• Title/Summary/Keyword: 경부전이

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CONTOUR RECONSTRUCTION OF FACIAL DEFECT WITH SPLIT STERNOCLEIDOMASTOID MUSCULAR FLAP FOLLOWING PAROTIDECTOMY (이하선 적출술 후 흉쇄유돌근을 이용한 안모결손부의 외형재건)

  • KIM, Myung-Jin;KIM, Taek-Kyoung;YOU, Jun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.144-152
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    • 1991
  • Various muscular flaps are used in oral and maxillofacial reconstructive surgery for the defects caused by tumor resection and trauma or for the correction of head and neck deformities. The sternocleidomastoid(SCM) muscle may be widely used as a muscular or myocutaneous flap in these lesion. The authors used SCM muscular flap for the expected parotid defect following benign tumor related conservative parotidectomy in three cases. We expected that prevention of post-operative facial deformity, reduction of dead-space and protection of denuded facial nerve etc. is lead by SCM muscular flap. But the total SCM flap can lead to some complications such as "flat neck deformity", limitation of neck movement and overcontouring of parotid defect. Therefore, the authors used split pedicled SCM muscular flap and it lead good favorable results of post-operative functional and esthetic problems.

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Papillary Thyroid Microcarcinoma Presenting as Neck Masses (경부 종물로 발현된 유두 미세 갑상선암)

  • Kim Young-Mo;Park Sun-Ki;Shin Jun-Sun;Jeon Yong-Sun;Han Chang-Jun;Cho Jung-Il
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.1
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    • pp.65-70
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    • 2002
  • Background and Objectives: Recently the tenn 'papillary microcarcinoma' has been proposed to designate carcinoma of 10 mm or less in diameter. In some cases, cervical lymph node metastasis preceding the occurrence of the primary tumor may be the first and sole manifestation of the disease. The objective of this study is to assess the clinical features of cervical metastasis in papillary microcarcinoma of thyroid glands. Materials and Methods: 9 cases with papillary microcarcinoma with neck metastasis were analyzed retrospectively. 5 cases are men and 4 are women. All patients complained of painless, movable neck mass. The symptom had been present from 1 month to 36 months. We reviewed clinical history, imaging studies, the results of fine needle aspiration, the surgical method, the pathologic results. Results: In 9 cases, no abnormalities of the thyroid gland were shown by imaging studies and thyroid scan. 3 cases were diagnosed by fine needle aspiration cytology. the others were not. Total thyroidectomy and neck dissection were performed in 9 cases and then pathology reports showed 2 case of multiple, 2 case of contralateral single and 5 cases of unilateral single thyroid microcarcinoma. They have no recurrence during follow-up period. Conclusions: Cervical metastasis from papillary microcarcinoma is variable clinical manifestation. The diagnosis of cervical metastasis from papillary microcarcinoma should be considered in patient with neck mass. We recommend total thyroidectomy with neck dissection and postoperative radioactive iodine ablation therapy in neck metastasis from papillary thyroid microcarcinoma.

Patterns of Neck Node Metastasis and Bilateral Neck Dissections in Supraglottic and Hypopharyngeal Cancers (성문상부암과 하인두암의 경부전이 양상과 양측 경부청소술의 의의)

