• 한국간담췌외과학회지
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• 제26권4호
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• pp.347-354
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• 2022

Backgrounds/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) remains the primary treatment for a subset of patients with pancreatic fistulae. The objective of this study was reporting outcomes of ERCP and predictors of resolution in patients with pancreatic fistulae refractory to conservative therapy. Methods: Retrospective review of patients who underwent ERCP and pancreatic stent placement for pancreatic fistula not responding to medical therapy was performed. Clinical features, laboratory parameters, radiological features and pancreatogram findings were noted. Clinical resolution of fistula was the primary outcome measure. Results: Sixty-eight patients underwent ERCP for high-output pancreatic fistula (Mean age 34.1 years, 91.1% males, 35/68 chronic pancreatitis, 52.9% alcohol etiology). Internal fistulae (pancreatic ascites, pleural effusion, or pericardial effusion) were seen in 55 (80.9%) patients and external fistula in 13 (19.1%) patients. Technical success for ERCP was 92.6% (63/68). Leak was seen in 98.4% (62/63). The most common leak site was body (69.8%). Multiple leak sites were seen in 23.1%. Pancreatic stricture was found in 36.5%. In 44 (69.4%) patients, stent was placed beyond the site of the leak. Resolution at six weeks was achieved in 76.4% (52/68). On univariate and multivariate analyses, placement of stent beyond site of leak was significantly associated with resolution of high-output fistulae (3/41 [7.3%] vs. 5/19 [26.3%], p = 0.03; odds ratio: 6.5, 95% confidence interval: 1.211-34.94). Conclusions: In our experience, ERCP was successful in 76% of patients with pancreatic fistulae refractory to conservative therapy. Stent placement beyond the site of leak was associated with higher resolution of fistulae.

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.193-199
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• 1986

1984년 10월부터 1986년 5월까지 영남대병원 임상병리과에 의뢰된 132예의 복수액과 늑막액의 진단적가치를 설정하기위한 연구로서 총 LD, LD 동위효소의 활성도, 생화학 및 혈액학적 검사, 세포진검사 등의 소견을 연구한 결과 다음과 같은 결론을 얻었다. 1. 복수액은 총 LD활성도 및 단백양으로 여출액의 감별이 가능하였다. 2. 복수액과 늑막액의 악성삼출액은 LD2가 염증성 삼출액에 비하여 증가되었고(P<0.01), 혈청에 비하여 LD4가 증가되어(P<0.05) 통계적 유의성을 나타내었다. 3. 늑막액과 복수액의 염증성 삼출액은 LD5가 증가하여 혈청과 악성삼출액에 비하여 의의성 있는(P<0.05) 증가를 나타내었다. 4. 복수액에서는 염증성 삼출액의 총 LD양은 악성삼출액에 비해 유의한 증가를 보여 총 LD활성도에 의한 삼출액의 구별이 가능하였으나 늑막액에서는 악성 삼출액과 결핵성 삼출액의 총 LD 활성도 차이의 통계적 유의성은 없었다. 5. 총 LD 및 LD5동위효소의 삼출액에서 백혈구수와 상관관계가 성립하지 않았다.

• 대한세포병리학회지
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• 제10권2호
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• pp.121-126
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• 1999

체강액 내의 악성 종양세포와 중피세포의 구분이 종종 어려우나 환자의 치료나 종양의 임상기 결정에 큰 영향을 미치기 때문에 정확히 감별하는 것이 매우 중요하다. E-cadherin은 상피세포에서 표현되는 유착단백질이다. 본 연구에서는 체강액의 세포학적 검사에서 악성세포의 표지자로서 E-cadherin의 유용성을 알아보기 위하여 세포검사후 조직검사로 진단을 확인한 33예를 대상으로 체강액으로부터 만든 세포 블록에 대하여 E-cadherin에 대한 면역세포화학염색을 시행하였다. 33 예의 세포학적 진단은 선암종 25예, 비정형세포 8예였다. 선암종으로 진단하였던 25 예중 21예(84%)에서 E-cadherin 에 양성이었다. 비정형세포라고 진단하였던 8예중 6예에서 음성이었으며 양성으로 염색된 2예는 조직학적 검사로 전이성 암종임을 확인하였다. 반응성 중피세포나 염증세포는 모두 음성이었다. 민감도와 특이도는 각각 84%와 75%였다. 결론적으로 E-cadherin은 체강액에서 악성 종양세포와 반응성 중피세포와의 구분에 유용한 보조적인 표지자이다.

