• 제목/요약/키워드: surgical diseases

검색결과 924건 처리시간 0.021초

근치적 수술 후 재발한 I, II 병기 비소세포폐암의 임상양상 및 조직학적 유형의 차이 비교 (Clinicopathologic Characteristics of Recurrence after Curative-intent Surgical Therapy of Non-small Cell Lung Cancer)

  • 송성헌;손장원;곽현정;김사일;이승호;김상헌;김태형;윤호주;신동호;박성수
    • Tuberculosis and Respiratory Diseases
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    • 제70권4호
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    • pp.330-337
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    • 2011
  • Background: The clinicopathologic characteristics of patients with non-small cell lung cancer (NSCLC) have been changing. Recently, Positron emission tomography-computed tomography (PET-CT) has usually been used for diagnosis, follow-up to treatment and surveillance of NSCLC. We studied the pattern of recurrence and prognosis in patients who underwent complete resection for NSCLC according to histologic subtype. Methods: All patients who underwent complete resection for pathological stage I or II NSCLC between January 2005 and June 2009 were identified and clinical records were reviewed retrospectively, especially the histologic subtype. Results: Recurrences were identified in 50 of 112 patients who had complete resection of an NSCLC. Sites of recurrence were locoregional in 15 (30%), locoregional and distant in 20 (40%), and distant in 15 (30%). Also, sites of recurrence were intra-thoracic in 29 (58%), extrathoracic and intra-thoracic recurrence in 15 (30%), and extrathoracic in 6 (12%). In locoregional recurrence, there was 37% recurrence for non-squamous cell carcinoma (non-SQC) and 25% for squamous cell carcinoma (SQC). In distant recurrence, there was 39% recurrence for non-SQC and 18% for SQC. Locoregional recurrence in the bronchial stump was more common in SQC than non-SQC (14% vs. 45%, p=0.025). Prognosis of recurrence was not influenced by histologic subtype and the recurrence-free survival curve showed that the non-SQC group did not differ from the SQC group according to stage. Conclusion: The prognosis for recurrence does not seem to be influenced by histologic types, but locoregional recurrence in the bronchial stump seems to be more common in SQC than non-SQC in completely resected stage I and II NSCLC.

악성 흉선종으로 오인된 결핵성 심낭농양 1예 (A Case of Tuberculous Pericardial Abscess Mimicking Thymic Carcinoma)

  • 박지영;박승아;안영환;장길수;김소연;안정선;홍은영;임수영;김건일;서진원;박성훈
    • Tuberculosis and Respiratory Diseases
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    • 제70권4호
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    • pp.347-351
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    • 2011
  • We report here an unusual case of pericardial tuberculoma that was misdiagnosed as thymic carcinoma on an imaging study. A 48-year-old woman was referred for evaluation of an anterior mediastinal mass. Computed tomography (CT) scans of the chest displayed cystic masses mimicking thymic carcinoma at the anterior mediastinum. Pericardiotomy and surgical drainage of the cystic masses were done, and pathologic examination of the excised pericardial specimen showed a chronic granulomatous inflammation with necrosis, compatible with tuberculosis. Acid-fast bacilli were also identified in the specimen. After treatment with anti-tuberculosis drugs and steroids, the patient showed clinical improvement. Although tuberculous pericarditis usually presents as pericardial effusion or constrictive pericarditis, it can also present as a pericardial mass mimicking thymic carcinoma on CT. Therefore, we suggest that tuberculous pericardial abscess should be included in the differential diagnosis of a mediastinal mass in Korea, with intermediate tuberculosis prevalence.

단일 분절 퇴행성 경추질환에서 Titanium Cage를 이용한 전방 융합술의 조기 치험 : 골편 이식을 동반하지 않은 경우의 임상적 방사선학적 초기 결과 (Preliminary Experience with Cervical Implantable Titanium Cage(RABEA) in Patients with Monosegmental Degenerative Disease : Clinical and Radiological Outcomes without Cancellous Bone Filling into Cage)

