• 제목/요약/키워드: local recurrence

검색결과 790건 처리시간 0.034초

하지에 발생한 연부 조직 종양의 광범위 절제술 후 재건술에서 전외측 대퇴부 유리 피판술의 유용성 (The Signification of Anterolateral Thigh Free Flap for Reconstruction of Soft Tissue Defect in Malignant Soft Tissue Tumor of Lower Extremity)

  • 권영호;이근우
    • Archives of Reconstructive Microsurgery
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    • 제20권2호
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    • pp.89-95
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    • 2011
  • Purpose: The purpose of this study was to evaluate the clinical results of anterolateral thigh free flap on soft tissue defect following wide excision in malignant soft tissue tumor of lower extremities. Methods: Between February 2005 to April 2010, we followed up 19 cases who were undergoing anterolateral thigh free flap because of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity, including 9 cases were heel, 5 cases in foot, 3 cases in ankle, 2 cases in knee and leg. We observed that of implanted area's color, peripheral circulation at 3, 5, 7 days after operation and evaluated operating time, amount of hemorrhage, implanted skin necrosis, additional operations, complications. And we also evaluated the oncologic results, including local recurrence, metastasis, and morbidity. Results: Average operation time of wide excision and anterolateral thigh free flap was 7 hour 28 minutes. 18(94.7%) of total 19 cases showed successful engraftment, on the other hand, failure of engraftment due to complete necrosis of flap in 1 case. In 18 cases with successful engraftment, reoperation was performed in 4 cases. Among them, removal of hematoma and engraftment of flap after bleeding control was performed in 3 cases, because of insufficient circulation due to the hematoma. In the remaining 1 case, graft necrosis due to flap infection was checked, and grafted after combination of wound debridement and conservative treatment such as antibiotics therapy, also skin graft was performed at debrided skin defect area. Skin color change was mainly due to congestion with hematoma, flap was not observed global congestion or necrosis except 4 cases which shows partial necrosis on margin that treated with conservative therapy. Conclusions: Anterolateral thigh free flap could be recommended for reconstruction of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity.

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Value of Porous Titanium Alloy Plates for Chest Wall Reconstruction after Resection of Chest Wall Tumors

  • Qi, Yu;Li, Xin;Zhao, Song;Han, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권11호
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    • pp.4535-4538
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    • 2014
  • Objective: To explore the value of porous titanium alloy plates for chest wall reconstruction after resection of chest wall tumors. Materials and Methods: A total of 8 patients with chest wall tumors admitted in our hospital from Jan. 2006 to Jan. 2009 were selected and underwent tumor resection, then chest wall repair and reconstruction with porous titanium alloy plates for massive chest wall defects. Results: All patients completed surgery successfully with tumor resection-induced chest wall defects being $6.5{\times}7cm{\sim}12{\times}15.5$ cm in size. Two weeks after chest wall reconstruction, only 1 patient had subcutaneous fluidify which healed itself after pressure bandaging following fluid drainage. Postoperative pathological reports showed 2 patients with costicartilage tumors, 1 with squamous cell carcinoma of lung, 1 with lung adeno-carcinoma, 1 with malignant lymphoma of chest wall, 2 with chest wall metastasis of breast cancers and 1 with chest wall neurofibrosarcoma. All patients had more than 2~5 years of follow-up, during which time 1 patient with breast cancer had surgical treatment due to local recurrence after 7 months and none had chest wall reconstruction associated complications. The mean survival time of patients with malignant tumors was ($37.3{\pm}5.67$) months. Conclusions: Porous titanium alloy plates are safe and effective in the chest wall reconstruction after resection of chest tumors.

Use of regenerative tissue matrix as an oral layer for the closure of recalcitrant anterior palatal fistulae: a pilot study

  • Richardson, Sunil;Hoyt, James S.;Khosla, Rohit K.;Khandeparker, Rakshit Vijay Sinai;Sukhadia, Vihang Y.;Agni, Nisheet
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제42권2호
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    • pp.77-83
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    • 2016
  • Objectives: To evaluate the effectiveness of regenerative tissue matrix (Alloderm) as an oral layer for difficult anterior palatal fistula closure. Materials and Methods: The authors have tested the feasibility of a novel surgical technique of adding a regenerative tissue matrix (Alloderm) as an oral layer for closure of recalcitrant large anterior palatal fistulae and report the outcome of the first 12 patients in this pilot study. Patients with recurrent large fistula who otherwise would require either a local pedicled flap, free flap, or an obturator were treated with this technique and followed up for at least 6 months to monitor the progress of healing. Results: Of the 12 patients, 8 patients (66.7%) had complete closure of the fistula, and 2 patients (16.7%) showed reduction in size of the fistula to the extent that symptoms were eliminated, for an overall success rate of 83.3% (10/12 patients). Premature graft loss and recurrence of the fistula were noted in 2 patients (16.7%). Conclusion: Alloderm provided an adequate barrier allowing healing to occur unimpeded and allowed closure of the palatal fistula. In our experience, this new technique using regenerative tissue matrix as an adjunct to the oral layer in large anterior palatal fistula has an advantage compared to other more invasive complex procedures and has been shown to provide satisfactory results.

