• Title/Summary/Keyword: 내시경 검사

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A Case of Unknown Primary Malignant Melanoma with Pulmonary and Endobronchial Metastasis (다발성 폐종괴 및 기관지 점막으로 전이한 원발불명의 악성 흑색종 1예)

  • Min, Young-Hoon;Kim, Sung-Wook;Chin, Hui-Jong;Lee, Tae-Yoo;Song, Hun-Ho;Lee, Keun-Seok;Lee, Jung-Ae;Park, Young-Lee;Hyun, In-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.196-201
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    • 2002
  • Malignant melanoma is a highly malignant form of cutaneous cancer derived from melanocytes. The lesion frequently metastasizes to the lymph nodes, lung, liver and bone. However, an endobronchial metastasis and a primary malignant. melanoma of the lung are quite rare. We report a case of an unknown primary malignant melanoma with a pulmonary and endobronchial metastasis in a 34 years old male. He complained of coughing and black-colored sputum. Abnormal skin and mucosal lesions were not found during a physical examination. A chest X-ray revealed multiple nodular masses in both lung fields. A flexible bronchoscopy showed two yellowish small nodules at the entry of left lower bronchus. Vimentin, the S-100 protein, and HMB-45 stain positive melanoma cells were detected at the bronchoscopic biopsy specimen.

Transbronchial Needle Aspiration in the Diagnosis of Submucosal and Peribronchial Bronchogenic Carcinoma (기관지주위 병변과 점막하 병변을 보이는 폐암의 진단에 있어서 경기관지 침흡인술의 유용성)

  • Chung, Jae Ho;Choi, Jeong Eun;Park, Moo Suk;Kim, Young Sam;Chang, Joon;Kim, Sung Kyu;Kim, Se Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.4
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    • pp.374-380
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    • 2004
  • Although exophytic endobronchial lesions can readily be diagnosed by routine forceps biopsy through the fiberoptic bronchoscope, submucosal or peribronchial tumor can be difficult to diagnose. So we evaluated the diagnostic utility of transbronchial needle aspiration (TBNA) through the fiberoptic bronchoscope in patients presenting with endoscopic abnormalities suggestive of submucosal or peribronchial tumor. Patients and Methods : Retrospective review of 120 lung cancer patients who were found to have the lesions suggestive of peribronchial and submucosal tumor during fiberoptic bronchoscopy was performed from Jan. 1994 to Dec. 2002 at Severance Hospital, Yonsei University College of Medicine. Results : Forcep biopsy was positive in 63 cases (52.5%) and TBNA in 91 (75.8%), which was significantly better than forcep biopsy (p=0.001). The combination of forceps biopsy and TBNA was positive in 106 cases (88.3%), which was significantly better than forceps biopsy alone (p=0.0001). The difference of TBNA yield according to cell type or bronchoscopic appearance of lesion was not significant, but it showed the relatively better result in small cell carcinoma. Conclusions : We concluded that TBNA significantly increase the yield over forcep biopsy alone in the detection of submucosal or peribronchial bronchogenic carcinoma.

A Glomus Tumor of the Trachea (상부 기관에 발생한 사구 종양 1예)

  • Lee, Seung Min;Lee, Jung Hyun;Hwang, Jae Jun;Lee, Song Am;Lee, Jeong Geun;Kim, Wan Seop;Han, Hye Seung;Lee, Tae Hoon;Yoo, Gwang Ha;Lee, Kye Young
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.2
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    • pp.183-187
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    • 2007
  • A glomus tumor is composed of modified smooth muscle cells that are similar to those of the glomus body. Its occurrence in the trachea is quite rare. To our knowledge, only 20 cases of glomus tumor of the trachea have been reported worldwide and there has been only 1 case in Korea. We report one case of a 58-year-old man with dyspnea who had a glomus tumor in the upper trachea with a review of literatures. The chest CT scan and bronchoscopy demonstrated a 2.5 cm sized lobulated tumor at the posterior wall of the upper trachea. It had an elongated shape with a broad base and with a highly vascularity. A simple resection of 3 levels of the trachearing was with a tumor and end-to-end anastomosis performed. Microscopic and immunohistochemical staining of the tumor revealed the characteristics of a glomus tumor.

