• Title/Summary/Keyword: 비장보존

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Splenic Arterial Embolization in Salvage of the Injured Spleen in Children (소아의 비장 손상시 비장 보존을 위한 비장동맥색전술)

  • Hong, Soon-Hoon;Yoo, Soo-Young;Park, Jin-Su;Kim, Young-Ju
    • Advances in pediatric surgery
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    • v.5 no.1
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    • pp.15-25
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    • 1999
  • Injured spleens have been successfully managed without operation in a number of children; however, splenectomy or splenic-conserving surgery may not be avoided because of exsanguinating hemorrhage. This study was performed to evaluate the efficacy of splenic arterial embolization (SAE) to control hemorrhage from injured spleens in children. We compared the outcomes of two groups of children with splenic injury. The first group (G1) consisted of eighteen children who were managed with conventional selective nonoperative treatment between 1993 and 1994. The second group (G2) consisted of 23 children prospectively studied from 1996 to 1997 after SAE was added in the management protocol of splenic injury. The criteria for SAE were grade III or IV injury, extravasation of contrast material revealed by CT, or unstable vital signs without evidence of associated injuries. Laparotomy was performed in 6 patients of G1 (33.3 %), 2 of whom had associated injuries. Five underwent splenectomy and the overall salvage rate in G1 was 72.2 % (13/18). In G2, eight patients (34.8 %) had SAE, which stopped bleeding successfully in all patients. Two of G2 (8.7 %) had laparotomy because of associated injuries. Only one patient underwent splenectomy and the salvage rate was 95.6 % (22/23). No patients required transfusion after SAE. In conclusion, the SAE effectively controlled hemorrhage from injured spleens. More spleens were salvaged with a reduced laparotomy rate after application of SAE in splenic injury.

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Laparoscopy-assisted Total Gastrectomy with Pancreas-preserving Splenectomy for Early Gastric Cancer: A Case Report (조기위암에서 복강경보조 위전절제술 및 췌장보존식 비전절제술 1예)

  • Park, Jong-Min;Kim, Do-Yoon;Lee, Jae-Man;Leem, Chai-Sun;Jin, Sung-Ho;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.97-101
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    • 2007
  • We report our experience with a case of performing laparoscopy-assisted total gastrectomy along with pancreas-preserving splenectomy for treating early gastric cancer. laparoscopy-assisted total gastrectomy was planned for a 62-year-old male patient with a double early gastric cancer located in the upper and lower third of the stomach. Five trocars were placed and we used a harmonic scalpel to dissect the greater curvature. Enlarged splenic hilar lymph node was encountered and they were proved to be metastasis by frozen section biopsy. We then performed total gastrectomy with pancreas-preserving splenectomy for the purpose of completely dissecting the lymph nodes along the splenic artery and splenic hilum. We created a 4 cm sized longitudinal mini-laparotomy below the xiphoid process to remove the specimen, and anastomosis was done via the Roux-en-Y method. The patient was discharged on the 9th postoperative days after an uneventful recovery. Our experience shows that laparoscopy-assisted total gastrectomy with pancreas-preserving splenectomy is a relatively safe procedure for treating upper third early gastric cancer with metastatic splenic hilar lymph nodes.

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The Preservation of Left Gastric Artery in Laparoscopy-Assisted Subtotal Gastrectomy with Splenectomy of Stomach Cancer (위암에서 복강경보조 원위부 위아전절제술 및 비장합병절제술 좌위동맥의 보존 증례 보고)

  • Lee, Sang-Rim;Park, Jong-Min;Han, Sang-Uk;Cho, Young-Kwan
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.42-46
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    • 2007
  • Usually in the subtotal gastrectomy, the left and the right gastric arteries, as well as the left and the right gastroepiploic arteries are ligated. Thus, to avoid a blue stomach surgeons preserve the spleen and the short gastric arteries. When a radical subtotal gastrectomy with splenectomy is performed, meticulous caution is necessary; otherwise, the subtotal gastrectomy might have to be changed to a total gastrectomy to prevent a blue stomach. We report the case of a 67-year-old woman who had distal stomach cancer with a splenic solitary mass, for which splenic meatastasis could be excluded. We planned and performed a laparoscopy-assisted radical subtotal gastrectomy with splenectomy as the diagnostic and therapeutic option. In this case, to avoid a remnant stomach infarction or total gastrectomy we saved the left gastric artery and vein with clearing perivascular soft tissue, lymphatics, and lymph nodes. Thus the radical therapeutic goal was reached, and serious complications were avoided.

