• Archives of Reconstructive Microsurgery
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• 제2권1호
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• pp.20-28
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• 1993

From 1981 to 1991, twenty one vascularized bone grafts had been performed for the treatment of large bone defects of the extremities, with average follow-up of 65.4 months. Fibulae were used in 15 patients Including two cases of osteocutaneous flap, iliums in 5 including two of osteocutaneous flap, and osteocutneous rib in one. Ten of these patients were treated for segmental defects derived from trauma or infection sequelae of long bones, while eight for locally aggressive benign or malignant bone tumors ; and three for congenital pseudarthrosis of tibia. The location of the lesions were 8 cases in tibia; 7 in humerus ; 3 in forearm bone ; 2 in foot ; and 1 in femur. The length of bone defects were averaged as 10 cm, ranging from 3 to 17.5. In eighteen patients(85.7%), the operation was successful. The duration from operation to bony union was average 5.1 months on successful cases, and three of them needed additional procedures, such as bone graft and electrical stimulation to promote bony union. Local recurrence was found in one case of chondrosarcoma, resulting in AK amputation. Wound infections were noted each one case on donor or recipient site. In five cases, the fracture of grafted bone, which united with cast immobilization in four, occurred average 16.7 months after operation.

• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.147-150
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• 1996

미세수술의 발달과 더불어 악성 및 양성 종양의 치료로서 병소 조직 절제후에 결손부에 혈관 부착 골이식술을 시행하는 골종양재건술이 많이 이용되고 있으나 원래 병소가 이식골에 전이되는 보고는 많지 않다. 본 교실에서는 양성 골종양인 섬유성 골이형성증에서 종양조직 절제술후에 생비골 이식술을 시행한 후, 이식골에 원래 종양이 재발한 예를 체험하였기에 적출술 후 생골이식술로서 결손부를 대치하는 수술시에 충분한 병소의 제거 및 지속적인 추시를 통하여 재발 여부를 확인하는 것이 필요하다고 제안하는 바이다.

• 한국가스학회지
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• 제14권2호
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• pp.27-33
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• 2010

본 논문에서는 국내 가스사고의 발생 환경을 분석하여 가스사고의 재발을 방지하고자 1998년부터 2009년 6월까지 11년 6개월간의 가스사고를 유형별로 분석하였다. 가스사고는 감소하지 않고 지속적으로 발생하고 있고, 사고의 내용에서도 시기별, 날씨 등에 따라 가스사용형태가 변하고 있어 가스의 사용 환경과 가스사고는 밀접할 수밖에 없다. 가스사고는 가스사용이 많은 수도권과 특정 지자체에서 많이 발생하였고, 맑은 날 풍속이 낮고 습도가 중간정도일 때 가장 발생가능성이 높은 것으로 나타났다. 또한, 가스사고 발생 형태의 모형을 관찰한 결과, 가스로 인한 누출, 화재나 폭발 사고의 경우도 날씨와 밀접한 관계가 있을 것으로 판단되는데 이를 날씨와도 연계하여 분석해보면 발생 가능한 전체 가스사고도 예측 가능할 것으로 판단된다.

• 대한골관절종양학회지
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• 제17권2호
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• pp.91-94
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• 2011

기괴성 방골성 골연골성 증식증은 수부와 족부의 단관골의 표면에 발생하는 양성 종양이다. 치료는 일반적으로 변연부 절제술을 시행하지만 절제 후 국소적인 재발을 잘한다. 국내에서는 족부에 발생한 기괴성 방골성 골연골성 증식증에 대한 보고가 극히 드물다. 저자들은 44세 여자 환자에서 우측 제3족지의 근위지골에 발생한 기괴성 방골성 골연골성 증식증을 경험하고 이를 보고하고자 한다.

