유암에 대한 임상적 연구

장일성 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2

This is clinical analysis and review of 34 cases of breast cancer patients which treated at this department of Chungnam National University Hospital during 5 years from July, 1979 to June, 1984. 1) Most cases of breast cancer were female (97.6%), high incidence of age group was between 40 and 59 years old. 2) All cases were complaint of breast mass, the most frequent period of interval between symptom and arrival to hospital was within 3 months (18 case, 52.9%). 3) Predominent group in size of mass was 2-5cm. in diameter (18 cases, 52.9%). 4) Left breast cancer was more frequent than right breast cancer (1. 2 : 1), and the highest incidence of site was upper outer quadrant (47%) 5) 20 cases (58.8%) had axillarv lymph node metastasis, most frequent group of number of metastatic lymph node was 1-3 (44.1%). 6) In T. N. M. classification: most frequent group was stage II (50%). 7) In pathologic classification: most breast cancer wvas infiltrating ductal cancer (94. 1%). 8) The most frequent method of operation was radical mastectomy (55. 9%). and then modified radical mastectomy (32.4%). 9) 12 cases (35.4%) was noted systemic metastasis. 10) The complication of operation were skin edge necrosis(29. 4%), seroma (26. 5%), arm edema (14.7%) and motion limitation (5.9%)

Quardrantectomy with axillary Lymph node dissection in Breast cancer

장일성,김영일 대한외과학회 1991 대한외과학회 학술대회 초록집 Vol.1991 No.11

腎性高血壓의 實驗的 模型에 있어 腎臟의 RENIN遊離의 特性

張一成,曺景宇 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.1

It has long been suggested that the change of renin-angiotensin system is responsible for increased arterial blood pressure in experimental hypertension. But the exact nature of the cause and maintenance of early and late phase of renal hypertension is still controversial. To clarify the nature of the renin release in both clipped and non-clipped kidney of two-kidney one-clip Goldblatt hypertensive model, in vitro slice experiments have been done in rats. Experiments were carried out in the rats of 3, 7, and 35 days of operation. Percent release of renin from the clipped kidney was suppressed compared to its corresponding sham-operated and control rats. Percent release of renin from the untouched non-clipped kidney 3 to 7 operation days of rats was much more suppressed than the clipped kidney. The responsiveness of the 3 and 7 days non-clipped kidney to the beta-receptor agonist, isoproterenol was accentuated by 290 and 210 percent respectively, while the increments of the clipped kidney were not different from its corresponding sham-operated and control rats. Renin suppression of clipped and non-clipped kidney by angiotensin II was attenuated compared to its control rats but was no differences between both kidneys of Goldblatt rats. These data suggest that the renin response to beta-receptor agonist, isoproterenol, has been accentuated in the non-clipped kidney by some changes in adrenergic beta-receptor or intracellular renin pools, and that the negative feedback control mechanism controlling renin-angiot system by angiotensin has been attenuated in two-kindey, one-clip Goldblatt hypertensive rats.

Fibroadenoma에 대한 임상적 고찰

장일성,김지연,이희만 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Fibroadenoma is the most common benign tumor of breast in human female between the age of 20 and 35 years. The great majority of patients should be treated by excisional biopsy to remove the tumor and establish the diagnosis. Authors have reviewed 110 case of fibroadenoma who underwent surgical operation during the period from Jaunary 1990 to Jaunary 1993 at the department of General Surgery in Chungnam National University Hospital. The circumareolar skin incision was selected if the tumor was compatible with benign fibroadenoma on the finding of preoperative mammogram and sonogram. But, the diagnosis was uncertain and the distance from the mass to nipple was over 3 cm, the skin incision was made on the just above the palpable mass. In order to minimize the seroma, hemostasis was taken completely, the use of electrocautery was restricted as possible, a close suction drain was kept to surgical dead space via the main wound by vaccum tube in case of leaving large dead space, and compressive dressing was applied on the defected wound site after the operation. The major complication after the excision of suspicious fibroadenoma was seroma, and its complication rate was about 8% (9/110 cases). But, another complication was not found. The rate of discharge at the first postoperative day was calculated to 73.2 % among the total patients and the remaining of all patients could be discharged at the second postoperative day. In conclusion, the young female who was under suspicion of fibroadenoma must be treated with excision and the excised specimen should undergo histologic examination to rule out carcinoma or to confirm the diagnosis. The associated major complications were revealed to minimal.

