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Clinical Investigation of Cervical Tuberculous Lymphadenitis (결핵성 경부 임파선염의 임상적 고찰)

  • Park, Mi-Ran;Kim, Chang-Sun;Seo, Jee-Young;Son, Hyung-Dae;Rheu, Nam-Soo;Cho, Dong-Il
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1225-1233
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    • 1997
  • Background : Cervical tuberculous lymphadenitis(CTL) is one of the most common extra-pulmonary tuberculosis. Recently overall incidence of pulmonary tuberculosis has decreased, but the incidence of tuberculous lymphadenitis has not decreased. Its duration of treatment is still controversial and the pathogenesis, prognosis and relationship with other site tuberculous are poorly published. So we did a retrograde study of 120 cases of confirmed CTL about its clinical manifestations. Method : All patients were applied fine needle aspiration(FNA) of palpable enlarged cervical lymph nodes and 114 patients were examined for AFB smear and 34 patients for TB culture with aspirated fluid. 57 patients were examined Mantoux test(5TU with PPD-S). With above methods, a total of 120 patients was diagnosed as having CTL. Results : 1) CTL is most prevalent in young women between the age of 20~30 years and the incidence of CTL in female is 2.5 times higher than that of male. It is located most commonly in the posterior cervical area. The most common presenting symptom is painless palpable enlarged cervical lymph nodes. 2) With FNA of enlarged cervical lymph nodes, the percentage of histopathological positivity is 82.3%. The percentage of AFB smear positivity is 38.6%, and that of TB culture positivity is 17.6%(p<0.001). 3) Pulmonary tuberculosis is noted in 79 cases(65.8%). And 42 cases(53.5%) of them had minimal pulmonary tuberculosis. In 14 cases(11.7%), other extrapulmonary tuberculosis coexsisted and pleural tuberculosis was most Common in the order. 4) CTL was treated with anti-tuberculous medication(first line drug) and median treatment duration was 18.5months. During treatment, the size of involved lymph nodes decreased gradually in 62 cases(75.8%), newly developed lymph nodes were found in 25 cases(30.4%), fluctuation formation in 22 cases(26.8%) and fistula formation in 14 cases(17.0%). Conclusion : CTL is prevalent in women between the age of 20~40 years and it involves posterior cervical area most commonly. CTL is treated with long-term anti-tuberculous chemotherapy. We think it is one manifestation of systemic disease and frequently coexisting with pulmonary tuberculosis. Despite anti-tuberculous chemotherapy, the size of involved lymph nodes was increased, new lymph nodes were developed or fluctuation and fistula formed in involved lymph nodes. After sufficient medication, when the patient felt pressure discomfort from enlarged lymph node or fistula was formed, we recommended total excision of involved lymph nodes.

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Rapid Detection of Rifampicin Resistant M. tuberculosis by PCR-SSCP of rpoB Gene in Clinical Specimens (RpoB 유전자 PCR-SSCP법에 의한 임상검체내 Rifampicin 내성 결핵균의 신속진단)

  • Shim, Tae-Sun;Kim, Young-Whan;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1245-1255
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    • 1997
  • Background : Rifampicin(RFP) is a key component of the antituberculous short-course chemotherapy and the RFP resistance is a marker of multi-drug resistant(MDR) tuberculosis. RPoB gene encodes the $\beta$-subunit of RNA polymerase of M. tuberculosis which is the target of RFP. And rpoB gene mutations are the cause of RFP resistance of M. tuberculosis. Although several reports showed that PCR-SSCP would be a rapid diagnostic method for identifying the RFP resistance, there were few reports Performed using direct, clinical specimens. So we Performed PCR-SSCP analysis of rpoB gene of M. tuberculosis in direct, clinical specimens. Methods : 75 clinical specimens were collected from patients at Asan Medical Center from June to August 1996. After PCR of IS 6110 fragments, 43 both AFB smear-positive and IS6110 fragment PCR-positive specimens were evaluated. The RFP susceptibility test was referred to the referral laboratory of the Korean Tuberculosis Institute. DNA was extracted by bead beater method. And heminested PCR was done using 0.1ul(1uCi) [$\alpha-^{32}P$]-dCTP. SSCP analysis was done using non-denaturating MDE gel electrophoresis. Results : The results of PCR of IS6110 fragments of M. tuberculosis were positive in 55(73%) cases of 75 AFB smear-positive clinical specimens. Of the 55 specimens, RFP susceptibility was confirmed in only 43 specimens. Of the 43 AFB smear-positive and IS6110 fragment-positive specimens, 29 were RFP susceptible and 14 were RFP resistant. All the RFP susceptible 29 strains showed the same mobility compared with that of RFP sensitive H37Rv in SSCP analysis of ropB gene. And all the other RFP resistant 13 strains showed the different mobility. In other words they showed 100% identical results between PCR-SSCP analysis and traditional susceptibility test. Conclusion : The PCR-sseP analysis of rpoB gene in direct clinical specimens could be used as a rapid diagnostic method for detecting RFP resistant M. tuberculosis.

