• Radiation Oncology Journal
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• 제19권2호
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• pp.136-141
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• 2001

목적 : 방사선치료 중에 혈중 Squamous Cell Carcinoma Antigen (SCC) 값의 변화를 관찰하여 치료에 대한 반응을 감시할 수 있는 가능성을 알아보고 특히 치료중 원격전이 등으로 인한 치료실패가 발생할 경우에 조기에 발견할 수 있는지 알아보기 위해서 본 연구를 시행하였다. 대상 및 방법 : 1998년 12월부터 1999년 8월까지 단국대학병원 치료방사선과에서 원발성 자궁경부암으로 근치적 방사선치료를 시행 받은 환자 중 13례를 대상으로 하였고 치료전 및 외부조사 방사선치료 중 매주 1회씩, 그리고 치료 후에 혈중 SCC 치를 측정, 분석하였다. 결과 : 13례 중 9례에서는 외부조사 방사선치료 종료 후에 시행한 검사상 원격전이의 소견이 없어서 자궁강내 근접방사선치료를 시행할 수 있었다. 이들 9례 중 7례는 방사선치료 전에 혈중 SCC 치가 상승되어 있었다. 이 7례중 6례에서 치료 후 완전 관해의 소견을 보였는데 그중 5례에서는 혈중 SCC 치가 정상화되었다. 부분관해를 보인 1례에서는 혈중 SCC 치가 치료전보다 낮아졌으나 정상범위보다는 높았다. 13례 중 나머지 4례에서는 외부조사 방사선치료 종료시점에 원격전이가 확인되어서 자궁강내 근접방사선치료를 시행하지 못하였다. 이 중 3레는 방사선치료 전에 혈중 SCC 치가 상승되어 있었는데 외부조사 방사선치료 종료 직후 시행한 흉부단순촬영 사진상 원격전이의 소견이 나타났음에도 불구하고 이 때의 혈중 SCC 치는 감소하였다. 치료 전에 혈중 SCC가 상승되어 있었던 10례 중 7례에서 9 Gy 치료 후에 혈중 SCC 값이 더욱 증가하였으며 통계적으로 유의한 증가였다. 18 Gy 시행한 후의 값은 9 Gy 시행한 경우에 비해서는 3례에서 증가하였고 7예에서 감소하였으며 치료 전에 비해서는 4례에서 증가하였고 6례에서 감소하였다. 18 Gy 이후에는 방사선량의 증가에 따라서 계속적으로 혈중 SCC 치가 감소하여 종양이 완전 관해에 이르면 정상범위에 도달하였다. 결론 : 방사선치료 중에 혈중 SCC 치는 9 Gy까지는 치료 전에 비해서 일시적으로 증가하고 18 Gy에서는 치료전의 값과 비슷해지며 그 후에는 빠르게 감소해서 종양이 완전 관해에 이르면 정상치에 도달하였다. 외부조사 방사선치료 종료 후 흉부단순촬영 사진상 폐 전이의 소견을 보인 경우들도 혈중 SCC 치는 주로 자궁경부의 주종양의 관해도에 따라 감소하여 주종양의 완전관해시 정상화되었고 폐 전이의 발현에도 불구하고 증가하지 않았다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3281-3285
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• 2012

Objectives: To evaluate the clinicopathologic correlation and prognostic value of HPV18 DNA viral load in patients with early-stage cervical neuroendocrine carcinoma (NECA). Methods: Formalin-fixed, paraffin-embedded tissue of cervical NECA patients with known HPV18 infection and clinicopathologic data including follow-up results were collected. The HPV18 DNA load was assessed with quantitative PCR targeting the HPV18 E6E7 region. Results: Twenty-one patients with early-stage (IB-IIA) cervical NECA were identified. HPV18 DNA viral load ranged from 0.83 to 55,174 copies/cell (median 5.90). Disease progression, observed in 10 cases (48%), was not significantly associated with any clinicopathologic variables. However, the group of patients with progressive disease tended to have a higher rate of pelvic lymph node metastasis (50% versus 9%, p=0.063) and a lower median value of HPV18 DNA viral load (4.37 versus 8.17 copies/cell, p=0.198) compared to the non-recurrent group. When stratified by a cut-off viral load value of 5.00 copies/cell, the group of patients with viral load ${\leq}5.00$ copies/cell had a significantly shorter disease-free survival than the group with viral load >5.00 copies/cell (p=0.028). The group with a lower viral load also tended to have a higher rate of disease progression (75% versus 31%, p=0.080). No significant difference in the other clinicopathologic variables between the lower and higher viral load groups was identified. Conclusion: HPV18 DNA viral load may have a prognostic value in patients with early-stage NECA of the cervix. A low viral load may be predictive of shortened disease-free survival in these patients.

