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        • 비/비인강 비호즈킨 림프종의 임상양상과 예후 인자

          박순서(Soon Seo Park), 서철원(Cheol won Suh), 박종범(Jong Beom Park), 박지운(Ji Woon Park), 임소덕(Soo Duk Lim), 허주령(Joo ryung Huh), 남순열(Soon Yuhl Nam), 김상윤(Sang Yoon Kim), 이호규 장혜숙(Hye sook Chang), 김태원(Tae Won Kim), 이제환(Je Hw) 대한두경부종양학회 1999 대한두경부 종양학회지 Vol.15 No.2

          '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

          Objectives: To study the clinical features of the primary nasal/nasopharyngeal non-Hodgkin's lymphomas and to evaluate the implication of immunophenotyping as a prognostic factor. Patients and Methods: From January 1990 to December 1997,41 patients(median age, 41 years) of primary nasal/nasopharyngeal non-Hodgkin's lymphoma were studied. The clinical records and paraffin-embedded tissue blocks were reviewed retrospectively. The histologic features, immunophenotypic findings(pan-T, pan-B, CD3, CD56) and Epstein-Barr virus in situ hybridizatios were examined. The prognostic factors for clinical outcome were evaluated in these patients. According to Ann-Arbor system, there were 30 patiets(73%) with stage IE, 4(10%) with stage IIE, 3(7%) with stage IIIE, 4(10%) with stage IVE lymphoma. Among the patients with stage IE/IIE, 4 patients received local radiation alone, 4 received chemotherapy alone, 25 received combination chemotherapy and radiotherapy and 1 refused treatment. The patients with stage IIIE/IVE were given combination chemotherapy and radiotherapy. Results: Immunophenotyping were performed in 40 patients and staining results were as follows: 3(7%) patients with B cell, 17(42%) with T cell, 18(44%) with NK/T cell(CD56 positive), and two patients with unclassifiable result. Epstein-Barr(EB) virus in situ hybridization were performed in 28 patients and 23(82%) patients had positive EBV-encoded RNAs(EBERs). 21(55%) patients achieved a complete remission. There was no difference in complete remission between radiation alone and combination therapy. With median follow-up of 30 months, 5-years disease free survival of complete responders was 60% and 5-years overall survival rate was 36%. Multivariate analysis showed that better overall survival was related with absence of B symptoms, ECOG performance ≤1 and non-NK cells. Conclusion: Most of all cases were positive for EBER. Since NK/T phenotype carried the worst prognosis, analysis for CD56 expression should be done. Further prospective studies were warranted to evaluate the role of chemotherapy in stage IE/IIE.

        • KCI등재

          생리적 발성 기법의 변성발성장애 치료 적용 효과

          김성태(Kim Seong-Tae), 남순열(Nam Soon Yuhl) 한국음성학회 2011 말소리와 음성과학 Vol.3 No.2

          The treatment for patients with mutational dysphonia typically is useful with vegetative phonation, but has not yet been studied. This study attempts to identify the effect of SKTCLP<SUP>?</SUP> using throat clearing and laughing in patients with mutational dysphonia. The study, which was designed by the author, included 26 patients aged from 14 to 32 years (mean: 18.7 years) who had been diagnosed with mutational dysphonia between January 2007 and June 2010. Voice therapy for these patients included SKTCLP<SUP>?</SUP>, ranging from two to seven sessions (mean: 3.8 sessions). Results were evaluated by videostroboscopy, perceptual evaluation of GRBAS scale, aerodynamic test, and acoustic analysis before and after therapy. Most patients could phonate with low pitch from the beginning and sustain with normal pitch sound in the last session. We had found that glottic gap reduced after therapy and anterior-posterior compression of superior laryngeal part at the first time, and these patients had complete closure of the glottis after treatment. The results of acoustic and aerodynamic measures after treatment indicated significant decreases in Fo, Jitter, Shimmer, SFF, and SPI, and increases in MPT, Psub, and vocal efficiency (p<.05). SKTCLP<SUP>?</SUP> may be a useful treatment method in managing mutational dysphonia. We can suggest this technique may be useful in improving the voice quality of other functional dysphonia having glottal chink or functional aphonia.

