• Title/Summary/Keyword: 수술적 절제술

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Comparative Analysis of T2 Selective Division of Rami-communicantes (Ramicotomy) to T2 Sympathectic Clipping in Treatment of Craniofacial Hyperhidrosis (안면 다한증에서 T2 Sympathetic Clipping과 T2 Ramicotomy의 비교 연구)

  • 김도형;백효채;강두영;전세은;이두연
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.267-271
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    • 2004
  • Compensatory sweating is the main cause of patient dissatisfaction after sympathetic surgery for craniofacial hyperhidrosis. Surgery that sympathetic nerve trunk preserved and extent of resection limited was introduced to decrease compensatory sweating. From Jan 2000 to July 2002, the vidio-assisted thoracoscopic T2 sympathetic clipping and rami comunicantes selective division were performed in 36 patients suffering from craniofacial hyperhidrosis. Twenty two patients underwent a T2 sympathetic nerve clipping (Group 1), and fourteen patients underwent division of the T2 ramicommunicates (Group 2). We retrospectively analysed the rate of satisfaction, dryness of face, the rate of compensatory sweating, grade of compensatory sweating. The dryness of face was that no statistical difference between group 1 and group 2 (p=0.387); group1: dry 22.7% (5/22), humid 77.3% (17/22) group 2: dry 14.3% (2/14), humid 78.5% (11/14), persist 7.2% (1/14). The rate of satisfaction was 77.3% in T2 clipping and 64.2% in T2 sympathicotomy with no significant in the statistic analysis (p=0.396). The rate of compensatory sweating on group 2 was lower than group 1 (p=0.042); 95.4% (21/22) in T1 sympathetic clipping and 71.4% in T2 ramicotomy. The rate of embarrassing and disabling compensatory sweating was 70.5% (embarassing 8 patients, disabling 9 patients) in T2 clipping and 42.9% (embarassing 8 patients, disabling 9 patients)in T2 ramicotomy with statistically significant difference (p=0.036). The sympathetic trunk preservation surgery for craniofacial hyperhidrosis (T2 ramicotomy) redueced the rate of compensatory sweating when compared to the blocking surgery of sypathetic trunk (T2 clipping).

Malignant Fibrous Histiocytoma of the Lung - A case report - (폐 악성 섬유성 조직구종 -1예 보고 -)

  • Kim, Dae-Hyun;Kim, Jung-Heon;Kim, Bum-Shik;Park, Joo-Chul
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.786-788
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    • 2007
  • Primary malignant fibrous histiocytoma of the lung is extremely rare, A 12-year-old child was admitted to the hospital due to an incidentally detected lung mass. A $2.5{\times}2.5 cm$ sized mass located in the right lower lobe was seen on the chest X-ray, the chest computed tomogram and the positron emission tomogram. We resected the mass through a right lateral thoracotomy and the mass was revealed to be a malignant spindle cell neoplasm on the frozen section diagnosis. So, we performed lobectomy of the right lower lobe with systemic dissection of the mediastinal lymph nodes; the final histopathological diagnosis of the mass was malignant fibrous histiocytoma. The patient was discharged on postoperative day 7 and adjuvant chemotherapy was not applied.

Pasteurized Osteoarticular Graft for Periacetabular Sarcoma - A Case Report - (비구 주위 육종의 저온 열처리한 골연골 이식술 - 증례 보고 -)

  • Song, Won-Seok;Byun, Woo-Jin;Cho, Sang-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.185-189
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    • 2007
  • Advancement of imaging and surgical technique makes the internal hemipelvectomy one of the routine procedures of pelvis sarcoma. However, optimal reconstructive option for skeletal defect is still controversial. Pasteurized autogenous bone-total hip composite is a biologic method and its anatomical appropriateness gives good indication for selected cases. Nevertheless, in case of complication such as infection or mechanical breakage, removal of hardware including graft is inevitable. In those cases, marked limb length discrepancy induce marked functional deficit. To overcome this problem, the authors report 1 case, refining previous technique, saving the femoral head and reinsertion of osteoarticularly pasteurized host bone.

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Inflammatory Myofibroblastic Tumor of the Lung in a Child -A case report- (소아에시 발생한 폐 염증성 근섬유아세포종 -1예 보고-)

  • Kim Hee-Jung;Park Chang-Ryul;Jung Jong-Pil;Shin Je-Kyoun
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.332-334
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    • 2006
  • Inflammatory myofbroblastic tumor in the lung is a rare tumor. The etiology is not clear. This tumor in children is a benign tumor rarely presented with local invasiveness, recurrence, distant metastasis or malignant changes can occur. The complete surgical resection is chosen as the optimal management. A 12-years-old boy visited the outpatient clinic with a 4 cm sized pulmonary mass in left upper lung field. The patient underwent left upper lobectomy. Histopathologically, inflammatory myofibroblastic tumor was confirmed. The patient was discharged without any problems and there was no evidence of recurrence during 3 months follow-up.

