선천성 식도 협착증

이성철,한원식,김기홍,정성은,박귀원,김우기,Lee, Seong-Cheol,Han, Won-Shik,Kim, Ki-Hong,Jung, Sung-Eun,Park, Kwi-Won,Kim, Woo-Ki 대한소아외과학회 2000 소아외과 Vol.6 No.1

Congenital esophageal stenosis (CES) is a narrowing of the esophageal lumen from birth. Three types of CES have been described; tracheobronchial remnants (TBR), membranous web (MW), and fibromuscular stenosis (FMS). We reviewed the clinical features and the surgical outcome of 14 patients, pathologically confirmed as CES. Nine patients had TBR, 3 FMS, and 2 MVV. The mean age at operation was 3.8 years. Five patients were boys and 9 girls. Four patients had other congenital anomalies. Segmental resection of the lesion and end to end anastomosis was utilized in all cases except one who underwent myotomy. The stenotic segment was located at the distal esophagus in all patients. There were 8 complications in 6 patients, but no mortality. The mean follow-up period was 68 months. There were no feeding problems but 3 patients had minor gastroesophageal reflux. Our result indicates that segmental resection and anastomosis is a satisfactory surgical procedure in the management of CES.

타목시펜 사용과 연관되어 빠르게 진행하는 다발성 자궁내막폴립 1예

이희준,김훈,구승엽,한원식,김석현,최영민,김정구,문신용,Lee, Hee-Jun,Kim, Hoon,Ku, Seung-Yup,Han, Won-Shik,Kim, Seok-Hyun,Choi, Young-Min,Kim, Jung-Gu,Moon, Shin-Yong 대한생식의학회 2010 Clinical and Experimental Reproductive Medicine Vol.37 No.2

The antiestrogen tamoxifen is currently the most commonly used adjuvant treatment of breast cancer with antiestrogenic effect on mammary tissue. However, it is also associated with endometrial abnormalities, including hyperplasia, polyps, carcinoma, mostly interpreted as evidence of estrogenic effect on the endometrium. Previously, tamoxifen-associated polyp in breast cancer has been reported in the literature. Most studies had a long follow-up period and tamoxifen-associated polyp developed more than 1 year after tamoxifen treatment. In this case, we report an unusual case of rapid growing and multiple endometrial polyps that were developed only after 3 months' tamoxifen treatment in a postmenopausal breast cancer patient who received quadrant mastectomy with a brief review of literature. 유방암의 치료는 수술, 항암치료 및 방사선 치료 등의 주 치료법이 있으며, 유방암 환자에서 주 치료 후 보조적 치료 수단으로 호르몬 치료가 사용된다. 이 호르몬 치료에는 타목시펜이 가장 보편적으로 사용되며, 타목시펜은 체내에서 항에스트로겐 효과를 보여 유방암 치료에 도움을 주며 유방암의 재발방지에도 효과가 있다고 알려져 있다. 그러나 타목시펜의 부작용 또한 여러 가지가 있으며 문헌에 보고된 것으로는 자궁내막폴립, 자궁내막증식증, 자궁내막암 등이 있다고 알려져 있다. 본원에서도 유방암으로 수술 치료를 시행 받은 후 보조적 치료로서 호르몬 제제인 타목시펜을 사용하여 왔으며 이러한 환자들은 모두 외과와 협진하여 산부인과 외래로 추적 관찰하고 있다. 최근에 본원산부인과 외래로 추적 관찰 중인 타목시펜 사용 환자 중에서, 호르몬 치료 시작 3개월 후의 단기간 내에 빠르게 진행하는 다발성의 자궁내막폴립의 1예가 발견되었으며, 이는 타목시펜의 부작용으로 발생한 것으로 사료된다. 이에 저자는 유방암 수술 후 보조적 치료로 타목시펜을 사용한 환자들 중 우연히 발견된 빠르게 진행하는 다발성의 자궁내막폴립의 1예를 문헌고찰과 함께 보고하는 바이다.

Sclerosing Adenosis Diagnosed by Needle Biopsy

Heon Jin Jung(정헌진),Won Shik Han(한원식),Hyeong-Gon Moon(문형곤),Soo Kyung Ahn(안수경),Ji-Sun Kim(김지선),Dong-Yong Noh(노동영),Jung-Min Chang(장정민),Nariya Cho(조나리야),Woo Kyung Moon(문우경),In-Ae Park(박인애),Hee-Chul Shin(신 대한종양외과학회 2012 Korean Journal of Clinical Oncology Vol.8 No.2

