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Cartilage Shaving Procedure for Thyroid Carcinoma Invading the Tracheal Cartilage: Is it an Appropriate Treatment? (기관연골 침윤 갑상선암의 면도식 절제술식의 평가)

  • Park Cheong-Soo;Suh Kwang-Wook;Min Jin-Sik
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.1
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    • pp.1-5
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    • 1992
  • 기관연골까지만 침윤된 갑상선암에서 침윤된 기관연골을 면도식으로 깍아 내는 술식을 선택했을때 효과적인 치료방법이 되는가를 알아보기 위하여 본 연구를 실시하였다. 1979년 부터 1988년까지 10년간수술이 시행된 갑상선암환자 432예중 기관연골까지만 침윤된 환자는 16예 이였다. 남자가 3예, 여자가 13예 이었으며, 이들의 평균 연령은 55.8세 이었고, 조직학적으로는 유두상암이 14예, 여포상암이 2예 였다. 전예에서 침윤된 기관연골을 면도식으로 깍아내였으며, 수술후 보조치료로 방사성 동위원소 치료나 외부 방사선 조사를 추가하였고, 또한 갑상선 홀몬 투여로 TSH 억제 치료를 하였다. 평균 추척 기간은 67.7개월이었다. 16예중 무병생존은 4예에 불과하였고, 12예가 치료에 실패했는데 이중 7예는 갑상선암의 재발로 사망하였다. 이상의 결과로 면도식 절제술은 갑상선암이 기관연골에 침윤되었을 때의 술식으로는 부적당하며 무병 생존율을 향상시키기 위해서는 비록 표재성인 기관연골 침윤이라도 기관제술과 같은 적극적인 술식 선택이 바람직하다고 사료되었다.

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Characteristic CT Images in Diffuse Lung Disease (미만성 폐질환(肺疾患)에 있어서 특징적(特徵的)인 CT상(像)에 관하여)

  • Ichikawa, Hidel;Kanamori, Isao
    • Journal of radiological science and technology
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    • v.18 no.2
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    • pp.37-48
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    • 1995
  • 1) 천식 기관지 확장증에서는 기종상 음영이나 기관지가 확장된 상이 있고, 또한 미만성 범세기관지염 5예에서는 미세 반점상 음영이 전체 예에서 인정이 되었다. 2) 폐염에서는 기관지의 확장이나 점액이 고여 침윤음영이 전체 예에 나타나고 있었다. 한편, 간질성 폐염 29예에서는 반점상 음영(불균일 CT치의 상승과 내부에 작은 기관지 확장으로 작은 air상)이 보였다. 폐섬유증 19례에서는 기종상 농포상 음영이나 혈관 기관의 부정 확장, 반점상 음영이 15예로 79 %를 차지하고 있다. 만성 폐기종에서는 기종상, 다발성 농포상 음영, 고목상 혈관이 특징적인 소견이었다. 3) 속립성결핵에서는 작은 입상 음영, 폐결핵 15예에서는 공동 음영 7예, 원형의 융합음영 8예, 침윤음영, 다수의 석회화상, 혈관 기관의 부정 확장 등이 특징적이었다. Aspergillus증에서는 공동 음영 내부에 fungus ball이 보였다. 이상은 미만성 폐질환의 특징적인 CT의 이상 소견에 대해서 검토하였으나, 꼭 일치되는 것은 아니며, 기타 기초적 검사나 임상적인 경과관찰이 필요하였다. 끝으로, 대한방사선기술학회의 발전과 학회원 여러분의 건승을 기원합니다. 그리고 한국과 일본의 우호적인 학술교류가 지속되기를 희망합니다.

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Application Plan of Flooding Forecasting and Warning System by Site Type of Excavation Work (굴착공사현장 수재해 예방을 위한 침수 예·경보 시스템 적용방안에 관한 연구)

  • Wang, Jeong Ah;Park, Jong Pyo;Lee, Woo Jin;Jun, Hwan Don
    • Proceedings of the Korea Water Resources Association Conference
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    • 2022.05a
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    • pp.379-379
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    • 2022
  • 기후변화로 인해 집중호우, 돌발 홍수 및 태풍의 규모가 대형화되고 있고, 이에 따른 수재해 피해 사례도 증가하는 추세이다. 특히 건설 현장 중 굴착공사 현장에서의 침수로 인한 사고는 인명피해로 이어질 가능성이 더 크기 때문에 더욱 주의가 필요하다. 하지만 현재 국내에서 실질적으로 굴착현장에 적용하기 위한 침수 대응 예측 시스템 및 구체적인 침수 예경보 체계, 기준, 매뉴얼은 존재하지 않는 실정이다. 따라서 본 연구에서는 굴착공사현장의 수재해 예방을 위한 침수 예·경보 시스템의 적용방안을 제시하였다. 또한 경제적이고 효과적인 측면을 고려하여, 공사현장 규모에 따라 적용하는 침수 예·경보 시스템을 이분화하여 소규모 공사현장에는 Track A, 대규모 공사현장에는 Track B 침수 예·경보 시스템을 적용하도록 제안하였다. 이러한 이유는 소규모 공사현장의 특성상 전체 공사비가 작고 운영되는 장비와 인력이 제한적이므로 침수 예·경보에 필요한 비용과 인력 투입이 어려울 수 있기 때문이며, 또한 대피가 필요한 전체 인원이 대규모 현장에 비해서는 적기 때문에 비교적 신속하고 원활한 대피가 가능할 것이라고 판단하였기 때문이다. 본 연구에서는 각 시스템별 적절하다고 판단되는 예·경보 기준을 제시하였다. Track A에서는 강우법에 의한 최소한의 경보시스템으로 필요한 안전목표를 달성할 수 있도록 고려하였고, Track B에서는 현장인원 대부분이 성인 남성임을 고려하여, 성인 남성의 부상을 유발할 수 있는 수심(H)과 유속(V)의 곱을 척도로 하는 한계 H·V곡선을 기준으로 운영되는 경보시스템을 제안하였다.