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PHYSIOANATOMY OF NASOPHARYNGEAL SPACE AND HYPERNASALITY IN CLEFT PALATE (구개열에서 비인두강의 생리해부학적 구조와 과비음과의 연관성 연구)

  • Cho, Joon-Hui;Pyo, Wha-Young;Choi, Hong-Shik;Choi, Byung-Jai;Son, Heung-Kyu;Sim, Hyun-Sub
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.721-728
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    • 2004
  • Velopharyngeal closure is a sphincter mechanism between the activities of the soft palate, lateral pharyngeal wall and the posterior pharyngeal wall, which divides the oral and nasal cavity. It participates in physiological activities such as swallowing, breathing and speech. It is called a velopharyngeal dysfunction when this mechanism malfunctions. The causes of this dysfunction are defects in (1) length, function, posture of the soft palate, (2) depth and width of the nasopharynx and (3) activity of the posterior and lateral pharyngeal wall. The purposes of this study are to analyze the nasopharynx of cleft palate patients using cephalometry and to evaluate the degree of hypernasality using nasometry to find its relationship with velopharyngeal dysfunction. The following results were obtained : 1. In cephalometry, there were significant differences in soft palate length, soft palate thickness, nasopharyngeal depth, nasopharyngeal area, and adequate ratio between two groups. 2. In nasometry, there were significant differences between two groups in vowel /o/ and sentences including oral consonants. 3. In cleft palate patients, though no general correlation was found between Anatomic VPI and nasalance scores, vowel /i/ and sentences including oral consonants were slightly correlated. In conclusion, cephalometry and nasometer results were significantly different between the two groups. Though in the cleft palate group, Anatomic VPI and nasalance scores, which are indices for velopharyngeal closure, excluding the vowel /i/ and sentences including oral consonants show generally no significance.

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Case Study of Teaching Practices of Biology Teachers with and without Research Experience in Evolution Education (진화 교육 연구 경험 유무에 따른 생명과학 교사의 교수 실행 사례 연구)

  • Ko, Yuseon;Cha, Heeyoung;Lim, Mili
    • Journal of The Korean Association For Science Education
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    • v.37 no.4
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    • pp.747-761
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    • 2017
  • The purpose of this study is to analyze differences in the teaching practices of biology teachers according to their awareness of the importance of evolution. For this purpose, two teachers who experienced study of evolution and recognized its importance, along with two teachers with no experience in evolution education in the comparison group, were included in the sample. To observe teaching practices, two classes each on biological evolution and non-evolution were selected, recorded and transcribed. The content analyzed included the teachers' view on evolution education and teachers' evolution concepts reflected in teaching practice. As a result, the level of understanding of the teachers' evolution concept was unrelated to teachers' awareness of the importance of evolution. Instead, each teacher would not feel the need for religious beliefs or awareness of the importance of evolution to have a negative impact on the awareness of the importance of evolution. Inexperienced teachers tend to reject the retraining opportunities to recognize the importance of evolution. In addition, inexperienced teachers were only superficially aware of the evaluation and improvement of evolution presented in textbooks and curricula. In actual teaching practice analysis, inexperienced teachers' utilizing ratio of the evolution key concept was higher than that of experienced teachers. Only experienced teachers were aware of the misconceptions presented in their execution and described the causes that appear in these misconceptions. Teachers who recognized the importance of evolution were widely using the key concepts of evolution, as well as more practical in preventing the misconceptions related to evolution forms. It indicates that biology teachers who do not realize the importance of evolution in biology education need to experience explicit and practical education programs as well as instructional materials on evolution.

