• 제목/요약/키워드: nodules

검색결과 1,178건 처리시간 0.027초

양성 갑상샘 결절의 수술적 치료에서 결절절제술의 임상적 의의 (Clinical Significance of Nodulectomy in Surgical Treatment of Benign Thyroid Nodules)

  • 이동우;김상효
    • 대한두경부종양학회지
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    • 제22권2호
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    • pp.137-141
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    • 2006
  • Purpose : It has been generally accepted that lobectomy is a standard surgical procedure in treatment of benign thyroid nodules. However lobectomy may cause postoperative hypothyroidism. Most of surgeons believe that nodulectomy has its limitation in treatment of thyroid nodules due to recurrence of nodules and presence of cancer. The current study attempts to determine whether nodulectomy is justified in aspects of preservation of thyroid function, risk of recurrence and complications. Methods: Data was collected retrospectively on 74 patients undergoing thyroidectomy(single nodulectomy, n=43;bilateral nodulectomies, n=9;lobectomy with nodulectomy, n=22) for benign thyroid nodules from 1999 to 2004. All patients were evaluated for complication, postoperative thyroid function, and recurrence of benign nodule and cancer were followed by regular ultrasonographic examination for 2-6 years. Results : The pathologic results of 74 patients were nodular hyperplasia(55 patients), Hashimoto's thyroiditis(8 patients), follicular adenoma(7 patients) and papillary carcinoma(4 patients). Average operation time was 30 minutes from skin incision to specimen out. In postoperative follow-up of 70 patients, six cases(8.5%) became mild hypothyroid, and ultrasonographically detected micronodule was also six cases(8.5%). There were no other complications. Conclusion : Thyroid nodulectomy appears to have advantages of relatively few complication and simple procedure with no access to laryngeal nerves. Therefore, it may be one of treatment options in selected cases of benign thyroid nodules.

고정형(固定形) Bed와 컬럼을 이용(利用)한 망간 단괴(團塊)에 의한 폐수(廢水) 중의 구리이온 제법(除去) (Removal of copper ion from the waste water by Manganese Nodules using fixed bed and column)

  • 박경호;남철우;강남희
    • 자원리싸이클링
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    • 제20권5호
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    • pp.64-68
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    • 2011
  • 망간단괴는 높은 비표면적과 주 구성성분이 ${\delta}$-MnO$_2$ 이기 때문에 폐수 중의 중금속 흡착제로서 적합하다. 본 연구에서는 구리 함유 폐수를 이용하여 고정형 컬럼과 bed형 흡착장치를 사용하여 현장에서 망간단괴의 중금속 흡착제로서 사용 가능성에 대하여 검토하였다. l kg의 망간단괴 (입자크기 1-3 cm)를 사용하여 구리이온을 0.97 g/L 함유한 폐수를 3시간 처리한 결과 고정형 칼럼과 고정형 bed에서 각각 4.0g과 2.3g의 구리가 흡착, 제거되었다.

흉부 X선 영상에서의 폐 노쥴 자동 탐지 기법 ((Automatic detection of pulmonary nodules in X-ray chest images))

  • 성원;김의정;박종원
    • 한국컴퓨터산업학회논문지
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    • 제3권9호
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    • pp.1279-1286
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    • 2002
  • 일반적으로 방사선 의사들(radialogists)이 폐 노쥴(pulmonary nodule)을 탐지하는 데는 실제적으로 30%의 실패율을 가진다고 알려져 있다. 만약 자동화된 시스템이 체스트 영상에서 의심스런 노쥴들의 위치들을 방사선 의사에게 알려줄 수 있다면 잘못 판단되는 노쥴들의 수를 잠재적으로 줄일 수 있다. 우리는 형태학적 필터들 (morphological filters)과 두가지 특징-추출(feature-extraction) 기술들을 포함하는 컴퓨터 자동 처리 시스템을 구현하였다. 본 시스템에서는 첫째로 형태학적 필터(morphological filtering) 처리를 행한다. 이 과정은 원래의 영상에 침식(erosion)과 확장(dilation)을 연이어서 행하는 것으로 처리가 어려운 X선 영상을 좀 더 다루기 쉬운 상태로 바꿔주는 역할을 하게 된다. 둘째는 일차적으로 노쥴로서 컴퓨터에 선택된 의심 부분에 가해주는 특징-추출 테스트로서 이 작용은 노쥴로 감지되었으나 실제로는 노쥴이 아닌 경우인 false-positive 갑지들을 줄이기 위해서 사용된다. 그리하여 본 시스템은 노쥴의 정확한 판독이 어려운 폐의 X선 영상에 적용되어 false-positive들을 효과적으로 줄임으로써 보다 효율적인 폐 노쥴의 탐지를 가능하게 하였다.

