• Title/Summary/Keyword: 동반경

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Surgical Treatment of Traumatic Rupture of Thoracic Aorta (외상성 흉부대동맥 파열 수술)

  • Hahm, Shee-Young;Choo, Suk-Jung;Song, Hyun;Lee, Jae-Won;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.774-780
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    • 2004
  • Although traumatic thoracic aortic rupture is potentially a fatal condition requiring surgical attention, the presence of concomitant injury involving other parts of the body may greatly increase the risk of cardio-pulmonary bypass. We report our experience of treating associated injuries prior to the thoracic aortic rupture in these patients. Material and Method: From 1997 to 2003, the medical records of 24 traumatic aortic rupture patients were retrospectively reviewed and checked for the presence of associated injury, surgical method, postoperative course, and complications. Surgical technique comprised thoracotomy with proximal anastomosis under deep hypothermic circulatory arrest followed by side arm perfusion to reestablish cerebral circulation. CSF drainage was performed to prevent lower extremity paraplegia. Result: Major concomitant injuries (n=83) were noted in all of the reviewed patients, Of these, there were 49 thoracic injuries, 18 musculoskeletal injuries, and 13 abdominal injuries, Operations for associated injuries (n=16) were performed in 12 patients on mean 7.6$\pm$12.6 days following the injury. The diagnosis of aortic rupture at the time of injury was detected in only 18 patients. Delayed surgery of the thoracic aorta was performed on average 695$\pm$1350 days after injury and there were no deaths or progression of rupture in any of these patients during the observation period. There were no operative deaths and no major postoperative complications. Conclusion: Treating concomitant major injuries prior to the aortic injury in traumatic aortic rupture may reduce surgical mortality and morbidity.

Synchronous Double Primary Malignant Neoplasm Consisted of Myxofibrosarcoma of the Forearm and Adenocarcinoma of Rectum (전완부의 점액섬유육종과 직장의 선암이 동반된 동시성 다발성 원발성 종양)

  • Chung, Kee-Yun;Chun, Young-Soo;Han, Chung-Soo;Choi, Il-Hoen
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.146-151
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    • 2008
  • Multiple primary malignant neoplasm of the combination of the musculoskeletal system and the gastrointestinal system were very rare. A case of synchronous double primary malignant neoplasm consisted of myxofibrosarcoma of forearm and adenocarcinoma of rectum in a 52 year-old man was found. The patient had pain and swelling on forearm for 1 year. Histologically, the lesion on forearm showed myxofibrosarcoma. In systemic evaluation, the adenocarcinoma of rectum was found by the sigmoidoscopy, and metastasis on lung and intracardiac mass were found by the CT scan. We performed surgical excision and pre and postoperative chemotherapy after pathologic confirmation. He died of pulmonary thromboembolism after postoperative 2 months. We report this case of exceedingly rare combination of the musculoskeletal system and the gastrointestinal system.

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A Influencing Factors in Korea Adults Stroke (한국인의 뇌졸중에 영향을 미치는 요인)

  • Shin, Seung-Ok;Roh, Eun-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.12
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    • pp.6227-6236
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    • 2013
  • This study examined the health behavior and comorbidity based on a community health survey of stroke patients in 2010. The subjects were 4,449 adults over the age of 19 years, who were diagnosed by doctors and completed a community health questionnaire. The subjects demographic characteristics, health behavior and comorbidity were analyzed. Significant differences in age, education, smoking and alcohol consumption were observed. The influencing factors for comorbidity according to gender included myocardial infarction, diabetes and depression. According to the characteristics of comorbidity of the life cycle, hypertension, myocardial infarction and depression. The influencing factors related to the 19-44 year age group included Ex-smokers, 45-64 year old ex-smokers, diabetes, hyperlipidemia, atopic dermatitis, and the 75 year and over group with diabetes, hyperlipidemia, tuberculosis, and atopic dermatitis. This study suggests that health education and a health policy approach based on the relevance between stroke and comorbidity, and the health behavior according to the life cycle and gender are needed.

