• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.4071-4075
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• 2016

Background: FDG PET/CT is at an equivocal stage to recommend for staging of colorectal cancer as compared to contrast-enhanced CT (ceCT). This study was intended to evaluate the value of FDG PET/ceCT in colorectal cancer staging as compared to ceCT alone. Materials and Methods: PET/ceCT was performed for 61 colorectal cancer patients who were prospectively enrolled in the study. Three patients were excluded due to loss to follow-up. PET/ceCT findings and ceCT results alone were read separately. The treatment planning was then determined by tumor board consensus. The criteria for T staging were determined by the findings of ceCT. Nodal positive by PET/ceCT imaging was determined by visual analysis of FDG uptake greater than regional background blood pool activity. The diagnostic accuracy of T and N staging was determined only in patients who received surgery without any neoadjuvant treatment. Results: Of 58 patients, there were 40 with colon cancers including sigmoid cancers and 18 with rectal cancers. PET/ceCT in pre-operative staging detected bone metastasis and metastatic inguinal lymph nodes (M1a) that were undepicted on CT in 2 patients (3%), clearly defined 19 equivocal lesions on ceCT in 18 patients (31%) and excluded 6 metastatic lesions diagnosed by ceCT in 6 patients (10%). These resulted in alteration of management plan in 15 out of the 58 cases (26%) i.e. changing from chemotherapy to surgery (4), changing extent of surgery (9) and avoidance of futile surgery (2). Forty four patients underwent surgery within 45 days after PET/CT. The diagnostic accuracy for N staging with PET/ceCT and ceCT alone was 66% and 48% with false positive rates of 24% (6/25) and 76% (19/25) and false negative rates of 47% (9/19) and 21% (4/19), respectively. All of the false negative lymph nodes from PET/ceCT were less than a centimeter in size and located in peri-lesional regions. The diagnostic accuracy for T staging was 82%. The sensitivity of the peri-lesional fat stranding sign in determining T3 stage was 94% and the specificity was 54%. Conclusions: Our study suggested promising roles of PET/ceCT in initial staging of colorectal cancer with better diagnostic accuracy facilitating management planning.

• Journal of Preventive Medicine and Public Health
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• 제33권3호
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• pp.334-342
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• 2000

이 연구는 당일수술을 실시하고 있지 않은 병원에서 당일수술이 가능한 질병으로 입원하고 있는 환자를 대상으로 당일수술에 대한 인지도와 선호도를 조사하고, 당일수술 가능 질병의 평균 재원일수를 분석하며, 마취 후 퇴원점수체계를 이용한 시간대별 퇴원 가능한 환자의 비율을 분석하여 당일수술 가능여부를 판단하기 위하여 실시되었다. 자료수집은 1999년 2월 1일부터 동년 3월 31일까지 $\bigcirc\bigcirc$대학교 의과대학 부속병원에 입원하여 백내장, 편도선 비대, 탈장, 사시, 안검하수, 담석증, 질, 치루로 수술 받은 환자 353명을 대상으로 하였다. 자료 수집 방법은 설문지를 이용하여 설문과 면담을 하였고, 간호사용 마취 후 퇴원점수체계(PADS)를 이용하여 환자의 수술 후 활력징후, 활동력과 정신상태, 통증, 오심 구토, 출혈, 식이 및 배뇨 등의 환자상태를 조사하였다. 당일수술에 대한 인지도는 52.7%이었으며, 당일수술 의향이 있는 환자는 52.1%이었다. 당일수술을 받고 싶은 이유로는 "질병이 경미하고 수술이 간단하여"가 43.1%, "집에서 안정을 취해도 충분하므로"가 30.4%이었고, 당일수술을 받고 싶지 않는 이유는 "집에 있기 불안해서"가 56.5%로 가장 높았다. 당일수술 후 가장 염려되는 것은 응급 상황발생에 대한 것이었다. 당일수술의 가장 큰 장점은 입원기간 절약(39.1%)이었으며 단점은 응급상황 시 불안하다는 것이 53.9%로 가장 많았다. 환자의 주관적 판단에 의한 퇴원시기는 수술 후 1-2일이라고 생각하는 사람이 47.6%로 가장 많았다. 수술명에 따른 평균 재원일수는 백내장적출술 2.9일, 사시 교정술 2.2일, 편도선제거술 3일, 탈장교정술 3.8일, 안검복원술 2.2일, 담석증복강경술 4.9일, 치질제거술 4.1일, 치루제거술 4.6일로, 이들 전체의 평균 재원일수는 3.1일이었다. 수술 후 나타난 증상으로는 통증이 45.6%로 가장 많았고, 다음으로 오심 구토(10.5%) 및 두통(7.9%)의 순이었다. 시간대별 퇴원 가능 환자 수는 3시간대에 95.2%, 12시간대에 99.2%, 24시간대에는 100%로 나타나 이 연구에서 선정된 모든 수술이 마취 후 퇴원점수체계에 의한 24시간 이내 퇴원 기준을 충족시켰고, 통상적으로 당일수술 3시간 뒤에 환자가 퇴원하는 것을 고려하면 의학적인 측면에서 당일수술이 가능한 수술은 백내장적출술과 사시교정술로 판단되었다. 당일수술의 경과에 대한 설명과 수술 시행 후에 환자들에게 발생할지도 모르는 응급상황에 대한 대처 방안이 잘 강구 된다면 당일수술의 수요가 증가할 것이며, 그 서비스에 대한 만족도도 높아져 당일수술이 활성화될 것이다.

