• Journal of Chest Surgery
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• 제52권3호
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• pp.186-188
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• 2019

We report an unusual case of delayed bleeding after open surgical repair of a thoracoabdominal aortic aneurysm. A 79-year-old man developed a massive retroperitoneal hematoma 49 days after Crawford type III thoracoabdominal aorta replacement. During emergency surgery, a tear was found in the prosthetic vascular graft caused by a sharp bony spur arising from the second lumbar vertebral body. This rare, but potentially lethal, complication indicates that attention should be paid to sharp bony structures during open repair of the descending aorta.

• Journal of Yeungnam Medical Science
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• 제38권1호
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• pp.10-18
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• 2021

Endometriosis is a chronic disease associated with pelvic pain and infertility. Several classification systems for the severity of endometriosis have been proposed. Of these, the revised American Society for Reproductive Medicine classification is the most well-known. The ENZIAN classification was developed to classify deep infiltrating endometriosis and focused on the retroperitoneal structures. The endometriosis fertility index was developed to predict the fertility outcomes in patients who underwent surgery for endometriosis. Finally, the American Association of Gynecological Laparoscopists classification is currently being developed, for which 30 endometriosis experts are analyzing and researching data by assigning scores to categories considered important; however, it has not yet been fully validated and published. Currently, none of the classification systems are considered the gold standard. In this article, we review the classification systems, identify their pros and cons, and discuss what improvements need to be made to each system in the future.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.276-280
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• 2023

Fungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical debridement. A 70-year-old male patient injured by a falling object weighing 1,000 kg was transferred to our hospital. A contained rupture of the abdominal aorta with retroperitoneal hematoma was treated with primary aortic repair, and a small bowel perforation with mesenteric laceration was treated with resection and anastomosis. After a computed tomography scan, the patient was diagnosed with thrombophlebitis of the left internal jugular vein and brachiocephalic vein. Despite antifungal treatment, fever and candidemia persisted. Therefore, emergency debridement and thrombectomy were performed. After the operation, the patient was treated with an oral antifungal agent and direct oral anticoagulants. During a 1-year follow-up, no signs of candidemia relapse were observed. There is no optimal timing of surgical treatment for relapsed fungal central thrombophlebitis. Surgical treatment should be considered for early recovery.

• Anatomy and Cell Biology
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• 제56권1호
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• pp.141-144
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• 2023

Knowledge of variations of renal vessels is of utmost importance in retroperitoneal surgeries and kidney transplant surgeries. We report concurrent variations of the right renal vessels, observed in an adult male cadaver during dissection classes. The right kidney was supplied by three renal arteries, out of which two entered the kidney through the hilum and the other one entered through the lower pole of the kidney. There were five renal veins, emerging independently from the hilum and opening separately through five openings into the inferior vena cava. Among the veins, only one emerged anterior to the renal pelvis and the other four emerged behind it. Four of them terminated into the posterolateral aspect of the inferior vena cava, whereas one terminated into its anterior aspect. Fourth vein from above, received the right testicular vein. The renal hilum was clogged with the presence of seven vessels and renal pelvis.

• Journal of Applied Biological Chemistry
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• 제53권1호
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• pp.44-50
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• 2010

본 연구에서는 고지방식이로 비만을 유도한 암컷 백서에게 태음조위탕과 도담탕을 8주 동안 경구 투여하였을 때 에너지와 포도당 대사에 미치는 영향을 조사하였다. 태음조위탕은 체중과 복부지방에 지방 축적을 나타내는 mesenteric fat과 retroperitoneal fat 양을 감소시키는 경향은 있었지만 통계적으로 유의한 차이를 나타내지는 않았다. 태음조위탕은 대조군에 비해 식이섭취량을 감소시키는 경향을 나타내었다. 반면에 도담탕은 대조군에 비해 체중과 복부지방을 통계적으로 유의하게 감소시켰으며 이것은 식이 섭취량의 감소에 기인하였다. 에너지 소모량은 고지방식이군과 저지방식이군에 차이가 없었고 태음조위탕과 도담탕도 에너지 소모량에 영향을 미치지 않았다. 그러나 에너지원으로 지방을 사용하는 것은 도담탕이 대조군에 비해 높았다. 고지방식이에서는 체내 인슐린 저항성을 나타내는 $HOMA_{IR}$의 값이 높았고, 도담탕은 이것을 통계적으로 유의적으로 낮추었다. 또한, 간에 저장된 글리코겐양도 도담탕을 섭취한 백서에서 가장 많았고, 반면에 간에 저장된 중성 지방 함량은 가장 낮았다. 결론적으로 고지방을 장기간 투여한 암컷 백서에서 체내 에너지와 포도당 대사에 장애가 나타났으며, 태음조위탕과 도담탕이 모두 이러한 장애를 해소하는 경향이 있었으나 도담탕이 효과적으로 에너지와 포도당 대사를 정상화시켰다. 그러므로 비만인 사람에게서 효과적으로 에너지와 포도당 대사를 정상화시킬 수 있는 지에 대한 인체 실험을 하는 것이 필요할 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.763-771
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• 2000