  • 이영균;한영민;김종태;정동섭;박영섭;박춘근;강준기
    • Journal of Korean Neurosurgical Society
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    • 제30권sup2호
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    • pp.300-308
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    • 2001
  • Objectives : Anterior cervical discectomy and interbody fusion has become a well-accepted surgical treatment of degenerative cervical diseases. Implatable cages have a stabilizing effect without plates and no need for autogenous bone graft. The authors evaluates the effect of implatable titanium cage(RABEA) on the clinical and radiological outcomes. Methods : 34 patients with symptomatic cervical degenerative diseases due to one level disc pathology were underwent anterior cervical discectomy and interbody fusion with titanium cages(RABEA) which were not filled with cancallous bone grafts from January 1999 to May 2001. Patients with osteoporosis and older than 65 years were not included. Among them, 15 patients could be followed-up for at least 1 year. The authors retrospectively reviewed the charts and radiographic data. Mean follow-up period was $1.3{\pm}0.2years$. Results : Clinical results according to the Odom's criteria was exellent and good in 14(93%) patients. One patient with fair result showed complete loss of the disc space height due to settlement of the cage. Preoperatively, the mean height of the disc space(${\pm}$standard deviation) was $3.42{\pm}1.10mm$(range 2.0-5.5mm), and at 1 day postoperatively it was $7.88{\pm}0.90mm$(range 6.50-9.0). The mean height of the disc space after 1 year was $6.50{\pm}1.38mm$(range 3.0-8.0). The restoration of the height was statistically significant(p<0.05). The mean height after 1 year was $82.7{\pm}15.9%$ of the height at 1 day postoperatively. Preoperatively the mean value of the cervical lodortic angle was $21.8{\pm}11.8^{\circ}$ and 1 year postopertively, it was $24.5{\pm}8.3^{\circ}$, which was statistically not significant. All patients showed no abnormal movements on flexion and extension lateral film after 6 months. Conclusion : Implantable titanium cages appear safe and effective in selected patients, and their use helps to avoid complications associated with bone graft harvest. Subsidence of the cage seems to be a potential risk factor for recurrence of the symptoms. For long-term results, a longer follow-up is required.

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건강한 소아에서 살모넬라 장염의 합병증으로 발생한 독성거대결장 (Toxic Megacolon as a Complication of Infectious Colitis Caused by Salmonella enteritidis Group D in a Previously Healthy Child)

  • 전성배;소철환;조영민;유승택
    • Pediatric Infection and Vaccine
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    • 제28권2호
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    • pp.110-117
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    • 2021
  • 독성거대결장은 염증성 장질환, 감염성 대장염 등에 의해 발생하는 치명적인 합병증이다. 중증도에 따라 장절제부터 사망까지 예후가 나빠 조기 진단과 적절한 치료가 매우 중요한 질환이다. 하지만, 소아에서 그 유병률은 매우 낮으며 염증성 장질환과 같은 기저질환이 없이 발생할 경우 조기진단이 늦어질 수 있다. 기저질환이 없는 12세 남자가 하복부 통증과 발열, 그리고 혈변을 주소로 병원을 방문했다. 항생제 치료에도 불구하고 환자의 증상은 악화되었다. 3병일째 복부 컴퓨터단층촬영에서 횡행결장의 심각한 팽창이 관찰되었고 이를 통해 독성거대결장으로 진단할 수 있었다. 광범위항생제와 함께 정맥 스테로이드 치료를 시행하였으며, 환자의 증상은 호전되었다. 이후 대변 배양 검사에서 Salmonella enteritidis group D가 배양되었으며, 직장 내시경 검사를 통해 염증성 장질환을 배제할 수 있었다. 저자는 독성거대결장을 적절한 영상 검사를 통해 조기 진단하였고, 내과적으로 성공적인 치료를 하여 이에 대한 경험을 공유하고자 한다.

