• 대한두경부종양학회지
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• 제10권1호
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• pp.25-30
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• 1994

최근 7년간 저자들이 치험한 소타액선 종양 26례에 대하여 임상양상과 치료 결과를 분석하여 다음과 같은 성적을 얻었다. 1) 발생부위를 구개 10례 (38.5%), 비강 및 부비동 8례 (30.8%), 설근부 2례 (7.7%), 협부 점막 2례 (7.7%), 구순 1례(3.8%), 후두개곡 1례(3.8%), 구강저 1례(3.8%), 비인강 1례(3.8%)이었다. 2) 병리조직학적 소견은 양성 종양 10례, 악성종양 16례이었으며, 양성 종양은 전례가 다형성선종이었으며, 구개에서 6례로 가장 많았고, 악성종양은 비강 및 부비동 5례로 가장 많았으며, 선양낭성암종 9례, 악성혼합종 2례, 점액표피암종 2례, 다형성선암종 2례, 상피근상피성암 1례이었다. 악성화율은 61.5%이었다. 3) 치료는 양성 종양은 모두 적출술을 시행하였고 악성 종양은 광범위 적출술 4례(25.0%), 수술 및 방사선요법의 병합요법 9례(45.2%), 항암화학요법 및 방사선요법의 병합요법 1례(5.25%), 방사선 요법 2례(12.3%)등을 시행하였다. 4) 악성 종양에 대한 치료 결과는 근치적 치료를 시행한 8례에서는 무병생존 6례, 유병생존 1례, 유병사망 1례를 보였으며, 고식적 치료를 시행한 6례에서는 유병생존 2례, 유병사망 4례를 보였다. 이상의 성적에서 소타액선 종양은 대타액선 종양에 비하여 악성화 비율이 높고 선양낭성암종의 발생 빈도가 높아 그 침범 부위를 정확히 파악하는 것이 치료에 많은 도움을 줄 수 있으며, 고식적 치료의 범위를 확대하여 보다 적극적인 치료가 필요할 것으로 생각된다.

• 대한두경부종양학회지
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• 제9권2호
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• pp.210-220
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• 1993

Histologically proven 465 cases of neck mass in children were analized for the determination of the nature of lesions. Pathologic specimens were obtained during 10 years from January 1981 to December 1989 at Severance Hospital, Yonsei University, College of Medicine. 1) Congenital lesion was most common in neonate(80%) and congenital lesion and inflamatory disease were common in infancy and inflammatory disease was most common in more than one year old children. Thyroglossal duct cyst was most common(35.4%) disease of the congenital lesion. followed by cytic hygroma(34%) and branchial cleft remnants(29.2%). 2) Benign tumors were discovered most frequently in adolescence (55.2%) and thyroid adenoma(23.7%) and epithelial tumor(21.1%) and hemangiomas(19.7%) were most common. Most common malignant tumors were malignant lymphoma (50%) and Hodgkin's disease and were present in the older children. Metastatic cancers were very rare and their primary sites were deductable in all cases. 3) Reactive hyperplasia of lymph node was most common in inflammatory disease(23.7%). Tuberculosis lymphadenitis was more common than nonspecific lymphadenitis. 4) Bilaterality of lesion was commonly seen in malignant disease(41.7%), reactive hyperplasia of lymph node (38.85%) and metastatic disease(33.3%). Size and duration of the masses were not helpful in the differential diagnosis of the cause of the masses. Pediatric neck mass must be evaluated with its characteristics. sites, bilaterality, size and its cange, duration and patient's age but any of these alone cant not be predicted its causes without biopsy or excision. Biopsy or excision can be done with few complication but biopsy of lymph node for diagnosis is carefully made because a large number of lymph node biopsy showed no definite diagnosis in these selected cases of patients.

