• Journal of Gastric Cancer
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• v.9 no.4
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• pp.177-185
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• 2009

Purpose: Preoperative clinical staging of gastric cancer is very important for determining the treatment plans and predicting the prognosis. The previous reports regarding the accuracy of computed tomography or endoscopic ultrasound for the preoperative staging of gastric cancer have shown various outcomes. We analyzed the diagnostic performance of CT and EUS, which are important staging tools for the staging of TN gastric cancer. Materials and Methods: We retrospectively analyzed 1,174 patients who underwent gastrectomy for gastric cancer at Seoul National University Bundang Hostpital from May, 2003 to December, 2007. We derived the Kappa value to examine the agreement of the preoperative staging obtained from CT and EUS with the pathological staging. Results: The mean age of the 1,174 patients was $59.31{\pm}11.98$ years. Six hundred thirty seven patients had early gastric cancer and 536 had advanced gastric cancer. The diagnostic performance between CT and EUS for the T staging showed no significant difference between CT and EUS for the kappa values. The kappa values showed moderate agreement at 0.4039 (P=0.021) and 0.4201 (P=0.026), respectively. This suggests that there is no difference between the two examinations for the overall T staging. Analysis of the discrimination of mucosal and submucosal lesions with EUS showed an accuracy of 58.92% and a Kappa value of 0.206 (P<0.001), suggesting fair agreement and a lower diagnostic performance than expected. To differentiate lesions with stages higher than or equal to T2 or T3 from the lesion with stages lower than T2 or T3, respectively, adoption of the higher stage from the CT staging or the EUS staging showed a larger AUC of 0.84 than that from either stage alone. The CT-derived node stage had the higher diagnostic performance (68.55%) than that of the EUS-derived node stage (60.82%) for the node staging. Conclusion: The CT-derived stage and EUS-derived stage showed comparable results for determining the T stage of gastric cancer. Yet the higher stage of the two stages from CT and EUS most accurately discriminated between those lesions with stages higher than T2 and those lesions with stages lower than T2.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.1
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• pp.24-29
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• 2018

Background and Objectives : The purpose of this study was to evaluate the impact of surgical extent on voice using acoustic and aerodynamic measurements in a serially followed thyroidectomy patients. Materials and Method : From October 2015 to January 2017, 108 patients who had undergone thyroid surgery and voice test for preoperative, 2, 3, and 6 months postoperatively were classified into five operative types. The radiological stage preoperatively and histopathological stage postoperatively were classified according to the invasion of thyroid capsule and surrounding tissue. For each classification, the results of the voice analysis according to the period were compared and analyzed. Results : The difference of voice according to surgical extent, radiological stage, and histopathologic stage showed significant difference only with Maximal phonation time (MPT) over time. However, in the analysis of interaction between each classification and period, Phonation threshold pressure (PTP) only showed significant results. Conclusion : Differences in imaging and histopathologic stages have no significant effect on recovery of voice symptoms after thyroid surgery. As the extent of operation increases, the pressure to start vocalization is relatively higher, which also varies with time after surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2211-2215
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• 2014

Background: To examine the incidence of positive vaginal surgical margins and determine the predicting factors following radical hysterectomy for stage IB1 carcinoma of the cervix. Materials and Methods: The clinical and histological data of 656 FIGO stage IB1 cervical cancer patients who had radical hysterectomy with bilateral pelvic lymphadenectomy (RHPL) from January 2003 to December 2012 were retrospectively reviewed and were analyzed for their association with a positive vaginal surgical margin. A p-value of < 0.05 was considered significant. Results: Thirty-five patients (5.3%) had positive vaginal surgical margins following RHPL; 24 (3.7%) for intraepithelial lesions and 11 (1.7%) for carcinoma. On multivariate analysis, microscopic vaginal involvement by high-grade squamous intraepithelial lesion and/or carcinoma (adjusted odd ratio (OR) 186.8; 95% confidence interval (CI) 48.5-718.5) and squamous histology (OR 8.7; 95% CI 1.7-44.0), were significantly associated with positive vaginal surgical margin. Conclusions: Microscopic vaginal involvement by HSIL and/or carcinoma are strong predictors for positive vaginal surgical margins for stage IB1 cervical cancer patients undergoing radical hysterectomy. Preoperative 'mapping' colposcopy or other strategies should be considered to ensure optimal vaginal resection.

