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말초성 신경아세포종 : 두개골 발생 증례 보고 Involving Skull
박양화,권익승,류연석,신미경,최문배,홍승관,문명선 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.4
The peripheral neuroblastomas are malignant neoplasms that originate from the adrenal gland and sympathetic nervous tissues. They usually occur in childhood. They exhibit such malignant features that they metastasize early to lung, liver, bone, rarely skull and other structures. The patients with peripheral neuroblastoma have short duration of symptom and short survival period. They reveal the characteristic light microscopic features that resemble other small cell carcinomas. The establishment of final diagnosis of peripheral neuroblastoma needs various special stainings for small cell carcinomas, and the electron microscopic findings are the most reliable. The authers recently experienced a case of peripheral neuroblastoma in a 26-year old man which involved right frontoparietal skull vault. The only chief complaint was a local non-tender mass at right frontoparietal scalp. Neither headache nor any neurological deficits was detected. Simple skull X-ary revealed a punched out rediolucency at right frontoparietal bone and brain CT showed a superficial elliptical high density mass that enhanced strongly. The mass was totally removed by wide craniectomy. The tumor invaded and penetrated the dura but the arachnoid membrane. at the tumor bed was not invaded by the tumor. The tumor was confirmed as peripheral neuroblastoma by various special stainings for small cell carcinomas. Following surgical resection of the mass, post-operative radiotherpy was offered(4800 rads for about 5 weeks). The patient aggrevated progressively and showed numerous metastases to such bones as lumbar vertebrae, pelvis and humerus to became paraplegic. 8 months after the operation, the patient died.
젊은 습관성 음주자에서 도플러 심초음파를 이용한 좌우심실 이완 기능에 관한 연구
최석영(Seuk Young Choi),이승현(Seung Hyun Lee),김덕희(Deuk Hee Kim),이재성(Jae Seung Lee),박경식(Kyung Sik Park),김희식(Hee Sik Kim),박태규(Tae Kue Park),이동화(Dong Hwa Lee),김종연(Jong Yeun Kim) 대한내과학회 1998 대한내과학회지 Vol.54 No.4
N/A Objectives: It is well known that many chronic alcoholics manifest diastolic dysfunction of left ventricle in its early stage. But the effects of chronic alcohol drinking on right ventricular function are not well understood. Thus left ventricular filling impairment and its effects to right ventricular diastolic function were evaluated in young chronic alcoholics. Methods: For the evaluation of left and right ventricular diastolic function in chronic alcoholics, 30 young chronic alcoholics and 28 control subjects were studied by pulsed Doppler echocardiography at the left and right ventricular inflow. Peak E velocity, peak A velocity, E/A velocity ratio, acceleration time and deceleration time were measured as diastolic filling parameters. Results: 1) In the chronic alcoholics, the interventricular septum and posterior wall were thicker and left ventricular muscle mass was significantly increased than that in controls. 2) Among 30 cases of chronic alcoholics, 8 cases(26.7%) showed that the E/A ratio of the left ventricle was less than 1.0 and the deceleration time of the left ventricle was more than 240msec, where- as 12 cases(40.0%) showed that the E/A ratio of the left ventricle was less than 1.0. 3) Among 30 cases of chronic alcoholics, 8 cases (26.7%) showed that the E/A ratio of the right ventricle was less than 1.0 and the deceleration time of the right ventricle was more than 232msec, whereas 14 cases(46.7%) showed that the E/A ratio of the right ventricle was less than 1.0. 4) The HV E/A ratio was significantly correlated with the LV E/A ratio(r=0.697, p<0.001). 5) Blood pressure, ejection fraction, left ventricular mass, E/A ratio and deceleration time of both ventricles were not significantly different in comparison with the daily average amount, duration of ingestion, and total lifetime dose of alcohol. Conclusion: In all chronic alcoholics less than 50 years of age, the left ventricular systolic function was normal. But Doppler echocardiography showed that diastolic dysfunction of the left and right ventricles was present in 8 cases of 30 chronic alcoholics. Right ventricular diastolic dysfunction was closely related with left ventricular diastolic dysfunction. In conclusion, diastolic dysfunction of both ventricle in chronic alcoholics may be the earliest functional sign of preclinical alcoholic cardiomyopathy.