An Exploratory Empirical Study on Shopping Choice in Retail Channels by the Selective Characteristics of Foods (상품 선택 특성에 따른 쇼핑채널 선택에 관한 연구: 식품 MD를 중심으로)

  • Ha, Kwang-Ok;Lee, Jung-Hee
    • The Journal of Small Business Innovation
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    • v.20 no.1
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    • pp.35-46
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    • 2017
  • The purpose of this study is to obtain the implications for establishing a marketing strategy for retailers by analyzing whether the consumer's preference for products (food) is influenced by on-line, off-line, and omni-channel preferences. The research model consisted of the effects of consumers' food selection characteristics on business preference and omni channel preference. The results of analysis based on 477 questionnaires are summarized as follows. First, food purchasing characteristics that utilize the seven characteristics of (1) freshness of food, (2) taste, (3) quality and safety, (4) tasting, (5) food function and information, (6) country of origin, and (7) brand loyalty, has various effects on types of business preference, omni-channel preference. The adopted hypotheses were selected in order of brand loyalty (5 times), freshness (3 times), tasting (3 times), and origin (1 time). The selective attributes on foods are: (1) what kind of brand, (2) how good the freshness is, (3) tasting. (4) The country of origin is to be compressed. Actually consumers seem to utilize only the core selective factors that are appropriate to the characteristics of the distribution channel rather than all of them in the shopping of the food, and there is three characteristics on Convenience Store and only one or two factors in the other types of business. Second, in the analysis of the omni-channel preference analysis, food selection characteristics has been shown to have a limited effect, which is attributed to the fact that the consumer has not yet understood the concept of omni channel. Third, the results of this study suggest that there is a need to reflect the selection characteristics of foods that have diverse influences by business type in the marketing strategies. Because consumers make reasonable consumption to use both on-line and off-line simultaneously, consumers who use Omni Channel focus on quality and safety of food, identify products through tasting, pursue brands that can trust anywhere. Customers who pursue rationality will have a high preference for using Omni Channel. Product choice characteristic has significant effect on omni-channel preference. For a few years, omni-channel strategy of retailers meets with a difficulty. This study make a first attempt to study omni-channel preference changing retailing paradigm.

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Economic Crisis and the Lowest-Low Fertility (경제위기와 저출산)

  • Lee, Sung-Yong
    • Korea journal of population studies
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    • v.29 no.3
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    • pp.111-137
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    • 2006
  • The purpose of this study is to analyze how to change the fertility behavior at each parity after/before the economic crisis, and to find its significant determinants. The study assumes that because the socioeconomic changes have significant effects on the individual's fertility behavior, the individual's fertility behaviors and the determinants affecting fertility at each parity may change with economic crisis. Such assumption has been proven in this study. After the economic crisis, Korean fertility behavior at each parity has changed. The proportion of women having no child has increased. However, women who want to have a second child or a third one are more likely to do so within shorter period after marriage. The rectangularization of fertility has appeared after the economic crisis, because women married at later ages tends to finish their child bearing within the short period, especially before age 35. Based on the multiple variable analysis, the determinants affecting the fertility behavior have changed after the economic crisis. Interestingly, the men's safety job have the positive effects on the first childbearing while the women's safety careers have the negative effects on it, after the economic crisis. Before the economic crisis, both do not have significant effects on the first childbearing. This findings point out the limitation of women career favor policy, which purpose to raise the fertility rates by making good environments for women having children to work comfortably without the anxiety of child care.

Family Structure and Succession of the Late Chosun Seen through Male Adoption (양자제도를 통해 본 조선후기 가족구조와 가계계승: 의성김씨 호구단자 분석을 중심으로)

