• Journal of Chest Surgery
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• 제24권8호
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• pp.824-829
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• 1991

We have experienced a case of 42-year-old woman with congenital broncho-esophageal fistula. The patient had productive coughing since childhood. A barium-swallowing examination showed a lower esophageal diverticulum communicating via a fistula with posterior basal segment of right lower lobe. Bronchography showed bronchiectasis in right middle and lower lobes. At thoracotomy resection of the diverticulum, bronchoesophageal fistula, and right middle and lower lobe of lung were performed. The postoperative course was uneventful.

• Korean Journal of Radiology
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• 제1권1호
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• pp.33-37
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• 2000

Objective: To describe the radiologic findings of migrating lobar atelectasis of the right lung. Materials and Methods: Chest radiographs (n = 6) and CT scans (n = 5) of six patients with migrating lobar atelectasis of the right lung were analyzed retrospectively. The underlying diseases associated with lobar atelectasis were bronchogenic carcinoma (n = 4), bronchial tuberculosis (n = 1), and tracheobronchial amyloidosis (n = 1). Results: Atelectasis involved the right upper lobe (RUL) (n = 3) and both the RUL and right middle lobe (RML) (n = 3). On supine anteroposterior radiographs (n = 5) and on an erect posteroanterior radiograph (n = 1), the atelectatic lobe(s) occupied the right upper lung zone, with a wedge shape abutting onto the right mediastinal border. On erect posteroanterior radiographs (n = 6), the heavy atelectatic lobe(s) migrated downward, forming a peri- or infrahilar area of increased opacity and obscuring the right cardiac margin. Erect lateral radiographs (n = 4) showed inferior shift of the anterosuperiorly located atelectatic lobe(s) to the anteroinferior portion of the hemithorax. Conclusion: Atelectatic lobe(s) can move within the hemithorax according to changes in a patient s position. This process involves the RUL or both the RUL and RML.

• 핵의학기술
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• 제22권1호
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• pp.90-97
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• 2018