• 한국임상수의학회지
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• 제24권4호
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• pp.627-630
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• 2007

잡종의 사냥개가 멧돼지 사냥 중에 대퇴와 서혜부의 열상을 입고, 음경이 절단되었다. 음경은 요도, 해면체, 그리고 좌우측의 음경등쪽정맥을 문합함으로써 재접합되었다. 절단된 음경은 해부학적 그리고 기능적으로 회복되었다. 술 후의 음경 원위부의 부종이나 괴사는 발견되지 않았으며, 술 후 20일째 요도조영술에서 누관이나 협착 또한 발견되지 않았다. 본 수술과 별도로, 3마리의 비글견에서 음경등쪽정맥의 문합의 중요성을 확인하고자 실험적 해면체조영술을 실시하였다. 해면체조영에서 음경망울에 주입된 조영제는 좌우측의 음경등쪽정맥을 통해 배출되었고, 좌골궁 부위에서 하나의 혈관으로 수렴된 후 다시 좌우측 속음부정맥으로 분기되었다. 따라서 개의 절단된 음경의 증례에서 좌우측의 음경등쪽정맥의 재문합은 술 후 좋은 예후를 위해 중요하다고 사료된다.

• Archives of Reconstructive Microsurgery
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• 제8권1호
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• pp.77-83
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• 1999

전북대학교병원 정형외과에서 1993년 8월부터 1997년 8월까지 족부 및 수부 손상 5례에 대하여 족 배 유리 피부판 이식술을 시행하고, 1999년 3월까지 최소 19개월부터 최장 67개월간 추시하여 다음과 같은 결과를 얻었다. 1. 나이별로는 9세부터 35세까지로 평균 23세 이었으며, 성별로는 전례가 남자이었으며, 족부에서 시행하였던 예가 4례, 수부에서 1례이었다. 2. 족부의 손상 원인은 교통사고 2례, 기계 사고 1례, 자전거 바퀴 사고 1례 이었으며, 수부에서는 교통사고에 의하여 전완부 요골의 개방성 골절이 동반되고 수부 배부의 다발성 신전 건 파열 및 피부 괴사에 의한 신전 건 노출 1례이었다. 3. 수여 동맥은 족 배 동맥 2례, 전 경골 동맥 1례, 후 경골 동맥 1례 그리고 척골 동맥이었으며, 수여 정맥은 족부 4례에서 2개 정맥을 문합하였으며, 5례(100%) 전례에서 성공하였다. 4. 추시 결과 유리 피판 이식술 후 외양(exterior)과 일상생활시 피부판이 손상되는 분쇄(maceration) 정도는 우수하였으나, 감각 회복 정토는 불량하였다. 5. 제공 부위인 족 배부는 유리 피판 이식술 3주 후 전층 식피술을 시행하여 완전 접착되었으며, 추시상 유병율없이 우수한 결과를 보였다.

• 한국임상수의학회지
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• 제30권1호
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• pp.66-70
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• 2013

