• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권3호
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• pp.152-159
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• 2012

Objectives: This study evaluated bisphosphonate-related osteonecrosis of the jaws (BRONJ) in patients diagnosed with malignant bone tumors. Demographic findings, laboratory, and radiographic analyses were performed to characterize disease severity and progression. Materials and Methods: Patients who had been diagnosed with BRONJ (2005-2010) at the authors' hospital according to the American Association of Oral and Maxillofacial Surgeons were investigated. Twenty-one patients (12 with multiple myelomas, 7 with breast cancer, and 2 with prostate cancer) who had been treated with bisphosphonates (BPs) for malignant bone tumors were included. Radiographic evaluations with a panorama, computed tomography, whole body bone scan, and laboratory findings were evaluated for erythrocyte sedimentation rate (ESR), c-reactive proteins (CRPs), and c-terminal cross-linked telopeptides (CTXs). Results: The average age of the patients was 64.3 (range 51-80), and they were treated with BPs for an average of $35{\pm}19$ months before BRONJ was diagnosed. Types of BPs were zolendronic acid (81%, intravenous [IV]), pamidronate (4.8%, IV), zoledronic acid+pamidronate (4.8%, IV), alendronate (4.8%, per os [PO]), and ibadronate (4.75%, PO). Extraction (67%) and persistent irritation of dentures (20%) were the most common triggering factors. BRONJ in the mandible was reported in 62% of the cases, in the maxilla 24%, and both 14%. BRONJ occurred more frequently in patients with multiple myelomas (n=12, 57.1%). Most of the patients revealed an advanced BRONJ stage; Stage I (n=2, 9%), Stage II (n=13, 62%), and Stage III (n=6, 29%). Conclusion: The differences of the ESR, CRP, and CTX values between the BRONJ-recurring and non-recurring patients after the treatment were not evident. Later stage BRONJ patients showed lower CTX levels. A drug holiday after the diagnosis of BRONJ did not remarkably influence the surgical outcomes. However, the limited number of patients in the study should be considered.

• Archives of Plastic Surgery
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• 제32권6호
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• pp.760-762
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• 2005

Synovial Sarcoma is the fourth most common sarcoma, accounting for 8-10 % of all sarcomas. Synovial sarcoma is highly malignant tumor of mesenchymal origin but rarely occurres in head and neck area. Less than 100 cases of synovial sarcoma occurring in head and neck area have been reported all over the world. Pathologically, there is two type of synovial sarcoma: monophasic variant is composed of only one cell type and "classic" (biphasic) synovial sarcoma has two cellular component, a spindle cell(fibrosarcoma-like) component and a pseudoepithelioma component. Recommended treatment is wide resection with negative margins. The role of chemotherapy and radiation therapy is controversial. We experienced a 42-year-old male patient with slowly enlarging, deep seated mass on right cheek. In the first operation, we suggested that the mass maybe benign tumor. But, initial excisional biopsy specimen of the primary lesion was consistent with synovial sarcoma. The final diagnosis was monophasic synovial sarcoma which was composed of spindle cells. Radical resection was performed two months later because remnant tumor was found on follow up MRI. No further treatment was done. There were no recurrence or metastasis on follow up MRI, chest CT and whole body bone scan after 15 months. This is a report of a rare case of synovial sarcoma of the face with a literature review.

• 대한두경부종양학회지
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• 제14권2호
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• pp.214-219
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• 1998

