• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.55-57
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• 2017

A 64-year-old man was admitted due to jaundice for 2 weeks. Radiologic findings revealed biliary stricture at the hepatic hilum with intrahepatic duct dilation suggesting Bismuth type IV Klatskin tumor. Jaundice improved spontaneously several days after hospitalization. Surgical treatment was considered but he only wanted to observe without specific treatment. Ten months later, he was re-admitted due to the recurrence of jaundice. Computed tomography (CT) showed no significant difference compared to previous results. Serum cancer antigen 19-9 and Immunoglobulin G4 were normal. Endoscopic forcep biopsy during endoscopic retrograde cholagiopancreatography (ERCP) revealed chronic inflammation. After steroid use under possible diagnosis of IgG4 related cholangiopathy, biliary stricture improved slightly. Four years later, he was hospitalized with the occurrence of acute cholangitis. Endoscopic retrograde biliary drainage was performed following endobiliary forcep biopsy. Pathology revealed well-differentiated adenocarcinoma at this time. Combined chemotherapy based on gemcitabine and cisplatin was performed. Six months later, CT revealed partial response.

• Archives of Plastic Surgery
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• 제32권5호
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• pp.573-581
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• 2005

Breast cancer is the second leading cause of death in woman. Unfortunately, the frequency of breast cancer and mastectomy are increasing in Korea. This paper introduces the breast reconstruction by use of pectoralis major muscle transfer with breast implant for small size defect after skin sparing mastectomy for more satisfaction. We reviewed 24 consecutive patients who underwent breast reconstruction by pectoralis major muscle transfer with implant and only breast implant in Dong-A University from April 2002 to March 2004. The patient's age ranged between 29 and 54 years with mean of 42.3 years. We used pectorals major muscle transfer with breast implant in 12 patients and breast implant alone in 12 patients as control. The follow-up period of patients ranged from 10 months to 3 years with mean of 18.5 months. The points of comparison with control group reconstructed by breast implant alone were doctor and patient satisfaction score, operation time, duration of admission, amount of drainage, complication and satisfaction according to mass location. In conclusion, there is no difference with control group in the point of operation time, mount of drainage, duration of admission. And there is higher level of doctor's and patient's satisfaction in group reconstructed by pectoralis major muscle transfer with breast implant than implant only group. Especially, pectoralis major muscle transfer with breast implant was especially necessary for the defect in upper lateral quadrant of the breast to get more satisfaction. The advantage of pectoralis major muscle transfer with breast implant is prevention of the protruding and palpability of implant and aesthetically satisfactory result by intraoperative modification of breast shape.

• 한국작물학회지
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• 제52권3호
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• pp.259-263
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• 2007

최근 맥류 파종기의 잦은 강우로 파종이 늦어지는 경우가 많은데 기존의 파종방법으로는 습한 포장에서의 파종이 쉽지 않아 만파의 유인 중 하나가 되고 있다. 이에 따라 과습 상태의 토양에서도 논에서 맥류의 파종이 가능한 새로운 파종 법의 개발이 필요하다. '99년에 벼 파종용으로 개발된 부분 경운 건답 직파기를 이용하여 논에서 맥류를 파종할 때의 생육 및 수량에 대해 $2001{\sim}2003$년에 걸쳐 시험하였다. 가. 배수 후 $1{\sim}3$일, 즉 토양수분이 각각 50% 이상, 40%, $27{\sim}30%$를 보이는 토양에서 휴립 광산파와 세조파의 경우는 정상적인 파종이 불가능하였으나 부분경운 파종기를 사용하여 파종한 경우 토양수분 40%(배수 후 2일)만 되어도 정상적인 작업이 이루어져 파종이 가능하였고 초기 생육도 양호하였다. 반면 세조파종법과 휴립광산파는 토양수분 40%에서 뿐만 아니라 토양수분이 27%로 낮아져도 작업기주변에 흙이 범벅이 되어 종자가 흙과 함께 쓸려가 제 위치에 종자가 놓이지 못하였다. 이로 인해 파종법사이의 보리 입모 차이가 확연하였다. 나, 토양수분 함량 30-40%(배수후 2일)에 파종된 부분 경운파종구의 생육을 세조파종구와 비교해 볼 때 부분경운 파종기 구의 입모수가 충분히 확보되었고 이로 인해 수수도 충분히 확보되어 같은 수분함량에서 파종된 휴립광산파와 세조파에 비해 높은 수량을 보였다. 벼를 위해 개발된 부분경운파종법은 토양 과습시 보리의 파종작업에 유리한 점이 많아 농가에 보급되어 벼, 보리 모두에 이용 가능할 것으로 판단되었다. 다. 부분경운파종기에 부착된 배토기의 배수로 폭이 14cm로 좁고 깊이도 일반배토기에 비해 얕아 배수로 역할을 제대로 하지 못하였으므로 파종 후 과습이 계속될 경우에는 추가적인 배수로 보완 또는 작성 작업이 필요하며 잡초도 일반 포장에 비해 많이 발생할 우려가 있음이 보고되고 있어 적기에 잡초방제를 해야 할 것이다.

