• Archives of Reconstructive Microsurgery
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• 제20권2호
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• pp.89-95
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• 2011

Purpose: The purpose of this study was to evaluate the clinical results of anterolateral thigh free flap on soft tissue defect following wide excision in malignant soft tissue tumor of lower extremities. Methods: Between February 2005 to April 2010, we followed up 19 cases who were undergoing anterolateral thigh free flap because of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity, including 9 cases were heel, 5 cases in foot, 3 cases in ankle, 2 cases in knee and leg. We observed that of implanted area's color, peripheral circulation at 3, 5, 7 days after operation and evaluated operating time, amount of hemorrhage, implanted skin necrosis, additional operations, complications. And we also evaluated the oncologic results, including local recurrence, metastasis, and morbidity. Results: Average operation time of wide excision and anterolateral thigh free flap was 7 hour 28 minutes. 18(94.7%) of total 19 cases showed successful engraftment, on the other hand, failure of engraftment due to complete necrosis of flap in 1 case. In 18 cases with successful engraftment, reoperation was performed in 4 cases. Among them, removal of hematoma and engraftment of flap after bleeding control was performed in 3 cases, because of insufficient circulation due to the hematoma. In the remaining 1 case, graft necrosis due to flap infection was checked, and grafted after combination of wound debridement and conservative treatment such as antibiotics therapy, also skin graft was performed at debrided skin defect area. Skin color change was mainly due to congestion with hematoma, flap was not observed global congestion or necrosis except 4 cases which shows partial necrosis on margin that treated with conservative therapy. Conclusions: Anterolateral thigh free flap could be recommended for reconstruction of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity.

• 대한골관절종양학회지
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• 제11권2호
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• pp.141-147
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• 2005

목적: 악성 흑색종의 치료 중 가장 중요한 것은 외과적 전절제술이며, 수술시 광범위 절제술을 시행한다. 저자 등은 광범위절제와 면역화학요법을 시행한 후 각 병기별 5년 생존율을 알아보고 예후에 영향을 주는 요인을 주는 요인들을 분석하고자 한다. 대상 및 방법: 1995년 3월부터 2003년 8월까지 악성 흑색종으로 진단 받았던 35명(남자 17명, 여자 18명)을 대상으로 광범위절제술과 면역화학요법을 시행한 후 추시 관찰하였다. 절제술은 종양의 크기나 피부층의 침범정도와 상관없이 종양의 변연으로부터 2 cm으로 하였고, 절제술 후 덮이지 않는 피부 결손부는 피판 이식술이나 전층 피부 이식술을 이용하였다, 면역화학요법으로는 dacarbazine (DTIC) 400 mg과 인터페론-${\alpha}$ 300만 IU를 병용 투여 하는 방법을 사용하였다. 면역화학요법은 III기 이상의 환자에게 시행하였고, 병기는 2002년 개정된 AJCC 병기를 이용하여 판정하였다. 또 이들 환자들에 대해 국소재발과 국소전이, 그리고 원격전이여부를 조사하였고, 각 병기별 5년 생존율을 조사하였다. 결과: 발생부위는 족부가 15명(42.8%)으로 가장 많았고, 족관절부 5명(14.2%), 하퇴부 2명(5.7%), 대퇴부 2명(5.7%), 수부에 5명(14.2%)이었다. 병기별 발생빈도는 IA 8명(22.8%), IB 9명(25.7%), IIA 4명(11.4%), IIB 2명(5.7%), IIIA 1명(2.8%), IIIB 2명(5.7%), IIIC 2명(5.7%) 그리고 IV기는 7명(20.0%) 이었다. 각 병기별 5년 생존율은 I기에서 94.1%, II기에서 66.8%, III기에서 40%, IV기에서 14.3%로 나타났다. 결론: 악성 흑색종은 III기 이상에서는 5년 생존율이 낮았다. 악성 흑색종의 치료는 초기에 진단하여 병기에 따라 치료의 방법을 달리하므로 수술전 병기의 확인이 매우 중요하다. 광범위 절제연에 대해서는 종양 두께에 따라 1~3 cm의 절제연으로 광범위 절제를 권유한다.

