• 제목/요약/키워드: local recurrence

검색결과 800건 처리시간 0.043초

비배부 접근법을 통한 비중격 성형술 (Septoplasty Through Dorsal Approach)

  • 권용석;이근철;정기환;한재정;박정민;김석권;박시현;김주헌
    • Archives of Plastic Surgery
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    • 제32권1호
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    • pp.43-48
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    • 2005
  • Septal deviations interfere with the nasal airflow and contribute to the deformities in the external appearance of the nose. An aesthetically and functionally satisfactory correction of severe septal deformities often requires temporary intraoperative removal of the septal cartilage for appropriate remodeling. This article describes septoplasty through dorsal approach for the correction of septal deviation. From March 2001 to April 2004, the author performed septoplasty through dorsal approach for the correction of septal deviations on 45 patients, of whom 22 of whom had nasal obstruction. Open rhinoplasty was used for dorsal approach in all patients and operation was performed under the general anesthesia or local anesthesia. The follow-up period of the patients ranged from 3 to 15 months with a mean of 10 months, and postoperative results were quite satisfactory. There was neither incidences of patients' complaints, nor any complications such as hematoma, septal perforation, supratip deformity, or recurrence. And there was some improvement of nasal obstruction in 15 patients. In conclusion, Septoplasty through dorsal approach is an effective method for the correction of septal deviation and improvement of the nasal airway obstruction.

식도암의 외과적 치료 (Surgical Treatment for Carcinoma of Esophagus)

  • 조민섭;윤정섭
    • Journal of Chest Surgery
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    • 제30권1호
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    • pp.40-47
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    • 1997
  • 본 교실에서는 1990년 1월부터 1994년 3월까지 61명의 식도암 환자를 치험하였으며 이들의 의무기록을 조사하여 식도암 수술의 위험 인자를 조사하였다. 평균연령은 58.3세로 36세부터 74세까지였으며 성비는 남자에서 14:1로 호발하였다. 연하곤란은 평균 3.8개월간 있었으며, 연하곤란의 정도는 4등급이 제일 많았다. 술후 종양의 병기는 I기 2명, II기 23 명, III기 27명, 그리고 IV기 9명이었으며 49명의 환자가 완전한 종양절제가 가능하여 종양절제율은 78.7%이 었다. 5명은 불완전 종양절제와 고식적 식도위문합술을 시행하였으며 5명에서는 위루술을 시행하였고 2명은 Celestin관 삽입을 하였다. 가장 흔한 수술합병증은 폐 허탈과 폐렴이었으며 조기 사망율은 5.6%이었다. 9명의 환자에서 수술후 국소재발이나 원격전이가 발견되었다. 장기 생존율은 1년 73.4%, 2년 54.7%, 4년 23.1%이었다 식도암의 외과적 치료의 조기성적에 나쁜 영향을 미치는 인자로는 종양 의 병 기 (p = 0.02)이었다.

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국소 방사선 치료에 완전 관해된 구개편도에 발생한 골수외 형질세포종 (A Case of Extramedullary Plasmacytoma in Palatine Tonsil Achieved Complete Remission by Radiotherapy)

  • 이정화;김기성;김효정;박희철;배훈식;하준욱;장대영
    • 대한두경부종양학회지
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    • 제21권2호
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    • pp.165-169
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    • 2005
  • 골수외 형질세포종은 드문 종양으로 두경부에 주로 발생하며 수술 혹은 방사선의 국소 치료로 완치가 가능한 종양이다. 저자들은 구개편도에 발생 후 국소 방사선 치료로 완전 관해된 골수외 형질세포종 1예를 경험하였기에 보고하는 바이다.

미세 수술 수기를 이용한 생비골 이식 (The Vascularized Fibular Transfer Using Microsurgical Technique)