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A Clinical Use of CT Scan in Rectal Cancer (직장암 단층촬영(CT)의 임상적 이용)

  • Suh, Bo-Yang;Chung, Yong-Sik;Lee, Su-Jeung;Shim, Min-Chul;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.67-72
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    • 1986
  • Authors evaluated the accuracy of preoperative pelvic CT scan staging and its effects on management in 12 biopsy proved rectal cancer patients. Authors also studied postoperative CT in 5 patients to detect disease recurrence and metastasis. Preoperative CT staging was identical to surgical and/or pathological staging in 9 patients(75%), but it was underestimated in two cases and overstimated in one instance than in surgical stagings. In 7 cases, CT scan didnot alter original choice of procedures. However, preoperative CT staging gave definitive informations to change management plans in 5 cases otherwise the treatment would be difficult and inadequate. Postoperative CT showed local recurrence in one and liver metastases in 2 cases. One of them was not detected at exploratory laparotomy.

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Surgical Treatment of Cardiac Tumor (심장에 발생한 종양의 수술적 치료)

  • Jung, Tae-Eun;Han, Sung-Sae;Lee, Dong-Hyup
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.810-814
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    • 2006
  • Background: Tumors of the heart are uncommon. The aim of this study is to review our clinical experience and outcome of surgical treatment of cardiac neoplasm. Material and Method: From March 1990 to December 2005, 35 patients(14 males and 21 females) with mean age of 52.4 years underwent surgical treatment of cardiac neoplasm. The clinical and pathologic data were analyzed retrospectively. Surgical treatment consisted in complete resection of the tumor in all cases but 1 patient who was left ventricular fibroma received biopsy only. Result: Thirty cases were benign and five cases were malignant tumor. Benign tumors were myxoma(29 cases) and fibroma(1 case). Five malignant tumors were osteosarcoma, hepatocellular carcinoma, renal cell cancer, yolk sac tumor, and unclassified myxoid spindle cell type sarcoma. There were no operative mortality in benign cases and twenty seven cases of myxoma were followed up for 8 months to 15 years without recurrence. But four patients of malignant tumor were expired within six months after operation. Conclusion: Left atrial myxomas are most common benign neoplasm. Surgical treatment is effective for the benign cardiac tumors but prognosis is poor in patients with malignant cardiac tumors.

CLINICO-AUDIOLOGICAL EVALUATION OF NON-OTOLARYNGOLOGICAL INPATIENTS CONSULTED FOR AUDIOMETRIC TEST (청력검사를 의뢰한 타과 입원환자의 임상청각학적 고찰)

  • Park, Ki-Hyun;Park, Soon-Il;Lee, Yang-Sub;Kwon, Jun;Lee, Jin-Ho;Kang, Jung-Soo
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.10.2-10
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    • 1987
  • 최근 사회구조의 발달로 우리주변에는 뜻하지 않은 청력장애를 일으키는 경우가 많고 의료보험 실시와 더불어 생활수준의 향상으로 이비인후과 외래를 찾는 청력장애자들이 많아지고 있다. 또한 청력장애를 호소하여 청각검사를 의뢰하는 타과 입원환자도 점차적으로 증가하고 있는 실정이다. 이에 저자들은 1985년 1월 1일부터 1986년 12월 31일까지 만2 년간 연세대학교 원주의과대학부속 원주기독병원 이비인후과로 의뢰된 타과 입원환자 1063예중 청각검사를 시행한 182예를 대상으로 임상청각학적 고찰을 하여 다음과 같은 결과를 얻었다. 1) 의뢰한 과별로는 신경외과(50.5%)가 제일 많았고 다음 내과(23.6%)의 순이었다. 2) 원래질환과 청력장애사이에 연관관계가 있는 경우는 102예 (56.0%)이었으며 이중 외상이 87예(86.2%)로 제일 많았다. 3)외상의 경우 폭발사고가 35예 (40.2%)로 제일 많았고 다음 교통사고 28예(32.1%)의 순이었다. 이 중 계속적인 추적치료를 시행한 경우가 9예 (10.3%)에 불과하였다. 4) 외상의 경우 청력손실의 형태별로는 전음성이 41예 (47.1%), 감음신경성이 30예(34.4%), 혼합성이 7예 (8.2%) 였으며, 사병자(malingerer)가 9예 (10.3%) 였다. 결론적으로 강원도의 지역적 특성상 탄광폭발 사고로 인한 외상후 이차적으로 청력손실을 호소하는 환자가 많은 편으로 이에 대한 적극적인 진단 및 추적치료를 위하여 특히 신경외과와 상호협조 체제가 필요할 것으로 사료된다.

