• The Korean Society of Law and Medicine
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• v.18 no.1
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• pp.265-295
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• 2017

Breast tissue is composed of skin, mammary gland(including lactiferous duct), subcutaneous fat layer. The anatomical position is on the anterior chest wall(the outside of the chest cavity) but not on the inside of the thorax. Therefore, when the internal organs in the thoracic cavity are defined and expressed as 'organs' and the internal organs of each are labeled for a long time, for the breast located outside the thoracic cavity, it is thought that there is considerable difficulty in defining and recognizing the breast tissue as organs. For this reason, it is necessary to discourage the controversy over whether or not the breast is contained in the chest(or intra-thoracic cavity). In order to completely exclude it, it is assumed that the "chest-abdomen" can be called the "intra-thoraxic or intra-abdominal." But it is difficult to change the terms in various laws and regulations, I think that it would be necessary to insert only the clue clause "Breasts are excluded" in the detailed criteria for grading. In order to include it, it is necessary to change the terms of the ordinance or to say that the breast is exceptionally included.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.930-936
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• 2001

Background: The origin site of carcinoma invading esophagogastric junction is variable. It may arise from squamous cell carcinoma of low esophagus, adenocarcinoma arising from Barrett's esophagus, adenocarcinoma of gastric cardia, or extension from proximal stomach cancer. In Korea, the majority of adenocarcinoma invading esophago-gastric junction seems to arise from proximal gastric carcinoma. Material and Method: We reviewed the data of surgically-resected gastric adenocarcinoma involving esophagogastric junction in KCCH between 1988 and 1999. Result: There were 212 cases. Male to female ratio was 156 to 56. Age distribution was between 22 and 78. Variable surgical approaches including median laparotomy, laparotomy with left or right thoracotomy, left thoracotomy, and thoracoabdominal approach were used. Postoperative pathologic stages were : Stage IA-7, IB-11, Ⅱ-25, ⅢA-73, ⅢB-34, and Ⅳ-57. Curative resection was performed in 199 patients, and total gastrectomy was performed in 200 patients. There were 77.4%(164 cases) with esophageal involvement, 74.1％(157 cases) with tumor involvement in the abdominal LN, and 8%(17 cases) with mediastinal LN metastasis. Operative mortality was 3.3%, and over-all 5 year survival rate was 35%. Conclusion: There are various surgical approaches and many things to consider for surgical resection, thoracic and abdominal approach may need for obtain proper resection margin and adequate lymph node dissection in stomach cancer invading esophagogastric junction.

• Advances in pediatric surgery
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• v.19 no.1
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• pp.25-31
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• 2013

성선 외 생식세포종양은 비교적 드물어 모든 생식세포종양의 5% 미만을 차지한다. 주로 천미부생식세포종양이 골반부나 후복막으로 확장된 경우가 대부분이며, 후복막이나 복강 내에 발생하는 생식세포종양은 매우 드물다. 저자는 복부 종괴를 주소로 내원한 18개월 된 여아에서 간 전이를 동반한 복강 내 혼합 생식세포종양을 치료하였다. 복부 초음파 및 전산화 단층촬영에서 복부 좌상사분역에 석회화, 고형 및 지방 성분을 포함하고 있는 낭성 종괴와 간에 1cm 크기의 결절이 관찰되었다. 종괴는 개복 후 제거되었으며, 병리조직학적으로 대부분의 내배엽동 종양과 적은 성숙 기형종으로 구성된 혼합 생식세포종양으로 진단되었으며, 간의 전이병변도 동일하게 진단되었다. 수술 후 항암화학요법을 시행하였으며, 환자는 현재 수술 후 10년이 경과하였으나 재발의 소견은 없다.

• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.721-724
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• 2005

Aortocaval fistula is a rare complication of abdominal aortic aneurysm, involving less than $1\%$ of all abdominal aortic aneurysms. A 64-years old man with a long history of hypertension and abdominal aortic aneurysm had chest pain, dyspnea, epigastric discomfort and palpable abdominal pulsating mass. Physical examination revealed hypo­tension with a systolic blood pressure of 70 mmHg, a large pulsatile mass and a systolic abdominal bruit. Laboratory data revealed a hemoglobin values of 11.0 g/dL, blood urea nitrogen (BUN) value of 5 mg/dL, and creatine value of $2.5 mg\%$. Abdominal Angio CT showed a 10cm infrarenal abdominal aortic aneurysm with dilatation of the IVC and aortocaval fistula from the aortic aneurysm, which was confirmed at emergency surgery. When the aneurysm was opened and the thrombus was removed, a 1 cm communication was identified between the aorta and IVC. This was controlled with Foley catheters ballooning, and the fistula was closed by continuous suture placed outside the aneurysm. A bifurcated aorto-iliac graft was used to restore arterial continuity. The patient was discharged home after uncomplicated postoperative course.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.26 no.1
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• pp.32-41
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• 2019

Purpose: The purpose of this study was to identify the risk factors for postoperative pulmonary complications (PPCs) after upper or lower abdominal digestive tract surgery. Methods: Participants in this retrospective observational study had undergone upper or lower digestive tract surgery and entered the surgical intensive care unit between March 1, 2016 and February 28, 2017. Data were collected from the medical records, operative records, results of laboratory test, and the nursing records of the hospitals. Results: Of the patients, 544 patients were enrolled in the study and PPCs -developed in 335 (61.6%) patients. On multivariate logistic regression analysis, significant risk factors of PPCs were identified: BMI (Body Mass Index; $kg/m^2$), preoperative serum BUN (Blood Urea Nitrogen; mg/dL), abdominal open surgery, or blood transfusion during operation. Conclusion: These risk factors could be used to help identify patients at risk for PPCs and then appropriate nursing interventions could be provided for patients at risk of PPCs.

