• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.4013-4018
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• 2015

Objective: To explore the clinical application of recombinant human endostatin (Endostar) in the treatment of patients with non-small cell lung cancer (NSCLC) in Chinese mainland. Materials and Methods: A total of 75 patients diagnosed as NSCLC were randomly divided into control group (37 cases) and treatment group (38 cases). Control group was treated with postoperative complementary chemotherapy containing two-agent platinum protocol on postoperative d21, 3 weeks as a cycle, for totally 4~6 cycles. On this basis, treatment group was added with Endostar $7.5mg/m^2$ on postoperative d8~9, 3~4 h/time, qd, 14 weeks as a cycle, for totally 4 cycles. The interval between every two cycles was 7 d. The 5-year progression-free survival (PFS), 5-year survival time and complications in both groups were observed. Results: Compared with control group, the average PFS increased evidently in treatment group by 9.8 months (41.6 months vs. 31.8 months), and there was significant difference (P<0.05). And the median PFS was 42.5 months in treatment group, obviously longer than that in control group (33.7 months) by 8.8 months (P<0.05). Additionally, the 5-year overall survival rate (OS), average survival time and median survival time (MST) were 47.4%, 50.1 months and 59.3 months in treatment group, significantly higher than the 29.7%, 42.1 months and 43.5 months in control group (P<0.05). Only 1 patient showed poor healing of surgical wound in treatment group, but no surgery-associated complication was found in control group. Moreover, the postoperative complementary therapy-connected complication rates were 63.2% (24/38) and 59.5% (22/37) in treatment group and control group respectively, but there was no significant difference (P>0.05). Conclusions: The application of Endostar combined with sensitive platinum-contained chemotherapeutic agents in the postoperative complementary chemotherapy can be widely used in clinic because it can significantly prolong the long-term survival time of patients with NSCLC.

• Journal of Chest Surgery
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• 제31권2호
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• pp.208-211
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• 1998

반사성 교감신경 위축증은 과도하며 지속적인 통증, 혈관운동성 및 그 밖의 자율성 장애, 기능회복의 지연과 이영양성 변화를 특징으로 하는 중요한 임상양상이다. 이 증후군은 임상에서 자주 마주치는 문제중 하나일뿐더러 정확한 진단과 치료가 결정적이기 때문에 중요하다. 유발인자는 사고나 수술, 또는 다양한 질환이 될 수 있다. 정확한 진단과 치료는 증상의 빠른 소실과 완전한 회복을 기대할 수 있다. 56세 남자환자로 1996년 5월 좌측 제2수지 원위관절부 완전절단상을 입었고, 고대부속병원 재건성형외과에서 응급으로 재접합술을 시행받았다. 그 후, 좌측 제 2수지의 경감되지 않는 지속적인 통증과 좌측상지 근위부로 퍼져가는 통증 및 좌측 견갑부 운동장애를 호소해 왔다. 많은 치료법이 사용되었지만 효과적이지는 못하였다. 그리하여 좌측 흉부 교감신경절제술을 본 과에서 시행하였다. 이 후 성공적으로 통증이 완화되었고, 견갑부 운동상태도 향상되었기에 문헌고찰과 함께보고하는 바이다.

• Journal of Chest Surgery
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• 제35권5호
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• pp.381-386
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• 2002

배경 및 목적: 기관지 유암종은 전체 폐암의 약 2%를 차지하며 전형적 유암종과 이형성 유암종으로 나누어진다. 이형성 유암종은, 신경 내분비성 폐암의 범주에서 양끝을 차지하는, 낮은 악성도의 전형적 유암종과 높은 악성도의 소세포 폐암의 중간형으로 여겨지고 있다. 이형성 유암종의 수술 범위, 수술 후 전신적인 치료의 필요성에 관해서 상반되는 주장이 있다. 이에 본원에서 수술 받은 기관지 유암종 환자들을 대상으로 후향적 연구를 시행하였다. 대상 및 방법: 1990년부터 2000년까지 연세의료원에서 15명의 기관지 유암종 환자가 수술 치료를 받았다. 그중 전형적 유암종이 10명, 이형성 유암종이 5명이었다. 병리학적 진단은 WHO/IASLC(1999)의 기준에 따랐다. 결과: 수술은 전폐 절제술 3예, 폐엽절제술 11예, 구획 절제술 1예였다. 전형적 유암종의 경우 1명(10%)에서 국소 림프절 전이를 보였고, 이형성 유암종의 경우 3명(70%)에서 종격동 림프절 전이를 나타내었다. 수술 후 원격 전이는 전형적 유암종에서는 1명(10%)이었으나, 이형성 유암종에서는 4명(80%)에서 나타났다(p=0.017). 수술 후 5년 생존율은 전형적 유암종에서는 100%인 반면, 이형성 유암종에서는 20%로 통계학적으로 유의하게 전형적 유암종의 생존율이 높았다(p=0.0039). 결론: 이형성 유안종의 경우 진단 당시부터 종격동 림프절 전이가 많고 수술 후 생존율도 낮으므로, 비소세포성 폐암에 준하여 폐엽절제술 이상의 수술을 시행하고 종격동 림프절 전이가 있는 경우에는 수술 후 항암화학 요법이 필요할 것으로 생각된다.

