Antiadhesive effect and safety of oxidized regenerated cellulose after thyroidectomy

Kyoung Sik Park,Kyu Eun Lee,Do Hoon Ku,Su-Jin Kim,Won Seo Park2,Hoon Yub Kim3,,Mi Ra Kwon1,Yeo-Kyu Youn1 대한외과학회 2013 Annals of Surgical Treatment and Research(ASRT) Vol.84 No.6

Purpose: To evaluate the antiadhesive effects and safety of an oxidized regenerated cellulose (Interceed) after thyroidectomy. Methods: Seventy-six thyroidectomized patients were prospectively randomized into two groups with regard to the use of Interceed. We evaluated each group for their adhesive symptoms using four subjective and four objective items at the 2nd week, 3rd and 6th month after thyroidectomy. All patients were examined for vocal cord motility by indirect laryngoscope at each period. Results: Total adhesion scores at each postoperative follow-up period decreased with time, but were not significantly different in each group. The median score for swallowing discomfort for liquid was significantly lower in the Interceed group than in the control group 2 weeks after surgery. In addition, the severity of skin adhesion to the trachea was reduced in the Interceed group compared with the control group 6 months after surgery. During the study, there were no adverse effects or significant differences in postoperative complications between the groups. Conclusion: Interceed appeared to be safe and effective in improving neck discomfort at early postoperative periods and preventing skin adhesion to the trachea 6 months after thyroidectomy.

건초 섬유종 1예

문경원,김소연,최유원,명기범,김성현 대한피부과학회 2006 大韓皮膚科學會誌 Vol.44 No.4

교육과정 개혁과 학습문화

서경혜,이주연,현성혜,이자연,심수원,김지혜 한국교육과정학회 2007 교육과정연구 Vol.25 No.3

급성 충수돌기염의 조기 진단을 위한 초음파검사의 의의

오병연,임경수,이영주,김원,최옥경 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background: In the most of emergency department, the diagnosis of appendicitis has been carried by clinical history, physical examination and plain X-ray. But the diagnostic accuracy by these methods was so low that unnecessary operation was common performed, and sometimes the operation was delayed till the physicians could confirm the acute appendicitis clinically. Although many kinds of diagnostic tools such as CT scan, laparoscope, and etc, we believe that ultrasonography(US) would be a quick and sensitive diagnostic method for the evaluation of acute appendicitis in the Emergency Department. Methods: Forty-seven patients who were clinically suspected as acute appendicitis were evaluated with the grayscaled US by emergency physician. The probe of US was placed on maximal tender point of abdomen, and the appendix image was evaluated while probe was pressed deeply and gently. When the blind loop was found at maximal tender point of abdomen, we evaluated the diameter of appendix, the presence of compressibility, peri-appendiceal fluid collection and other mass effect. As soon as the ultrasonographic evidences of the appendicitis were noticed, the operations were done and pathologic report were reviewed later. Results: Among the forty-seven patients, forty patients were diagnosed as a appendicitis by Us, and most common ultrasonic findings were as follows; 1) non-compressible blind loop larger than 5 mm in diameter, 2) wall thickening more than 3 mm, 3) peri-appendiceal fluid collection, 4) periappendiceal mass. Among remaining 7 patients in whom we could not get any positive findings of appendicitis, abdominal CT scan was carried in 2 cases who had direct and rebound tendemess on right lower abdomen, and CT scan showed the evidences of the appendicitis. The other 5 cases without rebound tendemess were observed for 2 hours, and abdominal pain was disappeared lately. Finally forty-two patients were operated and confirmed as acute appendicitis by pathologic reports; 24 were reported as suppurative appendicitis, and 12 cases of gangrenous appendicitis, 3 cases of perforated appendicitis, and 3 cases were peri-appendiceal abscess. The specificity of US in the diagnosis of acute appendicitis was 71.4%, and the sensitivity was 95.2%. Conclusions: In some patients suspected appendicitis, emergency physicians could diagnosis acute appendicitis accurately and rapidly by use of ultrasonography. Although the US was an accurate imaging modality to diagnosis acute appendicitis and evaluate its complications, we recommend a laparotomy or abdominal CT scan in the patients with negative US findings in spite of presence of peritoneal irritation signs such as rebound tenderness and/or muscle guarding on right lower abdomen.

