• Journal of Trauma and Injury
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• 제36권3호
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• pp.165-171
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• 2023

Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.

• Journal of Chest Surgery
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• 제29권4호
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• pp.433-439
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• 1996

경북대 학교병원에서는 1980년 1월부터 1995년 7월까지 들상에 의한 횡격 막 손상 환자 32례와 관통상 에 의한 12례를수술 치료하였다. 평균연령은둔상의 경우)7.6세,관통상의 경우29.2세로,들상의 경우 가 평 균 8.4세가 높았다(p<0.05). 진단은 단순 흉부 X-선 사진으로 횡격막 손상을 진단한 경우가 둔상에서는 24례 (75%), 관통상에서는 4fl (33%)였다. 관통상에서는 횡격막 손상의 의심 없이 다른 장기손상으로 수술하여 횡격막 파열이 발견 된 경우가 7례 (58%)였다. 탈장은 둔상시 24례 (75%), 관통상시 5례 (42%)에서 발생 하였다. 탈장이 발생 한 29례의 횡격막 손상의 크기는 10.9 $\pm$ 4.3cm, 발생하지 않은 15례는 3.5 $\pm$ 2.9cm로 양군간의 크기 의 차 이가 있어 (p<0.05) 횡격막 손상의 크기와 탈장과는 밀접한 관계가 있었다. 수출은 진단 즉시 시 행하였으며, 수술시 절개방법은 들상의 경우 20례 (6)%)에서 개흥술, 9례 에서 개 복술, 2례 에서 개흥복술, 1례 에서 개흥술 및 개복술을 분리 시행하였으며, 관통상시에는 6례 (50%)에서 개복술, 4례에서 개흥술, 2례에서 개흥술 및 개복술을 분리 시행하였다. 수술 후 합병증은 둔상시 6례 (19%), 관통 澯\ulcorner3례 (25%)에서 발생하여 비교적 높았다. 수술 후 사망률은 들상의 경우 2례 에서 사망하 였고(6.3%), 관통상의 경우는 사망례가 없어 전체 사망률은 4.5%였다. 결론적으로흥복부 외상시 횡격막 손상의 가능성을 염두에 두어야하며, 둔상의 경우횡격막손상의 크기는 관통상에 의한 경우보다 더 크며, 탈장도 횡격막 손상의 길이 에 비례하여 더 많이 발생하였다.

• 한국콘텐츠학회논문지
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• 제20권10호
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• pp.411-423
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• 2020

본 연구의 목적은 국민건강영양조사 자료를 활용하여 한국 성인의 대사증후군 및 그 구성요소가 성별에 따른 건강관련 삶의 질 손상에 미치는 영향을 알아보기 위한 것이다. 참가자는 19세 이상 성인 16,657명이었으며, 대사증후군은 NCEP-ATP III에 따라 정의되었고, HRQOL는 EQ-5D를 사용하여 평가되었다. 연구 대상자의 대사증후군 유병율은 34.3%였고 남성이 여성보다 높았다. 건강관련 삶의 질 평균 점수는 남성이 96.7점, 여성이 94.5점으로 남성이 높았다. 인구학적, 건강행위, 건강관련특성을 보정변수로 통제 한 후 다중 로지스틱 회귀분석을 실시한 결과, 대사 증후군이 있는 여성은 대사증후군이 없는 여성에 비해 건강관련 삶의 질 손상의 교차비가 1.27(95% CI: 1.09-1.46)이었다. 대사증후군의 구성요소 중 복부비만(OR=1.72, 95% CI: 1.50-1.97)과 고혈압(OR=1.26, 95% CI: 1.06-1.50)은 건강관련 삶의 질 손상과 연관이 있었다. 반면, 남성에서는 유의하지 않았다. 결론적으로 여성의 건강관련 삶의 질 향상을 위해서는 여성의 특성을 고려한 대사증후군 위험요인을 감소시키는 접근전략이 필요함을 시사한다.