• Journal of Periodontal and Implant Science
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• 제27권2호
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• pp.317-328
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• 1997

Since laser therapy has been applied to dentistry, many dental practitioners are very interested in laser therapy on various intraoral soft tissue lesions including gingival hyperplasia and aphthous ulcer. The purpose of the present study was to determine the therapeutic effect and the harmful effect of a pulsed-Nd:YAG laser irradiation on human gingival tissue. In twenty periodontal patients with gingival enlargement, the facial gingival surface of maxillary anterior teeth was randomly irradiated at various power of 1.0W(100mJ, 10Hz), 3.0W(100mJ, 30Hz) and 6.0W(l50mJ, 40Hz) for 60 seconds by contact delivery of a pulsed-Nd:YAG laser(EN.EL.EN060, Italy). Immediately after laser irradiation, the gingival tissues were surgically excised and prepared in size of 1mm3. Subsequently the specimens were processed for prefixation and postfixation, embedded with epon mixture, sectioned in $1{\mu}$ thickness, stained with uranyl acetate and lead citrate, and observed under transmission electron microscope(JEM 100 CXII). Following findings were observed; l. In the gingival specimens irradiated with l.OW power, widening of intercelluar space and minute vesicle formation along the widened intercellular space were noted at the epithelial cells adjacent to irradiated area. 2. In the gingival specimens irradiated with 3.0W power, the disruption of cellular membrane, aggregation of cytoplasm, and loss of intercellular space were observed at the epithelial cells adjacent to irradiated area. 3. In the gingival specimens irradiated with 6.0W power, the disruption of nuclear and cellular membrane was observed at the epithelial cells adjacent to irradiated area. The ultrastructural findings of this study suggest that surgical application of a pulsed-Nd:YAG laser on human gingival tissue may lead somewhat delayed wound healing due to damage of epithelial cells adjacent to irradiated area.

• Journal of Periodontal and Implant Science
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• 제27권2호
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• pp.363-377
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• 1997

The main goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal diseases. Although conventional forms of periodontal therapy show sound clinical results, the healing results in long junctional epithelium. There have been numerous materials and surgical techniques developed for new attachment and bone regeneration. Bone grafts can be catagorized into: autografts, allografts, xenografts and bone substitutes. Synthetic bone substitute materials include hydroxyapatite, tricalcium phosphate, calcium carbonate, and Plaster of Paris. Calcium sulfate has found its use in dental practice for the last 30 years. Recent animal studies suggest that periodontal regeneration in 3 wall intrabony defect may be enhanced by the presence of calcium sulfate. And it is well known that 2 wall & 1 wall defect have less osteogenic potential, So we need to study the effect of calcium sulfate in 1 wall intrabony defect in dogs. The present study evaluates the effects of calcium sulfate on the epithelial migration, alveolar bone regeneration and cementum formation in intrabony defects of dogs. Four millimeter-deep one-wall intrabony defects were surgically created in the mesial aspect of anterior teeth and mesial & distal aspects of premolars. The test group received calcium sulfate grafts with a flap procedure. The control underwent flap procedure only. Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of junctional epithelium were: 2.52mm in the control, and 1.89mm in the test group. There was no statistical significance between the two groups. 2. Alveolar bone formation were: 0.61mm in the control, and 1.88mm in the test group. There was a statistically significant difference between the two groups (p<0.05). 3. Cementum formations were: l.lmm in the control, and 2.46mm in the test group. There was a statistically significant difference between the two groups (p<0.05). 4. The length of CT adhesion were: O.97mm in the control, and 0.17mm in the test group. There was no statistically significant differences between the two groups These results suggest that the use of calcium sulfate in intrabony defects has little effect on junctional epithelium migration, but has significant effects on new bone and new cementum formations.