• Korean Journal of Radiology
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• 제24권9호
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• pp.912-923
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• 2023

Objective: This study aimed to validate the risk stratification system (RSS) and biopsy criteria for cervical lymph nodes (LNs) proposed by the Korean Society of Thyroid Radiology (KSThR). Materials and Methods: This retrospective study included a consecutive series of preoperative patients with thyroid cancer who underwent LN biopsy, ultrasound (US), and computed tomography (CT) between December 2006 and June 2015. LNs were categorized as probably benign, indeterminate, or suspicious according to the current US- and CT-based RSS and the size thresholds for cervical LN biopsy as suggested by the KSThR. The diagnostic performance and unnecessary biopsy rates were calculated. Results: A total of 277 LNs (53.1% metastatic) in 228 patients (mean age ± standard deviation, 47.4 years ± 14) were analyzed. In US, the malignancy risks were significantly different among the three categories (all P < 0.001); however, CT-detected probably benign and indeterminate LNs showed similarly low malignancy risks (P = 0.468). The combined US + CT criteria stratified the malignancy risks among the three categories (all P < 0.001) and reduced the proportion of indeterminate LNs (from 20.6% to 14.4%) and the malignancy risk in the indeterminate LNs (from 31.6% to 12.5%) compared with US alone. In all image-based classifications, nodal size did not affect the malignancy risks (short diameter [SD] ≤ 5 mm LNs vs. SD > 5 mm LNs, P ≥ 0.177). The criteria covering only suspicious LNs showed higher specificity and lower unnecessary biopsy rates than the current criteria, while maintaining sensitivity in all imaging modalities. Conclusion: Integrative evaluation of US and CT helps in reducing the proportion of indeterminate LNs and the malignancy risk among them. Nodal size did not affect the malignancy risk of LNs, and the addition of indeterminate LNs to biopsy candidates did not have an advantage in detecting LN metastases in all imaging modalities.

• Journal of Chest Surgery
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• 제23권2호
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• pp.285-298
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• 1990

The records of 67 patients who had been operated as an esophageal cancer during the period from 1973 to 1989 at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital were reviewed retrospectively. The results were summarized as follows ; The age ranged from 28 years old to 80 years old. The highest incidence was 5th decades, then 6th decades, and the incidence of male was 10 times as the incidence of female[M:F= 10.16: 1]. The locations were lower esophagus 44%, middle esophagus 38.8%, upper esophagus 11.9% and cervical esophagus 4.4% The frequent symptoms were dysphagia [88%], epigastric or substernal pain and discomfort [29.8%], weight loss [20.8%], and laryngeal dryness [1.4%]. The most common interval between the onset of dysphagia and admission was 2-3 months; 82% of patients was within 6 months, The cancer consisted of stage I [3%], stage II [11.9%], stage III[47.6%], and stage IV [33.7%] The resectability of cancer was 67%. The organs of substitute were stomach in 21 cases, right colon 6 cases, and jejunum in 8 CRSCS. The relation between invasion of tumor and lymph node metastasis was analyzed: mucosal involvement: 1 case/2case, muscle invasion; 0/2 full thickness; 4/6, adjacent structure 7/12. Postoperative complications were pneumonia, pleural effusion, hoarseness, mediastinitis, anastomosis site leakage, reoperation due to stenosis, chylothorax, empyema, mechanical ileus, wound infection, meat impaction at anastomosis site, and repair of gastrostomy site leakage. Adjuvant therapies were irradiation [15cases], chemotherapy [14cases], and Bougie dilatation [4 cases],

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권4호
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• pp.276-279
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• 2012

The development of multiple primary tumors is a problem leading to the treatment of patients diagnosed with gingival squamous cell carcinoma (SCC). The occurrence of multiple primary cancers in patients with SCC of the head and neck is uncommon. Thyroid carcinomas have been found incidentally in the cervical lymph nodes after histopathologic examination. A 72-year-old male with SCC of the lower gingiva at the clinical stage T2N0M0 was treated with partial mandibulectomy and selective neck dissection. Histopathologic examination showed the foci of papillary thyroid carcinoma metastasis. The patient subsequently underwent total thyroidectomy. We report a case of papillary thyroid carcinoma associated with SCC of the oral gingiva along with a review of literatures.