• Journal of Chest Surgery
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• 제51권3호
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• pp.195-201
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• 2018

Background: We investigated the surgical outcomes of patients who underwent therapeutic surgery for malignant pleural mesothelioma (MPM) at a single center. Methods: A retrospective review of 21 patients who underwent therapeutic surgery for MPM from January 2001 to June 2015 was conducted to assess their outcomes. The patients' characteristics and postoperative course, including complications, mortality, overall survival, and recurrence-free survival, were analyzed. Results: Of the 21 patients who underwent therapeutic surgery, 1 5 (71.4%) underwent extrapleural pneumonectomy, 2 pleurectomy (9.5%), and 4 excision (1 9.1 %). The median age was 57 years (range, 32-79 years) and 15 were men (71.4%). The mean hospital stay was 1 6 days (range, 1-63 days). Median survival was 14.3 months. The survival rate was 54.2%, 35.6%, and 21.3% at 1, 3, and 5 years, respectively. In patients' postoperative course, heart failure was a major complication, occurring in 3 patients (14.3%). The in-hospital mortality rate was 2 of 21 (9.5%) due to a case of severe pneumonia and a case of acute heart failure. Conclusion: A fair 5-year survival rate of 21.3% was observed after surgical treatment. Heart failure was a major complication in our cohort. Various surgical methods can be utilized with MPM, each with its own benefits, taking into consideration the severity of the disease and the comorbidities of the patient. Patients with local recurrence may be candidates for surgical intervention, with possible satisfying results.

• 대한두경부종양학회지
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• 제19권2호
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• pp.127-132
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• 2003

Objectives: The best treatment for the malignant parotid tumor still remains to be defined, and a better knowledge about the tumor features that predict the treatment result is needed. The aim of this study is to evaluate the treatment outcomes and to suggest the optimal treatment modality for the parotid cancer. Materials and Methods: The clinicopathologic characteristics of 113 patients who were treated for parotid cancer from January 1990 to December 2002 were retrospectively analysed. Univalate analyses were performed to establish the prognostic influence of pateint age, gender, tumor size, histologic grade and lymph node metastasis. Results: The mean age was 46.4 years old (15-81 years) and. The male to female ratio was 1 : 1.1. The chief complaint was a palpable mass in 85%, pain was in 12.4% and facial nerve palsy was accompanied with 2.7%. The mean tumor size was 3.5cm in diameter. The most common malignant tumor was mucoepidermoid carcinoma (33.6%), followed by acinic cell carcinoma (15%), adenoid cystic carcinoma (11%), carcinoma expleomorhpic adenoma (11%), basal cell carcinoma (7%). The most common operative procedure was total parotidectomy (47.8%) and various types of cervical lymph node dissection were added in 69.9%. Postoperative radiotherapy was done in 61.1 %. Postoperative complications developed in 54 cases (47.8%), including 46 cases (40.7%) of facial nerve palsy and 9 cases (8%) of Frey's syndrome. Recurrences developed in 21 cases (18.6%) and deaths in 15 (13.3%). Cumulative survival at 5 year was 75.4%. Univariate analysis of clinical factors showed that histologic grade and positive cervical lymph node significantly influenced survival (p<0.05). Conclusion: These results suggests that the radical resection with lymph node dissection and postopertaive XRT would be necessary to improve the survival of the patients with high grade cancer or positive lymphnode metastasis.

• 대한기관식도과학회지
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• 제4권2호
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• pp.211-218
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• 1998

