• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.15.2-16
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• 1987

사성이란 후두의 발생기능에 장애가 있을 때 생기는 후두질환의 가장 대표적인 주증상으로 인간 문화의 발달에 병행되어서 대화에 의한 전달수단이 중요시되고 또한 암에 대한 인식이 높아져 사성을 호소하는 환자들이 많아지는 경향이 있다. 이에 저자는 1980년 1월부터 1984년 12월까지 이화여자대학교 의과대학 부속병원 이비인후과 외래에 내원한 신외래환자 총 24,949명 중 사성을 주소로 한 800명의 환자에 대하여 병력지를 기준하여 각 질환을 통계적으로 분석 검토하여 다음과 같은 성적을 얻었다. 1) 이비인후과 외래환자 총 24,949명중 사성환자는 800명으로 약 3.2%이었다. 2) 외래사성환자 800명중 남자 336명, 여자 464명으로 남녀비는 약 1 : 1.4이었다. 3) 질환별로는 급성 후두염 248예(31.0%), 만성 후두염 186예(23.3%), 성대결절 160예(20.0%), 성대폴립 90예(11.3%), 성대마비 56예(7.0%), 후두 유두종 12예(1.5%), 후두암 9예(1.1%)이었다. 4) 연령별로는 30대가 213예(26.6%), 20대가 190예(23.8%), 40대가 179예(22.4%)의 순이었다. 5) 각 질환별 최다연령은 급성 후두염 30대 73예(29.4%), 만성 후두염 30대 53예(28.5%), 성대결절 30대 52예(32.5%), 성대폴립 40대 26예(28.9%), 성대마비 40대 14예(25.0%), 후두암 50대 6예(66.7%)이었다. 6) 발병부터 초진까지의 기간은 10일 이내가 153예(19.1%)로 제일 많았고 1개월∼3개월 138예(17.3%), 11일∼l개월 119예(14.9%)의 순이었다. 7) 각 질환에 따른 발병부터 초진까지의 기간의 최다분포는 급성 후두염은 10일 이내가 117예(47.2%), 만성 후두염은 3개월∼6개월이 44예(23.7%), 성대결절은 3개월∼6개월이 40예(25.0%), 성대폴립은 6개월∼1년이 20예(22.2%), 성대마비는 10일이내가 12예(21.4%)이었다. 8) 질환별 동반증상 분포는 사성만을 호소한 경우가 394예(41.4%)로 가장 많았고 동반증상으로는 인두통, 이물감, 객담, 기침, 연하장애, 호흡곤란의 순이었다. 9) 저자의 연도별 사성환자의 평균발생빈도(3.2%)를 문(1981)의 1975년 1월부터 1979년 12월(만 5년간)까지의 평균발생빈도(2.9%)와 비교할 때 증가하였다.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.39-48
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• 1990

Congenital duodenal obstruction in the newborn infant may be due to a variety of causes. Duodenal obstruction often presents with bilious vomiting and upper abdominal distention. Diagnosis is usually established on plain x-ray of the abdomen by the classic finding of the double-bubble. In the period July 1986 to June 1990, 16 patients with congenital duodenal obstruction were operated and the following results were obtained. 1. Sixteen patients were comprised of 11 males and 5 females, the ratio of male and female was 2.2:1. 2. Thirteen patients(81%) had been admitted to our hospital during one month of life. 3. Congenital duodenal obstruction was in 16 cases; malrotation in eight(50%), annular pancreas in six(38%), type 1 atresia in one(6%), and wind-sock anomaly in one(6%). 4. There were two premature patients and six patients of small for gestational age. 5. Overall, bilious vomiting, occurring in three fourths, was the single most frequent presenting complaint. 6. Polyhydramnios occurred in two of the patients. 7. Diagnosis was possible with clinical symptom and simple abdomen. 8. The operative procedures performed were ; duodenoduodenostomy in five, duodenojejunostomy in two, excision of wind-sock membrane in one, and Ladd's procedure in eight. 9. A total of ten asociated congenital anomalies were found in six patients. 10. Postoperative complications occurred in five cases(31%).

