Multimodal Assessment of Magnitude of Necrosis after Laser Therapy in the Tracheobronchial Tree

여고은,한유진,옥소영,옥철호,장태원,정만홍,안예찬 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.-

Background: The extent of effects of laser on bronchial tissue are still unknown, and there could be a possible hazard of bronchial wall perforation. Purpose: We investigated microscopic appearance, histologic changes, EBUS and OCT image of damaged mucosal lesions after laser irradiation. Method: The laser system has diode laser with 810nm wave length. The rabbit trachea (n=20) was used for laser irradiation(2.5 J/cm2, 5 J/cm2, 10 J/cm2, 15 J/cm2) aftr euthanasia. We built an 850 nm spectrometer-based OCT system with a full width at half maximum of 100 nm was used. EBUS with20-MHz frequency ultrasonic radial probe (UM-BS20-26R; Olympus) were utilized. Result: Microscopic appearance after a 2.5 J/cm2 application revealed whitening of the mucosa with a small, well-defined lesion (0.11 mm (0.05-0.20)), 5 J/cm2 with submucosal damage, some charring (0.20 mm (0.10-0.35)). 10-15 J/cm2 with deeper crater-shaped lesions with tracheal cartilage perforation, more profound charring (0.52 mm, 1.22 mm respectively). Examination of EBUS and OCT image showed crater-shaped appearance of the mucosal lesions containing varying quantities of coagulation necrosis after 2.5-5 J/cm2. However, after 10-15 J/cm2 applications, cartilage damage was already seen. Conculsion: There is the good correlation between the visibility of mucosal damage during laser treatment, the finding of optical coherent tomogram, and the ultimate histologic changes is of great practical value.

기도 이물에 대한 굴곡성 기관지경을 이용한 냉동 제거술의 효용성

여고은,남성진,한유진,김은정,김남규,옥소영,이원형,옥철호,정만홍,장태원 고신대학교(의대) 고신대학교 의과대학 학술지 2014 고신대학교 의과대학 학술지 Vol.29 No.1

Objectives: Endobronchial foreign body impaction is a medical emergency because of the air way obstruction. Therefore, immediate foreign body removal is crucial in such situations. Recently, there have been several reports about cryoprobe use as a tool for removal of foreign bodies. In this study, we determined the efficacy and complications of foreign body removal using a cryoprobe during flexible bronchoscopy. Methods: This is a retrospective review of 27 patients who visited Kosin University Gospel Hospital from August 2007 to August 2010 with respiratory symptoms due to a foreign body in the airway. There were 17 males and 10 females, aged from 7 to 78 years. The foreign bodies were more frequently located (55%) in the right bronchus. The cryoprobe was inserted through the forceps channel of the flexible bronchoscope under local anesthesia. The lesion was quickly frozen for 5 seconds at -80℃, and the bronchoscope was removed with the probe after crystal formation on the contacted area. Results: The success rate of removal of foreign bodies was 85% (23/27) using the cryoprobe. One case of broncholith did not undergo attempted removal because of the possibility of excessive hemorrhage by the tight bronchus impaction, and three cases (plastic,silicon,and implant) failed due to limited crystal formation. There were no severe hemorrhages, arrhythmias, or casualties during the procedure. Conclusions: The removal of foreign body using a cryoprobe during flexible bronchoscopy was shown to be safe and effective. The nature of the material should be attempted before removing a foreign body.

우연히 발견된 십이지장 상피하 종양: 내시경 절제술로 치료된 신경절세포 부신경절종

여고은,권혜정,김재현,장희경,박정구 대한상부위장관ㆍ헬리코박터학회 2019 Korean Journal of Helicobacter Upper Gastrointesti Vol.19 No.2

Gangliocytic paraganglioma is a very rare tumor that is usually located in the duodenum. It is characterized by benign behavior and favorable outcomes; however, it sometimes shows regional lymph node metastasis. The clinical management of gangliocytic paraganglioma has not yet been standardized. A 36-year-old Korean man visited Kosin University Gospel Hospital for the management of a duodenal subepithelial mass that was detected incidentally. Endoscopic mucosal resection was performed without any adverse events. Pathological examination of the resected specimen revealed gangliocytic paraganglioma. The patient has remained in good health during the 6 months of follow-up after the procedure.