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정상 아동과 성대 결절 아동의 음성 오용 및 남용 행동의 발생 빈도 비교 (Comparison on Frequency of Vocal Misuse and Abuse Behavior in Normal and Vocal Nodules Children)

  • 이무경
    • 한국콘텐츠학회논문지
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    • 제11권9호
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    • pp.429-436
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    • 2011
  • 음성 오용이나 남용이 후두염, 성대 결절, 성대 폴립 등과 같은 후두 질환 뿐 아니라 음성 문제의 원인이 된다는 사실을 여러 문헌들에서 밝히고 있지만 음성 환자들이 음성을 오 남용하는 양이나 비율에 관해서 이루어진 연구는 매우 부족하다. 본 연구는 성대 결절 환자의 이러한 음성 오 남용 비율을 측정하기 위하여 연구 목적에 부합하는 실험 도구를 개발하였고, 정상 아동과 성대 결절 아동의 음성 오 남용 행동의 발생 빈도를 정량적으로 비교하였다. 실험은 초등학교 저학년(1학년~3학년) 남자 아동 가운데, 정상 아동 5명과 성대 결절 아동 5명을 대상으로 하였다. 연구 결과, 성대 결절 아동의 음성 오.남용 빈도수는 평균 5,411(${\pm}145$)회, 정상 아동은 평균 3,133(${\pm}257$)회였으며, 성대 결절 아동이 정상 아동 집단 보다 음성 오 남용 행동의 발생 빈도수가 1.5배 정도 유의하게 높은 것으로 나타났다(p<.001).

외과적 갑상선 결절에 대한 임상적 고찰 (A Clinical Study on Surgical Thyroid Nodules)

  • 박현정;문상은
    • 대한두경부종양학회지
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    • 제9권2호
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    • pp.234-243
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    • 1993
  • The thyroid nodules are the most common endocrine disease requiring surgical management. Up to date, various diagnostic techniques and surgical management have been developed. Authors analysed 2285 cases of thyroid nodules who were treated at Department of Surgery, Pusan National University for the duration of 10 years from January 1980 to December 1989 and the results obtained were summerized as follows: 1) Patients were composed of 1727 cases(75.8%) of benign nodule and 558 cases(24.5%) of malignant nodule. Benign nodule was prevalent in forth and fifth decade comparing with malignant nodule was sixth and fifth decade. The sexual distribution revealed female preponderance with 1:10.8 in benign nodule and 1:9.3 in malignant nodule. 2) The histopathologic classfication of benign nodule in decreasing order of frequency were follicular adenoma 1009 cases(54.8%), adenomatous goiter 573 cases(33.3%), simple cyst 65 cases(3.8%), and Hashimoto's thyroiditis 52 cases(3.0%). The malignant disease were papillary adenocarcinoma 460 cases(82.4%), follicular adenocarcinoma 69 cases(12.4%), undifferentiated carcinoma 13 cases (2.0%), and medullary carcinoma 7 cases(1.0%). 3) Fine needle aspiration cytology was performed in 1758 cases and it showed 80.5% of sensitivity, 96.5% of specificity, 19.5% of false negative and 80% of accuracy. 4) The location of nodule was 87.7%, in unilateral, 12.2% in bilateral. 5) On the radioiodine scanning, the incidence of benign nodule with cold nodule was 83.9% and the incidence of benign nodule with hot nodule was 7.5%. The incidence of thyroid carcinoma with cold nodule was 88.3% and the incidence of thyroid carcinoma with hot nodule was 4.6%. 6) Most cases of benign nodules were treated with lobectomy 82.6%, subtotal thyroidectomy 10.1% and subtotal lobectomy 3.0%. Malignant nodules were treated with lobectomy and/or isthmusectomy 37.6%, total thyroidectomy 17.7%, subtotal thyroidectomy 15.4%, and any thyroidectomy and neck dissection 13.5%. 7) Postoperative complications were developed in 3.8% of benign nodules and 13.8% of malignant nodules.

