• Radiation Oncology Journal
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• 제12권3호
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• pp.331-336
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• 1994

Purpose : To assess the effectiveness and problems of the primary radiation therapy and salvage surgery in a series of patients affected by T1-T2NO glottic cancers treated from 1985 to 1991 at the Pusan National University Hospital. Materials and Methods : From 8/85 to 12/91,34 patients affected by early glottic carcinoma histologically proven were treated with curative radiation therapy, Distribution of patients according to T stage was 30 for T1 and 4 for T2. Male to female ratio was 33:1. Age of patients ranged from 31 to 73 with mean age of 58 years. All of the patients were treated with radical radiation with total tumor dose of 63-75. 3Gy(median 68.2Gy), of 5 weekly fractions of 1.8-2Gy and with 6MV photon beams through two laterally opposed fields. Results : The overall 5-year local control rates were $74\%$(8/30) for Tl, and $25\%$(3/4) for T2. The main cause of failure was progression or recurrence in T(10/11). One failures were observed in T and N at the same time. Of these 11 patients, 9($81\%$) were salvaged with surgery, After surgical salvage of radiation failures, the 5-year survival rates were $96\%$ for T1 and $75\%$ for T2. Among the survivors, $73\%$ of T1 and $33\%$ of T2 were able to preserve the larynx. Conclusion : It can be concluded that radiotherapy is the first choice in the treatment of glottic T1 carcinoma.

• Journal of Chest Surgery
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• 제28권7호
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• pp.678-683
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• 1995

Arterial bypass for the chronic ischemia of the lower extremities underlying atherosclerotic obliterans has been performed with a number of alternative conduits from 1941 by Kunlin. It is indicated for the limb salvage of patients with threatened limb loss despite of several controversies in surgical treatment of atherosclerotic obliterans. From March 1991 to January 1995, 26 arterial bypasses were performed in 23 patients with the chronic ischemia of the lower extremities in our hospital. Their mean follow up period is 18.9 months ranging from 4 months to 44 months. Mean age is 60.9 years ranging 47 years to 76 years and the most prevalent incidence is the 6th decade. 21 patients are male and 2 patients are female. 19 of 23 patients are smokers. Clinical classifications by Fontaine are class II[21.7% , class III[34.8% and class IV[43.5% .Diabetes mellitus[47.8% , hypertension[43.5% , hyperlipid-emia[26% , tuberculosis[21.7% , cerebrovascular accident[13.0% and cardiac diseases[8.7% are associated. Aorto-single femoral bypass in 4 cases, aorto-bifemoral bypass in 5 cases, aortofemoral & femoropopliteal bypass in 2 cases, femoropopliteal bypass in 10 cases, popliteotibial bypass in 3 cases, femoropedal bypass[composite graft bypass in 2 cases were surgically approached. There are complicated early thrombosis in 4 cases those are required immediately reoperation, wound infection in 3 cases, hematoma in 3 cases, and so on. Postoperative complication rate is 53.8%.Postoperative patency rates are 84.6% at 6 months, 75.0% at 1 year, 70.0% at 2 years and 66.7% at 3 years. We usually used 6 mm & 8 mm graft for bypass, and the rate of thrombosis formation is 28.6%[2/7 in 6 mm graft and 12.5%[2/16 in 8 mm separately. In according to the graft materials, the rate of thrombosis formation is higher in the group using artificial graft than in that using autologous saphenous vein[16.6% vs 12.5% . Limb salvage rate is 76.9%. Postoperative mortality rate is zero %.

• Vascular Specialist International
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• 제34권4호
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• pp.88-93
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• 2018