폐 관류 스캔은 방사성 물질의 폐동맥 내 미세색전증을 이용하여 폐색전증의 진단에 이용되고 있으며, 만성 폐쇄성 질환이나 국소 폐 관류평가 및 조기 폐암발견 등에 이용된다. 또한 폐암환자에서의 수술 및 방사선 치료 전, 후 국소 폐 기능 예측을 위하여 이용된다. 이를 위하여 관류의 정확한 정량화가 필요하다. 이에 본 연구에서는 모든 병변 및 장기에 추적자의 흡수율 정량화가 가능한 SPECT/CT의 Q-Metrix (GE Healthcare, USA)프로그램을 활용하여 실제로 많이 이용되고 있는 평면영상의 두 가지 결과 산출 방법에 대한 상관관계 및 각 엽의 차이를 비교 평가하고자 한다. Discovery NM/CT 670 scanner (GE Healthcare, USA)장비에서 2015년 5월 1일부터 2016년 9월 13일까지 수술 전 폐암환자 50명을 대상으로 시행하였다. 환자에 대하여 $^{99m}Tc-MAA$(macro aggregated albumin) 185 MBq (5 mCi)를 정맥 주사하였고 후면 영상(Posterior view)을 기준으로 전면, 우측면, 좌측면, 우후사면, 좌후사면 영상을 획득하였다. 평면 폐 관류검사 직후 SPECT/CT를 시행하였고 영상의 Processing은 GE사 Xeleris 3.1 Workstation에서 시행하였다. 후방사면 방법은 오른 엽과 왼 엽에 사각형의 관심영역을 설정하였고 RPO영상은 3엽, LPO영상은 2엽으로 나누어 각 엽에 대한 흡수율을 얻었다. 전후 방법은 오른 엽, 왼 엽에 각각 3개의 사각형의 ROI를 설정하여 흡수율을 구하였고 왼 엽은 2엽으로 구분되어 Left middle lobe은 Left upper lobe로 포함시켜 결과를 산출하였다. Q-Metrix Method는 CT영상에 직접 관심 영역(Region of interests, ROI)을 설정하였다. 시상면(Sagittal)영상에서 2개의 Slice마다 ROI를 설정하였고 관심부피(Volume of interest, VOI)를 이용하여 체적에 대한 흡수율을 분석하였다. 통계 분석은 SPSS version 23.(SPSS Inc. USA)를 이용하여 분석하였다. Q-Metrix 방법과 후방사면 방법의 흡수율에 대한 일치 상관관계는 Right upper lobe(RUL)는 0.663, Right middle lobe(RML)는 0.623, Right lower lobe(RLL)는 0.702이고 Left upper lobe(LUL)는 0.754, Left lower lobe(LLL)는 0.823로 가장 높은 상관관계를 보였다. 전후 방법은 RML는 0.035로 흡수율이 증가되어 가장 낮은 상관관계를 보였고, RUL는 0.224, RLL는 0.447로 흡수율이 감소되었다. 왼 엽에서 LUL는 0.643, LLL는 0.456로 나타났다. 전체적인 상관관계는 후방사면 방법은 0.795로 높은 상관관계를 보였고, 전후 방법은 0.161로 나타났다. 각 엽의 차이는 Q-Metrix방법 평균${\pm}$표준편차는 RUL, RML, RLL순서대로 각각 $20.12{\pm}6.21$, $10.86{\pm}3.83$, $24.57{\pm}7.80$이고 LUL, LLL는 각각 $24.34{\pm}6.47$, $20.12{\pm}7.11$로 나타났다. 동일한 순서대로 후방사면 방법의 오른 엽은 $17.4{\pm}5.0$, $10.5{\pm}3.6$, $27.3{\pm}6.0$이었고, 왼 엽은 $21.6{\pm}4.8$, $23.1{\pm}6.6$으로 나타났다. 전후 방법에 대한 오른 엽의 평균${\pm}$표준편차는 $11.6{\pm}4.5$, $26.9{\pm}6.2$, $17.8{\pm}4.2$이고, 왼엽은 $28.4{\pm}4.8$, $15.4{\pm}5.6$로 나타났다. 본 논문에서 Q-Metrix방법에 대한 평면영상의 두 가지 방법 간에는 차이가 있는 것으로 보였다. 전후 방법의 RML는 과대평가 되었으며 RML, RLL는 상대적으로 과소평가 되었고, 모든 엽에서는 통계적으로 유의한 차이가 있었다(P<0.05). 후방사면 방법은 전후 방법보다 4배정도의 높은 상관관계를 보였고, oblique영상을 활용하여 흡수율이 과대, 과소평가가 되는 것을 줄일 수 있었다. SPECT/CT검사를 시행하지 않거나 planar image 획득 시 후방사면 방법을 이용하면 보다 실용적인 결과 값을 기대할 수 있을 것으로 생각된다. 또한 많은 환자에 대한 데이터 분석과 호흡에 대한 보정, 객관적인 방법으로 관심영역을 설정한다면 보다 정확한 결과를 산출할 수 있을 것이라 사료된다.

• 대한기관식도과학회지
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• 제5권1호
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• pp.78-84
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• 1999

Broncholithiasis is defined as a condition in which calcified material is present within the bronchial lumen. It is a rare but troublesome disease that can cause life-threatening complications such as massive fatal hemoptysis. Therefore, pulmonary resection is frequently required to remove the broncholiths and irreversibly damaged parenchyma. We experienced 3 cases of broncholithiasis. In one case, a 36 year old female patient suffered from coughing, massive hemoptysis with lithoptysis caused by intrinsic obstructive broncholiths in the right middle and lower lobe. In the 2nd case, a 41 year old male patient complained of long-standing blood tinged sputum and frequent pneumonic symptoms for 10 months because of extrinsic broncholithiasis where the calcified peribronchial lymph node eroded into the bronchial lumen of the right lower lobe. The remaining case involved a 30 year old female patient who complained of intermittent blood-tinged sputum induced by intrabronchial broncholith in the orifice of the right middle lobe bronchus. Two patients underwent bilobectomy(right middle and lower lobe) for removal of the broncholiths, damaged bronchi and parenchyma. The other patient was treated with right middle lobectomy and stone removal by bronchotomy of bronchus intermedius. In all patients, the post-operative course was uneventful.