• 대한골관절종양학회지
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• 제1권1호
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• pp.84-90
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• 1995

To evaluate the role of radiation and chemotherapy after limb-saving operation in the management of soft tissue sarcoma, the authors analysed retrospectively 33 patients treated in department of Orthoaepdic Surgery and Radiation Therapy, Catholic University Medical College, in terms of survival rate, local recurrence rate and prognostic factors. There were 16 males and 17 females. The age distribution ranged from 16 to 81 years with mean age of 48. The follow-up period ranged from 2 to 10 years with average of 5.5 years. The histologic diagnoses were 9 liposarcoma(27.2%), 8 malignant fibrohistiocytoma(24.2%), 7 unclassifiable(21.2%), 3 rhabdomyosarcoma(9.1%), 2 malignant schwannoma, 2 synovral sarcoma, and 2 fibrosarcoma(6.1%) in orders. While marginal and intralesional margins were gained in 24 patients(72.7%), wide and radical margins were obtained only in 9 patients(27.3%). On postoperative 3 weeks, local irradiation of 5000-7000 cGy was delivered to all patients by shrinking field technique for 5-8 weeks. Of 33 patients, 16(45.5%) patients were received adjuvant chemotherapy in combination of adriamycin, cyclophosphamide & vicristine, or VP16 & ifosfamide based on histologic type and obtained surgical margin. The survival rates by direct method at 2 years and 5 years were 58% and 37% respectively. Local recurrences occured in 15 patients(45.5%) at average 16 months after operation. Survival rates at 2 years and 5 years were 37% and 22% in case of intralesional and manginal excision, 75% and 47% in case of wide and radical excision respectively with statistical significance(p<0.05). They were 25% and 17% in the presence of local recurrence, 67% and 42% in the absence of local recurrence respectively with statistical significance(p<0.05). Even though there was no statistical correlation between survival rate and tumor size(p>0.05), the authors considered tumor size as a significant prognostic factors as well as surgical margin and the presence of local recurrence.

• Journal of Chest Surgery
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• 제18권3호
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• pp.513-516
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• 1985

Hemangiopericytoma is a rare tumor of vascular origin, first described by Stout and Murray in 1942. It is characterized by proliferation of capillaries surrounded by pericytes. There is no characteristic clinical or radiological finding. Wide excision is the treatment of choice. A 21 year-old man was admitted with one year history of productive cough. On admission, chest film showed large lobulated mass and Right lower lobe atelectasis. Rt. pneumonectomy was performed and the tumor was confirmed as malignant hemangiopericytoma of the lung. Local recurrence didn`t occur until now.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권4호
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• pp.173-177
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• 2014

The present report describe the surgical therapy, clinical course, orthodontic treatment and morphological characteristics of an adenomatoid odontogenic tumor in the maxilla of an 11-year-old patient. The cystic tumor filled the maxillary sinus and involved a tooth. Marsupialization was accompanied by partial enucleation and applied traction to the affected tooth by a fixed orthodontic appliance. Healing was uneventful and no local recurrence was observed during a 1-year period of follow-up control.

• 임상이비인후과
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• 제29권2호
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• pp.250-253
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• 2018

Schwannomas originating from the external auditory canal are relatively uncommon whereas they are commonly found in head and neck region. The authors recently experienced a 18-year-old male with a large mass in his right side external auditory canal. The mass was reported as a schwannoma and after the local excision, no symptom or sign of recurrence was identified. We report the case with literatures.

• 대한골관절종양학회지
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• 제20권2호
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• pp.54-59
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• 2014

목적: 사지에 발생한 연부 조직 악성 근상피종의 진단, 치료 및 예후에 대하여 알아보고자 하였다. 대상 및 방법: 2008년 1월부터 2014년 10월까지 연부 조직 악성 근상피종으로 진단받고 본원에서 치료받은 6명의 환자를 대상으로 하였다. 2명의 환자는 타원에서 조직 검사 없이 무계획 절제술(unplanned excision)을 시행받은 이후 본원으로 전원되었으며, 나머지 4명의 환자는 모두 본원에서 조직 검사 및 광범위 절제술을 시행받았다. 결과: 평균 연령은 41세(33-54)였고, 남자가 3예, 여자가 3예였으며 평균 추시 기간은 28개월(9-45)이었다. 1명의 환자에서만 술 후 항암요법을 시행하였다. 연구 대상 환자 중 4명만이 악성 연부 조직 종양 의심하에 조직 검사 후 광범위 절제술을 시행하였다. 본원에서 광범위 절제술을 시행한 환자 4명은 모두 절제연에 종양 세포가 관찰되지 않았다. 무계획 절제술 이후 전원된 환자 2명 모두 본원에서 재절제술 시행받았으며, 이중 한명은 재절제술 병리 조직에서 잔존하는 종양 세포는 관찰되지 않았다. 6명의 환자 모두에게서 수술 후 평균 6개월(3-29)에 국소 재발 소견이 관찰되었고 4명의 환자에서는 수술 후 평균 7개월(3-14)에 원격 전이도 관찰되었다. 원격 전이가 발생한 4명의 환자는 모두 질병으로 인하여 사망하였고, 국소 재발만 발생한 2명의 환자중 1명은 환자는 재발하여 추시 관찰 중이며 나머지 1명의 환자는 재수술후 2년간 재발이나 전이 없이 경과 관찰 중이다. 결론: 연부 조직 악성 근상피종은 극히 드물게 발병하는 질환으로 재발과 전이를 잘 하는 공격적인 악성 연부 조직 종양으로 적절한 치료법으로는 광범위 절제술이 권장되며, 국소 재발을 줄이기 위해서는 악성 연부 조직 종양일 가능성을 염두에 두고 반드시 술 전 조직 검사를 하여 악성임을 확인하고 이후 계획된 광범위 절제술을 시행하는 것이 중요하다고 생각된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권3호
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• pp.281-288
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• 2001