There have been few large scale surveys of salivary gland tumors, because the salivary gland tumors comprised less than 3 percent of all neoplasms of the head and neck. Also there is a problem that the incidences of specific types of tumors have the variation according to the geographic regions. ]'nother Korean reports about salivary gland tumor, they only treated about 100 cases only. Objectives : The purpose of this study is to identify the frequency and clinical characteristics of salivary gland tumors and to compare with other Korean reports. Materials and Methods : We had performed to analyze 387 cases of salivary gland tumors from 1983 to June 1997, were reviewed in histopathological and clinical aspects. The diagnoses of individual tumors were based on the World Health Organization classification. Tumors were analyzed according to the histologic type site, age and sex. Results : The majority (79.1%) of cases occurred in the major salivary glands and 20.9% in the minor. The parotid gland was the most frequent site with 52.4％ and submandibular glands with 26.3%. Benign tumors were 79.3% of the tumors and malignant tmon were 20.7%. The most frequent tumor was pleomorphic adenoma occupied 63.8% of the total and frequency percent of histologic type of 98 malignant tumors showed 35.7% of mucoepidermoid carcinomas, 24.5% of adenoid cystic carcinomas. Overall gender with female predominance with 1 : 1.4 of male to female ratio. The average age of patients was 42.8 years. The most frequent chief complaint was a palpable mass. The duration of the symptom was shorter in the malignant salivary gland tumors (26.7 months) than in the benign salivary gland tumors (38.2 months). Conclusion : Comparing to the previous Korean reports, the present study confirms that the incidence of salivary gland tumor was lower in the parotid gland, and was higher in the submandibular and minor salivary glands.

• 한국임상수의학회지
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• 제24권3호
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• pp.331-336
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• 2007

Mammary gland tumors are the most common neoplasms occurring in female dogs. The treatments of mammary gland tumors are surgery, chemotherapy, hormonal therapy and radiational therapy, but surgical removal remains widely accepted treatment option for mammary gland tumors. The purpose of this study is to evaluate clinical outcomes of dogs which are performed surgical excision. Medical records were reviewed for dogs(79 cases) with mammary gland tumors treated surgically at Veterinary Medical Teaching Hospital in Seoul National University from 2001 to 2005. While 49 cases(62.0%) were benign, 30 cases(38.0%) were malignant tumors. The mean age of these dogs was 10.4 years old(range $1{\sim}16$ years). The maximal diameter of malignant tumors were various, whereas most of the benign tumors were smaller than 3cm(36 cases, 73.5%). In 12 cases(15.2%), regional lymph nodes were enlarged and lymph nodes of 3 cases had resected surgically. The performed techniques were total mastectomy, regional mastectomy, simple mastectomy, lumpectomy and unilateral mastectomy in order. Twenty-eight cases(35.4%) had postoperative complications consisted of recurrence of tumors, necrosis, dehiscence, delayed healing and edema of limbs. The recurrence rates of benign and malignant mammary gland tumors were 8 cases(16.3%) and 6 cases(20.0%). Metastasis rate was 7 cases(8.9%). Although postoperative complications were no remarkable difference in recurrence rates among surgical techniques in this study, other complications such as edema of limbs, necrosis, dehiscence and delayed healing were remarkable difference as surgical techniques. Therefore, this result suggest that choice of appropriate surgical techniques should be determined according to each patient's physical status and characteristics of tumors.

• 대한영상의학회지
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• 제79권6호
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• pp.303-310
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• 2018

목적: 이 연구의 목적은 흉부 전산화단층촬영(CT)에서 우연히 발견된 유방 병변의 임상적 중요성을 평가하고 유방 전문 진료 의뢰가 필요한 영상 소견을 제안하는 것이다. 대상과 방법: 2009년 5월부터 2014년 4월까지 촬영된 조영증강 흉부 CT 중에서 판독문에 '유방'이라는 단어가 포함된 검사를 후향적으로 검토하였다. 이 중 우연히 발견된 유방 병변으로 유방 초음파와 유방 촬영술을 한 뒤, 병리학적 확인이나 1년 이상의 추적 관찰을 받은 총 86명의 환자(모두 여성, 평균 연령, $48.9{\pm}12.6$세)를 대상으로 하였다. 흉부 CT에서 유방 병변의 크기, 위치, 모양, 경계 및 조영 증강을 포함한 영상 특징을 평가하였다. 다양한 CT 특징과 병리소견과의 연관성을 평가하고 여러 조합의 CT 특징의 진단 정확도를 평가하였다. 결과: 흉부 CT에서 우연히 발견된 유방 병변 중 악성 종양은 16.3%(14/86)였다. 악성 병변은 양성 병변에 비해 불규칙한 모양, 불분명한 경계, 높은 조영증강을 보였다. CT 특징의 조합 중 불분명한 경계와 높은 조영증강의 조합이 악성 병변을 예측하는데 가장 높은 정확도를 보였다(97.7%). 결론: 흉부 CT에서 우연히 발견된 유방 병변의 16.3%는 악성이었으며, 불분명한 경계와 높은 조영증강을 동시에 보일 경우 악성 가능성이 높으므로, 정확한 진단을 위해 유방 전문 진료 의뢰가 필요하다.