유방의 양성 엽상종양 및 섬유선종에 대한 세포학적 비교 검색 (Cytologic Features of Benign Phyllodes Tumors as Compared to Fibroadenomas of the Breast)

  • 서재희;공경엽;박정미;안세현;김온자
    • 대한세포병리학회지
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    • 제7권2호
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    • pp.151-156
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    • 1996
  • Phyllodes tumor(PT) is a rare distinctive fibroepithelial breast tumor that occasionally shows unpredictable clinical behavior. Wide excision should be the primary treatment of PT and enucleation, the standard procedure for fibroadenoma(FA), is proscribed due to high frequency of local recurrence. Therefore an accurate preoperative diagnosis of PT is essential in order to ensure proper surgical treatment. However, the differentiation between benign PT and FA is often difficult on the basis of cytologic findings. In an attempt to better understand the cytologic features of benign PT and possibly to differentiate PT from FA on the findings of fine needle aspiration(FNA) smears, we reviewed cytologic smears from 22 histologically diagnosed cases each of benign PT and FA, respectively. The cytologic features assessed were cellularity and atypia of both epithelial and stromal components, and shape of epithelial cell clusters. Atypia of stromal cells was more frequent in PT, while blunt branching pattern of epithelial cells was more frequent in FA. The specific cytologic diagnosis of PT is not possible in many cases, but the abundance of stromal cells with moderate nuclear atypia in the correct clinical setting such as older age and larger size(>4cm) allows the diagnosis.

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자가 용혈성 빈혈을 동반한 흉선종 1예 (Thymoma accompanying Autoimmune Hemolytic Anemia)

  • 이신화;박능화;이금희;김영우;장태원;정만홍;정규식;조성래
    • Tuberculosis and Respiratory Diseases
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    • 제42권3호
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    • pp.381-386
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    • 1995
  • 45세의 침윤형 흉선종 환자에서 혈색소는 6.2g/dl, 직접 및 간접 Coombs' test는 모두 양성인 심한 자가 면역 용혈성 빈혈이 동반되어 있었다. 흉선종 적출술과 부신피질호르몬제의 투여로 용혈성 빈혈의 호전이 보였으나 부신피질호르몬제를 중단한 2달후에 용혈성 빈혈이 재발되어 현재 prednisolone 15mg/day을 투여 중이며 국소재발이나 용혈성 빈혈의 소견없이 8개월째 경과관찰 중이다.

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90 UCA의 특성다항식과 전이규칙 블록을 이용한 CA 합성법 (Characteristic Polynomial of 90 UCA and Synthesis of CA using Transition Rule Blocks)

  • 최언숙;조성진
    • 한국전자통신학회논문지
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    • 제13권3호
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    • pp.593-600
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    • 2018
  • 효과적인 암호시스템 설계에 셀룰라 오토마타(이하 CA)가 적용되고 있다. CA는 국소적 상호작용에 의해 상태가 동시에 업데이트되는 성질이 있어서 LFSR보다 랜덤성이 우수하다. 이런 CA를 암호 시스템에 적용하기 위해 주어진 다항식에 대응하는 CA를 합성하는 방법에 대한 연구가 진행되었다. 본 논문에서는 90 UCA의 특성다항식과 전이규칙이 <$00{\cdots}001$>인 90/150 CA의 특성다항식의 점화관계를 분석한다. 또한 f(x)=f(x+1)을 만족하는 삼항다항식 $x^{2^n}+x+1$에 대응하는 90/150 CA를 90 UCA 전이규칙 블록과 특별한 전이규칙 블록을 이용하여 합성한다. 또한 $x^{2^n}+x+1$의 기약인수에 관한 성질을 분석한 후 $x^{2^n}+x^{2^m}+1(n{\geq}2,n-m{\geq}2)$에 대응하는 90/150 CA 합성 알고리즘을 제안한다.

외음부에 발생한 원발성 피부 선상 낭종성 암의 치험례 (A Case of Primary Cutaneous Adenoid Cystic Carcinoma at the Genital Area)

  • 정회준;손대구;권선영
    • Archives of Plastic Surgery
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    • 제35권3호
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    • pp.333-336
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    • 2008
  • Purpose: Adenoid cystic carcinoma is a rare type of eccrine sweat gland carcinoma. Although it is mostly known as a neoplasm of the salivary gland, it could occur as a primary skin tumor. We present a patient with a primary cutaneous adenoid cystic carcinoma at the genital area. Methods: A 60-year-old man had a slowly growing 1 cm sized single tender mass near the left scrotum and he underwent excisional biopsy at a local clinic. A diagnosis of adenoid cystic carcinoma was made and thus he was transferred to our hospital. In physical examination, other specific findings were not detected except a linear scar caused by a previous skin biopsy near the left scrotum. In CT scan, PET-CT scan and endoscopy, there was no evidence of neoplasm in other organs. It was diagnosed as the primary cutaneous adenoid cystic carcinoma and then wide excisions were performed including total 4.5 cm margin of normal skin. Results: Microscopic findings revealed proliferation of tumor cell islands with cribriform or tubular patterns containing several round, pseudocystic structures. The tumor cells showed basaloid cells with uniform and small nuclei. Tumor cells infiltrated into the dermis and upper portion of subcutaneous tissue. There was multifocal perineural invasion of tumor cells. In postoperative 6 months, we found no recurrence and other complications. Conclusion: Herein we found a rare case of primary cutaneous adenoid cystic carcinoma at the genital area.

