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顎下部에 發生한 Cystic Hygroma의 治驗例 및 文獻的 考察
Sang Chull Lee(李相喆),Yeo Gab Kim(金麗甲),Jae Hee Ahn(安在羲),Seon Sik Kong(孔宣植) 대한구강악안면외과학회 1984 대한구강악안면외과학회지 Vol.10 No.1
This is to report a case of cystic hygroma occured in the left submandibular area of 12 year-old male patient. The patient was admitted to Department of Oral and Maxillofacial Surgery, Kyung-Hee University Medical Center with the chief complaints of left submandibular swelling. Cystic hygroma are a benign neoplasm of developmental origin that are characterized by large endothelial-lined space and found predominantly in the region of the head and neck, commonly in the posterior trianglar of the neck, but in this case, the lesion was found in the anterior triangle. In this case, cystic hygroma is not invade the floor of the mouth and base of the tongue and surgically excised specimen is ovoid, lobulated and 6㎝ × 2㎝ × 4㎝ in size and that is filled with watery, straw-colored fluid. The histological appearance is that of multiple dilated and collapsed lymphatic channels lined by a single layer of flattened endothelium. Focal lymphocytic infiltration as well as small sprouts or buds of lymphangiomatous tissue may extend into adjacent tissue. It is best treated by surgical excision soon after recognition in order to prevent extensive local growth and expansion. This case is of interest because their diagnosis was made when the patient was 12 year-old male patient.
Could cluster of risk factors predict clinical outcome in patients with acute myocardial infarction?
( Sang Mi Park ),( Hong Nyun Kim ),( Se Yong Jang ),( Myung Hwan Bae ),( Dong Heon Yang ),( Hun Sik Park ),( Yongkeun Cho ),( Shung Chull Chae ),( Jang Hoon Lee ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Purpose: Conventional risk factors are differently contributed to short-term prognosis of acute myocardial infarction (AMI); hypertension and diabetes increase adverse outcome, whereas hyperlipidemia, smoking, and obesity paradoxically decrease adverse outcome of post-MI patients. The aim of this study is to assess whether cluster of conventional risk factors, PARADOCS (Pressure of ARtery Abnormality, Diabetes, Obesity, Cholesterol, Smoking) score, would improve the ability to predict major adverse cardiac events (MACEs) in patients with AMI. Methods: Between November 2005 and July 2011, 24,020 patients (17,232 men; mean age=63.0±12.8) with AMI were analyzed from Korean AMI registry. PARADOCS score was calculated as follows; [number of non-paradoxical risk factors (NRF) -number of paradoxical risk factors (PRF)]+3 in which non-paradoxical risk factors are hypertension and diabetes, and paradoxical risk factors are the rest. The 1-year MACEs were defined as death and non-fatal MI. Results: NRF including hypertension and diabetes were present in 49.6% and 27.0%, whereas PRF including hyperlipidemia, smoking, and obesity were present in 12.3%, 43.0%, and 34.6%, respectively. During the follow-up, 1,409 (5.9%) MACEs occurred. PARADOCS score was significantly higher in patients with 1-year MACEs (3.38±1.03 versus 2.81±1.08, p<0.001). In Cox proportional hazards model, PARADOCS score was an independent predictor of 1-year MACEs (hazards ratio 1.26, 95% confidence interval 1.18-1.34; p<0.001) after adjusting for confounding variables. Patients were categorized into 3 groups according to the PARADOCS score; PARADOCSLOW (0-1, n=2,446), PARADOCSMID (2-3, n=14,594), and PARADOCSHIGH (4-5, n= 6,980). Kaplan-Meier survival curve showed that there were significant differences in the 1-year MACEs among three groups including 3.5% in PARADOCSLOW, 8.5% in PARADOCSMID, and 16.4% in PARADOCSHIGH, respectively (long-rank p<0.001). Conclusions: In post-MI patients, conventional risk factors are differently associated with short-term prognosis, and score of these risk factors, PARADOCS score, can provide useful prognostic information to clinicians.
