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원발성 폐암 154례에서의 수술율 및 술후 생존 (An Analysis of the 154 Cases of Lung Cancer)

  • 손광현
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.81-91
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    • 1987
  • During the period of 10 years from July, 1976 to July, 1986, 154 cases of primary carcinoma of the lung - by the cell type, stage, operability, and survival rate in the resectable cases - are analyzed at the Dept. of Thoracic Surgery, Paik Hospital in Seoul. The results are as follows: 1] Histopathological types are squamous cell carcinoma 49% [76 cases], adenocarcinoma 25% [39 cases], undifferentiated large cell carcinoma 9% [14 cases], undifferentiated small cell carcinoma 6% [9 cases], bronchioloalveolar carcinoma 4% [6 cases] and adenosquamous carcinoma 3% [4 cases]. 2] Peak incidence is observed in the 4th decade of life [33%], then 5th [29%] and 3rd [21%] respectively. Male to female ratio is 4 to 1. 3] Evidence of inoperability is observed in 64% [99 cases] by clinical staging workup. Thirty six percent [55 cases] were operated. Of these, post-surgical stage I was 5% [3 cases], stage II, 64% [35 cases] and stage III, 31% [17 cases]. Among total 17 cases of stage III, 14 cases were unresectable with evidence of T2N2M0, while 3 cases were resectable. Resectability is 27%, [41 cases] from the total number of 154 cases. And the resectability for the ex 55 cases is 75% [41 cases]. 4] By cell type, highest resectabitity is the squamous cell carcinoma, 49% [20 cases]. Adenocarcinoma is 32% [13 cases] and bronchioloalveolar, 12% [5 cases]. 5] Survival rate is evaluated for 38 cases of 41 resectable stage I, II and III. Overall 5 year survival rate is 24%, 3 year 32% and 10 year 8%. Survival rate in stage II for 5 year is 25%. In squamous cell type for, 5 year is 42%. Authors believe when surgeons continuous effort of early detection is met with patients early visit, 5 year survival rate for the stage I K II resectable patients will improve more effectively. As well, When the efforts are added to combined modality with radiotherapy and chemotherapy for the stage III selected cases of non-small cell carcinoma patients, the enhancement in survival rate is expected.

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폐양성 종양 61례의 외과적 고찰 (Clinical Study of 61 cases Benign Lung Tumor)

  • 박종원
    • Journal of Chest Surgery
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    • 제22권2호
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    • pp.272-289
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    • 1989
  • Benign lung tumors compose a heterogeneous group of solid growths that present variations in clinical features, depending on whether the origin is within the bronchus on lung parenchyma or from visceral pleura. Benign tumors of the lung are relatively uncommon, and series are to be found in the literature and the classification of benign tumors of the lung continues to be controversial because of disagreement concerning the origin and prognosis of many common lesions. We adopt Liebows original classification but excluded bronchial adenoma which no longer considered as benign tumor and added pulmonary A-V fistula and congenital cystic adenomatoid malformation. We analyzed 61 cases of benign tumors which were composed of 16 original Korean cases and 45 cases which were reported on journal of Thoracic & Cardiovascular Surgery. The results were. [1] Incidence; Of 61 cases, chondromatous hamartoma was 2 cases [41 %], congenital cystic adenomatoid malformation 10 cases [16.4 %], pulmonary A-V fistula 5 cases [8.1 %], sclerosing hemangioma 4 cases [6.5 %], teratoma, plasma cell granuloma & mesothelioma were 3 cases [4.9%], Castlemans disease 2 cases [3.3%], and mucous gland adenoma, paraganglioma, and leiomyoma 1 case [1.6 %]. [2] Age & Sex distribution; Male 30 cases and female 31 cases. Mean age was 31.4 years old. [3] Main symptom; was coughing, 32.8%, and no symptom, 24.6%. [4] Sixty eight percentage of chest film showed mass density, and 4 cases showed calcification, 2 cases had lobulation. [5] Size of mass was large and multiple mass was 2 cases. Endobronchial tumors were 9 cases, 14.9 %. [6] Three cases of endobronchial tumor were preoperatively diagnosed by bronchoscopy and 2 cases of pulmonary A-V fistula were diagnosed by pulmonary arteriography. [7] Seven cases, 11.5%, had associating diseases such as bronchogenic cyst, thymic cyst, Schwannoma, situs inversus, bronchiectasis and bronchogenic carcinoma. [8] Minor resection such as excision 8i: wedge resection were 15 cases, 26.2 %, and 6 cases, 75.4 %, of lobectomy were performed including 5 cases of pneumonectomy 5 cases had. [9] Postoperative complications; One case, 1.6 %, expired due to respiratory insufficiency. Two cases had re-operation due to bleeding and hemoptysis.