Objectives: To assess the effectiveness of the low-dose(30mCi) I-131 ablation therapy for remnant thyroid tissue following total thyroidectomy for differentiated thyroid cancer. Methods: Between March 1995 and December 1997, forty-eight patients were given ablative doses(30mCi) of I-131 after total thyroidectomy for differentiated thyroid cancer in the presence of I-131 uptake in remnant thyroid tissue. Effective ablation of remnant thyroid tissue was determined by following I-131 whole body scan. if remnant thyroid tissue remained, we repeated the same management at 6 months interval. Results: Thirty-eight(79.1%) patients had papillary, 8(16.7%) follicular, 1(2.1%) medullary and 1(2.1%) Hurthle cell type cancer. Forty-eight patients underwent total thyroidectomy, among those central neck dissection was performed in 35 cases, and modified radical neck dissection in 14 cases. Postoperative complication developed in 8 cases, which included 4 cases of transient hypoparathyroidism, 1 case of permanent hypoparathyroidism, 2 cases of transient recurrent laryngeal nerve palsy, and 1 case of wound hematoma. There were significant remnant thyroid tissue in 46 cases(95.8%) of patients after total thyroidectomy, which could be ablated by low dose(30mCi) I-131. There were no statistical difference between operative procedures and number of treatment of I-131. Conclusions: These results suggested that repeated low-dose(30mCi) I-131 therapy would be needed, therefore, high -dose I-131 therapy could be considered as ablation therapy for the remnant thyroid tissue after total thyroidectomy for differentiated thyroid cancer.

• Journal of Trauma and Injury
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• 제35권3호
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• pp.215-218
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• 2022

The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.

• 대한정형외과학회지
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• 제56권3호
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• pp.266-271
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• 2021

임신 및 수유와 연관된 골다공증은 젊은 여성에서 골다공증성 척추 압박골절을 일으킬 수 있는 희귀한 질환이다. 환자들은 주로 요통을 호소하며, 이는 임신과 출산, 수유에 의한 통증으로 오인되기 쉬워 빠른 진단과 치료가 어렵다. 저자들은 요통을 주소로 내원한 29세 여자 환자와 31세 여자 환자에 대해 신체 진찰, 단순 방사선 검사, 전신 골주사 검사, 자기공명영상 검사, 골밀도 검사, 혈액 검사 등을 통하여 임신과 수유에 연관된 골다공증성 척추 압박골절을 진단하였으며, 테리파라타이드(teriparatide) 주사와 흉요천추 보조기 착용, 칼슘과 비타민 D 제제 복용을 통해 증상이 호전된 2예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 한국임상수의학회지
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• 제40권2호
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• pp.158-163
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• 2023

A 9-year-old spayed female Shih-Tzu was presented with a mass on the upper eyelid of the right eye (OD). The eyelid mass continued to enlarge along the eyelid margin and the eyelid skin. Throughout the follow-up examinations, the mass did not affect the palpebral conjunctiva OD. Until 9 months since the mass was first identified, the dog did not show any clinical signs related to the mass. However, after 11 months, the owner complained of the dog's discomfort on OD and decided on surgical excision of the mass. There were no abnormalities in the complete blood count and serum chemistry profiles. The pentagonal resection was performed to completely remove the mass in the eyelid. There were no suspicious findings of metastasis on whole-body computed tomography scan immediately before the surgery. On histopathology and immunohistochemistry for multiple myeloma oncogene-1, the eyelid mass was diagnosed as extramedullary plasmacytoma (EMP). Surgical margin of the mass was clearly cut. No recurrence was observed during the 5-month follow-up. EMPs on the eyelid have rarely been reported in dogs. Although EMP is a benign tumor, the mass showed invasive growth and grew toward the skin rather than the palpebral conjunctiva. No recurrence occurred when surgically removed with clean margins.

• 한국의학물리학회지:의학물리
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• 제10권1호
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• pp.23-32
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• 1999

