• 제목/요약/키워드: lung mass

검색결과 665건 처리시간 0.024초

폐결핵의 절제술에 대한 임상적 고찰 (Surgical Treatment of Pulmonary Tuberculosis)

  • 김애중;구자홍;김공수
    • Journal of Chest Surgery
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    • 제29권4호
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    • pp.397-402
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    • 1996
  • 전북대 학교병 원 흉부외과에서는 1979년 1월부터 1992년 12월까지 폐결핵으로 폐절제술을 실시한 44 명중 자료가 충실하였던 36명을 연구대상으로 하였다. 연령분포는 20, 30대가 55 %를 차지하여 가장 많 았고, 남녀비는 3.5 : 1이 었다. 증상은 흥통과 객혈 또는 혈액 이 약간 섞인 객담이 27예 (74.9 %)로 가장 많 았다. 병 력기간은 1년 미만이 12예 (33.3 %), 1~5년이 17예 (47.2 %), 5~10년이 4예 (11.1 %), 10년이상이 3예 (8.3 %)이 었다. 술전 객담도말검사상 균음성예는 77.8 %였고 화학요법에도 불구하고 균양성 예는 8 %이었다. 수술 적응은 공동을 동반한 폐구역 및 폐엽의 심한 파괴가 58.3 %로 가장 많았으며, 결핵병소는 우상 엽이 27.8 %로 가장 많았다. 술식은 폐 엽 절제가 50 %였고, 폐구역 절제가 27.8%, 전폐 절제가 16.7 %이 었다. 폐기능 검사는술식에 관계없이 술전에 비해 술후에 모두 향상되었으나 통계학적 유의 수준에는 미치지 못하였다. 술후 주요 합병증으로는 기관지늑막루가 동반된 농흥이 2예 (5.5 %), 사강이 4예 (11.1 %), 결핵균의 확산이 2예 (5.5 %)이 었다. 1예 에서 좌상엽 절제후 합병한 약제과민성으로 인한 궤양\ulcorner 대장염으로 인공항 문성형술을 시행후 2일째 호흡부전으로 사망하여 술후 사망율은 2.7 %이었다.

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CT 유도하 국소적 폐질환의 경피적 흡입생검의 장점과 결과 분석 (Analysis of the Result and Merit of Computed Tomography Guided Percutaneous Needle Aspiration Biopsy of Focal Lung Lesion)

  • 장유송;조길호;변우목;황미수;박복환
    • Journal of Yeungnam Medical Science
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    • 제10권1호
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    • pp.127-134
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    • 1993
  • PTNB는 최근 CT 기술의 발전과 20 gauge 또는 22 gauge의 세침의 개발로 합병증을 줄이는 한편, 성공율이 높아 점차 임상적으로 널리 이용되는 추세에 있다. 이에 저자는 최근 44례의 PTNB를 분석하여 다음과 같은 결과를 얻었다. 환자의 분포는 50대 남자가 17례로 가장 많았고 종괴의 크기와 위치는 4cm 전후가 36례(84%)로 가장 많았다. 종괴의 국소적 위치는 변연부에 위치한것이 33례(75%)의 주로 폐의 변연부에 위치하였다. 조직 채취는 42례(95%)에서 가능했으며, PTNB의 민감도는 61%(27/44)였고 악성종괴와 양성종괴에 대한 민감도는 각각 79%(19/24), 44%(8/18)였다. 민감도가 비교적 낮은 이유는 단 1회 시술로 결과를 얻었고 민감도를 높이기 위한 반복 PTNB는 시행하지 않았기 때문으로 생각한다. 합병중인 기흉이나 각혈은 각각 1례에서 얻었고 모두 특별한 치료없이 호전되었다. 이상에서 PTNB는 다른 검사 방법 보다 간편하고 안전하며 기관지경을 통한 생검이 불가능하거나 생검후에도 병리소견을 못얻을 경우 PTNB를 통해 양성질환과 악성질환을 구분하므로서 환자의 치료 방침 결정에 도움을 줄 수 있을 것으로 사료되며, 국소적 폐 질환의 진단에 있어서 PTNB의 유용성은 더욱 증가하리라고 전망된다.

