선천성 갑상선 발육이상 9例에 대한 보고

이삼열(Sam uel Lee),이석재(Seug Zae Lee),이혁진(Hyouk Jin Lee),전성은(Seong Eun Chon),박윤규(Yoon Kyu Park) 대한두경부종양학회 1994 대한두경부 종양학회지 Vol.10 No.2

1) 선천성 갑상선 발육이상 환자 9명 모두, 경부종피를 호소하였으며, 이 중 1예는 연하통을 동반하였다. 2) 선천성 갑상선 발육이상을 세분하여보면, 이소성갑상선이 44.4%,편측발육부전 및 이소성갑상선을 동반한 경우가 33.3%였고, 편측발육부전을 보인 경우가 22.2%였다. 3) 이소성갑상선을 위치별로 보면 설기저부가 6예(85.7%-1예 중복됨), 갑상설관이 2예였다. 4) 정상 갑상선기능을 보인 경우가 77.8%였고, 갑상선기능저하증을 보인 경우가 22.2%였다. 정상기능을 보인 7명의 환자 중 4명에서 갑상선자극호르몬(TSH)이 증가되어 있었다. 5) 총 9명중 7명에서는 갑상선억제요법만 시행하였고, 2명에서는 갑상선억제요법에 반응하지 않아 절제술을 시행하였으며, 2명 모두 설갑상선이었다. 수술후 계속적으로 갑상선호르몬을 복용중이다. Congenital thyroid dysgenesis including agenesis, hypoplasia and ectopia is the predominant cause of permanent hypothyroidism. Of these, two thirds are due to an ectopic thyroid and about one third to complete thyroid agensis. From Jan. 1981 to Dec. 1992, authors experienced the 9 cases of congenital thyroid dysgenesis. Aberrent thyroid was 4 cases (44.4%), thyroid hemiagenesis with aberrent thyroid was 3 cases(33.3%) and thyroid hemiagenesis was 2 cases(22.2%). The most predominant site of aberrent thyroid is the base of tongue(85.7%). 7 patients(77.8%) revealed euthyroidism and among them, 4 patients showed elevated TSH level. Hypothyroidism was 2 patients (22.2%). 7 cases responded to thyroid suppressive therapy. 2 cases of lingual thyroid which did not responed to thyroid suppressive therapy underwent surgery and they have placed on thyroid suppressive therapy postoperatively.

신장 이식 후 발생한 Kaposi 육종에서 sirolimus와 vincristine으로 치료한

이승민 ( Seung Min Lee ),박소연 ( So Yeon Park ),김수진 ( Soo Jin Kim ),송영수 ( Young Soo Song ),송헌호 ( Heon Ho Song ),이삼열 ( Sam Uel Lee ),남은숙 ( Eun Sook Nam ),오지은 ( Ji Eun Oh ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.1

The incidence of Kaposi`s sarcoma (KS) increases in kidney transplant recipients who had the immunosuppressive therapy. The usual treatment of KS is to reduce the dosage of immunosuppressive agents, with chemotherapy and/or radiotherapy. Several studies have recently demonstrated that the conversion to proliferation signal inhibitors (PSIs) from calcineurin inhibitors (CNI) leads to the remission of some post-transplant tumors such as KS. PSIs were well tolerated with stable renal function and no episode of acute rejection was reported. On the basis of these findings, we report a case of Kaposi`s sarcoma in the kidney transplant patient, who had multiple lymphadenopathy and hepatic involvement without skin lesions. This patient responded well to the change of the immunosuppressive treatment from cyclosporine to sirolimus, one of PSIs.

두경부 신경성 종양에 관한 임상적 고찰

박철오(Cheol Oh Park),이삼열(Sam Uel Lee),오성수(Sung Soo Oh),박윤규(Yoon Kyu Park) 대한두경부종양학회 1993 대한두경부 종양학회지 Vol.9 No.1

A group of 49 patients with neurogenic tumor in head and neck except intracranial tumor & Von-recklinghausen's disease was treated at the Department of Surgery. Presbyterian Medical Center during 12 years from January, 1980 to December, 1991. Of the 49 cases, 24 cases were neurilemmoma, 23 cases neurofibroma and 2 cases malignant schwannoma. The lateral cervical region was the commonest location of the neurogenic tumors, 24 cases (49%) arose from posterior triangle of neck and 12 cases from anterior triangle of neck. The origin of nerve was identified in 28 cases(57%). Cervical plexus(10 cases) and brachial plexus(7 cases) were most commonly affected. The most common site of neurogenic tumors arose from cranial nerve was anterior cervical triangle.