This report compared paramedian and flank approaches for the effective removal of abdominal unilateral cryptorchidism in calves. Two Korean native calves of approximately 300 kg in body weight, which had undergone the removal of a testis from the scrotum, were diagnosed as having abdominal unilateral (left) cryptorchidism by rectal palpation. One calf was administered with xylazine (0.2 mg/kg, IV) and was restrained in the dorsal recumbency position on the ground of barn for the paramedian approach, while the other calf was sedated with xylazine (0.03 mg/kg, IV) and restrained in the standing position for a flank approach. For the two calves, 2% lidocaine was administered by local infiltration, along the proposed incision line. Following incisions of the skin, muscle and peritoneum, the testis, which was located between the left kidney and inguinal canal, was grasped, exteriorized out of the abdominal cavity and detached from the gubernaculum testis. Then spermatic cord was ligated and cut. Finally, the testis was removed. An assistant was required to restraint a calf in dorsal recumbency for paramedian approach, and cryptorchidectomy was carried out with operator in a rather uncomfortable squatting posture, while restraint was rather simple and cryptorchidectomy was proceeded with operator in a standing posture where the flank approach was taken. During surgery, the gubernaculum testis was more strained during pulling the testis in the flank approach than in the paramedian approach, as the distance between incision site and the gubernaculum testis was greater in the flank approach than that in the paramedian approach. On the other hand, intra-abdominal pressure was greater in the paramedian approach than in the flank approach during surgery. The elapsed time between restraint and the end of surgery was 10 min shorter where the flank approach (35 min) was taken, than where the paramedian approach (45 min) was taken. In conclusion, this case study demonstrated that the flank approach might be more convenient than the paramedian approach for abdominal unilateral cryptorchidectomy in calves.

• Archives of Plastic Surgery
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• 제35권4호
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• pp.385-392
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• 2008

Purpose: The most effective methods of harvesting, preparing, and injecting autologous fat grafts have been inconsistent and conflicting. With its limitation as resorption in fat grafting, handling various techniques affect adipocyte survival, and is crucial to optimizing its long-term survival. To improve graft survival, re-implantation of cryopreserved adipocytes was developed. In addition, adipocytes do not induce immune rejection in response to non-self lymphocytes in a mixed lymphocyte reaction. The purpose of this study is to analyze the changes in cryopreserved adipocytes so as to determine the most efficient long-term storage period, and to analyze the changes in cryopreserved allografted adipocytes so as to determine the efficacy of cryopreserved adipocytes allografting. Methods: Fat tissues were harvested from the inguinal and retroperitoneal fat pad of mice. After the centrifugation of the harvested fat tissues, they were disintegrated with collagenase. The adipocytes were obtained by centrifugation of the disintegrated fat tissues. The adipocytes were treated as follows: (1) They were examined for weight and then frozen at $-20^{\circ}C$(n=25). For four months, each five frozen samples were taken and examined for weight and histologic changes in the 1st week, the 1st month, the 2nd month, the 3rd month, and the 4th month, respectively. (2) The adipocytes were immediately frozen at $-20^{\circ}C$(n=125). For four months, five frozen samples were taken, and allografted in the same time period as above. Finally, for four months, five cryopreserved allografted adipocytes were taken and examined for histologic changes in the same time period as above. Results: (1) Significant weight changes and histologic findings with inflammatory and destructive changes were observed in the cryopreserved adipocytes in three months. (2) Significant fat necrotic changes in the histologic changes with Hematoxylin and eosin stain were observed in the cryopreserved allografted adipocytes since the first week, independent of the freezing period. Conclusion: The study results show that the adipocytes that were cryopreserved for more than three months underwent obvious weight reductions and necrotic changes, and the adipocytes that were allografted without freezing were viable for four months, but the cryopreserved allografted adipocytes had obvious necrotic changes since the first week regardless of the freezing period.

• 대한골관절종양학회지
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• 제15권1호
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• pp.69-74
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• 2009

슬와부위의 연부조직육종은 사지의 연부조직 육종 중 5% 이하를 차지하는 드문 질환이다. 주요 혈관과 신경이 지나가는 슬와, 주와, 서혜부와 같은 구획외 공간에서는 사지 구제술 시 적절한 절제연을 얻으면서 절제를 시행하기가 쉽지 않으며 불가피하게 변연부 절제를 시행해야 하는 경우도 있다. 슬와부 종양 절제시는 후방 도달법을 시행하는 경우가 일반적이다. 크기가 작고 주변 조직에 유착이 없는 종양일 경우 후방 도달법으로 신경다발막과 혈관외막을 박리하여 종양을 쉽게 절제할 수 있다. 그러나 종양의 크기가 크고 주변조직으로 침범이 있는 경우에는 종양의 절제 자체가 어려울 수 있다. 이런 경우는 절단술의 상대적 적응증이며 종양이 전방 및 후방 구획을 동시에 침범하였을 경우에는 절단술이 불가피하다고 생각되는 경우가 많았다. 저자들은 전방 및 후방 구획을 동시에 침범한 연부조직종양을 골 외측으로 종괴를 형성한 골종양으로 간주하여 근위 경골과 비골을 종양과 함께 절제함으로써 적절한 절제연을 얻으면서 사지구제술이 가능하였기에 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.97-100
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• 1998