Objectives : Thoracolumbar burst fractures(TBLF) result in not only compressive deformity of vertebral body but also spinal cord compression by bony fragments. Many thoracolumbar burst fractures demand both anterior decompression and intervertebral fusion. Most of spinal surgeons use anterior instrumentation for anteior intervertebral bony fusion. The use of Z-plate has been increased recently, however there has been only a few reports regarding its clinical long-term strength. We studied nineteen patients with TBLF to find out the long-term stability of Z-plate. Methods : We have operated 19 patients from March 1996 to August 1998. They were treated with anterior decompression through either a transthoracic, retroperitoneal extrapleural or retroperitoneal approach. Retropulsed bony fragments were removed completely by corpectomy. Iliac bone graft was used for interbody fusion in all of the cases. They were evaluated by plain X-ray films including flexion and extention lateral films. Cobbs angle was used to evaluate kyphotic and lateral wedging deformity. Results : Burst fractured sites were T11 in two, three T12, nine L1, and five L2. Mean follow-up duration was fifteen months. Preoperative average kyphotic angle was 23.7 degree. Immediate postoperative kyphotic angle was 10.2 degree. Follow-up resluts of average kyphotic angles revealed 14 degrees. Four patients(21%), including two spinal 3-column injury, showed increasement of kyphotic angle more than 5 degree or breakage of intrumentation. Two patients showed the difference of kyphotic angle more than 3 degree. Five patients(26%) revealed lateral wedging deformity more than 3 degrees. Postoperative complications were two meralgia parestheticas, one pulmonary atelectasis and two donor site infections. Four of the eight patients, who initially showed incomplete spinal cord deficits, were nerologically improved by Frankel's grade. Conclusion : Z-plate fixation and iliac bone graft after anterior decompression in thoracolumbar burst fractures is a safe and easy method. Immediate postoperative results revealed excellent correction of posttraumatic kyphosis, but long-term follow-up evalution showed insufficient strength. Therefore we believe that use of Z-plate should be carefully decided, especially in the case of large lumbar fracture or 3-column injury.

• 한국산학기술학회논문지
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• 제14권10호
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• pp.4962-4969
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• 2013

본 실험의 목적은 TSE-SPIR 지방소거기법과 GE-PROSET 지방소거기법을 비교하여 복부자기공명영상에서 최적의 T2 강조 지방소거기법을 평가하고자 한다. 자기공명영상 검사는 16채널 다중채널을 사용하여 1.5 T(Philips, Medical System, Achieva)기기로 수행하였다. 모든 영상은 TSE-SPIR과 GE-PROSET을 이용하여 축면상(axial plane)을 얻었다. TSE-SPIR과 GE-PROSET에 대한 후복막 지방의 평균 SNRs는 31.50, 4.15 이었으며, 장간막 지방에 대한 SNRs는 32.39, 7.03이었다. TSE-SPIR과 GE-PROSET에서 장과 후복막 지방, 장간막 지방의 CNRs는 152.69, 74.54 와 26.12, 68.78이었다. 장벽에 대한 묘출도는 TSE-SPIR(2.4), GE-PROSET(1.8)로 TSE-SPIR가 높게 나타났으며, 췌장벽(pancreas wall)에 대한 묘출도는 TSE-SPIR(1.90), GE-PROSET(2.80)로 GE-PROSET가 높게 나타났다. 결론적으로, T2 강조 지방소거 복부자기공명영상에서 GE-PROSET 지방소거기법 보다 TSE-SPIR 지방소거기법이 우위성 있은 평가를 얻었다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6691-6696
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• 2015