Purpose: This study aimed to compare surgical revisions and balloon angioplasty after surgical thrombectomy on thrombosed dialysis access as a first event. Materials and Methods: Records of patients undergoing creation of arteriovenous grafts (AVGs) at the Gachon University Gil Medical Center between March 2008 and February 2016 were reviewed. Among them, patients who underwent treatment on first-time thrombotic occlusion after AVG creation were identified. Outcomes were primary, primary-assisted, and secondary patency. The patency was generated using the Kaplan-Meier method, and patency rates were compared by log-rank test. Results: A total of 59 de novo interventions (n=26, hybrid interventions; n=33, surgical revisions) for occlusive AVGs were identified. The estimated 1-year primary patency rates were 47% and 30% in the surgery and hybrid groups, respectively. The estimated primary patency rates were not different between the two groups (log-rank test, P=0.73). The Kaplan-Meier estimates of 6 and 12 months for primary-assisted patency rates were 68% and 57% in the surgery group and 56% and 56% in the hybrid group. The Kaplan-Meier estimates of 12 and 24 months secondary patency rates were 90% and 71% in the surgery group and 79% and 62% in the hybrid group. There were no differences in the estimated primary-assisted and secondary patency rates between the two groups. Conclusion: Our results showed no significant difference between the two groups in terms of primary patency (P=0.73), primary-assisted patency (P=0.85), and secondary patency (P=0.78). However, percutaneous transluminal angioplasty can give more therapeutic options for both surgeons and patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권5호
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• pp.277-283
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• 2013

Purpose: Well vascularized pectoralis major myocutaneous flap (PMMF) had been a commonly used versatile flap in reconstructive oromaxillofacial surgery since the 1970s. However, after the advent of microvascular surgery in the 1980s, the PMMF was used less frequently. But, to date, PMMF has been useful and has some advantages such as covering wide defects, covering vital structures, back-up procedure in cases of free flap failure, and reconstruction for radiotherapy patients. The purpose of this study is to evaluate the role, indication, complications, functional, and aesthetic results of this flap in the era of free flap with a literature and chart review. Methods: A retrospective study was conducted of 16 oral cancer patients undergoing reconstructive surgery with PMMF for reconstruction of defects from 2001 to 2012 at Kyungpook National University Hospital. The male to female ratio was 10:6, with a mean age of 63 years (16~79 years). Basic demographic data, previous treatment history, indications, dimension of the flap, site of reconstruction, postoperative complications, and patients' final status were systemically analyzed from chart review. Results: The pathology of the disease included squamous cell carcinoma in the majority of cases (n=14). The remaining cases were fibrosarcoma and mucoepidermoid carcinoma. Of the 16 PMMF reconstructions, 13 flaps were applied as primary reconstructive procedures, whereas three flaps were; salvage; procedures (vascularized free flap failure). Twelve patients had complications such as wound dehiscence, infection, hematoma, fistula, flap bulkiness, and partial flap necrosis. The higher complication rates showed an association with utilization of the flap in preoperative radiotherapy cases. However, all patients were discharged without failure. Conclusion: In reconstructive oromaxillofacial surgery, the PMMF is still a useful flap for huge defects. In addition, the PMMF can be used as a salvage procedure after vascularized free flap failure and reconstruction for patients with a history of preoperative radiotherapy.

• Advances in pediatric surgery
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• 제5권1호
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• pp.15-25
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• 1999

최근 소아의 비장 손상시는 비수술적 처치로 치유되는 경우가 대부분이나 대량출혈이 있거나 혈관 손상이 있을 경우에는 수술적 처치가 불가피한 실정이다. 본 연구에서는 소아에서 심한 비장손상 시 비장동맥색전술을 시행하여 비장 출혈을 어느정도 저지 시킬 수 있는지에 대해 검토하였다. 환아는 두 군으로 나누어 제 1군은 1993년 1월 부터 1994년 12월까지 비장 손상으로 내원 후 기존의 비수술적 처치 원칙에 따라 치료받은 환자 18례를 대상으로 하였고 제 2군은 1996년 1월부터 1997년 12월까지 내원하여 비장 동맥 색전술이 치료원칙에 도입된 후 치료 받은 환자 23례를 대상으로 하였다. 비장동맥 색전술은 grade III 또는 IV의 비장 손상시, 복부전산화 단층 촬영상 조영제의 누출 있는 경우, 동반장기의 손상 없이 활력 징후에 이상 있을 경우 등에서만 시행하였다. 제 1군에서는 18례중 6례(33.3%)에서 개복술이 시행되었고 이중 2례는 복강내 장기의 동반 손상이 있었다. 6례중 5례는 비장 절제술 1례는 비장 부분절제술이 시도 되어 총 비장 보존율은 72.2 % 였다. 제 2군에서는 8례에서 동맥 조영술상 비장 출혈이 확인된 후 색전술이 시행되었고 모두 성공적으로 비장 출혈을 멈출 수 있었다. 제 2군에서 개복술이 시행된 경우는 2례였는데 모두 동반 장기 손상으로 수술이 시행되었으며 이중 1례에서만이 비장절제술이 시행되어 제 2군에서의 비장보존율은 95.6%였으며 색전술후 수혈을 필요로 했던 경우는 없었다. 결론적으로 비장동맥 색전술은 비장 손상에 의한 비장 출혈시 매우 효과적인 방법으로, 이를 통해 보다 많은 비장을 보존할 수 있을 뿐더러 불필요한 개복술을 줄일 수 있을 것으로 사료된다.

