폐결핵 잔류병변에 대한 폐늑막 절제술 100례

손광현,이남수,Son, Gwang-Hyeon,Lee, Nam-Su 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.1

During the period of seven years from Jan. 1976 to Jan. 1983, one hundred cases of pulmonary tuberculous residual lesions were resected at the Department of Thoracic Surgery, Paik Hospital in Seoul, Korea. During the period of this study, 1764 patients were admitted with the diagnosis of pulmonary and/or pleural tuberculosis in the medical and surgical department as a primary or associated conditions. Among these 1764 patients, one hundred selective cases were operated. The results were as follows; l. Extents of the disease by the predominant clinical pictures were: totally destroyed lung; 18, destroyed lobe; 6, cavitary lesion with or without positive sputum; 35, bronchiectasis; 7, bronchostenosis with atelectasis; 2, empyema with or without BPF; 20, pleural thickening; 4, tuberculoma; 3, bullous cyst with tuberculosis; 5 cases, or per cent [Table 1]. 2. Male and female ratio was 1.2:1 or 55 and 45 per cent. Age distribution ranged 15 and 55 with average of 33 years [Table 2]. 3. Type of procedures were: pleuropneumonectomy; 15, pneumonectomy; 25, lobectomy; 37, bilobectomy; 6, lobectomy plus segmentectomy; 3, pleurectomy; 14 cases, or percent, Site of resections were: right; 58 and left; 42 cases, or per cent [Table 3]. 4. Incidence of complications were 10 per cent and the mortality was 4 per cent. The causes of morbidity were analyzed. The main causes of death were pulmonary insufficiency; 2, cardiac arrhythmia; 1, and hepatic insufficiency; 1 case or per cent [Table 4]. 5. Pathologic examinations of the resected pulmonary and pleuropulmonary lesions were observed by gross specimen, correlating with the pre-operative indications of the disease [Fig. 1, 2, 3, 4, 5, 6].>br> 6. Anti-tuberculous chemotherapy was done for 6 to 18 months, post-operatively, in 80 patients. Of these 49 cases were need medication for 12 months [Table 5]. Except the four operative mortality and a case of post-operative recurrent buberculosis under medication, all the other 95 cases are well in activity and free from the disease at the moment.

미세골절술 후 생체막 덮개가 연골 재생에 미치는 영향 : 고식적인 미세골절술과의 전향적 비교 연구

손광현,김진호,곽규성,박장원,윤경호,민병현,Son, Kwang-Hyun,Kim, Jin-Ho,Kwak, Kyu-Sung,Park, Jang-Won,Yoon, Kyoung Ho,Min, Byoung-Hyun 대한관절경학회 2011 대한관절경학회지 Vol.15 No.2