• Journal of Chest Surgery
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• 제30권5호
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• pp.493-500
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• 1997

심방 이성체를 가지는 복합 심장 기형 환자에서 n시행시 간정맥 환류의 형태를 분석하고 전대정맥폐단 락술시 어떠한 도움을 줄 수 있는지를 평가하여 bnl의 임상적 유용성을 알아보고 자 하였다. 22명의 이성체(좌이성체 9명,우이성체 13명)를 가진 복합 심장 기형 환자를 대상으로 m을 시행하여 간 정맥이 심방으로 환류되는 개구(opening)의 수와 위치, 하대정맥과의 연결 등을 조사하였다. 전대정맥폐단락 (total cavopulmonary shunt)을 시행한 6명의 환자에서 간정맥환류에 대한 수술 방법과 수술 후 체동맥 산소 분 압을 비교하였다. 9명의 모든 좌이성체 .환자에서 하대정맥 단절이 있었고 간정맥은 심방으로 직접 연결되었다. 이 중 1예에 서 간정맥이 두개의 개구를 통하여 땅측 심방으로 각각 환류되었다. 13명의 우이성체 환자중 1예에서는 모든 간 정맥은 하나의 개구를 통하여 하대 정맥과는 분리되어 심방으로 연결되었다. 4예에서는 일부의 간 정맥은 하대정맥과 연결되어 심방으로 들어갔고 일부의 간정맥은 직접 심방으로 연결되었다. 전대정맥폐단락 수술 을 시행한 6예 중 심방으로 연결되는 하대정맥 또는 간정맥의 개구가 하나인 경우나 2개 嗤\ulcorner같은 쪽 심방 에 위치한 4예는 심방내 터널 형성에 의해 모든 간정맥에서 환류되는 혈액이 폐순환을 할 수 있게 수술하였 고 수술 1주후 체동맥 산소 포화도는 평균 91.5%였다. 간정맥 또는 하대정맥의 개구가 2개이며 심방의 양측 으로 각각 연결된 2예중 1 예에서는 간정맥의 일부만 폐순환을 할 수 있게 수술하였고 1예는 수술후 로든 간정맥혈이 폐 순환을 거치지 않게 되었다. 이들의 수술 1 주후 체동맥 산소 포화도는 각각 88.6%와 90%였 다. 심방 이성체 환자에서 다양한 간정맥 환류 기형이 자주 동반되며 간정맥 환류 이상을 수술 전에 발견하는 것이 전대정맥폐단락 수술시 간정맥의 폐순환 여부를 결정하는데 도움을 준다. m은 복합 심장 기형을 가 진 이성체 환자에서 간정맥 환류를 고사하는데 유용하다.