Clinical Outcome of Multicenter Domino-Kidney Transplant

이유지 ( Yu Ji Lee ),김대중 ( Dae Joong Kim ),이삼열 ( Sam Uel Lee ),정상영 ( Sang Young Chung ),조백환 ( Baik Hwan Cho ),곽진영 ( Jin Young Kwak ),강종명 ( Chong Myung Kang ),한덕종 ( Duck Jong Han ) 대한신장학회 2008 춘계학술대회 초록집 Vol.28 No.1

Coagglutination에 의한 $\beta$-용혈성 연쇄구균의 혈청군 동정

정윤섭,윤양숙,김윤정,이삼열,김성광,이병수,김주덕,Chong, Yun-Sop,Yoon, Yang-Sook,Kim, Yoon-Chung,Lee, Sam-Uel Y.,Kim, Sung-Kwang,Lee, Byung-Soo,Kim, Joo-Deuk 대한미생물학회 1979 大韓微生物學會誌 Vol.14 No.1

Identification of group A $\beta$-phemolytic streptococci is very important to provide an appropriate preventive measure of possible rheumatic fever and acute glomerulonephritis. For such purpose bacitracin susceptibility of streptococci because of its simplity has been most widely used despite of its occasional faulty results. Recently, a coagglutination technique was advocated using streptococcal group specific antibodies adsorbed to protein A-containing staphylococci. This study was conducted to evaluate the coagglutination technique using reagents prepared by ourselves. The specificity, reproducibility and stability were ascertained and the following results were obtained. 1. The identification by coagglutination technique using our own reagent gave the same results compared with the Lancefield precipitation technique. The result also agreed with the Phadebact grouping. 2. There were no variation in group A and B identification due to lot difference. However, there were a few discrepant results in group C and G identification which was conducted in different days with different lots of our reagent. 3. The stability of our reagents was less satisfactory compared to the commercial product. An effort to improve the stability was considered necessary. 4. For coagglutination, it was found convenient to use supernatant of Todd-Hewitt broth incubated for 24 hours. Both parafin-ringed slide glass and RPR card gave comparable results and the former could be used when the latter is not available.

갑상선 결절 1547예에 대한 임상적고찰

박원갑(Weon Gap Park),이삼열(Sam uel Lee),오성수(Sung Soo Oh),박윤규(Yoon Kyu Park) 대한두경부종양학회 1992 대한두경부 종양학회지 Vol.8 No.2

A pathologic review was made of 1547 cases of thyroid nodule during the 20 years from 1970 to 1989 at the department of Head and Neck surgery of Presbyterian Medical Center in Chonju. 1547 cases were analysed in regard to cancer incidence of thyroid nodule, correlation of preoperative diagnosis with pathology and of frozen section diagnosis with final pathology, surgical procedures employed in managing thyroid itself, location of metastatic nodes, further definite procedure in cnacer cases, effectiveness of prophylactic neck dissection with lymph node pathology. The results are summarized as follows: 1) The cancer incidence of thyroid nodule was 21.7%. 2) The incidence of thyroid cnacer in total neoplasms increased from 1.6% to 2.9%. 3) The thyroid cancer was prevalent in female(5.9:1) and in fifth, fourth and sixth decade of life. 4) The incidence of solitary cold nodule in thyroid cancer was 72.7% (210/289). 5) The incidence of thyroid cancer in solitary cold nodule was 28.7% (210/782). 6) The false negative of frozen section (1240 cases) was 19.8%. 7) Histologically, well differentiated carcinoma comprises about 94% of all cases and papillary carcinoma was 78.5% of all cases 8) The most frequent lymphatic metastasis was pre- & paratrachel nodes(63.3%), followed by Level III(50%) and Level II(47.7%). 9) 47.7% among 130 cases of papillary adenocarcinoma and 12.5% among 16 cases of follicular adenocarcinoma, each group treated with prophylactic neck dissection, were confirmed to be occult cervical node metastasis.

