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Histopathological Studies on Carcinomas of the Stomach in the Taegu Area (대구지방의 위암에 대한 병리조직학적 연구)

  • Hong, Suk-Jae;Lee, Tae-Sook;Choi, Won-Hee;Lee, Kyung-Chul
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.65-69
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    • 1985
  • For evaluation on the histopathologic studies, and age and sex distribution of the gastric carcinomas in the Taegu Area, the gastrectomized and gastoroscopic biopsy materials were collected at the Department of Pathology, College of Medicine, Yeungnam University, and the analyzed results were as follows: 1. In total of 350 cases of gastroscopic biopsy materials adenocarcinomas are 344 cases (98.3%), squamous cell carcinomas and undifferentiated carcinomas are only 6 cases (1.7%). In adenocarcinomas the most of all are tubular type, 215 cases (61.4%). In age distribution the highest is the 50th age group, and 120 cases (34.3%), the next, 60th, 81 cases (23.1%), 40th, 76 cases (21.7%), respectively. 2. In total of 130 cases of gastrectomized materials adenocarcinomas are 127 cases (97.7%), and are the highest incidence, the next, carcinomas originated from chronic peptic ulcer of the stomach, and are 3 cases (2.3%). In adenocarcinomas the highest are tubular type, 86 cases (66.2%), the next, signet-ring cell type, 20 cases (15.4%). The highest age incidence of the age group IS 50th, and the next, 60th, 40th, 30th, 70th and 10th age group, respectively.

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Clinical and Bacteriological Observation of 128 Cases of Chronic Otitis Media (중이수술 128례에 대한 임상적 세균학적 고찰)

  • 김광수;김정중;이계실;차인숙
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.19.2-19
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    • 1983
  • A Clinical and bacteriologcal observation was performed 128 cases of chronic otitis media who had taken middle ear surgery at Dept. of otolaryngology of St. Benedict Hospital during the period of Feb. 1981 to Feb. 1983. The following results were obtained. 1) Among total 128 cases, male were 60 cases (46.9%) and female were 68 cases (53.1 %) and age distribution showed 48 cases (37.5 %) in 3rd decade, 37 cases (28.9 %) in 2nd decade and 27 cases (21.1 %) in 4th decade. 2) Site distribution were 71 cases (55.5%) in right, 57 cases (44.5 %) in left. 3) Degree of preoperative hearing loss were 64 cases (50%) in moderate, 32 cases (25% ) in mild, 27 cases (21.1 %) in severe and 5 cases (3.9%) were normal. 4) Central perforation were observed in 65 cases (50.8 %), total perforation in 44 cases (34.4 %), attic perforation in 12 cases (9.4 %) and marginal perforation in 7 cases (5.4 %). 5) Pathologic changes of middle ear and mastoid antrum showed granulation in 81 cases (63.3 %), cholesteatoma in 47 cases (36.7%). 6) The route of approach were 123 cases (96.1%) in postauricular, 3 cases (2.3%) in transmeatal and 2 cases (1.6 %) in endaural. 7) Type of operation were 53 cases (41.4 %) in intact canal wall tympanoplasty with mastoidectomy, 42 cases (32.8 %) in tympanoplasty without mastoidectomy, 23 cases (18%) in modified radical mastoidectomy and 10 cases (7.8%) in radical mastoidectomy. 8) Type of anesthesia were 95 cases (74.2 %) by local anesthesia, 33 cases (25.8 %) were by general anesthesia. 9) Among 93 specimens of culture, proteus (31.2%), staphylococcus (28.7%), pseudomonas (23.7 %), streptococcus (7.5 %) and etc. (8.7%) in order of frequency.

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Fine Needle Aspiration Cytology of the Mediastinal Lesions (종격동 병변의 경흉 세침흡인 세포학적 진단)

  • Park, In-Ae;Ham, Eui-Keun
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.43-50
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    • 1990
  • The authors report 16 cases of mediastinal fine-needle aspiration cytology from Jan. 1985 to Mar. 1988 at the Seoul National University Hospital. Among them, diagnostic material were obtained in fifteen cases, establishing the diagnosis of 7 thymomas, 2 germinomas, 2 neurogenic tumosr, 1 lymphoma, and 3 meastatic carcinomas. The 9 cytologic diagnoses could be confirmed by histologic examination in 8 patients and by another cytologic method in one patient, allowing concordance rate of 77%.

