• 농촌의학ㆍ지역보건
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• 제26권2호
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• pp.59-78
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• 2001

경상북도 지역의 암사망 신고자료의 정확성을 제고하고, 질 높은 지역보건사업계획의 수립을 위한 자료수집을 위해 기존의 사망신고체계에 보건소망을 추가로 이용하여 1991년부터 1998년까지 의 암사망 신고자료를 수집 분석하였다. 경상북도의 전체 사망자중에서 암사망자가 차지하는 비율은 1991년에는 16.7%에서 1998년에는 19.3%로 증가되었는데, 남자는 1991년 19.4%에서 1998년에는 22.3%로 증가하였고, 여자는 1991년 12.4%에서 1998년에는 15.5%로 여자에서의 비율의 증가가 컸다. 암 종류별 사망자는 전체적으로는 1991년에는 위암(41.5%), 간암(28.8%), 폐와 기관지암(8.7%)순이었고, 1998년에는 위암(24.7%), 간암(22.7%), 폐와 기관지암(19.3%)순으로 순위는 같았으나 사망비율의 차이는 있었다. 남자는 1991년에는 위암(40.2%), 간암(33.7%), 폐와 기관지암(10.2%) 순이었으나, 1998년에는 간암이 25.0%, 위암과 폐 기관지암이 공히 22.8%를 차지하여 순위의 변동이 있었다. 여자는 1991년에는 위암(44.7%), 간암(16.7%), 폐와 기관지암(5.0%)순이었고, 1998년에는 위암(27.8%), 간암(18.5%), 폐 기관지암(12.7%)순이었으며, 위암이 가장 많이 감소하였고, 폐 기관지암이 가장 많이 증가하였다. 암 종류별로 보면 위암, 간암, 후두암에 의한 사망은 감소하였고, 폐 기관지암, 식도암, 췌장암, 직장암에 의한 사망은 증가하였다. 여자의 경우는 유방암에 의한 사망은 증가하였고, 자궁암은 감소하는 추세였다. 1995년도 인구를 기준으로 연도별 연령보정 표준화 사망률을 산출하였는데, 전체적으로는 1991년에는 84.25명이었으며, 1998년에는 77.67으로 감소하였다. 남자는 1991년에 119.81명에서 101.82명으로 크게 감소하였고, 여자는 1991년 48.64명에서 1998년 53.80명으로 증가하였다. 연령대별로는 40대 미만에서는 위암, 간암, 폐 기관지암, 자궁암, 식도암은 감소하고, 췌장암, 직장암과 유방암은 증가하였다. 40대 이상에서는 위암, 간암, 자궁암, 후두암은 감소하였고, 폐 기관지암, 식도암, 백혈병, 췌장암, 직장암, 유방암은 증가하는 추세였다. 이상의 결과 경북지역에서는 전반적으로 폐 기관지암, 직장암, 식도암, 췌장암, 유방암 등에 의한 사망이 증가하는 추세이므로 이를 고려한 지역암보건사업이 이루어져야 하겠으며, 전국적으로도 국가암등록사업과 사망자료의 연계를 통한 정확한 사망통계를 근거로한 국가암보건계획의 수립과 평가가 필요하며, 이를 위하여 공공보건기관에서 정확한 암 사망통계의 산출을 위한 추진방안이 개발되어야 할 것으로 생각된다.

• Journal of Chest Surgery
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• 제7권1호
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• pp.31-36
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• 1974

The clinical observations on the bronchogenic cancer of one hundred sixty cases treated in the Department of Thoracic Surgery, Seoul National University Hospital are as follows: 1] Most of them,. 90 percent of the cases were over 40 years of age and male was predominated over female with sex ratio of 6 to 1. 2] The average duration of symptoms before the first examination was about 5 months arid the most common complaints were cough, chest pain, breathing difficulty and blood-tinged sputum. 3] In ninety-four cases[59%] thoracotomy was undertaken with resection of the lesion in 52 cases[33% ]. 4] Histopathological diagnoses made in 141 cases were squamous cell carcinoma in 47.5%, undifferentiated cell carcinoma in 33.3%, adenocarcinoma in 9.2,% and alveolar cell carcinoma in a single case.

• Journal of Chest Surgery
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• 제44권2호
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• pp.193-196
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• 2011

Bronchogenic carcinoma involving the carina has remained a challenging problem for thoracic surgeons. Carinal resection and reconstruction is limitedly indicated because this aggressive surgical approach has been reported to be associated with significant morbidity and mortality while long-term outcome has not been determined. Wesuccessfully performed carinal reconstruction and sleeve right upper lobectomy assisted with ECMO for a 60-year-old male with squamous cell carcinoma in the right upper lobe extending to the carina.