Prediction of Postoperative Lung Function in Lung Cancer Patients Using Machine Learning Models

  • Oh Beom Kwon;Solji Han;Hwa Young Lee;Hye Seon Kang;Sung Kyoung Kim;Ju Sang Kim;Chan Kwon Park;Sang Haak Lee;Seung Joon Kim;Jin Woo Kim;Chang Dong Yeo
    • Tuberculosis and Respiratory Diseases
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    • 제86권3호
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    • pp.203-215
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    • 2023
  • Background: Surgical resection is the standard treatment for early-stage lung cancer. Since postoperative lung function is related to mortality, predicted postoperative lung function is used to determine the treatment modality. The aim of this study was to evaluate the predictive performance of linear regression and machine learning models. Methods: We extracted data from the Clinical Data Warehouse and developed three sets: set I, the linear regression model; set II, machine learning models omitting the missing data: and set III, machine learning models imputing the missing data. Six machine learning models, the least absolute shrinkage and selection operator (LASSO), Ridge regression, ElasticNet, Random Forest, eXtreme gradient boosting (XGBoost), and the light gradient boosting machine (LightGBM) were implemented. The forced expiratory volume in 1 second measured 6 months after surgery was defined as the outcome. Five-fold cross-validation was performed for hyperparameter tuning of the machine learning models. The dataset was split into training and test datasets at a 70:30 ratio. Implementation was done after dataset splitting in set III. Predictive performance was evaluated by R2 and mean squared error (MSE) in the three sets. Results: A total of 1,487 patients were included in sets I and III and 896 patients were included in set II. In set I, the R2 value was 0.27 and in set II, LightGBM was the best model with the highest R2 value of 0.5 and the lowest MSE of 154.95. In set III, LightGBM was the best model with the highest R2 value of 0.56 and the lowest MSE of 174.07. Conclusion: The LightGBM model showed the best performance in predicting postoperative lung function.

Assessing Misdiagnosis of Relapse in Patients with Gastric Cancer in Iran Cancer Institute Based on a Hidden Markov Multi-state Model

  • Zare, Ali;Mahmoodi, Mahmood;Mohammad, Kazem;Zeraati, Hojjat;Hosseini, Mostafa;Naieni, Kourosh Holakouie
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권9호
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    • pp.4109-4115
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    • 2014
  • Background: Accurate assessment of disease progression requires proper understanding of natural disease process which is often hidden and unobservable. For this purpose, disease status should be clearly detected. But in most diseases it is not possible to detect such status. This study, therefore, aims to present a model which both investigates the unobservable disease process and considers the error probability in diagnosis of disease states. Materials and Methods: Data from 330 patients with gastric cancer undergoing surgery at the Iran Cancer Institute from 1995 to 1999 were analyzed. Moreover, to estimate and assess the effect of demographic, diagnostic and clinical factors as well as medical and post-surgical variables on transition rates and the probability of misdiagnosis of relapse, a hidden Markov multi-state model was employed. Results: Classification errors of patients in alive state without a relapse ($e_{21}$) and with a relapse ($e_{12}$) were 0.22 (95% CI: 0.04-0.63) and 0.02 (95% CI: 0.00-0.09), respectively. Only variables of age and number of renewed treatments affected misdiagnosis of relapse. In addition, patient age and distant metastasis were among factors affecting the occurrence of relapse (state1${\rightarrow}$state2) while the number of renewed treatments and the type and extent of surgery had a significant effect on death hazard without relapse (state2${\rightarrow}$state3)and death hazard with relapse (state2${\rightarrow}$state3). Conclusions: A hidden Markov multi-state model provides the possibility of estimating classification error between different states of disease. Moreover, based on this model, factors affecting the probability of this error can be identified and researchers can be helped with understanding the mechanisms of classification error.

패혈증으로 진행된 치성 감염 : 증례보고 (SEPSIS FROM ODONTOGENIC INFECTION : A CASE REPORT)

  • 오성섭;박은진;김일규;최진호;김형돈;오남식
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제25권4호
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    • pp.375-378
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    • 1999
  • 우수한 항생제 요법이후 치성 감염으로 인한 Ludwig's angina의 합병증으로 인한 사망은 극히 드문 것으로 알려져 왔다. 본 교실에서는 고혈압의 기왕력을 지닌 57세 여환이 하악 전치부의 치근단 농양을 원인으로 하는 좌측 협간극의 감염으로 인하여 개구장애와 동통을 주소로 내원하여 입원치료중, Ludwig's angina 및 심경부감염으로 확산되고 입원 10일째 패혈증과 성인 호흡장애 증후군(ARDS)및 산발성 혈관내 응고증(DIC)의 진단하에 사망한 증례를 통하여 패혈증의 소견과 진단 및 그에 따른 처치 등에 대한 지견을 얻었기에 진단과 예방에 도움을 주고자 문헌고찰과 함께 보고하는 바이다.