자기공명영상과 relaxogram 기법을 통합적으로 운용하는 새로운 기법을 도입하여 인체나 생체에서의 지방성분을 연구하는데 매우 우수한 기법을 개발하고자 하였다. 본 기법을 검증하기 위하여 미리 성분비를 알고 있는 phantom들을 제작하여 자기공명영상과 역 라플라스 변환에 기초한 CONTIN 기법을 적용하였다. phantom 들은 근육내에 미세한 형태로 존재하는 지질을 모방하도록 제작하였으며 정확한 분석을 위해 400 MHz NMR 장비를 이용하여 혼합된 두 물질의 양성자 스핀 밀도의 차이를 먼저 분석하여 성분비 계산시 보정인자로 사용하였다. 자기공명영상은 스핀반향기법을 사용하여 반복시간 (TR)을 달리하며 45개의 영상을 획득하였고 얻어진 영상들은 CONTIN 기법을 사용하여 분석하였다. 분석 결과로 얻어진 relaxogram 으로부터 스핀이완시간의 분포 및 상대적인 성분비를 계산하였다. 스핀밀도의 차이를 보정한 후의 실제 성분비와 본 기법으로부터 계산된 성분비는 $\pm$7% 오차내에서 서로 잘 일치하는 결과를 보였다. 결론적으로 자기공명영상과 relaxogram 기법을 통합적으로 운용하는 경우 자기공명영상의 대조도만으로는 분석이 불가능한 미 세 지질의 함량 및 분포를 매우 우수한 정확도를 가지고 분석할 수 있을 것으로 사료된다.

• 대한두경부종양학회지
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• 제15권1호
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• pp.46-51
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• 1999

Background: Total thyroidectomy and postoperative radiodiodine ablation therapy in differentiated thyroid carcinomas enhance the reliability of serum thyroglobulin(Tg) levels and radioiodine scan in detecting recurrence or distant metastasis. There have been, however, some limitations in using these methods under certain conditions. Recently, several reports have indicated that thyroid peroxidase(TPO) could be used as an alternative tumor marker. We aimed to estimate the significance of serum TPO levels in differentiated thyroid carcinoma. Materials and Methods: Forty-eight patients who had undergone total thyroidectomy due to papillary thyroid carcinomas and who had been followed-up for at least 3 years were classified into two groups: 27 patients without any evidence of recurrence in group 1; and 20 patients with recurrence or distant metastasis in group 2. All patients were examined by radioiodine scans. Serum Tg, TSH, antithyroglobulin antibody, and TPO were measured and the relationships were statistically analyzed. The sensitivity and specificity of $^{131}I$ scan, serum Tg, and serum TPO were evaluated. Results: Serum Tg levels were $3.81{\pm}5.16ng/mL$ in group 1 and $147.02{\pm}193.75ng/mL$ in group 2. Only 2 patients in group 1 showed Tg levels exceeding 10ng/mL. In contrast, 4 patients in group 2 were under 10ng/mL. Serum antithyroglobulin antibody and TSH levels showed no statistical difference between the two groups. In group 1, 16 patients showed negative serum TPO results, and 4 patients in group 2 showed negative results. There was no correlation among serum Tg levels, antithyroglobulin antibody titers, and serum TPO levels in each group. In group 2, 4 patients with negative serum Tg levels showed positive TPO results and positive whole body scans. Two cases with false negative $^{131}I$ scans showed positive serum TPO and Tg results. In 4 cases showing false negative serum TPO levels, serum Tg levels and $^{131}I$ scans were positive. Conclusion: Serum Tg levels, radioiodine scans, and serum TPO levels can be clinically used as complementary methods in the diagnosis of recurrent or metastatic thyroid carcinomas. Serum TPO levels may be helpful when other methods fail to detect recurrences or distant metastasis in highly suspected patients.

• Investigative Magnetic Resonance Imaging
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• 제7권2호
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• pp.108-115
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• 2003