EXPERIMENTAL STUDIES ON THE EFFECT OF RLN ANASTOMOSIS REMOVAL ON PHONATION (반회신경 문합과 후윤상피열근 절제가 발성기능에 미치는 영향에 대한 실험적 연구)

  • 김영모;이영구;이정식;이준열;김광문;김기령;홍원표;최홍식
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.11-12
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    • 1991
  • 편측 성대마비의 음성개선을 위하여 현재까지 알려진 치료방법은 teflon 또는 silicone 주입술, 외과적 성대 내전술, 갑상연골 성형술, 신경재식술, 등이 있으며, 근래까지는 Teflon 또는 Gelform 주입술이 제일 효과적인 방법이라 알려져 있으나, 이는 음의 높낮이 조절능력의 한계가 있고, 신경재식술의 결과 역시 만족스럽지 못한 경우가 많다. 따라서 저자는 발성기능의 생리학적인 측면에서, 보다 효과적인 음성개선의 방법을 찾기 위하여, 사람의 후두와 비교적 유사한 특성을 가진 개를 사용하여 실험을 하였다. 반회신경을 절단하여 편측 성대 마비를 유발한 뒤, 동측의 유일한 외전근인 후윤상피열근을 절제후 절단된 신경을 문합하여, 성대의 외전근 작용의 소실과, 발성시에 주로 작용하는 내전근만의 작용을 유도하여, 공동운동의 차단과, 내전운동의 향상을 기대하였다. 본 실험에 앞서, 임의적으로 신경을 자극시킬 수 있는 신경자극기와, 주위조직으로부터 신경만을 분리하여 자극할 수 있는 전극을 개발하여 사용하였으며, 또한 성대의 발성음을 임의대로 유발시킬 수 있는 생체 내 후두발성 모형(in vivo laryngeal phonation model)을 Moore(1987, 1988)등이 발표한 모형을 토대로 자체 개발하여 사용하였다. 실험은 13마리의 개를, 반회신경 절단군(3 마리), 반회신경 절단 및 후윤상피 열근 절제군(3 마리), 후윤상피열근 절제군(3 마리), 반회신경 문합 및 후윤상피 열근 절제군(4 마리)등으로 나누어 실험하였으며, 3 개월 후, 현수후두경, 후두 내시경, videolaryngoscopy, 신경자극 검사 등으로 성대의 내전운동 및 위치 변화의 관찰, 발성음의 음향분석 및 갑상피열근의 형태학적 변화를 관찰하여 다음과 같은 결과를 얻었다. 1. 반회신경 절단군과 반회 신경 절단 및 후윤상피열근 절제군은, 수술후 3 개월에 성대의 움직임이나 각도의 변화가 없었으며, 음향분석 결과 발성음이 아닌 잡음만이 포착되었다. 즉, 절단된 신경의 문합 없이 후윤상피열근 절제 만으로는 음성개선은 기대할 수 없었다. 2. 후윤상피열근 절제군에서는 수술 후 3 개월에 정상적인 성대의 내전운동이 관찰되었으며, 음향분석상 기본주파수 동요율 및 발성음의 강도는 약간의 증가를 보였다. 즉, 반회신경이 절단되지 않은 상태에서 후윤상피 열근 만을 절제하면, 발성음의 변화는 거의 없었다. 3. 반회신경을 절단후 문합하고 후윤상피열근을 절제한군 에서는 수술후 3 개월에, 성대의 정상적인 내전운동을 보였고, 음향분석상 수술직후에는 잡음만이 포착되었으나, 3 개월 후에는 잡음이 아닌 발성음을 들을 수 있었으며, 이 발성음의 기본주파수 및 강도는 수술전보다 감소되어 있었으나, 기본주파수 동요율은 증가되어 있었다. 즉 이 술식으로 인한 뚜렷한 발성음의 향상이 있었다. 이상의 결과로 미루어, 편측 신경 절단으로 인한 성대마비시, 절단된 신경을 봉합하고 성대의 유일한 외전근인 후윤상피열근을 절제하면, 공동운동의 차단과, 내향운동의 향상으로, 음성개선에 효과적이라고 사료되었으며, 이 방법이 편측 성대마비 환자의 효과적인 음성개선의 치료방법의 하나로 응용될 수 있으리라 생각된다.

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A Study on the Comparison of Learning Performance in Capsule Endoscopy by Generating of PSR-Weigted Image (폴립 가중치 영상 생성을 통한 캡슐내시경 영상의 학습 성능 비교 연구)

  • Lim, Changnam;Park, Ye-Seul;Lee, Jung-Won
    • KIPS Transactions on Software and Data Engineering
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    • v.8 no.6
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    • pp.251-256
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    • 2019
  • A capsule endoscopy is a medical device that can capture an entire digestive organ from the esophagus to the anus at one time. It produces a vast amount of images consisted of about 8~12 hours in length and more than 50,000 frames on a single examination. However, since the analysis of endoscopic images is performed manually by a medical imaging specialist, the automation requirements of the analysis are increasing to assist diagnosis of the disease in the image. Among them, this study focused on automatic detection of polyp images. A polyp is a protruding lesion that can be found in the gastrointestinal tract. In this paper, we propose a weighted-image generation method to enhance the polyp image learning by multi-scale analysis. It is a way to extract the suspicious region of the polyp through the multi-scale analysis and combine it with the original image to generate a weighted image, that can enhance the polyp image learning. We experimented with SVM and RF which is one of the machine learning methods for 452 pieces of collected data. The F1-score of detecting the polyp with only original images was 89.3%, but when combined with the weighted images generated by the proposed method, the F1-score was improved to about 93.1%.

