개방성 제장간막관 1예 보고

서동현(Dong Hyun Suh),김진회(Jin Hoe Kim),노승무(Sung Moo Rho),김인구(In Koo Kim),손기섭(Ki Sub Son) 대한외과학회 1981 Annals of Surgical Treatment and Research Vol.23 No.1

조기위암의 심달도 진단에서 내시경 검사의 정확도

서승원(Seung Weon Seo),정현용(Hyun Yong Jeong),이승민(Seug Min Lee),이병석(Byoung Seok Lee),김진희(Jin Hee Kim),김남재(Nam Jae Kim),노승무(Seung Moo Rho),송규상(Kyu Sang Song),신경숙(Kyung Sook Shin),조준식(June Sik Cho) 대한내과학회 2001 대한내과학회지 Vol.60 No.4

N/A Background: In order to decide on a strategy of the treatment against gastric cancer, an accurate preoperative evaluation of the depth of tumor invasion is essential. We have studied the depth of invasion in early gastric cancer by endoscopic findings. Methods: The preoperative endoscopic diagnosis of the depth of invasion was compared with pathologic findings in a total of 108 cases with early gastric cancers (EGC) which were confirmed pathologically in resected specimen. Results: Of one hundred eight EGCs, forty-one were elevated type, others were flat-depressed type. There was no relationship between the depth of invasion and macroscopic type of EGC. All of the elevated typed EGCs were differentiated carcinoma. In the depressed typed EGCs, Forty-five percent was differentiated carcinoma and fifty-five percent was undifferentiated carcinoma. The incidence of lymphnode metastasis in submucosal cancers (14.8%) was significantly more than in mucosal cancers (1.6%). Among the submucosal cancers, the incidence of nodal metastasis in double lesions (100%) was significantly more than in single lesions (14.8%). In the elevated typed EGCs, mucosal cancers were small in size less than 3.0 cm (83%), and contained whitish patches, and showed uneveness and erosion. Submucosal cancers were large in size, and contained ulcers, and showed submucosal tumor-like shapes and bridging folds. In the depressed typed EGCs, it was difficult to determine endoscopically the depth of invasion. Submucosal cancers showed the fusion of converging folds and unevenness of the depressed base. The regularity of the depressed base without ulcer was primarily found in mucosal cancer. Conclusion: When the tumor was elevated, the endoscopic diagnosis for the depth of invasion was determined easily by size of the lesion and features of the elevated surface. For the depressed tumor, diagnostic clues were the pattern of the base of the depression and the converging fold, and the endoscopic diagnosis of the depth of invasion was much more difficult than the elevated type EGC.(Korean J Med 60:330- 336, 2001)

항문직장 기형에 대한 임상적 고찰

노승무,장일성 대한대장항문학회 1989 Annals of Coloproctolgy Vol.5 No.1

수술전 영양결핍상태의 위암 환자에 대한 Solgreen^�(12.5% aminoacid)의 투여 효과

강민규,노승무,장일성 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

The effects of Solgreen (12.5% aminoacid) injection was evaluated in 22 stomach cancer patients with preoperative nutritional deficiency. In this study, 500㎖ of Solgreen was intravenously injected daily for 5 days in 16 patients (A group) and Solgreen was not injected in 6 patients (B group). 24 hour urine creatinine, creatinine-height index (reflects body protein) and serum albumin were measured. The results were as follows: 1. Increase in creatinine-height index was greater in Solgreen injected group than non-injected group. 2. Among group of Solgreen injection, creatinine-height index was higher in post-injection day than in pre-injection day. 3. Increase in serum albumin was greater in Solgreen injected group than non-injected group.

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).