목적 : 본 연구는 침생검을 통해 진단 받은 경화성 선증에 대해 추가적인 수술 없이 경과 관찰했을 때의 잠재적 안정성을 알아보고자 하였다. 방법 : 1996년 1월부터 2010년 5월까지 침생검을 통해 경화성 선증으로 진단된 143명의 환자의 145개 병변을 대상으로 (core-needle biopsies 118례, vacuum-assisted biopsies 27례) 의무기록 검토를 토대로 한 후향적 고찰이다. 결과 : 환자들의 BI-RADS(The American College of Radiology Breast Imaging Reporting and Data System) 분류는 다음과 같다: C3(n=8), C4a(n=123), C4b(n=11), C4c(n=e), C5(n=1). 그 중 14명은 조직검사를 재시행하였고 BI-RADS 분류 C5이면서 영상의학적 소견과 병리학적 소견의 불일치를 보인 1명의 환자가 침윤성 유방암으로 진단되어 수술을 시행하였다. 나머지 환자들은 정기적인 초음파 검사 및 유방촬영술을 통해 경과 관찰하였고, 평균 추적관찰 기간 40개월 동안 144개의 병변의 최종 BI-RADS 분류는 다음과 같다: C1(n=5), C2(n=107), C3(n=32), 경과 관찰기간 동안 142명의 환자에서 악성 유방질환이 발견된 환자는 없었다. 결론 : 침생검을 통해 경화성 선증으로 진단된 환자에 있어서 추가적인 수술 없이 정기적인 검진을 통하여 경과 관찰하는 것은 잠재적 안전성을 가지고 있다. 하지만 조직검사와 영상검사 결과의 불일치 소견을 보이는 경우 수술적 생검을 통한 최종 진단이 필요하다. Background : The aim of this study was to assess the potential safety of follow up for patients diagnosed with sclerosing adenosis through needle biopsies without additional surgery. Patients and Methods : From January 1996 to May 2010, 145 lesions in 143 sclerosing adenosis patients who underwent core-needle biopsies (n=118), vacuum-assisted biopsies (n=27) in our institution were followed. Results : The American College of Radiology Breast Imaging Reporting and Data System (BI-BADS) classification in these patients was as follows : C3(n=8), C4a(n=123), C4b(n=11), C4c(n=e) and C5(n=1). After sclerosing adenosis was diagnosed by needle biopsy, 14 patients underwent re-biopsy. Only 1 patient who had BIRAD C5 sonographic features was diagnosed with invasive ductal carcinoma and surrounding ductal carcinoma in situ. The remaining 142 patients received regular medical exam with ultrasonography and/or mammography. 144 lesions’ BI-RADS category were C1(n=5), C2(n=107) and C3(n=32). With the median follow-up period of 40 months, none of the patients developed breast malignancy. Conclusions : Our study suggest that patients with sclerosing adenosis diagnosed by needle biopsies can be safely followed without additional surgery. However, in case of discordance with images and biopsy result, surgical excision for definite diagnosis is recommended.

산불의 온도 조건에 따른 토양 지하수 환경 블랙카본의 특성 변화

전소담(Sodam Jeon),서란(Ran Seo),정성욱(Sungwook Choung),장경순(Kyoung-Soon Jang),한원식(Won Shik Han) 대한지질학회 2020 대한지질학회 학술대회 Vol.2020 No.10

일반총설 : 유방암줄기세포: 암치료의 새로운 방향?

이정언 ( Jeong Eon Lee ),고은영 ( Eun Young Ko ),김종빈 ( Jong Bin Kim ),이경민 ( Kyung Min Lee3 ),한원식 ( Won Shik Han ),노동영 ( Dong Young Noh ) 한국조직공학과 재생의학회 2007 조직공학과 재생의학 Vol.4 No.3

농업용 S/W의 개발과 이용 활성화 방안

강정옥,이철희,한원식 한국농업정책학회, 한국축산경영학회 2001 농업경영정책연구 Vol.28 No.2

This study aims to the examine the development strategy and usage of software for farmers through demand survey of farmers. This study also analyzes the situations and problems that farmers encounter when using software, demand on software, and kind of software that they want to use in their farm management in the future. The category of satisfaction and dissatisfaction on software for farm management is classified for useful software development and the reason of quitting using software. Results of the survey revealed that to increase software utilization after development and distribution of software, educational opportunity for farmers should be provided; use of various distribution channels and distribution of appropriate software.

비장동맥류

김상준,조병선,한원식,윤익진,하종원,정인목 대한혈관외과학회 1998 Vascular Specialist International Vol.14 No.1

Splenic artery aneurysms (SAA) are the third most common intra-aMominal aneurysm and most common splanchnic artery aneurysm. They remain the subject of continued interest since the first case reported by Beaussier in 1770. The cause and indications for surgical treatment are controversial. In most cases, SAAs are detected as incidental findings. Their importance lies in their potentially fatal consequence due to rupture. We reviewed clinical features and treatment results of patients with splenic artery aneurysm experienced in Seoul National University Hospital from January, 1987 to June, 1997. Six patients of SAAs were treated during this period. Male to female ratio was 3:3, and median age was 56 years. The mean parity of all women was 3.7 and there were no pregnant women. Common symptoms were abdominal pain, hematemesis, and abdominal mass. Two patients(33.3%) were asymp- tomatic. The associated diseases that might cause the aneurysms were pancreatitis in 2 patients, portal hypertension in 1, operative trauma in 1, and mycotic aneurysm in 1 patient. Rupture occurred in 2 patients. One patients presented repeated hematemesis due to formation of gastro-aneurysmal fistula. Except one patient diagnosed as SAA incidentally during gashectomy, all aneurysms were confirmed by angiography. Abdominal sonography was performed in 4 patients, and CT scan in 3. The size of the aneurysms ranged from 1 cm to 8 cm in diameter, with larger than 3 cm in 66%, smaller than 2 cm in 33% of aneurysms. About location, 33% located at proximal vessels, 17% at mid-third and 50% at distaL Five patients underwent surgical treatment. Splenectomy was performed in 3 patients, and exclusion of aneurysm in 2. We could preserve spleen in 1 case of distally located aneurysm by aneurysmal exclusion and end-to-end anastomosis of splenic artery. One patient underwent percutaneous embolization of the lesion and successfully treated. Two postoperative complications developed in ruptured cases and were managed conservatively. There was no postoperative mortality. In conclusion, complication and mortality in elective operation of SAA decreased due to recent improvement of radiologic tools and operative techniques. Considering severe fatality and morbidity of rupture of aneurysm, prompt and aggressive treatment is required in patients with high risk of rupture.