• Archives of Plastic Surgery
• /
• 제38권4호
• /
• pp.415-420
• /
• 2011

Purpose: The reconstruction of a soft tissue defect of the heel pad can be challenging. One vital issue is the restoration of the ability of the heel to bear the load of the body weight. Many surgeons prefer to use local flaps or free tissue transfer rather than a skin graft. In this study, we evaluated the criteria for choosing a proper flap for heel pad reconstruction. Methods: In this study, 23 cases of heel pad reconstruction were performed by using the flap technique. The etiologies of the heel defects included pressure sores, trauma, or wide excision of a malignant tumor. During the operation, the location, size and depth of the heel pad defect determined which flap was chosen. When the defect size was relatively small and the defect depth was limited to the subcutaneous layer, a local flap was used. A free flap was selected when the defect was so large and deep that almost entire heel pad had to be replaced. Results: There was only one complication of poor graft acceptance, involving partial flap necrosis. This patient experienced complete recovery after debridement of the necrotic tissue and a split thickness skin graft. None of the other transferred tissues had complications. During the follow-up period, the patients were reported satisfactory with both aesthetic and functional results. Conclusion: The heel pad reconstructive method is determined by the size and soft-tissue requirements of the defect. The proper choice of the donor flap allows to achieve satisfactory surgical outcomes in aesthetic and functional viewpoints with fewer complications.

• Journal of Gastric Cancer
• /
• 제9권3호
• /
• pp.143-151
• /
• 2009

목적: 위암은 한국에서 제일 흔한 암으로 저자들은 단일 술자에 의해 위절제술을 시행받은 환자들을 대상으로 임상병리학적 특성 및 5년 생존율과 이에 따른 예후인자를 알아보고자 한다. 대상 및 방법: 1998년 9월부터 2003년 8월까지 만 5년간 위암으로 진단되어 인제대학교 서울백병원 한국위암센터에서 위절제술을 시행한 위암환자 1,435예의 환자를 대상으로 성별 및 연령, 종양의 위치 및 크기, 육안적 분류 및 조직학적 분류, 위벽 침윤도, 림프절 전이, 혈관, 신경초, 림프관 침윤 및 수술 방법 등의 인자들을 후향적으로 조사하였다. 결과: 남녀 비는 2.29 : 1이었고 평균 연령은 56.7세였으며 UICC TNM Stage IA 35.4%, Stage IB 14.1%, Stage II 12.6%, Stage IIIA 12.3%, Stage IIIB 8.3%, Stage IV 17.3%였고 전체 5년 생존율은 69.6%였다. 단변량 분석 결과 연령, 종양의 위치, 종양의 크기, Borrmann type, 분화도, Lauren 분류, 위벽 침윤도, 림프절 전이, UICC TNM 변기, 신경초 침윤, 혈관 침윤, 림프관 침윤, 수술방법에 따라 생존율에 유의한 차이가 있었다. 다변량 분석결과 위벽 침윤도, 림프절 전이만0| 독립적인 예후인자였다. 결론: 다양한 임상병리학적 특성들이 위암환자의 예후에 영향을 주지만 이들 인자들 중 결국 위벽 침윤도와 림프절 전이, 즉 병기가 예후에 가장 중요함을 알 수 있었다. 따라서 위암환자 생존을 향상을 위해서 조기 검진을 통한 위암의 조기 발견과 예후 영향인자에 대한 다각적인 치료 방법이 연구, 개발되어야 하겠다.

• Journal of Gastric Cancer
• /
• 제1권2호
• /
• pp.92-99
• /
• 2001

Purpose: E-cadherin is an adhesion molecule essential for tight connection between cells, forming the cadherin/catenin complex. Truncated $\beta$-catenin disrupts the interaction between E-cadherin and $\alpha$-catenin, leading to the loss of intercellular adhesion. Met protein, the hepatocyte growth factor receptor, plays important roles in signal transduction. We investigated the relationships between the expressions of E-cadherin, $\beta$-catenin, and c-met protein and the clinicopathological and prognostic parameters in gastric adenocarcinomas. Materials and Methods: The patterns of E-cadherin, $\beta$-catenin, and c-met protein expression were studied using immunohistochemistry in formalin-fixed, paraffin-embedded archival tissues from 76 surgically resected gastric adenocarcinomas. Results: Increased expressions of E-cadherin, $\beta$-catenin, and c-met were more significantly correlated in early gastric cancers (EGC) than in advanced gastric cancers (AGC) (P=0.002, P=0.003 and P=0.026). The positive immunoreactivities of all three markers were markedly lower in signet ring-cell type and poorly differentiated type lesions than in intestinal-type lesions. Decreased expression of the $\beta$-catenin protein correlated well with increased tumor invasion depth (P=0.039), and increased lymph node metastasis correlated well with reduced expression of c-met (P=0.046). Conclusion: In gastric cancers, reduced expressions of the E-cadherin, $\beta$-catenin, and c-met proteins may play some role in poorer tumor differentiation, deeper tumor invasion, and increased lymph node metastasis. Also, the c-met gene is thought to play a specific role in the mechanism of the yet unknown catenin action.