쉴드터널 시공 시 막장안정을 위한 지보압의 이론적.수치해석적 고찰
김광진,고성일,추석연,김종수,Kim, Kwang-Jin,Koh, Sung-Yil,Choo, Seuk-Yeun,Kim, Jong-Soo 한국터널지하공간학회 2006 한국터널지하공간학회논문집 Vol.8 No.3
대단면 쉴드 TBM을 이용한 터널굴착공법은 여러 기계화 시공법과 함께 향후 터널 연장의 장대화 추세에 부합하여 국내 활용도가 더욱 높아질 것으로 예상되는 터널 굴착공법이다. 특히 쉴드공법은 지반조건이 열악한 얕은 심도의 터널에 적용성이 우수한 공법으로 인식되고 있으나, 부적절한 장비선정, 터널 시공중 장비결함, 예상치 못한 지반조건 조우 등의 문제로 인하여 시공 중 사고 트러블 사례가 종종 발생되고 있다. 특히 터널막장에서의 트러블 발생 빈도가 매우 높아, 안정적이고 효율적인 굴착을 위해서는 굴착중 막장압 관리가 매우 중요하다. 따라서 본 연구에서는 터널막장의 안정화를 위한 이론적 막장지보압 산정방법의 고찰과 수치해석적 방법에 의한 지보압에 따른 지반거동 양상을 비교 분석 하였다. A large sectional tunnelling method using Shield TBM is expected to be popular as domestic demand of long tunnel gets growing. Although a shield tunnelling method has been recognized as prominent method in consideration of stability and applicability in shallow and poor ground, the cases of accident and constructional trouble have been often happened due to unexpected poor ground condition, or selection and use of improper shield machine. Especially, troubling cases at tunnel face are frequently occurred, so supporting pressure control of tunnel face would be the main issue for securing safer and more efficient tunnel excavation using Shield TBM. In this point, we carried out the numerical feed-back analysis to compare the ground deformation pattern with theoretical result at tunnel face.
조용근(Yong Keun Cho),김상훈(Sang Hoon Kim),김연재(Yeun Jae Kim),이영석(Yung Seuk Lee),이원식(Won Sik Lee),정태훈(Tae Hoon Jung),김용주(Yong Joo Kim) 대한내과학회 1991 대한내과학회지 Vol.40 No.2
N/A To evaluate the effectiveness of bronchial artery embolization (BAE) in control of massive or recurrent hemoptysis, a retrospective comparison study was made between 74 patients treated with BAE and 116 patients treated without BAE. The most frequent cause of hemoptysis was tuberculosis (67%)-43% active and 24% inactive, followed by bronchiectasis (20%). Immediate control of hemoptysis was achieved in 49 of 74 patients (66.2%) treated with BAE and 49 of 116 patients (42.2%) treated without BAE; the patients treated with BAE showed a higher success rate. The rebleeding rate was 69% in patients with BAE and 58% in patients without BAE, with no remarkable difference. The complications such as chest pain, voiding difficulty, fever, rash and paralysis of lower limbs were recovered. These facts suggest that the BAE is relatively safe and more useful in immediate control of massive hemoptysis.
T 형 만성 림프구성 백혈병에 동반된 순수 적혈구 형성부전증 1 예
곽재용,이홍,이미경,장재호,임창열,최삼임,송현모,최병문,박상석,이성중,조용곤,김윤정,이혜수 대한내과학회 1997 대한내과학회지 Vol.52 No.2
Pure red cell aplasia(PRCA) is characterized by anemia, absence of reticulocytes in the peripherial blood and selective erythroid hypoplasia in the bone marrow. Acquired PRCA is often associated with thymoma but may also occur in many diverse conditions, such as chromic lymphocytic leukemia, systemic lupus erythematosus, autoimmune disorders, T gamma lymphocytosis, acquired hypogammaglobulinemia, acquired immunodeficiency syndrome. Recently we experienced a case of T cell chronic lymphocytic leukemia associated with pure red cell aplasia. A 65-year-old man was presented with severe anemia. absolute reticulocytopenia, hepatosplenomegaly and lymphocytosis(T cell marker' CD2, CD7 positive). Bone marrow findings showed a marked decrease in erythroid precursors and normal maturations of granulocytic and megakaryocytic series, which were consistent with pure red cell aplasia. So we report this case with a review of the literature.