Surgical Treatment of Main Pulmonary Artery Aneurysm with Patent Ductus Arteriosus -A Case Report- (동맥관개존증에 동반된 주폐동맥류의 수술치험 - 수술치험 1례)

  • 김대식;이성주;권오우;김창회;채성수;오성철
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1270-1275
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    • 1996
  • Pulmonary artery aneurysms are extremely rare conditions usually associated with congenital cardiac defects that cause increased pulmonary blood flow and pulmonary hypertension. The prognosis of pulmonary artery aneurysms is fatal due to the potential for rupture of the aneurysm and the underlying severe pulmonary hypertension. A 40-year old woman was admitted to our hospital with headache following traffic accident. On admission a continuous murmur was heard over the 2nd to 3rd intercostal space along left sternal border and a calcified cystic mass at left hilar portion was incidentally discoverd on chest reontgenogram. Cardiac catherization was diagnostic of a left to right shunt at main pulmoanry artery level and pulmonary hypertension. Pulmonary angiogram demonstrated a large aneurysm of main pulmonary artery extending into proximal left pulmonary artery. The pulmonary artery aneurysm associated with patent ductus arteriosus was diagnosed definitively and the patient was underwent resection of pulmonary artery aneurysm, closure of PDA and Dacron prosthetic graft replacement under cardiopulmonary bypass. The postoperative course was uneventful and the patient was discharged without any problem.

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The Clinical Results of Meniscus Allograft Transplantation - Comparison between medial, Lateral, Isolated and Combined Procedure Groups - (동종 반월상 연골 이식술의 임상적 결과 - 내측과 외측 및 동반 손상의 유무에 따른 비교 -)

  • Cho, Seung-Mok;Yoon, Kyoung-Ho;Lee, Jung-Hwan;Bae, Dae-Kyung;Song, Sang-Jun;Kang, Chang-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.28-33
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    • 2009
  • Purpose: To compare the clinical outcomes after meniscus allograft transplantation between lateral and medial or isolated and combined procedure groups. Materials and Methods: Of the patients who had undergone arthroscopic meniscal allograft transplantation between Dec. 1997 and Jun. 2007, 52 patients were available for retrospective evaluation. Patients were grouped into lateral(33 cases) and medial(19 cases) transplant groups as well as those with isolated(18 cases) and combined(34 cases) procedure. The average age was 34.2 years and the mean follow-up period was 42.2 months. Postoperative range of motion (ROM), visual analog scale (VAS), International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner score, patient's subjective satisfaction, $2^{nd}$ look arthroscopy and MRI were evaluated retrospectively. Results: Mean postoperative ROM was $130.3^{\circ}$. The VAS showed an improvement from 5.96 to 3.05 at the last follow up. IKDC subjective score and Lysholm score also showed an improvement from 46.5 to 64.5 and from 61.9s to 79.58 respectively. Tegner score was improved from 2.9 to 3.6. Overall, 61.5% of patients reported they were completely or mostly satisfied with procedure. There were no significant differences noted between lateral and medial groups as well as isolated and combined groups. In 2nd look arthroscopy, 10 of 18 cases showed good pheripheal healing and there were 6 cases of partial and 2 of complex tear. We observed graft subluxation or extrusion in 12 of 16 cases who were evaluated with follow-up MRI. Conclusion: Meniscus allograft transplantation alone or in combination with other procedure showed an improvement in knee pain and clinical score. But there were no significant difference between lateral and medial groups or isolated and combined procedure groups.