• 대한정형외과학회지
• /
• 제54권4호
• /
• pp.293-301
• /
• 2019

사지와 몸통의 연부조직 종양은 정형외과 의사가 직면할 수 있는 흔한 문제이다. 비록 연부조직 종양은 대부분 양성이지만 정형외과 의사는 양성과 악성 종양을 구별할 수 있는 특징을 알고 있어야 한다. 연부조직 종양의 임상적 특징 및 역학을 이해하게 되면 올바른 진단 및 수술적인 치료를 할 수 있게 된다. 종양의 크기와 깊이는 종양의 진단을 위해 가장 중요한 요소이다. 종양의 감별 진단을 하기 위해서 우선적으로 상세한 병력청취와 자세한 신체 검사가 필요하며, 이후 단순 방사선 촬영, 초음파, 자기공명영상(magnetic resonance imaging), 양전자 방출 단층촬영술(positron emission tomography), 컴퓨터 단층촬영(computed tomography), 뼈 스캔, 혈관 조영술 등의 다양한 영상 촬영법을 사용하여 종양을 진단하고 진단된 종양의 특성을 확인하여야 한다. 특히 초음파 검사는 외래에서도 쉽게 수행할 수 있어 유용하다. 그러나 검사자의 숙련도에 따라 검사 정확도의 차이가 발생할 수 있다는 단점이 있다. 종양의 생검을 통한 조직검사는 종양에 대한 모든 영상 검사를 시행한 후 최종적으로 시행하는 것이 원칙이다. 조직 검사를 시행할 때는 세심한 주의를 기울여야 하며, 최종적인 진단 후에는 치료를 위해 다각적인 접근을 시행하여야 하며 필요한 경우에는 경험 있는 근골격계 종양전문의사에게 의뢰하는 것이 필요하다.

• 대한전기학회:학술대회논문집
• /
• 대한전기학회 2007년도 춘계학술대회 논문집 전기기기 및 에너지변환시스템부문
• /
• pp.159-161
• /
• 2007

$CO_2$ laser sees that is most suitable to get this effect through minimum formation damage and advantage that is root enemy of effect that happen in minimum cellular tissue depth of 0.1mm is stable living body organization or internal organs institution. Formation damage by ten can be related in formation's kind or energy density, length of evaporation time. If shorten evaporation time, surroundings cellular thermal damage 200 - because happen within 400ums laser beam in rain focus sacred ground surroundings cellular tissue without vitiation me by evaporation Poe of very small floor as is clean steam can. Application is possible to vulva cuticle cousins by a paternal aunt quantity, uterine cancer, cuticle tumor by laser system that $CO_2$ laser gets into standard in obstetrics and gynecology application. Because effect that super pulse output is ten enemies of laser if uniformity one pulse durations are short almost is decreased, most of all pulse module special quality of pulse style $CO_2$ laser for obstetrics and gynecology mode stabilization by weight very, in this research to get into short pulse duration and higher frequency density, do switching by high frequency in DC-DC Converter output DC's ripple high frequency to be changed, high frequency done current ripple amount of condenser for output filter greatly reduce can. Ripple of output approximately to Zero realization applying possible inductor realization through a special quality experiment do.

• 대한전기학회:학술대회논문집
• /
• 대한전기학회 2007년도 심포지엄 논문집 정보 및 제어부문
• /
• pp.55-57
• /
• 2007

$CO_2$ laser sees that is most suitable to get this effect through minimum formation damage and advantage that is root enemy of effect that happen in minimum cellular tissue depth of 0.1mm is stable living body organization or internal organs institution. Formation damage by ten can be related in formation's kind or energy density, length of evaporation time. If shorten evaporation time, surroundings cellular thermal damage 200 - because happen within 400ums laser beam in rain focus sacred ground surroundings cellular, tissue without vitiation me by evaporation Poe of very small floor as is clean steam can. Application is possible to vulva cuticle cousins by a paternal aunt quantity, uterine cancer, cuticle tumor by laser system that $CO_2$ laser gets into standard in obstetrics and gynecology application. Because effect that super pulse output is ten enemies of laser if uniformity one pulse durations are short almost is decreased, most of all pulse module special quality of pulse style $CO_2$ laser for obstetrics and gynecology mode stabilization by weight very, in this research to get into short pulse duration and higher frequency density, do switching by high frequency in DC-DC Converter output DC's ripple high frequency to be changed, high frequency done current ripple amount of condenser for output filter greatly reduce can. Ripple of output approximately to Zero realization applying possible inductor realization through a special quality experiment do.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권15호
• /
• pp.6353-6356
• /
• 2014

