• Title/Summary/Keyword: 간 절제술

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A Clinical Use of CT Scan in Rectal Cancer (직장암 단층촬영(CT)의 임상적 이용)

  • Suh, Bo-Yang;Chung, Yong-Sik;Lee, Su-Jeung;Shim, Min-Chul;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.67-72
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    • 1986
  • Authors evaluated the accuracy of preoperative pelvic CT scan staging and its effects on management in 12 biopsy proved rectal cancer patients. Authors also studied postoperative CT in 5 patients to detect disease recurrence and metastasis. Preoperative CT staging was identical to surgical and/or pathological staging in 9 patients(75%), but it was underestimated in two cases and overstimated in one instance than in surgical stagings. In 7 cases, CT scan didnot alter original choice of procedures. However, preoperative CT staging gave definitive informations to change management plans in 5 cases otherwise the treatment would be difficult and inadequate. Postoperative CT showed local recurrence in one and liver metastases in 2 cases. One of them was not detected at exploratory laparotomy.

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Recurrent Early Gastric Cancer with Liver Metastasis Mimicking Pancreaticobiliary Cancer (조기위암으로 위 절제술 후 갑자기 발생한 췌담도암으로 오인되었던 재발성 위암 1례)

  • Byung Hoo Lee;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.48-51
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    • 2013
  • We report an unusual case of postoperative early gastric cancer with liver metastasis mimicking pancreaticobiliary carcinoma. A 73-year-old man with early gastric cancer was transferred for endoscopic treatment. The patient underwent endoscopic submucosal dissection for the treatment of the early gastric cancer. The pathological diagnosis was adenocarcinoma with extension to the deep submucosa and some lymphatic invasion. Therefore, subsequent a subtotal gastrectomy was performed. The histological results demonstrated residual adenocarcinoma confined to the mucosa. The resection margin and lymph node metastasis were negative. Thus, he was closely monitored for recurrence every 6 months. After 2 years, he was suddenly suspected of developing liver metastasis and local recurrence. He received a liver biopsy, and the pathological result was poorly differentiated adenocarcinoma. Immunohistochemical staining suggested pancreaticobiliary carcinoma rather than metastatic adenocarcinoma from the stomach or colon, but primary focus was not found. We were sure that the recurrent stomach cancer metastasized to the liver because stomach cancer can show heterogeneous cytokeratin (CK) expression pattern with various histological features. Therefore, no single CK expression pattern has diagnostic value for distinguishing gastric carcinoma. The patient underwent chemotherapy for metastatic stomach cancer.

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A Case of Bronchial Obstruction Due to Bronchial Angulation after Upper Lobectomy (엽절제술 후 기관지 꺾임에 의하여 발생한 기관지 폐쇄 1예)

  • Lee, Ho-Su;Yim, Ji-Hye;Kim, Woo-Jin;Shin, Ji-Hoon;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.216-219
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    • 2009
  • A bronchial obstruction of the remaining lung is a rare complication of thoracic surgery. We report a case of this rare complication after a right upper lobectomy due to a giant bulla. Post-resectional angulation of the bronchus intermedius caused the bronchial obstruction. An intrabronchial stent was inserted into the bronchus intermedius, which relieved the obstruction.

Circular Stapled Billroth I Anastomosis after Distal Subtotal Gastrectomy - Anastomotic Complications and Prevention - (원위부 위아전절제술 후 원형문합기를 이용한 위십이지장 문합술 - 문합부 합병증과 예방책 -)

  • Lee, Moon-Soo;Kang, Gil-Ho;Cho, Gyu-Seok;Kim, Yong-Jin;Kim, Hyung-Soo;Lee, Hwa-Soo;Kim, Sung-Yong;Baek, Moo-Jun;Kim, Chang-Ho;Cho, Moo-Sik
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.103-108
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    • 2006
  • Purpose: The circular stapled Billroth I gastrectomy has been gradually popularized because of several advantages. Thus, this study aims to identify what to be supplemented for the safety of this technique by examining the potential complication after the circular stapled Billroth I gastrectomy. Materials and Methods: This study selected 594 patients who underwent the circular stapled Billroth I gastrectomy because of the gastric cancer in our department of surgery from Jan. 1998 to Dec. 2004 as the subjects. As of Jan. 2001 when the bleeding on the anastomosis site was visually checked through the small incision at the opposite curvature to the lesion of the stomach to be resected and so the operation was completed, the patients were divided into the Group I (n=219) and Group II (n=375), which were the patients before and after Jan. 2001, respectively. Then, the clinical characteristics and postoperative anastomotic complications of both groups were compared. Results: For the comparison of complications between two groups, the anastomotic leakage was found in four cases in Group I and three cases in Group II (p=0.196). The stenosis on the anastomosis region was not observed in both groups. The bleeding on the anastomosis region illustrates the statistically significant difference between Group I and Group II, with 43 cases and 2 cases, respectively (P=0.0019). Conclusion: The circular stapled Billroth I gastrectomy is recommended because of several advantages of this technique. However, the bleeding on the anastomosis site may be indicated as the critical issue. Accordingly, the visual check on the bleeding on the anastomosis site during the operation will improve the safety of circular stapler.