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유방절제 환자의 브래지어 착용 관련 의생활 분석연구 (Survey of Brassiere Related Clothing Tendency for Mastectomy Patients)

  • 김연주;구다솜;남윤자;서관식;이은신;노동영;조규진
    • 한국의류산업학회지
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    • 제21권6호
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    • pp.800-812
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    • 2019
  • Secondary diseases that occur during the rehabilitation of breast cancer survivors are factors that can negatively change the physical and psychological state of the patient. The rehabilitation after treatment of breast cancer survivors is an important process to prevent cancer recurrence and increase the survival rate because a negative psychological state significantly impacts the long-term survival rate. This study identifies user requirements for the development of functional bras for mastectomy patients in Korea. Participants included 133 patients with one or more breasts removed due to breast cancer and an average age of 53.2 years (53.21 ± 7.57 years, minimum 33 years, maximum 69 years). Women in their 50s had the highest participation rate of 48.9%. Most maintained the same bra size before surgery; however, some experienced changes in bra size because they are not irritated by wounds caused by surgery. Therefore, it is important to pay attention to material when designing a functional bra because it can irritate the surgical site. Only about 41.4% of bras were worn by breast cancer patients because of price burden and lack of education, not complaints related to clothing design and wearability or body shape. Most purchases at hospitals or medical institutions require consultation with a specialist who provides information about a bra mainly at the hospital. The most important considerations when buying a breast cancer bra were size, fit and shape stability.

M.S.T로 호전된 요통 환자 1례 보고 (Case Report of Low Back Pain patient treated with Motion Style Treatment)

  • 권승로;유혜경;김규태
    • 대한추나의학회지
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    • 제5권1호
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    • pp.93-100
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    • 2004
  • 본 증례는 요각통 환자에게 다양한 한방치료를 시술하였으나 별무호전인 경우 M.T.S요법을 추가로 시행함으로써 양호한 결과를 보인 임상례이다. 요통환자가 장기간의 치료에도 차도가 없거나 호전에 미미했을 때 물론 의사의 마음에도 불가피하게 수술을 해야 될 것이라는 생각이 떠오르게 된다. 하지만 수술을 해야 할 것인지 혹은 하지 말아야 할 것인지 결정을 내리기 전에 충분히 다른 치료법을 시행해 볼 필요가 있다. 이에 저자는 장기간의 치료에도 차도가 없거나 호전이 미미한 요통 환자에게 M.S.T 요법을 시행할 경우 양호한 결과를 얻으리라 사료되어 보고하는 바이다.

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Non-Melanocytic Benign Tumors of the Face: A Retrospective Study

  • Lee, Kyoung Min;Lim, Jung Soo;Min, Kyung Hee;Lee, Jong Hun;Hong, Sung Hee;Lee, Hye Kyung
    • Archives of Plastic Surgery
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    • 제42권2호
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    • pp.201-206
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    • 2015
  • Background Although plastic surgeons daily encounter various facial tumors in the field, reports limited on face are scarce. In our study, we want to provide basic epidemiologic data to help clinicians to decide the proper management for their patients. Methods We retrospectively reviewed the medical records of patients including age and gender, location and size of the tumor, histopathologic result, recurrence, type of anesthesia and any associated disorders who had undergone a surgical removal of their facial tumors and received the histopathologic report in the same institution between January 2009 and October 2012. Results One hundred eighty-nine patients with 203 non-melanocytic benign tumors were included. The most frequent site of tumors was the central subunit of the forehead, followed by the lateral subunit of the cheek and the auricular unit. Of 36 different histopathologic results, the epidermal cyst was most frequent, followed by lipoma, pilomatricoma and osteoma. Statistical analysis showed that males were dominant in the epidermal cyst and lipoma groups. While, females were dominant in the osteoma and pilomatricoma groups. No associations were found between lesions and other diseases. Conclusions Our study is the at most specific and concentrated study on non-melanocytic benign tumors of the face. We expect the epidemiologic data of our study may help plastic surgeons who are confronted with so many facial lesions in the field to decide on the most proper management for their patients.