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원발성 폐암의 외과적 치료 (Surgical Treatment of Primary Lung Cancer)

  • 곽문섭
    • Journal of Chest Surgery
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    • 제21권1호
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    • pp.87-100
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    • 1988
  • The authors evaluated 200 cases of primary carcinoma of lung in terms of the cell type, operability, resectability and survival rate, that proved by histopathologic examination at the Dept. of Thoracic and Cardiovascular Surgery, Catholic Medical College during the period of 11 years from Jan., 1977 to Dec., 1987. The results are as follows; 1] The peak incidence was observed in the 7th decade of life [34%] and followed by 6th [30%] 8 5th decade [25%]. Male to female ratio was 3.4:1. 2] Histopathologic classifications were squamous cell carcinoma 48% [96 cases], adenocarcinoma 27% [34 cases], small cell carcinoma 13%[26 cases], ;bronchioloalveolar cell carcinoma 5% [10 cases], large cell carcinoma 4.5% [9 cases], adenosquamous cell carcinoma 1.5% [3 cases] and adenoalveolar cell carcinoma 0.5% [1 case]. 3] Among 200 cases of primary lung cancer, the operability was 47.5% [95 cases], refusal of operation 6.0% [12 cases] and inoperability 46.5% [93 cases]. 4] Ninety five cases [47.5%] were operated. Of these, post-surgical stage I was 18.9% [18 cases], stage II 24.2% [23 cases] and stage III 56.8% [54 cases]. Among 54 cases of stage III, 32 cases were unresectable, while 22 cases were resectable. Consequently, the resectability was 31.5% [63 cases] from the total numbers of 200 cases, and the resectability for the operable 95 cases was 66.3% [63 cases]. 5] Surgical complications were empyema with bronchopleural fistula [4 cases], G-I bleeding [1 case], tedious pleural effusion [1 case] and acute respiratory insufficiency [1 case]. Operative mortality was 3.2% [2 cases], which caused by massive G-I bleeding [1 case] and respiratory insufficiency [1 case]. 6] On the long term follow-up of resectable 63 cases, overall 3 year survival rate was 35%, 5 year 22% and 9 year 2%. Five year survival rate was 39% in stage l, 30% in stage II and 0% in stage III. As for the cell types, the higher 5 year survival rate was observed in resectable squamous cell carcinoma [35%] as compared to adenocarcinoma [15%], alveolar cell carcinoma [14%], small cell carcinoma [0%] and large cell carcinoma [0%].

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애성환자에 대한 임상적 고찰 (A Clinical Study of Patients with Hoarseness)

  • 문영일
    • 대한후두음성언어의학회지
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    • 제3권1호
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    • pp.13-21
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    • 1989
  • A clinico-statistical analysis was performed on 1373 cases who complained of hoarseness at the Dept. of Otolaryngology of Ewha Womans University hopital during the past 10 years from fan 1975 to Dec 1984 and the following results were obtained. 1) Among total of 44,912 who visited the Dept. of Otolaryngology. the patients with hoarseness were 1373 cases(3.1%). 2) Among total of 1373 cases, male were 586 and female were 787, the ratio being 1:1.3. 3) The underlying diseases causing hoarseness in order of frequency were acute laryngitis 374 cases(27.2%), chronic laryngitis 325 cases(23.7%), vocal nodule 248 cases(18.1%), vocal polyp 130 cases(9.5%), vocal cord paralysis 101 cases(7.4%), laryngeal cancer 24 cases(1.7%). 4) The highest incidence of age causing hoarseness in order of frequency were 3rd decade 368 cases(26.8%) 2nd decade 312 cases(22.7%) 4th decade 297 cases(21.6%), 5) The highest incidence of age for underlying diseases in order of frequency were as that follows: acute laryngitis in 2nd decade 114 cases(30.5%), chronic laryngitis in 3rd decade 92 cases(28.3%), vocal nodule in 3rd decade 81 cases(32.7%), vocal polyp in 4th decade 38 cases(29.2%), vocal cord paralysis in 5th decade 19 cases(18.8%), laryngeal cancer in 5th decade 13 cases(54.2%). 6) Number of the patients who came the hospital within 10 days after the onset of hoarseness were 272 cases(19.8%), 15 cases(1.1%) had medical attention for first time 10 years after hoarseness. 7) The highest incidence of the duration from the onset to consultation for the underlying diseases were as that follows: acute larynsitis within 10 days 205 cases(54.8%), chronic laryngitis 3M-6M 76 cases(23.4%), vocal nodule 3M-6M 55 cases(22.2%) vocal polyp 6M-lYr 32 cases(24.6%), vocal cord paralysis 3M-6M 20 cases(19.8%)