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항암화학요법후 골수억제가 수반된 진행암환자에서 rh GM-CSF(LBD-005)의 제1b 상 및 약동태학 연구

  • 라선영;이경희;이혜란;최진혁;정현철;노형근;김범수;노재경;한지숙
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.314-314
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    • 1994
  • 대상환자는 15예로, 14예에서 평가 가능하였으며 남녀비는 8:6, 중앙연령 32세(10-70세) 이었고, 대상질환은 악성골옥종 7예, 악성임파종 2예, 위암 2예, 폐암 2예, 그리고 자궁평활근육종 1예였다. rhGM-CSF 50 $\mu\textrm{g}$/$m^2$ 3예, 100 $\mu\textrm{g}$/$m^2$ 3예, 150 $\mu\textrm{g}$/$m^2$ 3예, 250 $\mu\textrm{g}$/$m^2$ 3예, 350 $\mu\textrm{g}$/$m^2$ 3예, 500 $\mu\textrm{g}$/$m^2$ 6예, 700 $\mu\textrm{g}$/$m^2$ 용량 3예에서 시행되었다. 1주기 시행한 환자는 7예, 2주기 5예, 3주기, 4주기 각각 1예씩 있다. 부작용은 50-150 $\mu\textrm{g}$/$m^2$에서 WHO grade I의 발열, 전신쇠약, 식용부진등이 관찰되었으나 grade II이상의 부작용은 없었다. 250 $\mu\textrm{g}$/$m^2$이상의 용량에서도 grade II의 발열이 관찰되었을 뿐 다른 중증의 부작용은 관찰되지 않았다. 최고용량인 700 $\mu\textrm{g}$/$m^2$ 에서도 grade II의 발열외의 중한 부작용은 관찰되지 않았다. 각 용량에 따른 백혈구 증가율(%투여제2일/투여제1일)은 130-500% 이었다. rhGM-CSF는 투여 2-4 시간후 혈중최고치 (0.42-15.4 ng/ml)가 관찰되었으며 투여 12시간까지 0.2-2 ng/ml 의 농도가 지속되었다. 소변내 rh GM-CSF 배설량은 총투여량의 1% 미만이었다.

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A Clinical Study for Gall Bladder Stones in Children (소아 담석증에 대한 임상적 연구)

  • Eun, Ho Seon;Baek, Seoung Yon;Chung, Ki Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.194-201
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    • 2005
  • Purpose: Gall bladder (GB) stones in children are rarely observed, and so reports of them have been quite limited in Korea. Therefore, we tried to assess the epidemiology and clinical features of children with GB stone diagnosed at Severance Hospital. Methods: A clinical study was performed on 18 patients below 15 years of age diagnosed with GB stone by abdominal ultrasonography or CT scan at Severance hospital from January 1999 to May 2005. Results: Concerning patients' profile, their sex ratio of male to female in total 18 cases was 2 : 1 with the mean age of $6{\pm}4.3years$. 15 patients (83.3%) were asymptomatic. Inducing factors were found in 14 children (77.8%) including ceftriaxone therapy in 6 cases (33.3%), infection in 4 cases (22.2%), spherocytosis in 3 cases (16.7%), Down syndrome and abdominal operation in 1 case (5.6%) respectively. Single stone was found in 13 cases (76.5%) and multiple in 4 cases (23.5%). 15 cases (88.2%) had the stones less than 5 mm in size, and 2 cases (11.8%) between 5 and 10 mm. 17 patients received conservative treatment, and one patient had cholecystectomy due to Meckel diverticulum. Conclusion: In this report, Pediatric GB stones are predominant in male children, without typical symptoms, having inducing factors, single and small. Recently the diagnosis of them has been increased because of the development of imaging study. But the reports for them were still rare in Korea. Therefore the study for them is more necessary to find it's clinical characteristics.

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Clinical Manifestations of 15 Cases of Pulmonary Sequestration (폐격리증 15예의 임상양상에 관한 고찰)