• The Journal of Korean Physical Therapy
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• 제15권3호
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• pp.295-345
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• 2003

This study investigated activation of cerebral cortex in patients with hemiplegia that was caused by neural damage. Key-point control movement therapy of Bobath was performed for 9 weeks in 3 subjects with hemiplegia and fMRI was used to compare and analyze activated degree of cerebral cortex in these subjects. fMRI was conducted using the blood oxygen level-dependent(BOLD) technique at 3.0T MR scanner with a standard head coil. The motor activation task consisted of finger flexion-extension exercise in six cycles(one half-cycles = 8 scans = $3\;sec{\times}\;8\;=\;24\;sec$). Subjects performed this task according to visual stimulus that sign of right hand or left hand twinkled(500ms on, 500ms off). After mapping activation of cerebral motor cortex on hand motor function, below results were obtained. 1. Activation decreased in primary motor area, whereas it increased in supplementary motor area and visual association area(p<.001). 2. Activation was observed in bilateral medial frontal gyrus, middle frontal gyrus of left cerebrum, inferior frontal gyrus, inter-hemispheric, fusiform gyrus of right cerebrum, superior parietal lobule of parietal lobe and precuneus in subjedt 1, parahippocampal gyrus of limbic lobe and cingulate gyrus in subject 2, and inferior frontal gyrus of right frontal lobe, middle frontal gyrus, and inferior parietal lobule of left cerebrum in subject 3 (p<.001). 3. Activation cluster extended in declive of right cellebellum posterior lobe in subject 1, culmen of anterior lobe and declive of posterior lobe in subject 2, and dentate gyrus of anterior lobe, culmen and tuber of posterior lobe in subject 3 (p<.001). In conclusion, these data showed that Key-point control movement therapy of Bobath after stroke affect cerebral cortex activation by increasing efficiency of cortical networks. Therefore mapping of brain neural network activation is useful for plasticity and reorganization of cerebral cortex and cortico-spinal tract of motor recovery mechanisms after stroke.

• Journal of Chest Surgery
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• 제27권10호
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• pp.878-881
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• 1994

Primary malignant lymphomas of the lung are rare and known often to be localized, solitary pulmonary lesions, in chest radiograph. Because they are highly treatable contrast to the other primary lung cancer, the distinction is important. A 35-year old man who was admitted for a solitary pulmonary nodule in the right middle lobe. Percutaneous needle aspiration disclosed diffuse, small cell lymphoma. Bone marrow biopsy showed no evidence of neoplastic lymphoid cell infiltration. There were a walnut sized mass involving right middle lobe with a small satellite nodule at 2cm distal to the right upper lobe bronchial orifice. The histopathology of the bilobectomized specimen showed diffuse, small cell, malignant, non-Hodgkin`s lymphoma. Immunologic subtype was defined as B-cell type.

• Journal of Chest Surgery
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• 제24권2호
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• pp.217-221
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• 1991

Bronchiectasis is bilateral in approximately 30% of patients. Although the presence of bilateral bronchiectasis was frequently considered a contraindication to surgical resection due to excessive loss of functional pulmonary parenchyma, it is a correct view that the involved broncho-pulmonary segments are functionless and risks to the as yet uninvolved segments and should be removed if the patient`s pulmonary function is tolerable. We report a case of multisegmental bilateral bronchiectasis treated by bilateral simultaneous pulmonary resection through a median sternotomy. Five bronchiectatic segments were resected, which were right middle lobe, anterobasal segment of the right lower lobe, and lingula of the left upper lobe.