• Journal of Gastric Cancer
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• v.1 no.4
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• pp.215-220
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• 2001

Purpose: The aim of the study was to obtain data on the anatomic and histologic distributions, the clinical features, and the treatment results for patients with primary gastric non-Hodgkin's lymphoma. Materials and Methods: One hundred thirty-two patients who were treated at 8 university hospitals and 2 general hospitals between January 1991 and December 2000 were enrolled to evaluate clinico-pathologic features. Results: The lower one-third of the stomach was the most frequent site ($42\%$), and the most frequent chief complaint was epigastric pain ($54\%$). Gastric resection was performed in 114 cases. Pathologic findings of preoperative endoscopic biopsy specimens from the 114 patients that underwent surgery were a gastric lymphoma in 94 cases ($82\%$), a carcinoma in 15 cases ($13\%$), an ulcer in 4 cases ($4\%$), and a gastrointestinal stromal tumor in 1 case ($1\%$). The stage distributions by Musshoff's criteria were 71 cases ($54\%$) of stage IE, 36 cases ($27\%$) of stage $II_{1}E$, 8 cases ($6\%$) of stage $II_{2}E$, 2 cases ($2\%$) of stage IIIE, and 15 cases ($11\%$) of stage IVE. Histologic gradings by the Working Formulation in were 31 cases ($23\%$) of low grade, 96 cases ($73\%$) of intermediate grade, and 5 cases ($4\%$) of high grade. Chemotherapy-related complications occurred in 25 cases ($22\%$) while operation-related complications occurred in 6 cases ($5\%$). Seventeen patients ($13\%$) only underwent surgery, 19 ($14\%$) had chemotherapy (CTx) and/or radiotherapy (RTx) only, and 96 patients ($73\%$) received surgery and CTx and/or RTx. No substantial differences in survival were found in relation to the different histologic grades and different treatments. The five-year survival was $85\%$ in stage I or II and $47\%$ in stage III or IV (P=0.0000). Conclusion: Pathologic stage appears to be the single most important prognostic indicator. Survival differences according to treatment modalities were not statistically significant. However, the low number of patients treated with various approaches over a long period precludes a firm conclusion.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.473-482
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• 1987

The records of 65 patients with a confirmed diagnosis of primary lung cancer who underwent surgical therapy at the Department of Thoracic and Cardiovascular Surgery of the Keimyung University Hospital were analyzed during the period of 8 years and 4 months, from August, 1978 to December, 1986. The peak incidence was observed in the 5th decade of life and the mean age was 52.9 years old. Male versus female ratio was 8.3:1 Cough was the most frequent presenting symptom, 76.9% then chest discomfort, hemoptysis and dyspnea followed in order. 44.6% of the patient had 2 months of prediagnostic symptomatic period, 72.3% had 5 months, and the mean was 5.7 months. As for preoperative diagnosis, 62 of total 65 patients revealed the mass lesion on simple chest x-ray, and 56 of 65 patients on bronchoscopic biopsy, 10 of 37 patients on sputum cytology and 15 of 15 patients on computerized tomography of the chest were positive. Of the 65 patients, 35 [53.9%] had squamous cell carcinoma, 18 [27.7%] adenocarcinoma, 3 [4.6%] large cell carcinoma, and 3 [4.6%] small cell carcinoma all which was oat cell carcinoma. 83.1% of the total patient was resectable, and 34 underwent pneumonectomy and 20 lobectomy. Of these 65 operations, 29 was radical resection, 25 palliative, and 11 exploratory thoracotomy. As for clinical stagings, 23 patients were in Stage, I, another 23 in Stage II and 19 in Stage III, while 16 was in stage, I, 14 in stage ll and 35 in stage III in postoperative staging evaluation. In correlation of postoperative TNM classification and radical resection, those patients who had lung cancer of stage I [14/16] and stage II [9/13] had more radical resection. As postoperative complications, one patient had massive bleeding, two empyema, one empyema with bronchopulmonary fistula, and one cardiac herniation. Operative mortality rate was 1.5% [1 patient]. Mean duration between 1st operation and discovering recurrence in 18 patients was 12.7 months.