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소아기관지(小兒氣管支) 천식(喘息)의 임상적(臨床的) 고찰(考察 ) (제(第)II보(報)) (A clinical Study on Pediatric Bronchoarthma (II))

  • 정규만;김덕곤;이동현
    • 대한한방소아과학회지
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    • 제1권1호
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    • pp.79-89
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    • 1986
  • During 34 months from October 1982 to July 1985, a clinical study was made on 217 cases of out-patients with pediatric bronchoarthma at Kyung-Hee University Oriental Hospital. ?The observed results were as follows; ?1. In the age of the patients ranged from six months to twelve years; they were almost under six years (73.1 %) The ratio of male to female was 3: 1. ?2. In case of the age to be attacked with bronchoarthma, the age 3 covered 43.9% (95 cases), and the ages of less than 6 years 86.3% (187 cases); and, especially, the age 2 - 3 covered the highest rate (18.4%; 40 cases) ?3. The contraction period of bronchoarthma was almost less than one year (70.1%; 152 cases); especially, less than one week covered the highest rate (22.1 %; 48 cases) ?4. In case of the contraction season; winter (December to February) had the highest rate (33.2%; 72 cases), and fall, spring and summer came after it. And 13 cases (6%) were attacked in all seasons. ?5. Of a day, the severe symptom was shown most frequently from 6 pm to midnight (31.3%; 68 cases), and next from midnight to 6 am (29.1%; 62 cases) ?6. The common symptoms of out-patients were productive cough (24.0%; 147 cases), easily-catch-cold (22.5%; 138 cases), dry cough (11.4%; 70 cases), and so on. ?7. In case of the history of the patients, upper respiratory infections covered 52.1 % (113 cases) bronchitis(29.0%; 63 cases), pneumonia(17.1%; 37 cases), and tonsilitis& pharyngitis(6.0%; ?13 cases): and allergic symptoms covered (42 cases: 19.3%) fetal fever & eczema (11.5%: 25 cases), and allergie Rhinitis (7.8%: 17 cases) ?8. The family of the patients were shown to have the history of bronchitis (21.6%; 47 cases), bronchoarthma (21.2%; 46 cases), and tuberculosis (16.6%; 36 cases) ?9. The factors of bronchoarthma were shown as upper respiratory infections (38.3%; 38 cases), cold weather (18.9%; 41 cases), and exercise (175%; 38 cases) ?10. Of the treatment periods of the patients, less than one month (69.2%; 150 cases) took the highest rate, in which less than a week was 33.2% (72 cases) and one or two weeks 15.2% (33 cases) ?11. The main prescriptions were kunpyunetang (79 cases; 17.0%), Agoayangyuegunpyuetang (73 cases; 15.7%) and Haepyoyangjintang (72 cases; 15.6%) ?12. In the results of treatment, 132 cases (60.9%) was improved; especially, subjective signs of 33 cases (15.2%) of them, was almost removed.