Survival Value of Myocutaneous Flaps in the Management of Epidermoid Carcioma of the Oral Cavity

설대위(David John Seel),박철영(Chul Young Park),유정준(Chung Joon Yoo),이삼열(Sam uel Lee),박윤규(Yoon Kyu Park) 대한두경부종양학회 1990 대한두경부 종양학회지 Vol.6 No.2

본 논문은 구강암의 근치적 절제술후 결손부위 재건을 위한 근피부판(myocutaneous flaps)이 환자의 생존율에 미치는 의의를 알아보고자 저자들의 경험을 살펴본 것이다. 1974년부터 1988년까지, 만 15년간 98명의 환자들이 구강 및 구인두 부위에 발생한 암으로 절제술을 받았다. 이 중 14명은 하악골 절제술없이 근치적 복합적 절제술(composite resection)을 받았으며, 4명은 방사선 조사후 재발한 경우로서 경부곽청술없이 광범위 단순절제술(enbloc resection)만을 시행받았다. 이들을 제외한 근피부판을 사용또는, 사용하지 않은 COMMANDO를 시행받은 84명의 나머지 환자들을 대상으로 여러가지 술식에 따른 재발율 및 생존율을 비교 분석하여보았다. 1) 술기에 있어서 국소 또는 근피부판을 사용하지않은 표준 COMMANDO술식이 24 예, 전두피부판(forehead flap)을 사용하여 재건한 경우가 12 예, 후경부피부판(Nape flap)을 사용한 경우가 19 예, 큰피부판 또는 골근피부판(osteomyocutaneous flap)을 사용한 경우가 27 예였으며 두 종류의 피부판 복원을 시행한 경우가 2 예였다. 2) 비교정(uncorrected) 2년 무병생존율은 표준 COMMANDO가 14%, 전두피부판을 이용한 COMMANDO가 17%, 후경부피부판 사용 COMMANDO가 35% 이었으며 근피부판을 이용한 COMMANDO에서도 역시 35% 이었다. 3) 병기(stage)에 따른 2년 무병생존율은 제 1병기가 100%, 제 2병기가 45%, 제 3병기가 41% 이었으며, 제 4병기에서는 18% 이었다. 4) 근피부판을 사용한 경우와 조직학적으로 이에 상응하는 제 1대조군, 즉 표준 COMMANDO를 시행했거나 국소피부판(전두피부판 빛 후경부피부판)을 사용한 COMMANDO 경우 들과 비교하였을 때 ,2년 무병생존율은 큰 차이가 없이 대조군 양쪽 모두에서 공히 40% 이었다. 5) 근피부판을 사용한 경우를 제 2대조군, 즉 국소피부판(전두피부판 및 후경부피부판) 복원만을 시행한 경우들과 비교했을 때에도 역시 차이가 없이대조군 양쪽 모두에서 27%의 2년 무병생존율을 보였다. 6) 근피부판을 사용한 경우를 제 3대조군 즉 어떠한 종류의 피부판도 사용하지않고 단순한 표준 COMMANDO만을 시행한 경우들과 비교했을 때는 큰 차이를 보였다. 즉, 근피부판을 사용하여 복원했던 경우는 50%의 2년 무병생존율을 보인데 비해, 표준 COMMANDO만을 시행했던 경우는 25%의 생존율을 보였다. 7) 국소재발율은 표준 COMMANDO에서 25%, 후경부피부판 사용 경우에서 26%, 전두 피부판 사용경우에서 33% 이었으나 근피부판을 사용한 경우는 재발율이 가장 낮아 22% 이 었다. 이러한 결과들을 병기가 진행된 예(stage III & IV)에서 본다면, 표준 COMMANDO에서 67%가 제 3, 제 4병기이었고, 후경부피부판을 사용한 경우는 79%에서 제 3, 제 4병기이었다. 전두피부판을 사용한 예에서는 100% 모두가 제 3, 제 4병기이었고, 근피부판을 사용했던 경우는 96% 에서 제 3, 제 4병기이었던 점을 고려한다면 매우 중요한 의미가 있다고 하겠다. This paper is a review of our experience with radical resection for cancer of the oral cavity with particular emphasis upon the value of myocutaneous(i.e., musculocutanous) flaps employed in the surgical reconstruction in patient survival. During the past 15 years, 98 patients underwent resection of cancer arising in the oral cavity and oropharynx. Of these, 14 had composite resections in which the mandible was not sectioned, and 4 underwent en bloc resections without neck dissections in the face of post-radiation recurrence. When these excluded, 84 patients who underwent COMMANDO procedures with or without myocutaneous flaps were suitable for analysis of recurrence and survival according to the various surgical technics employed. 1) According to the surgical technic, there were 24 standard COMMANDO procedures in whom no regional or myocutanous flap was used; 12 patients who underwent reconstruction employing a forehead flap; 19 patients in whom a posterior cervical 'nape' flap was employed; 27 patients who underwent myocutaneous or osteo-myocutaneous flap repair; and two patients who had double flap repair. 