• Title/Summary/Keyword: Rare

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Clinical Analysis of Bronchogenic Cyst (기관지성 낭종의 임상적 고찰)

  • 안재범;정성철;김우식;신용철;유환국;이정호;김병열;김인섭
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.585-590
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    • 2004
  • Bronchogenic cyst is a rare and benign disease. Because of its complication or associated disease, Bronchogenic cyst requires surgical treatment. Recently, with the development of diagnostic methods, its incidence has increased. So we reviewed our results from the past 30 years. Material and Method: We reviewed 27 cases surgically treated from March 1971 to March 2003. This investigation is designed to illustrate the peak age incidence, sex ratio, symptoms, anatomic location, radiologic imagings, associated diseases, operative methods, postoperative pathologic findings and postoperative complications. Result: The peak age incidence laid in the 1st to 3rd decade and the ratio of male and female was 1 : 1.5. The most common complaints were cough and dyspnea, but some had hemoptysis. There were 22 cases (81%) of Intrapulmonary bronchogenic cysts and 5 cases(19%) of mediastinal bronchogenic cysts. Thirteen cases (48.1%) showed cystic lesion in simple chest X-ray. Ten cases showed cystic lesion among 13 cases that had taken computed tomography. We found associated disease in 15cases (56%). The inflammatory diseases from infection were many in intrapulmonary bronchogenic cysts and especially, one case showed carcinosarcoma. Mitral regurgitation and Bronchial obstruction could be seen in mediastinal bronchogenic cysts. The 13 cases (48%) were managed by lobectomy, and cystectomy, pneumonectomy, and segemental resection were done in 7 cases (26%), 4 cases (15%), 3 cases (11%) respectively. Cystic contents were mucus in 9 cases, pus in 9 cases, blood in 2 cases, and carcinosarcoma in 1 case. Bronchotracheal communications were in 13 cases (48%). Five cases showed Postoperative complications, which were pneumothorax, empyema, bleeding. Postoperative death could not be found. Conclusion: Almost all patients had clinical symptoms. Severe complications could be associated with bronchogenic cysts. Recently, With the development of diagnostic methods, preoperatively accurate diagnosis is possible; therefore, invasive study has decreased. Bronchogenic cyst is a benign disease. However, because of its clinical symptoms, complications, and possibility of malignant change, immediate surgical treatment is needed.

Clinical Experience of the Surgical Treatment of Cardiac Tumor (심장 종양의 수술적인 치료의 임상적 고찰)

  • Bang, Jung-Hee;Woo, Jong-Soo;Choi, Pill-Jo;Cho, Gwang-Jo;Kim, Si-Ho;Park, Kwon-Jae
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.375-380
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    • 2010
  • Background: Primary cardiac tumors are extremely rare. The most common type are benign myxomas, and these are almost completely curable with early surgery. Malignant tumors, however, such as sarcomas, are difficult to remove surgically, and their prognosis is known to be poor. In this study, data on patients who had undergone surgical treatment of cardiac tumor in the authors' hospital were collected and analyzed. Material and Method: The subjects included 28 patients who had undergone surgical treatment of cardiac tumor from August 1993 to December 2008. Their medical records were reviewed and retrospectively analyzed. Result: The patients were aged from 20 to 76 years (mean age: $54.2{\pm}15.6$), and 11 were male (39%) and 17 female (61%). Fifteen of them (54%) underwent emergency surgery to improve heart failure symptoms. The most common preoperative symptom was dyspnea (15 cases, 54%). Preoperative echocardiography was performed on all the patients. The average size of the tumor as measured during the operation was $7.0{\pm}6.9cm$ (the average length of the long axis was 2∼40 cm), and the sites of tumor attachment were the interatrial septum (18 cases, 64%), the left atrium (9 cases, 32%), the mitral valve annulus (2 cases, 7%), and the left ventricle (2 cases, 7%). The operation was performed with an incision through both atria in all the patients, and a complete excision was made in 25 cases (89%). According to the biopsy results, there were 4 cases of sarcoma (14%), 1 case of lipoma (4%), and 23 cases of myxoma (82%). The three cases in which the tumors were not completely excised were sarcomas. No operative deaths occurred after the operations. Outpatient follow-up was possible for 24 cases (86%), with a mean follow-up period of $46.8{\pm}42.7$ months. Late death occurred in 3 of the 24 patients; each of these patients had sarcomas. Of these patients, the first had undergone two repeat surgeries, the second had metastatic sites removed, and the last had only chemotherapy. The average recurrence time was $12.7{\pm}10.8$ months, and the average metastasis time was $20.5{\pm}16.8$ months. Conclusion: Most cardiac tumors are benign myxomas. In principle, they should be surgically treated because they can create risks such as embolism, and can be radically treated when surgically removed. In most cases, however, malignant sarcomas are already considerably advanced with severe infiltration into the neighboring tissues at the time of diagnosis. The surgical removal of malignant sarcomas is known to be difficult because of the advanced stage and degree of infiltration. We suggest that excision of the removable portion of the tumor sites to alleviate symptoms such as heart failure can improve quality of life.