조기 위암의 임상적 고찰

장일성,김영일 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

This report is a clinical review of 50 cases of early gastric cancer that were treated and followed during 6 years from June. 1985 to June 1990. 1. The peak incidence age was 50 decade(38%), the mean age was 50 years, the ratio of male to female was 3:2. 2. The preoperative diagnostic rate was 52% by double conrast and 60% by endoscopy and biopsy. 3. The most common size of lesions was 1.1-2cm(32%) the smaller of lesion, the greater incidence of invasion rate to submucosa but no relation to lymph node matastasis rate. 4. The most common type of lesion was IIc(28%), the depressed type(III, IIb+c, IIc) was lymph node metastasis, but the elevated type and flat type was not lymph node matastasis. 5. The most common histological type was moderate differentiated and signet-ring cell types(32.5%) the most common type of metastatic rate was moderate differentiated type (30.7%), the badder of differentiated type, the greater incidence of metastatic rate to lymph node. 6. The common sites were lower third and lesser curvature(50%). The greater incidence of metastatic rate and invasion rate to submucosa the site of posterior wall was. 7. The rate of lymph node matastasis was 6.3% in mucosa, 26.4% in submucosa and 20% in total. 8. Follow up studies were possible in 45 cases, in these 1 case was died, 1 case was recurred but alive.

양측성 유방암에 대한 임상적 고찰

장일성,김장용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

There are many difficulties in predicting the strateges of the treatments or prognosis of the bilateral breast cancer, because of its less statistic datas and numbers of cases than unilateral breast cancer. Recently, some of studies were reported with pathological, biological and clinical results, but definite conclusions were not yet made. And so, we analyzed the 5 cases of them clinically to help diagnosis and strategy of the treatments of the bilateral breast cancer at Chungnam National University Hospital, from Oct. 1995 to Apr. 1998. The results of the study were obtained as follows : I) The mean age was 35 years old with range of 30 to 38. 2) The chief complaints were breast mass in 3 cases and bloody nipple discharge in 1 case. 3) The serum tumor markers(CEA, AFP, CA 15-3) were rised in 2 cases at the time of first diagnosis, and were rised at the time of tumor metastasis in 1 case. 4) There were invasive ductal carcinomas in all cases, and different pathologic findings to contralateral breast tumor in 3 cases. 5) The 1 case was expired due to brain metastasis after operation, 1 case had chest and abdominal wall and neck metastasis, and others have no evidence of metastasis or recurrence and being follow-up till now.

갑상선암의 임상적 고찰

장일성,노승무,최길돈 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

The thyroid cancer are more frequntly detected in anually due to improvement of diagnostic method and interesting knowledge of the cancer among the general population. This paper represent a clinical study of 80 cases of carcinoma of the thyroid gland which were histol ogically diagnosed and treated surgically at Chungnam National University Hospital from January 1981 to September 1988 with special emphasis on the surgical management of the thyroid cancer. The results were summerized as follows: 1) The incidence of the thyroid cancer was 22.22% among the 360 cases of the surgical thyroid disease and incidence of the thyroid cancer was increased anually. 2) The thyroid cancer was prevalent in third fourth decades of life (51.25% of all) and in female (5.67 to 1). 3) The average duration of the thyroid cancer was 2.9 years. 4) In histopathological classification of the thyroid cancer, papillary adenocarcinoma was 78.75% of all casses of thyroid cancer. 5) In the location of the thyroid cancer nodule,' 40/% of the thyroid cancer nodules were located in right lobe, 25% at the left lobe and the most prevalent location was right upper lobe(18.9O% of all). 6) In thyroid scanning of the thyroid cancer, the prevalent nodules were cold nodules, The most prevalent nodules were single cold nodules(62.50% of all). 7) In thyroid function test of the thyroid cancer, all most revealed normal function(88.75% of all). 8) Cervical lymphnode metastasis were present 29 casses (36.25%) and most common in papillary adenocarcinoma 26 cases(25%). Distant metastasis was present one case (1.25%), anaplastic cell carcinoma and the site was left breast. 9) The surgical procedure performed in thyroid cancer were followed unilateral lobectomy (28 cases), near total thyroidectomy (26 cases) and total thyroidectomy with neck dissection (1lcases) 10) The most common postoperative complication was transient hoarser ness in 14 casee (17.5O%). 11) After operation, the thyroid cancer recurrence rate was 8 cases (10% of all).