Hinman 증후군(비신경인성 신경인성 방광) 1예

이경욱,채정호,이승주,김세웅,박원명,전태연,김광수 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.3

Objectives : The Hinman Syndrome is a condition representing urinary voiding dysfunction in a neurologically intact child. This syndrome probably is an acquired behavioral and psychosocial disorders. We present a case presenting voiding dysfuntion with no neurologic etiology. Case : The departmcnt of urology consulted the department of psychiatry for a psychiatric evaluation of a 14-year-o1d girl with a history of recurrent urinary tract infections, enuresis, and urinary dribbling since early childhood. She visited the emergency room bccausc of severe abdominal pain and hematuria. She was admitted to the department of urology. Neurological tests showed no abnormality, but a retrograde cystogram showed free vesicoureteral reflux to the level of the dilated intrarenal collecting systems. Marked blunting and dilatation of the caliccs suggested longstanding urinary flow obstruction. She had a history of scparation anxiety disorder and was very competetive, perfectionistic, and nervous. She also had very poor relationships with her friends and had difficults in managing them. Afer admission, she had stent operation and cystostomy. Antidepressant and anxiolytic medications with supportive psychotherapy were administered to treat anxiety, tension and depression. Gradually, her depressive symptoms and voiding difficulties improved. Conclusions : Psychological factors such as a perfectionistic and obsessive personality, a history of severe separation anxiety, stressors from poor interpersonal relationships and Ihe failure of an entrance examination seem to have contributes to the development and exacerbation of the urinary dysfunction. Pharmacotherapy and supportive psycho-therapy may be efective in treating associated psychiatric problems of these patients with hinman syndrome.

양극성 장애 1형에서 종양괴사인자 베타 유전자 다형성

전태연,이경욱,배치운,김원,우영섭,채정호,박원명 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6

Objectives : Bipolar disorder is known to have a high genetic predisposition. Recently, the main focus of etiologic studies in bipolar disorder has been concentrated on molecular genetic approach including gene polymorphism analysis. The present study was conducted to investigate whether TNFB polymorphism is associated with bipolar I disorder in the Korean population. Methods : 89 bipolar I disorder patients diagnosed by DSM-IV criteria were assigned as the patient group and 202 normal population, matched on age and sex from Catholic hemopoietic stem cell bank (Seoul, Korea), were enrolled as the control group in this study. Genotyping was performed by a polymerase chain reaction-restriction fragment length polymorphism method. All data was analyzed by x² test. Results : There were no significant differences in frequency of TNFB*1/1,TNFB*1/2 and TNFB*2/2 between bipolar I disorder patient group and normal control group. The frequency of TNFB*1 was not statistically different between bipolar I disorder patient group and normal control group. Conclusion : The difference of frequency in TNFB*1/TNFB*2 gene between the bipolar I disorder gropup and the normal contro1 could not be verified. The present result suggested that the gene polymorphism of TNFB may not play a significant role in susceptibility to bipolar I disorder. Studies with a larger number of subjects from different ethnic backgrounds, considring clinical phenotype and controlling various factors, should be launched to further determine the role of TNFB in bipolar I disorder.

여름 캠프활동에 관한 연구 : 서울여대 부속유치원 여름 캠프활동을 중심으로

민행난;최윤선;최인경;민혜원;임양선;이윤희;이상희 서울여자대학교 1998 아동연구 Vol.3 No.-

[초록없음]