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Ultrasound Score to Select Subcentimeter-sized Thyroid Nodules Requiring Ultrasound-guided Fine Needle Aspiration Biopsy in Eastern China

  • Cheng, Pu;Chen, En-Dong;Zheng, Hua-Min;He, Qiu-Xiang;Li, Quan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권8호
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    • pp.4689-4692
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    • 2013
  • Ultrasound-guided fine needle aspiration biopsy (FNAB) is a costly diagnostic item with a low yield in identifying the tiny proportion of nodules that actually represent malignant disease. Our aim through this study was to obtain an ultrasound (US) score for selecting subcentimeter-sized thyroid nodules requiring FNAB in eastern China. Some 248 patients for a total of 270 thyroid nodules less than 1 cm in diameter underwent FNAB and subsequent surgery from January 2006 to March 2012 at our hospital. The clinicopathological and US data from all the nodules were analyzed retrospectively. An US score was developed on the basis of independent predictive factors for malignancy. Irregular shape, hypoechogenicity, no well-defined margin, presence of calcifications and ratio between antero-posterior and transversal diameters (AP/TR) ${\geq}1$ were independent predictive factors for malignancy on logistic regression analysis. US score were statistically significant, with ${\leq}2$ favoring benignancy with an 80.3% sensitivity and a 72.7% specificity. US score is useful for differentiating between malignant and benign subcentimeter-sized thyroid nodules. We suggest FNAB for nodules when the US score is higher than 2.

Shorter Distance Between the Nodule and Capsule has Greater Risk of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma

  • Wang, Qiu-Cheng;Cheng, Wen;Wen, Xin;Li, Jie-Bing;Jing, Hui;Nie, Chun-Lei
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권2호
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    • pp.855-860
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    • 2014
  • Background: The purpose of this study was to assess the relationship between different sonographic features of papillary thyroid carcinoma (PTC) on high-frequency ultrasound and cervical lymph node metastasis (CLNM). Materials and Methods: We enrolled 548 patients who underwent initial surgery for PTC between May 2011 and December 2012 in our hospital at diagnosis. The sonographic features of 513 PTC nodules in 513 eligible patients, who had single PTC nodules in their thyroid glands, were retrospectively investigated. All patients with a suspect malignant nodule (d<0.5cm) among multiple nodules were initially diagnosed by fine-needle aspiration biopsy (FNAB) to ascertain if the suspect nodule was PTC. The final diagnosis of all the thyroid nodules and existence of CLNM were based on postoperative pathology. Patients were divided into two groups: a positive group with CLNM (224 nodules) and a negative group without CLNM (289 nodules). The following factors were investigated: gender, age, echogenicity, echotexture, size, shape, location, margin, contour, calcification morphology, distance between the nodule and pre- or post-border of the thyroid capsule, vascularity and the differences between the two groups. Results: Correlation analysis showed that shorter distances between the nodule and pre- or postborder of thyroid capsule resulted in greater risk of CLNM (Spearman correlation coefficient=-0.22, p<0.0001). The significant factors in multivariate analysis were age<45yrs, larger size (d>1cm), "wider than tall" shape, extrathyroid extension and mixed flow (internal and peripheral) (p<0.05, OR=0.406, 2.093, 0.461, 1.610, 1.322). Conclusions: Significant sonographic features of PTC nodules in preoperative high-frequency ultrasound are crucial for predicting CLNM.