목적 : MRI를 촬영하면서 동시에 측정한 뇌전도 신호에 가장 크게 영향을 미치는 것은 경사자계 유발 잡음이다. MRI와 동시에 측정한 뇌전도 신호에서 전류원 국지화를 수행할 때, 경사자계 유발 잡음이 미치는 영향을 분석하고자 한다. 대상 및 방법 : 사람의 머리와 유사하게 만든 뇌전도 팬텀과 MR compatible 뇌전도 측정시스템, 그리고 3.0 Tesla MRI 시스템을 실험에 사용하였다. 3.0 Tesla MRI 시스템 안에 전류원이 설치되어 있는 뇌전도 팬텀을 놓고, EPI 촬영을 하는 동안 뇌전도 신호를 측정하였다. 경사자계의 세기와 전류원의 위치를 조절하면서 뇌전도 신호 측정을 하였고, 측정된 뇌전도 신호에 대하여 전류원 국지화를 수행할 때 나타나는 국지화 오차를 평가하였다. 결과 : 경사자계 유발잡음에 의한 국지화 오차는 경사자계의 세기와 전류원의 위치에 따라 변화하는 것을 관찰하였다. 또한 경사자계 유발잡음이 Gaussian 잡음보다 전류원 국지화에 미치는 영향이 큰 것을 관찰하였으며, 경사자계 유발 잡음의 전력이 뇌전도 신호 전력의 $10\%$ 이하일 때는 전류원 국지화에 미치는 영향이 미미함을 관찰하였다. 결론 : 경사자계 유발 잡음 전력을 뇌전도 신호 전력의 $10\%$ 이하로 줄인다면 MRI를 하면서 동시에 측정한 뇌전도 신호로도 전류원 국지화를 할 수 있음을 알 수 있었다.

• 핵의학기술
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• 제13권3호
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• pp.24-30
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• 2009

국내의 암 발생 변화 추이를 고려해보면, 현재 남성에게 발생하는 전립선암의 비중이 나날이 증가하고 있다. 전립선 암의 경우 림프절이나 뼈에 전이가 되면 90% 이상 사망에 이른다. 따라서 최근 핵의학 분야에서는 전립선 암의 뼈 전이를 보다 정확하게 진단하기 위해 여러 영상기법과 방사성 의약품의 개발이 진행, 소개되고 있다. 본 연구에서는 전립선 암세포의 뼈 전이에 대한 보다 정밀한 영상을 획득하여 진단능을 향상시키는 $^{18}F$-Fluoride PET/CT의 유용성을 알아보고자 한다. 본 연구는 총 33명의 전립선암으로 진단된 환자로서, 평균 $67.8{\pm}10.2$세의 남자를 대상으로 하였다. 동일한 환자에게 각각 전신 뼈 검사(Whole Body Bone Scan; WBBS)와 뼈 양전자 방출 컴퓨터 단층 촬영(18F-Fluoride Positron Emission Tomography/Computed Tomography; $^{18}F$-Fluoride PET/CT)을 시행하였으며, 각 검사에서 나타난 병변을 확인하여 ROC곡선(Receiver Operating Characteristic Curve)을 통해 AUROC (The Area Under an ROC)분석하였다. 또한 두 검사의 민감도와 특이도, 양성예측률과 음성예측률 그리고 두 검사의 정확도를 비교 분석하였다. 총 33명 중 22명의 환자(66.6%)에게서 뼈 전이가 있었으며, $^{18}F$-Fluoride PET/CT에서 모두 우수한 결과치가 나타났다. WBBS의 민감도는 63.6%, 특이도는 81.8%였고, $^{18}F$-Fluoride PET/CT에서는 민감도 100%, 특이도 90.9%로 나타났으며, AUROC를 비교한 결과 WBBS에서 0.778, $^{18}F$-Fluoride PET/CT는 0.942로 분석되었다. $^{18}F$-Fluoride PET/CT는 WBBS에 비하여 높은 민감도와 특이도를 보였으며, 3D 영상 구현으로 암세포의 뼈에 대한 전이성 병소를 더욱 정확하고 명확하게 발견할 수 있었다. 또한 WBBS의 장시간 검사에 비하여 $^{18}F$-Fluoride PET/CT는 상대적으로 단시간에 뼈의 생리적인 변화에 대한 정확한 영상을 얻을 수 있어 환자의 불편함을 최소화 할 수 있었다. 고가 검사비용에 대한 부담을 줄일 수 있다면 $^{18}F$-Fluoride PET/CT를 통해 더욱 정확한 영상을 제공하여 임상에서의 진단능을 향상 시킬 수 있을 것으로 사료된다.