Parent Materials and Pedogenic Properties of the "Yongil" Series Distributed in Eastern Coastal Area of Korea (한국 동남해안지대에 분포된 영일통의 모재와 생성학적 특성)

  • Yun, Eul-Soo;Jung, Yeun-Tae;Son, Il-Soo;Jung, Ki-Yuol;Lee, Dong-Chang
    • Korean Journal of Soil Science and Fertilizer
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    • v.35 no.3
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    • pp.137-144
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    • 2002
  • To obtain the basic information about pedo-genetic properties and origin of the parent materials of "Yongil" series in Korea, this study was conducted. The soil characteristics such as chemical and sand particles of typifying pedon, and distributional patterns in the area were analysed. The typifying pedon of "Yongil" series was distributed on the top of rolling area in the eastern coastal area of Korea, Yonggan-ri, Heunghae-eup, Pohang-si, Gyongbuk province. The results are as follows; The "Yongil" series in Korea was distributed on the rolling hill under altituede of 50m, and was used for cultivated upland, and the total acreage about 376ha. The content of sand was more than 50%, however the clay content in the depth of 40~100cm of the soil profile rapidly increased. The medium sand (0.5~0.1mm in size) are dominant among sand fraction, but coarse one are rare. So the rate of medium to total sand was higher in IIB horizon as 0.62~0.76 than A and C horizons. The content of heavy minerals in medium sand was low as 1.0~6.6% and the ratio of quartz to feldspars was higher in Ap2 and B1 horizon as 1.7 than IIB horizon which had less than 1.39. The cumulative curves of sand particles in Yeongil series showed the well sorted and differ from residuum soils derived from sand stone, but similar to dune soils(Haeri series). So it could be deducted from this study that "Yeongil" series are aeolian deposits derived from aeolian materials and have bisequum profile; the upper part depth of 40cm was recent cover sand, the horizon of 40~100cm depth was developed in Pleistocene epoch from the same materials.

Changes in Flora Dynamics on the Reclaimed Tidal Flats of Kyonggi-Bay in the Mid-west Coast of Korea (우리나라 중서부 해안 경기만 간척지에서 식생변화)

  • Kim, Eun-Kyu;Jung, Yeong-Sang;Chun, Soul;Joo, Young-K.;Jeong, Hyeung-Geun
    • Korean Journal of Soil Science and Fertilizer
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    • v.42 no.4
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    • pp.289-300
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    • 2009
  • Flora distribution was surveyed in the newly reclaimed tidal flats in the west coastal area in Korea to understand changes in flora dynamics after reclamation. The surveyed reclaimed tidal flats were the newly reclaimed tidal flat in Hangdam, the mid Kyonggi Bay in 2002, and three reclaimed lands in Seukmun and Daeho, Chungnam, and Hangdam in Kyonggi Bay, of which reclamation years based on embankment were 7, 9 and 18 years, respectively. In the newly reclaimed tidal flat, the dominant flora was Suaeda japonica and other florae were rare, while various halophytes and glycophytes were distributed in the reclaimed lands. On the newly reclaimed tidal flat, four species of halophytic pioneer florae, Salicornia europaea, Suaeda glauca, Suaeda japonica, and Suaeda maritime occurred, and along with age facultative halophyte and glycophyte occurred sequently. On the reclaimed lands, the florae were more complex with various facultative halophyte and glycophyte, so these were predominated rather than pioneer halophyte, while one of pioneer halophyte that Suaeda japonica was not occurred. Increasing of various facultative halophyte and glycophyte, and decreasing of pioneer halophyte indicated that flora changed toward to increase of facultative halophyte and glycophyte by aged after reclamation. On the newly reclaimed tidal flat the ratio of flora species changed rapidly with the invasion of plant. This implied that the flora had begun to change in the early stage of reclamation. Facultative halophyte and glycophyte started to increase on the early stage of reclamation but relative density and frequency of pioneer halophyte was higher than facultative halophyte and glycophyte. According to the investigation up to 3 years after reclamation, pioneer halophyte predominated on it. Although flora changed, there were common representative halophytes among the reclaimed tidal flats: Salicornia europaea, Suaeda maritima, and Suaeda glauca as pioneer halophyte, Aster tripolium, Sonchus brachyotus, and Phragmites communis as facultative halophytes.