        • 타액선 악성종양의 경부 림프절 전이의 위험 요소

          이시형(Si Hyung Lee), 남순열(Soon Yuhl Nam), 최승호(Seung Ho Choi), 박정제(Jung Je Park), 김찬종(Chan Jong Kim), 강우석(Woo Seok Kang), 김상윤(Sang Yoon Kim) 대한두경부종양학회 2004 대한두경부 종양학회지 Vol.20 No.1

          '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

          Background and Objectives: Nodal metastasis is one of the prognostic factors in salivary gland cancer. The purpose of this study is to identify risk factors of nodal metastasis considered as a predictor of poor prognosis in patients with salivary gland cancer. Material and Methods: The authors retrospectively studied 82 patients with salivary gland cancer who underwent surgery from 1992 to 2002. We analyzed age, sex, tumor size, histologic type and 5-year survival rate to compare patients with and without nodal metastasis. Results: Mean age was 55.4 years, with a male-female ratio of 1 : 1.28. The overall 5-year survival rate was 85.5%. Among the 82 patients, 14 patients had nodal metastasis. There was no nodal metastasis in low grade malignancy. In patients without nodal metastasis, mean age was 52.5 years and the overall 5-year survival rate was 94.2%. In patients with nodal metastasis, mean age was 69.4 years and the overall 5-year survival rate was 42.9%. In patients with less advanced cancer (T1-T2 stage), the nodal metastasis was 7.5% and with advanced cancer (T3-T4 stage), 33.3%. Conclusion: Nodal metastasis significantly decreases survival in patients with salivary gland malignancy. High grade malignancy, large tumor size and old age are important risk factors of nodal metastasis. Nodal metastasis is more common in submandibular gland cancer compared with parotid gland cancer.

        • 갑상선 유두상미세암종에서 갑상선외 침윤, 다원성 및 경부전이에 대한 Matrix Metalloproteinase 2 및 Tissue Inhibitor of Matrix Metalloproteinase 2 발현의 의의

          최승호(Seung Ho Choi), 남순열(Soon Yuhl Nam), 조경자(Kyung Ja Cho), 김상윤(Sang Yoon Kim) 대한두경부종양학회 2005 대한두경부 종양학회지 Vol.21 No.2

          '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

          Objectives: To investigate the role of MMP-2 and TIMP-2 in the invasion and metastasis of thyroid papillary microcarcinomas. Materials and Methods: We performed immunohistochemical study on MMP-2 and its tissue inhibitor (TIMP-2) using tissue microarrays containing 2 cores of 40 microPTC and 8 non-neoplastic thyroid tissue. The expression intensity was semiquantitatively scored as -, ±, +1, +2, and +3. Results: Both MMP-2 and TIMP-2 expression was observed in all tumors(100%) and in 1 of 8 non-neoplastic tissue(12.5%), and the positive staining was restricted to the epithelial cells. In 17 and 23 tumors with or without extrathyroid invasion, respectively, 8(47%) and 10(43%) cases showed moderate to strong(+23) positivity for MMP-2. TIMP-2 expression was moderate to strong in 13 cases(76%) and 16 cases(70%) in each group. In multifocal and solitary tumors, 3 of 6(50%) and 11 of 21(52%) cases showed moderate to strong MMP-2 expression, and 5/6(83%) and 15/21(71%) showed moderate to strong TIMP-2 expression. Conclusion: There is no relationship between MMP-2 or TIMP-2 expression and extrathyroid invasion or tumor multifocality in papillary microcarcinoma of the thyroid gland.

        • 두경부 편평세포암종의 경부 전이에 대한 F-18 FDG PET의 진단적 유용성

          김찬종(Chan Jong Kim), 김재승(Jae Seung Kim), 강우석(Woo Seuk Kang), 남순열(Soon Yuhl Nam), 최승호(Seung Ho Choi), 김상윤(Sang Yoon Kim) 대한두경부종양학회 2003 대한두경부 종양학회지 Vol.19 No.2