• Journal of Korean Neurosurgical Society
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• 제61권4호
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• pp.525-529
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• 2018

Objective : To evaluate the efficacy of fractionated stereotactic radiosurgery (FSRS) performed using the Novalis $Tx^{(R)}$ system (BrainLAB AG, Feldkirchen, Germany; Varian Medical Systems, Palo Alto, CA, USA) for brain metastases. Methods : Between March 2013 and July 2016, 23 brain metastases patients were admitted at a single institute. Twenty-nine lesions too large for single session stereotactic radiosurgery or located in the vicinity of eloquent structures were treated by FSRS. Based on the results obtained, we reviewed the efficacy and toxicity of FSRS for the treatment of brain metastases. Results : The most common lesion origin was lung (55%) followed by breast (21%). Median overall survival was 10.0 months (95% confidence interval [CI], 4.9-15.0), and median progression-free survival was 10.0 months (95% CI, 2.1-13.9). Overall survival rates at 1 and 2 years were 58.6% and 36.0%, respectively. Local recurrence and neurological complications affecting morbidity each occurred in two cases. Conclusion : FSRS using the $Novalis-Tx^{(R)}$ system would appear to be an effective, safe noninvasive treatment modality for large and eloquently situated brain metastases. Further investigation is required on a larger number of patients.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.361-364
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• 2009

Purpose: Sebaceous carcinoma is a rare malignant tumor derived from the adnexal epithelium of sebaceous glands. This tumor usually occurs on the eyelids, but uncommonly it may occur on the extraocular sites. It is characterized by a tendency of local recurrence and occasional metastasis. Surgical excision is appropriate treatment for patients with sebaceous carcinoma. Because this kind of case is rare, we report two cases of sebaceous carcinoma developed on scalp. Methods: Case 1 was a 69 - year - old woman. She visited the hospital with a $1.5{\times}2.5cm$ sized reddish yellow - colored, slowly growing mass on left parietal scalp. The mass began at birth and started growing at 5 years ago. Case 2 was a 67 - year - old woman. She had $2.5{\times}3.0cm$ sized yellow - colored mass on right parietal scalp. It occured at birth and started growing at 3 years ago. And the masses had erythematous ulcer with sanguineous discharge. In the beginning, the masses were miliary nodule. Results: CT scan and fine needle biopsy were done. Case 1 and 2 were diagnosed as sebaceous carcinoma. Wide excision with safety margin of 10 mm and split thickness skin graft was done. Histological examination revealed well demarcated, irregular, variable sized tumor lobules. Each lobule was composed of sebaceous and undifferentiated cells. Postoperatively, the patients did well and the lesion had not recurred. Conclusion: Sebaceous carcinoma is an aggressive malignant tumor. It often can be mistaken for other skin tumors. Authors experienced two rare cases of sebaceous carcinoma developed on scalp. We recommend early wide excision with enough safety margin as treatment of sebaceous carcinoma.

• Radiation Oncology Journal
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• 제6권2호
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• pp.283-288
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• 1988

초기 유방암의 치료는 근치적 절제술이 오랫동안 주된 치료방법으로써 선택되어 왔으나, 근래에는 여성의 유방을 보존하고 미용효과를 기대할 수 있는 보조적 절제술 후 근치적 방사선치료법이 개발되어 지대한 관심과 상당한 논란이 거듭되어 왔다. 이러한 논란을 해결하기 위하여 그동안 세계적으로 많은 후향성 또는 전향성 분석을 시행하여 두 치료방법사이의 치료효과를 비교하여 본 결과, 국소치료율, 재발을, 그리고 생존율에 있어서 큰 차이를 보이지 않았다. 이와 같은 치료성적의 결과를 토대로 하여 최근에는 보조적 절제술 후 근치적 방사선치료법이 여성들의 유방을 보존하고 미용효과를 향상시킬 수 있을 뿐만 아니라 국소치료율, 재발율, 생존율도 근치적 절제술의 성적과 대동소이하므로 초기 유방암의 치료에 활발히 이용되기에 이르렀다. 본원에서도 이러한 추세에 따라서 보조적 절제술 후 근치적 방사선치료를 시행한 초기 유방암 1예를 보고하면서 아울러 많은 문헌고찰과 함께 향후 치료방침을 세우고자 한다.