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불임시술의 합병증에 관한 역학적 연구 (An Epidemiological Study on the Complications caused by the Sterilization Program)

  • 홍명선
    • 지역사회간호학회지
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    • 제7권1호
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    • pp.138-153
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    • 1996
  • Intending to offer basic information for a prospective health services in Korea, this study is to investigate the complication caused by sterilization in goverment family planning program from 1962 to 1995. The results are as follows: 1. Total number of sterilization performed during the period from 1962 to 1995 were 1.367,772 cases of male sterilization and 2,889,635 cases of female sterilization. 2. Incidence of the complication caused by sterilization operation from 1980 to 1995 were 1,883(0.20%) out of 925,801 cases in vasectomies and 15,866(0.70%) out of 2,256,020 cases in tubal sterilizations. 3. Major complications in vasectomy were epididymities of 658 cases (34.9%), vas recanalization of 326 cases(17.3%), hematoma of 266 cases(14.1%), scrotal abscess of 184 cases(9.8%), sperm granuloma of 76 cases(4.0%),and other of 373 cases(19.8%). On the other hand, in tubal sterilization, ectopic pregnancy was the most significant complication of 15,078 cases (95.0%) among 15,866 total complications, followed by pelvic inflammatory diseases of 155 cases(0.9%), peritonities of 96 cases(0.6%), ovarian & tubal bleeding of 31 cases(0.2%), intestinal perforation of 16 cases (0.1%), uterine bleeding of 14 cases(0.1%), uterine cervix laceration of 1 case (0.1%), and other of 271 cases(1.7%), while 161 pregnancies(0.1%) were terminated and 43 cases(0.3%) with normal delivery. 4. The occurrence rate of the complication for each period showed that most of the complication cases by vasectomy occurred in a year after the operation -the cases were 1,256 (66.7%). 254 cases(13.5%) occurred between the next year and the 2nd year, 138 cases (7.3%) between the 2nd year and the 3rd year, 73 cases(3.9%) between the 3rd year and the 4th year, 52 cases(2.8%) between the 4th year and the 5th year, 31 cases(1.6%) between the 5th year and the 6th year, 79 cases(4.2%) over the 6th year. Tubal sterilization indicated that the occurred complication cases in a year were 2,175 cases(13.7%), 2,113 cases(13.3%) occurred between the next year and the 2nd year, 2,082 cases(13.1%) between the 2nd year and the 3rd year, 2,049 cases (12. 9%) between the 3rd year and the 4th year, 1,819 cases(11.5%) between the 4th year and the 5th year, 621 cases(10.2%) between the 5th year and the 6th year, 4,007 cases(25.3%) over the 6th year. 5. For the cost of complication treatment, total \7,928,229,000 were paid as medical expenditure in which \609,438,000 for vasectomy and \7,318,791,000 for tubal sterilization. Accordingly per capita expenses were \345,000 for vasectomy and \467,000 for tubal sterilization. As the proportion of government sterilization program was decreased after 1988, that of private sterilization program would be increased. So it is recommended to set a guideline for the private sterilization program and to continue government sterilization program for the lower class.

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자연기흉의 임상적 고찰 (A Clinical Evaluation of Spontaneous Pneumothorax - A Review of 237 Cases -)

  • 김창수
    • Journal of Chest Surgery
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    • 제25권9호
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    • pp.955-961
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    • 1992
  • In this study, 237 cases of spontaneous pneumothorax experienced at the department of Thoracic and Cardiovascular Surgery, Kosin Medical College during from January 1986 to December 1990 were analysed retrospectively. 1. The ratio of male to female was 4.6: 1, predominent in male. The incidence of age group was highest as 36% between 21 and 40 years old. 2. The associated diseases of pneumothorax were 27 cases, in which pyothorax were 8 cases, and hydrothorax were 19 cases. 3. The site of pneumothorax was as follows: right side was 53%, left side was 45%, and both side was 2%, so right side was slight high. 4. The empolyed managements were as follows: bed rest with oxygen inhalation in 13 cases, closed thoracostomy in 155 cases, open thoracotomy in 69 cases. 5. The operative procedures of thoracotomy were as follows; simple pleurodesis in 2 cases, blebectomy & bullectomy in 38 cases, parietal pleurecttnny in 4 cases, segmentectomy in 12 cases, lobectomy in 9 cases. 6. The indication of open thoracotomy were as follows, recurrent history in 35 cases, contralateral pneumothorax history in 2 cases, continuous air leakage in 24 cases, bilateral pneumothorax in 2 cases, and visible blebs & bullaes on the chest X-ray in 6 cases. 7. The hospital duration after management was as follow, open thoracotomy in 13.2 days, closed thoracostomy in 22.4 days. The recurrent pneumothorax after closed thoracostomy was 25 cases, about 15%.