          '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

          Purpose: Accurate evaluation of metastatic cervical lymph nodes plays a decisive role in the treatment and prognosis of patients with squamous cell carcinoma of the head and neck. The purpose of this study is to investigate the usefulness of FDG-PET for diagnosis of cervical metastasis in the head and neck cancer by comparing with the conventional imaging study. Materials and Methods: The subjects on this study were 30 patients (24 males and 6 females, aged 39 to 76, mean 57.1) diagnosed as pathologic-proven squamous cell carcinomas of the head and neck. All patients underwent preoperative FDG-PET, CT(n=27) or MRI (n=3). Their medical records were reviewed retrospectively. Using pathologic reports as a golden standard, the results of FDG-PET were compared with conventional imaging study (CT/MRI) in the evaluation of cervical metastasis. Results: Thirty patients had five different primary sites which were tongue (11), supraglottis (10), glottis (6), hypopharynx (2) and tonsil (1). A total of 40 neck dissections were performed unilaterally in 20 patients and bilaterally in 10 patients. Of these, 16 showed pathologically positive for lymph node metastasis. The sensitivity and specificity of FDG-PET for the diagnosis of cervical metastasis was 75% and 100% respectively, compared with conventional imaging of 56.3% and 95.8%, respectively. The difference of sensitivity was not statistically significant (p=0.453). Of 5 cases with small metastatic node (<1cm), 3 were detected on PET detected correctly but none were detected by CT. Conclusion : FDG-PET was more accurate than conventional imaging study in the diagnosis of metastatic lymph nodes in squamous cell carcinomas of the head and neck, especially detection of small metastatic node. FDG-PET might be useful adjunct to conventional image in the preoperative evaluation of head and neck squamous cell carcinoma.

        • KCI등재후보

          비인강암 환자의 예후에서 2-[18F] Fluoro-2-Deoxy-D-Glucose PET 영상에서 계산되는 Standardized Uptake Value의 의의

          이상욱(Sang-wook Lee), 임기천(Ki Chun Im), 남순열(Soon Yuhl Nam), 김재승(Jae Seung Kim), 최은경(Eun Kyung Choi), 안승도(Seung Do Ahn), 신성수(Seong Soo Shin), 류진숙(Jin Sook Ryu), 김상윤(Sang Yoon Kim), 이봉재(Bong-Jae Lee), 최승호(Seung-Ho C) 대한방사선종양학회 2005 Radiation Oncology Journal Vol.23 No.1

          '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

          목 적: 원격장기의 전이가 없는 비인강암에서 동시항암화학방사선치료를 시행 받은 환자에서 진단 당시 시행한 양전자단층촬영의 fluorodeoxyglucose (FDG) 섭취정도가 예후에 미치는 영향을 알아보고자 하였다. 대상 및 방법: 본원에서 원격장기의 전이가 없는 비인강암으로 진단 받고 진단 당시 [18F]FDG-PET을 시행한 환자는 총 41명이었다. PET 검사는 모두 항암방사선치료 전에 시행되었다. FDG 섭취 정도를 알아보기 위해서 종양 내에서 측정된 최대 standardized uptake value (SUV)를 측정하였다.결 과: 항암화학방사선치료 후 모든 환자는 완전반응을 보였다. 전체 41명 중에서 10명이 재발하였는데 재발하지 않은 환자의 SUVmax 중앙값은 6.48 (range: 2.31∼26.07)이었고 재발한 환자의 중앙 SUVmax는 8.55 (2.49∼14.81)이었다. 양 군 간의 SUV의 차이는 p값이 0.0505로 통계적 차이가 관찰되지 않았다. SUVmax를 중앙값을 기준으로 나누어 보았을 때 SUVmax가 높은 환자의 3년 생존율이 통계적으로 유의하게 저조하였다(51% ν 91%, p=0.0070).결 론: 원격전이가 없는 비인강암에서 항암화학방사선치료를 시행 받은 환자에서 진단 당시 시행한 FDG 섭취 정도는 예후를 예측하는데 유용할 것으로 생각되었다. 따라서 진단 당시 시행한 FDG-PET에서 SUV가 높은 경우(8 이상)에는 좀더 적극적인 치료가 필요할 것으로 생각하였다. Purpose: To prospectively evaluate the use of positron emission tomography with the glucose analog fluorodeoxyglucose (FDG-PET) to predict disease-free survival (DFS) after concurrent chemo-radiotherapy (CCRT) in patients with non-disseminated nasopharyngeal carcinoma (NPC). Materials and Methods: We studied 41 patients with non-disseminated NPC scheduled to undergo platinumbased CCRT were eligible for this study. Patients were studied by FDG-PET prior to the CCRT. FDG uptake of tumors were measured with the maximal standardized uptake value (SUV). Results: Complete response rate was 100%. In ten patients who presented with any component of treatment failure, the median SUVmax was 8.55 (range: 2.49∼14.81) in any component of failure and the median SUVmax was 6.48 (range: 2.31∼26.07) in the remaining patients without any such failure. Patients having tumors with high FDG uptake had a significantly lower 3-year DFS (51% ν 91%, P=0.0070) compared with patients having low uptake tumors. Conclusion: FDG uptake, as measured by the SUV, has potential value in predicting DFS in NPC treated by CCRT. High FDG uptake may be a useful parameter for identifying patients requiring more aggressive treatment approaches.