• Journal of Chest Surgery
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• 제29권7호
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• pp.734-740
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• 1996

1981년 1월부터 1994년 12월까지 흉선종으로 세브란스병원에서 수술한 65명의 환자를 대상으로 하였다. 환자중 28명(43.1%)이 중증근무력증을 동반하고 있었으며 마사오카 병기에 의하면 1기 28명(43. 11%), 2기 13명 (20.0%), 3기 22명 (33.8%), 4기a와 4기b가 각각 1명 (1.5%) 이었다. 수술사망은 없었고 완전절제가 48명 (73.8%)에서 가능했으며 수술 후 보조치료는 10명에서 시 행하여졌다. 병리학적분류로 24.6%가 상피세포형, 27.7%가 림파구형, )3.9%가 혼합형이 었다. 5년과 10년 생존율은 각각 87%, 82% 이었으며 흉선종의 수술 후 예후인자는 종양의 국소침윤여부, 종양의 완전절제여부, 흉선암, 병기, 중증 근무력증의 동반 여부였다. 1기 흉선종 환자에서는 재발이 없었다.

• 대한두경부종양학회지
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• 제26권2호
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• pp.183-186
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• 2010

Purpose : Papillary thyroid carcinoma (PTC) is known for malignant tumor which has a favorable prognosis and long-term survival. Although the prognosis for patients with PTC is generally good, PTC tends to have highly metastatic property. The purpose of this study was to analyze the central compartment lymph node in papillary thyroid cancer with no lymph node metastasis clinically and to assess the significance of prophylactic node dissection. Methods : A retrospective review was carried out in 394 patients with PTC who underwent surgery for the period from January 2004 to December 2006. The positive rate of the lymph node metastasis was analyzed. The relations between the central compartment lymph nodes and the patients' age, gender, tumor size, exrathyroidal extension(ETE), multifocality, and bilaterality were comparatively analyzed in PTC patients with preoperative no lymph node metastasis. Results : The enrolled patients were 40 male and 354 female cases. The 118 cases of them were found to have cervical lymph node metastasis. The mean age was 46 years(range, 15-77years). Tumor size(p=0.000), ETE(p=0.001), multifocality(p=0.014), and bilaterality(p=0.001) were significantly related factors for cervical lymph node metastasis clinically in papillary thyroid cancer. However, age and gender were not significantly related with lymph node metastasis. Conclusion : Although no lymph node metastasis clinically, prophylactic neck node dissection can be performed to avoid risks of local recurrence and reoperation in the light of PTC nature. The pathological status and high positive rate of central compartment lymph node relate to tumor size and extrathyroidal extension. Close surveillance for nodal status is required in follow-up.

• 대한두경부종양학회지
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• 제26권2호
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• pp.243-246
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• 2010

Purpose : Eosinophilic granuloma is a rare benign tumor that is characterized histologically by the presence of destructive granulomas containing numerous Langerhans, cells. The most common presentation of eosinophilic granuloma is a painful, immobile scalp mass in the frontal and parietal bones occurring predominantly in children and adolescents or young adults. We report a representative case of eosinophilic granuloma. Methods : A 16-year-old woman complained of an enlarging fixed scalp mass without pain and tenderness which measured $3{\times}4.5cm$ at the frontal area, which had been found incidentally 2 months before. Plain skull x-ray showed a punched-out bone lesion. Computed tomography and magnetic resonance imaging showed a non-enhancing osteolytic lesion. The tumor and surrounding bony edges were completely removed via a bicoronal approach. The bony defect was reconstructed with bone cement. Results : The tumor was involved frontal bone and dura mater. We confirmed the tumor by the documentation of Birbeck's granules by electron microscopy. There is no evidence of local recurrence during postoperative 1.5 years. Conclusion : The present case shows the characteristic feature of frontal bone involvment of the eosinophilic granuloma. The prognosis of eosinophilic granuloma depend on age at diagnosis and number of bones involved. We consider that best choice of treatment for eosinophilic granuloma is surgical excision.