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Complications Following and Supplementary Procedures for a Pancreas-preserving Total Gastrectomy (위 전절제술에서 췌장보존 비장적출술의 합병증 및 보완술식)

  • Lee, Moon Soo;Kang, Gil Ho;Cho, Gyu Seok;Kim, Yong Jin;Kim, Sung Yong;Baek, Moo Jun;Kim, Chang Ho;Cho, Moo Sik
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.31-37
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    • 2007
  • Purpose: A pancreas-preserving total gastrectomy (PPTG) was introduced to decrease the postoperative complications due to pancreatic resection. However, some complications, such as leakage of pancreatic juice, are still reported. Thus, the purpose of this study was to propose a supplementary procedure based on the results of treatment for gastric cancer at our hospital. Materials and Methods: From Jan. 1997 to Dec. 2004, the cases of 141 patients who underwent a PPTG for gastric cancer were reviewed retrospectively. The patients were divided into Group A (38 cases), patients who were treated using a conventional PPTG, and Group B (103 cases), patients who were treated using a new and improved PPTG. Their postoperative complications were compared. Results: No statistically significant differences in clinicopathologic data were noted between the two groups. The comparison of complications showed for groups A and B, respectively, 4 and 0 cases of pancreatic fistula, 1 and 0 cases of intraabdominal abscess, 2 and 0 cases of intraoperative pancreatic necrosis, and 2 and 2 cases of minor leakage. The difference in the prevalence of complications between the two groups was statistically significant (P=0.0001). Conclusion: In order to reduce the risk of PPTG-related complications, we used vascular clamps to observe the necrosis of the pancreatic tail before dividing the splenic artery, and this method resulted in a significant decrease in postoperative complications. Thus, we conclude that our use of vascular clamps in a PPTG is a simple and useful method for preventing postoperative complications.

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중국의 핵실험 배경과 전망

  • Lee, Hong-Pyo
    • Defense and Technology
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    • no.7 s.209
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    • pp.12-17
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    • 1996
  • 중국은 탈냉전 시기에 효과적인 국가안보를 위한 군사상 비장의 카드로 값싸고, 손쉬운 핵병기의 현대화를 추진하고 있다. 중국은 이러한 핵전력의 강화를 통한 지역 대국으로서의 국가적 위신을 보존하고자 하려는 것 같다. 또한 중국이 국제여론에 역행하는 핵실험을 강행하는 것은 중국이 핵실험 이슈를 대외관계에 있어서 하나의 정치적 카드로 사용하고자 하는 의도와 관련 있어 보인다

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소 비장유래 macrophage의 체외배양시 IL-I$\alpha$가 TGF-$\beta$의 생산에 미치는 영향

