결장직장암 환자의 임상적 고찰 : 조선대학교 부속병원의 10년 간의 결과

나은종,문성표,장정환,김권천,민영돈,김성환,조현진,김정용,김경종 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Background and Objectives: The colorectal cancer rates 4th in the total cancer prevalence in Korea. The clinical patient demographics were considered with the incidence rate of the colon and rectal cancer. The clinicopathological factors were analyzed for the 5 year survival rate. Materials Methods: Of the 282 patients who were operated from Jan. 1, 1992 to Dec. 31, 2001 and diagnosed by pathological biopsy as colo-rectal cancer, 234 patients were followed up. The age, sex, location of the cancer, TNM stage, operation method, histopathological classification, metastatic region, complications after operation and the survival rate were investigated. Results: Of the 234 patients, male and female consisted of 120 cases (51.3%) and 114 cases (46.7%), with an average age of 61.6 years. The average follow up period was 52.3 months and the peri operative mortality was 5.6%. The site of the cancer was most frequent at the rectum with 127 cases (54.3%). The patients were classified according to the TNM stages with 38 cases of stage 1 (16.2%), 98 cases of II (41.9%), 72 cases of III (30.8%) and 26 cases of IV (11.1%). The 5 year survival rate in the age group older than 50 was 63.3 % and 73.5% in the group younger than 50. In regard to the operation type, the 5 year survival rate was 65.4% for elective operation and 65.8% for emergency operation. The 5 year survival rate for well differentiated, moderately differentiated, poorly differentiated cancer, and mucinous adenocarcinoma was 73.7%, 60.2%, 58.3%, and 92.6%, respectively. The 5 year survival rate of each of the TNM stage is 81.1%, 74.8%, 57.0%, and 11.5% for Classes I, II, III, and IV, respectively. Conclusion: The clinical factors were analyzed for the 5 year survival rate with no statistical significance for the age, sex, and location of the cancer. The TNM stage and histopathological differentiation were statistically significant. The colon cancer showed better prognosis compared to the rectal cancer.

외과적 치료를 시행한 갑상선 결절의 임상적 고찰

장용근,김권천,배학연 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1

유방통을 호소하는 한국 여성에서 Gamma Linolenic acid의 임상적인 효과

정재헌,김권천,조현진,민영돈,김성환,김정용,장정환 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Background and Objectives : Recently, the incidence of breast cancer is gradually increasing in korea. Many patients visit the hospital with a fear of breast cancer, if she had the pain in her breast. But Breast pain is not a cardinal sign of breast cancer. Only 7% of patient in breast cancer has breast pain. Materials and Method : To know the clinical effects of gamma-linolenic acid(GLA), we analyzed the medical records of 55 cases with breast pain, who visited the outpatient clinic of Chosun university hospital, between July of 1999 to December of 1999. Of the 55cases of breast pain, we analyzed 26 cases of patient with breast pain who was treated with GLA for 2 month and we excluded patients of breast pain who had breast mass or were treated with other drug. Results : 2 Patients we are dropped out because nausea and vomiting were developed, 4 Patient with breast pain were treated with GLA for 1 month, and relieved completely from mastalgia and 8 patients with breast pain were treated with GLA for 2 months and breast pain was relieved completelys. 4 patient had treatment for 2 months, were relieved slightly. But 8 patients with breast pain didn't reveal the relief of symptom after the intake of GLA. Conclusion : We conclude that GLA could be considered a first line drug in patients with mastalgia.

갑상선에 전이된 유방암 1예

장기훈,김준성,조현진,김권천 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.1

The thyroid gland has been considered as an infrequent metastasis site. However, the incidence of thyroid involvement in reported autopsy series varies from 1.25% to 24%. In most autopsy series, breast and lung cancers have been the most frequent metastatic diseases to the thyroid gland, In contrast, renal cell carcinoma is the most frequent source of metastasis in clinical series. Many reports suggested that ultrasonography and subsequent ultrasonography-guided FNAB are mostly best suited for diagnosis of thyroid metastasis. Metastasis to the thyroid gland is associated with a poor prognosis and the prognosis depends essentially on the primary cancer. Surgery may prolong survival in a patient in whom the thyroid metastasis isolated, and thus early diagnosis and aggressive treatment should be performed in patients with the history of cancer.

