• Journal of Chest Surgery
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• 제42권1호
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• pp.22-27
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• 2009

배경: 관상동맥우회술은 관상동맥질환의 대표적인 치료법으로 서구에서는 장기 성적에 관하여 많은 보고들이 있으나, 우리나라에서는 매우 드물다. 따라서, 본원에서의 장기 임상성적에 관하여 알아보고자 하였다. 대상 및 방법: 1984년 2월 본원에서 처음으로 관상동맥 우회로술을 시행한 이후 2006년 12월 31일까지 시행하였던 342명의 환자를 대상으로 하였으며, 의무기록을 토대로 후향적으로 분석하였다. 총 286명(83.6%)에서 추적관찰이 가능하였으며, 평균추적관찰기간은 $75.7{\pm}46.1$개월이었다. 결과: 조기사망은 5.6%였으며, 만기사망은 23.1%였다. 1년 생존율은 91.5%였으며, 5년 생존율은 82.1%, 10년 생존율은 60.7%, 15년 생존율은 50.0%였다. 60세 이상의 고령의 환자(p=0.002), 당뇨(p=0.000), 고혈압(p=0.002), 다중혈관질환 환자(p=0.006), 그리고, 좌심실 기능부전 환자들(p=0.015) 환자들에서 생존율이 유의하게 낮았으며, 성별은 장기생존에 차이가 없는 것으로 나타났다. 다변량 분석에서는 당뇨(p=0.001), 나이(p=0.005), 좌내흉동맥을 사용하지 않는 경우(p=0.037)가 유의한 위험인자로 나타났다. 결론: 관상동맥우회술은 관상동맥질환 환자에게 있어서 효과적인 치료방법이라고 생각되며, 장기 생존을 위해서는 내흉동맥의 적극적인 사용과 당뇨환자에서 술후 혈당조절과 같은 적절한 약물치료와 외래추적관찰이 필요할 것으로 생각된다.

• Journal of Trauma and Injury
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• 제30권2호
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• pp.33-40
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• 2017

Purpose: The role for minimally invasive surgery in chest trauma is vague, one that recently is more frequently performed, and one attractive option to be considered. Thoracoscopic surgery may improve morbidity, mortality, hasten recovery and shorten hospital stay. Methods: A total of 31 patients underwent video assisted thoracoscopic surgery for the treatment of blunt and penetrating chest trauma from June 9th, 2013 to March 21st, 2016 in Jeju, South Korea. Results: Twenty-three patients were males and eight patients were females. Their ages ranged from 23 to 81 years. The cause of injury was due to traffic accident in 17 patients, fall down in 5 patients, bicycle accident in 2 patients, battery in 2 patients, crushing injury in 2 patients, and slip down, kicked by horse, and stab wound in one patient each. Video assisted thoracoscopic exploration was performed in the 18 patients with flail chest or greater than 3 displaced ribs. The thoracoscopic procedures done were hematoma evacuation in 13 patients, partial rib fragment excision in 9 patients, lung suture in 5 patients, bleeding control (ligation or electrocautery) in 3 patients with massive hemothorax, diaphragmatic repair in two patients, wedge resection in two patients and decortication in 1 patient. There was only one patient with conversion to open thoracotomy. Conclusion: There is a broad range of procedures that can be done by thoracoscopic surgery and a painful thoracotomy incision can be avoided. Thoracoscopic surgery can be done safely and swiftly in the trauma patient.

• Advances in pediatric surgery
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• 제8권2호
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• pp.138-142
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• 2002

Mesenteric and omental cysts are rare intra-abdominal lesions in childhood, and may present various clinical features such as an asymptomatic mass or an acute abdomen. Therefore, these entities are frequently misdiagnosed preoperatively or are found only incidentally at operation for other conditions. We analyzed our experiences of 19 cases in a 19 year period from 1981 to 1999, at College of Medicine, Catholic University of Korea. There were 12 boys and 7 girls with a mean age of 4.8 years (range, 3 days to 15 years). Common presenting symptoms were abdominal pain (47%), abdominal distension (31%), abdominal mass (24%), vomiting (15%) and fever (10%). Ultrasonography was the most preferred method of diagnosis. Other diagnostic modalities include CT, MRI, and abdominal ascites tapping in selected patients. Location of the mesenteric cysts was small bowel mesentery in nine, the right mesocolon and retroperitoneum in one, the left mesocolon in one, and the jejunum, sigmoid-colon mesentery in one. Most of the patients underwent cyst excision, but six patients required concomitant bowel resection for complete removal of the lesions, and two patients underwent unroofing and simple aspiration respectively. There was one mortality case due to sepsis.

