• Title/Summary/Keyword: 후복강

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Learning Curve of a Laparoscopy Assisted Distal Gastrectomy for a Surgeon Expert in Performing a Conventional Open Gastrectomy (개복 위절제술에 경험이 풍부한 술자에 의한 복강경 보조하 원위부 위절제술의 Learning Curve)

  • Kim, Ji-Hoon;Jung, Young-Soo;Jung, Oh;Lim, Jeong-Taek;Yook, Jeong-Hwan;Oh, Sung-Tae;Park, Kun-Choon;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.167-172
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    • 2006
  • Purpose: The laparoscopy assisted gastrectomy has been increasingly reported as the treatment of choice for early gastric cancer. However, expert surgeons, who have performed a conventional open gastrectomy for a long time, tend to have a negative attitude toward laparoscopic procedures. The aim of this study was to determine the learning curve of a laparoscopy assisted distal gastrectomy (LADG) for a surgeon expert in performing an open gastrectomy and to analyze the factors that have an effect on a LADG. Materials and Methods: Between April 2005 and March 2006, 62 patients underwent a LADG with D1+beta lymph-node dissection. The 62 patients were divided into 10 sequential groups with 6 cases in each group (the last group was 8 cases), and the time required to reach the plateau of the learning curve was determined by examining the average operative times of these 10 groups. Other factors, such as sex, BMI, complications, transfusion requirements, the number of retrieved lymph nodes, and change of postoperative hemoglobin level, were also analyzed. Results: With the $5^{th}$ group (after 30 cases), the operative time reached a plateau (average: 170 min/operation). The differences between before the $30^{th}$ case and after the $31^{st}$ case with respect to changes in the postoperative hemoglobin level, the number of retrieved lymph nodes, the transfusion requirements, and the complications rate were not significant. Conclusion: According to an analysis of the operative time, experience with 30 LADGs in patients with early gastric cancer is the point at which the plateau of the learning curve (7 months) is reached. Abundant experience with a conventional open gastrectomy and a well-organized laparoscopic surgery team are important factors in overcoming the learning curie earlier.

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Effects of Postoperative Oral Care Using Cold Therapy on Nausea, Vomiting and Oral Discomfort in Patients with Laparoscopic Myomectomy (냉요법을 이용한 수술 후 구강간호가 복강경 자궁근종절제술 환자의 오심, 구토 및 구강 불편감에 미치는 효과)

  • Jung, Mi-Young;Choi, Hyo-Sun;Park, Kyung-Yeon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.3
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    • pp.292-301
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    • 2012
  • Purpose: The purpose of the study was to evaluate the effects of postoperative oral care using cold therapy on nausea, vomiting and oral discomfort after laparoscopic myomectomy. Method: The study was conducted with an experimental group (n=29) and a control group (n=35) sampled from patients admitted to a women's hospital in a metropolitan city in Korea. Data were collected between October 10, 2011 and January 31, 2012 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANCOVA with SPSS/WIN 19.0. Results: After the intervention, postoperative nausea (p<.001) and oral discomfort for patients in the experimental group were significantly lower than in the control group. There were significant differences in the presence of vomiting between both groups at 12 hours (p<.001) and 24 hours (p=.003) after leaving the recovery room. Conclusion: Oral care using cold therapy was found to be an effective nursing intervention for reducing postoperative nausea, vomiting and oral discomfort up to 24 hours after recovery in patients with laparoscopic myomectomy.

A RADIOAUTOGRAPHIC STUDY OF POSTNATAL DEVELOPMENT OF THE TONGUE FOLLOWING 5-FLUOROURACIL ADMINSTRATION IN MICE

  • Jang, Sang-Heon
    • The Journal of the Korean dental association
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    • v.14 no.3
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    • pp.297-305
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    • 1976
  • 신생의 Balb/C strain 백서20두를 사용하였고, 실험군과 대조군으로 구분하여 실험군에는 5-fluorouracil의 체중 25 mg/kg씩 2회를 복강내주사하였다. 실험군가 대조군에 모두 희생 2시간전에 체중그람당 5μ Ci의 thymidine-H³ (Specific activity는 9.0 Ci/mM 이상)를 복강내 주사하였다. 각군은 5-fluorouracil 최종 주사후 1, 3, 7, 14, 21일 간격으로 희생시키고, 두부를 4% formalin에 고정하였다. 조직을 0.5M EDTA에 탈회하고 parlodion과 paraplast에 이중 매몰을 하여 Parasagittal serial section 을 10μ의 절편을 만든 후 자기방사용표본을 제작하였다. 그 결과는 다음과 같다. 1. 5-fluorouracil이 백서설의 기저세포층의 핵산합성 및 단백합성에 미치는 영향은 실험초일인 제 1일부터 억제하기 시작하여 (80.9%) 제3일 76.9%이고, 제 7일이 가장 극심하고 (66.2%) 그후부터는 다소회복되기 시작하여 제14일이 92/3%이고, 제21일인 98.9%로서 서의 대조군수치에 접근하였다. 2. 5-fluorouracil은 설유두중 nallate papillae 성장에 가장 억제적 현상을 보였고, 그 다음이 fungiform papillae, filiform papillae의 순위였다. 3. 5-fluorouracil 이 백서설의 기저세포층의 핵산합성을 억제함을 알 수 있고, 아울러 백서설의 조기정상 발육에 영향을 줌울 알 수 있다.

