• Journal of Chest Surgery
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• 제51권4호
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• pp.280-282
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• 2018

Unilateral absence of a pulmonary artery (UAPA) is a rare congenital anomaly that may present with various symptoms, depending on the nature and severity of other cardiovascular anomalies. Furthermore, contralateral lung surgery in patients with UAPA is extremely rare, and clinical experience is limited. This report describes a case of surgical treatment of contralateral primary lung cancer in a patient with isolated UAPA. A 56-year-old man was diagnosed with primary lung cancer accompanied by isolated UAPA on the contralateral side. He underwent meticulous cardiorespiratory function tests preoperatively. We performed a right lower lobectomy. Although in the immediate postoperative period, the patient suffered from a mild decline in his respiratory function, he recovered uneventfully. The present case shows that preoperative awareness of UAPA and meticulous perioperative management enable contralateral lung surgery to be performed safely.

• Tuberculosis and Respiratory Diseases
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• 제44권6호
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• pp.1426-1432
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• 1997

Sj$\ddot{o}$gren's syndrome(SS) is a chronic inflammatory disorder characterized by lymphocytic infiltration of lacrimal and sailvary glands, which results in dry eyes and dry mouth. SS may exist as a primary condition or as a secondary condition in association with connective tissue disease such as rheumatoid arthritis, systemic lupus erythematosus, or progressive systemic sclerosis. We experienced a patient with primary SS who developed multiple bullae, nodular type of pulmonary amyloidosis and lymphocytic interstitial peumonitis. We believe this to be the first reported case of SS acompanied by these three types pulmonary manifestations at the same time.

• 대한두경부종양학회지
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• 제31권1호
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• pp.31-33
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• 2015

The extranodal non-Hodgkin lymphoma is uncommonly occurred in larynx, accounting for less than 1% of all laryngeal neoplasm. In general, the laryngeal lymphoma is appeared as submucosal mass without mucosal ulceration and is most commonly found in supraglottis. The primary laryngeal lymphoma constitute a diagnostic challenge because they are characterized by absence of clinical and gross differential criteria, compared with squamous cell carcinoma (SCC). We encountered a 74-year-old man with hoarseness and lump sensation in the throat. On direct laryngoscope, multiple ulcerative and exudative mass in glottis and supraglottic areas were observed. The patient was finally diagnosed as large B-cell lymphoma through the laryngeal microsurgery. He received radiation therapy and there is no evidence of recurrence. Although the laryngeal mass has superficial mucosal change, primary laryngeal lymphoma must be included in the differential diagnosis.

• 대한두경부종양학회지
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• 제10권2호
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• pp.185-191
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• 1994

Authors reviewed 73 cases of primary skin cancer arising from head and neck, including comparative clinical data of 63 cases of squamous cell carcinoma and basal cell carcinoma retrospectively. There was no significant sexual predilection in each type of cancer and 77% of all cases were occurred after age of 50. The data of occurring site and occupation(farmer; 41%) implied that sunlight exposure strongly concerned in development of skin cancer. Comparing the data of 63 cases of squamous cell carcinoma and basal cell carcinoma, authors found out no remarkable difference in mean diameter of primary lesion at first visit of clinic, but some difference in mean duration, the percentage of the cases less than 1 year­duration and percentage of T1 lesion with no statistical significance(p>0.05). Combination of surgery and radiotherapy had relatively lower recurrence rate (11%) than surgery alone (13%). Squamous cell carcinoma had higher recurrence rate(34%) and metastasis rate(28%) than basal cell carcinoma; 6% and 3%, respectively(p<0.05).

• Clinical Pain
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• 제19권1호
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• pp.40-44
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• 2020

The foot or lower extremity is rarely the initial site in adult-onset dystonia, whereas dystonia in children often begins in the foot. Isolated lower extremity dystonia in adults is rarely on a primary basis. Oral anti-dystonic medications have been found unsatisfactory in providing adequate symptomatic relief. On the other hand, botulinum toxin injections have been reported as beneficial. It is also known that personalized orthosis can be an effective solution for patients of dystonia. The purpose of this report is to demonstrate a case of primary focal foot dystonia that was effectively treated with botulinum toxin injection and the custom-made ankle-foot orthosis.

• 대한두경부종양학회지
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• 제19권1호
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• pp.34-40
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• 2003

Objective: To analyze the treatment-related parameters after the radiotherapy of T1N0 squamous cell carcinoma of the glottic larynx. Materials and Methods: Between October 1989 and August 2000, 54 patients with histologically proven T1N0 squamous cell carcinoma of the glottic larynx who received definitive radiation therapy in Department of Radiation Oncology, Asan Medical Center were analyzed. They were all males with age ranged from 31 to 80 years (median 61 years). 1997 AJCC stages were 31 T1a, 23 T1b. Patients were treated with 4-MV X-rays with a parallel-opposed two-field technique. Ten patients received 66.0-68.4Gy at 1.2Gy per fraction twice daily, 21 patients received 64.8-66.6Gy at 1.8Gy per fraction once daily, and 23 patients received 66.0Gy at 2.0Gy per fraction once daily. Follow-up period was 16-119 months (median 56 months). Results: 5-year overall survival and local control rates for patients with T1 lesions were 87.0% and 88.5%, respectively. 5-year local control with larynx preservation rate was 90.5%. Host and tumor-related prognostic factors including age, stage, anterior commissure involvement and tumor bulk proved not to be significant. Only shorter overall treatment time among treatment-related factors had correlation with imporved local control. Conclusion: Comparable high local control rate with organ preservation was achieved with primary radiation therapy and salvage surgery. Shortening of overall treatment time is related to improved local control rate. To determine the optimal fractionation scheme, randomized trial is mandatory.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.228-234
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• 2001

