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Percutaneous Electromagnetic Transthoracic Nodule Localization for Ground Glass Nodules
송승환,이현수,문덕환,이성수 대한흉부외과학회 2021 Journal of Chest Surgery (J Chest Surg) Vol.54 No.6
Background: A recent increase in the incidental detection of ground glass nodules (GGNs) has created a need for improved diagnostic accuracy in screening for malignan- cies. However, surgical diagnosis remains challenging, especially via video-assisted tho- racoscopic surgery (VATS). Herein, we present the efficacy of a novel electrical navigation system for perioperative percutaneous transthoracic nodule localization. Methods: Eighteen patients with GGNs who underwent electromagnetic navigated percutaneous transthoracic needle localization (ETTNL), followed by 1-stage diagnostic wedge resections via VATS between January and December 2020, were included in the analysis. Data on patient characteristics, nodules, procedures, and pathological diagnoses were collected and retrospectively reviewed. Results: Of the 18 nodules, 17 were successfully localized. Nine nodules were pure GGNs, and the remaining 9 were part-solid GGNs. The median nodule size was 9.0 mm (range, 4.0–20.0 mm); and the median depth from the visceral pleura was 5.2 mm (range, 0.0–14.4 mm). The median procedure time was 10 minutes (range, 7–20 minutes). The final patho- logic results showed benign lesions in 3 cases and malignant lesions in 15 cases. Conclusion: Perioperative ETTNL appears to be an effective method for the localization of GGNs, providing guidance for a 1-stage VATS procedure.
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송승환,김종훈,문덕환,이성수 대한흉부외과학회 2020 Journal of Chest Surgery (J Chest Surg) Vol.53 No.5
Background: Radiographic modalities have been commonly used to evaluate pectus carinatum (PC), and compressive orthotic bracing is the most widely accepted treatment method. The aim of this study was to determine the efficacy of 3-dimensional (3D) body surface scanning as an alternative modality for the evaluation of PC. Methods: The medical records of 63 patients with PC who were treated with compressive orthotic bracing therapy between July 2017 and February 2019 were retrospectively analyzed. Using both 2-view chest radiography (posteroanterior and lateral view) and 3D body scanning, the height of maximal protrusion of the chest wall was measured both before and after 2 weeks of bracing therapy. The difference between the pre- and post-treatment measurements was calculated for both modalities, and these differences were compared and analyzed. Results: Based on the comparison between the pre- and post-treatment radiographs, bracing therapy produced favorable outcomes in all patients (p<0.001). The measurements obtained via 3D scanning were strongly correlated with those obtained via chest radiography (r=0.60). Conclusion: Based on the findings of this study, 3D body surface scanning appears to be an effective, radiation-free, and simple method for the post-treatment follow-up evaluation of PC, and thus can be considered an alternative to radiography.
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송승환,성시찬,장윤희,이창훈,신동훈 대한흉부외과학회 2006 Journal of Chest Surgery (J Chest Surg) Vol.39 No.8
선천적으로 발생한 식도 폐쇄증과 연관된 기관연화증은 매우 드문 기형이다. 본 증례는 생후 1일째 식도 폐쇄증 수술을 받은 환아가 기관연화증으로 진단되어 생후 40일에 교정수술을 하였다. 식도수술 후에 진행하는 호흡곤란과 천명음을 보였으며, 삼차원 컴퓨터촬영상 기관 중부에 심한 협착소견을 보였다. 심폐바이패스 하에서 협착부를 절제하고 단단 문합하였다. 조직학적 검사상 연골이 없을 뿐 아니라 식도조직을 보여 선천성 기관연화증으로 진단할 수 있었다.
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완전히 탈수한 $Ag_{12-2x}Co_x-A$ (x = 3 및 4.5)의 결정구조
송승환,김덕수,박종열,김은식,김양,Seung Hwan Song,Duk Soo Kim,Jong Yul Park,Un Sik Kim,Yang Kim Korean Chemical Society 1988 대한화학회지 Vol.32 No.6
$Co^{2+}$ 이온과 $Ag^+$ 이온으로 교환된 제올라이트 A 즉, $Ag_6Co_3-A$(a = 12.131(5)$\AA$) 과 $Ag_3Co_{4.5}$-A(a = 12.145(1)$\AA$)의 결정구조를 X-선 단결정회절법으로 입방공간군 Pm3m을 사용하여 해석하였다. I > 3$\sigma$(I)인 189개의 회절반점을 써서 $Ag_6Co_3-A$구조에 대해서는 R1=0.06, R2 = 0.076까지 정밀화시켰으며 $Ag_6Co_3-A$ 구조에 대해서는 I > 3$\sigma$(I)인 258개의 회절반점을 써서 R1 = 0.045, R2 = 0.041까지 정밀화시켰다. 두 구조 모두 Co(II) 이온은 골조의 3개의 산소와 배위하고 있었고 Co(II)-O(3) 거리는 $Ag_3Co_{4.5}-A$에서는 2.118(4)$\AA$이었고 $Ag_6Co_3-A$에서는 2.106(4)$\AA$이었다. 또 두 구조 모두 O(3)-Co(II)-O(3) 각도는 약 $120^{\circ}$로서 Co(II)와 3개의 O(3)는 거의 이상적인 삼각 평면형의 배열을 갖고 있었다. 단위포당 양이온의 총수가 8개 이상이면 $Ag^+$이온은 8-링 위치에 $Co^{2+}$ 이온은 6-링 위치의 골조산소와 우선적으로 결합한다. Co(II)이온의 수가 단위포당 4.5개 이상이 되면 $Ag_{12-2x}Co_x-A (x > 4.5)$ 결정은 X-선 회절패턴이 없었고, 이것은 $Co^{2+}$ 이온이 $H_2O$분자를 가수분해하여 생성되는 $H^+$이온 농도가 축적되어 제올라이트 골조를 파괴시켰을 것으로 생각된다. The crystal structures of $Co^{2+}\;and\;Ag^+\;exchanged\;zeolite\; A,\; Ag_6Co_3$-A(a = 12.131(5)$\AA$) and $Ag_3Co_{4.5}$-A(a = 12.145(1)$\AA$), have been determined by single crystal X-ray diffraction techniques. Both structures were solved and refined in the cubic space group Pm3m at 21(1)$^{\circ}C$. Full-matrix leastsquares refinement converged to the final error indices of R1 = 0.045 and R2 = 0.041 for $Ag_3Co_{4.5}-A,\; and\; R1 = 0.066\; and\; R2 = 0.076\; for\; Ag_6Co_3$-A using the 258 and 189 reflections, respectively, for which I > 3$\sigma$(I). Both structures indicate that CO(Ⅱ)ions are coordinated by three framework oxygens; the Co(II) to O(3) distances are 2.118(4)$\AA$ for $Ag_3Co_{4.5}$-A and 2.106(1)$\AA$ for $Ag_6Co_3-A$, respectively. In each structure, the angle substended at Co(II), O(3)-Co(II)-O(3) is ca 120°, close to the idealized trigonalplanar value. $Co^{2+}$ ions prefer to 6-ring sites and $Ag^+$ ions prefer to 8-ring site when total number of cations is more than 8. The crystals of hydrated and dehydrated $Ag_{12-2x}Co_x-A (x > 4.5)$ had no crystalline diffraction pattern, indicating the apparent exchange limit of $Co^{2+}\; into\; Ag_{12}-A\; is\; 4.5 Co^{2+}$ ions per unit cell. $Co^{2+}$ ions hydrolyze $H_2O$ molecules and $H_3O^+$ concentraction is accumulating. These $H_3O^+$ ions destroy the zeolite structures.
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