• 대한두경부종양학회지
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• 제9권2호
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• pp.193-199
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• 1993

The prognosis of supraglottic cancer is worse than that of glottic cancer. Supraglottic cancers by subsites have different microenvironment of cancer cells, locoregional spread patterns. Therefore we presume that high therapeutic efficacy, while preserving the organ, can be obtained when supraglottic cancer is treated effectively according to its biological behaviors. For the purpose of determination of clinical characteristics and causes of treatment failures by subsites of supraglottis, the authors analyzed 24 cases(stage III 14 cases, stage IV 10 cases) of supraglottic cancer which were managed mainly by surgery in our institute. The results were as follows; 1) The suprahyoid group had worse pathologic grades, more frequent spread to hypopharynx, more freguent recurrence at primary site, and better three-year survival rate than the infrahyoid group. 2) The infrahyoid group had more frequent spread to glottis, understaging, recurrence at cervical nodes than the suprahyoid group. 3) There was no differences in nodal metastasis by sub sites. These results suggest that the suprahyoid group may have more aggressive spread pattern but better prognosis than the infrahyoid group.

• 대한두경부종양학회지
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• 제23권2호
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• pp.181-184
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• 2007

Hypopharyngeal cancer usually has invasiveness to adjacent tissue and frequent metastasis to cervical lymph node. In addition, because it often accompanies submucosal extension and second primary malignancy, the sacrifice of larynx and postoperative radiation therapy had been performed in the past. However, it has been reported that conservative surgery of hypopharyngeal cancer show good functional and oncologic outcome according to the development of diagnostic tool and reconstructive technique. We report a case of hypopharyngeal cancer that received conservative surgery followed radiation therapy and intraoperative radiation therapy for neck recurrence.

• 여성건강간호학회지
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• 제12권4호
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• pp.308-315
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• 2006

Purpose: This study was conducted to identify sexual functioning in women with gynecologic cancer. Method: Sexually active women with gynecologic cancer without evidence of distant metastasis were recruited in Seoul, Korea from a university medical center. Subjects were asked to complete an anonymous mail-back survey on their sexual functioning. Result: One hundred eighty four women completed questionnaires. Their mean age was 51.0 years and 96.2% lived with their husbands. Subjects were diagnosed with cervical cancer(53.8%), ovarian cancer (27.7%), or endometrial cancer(18.5%). Sexual functioning for women with gynecologic cancer was relatively low, 15.4, in comparison to Rosen's cutoff scores of 26.6. Univariate analyses indicated that age, employment status, and their monthly income were significantly associated with sexual functioning. Tumor staging, treatment modality, and hormone replacement therapy were also significantly associated factors with women's sexual functioning. Sexual arousal, orgasm, and pain were affected by time since last treatment. Conclusion: Sexual counselling or education for women with gynecologic cancer should be considered by medical professionals in order to improve their quality of life including sexual functioning.

• The Korean Journal of Pain
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• 제9권1호
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• pp.239-243
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• 1996

MS-Contin is an oral controlled-release preparation of morphine sulfate that has been used widely in the management of advanced cancer pain. It prolongs plasma concentration of morphine with no observable accumulation properties following repeated dosing, thereby promoting uninterrupted sleep and hopefully improving patient's quality of life. The common side effects of MS Contin are nausea, vomiting, drowsiness and constipation. But these symptoms are usually mild and respiratory depression is a rare problem. We experienced respiratory depression during oral administration of MS contin for the pain management of advanced gall bladder cancer of 76 years old male patient with metastasis at liver, intestine and cervical lymph node. After we increased the dosage of MS Contin from 160mg to 220mg per day, due to abdominal pain, we observed morphine reaction of MS Contin overdose such as pinpoint pupil, deeply slow respiration below 8/minute, and drowsiness. After intravenous bolus injection of 0.4 mg naloxone followed by continuous administration of 0.2 mg/hr for 4 hours, the patient regained consciousness. The administered route of morphine was changed to intravenous PCA (patient controlled analgesia). There was no aspiration sign as confirmed by chest x-ray. The patient was comfortable and delayed no signs of respiratory depression until now.

• 대한두경부종양학회지
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• 제30권1호
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• pp.23-27
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• 2014

Low-grade myofibroblastic sarcoma is a rare disorder of malignant soft tissue tumor and is usually occurred various regions that often manifests in the head and neck region. The most common clinical presentation of this entity is non-tender cervical lymphadenopathy. This disease usually presents high possibility of local recurrence and low possibility of distant metastasis. We report a rare case of low-grade myofibroblastic sarcoma occurring in the sternocleidomastoid muscle and invading to the mastoid tip. A 56-year-old male visited the clinic with a complaint of slowly growing postauricular mass for 6 months. Mass originating from sternomastoid muscle and invasion to mastoid tip was observed by imaging studies. Surgical complete excision with simple mastoidectomy was performed via modified facelift approach. The histopathologic findings revealed malignant spindle cell tumor with positive staining with smooth muscle actin. The patient has no recurrence for 2years without any complication.