• 한국정보통신학회논문지
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• 제15권7호
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• pp.1573-1582
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• 2011

흉부의 폐질환으로 폐암발생은 꾸준히 증가하고 있다. 일차적인 폐암진단 방법에는 흉부X선영상이다. 흉부X선영상 이용하여 폐암진단을 하기 위해서는 임상경험이 풍부한 의사가 필요하다. 그러나 풍부한 경험을 가진 의사라도 오진이 발생할 수 있고 이한 폐암의 조기진단과 생존률을 낮게 한다. 본 논문에서는 주성분분석을 이용하여 학습영상의 데이터베이스와 질병이 있는 흉부영상을 진단함으로써 컴퓨터보조진단의 기반을 마련하고자 한다. 이를 의사가 진단하기 전의 예비판독의 단계로 이용한다면 오진으로 인한 환자의 조기 진단률의 감소를 줄일 수가 있다. 실험은 정상흉부X선영상과 악성폐암인 기관지암(Bronchogenic Carcinoma)과 양성종양인 육아종(Granuloma)으로 실험하였다. 영상은 주성분분석 후 정상영상과 질환 영상의 고유영상을 추출하고 상호 비교한 뒤 인식효율을 비교하였다. 결과로는 정상영상과 질환영상간의 인식률은 높았으나 질환간의 인식효율은 정상에 비해 다소 떨어지는 것으로 나타났다. 흉부질환간의 인식효율을 높이기 위해서 관련 알고리즘에 관한 연구가 계속 이어진다면 컴퓨터보조진단에 좋은 연구기반이 되리라 생각한다.

• Journal of Chest Surgery
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• 제6권1호
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• pp.15-22
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• 1973

The definition of cancer, its diagnosis and its prognosis all depend upon description of growth. To the layman a synonym for cancer is a "growth". There are no quantitative terms for the description of growth or growth rate in clinical use. There has been no attempt to assign values that would define "rapidly" or "slowly" growing. Estimates of growth potentiality are implied in the descriptive phrases "poorly differentiated" or "well differentiated", "highly malignant" or "low grade malignancy". and in systems of grading. These qualifying terms represent a personal impression, clinically useful in prognosis, but relative in nature. They do not lend themselves to uniform application or precise measurement for purpose of comparison. Growth is related to size and time. The volume of tumor depends upon the duration of the period of growth and the rate of growth. If the interval and change in volume are known. the average growth rate can be determined. If the growth rate is determined, and assumed to be constant., the duration of a given tumor and the time of inception can be estimated. The commonest concept of the origin of cancer is that as a result of a mutation involving a single cell, succeeding divisions of cells establish a colony with the characteristics recognizable as cancer. If the growth rate of the hypothetical tumor were constant it could be described in terms of "tumor volume doubling time". In the department of thoracic surgery of St. Mary hospital in Catholic Medical College, a clinical evaluation for the growth rate, degree of malignancy, resectability and prognosis was done on a total 24 cases of primary bronchogenic carcinoma which contour was significant on the chest X-ray film as possible estimating the tumor volume doubling time. The following results were obtained: 1. In the cases of 6.0cm or more in diameter of minor size at operation the resectability rate was lower and in the cases of 60 days or more in the tumor or volume doubling time the resectability rate was higher. 2. If differentiation of cancer cells was lower graded in tissue pathology, the tumor volume was shorter and the resectability rate was lower. 3. The tumor volume doubling time of the primary bronchogenic carcinoma occured more over 60 years of age was slightly shorter than under 60 years of age. 4. The tumor size at operation was more important to evaluate the survival time and prognosis than the tumor volume doubling time because the tumor growth was not always constant, we presume.mor volume doubling time because the tumor growth was not always constant, we presume.

• Journal of Chest Surgery
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• 제13권3호
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• pp.298-300
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• 1980

The hamartoma is the most common benign tumor of the lung, but the incidence is very low. Most of hamartomas are revealed accidentally as coin lesion of routine chest X-ray because of no symptoms usually. The differential diagnosis should include tuberculoma, bronchogenic carcinoma, and other forms of tumor. Definitive diagnosis usually is established at exploratory thoracotomy. In this report, we present one case of a 42-year-old female having hamartoma of the left lower lobe of the lung that removed successfully and confirmed histopathologically. Her postoperative course was uneventful. She was discharged in good condition.

