갑상선 편평 세포암 1예

노진우(Jin Woo Roh),이상춘(Sang Choon Lee),이수정(Soo Jung Lee),권굉보(Koing Bo Kwun),남해주(Hae Joo Nam) 대한두경부종양학회 1990 대한두경부 종양학회지 Vol.6 No.2

Squamous cell carcinoma of the thyroid gland is an extremely rare primary neoplasm, comprising only 1.1% of all primary thyroid cancers. The cancer is characterized by rapidly progressive clinical course in spite of its differentiated morphologic feature. Histogenetic origin of the cancer has also been debated. In most cases, a squamous epithelium is believed to be a result of metaplasia of a follicullar epithelium, although in rare exceptions, it can originate from a remnant of the thyroglossal duct or ultimobrachial body. Squamous cell carcinoma of the thyroid can occur in a pure form or mixed with adenocarcinoma; the latter may be designated as adenoacanthoma. Because this lesion typically runs a fulminant course, radical surgical resection at the earliest opportunity offers the best hope for cure. The lesions are usually radioresistant, and chemotherapy has not been shown to alter the course of this disease. We experienced a case of squamous carcinoma of the thyroid. This report summarize our experience and review of the literatures.

간장 ( 肝臟 ) , 담도 ( 膽道 ) 및 췌장 ( 膵臟 ) : 약제에 의한 간장의 허혈 및 재관류 손상의 방지

김홍진(Hong Jin Kim),심민철(Min Chul Shim),권굉보(Koing Bo Kwun),박동일(Dong Il Park),노진우(Jin Woo Roh) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3

N/A Several drugs known to be vasodilators and/or membrane stabilizers were studied to evaluate whether these would have protective effects against experimental eschemia-reperfusion induced liver injury in rats. The aninmals were divided into six groups-control, treatment with pentoxifylline, aprotinin, FDP, verapamil, and sham operation. Drugs were administered systemically through IVC 5 minutes before induction of ischemia. The hepatic arterial and portal venous blood supply to the left lateral and median lobes of the liver was interrupted with an surgical clip for 90 minutes to induce hepatic ischemia, and after then the clip was removed for reperfusion. The arterial blood SGOT, SGPT, ALP, LDH, and hepatic MDA were measured before and 90 minutes after ischemia, and at the end of 60 minutes reperfusion. The control group showed sharp elevation of the all liver enzymes following both hepatic ischemia and reperfusion. However the treated groups with pentoxifylline, aprotinin, FDP, and verapamil demonstrated significantly lower level of liver enzymes compare with the values of the control group. Verapamil thought to be most effective in protection of liver from ischemia- reperfusion injury. The hepatic MDA l evel decreased during ischemia-reperfusion procedures, and showed no significant difference between control and treatment groups.

간장 ( 肝臟 ) , 담도 ( 膽道 ) 및 췌장 ( 膵臟 ) : 단순 담낭 절제술 후 배액술의 필요성

김홍진(Hong Jin Kim),심민철(Min Chul Shim),권굉보(Koing Bo Kwun),노진우(Jin Woo Roh),김재황(Jae Hwang Kim) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3

N/A A retrospective review is undertaken to evaluate the effects of drainage versus nondrainage of the gallbladder bed after elective cholecystectomy. Ninety one charts of patients who underwent elective cholecystectomy without choledochotomy were reviewed. Patient selection was based upon following criteria: 1) No evidence of empyema, pericholecystic abscess or cholangitis 2) No bleeding or leakage of bile from the bed of the gallbladder after cholecystectomy 3) Lack of exploration of the common bile duct. Two groups were analyzed. Those who had postoperative drainage of the subhepatic space and those who didn't have drainage. The results are as follows. Postoperative length of hospital stay was longer in the drainage group (p<0.05). The average days of hospital stay were 7.75 (+- 1.20) in nondrainage group and 8.16 (+- 1.21) in drainage group. Maximum postoperative temperature elevation was higher in the drainage group (p<0.05). The average maximum postoperative temperature were 37.20 (+- 0.33)C in nondrainage group and 37.94 (+- 0.42)C in drainage group. There was no significant difference in the duration of the postoperative fever between the drainage and nondrainage group. The average druation of the postoperative fever were 1.91 (+- 1.44) days in the nondrainage group and 2.27 (+- 1.47) days in the drainage group. There was no significant difference in the dose of the postoperative analgesics between the drainage and nondrainage group. The average dose of the postoperative analgesics were 4.45 (+- l. 47) in the nondrainage group and 4.98 (+- 2.12) in the drainage group. There was no significant difference in the complication rate between the drainage and nondrainage group. It is concluded that routine drainage of the subhepatic space after elective cholecystectomy without choledochotomy is unnecessary and contributes to increased length of postoperative hospotal stay and a higher rate of patients discomfort.