기관지에서 기원한 평활근육종 -1예 보고 - (Leiomyosarcoma of the Bronchus -A case report with long-term follow-up -)

  • 김형태;이철주;윤유상;최호;강준규;김정태
    • Journal of Chest Surgery
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    • 제36권12호
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    • pp.991-994
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    • 2003
  • 원발성 폐평활근육종(primary pulmonary leiomyosarcoma)은 드문 질환으로 전형적인 X-ray소견이나 증상을 보이지 않는다. 치료는 외과적 절제술이 가장 일반적이며 예후는 병소의 크기, 분화도, 전이 등과 관계되는 것으로 보고되고 있다. 25세 여자 환자가 한 달 전부터의 흉부동통과 기침을 주소로 내원하였다. 내원 후 시행한 흉부 X-ray상 좌상엽에 폐결절 소견을 보여 경피적 세침흡입검사를 시행하였다. 검사 결과 방추세포종괴(spindle cell tumor) 소견을 보였고, 좌상엽절제술을 시행 받았다. 수술 후 시행한 조직학적 검사상 기관지에서 기원한 평활근육종으로 나타났으며, 환자는 현재 5년째 특별한 합병증이나 재발 없이 외래에서 추적 중이기에 보고하는 바이다.

지방 육종의 생존율과 예후 인자 (Survival Rate and Prognostic Factors of Liposarcoma)

  • 김재도;박건;손정환;홍영기;박정호
    • 대한골관절종양학회지
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    • 제2권1호
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    • pp.54-59
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    • 1996
  • Liposarcoma is second in frequency only to malignant fibous histocytoma among the soft tissue sarcoma. Many different factors which might affect the survival rate of liposarcoma have been reported by many authors. The purpose of this study was to evaluate survival rate of liposarcoma and define the prognostic factors that affected survival rate. The authors analysed retrospectively 17 patients of liposarcoma in extremities from May 1984 to Dec. 1995 who had been treated in department of orthopaedic surgery of Kosin University Medical Center. All cases were resected with marginal or wide margin. There were 9 men and 8 women. The mean age was 48 years. The follow-up period ranged from 15 to 96 months. We compared the prognosis of the patients with several factors; age, sex, surgical staging, size, site, histologic type and treatment modality. At last follow-up, the presence of local recurrence was in 3 cases and the presence of lung metastasis was in 8 cases. The survival rates by Kaplan-Meier product limit method at 2 years and 5 years were 87% and 57% respectively. The statististically significant difference was estimated in histologic type, but was not estimated in age, sex surgical staging, size, site and treatment modality. In conclusion, the histologic type is considered as the most important factor of the prognosis in liposarcoma. Although it was too few patients for the differences to be statistically significant, we consider that surgical staging, site, size, the radio-therapy and chemothrapy in liposarcoma will affect the prognosis.

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저 악성도 연골육종으로 악성 변화한 섬유성 이형성증으로 오진하여 치료방침의 오류가 발생한 연골 모세포형 골육종 - 증례 보고 - (Secondary Chondroblastic Osteosarcoma from Polyostotic Fibrous Dysplasia Initially Misdiagnosed as Low Grade Chondrosarcoma Provoking Fallacy in Treatment Strategy)

  • 이승준;고재수;원호현;전대근
    • 대한골관절종양학회지
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    • 제14권1호
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    • pp.62-67
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    • 2008
  • 섬유성 골 이형성증이 골육종, 연골육종, 섬유육종 등으로 악성 변환을 하는 것은 매우 드무나 잘 알려져 있다. 악성 변화가 흔히 일어나는 부위는 두경부, 근위 대퇴골, 상완골, 골반골, 경골, 및 견갑골 순이다. 41세 다발성 섬유성 이형성증 환자가 상완골의 동통을 주소로 내원하였다. 방사선 상 상완골 간부의 골 팽윤 및 파괴를 보였다. 생검 상 저악성도의 연골육종으로 진단하여 변연부 절제를 하였으나 7개월 만에 근위부에서 국소 재발 후 재 절제한 표본은 연골아세포형 골육종으로 진단하였다. 다발성 섬유성 이형성증에서 속발한 연골아세포형 골육종을 저악성도 연골육종으로 오진하여 치료방침에 오류가 있었던 1례를 문헌고찰과 함께 보고하는 바이다.

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