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A STUDY ON THE CHANGES OF PHARYNGEAL AIRWAY, HYOID BONE AND HEAD POSTURE BEFORE AND AFTER TONSILLECTOMY IN FUNCTIONAL CLASS III MALOCCLUSION PATIENTS (기능성 III급 부정교합자에서 편도 절제술 전 후의 pharyngeal airway, hyoid bone, head posture에 관한 연구)

  • Park, Won-seo;Lee, Jin-Woo;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.231-243
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    • 1997
  • This study was carried out in order to find out the changes of the pharyngeal airway, hyoid bone and head posture before and after tonsillectomy in functional class III malocclusion patients. For this study, 21 Angle's class I patients and 21 Angle's class III patients, totally 42 subjects were chosen. The results were as follows; 1. In comparison to Class I group, tongue was more anteriorly and hyoid bone was more inferiorly positioned in functional Class III group 2. In comparison to pre-tonsillectomy, tongue was more posteriorly positioned and larger nasopharynx depth was shown in post-tonsillectomy. In post tonsillectomy, the hyoid bone was displaced posteriorly and superiorly and counterclockwise rotation was shown. 3. The level of significance for the correlation shown was 5 percent (p<0.05) indicating that: The change of nasopharyx depth was correlated to the inclination of lower incisors. Vertical change of tongue posture was correlated to the hyoid axis change. Vertical change of hyoid bone was correlated to the horizontal change of hyoid bone, craruocervical inclination. The change of craniocervical inclination was correlated to the inclination of lower incisors. 4. After the tonsillectomy, counterclockwise rotation of hyoid axis was associated with decease of hya-NL and large nasopharyngeal airway. High posture of the tongue was associated with decrease of hya-NL. Posterior posture of the tongue was associated with increase of h-hl,and decrease of hya-ba-n.

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Surgical Treatment of Multiple Lung Abscesses with Adenoid Cystic Carcinoma - A Case Report - (선양 낭포암에 의한 다발성 폐농양의 외과적 치료 - 1례 보고 -)

  • 김도형;조현민;정은규;강두영;손국희;이두연
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.73-76
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    • 2002
  • Adenoid cystic carcinoma is a very slowly growing and directly invasive cancer. The treatment of choice is complete surgical resection but if major complications associated with remaining carcinoma occur, aggressive conservative treatment to prevent complication is able to gain long term survival even though remaining carcinoma metastases to other organs. We experienced a case of surgical treatment of uncontrollable fever that caused by multiple lung abscesses due to obstruction of left main bronchus with adenoid cystic carcinoma. The post operative course was uneventful for 4 months to now.

Arthroscopic Treatment for the Pigmented Villonodular Synovitis in the Knee (슬관절에 발생한 색소 융모 결절성 활액막염의 관절경적 치료)

  • Bae, Dae-Kyung;Cho, Nam-Su
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.22-26
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    • 2001
  • Purpose : To confirm the efficacy of arthroscopic synovectomy fur the pigmented villonodular synovitis in the knee. Materials and Methods : Between October 1996 and February 2000, the arthroscopic synovectomy had been performed in six patients(six knee joints), whose diagnoses were confirmed by pathologist. All patients complained of painful swelling in involved knee and four of the six patients had trauma history. There were three male and three female patients. Average age was 35.8 years ranging from 16 to 67 years. Follow up period was average 22.7 months(range, $13\~53$ months). Results : According to arthroscopic findings, there were three localized forms and three diffuse forms. At their last follow-up examinations, all patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : Complete arthroscopic excision is the definitive treatment for localized pigmented villonodular synovitis and meticulous arthroscopic excision through all portals including posterior portal can be considered as a valid alternative to traditional open synovectomy for the patients with diffuse pigmented villonodular synovitis.