Usefulness of Rapid On site Microscopic Evaluation (ROME) of Core Biosy-specimen to Improve Diagnostic Efficasy of EBUS-TBNA

옥소영,여고은,한유진,옥철호,장태원,정만홍,천봉권 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.-

Background: EBUS-TBNA is performed to harvest cytologic and core-biopsy specimen. Although feedback from rapid cytology tests are expected to improve diagnostic rates, the value of the routine use of rapid cytology tests has not been established. Puorpose: We evaluated the clinical relevancy of Rapid on site microscopic evaluation (ROME) of core-biopsy specimens using USB microscope. Methods: We performed ROME in 20 core-biopsy specimens after EBUS-TBNA. The core-biopsy specimens were classified to five groups under microscopic view. The first group have no visual evidence of whitish tumor islet (-). The second group have one or several tiny suspicious tumor islet (-/+). The third group have less than 5 visible tumor islets (+). The fourth group have 5-10 ten tumor islets (++), The fifth group have more than 10 tumor islets (+++). The ROME was compared with final pathologic examination. Results: Among 20 specimens, 3 (15%) specimens were classified as first group (-), 2 (10%) as second group (-/+), 5 (25%) as third group (+), 7 (35%) as fourth group (++), 3(15%) as fifth group, respectively. 100% (10/10) clinical relevancy was confirmed in the fourth, the fifth group with 90% (9/10) diagnostic rate. 70% (5/7) clinical relevancy was confirmed in third group with 57% diagnostic rate (4/7). There was no clinical relevancy(5/5) in the first group and second group with no diagnostic value (5/5). Conclusion: ROME have usefullness for predicting the diagnostic value and clinical relevancy in EBUS-core biops specimens. The further study would be warranted to suppor the usefulness of ROME.

Kano Test for Social Nicotine Dependence (KTSND-K) 설문지를 이용한 폐암환자의 사회적 니코틴 의존도

한유진,여고은,옥소영,옥철호,장태원,정만홍,( Chiharu Yoshii ) 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.0

연구배경: 흡연은 많은 질병과 사망의 가장 중요한 원인이나 니코틴의존성으로 인해 금연이 어렵고 이로 인한 사회적, 의료적 손실이 증가함에도 불구하고 개선되지 못하고 있다. 한국인의 니코틴의존성에 관해 일반인에 대하여 선행연구가 있어왔지만 폐암환자에 대한 연구는 없어서 본 연구는 폐암환자의 사회, 문화적 니코틴의존성을 알아보고자 하였다. 방법: 2012년 3월부터 8월까지 고신대학교 복음병원에서 폐암으로 처음 진단된 환자들을 대상으로 KTSND-K 설문지를 이용하여 흡연에 관한 의식 조사를 시행하였다. 총 100명 중 평균 연령은 65.8±11.6세이었 고, 남자는 68명(68.8%)이었다. 흡연력은 현재흡연자 24명 (24.0%), 과거흡연자 47명(47.0%), 비흡연자 29명(29.0%)이었다. 조직형에 따라 편평상피암세포암 50명(50%), 선암 40명(40%), 소세포폐암 10명(10.0%)이었다. 결과: 폐암환자의 KTSND총점은 12.84±5.65였다. 흡연력에 따른 KTSND 총점은 남녀 각각 13.51±6.12, 12.01±5.72로 흡연율이 높은 남성이 유의하게 높게 나타났다(p<0.001). 현재흡연자, 과거흡연자, 비흡연자에서 각각 13.85±5.87, 14.21±5.65, 10.48±5.16으로 흡연자일수록 의미 있게 높게 나타났다(p<0.001). 결론: KTSND 설문지는 폐암환자의 사회적 니코틴의존성을 평가할 수 있는 유용한 방법이 될 수 있다고 생각된다.