• Journal of Chest Surgery
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• v.33 no.2
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• pp.173-178
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• 2000

Background: Though the surgical treatment of stage IIIB lung cancer is not generalized due to low complete remission rate high morbidity and mortality there are several reports on the improvement of long term survival after preoperative and postoperative adjuvant therapy. In this study we analyzed the prognostic factors affecting long term survival after surgical treatment of stage IIIB lung cancer Material and method: We analyzed the long term survival for age pathology invaded mediastinal organ n stage type of operation complete or incomplete resection and adjuvant therapy through a retrospective review of patients underwent surgical treatment. Result: From 1990 to 1998 56 patients(51/male 5/female0 with stage IIIB lung cancer were trated surgically. Forty two patients underwent radical resection and morbidity and mortality were 17% 12% respectively. The survival rate for overall patients and the radical resection group were 9% 12% respectively. In the radical resection group excluding explothoracotomy only(n=14) and the surgical mortality patients(n=5) the age the type of operation celly type resectability and N stage had no influence on the long term survival. The survival rate of radical resection group was significantly better than that of the explothoracotomy only group(p=0.04) The long term survival rate of postoperative combination therapy group was significantly better than chemotherapy or radiotherapy alone(p=0.04) Conclsion: Age type after surgical treatment of stage IIIB lung cancer. We conclude that combined modality of adjuvant treatment after radical resection of stage IIIB lung cancer seems to offer better long term survival in selective patients. The numbers of patients involved was small. Nevertheless these preliminary findings indicate questions that will need to be experienced further in larger studies.

• Radiation Oncology Journal
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• v.2 no.2
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• pp.253-260
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• 1984

Between January 1971 and December 1580 fifteen patients diagnosed of adenocarcinoma of the endometrium, stage II seen and treated at the University of Michigan Hospitals. are reviewed. Ten patients were treated with radiation therapy alone. five received hysterectomy after radiation. The five year survival of the patients receiving radiation and surgery was $100\%$ although one of them died after 62 month aster treatment. Of those receiving radiotherapy alone two died at i and 24months after therapy. All of the patients died of distant metastasis. Radiation cystitis was observed among surgically treated patients. while proctitis was observed in 3 cases receiving radiation alone. Though the number of cases reported is small due to rarity of the disease. it appears that radiation alone could provide reasonable tumor control. Also it appears that preoperative irradiation might lead to a longer survival. One patient who survived 62 months had para-aortic node involvement.

• Journal of Korean Foot and Ankle Society
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• v.16 no.3
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• pp.156-161
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• 2012

Brachymetatarsia is a rare congenital deformity which occurs most commonly in the fourth metatarsal. Most common purpose of surgery is to make a normal metatarsal parabola for better external appearance as well as physiological load bearing under the metatarsal heads. Common surgical treatment for brachymetatarsia is lengthening of short metatarsal either by one-stage lengthening with intercalary bone graft or gradual lengthening by distraction osteogenesis. Sometimes shortening of long metatarsal is combined with lengthening of the short metatarsal. The function of the foot is diminished due to diverse complication accompanying lengthening of the metatarsal, therefore preoperative consultation about the functional result is essential.

• Journal of Korean Neurosurgical Society
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• v.39 no.4
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• pp.310-313
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• 2006

Although lipomyelomeningocele and dermoid cyst are formed during a similar embryologic developmental stage of 'neural tube formation', they are caused by entirely different embryologic mechanisms. We encountered a case, which has not been previously reported, that had a lumbar subcutaneous dermoid cyst associated with lipomyelomeningocele. A 52-year-old man presented with a slowly growing lumbar mass of 3 years duration, which had been present since birth. Lumbosacral magnetic resonance imaging[MRI] showed lipomyelomeningocele at the L3, 4 and 5 levels and a subcutaneous cystic mass of high signal intensity on the T2 weighted image and iso or low signal intensity on the T1 weighted image. He underwent total resection of the lumbar subcutaneous mass. Intraoperative findings and histological examination were consistent with the preoperative diagnosis of a 'dermoid cyst'. We demonstrate that the formation of a dermoid cyst might coexist with lipomyelomeningocele during the embryologic developmental stage.

• Journal of Chest Surgery
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• v.51 no.6
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• pp.415-418
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• 2018

A solitary fibrous tumor (SFT) is a mesenchymal fibroblastic tumor inside the pleura, for which complete surgical resection is the standard treatment. For large SFTs, preoperative identification of tumor-feeding vessels using angiography is important for achieving complete resection without unexpected operative bleeding. Extensive adhesions can make resection difficult in a limited operative window, and pulmonary resection may be required to achieve complete SFT resection. Herein, we report successful resection of a large pleural SFT in a 39-year-old man without any complications using a 2-stage approach, in which ligation of the feeding vessels through small another operative window was the first step.