• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5729-5733
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• 2012

Background and Objectives: This study aimed to present the clinicopathological characteristics and treatment of patients with bladder carcinoma with sarcomatoid differentiation at our institution. Methods: Between 1995-2009, 950 patients were followed-up for bladder carcinoma. Among them, 14 patients with sarcomatoid carcinoma were retrospectively reviewed, and their clinical, pathological features and treatment were recorded. Results: Median age of the patients was 65 years (range: 41-86 years), 12 (86%) being male and 2 (14%) female. All the patients presented with hematuria and 11 (88%) had a history of smoking. The tumor growth pattern was solid in 10 patients, papillary in 2, and mixed in 2. In all, 5 of the patients had urothelial carcinoma with sarcomatoid differentiation and 9 were diagnosed with sarcomatoid carcinoma. Five patients underwent radical cystectomy with ileal conduit surgery, 2 patients refused cystectomy, and 8 patients underwent re-TUR. Following diagnosis, 12 of the patients died in mean 10.7 months (range: 1-48 months). Conclusion: Urothelial carcinomas with sarcomatoid features are aggressive and are usually at advanced stage at the time of diagnosis. The outcomes of multimodal treatment are not satisfactory. Significant findings of the present study are that early diagnosis positively affect survival and that gemcitabine and cisplatin in combination can positively affect survival.

• Radiation Oncology Journal
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• 제19권3호
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• pp.237-244
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• 2001

목적 : 침윤성 방광암 환자를 대상으로 TURBT (Transurethral Resection of Bladder Tumor)과 유도 항암화학요법(neoadjuvant MCV chemotherapy) 후 방사선 항암화학 병용요법(cisplatin chemotherapy and radiotherapy)을 받은 환자에서 치료의 적응도, 국소 반응율, 방광 보존율과 생존율을 알아보고자 하였다. 대상 및 방법 : 1990년 10월부터 1998년 6월까지 TURBT 시행 후 병리 조직검사 상 침윤성 방광 이행상피암으로 진단 받은 병기 T2-T4, Grade II 환자 21명을 대상으로 하였다. 치료과정은 TURBT 후 4주 간격으로 2회의 유도 MCV(methotrexate, cisplatin, vinblastine) 복합 항암화학요법을 시행하고 그 후 cisplatin과 방사선 동시 병용요법을 시행하였다. 방사선치료는 $6\~15$ MV X-ray를 사용하여 하루 1.8 Gy씩 $39.6\~45\;Gy$를 전 골반에 $4\~5$주간에 걸쳐 조사하였다. 치료 종료 후 방광내시경을 통해 관해율을 판정하여 완전 관해인 경우 $1\~2$주 후 보강 방사선조사를 cisplatin과 병용하여 19.8 Gy를 시행하였다. 부분 관해인 경우 근치적 방광 절제술을 예정하였고 수술이 불가능한 경우에는 항암제 병용 강화 방사선치료를 받도록 하였다. 환자의 추적관찰기간은 $34\~67$개월로 중앙값이 49.5개월이었다. 결과 : 총 26명의 환자가 유도 항암화학요법을 위해 등록되었으며 유도 항암화학요법과 방사선 항암화학 병용요법을 완료한 환자는 21명$(81\%)$이었다. 유도 항암화학요법과 방사선 항암화학 병용요법 후 방광내시경을 통해 완전 관해 판정을 받은 환자는 21명 중 7명$(33\%)$이었고 부분 관해 환자는 14명$(67\%)$이었다. 완전 관해 환자 중 강화 항암제 병용 방사선 19.8 Gy를 받은 환자는 7명 중 6명$(85\%)$이었고, 이들 중 5명$(14\%)$은 재발 없이 방광을 보존하였다. 부분관해 환자중 1명이 근치적 방광적출술을 받았으며 3명이 TURBT와 2회의 MCV 항암요법을, 10명이 추가의 항암화학 방사선 병용요법을 받았다. 근치적 방광적출술을 받은 1명은 수술 소견상 방광 내 종양이 존재했으나 수술 후 재발이 없었다. 전체 21명의 환자중 12명$(58\%)$이 방광을 보존하면서 생존하고 있고 8명이 방광암으로 사망하였으며 1명이 다른 질병으로 사망하였다. 전체 환자의 중앙 생존기간은 27개월이며, 5년 생존율은 $55\%$ 였다. 유도 항암화학요법과 항암제 방사선치료 후 완전 관해 환자의 경우 5년 생존율은 $80\%$, 부분 관해 환자 $14\%$로 의미 있는 차이를 보였다(p=0.001). 유도 항암화학요법과 항암제 병용 방사선치료를 받은 환자에서 grade 3 이상의 혈액학적 부작용의 빈도는 각각 백혈구 감소증 6명$(29\%)$, 혈소판 감소증 1명$(4\%)$이었으며 이로 인한 화학요법의 지연은 1명$(4\%)$에서 관찰되었다. 결론 : 침윤성 방광암 환자에서 유도 항암화학요법 및 항암제 병용 방사선치료를 적용하여 방광 보존을 및 5년 생존율에 있어 만족할 만한 결과를 얻었다. 완전한 TURBT와 유도 MCV 항암요법과 cisplatin 방사선 병용요법에서 완전관해 여부가 방광보존가능성과 생존율에 영향을 미치는 요소로 생각되고 만약 완전관해를 이루지 못하면 근치적 방광적출술을 시행하는 것이 바람직할 것이다.