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Risk Factors for Renal Function Impairment Following Radiofrequency Ablation of Renal Tumors (신장 종양 고주파 절제술 이후 신장 기능 저하의 위험요소)

  • Il Cheol Park;Seong Kuk Yoon;Dong Won Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.317-330
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    • 2022
  • Purpose To evaluate the various factors that affect renal function following percutaneous radiofrequency ablation (RFA) therapy in patients with renal tumors. Materials and Methods Between 2010 and 2018, 91 patients diagnosed with renal tumors using ultrasonography and CT-guided RFA were enrolled. We retrospectively investigated the serum creatinine (SCr) level and estimated glomerular filtration rates immediately prior to RFA and during post-treatment follow-up. The patients were divided into two groups based on the degree of change in SCr level (0.3 mg/dL). Group comparisons were performed using univariable and multivariable logistic regression analyses to determine the factors impacting renal function. Results Impaired renal function was associated with solitary kidney, chronic kidney disease (CKD) over stage 3, and pyeloureteral injury. Sex, age, other cancers, tumor size, location, growth pattern, and proximity to the collecting system were not significantly associated with impaired renal function. There was a difference in the overall change over time between the association with and without solitary kidney, CKD stage 3, and pyeloureteral injury. Conclusion Among the medical conditions present prior to RFA, solitary kidney and CKD over stage 3 could be considered as risk factors for impaired renal function. Post-procedural pyeloureteral injury can also be considered a risk factor.

Intermediate Term Follow Up for R3 Sympathicotomy in Palmar Hyperhidrosis (수장부 다한증에서의 제3번 늑골 위 교감 신경(R3) 차단술의 중기 결과)

  • 손국희;김광호;백완기;김정택;김현태;김영삼;윤용한
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.530-535
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    • 2004
  • Background: Thoracoscopic R3 (above the third rib)sympathicotomy has been performed as an effective method in treating palmar hyperhidrosis because it is effective in eliminating the symptoms of hyperhidrosis and has lower degree of compensatory hyperhidrosis than that of sympathectomy. Most of the results published were based on the short-term follow up. So we evaluated the intermediate term follow up results of the R3 sympathicotomy. Material and Method: From April 1999 to August 2001, ninety-four patients with palmar hyperhidrosis had been treated by R3 sympathicotomy at the Inha University Hospital. Follow-up study was completed for 76 patients (male 38, female 38) and average follow-up period were 25$\pm$9.1 (15∼50) months. The sympathetic trunk passing above the upper border of third rib was divided by electric cautery. The patient's satisfaction after surgery was estimated using the analogue scale from score 0 to 100 (100 means perfect satisfaction). Result. The scale of patient's satisfaction immediately after operation was 92.36$\pm$9.93. After 15 months, the scale of satisfaction was decreased to average 71.80$\pm$20.24 and it is statiscally significant. The cause of dissatisfaction were compensatory hyper-hidrosis and recurrence of symptom. The degree of sweating immediately after operation was mean 0 and after 15 months it increased to mean 1.5. The degree of the compensatory hyperhidrosis immediately after operation was mean 1 and it increased to mean 5 after 15 months. Conclusion: R3 sympathicotomy has excellent therapeutic results immediately after operation but therapeutic effectiveness is becoming to decrease 15 months after operation. The common causes of dissatisfaction are compensatory hyperhidrosis and recurrence of hyperhidrosis.

Arthroscopic Meniscectomy in Patients Aged Over 50 - More than 3 Years Follow-Up Result - (50세 이상 환자에서의 반월상 연골 절제술 - 최소 3년 이상 추시 결과 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Go, Sang-Hun;Jung, Kwang-Hwan;Cha, Jae-Ryong;Lee, Chae-Chil;Jeong, Ji-Young;Seo, Dong-Kyo
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.107-111
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    • 2008
  • Purpose: To evaluate the clinical and radiographical results of arthroscopic meniscectomy in patients aged over 50 with minimum 3-year follow-up. Materials and Methods: Of the patients who had undergone arthroscopic meniscectomies between Dec. 1997 and Dec. 2003, 36 patients(36 knees) were available for retrospective evaluation. The average age at the time of surgery was 56.4 years and the mean follow-up period was 63 months. According to the Kellgren-Lawrence classification, grade I change were noted in 16 patients, II in 12, III in 6 and IV in 2. According to Outerbridge classification, grade I articular lesions were noted in 16 patients, II in 10, III in 7 and IV in 3. Postoperative Lysholm score, patient s subjective satisfaction and radiographic changes were evaluated retrospectively. Results: Twenty-four patients(66.7%) were good or excellent for the Lysholm score and 26 patients(72.2%) were satisfied at final follow-up. Tibiofemoral angle was changes from mean valgus 3.9 degrees to mean valgus 2.6 degrees and 22 patients(61.1%) showed the progression of osteoarthritic changes. Conclusion: The satisfactory results could be obtained in 72.2% of patients aged over 50 with a minimal follow-up of 3 years after arthroscopic meniscectomy. The results tended to be worse in patients with moderate or severe tibiofemoral osteoarthritic changes or with articular cartilage lesions.

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