림프관종의 치료에 있어 전통적으로 수술적요법만이 선호되어져 왔으나 최근 Ogita 등에 의해 소개된 OK-432는 안전성과 효과면에서 기존의 경화제에 비해 뚜렷이 구별되는 효과를 지니고 있는 것으로 여러 저자등에 의해 보고되고 있다. 특히 수술이 매우 어려운 부위에 존재하는 경우라든지 수술후 재발된 증례등에서 일차 혹은 이차적으로 투여하여 높은 성공률을 보였다고 하였고 더불어 OK-432 투여후 시행된 수술시에도 섬유성유착등의 어려움없이 병소를 절제할 수 있다고 하였다. 본 증례의 경우도 일차적인 OK-432 투여후 8개월째 시행된 이차적인 수술에서 큰 어려움없이 병소를 절제할 수 있었다. 이에 저자등은 좌측 혀 및 구강저와 경부의 급성 부종으로 인한 호흡부전 및 대설증의 증상을 보여 본원 소아과에서 의뢰된 생후 5개월된 환자에게 병력 및 임상검사와 방사선적 검사를 시행한 결과 림프관종으로 진단하고 일차적으로 흡입천자를 통한 감압술과 OK-432 를 통한 경화요법을 시행하였고 이차적인 연속수술을 시행하여 병소를 완전히 절제하였으며 술후 현재까지 재발소견없이 양호한 결과를 보였기에 이에 보고하고자 한다.

• 대한골관절종양학회지
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• 제1권1호
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• pp.1-6
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• 1995

Giant cell tumors are primary bone tumors originating from non-osteoblastic connective tissue. The sites of involvement were commonly distal femur, proximal tibia, proximal humerus, distal radius and others (including os calcis, ilium and sacrum). Giant cell tumor located around knee joint has been difficult to treat because of local recurrence following curettage with or without bone graft. Although primary resections reduce recurrence of the lesion, the joint function will be markedly impaired. Marginal excision was very often complicated by a loss of joint integrity since all the giant cell tumors occupy juxtaarticular positions. Techniques involving physical adjuncts(high speed burr and electric cauterization) have been used in the hope of decreasing the rate of local recurrence and avoiding the morbidity of primary resection. A meticulous clinical, radiological and histological evaluation is needed to choose the correct treatment, keeping in mind the possibility of recurrence after each treatment modality.

• Journal of Chest Surgery
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• 제26권3호
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• pp.204-208
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• 1993

The review of 68 patients, who were diagnosed as spontaneous pneumothorax during the period from Dec, 1991. to Jul, 1992. were performed thoracoscopy of 70 cases under local anesthesia with 1% lidocaine at the department of thoracic & cardiovascular surgery, HanYang University Hospital. Clinical data on distribution of Age & Sex, Location, Frequency of Reccurrence and other aspects of pneumothorax were summerized.37 cases were treated by thoracoscopic management and closed thoracostomy. As thoracoscopic management, Electrocauterization of bullae or blebs[37 cases], Endo-clip application [2 cases], Removal of foreign body[1 case] were performed. 31 cases were cured by open thoracotomy. The thoracotomy indications under thoracoscopic finding were followed as: 1. Severe pulmonary adhesion and destroyed lung parenchyme 2. multiple bullae or blebs on several areas 3. finding of pulmonary tuberculous caseous lesion 4. persistant air leakage after 7 days from thoracoscopic management Excision, wedge resection of bullae or blebs was performed in most cases [22 cases], 2 cases by median sternotomy and Segmentectomy of 7 cases were carried out depending on the pathologic change of lung.There was no operative mortality and Follow-up for all patients were showed good results.