• 대한세포병리학회지
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• 제10권1호
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• pp.61-66
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• 1999

Angiosarcomas are rare tumors, seen most commonly in the skin and soft tissue of head and neck legion. But it has been described in numerous body sites including thyroid, breast, liver, spleen, bone, etc.. Their biological behaviors depend on the microscopic grade, site of origin, and multifocality. We report the unique cytological features of an angiosarcoma in pleural fluid. A 61-year-old woman presented with a 6 month history of dyspnea on exertion and chest pain. Chest computerized tomography(CT) revealed multiple subpleural small nodules in the right lung and widespread all space consolidation and pleural effusion in the left lung. CT of liver revealed multiple small low attenuated lesion. The smears obtained from pleural fluid showed hypocellularity with a hemorrhagic background. The tumor cells were highly pleomorphic oval or spindle in shape and presented singly, in loose groups, in knitted syncytial aggregates, and in acinar pattern. Their nuclei had vesicular chromatin with delineated, thick nuclear membranes and occasionally a large eosinophilic, prominent nucleolus. The cytoplasm was plump, thin or protected in spindly fashion. Almost ail tumor cells showed variable sized intracytoplasmic vacuoles and their nuclei were sometimes crescentic by a huge vacuole. Occasional binucleated tumor cells and mitotic figures were present. Cellular debris and streaky materials were identified. Needle biopsy specimen from the pleura revealed anastomosing slit-like spaces lined by pleomorphic tumor cells. The tumor cells showed a strong reactivity for CD31 and vimentin and focal weak reactivity for factor VIII-related antigen.

• 동의생리병리학회지
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• 제26권4호
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• pp.539-545
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• 2012

To evaluate of the ultrasonographic changes in hemiplegic and unaffected knee joints of hemiplegic ambulators with recent onset stroke. Twenty patients (40 knees) with prevalence duration of 14-39 weeks (mean 24.70 weeks) after a stroke insult were included. All participants were walking independently without leg dragging, had no previous knee injury. There were significant differences in intercondylar cartilage thickness and pes anserinous tendinopathy (PAT) between hemiplegic and unaffected knees (p<0.05). There were no differences in cartilage thickness of medial condyle and lateral condyle, patellar tendinitis/bursitis, suprapatellar effusion, synovitis, joint space narrowing, and Baker's cyst of ultrasonographic findings and x-ray findings in hemiplegic knee compared to the control except PAT (p<0.05). In hemiplegic knee, medial or lateral condylar cartilage thickness was significantly correlated with body weight, intercondylar cartilage thickness, and PAT (p<0.05). PAT was significantly correlated with Brunnnstrom stage and condylar cartilage thickness (p<0.05). Knee pain was significantly correlated with lateral condylar cartilage thickness (p<0.1). The hemiplegic knee had more ultrasonographic abnormalities including PAT and more cartilage thickness preservation in patient with recent onset stroke. Intraarticular sonographic findings including cartilage thickness was significantly correlated with extraarticular findings including PAT and a symptom of knee pain.

• 자원환경지질
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• 제26권1호
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• pp.55-65
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• 1993

Udo Island, some 3 km off the coast of Sungsan Peninsula at the eastern promontory of Cheju Island, occurs in such a regular pattern on the sequences which reprent an excellent example of an eruptive cycle. The island comprises a horseshoe-shaped tuff cone, a nested cinder cone on the crater floor, and a lava delta which extends over northwest from the moat between two cones. The volcanic sequences suggest volcanic processes that start with emergent Surtseyan eruption, progress through Strombolian eruption and end with lava effusion followed by reworking of smooth tephra on the tuff cone. Eruptive environment and hydrology of vent area in the Udo tuff cone are poorly constrained because the stratigraphic units under the tuff cone are unknown. It is thoughl, however, that the tuff cone could be mainly emergent because the present cone deposits show no evidence of marine reworking, and standing body of sea water could play a great role. The emergent volcano is characterized by distinctive steam-explosivity that results primarily from a bulk interaction between rapidly ascending magma and a highly mobile slurry. The sea water gets into the vent by flooding accross or through the top or breach of tephra cone. Udo tuff cone was constructed from Surtseyan eruption which went into with tephra finger jetting activities in the early stage, late interspersed with continuous uprush activities and proceeded to only continuous uprush activities in the last. When the enclosure of the vent by a long-lived tephra barrier would prevent the flooding and thus allow the vent to dry out, the Surtseyan eruption ceased to transmit into Strombolian activities, which constructed a cinder cone on the crater floor of the tuff cone. The Strombolian eruption ceased when magma in the conduit gradually became depleted in gas. In the case of Udo, the last magmatic activity was Hawaiian-type (and/or fountain) which accumulated basalt lava delta. And then the loose tephra of the tuff cone reworked over the moat lava and the northeastern flank.

• 대한영상의학회지
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• 제81권5호
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• pp.1109-1120
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• 2020

흉막의 종괴는 다양한 양성과 악성 종양이 있고 종양은 아니지만 종양 같은 질환들에 의해 발생한다. 일차 흉막 종양에는 고립섬유종양, 악성중피종, 그리고 원발성 흉막 비호지킨 림프종이 있다. 흉막에 발생하는 가장 흔한 종양은 전이성 질환이며, 림프종, 백혈병, 다발성 골수종 등의 혈액 종양을 가진 환자에서 드물게 나타난다. 흉수는 주로 흉막의 악성 질환과 연관이 있다. 드물지만 흉막 종양이 만성 농흉에서 생길 수 있으며, 그중 가장 흔한 것은 비호지킨 림프종이다(농흉과 연관된 림프종). 종양이 아닌 흉막 종괴로는 다양한 양성 질환에서 보일 수 있으며, 여기에는 결핵, 석면 흉막판, 그리고 흉막 유리체가 포함된다. 이 임상화보에서 저자들은 흉막의 다양한 양성과 악성 종양 및 종양성 질환들에 대한 특징적인 전산화단층촬영 소견에 대해 알아보고자 한다.