Granular Cell Tumor of the Axillary Accessory Breast: A Case Report (액와부 부유방에 발생한 과립 세포 종양: 증례 보고)

  • Youn Joo Jung;Kyung Jin Nam;Ki Seok Choo;Kyeyoung Lee
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.275-279
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    • 2023
  • Granular cell tumors (GCTs) are rare benign soft tissue tumors that can occur throughout the body, particularly the head and neck; only 5%-8% of GCTs occur in the breast. We report a case of a GCT of the axillary accessory breast, which is a rare location of this tumor. A 50-year-old woman had a 2-month history of a palpable mass in the left axilla. Physical examination, as well as mammographic and ultrasonographic findings suggested a breast malignancy. Histopathological examination showed a benign GCT, and wide local excision was performed. The patient has remained disease-free over 2 years postoperatively. Although most GCTs are benign, wide complete resection of the tumor and follow-up are required considering the possibility of recurrence. The radiologist should know the characteristics of GCTs as a differential diagnosis of breast and axillary lesions to prevent unnecessary treatment.

A Case of Primary Diffuse Nodular Pulmonary Amyloidosis Localized in the Lung (원발성 결절성 폐실질형 유전분증 1예)

  • Jung, Sung-Kwoen;Oh, Joon;Roh, Yang-Won;Kong, Hee-Sang;Park, Kae-Young;Park, Jeong-Woong;Park, Jae-Kyung;Nam, Gui-Hyun;Ha, Seong-Hwen;Lee, Han-Kyung;Jeong, Seong-Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.365-371
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    • 2000
  • Nodular pulmonary amyloidosis is one of the rare manifestation of amyloid disease. It is known to be caused by amyloid L fibrils in the majority of cases. We experienced an unusual case of a forty-one year-old woman who was presented with multiple nodular lesion on the chest X-ray. CT-guided core needle biopsy, performed on the lesion, showed apple green birefringes, when stained Congo red and examined under polarized light, Ultrastructurally, there are randomly oriented, forming densed networks, and consists of fine, 7.5 to 10nm diameter, rigid, non-branching filaments of various lengths in electron-microscopic finding. We report a case of primary diffuse nodular pulmonary amyloidosis only localized in the lung, which was confirmed by CT guided core needle biopsy.

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Trestment Results and Prognostic Factors in Localized Gastrointestinal Non-Hodgkin's Lymphoma (국소적 위장관 악성 림프종의 치료성적 및 예후인자 분석)

  • Oh, Young-Taek;Suh, Chang-Ok;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.349-359
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    • 1994
  • Purpose: The primary gastrointestinal non-Hodgkin's lymphoma(GI-NHL) is the most common extranodal NHL. Surgery with postoperative radiotherapy or chemotherapy was tried with some success, but proper management guidelines have not been estabilished in localized GI-NHL due to its rarity and the lack of randomized trials. So we designed this study to evaluate treatment results and the lack of randomized trials. So we designed this study to evaluate treatment results and prognostic factors in localized GI-NHL, and to assess proper treatment mdality after surgical resection accordig to risk factors by survival analysis. Method: Seventy three patients who received surgical resection due to localized GI-NHL from Jan. 1916 to Apr. 1991 were reviewed in this study. Prognostic factors were analyzed by multivariate analysis program including postoperative treatment methods, and treatment results were compared according to prognostic factors and treatment modalities. Results: Overall 5-year survival rate was 62.3%, for all patients. The 5-year survival rate was 80.0% for patients with stage I GI-NHL and 45.7% for those with stage II. Chemotherapy or not, stage and residuum or not after surgical resection were significant independent prognositic factors. Postoperative adjuvant treatments showed significant survival benefit. In patients with high risk factors such as stage II or residuum after surgical resection, postoperative combined chemotherapy and radiotherapy showed better survival than those treated with single modality. Conclusions: Chemothrapy or not, stage, and residuum or not were important prognostic factors of patients with localized GI-NHL after surgical resection. Either chemotherapy or radiation therapy alone after surgical resection is recommanded for patients without high risk factors(stage II or residuum after surgical resection) but the postoperative combined chemotherapy and radiotherapy seems to be beneficial for patients with high risk factors.