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.175-182
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• 1997

Forty-two preoperative CT scans with renal cell carcinoma were reviewed and compared with pathologic findings to evaluate the differential points between stage I and II. Regardless of whole body staging, perirenal fat infiltrations were seen in 9 cases and the other 33 cases showed no infiltration onto perirenal fat tissue. We retrospectively reviewed them by comparing tumor size and CT findings, following three view points, lobulating contour of tumor margin, thickening of Gerota's fascia and strands in perirenal fat tissue. The size of them was 2-15 cm, size of the stage I tumors was 2-15 cm and that of stage II was 6-15 cm. In stage I(n=33), 25 cases(76%) showed smooth margin, and the others(n=8) showed lobulating contours. Thickening of Gerota's fascia was observed in 7 cases(21%) and strands in perirenal fat tissue in 14(42%). Of these, only one positive finding was seen in 7 cases(21%), 2 findings in 6(18%), 3 findings in 3 (9%) and nothing in 17cases(51%). In stage II(n=9), 3 cases(34%) showed smooth margin, and the others(n=6) showed lobulating contours. Thickening of Gerota's fascia were observed in 5 cases(55%) and strands in perirenal fat tissue in 9(100%). Of these, one finding was seen in 2 cases(22%), 2 findings in 3(33%), 3 findings in 4 (44%). In conclusion, it is insufficient to evaluate the perirenal fat infiltration in renal cell carcinoma with only one positive finding of 3 view points; lobulation of tumor margin, thickening of Gerota's fascia, strands in perirenal fat tissue. But if all these findings are shown, it is helpful to determinate perirenal fat infiltration of renal cell carcinoma.

• School Mathematics
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• v.15 no.4
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• pp.743-758
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• 2013

This paper analyses the examples of polygons taken in the 1st grade middle school mathematics textbooks. We analysed generic examples, non-examples and counter-examples represented in these textbooks. And also we classified and analysed with examples of the concept and the application of a procedure. We analysed the differences of methods among these textbooks representing the same concepts or procedures. The findings from the analysis showed that these textbooks mostly make use of generic examples. The examples of concept and procedure vary depending upon the textbooks. Also, many textbooks haven't properly represented various positions and figures of polygons. Textbooks need to represent various and appropriate examples in order to expand the example space of the students.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1195-1199
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• 1998

Bafckground: Thr role and indication of surgery in the treatment of small cell lung cancer(SCLC) is currently limited and unsettled. Material and Method: We analyzed the surgical results of 9 patients with SCLC at Yosei Medical Center from January 1990 to December 1996. There were 8 males and 1 female, and their mean age was 57.2 years (range; 35-76). Preoperatively SCLC was confirmed in 5, but the other 4 cases were diagnosed as undifferentiated squamous cell carcinoma. All patients underwent pulmoinary resection(lobectomy;5, lobectomy, segmentectomy and en-bloc resection of rib;1, bilobectomy; 2, pneumonectomy;1) and mediastinal lymph node dissection. Results: There were no operative mortality with two complications(postoperative bleeding;1, arrhythmia;1). All cases were diagnosed as SCLC histologically and their TNM staging were confirmed as follows: T1N0M0;1, T2N0M0;4, T3N0M0;1, T3N1M0;1, T2N2M0; 1, T4N0M0;1. All patients had received postoperative chemotherapy, and radiotherapy was combined in 4 patients. During follow up period(range 1-63 months; mean 33.0months), there was only one metastasis to pelvic bone among 8 patients without lymph node metastasis, and all patients were alive. On the other hand, among 3 patients who had regional and/or mediastinal lymph node metastasis or T4 lesion, all patients had recurrences(local;2, brain;1), and 2 patients died. Conclusion: We suggest that the use of TNM staging is beneficial, and surgical resection should be recommended in the patients with early staged SCLC as an important treatment modality.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.262-265
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• 1998

