• Tuberculosis and Respiratory Diseases
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• 제80권4호
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• pp.368-376
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• 2017

Background: A ground-glass nodule (GGN) represents early-stage lung adenocarcinoma. However, there is still no consensus for preoperative staging of GGNs. Therefore, we evaluated the need for the routine use of positron emission tomography/computed tomography (PET)/computed tomography (CT) scans and brain magnetic resonance imaging (MRI) during staging. Methods: A retrospective analysis was undertaken in 72 patients with 74 GGNs of less than 3 cm in diameter, which were confirmed via surgery as malignancy, at the Samsung Medical Center between May 2010 and December 2011. Results: The median age of the patients was 59 years. The median GGN diameter was 18 mm. Pure and part-solid GGNs were identified in 35 (47.3%) and 39 (52.7%) cases, respectively. No mediastinal or distant metastasis was observed in these patients. In preoperative staging, all of the 74 GGNs were categorized as stage IA via chest CT scans. Additional PET/CT scans and brain MRIs classified 71 GGNs as stage IA, one as stage IIIA, and two as stage IV. However, surgery and additional diagnostic work-ups for abnormal findings from PET/CT scans classified 70 GGNs as stage IA, three as stage IB, and one as stage IIA. The chest CT scans did not differ from the combined modality of PET/CT scans and brain MRIs for the determination of the overall stage (94.6% vs. 90.5%; kappa value, 0.712). Conclusion: PET/CT scans in combination with brain MRIs have no additional benefit for the staging of patients with GGN lung adenocarcinoma before surgery.

• Journal of Chest Surgery
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• 제36권6호
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• pp.444-447
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• 2003

기관분기부에 침범한 악성 종양의 치료로 이용되는 소매 전폐 절제술은 수술 후 높은 유병률과 사망률을 동반하나 기관 분기부위의 악성 종양이 일측 폐를 완전히 허탈시키고 반대편 기관지의 허탈의 가능성이 있는 경우는 좋은 수술적 방법이 될 수 있다. 본 64세된 남자환자는 과거력에서 13년 전에 승모판 협착증 및 삼첨판 폐쇄 부전증으로 타 병원에서 승모판 치환술 및 삼첨판륜 성형술을 시행 받았으며 2년 전에는 성대에 생긴 유두종으로 종양절제술을 시행받았다. 최근에는 혈담을 주소로 내원하여 기관지내시경 및 흉부 컴퓨터단층촬영에서 하부 기관부터 좌측 주 기관지까지 약 3.5 cm의 악성 편평상피세포암이 관찰되었으며 좌측 주 기관지를 완전히 막고 있는 소견이 있었고 grade III의 삼첨판 폐쇄부전이 있었다. 심폐 바이페스 없이 순차적 양측 후측방 개흉술을 통해 좌측 소매 전폐절제술을 시행하였고 수술 후 병리 조직검사에서 T4N0M0인 악성 편평상피세포암으로 확인되었고 수술 후 특별한 문제없이 퇴원하였다.

• Journal of Chest Surgery
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• 제28권3호
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• pp.221-227
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• 1995

Malignancy is one of the several exogenous and endogenous factors that increase serum alpha 1-PI. In fact, serum levels of alpha 1-PI were significantly elevated in the patients with the nonresectable bronchogenic cancer. the purpose of this work was to determine if the immediate postoperative change of serum alpha 1-PI level following tumor resection relates to the patient`s postoperative course. Clinical experimental study was carried out to investigate the postoperative changes of serum alpha 1-PI level following operation for 20 cases of bronchogenic cancer and 10 cases of control, nephrectomy patients Alpha 1-PI concentrations in serum was quantitated by use of radial immunodiffusion technique.The results were as follows ; Preoperative serum level of alpha 1-PI was significantly elevated in patients with bronchogenic cancers [p < 0.001 , when compared to normal control levels. Immediate postoperative serum alpha 1-PI level was significantly increased in patients with bronchogenic cancer [p < 0.05 , but slightly decreased at control groups. The peak serum level of alpha 1-PI was the postoperative three days, and then gradually decreased at the 5, 9, 14 days, but slightly elevated comparing to preoperative alpha 1-PI levels. Serum alpha 1-PI level in patients with adenocarcinoma was elevated, when compared to squamous cell carcinoma, but not significantly. According to the stages of the bronchogenic cancer, each levels of the serum alpha 1-PI were slightly different, but the whole postoperative changes were the general similarity. There were no significant difference in changes of the serum alpha 1-PI level, according to the operative procedures. As the alpha 1-PI is acute reactant, that it was required at the reoperative state of the bronchogenic cancer and rapid response, consumption or requirement were occurred, postoperatively. Therefore, alpha 1-PI can be perioperative indicator for the evaluation of the bronchogenic cancer.