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Lymph Nodes Metastasis Pattern and Prognosis of Resected T1 Esophageal Cancer (표층부(T1) 식도암에 있어서 암종의 침윤정도에 따른 림프절 전이의 양상)

  • 박창률;김동관;김용희;김종욱;박승일
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.665-671
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    • 2004
  • Background: Lymph node metastasis is commonly reported in thoracic esophageal cancer, even in the early esophageal cancer which may be localized only in the mucosa or within the submucosal layer. Although lymph node metastasis greatly influence long-term outcome and cure of the disease, endoscopic mucosal resection or photodynamic therapy without lymph node dissection is widely attempted. The investigation of the pattern of lymph node metastasis and results of surgical resection of superficial esophageal cancer is needed. Material and Method: Pattern of lymph node metastsis and depth of tumor invasion were studied retrospectively from 44 patients with early esophageal cancer who underwent radical resection of the tumor from December, 1995 to August, 2001. Result: Lymph node metastasis was found in 10 patients (22.7%) out of total of 44 patients. Lymph node metastasis was found in 0% (0 of 3), 0% (0 of 4), 50% (2 of 4), and 24.24% (8 of 33) of tumors that invaded the intraepitherium, lamina propria, muscularis mucosa, and submucosa respectively. Anatomically distant lymph node metastases were found more frequently in recurrent laryngeal nerve node(5 cases of 10 patients) and in intraperitoneal node (8 cases of 10). than intrathoracic node (3 cases of 10). There was no operative mortality, however, there were 1 hospital death in patient with lamina propria cancer, 1 late death in patient with submucosal cancer. Three-year survival rates (except hospital death) were 100% in mucosal cancer and 97.0% in submucosal cancer (p>0.05), and 100% in the node negative group and 90.0% in the node positive group (p>0.05). Conclusion: The survival rate of superficial esophageal cancer patient who was recieved operative resection was excellent. But, lymph node metastasis were found in superficial esophageal cancer, even in esophageal cancer limited to the muscularis mucosa. Systemic lymph node dissection which includes recurrent laryngeal nerve nodes and intraperitoneal nodes was recommended for favorable outcome in superficial esophageal cancer.

Elastofibroma Scapulae (견갑부 탄성섬유종)

  • Kang, Hyun-Guy;Cho, Hwan-Seong;Park, Weon-Seo;Lee, Joo-Hyuk;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.118-125
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    • 2006
  • Purpose: We report elastofibroma which is a rare fibrous lesion that most commonly occurs in the between subscapularis and thoracic cage. Materials and Methods: Four patients include one man and three women, the average age was 70 years and the average follow up period was six months. Two patients had on left side, two patients had on both sides. Main symptom was palpable mass. One patient complained mild pain, two complained scapular snapping. Results: All four masses removed with marginal or wide margin. Average mass size was 9.7${\times}$7.2${\times}$3.8 cm. Preoperative symptoms disappeared after surgery. All of the patients have returned to their daily living and showed no recurrence. There was no serious complication such as limitation of shoulder motion and winged scapula. Conclusion: Elastofibroma scapulae can be diagnosed through patient's age, tumor location and radiological finding without preoperative biopsy. When patient is symptomless, observation is enough without surgical operation. Surgical operation considered for relieve of symptoms of pain and snapping.

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The Clinical Outcome of Pulmonary Thromboendarterectomy for the Treatment of Chronic Pulmonary Thromboembolism (만성 폐동맥 색전증 환자에서의 폐동맥 내막절제술의 임상적 결과)

  • Bang, Jeong-Hee;Woo, Jong-Soo;Choi, Pil-Jo;Jo, Gwang-Jo;Park, Kwon-Jae;Kim, Si-Ho;Yie, Kil-Soo
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.254-259
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    • 2010
  • Background: Diagnosing chronic pulmonary embolism at an early stage is difficult because of the patient’s nonspecific symptoms. This condition is not prevalent in Korea, and in fact, there have been only a few case reports on this in the Korean medical literature. We analyzed the surgical outcome of performing pulmonary thromboendarterectomy in patients with chronic pulmonary embolism. Material and Method: The study subjects included those patients who underwent surgery for chronic pulmonary embolism from 1996 to 2008. For making the diagnosis, echocardiography, chest CT and a pulmonary perfusion scan were performed on the patients who complained of chronic dyspnea. Result: Pulmonary endarterectomy was performed as follows: by incision via a mid-sternal approach (7 patients); by incision via a left posterolateral approach (1 patient); using the deep hypothermic circulatory arrest technique (4 patients); under ventricular fibrillation (3 patients); and under cardioplegic arrest (1 patient). The postoperative systolic pulmonary artery blood pressure significantly decreased from a preoperative value of $78.9{\pm}14.5\;mmHg$ to $45.6{\pm}17.6\;mmHg$ postoperatively (p=0.000). The degree of tricuspid regurgitation was less than grade II after surgery. Two patients died early on, including one patient who had persistent pulmonary hypertension without improvement and right heart failure. Conclusion: Patients who have chronic pulmonary embolism are known to have a poor prognosis. However, we think that early surgical treatment along with making the proper diagnosis before the aggravation of right heart failure can help improve the quality of a patient's life.