven patients of group 1 did not receive postoperative adjuvant chemotherapy, and in three of them, the tumor recurred. Twenty-five patients (group 2) underwent postoperative adjuvant chemotherapy, and there was only one recurrence. One patient who did not receive postoperative adjuvant chemotherapy and expired 10 months after operation because of tumor recurrence and distant metastasis. The overall 5-year event free survival (EFS) was 84.2 %: group 1 in 44.4 %, and group 2 in 95.7 %. Tumor recurrence was related to the postoperative adjuvant chemotherapy (p=0.004). In conclusion, proper surgical procedures with relevant postoperative adjuvant chemotherapy might improve clinical results in children with malignant ovarian tumors.

• Water for future
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• v.7 no.2
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• pp.75-82
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• 1974

본시험은 관개 및 배수 설계를 위한 기초자료 제공을 목적으로 토양수분 및 지하수위의 변화상태를 구명하고자 하는 것으로 카나다 퀴백(Quebec) 지방 저지대의 대표적인 2종의 태양인 점토와 사질로움 토양에 대해서 일차적으로 지표, 지하배수간의 토양수분과 지하수위의 변화를 연구분석한 것으로 그 결과를 요약하면 다음과 같다. 1. 2종의 토양(점토, 사질로움)에 있어서 공히 토양수분은 지표로부터 지하로 내려갈수록 증가되는 상태를 나타냈으면 이는 하층토로 내려감에 따라 팽창된 치밀한 토양 조직을 가지고 있음을 시사하며 2. 동기에 있어서는 지표로부터 12inch 깊이의 토양수분이 더 깊은 18inch나 24inch 깊이의 토양수분보다 증가된 상태를 유지하였다. 이는 토양내의 빙결막이나 지표면의 눈 또는 어름에 영향으로 생각되며 이 경향은 점토질 토양에서 보다 토양내 빙결막으로의 수분 이종을 조장해주는 투수 계수가 큰 사질로움 토양에서 더 높았다. 3. 양식험구 공히 지표에서 얕은 지하 0∼3inch 이내의 토양수분은 항우를 전후해서 급격한 변화를 가져왔다. 여기에서 수분의 급상승은 호우시나 표층토가 하층토의 토양수분에 영향을 주는 항우이전에 포장용수량(Field capacity)에 달했기 때문에 급항하는 지표면의 물 분자가 열에너지에 의해 증발산되고 천층에 산재한 초, 수근에 의해 소비되는 때문인 것으로 사료된다. 4. 지하수위하의 토양수분은 포화에 달하여 거의 일정할 것으로 기대되었지만 실제로 많은 변화를 가져왔다. 이들 변화에는 부분적으로 토양사극이 지하수위하이라도 채워지지 않았거나(Capillary pressure가 작을 시) 혹은 관측기간 중에 토양의 융기와 수축에 기인된다고 생각된다. 5. 지하배수구가 지표배수구에 비해 지하수위항하가 빨랐음은 물론 사질로움 토양에서는 보다 높은 투수계수로 인해서 지하수위의 항하가 점토질 토양에서 보다 훨씬 빨랐음을 보여주고 있다.표시할 수 있다.된다.acid $0.41{\sim}0.65%$, 오미자는 malic acid $1.51{\sim}3.90%$, citric acid $2.40{\sim}3.92%$로 주요 유기산이 있다. 타닌은 물보다 에탄올 추출물이 다소 함량이 높았으며 특히 오갈피는 $3.35{\sim}3.85%$로 매우 높은 함량이었다.a 6 cases, etc. 2. The retroperitoneal space including kidneys were the most commonly involved site (43.5%), of which Wilms' tumor was the commonest. 3. About 2/3 of tumors developed under the age of 6 and the commonest lesion was Wilms' tumor and the next being neuroblastoma, teratoma, ovarian cyst and so forth. 4. In all tumors except ovarian tumor and choledochal cyst, male was more frequently affected. 5. In plain abdomen 75% of neuroblastoma crossed the mid line while in Wilms' tumor only 2 cases (14%) showed midline cross. Calcific density was 입력불가 in all 6 cases of teratoma (100%) as dense and discrete ossification, in 3 case of neuroblatoma (38%) characteristically in diffuse stippled appearance and in one case

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1609-1613
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• 2015

Purpose: To determine the rate of lymph node metastasis, oncologic and pregnancy outcomes in apparent early-stage malignant ovarian germ cell tumor (MOGCT). Materials and Methods: Medical records of apparent early-stage MOGCT patients undergoing primary surgical treatment at Siriraj Hospital, Bangkok, Thailand, between January 2006 and December 2013, were retrospectively reviewed. Results: Thirty-eight patients had apparent stage I-II MOGCT. The mean age was $22.1{\pm}7.7years$ (median, 20.8 years; range, 7.7-35.6 years). The mean tumor size was $17.8{\pm}6.5cm$ with a median of 20 (range 4-30) cm. Three most common histopathologies were dysgerminoma (12 patients, 31.6%), immature teratoma (12 patients, 31.6%), and endodermal sinus tumor (6 patients, 15.8%). Twenty-seven of 38 patients underwent lymphadenectomy; 13 patients (48.2%) were stage IA and 8 patients (29.6%) were stage IC. The rate of retroperitoneal nodes metastasis was 7.4% (2/27 patients). At 26.1 months of median follow-up time (range 1.9-88.5 months), 9 patients retained fertility functions, with uneventful pregnancies in 3 of these. Only one patient (2.6%) had progression of disease at 4.9 months after surgery. The 5-year survival rate was 97.4%. Conclusion: As the rate of pelvic or para-aortic node metastasis in MOGCT is considerable, lymphadenectomy should be incorporated in surgical staging procedures.

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.130-134
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• 2024

Refractory chylous ascites can cause significant nutritional and immunologic morbidity, but no clear treatment has been established. This article introduces a case of a 22-year-old female patient with an underlying lymphatic anomaly who presented with refractory chylous ascites after laparoscopic adnexectomy for ovarian teratoma which aggravated after thoracic duct embolization. Ascites (>3,000 mL/d) had to be drained via a percutaneous catheter to relieve abdominal distention and consequent dyspnea, leading to significant cachexia and weight loss. Two sessions of hybrid lymphovenous anastomosis (LVA) surgery with intraoperative mesenteric lymphangiography guidance were performed to decompress the lymphatics. The first LVA was done between inferior mesenteric vein and left para-aortic enlarged lymphatics in a side-to-side manner. The daily drainage of chylous ascites significantly decreased to 130 mL/day immediately following surgery but increased 6 days later. An additional LVA was performed between right ovarian vein and enlarged lymphatics in aortocaval area in side-to-side and end-to-side manner. The chylous ascites resolved subsequently without any complications, and the patient was discharged after 2 weeks. The patient regained weight without ascites recurrence after 22 months of follow-up. This case shares a successful experience of treating refractory chylous ascites with lymphatic anomaly through LVA, reversing the patient's life-threatening weight loss. LVA was applied with a multidisciplinary approach using intraoperative mesenteric lipiodol, and results showed the possibility of expanding its use to challenging problems in the intraperitoneal cavity.