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원발성 폐동맥 육종 1례 (A Case of Primary Pulmonary Artery Sarcoma)

  • 김희정;서석민;김성용;김명숙;김승준;김영균;김관형;문화식;송정섭;박성학
    • Tuberculosis and Respiratory Diseases
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    • 제54권2호
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    • pp.230-235
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    • 2003
  • 저자들은 폐색전증 의심하에 항응고제를 포함한 약물치료를 시행하였으나 임상증상의 호전이 없는 환자에서, 흉부 전산화단층촬영과 흉부 자기공명영상촬영을 통해 색전을 동반한 혈관의 종물을 발견한 후 수술적 제거로 진단한 원발성 폐동맥 육종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

The Survival Rate of Korean Patients with COPD with or without Acute Exacerbations

  • Uh, Soo-Taek;Lee, Ji-Yeon;Koo, So-Mi;Kim, Yang-Ki;Kim, Ki-Up;Park, Jong-Sook;Park, Sung-Woo;Jang, An-Soo;Kim, Do-Jin;Choi, Jae-Sung;Na, Joo-Ok;Suh, Ki-Hyun;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • 제70권6호
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    • pp.474-481
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    • 2011
  • Background: Chronic obstructive pulmonary disease (COPD) is characterized by air low limitation, which is one of the leading causes of mortality worldwide. There have been many studies on survival rates in the world literature, but there have been few reports regarding the survival rate in Korean patients with COPD. Acute exacerbation is regarded as a risk factor for mortality in patients with COPD. The purpose of this study was to investigate the survival rate and the effect of acute exacerbations on the survival rate of Korean patients with COPD. Methods: A total of 502 COPD patients who were diagnosed on the basis of history and lung function tests were enrolled in this study. The frequency of acute exacerbations, body mass index (BMI), C-reactive protein (CRP) and pulmonary hypertension were analyzed. Results: The 3- and 5-year survival rates were 98% and 83%, respectively. The median survival time was 78 months. The median survival time was 55 months in 322 patients with one or more acute exacerbations. The 3- and 5-year survival rates were significantly lower in the 322 patients with one or more acute exacerbations than in those without any. The mortality rate was significantly higher in patients with CRP>3 mg/L than in those with CRP ${\leq}3$ mg/L (p<0.005); it was significantly higher in patients with pulmonary hypertension than in those without it (p<0.01). Conclusion: Because the 5-year survival rate is 83% in Korean patients with COPD, the management of stable patients with COPD should focus on the prevention of acute exacerbations.

Acute Pulmonary Toxicity and Body Distribution of Inhaled Metallic Silver Nanoparticles

  • Kwon, Jung-Taek;Minai-Tehrani, Arash;Hwang, Soon-Kyung;Kim, Ji-Eun;Shin, Ji-Young;Yu, Kyeong-Nam;Chang, Seung-Hee;Kim, Dae-Seong;Kwon, Yong-Taek;Choi, In-Ja;Cheong, Yun-Hee;Kim, Jun-Sung;Cho, Myung-Haing
    • Toxicological Research
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    • 제28권1호
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    • pp.25-31
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    • 2012
  • The purpose of this study was to determine the acute pulmonary toxicity of metallic silver nanoparticles (MSNPs, 20.30 nm in diameter). Acute pulmonary toxicity and body distribution of inhaled MSNPs in mice were evaluated using a nose-only exposure chamber (NOEC) system. Bronchoalveolar lavage (BAL) fluid analysis, Western blotting, histopathological changes, and silver burdens in various organs were determined in mice. Mice were exposed to MSNPs for 6 hrs. The mean concentration, total surface area, volume and mass concentrations in the NOEC were maintained at $1.93{\times}10^7$ particles/$cm^3$, $1.09{\times}10^{10}\;nm^2/cm^3$, $2.72{\times}10^{11}\;nm^3/cm^3$, and 2854.62 ${\mu}g/m^3$, respectively. Inhalation of MSPNs caused mild pulmonary toxicity with distribution of silver in various organs but the silver burdens decreased rapidly at 24-hrs post-exposure in the lung. Furthermore, inhaled MSNPs induced activation of mitogen-activated protein kinase (MAPK) signaling in the lung. In summary, single inhaled MSNPs caused mild pulmonary toxicity, which was associated with activated MAPK signaling. Taken together, our results suggest that the inhalation toxicity of MSNPs should be carefully considered at the molecular level.

10년간 크기가 서서히 증가한 고립성 폐결절이 선암으로 진단된 1예 (A Case of Adenocarcinoma Presenting a Solitary Pulmonary Nodule that Grows Slowly Over 10 Years)

  • 권기두;김지형;김대용;최문한;최재혁;신동원;최종효;이설희;윤진아;최재성;나주옥;서기현;김용훈;오미혜
    • Tuberculosis and Respiratory Diseases
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    • 제64권4호
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    • pp.318-323
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    • 2008
  • 본 증례는 2년간 크기의 변화가 없다가 천천히 자라는 고립성 폐결절을 경피부 흉강 세침생검을 시행하여 분화도가 좋은 원발성 폐선암을 진단하였고, 근위 림프절 절제를 포함한 좌상엽절제술을 시행하였다. 저자들은 비록 폐결절 크기의 배가시간이 느리며, 알려진 악성의 위험인자가 거의 없어 양성의 가능성이 높은 폐결절이라 하더라도, 조기에 조직검사 를 포함한 적극적인 검사와 치료가 필요하며, 조직검사가 어려울 경우 크기 변화를 예측하기 위해서는 흉부전산화단층촬영으로 추적관찰 하는 것이 필요 하다고 사료되어 이를 문헌고찰과 함께 보고하는 바이다.