Textural Implications of Fine-Grained Peridotite Xenoliths in Basaltic Rocks from Jeju Island (제주도 현무암에 포획된 세립질 맨틀 페리도타이트 포획암의 조직적 특성)

  • Yang, Kyoung-Hee;Nam, Bok-Hyun;Kim, Jin-Seop;Szabo, Csaba
    • Journal of the Mineralogical Society of Korea
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    • v.22 no.1
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    • pp.1-11
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    • 2009
  • Fine-grained peridotite xenoliths are rarely trapped in the basaltic rocks from the southeastern part of Jeju Island. Based on textural characteristics of the constituent phases showing uniform-sized, fine-grained tabular to mosaic grains with rare porphyroclastic relics, the studied samples can be defined as fine-grained, foliated porphyroclastic peridotites (FPP). Almost no significant difference among the FPPs in textures and major element compositions implies that the FPPs were derived from a structural domain, experiencing similar deformation events and deformation patterns. Moreover, the bimodal distribution with kink-banded porphyroclasts ($2{\sim}3mm$) and stain-free neoblasts ($200{\sim}300{\mu}m$), straight to gently curved grain boundaries with triple junctions, interstitial melt pockets, and microstructures for migrating grain boundary suggest that the studied samples went through dynamic recrystallization (${\pm}$ static recrystallization) in the presence of melt/fluid movement along foliation planes. No notable difference between the FPP and common protogranular xenoliths in major element compositions and geochemical evolution also implies that the FPP and protogranular xenoliths were from a similar horizon. Thus, the textural and geochemical characteristics of the FPPs reflects deformation events occurred at a localized and narrow zone within the lithospheric mantle beneath the Jeju Island. Although further detailed studies are necessary to define deformation events, the most possible process which could trigger deformation in the FPP in the rigid upper mantle was the ascending basaltic magma forming high-stress deformation zones. The suggested high-stress deformation zones in the lithosphere beneath the Jeju Island may be produced by paleo-faulting events related to the ascent of basalt magma before Jeju Island was formed.

A Study on the Expression of Glycosaminoglycans in the Experimental Tooth Movement of Rat and in Cultured Periodontal Ligament Cells (실험적 치아이동시 glycosaminoglycan의 발현에 관한 연구)

  • Lee, Kyung-Hwan;Lee, Jong-Jin;Kang, Kyung-hwa;Kim, Eun-Cheol;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.31 no.4 s.87
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    • pp.447-458
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    • 2001
  • The purpose of this study was to evaluate 1) in vivo, the expression of chondroitin 4-sulfate (CH-4S), a structural element of glycosaminoglycans(GAGs), in periodontal tissue during the experimental movement of rat incisors, by labelled streptavidine biotin immunohistochemical staining for CH-4S, 2) In vitro, the expression of CH-4S in cultured human periodontal ligament(PDL) cells supplemented with 10ng/ml of $TGF-{\beta}_1$, 20ng/ml of PDGF-BB, 1ng/ml $TNF-\alpha$, or $1{\mu}g/ml$ LPS by western blot analysis. The results of this study were as follows ; 1. The expression of CH-4S was stronger in pulp, PDL, osteoblasts, osteoclasts and osteocytes in experimental group than in control group, but was rare in dentin, and cementum of experimental groups, regardless of the duration of force application, which was not different from that of control group. 2. In experimental group, the expression of CH-4S in pulp began to increase at 1 day after force application and got to the highest degree at 7 days. After 14 days, the expression in CH-4S immunoreactivity was decreased, and became similar to that of control group at 28 days. 3. The expression of CH-4S in PDL was noted in adjacent to alveolar bone. PDL showed higher intensity of immunolabelling after 1 day of orthodontic tooth movement. And the expression was more stronger in the tension side than that of pressure side of PDL at 1 day, but more stronger in the pressure side than that of tension side of PDL at 4 days. After 7 days, a decrease in CH-4S expression was observed. 4. The expression of CH-4S in alveolar bone got to the highest degree at 4 days, and At 7 days, a decrease in CH-4S expression was observed. 5. PDGF-BB notably raised the expression of CH-4S in the PDL cells at 3 days of cultivation 6. The expression of CH-4S of PDL cells was decreased with the application of $TNF-\alpha$ at 1 day. 7. Admixture of $TGF-{\beta}_1$ and PDGF-BB got more expression of CH-4S in PDL as compared to only $TGF-{\beta}1$ or PDGF-BB. A similar decrease of the expression of CH-4S was observed in the case of application of LPS or $TNF-\alpha$.

