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전폐조사로 유발된 마우스의 급성폐손상에 대한 스테로이드의 효과
성낙관(Nak Kwan Sung),신세원(Sei One Shin),권건영(Kun Young Kwon) 대한방사선종양학회 1997 Radiation Oncology Journal Vol.15 No.1
목 적 : 방사선량에 따른 급성폐손상을 병리조직학적으로 분석하고 예방목적으로 투여한 스테로이드의 효과를 확인하여 방사선에 의한 폐손상의 감소방안을 모색하고자 한다. 대상 및 방법 : 생후 30일 정도인 체중 25+2g의 ICR 마우스 120마리를 암수 구별없이 사용하였고, 대조군은 전폐선량이 각각 8Gy와 12Gy인 방사선조사만 시행한 군과 방사선조사와 생리 식염수를 투여한 또다른 군으로 하였으며, 실험군은 방사선조사와 스테로이드를 복강내로 투여한 군으로 하여 방사선량과 스테로이드투여에 따른 급성폐손상의 양상을 광학 현미경 및 투과 전자현미경을 이용하여 병리조직학적으로 분석하였다. 결 과 : 8Gy 대조군에서는 경미한 염증세포의 침윤, I형 폐포상피세포는 세포질이 파괴되거나 폐포강내로 돌출하였으며, 폐포 모세혈관은 경미하게 확장되었고 내피세포의 세포질과 간질은 경한 부종을 보였다. 8Gy 실험군에서는 대조군에서 보였던 폐포상피세포 및 내피 세포의 변화가 정도가 매우 약하였으나 섬유모세포의 증식과 기저판의 파괴정도는 대조군과 비슷하였다. 12Gy 대조군에서는 8Gy 대조군과 비교하여 염증세포의 침윤이 증가되었고 폐포강내에는 파괴된 조직파편이 산재해 있었으며 폐실질의 출혈과 무기폐가 관찰되었다. 12Gy 실험군에서는 대조군에서 보이던 현저한 염증변화가 많이 감소하였으며 폐포벽의 부종과 무기폐는 대조군과 비교하여 많이 감소되었으나 섬유모세포의 증식과 기저판의 왜곡 및 파괴는 차이가 없었다. 결 론 : 방사선조사에 의한 급성폐손상은 전폐조사량이 8Gy에서 12Gy로 증가함에 따라 염증세포의 침윤, 폐포상피세포의 손상, 모세혈관 내피세포의 손상, 간질의 부종정도가 증가하였으며, 방사선조사후 스테로이드를 2주일에서 4주일간 투여한 결과 이들 소견이 많이 감소하였으나 섬유모세포의 증식정도와 기저판의 변화는 조사된 방사선량이나 스테로이드투여여부와 무관하였다. Purpose : To investigate ultrastructural changes of the mouse lung induced by whole lung gamma irradiation and to evaluate the effect of prophylactic administration of steroid against acute lung injury. Materials and Methods : One hundred and twenty ICR mice were used and whole lung was irradiated with telecoba lt machine . Whole lung doses were 8 and 12Gy, and 10mg of methyl prednisolone was administrated intrape ritoneally for two and four weeks . At the end of the obse rvation period, mice were sacrificed by cervical dis location. The lungs were removed and fixed inflated. Histopathological examination of acute radiation injuries we reperformed by light microscopic and transmiss ion electron microscopic examination. Re s ults : Control group with 8Gy is cha racte rized by damage to the type I pneumocyte and the endothe lial cell of the ca pillary, edema of a lveolar wall and inte rstitium, and fibroblast prolife ration. Control group with 12Gy is characte rized by more severe degree of type I pneumocyte damage and more prominant inflammatory cell infiltration. Destructed cell debris within the a lveolar space were a lsonoted. After steroid administration, 8Gy experimental groups howed decreased degree of inflammatory reactions but fibroblast prolife ration and basal lamina damages we re uncha nged. Experimental group with 12Gys howed lesser degree of inflammatory reactions similar to changes of 8Gy experime ntal group. Conclusion : These studies suggest that the degree of interstitial edema and inflammatory changes were related to radiation dose but proliferation of the fibroblast and structural changes of basal lamina were not related to radiation dose . Experimental administration of steroid for 2 to 4 weeks after whole lung irradiation suggest that steroid can suppress a lveolar and endothelial damages induced by whole lung irradiation but prolife ration of the fibroblast and structural changes of basal lamina were not related to administration of steroid.
