• 대한미생물학회지
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• 제13권1호
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• pp.1-5
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• 1978

Listeria monocytogenes infection was considered a rather rare disease and occurs mostly either in newborn babies or in young children. However, there has been increasing reports of this infection in elderly person with various underlying disease. Recently we have experienced two cases of Listeria meningitis; one in a 4-year-old male with an acute lymphoblastic leukemia, and the other in a 43-year-old female with a breast cancer. Both were on various chemotherapeutic agents for their primary diseases when the organism, L. monocytogenes was found in their celebospinal fluid(CSF). The degree of CSF pleocytosis were quite different by cases. The former case showed a marked increase, $3,350/mm^3$, and the latter slight, $410/mm^3$, Both showed a slight decrease of CSF glucose ranging 39 to 43mg/100ml. It seems that a routine CSF analysis bears a limitted value in the diagnosis or Listeria meningitis. A direct smear of CSF with Gram's stain revealed gram-positive bacilli in one case, but none in the other. Bacterial culture of CSF yielded plenty colonies in one case, but a few in the other. It seems that isolation of L. monocytogenes must not be considered very easy, and a negative direct smear does not necessarily mean a negative culture. The two isolates we obtained showed the typical cultural and biochemical characteristics of L. monocytogenes and were found to belong to serotypes 1b and 4b. It was our experience that the identification of this organism was not very much matter because of its distinct characteristics, but the most important matter was how to think of the possibility of this organism at the begining. The two isolates were both susceptible to cephalothin, chloramphenicol, erythromycin, tetracycline and gentamicin; intermediate to ampicillin, penicillin and kanamycin; and resistant to cloxacillin.

• Journal of Chest Surgery
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• 제5권1호
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• pp.45-56
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• 1972

Esophageal perforation is one of the most grave prognostic problems among thoracic and general surgical emergencies which necessitate urgent operative measures. In Korea,there are still many persons ingesting lye for suicidal attempt and thoracic surgeons in Korea have more chances to deal with lye burned esophagus with or without instrumental perforation than those in Western countries. Main cause of esophageal perforation in Korea is instrumental perforation in patients with lye stricture of the esophagus during diagnostic endoscopy or therapeutic bouginage. Other causes are corrosion of the esophagus due to ingestion of caustic agents, pathologic perforation, surgical trauma, stab wound and spontaneous rupture of the esophagus in our series. Therapeutic measures are various,and depend on duration of perforation, severity of its complications, pathology of perforated portion of the esophagus and degrees of inflammation at the point of perforation. The most important therapeutic measures are prevention of this grave condition during esophagoscopy, bouginage and surgical procedures on lungs and mediastinal structures and to make early diagnosis with prompt therapeutic measures. During the period of January, 1959, to December, 1971, the authors experienced 65 cases ofesophageal perforation including acquired esophagorespiratory fistula at Dept. of Chest Surgery, the National Medical Center in Seoul, and obtained following results in the series. 1. Female were 35 cases, and peak age incidence was 2nd and 3rd decades of life. 2. Among 65 cases, 43 were corrosive esophagitis or benign stricture of the esophagus due to caustic agents, 7 were patients with esophageal cancer. and there were 5 cases of esophageal perforation developed after pneumonectomy or pleuropneumonectomy. 3. Causes of perforation are instrumental perforation in 45, acute corrosion in 7, pathologic perforation in 7, surgical trauma in 3, stab wound in 2 cases, and one spontaneous rupture of the esophagus. 4. Most frequent sites of esophageal perforation were upper and mid thoracic esophagus, and 8 were cases with cervical esophageal perforation. 5. Complications of esophageal perforation were mediastinitis in 42, empyema or pneumothorax in 35, esophagorespiratory fistula in 12, retroperitoneal fistula or abscess in 5,pneumoperitoneum in 3, and localized peritonitis in 1 case. 6. Cases with malignant esophagorespiratory fistula were only 3 in the series which is predominant cause of acquired esophagorespiratory fistula in Western countries. 7. Various therapeutic measures were applied with mortality rate of 27.7% in the series. 8. In usual cases early treatment gave better prognosis, and least mortality rate in cases with perforation in mid thoracic esophagus. 9. Main causes of death were respiratory complications,acute hemorrhage with asphyxia, and septic complications. 10. Esophageal perforation developed after pneumonectomy gave more difficult therapeutic problems which were solved in only 1 among 5 cases.