  • Park, Soo-Mi
    • Korea journal of population studies
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    • v.30 no.2
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    • pp.71-95
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    • 2007
  • This paper attempts to identify the principle of family succession and family patterns of yangban in the late Chosun period through an analysis of male adaptation cases found in family registration records. The primary source of analysis is the family registration documents of Uiseong Kim's from the late 17th century to the early 20th century. As a result, it is found that there is a substantial change in the patterns of family from the early and mid Chosun period to the late Chosun period. The change is the strengthening of the principle of patriarchy succession through male adoption. Looking at the data as a whole, the average number of household members is increased and the membership of kinship also expanded. In contrast to the family patterns of the early Chosun period, not only the patterns of Uiseong Kim's family are predominately immediate family or collateral family but also the majority is extended family in the 18th and 19th centuries. The male adoption cases recorded in Uiseong Kim's family registration documents take up 33.8% of the male adoption cases in the entire family registration documents. This goes to show that the strengthening of the principle of primogeniture succession at a time when child mortality rate is very high resulted in the increase of male adoption. In conclusion, the late Chosun society was a society where the seat of primogeniture was much more important than immediate hereditary members in the family succession.

A Study on the DC Resistivity Method to Image the Underground Structure Beneath River or Lake Bottom (하저 지반특성 규명을 위한 수상 전기비저항 탐사에 관한 연구)

  • Kim Jung-Ho;Yi Myeong-Jong;Song Yoonho;Choi Seong-Jun;Lee Seoung Kon;Son Jeong-Sul;Chung Seung-Hwan
    • Geophysics and Geophysical Exploration
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    • v.5 no.4
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    • pp.223-235
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    • 2002
  • Since weak Bones or geological lineaments are likely to be eroded, there may develop weak Bones beneath rivers, and a careful evaluation of ground condition is important to construct structures passing through a river. DC resistivity method, however, has seldomly applied to the investigation of water-covered area, possibly because of difficulties in data aquisition and interpretation. The data aquisition having high quality may be the most important factor, and is more difficult than that in land survey, due to the water layer overlying the underground structure to be imaged. Through the numerical modeling and the analysis of a case history, we studied the method of resistivity survey at the water-covered area, starting from the characteristics of measured data, via data acquisition method, to the interpretation method. We unfolded our discussion according to the installed locations of electrodes, ie., floating them on the water surface, and installing them at the water bottom, because the methods of data acquisition and interpretation vary depending on the electrode location. Through this study, we could confirm that the DC resistivity method can provide fairly reasonable subsurface images. It was also shown that installing electrodes at the water bottom can give the subsurface image with much higher resolution than floating them on the water surface. Since the data acquired at the water-covered area have much lower sensitivity to the underground structure than those at the land, and can be contaminated by the higher noise, such as streaming potential, it would be very important to select the acquisition method and electrode array being able to provide the higher signal-to-noise ratio (S/N ratio) data as well as the high resolving power. Some of the modified electrode arrays can provide the data having reasonably high S/N ratio and need not to install remote electrode(s), and thus, they may be suitable to the resistivity survey at the water-covered area.