거대한 단발성 측경부 종물로 나타난 전이성 갑상선암 1례
성낙관(Nak Kwan Sung),김광훈(Kwang Hoon Kim),박재율(Jae Yul Park),손진호(Jin Ho Sohn) 대한두경부종양학회 1999 대한두경부 종양학회지 Vol.15 No.1
We experienced a case of the papillary thyroid carcinoma seen as a huge solid lateral neck mass. The mass grew very slowly over the period of 30years up to 10cm in diameter while relatively well sparing the surrounding tissues. Physical examinations, CT scan, and fine needle aspiration cytology did not reveal any strong suggestions for evidence of malignancy. But it was pathologically diagnosed as metastatic thyroid carcinoma by excisional biopsy. We emphasize that for a large solitary neck mass which persists for several decades, head and neck surgeons should always keep in mind the possibility of metastasis from the malignancy of thyroid gland.
양익,성동욱,윤엽,성낙관,Yang, Ik,Sung, Dong-Wook,Yoon, Yup,Sung, Nak-Kwan 대한영상의학회 1992 대한영상의학회지 Vol.28 No.3
Chest CT is the most useful modality in the diagnosis of primary lung cancer, particularly in patients with recurrent pneumonia which are resistant to antibiotic therapy and in high risk age groups for cancer. The purpose of this examination is to assess the usefulness of CT in pneumonic types of lung cancer. The authors retrospectively analyzed 15 histologically proven cases of pneumonic type lung cancer, which had no evidence of primary lung mass, mediastinal lymphadenopathy or other metastatic lesion on plain chest radiography. On CT scan, a primary lung mass was identified in 13 patients(87%), bronchial obstruction was identified in 12 patients(80%), and metastatic foci was found in the bone(one patient), liver(one patient), and spleen(one patient). In Conclusion, CT scan is a useful method to detect the mediastinal lymphadenopathy or pulmonary mass and also should be the initial radiolographic procedure for diagnosis of lung cancer in patients with recurrent pneumonia on imple chest radiography.
서광휘(Kwang Hee Seo),정혜경(Hye Kyeong Chung),김명곤(Myeong Gon Kim),정덕수(Duck Soo Chung),성낙관(Nak Kwan Sung),김옥동(Ok Dong Kim) 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.1
N/A Retrospective analysis of cholescintigraphy and ultrasonography was done in 76 patients with clinically suspected acute cholecystitis to assess the relative value of the two modalities. Excluding the patients with obstructive jaundice, the overall results of cholescintigraphy(sensitivity 100%, spectificity 95%, false positive rate 5%, false negative rate 0%, accuracy 97%) are nearly identical with or rather superior to those of the ultrasonography(sensitivity 94%, specificity 100%, false positive rate 0%, false negative rate 5%, accuracy 97%). We recommend the cholescintigraphy as the initial modality in patients with clincally suspected acute cholecystitis, and ultrasonography can be used in jaundiced patients to exclude the possibility of the false positive of cholescintigraphy.
원위기저 근막-피하조직 피판을 이용한 원위하지 및 족부재건
성낙관,손윤호,이무상,서만수 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.2
Reconstruction of soft tissue defects on the lower leg and foot remains a difficult challenge for surgeons. If the defect was large and complicated by bone defects, an excellent result could be obtained with free tissue transfer. In case of no bony problem, no major infection and relatively small defect, a local flap is more convenient and economic than free tissue transfer because of its simple, one-stage and reliable operation. The vascularization of the subcutaneous tissue reveals the predominance of the vascular network in this layer with regard to the dermal or fascial plane. The dermal vascular network at the donor site is sufficient to let the skin survive without its underlying subcutaneous vascular support. Distally based adipofascial flaps, nourished by the lower perforator originating from the major vessel as link pattern were used successfully for reconstruction of the bone and/or tendon exposure of the lower leg and foot in 10 patients. Between February 1992 and December 1995, ten cases underwent this procedure to reconstruct soft tissue defect on the lower leg and foot. The average age of the patients was 50.6 years (range5 - 73 years). Follow-up was from 10 months to 38 months (mean 21months). The average time of the operation was about 2 hours 18 minutes. The length to width ratio of adipofascial flap was 2.4-5:1 (mean 3.4:1). The advantages of this method are easy dissection, short operation, preservation of the major vascular pedicles of the lower limb, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar, and versatility (it is supple and can adapt to every surface, and it can be grafted on the deep or the superficial side). In conlcusion, this technique is an useful and alternative method for reconstruction of soft tissue defects on the lower leg and foot in selected cases.
박기혁,한영석,성낙관 대한혈관외과학회 2000 Vascular Specialist International Vol.16 No.2
Purpose: Proximal subclavian artery stenosis is relatively uncommon and usually asymptomatic. It is well known that the retrograde flow through ipsilateral vertebral artery is not related with onset of clinical symptom and not a definite indication of treatment. Method: We reviewed six patients including four patients who underwent percutaneous transluminal angioplasty to correct the difference of blood pressure between arms. Result: Nobody shows marked clinical improvement even though there was definite technical success. Conclusion: It is considered that angioplasty could be done for the treatment in most of subclavian artery stenosis.