• Archives of Plastic Surgery
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• 제33권6호
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• pp.706-710
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• 2006

Purpose: Keloid is a clinical term characterized by elevation and extension of scar tissue beyond wound margin. Currently, there is no known treatment that shows consistent effect in all patients. Postoperative radiation therapy is known to prevent recurrence of keloid. Methods: We reviewed data of patients who had undergone operation or operation followed by radiation therapy at our institute for the last 12 years. Follow up was possible in 39 patients(21 patients treated only by operation and 18 treated by operation and radiation therapy) We then investigated recurrence in both groups by VAS score. By mail, patients were asked to score their current condition on the bar in 4 aspects(itching, pain, mass lesion(by patients and other persons)). Two criteria were used for defining successful treatment. One is the case which total VAS score was 0, and the other is sum of VAS score of mass lesion was 0 to 5. Results: In the former, recurrence rate is 90.5% in operations-only group but 66.7% in operations plus radiation therapy group(p < 0.05). In the latter, recurrence rate is 66.7% in operation-only group but 22.2% in operations plus radiation therapy group(p < 0.05). Conclusion: These results shows postoperative radiation therapy is effective method in keloid treatment.

• Radiation Oncology Journal
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• 제37권3호
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• pp.193-200
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• 2019

Purpose: To explore the role of salvage radiotherapy (RT) for recurrent thymoma as an alternative to surgery. Materials and Methods: Between 2007 and 2015, 47 patients who received salvage RT for recurrent thymoma at Yonsei Cancer Center were included in this study. Recurrent sites included initial tumor bed (n = 4), pleura (n = 19), lung parenchyma (n = 10), distant (n = 9), and multiple regions (n = 5). Three-dimensional conformal and intensity-modulated RT were used in 29 and 18 patients, respectively. Median prescribed dose to gross tumor was 52 Gy (range, 30 to 70 Gy), with equivalent doses in 2-Gy fractions (EQD₂). We investigated overall survival (OS), progression-free survival (PFS), and patterns of failure. Local failure after salvage RT was defined as recurrence at the target volume receiving >50% of the prescription dose. Results: Median follow-up time was 83 months (range, 8 to 299 months). Five-year OS and PFS were 70% and 22%, respectively. The overall response rate was 97.9%; complete response, 34%; partial response, 44.7%; and stable disease, 19.1%. In multivariate analysis, histologic type and salvage RT dose (≥52 Gy, EQD₂) were significantly associated with OS. The high dose group (≥52 Gy, EQD₂) had significantly better outcomes than the low dose group (5-year OS: 80% vs. 59%, p = 0.046; 5-year PFS: 30% vs. 14%, p=0.002). Treatment failure occurred in 34 patients; out-of-field failure was dominant (intra-thoracic recurrence 35.3%; extrathoracic recurrence 11.8%), while local failure rate was 5.8%. Conclusion: Salvage RT for recurrent thymoma using high doses and advanced precision techniques produced favorable outcomes, providing evidence that recurrent thymoma is radiosensitive.

• Radiation Oncology Journal
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• 제31권1호
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• pp.1-11
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• 2013

Purpose: Compared to conventional radiotherapy (RT), intensity-modulated radiotherapy (IMRT) significantly reduces the rate of treatment-induced late toxicities in head and neck cancer. However, a clear survival benefit of IMRT over conventional RT has not yet been shown. This study is among the first comparative study to compare the survival rates between conventional RT and helical tomotherapy in head and neck cancer. Materials and Methods: From January 2008 to November 2011, 37 patients received conventional RT and 30 patients received helical tomotherapy for management of head and neck cancer. We retrospectively compared the survival rates between patients treated with conventional RT and helical tomotherapy, and analyzed the prognostic factors for survival. Results: The 1- and 2-year locoregional recurrence-free survival rates were 61.2% and 58.1% for the conventional RT group, 89.3% and 80.3% for the helical tomotherapy group, respectively. The locoregional recurrence-free survival rates of the helical tomotherapy group were significantly higher than conventional RT group (p = 0.029). There were no significant differences in the overall and distant metastasis-free survival between the two groups. RT technique, tumor stage, and RT duration were significant prognostic factors for locoregional recurrence-free survival. Conclusion: This study showed the locoregional recurrence-free survival benefits of helical tomotherapy in the treatment of head and neck cancers.