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COMPARATIVE STUDY UPON THE CHARACTERISTICS OF WRITING BETWEEN THE PATIENTS WITH WRITING DISABILITIES AND NORMAL ELEMENTARY SCHOOL STUDENTS (쓰기 장애 환자와 정상 초등학교 학생의 쓰기 특성 비교)

  • Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.51-70
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    • 2001
  • Characteristics of handwriting were investigated and compared between the patients with writing disabilities and normal elementary school pupils. Generally, the heights of the letters of the patients were significantly larger than those of normal children, and letters of the patients were more sparsely distributed than those of controls. The distance between the words were significantly reduced in the patients’ writings, which indicated that patients had much more problems of space-leaving than normal pupils. Letter heights differences were significant across all grades in the patients and normal controls. The heights of the letters decreased as they grew older, and the slope of the decrements were more steeper in normal girls(r=-0.45) than girls with writing disabilities(r=-0.16). Sex differences were found in the letter spacings in low grades(grades 1, 2), that is, the distances between the letters were significantly narrower in the male patients than normal boys in these grades, and the differences were almost indiscriminating in grades 3 through 5, and finally, in sixth grade, letter spacings were signifycantly broader in normal boys than male dysgraphics. In girls, letter spacings were significantly broader in the patients across all grades. These findings supports the hypothesis that male and female writings were qualitatively different and that distinct mechanisms served in boys and girls dysgraphics. Across all grades and sexes, spaces between the words of the patients were significantly broader than normal pupils, which suggested that space-leaving between the words was important in Korean writings. There was trend that letter spacings and word spacings decreased across grades, but in girls, no correlations between the letter spacings and grades were found. Correlation analyses revealed that letter heights and letter spacings had mild correlation(r=0.11-0.15), and that letter spacings and word spacings had robust correlation(r=0.99). Phonological errors were mostly found in last phoneme(Jong-seong), especially double-phoneme(ㄳ, ㄵ, ㄶ, ㄺ, ㄻ, ㄼ, ㄾ, ㄿ, ㅀ, ㅄ), and in the case the sound values changed due to assimilations of phonemes. Semantic errors were rare in both groups. Space-leaving errors were correlated with phonological errors, and more frequent in boys than girls. In conclusion, significant differences existed in the letter heights, letter spacings, word spacings, and frequencies of phonological errors and spaceleaving errors between the patients with writing disabilities and normal pupils. The characteristics of writings changed across grades and the developmental profiles were somewhat quantitatively different between the groups. The differences became obvious from the second-third grades.

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A Study on Effect of B/L's Exemption Clauses Relating to the Governing Law of English Law (영국법의 준거법과 관련한 선하증권 면책약관의 효력에 관한 연구)

  • Han, Nak-Hyun;Jung, Jun-Sik
    • Journal of Korea Port Economic Association
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    • v.22 no.4
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    • pp.1-17
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    • 2006
  • In the Bill of Lading of The Irbenskiy Proliv is not subject to the Hague-Visby Rules in accordance with paragraphs (A) and/or (E) of cl.1 or to the Hague Rules in accordance with paragraphs (B) and/or (D) of cl.1. The Irbenskiy Proliv is very rare case that is effective to exempt the carrier as literal words of Bill of Lading. The action concerns cargoes of perishable goods shipped from Brazil to Japan, under Bills of Lading each of which contained an extensive carrier's exemption clause. A preliminary issue was ordered to be determined on the question whether c1.4 is effective to exempt the ralliers from any potential liability for the claims in this case. The court held that there is no reason to reject c1.4 as part of each of the contracts contained in or evidenced by the bills of lading; and it protects the carrier where damage to the goods shipped results from such causes. It is therefore effective to exempt the carriers from any potential liability for those claims.