  • 최선호;성환후;장유민;이장희;연성흠;류일선;손동수;유충현
    • Proceedings of the Korean Society of Embryo Transfer Conference
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    • 2002.11a
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    • pp.88-88
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    • 2002
  • 인공수정 및 수정란기술의 활성화에 따라 소에 있어서 인공수정은 90%이상이 실시되고 있으나, 수정란이식은 수정란의 생산이 안정적이지 않아 활성화에 많은 지장을 초래하고 있다. 이의 원인은 수정란이식에 의한 수태율의 저하가 가장 크며, 수태율 향상을 위하여 수란우에 progesterone, hCG 등의 주사가 실시되고 있다. 그러나 이는 수정란의 착상에 있어서 자궁의 환경을 개선한다고 하나, 착상의 정확한 기전의 구명은 미미한 상태이다. 한편 비장유래 macrophage가 황체를 자극하고 TGF-$\beta$의 생산을 유도하는 것으로 보고되고 있으며, IL-I $\alpha$$\beta$에 따라 TGF-$\beta$ 생산에 있어서 약간의 차이를 보이는 것으로 보고되고 있다. 따라서 본 연구는 비장유래 macrophage가 TGF-$\beta$의 생산시 임신관련 Cytokine인 IL-I$\alpha$와의 관계를 조사하기 위하여 실시하였다. 임신 및 비임신 도축 암소의 비장을 채취하여 얼음에 채워 실험실로 운반한 후 비장의 표면을 70%의 알콜로 세척하고, 표피를 벗겨 비장조직을 세절하여 10% FBS+DMEM에 넣어 조직을 눌러 짜면서 조직속의 세포를 분리하였다. 세척한 배양액은 4-5$m\ell$를 100mm 유리 petri dish에 넣고 39$^{\circ}C$, 5% $CO_2$, 95% 공기인 배양기에서 2시간이상 배양하였으며, 배양 후 냉장된 buffer A 용액으로 세척하여 유리 petri dish의 바닥에 부착된 macrophage만을 cell scraper로 분리하였다. 분리한 macrophage는 0.5-1 $\times$ $10^{6}$ cells/$m\ell$가 되게 조정하여, IL-I 을 0.001, 0.01, 0.1 또한 1 ng/$m\ell$를 첨가하여 농도에 따른 효과를 조사하였고, 각각 24, 48, 72, 96 또한 120시간을 배양하여 시간에 의한 효과도 실시하였다. 각 배치구에서 얻어진 배양액은 TGF-$\beta$를 조사하기 전까지 -2$0^{\circ}C$에 동결 보존하였다. TGF-$\beta$의 측정은 TGF-$\beta$ kit(promega, USA)를 이용하여 실시하였으며, 통계학적 분석은 Anova test를 Statview program을 이용하여 분석하였다. 시험의 결과 대조구에 비해 IL-I 첨가구는 2-3배의 TGF-$\beta$생산을 보였으며, 배양시간에 따른 생산은 시간이 지남에 따라 약간 상승하는 경향을 보였으나, 유의적인 차이를 보이지는 않았다. 또한 IL-I의 농도에 따른 생산의 변화는 IL-I의 농도에 따라 약간의 차이를 보였고 유의적인 차이는 인정되지 않았다. 임신 및 비임신의 경우 임신우의 비장 macrophage가 비임신보다는 약간 상승하는 거스로 나타났다. 이상의 결과로 볼 때 IL-I $\alpha$$\beta$subunit 보다 TGF-$\beta$ 생산에 있어서 서로 다른 양상을 보일 것으로 추정되며, IL-I은 macrophage의 직접적인 영향을 주기보다는 황체세포를 매개로 한 자궁에 TGF-$\beta$의 생산을 유도하는 것으로 사료되며, 임신관련 cytokine에 대한 다양한 연구가 요구되고 있다.

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Total Gastrectomy with Distal Pancreatico-splenectomy for Treating Locally Advanced Gastric Cancer (진행 위암에서의 위 전절제술에 동반된 원위부 췌-비장 절제)

  • Lee, Sung-Ho;Kim, Wook;Song, Kyo-Young;Kim, Jin-Jo;Chin, Hyung-Min;Park, Jo-Hyun;Jeon, Hae-Myung;Park, Seung-Man;Ahn, Chang-Jun;Lee, Jun-Hyun
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.74-81
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    • 2007
  • Purpose: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. Results: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 0.8%. Conclusion: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.

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Development of New Arirang Gymnastics (신 아리랑 체조의 개발)

  • You, Myung Ok
    • Journal of Naturopathy
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    • v.7 no.2
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    • pp.47-50
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    • 2018
  • Purpose: Arirang, the most beautiful song in the world, has been meeting with natural healing to increase synergy. Arirang and nature healing have pioneered the field of Arirang music healing by crossing different boundaries. Methods: Arirang Gymnastics was used. Results: New Arirang Gymnastics is part of the healing of Arirang music, which consists of six movements. Starting with warm-up exercises in time for Seoul Arirang, the patient will apply pressure to the pit of the pit of the stomach, the head of the stomach, and the non-surface field. To match Haeju Arirang, massage the right side of abdomen, left side underbed, top (stomach), and lower bladder. Tap the Danjeon, the bladder, the heart, and the lungs in accordance with Millyang Ariryang. Stretching both arms and shoulders in line with Arirang in Gangwon Province, the two sides meet behind each other. Rotate the shoulders and wrists in line with the progress of the arm. Conclusions: Aerobic exercise that is tailored to new Arirang and their gymnastics are useful for health and healing of the body and mind.