앉은 자세에서 탄력밴드를 이용한 PNF 팔 패턴의 방산효과가 골반의 압력에 미치는 영향

양재만,여고은,김동욱,이정훈 대한고유수용성신경근촉진법학회 2019 PNF and Movement Vol.17 No.3

Purpose: This study evaluated the relationship between pelvic pressure and irradiation of the proprioceptive neuromuscular facilitation (PNF) upper arm pattern exercises with an elastic band while in a sitting position. Methods: Fourteen subjects with asymptomatic pelvic pressure participated in this study. Pelvic pressure was measured using a Gaitview® system while sitting and performing PNF bilateral upper arm patterns. Resistance strength was provided by the blue elastic band. The statistical significance of the results was evaluated using a repeated one-way ANOVA and the independent t-test. The Bonferroni method was used for the post-hoc test. Results: The results revealed a significant change in the pelvic pressure when performing the PNF arm pattern. The average resistance pressure on the pelvis, with the elastic band, significantly increased after the initial sitting position (F=3.91, 3.92; p<0.05). No significant pelvic pressure changes were noted for each PNF upper arm pattern (p>0.05). Conclusion: The results of this study showed a positive relationship between pelvic pressure and the irradiation of PNF upper arm pattern exercises with resistance in the sitting position.

2000년도 이후에 진단된 중심성 폐암과 말초성 폐암의 임상적 차이

옥소영,장태원,한유진,여고은,김은정,이원형,김남규 고신대학교(의대) 고신대학교 의과대학 학술지 2014 고신대학교 의과대학 학술지 Vol.29 No.1

Objectives: The aim of this study was to explore the changes of bronchoscopic features according to epidemiologic change of lung cancer. Methods: We performed a retrospective review of the clinical characteristics of 1,139 lung cancer patient who underwent bronchoscopy at Kosin University Hospital from January 2000 to December 2010. Results: The age of patients increased significantly during the last decade (P < 0.001). The most common histological type was adenocarcinoma (38.1%), followed by squamous carcinoma (35.7%) and small cell carcinoma (15.3%). There was an increasing incidence of adenocarcinoma over the time (P < 0.001). Bronchoscopic feature were divided into two classes; central type, peripheral type. The peripheral type was predominant (62.3%). The proportion of peripheral type has been increased in process of time (49.7% vs. 63.7% vs. 73.7%; P < 0.01). Among the major histopathologic type of lung cancer, adenocarcinoma (81.3%) and unclassifiable non-small-cell lung cancer (73.4%), small cell carcinoma (56.9%) were associated with preferential occurrence of peripheral type. Squamous cell carcinoma of the lung more often arised in central type (59%). However, the proportion of peripheral squamous cell carcinoma has been increased. On the subgroup analysis, the median survival time of peripheral type with adenocarcinoma and small cell carcinoma were longer than central type (P < 0.05). Conclusions: The age of the lung cancer patients at diagnosis was getting older. The most frequent histopathologic type was adenocarcinoma. The proportion of peripheral type lung cancer gradually increased over the time. The survival time of peripheral type lung cancer was longer than central type.

여포성 종양 또는 휘틀세포 종양에서 암의 진단에 있어 수술전 혈청 갑상선글로불린의 진단적 가치

김남규,강성주,이원형,여고은,한유진,김부경,권수경,박요한,최영식 고신대학교(의대) 고신대학교 의과대학 학술지 2014 고신대학교 의과대학 학술지 Vol.29 No.1