• Korean Journal of Radiology
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• 제22권4호
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• pp.502-512
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• 2021

Objective: To objectively and subjectively assess and compare the characteristics of monoenergetic images [MEI (+)] and polyenergetic images (PEI) acquired by dual-energy CT (DECT) of patients with breast cancer. Materials and Methods: This retrospective study evaluated the images and data of 42 patients with breast cancer who had undergone dual-phase contrast-enhanced DECT from June to September 2019. One standard PEI, five MEI (+) in 10-kiloelectron volt (keV) intervals (range, 40-80 keV), iodine density (ID) maps, iodine overlay images, and Z effective (Z_eff) maps were reconstructed. The contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) were calculated. Multiple quantitative parameters of the malignant breast lesions were compared between the arterial and the venous phase images. Two readers independently assessed lesion conspicuity and performed a morphology analysis. Results: Low keV MEI (+) at 40-50 keV showed increased CNR and SNR_{breast lesion} compared with PEI, especially in the venous phase ([CNR: 40 keV, 20.10; 50 keV, 14.45; vs. PEI, 7.27; p < 0.001], [SNR_{breast lesion}: 40 keV, 21.01; 50 keV, 16.28; vs. PEI, 10.77; p < 0.001]). Multiple quantitative DECT parameters of malignant breast lesions were higher in the venous phase images than in the arterial phase images (p < 0.001). MEI (+) at 40 keV, ID, and Z_eff reconstructions yielded the highest Likert scores for lesion conspicuity. The conspicuity of the mass margin and the visual enhancement were significantly better in 40-keV MEI (+) than in the PEI (p = 0.022, p = 0.033, respectively). Conclusion: Compared with PEI, MEI (+) reconstructions at low keV in the venous phase acquired by DECT improved the objective and subjective assessment of lesion conspicuity in patients with malignant breast lesions. MEI (+) reconstruction acquired by DECT may be helpful for the preoperative evaluation of breast cancer.

• 대한영상의학회지
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• 제84권3호
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• pp.676-685
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• 2023

목적 본 연구는 무증상 여성의 유방 초음파에서 발견된 군집 미세낭종의 발생률, 임상적 결과 및 영상 소견을 알아보고, 적절한 조치 가이드라인을 제시하고자 한다. 대상과 방법 2014년 8월부터 2019년 12월까지 무증상 여성에서 시행한 유방 초음파에서 발견된 군집 미세낭종 병변에 대해 분석하였다. 최종 진단은 병리학적 결과 및 12개월 이상의 추적관찰로 하였다. 결과 100명의 환자에서 117개 병변이 후향적으로 연구되었으며, 군집 미세낭종의 발생률은 1.5%였다. 총 117개의 병변 중, 3개(2.6%)는 악성, 2개(1.7%)는 고위험 병변, 112개(95.7%)는 양성이었다. 악성 병변 중 2개는 관상피내암이었고, 1개는 침윤성 유관암이었다. 이중, 유방 촬영술에서 의심스러운 미세석회화 또는 초음파에서 내부 혈류를 보인 2개의 병변은 category 4로 분류되었다. 나머지는 12개월 뒤 시행한 초음파에서 echo pattern의 변화를 보인 위 음성의 증례였다. 결론 무증상 여성에서 시행한 유방 초음파에서 군집 미세낭종의 유병률은 1.5%였으며, 악성률은 2.6%였다. 군집 미세낭종의 악성률과 양성 및 악성 영상 소견을 아는 것은 영상의학과 의사들이 병변을 분류하고 적절한 조치를 권유하는 데 도움이 될 것이다.

