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김홍섭,성원섭,양상국,노용수 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-
The prevalence of adrenal incidentalomas as discovered by ultrasound, CT scan and MRI are estimated to be 1 to 4.4%. The increasing occurrence of incidentally discovered benign adrenocortical tumors has become a clinical dilemma because of the difficulties in differentiating them from their malignant. Genetic alterations, such as LOH at the 17p13 and 11p15 loci and overexpression of the insulin-like growth factor-Ⅱ gene, are associated with the malignant phenotype in sporadic adrenocortical tumors. The most adrenal incidentalomas is benign and nonhypersecreting but all should be evaluated for hormonal activity and assessed for their risk of malignancy. Hormonal screening tests, including baseline cortisol and after dexamethasone, aldosterone-to-plasma renin activity ratio, DHEAS and catecholamines, are recommended to detect hypersecreting tumors. In all cases hormonal hypersecreting tumors(pheocromocytoma, hyperaldosteronism and subclinical hypercortisolism) should be removed. A difficult problem, however, is to distinguish between benign and malignant rimary or secondary tumors. Attenuation values on CT, chemical shift MRI, scintigraphy and FDG-PET reveal the nature of the mass in most cases. Radiologic evaluation by CT, MRI, scintigraphy and FDG-PET provide useful parameters toidentify malignant lesions. Size less than 4 ㎝ and an unenhanced CT attenuation under 10 HU are findings in favor of a benign adrenocortical adenomas. Norcholesterol and MIBG scans are able to detect benign tumors such as adenoma and pheochromocytoma, respectively. Conversely, FDG-PET allows for recognition of malignant adrenal lesions. Adrenalectomy is indicated for masses larger than 5 ㎝ in diameter or suspected of malignancy. Nonfunctioning cortical adenomas < 4 ㎝ size also should be followed clinically and radiographically. Laparoscopic adrenalectomy has been used increasingly as the preferred approach in patients who require surgical resection whereas open adrenalectomy is reserved for patients with > 6 ㎝ in size and malignant tumors. Fine needle aspiration biopsy should not be used routinely but reserved for cases suspected of other extra-adrenal malignancy.
중수골 골절 후 발생한 조갑판의 성장 장애- 4예 보고 -
이대희,허윤무,이진웅,남효종,성원섭 대한수부외과학회 2013 대한수부외과학회지 Vol.18 No.4
The fingernail is damaged and deformed by various causes such as crushing,laceration, avulsion injury, infection, tumor and personal habit. The growth disturbance of nail plate may be caused by systemic diseases or trauma without a direct injury of the fingernail and is usually found in accident. We experienced abnormal growth of nail plate in four patients with previous fractures of metacarpal bone. At about 8 weeks after trauma, a swelling and tenderness on the eponychium and a growth disturbance of affected nail plates occurred. All affected fingernails were treated with the nail extraction. The authors report four cases of growth disturbance of nail plates which obtained the satisfactory results by using the nail extraction. 조갑은 압궤 손상, 열상, 견열 손상, 개인의 습관, 감염, 종양 등 다양한 원인에 의하여 손상되고 변형이 발생한다. 조갑판의 성장 장애는 직접적인 외상이 없어도 전신 질환 또는 외상에 의해서 유발될 수 있으며 대부분 우연히 발견된다. 저자들은 중수골 골절 후 발생한 조갑판의 성장 장애를 4예 경험하였다. 이들은 외상이 발생하고 약 8주 후에 조상막의부종 및 압통과 손톱의 비정상적 성장을 호소하였다. 증상을 호소하는 모든 조갑에 대하여 조갑 적출술로 치료하였고만족스러운 결과를 얻었다.
Changes in Bone Mineral Density of Both Proximal Femurs after Total Knee Arthroplasty
김광균,원예연,허영무,이대희,윤정용,성원섭 대한정형외과학회 2014 Clinics in Orthopedic Surgery Vol.6 No.1
Background:This study investigated the effects of total knee arthroplasty (TKA) on bone mineral density (BMD) of the proximal femur in patients who underwent the procedure. Methods: Forty-eight patients scheduled to undergo unilateral TKA because of primary knee osteoarthritis were included in this study, which was conducted at a medical center between October 2006 and October 2009. In these 48 patients, 96 hips were evaluated. Measurement of BMD was performed preoperatively and one month, three months, six months, and one year after unilateral TKA. Repeated measured analysis of variance and paired t-tests for comparison of two repeated samples were used to compare differences between time points (preoperation, one, three, six, and 12 months) and between the operative and nonoperative sides. Results: Preoperatively, BMD of the femoral neck, trochanter, and total hip on the operative side were lower than on the nonoperative side; however, there was no statistical difference. BMD of both femoral neck areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both trochanter areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both total hips was significantly lower than preoperative BMD at three months after TKA. However, no statistical differences of changes in BMD were observed between the operative and nonoperative sides at each measurement time. Conclusions: According to our results, TKA was found to affect both proximal femurs during the acute period. However, TKA did not affect a change in BMD of the proximal femur during one year postoperative.
혈액투석 환자에서 경요도방광종양절제술 후 발생한 경요도절제후 증후군 2예
정은호 ( Eun Ho Jeong ),김은나 ( Eun Na Kim ),왕희배 ( Hee Bae Wang ),김태호 ( Tae Ho Kim ),박정석 ( Jeong Suk Park ),김태형 ( Tae Hyung Kim ),김진우 ( Jin Ou Kim ),서상렬 ( Sang Yeol Suh ),성원섭 ( Won Sub Seong ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.4
Transurethral resection syndrome (TURS) is one of the complications of endoscopic transurethral operation with irrigation fluid. TURS comprehensively refer to several clinical symptoms and signs caused by intravascular absorbtion of irrigation fluid, hypertension, bradycardia, arrhythmia, respiratory distress, hypotension, confusion, blindness, seizure, coma, hyponatremia, and hypoosmolarity. TURS is mainly known as the complication of the transurethral resection of prostate (TURP), and rarely found in the procedures such as transurethral resection of bladder tumor (TUR-BT), hysteroscopy, cystoscopy, and arthroscopy. Only a few cases of TURS after TUR-BT have been reported. The patients on maintenance hemodialysis were restricted in the amount of water intake for volume control. They were susceptible to the absorption of irrigation fluid during TUR-BT since they had anuria. We hereby report the 2 cases maintenance hemodialysis patients who were led to TURS after TUR-BT.