간장 손상에 대한 임상적 고찰

장일성 충남대학교 의과대학 지역사회의학연구소 1981 충남의대잡지 Vol.8 No.2

Despite the relative protection from external injury offered by rib cage, the liver is frequently injured. Injuries to the liver present difficult problems in operative management and in the detection and treatment of postoperative complications. Convalescence from liver injury may be complicatedly infection or bleeding, resulting in increasing morbidity and mortality. A clinical analysis was made about 42 cases of traumatic liver injury, operated at department of Surgery, Chungnam National University Hospital, during the past 7 years and 9 months from Jan, 1974 to Sept, 1981. The following results were obtained. 1. The prevalent age was 2nd, 3rd, and 4th decade. The male to female ratio was 9.5:1. 2. Twenty-nine cases were blunt injuries and its most common cause was traffic accident, and 13 cases were penetrating injuries and its most common cause was knife. 3. The associated injuries were 26 cases and the most common injury was rib fracture. Among the intra-abdominal organs, the blood vessel was the most frequently injured. 4. The right lobe injuries were 29 cases, left were 10 cases, and both lobe injuries were 3 cases. The most common type of injury was simple laceration with bleeding(66.7%), and then multiple or stellate laceration (21.4%), fracture(9.5%), and subcapsular hematoma(2.4%). 5. Most of hepatic injuries were treated by simple suture and 4 cases treated by hepatic resection and 1 case was by gauze packing. Among them hepatic artery ligation was done in 4 cases. Drainage was done in all the hepatic surgery. 6. The postoperative complications were noticed in 16 cases(38.0%). Wound infection and bile leakage were common complications. 7. Five cases (11.9%) were expired and the cause ofs death were renal failure, hemorrhage, and combined brain damage.

대량 간장출혈 환자의 간동맥 결찰술에 의한 치험 5례

張一成 충남대학교 의과대학 지역사회의학연구소 1979 충남의대잡지 Vol.6 No.2

Massive bleeding from the liver, due to trauma or ruptured hepatoma, is very dangerous to the life, so emergency treatment is required. But the control of the hepatic bleeding is dificult, and simple closure, gauze-packfing, and liver resection were used for the purpose of the bleeding control. Recently, hepatic artery ligation is being used for the simplest and best form of the thery for massive hepatic bleeding.

여성형유방(Gynecomastia)에 대한 임상적 고찰

장일성,이희만,홍은표 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

A Clinical Study was made in 94 cases of the gynecomastia at the department of General Surgery. Chungnam National University Hospital from January, 1986 to August, 1994. The results were as follows : 1) The most frequent age group in gynecomastia was sixties, 27 cases(28.7 %). 2) The most common duration from symptom onset to the first visit was within 6 months, 73 cases (77.7%). 3) The breast masses were located at the left breast in 45 cases (47.9%), at the right breast in 35 cases (37.2%), and bilateral in 14 cases (14.9%). 4) The most prominent symptom was palpable mass in 62 cases (66.0%), followed by palpable mass and pain in 30 cases(31.9%), palpable mass and nipple discharge in 2 cases(2.1%). 5) The etiology of gynecomastia was as follows : Association with other systemic diseases in 25 cases(26.5%), pubertal gynecomastia in 20 cases(21.3%), senescent gynecomastia in 17 cases(18.1%), idiopathic gynecomastia in 19 cases(20.2%), drug related gynecomastia in 12 cases(12.8%), and chromosomal abnormality in one case(1.1%). 6) The results of laboratory test were as follows : Liver function test was performed in 67 cases(71.3%), ultrasonography of liver in 26 cases(27.6%), liver scan in 10 cases(10.6%), and hormonal assay in 13 cases(13.5%). The results of liver function test were reported as abnormal in 12 cases(12.8%), the results of ultrasonography as abnormal in 8 cases(8.6%), the results of liver scan as abnormal in one case(1.1%), and the resutls of hormonal assay as normal in all cases. 7) Excision was performed in 16 cases(17.0%), pathological diagnosis of all cases were gynecomastia and one case was gynecomastia with intraductal papillomatosis.