Interpretation of Making Techniques through Surface Characteristic Analysis and Non-destructive Diagnosis for the Gilt-bronze Seated Buddha in Dangjin Sinamsa Temple, Korea (당진 신암사 금동여래좌상의 표면특성 분석과 비파괴 정밀진단을 통한 제작기술 해석)

  • CHOI Ilkyu ;YANG Hyeri ;HAN Duru;LEE Chan Hee
    • Korean Journal of Heritage: History & Science
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    • v.56 no.1
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    • pp.100-116
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    • 2023
  • The Sinamsa Temple was built in the late Goryeo Dynasty and a gilt-bronze seated Buddha is enshrined in Geungnakjeon hall in the precinct. Various damages occurred in the gilt layer of the Buddha, such as peeling of the gilt layer and deteriorating gloss. In the study, the conservation conditions of the inside and outside on the statue were accurately investigated, and the making technique was interpreted through the material characteristics and non-destructive diagnosis of the statue. As a result, it is estimated that gold-gilding layer is pure gold, coloration pigment of black is carbon, green is malachite, atacamite and verdigris, red is red lead and cinnabar, respectively. In the deterioration evaluation, peeling, cracking, break out and exfoliation of the gilt layer are confirmed as damages, but the conservation condition is relatively wholesome. However, the gloss of the gilt layer is calculated to be wider in the poorer part than the maintenance part. The ultrasonic velocity of the statue was calculated to be 1,230 to 3,987 (mean 2,608) m/s and showed a relatively wide range. In infrared thermography, peeling was not confirmed, and no special bonding marks were found. In endoscope, some biological damage and corrosion were observed on the surface of the internal metal, and sealed artifacts were identified. Manufacturing technique based on the study, it is considered that the gilt-bronze seated Buddha was cast at once, and the mold was inverted to inject molten metal.

Estimated Exposure Dose and Usage of Radiological Examination of the National Health Screening (국가건강검진의 방사선검사 이용량 및 피폭선량 추정)

  • Gil, Jong Won;Park, Jong Hyock;Park, Min Hui;Park, Chan Young;Kim, So Young;Shin, Dong Wook;Kim, Won Dong
    • Journal of Radiation Protection and Research
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    • v.39 no.3
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    • pp.142-149
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    • 2014
  • Korea conducts a national health screening program to improve and check-up on public health and in recent years, the screening usage has been increased. Given the increased screening usage for radiographic exams, this study predicts the frequency of using radiographic exams and the exposure dose. This study estimates the usage of radiographic exams by isolating radiographic exams from the 2011 analysis of the national health insurance corporation, and estimates the public exposure dose by applying each procedure's dose table from UNSCEAR 2008. As a result of the analysis, in the 2011 National Health Screening, the average exposure dose per person is assumed to be 0.57 mSv, and depending on the type of screening program from the radiographic exam, an examinee could be exposed to between 0.2 mSv and 11.081 mSv. The frequency of using radiographic exposure was found to be 16,005,914 and the exposure dose was 6,311.76 person-Sv. The most frequent exam is the Chest X-ray, which was performed 1,070,567 (69.17%), and the UGI has the highest exposure dose at 5,217.94 person-Sv (82.67%). The outcome is categorized based on gender and age, excluding those under 39 years old. In all age groups, the screening usage and exposure dose are higher in females than in males. In particular, females between 50 and 54 years old have the highest screening usage (1,674,787, 10.5%) and exposure dose (701.59 person-Sv, 11.1%). As UGI accounts for 82.76% of procedures, except when done for medical purposes, if the government supports a voluntary UGI exam (which includes the UGI exam in the National Screening Program) or abolishes it completely, as seen overseas, the cost-effectiveness and validity of the UGI exam, as well as the exposure dose from the National Screening Program will all decrease significantly.

Clinical Features of Simple Bronchial Anthracofibrosis which is not Associated with Tuberculosis (비결핵성 기관지탄분섬유화증의 임상 양상)

  • Lee, Hee-Seub;Maeng, Joo-Hee;Park, Pae-Gun;Jang, Jin-Gun;Park, Wan;Ryu, Dae-Sik;Kang, Gil-Hyun;Jung, Bock-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.510-518
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    • 2002
  • Background : Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. Methods : We reviewed the patients' charts retrospectiely and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. Results : Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). Conclusion : Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.