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Malignant Melanoma (악성 흑색종)

  • Rhee, Seung-Koo;Kang, Yong-Koo;Park, Won-Jong;Chung, Yang-Guk;Lee, Hyuk-Je
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.1
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    • pp.13-19
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    • 2001
  • Background : The incidence of malignant melanoma is currently increasing at a rate greater than any other cancer occuring in human. At this time, early diagnosis and surgical excision were the mainstay of treatment for patients with malignant melanoma. We reviewed the results of average 4 years of follow-up after surgical excision of total 16 cases of malignant melanoma since 1985. Materials and Methods : There were 16 patients (mean age 58.5 years, 5 men, 11 women). The site of the primary lesion was foot and toe (6), back (3), hand (2), thigh (2), shoulder (1), lower abdomen (1) and lip (1). The lymph node was involved at 9 patients. The histologic diagnosis was made with H-E, S-100 stain, and HMB-45 stain as a special stain. Results : Histologically, there were Clark's stage I for 3 patients, II in 4, III in 2, IV in 3, and stage V in 4 patients. The wide excision only greater than 2cm margin was performed for 4 patients. The wide excision and lymph node dissection were performed for 4 patients. The amputation was only performed for 3 patients, and the amputation and lymph node dissection were performed for 5 patients. After surgical excision, chemotherapy was done with Taxol for each 2 patients of stage IV and V. After long term follow-up for mean 4 years, 4 patients died related with melanoma, 1 patient was recurred, and 11 patients were cured. Conclusion : The incidence of malignant melanoma was rare in Korea, but early involvement of lymph node at initial diagnosis was found in many cases (9/16, 56%). And then, early detection and appropriated excision as well as careful dissection of adjacent lymph nodes will offer the patient the best chance for cure.

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A Clinical Study of Protruding Lesions That Arise at the Scar of an Endoscopic Mucosal Resection for an Early Gastric Carcinoma and a Gastric Flat Adenoma (위 편평선종 및 조기위암에서 내시경적 점막절제술 후 절제부위에서 발생한 융기형 병변에 관한 임상적 고찰)

  • Cheon Young Koog;Ryu Chang Beom;Ko Bong Min;Kim Jin Oh;Cho Joo Young;Lee Joon Seong;Lee Moon Sung;Jin So Young;Shim Chan Sup
    • Journal of Gastric Cancer
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    • v.1 no.1
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    • pp.55-59
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    • 2001
  • Purpose: Several studies of an endoscopic mucosal resection(EMR) have been reported, but reports about benign protruding lesions that arise at the scar of EMR for early gastric cancer (EGC) or a gastric adenoma are rare. The purpose of this study was to elucidate endoscopic and histological characteristics of benign protruding lesions which arise at the scar of an EMR for EGC and a gastric flat adenoma. Materials and Methods: In 101 lesions (73 gastric flat adenomas and 28 EGCs) from 96 patients, 16 lesions developed new protruding lesions that arose at the scar of the EMR. We retrospectively analyzed the endoscopic findings of initial and protruding lesions, and several other clinical factors (H. pylori infection, eradication therapy, and proton pump inhibitor (PPI) or H2-blocker use). Results: 1. The mean duration until detection of the protruding lesion was 8.9 months ($1.5\∼27$). Protruding lesions arose at the scar of the EMR in 1 of 28 EGCs ($3.6\%$) and from 15 of 73 gastric flat adenomas ($20.5\%$). All of the patients were men. 2. With respect to the endoscopic findings, the shapes of the protruding lesions were as follows: 10 Yamada (Y) I, 4 Y-II, 1 Y-III, and 1 flat lesion. Histological examination of the protruding lesions revealed regenerating hyperplasia in 5 lesions, intestinal metaplasia in 5, and both in 6. 3. The incidence of these lesions was higher in cases of tubular adenomas with focal high-grade dysplasia than in cases of tubular adenomas without dysplasia (p<0.05). 4. The incidence of H. pylori infection was higher in patients ($81.7\%$) who developed a protruding lesion than in those ($51.8\%$) who did not develop (p=0.029); also, the incidence of use of PPI was higher in those patients (p=0.045). However, eradication therapy for H. pylori and duration of use of PPI or H2-blocker showed no difference between groups. Conclusions: It may be possible that the potential hyperplasia that may reside in normal mucosa surrounding EGC or a gastric adenoma might awaken during the healing process of the EMR ulcer and develop to benign protruding lesions. And, H. pylori and PPI might also be related to the development of the protruding lesions.

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