• Tuberculosis and Respiratory Diseases
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• 제87권1호
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• pp.80-90
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• 2024

Background: There are many methods of evaluating diaphragmatic function, including trans-diaphragmatic pressure measurements, which are considered the key rule of diagnosis. We studied the clinical usefulness of chest ultrasonography in evaluating stable chronic obstructive pulmonary disease (COPD) patients and those in exacerbation, focusing on diaphragmatic measurements and their correlation with spirometry and other clinical parameters. Methods: In a prospective case-control study, we enrolled 100 COPD patients divided into 40 stable COPD patients and 60 patients with exacerbation. The analysis included 20 age-matched controls. In addition to the clinical assessment of the study population, radiological evaluation included chest radiographs and chest computed tomography. Transthoracic ultrasonography (TUS) was performed for all included subjects. Results: Multiple A lines (more than 3) were more frequent in COPD exacerbation than in stable patients, as was the case for B-lines. TUS significantly showed high specificity, negative predictive value, positive predictive value, and accuracy in detecting pleural effusion, consolidation, pneumothorax, and lung mass. Diaphragmatic measurements were significantly lower among stable COPD subjects than healthy controls. Diaphragmatic thickness and excursion displayed a significant negative correlation with body mass index and the dyspnea scale, and a positive correlation with spirometry measures. Patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D showed lower diaphragmatic measurements (thickness and excursion). Conclusion: The TUS of COPD patients both in stable and exacerbated conditions and the assessment of diaphragm excursion and thickness by TUS in COPD patients and their correlations to disease-related factors proved informative and paved the way for the better management of COPD patients.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5551-5556
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• 2012

Cytological examination is widely used as a diagnostic tool because of the ease of collecting cells from the involved area. However, the diagnostic yield of cytological examination is unsatisfactory; the reasons include sampling error, poorly prepared samples, small numbers of malignant cells, and low grades of cellular atypia. In this study, we focused on the high infectivity of adenovirus towards epithelial cells and applied the luciferase-expressing adenoviral vector to a new cancer cell detection tool. In addition, adenoviral infectivity was enhanced by modifying viral fiber proteins. The sensitivity of the diagnostic tool was tested using the NCI-H1299 lung cancer cell line, and validated in body fluid samples from cancer patients with a variety of etiology. Results showed that the adenovirus efficiently transfected NCI-H1299 with high sensitivity. Only 10 cancer cells were sufficient for detection of luciferase signals. In body fluid samples, the adenovirus confirmed the diagnosis for malignant and benign cancer, but not in non-epithelial cell derived samples. This study provides proof-of-concept for a more reliable and sensitive diagnostic tool for epithelium-derived cancer.

• Journal of Chest Surgery
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• 제29권10호
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• pp.1133-1137
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• 1996

흉강경을 이용한 흉부수술의 경우 최근 들어 상당한 발전이 계속되면서 시술할 수 있는 분야가 크게 증가하였다. 중앙대학교 흉부외과에서는 1994년 9월부터 1995년 8월까지 비디오흉강경을 이용한 수술 67례의 임상결과를 보고하는 바이다. 1. 진단은 기흉 35례, 미만성 간질성 폐질환 9례, 농흉 7례, 폐암에 의한 삼출액 3례, 다한증 3례, 흉강내 이물질 2례, 중피종 1례, 속립성 폐결핵 1례, 기질화된 폐렴 1례였다 2. 수술은 기흉환자 35례중 흉막 유착이 심하여 개흉술로 전환한 2례를 제외한 33례 에서 비디오 흉강경 기포절제술을 시행하였다. 그외에 흉강경을 이용한 지혈 5례, 세척술 7례, 이물질 제거 2례, 악성 늑막 삼출시 활석분무 3례, 교감신경 절제 술을 3례 시행하였다. 흉강경적 생검은 12례 시행하였다. 3. 기흉환자중 재발성 기흉으로 18례 수술하였고 지속적 공기누출 12례, 단순흉부사진상 기포가 보인 례가 5례 있었다. 심한 유착을 보여 흉강경에서 전환한 개흉적 기포제거술 2례를 시행하였다. 4. 비디오흉강경적 생검을시행한 12례의 병리학적 소견은 특발성 폐섬유화증 9례, 속립성 결핵 1례, 중피종 1례 및 기질화된 폐염 1례였다. \ulcorner鈒\ulcorner폐섬유화증 9례중 7례는 박리성 간질성 폐염, 2례는 통상 성 간질성 폐염이었다. 5. 비디오흉강경 67례중에서 63례에서 특별한 합병증 없이 퇴원하였고 4례에서 합병증이 발생하였다. 2 례가 계속된 공기누출, 2례는 반대측의 무기폐가 발생하였다. 따라서 비디오홍강경 수술은 비교적 안전하고 합병증이 적으며 앞으로 흉부수술영역에서 사용범위가 확대될 것으로 생각된다.