A retrospective analysis was performed on the 72 cases of peripheral artery occlusive disease treated at Yonsei Medical School Yongdong Severance Hospital, from March 1, 1990, through July 31, 1992, focusing on the operative procedures, surgical results and perioperative complications. The etiologic causes of vascular obstruction were atherosclerosis in 28 cases, Buerger's disease in 31, traumatic orgin in 7, operative complications in 4, and malignancy and arteritis in one case each. Treatment modalities, actually performed include bypass graft.(27), infusion of PGE1 (23), Embolectomy (16), Sympathectomy (4) and end-to-end anastomosis (2). There were 21 satisfactory cases and 9 unsatisfactory cases of atherosclerotive occlusive disease, defining the operative outcome as“satisfactory”if the obstructive symptoms disappeared completely and “unsatisfactory”if they did not. The patients of TAO induced Buerger's disease with preoperative Foutain class III or IV were surgically converted to class 0 in 14 cases, class I in 12 and class II in 3.

• Journal of radiological science and technology
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• v.25 no.2
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• pp.65-70
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• 2002

The pain of chronic pancreatitis associated intraductal stones is related to increased intraductal pressure. Decom-pression of the pancreatic duct along with extraction of stones are the goals of a combined endoscopic-extracorporeal shock wave lithotripsy approach. The aim of this study is to define radiographic prognostic criteria for better complete free rate of pancreatic head and body ductal stones for extracorporeal shock wave lithotripsy. Fifty-nine patients with chronic pancreatitis were treated by extracorporeal shock wave lithotripsy for endoscopically unretrievable stones. The stones on endoscopic retrograde pancreatograms were classified into four characteristics including number, size of longest diameter, density compared with vertebral body, and shape. Complete stone free were obtained in 45 of 59(76.3%). Pancreatic ductal stones with radiographic characteristics including higher density than vertebral body, square shape, and rim calcified stones were hindrance factors for extracorporeal shock wave lithotripsy. We propose that patients with rim calcified stone of our three hindrance factors should be treated by other technique.

• Tuberculosis and Respiratory Diseases
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• v.41 no.6
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• pp.616-623
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• 1994

Objectives: Careful evaluation about mediastinal involvement is important in the management of patients with non-small cell lung cancer. Invasive staging procedure such as mediastinoscopy is advocated because of the unreliability of noninvasive staging methods such as CT, MRI. We compared differences between pre- and postoperative staging in non-small cell lung cancer without lymphadenopathy on CT scan and investigated the methods for more accurate preoperative staging. Methods & Results: 1) Records of a total of 41 patients with preoperative $T_{1-3}N_0M_0$ non-small cell lung cancer were reviewed and the histologic types of tumors were squamous cell carcinoma in 32 cases, adenocarcinoma in 6 cases and large cell carcinoma in 3 cases. Twenty-four cases were central lesions and seventeen cases were peripheral lesions. 2) Among the 32 cases with preoperative $T_2$, 2 cases were identified postoperatively as $T_3$ with invasion of chest wall and among 6 cases with preoperative $T_3$, 1 case was identified postoperatively as $T_4$ with invasion of aorta and pulmonary arteries. 3) After the operation of 35 cases with $T_{1-2}$, 5 cases were $N_1$ and 3 cases were $N_2$ postoperatively. After the operation of 6 cases with $T_3$, 2 cases were $N_1$ and 3 cases were $N_2$ postoperatively. Preoperative $T_3$ showed more intrathoracic lymph node metastases and higher $N_2/N_1$ involvement ratio than preoperative $T_{1-2}$. 4) Complete surgical resections were done in 34 out of 41 cases. Incomplete resection were done in all postoperative $N_2$ tumors. Conclusion: Invasive staging procedures such as mediastinoscopy should be considered in the case of preoperative $T_3$ non-small cell lung cancer even though mediastinal lymphadenopathy is not recognized on the CT scan of the chest.