• Tuberculosis and Respiratory Diseases
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• 제45권2호
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• pp.388-396
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• 1998

연구배경: 흉수의 원인을 규명하는 방법으로는 임상소견, 흉수 분석, 그리고 흉막생검 등이 있다. 그러나 이와 같은 적극적인 검사에도 불구하고 약 20%의 환자에서 흉수의 원인을 모르는 것으로 알려져 있다. 결핵성 흉막염은 우리나라에서 가장 흔히 보는 흉막질환이지만 흉수에서 결핵균 양성율은 20-30%에 불과하고 흉막생검 양성율도 50%를 넘지 않아 감별진단이 어려운 경우를 임상에서 종종 경험하게 된다. 본 연구에서는 흉수의 감별진단에 있어 흉수에서의 ADA(adenosine deaminase) 및 동종효소의 활성도 측정의 유용성을 평가하고자 하였다. 방 법: 1996년 1월 부터 6월까지 단국대병원 내과에 흉수로 입원한 54명의 환자들의 흉수와 혈청에 대해 ADA 및 동종효소의 활성도를 측정하였다. 흉수의 원인으로는 결핵성 흉수가 25명, 부폐렴성 흉수가 10명, 악성 흉수가 14명, 여출성 흉수가 5명이었으며, 이들 중 소방형 흉수를 보인 경우는 결핵성 흉수가 5명, 부폐렴성 흉수가 6명이었다. 총 ADA 활성도와 동종효소 활성도 측정은 spectrophotometry로 시행하였으며, ADA2 동종효소의 활성도 측정은 ADAl의 강력한 억제제인 EHNA(erythro-9-(2-hydroxy-3-nonyl) adenine)을 이용하여 측정하였다. 결 과: 결핵성 흉수에서의 총ADA 활성도는 악성 흉수보다 높았으나 (p<0.l), 결핵성 흉수와 부폐렴성 흉수사이에는 유의한 차이가 없었다(결핵성 흉수 : $148.9{\pm}89.9IU/L$, 부폐렴성 흉수 : $129.0{\pm}119.4IU/L$, 악성흉수 : $60.7{\pm}17.8%$). 흉수에서 총 ADA에 대한 ADA2 동종효소의 활성도의 비 (ADA2%)는 결핵성 흉수에서 부폐렴성 흉수에 비해 유의하게 놓았으나(p<0.05), 결핵성 흉수와 악성 흉수 사이에는 유의한 차이가 없었다(결핵성 흉수: $57.2{\pm}10.7%$, 부폐렴성 흉수 : $35.9{\pm}17.8%$, 악성 흉수 : $60.7{\pm}17.8%$). 소방형 흉수의 경우 총 ADA 활성도는 결핵성흉수와 부폐렴성 흉수 사이에 유의한 차이가 없었으나(결핵성 흉수 : $157.8{\pm}100.8$ IU/L, 부폐렴성 흉수 : $164.3{\pm}132.3$ IU/L), ADA2% 는 결핵성 흉수에서 부폐렴성 흉수보다 유의하게 높았다(p<0.005)(결핵성 흉수 : $53.3{\pm}3.9%$, 부폐렴성 흉수 : $27.8{\pm}7.9%$). 결 론: 흉수에서 ADA동종효소의 측정은 결핵성 흉수와 부폐렴성 흉수의 감별진단에 유용하며 특히 소방형 흉수의 경우와 같이 임상적으로 강별이 용이치 않은 경우에 더욱 유용할 것으로 생각된다