Objectives: The aim of this retrospective study was whether serum Tg predicts malignancy in follicular or Hürthle-cell neoplasms on fine needle aspiration. Methods: A chart review of 111 patients (90 females, 21 males; mean age 46.8 ± 11.9 years) with follicular or Hürthle-cell neoplasms on fine needle aspiration, who were surgically treated between Sep. 2001 and Sep. 2011, was performed. Predictive factors for malignancy were identified by the chi-squared test and multivariate logistic regression. Results: There were no differences between 41 malignant and 70 benign lesions in serum Tg or any of the normalized indexes. Receiver-operator characteristic analysis revealed no cut-off value. Lesions with serum Tg levels greater than 500 g/L had no significant difference. And also there were no independent predictors of malignancy by multivariate logistic regression. Conclusions: In this study, the author found that serum Tg has poor accuracy for predicting malignancy in follicular or Hürthle cell neoplasms on fine needle aspiration.

A Case of Ischemic Colitis Related with Usual Dosage of Ibuprofen in a Young Man

김은정,박무인,박선자,문원,여고은,이원형 고신대학교(의대) 고신대학교 의과대학 학술지 2014 고신대학교 의과대학 학술지 Vol.29 No.2

Ischemic colitis is a medical condition in which inflammation and injury of the large intestine result from inadequate blood supply. Although uncommon in the general population, ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia. Other possible causes include medications such as NSAIDs(non-steroidal antiinflammatory drugs), oral contraceptives, diuretics and others. In recent years, many of NSAID use in young age can cause ischemic lesions, but it is not common. Here we report a case of ischemic colitis in a 31-year-old man who had no specific medical history except taking 200mg of ibuprofen three times a day for seven days. It suggests the importance of precise history taking, including medications usage such as NSAIDs and other risk factors.

The Impacts of C-Reactive Protein and Atrial Fibrillation on Carotid Atherosclerosis and Ischemic Stroke in Patients with Suspected Ischemic Cerebrovascular Disease:A Single-Center Retrospective Observational Cohort Study

옥소영,조경임,김형준,이나영,김은정,김남규,이원형,여고은,허재준,한유진,차태준 대한심장학회 2013 Korean Circulation Journal Vol.43 No.12

Background and Objectives: Carotid intima-media thickness (IMT) is associated with chronic inflammation, and C-reactive protein (CRP)level is elevated in patients with atrial fibrillation (AF). We investigated the impacts of CRP and AF on carotid atherosclerosis and ischemic stroke in patients with suspected ischemic cerebrovascular disease. Subjects and Methods: One-hundred forty patients (78 males) with suspected ischemic cerebrovascular disease underwent carotid ultrasonography. The mean common carotid artery IMT, mean internal carotid artery (ICA) IMT, and plaque score were measured. Patients were divided into four groups according to the presence of AF and elevated CRP level {n=46 for AF(-)CRP(-), n=38 for AF(-)CRP(+), n=43for AF(+)CRP(-), and n=13 for AF(+)CRP(+)}. Results: Common carotid artery IMT was significantly higher in the AF(-)CRP(+) (0.98±0.51 mm) and AF(+)CRP(+) (0.96±0.27 mm)groups compared to the AF(-)CRP(-) (0.80±0.32 mm) and AF(+)CRP(-) (0.77±0.19 mm) groups (p=0.027). Although there was no significant difference in mean ICA IMT among the groups, plaque score was the highest in the AF(+)CRP(+) (4.18±3.84 mm) group, followed by AF(-)CRP(+) (3.87±2.78 mm), AF(+)CRP(-) (1.34±2.61 mm), and AF(-)CRP(-) (1.17±2.02 mm) (p<0.001). The AF(+)CRP(+) group showed significantly higher incidence of ischemic stroke than the other groups (all p<0.05). Binary logistic regression analysis showed that age {odds ratio (OR)=1.033, p=0.001}, elevated CRP (OR=3.884, p=0.001), and the presence of AF (OR=1.375, p=0.018) were significantly correlated with incidence of ischemic stroke. Conclusion: Elevated plasma CRP concentration may be a reliable surrogate marker for predicting carotid atherosclerosis in patients with AF, which may be related to increased risk of ischemic stroke.