  • 이광석;김학윤;박종훈
    • Archives of Reconstructive Microsurgery
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    • 제3권1호
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    • pp.9-15
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    • 1994
  • It is difficult to obtain a satisfactory bony union of large bone defect secondary to trauma, tumor resection, congenital pseudarthrosis of tibia and bony metaplasia following infection with conventional methods. Conventional nonvascularized autologous bone graft do not provide adequate large amounts of donor bone and usually undergo necrosis or nonunion due to lack of vascular nutrition. Currently, advanced in microsurgery have made it possible to provide a continuing circulation of blood in bone grafts so as to ensure viability. With the nutrient blood supply preserved, healing of the graft to the recipient bone is facilitated without the usual replacement of the graft by creeping substitution. Thus, the grafted bone is achieved more rapid stabilization without sacrificing viability. We reviewed 11 cases of vascularized fibular grafts which were performed from December 1982 to January 1993 and the following results were obtained: 1. Large bone defects with chronic osteomyelitis secondary to trauma were could be successfully treated by the vascularized fibular transfer. 2. In our experience, the vascularized fibular transfer was thought to be one of good methods of treatment for congenital pseudathrosis of tibia. 3. Complete tumor resection was followed by a free vascularized fibular transfer, resulting in good functional improvement, without local recurrence. Long bone defect secondary to bony dysplasia was could be reconstructed by the vascularized fibular transfer. 4. The transferred vascularized fibula had been hypertrophied with bony union during follow-up period and there was no resorption of the grafted fibula.

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경기북부지역 정밀 수치기후도 제작 및 활용 - I. 수치기후도 제작 (Development and Use of Digital Climate Models in Northern Gyunggi Province - I. Derivation of DCMs from Historical Climate Data and Local Land Surface Features)

  • 김성기;박중수;이은섭;장정희;정유란;윤진일
    • 한국농림기상학회지
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    • 제6권1호
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    • pp.49-60
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    • 2004
  • Northern Gyeonggi Province(NGP), consisting of 3 counties, is the northernmost region in South Korea adjacent to the de-militarized zone with North Korea. To supplement insufficient spatial coverage of official climate data and climate atlases based on those data, high-resolution digital climate models(DCM) were prepared to support weather- related activities of residents in NGP Monthly climate data from 51 synoptic stations across both North and South Korea were collected for 1981-2000. A digital elevation model(DEM) for this region with 30m cell spacing was used with the climate data for spatially interpolating daily maximum and minimum temperatures, solar irradiance, and precipitation based on relevant topoclimatological models. For daily minimum temperature, a spatial interpolation scheme accommodating the potential influences of cold air accumulation and the temperature inversion was used. For daily maximum temperature estimation, a spatial interpolation model loaded with the overheating index was used. Daily solar irradiances over sloping surfaces were estimated from nearby synoptic station data weighted by potential relative radiation, which is the hourly sum of relative solar intensity. Precipitation was assumed to increase with the difference between virtual terrain elevation and the DEM multiplied by an observed rate. Validations were carried out by installing an observation network specifically for making comparisons with the spatially estimated temperature pattern. Freezing risk in January was estimated for major fruit tree species based on the DCMs under the recurrence intervals of 10, 30, and 100 years, respectively. Frost risks at bud-burst and blossom of tree flowers were also estimated for the same resolution as the DCMs.

등에 발생한 에크린한공암종의 치험례 (A Case of Eccrine Porocarcinoma on Back)

  • 최석민;김철환;강상규;탁민성;박상모;진소영
    • Archives of Plastic Surgery
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    • 제35권1호
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    • pp.100-103
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    • 2008
  • Purpose: Eccrine porocarcinoma is a very rare, potentially fatal tumor which arises from the intraepidermal portion of the eccrine sweat ductal apparatus. It does not have a characteristic clinical feature but does have a high incidence of metastasis. It may be developed de novo or in a preexisting benign eccrine poroma. It usually affects older people and is located most commonly on lower extremities. We report a rare case of eccrine porocarcinoma which developed on the back without metastasis. Methods: The patient was a 94-year-old woman who showed a painful, ulcerated, dark brown colored polypoid $3.5{\times}3.0cm$ sized mass on the back for 3 years. We totally excised the lesion including normal tissue. Results: After wide excision of the lesion, pathologist reported an eccrine porocarcinoma. Histopathologic findings reveal that the classic type of eccrine gland carcinoma, eccrine porocarcinoma. Immunocytochemical studies showed a positive reactivity to anti-EMA antibody and anti-CEA antibody. Conclusion: Authors experienced a rare case of primary eccrine porocarcinoma on the back. Because of the propensity to develop local recurrence, wide excision of the primary tumor with histologic confirmation of negative margins represents the only curative treatment regimen for eccrine porocarcinoma.