• Journal of Korean Neurosurgical Society
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• 제51권4호
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• pp.208-214
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• 2012

Objective : Discal cyst is rare and causes indistinguishable symptoms from lumbar disc herniation. The clinical manifestations and pathological features of discal cyst have not yet been completely known. Discal cyst has been treated with surgery or with direct intervention such as computed tomography (CT) guided aspiration and steroid injection. The purpose of this study is to evaluate the safety and efficacy of the percutaneous endoscopic surgery for lumbar discal cyst over at least 6 months follow-up. Methods: All 8 cases of discal cyst with radiculopathy were treated by percutaneous endoscopic surgery by transforaminal approach. The involved levels include L5-S1 in 1 patient, L3-4 in 2, and L4-5 in 5. The preoperative magnetic resonance imaging and 3-dimensional CT with discogram images in all cases showed a connection between the cyst and the involved intervertebral disc. Over a 6-months period, self-reported measures were assessed using an outcome questionaire that incorporated total back-related medical resource utilization and improvement of leg pain [visual analogue scale (VAS) and Macnab's criteria]. Results : All 8 patients underwent endoscopic excision of the cyst with additional partial discectomy. Seven patients obtained immediate relief of symptoms after removal of the cyst by endoscopic approach. There were no recurrent lesions during follow-up period. The mean preoperative VAS for leg pain was $8.25{\pm}0.5$. At the last examination followed longer than 6 month, the mean VAS for leg pain was $2.25{\pm}2.21$. According to MacNab' criteria, 4 patients (50%) had excellent results, 3 patients (37.5%) had good results; thus, satisfactory results were achieved in 7 patients (87.5%). However, one case had unsatisfactory result with persistent leg pain and another paresthesia. Conclusion : The radicular symptoms were remarkably improved in most patients immediately after percutaneous endoscopic cystectomy by transforaminal approach.

• Journal of Trauma and Injury
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• 제25권3호
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• pp.101-104
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• 2012

Bladder rupture following blunt trauma is rare, and no neobladder rupture following blunt trauma has yet been reported. We present a case of neobladder rupture following blunt trauma. The patient was a 65-year-old male patient who had been treated for bladder cancer via a radical cystectomy with an orthotopic ileal neobladder four years prior to this admission, and who was admitted to our emergency department due to multiple trauma after a 1.5 m fall. Primary repair was performed for the neobladder rupture.