Background: The purpose of this study was to investigate and evaluate risk factors for lymph node metastases (LNM) in cases of endometrial cancer (EC). Materials and Methods: A retrospective single institution analysis of patients surgically staged for EC at Ankara Oncology Education and Research Hospital from 1996 to 2010 was performed. Roles of prognostic factors, such as age, histological type, grade, depth of myometrial invasion, cervical involvement, peritoneal cytology, and tumor size, in the prediction of LNM were evaluated. Fisher's exact test and logistic regression analysis were used to assess the effects of various factors on LNM. Results: LNM was observed in 22 out of 247 patients (8.9%) and was significantly more common in the presence of tumors of higher grade, deep myometrial invasion (DMI), cervical involvement, size >2cm, and with positive peritoneal cytology. Logistic regression analysis revealed that DMI remained the only independent risk factor for LNM. NPV, PPV, sensitivity, and specificity for satisfying LNM risk were 98.0, 19.5, 86.3, and 65.3%, respectively for DMI. Conclusions: The incidence of LNM is influenced independently by DMI. If data support a conclusion of DMI, LND should be seriously considered.

• 대한기관식도과학회지
• /
• 제17권1호
• /
• pp.9-13
• /
• 2011

Endobronchial ultrasound (EBUS), which enables visualization of lesions beyond the bronchus, broadens the fields of bronchoscopy. Two types of ultrasound, radial and linear, are used for bronchoscopy. Radial EBUS is performed by inserting an ultrasound mini-probe through the working channel of a flexible bronchoscope. Evaluation of the depth of invasion of early endobronchial lung cancers using radial EBUS is useful in deciding endobronchial treatment. A central tumor limited to within the cartilaginous layer is a good indication for endobronchial photodynamic therapy. EBUS-guide sheath (GS) technique is a sampling method assisted by localization of peripheral lesions using EBUS. The diagnostic yield of EBUS-GS method is higher than that of conventional transbronchial biopsy. High diagnostic values of EBSU-GS method are reported even in small (${\leq}2cm$) peripheral tumors. Linear EBUS is used for endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA). EBUS-TBNA has high diagnostic yields in mediastinal staging of lung cancer even in patients having radiologically early stage lung cancers with normal CT or PET findings in the mediastinum. EBUS is a valuable method in evaluating early endobronchial tumors and peripheral small lung cancers and as well as in mediastinal staging.

• 한국의학물리학회지:의학물리
• /
• 제3권2호
• /
• pp.59-65
• /
• 1992

유방암은 여성암 가운데 세계에서 가장 빈도가 높으며, 한국에서도 세번째로 많은 것으로 보고하고 있다. 유방암에서 방사선치료는 photon beam를 이용하여 tangential field로 치료하거나 electron beam를 이용하여 치료하는 것이 보편적이다. 치료범위 내부의 밀도와 tumor까지의 깊이는 방사선치료에서 선량분포를 결정하는 중요한 요소들이다. CT planning를 이용하면 이러한 요소들을 정확하게 산출하여 선량과 선량분포를 결정하는데 이용할 수 있다. 저자들이 유방암 환자 65명중 전자선으로 치료를 받은 45명을 분석한 결과 cheast wall의 두께와 internal mammary lyphnode의 깊이가 1.5cm 이하인 경우에는 6MeV의 에너지가 적적함을 보여 주었으며, 1.5cm에서 2.0cm까지는 9MeV의 에너지가, 2.0cm에서 2.5cm까지는 12MeV의 에너지가 적절함을 보였다.

• 대한두개안면성형외과학회지
• /
• 제16권1호
• /
• pp.43-46
• /
• 2015

Microcystic adnexal carcinoma is a rare type of tumor, with about 300 cases reported globally. Due to its similar histology with other tumors, it is occasionally misdiagnosed as desmoplastic trichoepithelioma, basal cell carcinoma, syringoma, and so on. We present a patient with a mass on the perioral area who was preoperatively diagnosed with trichoepithelioma. Microcystic adnexal carcinoma was diagnosed after excisional biopsy and a wide excision. Defects were reconstructed with a mucosal advancement flap. There was no recurrence and there were no significant complications during the 18-month follow-up period. Because superficial punch biopsy has limitations in width and depth, surgeons should always consider the possibility of malignancy of a mass even if a biopsy shows a benign result.