• Advances in pediatric surgery
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• 제17권1호
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• pp.65-71
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• 2011

Currarino syndrome is a hereditary syndrome characterized by the triad of a sacral bony defect, presacral mass and anorectal malformation. We retrospectively reviewed 13 Currarino syndrome patients who were treated in our center between 1997 and 2010. Demographic data, initial symptoms, initial diagnosis. pathologic diagnosis of presacral mass, associated anomalies and managements were analyzed. There were 8 boys and 5 girls. Four patients were diagnosed as Currarino syndrome immediately after birth with failure of passage of meconium and abdominal distension. Four patients underwent surgery for imperforate anus immediately after birth and W8re diagnosed as Currarino syndrome later and underwent reoperation. Three patients were diagnosed during work-up and management with of the tentative diagnosis of Hirschsprung's disease. Diagnosis of the remaining two patients was at the age of 26 months and 9 years and anorectal malformation was not associated. Twelve patients showed hemi-sacrum and one patient showed bilateral sacral subtotal agenesis. Two patients without anorectal malformation underwent presacral mass excision, untethering of spinal cord and repair of myelomeningocele. Six out of 8 patients, excluding 3 that expired or were lost to follow up, with anorectal malformation underwent colostomy, presacral mass excision, untethering of spinal cord, repair of myelomeningocele, posterior sagittal anorectoplasty and colostomy repair. One patient underwent only posterior sagittal anorectoplasty after colostomy. One waits the scheduled operation only with Hegar dilatation. Pathologic examation of presacral masses showed myelomeningoceles in 4 patients, lipomyelomeningoceles in 3 patients and dermoid Cyst in one patient. Teratoma was combined in 2 patients. Eight patients needed neurosurgical operation for spinal cord problems. Seven patients had urologic anomalies and two of them underwent operation. Currarino syndrome should be considered as a differential diagnosis in pediatric patients with abdominal distension, constipation and anorectal malforlnation. For proper evaluation and treatment, a multi-disciplinary approach is recommended.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.217-222
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• 2012

Purpose: Diaphragmatic rupture following trauma is often an associated and missed injury. This report is about our experience with treating traumatic diaphragmatic rupture (TDR). Methods: From January 2007 to September 2012, 18 patients who had a diaphragmatic rupture due to blunt trauma or penetrating injury underwent an operation for diaphragmatic rupture at our hospital. We retrospectively reviewed their medical records, including demographic factors, initial vital signs, associated injuries, interval between trauma and diagnosis, injured side of the diaphragm, diagnostic tools, surgical method or approaches, operative time, herniated organs, complications, and mortality. Results: The average age of the patients was 43 years, and 16 patients were male. Causes of trauma included motor vehicle crashes (n=7), falls (n=7), and stab wounds (n=5). The TDR was right-sided in 6 patients and left-sided in 12. The diagnosis was made by using a chest X-ray (n=3), and thorax or upper abdominal computed tomography (n=15). Ten(10) patients were diagnosed within 12 hours. A thoracotomy was performed in 8 patients, a video-assisted thoracoscopic surgery in 4 patients, a laparotomy in 3 patients, and a sternotomy in one patient. Herniated organs were the omentum (n=11), stomach (n=8), spleen and colon (n=6), and liver (n=6). Eighteen diaphragmatic injuries were repaired primarily. Seven patients underwent ventilator care, and two of them had pneumonia and acute respiratory distress syndrome. There were no operative mortalities. Conclusion: Early diagnosis and surgical treatment determine the successful management of TDR with or without the herniation of abdominal organs. The surgical approach to TDR is chosen based on accompanying organ injuries and the injured side.