e-Navigation 관련 산업현황에 관한 기초연구

  • Choe, Han-Gyu;Gang, Byeong-Jae
    • 선박안전기술공단연구보고서
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    • s.4
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    • pp.1-108
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    • 2007
  • 2007. 7. 23 IMO의 NAV(항해안전전문위원회)53차 회의에서는 e-Navigation을 해상에서의 안전, 보안, 해양환경보호를 목적으로 전자적인 수단에 의해 선박과 육상에서 해양정보를 수집, 교환, 표시함으로써 항구와 항구간의 항해 및 관련된 서비스를 향상시키는 것으로 정의하고 있다.2005년 11월 영국의 교통부 장관 Stephen 박사는 Royal Institute ofNavigation에서의 연설에서 해상안전과 환경보호를 위하여 선박의 항해를 감시하는 관제소 및 항행하는 선박에 유용하고 정확한 정보가 더 많이 필요함을 역설하였다. 그리고 첨단 기술에 의해 자동화된 항공 항법분야를 예로들면서, 선박의 항법 분야도 항해와 관련된 모든 시설 및 작업을 전자적 수단으로 대체하는 개념인 e-Navigation으로 전환되어야 하며 영국은 이에 필요한 작업을 주도하겠다는 의견을 피력하였다. Stephen은 e-Navigation 도입으로 얻을 수 있는 이익으로 첫째, 항해 실수로 인한 사고 확률저감, 둘째,사고 발생 시 인명 구조 및 피해 확산을 위한 효율적 대응, 셋째, 전통적인항해시설 설치 불필요로 인한 비용 저감, 넷째 선박입출항 수속의 간편화 및항로의 효율적 운용으로 인한 상업적 이익 등을 들었다. 반면에e-Navigation 체계로 전환 시 예상되는 장애로는 첫째, 체계 구축을 위한 비용(특히 개발도상국가들의 경우 어려움 예상), 둘째, e-Navigation의 성과 달성을 위하여 세계 전 해역의 모든 선박이 e-Navigation 체계에 동참하도록유도하는 문제, 셋째, 전자해도 표시 및 선교 장비들에 대한 표준화 문제, 넷째, 육상에 설치할 e-Navigation 센터의 설계 및 구축 등을 꼽았다.IMO는 2005년 81차 MSC(해사안전위원회) 회의에서 영국이 일본, 마샬아일랜드, 네덜란드, 노르웨이, 싱가포르, 미국과 공동으로 제안한 ‘e-Navigation전략 개발’ 의제를 2006년 82차 MSC 회의에서 채택하고, NAV(항해 전문위원회)를 통하여 2008년까지 e-Navigation의 구체적 개념을 정립하고 향후 개발하여야 할 전략적 비전과 정책을 수립하기로 하였다. 이어서 영국을 의장으로 e-Navigation 전략개발 통신작업반이 구성되었는데, 지난 년간 19개국, 16개 전문기관이 참여하여 아래의 작업이 수행되었다. ○ e-Navigation 개념의 정의와 목적 ○ e-Navigation에 대한 핵심 이슈 및 우선 순위 식별 ○ e-Navigation 개발에 따른 이점과 단점의 식별 ○ IMO 및 회원국 등의 역할 식별 ○ 이행계획을 포함한 추가 개발을 위한 작업계획의 작성 IMO에서 수행되고 있는 e-Navigation 전략 개발 의제 일정은 2008년까지이다. 이 전략 개발에 있어서 중요한 요소는 e-Navigation이 포함할 서비스범위, 포함하는 서비스 제공에 필요한 인프라 및 장비의 식별, 인프라 구축및 운용비용을 부담할 주체에 대한 논의, e-Navigation으로 인한 이익과 투자비용에 대한 비교 분석 등이다. 이 과정에서 정부, 선주, 항만운영자, 선원등의 입장 차이와 선진국과 개발도상국 간의 경제 수준 차이는 전략 개발에있어 큰 어려움을 줄 것이므로, 이들이 합의된 전략을 만들기 위해서는 예정된 기간보다 다소 늦어질 가능성도 있다.e-Navigation 전략 개발이 완료되면 1단계로는 해상교통 관제시스템, 선박선교 장비, 무선 통신장비 등에 대한 표준화 작업이 이루어질 것이다. 이 과정에서 각국 간에 자국 보유 기술을 표준화시키기 위한 경쟁이 치열할 것으로 예상된다. 2단계에서는 e-Navigation 체계 하에서의 다양하고 풍부한 서비스 제공을 위한 관련 소프트웨어 및 하드웨어의 개발이 이루어질 것으로전망되는데, 이는 지난 10년간 육상에서 인터넷망 설치 후 이루어진 관련 서비스 산업의 발전을 돌아보면 쉽게 짐작할 수 있을 것이다.e-Navigation 체계 하에서 선박의 항해는 현재와는 전혀 다른 패러다임으로 바뀔 것이다. 예를 들어 현재 입출항 시 요구되던 복잡한 절차는one-stop 쇼핑 형태로 단순화되고, 현재 선박 중심의 항해에서 육상e-Navigation 센터가 적극적으로 관여하는 항해 체계로 바뀔 것이며, 해상정보의 공유와 활용이 무선 인터넷을 통해 보다 광범위하게 이루어질 것이 다.e-Navigation의 잠재적 시장 규모는 선박에 새로이 탑재될 지능형 통합 항법시스템 구축과 육상 모니터링 및 지원 시스템 등 직접 시장이 약 50조원,전자해도, 통신장비, 관련 서비스 컨텐츠 등 간접 시장의 규모가 150조원으로 총 200조원으로 대략 추산하고 있다. 향후 이 거대한 시장을 차지하기 위한 전략 수립이 필요한 시점이다. 지금까지 항해 장비 관련 산업은 선진국의일부 업체들에 의해 독점되어 왔다. 우리나라는 조선과 해운에서 모두 선진국임에도 불구하고 이 분야에서는 대부분 수입에 의존해 왔다. e-Navigation체계 하에서는 전체 시장이 커지고 장비의 사양이 표준화됨에 따라 어느 소수 업체가 현재처럼 독점하기는 더 이상 어려울 것으로 예상된다. 따라서e-Navigation은 우리나라도 항해 장비 분야 시장을 차지할 수 있는 좋은 기회라고 할 수 있다. 특히 조선 1위의 장점을 적극 활용한다면 다른 나라보다우위의 경쟁력을 확보할 수도 있다. 또한, 서비스 분야의 시장은 IT 기술과밀접한 관계가 있으므로 IT 강국인 우리나라가 충분한 경쟁력을 갖고 있다고 할 수 있다.그러나, EU를 비롯한 선진국에서는 이미 e-Navigation 에 대비한 연구를10여년 전부터 수행해 왔다. 앞에서 언급한 EU의 MarNIS 사업은 현재 거의마무리 단계로 당장 실용화 할 수 있는 수준에 있는 것으로 보인다. 늦었지만 우리도 이를 따라잡기 위한 연구를 서둘러야 할 것이다. 국내에서도e-Navigation의 중요성을 깊이 인식하고, 2006년에는 관련 산학연 전문가들로 작업반을 구성하여 워크숍 등을 개최한 바 있다. 또한 해양수산부에서도e-Navigation 핵심기술 개발을 위한 연구사업을 기획 추진하고 있다.그러나 현재 항해통신장비들의 기술기준은 ITU의 전파규칙(RR)과 IMO결의 및 SOLAS 협약을 따르고 있는데 이들 규약이나 결의에 대한 국제적인 추이와 비교할 때 국내의 기술은 표준화되지 못한 부분이 많은 실정이다.본 연구에서는 e-Navigation sytem중 표준화가 필요한 요소와 전자해도,AIS 등 e-Navigation(통합전자항법시스템)관련 국내산업현황 실태조사를 통해 국내 e-Navigation기술개발 동향에 대해 조사하고자 한다.