Systemic lupus erythematosus is a severe cutaneous-systemic disorder of unknown etiology, It is represented with erythematous patches on the face in a so-called butterfly distribution, and characteristically classified as an autoimmune disease with antinuclear antibodies. The autoimmune diseases such as systemic lupus erythematosus, $Sj{\ddot{o}}gren$ syndrome, rheumatoid arthritis have been associated with lymphoid malignancy - leukemia, malignant lymphoma - which could involve various organs(spleen, liver, brain, mediastinal lymph node, supraclavicular lymph node, inguinal lymph node, cervical lymph node etc.). Many authors have studied about the association of systemic lupus erythematosus and malignant lymphoma, but exact etiology is still unknown. A common viral etioloty for systemic lupus erythematosus has been suggested since virus-like particles have been found in the glomerular endothelium of patients with systemic lupus erythematosus. These oncogenic viruses may be responsible for the higher frequency of malignant lymphoma in patients with systemic lupus erythematosus. In the other theory, the causes of malignant lymphoma are the defect of immune system due to systemic lupus erythematosus and the long-term use of therapeutics for treatment of systemic lupus erythematosus. When the cellular immune system(delayed hypersensitivity) is impaired by immunosuppressive drugs, it is likely that the body is no longer able to recognize and reject malignant cells as they arise; they continue to grow and divide unhindered. The impairment of the cellular immune system may allow growth of oncogenic virus or the survival of neoplatic tissues. 47-year old female patient treated systemic lupus erythematosus with steroid and immunosuppressive drugs for 5 years visited to our hospital due to elevated mass on left upper anterior maxilla area. By performing biopsy, we diagnosed this lesion as malignant lymphoma and referred to oncologist for chemotherapy. So we report a case of malignant lymphoma due to systemic lupus erythematosus with review of literatures.

• Journal of Korean Neurosurgical Society
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• 제49권4호
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• pp.241-244
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• 2011

Sparganosis is a rare parasitic infection affecting various organs, including the central nervous system, especially the lumbar epidural space. This report describes the identification of disease and different strategies of treatments with preoperative information. A 42-year-old man presented with a 2-year history of urinary incontinence and impotence. He had a history of ingesting raw frogs 40 years ago. Magnetic resonance (MR) imaging showed an intramedullary nodular mass at conus medullaris and severe inflammation in the cauda equina. A 51-year-old woman was admitted with acute pain in the left inguinal area. We observed a lesion which seemed to be a tumor of the lumbar epidural space on MR imaging. She also had a history of ingesting inadequately cooked snakes 10 years ago. In the first patient, mass removal was attempted through laminectomy and parasite infection was identified during intra-operative frozen biopsy. Total removal could not be performed because of severe arachnoiditis and adhesion. We therefore decided to terminate the operation and final histology confirmed dead sparganum infection. We also concluded further surgical trial for total removal of the dead worm and inflammatory grannulation totally. However, after seeing another physician at different hospital, he was operated again which resulted in worsening of pain and neurological deficit. In the second patient, we totally removed dorsal epidural mass. Final histology and enzyme-linked immunosorbent assay (ELISA) confirmed living sparganum infection and her pain disappeared. Although the treatment of choice is surgical resection of living sparganum with inflammation, the attempt to remove dead worm and adhesive granulation tissue may cause unwanted complications to the patients. Therefore, the result of preoperative ELISA, as well as the information from image and history, must be considered as important factors to decide whether a surgery is necessary or not.

• Journal of Korean Neurosurgical Society
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• 제40권4호
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• pp.267-272
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• 2006

Objective : There have been recent reports that mesenchymal stromal cells that are harvested from adipose tissue are able to differentiate into neurons. In the present study, we administered adipose tissue derived stem cells in rats with cerebral infarction in order to determine whether those stem cells could enhance the recovery of motor function. Methods : Cerebral infarction was induced by intraluminal occlusion of middle cerebral artery in rats. The adipose tissue-derived mesenchymal stem cells were harvested from inguinal fat pad and proliferated for 2 weeks in DMEM media. Approximately $1{\times}10^6$ cells were injected intravenously or into subdural space of the peri-lesional area. The rotor rod test was performed at preoperative state[before MCA occlusion], and 1, 2, 3, 4, 6, 8 and 10 weeks after the cell therapy. Results : The motor functions that were assessed by rotor rod test at 1 week of the cell therapy were nearly zero among the experimental groups. However, there was apparent motor function recovery after 2 weeks and 4 weeks of cell injection in intravenously treated rats and peri-lesionaly treated rats, respectively, while there was no significant improvement till 8 weeks in vehicle treated rats. Conclusion : These results demonstrate that the adipose derived stem cell treatment improves motor function recovery in rats with cerebral infarction.