• Advances in pediatric surgery
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• 제17권2호
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• pp.154-161
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• 2011

Tracheoesophageal fistula without esophageal atresia (H-type TEF) is a congenital anomaly that is characterized by a fistula between the posterior wall of the trachea and the anterior wall of the esophagus, not accompanied by esophageal atresia. The purpose of this study is to investigate the clinical characteristics, diagnostic time, the side of cervical approach and short term result after surgery by searching medical records of patients treated for H-type TEF. The search was done at University of Ulsan, Department of Pediatric Surgery of Asan Medical Center, and the total number of patients from May 1989 to December 2010 was 9 with M:F ratio of 1:2. The median gestational age was $39^{+6}$ ($32^{+6}{\sim}41^{+0}$) wks. Seven out of nine patients were born at term and the other two were born premature. The clinical presentation was aspiration pneumonia, difficulty in feeding, chronic cough, vomiting, abdominal distension and growth retardation. The symptoms presented right after birth. The diagnosis was made with esophagography and the median time of diagnosis was 52 days of life. The majority of surgical corrections were performed within two weeks of diagnosis (median; 15d, range; 1d - 6m). Six patients had associated anomalies, and cardiac anomalies were most common. The cervical approach was utilized in all cases (right 2, left 7). Transient vocal cord palsy and minor esophageal leakage complicated two cases. Although the diagnosis of H-type TEF was difficult and often delayed, we had a good short term result. The left cervical approach was preferred.

• 한국축산식품학회지
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• 제30권1호
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• pp.87-94
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• 2010

본 연구는 저지방 고품질 돈육의 생산을 위해 돼지 복강 및 피하지방 감소를 위한 다클론 항체의 개발 및 실제 세포에 미치는 세포독성효과를 확인하고자 실시되었다. 항원으로써 돼지의 복강 및 피하지방세포 PMP를 분리하여 면양에 3회에 걸쳐 수동면역 주사하고, 면역 주사 전 및 후에 비면역혈청과 항체를 생산하였다. 돼지 AAb 및 SAb 항체의 역가와 생체 주요 장기 조직인 심장, 신장, 간장, 폐, 근육 및 비장세포의 PMP에 대한 타장기 교차반응성을 조사하였다. 돼지 부위별 지방 조직에서 지방세포를 분리하고 각각 primary 배양시킨 후 개발된 AAb 및 SAb를 주입한 뒤 media 내 LDH 방출 수준을 조사하였다. 희석배율 1:1,000배를 기준으로 비면역혈청은 항원-항체 결합반응이 거의 측정되지 않았고, AAb 및 SAb는 희석배율 1:16,000배까지 각각 항원-항체 반응이 감지되었으며, 이는 본 연구에서 생산한 부위별 지방 감소 다클론 항체가 지방세포 PMP에 대해 강한 역가를 가진 항체임을 시사한다. 또한 AAb 및 SAb는 타 장기들과는 특이한 반응을 나타내지 않았다. 본 연구에서 개발한 두 항체들은 모두 항원으로 이용된 부위의 지방세포 PMP와 가장 높은 반응을 나타내었으며, 비면역혈청에 비해 유의적으로 높은 세포독성 효과가 있음을 확인할 수 있었다. 이상의 결과를 종합할 때 본 연구에서 개발된 AAb 및 SAb는 높은 역가, 타 장기 안전성 및 in vitro 지방 감소 효과가 있었으며 향후 영양생리 안전성 및 생체 지방 감소 효과 등의 추가 연구가 지속될 경우 저지방 고품질 돈육의 생산이 가능하리라고 판단된다.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2003년도 생물공학의 동향(XII)
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• pp.98-100
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• 2003

합성고분자(PET, ePTFE)로 제작된 기존의 혈관 패치는 혈전생성으로 인한 혈관 막힘 현상과 생체 비적합성으로 인한 석회화 현상 때문에 장기간 혈관 기능을 수행할 수 없다. 본 연구에서는 혈관조직을 형성하는 세포들로 분화가 가능한 중간엽줄기세포와 생체적합성 매트릭스를 이용하여 혈관용 패치를 개발하였다. 이식 후 3주에 관찰하였을 때 조직공학적으로 제조된 혈관 패치는 동물 임상시험에서 혈관막힘 현상 없이 혈관기능을 수행하였고 실제 혈관과 유사한 조직으로 재생되었다. 동물모델에서의 장기간 추가 보완 연구를 거친다면 본 연구에서 개발된 혈관 패치는 기존의 재료를 대체하여 많은 혈관질환 치료에 적용이 가능할 것으로 사료된다.