• Journal of Chest Surgery
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• 제42권3호
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• pp.364-367
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• 2009

후복막강 폐격리증은 극히 드문 질환으로 보통은 임신 6개월경에 시행하는 태아 초음파로 발견되며 드물지만 성인에서 우연히 발견된다. 후복막강 폐격리증은 그 위치와 방사선학적인 소견이 신경아세포종 등의 다른 후복막강 종괴와 아주 유사하기 때문에 그 발생 빈도가 극히 드물더라도 후복막강 종괴가 의심될 때 감별을 요한다. 세침 흡입 검사가 수술 전 진단에 도움이 된다고 하지만, 수술적 제거가 환자의 예후나 경과를 생각 했을때 좋은 치료 방법이라고 생각된다.

• Journal of Chest Surgery
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• 제31권8호
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• pp.799-803
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• 1998

대상 및 방법: 1981년 3월부터 1996년 7월 까지 본원에서 치험한 원발성 기관 종양은 14례로, 평균 연령은 45.9세 였으며, 남녀비는 1:1.8이였다. 결과: 14례중 9례가 악성이었으며, 선양낭성암이 5례로 가장 많았다. 대부분의 환자에서 단순흉부촬영 및 기관지 내시경, 전산화 단층촬영을 시행하였고 대부분의 종양은 중하부에 위치하였다. 수술적접근을 위해 기관을 편의상 상부, 중부, 하부기관으로 분류하였으며, 각각의 위치에 맞게 경부 칼라절개, 경부 칼라절개 및 부분적 정중 흉골 절개, 우측 개흉술, 그리고 정중 흉골 절개 및 후두 박리술을 시행하였다. 수술후에 문합부위 파열 및 그로인한 기도폐쇄,설골 상부 박리후에 후두부 부종으로 사망한 례가 각각 1례씩 있었으며, 추적관찰중 진단후 8개월만에 사망한 1례를 제외한 전환자는 추적기간중 비교적 양호한 임상 경과를 밟았다.

• Journal of Chest Surgery
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• 제42권2호
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• pp.268-271
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• 2009

고립성 골형질세포종은 형질세포종양의 $3{\sim}5%$를 차지하는 드문 질환이며 특히, 늑골에 발생한 고립성 골형질세포종에 관해 국내에서는 아직 보고된 바가 없다. 54세 남자 한자가 검진 시 시행한 단순가슴 사진에서 폐종양으로 의심되는 병변이 있어 타병원에서 전원되었다. 전산화 단층 촬영 및 양전자 방출 단층 촬영 결과 좌측 6번째 늑골의 종양으로 진단되어 수술적 절제를 하였다. 병리 검사 결과 골형질세포종으로 진단되었으며 술 후 선별검사에서 다발성 골수종의 증거는 없었다. 술 후 방사선 치료는 하지 않았으며 2년째 추적 관찰 중이나 새로운 병변은 발견되지 않았다.

• Journal of Chest Surgery
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• 제29권3호
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• pp.360-364
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• 1996

유미흉이란 유미액이 유출되는 현상이다. 그리고 드물게 미만성 폐림프관종증도유미흥을유발하나 이에 대해서는 잘 알려져 있지 않다. 본 교실에서는 유미흥을 동반한미만성 폐림프관종증을경험하였기에 보고하는바이다. 환자는 3세된 여자로 기 침과 발열감을 주소로 내원하였다. 단순 흉부 될영상 양측성 흥막 유출 소견과 간질성 침윤 소견을 보였다. 검사실 소견상흥막 유출은유미액으로밝혀 졌으며,폐쇄식 흥강내 삽관술로조절되지않아흥관결찰술을시행하였다. 병리 조직 검사상흥막과 소엽간중격에서 림프관을따라내퍼세포들이 연결되어 있었으며 림프관이 증식된간질부위에평활근조직을관찰할수있었다. 술후, 수차례의 화학적 홍막 유착술을 시행하여 유미흥을 치료하였으며 환자는 퇴원후 10개월동안 특별한 문제없이 잘 지내고 있다.