        • 좌측 하악골에 생긴 골육종(Osteosarcoma) 1예

          김찬종(Chan Jong Kim), 이재동(Jae dong Lee), 남순열(Soon Yuhl Nam) 대한두경부종양학회 2003 대한두경부 종양학회지 Vol.19 No.2

          '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

          Osteosarcoma is one of the most frequently occurring malignant bone tumor except for multiple myeloma. However, osteosarcoma of the mandible is rare and aggressive malignancy constituting about 5% to 13% of all cases of skeletal osteosarcoma. The authors experienced a case of osteosarcoma of the mandible in a 31-years old male patient. He visited our outpatient clinic with painless mass of the cheek. On the basis of the clinical and imaging findings, the differential diagnosis included giant cell tumor, histiocytosis and malignant bone tumor. In the first operation, the mass of the mandible was excised. Intraoperative microscopic examination of a frozen section did not yield a diagnosis: however, the final definitive histologic examination revealed osteoblastic osteosarcoma. After 15days, wide excision with hemimandibulectomy was completed followed by postoperative radiotherapy and chemotherapy. With our experience, we report the progression of diagnosis and management for mandibular osteosrcoma.

        • KCI등재

          국소 지혈제 사용이 갑상선 절제술 후 배액 양에 미치는 영향

          김호찬 ( Ho Chan Kim ), 임길채 ( Gil Chai Lim ), 김상윤 ( Sang Yoon Kim ), 남순열 ( Soon Yuhl Nam ), 노종렬 ( Jong-lyel Roh ), 최승호 ( Seung-ho Choi ) 대한갑상선학회 2008 International Journal of Thyroidology Vol.1 No.1

          Background and Objectives: The amount of postoperative drainage is important factor to decide hospitalization and medical expense. The purpose of this study was to verify the advantage of using topical hemostatic agents after total thyroidectomy with central neck dissection (CND) to reduce postoperative drainage. Materials and Methods: From Jun 2007 to March 2008, 79 patients underwent total thyroidectomy with CND by one surgeon. Before wound closure, the operative bed was covered with fibrin sealant (group A, Beriplast<sup>Ⓡ</sup>; n=22), microfibrillar collagen (group B, Avitene<sup>Ⓡ</sup>; n=30) or nothing (group C, control; n=27). The amount of drainage was measured every 24 hours until drain removal. The drainage amount, hospital stay, and total medical expense were compared among the 3 groups by T-test. Results: The drainage amount for group A, B and C was 43.4 ml, 48.5 ml, 49.7 ml on the first postoperative day, 41.9 ml, 48.5 ml, 49.7 ml on the second day, 16.3 ml, 21.8 ml, 20.2 ml on the third day, respectively, resulting in no significant difference (p=0.08∼0.8). Hospital stay was not different among 3 groups. Total medical expense for group A,B and C was 2,602,118 Korean Won (KRW), 2,657,255 KRW, 2,496,647 KRW, respectively, which showed significantly lower medical expense in group C than group A or B. Conclusion: Topical hemostatic agents are not helpful to reduce the amount of the postoperative drainage and medical expense in cases of total thyroidectomy with CND.