• 대한두경부종양학회지
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• 제25권2호
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• pp.128-131
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• 2009

Objectives : Mucosa-associated lymphoid tissue(MALT) lymphoma of the head and neck region is relatively rare, but it has variable clinical and biological characteristics. Although there were few studies on this topic, there is still controversy regarding the best treatment. The authors retrospectively investigated the clinical courses and treatment results in 10 patients presenting with MALT-lymphoma in head and neck region except ocular adnexa. Material and Methods : Ten patients with a histologically verified diagnosis of the extranodal marginal zone B cell lymphoma arising in thyroid glands(3), larynx(3), oral cavity(2), oropharynx(1), salivary glands(1) were analyzed. Results : Four patients were allocated to stage IE and another six patients to stage IIE according to the Ann Arbor staging system. Treatment consisted of local therapy(surgical resection and/or radiotherapy) in four patients and systemic chemotherapy with/without local therapy in six patients. Complete remission and partial remission were achieved in seven patients(70%) and two patients(20%), respectively. No recurrence or mortality was observed with a mean follow-up of 40.5 months. Conclusion : Patients with MALT-lymphomas of the head and neck region were potentially treated by local modality in localized disease state. However systemic chemotherapy was also effective even in localized disease state and was well tolerated by patients. And strict staging and close long-term monitoring were recommended considering its indolent progression.

• Journal of Chest Surgery
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• 제40권10호
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• pp.680-684
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• 2007

배경: IB기 비소세포폐암의 가장 효과적인 치료는 완전 절제이나, 수술 후 재발이 생기면 생존율이 떨어진다. 최근 IB기 비소세포폐암의 완전 절제 후 시행하는 보조 요법에 대해 관심이 높아지고 있다. 적절한 보조 요법을 사용하기 위해서는 재발의 위험 인자를 아는 것이 중요하다. 대상 및 방법: 114명을 대상으로 연구하였으며, 환자의 성별, 나이, 수술 방법, 조직학적 유형, 분화의 정도, 종양의 크기, 장측 흉막 침범 유무 등과 재발과의 관계를 분석하였다. 생존율과 무재발률은 Kaplan-Meier 방법으로 구하였으며, log rank test로 단변량 분석을, Cox's proportional hazard model을 이용하여 다변량 분석을 하였다. p값이 0.05 미만인 경우에 통계학적으로 유의하다고 판정하였다. 결과: 3년 생존율 및 무재발률은 각각 87.0%, 79.4%였다. 단변량 분석에서 분화도가 통계학적으로 의미가 있었으며, 다변량 분석에서도 저분화의 경우가 예후가 좋지 않았다. 결론: 완전 절제된 IB기 비소세포폐암 환자에서 저분화도가 재발과 연관된 인자이므로 수술 후 보조 요법이 필요할 것으로 기대된다.

• 대한두경부종양학회지
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• 제13권2호
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• pp.228-234
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• 1997

Squamous cell carcinoma originating in the parotid gland has rare occurrence. The primary squamous cell carcinoma of the parotid gland comprise about 0.3% and 9.8% of all parotid malignant tumor. We investigated the clinical behavior and treatment outcome of patients with primary squamous cell carcinoma of the parotid gland. We reviewed all cases of possible primary squamous cell carcinoma of the parotid gland treated at Yonsei Cancer Center, Seoul, Korea, from 1981 through 1995. A total of 128 had primary parotid malignancy. Metastatic squamous cell carcinoma and mucoepidermoid carcinoma were excluded in this study. Ten cases of primary squamous cell carcinoma of the parotid gland were identified. 6 cases of them are men & 4 cases are women. The age of patients ranged from 31 to 68 years with median age of 55 years. On physical examination, 5 cases had palpated cervical neck node and 6 cases had facial nerve palsy. Staging was done according to the current guidelines established by the American Joint Committee on Cancer (1992). Two cases were stage I, 1 in stage III, and 7 in stage IV. Six cases were performed operation and postoperative radiation therapy. Four cases were treated by curative radiation therapy, dose of more than 65 Gy on parotid gland region. The 5 year actual survival rate and the 5 year disease free survival rate were 30.8%, and 40.0%. Initial complete response rate was 70% for all patients. Local failure were occurred 3 of 7 patients with local controlled cases, failure sites were primary site, ipsilateral cervical neck node, contralateral supraclavicular node. Most recurrences developed within 1 year of initial treatment. Distant metastasis was appeared 2 of 3 patients who did not achieved local control. Primary squamous cell carcinoma of the parotid gland occured infrequently. A retrospective study at the Yonsei Cancer Center indicates incidence of 7.8%. At diagnosis, advanced stage, neck node presentation, facial nerve paralysis were associated with a poor prognosis. These results may suggested that radical surgical excision may be treatment of choice and that planned postoperative radiotherapy may be bendicial for reducing locoregional recurrence rates.