목적: 슬관절의 연골 결손에 대한 미세골절술 후 병변을 덮는 생체막을 이용한 환자들의 치료 결과를 비교, 분석하고자 한다. 대상 및 방법: 2008년 1월부터 2010년 1월까지 관절경 검사로 확인된 슬관절 연골의 국소적 전층 결손이 있으며, 골관절염을 보이지 않는 53명(총 59례)의 환자를 대상으로 하였다. 무작위로 선정된 36명(42례)은 미세골절술 후 생체막으로 병변을 덮어주었고(실험군), 나머지 17명(17례)은 고식적인 미세골절술만을 시행받았다(대조군). 모든 환자는 수술 후 6개월째에 임상적 결과를 IKDC 설문지와 통증, 만족도에 대한 VAS 점수를 이용하여 비교하였고, 자기공명영상 촬영을 통해 골연골 병변의 회복 상태를 비교하였다. 결과: 임상 결과(IKDC, 통증 VAS, 만족도 VAS)에서 실험군이 대체로 더 우수하였으며 IKDC에서는 두 군 간의 통계적으로 유의한 차이를 보였다. (IKDC, p=0.047, 통증 VAS, p=0.074; 만족도 VAS, p=0.001). MRI 추시결과에서 실험군의 33명(78.6%)에서 우수한 결손 치유(67~100%)를 보이고, 5명(11.9%)만이 불량한 치유 소견을 보인 반면, 대조군에서는 4명(23.5%)의 환자에서 양호한 결손 치유가 관찰되고 9명(52.9%)의 환자들에서 결손 치유가 불량하였다(p=0.001). 실험군에서 35명(83.3%), 대조군 중 6명(35.3%)에서 변연부 결합부에서 간격이 관찰되지 않았다(p=0.001). 생체막 사용과 관련하여 심각한 부작용은 발견되지 않았다. 결론: 슬관절의 연골 결손 병변에 대해 미세골절술 후 생체막으로 도포한 군에서 단기 추시 임상적 결과 및 MRI를 이용한 영상학적 결과에서 결손부의 연골재생이 잘 된 것을 확인하였고, 미세골절술 후 ArtiFilm$^{TM}$을 함께 사용했던 군에서 연골 치유가 더 잘되는 경향이 있음을 시사한다. Purpose: Microfracture has been used as a first-line treatment to repair articular cartilage defects. In this study, a new technique using an extracelluar matrix biomembrane to cover the cartilage lesions after microfracture was evaluated in terms of cartilage repairability and clinical outcome compared with conventional microfracture technique in a prospective randomized trial. Materials and Methods: A total of 53 patients (59 cases) without osteoarthritis who had focal full thickness articular cartilage lesions were randomly assigned in two group. Seventeen patients (17 cases) underwent conventional microfracture procedure (control group) and thirty-six patients (42 cases) received microfracture and placing biomembrane cover (ArtiFilm$^{TM}$) concomitantly (experimental group). Clinical assessment was done through 6 months postoperatively using the subjective International Knee Documentation Committee IKDC questionnaire, and visual analog scale (VAS) for pain and satisfaction. Magnetic resonance imaging (MRI) was performed at 6 months after the operation in all patients. Results: In clinical outcomes, the significant difference was observed between both groups in IKDC, but not in VAS for pain and for satisfaction (final outcomes of IKDC, p=0.001; VAS for pain, p=0.074; VAS for satisfaction, p=0.194). The MRI showed good to complete defect fill (67 to 100%) in 33 patients (78.6%) of experimental group and 4 patients (23.5%) of control group, respectively. In control group, 9 of 17 patients (52.9%) showed poor defect fill (less than 33%), whereas 5 (11.9%) in experimental group (p=0.001). Assessment of peripheral integration revealed no gap formation in 35 patients (83.3%) in experimental group and 6 patients (35.3%) in control group (p=0.001). No serious complications or adverse effects related to the biomembrane were found. Conclusion: Good short-term follow-up clinical results were obtained in the group whose cartilage defects in the knee joint were covered with biomembrane after the microfracture, with the MRI findings confirming the excellent regeneration of the defective cartilage area. This suggests that the surgery to cover the defective area with biomembrane (ArtiFilm$^{TM}$) after the microfracture procedure is a safe, more effective treatment to induce cartilage regeneration.

최근 5년간의 흉부손상 경험 -481 예-

손광현,구본일,김태영,Son, Gwang-Hyeon,Gu, Bon-Il,Kim, Tae-Yeong 대한흉부심장혈관외과학회 1986 Journal of Chest Surgery (J Chest Surg) Vol.19 No.3

