• Tuberculosis and Respiratory Diseases
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• 제45권3호
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• pp.596-603
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• 1998

소세포 폐암에 동반된 LEMS는 부종양성 증후군의 일종으로 LEMS가 진단된 환자의 50% 이상에서 소세포 폐암이 동반되는데 특히 흡연력이 있는 고령에서 잠재성암을 진단하기 위한 적극적인 노력이 필요하다. 저자 등은 기괸지경 검사상 조직학적으로 진단되지 않았으나 폐암이 강력히 의심되어 적극적으로 수술적 치료를 시행하여 소세포 폐암을 진단하였고, 수술 후 LEMS의 임상양상이 호전되었으며 항암 화학요법후 추가로 호전된 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제47권1호
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• pp.97-102
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• 1999

다발성대칭성지방종증은 드문 질환이나 그 임상양상이 독특하여 진단이 어렵지는 않으나 증상이 없고 문헌에 잘 소개되지 않아 진단을 하지 못하는 경우가 있을 것으로 생각된다. 또한 다른 대사질환이나 악성종양을 동반하는 경우가 있어서 이에 대한 관심이 필요하며 지방종이 인후나 기관을 누르는 경우 호흡곤란을 유발하기도 하고, 종격동등 심부 조직에 침투하는 경우 예후가 나쁠 수 있다. 국내에서 극히 드문 다발성 대칭성지방종증 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제17권4호
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• pp.762-774
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• 1984

A clinical analysis was performed on 49 cases of the benign esophageal diseases experienced at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during 7 year period from 1977 to 1983. Of 49 cases Of the benign esophageal diseases, there were 19 patients of esophageal stricture, 11 of achalasia, 6 of perforation, 3 of bronchoesophageal fistula, 3 of esophageal perforation, 3 of esophageal leiomyoma and one of esophageal foreign body. Twenty three patients were male and 26 were female. Ages ranged from 4 years to 74 years with the average age of 34.7 years. Of 19 patients of esophageal strictures, 7 patients were male and 12 were female and ages ranged from 6 years to 74 years with the average being 33.8 years. Causes of esophageal strictures were corrosive of esophageal strictures were dysphagia, vomiting, general weakness, weight loss and pain that order and developed on several different parts of esophagus. Operations were performed in 18 cases, of whom 7 patients were performed by esophagocologastrostomy, 4 gastrostomy, 4 esophagogastrostomy, 1 esophageal resection and esophagoesophagostomy, 1 esophagotomy and dilatation and 1 scar revision. Five patients had one or two complications; 2 anastomotic leakage, 1 wound infection, 1 localized empyema, 1 bilateral pneumothorax and 1 respiratory failure. One patient expired due to respiratory failure arising from aspiration pneumonia. The average age of achalasia patients was 33.1 years and symptom durations were from 2 months to 10 years with the average of 3.3 years. Main symptoms were dysphagia, vomiting, weight loss, pain and cough in that order. Modified Hellers myotomy was performed in 11 patients with one complication of restenosis. One patient was operated on by using longitudinal incision and transverse sutures with good result. Of 6 patient of esophageal diverticulum, 2 patients were traction diverticulum on the midesophagus, 2 were pulsion diverticulum on the midesophagus and 2 were pulsion diverticulum on the lower esophagus. Diverticulectomy was performed on 2 cases of traction diverticulum and esophagocardiomyotomy with or without diverticulectomy was erformed on 4 cases of pulsion diverticulum with good results. Of 5 patients of congenital bronchoesophageal fistula, the chief complaints were productive cough in 4 patients and hematemesis without respiratory symptoms in one patient. Two patients were operated on by using fistulectomy only and 3 by fistulectomy with pulmonary lobectomy. Of 3 patients of esophageal perforation, causes were foreign body ingestion, esophageal stricture after ECG and corrosive esophagitis. Two patient were operated on by using drainage and gastrostomy with symptomatic improvement but one patient died due to septic shock after thoracotomy. Three patients of esophageal leiomyoma were all male and 2 patients were operated on by using enucleation and one by distal esophagectomy with esophagogastrostomy. In one patient of esophageal foreign body, it was removed by esophagotomy through the right thoracotomy.