• Journal of Chest Surgery
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• 제7권2호
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• pp.163-168
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• 1974

Five cases of traumatic diaphragmatic hernia were repaired in the Department of Thoracic Surgery, Seoul National University Hospital, during the period from 1967 to 1974. The first case, a 14-year aid girl, was diagnosed as diaphragmatic hernia during laparotomy because of jejunal perforation 3 days after traffic accident. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture on left posterolateral portion was repaired with two layers of nonabsorbable sutures by transthoracic approach. The second case, a 26-year old man,was diagnosed immediately after traffic accident at a local clinic and transferred to this hospital 24 hours later. Herniated stomach, transverse colon and jejunum were repositioned amd diaphragmatic rupture,about 9 cm in length,from the posterolat.edge to the base of pericardium was sutured in two layers. The third case, a 26-year old man who had stab wound on the left lower lateral chest two years ago,was admitted with sudden abdominal pain and vomiting. Upper gastrointestinal series with barium meal revealed diaphragmatic hernia. The herniated stomach and transverse colon through the defect,about 3.5cm in diameter, at anterolateral portion on the left side,were repositioned and repaired with two layers of nonabsorbable sutures. The forth case, a 26-year old man, sustained blunt trauma to the chest by a roller and was transferred to the emergency room complaining of dyspnea 40 minutes after the accident. The diaphragmatic rupture extended from left midaxillary line to contralateral anterior axillary line,about 20cm long, at anterior portion of diaphragm, which was repaired with two layers, of nonabsorbable sutures. The fifth case, a 4-year old girl, had two separate diaphragmatic ruptures on both sides, which were caused by traffic accident. Immediate upper gastrointestinal series after injury showed herniated stomach, colon and spleen into left Chest cavity. Another small rupture with anterior edge of right lobe of the liver in chest cavity was noted. These were repaired with non-absorbable sutures via thoracotomy.

• 대한한방내과학회지
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• 제21권1호
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• pp.162-168
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• 2000

Irritable Bowel Syndrome(IBS) is the most common disease in the western male, and it is founded in $70{\sim}80%$ patient who has Gastrointestinal trouble. It is characterized by the formation of disorders of Gastrointestinal tract, for example, constipation, diarrhea, abdominal pain& discomfort, stool urgency, and so on. The etiology of IBS is uncertain, but the majority of patients has emotional problems. The aims of this study are to investigate and summarize the current trends of treatment for IBS so as to suggest the effective and available way to treat this disease. In Oriental Medicine, the IBS is recognized as Stagnation of the Iiver-qi(肝氣鬱結), Incoordination between the liver and the stomach(肝胃不和). So the point of treatment of IBS is Invigorating the spleen and relieving the depression of Iiver-qi(疏肝健脾), Regulating the function of the liver and the flow of qi(調肝理氣), Regulating the stomach and lowering the adverse flow(和胃降逆), and the treatment can be approached in several ways through herb drugs, acupuncture. Some of the herb drugs have substances which promote gastric and small intestinal emptying. Acupuncture and moxibustion therapies stimulate the meridian points of LR(足厥陰肝經), ST(足陽明胃經), LI(手陽明腸經), SI(手太陽小腸經) and is reported to be effective for releafing syndromes. Anal therapy, attachment of herb drug to umbilicus are annunced as the effective treatments. So, this study of the approach and application of these treatments on IBS would be necessary.