From January 1981 through December 1985, 481 thoracic civilian injuries were reviewed in the Department of Thoracic Surgery, Paik Hospital in Seoul. Sixty two percent of the injuries were caused by traffic accident, 18% fall down, 15% blunt trauma, 2% crushing injury, 2% stab wound, and 0.4% gunshot wound. Peak incidence of the trauma victim was fourth and fifth decades revealing 22% and 27% respectively. Sex ratio was 3.5:1 with male predominance. Elapsed time before admission was less than one hour in 36% and one to six hour in 30%. The types of the injuries were as follows: Non-penetrating injuries were the most part of the wounded, 97.6%. Rib fracture was the most common lesion occupying 292 patient out of 481 [61%]. Of these 292 patients, 72% was multiple rib fracture. The incidence of hemothorax or hemopneumothorax was 19% [102 patients] [Table 4]. Most common associated condition was head injuries, 98 patients [14%]. Thoracoabdominal injuries were seen in 31 patients [0.6%]. Tube thoracostomy was the definitive measures in the 20% of the wounded. Open thoractomy was performed in 5%. Additional procedures for the associated condition were done in the 16% of the cases, for example, reduction of long bone fracture and trephination for the head injury. Among 481 wounded, fatal complication occurred in 13 patients [2.7%]. This paper has also compared two series of patients according to period; one from 1970 to 1980 and the present series [Table 8]. Conclusively, the fatal complications or trauma death may be reduced by the effort 1] rapid transport of the victim, 2] initial correction or resuscitative measures of the circulatory and ventilatory deficit 3] early decision of definitive thoracostomy or thoracotomy and 4] proper prioritizing for the care of the multiple critically injured patient.

간질의 분류법에 대한 동서의학적 문헌고찰 및 새로운 제안

손광현,김문주,Son, Kwang-Hyun,Kim, Moon-Ju 대한예방한의학회 2010 대한예방한의학회지 Vol.14 No.2

The major purpose of this study is to evaluate the classification of epileptic seizure types and epilepsy described in the literatures of both Western and East Asian medicine, especially based on the two criteria- a theoretical and a practical aspect of the classification systems. Currently, the 1981 classification of epileptic seizure types, and the 1989 classification of epilepsy syndromes and epilepsies which were proposed and approved by the International League Against Epilepsy(ILAE) have been generally accepted worldwide, although a variety of modifications have been consistently suggested. A large proportion of epilepsy cases cannot be easily classified as either 'focal' or 'generalized' or as either 'symptomatic' or 'idiopathic', so they fail to be precisely fallen into any of the ILAE categories. Terms and concepts used in the East Asian medicine are also inadequate to identify epileptic seizure types and epilepsy syndromes as discrete diagnostic entities because of ambiguities in definition and use. Therefore, this article suggests an alternative approach not only more helpful in understanding mechanism of epilepsy but also more easily applicable and effective in clinical value.