만성 간염 환자에 대한 Malotilate(Kantecs^�)의 임상적 연구

배진선,노승무,송인상 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

Authors carried out the clinical study on Malotilate(Diisopropyl 1,3-dithio-2-ylidenemalonate) in patient with chronic liver diseases and in those with elevated SGOT and SGPT over normal range. We selected three patients with chronic liver diseases and six patients with elevated SGOT and SGPT levels, aged from 26 to 61 years. The daily dose was 3 tablets, each tablet containing 200mg of Malotilate(Kantecs). The clinical and laboratory evaluation were made before and after 8 weeks’ treatment. The results were as followings; 1. Serum total protein and albumin were significantly increased from 6.53±0.055gm/dL to 6.69±0.060gm/dL and from 3.43>0.065gm/dL to 3.71±0.096gm/dL respectively after 8 weeks’ administration of Malotilate(p<0.05, p<0.025). 2. Total cholesterol was significantly increased from 161.3±6.69mg/dL to 184.2±6.97mg/dL after 8 weeks’ administration of Malotilate(p<0.025). 3. The values of SGO, SGPT, and ν-GTP were significantly decreased after 8 weeks’ administration of Malotilate(p<0.05). 4. BUN,S-glucose, total bilirubin and alkaline phosphatase were not significantly altered after Malotilate administration. 5. No severe adverse side effects were found during 8 weeks‘ administration of Malotilate. Accordingly, it could said that Malotilate(Kantecs) was effective in the treatment of chronic hepatic parenchymal diseases without causing adverse effects.

조기 위암의 조직 분화도에 따른 내시경적 육안 소견

김남재,이경태,김진희,송규상,이승민,정현용,김석현,노승무,이병석,조준식 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.2

Background/Aims : The aim of this study was to investigate the endoscopic findings of early gastric cancer according to histological differentiation. Methods : One hundred eight cases of early gastric cancer (EGC) which had been confirmed surgically over a 1 year and 7 month period, were studied to assess the relationship between histological differentiation and endoscopic findings. Results : All elevated types of EGC (41 cases) were found to be differentiated carcinoma. 48.2% (30/67 cases) of the depressed type EGC was determined to be differentiated carcinoma, while the others (51.8%) were undifferentiated carcinoma. Twenty-four of thirty cases with differentiated depressed type EGC showed a reddish discolored surface (80%), and the others manifested a whitish or mixed colored surface of red and white. In the undifferentiated depressed type EGC, 73% (27/37 cases) revealed a whitish or mixed colored surface, while the others (27%) showed a reddish discoloration. In the differentiated depressed type EGC, the character of the depressed surface was mainly regular and soft or fine granular (77%), while that of the undifferentiated cases appeared as uneven large granules (43.2%) or fine granules (43.2%), sclerotic (2.8%) and/or elevated (10.8%). The margin of the depressed type EGC with differentiated carcinoma was mainly of a shoaling beach type (83.3%), and that of the undifferentiated carcinoma was not uniform and existed as a cliff type (60%), Riasis coast type (11.4%) and shoaling beach type (28.6%). Conclusions : All elevated types of EGC showed differentiated types, and histological differentiation of depressed type EGC was macroscopically determined by the size of lesions, color, and character of the depressed surface and margin of the depression.

조기위암의 내시경적 고찰

김진희,이충식,배진선,조준식,임의혁,정현용,김영건,이헌영,육은주,김성걸,노승무,장일성 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.2

In order to decide on appropriate treatment strategy against gastric cancer, an accurate preoperative evaluation of the depth of cancer invasion is essential. We studied 165 cases(19%) of early gastric cancer among 706 cases of gastric cancer. resected over a 6 year period. A retrospective study of early gastric cancer was done to evaluate the endoscopic accuracy and lymph node metastasis status, the following results were obtained: 1) The proportion of EGC according to macroscopic type was 68.5% of depressed type(II, III, IIa+III, IIc+III, III+IIc, IIb+IIc), 26% of elevated type(I, IIa, IIa+ IIb, IIa+IIc), 5.5% of flat type(IIb). 2) In the view of accuracy of endoscopic diagnosis, the rate of accurate diagnosis suitable for postoperative macroscopic type was 37.5%, the rate of unsuitable typed EGC was 33.3%, overestimation(diagnosed to AGC) was 20.6% and underestimation(diagnosed to benign diseases)was 8.6%. Overall accuracy of endoscopic diagnosis was 70.8%. 3) The cases confined to the mucosa were 40.6% and others were submucosal cancers(59.4%). 4) Positive lymph node metastasis was found in 1.5% of M-cancer and 18.4% of SM-cancer(overall 11.5%). 5) Node positive rate of differentiated cancer was 10.5%, undifferentiated carcinoma was 15.4%. There was no signficant difference in frequency of nodal metastasis according tumor size and macroscopic type. 6) Tumors which satisfy the following criteria may not metastasize to lymph nodes:(1) confined to the mucosa; (2) less than 2.0cm in diameter; (3) macroscopically elevated or flat; (4) histologically well or moderately differentiated.