고빈도 환기법에서의 기도 및 폐포압의 변화에 대한 연구

안재희(Jae Hee Ahn),노진우(Jin Woo Roh),이관호(Kwan Ho Lee),정재천(Jae Chun Chung),이현우(Hyun Woo Lee),이석강(Suck Kang Lee) 대한내과학회 1990 대한내과학회지 Vol.39 No.5

N/A An unexpected increase of airway and alveolar pressure has been reported in recent studies of high-frequency ventilation, especially during high-frequency oscillatory ventilation. This phenomenon increases with higher respiratory frequency, driving pressure and the inspiratory time ratio(IT%) To evaluate the changes of airway and alveolar pressure, a study was done on 8 healthy cats with high frequency jet ventilation (HFJV). The results are as follows. On fixed driving pressure at 1 psi: 1) Adequate ventilation occurred in 20% inspiratory time % during a frequency of 1 Hz or 2Hz, but did not occur during a frequency of 3 Hz and IT% 10% 2) The alveolar pressure and airway pressure increased with an increase of respiratory rate and IT% 3) The alveolar pressure was lower than the mean airway pressure, but higher than the end diastolic airway pressure. Accordingly, auto-PEEP phenomenon was observed. However, the value of auto-PEEP did not significantly vary with the changes of respiratory rate and IT%. In conclusion, under the constant driving pressure (1 psi), mean airway pressure and alveolar pressure was correlated with the respiratory rate and inspiratory time/cycle%(IT%) and auto-PEEP phenomenon was observed during high-frequency jet ventilation on healthy cats.

늑막삼출 환자에서 혈청과 늑막액의 Adenosine Deaminase ( ADA ) 와 Lysozyme 활성치의 임상적 의의

이재익(Jae Yik Lee),박종선(Jong Seon Park),유영훈(Young Hoon Yuh),이정미(Jung Mee Lee),이두하(Du Ha Lee),노진우(Jin Woo Roh),이충기(Choong Ki Lee),정진홍(Jin Hong Chung),이관호(Kwan Ho Lee),이현우(Hyun Woo Lee) 대한내과학회 1991 대한내과학회지 Vol.41 No.5

N/A To evaluate the diagnoostic value of ADA and lysozyme activity of serum and pleural fluid, we measured the ADA and lysozyme activity of serum and pleural effusions in 50 cases of pleural effusions due to tuberculosis (n=33), malignancy (n=13), and congestive heart failure (n=4). The results were as follows: 1) The mean value of serum ADA activity of tubercu-lous effusion was 45.533,3 U/L and was significantly higher than that of nontuberculous effusion(p<0,05). 2) The mean value of pleural ADA activity of tuber-culous effusion was 11.7±47.9 U/L and was significantly higher than that of nontuberculous effusion(p<0.005). 3) The mean value of the pleural and serum ADA ratio of tuberculous effusion was 2.9±1.4 and was significantly higher than that of nontuberculous effusion (p<0.05). 4) The serum lysozyme activity was not significant between tuberculous and nontuberculous effusions. 5) The mean value of pleural lysozyme activity of the tuberculous effusion was 18.0±10.3 μg/ml and was significantly higher than that of nontuberculous effusion. 6) The mean value of the pleural and serum lysozyme ratio of tuberculous effusion was 1.8±1.1 and was significantly higher than that of nontuberculous effusion. The ratio above 1.2 had a sensitivity of 70% and a specificity of 100% when used as a screening test for tuberculous effusion compared with malignant effusion. In conculusion, the measurements of serum and pleural ADA, lysozyme and their ratios were useful in the differential diagnosis between the tuberculous and nontuberculous pleural effusions.

폐외결핵 조직에서의 항산균 검출

노진우,최희진,김형일,정진홍,이관호,이현우,이삼범 영남대학교 의과대학 1994 Yeungnam University Journal of Medicine Vol.11 No.2