• Journal of Korean Neurosurgical Society
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• 제29권4호
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• pp.514-520
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• 2000

Objective : Stereotactic psychosurgery is known as one of effective means of treating in some medically intractable psychiatric illness. However, it is unfamiliar and it's long-term clinical result has not reported in our country. The authors evaluated its long-term results of pscychosurgery and discussed its neuroanatomical basis. Methods : Since 1993, eight patients underwent stereotactic psychosurgery for medically intractable psychiatric illnesses. All were referred from psychiatrist of these disorders, one was aggressive behavior, five were obsessive-compulsive disorders(OCD), and two were depression with anxiety disorders. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior, and limbic leukotomy was done for OCD and depression with anxiety. The results of OCD were evaluated with with YBOCS(Yale-Brown obsessive compulsive scale) and VAS (visual analogue scale), CGI(clinical global impairment) in OCD, and OAS(overt aggression scale), MMS, WAIS were checked for the evaluation of aggressive behavior. Hamilton depression scale(HAMD) was used for evaluation of depression. Ventriculography was used in the first five patients and MR-guided stereotaxy was used in recent three cases for localization of target. The lesions were made with radiofrequency lesion generator. Results : With long-term follow up(mean 45 months) in five OCDs, mean YBOCS declined from 34 to 3(n=5). All returned to previous social life. In OAS scores of aggressive behavior during six-year follow up, scores declined from 8 to 2 with clinical improvement. In two patients with depression with anxiety, HAMD declined from 28.5 to 16.5(n=2). There was no operative mortality and no significant morbidity except one case of mild transient urinary incontinence. Conclusion : With these long-term results, authors assumed that stereotactic psychosurgery could be one of safe and effective mtherapeutic methods in several medically intractable psychiatric illness.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5951-5957
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• 2014

Background: Traditional Chinese Medicine (TCM) possesses several advantages for treating patients with hepatocellular carcinoma (HCC). The theory of 'Jianpi Huayu Therapy' rooted from 'Jin Kui Yao Lue'is one of the most important therapies in this respect. This study was conducted to investigate the clinical effect and safety of hepatectomy combining with 'Jianpi Huayu Therapy' in the treatment of HCC. Materials and Methods: One hundred and twenty patients with HCC were randomized allocated into hepatectomy combined with 'Jianpi Huayu Therapy' group (treatment group, n=60) and hepatectomy alone group (control group, n=60). Disease- free survival (DFS) and overall survival (OS) were the primary end-points. Liver function at the end of one week after surgery, complications, average days of hospitalization as well as performance status (PS) at the end of one month post operation were also compared. Results: No significant differences existed between two groups on baseline analysis (p>0.05). No treatment related mortality occurred in either group. Post-operative complications were detected among 14 patients (23.3%) in the treatment group, and 12 (20.0%) in the control group (p=0.658). Alanine aminotransferase (ALT) at the end of one week after operation was lower in the treatment than control groups (p=0.042). No significant differences in other indexes of liver function were discovered between two groups. Average days of hospitalization reduced by 0.9 day in treatment group than in control (p=0.034). During follow-up, 104 patients (86.6%) developed recurrence. The rates of 1-, 3-, and 5-year DFS and median DFS for all patients were 77.4%, 26.3%, 9.0% and 25.6 months (range, 6.0~68.0), respectively (78.2%, 29.2%, 14.3% and 28.7 months for the 48 patients in the treatment group and 75.0%, 23.3%, 6.4%, and 22.6 months for the 56 patients in the control group (p=0.045)). 101 patients had died at the time of censor, with 1-, 3-, and 5-year overall survival rates and median survival for all patients of 97.5%, 76.4%, 40.5% and 51.2 months (range, 10.0~72.0), respectively (98.3%, 78.0%, 43.6% and 52.6 months, for treatment and 96.7%, 74.7%, 37.4%, and 49.8 months, for controls, respectively (p=0.048)). Conclusions: Hepatectomy combined with 'Jianpi Huayu therapy'was effective in the treatment of HCC, and reduced post-operative recurrence and metastasis and improved DFS and OS of HCC patients.

• Advances in pediatric surgery
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• 제18권2호
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• pp.59-67
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• 2012

Fundoplication is a common surgical procedure for gastroesophageal reflux Disease (GERD). Recently the procedure has been performed with increased frequency laparoscopically. The aim of this study is to compare laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF) for GERD in children. We studied retrospectively the 88 pediatric patients who underwent the Nissen fundoplication for GERD as primary antireflux surgery from 1994 and 2009. ONF was performed in 34 cases and LNF was in 54 cases. 58 patients have neurologic impairment. Time to initial food intake after the surgery were reduced in the LNF group (p= 0.032). Recurrent GERD symptom occurred in one patient in LNF group and four patients in ONF group within 1 year after the surgery (p= 0.012). There were no statistically significant differences in post operative morbidity and mortality between both groups. In conclusion, our practice of Nissen fundoplication indicates that LNF takes priority in most pediatric patients.

• 대한간호학회지
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• 제36권4호
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• pp.652-661
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• 2006

Purpose. The purposes of this study were to apply data mining tool to nursing specific knowledge discovery process and to identify the utilization of data mining skill for clinical decision making. Methods. Data mining based on rough set model was conducted on a large clinical data set containing NMDS elements. Randomized 1000 patient data were selected from year 1998 database which had at least one of the five most frequently used nursing diagnoses. Patient characteristics and care service characteristics including nursing diagnoses, interventions and outcomes were analyzed to derive the meaningful decision rules. Results. Number of comorbidity, marital status, nursing diagnosis related to risk for infection and nursing intervention related to infection protection, and discharge status were the predictors that could determine the length of stay. Four variables (age, impaired skin integrity, pain, and discharge status) were identified as valuable predictors for nursing outcome, relived pain. Five variables (age, pain, potential for infection, marital status, and primary disease) were identified as important predictors for mortality. Conclusions. This study demonstrated the utilization of data mining method through a large data set with stan dardized language format to identify the contribution of nursing care to patient's health.