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A Case of Papillary Thyroid Cancer Recurring as an Esophageal Submucosal Tumor
Seoung, Hyeog Gyu,Kim, Ji Hye,Choi, Jeong Cheon,Kim, Sang Mi,Kim, Sang Soo,Kim, Bo Hyun,Kim, In Ju,Song, Geun Am,Kim, Gwang Ha Chonnam National University Medical School 2012 CMJ Vol.48 No.1
<P>A 75-year-old woman who underwent a total thyroidectomy for papillary thyroid cancer 7 years previously presented with a palpable neck mass. Computed tomography (CT) showed two metastatic masses on the thyroid bed and another mass that looked benign originating from the esophageal wall. Endoscopic ultrasonography (EUS) showed a hypoechoic mass in the esophageal wall that looked similar to a gastrointestinal stromal tumor. The mass on the esophagus had intense fluorodeoxyglucose (FDG) uptake in positron emission tomography-computed tomography (PET-CT), which suggested the possibility of malignancy. Subsequently, after surgery, the mass in the esophagus was confirmed as a metastasis from the thyroid papillary carcinoma. Here we report this unusual case of papillary thyroid cancer that recurred as an esophageal submucosal tumor.</P>
항암화학요법과 방사선 병합요법으로 완전관해를 보인 위분문부로 벽내전이된 식도암 1예
김진희,김병호,임의혁,김영건,이헌영,성자원,김성걸,육은주,정현용 대한소화기내시경학회 1994 Clinical Endoscopy Vol.14 No.3
Esophageal carcinoma is a rare malignant neoplasm consisting of about 1.5% of the whole gastrointestinal tract neoplasm and has poor prognosis of which survival rate is below 5%. The squamous cell carcinoma of the esophagus could be multicentric in character and may have occured in 9.5-27% of incidence. The most common site is head and neck region. The metastasis of esophageal carcinoma occur through hematogenous, lymphatic spread, direct invasion and rarely intramural metastasis. Of theses, intramural metastasis has been occured in 7-14.3% of incidence and its presence has been regared to poor prognostic factor due to early regional or distant metastasis. Surgery, chemotherapy, radiotherapy alone or combination of these has been used as treatment modalities of esophageal cancer, but combination chemoradiotherapy with or without operation is prefered method than other at present. Authors report a case of esophageal carcinoma showing intramural metastasis to the gastric wall, which had the complete remission with preoperative chemoradiotherapy.
김진희,김병호,임의혁,정현용,김영건,이헌영,성자원,김성걸,육은주 대한소화기내시경학회 1994 Clinical Endoscopy Vol.14 No.1
Gastrointesinal polyp is a premalignant lesion, it is recommanded to be removed. Endoscopic polypectomy has long been considered as a safe and effective method for removal of polyps. One hundred forty eight endoscopic gastrointestinal polypectomy were done in 111 patients who visited Chungnam National University Hospital from January in l991 to August in l993, and clinical character including histopathology were evaluated. (continue...)
의료방사선관리의 국제화 연구 : 핵의학분야의 의료방사선관리
김인규,오헌진,김혁주,오현주,박기정,이광용,이병영,정승환,강영규,이현구,김귀야,한상용,김연교,양현규,이명철 식품의약품안전청 2001 식품의약품안전청 연보 Vol.5 No.-
의료방사선은 인간의 질병진료와 예밤에 활용되어 각종 질병으로부터의 적절한 진단 및 의학발전에 중대한 역할을 담당하고 띤다. 또한 인공방사선원중 가장 큰 비중을 차지하고 있으며, 방사선원을 이웅한 이득과 손실을 생각쌀 때 피폭선량의 최소화 및 곡률적영향의 최소화를 위해 이득을 최대화하는 노력을 하고 있다. 진단뿐만 아니라 치료에도 사응하고 있는 인공방사선원의 적절한 관리를 위한 조사 및 연구는 국내에서는 아픽까진 실시되지 않았으며, 국외에서는 이미 활발한 조사 덴 연구가 이루어 지 고 있다. 일반적으로 의료기관의 핵의학분야에서 환자의 진단 및 치료에 사용되는 방사성의약품으로는 Tc-99in, Ga-67, 1-131, 71-201 등이 있으며 이를 이용한 방사능측정웅장비 및 치료뭉장비에는 Gamma Camera, 감마선재측기, 베타선계측기, Dose CaTibrator, PET(양전자방출전산화단층촬영장치)등이 있다. 이어 식푿의약품안전청f"서는 핵의학분야의 방사선보건학적 연구를 위해 핵의학분야의 진료와 관련된 인력, 시설, 장비, 방사성의약품의 사응, 핵의학적 진료형태 및 핵의학적 진료장치에 대한 성능관리등에 대해 조사·연구하였다. A nationwide survey was conducted in the Korea in 2001 to determine the facilities available and the level of activity at centres where radionuclide and therapy was practised in 2000. A response rate of 75% indicated that 120 centres were providing radionuclide therapy and diagnosis. About the good treatment of radionuclide using in medical, researched so many country, but not yet in. Generally nuclear medical part use Tc-99m, Ga-67, I-131, Tl-201 in diagnosis and therapy, radiation detector and equipment for therapy use Gamma Camera, beta-counter, Dose Calibrator PET(Positron Emission Tomography). 81% rate of centre has Gamma Camera and 97% rate of use Tc-99m, I-131 radionuclide. In-vitro did more than in-vivo test absolutely. So in KFDA researched in unclear medical part in Man-Power, facilities, equipment use of nuclear medicine, part of diagnosis and diagnosis equipment.