• Journal of Chest Surgery
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• 제35권3호
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• pp.248-250
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• 2002

환자는 56세 남자로 과거력상 15년 전 식도암으로 본원에서 식도 절제술 및 위- 식도 문합술 후 방사선 치료받았던 환자이며 그동안 특별한 치료없이 지내오다 최근 발생한 발열 및 오한, 마른 기침, 호흡곤란, 흉통을 주소로 본원 응급실을 방문 하였다. 응급처치 후 시행한 심초음파상 소량의 심낭삼출 및 심낭기종이 관찰되었으며 상부 위장관 조영술로 위-심막루가 확진 되어 응급 수술을 시행하였으나 술 후 7일째 사망하였다. 식도절제술 및 위-식도문합술 후 양성 궤양으로 인한 위-심막루는 매우 드문 합병증으로 치명적 결과를 낳았으며 흉부 방사선, 심전도, 심초음파, 환자의 증상을 종합, 상부 위장관 조영술을 통한 조기 진단 및 적절한 치료가 즉각적으로 요할 것으로 사료된다.

• Journal of Chest Surgery
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• 제40권10호
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• pp.691-695
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• 2007

배경: 중심정맥 도관은 1979년 처음 사용된 이래로 암환자의 치료에 있어 많은 편의를 제공하였다. 이에 본원 흉부외과에서는 완전 거치형 정맥도관의 임상 양상 및 사용에 따른 합병증 등을 분석하여 향후 치료에 도움이 되고자 본 연구를 하였다. 대상 및 방법: 2004년 11월부터 2006년 2월까지 완전 거치형 정맥도관 시술을 받은 100명의 환자를 대상으로 후향적 연구를 하여 다음과 같은 결과를 얻었다. 결과: 완전 거치형 정맥 도관 시술의 삽입정맥으로는 우측 쇄골하정맥 삽입이 74예(74%)였으며 좌측쇄골하 정맥(21예, 21%), 우측 경정맥(3예, 3%), 좌측 경정맥(1예, 1%)을 사용하였으며 1예에서는 우측 대퇴정맥을 사용하였다. 초기 합병증으로는 위치 이상이 5예(5%)와 동맥천자한 경우 5예 있었다. 만기 합병증으로는 쇄골하 정맥 혈전 형성이 한 예 있어 현재 항응고제 복용중이며 pinch off 증후군이 2예 있었다. 그 외의 초기 또는 만기 합병증은 없었다. 결론: 완전 거치형 도관의 사용은 합병증의 발생률은 낮고 비교적 안전한 방법이지만 감염, 혈전 형성, 도관의 절단 등은 장기간 사용시 나타날 수 있는 합병증으로 초기에 진단 및 치료가 된다면 더 큰 합병증을 예방할 수 있다.

• 대한두경부종양학회지
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• 제13권2호
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• pp.161-168
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• 1997

Background: Cancers of the maxillary sinuses are not common and are the most difficult head and neck malignancies in which to make an early diagnosis. Objectives: This reports was conducted to evaluated the efficacy of combination therapy and the relationship between the treatment modalities and their outcome of maxillary sinus cancers. Materials and Methods: We retrospectively analyzed a clinical datas of 46 patients who were treated at the department of Otolaryngology-Head and Neck Surgery. The Catholic University of Korea over 10 years between 1987 and 1996. Results: According to AJCC TNM system, 35 patients presented with $T_4$, 10 with $T_3$, one with T1. Two patients were treated with radiotherapy alone, 4 patients with chemotherapy alone, 17 patients with radiotherapy and chemotherapy, 23 patients with combination of surgery, radiotherapy and chemotherapy. The overall 5 years survival rate for combination therapy group were 57%, but 23 patients treated with the other treatment modalities all died within 2 years except two cases with chemotherapy and radiotherapy or radiotherapy alone. There was a statistical trend for better survival and local control in those patients treated with combination therapy than others(p<0.05). Conclusion: The results of this study suggest that it may be possible to acheive better results with aggressive combination treatment including surgery in advanced cases and to avoid orbital excentration in patients with orbital invasion.