Objective : The goal of this study was to identify variables that were predictive of recurrence in primary intracranial ependymomas. Methods : We analyzed variables affecting recurrence in 30 patients with primary intracranial ependymomas. Age, location, CSF cytology, seeding on neuroimaging study, tumor grade, extent of surgery, use of chemotherapy, chemotherapy regimen, use of radiotherapy, and radiotherapy field were entered to test their impacts on recurrence. Results : Follow-up ranged from 2 to 110 months. Tumors were recurred at the primary tumor site only in 13 patients (43.3%). The overall average recurrence free period was 55 months, with overall recurrence free rates at 3 and 6 years of 61.0% and 20.9%, respectively. Extent of surgery was the strongest variable affecting recurrence. The median recurrence free period and 3-year recurrence free rate were 72 months and 78.4% for patients having complete excision and 33 months and 0% for those having incomplete excision(p=0.05). Other prognostic variables like age, location, tumor grade, use of chemotherapy, and use of radiotherapy did not affect recurrence(p=0.2848, 0.7899, 0.1714, 0.2157, 0.7076, respectively). Conclusions : Intracranial ependymomas have a propensity to recur after treatment, and recurrence at the primary site is still the main obstacle to cure. Among various variables, only extent of resection had the strongest impact on recurrence. Additional studies may still be needed to precisely define the prognostic variables on recurrence in intracranial ependymomas.

• 농촌의학ㆍ지역보건
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• 제2권1호
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• pp.30-35
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• 1977

Health care conditions in Korea are gradually improving along with the economic and social development. However, the volume of disease is still great, especially in rural areas. This study attempts, therefore, to initiate a comprehensive proposal of rural health care delivery system. The proposal is constructed three parts, problem of health care system, medical cost, medical education system. The proposal consist of the following components: I. The health care system 1. health sub-center is required to be locate in "Myun" the basis administrative unit of local government for delivering primary health care. But, in the viewpoint of medical economics, the primary health care is operated cautiously. 2. Health center is desirable to provide health services in coordinating the health sub-center and other private health institution. 3. The secondary health care is performed in regional combination hospitals, and the attitude that doctors accomodate this system is required. II. The medical cost, Insurance In the expenditure of medical care, the method of a third person's payment is required absolutely. III. The medical education system. 1. The medical education system (process) is changed from the medical education to regional doctor education. 2 In the nurse education system. nursing technical high school is resurrected.

• Journal of Korean Neurosurgical Society
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• 제53권4호
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• pp.228-234
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• 2013

Objective : We have limited understanding on the presentation and survival of primary spinal sarcomas. The survival, recurrence rate, and related prognostic factors were investigated after treatment for primary sarcomas of the spine. Methods : Retrospective analysis of medical records and radiological data was done for 29 patients in whom treatment was performed due to primary sarcoma of the spine from 2000 to 2010. As for treatment method, non-radical operation, radiation therapy, and chemotherapy were simultaneously or sequentially combined. Overall survival (OS), progression free survival (PFS), ambulatory function, and pain status were analyzed. In addition, factors affecting survival and recurrence were analyzed : age (${\leq}42$ or ${\geq}43$), gender, tumor histologic type, lesion location (mobile spine or rigid spine), weakness at diagnosis, pain at diagnosis, ambulation at diagnosis, initial treatment, radiation therapy, kind of irradiation, surgery, chemotherapy and distant metastasis. Results : Median OS was 60 months, the recurrence rate was 79.3% and median PFS was 26 months. Patients with distant metastasis showed significantly shorter survival than those without metastasis. No factors were found to be significant relating to recurrence. Prognostic factor associated with walking ability was the presence of weakness at diagnosis. Conclusion : Primary spinal sarcomas are difficult to cure and show high recurrence rate. However, the development of new treatment methods is improving survival.

• Journal of Chest Surgery
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• 제44권1호
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• pp.25-31
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• 2011

Background: Mature autogenous arteriovenous fistulas have better long term patency and require fewer secondary interventions compared to arteriovenous prosthetic graft. Our Study evaluated vascular patency rates and incidence of interventions in autogenous arteriovenous fistulas and grafts. Material and Methods: A total of 166 vascular access operations were performed in 153 patients between December 2002 and November 2009. Thirty seven caeses were excluded due to primary access failure and loss of follow-up. One group of 92 autogenous arterioveous fistulas and the other group of 37 arteriovenous prosthetic grafts were evaluated retrospectively. Primary and secondary patency rates were estimated using the Kaplan-Meier method. Results: The primary patency rate (84%, 67%, 51% vs. 51%, 22%, 9% at 1, 3, 5 year; p=0.0000) and secondary patency rate (96%, 88%, 68% vs. 88%, 65%, 16% at 1, 3, 5 year; p=0.0009) were better in autogenous fistula group than prosthetic graft group. Interventions to maintain secondary patency were required in 23% of the autogenous fistula group (average 0.06 procedures/patient/year) and 65% of prosthetic graft group (average 0.21 procedures/patient/year). So the autogenous fistula group had fewer intervention rate than prosthetic graft group (p=0.01) The risk factor of primary patency was diabetus combined with ischemic heart disease and the secondary patency's risk factor was age. Conclusion: Autogenous arteriovenous fistulas showed better performance compared to prosthetic grafts in terms of primary & secondary patency and incidence of interventions.