2) The uncorrected two-year disease free survival was 41% for standard COMMANDOs, 17% for forehead flap COMMANDOs; 35% for nape flap COMMANDOs; and 35% for myocutaneous flap COMMANDO procedures. 3) The two-year disease-free survival by Stage was 100% in Stage I, 45% in Stage II, 41% in Stage III, and 18% in Stage IV. 4) When myocutanous flaps cases were compared with Group I, comprised of matched historical controls including both Standard COMMANDOs and those who had undergone regional flap repairs(that is, forehead and nape flap COMMANDOs)there was no difference, both groups showing a 40% 2-year disease-free survival. 5) When musculocutanous flap cases were compared with Goup II, which was composed of matched historical controis limited to patients who had undergone regional flap repairs(that is, forehead and nape flap cases only)there was no difference, both groups showing a 27% 2-year desease-free survival. 6) When musculocutanous flap cases were compared with Group III, composed of patients who had undergone classic COMMANDO procedures without any sort of flap repair, there was a striking difference; the patients undergoing MC flap repair showed 50% 2-year disease-free survival, whereas the classic COMMANDO cases showed a 25% survival free of disease. 7) Locoregional recurrence was also evaluated in the four categories; for standard COMMANDO cases it was 25%, for nape flap cases 26% ; for forehead flap cases, 33%, and for the musculocutaneous flap cases, the lowest recurrence rate, 22%. These results are of particular significance in view of the fact that the proportion of advanced cases(Stage III and IV)in each category was 67% of standard cases, 79% of nape flap patients, 100% of forehead flap cases, and 96% of musculocutaneous flap cases.

신장 이식 환자에서 발병한 기관지내 아스페르길루스증 1예

허경미 ( Gyeong Mi Heo ),김원진 ( Won Jin Kim ),박동선 ( Dong Seon Park ),이정아 ( Jeong A Lee ),모은경 ( Eun Kyung Mo ),엄중식 ( Joong Sik Eom ),이삼열 ( Sam Uel Lee ),남은숙 ( Eun Sook Nam ),조성진 ( Seong Jin Cho ),오지은 ( Ji 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.4

침술후에 생긴 슬와동맥 가성동맥류

이영철,김수태,이진영,최창식,조홍래,배수동,이삼열,연현철 대한혈관외과학회 1995 Vascular Specialist International Vol.11 No.2

Traumatic pseudoaneurysms of the popliteal artery are an uncommon late complication of arterial injury. They occur less frequently in civilian trauma. Authors experienced the pseudoaneurysm of left popliteal artery after acupuncture. A case report of popliteal artery of pseudoaneurysm after acupuncture and review of the articles are presented.

불규칙항체 검출을 위한 manual hexadimethrine bromide (Polybrene^®)법의 유용성에 관한 연구

김희모,김현옥,이삼열,김휘준 大韓血液學會 1989 大韓血液學會誌 Vol.24 No.2