Lee, Chan-Hee,Lee, Sang-Hee,Park, Jong-Seon,Kim, Young-Jo,Kim, Kee-Sik,Chae, Shung-Chull,Kim, Hyo-Soo,Choi, Dong-Ju,Cho, Myeong-Chan,Rha, Seung-Woon,Jeong, Myung-Ho Science Press 2014 Journal of geriatric cardiology Vol.11 No.2
<P><B>Background</B></P><P>The benefit of statin use after acute ST-segment elevation myocardial infarction (STEMI) has been well established, however, the influence of the timing of statin administration has not been elucidated. The objective of this study focused on early clinical outcomes after percutaneous coronary intervention (PCI).</P><P><B>Methods</B></P><P>This analysis of the Korea Working Group on Myocardial Infarction registry (KorMI) study included 3,584 STEMI patients (mean age, 63 ± 13 years; male, 2,684, 74.9%) undergoing PCI from January 2008 to June 2009. Rates of major adverse cardiac events (MACE: all-cause death, recurrent MI, and target lesion revascularization) were compared among patients grouped according to statin therapy timing: I, both during and after hospitalization (<I>n</I> = 2,653, 74%); II, only during hospitalization (<I>n</I> = 309, 8.6%); III, only after discharge (<I>n</I> = 157, 4.4%); and IV, no statin therapy (<I>n</I> = 465, 13%). Mean follow-up duration was 234 ± 113 days.</P><P><B>Results</B></P><P>Multivariate factors of statin use during hospitalization included prior statin use, multiple diseased vessels, final thrombolysis in myocardial infarction flow grade III, and low-density lipoprotein cholesterol level. At 6-month follow-up, groups III and IV had the highest MACE rates (2.3%, 3.9%, 5.1%, and 4.9% for groups I-IV, respectively, <I>P</I> = 0.004). After adjusting for confounders, groups II-IV had a higher MACE risk than group I [hazard ratio (HR): 3.20, 95% confidence interval (95%CI): 1.31–7.86, <I>P</I> = 0.011; HR: 3.84, 95%CI: 1.47–10.02, <I>P</I> = 0.006; and HR: 3.17, 95%CI: 1.59–6.40, <I>P</I> = 0.001; respectively].</P><P><B>Conclusions</B></P><P>This study, based on the national registry database, shows early and continuous statin therapy improvs early outcomes of STEMI patients after PCI in real-world clinical practice.</P>
下顎骨에 發生한 Complex-Compound Odontoma의 治驗例
Sang Chull Lee(李相喆),Yeo Gab Kim(金麗甲),Jong Tae Lee(李宗泰),Sun Hee Park(朴善姬) 대한구강악안면외과학회 1985 대한구강악안면외과학회지 Vol.11 No.2
Odontomas are probably the most common of the odontogenic tumors, and have been defined as a tumor composed of dentin and enamel in which pulp and cementum also are present This is the report of a case of complex-compound odontoma occured in the right mandibular body area. The patient, 6 years-old male, was admitted to dept. of oral and maxillofacial surgery, Kyung Hee University Medical Center with the chief complaint of painless mass on the right mandibular body area. We were certained of complex-compound odontoma through clinical and radiographic feature, and then performed surgical enucleation of tumor including removal of involved teeth. Through surgical procedures and biopsy, this tumor confirmed to be a combination of complex and compound types. After 12 months follow up check, we noticed the bony replacement of operation site and no recurrence.
Sang Chull Lee(李相喆),Yeo Gab Kim(金麗甲),Hyoun Chull Kim(金賢哲),Jong Jae Lee(李宗泰) 대한구강악안면외과학회 1984 대한구강악안면외과학회지 Vol.10 No.2
Myxomas are rare tumor that probably arise from the mesenchymal portion of the dental papilla, dental follicle, or periodontal membrane. This is to report a case of myxoma occurred in the left maxillary alveolar portion, maxillary sinus and pterygomaxillary fossa. The patient, 28 years-old female, was admitted to Dept, of Oral & Maxillofacial Surgery, Kyung Hee University Medical Center with the chief complaint of painless mass on the upper left molar area. In this case, the roentgenographic findings revealed sun-ray appearance, root resorption, displacement of involved tooth and destruction of lateroposterior wall of maxillary sinus. The histopathological findings revealed a soft tissue covered by hyperplastic stratified squamous epithelium with prominent rate ridge and no cellular atypia, The upper portion of underlying connective tissue is composed of fibrous collagenous tissue with numerous proliferating fibroblasts and infiltration of large numbers of chronic inflammatory cells and deep portion is made up of loosely arranged, spindle shaped and stellate cells with long fibrillar process. Conservative local curettage is the preferred treatment. Removal of the maxilla or mandible should be avoided if at all possible. Removal should be done only when pathologic fracture or extension of the tumor into the vital anatomical structures is inevitable. In this case, we performed curettagement of the tumor via intraoral approach.
顎顔面部에 發生한 軟組織疾患의 診斷時 Ultrasonography의 應用에 관한 硏究
Lee Sang Chull(李相喆),Kim Yeo Gab(金麗甲),Kong Seon Sik(孔宣植) 대한구강악안면외과학회 1985 대한구강악안면외과학회지 Vol.11 No.2
Ultrasonography is known to provide valuable information concerning the size, nature and location of soft tissue lesions. So that It was utilized for diagnostic purposes for the ten years. It was originally utilized mainly in opthalmology and obstetrics and gynecology. But in recent years, it was very useful in diagnosis of soft tissue masses In oral and maxillofacial area. This technique is non-invasive and inexpensive, and has not radiation hazard when compared to computerized tomography. Ultrasonography is capable of differentiating not only cystic form solid lesions but also can be helpful in the diagnosis of malignant vs. benign masses. A ultrasonic study was performed in 5 patients with various soft tissue lesions in oral and maxillofacial region (cystic hygroma, intramuscular hemangioma, neurilemmoma, tuberculous lymphadenitis, abscess) using B-scan(gray scale) ultrasonography. The results are summerized below. 1. Cystic hygroma showed internal echo free pattern, enhancement of posterior detail and multiloculated well delineated oval shaped outline. 2. In intramuscular hemangioma, ultrasonography demonstrated internal echo free pattern and two posterior attenuation were made by two calified body. 3. Neurilemmoma showed homogenous internal echo pattern, and well delineated oval shaped outline. 4. In tuberculosis lymphadenitis, internal nature was not coincided with computerized tomography, but size and location were coincided with that. 5. Suppurative abscess on masseter muscle showed internal echo free pattern.