• 대한두경부종양학회지
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• 제10권2호
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• pp.218-224
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• 1994

Soft tissue sarcoma of the head and neck is not frequent neoplasm, accounting for less than 1% of all malignant neoplasm in the region. The histological varieties include osteogenic sarcoma, malignant fibrous histiocytoma, rhabdomyosarcoma, fibrosarcoma, tenosynovial sarcoma, angiosarcoma and chondrosarcoma. Rhabdomyosarcomas of the head and neck usually occur in children under the age of 10 years (over 70%) and rarely develop in adults over the age of 20 years. The prevalent sites of involvement include the orbit, nasal cavity, external ear, paranasal sinus and soft tissue of mouth and the primary location of tumor is considered to be one of the important prognostic factors. Before the 1960s, when surgical resection was the only method of treatment, the 5-year survival rate was less than 20%, but recently it has been greatly improved by the multimodality treatment, combining surgery with chemotherapy and radiation therapy. Here we treated a rhabdomyosarcoma woman with three cycles of high dose chemotherapy followed by radiation therapy. After the, completion of preoperative treatments, successful result of more than partial response was achieved. Three months later total maxillectomy and radical neck dissection was performed. There was no evidence of tumor infiltration in the resected tumor and regional lymphnodes but metastasized tumor cells in cervical lymphnodes were detected. Tumor cell infiltration was also found on the bone marrow biopsy to evaluate the pancytopenia which occurred during postoperative recovery. Two months later she died of secondary bone marrow failure. We think that this multimodality treatment combining pre-operative chemotherapy, radiotherapy and surgery might play an important role in curative resection and eyeball preservation in patients with rhabdomyosarcoma involving the eyeball.

• Journal of Oral Medicine and Pain
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• 제38권1호
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• pp.87-95
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• 2013

측두하악관절 골관절염은 측두하악장애의 한 형태로 관절조직의 생리적 내성을 초과하는 기능적 부하가 지속적으로 관절에 가해졌을 때 관절연골 및 연골하 골조직의 점진적 파괴와 이차적 염증을 특징으로 하는 질환이다. 관절면에 가해지는 물리적 하중은 관절내에서 기질파괴 단백효소나 염증성 cytokine, 유리기의 활성을 증가시키고, 그에 따라 골조직의 퇴행과 재형성 사이의 균형을 깨뜨려 골조직의 흡수를 야기한다. 최근에는 물리적 하중 이 외에 비만세포에서 유래하는 adipokine이 골흡수를 증가시킨다는 보고들이 있으나 측두하악관절에 적용하기에는 아직 추가적인 연구가 필요하므로 현재로서 골관절염의 치료는 관절의 기능적 부하를 줄이고 환자의 생리적 내성을 증가시키는 방향으로 이루어져야 한다. 임상증상은 충분한 기간 정확한 술식대로 시행한 물리치료, 약물치료, 교합안정 장치치료 등의 보존적 처치와 관절강내 주사요법이나 관절세척술 및 관절경 수술과 같은 추가적인 외과적 처치에 의해 성공적으로 조절될 수 있으나, 임상증상의 개선이 골파괴의 중지와 재형성을 담보하는 것은 아니므로 임상증상의 개선 이 후에도 지속적인 골변화의 추적관찰이 필요하다. 또한, 골변화 활성 자체를 직접적으로 조절할 수 있는 활용 가능한 치료법이 없는 한, 지속적인 동기유발과 행동조절을 통해 관절에 가해지는 기능적 부하를 환자 스스로 조절할 수 있도록 끊임없이 교육하는 것이 골변화를 겪는 측두하악관절로 하여금 보다 이른 시기에 보다 유리한 정형적 안정에 도달하게 함으로써 골관절염을 보다 성공적으로 조절할 수 있는 길이라고 할 수 있다.