  • Lee Hyung-Seok;Tae Kyung;Kim Joo-Mook;Park Joon-Soo;Kim Sun-Kon
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.24-29
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    • 1997
  • Background: Supraglottic and hypopharyngeal regions drain into the upper deep cervical lymph nodes. And bilateral neck node metastasis is frequently occured especially, in the early stage. It influences on the prognosis of above diseases. The prognosis for patients wih supraglottic and hypopharyngeal cancers, although usually poor, has improved by modern imaging technique, better application of treatment modalities, increasing assortment of reconstructive procedures and improved application of radiation therapy. Objectives: This study was designed to obtain objective data about the patterns of neck node metastasis and to identify the necessity of elective bilateral neck dissection. Material and Methods: Twenty four patients with supraglottic cancer and twenty six patients with hypopharyngeal cancer were investigated from the chart review. Results: In supraglottic cancer, the most frequent sites of neck metastasis is level II (52.9%) and level III (52.9%) in ipsilateral side, level II (29.4%) in contralateral side, in hypopharyngeal cancer, level II (73.7%) and III (52.6%) in ipsilateral side, level II (10.5%) in contralateral side. In elective neck dissection, the occult metastasis is about 50% in supraglottic cancer, but there is no occult metastasis in hypopharyngeal cancer. Conclusion: In supraglottic cancer, elective bilateral neck dissection is necessary because of early contralateral neck metastasis, but in hypopharyngeal cancer, elective contralateral neck dissection may not be always necessary because of rare occult metastasis and contralateral neck metastasis.

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Analyzing Effects of the Ticket Release Time on Train Reservation Time: Focusing on KTX Gyeongbu-line (해제시간에 따른 열차예매시간의 영향 분석: 경부선 KTX를 중심으로)

  • Kim, Su jae;Choo, Sang ho;Sohn, Byung hee
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.16 no.1
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    • pp.38-49
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    • 2017
  • In general, railroad operation companies sell tickets to maximize their profits by applying the ticketing release time (when selling any tickets regardless of trip distances). This study is to analyze the effect of the release time on KTX ticket reservation behavior. The reservation behavior in this study means the reservation time calculated by difference between ticketing time and departure time. The data come from KTX ticket sales data of Gyeongbu-line for a week including Saturday and Sunday. The results show that the factors to affect the reservation time are day of the week, trip distance and operation direction, in addition to the release time. Furthermore, most of tickets were reserved three hours before their departure time, and most of the up line weekend users reserved their tickets a day before the departure time. Before the release time, reservation time was affected by up line and long distance travel. On the other hand, after the release time, it was affected by long distance travel and Sunday.

The Utility of Fibrin Sealant and Safety of Thyroid Surgery without Drainage (배액관을 삽입하지 않은 갑상선수술의 안전성과 섬유소응고제의 유용성)

  • Lee, Kyeng-Suk;Youn, Jin;Kim, Mun-Jun;Yang, Yun-Su;Hong, Ki-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.1
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    • pp.8-11
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    • 2012
  • 배경 및 목적 : 섬유소 응고제(fibrin sealants)는 다양한 두경부수술에서 지혈목적으로 사용되고 있다. 본 연구의 목적은 배액관을 삽입하지 않는 갑상선 수술에서 섬유소 응고제의 효용성과 안정성을 알아보고자 하였다. 재료 및 방법 : 최근 1년간 108명의 갑상선 수술환자 중에서 수술 후 배액관의 삽입없이 수술을 받은 103명의 환자를 대상으로 하여 임상적인 특징을 분석하였다. 결과 : 103명의 대상환자 중에서 남성은 16예, 여성은 87예였다. 대상환자의 평균연령은 $46.7{\pm}13.0$세였고, 연령분포는 17세에서 72세였다. 갑상선 종물의 평균크기는 $2.08{\pm}1.61cm$였고, 종물의 크기는 최소 0.2cm에서 최대 10.0cm까지의 분포를 보였다. 수술에는 갑상선 엽절제술이 5예, 갑상선반절제술이 41예, 아갑상선 절제술이 8예, 갑상선 전절제술이 6예, 갑상선 전절제술과 중심경부림프절 절제술이 37예, 갑상선 전절제술과 선택적경부림프절 절제술이 6예가 있었다. 수술 후 합병증은 11예(10.6%)에서 발생하였고, 발생한 합병증으로는 장액성종창이 3예, 혈종이 1예, 일측성 성대마비가 3예, 저칼슘혈증이 4예 있었다. 성대마비는 수술 후 3개월 이내에 모두 호전되었고, 장액성 종창은 반복적인 세침흡인으로 호전되었다. 1예의 혈종은 지연성으로 발생하였고, 수술 후 5일째에 수술을 통해 제거하였다. 결론 : 이러한 결과에 근거하여 갑상선 수술에서 섬유소 응고제의 사용은 다양한 갑상선 수술에서 효과적인 지혈과 함께 안전하게 사용될 수 있으며, 배액관의 삽입을 감소시켜 줄 수 있을 것으로 생각된다.