  • Park, Kwang-Joo;Kim, Eun-Sook;Kim, Hyung-Jung;Chang, Joon;Ahn, Chul-Min;Kim, Sung-Kyu;Lee, Won-Young;Kim, Sang-Jin;Lee, Doo-Yun
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.401-408
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    • 1997
  • Background : Pulmonary sequestration is a rare congenital malformation, which is manifested by formation of nonfunctioning lung tissue lacking normal communication with the tracheobronchial tree. The preoperative diagnostic rate has been relatively low, and without consideration of pulmonary sequestration, unexpected bleeding from aberrant vessels may be a serious problem during the operation. The purpose of our study is to describe the clinical features of pulmonary sequestration based on a review of 15 cases treated by operation. Method : Fifteen patients with pulmonary sequestration who had undergone surgical treatment from 1991 through May 1996 at Yongdong Severance Hospital and Severance Hospital were reviewed retrospectively. Results : The mean age of the patients was 22.5 years (range 5~57), and male to female ratio was 9 : 6. Clinical presentations varied from recurrent respiratory infections such as fever, cough, and sputum or chest pain to no symptom. The chest simple X-rays showed multicystic shadow(10/15) and solid mass-like shadow(5/15). The chest CT scans, done in twelve cases, showed multicystic lesion with or without lung infiltration(8/12), solid mass-like lesion(4/12), The chest MRIs, done in three cases, revealed the aberrant arteries originating from descending aorta(2/3). Aortograms, done in four cases, showed the aberrant arteries originating from descending thoracic aorta(2/4), abdominal aorta(I/4), and intercostal artery(1/4). and the venous returns were via the pulmonary veins. Pulmonary sequestration was considered preoperatively in six patients of fifteen. Other preliminary diagnosis were lung tumor(3/15), lung abscess(21/15), bronchiectasis(2/15), and mediastinal tumor(2/15). In the operative findings, twelve cases were of intralobar type and three cases of extralobar type. The left lower lobe was most often affected(9/15) and one extralobar sequestration was in the pericardium. The aberrant arteries originated from descending thoracic aorta(6/15), abdominal aorta(1/15), internal thoracic arteries (2/15), intercostal artery(1/15), pericardiophrenic artery(1/15), but in four cases, the origins could not be defined. There was no mortality or complication postoperatively. Conclusion : In our study, preoperative diagnostic rate was relatively low, and clinical features were similar to previous reports. Preoperative vigorous diagnostic approach including aortography is strongly advocated not only for its diagnostic value, but also for accurate localization of the aberrant vessels, which is major concern to surgical procedure.

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Causes of Under-staging in Patients with Gastric Cancer That was Proven to be Unresectable after a Laparotomy - Correlation with CT Findings (비절제 위암의 원인분석-전산화단층촬영(CT) 소견을 중심으로)

  • Yoon, Hyuk-Jin;Shin, Jung-Hye;Kim, Gab-Chul;Yu, Wan-Sik;Chung, Ho-Young
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.263-269
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    • 2006
  • Purpose: The aim of this study was to investigate the causes of under-staging in patients with advanced gastric cancer that was proven to be unresectable after a laparotomy. Materials and Methods: We retrospectively analyzed 25 gastric cancer patients who had undergone a diagnostic laparotomy between 2001 and 2005. For the preoperative evaluation, spiral CT and multidetector-row CT were performed. We analyzed the clinicopathologic features of patients and compared the image findings and the results of surgery. The causes of under-staging were divided into 3 groups; patient factor, CT factor, and interpretation factor. Results: Grossly, there were 12 cases of Borrmann type-III tumors and 13 cases of Borrmann type-IV tumors. The most frequent histologic type was poorly differentiated adenocarcinomas (8 cases) and signet ring cell carcinomas (7 cases). There were 13 cases of adjacent organ invasion, and the pancreas was the most frequently invaded organ (9 cases). There were 17 cases of peritoneal metastasis, and 3 cases of distant lymph node metastasis. For the cause of under-staging, there were four cases of patient factor, 19 cases of interpretation factor, and 9 cases of CT factor. In three cases, the cause of under-staging could not be identified. Conclusion: CT interpretation factor was the most frequent cause of under-staging in the preoperative diagnosis with gastric cancer patients. Therefore, more cautious CT interpretation is necessary to avoid unnecessary laparotomies in gastric cancer patients.

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Reoperation for Dysfunction of Cardiac Valve Prosthesis (인공 심장판막 기능부전 환자에서의 심장판막 재치환술)

  • 윤정섭;김치경;조규도;이성호;곽문섭;김세화
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.242-246
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    • 1998
  • From January 1988 to December 1995, 27 patients, 11 men and 16 women, underwent surgical intervention at our institution for prosthetic valve dysfunctions. The mean age was 43.5$\pm$12.2 years. Seventeen(63.0%) patients had the mitral valve replacement, 8(29.6%) the aortic valve, 1(3.7%) the aortic composite graft, and 1(3.7%) the tricuspid valve. Mean follow-up period was 49.5$\pm$30.9 months. In 12 bioprostheses, mean interval between the previous valve replacement and the reoperation was 104.9$\pm$34.9 months. The causes of redo surgery were structural deterioration of the prosthetic valve (12/12, 100%), paravalvular leak (2/12, 16.7%), and prosthetic valve endocarditis(1/12, 8.3%). In 15 mechanical prostheses, the mean interval was 55.2$\pm$43.7 months. The causes of redo surgery were pannus formation (8/15, 53.3%), paravalvular leak(4/15, 26.7%), and valve thrombosis(3/15, 20.0%). Posto- perative complications occurred in 7 patients (25.9%). There was no intraoperative death. But one patient, who received mechanical aortic valve replacement died on the 3rd postoperative day due to low cardiac output and multiorgan failure.