Analysis of the Effects of Breast Reconstruction in Breast Cancer Patients Receiving Radiotherapy after Mastectomy

  • Kim, Seong-Hwan;Kim, Jeong-Min;Park, Sun-Hyung;Lee, Sam-Yong
    • Archives of Plastic Surgery
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    • 제39권3호
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    • pp.222-226
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    • 2012
  • Background : Immediate breast reconstruction after mastectomy and delayed breast reconstruction with post-supplementary treatment are the two types of breast reconstruction currently performed when treating breast cancer. Post-mastectomy radiation therapy (PMRT) not only reduces local recurrence but also improves overall survival. However, the complications and survival rates associated with PMRT need to be clear when determining the timing of breast reconstruction. Accordingly, we investigated the optimal timing of breast reconstruction by observing patients who underwent mastectomy followed by PMRT, based on their overall health and aesthetic satisfaction. Methods : We retrospectively reviewed 21 patients who underwent breast reconstruction with PMRT between November 2004 and November 2010. We collected data regarding the various methods of mastectomy, and the modality of adjuvant therapy, such as chemotherapy, hormone therapy, and radiotherapy. Telephone interviews were conducted to study the general and aesthetic satisfaction. Results : Patients who received PMRT after breast reconstruction showed a greater complication rate than those undergoing breast reconstruction after PMRT (P=0.02). Aesthetic satisfaction was significantly higher in the groups undergoing breast reconstruction after PMRT (P=0.03). Patients who underwent breast reconstruction before PMRT developed complications more frequently, but they expressed greater aesthetic satisfaction with the treatment. Conclusions : It is recommended that the complication rates and aesthetic satisfaction after breast reconstruction be carefully considered when determining the optimal timing for radiotherapy.

Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

  • Lee, Ja-Young;Kim, Sung-Hwan;Kim, Gi-Won;Yu, Mi-Na;Park, Dong-Choon;Yoon, Joo-Hee;Yoon, Sei-Chul
    • Radiation Oncology Journal
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    • 제30권1호
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    • pp.20-26
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    • 2012
  • Purpose: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. Materials and Methods: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Results: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Conclusion: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

미만형 악성 중퍼세포종의 늑막폐절제술 -1례 보고- (Extrapleural Pneumonectomy for Diffuse Malignant Mesothelioma -A Case Report-)

  • 김병구;배상일;오태윤;장운하
    • Journal of Chest Surgery
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    • 제29권6호
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    • pp.664-668
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    • 1996
  • 미만형 악성 중피세포종은 4∼18개월의 평균생존율을 지닌 치명적인 질환으로 여겨져 왔다. 그러나 종양을 최대한 절제한 후 다양한 접근을 통한 치료방법으로 생존기간을 연장할 수 있다 최근 저자들은 미만형 악성 중피세포종을 가진 49세 남자환자를 치험하였기 에 보고하는 바이다. 환자 는 수개월 동안 혈성객담 및 우측흥통을 호소하였고, 단순흉부사진 및 컴퓨터 단층촬영에서 우측 전흥 강이 진한 음영으로 가리워 져 있었으며 많은 양의 혈성삼출, 미만성 늑막비후와 폐허탈, 파괴 등의 소견 을 보였다. 저자들은 늑막케절제술을 시행하였고, cisplatin과 mitomycin으로 보조적인 항암화학요법을 하였다. 그후 환자는 수 개월간 외래 추적관찰을 받았으며 술후 4개월 현재까지 국소재발의 증거는 없었다.

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장측 늑막에서 발생한 저등급 섬유점액성 육종 - 1예 보고 - (Low Grade Fibromyxoid Sarcoma of the Visceral Pleura - A case report -)

  • 김연수;장선희;이성순;류지윤;박경택;장우익;김창영;조성준
    • Journal of Chest Surgery
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    • 제41권1호
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    • pp.141-144
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    • 2008
  • 저등급 섬유점액성 육종은 드문 심연부 조직의 악성 종양이다. 비록 조직학적으로는 양성 소견을 보이지만 임상적으로는 악성 경과를 보인다. 일반적으로 하지나 체벽에서 발생하는 종양이며, 장측 늑막에서 발생된 보고는 극히 드물다. 저자들은 37세의 남자에서 장측 늑막에서 기원한 저등급 섬유점액성 육종의 증례를 보고한다. 수술 33개월째 국소재발이나 원격전이 없이 추적 관찰 중이다.