Prevalence and Risk Factors of the Gallbladder Polyps Diagnosed by Ultrasound (복부초음파검사로 진단된 담낭용종의 유병률과 위험인자 분석)

  • LEE, Mi-Hwa;Cho, Pyong-Kon;Kwon, Duck-Moon
    • Journal of radiological science and technology
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    • v.38 no.2
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    • pp.127-134
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    • 2015
  • This study was designed to determine the prevalence of gallstones in the last three years and evaluate the associated risk factors in the population who underwent health screening. Although there are many studies reporting the prevalence and risk factors of GB polyp, the results varied among each report. The aims of this study were to evaluate the prevalence rate and risk factors of GB polyp, colon polyp and fatty liver in the population who underwent health screening. The study population consisted of 4,877 visited the health promotion center in Dalseogu, Daegu in Korea from January 2011 to December 2013. Each participant in the study had their biliary system gallbladder examined using ultrasonography. The prevalence of GB polyp was evaluated along with age, gender, metabolic syndrom, body mass index (BMI), Fatty liver, Colon polyp. A showed of total 383 (7.9%) people were found to have GB polyps. The prevalence of sex among 256 (9.8%) patients men and 127 (5.6%) women which showed significantly higher in male than in female subjects(p=0.001). The mean size of the GB polyps 4.92 mm (1.6-17 mm). The sizes of most GB polyps (73.6%) were less than 10 mm in diameter. 122 subjects (31.28%) had multiple GB polyps which 2 or more polyps and 261 subjects (68.2%) had single polyp. Independent risk factors related with GB polyp were male gender (OR 0.551, p<0.001), overweight that BMI above $23kg/m^2$ (OR 0.713, p=0.002) triglyceride (OR 0.571, P<0.001), metabolic syndrome (OR 0.049, p=0.033) and colon polyp (OR 1.409, p=0.002). In spite of the conclusion, the prevalence GB polyp was higher than previous Korea and other country reports. The GB polyp in a healthy population was results as 7.9%. The risk factors of GB polyps were found to be male, being overweight, triglyceride, metabolic syndrome and colon polyp. Not only the subject of a health examination is needed but, a further study of the general public when possible.

Jejunal Pouch Interposition (JPI) after Distal Gastrectomy in Patients with Gastric Cancer (위암 환자에서 원위부 위절제 후 공장낭 간치술)

  • Jeon, Hae-Myung;Kim, Wook;Hur, Hoon;Lee, Joon-Hyun;Won, Jong-Man
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.242-251
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    • 2004
  • Purpose: Recently, because of the increasing numbers of early gastric cancer patients and improvements in their survivals, greater attention has been directed towards the quality of life and nutritional status of gastric cancer patients after surgery. However, conventional reconstructions, Billroth- I, -II (B-I and B-II) or Roux-en-Y, have proven to have certain limitations, such as a small reservoir, and a malabsorption for iron, fat, calcium, and carotene. To overcome these limitations, we used a jejunal pouch interposition(JPI) after a distal gastrectomy not only to substitute for the small reservoir but also to maintain a physiologic pathway for ingested foods. Materials and Methods: A total of 196 gastric cancer patients who underwent a distal gastrectomy between March 2001 and February 2004 were divided into 3 groups: JPI group (n=100), B-I group (n=29), and B-II group (n=67). We assessed the patient's nutritional status, gastric emptying time, and gastrofiberscopic findings. Results: The percents of body weight loss at 6 months, 1 year, and 2 years postoperatively in the JPI group ($5.14\%,\;3.01\%,\;2.37\%$) were significantly less than those of the conventional B-I ($8.41\%,\;6.69\%,\;5.90\%$) and B-II groups ($7.50\%,\;7.65\%,\;5.86\%$) (P=0.011, 0.000, 0.013). The laboratory findings showed no significant differences between the 3 groups, except for a higher total protein level in the JPI group after 6 months postoperatively. Especially, stage I and II cancers in the JPI group showed much higher total protein levels after 1 year postoperatively. The gastric emptying times in the $\^{99m}$Tc- semisolid scans at 6 months, 1 year, and 2 years postoperatively were 102.5, 83.1, and 58.1 minutes in the JPI group, 95.5, 92.0, and 58.5 minutes in the B-I group, and 53.9, 69.1, and 50.2 minutes in the B-II group, respectively. Also, the symptomatic gastric stasis detected with a gastrofiberscope during the early postoperative period (6 months) was gradually improved. Conclusion: From a nutritional aspect, a jejunal pouch interposition after a distal gastrectomy could be an alternative reconstruction method, especially in stage I and II gastric cancer patients, in spite of the longer operation time and the probable delayed gastric emptying.

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