• Archives of Plastic Surgery
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• 제43권1호
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• pp.26-31
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• 2016

Background The global prevalence of myelomeningocele has been reported to be 0.8-1 per 1,000 live births. Early closure of the defect is considered to be the standard of care. Various surgical methods have been reported, such as primary skin closure, local skin flaps, musculocutaneous flaps, and skin grafts. The aim of this study was to describe the clinical characteristics of myelomeningocele defects and present the surgical outcomes of recent cases of myelomeningocele at our institution. Methods Patients who underwent surgical closure of myelomeningocele at our institution from January 2004 to December 2013 were included in this study. A retrospective chart review of their medical records was performed, and comorbidities, defect size, location, surgical procedures, complications, and the final results were analyzed. Results A total of 14 patients underwent surgical closure for myelomeningocele defects. Twelve cases were closed with direct skin repair, while two cases required local skin flaps to cover the skin defects. Three cases of infection occurred, requiring incision and either drainage or removal of allogenic materials. One case of partial flap necrosis occurred, requiring secondary revision using a rotational flap and a full-thickness skin graft. Despite these complications, all wounds eventually healed completely. Conclusions Most myelomeningocele defects can be managed by direct skin repair alone. In cases of large defects, in which direct repair is not possible, local flaps may be used to cover the defect. Complications such as wound dehiscence and partial flap necrosis occurred in this study; however, all such complications were successfully managed with simple ancillary procedures.

• Journal of Chest Surgery
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• 제34권9호
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• pp.672-679
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• 2001

배경: 폐정맥 및 상대정맥의 폐쇄와 동방결절의 기능장애 등은 상대정맥으로 환류되는 부분폐정맥 연결이상의 수술교정 이후 발생할 수 있는 합병증으로 술 후 정기성적을 결정하는 요인이 되어왔다. 저자들이 시행하고 있는 수술방법을 기술하고 조기결과를 분석하였다. 대상 및 방법: 1999년 4월부터 2000년 1월까지 세종병원과 대구가톨릭대학병원에서 5명의 환자가 상대정맥으로 환류되는 부분폐정맥 연결이상으로 교정수술을 받았다. 환자의 나이는 생후 2개월부터 66세까지였다. 수술방법은 우심방 피판(2례)이나 첨포(3례)를 사용하여 이상폐정맥을 심방간 통로를 통하여 좌심방으로 정상환류시키고, 상대정맥을 이상폐정맥의 상부에서 절단한 후 근위부를 폐쇄하고 상대정맥의 원위부를 우심방이에 단단문합함으로써 상대정맥과 우심방의 혈류를 재건하였다. 결과: 모든 환자가 합병증 없이 술 후 9일과 15일 사이에 퇴원하였다. 퇴원 후 본국으로 돌아간 러시아 환아를 제외한 4명의 환자는 평균 17.75$\pm$4.27 개월의 추적기간 동안 증상 없이 정상동율동을 보였다. 술후 12개월에서 24개월에 시행한 심장초음파검사상 폐정맥이나 상대정맥의 협착 및 잔류단락은 보이지 않았다. 결론: 저자들은 상대정맥으로 환류되는 부분폐정맥 연결이상 환자에서 기술한 수술방법으로 폐정맥 및 상대정맥 혈류의 협착 없이 좋은 결과를 얻을 수 있었다. 상대정맥과 우심방접합부위를 가로지르는 절개를 피함으로써 동방결절 및 그 동맥의 손상을 최소화 할 수 있을 것으로 생각된다.

• 교육시설
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• 제13권4호
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• pp.15-23
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• 2006

The purpose of this study is to establish the objective deterioration grades and evaluation criteria of building equipment system of educational facilities available for reasonable maintenance and remodeling of them. For the purpose of it, the actual conditions of building equipment systems of the 148 buildings of 84 middle and high schools in Seoul 20 years after construction are investigated and surveyed through one-on-one interviews and questionnaires. And, deterioration grades of them are estimated by the evaluation criteria which is proposed in this study. As a result of this study, the 10 deterioration grades and the 4 evaluation criteria of the 6 performances of building equipment system, which are heating and cooling, water supply and drainage, hot water supply and electrical power performance, are suggested. And, as a result of the survey, it showed that 24% of the investigated school buildings were estimated C grade which needs partial remodelling, and 51% of the school buildings were estimated D grade which needs extensive remodelling. And, 25% of the school buildings were estimated E grade which needs overall remodelling or alteration of building equipment system.