Background: Endometrial carcinoma is the most common gynecological cancer and its treatment is still controversial, especially in its early stages. There are conflicting data about the efficacy of retroperitoneal lymphadenectomy during abdominal hysterectomy and bilateral salpingoophrectomy treatment. Lymphadenectomy carries a risk of severe complications, especially in women with co-morbidities. Selective lymphadenectomy has been widely employed for staging evaluation of endometrial carcinoma because it is simple and seems to provide reliable data regarding nodal metastasis. This study was designed to evaluate accuracy of sentinel node sampling in detecting lymph node metastasis in primary endometrial carcinoma during staging laparotomy. Materials and Methods: Ninety-three women with endometrial carcinoma at high-risk for nodal metastasis were studied. During laparotomy, methylene blue dye was injected into sub-serosal myometrium, then retroperitoneal spaces were opened and blue lymph nodes within pelvic and para-aortic regions were removed as separate specimens for histopathological examination (sentinel lymph nodes = SLNs). Hysterectomy and selective lymphadenectomy then performed for all women included in this study. Results: Deposition of methylene dye into at least one lymph node was observed in 73.1% (68/93) of studied cases. 18.3% (17/93) of studied women had positive lymph node metastasis and 94.1% (16/17) of them had positive metastasis in SLNs. In this study, SNLs had 94.4% sensitivity and 100% specificity in prediction of lymph node metastasis. Mean number of lymph nodes removed from each case decreased when SLNs biopsy were taken. Conclusions: SLNs are the key lymph nodes in endometrial tumor metastasis and their involvement could be an indicator for whether or not complete systematic lymphadenectomy is needed during staging laparotomy.

• Journal of Chest Surgery
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• 제31권2호
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• pp.203-207
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• 1998

고대 안암병원 흉부외과에서는 각각 1개월과 20개월전에 수족장부 다한증으로 흉강경하 흉추 교감신경절 절제술을 시행받았으나 족장부 다한증이 지속되는 환자 2명에 대해 후복막강 내시경을 이용한 요추 교감신경절 절제술을 시행하였다. 첫 번째 환자의 경우 우측에서 트로카 삽입중 기복이 발생하여 개복적 방법으로 전환해야 했으며, 우측 요추 교감신경절의 불완전한 절제로 발한이 지속되어 재수술을 시행하였다. 술후 각각 70일과 30일이 경과한 시점에서 추적관찰하였으며 만족도 결과를 매우만족, 만족, 보통, 불만족으로 평가하였다. 첫 번째 환자는 '매우만족', 두 번째 환자는 항문주위 대상성 다한증이 있었으나 대체로 '만족'을 나타내었다. 족장부 다한증에 대한 후복막강 내시경하 요추 교감신경절 절제술은 통증이 적고 반흔이 작으며, 회복기간과 입원기간을 줄일 수 있어 족장부 다한증의 유용한 치료방법의 하나이다.

• 대한미생물학회지
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• 제21권2호
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• pp.211-226
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• 1986

To understand the pathogenesis of anicteric leptospirosis with severe pulmonary hemorrhage occured in Korea, the microbiological and pathological features were observed in the experimentally induced leptospirosis in guinea pigs infected with a virulent strain of Leptospira interrogans isolated from the patient at Wonju, Korea, and the results are summarized as follows. 1. The main pathological features were widespread hemorrhages, especially affecting lung, skeletal muscles, retroperitoneal and perirenal adipose tissues. The hemorrhages accompanied inflammatory process especially of vasculitic pattern as well as occasional coagulation necrosis in the liver, skeletal muscle, and myocardium. The main inflammatory cells were of plasma cell even in the fairly early stage of the infection. 2. Those pathologic changes were more exaggerated in the inoculation site. 3. Within 144 hours of infection, the longer the infection time, the more antigens were observed in the tissues, and the severer the pathologic changes. 4. Leptospiral antigens were detected at first by indirect immunofluorescent and immunoperoxidase technics. As the infection time extended, the antigens were observed in all of the tissues examined except in the skeletal muscle. The shape of the antigens was spiral or thread-like within 72 hours of infection. As the infection progressed, they became fragmented and granular. 5. Leptospires were detected in the blood within 144 hours of infection by darkfield microscopic examination. Thereafter, none was observed. 6. Antibody to leptospires were detected as early as 72 hours of infection. In summary, the virulent strain of L. interrogans used in this experiment induced widespread hemorrhages with inflammatory reaction especially in lung, skeletal muscles, and retroperitoneal adipose tissue. With these findings, it is suggested that the direct toxic effect of leptospires might playa great role in the pathogenesis of this infection.