맘모톰을 이용한 유방 종괴의 절제 생검에 대한 유용성

조태웅,김영숙,김권천,조현진 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.3

PURPOSE: The aim of this study is to evaluate the rate of residual lesion after US-guided mammotome biopsy for breast mass and evaluate the efficacy of mammotome biopsy device. MATERIALS AND METHODS: A total of 902 US-guided excisional mammotome biopsies were performed in 902 lesions of 474 women (mean age 42.1 years, age range 17-75 years), from January 2003 to December 2006 in Chosun University Hospital. After mammotome biopsy, ultrasonographic follow-up were performed on 6 or 12 months later to assess residual tumor. RESULTS: Remnant tumor was found in 39 lesions (4.3%, mean age 41.8years, range 19-55 years) of total 902 lesions underwent mammotome biopsy. Pathologic diagnoses were fibrocystic change in 16 lesions, fibroadenoma in 19 lesions and other benign breast lesions in 4. Mean size was 1.09 cm before mammotome biopsy. CONCLUSION: Ultrasound-guided vacuum-assisted biopsy device was an effective method for small breast mass. Although there was a possibility of remnant tumor, the remnant rate was low. Also, there was advantage of cosmetic effect for small incision scar. The results suggested that mammotome biopsy is a good alternative method for the diagnosis of small breast mass.

위암의 근치절제술 후 생존율과 예후인자

차윤정,박진영,장정환,김성환,김권천,조현진,민영돈 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background and Objectives: Gastric cancer is still the leading cause of cancer death in Korea, and surgery remains the only method of treatment that offers the potential for a cure. Purpose: The aims of this study are to examine the outcome of the patients with gastric adenocarcinoma who underwent curative resection and to identify the prognostic factors leading to improved survival rates in these patients. Materials and Methods: The medical records of 278 patients with gastric adenocarcinoma, treated curatively at the Chosun University Hospital between January 1990 and December 1994, were reviewed retrospectively from January 2000 to March 2000. Follow-up was obtained for 250 patients(89.9%). The survival rates were calculated by the Kaplan-Meier method, and the significance of differences between patient factors(age and sex), tumor factors(location, size, gross type, tumor depth, lymph node metastasis, and stage) and treatment factors(operation method and reconstruction type) were evaluated statistically by the log-rank test. Results: The overall five-year survival probability was 59.6%. There was no survival difference according to age and sex. The 5-year survival rates according to the tumor depth were 97.0% for Tl, 74.5% for T2, 39.6% for T3, and 23.1% for T4(p=0.0000); to the lymph node metastasis were 81,4% for N0, 51.9% for N1, and 21.2% for N2(p=0.0000); to the TNM stage were 96.7% for stage I a, 79.5% for stage I b, 68.8% for stage II, 52.9% for stage III a, 25.9% for stage III b, and 7.5% for stage IV(p=0.0000). Other statistically significant differences were shown in tumor location, size, gross type, operation method, and reconstruction type after subtotal gastrectomy. Conclusion: The most definitive prognostic factors affecting the survival rate of gastric adenocarcinoma were tumor depth, lymph node metastasis, and tumor stage. The keys to successful outcome includes early diagnosis and curative resection with radical lymph node dissection at early stage as possible.

위암 환자에서 절제된 림프절 수의 차이와 관련이 있는 인자

정귀애,박정희,변익건,김경종,장정환,김권천,민영돈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Purpose: By the definition of UICC TNM classification (fifth edition), the nodal stage of gastric cancer is based on the number of metastatic lymph nodes, which is influenced by the number of resected lymph nodes. And individual differences in the number of resected lymph nodes had been observed in patients with gastric cancer. The aim of this study is to verify the factors which are associated with the difference in the number of resected lymph nodes in patients with gastric cancer. Methods: We reviewed 613 patients with gastric cancer who underwent curative resection and D2 lymph node dissection with 15 or more resected lymph nodes. The number of resected lymph nodes was analyzed according to the characteristics of patients, the types of operation and prognostic factors of gastric cancer. Results: The mean number of resected lymph nodes per patient was 33.0 (median: 31.0, range: 15-88). The number of resected lymph nodes was significantly associated with the types of operation, the location and size of tumor, macroscopic types, depth of tumor invasion and the number of metastatic lymph nodes. Patient's age, gender and the histopathological finding's had no relationship with the number of resected lymph nodes. Conclusions: The number of resected lymph nodes from gastric cancer was different in each patient despite of same D2 lymph node dissection and it was associated with several prognostic factors of gastric cancer.