• 한국치위생학회지
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• 제1권2호
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• pp.181-192
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• 2001

The purpose of this was to evaluate the level of knowledge about Hepatitis B and AIDS among dental hygiene students at six dental hygiene educational programs in nationwide, compare the findings to those of Song's study. 1703 dental hygiene students surveyed by mail and answered a questionnaire, using the questionnaire used developed by DiClemente el al., on Hepatitis B vaccination, antibody production, experience of unintentional needle stick injuries, experience of surgical operation and blood transfusion, personal risk factors for HBV and HIV, management of HBV and HIV postexposure management et al. The data indicated that dental hygiene students (79.0%) in this study had more HIV vaccination than dental hygiene(74.3%) in Song's study. As for recognition of antibody production after Hepatitis B vaccination, only 34.6% of respondents answered they knew having antibody production and 95% of respondents knew not having antibody production. Over one-half of the respondents (55%) answered they didn't even recognize having antibody production. 52.3 percent of dental hygiene students experienced unintentional needle stick injuries. The findings on the knowledge about Hepatitis B and AIDS were that dental hygienists (76.5 points) received higher mean score than those of dental hygiene students (71.0 points) and that the distribution of right answer rate also showed wider range in dental hygiene students (27.7~97.5%) than those of dental hygienist (41.2~99.5%). There were no statistical differences among dental hygiene education programs. Finding of this study support that the curriculum of dental hygiene program should include instruction on sources and methods of transmission of infectious diseases, risk of virus transmission in the workplace and principles of infection control. Furthermore, infection-control practices should be utilized routinely and their application to dental personnel, management of HBV and HIV postexposure management. Furthermore, for preventing the further spread of infectious diseases (HBV, HIV and AIDS${\cdots}$) caused by bloodborne viruses, imposing an obligation rather than recommendation on Hepatitis B vaccination to all dental personnel and routinely utilizing infection-control guidelines for all dental patients in dental practices (include dental educational programs) should be accomplished by coordination the government agency.

• 대한두경부종양학회지
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• 제17권2호
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• pp.174-178
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• 2001

Background and Objective: Percutaneous ethanol injection therapy has been used in the treatment of the benign thyroid diseases. Although the reported side-effects of the therapy was mild and transient, some side-effects including local or radiating pain are troublesome to the patients. Radioactive iodine-131($Ra-^{131}I$) also has been effectively and safely used for management of the benign thyroid diseases. So we developed the percutaneous intranodular injection therapy of $Ra-^{131}I$ as an alternative of percutaneous ethanol injection therapy. Materials and Methods: From December 1998 to October 1999, we treated 29 outpatients (25 women and 4 men, mean age: $47{\pm}12$ years). Inclusion criteria were follows; age >30 years, cytologically benign, with normal thyroid function, cold nodule on thyroid scintigram, solid or mixed natured nodules in sonographical evaluation. Nodular volume was estimated by sonography according to the ellipsoid formula. $Ra-^{131}I$(0.1mCi/ml) was administered in a single dose injection. Follow-up studies every 3 months consisted of full history, thyroid function test, and sonography. We determined the therapeutic response is effective if the volume reduction of the nodule occurred above 30%. Results: After at least 3 months follow-up, 11 patients showed effective response, 12 patients showed minimal or unchanged response and 6 patients showed progression. Although side-effects such as injection pain, febrile reaction, and hormonal changes were absent, an infectious complication in injection site was developed from 1 case. Conclusion: Although we need a more prolonged follow-up to evaluate the delayed sequelae, we can suggest that percutaneous intranodular injection therapy of $Ra-^{131}I$ may be an attractive non-surgical treatment in selected cases of benign thyroid nodules.