• 대한두경부종양학회지
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• 제14권2호
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• pp.228-235
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• 1998

Objectives: Papillary microcarcinoma of the thyroid was evaluated as to the effectiveness of diagnostic modalities, lymphatic spread pattern, and therapeutic decision according to tumor size. Material and Methods: We retrospectively analyzed a clinicopathologic findings of 72 papillary microcarcinoma patients who were treated at the over 11 years between 1985 and 1995. The authors divided papillary microcarcinoma of the thyroid into two subgroups according to tumor size: $0{\leqq}5mm$ and $5<0{\leqq}10mm$. An analysis including age and gender distribution, diagnostic tools(thyroid sonogram, thyroid scan, thyroid function test, fine needle aspiration cytology, frozen section), pathological examination of lymphnode, and surgical procedures was carried out in each subgroups. Results: The carcinoma of smaller than 5mm were found in 32 patients, and of 6 -10mm were in 40 patients. The average age of patients was 45years and all of them were female. Cold nodules on thyroid scan were noticed in 53 patientss and normal findings were in 15 patients. Suspicious malignant lesions(fine calcification, solid mass, irregular margin) on thyroid sonography were detected in 23 patients and the sonography was more useful in detecting $0{\leqq}5mm$ small sized lesions than other diagnostic methods. FNAC were performed in 17 patients, and 7 patients were diagnosed as having thyroid papillary cancer. But diagnotic rate in $0{\leqq}5mm$ small sized lesions was very low(one of eights).Frozen section were performed in all patients, among these 15 patients were diagnosed as being benign diseases and false negative rates were higher in $0{\leqq}5mm$ small sized lesions than in $5<0{\leqq}10mm$ sized lesions(p-value<0.006). Only thyroidectomies were performed in 24 patients and thyroidectomy with node dissections in 48 patients. The lymphnode metastatic rates were much higher in multifocal lesions(61.5%) than in single lesion. The incidence of cervical lymphnode metastasis was 19.4% in $0{\leqq}5mm$ sized lesions and 47.9% in $5<0{\leqq}10mm$ sized lesions. Postoperative management were performed with TSH suppression therapy(T4, synthroid) in all patients and RI therapy in 29 patients. Conclusion: On the basis of our study, improved preoperative diagnostic tools for papillary microcarcinoma of the thyroid was helpful in the choice of surgical treatment. As a result of techninological progress(ultrasonography, FNAC), the pencentage of the discovery of papillary microcarcinoma has been increased. The thyroid ultrasonography was useful in detecting small sized lesions($0{\leqq}5mm$), but FNAC may not be beneficial in detecting small sized lesions($0{\leqq}5mm$). In the surgical procedure, thyroid lobectomy alone should be avoided because of the high rate of bilaterality and multifocality.

• 대한의용생체공학회:의공학회지
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• 제25권5호
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• pp.343-349
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• 2004

전기성문전도는 발성시에 성문의 진동이 전기적 임피던스를 이용하여 검출되는 신호이다. 본 연구는 이러한 전기성문전도를 기록하기 위한 장비를 구현하고 음성분석 및 후두질환 진단에 대한 적용생을 평가하고자 하였다. 전기성문전도의 하드웨어는 2 쌍의 링전극, 동조증폭기, 검파기, 저역통과필터, 자동이득조절부 등으로 구성되며, 2.7MHz의 반송파 신호를 이용하고 진폭 변조 방식의 검파를 통해 임피던스 신호를 추출하도록 하였다. 추출된 신호는 PC 사운드 카드의 라인 입력을 통해 샘플링되고 양자화되었다. 검출 신호를 분석하기 위한 파라미터는 패래 시간을(CQ), 개폐 속도율(SQ), 개폐속도지수(SI), 성대진동 주파수(F0), 성대진동 주파수변동지수(Jitter), 성대진동 진폭변동지수(Shimmer) 등을 추출하였다. 전기성문전도를 분석한 결과, F0가 증가할수록 CQ는 커지고, SQ와 SI는 작아지는 경향을 보였으며, 전기성문전도와 음성 선호의 기본주파수가 일치함을 알 수 있었다. CQ, SQ, SI는 정상인과 후두암 환자를 비교한 결과 유의한 차이를 보였다. 이러한 결과는 성대의 운동을 관찰할 수 있는 휴대용 전기성문전도 계측기의 구현이 가능하게 하였고, 성대 기능 이상 검사가 가능함을 시사하였다.

• Tuberculosis and Respiratory Diseases
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• 제53권3호
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• pp.285-293
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• 2002