• 대한관절경학회지
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• 제14권1호
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• pp.1-6
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• 2010

이 연구는 반월상 연골판 절제술의 적응증이 되는 복합성 외측 반월상 연골판 파열에서 슬와건을 바탕으로 시행한 구제적 성격의 관절경 봉합술의 임상 결과와 기술적인 방면에 대한 고찰을 위해 시행하였다. 2004년 6월부터 2006년 5월까지 32 사례의 젊고 증상이 있는 복합성 외측 반월상 연골판 파열 환자들을 all inside 방법으로 봉합하였다. 연구는 전향적으로 시행되었으며, 평균 연령은 29.2세(범위, 17~42)이었으며 평균 관찰기간은 42.8개월(범위, 24~50)이었다. 임상 결과는 라이슬럼 스코어(lysholm knee score)와 2차적으로 시행한 관절경 혹은 자기공명영상을 이용하여 평가되었다. 추적관찰은 약 80%에서 시행할 수 있었다. 추적 관찰된 환자들 대부분이 제한 없이 일상생활을 할 수 있었으며 평균 42.8개월의 추적관찰 동안에 재수술을 시행한 경우는 없었다. 평균 라이슬럼 스코어는 수술 전 65.4(범위는 55에서 75)에서 수술후 최종 추적관찰에서 평균 93.9(79에서 100사이)으로 증가되었다(p<.001). 80%에서 관절경으로 혹은 자기공명영상에서 병변의 치유가 확인되었다. 결론적으로 슬와건을 바탕으로 시행한 관절경적 외측 반월상 연골판 봉합술은 복합성 외측 반월상 연골판 파열을 가지고 있는 젊은 환자에서 구제적 성격의 시술로서는 효과적이었다.

• Radiation Oncology Journal
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• 제16권3호
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• pp.245-250
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• 1998

목적 : 조기 성문암의 방사선 치료 후 생존율, 실패 양상, 그리고 예후 인자에 대해 분석하였다. 대상 및 방법 : 1985년 6월부터 1992년 11월까지 방사선 치료를 위해 의뢰된 57례의 성문암환자를 대상으로 후향적 분석을 실시하였다. 연령 분포는 17세부터 71세까지 광범위했고 (중앙값 39세), 남자 55례와 여자 2례로 남성에서 호발하였다. 방사선 치료는 6 MV X-ray를 이용하여 1회 선량 2 Gy씩, 주 5회, 총선량 66 Gy를 조사하였다. 결과 : 방사선 치료에 대한 반응은 완전 관해 89.5% (51/57), 부분 관해 혹은 무반응 10.5%(6/57) 였다. 51례의 완전관해 환자 중에서 7례의 재발이 관찰되었고 7례 모두 수술로 구제되었다. 부분 관해 혹은 무반응 6례 중 4례에 대하여 구제수술을 시행하였고 2례에서는 수술을 시행하지 못하였다. 구제수술을 시행한 4례 중 3례가 구제되었고 1례는 다시 국소재발하였다. 3년 및 5년 무병생존율은 각각 72.9% 및 63.8%였다. 병소의 위치에 따른 5년 무병생존율은 후방인 경우 85.5%, 전방인 경우 61.6%였다 (P<0.05). 방사선치료에 대해 부분 관해 혹은 무반응을 보인 5례를 포함하여 13/57 (22.8%) 례의 치료 실패가 관찰되었고 그 중 10/13 (76.9%) 례가 수술로 구제되었다. 최종 5년 국소제어율은 92.3%였고 전체적으로 47/57 (82.5%) 례에서 음성을 보존할 수 있었다. 결론 : 높은 음성 보존율을 고려하면 초기 성문암에서 방사선치료가 우선적으로 고려되어야 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2131-2135
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• 2013