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CLINICAL STUDY OF SUDDEN DEAFNESS (돌발성 난청에 관한 임상적 고찰)

  • 이철희;전종범;홍석찬;장선오
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.5.2-6
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    • 1987
  • 저자들은 1978년부터 1986년까지 서울대학병원 이비인후과에 내원했던 원인불명의 돌발성 난청환자 중 추적조사가 가능하였던 60예에 대한 임상적 분석을 시행하여 다음과 같은 결과를 얻었다. 1) 60명의 환자중 45예가 입원 치료를 받았고 15예는 외래환자로 성별은 남자 36명. 여자 24명이었고 연령분포는 10대에서 50대에 걸쳐 널리 분포되었다. 2) 발생시기는 아침 기상시가 많았고 양측성인 경우는 4 예 있었다. 3) 동반증상은 이명, 이충만감, 현기증의 순으로 많았고 상기도염은 14예에서 있었다. 4) 입원치료는 prednisolone 경구투여와 저분자 dextran을 정맥주사하였고, 이중 25예는 histamine정맥주사나 heparin 피하주사를 추가로 겸용 치료하였다. 5) 청력회복의 결과는 Siegel의 분류방법을 따랐고, 입원 치료한 경우 완전회복이 6예, 부분회복이 8예, 경도호전이 9예로 23예(51.1%)에서 청력 호전이 있었다. Histamine과 heparin의 사용은 청력회복 결과를 높이지 못하였다. 외래환자의 경우는 입원치료군과 비교하는데 어려운 점이 있었으나 전체적으로 15예중 6예(40%) 에서 청력 호전이 있어서 입원 치료군이 좋은 성적을 보였다. 6) 치료의 예후에 관련된 요인으로 발병후 1주내에 치료를 시작한 경우 결과가 좋았다. 완전회복이 된 6예중 5예가 1주 내에 치료를 시작한 것이었다. 현훈이 동반된 경우는 현훈이 없는 경우보다 예후가 나빴다. 청력상이 하강형인 경우는 상승형이나 편평형보다 결과가 좋지 않았으며 내원시 고도의 심한 난청을 보인 경우는 청력회복이 거의 없었다.

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Risk factors of Pneumonectomy in Non-Small Cell Lung Cancer (비소세포폐암에시 전폐절제술의 위험 인자)

  • Hwang Eun-Gu;Baek Heejong;Lee Hae-Won;Park Jong-Ho;Zo Jae-Ill
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.616-621
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    • 2005
  • Background: In the resection of lung cancer, pneumonectomy occupied $20 {\~}35\%$ of all resections, and significantly high operative mortality is reported in right pneumonectomy ($10{\~}25\%$). The aim of this study is to identify the characteristics of morbidity, operative mortality and factors affecting operative mortality after pneumonectomy. Material and Method: This study recruited the database which performed pneumonectomy for lung cancer in Korea Cancer Center Hospital from Aug 1987 to Apr 2002. Result: Total of 386 pneumonectomies were peformed in that period. Sidedness were left in 238, right in 148; and the procedures were standard resection in 207, and extended resection in 179. Morbidity occurred in 115 cases ($29.8\%$, 115/386). Mortality occurred in 12 cases ($3.1\%$, 12 in 386). This mortality rate was similar to that of lobectomy ($2.1\%$, 13 in 613) during the same period. Morbidity consisted of 42 hoarseness, 17 (9) pneumonia and ARDS, 8 empyema, 5 (1) broncho-pleural fistula, 5 reoperation for bleeding, 5 (1) arrhythmia, 1 (1) pulmonary edema, and 25 others (The number in the parenthesis is the number of mortality case for that morbidity). Several factors affecting the operative mortality were evaluated. At first, extended procedure ($3.3\%$, 6 in 179) affected the operative mortality similar to the standard procedure ($2.9\%$, 6 in 207)(p=0.812). Second, the rate of operative mortality in an elderly group over 60 years ($5.5\%$, 10 in 182) was significantly higher than the younger group under 60 years ($1\%$, 2 in 204)(p=0.016). Third, sidedness of resection affects to operative mortality. Right pneumonectomy ($6.8\%$, 10 in 148) showed higher operative mortality than that of left pneumonectomy ($0.8\%$, 2 in 238)(p=0.002). The group over 60 years showed higher incidence of respiratory morbidity ($11.0\%$, 20 in 182) than that of the group under 60 years ($3.4\%$, 7 in 204)(p=0.005). Right pneumonectomy also showed significantly higher incidence ($11.5\%$, 17 in 148) than that of left pneumonectomy ($4.2\%$, 10 in 238)(p=0.008). Conclusion: Age and sidedness of pneumonectomy were the risk factors of operative mortality and respiratory complications, Therefore, careful selection of patients and more attention perioperatively were demanded in right pneumonectomy. However, because the operative mortality is acceptable, pneumonectomy could be done safely if the pneumonectomy is necessary for curative resection of lung cancer.