?????

1. ????? ?? ???

2. ??

3. ??(Lung cancer) ?? Adenocarcinoma ???,?30~40%,???,???????? ????,??????,???pleural effusion SCC ????,?25~40%,?????,???????? ???????,???? Small cell anaplastic carcinoma (oat cell) ?15~25%,???????? ???????,???? ????????,??????? Undifferentiated large cell carcinoma ??,???,????

4. ?????? ??????? ?????? ???????????????????? ??????????????????? ?????? BAL?tumor biopsy?blunt biopsy ??????????

5. ?????????????? ???????????????? ????????????????? ??IIIA?IIIB???????? ????? ???????????????? ????????????? ????????????????????? ??????

6. ????? ????? ?????? ?????? ??????? TNM???? T:?????????? N:??????? M:??????? ????????????,??? cTNM:????(clinical staging) sTNM:????(surgical staging) pTNM:????(pathological stagin)

7. ?? TNM stage T1:<=3cm T2:>3cm,???visceral pleural,?carina <2cm,atelectasis T3:??????,????????????????????????????,??????? T4:??????,????????????????????????????,??????? N1:?????????? N2:????????? N3:?????????????????????????

11. ??????? ??????? ???? ???? ???? ???? ????:stage I ~ stage IIa ???????? ??:????+?????? ????:stage IIb ~ stage IIIa ???????,????????????? ??:stage IIIb ~ stage IV ?????????????

12. ???????? ??????? ????: ????????????????? ????: ?????????????? ???????: ??????? ?????????????? ?????????? ???????: ????????? ???????

13. ????? Spirometry Lung volumes Diffusing capacity Ventilatory reserve

14. ?????????????(Lockwood) FEV1 < 1.2L ? < 35% FVC MVV < 28 L/min FVC < 1.7 L RV > 3.3 L TLC > 7.9 L RV/TLC > 47% ?????????(Miller) MVV > 55% prediction FEV1 > 1L FEF 25~75% > 0.6 L/min In gerneral FEV1 > 2L FEV1 > 60% prediction

15. ?????(bronchiectasis) ?? ??? Cystic fibrosis ? ??? Kartagerner’s syndrome ? ??? situs inversus Bronchiectasis sinusitis Congenital cystic bronchiectasis Primary hypogammaglobulinemia a1-Antitrypsin deficiency Congenital deficiency of bronchial cartilage Bronchopulmonary sequestration ??? Infection Bronchial obstruction Scarring secondary to TB Acquired hypogammaglobulinemia

16. ??? ????????6~9?? Isoniazid(INH) Rifampin Pyrazinamide(PZA) Ethambutol Vit B6 ????TB?indication ????????? ?TB?????? ??????????????????? ??????,????????? ??bronchiopleural fistula?empyema?

17. ?????? Liebow?? Epithelial tumors Papilloma Polyps Msodermal tumors Vascular Angiomas Lymphangiomyomatosis Bronchial tumors Fibroma Chodroma, osteochondroma Lipoma Granular cell tumor Leiomyoma Neurogenic tumors Developmental or unknown origin tumors Hamartoma Teratoma Chemodectoma Clear cell tumor Thymoma Inflammatory and other pseudo-tumors Plasma cell granuloma Pseudo lymphoma Xanthoma Amyloid Tracheobronchopathia osteoplastica Bronchial adenomas Carcinoid Salivary gland types Cylindroma Mixed tumors ???????????? Sclerosing hemangioma Harmatoma Papilloma Polyp Pulmonary arteriovenous fistula

18. Pulmonary Sequestration ??? ?????????? ?? ????(intralobar) ????????? ????????? ???????? ??:????????????? ????????? ????(extralobar) ????????,??????? ?????????? ?????azygus vein?para-azygus vein ???

19. ?????????indication Infantile lobar emphysema Cystic malformation of the lung

20. ???? ??????????,????2??? ??????(emphysema, COPD) ??????(cystic fibrosis, bronchiectasis) ??????(idiopathic pulmonary fibrosis) ??????(primary pulmonary hypertension) ???????????? ???????????????????? ???????? ???????????? ???????????? ????????????? ????????? ???????? ?? ????????

22. ????????? ????????? Ischemia-reperfusion injury Chronic allograft rejection ?????????????? Size-Mismatched Lungs Living Lobar Split Lung Transplantation Non-heart-beating Donors

24. ???

25. ????? ?? ??????? Trauma Foreign body swallowing Penetration Corrosive injury with perforation Boerhaave complex syndrome ???????? ?????????? ??????????????? ?? (?????….etc) ???:50~60%

26. ????? ??????????15% ?????????? Neurogenic tumor Neurofibroma??? Teratodermoids Lymphoma Thymoma Bronchogenic tumor Pericardial cysts Thyroid adenoma Enteric cysts

27. ????????? ??? Thymoma Lymphoma Thyroid adenoma Parathyroid adenoma ??? Thymoma Teratodermoid Carcinoma Lymphangioma Hemangioma lipoma ??? Pericardial cyst Bronchogenic cyst Lymphoma ??? Neurogenic tumor Enteric cyst

29. ???(Thymoma) ???????(95%) ???????(myathenia gravis)????30%~50% ????????????????10%~15% ??????????(3%) ??????????????????

34. Parathymic syndrome 40% with parathymic syndrome. Myasthenia gravis. Pure red cell aplasia. Immunoglobulin deficiency. Systemic lupus erythematosus—infrequently, 2.5%, poor prognosis. Nonthymic cancer—17-21%. Inappropriate antidiuretic hormone secretion(SIADH)-- rarely, malignant thymoma and spindle cell thymoma.

35. Myasthenia gravis Most commonly associated disease. 30% of patient with thymoma associate with MG. Only 5-15% patient with MG have thymoma. 10-15 older than patient with MG without tumor, younger than patient with thymoma without MG. Any type of thymoma except spindle type, marked associated squamous elements in thymus. Little affect on local presention, clinical behavior, prognosis. Better prognosis than patient with thymoma without MG.

36. Thymic carcinoma Low and high grade. Malignant cytologic and architectural feature. Staging not standardized.

38. Multiple endocrine neoplasia(MEN) MEN I(Werner syndrome) Single or multiple parathyroid adenoma Islet cell tumor of pancreas Adrenal neoplasm Thyroid adenoma Multiple lipoma MEN II(Sipple syndrome) Thyroid medullary carcinoma Pheochronocytoma Parathyroid neoplasia

39. ??

40. Tracheal tumors Malignant tumors Adenoid cystic carcinoma Bronchial carcinoids Neuroendocrine tumors Squamous cell carcinoma Benign tumors Squamous papillomas Cartilaginous tumors Tracheal stenosis Capillary perfusion pressure is a crucial consideration Tracheal foreign body Most are children, particularly aged 1-3 years A toy, with balloons accounting for 29% of deaths The mortality rate is approximately 1%. Tracheal rupture

41. ??(Tracheostomy) Indication Mechanical ventilation dependency Poor sputum expelling function Upper airway obstruction Method Incision should be made on 2nd~4th tracheal ring Complication Bleeding Wound infection Tracheal stenosis Subcutaneous emphysema Fistula

42. ??

43. ??????? ??????(pectus excavatum) ??????(pectus carinatum) Poland????(Poland’s syndrome) ????(sternal defects)

44. ??????(pectus excavatum) ??? ???=4:1 ??????(30%) Marfan’s syndrome???????????? Pectus index: ???????÷??????? ??3.25~3.4????? ????: Ravitch(<14y/o) Wada Nuss