• Title/Summary/Keyword: 비만 수술

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Surgery Alone and Surgery Plus Postoperative Radiation Therapy for Patients with pT3N0 Non-small Cell Lung Cancer Invading the Chest Wall (흉벽을 침범한 pT3N0 비소세포폐암 환자에서 수술 단독과 수술 후 방사선치료)

  • 박영제;임도훈;김관민;김진국;심영목;안용찬
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.845-855
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    • 2004
  • Background: No general consensus has been available regarding the necessity of postoperative radiation therapy (PORT) and its optimal techniques in the patients with chest wall invasion (pT3cw) and node negative (N0) non-small cell lung cancer (NSCLC). We did retrospective analyses on the pT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. And we compared them with the pT3cwN0 NSCLC patients who did not received PORT during the same period. Material and Method: From Aug. of 1994 till June of 2002, 22 pT3cwN0 NSCLC patients received PORT-PORT (+) group- and 16 pT3cwN0 NSCLC patients had no PORT-PORT (-) group. The radiation target volume for PORT (+) group was confined to the tumor bed plus the immediate adjacent tissue only, and no regional lymphatics were included. The prognostic factors for all patients were analyzed and survival rates, failure patterns were compared with two groups. Result: Age, tumor size, depth of chest wall invasion, postoperative mobidities were greater in PORT (-) group than PORT (+) group. In PORT (-) group, four patients who were consulted for PORT did not receive the PORT because of self refusal (3 patients) and delay in the wound repair (1 patient). For all patients, overall survival (OS), disease-free survival (DFS), loco-regional recurrence-free survival (LRFS), and distant metastases-free survival (DMFS) rates at 5 years were 35.3%, 30.3%, 80.9%, 36.3%. In univariate and multivariate analysis, only PORT significantly affect the survival. The 5 year as rates were 43.3% in the PORT (+) group and 25.0% in PORT (-) group (p=0.03). DFS, LRFS, DMFS rates were 36.9%, 84.9%, 43.1 % in PORT (+) group and 18.8%, 79.4%, 21.9% in PORT(-) group respectively. Three patients in PORT (-) group died of intercurrent disease without the evidence of recurrence. Few suffered from acute and late radiation side effects, all of which were RTOG grade 2 or lower. Conclusion: The strategy of adding PORT to surgery to improve the probability not only of local control but also of survival could be justified, considering that local control was the most important component in the successful treatment of pT3cw NSCLC patients, especially when the resection margin was not adequate. Authors were successful in the marked reduction of the incidence as well as the severity of the acute and late side effects of PORT, without taking too high risk of the regional failures by eliminating the regional lymphatics from the radiation target volume.

Reduction of Postsurgical Adhesion Formation of Reproductive Tract with Sodium Carboxymethylcellulose in Korean Black Goats (Sodium Carboxymethylcellulose가 개복 수술한 한국흑염소의 생식기 유착 방지에 미치는 영향 평가)

  • Shin, H.G.;Choi, Y.S.;Lee, S.J.;Lee, D.S.;Cho, J.K.;Shin, S.T.
    • Journal of Embryo Transfer
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    • v.22 no.1
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    • pp.63-67
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    • 2007
  • This study was performed to evaluate the efficacy of sodium carboxymethylcellulose (SCMC) for the prevention of postoperative uterus and ovary adhesion formation in the Korean black goats. Twenty adult female Korean black goats randomly were divided into five groups with four animals in each group. After the routine laparotomy, catheter for injection was inserted into the abdomen. Before abdominal closure, saline, 1% SCMC, 2% SCMC or 0.4% HA solution (50ml/10kg of body weight/head) were injected in the abdominal cavity in each group. Three weeks after surgery, second laparotomy was performed and the adhesions were scored on a scale of 0 to 10 according to their vascularity and adhesion size in uterus and ovary. This trial was repeated the four times with the interval of three weeks. In the first and second trial, the group treated with 2% SCMC significantly reduced the adhesion formation than other treatment groups (P<0.05). In the third trial, the adhesion formation was significantly reduced in 2% SCMC and 1% SCMC (P<0.05). In the fourth trial, 2% SCMC reduced the adhesion formation. However, there was no significant difference among other groups. This study showed that the 2% SCMC administered at the end of the surgery reduced the adhesion formation in the Korean black goats.