갑상선 미세 유두상 암의 임상적 특징

나병곤,배학연,조현진,김권천 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.3

Purpose: Papillary thyroid microcarcinoma (PTMC) is increasing in incidence because of ultrasound-guided fine-needle aspiration cyology (FNA). According to WHO, PTMC is defined as a papillary thyroid cancer of 1 cm or less in diameter. Within the group of patients with PTMC, prognosis is known to be very favorable. This study was carried out to evaluate the clinicohistological characteristics of PTMC and to determine a reasonable extent of surgery for them. Methods: From Mar. 2002 to Dec. 2007, 610 patients with thyroid diseases underwent thyroidectomy at Chosun University hospital. Among these patients, 205 patients (33%) had a thyroid papillary carcinoma less than or equal to 1 cm in great diameter. The clinicopathologic features and treatment outcome of these patients were evaluated retrospectively. Results: In the period 2002-2007, PTMC incidence rate in our institution increased from 10% to 20%. There were 19 men and 186 women with a median age of 46 years (range; 16-74). PTMC diameter ranged from 0.1 to 1 cm. (mean 0.54 cm) 15.7% of patients with PTMC presented with preoperative symptoms (palpable mass, fatigue, pain, hoarseness). Preoperatively 84.3% of these 205 cases were diagnosed by ultrasonography. We performed unilateral lobectomy (41%), near total thyroidectomy (44%), and total thyroidectomy (11%) with or without central compartment neck node dissection. During a mean follow-up of 36 months, 5 patients (2.4%) developed locoregional recurrence with no distant metastasis. There were no significant difference on recurrence rate by size, capsular invasion. But multiplicity of primary tumor has a higher locoregional recurrence rate (p= 0.04). The detection rate of PTMC is increasing due to FNA technique in our hospital. This study shows that PTMC may have capsular invasion, lymph node involvement, multiplicity and locoregional recurrence likely to larger (>1 cm) papillary carcinoma. Conclusion: We suggest that total or near total thyroidectomy with central compartment neck dissection is proper therapeutic operation for PTMC and modified neck dissection shoud be performed if lateral neck lymph node are enlarged or diagnosed as metastatic tumor.

조기위암의 형태학적인 분류에 따른 임파절 전이 양상

최은서,강길,박정희,장정환,김권천,김경종,민영돈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Currently, in the limited cases of early gastric cancer (EGC), endoscopic mucosal resection (EMR) is used for curative treatment. However, its completeness is still controversial. The purpose of this study was to review the suggested indications of EMR. We retrospectively analyzed 234 patients with EGC who underwent curative (RO) gastrectomy. The enrolled cases were further classified into mucosal and submucosal types, and mucosal EGC were further classified according to the size, gross type and histologic pattern. 133 patients had mucosal cancers and 101 patients submucosal. The overall incidence of positive lymph node was 14.1% (33/234), the incidence of mucosal cancer was 8. 3% (11/133), which was significantly lower than that of submucosal, 22% (22/101). Of 133 patients with mucosal EGC, 90 were smaller than 2㎝ in size and the incidence of lymph node metastasis was 5.6% (5/90), compared to 43 of larger than 2㎝ with the incidence of 14% (6/43). According to the gross type classification of mucosal cancer, incidence of lymph node metastasis in protruded type (EGC type Ⅰ, Ⅱa, Ⅰ+Ⅱa) was 15.4% (4/26), nat type(EGC type Ⅱb) 2. 9% (1/35), depressed type (EGC type Ⅱc, Ⅲ) 8.3% (6/72). Lymph node metastasis in differentiated type of mucosal cancer was 6.9% (5/72) and undifferentiatcd type 9.8% (6/61). In this study, there was no single indication free from lymph node metastasis, It is thought that the selection of EMR for the curative treatment of EGC should be considered carefully and more clinical studies with long-term follow up are necessary for EMR to be generally acceptable.

Novel MMIC protection technique in plasma etching process for mechanically movable RF mems antenna

Kim, Jung-Mu,Lee, Sanghyo,Kim, Yongsung,Kim, Jong-Man,Cheon, Changyul,Kwon, Youngwoo,Kim, Yong-Kweon Wiley Subscription Services, Inc., A Wiley Company 2008 MICROWAVE AND OPTICAL TECHNOLOGY LETTERS - Vol.50 No.12

<P>In this article, we proposed the novel monolithic microwave integrated circuit (MMIC) protection technique in plasma etching process for MMIC mounted mechanically movable RF MEMS antenna. We could eliminate the distortion of radiation pattern caused by RF feed line on antenna frame and torsional hinge as using MMIC direct mounting on antenna plate instead of using external RF power source. Silicon-based mechanically movable RF MEMS antenna was released using DRIE process, which was performed on the backside of silicon substrate after MMIC mounting on RF MEMS antenna plate. An aluminum layer on the front side of RF MEMS antenna plays a role of etch stop layer for DRIE process. We measured the radiation pattern as rotating the moving plate along the vertical- and horizontal-direction hinge mechanically. We could obtain the radiation pattern without gain reduction and distortion of radiation pattern. © 2008 Wiley Periodicals, Inc. Microwave Opt Technol Lett 50: 3089–3093, 2008; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.23870</P>