• 한국동물위생학회지
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• 제32권2호
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• pp.119-124
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• 2009

The epidemiological survey of mass outbreak region of bovine tuberculosis from January of 2007 through May in 2009. The results were enumerated as follows. The results of tuberculin skin test are: 7 (0.4%) out of 1,697 in 2007, 61 (2.8%) out of 2,163 in 2008, 80 (4.9%) out of 1,639 in 2009. The sex and age distribution among the incidence of positive: 135 (91.8%) out of 147 in female, 12 (8.2%) in male. Among female, age 1: 6.1%, age 2: 30.6%, 3: 38.8%, 4: 14.2%, 5: 0.7% and 6: 1.4%. Among male, age 1: 4.1%, 2: 1.4%, 3: 2.7% and more frequent occurrence in age 3, 38.8% in female and 2.7% in male. The rate of recurrence by farms: recurrence 1: 6 (35.3%), 2: 9 (52.9%), 3: 1 (5.9%), 6: 1 (5.9%), The recurrence rate of 2 or more was 64.7%. The ELISA test result among 114 heads over 14 farms: 75 (65.8%) showed positive and 39 (34.2%) negative. Geographical distribution of recurrence is characterized as concentrated along the major traffic and stream crossing the village, and spread from the high elevation to downward area.

• 대한기관식도과학회지
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• 제8권1호
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• pp.81-86
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• 2002

Background and objectives : There may be frequent lymphatic neck metastasis among supraglottic cancer patients after their primary surgery. The aim of this study was to evaluate the effectiveness of prophylactic neck dissections in supraglottic cancer patients to lower the neck metastasis. Material and method : The authors retrospectively reviewed medical records of 52 patients (7 females. 45 males) who had received the operations for the supraglottic cancer from 1995 to 2000. They were preoperatively examined with Computer Tomographic images, and also examined by the cervical neck palpations. Postoperative pathologic specimens were reviewed and the Pathologic stagings were confirmed by the pathologist. Results : Among 52 patients who received surgery for supraglottic carcinoma, 5 patients received ipsilateral neck dissection, 12 patients received ipsilateral neck dissection with postoperative radiation therapy, 10 Patients received bilateral neck dissection and 25 patients received bilateral neck dissection with postoperative radiation treatment. In comparison of the data of N0 to N+ conversion rate of neck, there were 11 ipsilateral T3 N0 patients and 2 patients(18%) were converted to N+ status, and there were 8 Patients with T4 N0 stages, and 3 patients(38%) were converted to N+ status. In comparing the data of contralateral neck dissection on N0 patient, there were 8 patients of T3 N0 patients, and there was 1 patient (13%) who showed recurrence. There were 5 patients of T4 N0 stages and there was 1(20%) patient with recurrences. When the ipsilateral N stages were N2a, and N2b, there 1 case of contraleral N+ conversions, respectively. In recurrences, there were 2 patients of N2b staged patients and 1 patient of N2c patient that showed recurrence during the follow up period. Conclusion : This data shows that at least an ipsilateral neck dissection is necessary in order to prevent the recurrences, and also suggests that bilateral neck dissection is necessary for the higher T stage. Since the higher N staged patients showed higher rate of recurrence, so that neck dissection is mandatory for the higher N staged patients.

• Journal of Chest Surgery
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• 제45권5호
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• pp.316-319
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• 2012

Background: The standard operative treatment of primary spontaneous pneumothorax (PSP) is thoracoscopic wedge resection, but necessity of pleurodesis still remains controversial. Nevertheless, pleural procedure after wedge resection such as pleurodesis has been performed in some patients who need an extremely low recurrence rate. Materials and Methods: From January 2000 to July 2010, 207 patients who had undergone thoracoscopic wedge resection and pleurodesis were enrolled in this study. All patients were divided into two groups according to the methods of pleurodesis; apical parietal pleurectomy (group A) and pleural abrasion (group B). The recurrence after surgery had been checked by reviewing medical record through follow-up in ambulatory care clinic or calling to the patients, directly until January 2011. Results: Of the 207 patients, the recurrence rate of group A and B was 9.1% and 12.8%, respectively and there was a significant difference (p=0.01, Cox's proportional hazard model). There was no significant difference in age, gender, smoking status, and body mass index between two groups. Conclusion: This study suggests that the risk of recurrence after surgery in PSP is significantly low in patients who underwent thoracoscopic wedge resection with parietal pleurectomy than pleural abrasion.

• Journal of Chest Surgery
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• 제52권2호
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• pp.61-69
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• 2019

Background: Scarce data have been reported on the efficacy of concomitant atrial fibrillation (AF) ablation in patients undergoing bioprosthetic valve replacement. Methods: From 2001 and 2014, 146 consecutive patients ($69.3{\pm}9.4years$, 84 females) who underwent bioprosthetic heart valve replacement concomitant with AF ablation were assessed. We evaluated long-term rhythm and valve-related outcomes. Results: During 49.1 months of follow-up (interquartile range, 22.5-96.8 months), 7 in-hospital and 49 (6.7% per person-year) post-discharge deaths occurred. The thromboembolic event-free survival rate at 5 years was $79.2%{\pm}3.5%$. The freedom from AF recurrence rate at 5 years was $59.8%{\pm}4.9%$. Multivariate analysis showed that old age (hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.02-1.11; p=0.002), previous cardiac operation (HR, 3.01; 95% CI, 1.22-7.43; p=0.02), and a large left atrial (LA) dimension (HR, 1.02; 95% CI, 1.00-1.05; p=0.045) were significantly associated with AF recurrence. Conclusion: The overall long-term clinical outcomes in these predominantly elderly patients undergoing AF ablation concomitantly with bioprosthetic valve replacement were satisfactory; however, AF recurrence was frequent. Older age, a history of prior cardiac surgery, and large LA size were associated with an increased risk of AF recurrence.