Background: To evaluate the efficacy and safety of distearoylphosphatidylcholine pegylated liposomal doxorubicin (DPLD) combined with carboplatin for the treatment of platinum resistant or refractory epithelial ovarian cancer (EOC) or fallopian tube cancer. Materials and Methods: A retrospective analysis of women who received DPLD with carboplatin for recurrent EOC or fallopian tube cancer in King Chulalongkorn Memorial Hospital Thailand from January 2006 to August 2011 was conducted. Patients were identified from the medical records and data on demographic factors, stage, histology, surgical findings, cytoreduction status, and prior chemotherapies were abstracted. The efficacy and toxicity of DPLD/carboplatin were evaluated. Progression-free (PFS) and overall survival (OS) were estimated by the Kaplan-Meier method. Results: A total of 65 patients, 64 with platinum resistant or refractory epithelial ovarian cancer and 1 with fallopian tube cancer, were enrolled. DPLD and carboplatin were given for an average of 4.46 cycles per patient with a total of 273 cycles. Among the 65 evaluable patients, 0% achieved CR, 7.69% PR, 15.4% SD and 76.% PD. The overall response rate was 23.1%. With a median follow-up of 27.4 months, the median progression-free and median overall survival in the 36 patients was 4.46 months and 8.76 months respectively. In the aspect of side effects, palmar-plantar erythrodysesthesia (PPE) occurred in 33.3% (Grade I 22.2%, Grade II 11.1%) and mucositis in 41.7% (Grade I 27.8%, Grade II 13.9%) of all treatment cycles, all Grade 1 or 2. Anemia, leukopenia and thrombocytopenia occurred in 58.3% (Grade I 41.7%, Grade II 16.7%), 66.7% (Grade I 47.2%, Grade II 19.4%), and 22.2% (Grade I 16.6%, Grade II 5.56%) of cycle respectively, and were mostly Grade 1 or 2. Conclusions: DPLD, the second-generation PLD drug combined with carboplatin every 4 weeks, is effective and has low toxicity for treatment of patients with recurrent platinum-resistant or refractory epithelial ovarian cancer.

• 대한기관식도과학회지
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• 제4권1호
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• pp.91-95
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• 1998

Background： Laryngeal cancer, the most common malignancy of head and neck, is being detected and treated in earlier and more effectively due to introduction of endoscope, continuous development of radiographic technology, and advancement in new surgical techniques such as laser surgery and conservation laryngeal surgery Objectives To compare the different treatment results for early laryngeal cancer to determine which methos provides the good prognosis. Materials and Methods： Retrospective study was done for 135 patients with early laryngeal squamous cell carcinoma(Stage I or II) who were treated at our institute between 1989 to 1996. There were 105 patients with glottic cancer(Stage I: 68 patients, Stage II：37 Patients) and 30 patients with supraglottic cancer(Stage I: 12 patients, Stage II：18 patients) Initial treatment included radiation therapy for 54 patients, endoscopic laser surgery for 8 patients, laryngofissure and cordectomy for 8 patients, vertical partial laryngectomy for 37 patients, supraglottic laryngecomy for 14 patients and supracricoid laryngectomy for 5 patiens, and total laryngectomy for 9 patients. Results : Salvage treatments, such as total laryngectomy, conservation laryngeal surgery, radiation therapy and neck dissection were performed for initial treatment failure with 9 patients after radiation therapy, 8 patients after conservation laryngeal surgery, 2 patients after endoscopic laser and 3 patients after total laryngectomy. Overall 3-year survival rate for glottic 71 was 92.4%, glottic f 84.3%, supraglottic 7172.7%, and supraglottic f was 63.%%. However, survival rate of the same stage was variable according to the choice of initial treatment. Conclusion New classification of the early laryngeal cancer was necessary and helpful for the choice of the initial treatment.

• 대한조선학회논문집
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• 제42권4호
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• pp.307-314
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• 2005

In recent years, many environmentally disastrous oil spill accidents from damaged vessels become worse especially when the early treatment is not prompt enough. To properly handle this type of accidents and prevent further disasters, international organizations establish and impose various rules and regulations. In assessing the damages and providing salvage operations, the propulsive performance of damaged vessels is of great importance, as well as for containing oil spill while the vessels are being towed or self-propelled. Until now, many naval hydrodynamics researches have focused on the propulsive performance in normal operating conditions and only a few studies for damaged vessels are found in literature. In this paper experimental method is used to study the Propulsive performance of a very large crude-oil carrier (VLCC) in .heeled and/or trimmed conditions.