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Adenoid Cystic Carcinoma of the Head and Neck (두경부의 Adenoid Cystic Carcinoma)

  • 박준식;설대위
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.14.2-14
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    • 1981
  • In 1859, Billroth used the term "Zylindrome" to describe a tumor arising in the paranasal sinuses. This neoplasm has been referred to by a variety of terms including cylindroma, basaloma, basaloid adenoma, cribriform adenocarcinoma, and "adenoid cystic carcinoma", now preferred by most authors. It most often arises in the major and minor salivary glands of the head and neck but has been noted in the trachea, lung, breast, skin and elsewhere. The tumors are characterized by a high incidence of local recurrence and ultimate distant metastases after agrressive attempts at surgical excision. Radiation therapy, while not curative, has proved uniformly useful in promoting tumor regression and pain relief as a palliative treatment. The present study was undertaken to review our experience with a group of 44 patients with adenoid cystic carcinoma of the head and neck, diagnosed at the Jeonju Presbyterian Medical Center between 1963 and 1980. The results are as follows: 1. Forty-four cases of adenoid cystic carcinoma represented 40% of the malignant salivary gland tumors during the same interval. 2. The most common primary sites were palate(8 cases) and submandibular gland (8 cases). 3. Thirteen patients (31%) had tumors. that arose in the major salivary glands; 29 (69%), minor salivary glands. 4. Of the 44 patients, there were 21 males. and 23 females. 5. Age at diagnosis ranged from 19 to 78 years; the average age was 50 years. 6. The tumor size was more than 4cm to 6cm in its greatest diamension in 10 patients. Clinically positive cervical lymph nodes were found in 7 patients; distant metastasis in one case at the time of diagnosis. 7. Radical excision was employed in 27 patients, 14 of whom combined with radiotherapy. 8. Of 29 patients available for follow-up the gross and determinate 3-year survival rates were 27.6% and 44.4%, respectively. Among twelve patients who received radical excision, the 3-year survival was 58%. 9. Ten of these 44 patients had local recurrence in an interval of 3 to 88 months. from the initial treatment. Of ten recurrences, 3 occured after 5 years. 10. Distant metastasis was found in 3 of the treated patients. All were pulmonary metastasis.

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