배 경 : 폐는 악성 종양이 흔히 전이되는 장소로 흔히 폐실질, 흉막, 혹은 임파선으로 주로 전이되며, 기관지내 전이는 흔하지 않아 악성 종양의 기관지내 발생율은 2%정도로 알려져 있다. 저자들은 굴곡성 기관지경 검사로 확인된 증례들을 대상으로 기관지내 전이암에 대한 임상적 특징을 알아보고자 하였다. 연구방법 : 1991년 6월부터 2001년 5월까지 10년 동안 연세대학교 의과대학 세브란스병원에서 굴곡성 기관지경 검사로 폐외 악성 종양의 기관지내 전이가 확인된 27예를 대상으로 임상 양상, 치료, 경과 등을 조사하였다. 연구결과 : 평균연령은 53세이고, 남자가 17예, 여자가 10예이었다. 원발 종양은 대장암이 가장 많았으며, 자궁경부암, 위암, 유방암의 순서이었다. 원발 종양의 진단에서부터 기관지내 전이를 발견할 때까지의 기간은 평균 45.5개월이었으며, 유방암이 85.3개월로 다른 종양들에 비해 길었다. 임상 증상은 기침이 가장 많았고, 흉부 X-선 소견은 폐문부 종괴음영, 단일결절, 무기폐가 많았다. 치료는 수술, 항암 화학요법, 방사선치료 등을 시행하였고, 생존기은 평균 12.3개월이었다. 결 론 : 기관지내 전이암은 임상에서 흔한 질환이 아니며, 증상, 방사선 소견, 기관지경 소견 등이 원발성 폐암과 유사하다. 따라서 악성 종양의 병력이 있으면서 지속적인 증상이 있거나 비전형적인 병리소견을 보일 때에는 기관지내 전이암의 가능성을 염두에 두고 접근하여야 한다.

• 한국지능시스템학회논문지
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• 제22권2호
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• pp.192-197
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• 2012

DNA 마이크로어레이 기술의 발달과 함께 이를 활용한 질병 진단 및 치료 예후 확인을 목적으로 하는 연구가 활발히 진행 되고 있다. 일반적으로 마이크로어레이 데이터를 이용한 실험에서는 특징들의 수에 비해 적은 샘플의 수, 내재적 측정 노이즈, 서로 다른 샘플들 간의 이질성 등이 분류 성능을 떨어트리는 원인이 된다. 이러한 문제를 극복하기 위해 패스웨이 기반의 기능적 모듈 단위의 마커를 사용하는 방법들이 새롭게 제안 되었다. 이들은 패스웨이의 멤버 유전자들의 발현 값을 요약하여 해당 패스웨이의 활성도로 사용하는데, 기존의 기법들과 비교하여 뛰어난 분류 성능과 재현성을 보여주었다. 그러나 이러한 활성도 계산 방법은 개별 유전자들과 표현형 사이의 상관관계를 무시하거나, 개별 유전자들이 갖는 발현 특성이 제거 되는 단점들이 있다. 본 논문에서는 선택된 기능적 모듈 단위의 유전자들의 부분집합들을 기반으로 약 분류기를 구성하고, 이들의 분류 결과를 결합하여 최종 결과를 추론하는 앙상블 분류 기법을 제안한다. 이 과정에서 유전자 상호작용 정보와 mRMR 필터를 사용하는 필터링과정을 통해 탐색 공간을 최소화하여 분류 성능을 높일 수 있도록 하였다. 제안 된 방법의 성능을 테스트하기 위해 폐암 데이터에 적용한 결과, 기존의 기법들에 비해 신뢰성이 있고 우수한 분류 성능을 보여주었다.

• 대한두개안면성형외과학회지
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• 제17권2호
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• pp.56-62
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• 2016

Background: The two most common skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The purpose of this study was to describe the detailed clinical behavior of BCC and SCC in the head and neck region over 19 years at a single institution. Methods: A retrospective analysis was performed for all patients with non-melanoma skin cancer who had undergone surgical resection over an 18-year period. Patient charts were reviewed for demographic information, tumor size, onset-to-diagnosis, anatomic location, clinical subtype, histologic differentiation, method of surgical treatment, and recurrence. Results: The review identified 265 cases of either BCC or SCC in 226 patients. Of the 226 patients, 80 (35.4%) were men and 146 (64.6%) were women. BCC (n=138, 55.9%) was more frequent than SCC (109, 44.1%). The most frequent age group was 70-to-79 year olds (45 patients, 35.2%) for BCC and 80-to-89 year olds (41 patients, 41.8%) for SCC. By aesthetic units of the face, the most common location was the nasal unit (44 cases, 31.9%) for BCC and the buccal unit (23 cases, 21.1%) for SCC. The most common clinical subtype of BCC was the nodular type (80 cases, 58.0%). Local flaps were most commonly used to cover surgical defects (136 cases, 55.1%). Recurrent rates were 2.2% for BCC and 5.5% for SCC. Conclusion: In our study, many characteristics of BCC and SCC were compared to previously published reports were generally similar, except the ratio of BCC to SCC. Further study can help to establish the characteristics of BCC and SCC.