침윤성 근육내 지방종 (Infiltrating Intramuscular Lipoma)

  • 서정탁;김정일;천상진;이춘기;구자경;김영균
    • 대한골관절종양학회지
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    • 제11권1호
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    • pp.40-45
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    • 2005
  • 목적: 침윤성 근육내 지방종의 임상적, 생물학적, 방사선학적 및 병리 조직학적 특징들을 분석하여 정확한 진단과 치료 방침을 확립하는데 있다. 대상 및 방법: 1998년 10월부터 2001년 10월까지 본원 정형외과에서 침윤성 근육내 지방종으로 수술받은 후 5년까지 추시 가능한 환자 12예를 대상으로 하였다. 환자의 나이는 12세에서 63세까지로 평균 45.8세였다. 남자 4예, 여자 8예였으며, 종양의 위치는 상지 5예, 하지 3예, 배부 3예, 대둔부에 발생한 1예가 있었다. 모든 예에서 술전 단순 방사선 사진과 자기공명 영상 검사를 시행하였으며 수술시 획득한 조직에 대해 병리 조직학적 검사를 하였고 종양의 재발을 추시 관찰 하였다. 결과: 술전 방사선 검사상 골격근에 침윤을 보인 경우는 7예였다. 1예를 제외하고 11예에서 종양 조직과 침윤된 주변 골격근의 제거가 완전히 이루어졌고 수술시 얻어진 조직에 대한 병리조직학적 검사상 피막이 있는 3예와 피막이 없는 9예가 있었으며 지방 세포와 골격근 세포가 혼합된 7예가 있었다. 완전 제거가 불가능하였던 1예를 제외하고는 추시 관찰상 재발은 없었다. 결론: 침윤성 근육내 지방종은 침윤성으로 인하여 분화가 잘된 지방 육종으로 오진될 수 있으므로 병리 조직학적 검사를 통해 정확한 병리 조직학적 진단이 필요하며 술전 연부조직 단순 방사선 사진과 자기 공명 영상 검사는 종양의 정확한 진단과 위치 파악에 도움이 된다. 치료 방법으로 침윤성 근육내 지방종과 침윤된 근육을 충분히 절제하였을 때 재발없이 만족스러운 결과를 얻었을 수 있었다.

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맥경(脈經) 권제팔(卷第八)의 황달(黃疸). 학질(?疾). 옹종(癰腫). 장옹(腸癰) 등증맥(等證脈)에 대한 연구 (Study on the Symptom & the Pulse of Jaundice, Intermittent Fever, Carbuncle, Intestines Carbuncle, & c. of the Maek Kyoung Vol. VIII)

  • 임동국;조경종;최경석;두자성;김종회;정헌영;금경수;박경
    • 동의생리병리학회지
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    • 제22권5호
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    • pp.1001-1034
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    • 2008
  • This thesis is a study composed of eight chapters from 9. to 16. of the Maek Kyoung(脈經) Vol. VIII. ; the symptom & the pulse of Jaundice(黃疸), Malarial Disease(?疾). Carbuncle(癰腫) Intestines Carbuncle(腸癰), & c. It is as follows : Chapter 9 refers to the symptom, pulse, treatment and prognosis of Jaundice(黃疸) and Malarial Disease(?疾). Chapter 10 refers to the cause, symptom, pulse and treatment of Cardialgia(胸痺), Cardiagra(心痛) and Nephric Accumulation(賁豚). Chapter 11 refers to the symptom, pulse and treatment of Abdominal Fuliness(腹滿), Cold Mounting(寒疝) and Abiding Food(宿食). Chapter 12 refers to the symptom and pulse of Accumulation and Mass of the Five Viscera(五臟積聚). Chapter 13 refers to the cause, pathogenesis, symptom, pulse, treatment and prognosis of Terror and Palpitation due to Fright(驚悸), Hematemesis(吐血), Nasal Hemorrhage(?血), Metrorrhagia(下血) and Extravasated Blood(瘀血). Chapter 14 refers to the cause, pathogenesis, symptom, pulse and treatment of Vomiting(嘔吐), Hiccough(?) and Diarrhea(下利). Chapter 15 refers to the cause, pathogenesis, symptom, pulse and treatment of Atrophy of Lung(肺?), Pulmonary Abscess(肺癰), Lung-distention(咳逆上氣) and Phlegm(痰飮). Chapter 16 refers to the cause, pathogenesis, symptom, pulse. treatment and prognosis of Carbuncle(癰腫), Intestines Carbuncle(腸癰), Wound(金瘡) and Acute Eczema(侵淫瘡). There have been abundant investigations in China. But we couldn't find a clear result yet, and they were written in archaic texts and colloquial Chinese, therefore it is needed to be translated into Korean. And there was only one inaccurate translation with insufficient annotation. So I hope this study will be useful to develope Oriental Medical Diagnostics.