• Journal of Chest Surgery
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• v.33 no.11
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• pp.876-880
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• 2000

배경: Maze수술은 승모판 질환에 동반되는 심방세동의 효과적인 치료방법으로 알려져있다. 이 연구는 승모판 수술과 심방세동 수술을 동시에 시행한 환자에서 심방세동 수술 후 중기적인 결과와 그 재발 여부를 조사하였다. 대상 및 방법: 심방세동 수술과 승모판 수술을 받은 11예의 환자(10예는 류마티스성 승모판 질환)를 대상으로 하였다. Maze II 수술 및 그 변형수술을 6예에서 시행했고, Maze III 수술 및 그 변형수술을 5예에서 시행하였다. 심방세동 수술 후 좌심방의 수축정도를 심방세동 수술 없이 승모판 수술만으로 동율동을 얻은 경우와 비교하였다. 결과: Maze II 수술을 받은 환자 6예 중 5예(83.3%)에서, maze III 수술을 받은 환자 5예 모두에서 동율동을 회복하였다(전체적으로 90.9%). 전자의 1예(20%)와 후자의 2예(40%)에서 수술 후 각각 23, 2, 13개월만에 심방세동이 재발하였다. 그 후 다시 2예는 동율동으로 전환되었으나, 1예는 재발된 심방세동을 그대로 유지하고 있다. 변형술을 받은 3예에서는 심방세동의 재발이 없었다. Maze 수술 후 4예(40%)에서만 좌심방의 수축기능을 보였으며, maze 수술 후 좌심방 수축 정도(승모판의 A파의 속도)도 maze 수술 없이 승모판 수술과 항부정맥제 투여로 동율동을 회복한 경우보다 낮았다. 결론: 심방세동을 동반한 승모판 수술 환자에서 maze 수술로써 심방세동으로부터 동율동을 회복할 수 있으나 중기적으로 재발할 수 있으며, maze 수술 후 좌심방 수축정도는 상당히 떨어질 수 있다고 생각된다.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1058-1066
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• 1998

Background: Actinomycotic infection is uncommon and primary actinomycosis of the lung and chest wall has been less frequently reported. This disease may present as chronic debilitating illness with radiologic manifestation simulating lung tumor, pulmonary infiltrating lesion, or chronic suppuration. Diagnosis of choice was not definded yet and role of bronchoscopy on diagnosis was not described yet. Methods: From 1989 to 1998, we experienced 17 cases of thoracic actinomycosis. We have reviewed the case notes of 17 patients with thoracic actinomycosis. The mean age at presentation was $53{\pm}13$ years, 11 were male. Results: Cough, hemoptysis, sputum production, chest pain and weight loss were the commonest symptoms. The mean delay between presentation and diagnosis was $6.6{\pm}7.8$ months. There were six patients who presented with a clinical picture of a suppurative lesion and eleven patients were suspected of having primary lung tumor initially. In no cases was made an accurate diagnosis at the time of hospital admission. Associated diseases were emphysema (1 case), bronchiectasis (2 cases) and tuberculosis (2 cases). Bronchoscopic findings were mucosal swelling and stenosis(n=4), mucosal swelling, stenosis and necrotic covering (n=2), mass (n=3), mass and necrotic covering (n=1) and normal(n=6). Radiologic findings were mass lesion(n=8), pneumonitis(n=3), atelectasis(n=3), pleural effusion(n=2), and normal(n=3). Final diagnosis was based on percutaneous needle aspiration and biopsy (n=3), bronchoscopic biopsy specimens (n=9), mediastinoscopic biopsy (n=1) and histologic examination of resected tissue in the remaining patients(n=4) who received surgical excision. Among 17 patients, 13 were treated medically and the other 4 received surgical intervention followed by antibiotic treatment. Regarding the surgically treated patients, suspected malignancy is the most common indication for operation. However. both medically and surgically treated patients achieved good clinical results. Conclusion: Thoracic actinomycosis is rare. but should still be considered in the differential diagnosis of a chrinic, localized pulmonary lesion. Thoracic actinomycosis may co-exist with pulmonary tuberculosis or lung cancer. If the lesion is located in the central of the lung. the bronchoscopy is recommanded for the diagnosis.