• 한국임상수의학회지
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• 제16권1호
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• pp.210-213
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• 1999

A 15 months old male pit bull terrier was shown submandibular swelling, which was extended from left submandibular area through mandibular symphysis to right submandibular area and toward around left neck. In history taking, recurrence of swelling was recorded after conservative surgical incision, drainage and dressing. Palpation revealed no pain and heating, partial flutuation and hardness. By paracentesis, it was showed blood-tinged tenacious exudate without bad-smelling. Left submandibular salivary gland was able to be movable freely and the size decreased to half of that of right submandibular salivary gland. It was diagnosed as cervical salivary mucocele. In operation, rostral portion of left sublingual salivary gland was observed to be damaged transversely, showed black color and leaked saliva. Submandibular gland and rostral portion of sublingual salivary gland were resected, after ligation of ducts of submandibular and sublingual salivary glands. At 15 days postoperation, serosanguineous exudate from operation wound was dramatically decreased and stable granulation tissue mass at this area was first palpated. At 39 days after operation, outline of left and right mandibular was appeared normal and skin tenderness of mandibular area was equal to that of the other body wall.

• Journal of Chest Surgery
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• 제8권2호
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• pp.81-88
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• 1975

Up to October 31, 1975, 34 cases of atrial septal defect, secundum type, operated in this department, were presented. This is 23.2% of all congenital heart diseases, operated utilizing cardiopulmonary bypass, in this department during this period [34 out of 146]. Out of 34 cases, 32 cases are pure ostium secundum type and one case is sinus venosus and another one is ostium secundum type with partial anomalous pulmonary venous drainage. Six cases of endocardial cushion defect and 3 cases of trilogy of Fallot are excluded in this report. All 34 cases are repaired under direct vision utilizing extracorporeal circulation. Among 34 cases of atrial septal defect, 16 cases are male, and 18 cases are female. Their ages range between 3 to 48 years, but over 59% of the cases are below the ages of 20 years. Thirty-two cases are repaired by direct sutures while 2 cases are repaired with Teflon patches. The average perfusion time is 30 minutes; the shortest 12 and the longest 81 minutes. The number of the defect is single in 31 cases, double in 2 cases, triple in one case. But the associated defect except the main defect are so small as can be closed by simple direct suture. The size of the defect is average $12cm^2$; the smallest 0.7 and the largest $25cm^2$. The surgical mortality is 2 cases [5.6%] and other cases are found to be excellent in the follow up studies.

• Journal of Chest Surgery
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• 제20권1호
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• pp.106-111
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• 1987

Twenty eight patients with atrial septal defect operated on from May, 1983, to July, 1986 at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, were analyzed retrospectively. Among the 28 patients of atrial septal defect, 8 were male and 20 were female. Their ages ranged from 4.6 years to 52.5 years old with the mean of 15.3 years. The main clinical symptoms on admission were exertional dyspnea [82%], frequent respiratory infection [75%], palpitation [54%] and easy fatigability [25%]. Electrocardiographic findings were as follows: Regular sinus rhythm [100%], RVH [54%], RBBB [25%] and first degree of A-V block [4%]. Hemodynamic studies were performed in all cases and mean pulmonary systolic arterial pressure was 34.1*11.8mmHg. and mean Qp/Qs was 2.6*0.9. All 28 patients were operated under direct vision using extracorporeal circulation. 23 cases were secundum type defect and a single hole was found in 22 cases. The associated cardiovascular anomalies were found in 11 patients: ventricular septal defect in 3, patent ductus arteriosus in 1, partial anomalous pulmonary venous drainage in 2, mitral regurgitation in 2, tricuspid regurgitation in 1, anomalous left atrial septation in 1 and valvular pulmonary stenosis in 1. The defect closed directly in 22 cases and with patches in 6 cases. Postoperative complications were wound infection, arrhythmia bleeding, intracardiac patch detachment, pneumothorax and urethral injury. But there was no operative mortality.