진단용 X-선장치의 성능관리를 위한 검사방법 개선에 관한 연구(Ⅱ)
김인규,김혁주,오현주,이광용,김지순,심선보,이병영,남정우 식품의약품안전청 2000 식품의약품안전청 연보 Vol.4 No.-
검사기관에서 수행하고 있는 진단용엑스선장치의 정기검사에 대한 신뢰성 확보를 위하여 검사결과를 확인검사 이전에 평가할 수 있는 방법으로서 열형광선량계를 이용하여 진단용엑스선장치의 관저압 측정방법을 개발하였다. 열형광신량계 판독치의 재현성 향상을 위하여 적정한 엑스선 조사조건을 선정하였고, 소자보정계수 변동계수r~# 3% 이하인 열형광선량계만을 선별하였으며, 관전압 변화에 대한 영역평균판독치의 비의 직선성을 향상시키기 위하육 Cu필터를 사용하였다. 그 결과 판독치의 재현성이 29.8% 향상하였으며, 영역팡균판독치의 비 Ef/El, (ElxE4)/ E22, El/(E2-E4)는 관전압 변화에 대하여 직선성을 유지하고 있었다. E3/El은 엑스선관의 총여과 변화에 래하여 일정간격으로 이동하t s셔이 있어서 Sf/Tl을 이용하여 관전압을 측정하는 방법을 개발하였다. 이 방법은 60kv~110kv 범위 내에서의 평근오차범위는 -5.89%~+3.04없이었다. The escmation method of tube potential using thermoluminescent dosimeter was developed to screen the test 1·esult of aagnostic x-ray cnit performed by inspection compan:F.X-ray exposure condition having stable TL output and thermoluminescent doslmeters within 3%of coefficient of variance for dosimeter correction factor were selected to improve reproducibifityof TL output and copper filters were used for having better TL output ratio against tubepotential change. The reproducibiBity of TL output was improved 29.8% and TL output ratioES/Tl, (El x E4)/E2" and Et/(I:2-E4) were linear to tube potential change. TL output ration Ef/fl was used for the estimation method of tube potential because Ef/Elhad constant shift against total filtration variance of diagnostic x-;·ay erluipment. Mean error ofthis method for tube potential between 60kv and 110kv ranged from -5.89% to +3.04%.
소화성 궤양 출혈의 내시경적 Hypertonic Saline-Epinephrine (HS-E) 용액 국소주사의 지혈효과
김남재,김진희,임의혁,정현용,김영건,서광식,이헌영,김성걸,육은주 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.3
Peptic ulcer bleeding is the most common cause of upper gastromtestinal bleeding. The efficacy of local injection of hypertonic saline-epinephrine(RS-E)solutiom around the base of the bleeding vessels under endoscopy was assessed, During the period between January 1991 and August 1994, 83 patients with active bleeding or stigmata of recent hemorrhage in peptic ulcers were included to this study. The major cause of bleeding in this study consisted of gastric ulcers(60) and duodenal ulcers(23). Twenty patients rebled and seven required emergency surgery and two patients were died. Definitive hemoatasis was achieved in 74(89.3%). Two patients rebled due to mucosal ischemia induced by HS-E injection, other significant complication was not found. We conclude that the endoscopic injection with hypertonic saline-epinephrine solution is one of the effective and safe therapeutic modality in peptic ulcer bleeding.