상악동에 발생한 국균증 2례

조용석,김경원,박현진,강지연,이건국,신향미 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.1

국균증은 토양, 유기체 그리고 모든 형태의 유기물 잔사에 광범위하게 존재하는 국균 (Aspergillus) 속에 의하여 발병한다.이 균의 포자는 공기 중에서 전염될 수 있으므로 가장 흔한 감염 진균 중 하나이다.부비동에 발생한 국균증은 초기 임상 증상이 만성 부비동염과 유사하며, 방사선 사진 등을 이용한 검사상도 일반 세균성 감염과 구별하기가 매우 어렵다.대개는 병리조직학적 검사로 국균을 확인해서 확진을 내리게된다.국균증의 치료는 외과적으로 상악동내의 병소를 완전히 제거하고 비강에로 충분한 공기를 통기시키는 것이 가장 중요하며 보조적으로 전신적인 항진균제를 사용해야한다. 증례는 40세와 24세인 여자 환자들로서 전신적으로는 건강했으며 임상적 방사선적으로 만성 상악동 증세를 보였다.상악동 근치술을 시행하면서 국균종으로 여겨지는 암갈색 덩어리들이 관찰되었고 술 후 병리조직검사상 국균증으로 진단되었다.국균증으로 진단 후 보조적으로 전신적 항진균제를 투약하였으며 재발없이 치유되었다. Aspergillus is a fungus of the Acetomyces class that is most commonly encountered in the human environment.Aspergillosis of the maxillary sinus is not common and it requires special consideration to diagnose and eradicate. The disease is characterized by a wide range of initial symptoms, and should be considered as a possible diagnosis in sinusitis refractory to antibiotics and antral lavage. Generally the diagnosis of sinus aspergillosis can be confirmed by histologic examination, however, characteristic radiographic appearance such as coherene of radiodense sinus concretions can be found by careful examination of the radiograms. The choice of treatment of maxillary sinus aspergillosis is radical surgery with adjunctive systemic antifungal therapy. We experienced two cases of maxillary sinus aspergillosis, which initially diagnosed as chronic maxillary sinusitis and showed a necrotic mass intraoperatively and histologically diagnosed as aspergillosis.We reports theses cases with review of literature.

성남시 지역주민의 정신질환에 대한 태도 연구

고영,신수경,황태연,이충순,박연수,김인숙,황은숙,정원재 용인정신의학연구소 1999 용인정신의학보 Vol.6 No.1

구개부 소타액선에 발생한 호산성 과립세포종

박현진,김경원,조용석,이경호,강지연,최희원 충북대학교 의학연구소 2002 忠北醫大學術誌 Vol.12 No.2

호산성 과립세포는 타액선을 포함하여 갑상선, 부갑상선 등 주로 선조직에서 발견되는 커다란 과립상의 호산성 상피세포를 말한다. 호산성 과립세포종은 모든 타액선 종양중 약 1.5%의 비율로 발생하는 비교적 드문 양성 종양이며, 주로 노년의 이하선에서 발생하고 악하선과 소타액선에서는 드물게 발생한다. 임상적으로 크기는 약 3-4 ㎝이며 잘 분화된 낭으로 싸여있다. 조직학적 검사에서 광학현미경상 호산성 과립세포로 채워진 세포질이 관찰되며 전자현미경상 과립을 함유한 다량의 비대된 미토콘드리아가 관찰된다. 호산성 과립세포종은 본질적으로는 양성 종양이며 치료를 위하여 완전한 절제가 추천된다. 국소적인 재발은 드물며 다발성인 경우에는 재발하기도 한다. 증례는 38세의 남자 환자로서 구개부의 소타액선에 발생한 약 2.0×2.5 ㎝ 크기의 무통성의 종괴로 절제술을 시행하였으며, 광학현미경과 전자현미경을 이용한 조직병리 검사상 호산성 과립세포종으로 진단되었으며, 수술 후 특별한 합병증 없이 치유되었다. 저자들은 구개부의 소타액선에서는 아주 드물게 발생하는 호산성 과립세포종에 대하여 진단 및 치료를 시행하고 양호한 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다. Oncocytes are large, granular, eosinophilic epithelial cells mainly found in many glandular tissue including salivary glands, the thyroid, parathyroid, pituitary, adrenal gland, testicle, fallopian tube, liver and stomach etc. Oncocytoma, which originate from oncocytes are uncommon benign neoplasm that present approximately 1.5% of all salivary gland tumors. They typically occur in parotid gland of elderly patients and rarely in submandibular gland or minor salivary gland. On gross examination, they are usually 3 to 4 ㎝ is size and possess a well-defined capsule. Histologically oncocytoma peculiarly consisted of oncocyte which has cytoplasm, filled with eosinophilic granules on light microscopy and a large number of enlarged and morphologically altered mitochondria by electron microscopy. Oncocytomas are essentially benign tumors and complete excision is recommended. Local recurrence is extremely rare, but when it occurs, it may be multifocal. We report a case of oncocytoma raised from minor salivary gland of palate in 38 years old male patient with literature.