A Case of Large Laryngomucocele (거대 후두점액낭종 1예)

  • Mun, Sue Jean;Lee, Ji-Eun;Hong, Seung No;Choi, Hyo Geun;Kim, Kwang Hyun;Jung, Young Ho
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.2
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    • pp.146-148
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    • 2012
  • 후두낭종은 후두소낭의 비정상적인 팽창으로 발생하는 드문 질환이다. 후두낭종의 크기와 증상에 따라 치료 방법은 단순 경과관찰에서부터 흡인, 경화제 주입, 수술적 치료까지 다양하다. 수술적 치료는 외적 접근법, 내시경적 접근법 또는 두 접근법을 혼용한 접근법을 통해 이루어진다. 최근 저자들은 경부 외적 접근법 및 연골막하 절제를 통한 혼합 후두점액낭종 1예의 치료를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Surgical Closure of Patent Ductus Arteriosus in Premature Infant -A report of two cases - (미숙아에서 동맥관 개존증 수술 2례)

  • 김삼현;서필원
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.777-779
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    • 1996
  • Recently we operated on two cases of PDA in premature infant. In both cases, indomethacin therapy had failed to close the PDA. The extremely small baby(body weight 540gm) died 28hrs postoperatively by unexpe ted intrathoracic bleeding probably due to coagulopathy related to septic condition and thrombocytopenia. The clinical course of the second case(body weight 1395gm) was complicated by ileal perforation sec- ondary to necrotizing enterocolitis. The baby underwent segmental resection of ileum with ileostomy on the 8th hospital day. On the 34th hospital day surgical closure of the PDA was done and the ile'ostomy was repaired simultaneously. Ventilator weaning was possible on the postoperative 6th day. The baby discharged on the postoperative 33th day with the body weight of 2050gm.

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Compressive Neuropathy in Upper Extremity (상지의 압박 신경병증)

  • Park, Jong Woong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.99-106
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    • 2009
  • Compressive neuropathy in the upper extremity can be clinically diagnosed by careful history taking, physical examination of the involved nerve. Electrodiagnosis for the suspected nerve informs severity of compression of the involved nerve and indicates specific site of the lesion. In the early stage of the disease, non-operative treatment generally cures the symptom, however, if the conservative treatment fails, confirmation of the exact site of the lesion should be preceded before the operation. Recently, ultrasonography, as a supportive tool for the diagnosis of compressive neuropathy has increasing popularity for its ability to find space occupying lesion, anatomical change of the nerve, and the pathologic change in the nerve itself. For the successful treatment of the compressive neuropathy, these various diagnostic tools have to be introduced in the orthopaedic clinic.

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Surgical Treatment of Multivalvular Endocarditis with Ventricular Septal Defect (심실중격결손과 동반한 다중판막 감염성 심내막염의 수술적 치료)

  • Kim, Seon-Hee;Je, Hyoung-Gon;Lee, Sang-Kwon;Kim, Sang-Pil
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.417-420
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    • 2010
  • As higher mortality rate and frequent incidence of morbidity, early surgical treatment is generally recommended for the multivalvular endocarditis. A 46-year-old female presented with high fever. Echocardiography showed the vegetation on pulmonic valve, tricuspid valve and mitral valve with a ventricular septal defect. Emergency operation was conducted due to uncontrolled infection. We present a clinical success of this rare case with review of the medical literature.

Atypical Middle Aortic Syndrome in a Middle Aged Woman -A case report- (중년 여자 환자에서 비전형적 Middle Aortic Syndrome의 수술치험 1예)

  • 김우식;배윤숙;정성철;신용철;유환국;김병열
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.80-83
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    • 2004
  • The aortic coarctation is located in the distal thoracic aorta or abdominal aorta, or both and is often called ‘middle aortic syndrome’ or ‘mid-aortic dyspastic syndrome’. Etiology is controversial and most cases are seen in young female women. Severe complication such as cardiac or renal dysfunction as well as cerebral hemorrhage may occur, so aggressive surgical intervention may take effect. Lately we experienced a middle aortic syndrome which was not typical because of the patient's advanced age at the time of clinical presentation. The Axillo-femoral artery bypass graft with 6 mm PTFE vascular graft was done.