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崔龍萬 梨花女子大學校 韓國生活科學硏究院 1977 韓國生活科學硏究院 論叢 Vol.19 No.-
경부의 종류는 어느 연령층에서나 이학적 소견상 흔히 발견되는 질병 또한 증상이지만 그 원인은 다양하며 조직학적 검사를 시행하지 않고서는 그 진단이 어려운 경우가 많다. 특히 경부의 임파 관계는 두안부 및 경부 자체 기관들로부터의 주입은 물론 상지와 흉부로부터 주입되는 경로와 더욱이 좌측에서는 Thoracic duct를 통한 복부 장기로부터의 경로 등으로 인하여 종류의 전이성 종양이 관찰될 수 있다. 이렇게 다양한 경부 종류에 대하여 구미에서는 부분 또는 총괄적으로 연구된 바가 많지만 아직도 우리나라에서는 이에 대한 총괄적인 연구 검토가 거의 없는 실정이다. 이에 저자는 우리나라의 경부 종류에 대한 총괄적 연구 검토 내지 특이성을 보기 위한 일환으로서 이화여대 부속병원에서 1970년부터 1975년까지 만 6년간 조직학적 생검에 의하여 진단이 확정된 530예에 대해서 임상적 고찰을 하였던 바 우측 일측성에 염증성 종류가 반수였음을 발견하였다. Neck mass was easily found on inspection and palpation but exact diagnosis was made only by histologic examination. A clinical review for 530 cases of neck mass was made during the six years from January 1970 to December 1975 at Ewha Womans University Hospital. Following results were obtained: (1) Histopathologically there were 14 cases in congenital lesion, 345 cases in inflammatory lesion, 151 cases in benign tumor, 13 cases in primary malignancy and 6 cases in metastatic malignancy. (2) The highest age incidence was in the group of 20~29 years (30.0%), and the sex ratio of male to female was 1:2.6. (3) In inflammatory lesion the age incidence was most high in 20~29 years (33.8%) with the sex ratio of male to female, of 1:7.9. (4) The unilateral lesion was 71.3%, bilateral 12.1%, and midline 16.6%. In the unilateral mass the lesion of the right side were than multiple(1:3.3)in cases. (5) Most frequent inflammatory lesion was nonspecific lymphadenitis and also most frequent benign tumor was thyroid adenoma. (6) Most common disease was nonspecific lymphadenitis in the unilateral and bilateral lesions but benign thyroid adenoma in the midline lesion.
최용만,최금자 中央醫學社 1976 中央醫學 Vol.30 No.4
Although rare perforation of the gall bladder is associated with high mortality. Perforation of the gall bladder is usually a consequence of acute cholecystitis with gangrene but occasionally results from other special conditions such as typhoid. One of the early classical articles on the subject of perforation of the gall bladder is by McWilliams(19I2). Strohl et al. reported an incidence of perforation in acute?cholecystitis of about 8 3 percent, and Glenn cites a mortality rate of from 5.8 to 75 percent; with an average 25.5 percent. Therefore, early or emergency operation for acute cholecystitis has been advised by many authors to avoid this mortality. This recommendation is justified since mortality and morbidity of, holecystectomy are low (1 to3 per cent). Also, mortality rates of emergency or early cholecystectomy and elective operation, appear to be the same. Authors are about to report two cases of spontanenous multiple perforation of gall bladder due to acute cholecystitis in one 58 year old female and the other 54 year old female in which the patients made recently a complete recovery following a surgical removal of the perforating gall bladder and abdominal drainage with massive antibiotics.
최용만 梨花女子大學校 醫科大學 醫科學硏究所 1991 EMJ (Ewha medical journal) Vol.14 No.4
Most of the progress in the diagnosis and treatment of biliary tract disease has been made in the last century. but the gallstones and their sequelae which cause most of the clinical problems. are not malady of modern times. Alternatives to traditional cholecystectomy were developed during the 1980s and are currently undue evaluation. They include oral chemolysis. extracorporeal shock wave lithotripsy. percutaneous dissolution and extaction, and laparoscopic cholecystectomy. One of the goals of interventional surgery is to simplify patient care by performing surgical techniques percutaneously. Cholecysrectomy is one technique that, lends itself to interventioal approach. one acan envision replacing surgery with a four step procedure. 1) percutaneous cholecystostomy 2) percutaneous stone removal 3) sclerosis and fibrosis of the gall bladder 4) cystic duct occlusion. Both percutaneous cholecystostomy and stone removal have been performed frequently and are in the interventional repertoire. Sclerosis of biliary system may be derived from experience with chemical agents. The aim of this study is a preliminary clinical application of chemical fibrosis of gallbladder with 95% Ethanol and 5% Phenol for treatment of gallbladder diseases. The following results were obtained: 1) The values of liver function test were normnal on postoperative 1 day. 1 week and 4 weeks in cystic duct ligated control group. 2) AST, ALT and ALP were increased markedly on postoperative 1 day after 10, 30 and 60 minutes injection groups into gallbladder with both 95% ethanol and 5% phenol. 3) The edema, congestion and inflammatory changes of gallbladder were mildly developed on postoperaive 1 day. 1 week and 4 weeks in 10, 30, and 60 minutes cystic duct ligated control group. 4) The fibrosis of gallbladder was moderately to severely developed on postoperative 4 weeks after 10, 30 and 60 minutes injection group into gallbladder with 95% ethanol. 5) The fibrosis of gallbladder was moderately developed on postoperative 4 weeks after 10, 30 and 60 minutes injection group into gallbladder with 5% phenol. Inspite of a limited number of observation, the chemical sclerosing agents may be useful treatmental method for gallstone patient if applied in selected cases and it should he opened for further study in lager experimental group.