A Study on the Direct connection Service Effectiveness in Gyeongbu(KTX) (경부선(KTX) 직결운행 도입 효과에 관한 연구)

  • Kim, Ik-Hui;Kim, Yeong-Jin
    • Journal of Korean Society of Transportation
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    • v.25 no.5
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    • pp.91-100
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    • 2007
  • This study suggests direct connection service which has advantage of high-speed operation of KTX and access convenience of general train, and Pre-feasibility studies on the direct connection service. And analyze transportation demand change by the method as follows; It is to analyze the demand change of before and after KTX operation by previous transport data of Gyeongbu line, and calculate the coefficient of utilization using triggering demand by opening the 2nd phase of Gyeongbu line (Dongdaegu${\sim}$Busan). Through Pre-feasibility analysis, reduction $70{\sim}100$ minutes of train travel time and total revenue will increase about $100 thousand per day. Also, there will be environment-friendly effects of decreasing $CO_2$ emissions. But, Direct connection service need to highly cost ; Buying and Operation cost of KTX train. Therefore, we will be get more correct result of Pre-feasibility study on direct connection service, if there are concrete on buying the KTX action plans.

OBC-LDC Integrated Charger with Entire ZVS Range using Common Leg (공통 레그를 이용하여 전 범위 ZVS를 갖는 OBC-LDC 통합형 충전기)

  • Yu, Gibum;Suk, Chaeyoung;Kim, Sunju;Choi, Sewan
    • Proceedings of the KIPE Conference
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    • 2020.08a
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    • pp.94-96
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    • 2020
  • 본 논문은 전 범위 ZVS를 가지는 OBC-LDC 통합형 차량용 충전기를 제안한다. 제안하는 통합형 충전기는 OBC의 절연부인 양방향 LLC 공진형 컨버터의 2차측 스위치 레그와 LDC의 위상천이 풀브릿지 컨버터의 lagging 레그를 공통으로 사용하여 스위치 개수를 2개 줄일 뿐아니라 경부하에서 ZVS 성취가 어려운 lagging 레그의 전 범위 ZVS 턴온을 가능케 한다. 제안하는 통합형 충전기는 OBC와 LDC의 동시동작이 가능하며 OBC와 LDC가 같이 동작할 때 전류 상쇄효과로 인해 도통손실을 저감할 수 있다. 또한 OBC와 LDC가 동일주파수로 동작하므로 고전압측 출력필터와 EMI 필터의 설계가 간단해지는 장점이 있다. 3.6kW급 LLC 공진형 컨버터와 1kW급 위상천이 풀브릿지 컨버터로 구성되는 통합형 충전기의 시작품을 제작하여 본 논문의 타당성을 증명하였다.

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Metastatic Carcinoma of the Neck Node from an Unknown Primary Site (확인불능의 원발병소로부터의 경부임파절 전이에 대한 치료 성적)

  • Kim, Jae-Sung;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.8 no.1
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    • pp.59-64
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    • 1990
  • From 1980 to 1986,26 patients with metastatic carcinoma of the neck node from an unknown primary site were seen in the Department of Therapeutic Radiology of Seoul National University Hospital. Among these, three patients were excluded from further analysis due to incomplete treatment. So a retrospective analysis was undertaken on 23 patients who had complete treat-ment with radiation therapy alone or in combination with surgical treatment and chemotherpay. The overall three year actuarial survival rate was $32\%$. According to the staging system of the American Joint Committee on Cancer, the three year survival rates with N2 and N3 patients were $43\%\;and\;13\%$, respectively. In 16 patients with squamous cell carcinoma and seven with non-squamous cell carcinoma, the three year survival rates were $34\%\;and\;29\%$, respectively. Analysis according to site of nodal involvement was also done. Patients with cervical node and supraclavicular node involvement recorded $44\%\;and\;17\%$ of three year survival, rate, respectively. In this study, six patients eventually manifested the primary sites (three in the lung, one in the esophagus, one in the stomach, one in the nasopharynx). Presence of the primary site seemed to influence the prognosis ($17\%\;vs\;38\%$). In analyzing the prognostic factors, the nodal stage and site of nodal involvement were important prognostic factors, and the presence of a primary site seemed to influence the patients' survival, but histology did not.