        • 샘낭암종에서의 C-kit 단백 발현 및 돌연변이 분석

          조경자(kyung Ja Cho), 최진(Jene Choi), 김상윤(Sang Yoon Kim), 남순열(Soon Yuhl Nam), 최승호(Seung Ho Choi), 김성배(Sung Bae Kim) 대한두경부종양학회 2003 대한두경부 종양학회지 Vol.19 No.2

          '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

          Objectives: To document the incidence and pattern of c-kit protein expression & mutation in adenoid cystic carcinomas. Materials and Methods: Twenty-five cases of adenoid cystic carcinomas of the major and minor salivary glands and the upper and lower respiratory tract were subjected to the immunohistochemical study for ckit(CD117 ; Dako). Nineteen cases of them were analyzed for mutations in exon 11 and exon 17 by PCR-SSCP, and in cases of need, by DNA sequencing. Results: Twenty-three cases (92%) showed c-kit expression, but none showed mutations in exon 11 and exon 17. The expression was restricted to the inner luminal cells in all tubular types and most of cribriform adenoid cystic carcinomas, while the staining was diffuse in all solid variants and two cribriform types. Conclusion: C-kit expression was common in adenoid cystic carcinomas, regardless of their origins. Although genetic bases await further studies, a clinical trial of tyrosine kinase inhibitors in adenoid cystic carcinomas, especially in solid variants, is considered encouraging.

        • Prediction of Regional Metastasis by the Expression of Lymphangiogenic Factors in Micropapillary Thyroid Carcinoma

          Sung Bu Lee(이성부), Seung-Ho Choi(최승호), Soon Yuhl Nam(남순열), Kyung-Ja Cho(조경자), Sang Yoon Kim(김상윤) 대한두경부종양학회 2011 대한두경부 종양학회지 Vol.27 No.1

          '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

          서 론 미세갑상선유두상암종 환자에서 불필요한 예방적 중앙 림프절절제술을 피하기 위해서 림프절 전이를 수술 전에 예측하는 수단이 필요하다. 림프관 생성 및 성장의 조절에 VEGF-C/D, VEGFR-3 pathway, podoplain이 관여 된다는 사실이 밝혀져 있다. 림프관 생성 및 성장과 관련된 인자인 VEGF-C/D, podoplanin에 대한 면역조직화학 염색과 반정량적 분석을 통해 미세갑상선유두상암종에서 림프절전이와의 관련성을 확인하고자 하였다. 대상 및 방법 2006년 9월부터 2008년 6월까지 본원에서 미세갑상선유두상암종으로 진단받고 1인 술자에 의해 갑상선 전 절제술 및 예방적 중앙 림프절절제술을 받은 104명의 환자 중 중앙 림프절 전이가 있었던 환자와 없었던 환자를 각각 25명씩 무작위로 선별하여 종양부위에 면역화학염색을 실시하여 림프관생성인자의 발현 정도를 비교하였다. 결 과 대상군 50예 중 VEGF-C/D는 50예(100%) 모두 발현이 되었고 podoplanin은 33예(66%)에서 발현이 되었다. 그 중 VEGF-C는 10예(20%)에서 약한 양성, 37예(74%)에서 중등도 양성, 3예(6%)에서 강한 양성소견을 보였고 VEGF-D는 9예(18%)에서 약한 양성, 37예(74%)에서 중등도 양성, 4예(8%)에서 강한 양성소견을 보였다. 중앙 림프절 전이 음성 환자 군과 양성 환자 군으로 분류하였을 때 VEGF-C/D의 발현율의 차이는 p-value가 각각 0.48, 1.00으로 통계적으로 유의한 차이를 보이지 않았다. 50예 전체를 대상으로 하여 종양의 개수, 최대크기, 검출된 전체 림프절의 수, 양성 림프절의 수, 주변조직 침범여부에 따른 VEGF-C/D의 발현도 통계적으로 유의한 차이를 보 이지 않았다. Podoplanin의 경우 염색 여부에 따라 양성군과 음성군으로 나누어 분석하였을 때 종양의 개수, 최대 크기, 검출된 림프절의 수, 양성 림프절의 수, 주변조직 침범여부도 통계적으로 유의한 차이를 보이지 않았다. 결 론 VEGF-C/D는 대상군 전체(100%)에서 발현이 되었고 podoplanin은 66%에서 발현이 되었다. 림프관 생성인자로 알려진 VEGF-C/D및 podoplanin이 미세갑상선유두상암종에서 많이 발현이 되는 것으로 보아 위 인자들이 림프절 전이를 일으키는 인자 중 하나로 생각된다. 하지만 미세갑상선유두상암종에서 중앙 림프절 전이를 예측할 수 있는 인자로 부적합 한 것으로 생각되며 향후 더 많은 증례를 통해 관련성 여부에 대한 연구가 필요하고 또 다른 인자의 관련성에 대해서 연구가 필요하겠다.

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