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Leiomyosarcoma of Small Intestine -Two cases report with literatural review- (소장의 원발성 평활근육종 2예)

  • Chung, Yong-Sik;Suh, Bo-Yang;Kwun, Koing-Bo;Lee, Tae-Sook
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.281-286
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    • 1985
  • Small bowel malignancy consists 1~2 % of overall gastrointestinal tract cancer and leiomyosarcomas of small intestine are 10~20% of small bowel malignancy. Small bowel leiomyosarcomas are rare in incidence and have no specific symptoms, signs or definite radiologic findings, so it is not easy to diagnose at early stage of disease. They are found occasionally by unknown origined gastrointestinal bleeding, abdominal pain, intestinal obstruction, perforation and palpable mass, and diagnosed mostly by operation. Recently annual case reports are increasing trend in Korea. We experienced two cases of small bowel leiomyosarcoma which was diagnosed finally by pathologic findings, so we report them With literatural review.

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Development of Safe Navigation Contents for Aging Seafarer in Tug-barge Transportation (고령 예부선 운항자를 위한 안전운항 교육 콘텐츠의 개발)

  • Kim, Hong-Tae;Chang, Hea-Jung;Kim, Hye-Jin
    • Journal of Navigation and Port Research
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    • v.35 no.5
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    • pp.351-358
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    • 2011
  • Recently, tugs and barges have become larger in size and increased in number. Also, most of tugs and barges are more than ten-years old. Total number of marine accident has been decreased, whereas that of accidental happening in tug-barge transportation has not been decreased. The statistics of marine accidents in 2010 shows that tug-barge accidents increased rapidly compared with those of 2009. The cause of accidental happening in tug-barge transportation is a quality of tug-barge operator the labour serious shortage of crew. This study is to give or suggest the various educational contents considering old age of crew and navigational environment for safe navigation in tug-barge transportation.

The Clinical Features of Endobronchial Tuberculosis - A Retrospective Study on 201 Patients for 6 years (기관지결핵의 임상상-201예에 대한 후향적 고찰)

  • Lee, Jae Young;Kim, Chung Mi;Moon, Doo Seop;Lee, Chang Wha;Lee, Kyung Sang;Yang, Suck Chul;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.671-682
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    • 1996
  • Background : Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method : The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 10 April 1996. The following results were obtained. Results: 1) Total 201 parients(l9.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146. and the male to female ratio was 1 : 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%. cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5 %, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous s.enosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, bronchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB slain positive in 36.4%. granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%. and non diagnostic biopsy finding in 14.1%. Conclusions : Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.

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Clinical Observations on 12 Children with Alport Syndrome (Alport 증후군 환아 12명의 임상적 고찰)

  • Bae Young-Min;Kim Seoung-Do;Kang Hyeon-Ho;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.48-56
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    • 2000
  • Purpose: Alport SD., the most common herectitary rephriris, is a renal disease with rapid progression. Deafness, ocular abnormalities and a specific EM finding may be associated in addition to a family history. We have aralyged retrospectively. Methods: We observed 12 children with Alport syndrome who were diagnosed at Dept. of pediatrics in Kyunghee Univ., College of Medicine, from Apr. 1991 until Jun. 1999. We used four criteria for diagnosis: renal disease, family history, deafness or eye abnormalities, and a specific finding in electron microscopy Results: 2 of 12 patients had all features of the four diagnostic criteria. We could not trace an exact family history in 3 patients, and 6 patients did not exhibit deafness or eye abnormality. One could not have renal biopsy because offer chronic renal failure. Other three criteria were observed in her. The ratio of male to female observed was 1:2 respectively and the mean age of initial renal symptom was 5.6 years. 9 of 12 patients had a family history of renal disease. In the audiogram and ocular examination for 11 of 12 cases, sensorineural hearing loss was observed in 6 and ocular abnormality in 2 cases. In electron microscopic finding, irregular thickness of the capillary basement membranes with lamination of lamina densa and foot process obliteration was noted in 9 of 11 and thin basement membrane with splitting and foot process obliteration was noted in the other 2. The mean period of follow-up was 3 6/12 years. And one patient developed the chronic renal failure until now and had kidney transplantation. Conclusion: For the diagnosis of Alport syndrome, the following four diagnostic criteria are very important : renal disease, family history, deafness or eye abnormalities, and a specific finding on electron microscopy. We expect that more patients can be detected through the analysis of these characteristics.

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