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Kikuchi Disease Manifesting as Multifocal Lymphadenopathy and Splenomegaly: Ultrasonography, CT, and 18F-FDG PET/CT Findings Mimicking Lymphoma (다발성 림프절염과 비장종대로 발현하여 림프종으로 오인된 기쿠치병의 초음파, CT, 18F-FDG PET/CT 소견)

  • Moin Ha;Bo-Kyung Je;Eung-Seok Lee;Seong Wook Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1486-1491
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    • 2020
  • Kikuchi disease is a type of benign, self-limiting necrotizing lymphadenitis that occurs most commonly in young women and usually manifests as palpable cervical lymph nodes and fever. Patients with an unusual location of lymph node involvement can be misdiagnosed with malignant disease. Here, we report a case of Kikuchi disease in a 15-year-old girl presenting with persistent fever for 2 weeks. Imaging studies, including ultrasonography, CT, and 18F-fluorodeoxyglucose PET/CT, revealed splenomegaly and enlarged lymph nodes in the neck, axilla, abdomen, retroperitoneum, and inguinal region. Laparoscopic excision of the celiac lymph nodes confirmed histiocytic necrotizing lymphadenitis, also known as Kikuchi disease. Conservative treatment with corticosteroids improved the patient's condition.

Development of Eimeriu tenezla in MDEK cell culture with a note on enhancing effeet of preincubation with chicken spleen cells (MDBK 세포 배양에서 Eimeria tenella 발육 상황 및 닭 비장세포에 의한 발육 항진 효과)

  • 채종일;이순형
    • Parasites, Hosts and Diseases
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    • v.27 no.2
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    • pp.87-100
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    • 1989
  • Eimeria tenella, an intracellular protozoan parasite infecting the epithelial cells of the ceca of chickens, causes severe diarrhea and bleeding that can lead its host to death. It is of interest that 2. tenezla first penetrate into the mucosal intraepithelial Iymphocytes (IEL) before they parasitize crypt or villous epithelial cells. This in vitro study was undertaken to know whether the penetration of E. tenella into such a lymphoid cell is a beneficial step for the parasite survival and development. Three sequential experiments were performed. First, the in vitro established bovine kidney cell line, MDBK cells, were evaluated for use as host cells for E. tenella, through morphological observation. Second, the degree of parasite development and multiplication in MDBK cells was quantitatively assayed using radioisotope labelled uracil ($^3H-uracil$) . Third, the E. tenella sporozoites viability was assayed after preincubation of them with thicken spleen cells. E. tenella oocysts obtained from the ceca of the infected chickens were used for the source of the sporozoites. Spleen cells (I) obtained from normal chickens (FP strain) were preincubated with the sporozoites (T) at the E:T ratio of 100:1, 50:1 or 25:1 for 4 or 12 hours, and then the mixture was inoculated into the MDBK cell monolayer. Morphologically the infected MDBK cells revealed active schisogonic cycle of E. tenella in 3~4 days, which was characterized by the appearance of trophozoites, and immature and mature schizonts containing merogoites. The 3H-uracil uptake by E. tenella increased gradually in the MDBK cells, which made a plateau after 48~60 hours, and decreased thereafter. The uptake amount of $^3H-uracil$ depended not only upon the inoculum sixte of the sporozoites but also on the degree of time delay (preincubation; sporozoites only) from excystation to inoculation into MDBK cells. The 3H-uracil uptake became lower as the preincubation time was prolonged. In comparison, after preincubation of sporozoites with spleen cells for 4 or 12 hours, the 3H-uracil uptake was significantly increased compared with that of control group. From the results, it was inferred that, although the penetration of E. tenella sporozoites into the lymphoid cells such as IEL is not an essential step, it should be at least a beneficial one for the survival and development of sporozoites in the chicken intestine.

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