• Journal of Chest Surgery
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• 제52권3호
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• pp.131-140
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• 2019

Background: The purposes of this study were to evaluate the appropriateness of the stage migration of stage IIA non-small cell lung cancer (NSCLC) in the seventh edition of the tumor, node, and metastasis classification for lung cancer to stage IIB lung cancer in the eighth edition, and to identify prognostic factors in patients with eighth-edition stage IIB disease. Methods: Patients with eighth-edition stage IIB disease were subclassified into those with seventh-edition stage IIA disease and those with seventh-edition stage IIB disease, and their recurrence-free survival and disease-specific survival rates were compared. Risk factors for recurrence after curative resection were identified in all included patients. Results: Of 122 patients with eighth-edition stage IIB NSCLC, 101 (82.8%) had seventh-edition stage IIA disease and 21 (17.2%) had seventh-edition stage IIB disease. Nonsignificant differences were observed in the 5-year recurrence-free survival rate and the 5-year disease-specific survival rate between the patients with seventh-edition stage IIA disease and those with seventh-edition stage IIB disease. Visceral pleural invasion was a significant risk factor for recurrence in patients with eighth-edition stage IIB NSCLC. Conclusion: The stage migration from seventh-edition stage IIA NSCLC to eighth-edition stage IIB NSCLC was appropriate in terms of oncological outcomes. Visceral pleural invasion was the only prognostic factor in patients with eighth-edition stage IIB NSCLC.

• Journal of Korean Neurosurgical Society
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• 제61권1호
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• pp.19-27
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• 2018

Objective : The objectives of this study were to evaluate the immediate and long-term efficacy and safety of coil embolization for large or giant aneurysms. Methods : One hundred and fifty large or giant aneurysm cases treated with endovascular coil embolization between January 2005 and February 2014 at a single institute were included in this study. Medical records and imaging findings were reviewed. Statistical analysis was performed to evaluate prognostic factors associated with major recurrence (major recanalization or rupture) and delayed thromboembolism after selective coil embolization. Results : Procedure-related symptomatic complications occurred in five (3.3%) patients. The mean clinical and radiological follow-up periods were 38 months (range, 2-110) and 26 months (range, 6-108), respectively. During the follow-up period, the estimated recurrence rate was 4.6% per year. Multivariate analysis using Cox regression showed the degree of occlusion to be the only factor associated with recurrence (p=0.008, hazard ratio 3.15, 95% confidence interval 1.34-7.41). The patient's history of rupture in addition to the size and location of the aneurysm were not associated with recurrence in this study. Delayed infarction occurred in eight cases, and all were incompletely occluded. Conclusion : Although immediate postprocedural safety profiles were reasonable, longterm results showed recanalization and thromboembolic events to occur continuously, especially in patients with incomplete occlusion. In addition, incomplete occlusion was associated with delayed thromboembolic complications. Patients with incomplete occlusions should be followed carefully for delayed recurrence or delayed thromboembolic events.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4717-4721
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• 2013

Complete surgical resection of the primary tumour is a crucial predictive step for head and neck squamous cell carcinoma (HNSCC), because incomplete resection may lead to increase in the recurrence rate. Molecular cancer markers have been investigated as potential predictors of prognosis marker, to identify patients who are at high risk of local recurrence. This retrospective study aimed to determine the prognostic correlation between p53 and eIF4E expression and clinical characteristics, recurrence and overall survival. Forty eight HNSCC patients were selected between 2006 and 2009 diagnosed at the Royal Darwin Hospital, Darwin, Northern Territory, Australia. Out of 48, only those 24 with negative surgical margins with hematoxylin and eosin (HandE) were chosedn for further analysis. A total of 77 surgical margins were obtained and subsequently analysed by immunohistochemical (IHC) staining with monoclonal p53 and polyclonal eIF4E antibodies. Contingency table and ${\chi}^2$-test were used to investigate the correlation between p53 and eIF4E expression and clinical characteristics, recurrence and overall survival of the HNSCC patients. The follow up period was 74 months (range 1-74 months). The Kaplan-Meier method was used to generate recurrence and survival curves. This is a first retrospective study of Northern Territory patients, including Indigenous and non-Indigenous Australians. Molecular study of surgical margins could help to identify patients with and without clear margins after surgery and help in choice of the most appropriate adjuvant treatment for HNSCC patients.