화제의 통어현상과 주어도치의 통사구조

손광현 청주대학교 인문과학연구소 1994 人文科學論集 Vol.13 No.-

발화행위의 기능적 제 양상 연구

손광현(Son Gwang-Hyun) 한국프랑스문화학회 2005 프랑스문화연구 Vol.11 No.-

Si l’on classifie les deux grandes tendances dans l’étude de la recherche linguistique, on trouve d’une part l’approche formelle dans laquelle la forme et la structure de la langue prennent la place la plus importante et d’autre part l’approche fonctionnelle dans laquelle la langue est expliquée par rapport à la fonction communicative du langage et au sens dans la situation de discours. Parmi ces deux approches, la première souligne le mécanisme explicatif et explicite qui permet premièrement de générer des phrases bien formées grammaticalement, et deuxièmement de rendre possible la description adéquate de la structure de la phrase. C’est pourquoi des éléments pragmatiques comme le contexte, la situation, le sens sont négligés en tant que phénomènes extralinguistiques. La deuxième considère, au contraire, que la langue n’est pas un système de dignes isolés par la situation de l’énonciation mais un système de communication avec lequel nous pouvons communiquer l’un l’autre. Nous devrions certes tenir compte de la structure syntaxique fondamentale et de la forme de la langue dans les recherches linguistiques parce que la langue elle-même possède des principes formels qui gouvernent ses diverses formes. C’est cette perspective que nous nous sommes proposés d’étudier dans cette thèse, à travers l’étude de la perspective fonctionnelle de l’énoncé et du rôle sématique du thème contrôlant la structure syntaxique en français moderne. Pour cela, nous avons commencé par critiquer les devers critères objectifs du thème, de l’école de Prague, pour en dégager quelques points qui nous paraissaient problèmatiques. Nous avons ensuite examiné quelques aspects de la syntaxe réalisés dans une phrase, afin d’en dégager les phénomènes de perspective fonctionnelle de l’énoncé, ce qui nous permet de mieux percevoir la fonction communicative des unités linguistiques au sein d’une phrase. Il en résulte que: en premier lieu nous constatons, dans l’étude du thème-rhème articulation, que l’on ne peut pas obtenir de résultats satisfaisants si l’on s’attache uniquement à la structure syntaxique, et en deuxième lieu, qu’il n’est possible d’obtenir un résultat satisfaisant que si l’on éffectue sa recherche dans le cadre de la situation de l’énoncé comprenant le contexte et les éléments sémantiques. Cette approche nous a également permis de saisir les points essentiels des phénomènes linguistiques obéissant à la notion de F.S.P. notament les aspects de F.S.P. reflètant l’intention du locuteur à travers l’utilisation de la forme passive et de la structure ségmentée. En s’appuyant sur cette méthode, nous avons compris que le thème jouait un rôle important pour éclaire la construction de l’inversion, et celle de la substitution de EN représentant 「de+SN」. Nous avons pu en déduire que la notion de fonction du thème telle que nous l’avons perçue dans cette étude est directement applicable à la recherche de solutions dans l’analyse syntaxique pour des problèmes pour lesquels la perspective formelle n’offre pas de solution. A travers notre travail, nous avons préssenti l’exigence d’une approche inter-complémentaire au niveau de l’analyse fonctionelle et de l’analyse formelle. Nous pensons que c’est dans une telle présupposition qu’il sera possible d’effectuer une analyse com

발화행위의 기능적 제 양산 연구

손광현 ( Gwang Hyun Son ) 한국프랑스문화학회 2005 프랑스문화연구 Vol.11 No.-

Bacillus subtilis로부터 항진균 리포펩타이드 물질 Iturin의 생산

손광현(Kwang-Hyun Son),이항우(Hang-Woo Lee),김성욱(Sung-Uk Kim),복성해(Sung-Hae Bok),김정회(Jung-Hoe Kim) 한국생물공학회 1994 KSBB Journal Vol.9 No.2

Localized pleural mesothelioma -수술치험 1예-

구본일,손광현,고일향,Gu, Bon-Il,Son, Gwang-Hyeon,Go, Il-Hyang 대한흉부심장혈관외과학회 1986 Journal of Chest Surgery (J Chest Surg) Vol.19 No.2

Pleural mesothelioma is the tumor of the cell of mesodermal origin lining the pleura. It is relatively uncommon tumor and its localized form is much rarer than diffuse form. Authors experienced a localized mesothelioma in a patient who was 44 year old male worker at copper plumbing field for 20 years, and admitted due to incidentally found abnormal chest X-ray. Exploratory thoracotomy was done and a 23 x 16 x 8 cm sized solitary mass was resected with adherent right middle lobe. Low grade malignancy of the pleural mesothelioma was confirmed by the pathology. We report the case with a literature review.

폐 국균증의 수술적 치료

박승일,손광현,Park, Seung-Il,Son, Gwang-Hyeon 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.10

Pulmonary aspergilloma resulting from colonization of Aspergillus fumigatus is potentially life-threatening disease due to massive hemoptysis. Between August 1990 and November 1993, twelve patients were operated for the treatment of pulmonary aspergilloma. The mean age was 38.8 years. All patients had underlying cavitary lung disease, and the tuberculosis is the most common cause. Ten patients have experienced hemoptysis, but the clinical presentation of hemoptysis at the time of operation was mostly intermittent and scanty. Operative procedures were segmentectomy in 1 patient, lobectomy in 8, pneumonectomy in 2, and pleuropneumonectomy in 1. There were three complications, bronchopleural fistula in one patient and prolonged air leak in 2. There was no postoperative death. Conclusively, our results suggest that established aspergilloma associated with tuberculosis or other cavitary lesions should undergo early elective pulmonary resection, even though it has only minimal hemoptysis.