• Journal of Chest Surgery
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• 제14권4호
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• pp.345-349
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• 1981

Pulmonary hamartoma is relatively common among the benign tumors of lung, and is credited to Albrecht who In 1904 described a disorganized arrangement of tissue normally present In an organ. But hamartoma has rare incidence of total pulmonary tumors, and especially endobronchial origin is extremely rare. We have experienced three cases of pulmonary hamartoma Including one bronchial origin. First case was a 27 years old woman who had multiple hamartomas, located all in right middle lobe and middle lobectomy was performed. Second case, a 56 years old woman, had endobronchial hamartoma, l x l .5x l .8cm in size and located at right intermediate bronchus. Right pneumonectomy was Inevitable because of It`s proximal location near the hilum. Third case, a 55 years old man, revealed sclerosing hemangioma microscopically, 4x4x5 cm In size, in right lower lobe and right lower lobectomy was performed. Postoperative course of all of them were uneventful and discharged with good general condition on the ~ 4th to 26th day postoperatively.

• The Korean Journal of Physiology
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• 제3권1호
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• pp.33-44
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• 1969

Electoromyographic studies were performed on the action of the muscles of the temporomandibular joints following exfoliation of the deciduous teeth. The subjects examined, being 50 children. between the age of 6 and 13 years, divided into 5 groups. They were; 1) Deciduous dentition were complete in the first group. 2) Deciduous incisors were missing in either upper or lower jaw in the second group. 3) Deciduous canine and molars were missing in the left side of either upper or lower jaw in the third group. 4) Deciduous canine and molars were missing in the right side of either upper or lower jaw in the fourth group. 5) Permanent dentition completed in the fifth group(except third molars). Electromyogram was recorded with 4 channel polygraph (Grass model VII modified for 7P3). Electrodes which were the cup-typed gold discs, 9 millimeters in the diameter, were located on the anterior, middle and posterior lobes of the temporal muscles, and also on the superficial and deep layers of the masseter muscles. Paired electrodes were held by electrode cream so that they were pressed on the skin surface at right angle, adhesive tape being used to anchor them. The distance of the pair electrodes was about 5 millimeters. The results obtained were as follow: 1) In rest position of mandible; All groups showed slight, electrical activities in the muscles involved, but in the middle lobe of temporal muscle they were slightly higher. 2) In molar occlusion of mandible; High activity-anterior lobe of temporal muscle and superficial layer of masseter muscle. Moderate activity-deep layer of masseter muscle. Low activity-middle and posterior lobes of masseter muscle. There were no differences among the first, the second and the fifth groups. In the third group the muscle activity was weaker than that of the right, and in the fourth group opposite characteristics was revealed. 3) In incisal bite of mandreble; Hight activity-superficial layer of masseter muscle. Modertae activity-deep layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. The first, the third, the fourth and the fifth groups showed no differences but the second group showed less activity than those of others. 4) In protrusion of mandible; High activity-deep layer of masseter muscle Moderate activity-superficial layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. In the first, the fourth and the fifth groups, there were no differences in the activities, but the second group showed less activity than the others. 5) In retrusion of mandible; High activity-deep layer of masseter muscle. Moderate activity-superficial layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. In the first, the third, the fourth and the fifth groups, there were no differences but the second group showed less activity than the others. 6) In lateral excursion of the mandible (either direction); High activity-posterior lobe of temporal muscle. Moderate activity-anterior and middle lobes of temporal muscle. Low activity-superficial and deep layers of masseter muscle. The muscle action potentials were weaker than those of the right side in the third group and vice ver'sa in the fourth group. 7) In chewing movement; Temporal muscle activities were higher than those of masseter, especially in the middle lobe of temporal muscle the activity was highest. Right side muscle activities were higher than those of the left in the third group and, on the contrary, the left side was dominant over the right in the fourth group.

• Journal of Chest Surgery
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• 제24권3호
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• pp.303-305
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• 1991

The tracheobronchial rupture from blunt trauma is an uncommon injury with a variety of clinical presentations. Most of traumatic tracheobronchial tears occur within 2.5cm of the tracheal carina; lobar or segmental bronchi are rarely affected. Recently we experienced one case of traumatic rupture of right middle lobar bronchus in a patient who had fallen from a bicycle. Bronchoscopy showed linear disruption of the right middle lobe bronchus at its bifurcation site. Emergency right middle lobectomy was performed. The patient was recovered without any sequelae.