• Advances in pediatric surgery
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• 제12권1호
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• pp.41-46
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• 2006

Mature cystic teratoma, commonly called dermoid cyst, is the most common benign germ cell tumor of the ovary in children. Malignant transformation is rare, approximately 2 %. As laparoscopic procedures are applied widely in pediatric surgery, a female chlid with a mature cystic teratoma may be an ideal candidate for laparoscopic surgery. Two children received laparoscopic operations successfuly for lower abdominal crises, twisted adnexa. There was no operative complication. Laparoscopic approach for ovarian lesions in infancy and childhood appears to be an effective and safe method for diagnosis as well as definitive therapy.

• Journal of Chest Surgery
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• 제23권4호
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• pp.720-730
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• 1990

The complicated pulmonary emphysema including “Giant bullae” and spontaneous pneumothorax often involve both lungs, and controversy exists concerning which is the more rational means of surgical treatment-bilateral simultaneous operation or two staged operation. We report three cases of the complicated bilateral bullous emphysema and two cases of bilateral spontaneous pneumothorax treated through median sternotomy. We performed the ligation of bullae, bullectomy, cystectomy, wedge resection, and left lower lobectomy through median sternotomy. No technical problems were encountered through this approach, which provided maximum benefit with one operation In conclusions, median sternotomy may be appropriate for resection of emphysematous bullae, specially in a severe COPD patient who may be poorly tolerated the superimposed loss of respiratory function due to incisional pain, because median sternotomy permit bilateral exploration, minimal impairment of pulmonary function, simultaneous restoration of pulmonary function, less incisional pain than routine lateral thoracotomy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5589-5594
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• 2015

Cystitis and proctitis are defined as inflammation of bladder and rectum respectively. Haemorrhagic cystitis is the most severe clinical manifestation of radiation and chemical cystitis. Radiation proctitis and cystitis are major complications following radiotherapy. Prevention of radiation-induced haemorrhagic cystitis has been investigated using various oral agents with minimal benefit. Bladder irrigation remains the most frequently adopted modality followed by intra-vesical instillation of alum or formalin. In intractable cases, surgical intervention is required in the form of diversion ureterostomy or cystectomy. Proctitis is more common in even low dose ranges but is self-limiting and improves on treatment interruption. However, treatment of radiation proctitis is broadly non-invasive or invasive. Non-invasive treatment consists of non-steroid anti-inflammatory drugs (NSAIDs), anti-oxidants, sucralfate, short chain fatty acids and hyperbaric oxygen. Invasive treatment consists of ablative procedures like formalin application, endoscopic YAG laser coagulation or argon plasma coagulation and surgery as a last resort.

• 한국임상수의학회지
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• 제21권1호
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• pp.62-65
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• 2004

A 13-year-old, male Maltese was refered to Veterinary Teaching Hospital of Konkuk University with inappropriate urination and hematuria. CBC, serum chemistry profile, urinalysis and urine culture were performed. Malignant cells were found in the urine sediment. Thoracic and abdominal radiography, retrograde positive-contrast cystography, retrograde double-contrast cystography, excretory urography, ultrasonography were performed. On the retrograde positive-contrast cystography examination, irregular filling defects were present on the left side of the cranial part of the bladder. Partial cystectomy performed and then medical therapy was conducted. On histopathological examinations, the lesion was confirmed as a transitional cell carcinoma of the urinary bladder.

• 대한세포병리학회지
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• 제5권2호
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• pp.167-171
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• 1994

Small cell carcinoma of the urinary bladder is a rare tumor which occurs in about 0.48 % of all bladder tumors. We report cytologic features of small cell carcinoma of the urinary bladder in a 66-year-old man who had painless total gross hematuria, which was confirmed by partial cystectomy. In urine cytology, abundant tumor cells appeared in scattered and clustered forms in a bloody background. The tumor cells were small and uniform in size with a high nuclear/cytoplasmic ratio. The nuclei of the tumor cells were hyperchromatic, characteristically molded and showed inconspicuous nucleoli. The cytoplasms were scanty and pale blue.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2006년도 제51차 추계학술대회
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• pp.124-125
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• 2006