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Clinical outcome in relation to stability of longitudinal meniscal tear associated with anterior cruciate ligament rupture (전방 십자인대 파열에 동반된 반월상 연골판 종파열의 파열부위 안정성에 따른 치료 결과)

  • Seo, Seung-Suk;Kim, Chang-Wan;Kim, Jin-Seok;Kim, Jeon-Gyo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.91-97
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    • 2010
  • Purpose: The purpose of this study was to evaluate the results of treatment for longitudinal meniscal tear in ACL rupture patients by clinical evaluation and $2^{nd}$ look arthroscopy. Materials and Methods: Among the patients who underwent surgery due to ACL rupture and longitudinal meniscal tear between 2002~2009, 32 patients were selected for the study. The patients were devided into three groups; group 1 had repair, group 2 had partial menisectomy due to impossible to repair, group 3 had conservative treatment due to stable meniscus. Comparative retrospective analysis was applied with KT 1000 arthrometer, Lysolm' score, Tegner activity score, IKDC subjective score, and $2^{nd}$ look arthroscopy. Results: Lysolm' score, Tegner activity score, IKDC subjective score showed no statistical difference in all three groups. KT-1000 side to side difference improved from 6.2, 6.15, 6.38 before surgery to 2.56, 2.49, 2.58 after surgery in group 1, 2, and 3, respectively. In group 1, second-look arthroscopy revealed complete healing in 12 patients, incomplete healing without any clinical symptoms in 2, and healing failure in 1. In group 2, second-look arthroscopy showed partial regeneration on margin of meniscectomy. In group 3, second-look arthroscopy revealed complete healing in 2 patients, while 4 showed incomplete healing so that have repaired. Conclusion: In the study, the outcome was better when the stable longitudinal meniscal tear on posterior horn with ACL rupture had active treatment.

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Transcholecystic Duodenal Drainage as an Alternative Decompression Method for Afferent Loop Syndrome: Two Case Reports (들장관증후군의 대체 감압 치료로서 경담낭 십이지장 배액술: 두 건의 증례 보고)

  • Jihoon Hong;Gab Chul Kim;Jung Guen Cha;Jongmin Park;Byunggeon Park;Seo Young Park;Sang Un Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.661-667
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    • 2024
  • Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

Laparoscopic Nissen Fundoplication and Collis Gastroplasty (복강경을 이용한 니센 위저추벽성형술 및 콜리스 위성형술)

  • Song Sang-Yun;Park Jeong-Min;Jung In-Suk;Anh Byung-Hee;Na Kook-Ju
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.733-738
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    • 2006
  • The prevalence of gastroesophageal reflux disease has been increased recently in Korea. The use of minimally invasive laparoscopic and thoracoscopic surgery has become popular in the operation of esophageal disease such as esophageal cancer or gastroesophageal reflux disorder. We experienced three cases of laparoscopic Nissen fun-doplications and one case of laparoscopic Collis gastroplasty, and we will describe the technical aspect of these surgeries.

Discoid Medial Meniscus in the Knee - A case report - (슬관절 내측 원판형 연골 - 1례 보고 -)

  • Kyung, Hee-Soo;Kim, Kyung-Hoon;Oh, Chang-Wug
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.58-62
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    • 2009
  • A discoid medial meniscus is a relatively rare pathology of the knee joint, and we recently encountered a patient with discoid medial meniscus, and this report is a case of therapeutic experience in this patient. The patient was twenty years old man who had a persistent dull pain for several years without specific trauma history. He was presumptively diagnosed as discoid medial meniscus by MRI, and arthroscopic examination confirmed the presence of the complete type of discoid medial meniscus with horizontal tear. We performed arthroscopic partial meniscectomy, and the patient could get free from symptom.

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Arthroscopic Assisted Reduction and Internal Fixation of Lateral Femoral Epiphyseal Injury in Old Adolescent Soccer Player - Report of 1 Case - (청소년기 축구선수에서 원위 대퇴외과 성장판 손상의 관절경하 정복 및 내고정 - 1례 보고-)

  • Lee, Yong-Seuk;Jung, Jae-Kyoung;Kong, Chae-Kwan;Shin, Yoon-Chang
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.66-69
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    • 2007
  • Sports-related knee injuries frequently occur in adolescent period and fractures are more common than ligamentous Injuries in this age group because of physiologic characteristics. We operated an adolescent soccer player with lateral femoral epiphyseal injury using arthroscopic assisted reduction and infernal fixation. In $2^{nd}$ look arthroscopy and metal removal at postoperative 2 years, articular cartilage was healed with good congruity and lower extremity entire long film showed normal axial alignment without residual deformity.

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