김진희,김병호,임의혁,김영건,이헌영,성자원,김성걸,육은주,정현용 대한소화기내시경학회 1994 Clinical Endoscopy Vol.14 No.4
Arteriovenous malformations occur predominantly in the cecum and ascending colon and is not associated with vascular lesions of the skin, central nerveous system. or lung Arteriovenous malformations involving gastrointastinal tract is often to be found to be cause of the recurrent painless bleeding without specific past history and family history and usually diagnosed by selective mesenteric arteriography or colonoscopy, But because of small size of the lesion and local occurence, diagnosis of the arteriovenous malformation is very difficult. Authors exprienced a case of arteriovenous maltormation in the colon. The patient had a history of repeated gastrointestinal bleeding, and were diagnosed by colonoscopy and were treated with colonoscopic resection.
김종형,오헌진,김혁주,김지순,김철현,이해룡,전재식 식품의약품안전청 1997 식품의약품안전청 연보 Vol.1 No.-
라돈과 라돈자핵종에 의한 알파방사선의위해 평가 및 극소화방아늬 기초자료로 활용하고자 인천광역시, 대전광역시, 충청남도, 충청북도 지역의 38개 시·군·구에 대하여 590개가옥을 대상으로 charcoal canister를 사용하여 옥내라돈농도를 측저운석하였고, 이 결과를 가옥형태, 가옥의층수, 건축연한 및 지역별로 분석하여싸. 인천, 대전, 충청남북도 지역의 옥내평규라돈농도는 24.3±20.3Bq/㎥을 나타내었고, 이 지역의 라돈농도준위는 2.7~145.7Bq/㎥으로 조사되고 있어 이는 미국환경청(EPA)에서 권고하는 기준치 148Bq/㎥(4pci/l)보다 낮은 값을 나타내었다. The district-wide survey of indoor radon concentrations in houses at 38 areas of Incheon, Daejion, Chwungnain and Chwungbwug was conducted to analysis the risk of population exposure to the alpha-radiation from radon and radon progenies. The indoor radon concentrations for 590 houses were measured and calculated using NaI (T1) scintillation detector and charcoal canisters exposed for 48 hours. The result were sorted by the types, floors and constructing years of dwellings and districts of sites measured. The arithmetic mean of indoor radon concentrations in houses in the surveyed areas was 24.3±20.3 Bq/㎥ and the range of indoor radon concentrations was 2.7 Bq/㎥ to 145.7 Bf/㎥. All of the arithmetic mean of indoor radon concentration in the area of Incheon, Daejion, Chwungnam and Chwungbwug districts were-below 148 Bq/㎥(4 pCi/ℓ) which is the reference value of U.S. Environmental Protection Agency.
소화불량증 환자 및 Helicobacter pylori 감염에 관한 일차 진료의 진료 현황
김수진 ( Kim Su Jin ),김학양 ( Kim Hag Yang ),이자영 ( Lee Ja Yeong ),김성은 ( Kim Seong Eun ),이진서 ( Lee Jin Seo ),강기주 ( Kang Gi Ju ),김경호 ( Kim Gyeong Ho ),박준용 ( Park Jun Yong ),김종혁 ( Kim Jong Hyeog ),이진헌 ( Lee J 대한내과학회 2003 대한내과학회지 Vol.65 No.6
배경: Helicobacter pylori (H.pylori )감염은 만성위염, 소화성 궤양, 위선암 및 위 림프종 등 여러 위장질환의 원인으로 알려져 있고, H.pylori 와 관련된 많은 연구 결과들이 있지만 대부분의 환자를 담당하고 있는 일차 진료의에게 어떻게 그리고 어느 정도 정확히 전달되고 있는지에 대한 연구는 미미하다. 이에 본 연구자들은 대한내과개원의협의회 소속 회원들에게 우편 설문을 통하여 소화불량 증상을 주소로 내원한 환자의 진료와 H. Background: Although Helicobacter pylori infection is now known to be the most common cause of various gastrointestinal diseases and progress in our knowledge about H. pylori is remarkable, whether this knowledge is transferred to general community of pra