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Clinical Analysis and Treatment of Esophageal Perforation (식도천공의 치료 및 임상고찰)

  • Park, Hoon;Park, Nam-Hee;Park, Chang-Kwon;Lee, Kwang-Sook;Keum, Dong-Yoon
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.111-116
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    • 2006
  • Background: Perforation of the esophagus is a deadly injury that requires expert management for survival. The mediastinal contamination with microorganisms, gastric acid, and digestive enzymes results in a mediastinitis that is often fatal if untreated. Material and Method: Between January 1990 and June 2004, 38 patients with esophageal perforation were treated in our hospital. Retrospective review of these cases has been performed. Result: There were 28 males and 10 females. The mean age was 43.84$\pm$18.89 years (range $1{\~}73$ years). Spontaneous rupture was found in $34\%$ of perforations, iatrogenic perforation in $32\%$ and traumatic perforation in $34\%$. Perforation occurred in the cervical esophagus in 8 cases, thoracic esophagus in 29 and abdominal esophagus in 1. In the cervical esophageal perforation, managements were primary closure in 8 and drainage in 2. In the thoracic esophageal perforation, managements were primary closure in 14, resection in 3 and conservative management in 12. The mortality rate was $25\%$ in cervical esophageal perforation and $34.5\%$ in thoracic esophageal perforation. We revealed risk factor of esophageal perforation to be peropertaive septic condition (p=0.005). Conclusion: Most important risk factor of esophageal perforation was preoperative septic condition. Preoperative prompt and aggressive preoperative treatment may improve the survival rate of esophageal perforation.

THE EFFECT OF RESTORATIVE MATERIALS ON THE STRESS DISTRIBUTION OF CLASS V COMPOSITE RESIN RESTORATIONS - A 3D FINITE ELEMENT INVESTIGATION (수복재료가 5급 복합레진 수복물의 응력분포에 미치는 영향에 관한 3차원유한요소법적 연구)

  • Ahn, Hyoung-Ryoul;Kim, Hyeon-Cheol;Hur, Bock;Park, Jeong-Kil
    • Restorative Dentistry and Endodontics
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    • v.31 no.1
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    • pp.20-29
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    • 2006
  • The purpose of this study was to analyze the stress distribution aspect of unrestored and restored combined shape (wedge shape occulusally and saucer shape gingivally) class V cavity, which found frequently in clinical cases. A maxillary second permolar restored with a combined shape class V composite restorations were modeled using the three dimensional finite element method. Static occlusal load of 170 N was applied on lingual incline of buccal cusp at the angle of $45^{\circ}$ with the longitudinal axis of the tooth. And three dimensional finite element analysis was taken by ANSYS (Version 6.0, Swanson Analysis System Co., Houston, U.S.A) program which represent the stress distribution on unrestored and restored cavity wall and margin. The conclusions were as follows. 1. Compared to the unrestored cavity, Von Mises stress at the cementoenamel junction and line angle of the cavity base were reduced and in restored cavity. 2. Von Mises stress at the occlusal and cervical cavity margin and wall were increased in restored cavity in comparison with the unrestored cavity. 3. In the hybrid and hybrid/flowable composite resin restoration, Von Mises stress at the cementoenamel junction and line angle of the cavity base were reduced more than in the flowable restoration. 4. In the hybrid and hybrid/flowable composite resin restoration, Von Mises stress at the occlusal and cervical cavity margin and wall were increased more than in the flowable restoration.