외과적으로 처치한 갑상선 결절 (A Clinical Study of Surgically Managed Thyroid Nodule)

  • 홍관의;이명복;문철;김익수
    • 대한두경부종양학회지
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    • 제10권2호
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    • pp.91-101
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    • 1994
  • Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

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해녀콩의 후기 뿌리혹에서 발현되는 4개의 cDNA 특성 (Characterization of Four cDNA Clones Expressed in Late Root Nodules of Canavalia lineata)

  • 안정선
    • Journal of Plant Biology
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    • 제38권4호
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    • pp.381-388
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    • 1995
  • 해녀콩(Canavalia lineata) 뿌리혹으로부터 만들어진 cDNA library를 뿌리의 총 RNA, leghemoglobin 및 uricasell cDNA를 competitor로 사용하여 차등 혼성화반응으로 후기 뿌리혹에서 발현되며 Cno이, Cne2, Cne3, Clb2로 명명된 4개의 cDNA 클론을 얻었다. Cnod1은 벼의 cysteine proteinase를 암호화하는 유전자와 유사한데 1450nt의 전사체외 혼성화 반응을 보였으며 뿌리혹에서만 발현되고 뿌리혹 발달 후기에서 가장 높은 발현을 보였다. Cne2는 벼의 Expressed Sequence Tag의 한 종류와 유사하고 900 nt의 전사체와 혼성화 반응을 보였으며 뿌리혹에서 주로 발현되었다. Cne2는 접종 후 13일째 발현이 증폭된 후 일정하게 유지되었다. Cne2는 완두의 tonoplast 막 내재 단백질 TRG31을 암호화하는 유전자와 유사하며 뿌리에서 가장 많이 발현되었다. Cne3는 1700 nt와 1400 nt의 전사체와 혼성화반응을 보였으며 뿌리혹의 성장, 발달과 일치하는 발현 양상을 보였다. Clb2는 800 nt의 전사체와 혼성화반응을 보였으며 접종 후 8일째부터 발현이 시작되어 13일째 증폭되고 그 이후 일정한 수준을 유지하였다.

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소아 성대 결절에 대한 음성 치료의 효과 (Efficacy of Voice Therapy for Children with Vocal Nodules)

  • 소윤경
    • 임상이비인후과
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    • 제29권2호
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    • pp.229-234
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    • 2018
  • Background and Objectives : Vocal nodules occur with a 12-22% prevalence in pediatric populations. Most otolaryngologists recommend voice therapy as the primary treatment. The aim of this study is to evaluate patient compliance with voice therapy and its effect on vocal nodules in children. Materials and Methods : We retrospectively reviewed 44 pediatric patients between 3 and 11 years old diagnosed with vocal nodules between March 2015 and December 2017. We evaluated the treatment adoption rate, dropout rate during voice therapy, and reasons for dropout. For patients who completed voice therapy, we measured the changes in nodule size, perceptual parameters, and acoustic parameters. We evaluated patient satisfaction using the pediatric voice handicap index (P-VHI). Results : Of the 44 pediatric patients diagnosed with vocal nodules, 22 (50%) agreed to voice therapy. Of the 22 patients who started voice therapy, 5 (22.7%) dropped out during therapy because they were unsatisfied with their treatment. Another 4 patients discontinued therapy for reasons unrelated to treatment effectiveness. Vocal nodule disappeared or decreased in all 13 patients who completed voice therapy. All voice parameters were improved and statistically significant changes were observed in perceptual, acoustic, and P-VHI parameters. Conclusions : Although compliance to voice therapy among the pediatric patients with vocal nodules was low, there were significant improvements in voice parameters for those who completed voice therapy. A change toward a positive perception of voice therapy is necessary and a multidisciplinary approach is needed to improve the effect of voice therapy on pediatric patients with vocal nodules.