• Tuberculosis and Respiratory Diseases
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• 제52권3호
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• pp.271-277
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• 2002

저자들은 기침 및 흉통을 주소로 내원한 53세의 알코올중독 남자 환자에서 발견된 종격동 췌장 가성낭종을 내시경적 역행성췌담도배액술과 somatostatin 유사체인 octreotide acetate를 투여하여 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제47권2호
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• pp.272-278
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• 1999

폐의 원발성 림프종은 드문 질환으로 저등급 B세포 림프종이 주를 이루며 경과와 예후가 양호한 반면 고등급 B세포 림프종은 경과와 예후가 저등급 B세포 림프종에 비해 좋지 않다. 그리고 그 치료에 대해서는 아직 정확히 제시된 바가 없고 치료경험들에 대한 증례 보고들이 몇몇 있었다. 본 저자는 폐내 종괴와 흉막삼출이 있었던 환자에서 흉막침범 소견이 있었으며 흉막생검을 통해 비교적 급속한 진행경과를 보이는 diffuse large B cell 림프종을 진단하였으며 cyclophosphamide, epirubicin, vincristine 그리고 prednisolone의 복합화학요법을 6회 시행후 종괴가 소실된 부분관해를 치험하였기에 문헌고찰과 함께 증례보고 하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제71권4호
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• pp.266-270
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• 2011

Background: Photodynamic therapy (PDT) is effective in managing small superficial early lung cancer patients who were deemed nonsurgical candidates. However, we do not have any previous report on the usefulness of PDT in early lung cancer in South Korea. Thus we report here our experience of PDT in early lung cancer patients. Methods: 10 patients who underwent PDT for managing early lung cancer between June 2006 and July 2010 were analyzed. PDT was carried out 48 hours after photosensitizer injection. Re-bronchoscopy was carried out 48 hours after PDT in order to remove a necrotic tissue from the PDT site. For evaluation of PDT response, bronchoscopy and chest computed tomography (CT) were performed after 3 months. Results: The median age of patients was 69 (49~77) and all patients were male. The smoking history of patients was 48 (20~75) pack-year and the median follow up of patients was 25 (11~52) months. Complete remission was observed in 10 patients and the recurrence of lung cancer was observed in 3 patients. Out of 10 patients, 3 patients died (one case of lung cancer progression and two cases of pneumonia). Conclusion: The PDT is a safe and effective treatment in early lung cancer patients who are not suitable for surgical resection. The PDT in clinical practice is an attractive option in the treatment of early lung cancer.

• Tuberculosis and Respiratory Diseases
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• 제65권3호
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• pp.212-215
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• 2008

본 증례는 와파린을 복용하던 72세 여자가 기침을 심하게 하던 중 하복부 통증과 압통을 보이는 복부 팽만이 발생하여 복부 전산화단층촬영을 통해 복직근초 혈종을 진단한 경우이다. 복직근초 혈종은 매우 드물지만 항응고제를 복용하는 고령 환자나 분만을 했거나 복부 수술을 받은 경우 등에서 발생할 수 있고, 드물게 기침에 의해서도 발생할 수 있다. 따라서 이런 환자에서 심한 복통이나 복부 종물이 관찰되는 경우 그 가능성을 한 번쯤 생각해보아야 하겠다. 전산화단층촬영은 복직근초 혈종 진단의 특이성과 민감도가 높아 진단에 도움이 되며 대부분은 보존적인 치료만으로 회복되므로 본 질환의 위험인자와 진단방법에 대해 숙지하고 정확한 진단을 하는 것이 무엇보다도 중요하겠다.

• Tuberculosis and Respiratory Diseases
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• 제65권3호
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• pp.216-221
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• 2008

저자들은 대량 객혈로 발현한 흉곽 내 만성 팽창성 혈종 1예를 보고한다. 이 증례는 이전의 증례와 달리 결핵성늑막염이나 흉부 수술, 외상의 과거력 없이 자연 발생한 증례라는 점에서 의의가 있다. 또한 무증상, 호흡곤란 등으로 발현했던 대부분의 증례와는 달리 드물게 대량객혈로 발현하였으며, 이러한 대량객혈이 기관지흉막루를 동반하여 발생하여 기관지동맥 색전술과 수술로 치료되었다는 점에서 특징적이다. 증례보고와 함께 문헌고찰을 통해 과거 보고된 흉곽 내 만성 팽창성 혈종의 임상양상에 대해 표로 정리하였다.