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The Reconstruction of the Injured Foot with Microsurgical Technique

  • 한수봉;박영희
    • Archives of Reconstructive Microsurgery
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    • 제6권1호
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    • pp.47-55
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    • 1997
  • One hundred and thirty-seven patients had reconstructive surgery of injured feet with microsurgical technique in the Department of Orthopaedic Surgery at Yonsei University College of Medicine from 1983 to 1997. The results were as follows: 1. There were 89 cases in men and 48 cases in women, who together had a mean age of 21.3 years. 2. The causes of injuries were 97 cases from traffic accidents, 15 cases from burns, 11 cases from machinery injury, 5 cases from infection, 2 cases from falling, 2 cases from glass injury, 2 cases from snake bite, 2 cases from explosive injury, and 1 case from ulceration. 3. There were 47 cases with inguinal flaps, 36 cases with scapular flaps, 36 cases with parascapular flaps, 7 cases with deltoid flaps, 4 cases with lateral thigh flaps, 3 cases with latissimus dorsi flaps, 2 cases with tensor fascia lata flaps, and 2 cases with dorsalis pedis flaps. 4. One hundred and twenty-seven(92.7%) cases were successful in reconstructive surgery with microsurgical technique. 5. Functionally, the thick skin flap or sensory flap has less ulceration and good protective sensation. We considered that the function and cosmetic appearance were excellent after reconstructive surgery of the injured feet with microsurgical reconstructive technique and that the thick skin flap or sensory flap has less ulceration and good protective sensation.

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최근 5년간 주요 중앙환경분쟁조정 사건의 내용 분석 (Content Analysis of Main National Environmental Dispute Cases from Five Recent Years)

  • 박정호;양성봉
    • 한국환경과학회지
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    • 제25권7호
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    • pp.989-998
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    • 2016
  • In this study, we analyzed the content and compensation factors of 337 cases of national environmental disputes from five recent years (2000~2014). Causes of damage were noise-vibration in 234 cases (69%), sunlight in 48 cases (14%), air pollution in 19 cases (6%), water pollution in 15 cases (4%), odor in 13 cases (4%), and others factors in 8 cases (3%). Sources of damage were construction in 224 cases (66%), structures in 36 cases (11%), vehicle on road in 31 cases (9%), industry in 18 cases (5%), environmental facility in 11 cases (3%), livestock facility in 6 cases (2%), and other sources in 11 cases (3%). From the results of logistic regression analysis, important factors associated with compensation were found to be damage amount, damage distance, zoning districts, source, and administrative disposition.

전폐절제술후 발생한 합병증에 대한 분석 (Analysis of Postpneumonectomy Complications)

  • 허강배
    • Journal of Chest Surgery
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    • 제26권8호
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    • pp.613-619
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    • 1993
  • As developing surgical techniques and postoperative cares, a pneumonectomy is a relatively popular surgical method in disease which is not treated completely with other type of pulmonary resection, but a postpneumonectomy complication is a life-threatening serious problem if it occurred. We performed one hundred twenty-five cases of pneumonectomy for treatment of various causes of pulmonary diseases in Kosin Medical College during about ten years, and we experienced 41 cases of postoperative complications in 29 patients, so we analyzed them. The most common complication is an empyema thoracis in 13 cases[10.4%], of which one case combined with bronchopleural fistula died on early postoperative day. Of them except one case, the early postoperative empyema thoracis[within 30 days] were 6 cases, and the late postoperative empyema thoracis[above 30 days] were 6 cases. The main etiologic pathogens were a staphylococcus in early postoperative empyema and a streptococcus in late postoperative empyema, but the most cases were mixed infections with pseudomonas, klebsiella, acinectobacter, and candida. The treatment of postoperative empyema thoracis were that 4 cases were treated with open drainage using chest tube, 7 cases with Clagett`s operation, and 1 case with thoracoplasty. The next common complication was a postoperative serious respiratory insufficiency in 7 cases. And the other complications were massive postoperative bleeding in 5 cases, of which 2 cases advanced to occurrence of postoperative empyema thoracis, and wound disruption in 4 cases, cardiac arrhythmia in 3 cases, contralateral pneumothorax and pneumonia in each of 2 cases, esophagopleural fistula in 1 case. The postoperative deaths were 9 cases[7.2%] of 125 cases, the causes of death were respiratory insufficiency in 6 cases, sepsis in 2 cases, and cardiac arrhythmia in 1 case.

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