소타액선 종양의 고찰 (A Review of Minor Salivary Gland Tumor)

  • 태경;지용배;진봉준;이승환;이형석
    • 대한두경부종양학회지
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    • 제21권2호
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    • pp.115-120
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    • 2005
  • Background and Objectives: Minor salivary gland tumors vary in their primary sites, histopathology and biological behavior. Therefore, various factors are considered in selecting the treatment modality and predicting the prognosis. We performed this study for the purpose of getting further understanding and more supporting ideas for the diagnosis and treatment of minor salivary gland tumor. Materials and Methods: A retrospective analysis of the patients with 52 cases of minor salivary gland tumor who were treated at the Hanyang University Hospital from 1996 to 2003 was performed. We analyzed demography, symptoms, histopathology, treatment and outcomes by the review of medical records. Results: Among 52 cases of minor salivary gland tumor, 46% were classified as benign and 54% were classified as malignant tumors. The most common benign tumor was pleomorphic adenoma. Adenoid cystic carcinoma(15/28) was the most common in malignant tumors. Eight patients were males and sixteen patients were females in benign tumors and 10 patients were males and 18 patients were females in malignant tumors. The most common site of benign tumor was the palate(17/22), whereas malignant tumors were most common in the nasal cavity and paranasal sinus(9/28). Asymptomatic mass was the most common symptom. According to the criteria given by the AJCC on staging, stage III and IV(21/28) were more common than stage I and 11(7/28). All benign tumors were treated with simple excision and had no recurrence. In malignant tumors, 25 patients underwent radical excisional operation and 13 patients of them had postoperative radiation therapy. Three of them were treated with additional chemotherapy. In whom treated with radical operation, 9 patients had recurrence. Three were recurred at the primary site with neck node metastasis, 3 were recurred at the primary site with lung metastasis, 1 was recurred at the primary site with neck node and lung metastasis, 1 was recurred only at neck node. Conclusion: In minor salivary gland tumor, malignant was more common than benign. Malignant tumor originated from minor salivary gland were more frequently diagnosed at advanced stage with high recurrence rate and distant metastasis. Early detection of the disease is needed to improve the prognosis of the patients with malignant tumors of the minor salivary glands.

개에서 땀샘 암종, 유선종양 및 방광 이행상피암종의 동시 발생 (Concurrence of Apocrine Carcinoma, Mammary Gland Tumors and Bladder Transitional Cell Carcinoma in a Dog)

  • 정연철;우계형;윤영민;김재훈
    • 한국임상수의학회지
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    • 제33권1호
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    • pp.74-79
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    • 2016
  • A 7-year-old female Pointer dog with multiple masses in the axilla, mammary gland, and bladder was submitted to the Pathology Department of the College of Veterinary Medicine in the Jeju National University. Grossly, mass between right axilla and 1st mammary gland, $15{\times}10cm$ in size, was well delineated and firm, slightly soft center, oval shape. And masses in right 1st, 3rd and 5th mammary gland were well delineated and sulphur yellow in color on the cut-surface. Numerous round to oval shaped masses, 0.3 to 2 cm in diameter were existed in the lung. Urinary bladder mucosa had rough and thick and round to oval papillary masses, 0.1 to 2 cm in diameter, on surface. Microscopically, masses in right axilla, 1st mammary gland, lung and axillary lymph node were composed of poorly differentiated tubules originated from apocrine gland. Lining neoplastic epithelium showed high mitotic figures, typical apical secretory blebs, and PAS-positive diastase-resistant cytoplasmic granules. Masses in 3rd and 5th mammary gland were confirmed as mammary complex adenoma and simple adenoma respectively. The masses in the urinary bladder were covered with stratified transitional epithelium with marked cellular atypia and high mitotic figures. Some neoplastic cells showed focal invasion into substantia propria of bladder. Immunohistochemaically, neoplastic transitional epithelium demonstrated positive reactions for cytokeratin 7, AE1/AE3, and MNF116. Based on the gross, histopathologic and immunohistochemical characteristics, this dog was diagnosed as apocrine carcinoma, mammary gland tumor including simple adenoma and complex adenoma and bladder transitional cell carcinoma. And distant metastases of apocrine carcinoma in right axilla were observed in axillary lymph node and lungs. This is the first report for concurrent occurrence of apocrine carcinoma, mammary gland tumor, and transitional cell carcinoma in a same dog.