• Journal of Chest Surgery
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• 제23권5호
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• pp.881-886
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• 1990

Thirty-three patients less than 40 years of age were diagnosed at CS Dept. of Catholic University Medical College between 1979 and 1988 as having primary lung cancer. There were 22 men and 11 women; the average age was 36.3 years. The youngest patients was 23 years old. Eighteen male patients were only habitual smokers more than 1 pack per day. In the 33 cases, the distribution by tumor type was as follows: squamous cell carcinoma 36.4%[13 cases]; adenocarcinoma 33.3%[11 cases]; small cell carcinoma 24.2%[8 cases]; and large cell carcinoma 3.0%[1 case]. At the time of diagnosis, 2 patients[6.1%] had stage I disease, 2[6.1%] had stage II disease, 5[15.6%] had stage IIIA disease, 10[30.3%] had stage lllB disease, and 14[42.4%] had stage IV disease. Thirteen patients[36.4%] underwent an exploratory thoracotomy. Of these patients, 9[27.3%] had surgical resection[six lobectomies, two pneumonectomies, and one wedge resection]. Thirty-one patients were treated with palliative radiation therapy, chemotherapy, or combinations of each. The survival rate at 1 year, 3 year, and 5 year were 48.2%, 14.5%, and 8.3% respectively. But in the resectable 9 patients, they were 78.1%, 43.6%, and 33.3% respectively.

• Tuberculosis and Respiratory Diseases
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• 제40권1호
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• pp.72-78
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• 1993

연구배경 : 원발성 폐암의 전이 병소 발견은 병변 자체와 위험한 합병증을 예방하기 위한 치료 계획의 수립에 중요하다. 원발성 폐암은 임파절, 부신, 뇌, 간장, 뼈로 잘 전이되며 뼈중에서는 주로 두개골, 척추, 늑골 그리고 장골 등을 침범한다. 편평상피암에서의 골전이는 다른 폐암에 비하여 비교적 낮은 빈도로 알려져 있으며 특히 원위부 족지골에의 전이는 매우 드물다. 방법 : 저자등은 연세대학교 의과대학 세브란스병원에서 우측 제 5 원위부 족지골에만 전이 병소가 발견된 폐암 1 예를 경험하였다. 결과 : 처음 편평상피암의 진단시에 T4N3MO의 상태였으며 세 번째 항암제 투여시 처음으로 원격 전이가 제 5 원위부 족지골에 국한되어 발견되었다. 단순 골사진과 전신 골 주사검사상 우측 제 5 원위부 족지골의 국소적 이상 소견이 관찰되었으며 제 5 족지의 절단 조직검사에서 폐의 편평상피암이 전이된 병변임을 병리조직학적으로 확인할 수 있었다. 결론 : 본 증례의 특징은 뼈중에서도 통상적으로 전이가 잘되는 두개골, 철추, 늑골이나 장골이외에 제 5 원위부 족지골에 처음 전이가 된 것이다. 따라서 원발성 폐암 환자에서 이학적 검사상 국소적인 염증같은 이상 소견이 발견되면 가능성은 비록 적더라도 전이성 병변을 의심해 보는 것이 필요하리라고 생각된다.

• Journal of Chest Surgery
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• 제11권1호
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• pp.26-34
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• 1978

We observed 82 cases of primary lung cancer clinically and statistically, which had been experienced at the dept. of thoracic surgery, Chonnam University Hospital, during the period of 13 years from 1964 to 1967. The results obtained were as follows: Peak incidence of age was from 5th decade to 6th decade, and the ratio of male to female was 3: 1. The frequency of lung cancer was higher in the heavy smoker than in the lighter smoker, and undifferentiated carcinoma showed low resectability in spite of the shorter clinical duration. Major symptoms were coughing and chest tightness & pain, especially coughing was initial symptom in the majority of patients. Of the 82 cases, operation was performed in the 32 cases [39%], but resection was possible in the 22 cases [27%]. The delaying factors led patients to an inoperable stage were physician’s misdiagnosis of bronchogenic carcinoma due to non-specific symptoms and signs of the patients, old age patients were dependence on herb medicine, and poor economical condition of the patients in our region especially. Basic conditions of treatment in lung cancer were early detection & early surgery, so, chest P-A would be checked per 3 to 6 months interval associated with sputum cytology in the smoker over 45 age routinely.

• Tuberculosis and Respiratory Diseases
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• 제39권3호
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• pp.278-281
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• 1992

Air fluid level in a large ring shadow poses a diagnostic problem. But a new development of fluid level in preexisting bullous lesion is another problem. A 60 year old man with chronic obstructive lung disease was noticed to have multiple bullae. A few years later fluid level was newly developed in some of the bullae. Fluid level persisted for several months and later completely filled the space. Surgical exploration revealed pus collection in the bullae and epidermoid carcinoma in the nearby bronchi.