• Journal of the Optical Society of Korea
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• 제19권1호
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• pp.69-73
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• 2015

The mesothelium is an essential lining for maintaining the normal homeostasis of the closed body cavity and a central component of pathophysiologic processes. The mesothelium has been known as the end target for asbestos which induces asbestos-related lung diseases. Malignant mesothelioma (MM) is a rare and fatal neoplasm predominantly due to asbestos exposure. Adaptation of an advanced and reliable technology is necessary for early detection of MM because it is difficult to diagnose this disease in its early stages. Optical coherence tomography (OCT) provides cross-sectional images of micro-tissue structures with a resolution of $2-10{\mu}m$ that can image the mesothelium with a thickness of ${\sim}100{\mu}m$ and, therefore, enable investigation of early development of MM. The mesothelium is typically located at the pleura and tunica vaginalis of the scrotum. In this study, we developed animal window models in the above two anatomical sites to visualize mesothelial layers within the mesothelium. OCT images at the two locations were also acquired.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8149-8153
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• 2016

An oncopathological state assessment was conducted among adults, children and teenagers in Aktobe region for 2004-2013. Overall the burden of mortality was in the range of 94.8-100.2 per 100,000 population, without any obvious trend over time. Ranking by pathology, the highest incidences among women were registered for breast cancer (5.8-8.4), cervix uteri (2.9-4.6), ovary (2.4-3.6) and corpus uteri, stomach, esophagus, without any marked change over time except for a slight rise in cervical cancer rates. In males, the first place in rank was trachea, bronchus and lung, followed by stomach and esophagus, which are followed by bladder, lymphoid and hematopoietic tissues pathology. Agian no clear trends were apparent over time. In children, main localizations in cancer incidence blood (acute lymphocytic leukemia, lymphosarcoma, acute myeloid leukemia, Hodgkin's disease), brain and central nervous system, bones and articular cartilages, kidneys, and eye and it's appendages, in both sexes. Similarly, in young adults, the major percentage was in blood and lymphatic tissues (acute myeloid leukemia, acute lymphocytic leukemia, Hodgkin's disease) a significant percentage accruing to lymphosarcoma, lymphoma, other myeloid leukemia and hematological malignancies as well as tumors of brain and central nervous system, bones and articular cartilages. This initial survey provides the basis for more detailed investigation of cancer epidemiology in Aktobe, Kazakhstan.

• Journal of Chest Surgery
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• 제29권3호
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• pp.346-349
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• 1996

This 32 year old female patient underwent left radical mastectomy due to ductal carcinoma on May 1990, and treated with FAM (5-fluorouracil, Adriamycin and Mitomycin C) regimen postoperatively. However, right cervical Iymph node enlargement and facial edema progressively developed since December 199). On April 1994, operation was performed, and findings were as followes; x4$\times$5$\times$7 to 1 : 1 $\times$ 1 cm sized multiple enlarged and hyperemic Iymph nodes were scatterred throughout submandibular area to the junction of superior vents cave and pericardium, and partially invaded both anterior segmental lobe, sternum and both distal tip of clavicles. After radical dissection of the nodes of neck and mediastinal nodes, and wedge resection of both anterior segments of lung, and partial resection of both clavicle tips and total sternum. The both innominate veins and superior vena cava were partially obstructed by invaded cancer SVC reconstruction was done with preclotted 10$\times$ 10$\times$ 18mm Y shap d woven Dacron graft, which was anastomosed to the point of the junction of subclavian vein and jugular vein after cross clamping both veins and 2cm above the pericardial junction with one arm clamp. After maintaining blood drainage to the SVC from the right side, left innominate vein was anastomosed with 4-0 Prolene continuous running suture. Bone cement was used for resected sternal portion and clavicular ends were fixed to postal portion with 18 Gauge wires. The patient was treated with radiation and chemotherapy after discharge, and there were no evidence of regrowing of the mass nor obstruction of the graft inspite of no antithrombotic therapy.