• Journal of Chest Surgery
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• v.29 no.11
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• pp.1248-1256
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• 1996

From June 1987 to December 1994, 372 patients underwent operation for resection of esophageal cancer, and 48 patients with metastasis to distant abdominal lymph nodes were analyzed.. The primary tumors were located predominantly in lower thoracic esophagus(n=29). The location of involved lymph nodes were celiac L/N(n=45), common hepatic L/N(n=4), paraaortic L/N(n=l), and retropancreatic L/N(n=l). Most tumors penetrated the esophageal wall(T3,T4, n=43), metastased to regional L/N(N1, n=41), but a few tumors were limited to the esophageal wall(T1,T2, n=5), metastased to distant abdominal L/N without metastasis to regional L/N(NO, n=7). Resectability rate was 87.5%(42/48), and complete resection was possible in 31 patients(64.6%). The most frequent cause of incomplete resection and unresectability was unresectable T4 lesions(n=8), extranodal invasion(n=7). Overall operative mortality and morbidity was 4.2%, 22.9%, and resection mortality was 4.8%. Adjuvant therapy was given to 27 patients, and postoperative follow-up was possible in all patients(median follow-up, 32 months). The 1 year and 3 year survival for resection group was 54.0%, 18.1%(median, 386 days) including operative deaths. Our results suggest that resection of the esophageal cancer with metastasis to distant abdominal lymph nodes(M1LYN) can be done with acceptable mortality and morbidity, and may playa role in long-term survival in carefully selected patients because prognosis is dismal in unresectable esophageal cancer. We recommend that lymph nodes around celiac axis be dissected thoroughly for exact staging and possible prolongation of survival, and multimodality therapy as necessary because most patients with M1(LYN) esophageal cancer do poorly with only primay surgical treatment.

• Journal of Chest Surgery
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• v.36 no.1
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• pp.26-29
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• 2003

Aorto-gastric fistulas are relatively rare. Fistula formation between the aorta and the gartrointestinal tract is a serious condition that results in severe hemorrhage with a very high mortality rate, We present an unusual case of successful surgical treatment in Chonnam national university hospital ; of a patient with a aortogastric fistula into thoracoabdominal aortic aneurysm.

• Proceedings of the Korea Information Processing Society Conference
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• 2023.05a
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• pp.546-548
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• 2023

인공지능 기술을 도입한 의료분야에서 진단 및 예측을 위한 관련 연구가 활발하게 진행되고 있다. 특히, 인공지능 기술 적용에 가장 많이 활용되고 있는 의료영상을 기반으로 하는 질환에 관한 진단 연구는 매우 복잡한 과정이 필요한 질환의 진단에 큰 영향을 미치고 있다. 복부 장기들의 분할은 환자의 질환 진단 지원 및 복강경등의 수술 지원에 매우 중요한 부분을 차지한다. 본 논문에서는 의료영상을 통해 13가지 복부 장기들을 분할하는 모델을 만들고 그 결과를 보인다. 본 논문에서 제안한 모델을 통해 13가지 복부 장기에 대한 분할로 영상분석을 통해 진단 지원이 가능할 것으로 기대한다.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.250-255
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• 2008

Purpose: The purpose of this study was to assess the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for detecting the lymph node (LN) metastasis of gastric cancer. Materials and Methods: 119 patients (M : F=89 : 30; mean age: 64) with gastric cancer were referred for preoperative FDG-PET/CT scanning and spiral enhanced abdominal pelvic CT from June 2006 to July 2008, and these were the subjects of our study. All the patients underwent curative radical gastrectomy and lymph node dissection. A final diagnosis was made for all the patients by the histology of the surgical specimens. Results: Both PET/CT and enhanced CT showed similar sensitivity for detecting regional lymph node metastasis (32.6% vs 39.5%, respectively). PET/CT was more accurate than enhanced CT for detecting regional lymph node metastasis (67.2% vs 63.0%, respectively), and PET/CT showed better specificity (86.8% vs 76.3, respectively) and a better positive predictive value (PPV) (58.3% vs 48.6%, respectively). PET/CT showed better specificity (98.0% vs 88.2%, respectively) and accuracy (79.4% vs 73.9%, respectively) than enhanced CT for detecting early gastric cancer. PET/CT showed better specificity (64.0% vs 52.0%, respectively), a better PPV (60.9% vs 57.1%), a better negative predictive value (NPV) (48.5% vs 46.4%, respectively) and better accuracy (53.6% vs 51.8%, respectively) than enhanced CT for detecting advanced gastric cancer. Conclusion: FDG-PET/CT is more usefulness than enhanced CT for making the preoperative diagnosis of regional LN metastases from gastric cancers.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.377-380
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• 2008

Abdominal aortic aneurysm has traditionally been treated by open repair. Aortic endovascular stent grafting has recently been introduced as a new modality. We report here on three cases of endovascular stent grafting that were performed by cardiovascular surgeons for the treatment of abdominal aortic aneurysm in the high risk patients with multiple comorbidities such as old age, hypertension, renal failure, cerebrovascular accident and immobility.