만성 육아성 염증으로 진단된 폐외결핵의 조직에서 항산균 도말검사상 항산균의 검출빈도를 조사해 보고자 조직검사상 폐외결핵으로 진단된 286례를 대상으로 조직에서의 항산균 검출빈도와 폐외결핵의 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1) 폐외결핵의 평균연령은 37.3세였고 성별에 따른 빈도의 차이는 임파절 결핵은 여자에서 2.3배 더 높았고 유방을 제외한 그 외의 폐외결핵은 남자에서 호발하였다. 2) 폐외결핵의 부위별 빈도는 늑막이 103례(36.0%)로 가장 높았고 임파절 87례(30.4%), 소화기 27례(9.4%), 피부 및 연조직 23례(8.0%), 뼈 19례(6.6%), 비뇨기계 13례(4.6%), 인후두 9례(3.2%), 유방이 5례(1.8%)였다. 3) 폐외결핵의 조직에서 항산균 검출은 총 286례중 87례에서 검출되어 평균 검출빈도는 30.4%였으며 각 장기별 항산균 검출빈도는 유방이 5례 중 3례(60.0%), 임파절이 87례 중 35례(40.2%)로 비교적 높았고 인후두는 9례 중 3례(33.3%), 비뇨기계는 13례 중 4례(30.8%), 뼈는 19례 중 5례(26.3%), 소화기계는 27례 중 7례(25.9%), 늑막은 103례 중 26례(25.2), 피부 및 연조직에서는 23례 중 4례(17.4%)였다. 4) 폐결핵과 폐외결핵과의 관계는 폐외결핵 286례 중 85례(29.7%)에서 흉부 X-선상 폐결핵병변이 있었고, 장기별로는 인후두 결핵이 9례 중 6례(66.6%), 소화기 결핵이 27례 중 14례(51.9%)에서 폐결핵과 동반되어 다른 부위의 폐외결핵보다 폐결핵 동반율이 더 높았다. To evaluate the isolation rate of acid-fast bacilli on Ziehl-Neelsen stain from biopsy specimens of extrapulmonary tuberculosis proven by chronic granulomatous inflammation, 286 cases of extrapulmonary tuberculosis were reviewed and the results are as follows: 1) Mean age was 27.3 years old and lymphatic tuberculosis was more prevalent in the female but others were more common in the male. 2) The most common site of extrapulmonary tuberculosis was pleura (103 cases;36%) followed by lymph nodes(87 cases;30.4%), gastrointestinal tract (27 cases;9.4%), skin and soft and soft tissue (23 cases;8.0%), bone(19 cases;6.6%), urinary tract (14 cases;4.6%), larynx (9 cases;3.2%) and breast (5 cases; 1.8%) in order of frequencies. 3) Of 286 cases, 30.4% (87 cases) of the biopsy specimens showed acid fast bacilli on microscopy. The isolation rate according to the sites was slightly higher in breast and lymph nodes as 3 of 5 cases (60.0%) and 35 of 87 cases (40.2%) respectively, and followed by 3 of 9 cases (33.3%) in the larynx, 4 of 13 cases (30.8%) in the urinary tract, 5 of 19 cases (26.3%) in the bone, 7 of 27 cases (25.9%) in the gastrointestinal tract, 26 of 103 cases (25.2%) in the pleura, and 4 of 23 cases (17.4%) in the skin and soft tissue, in order of frequencics. 4) The prevalence of extrapulmonary tuberculosis associated with pulmonary tuberculosis on chest X-ray was 85 of 286 cases (29.7%).

고립성 폐결절의 임상적 고찰

노진우,한승세,이현우,이관호,이정철,장병익,정진홍,박종선,이형우 영남대학교 의과대학 1990 Yeungnam University Journal of Medicine Vol.7 No.2

The authors conducted a clinical observation of 55 cases of solitary pulmonary nodules at Yeungnam University Hospital from June 1986 to October 1990, and the following results were obtained : 1. The age distribution was ranged from 18 to 77 years, and the male-to-female ratio was 1.8 : 1. 2. Among 55 cases of nodules, 28 cases were benign and 27 cases were malignant nodules, and of malignant nodules, the primary lung cancer was 23 cases and of benign nodules, 18 cases were tuberculoma. 3. 23 cases (41.8%) was asymptomatic and the other 32 cases were symptomatic ; chest pain 12 cases. hemoptysis ; 8 cases, cough ; 8 cases and dyspnea ; 4 cases. 4. The non-smoker-to-smoker ratio was 1 : 1.04, but among 23 smoker over 20 pack years, 14 cases were malignant nodules. 5. According to nodular size, there is no striking differences between benign and malignant nodules except 3-4cm sized nodules. 6. The lobar distribution of nodules, 35 cases were in the right lung (upper lobe ; 14 cases, middle lobe ; 11 cases, and lower lobe ; 10 cases) and 20 cases were in the left lung(upper lobe ; 9 cases, lower lobe ; 11 cases), and the malignant nodules were most commonly observed in the right upper lung.

심부 정맥 혈전의 진단에 있어 비침습성 검사의 타당성

서보양,노진우,권굉보 대한혈관외과학회 1991 Vascular Specialist International Vol.7 No.1

Unreliability of clinical diagnosis of deep vein thrombosis(DVT) led to wide use of venography for confirmation of diagnosis. However venography is invasive, expensive, and time consumming. Also it may cause a few untoward side reactions, such as superficial phlebitis, drug sensitivities, and etc. Therefore recently several noninvasive diagnostic modalities have been introduced in clinical practice. The purpose of this study is to validate such noninvasive tests by comparison of their results with the one of venography. Three noninvasive diagnostic tests-Doppler ultrasound, impedance plethysmography(IPG), and duplex ultrasonography and venography were performed for 40 patinets in whom DVT was suspected clinically. We compared the results of venogram with findings of noninvasive tests. The results are as follows. Doppler ultrasound was done in the 18 patients. The sensitivity was 77.8% and positive predictability was 100%. IPG was done in the 17 patients. The sensitivity, specificity, and positive predictability were 91.7%, 50,0%, and 84.6%. Duplex scan was done to the 18 patients. The sensitivity, specificity, and positive predictability were 91.7%, 83.3%, and 91.7%. Compared with IPG, duplex scan showed much higher specificity and positive predictability but same sensitivity. Therefore, if IPG and duplex scan are done together, the sensitivity and specificity were much higher than each modality alone. We concluded that the use of IPG and duplex ultrasonography together in same time will increase diagnostic reliability and replace venography in the diagnosis of deep vein thrombosis.