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Clinical Usefulness of a Totally Laparoscopic Gastrectomy (전(全)복강경하 위절제술의 임상적 유용성)

  • Kim, Jin-Jo;Kim, Sung-Keun;Jun, Kyong-Hwa;Kang, Han-Chul;Song, Kyo-Young;Chin, Hyung-Min;Kim, Wook;Jeon, Hae-Myung;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Park, Woo-Bae;Kim, Seung-Nam
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.132-138
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    • 2007
  • Purpose: In Korea, the number of laparoscopy-assisted distal gastrectomies for early gastric cancer patients has been on the increase. Although minimally invasive surgery is more beneficial, no reported case of a total laparoscopic gastrectomy has been reported because of difficulty with intracorporeal anastomosis. This study attempts, through our experience, to determine the safety and feasibility of a total laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linears stapler in treating early gastric carcinomas. Materials and Methods: We investigated the surgical results and clinicopatholgical characteristics of 81 patients that underwent a totally laparoscopic distal gastrectomy at our department between June 2004 and May 2007. The intracorporeal anastomoses were performed by using laparoscopic linear staplers. Results: The mean operative time was 287 minutes, the mean anastomotic time was 40 minutes, and the mean number of laparoscopic linear staplers used for an operation was 7.5. The mean time to the first flatus, the first food intake, and discharge from hospital was 2.9, 3.6, and 10.3 days respectively. There were 11 cases of postoperative complications, but no case of postoperative mortality or conversion to an open procedure. In 75 patients with an adenocarcinoma, the mean number of lymph nodes harvested was 38.1 and the stage distribution was as follows: stage I, 72 patients; stage II, 2 patients; stage IV, 1 patient. During the mean follow-up period of 14 months, 5 patients died of other causes and there were no cases of cancer recurrence. Conclusion: A total laparoscopic gastrectomy with intracorporeal anastomosis by using a laparoscopic linear stapler was found to be safe and feasible. We were able to obtain acceptable surgical outcomes in terms of minimal invasiveness.

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Effect of carboxymethyl chitosan on postoperative intraperitoneal adhesion formation in the rat (Rat에서 carboxymethyl chitosan의 복강수술후 유착형성에 미치는 효과)

  • Jang, Kwang-ho;Kwon, Yong-sam;Kim, Jung-eun;Kwon, Eun-ju;Oh, Tae-ho;Lee, Keun-woo;Jang, In-ho
    • Korean Journal of Veterinary Research
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    • v.40 no.3
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    • pp.635-643
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    • 2000
  • The aim of this study was to determine the effectiveness of carboxymethyl chitosan(CMC) solution on preventing intraperitoneal adhesions. In this study, 44 rats were divided into four groups ; an untreated control group and three experimental groups that were treated with 3 ml of 1, 2 or 3% CMC solution, respectively. The anti-mesenteric serosa of the ileum was exteriorized and then abraded in a standard manner by scraping with a scalpel blade to create homogenous petechial hemorrhagic surface over a $0.5{\times}1cm$ area. The adhesions were blindly assessed 2 weeks later by using a computerized tensiometer. The mean tensile strength(Newton) of formed adhesions was $2.48{\pm}0.88$ in control group, $1.86{\pm}0.56$ in the 1% CMC-treated group, $1.75{\pm}0.71$ in the 2% CMC-treated group and $1.55{\pm}0.60$ in the 3% CMC-treated group. The most favorable prevention against adhesion was achieved in the 3% CMC-treated group(p<0.01). We could conclude that CMC was effective on preventing the formation of postoperative small intestinal adhesions in the rat.

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Risk Factors for Malignancy of Pheochromocytoma and Abdominal Paraganglioma in Children: Clinicopathologic Perspectives (소아에서 갈색세포종과 복강내 부교감신경절종의 악성화 예측인자)

  • Chang, Jihoon;Kim, Soo-Hong;Min, Hye Sook;Kim, Hyun-Young;Jung, Sung-Eun;Park, Kwi-Won;Lee, Seong-Cheol
    • Advances in pediatric surgery
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    • v.19 no.2
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    • pp.108-121
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    • 2013
  • 목적 Pheochromocytoma of the Adrenal gland Scaled Score (PASS) 시스템과 면역화학염색 등을 통한 갈색세포종 및 부교감신경절종의 악성화 예측인자가 제시되고 있으나 명확한 병리학적 또는 분자생물학적 예측인자는 밝혀진 바 없다. 본 연구에서는 임상적, 병리학적 분석을 통해 갈색세포종 및 복강내 부교감신경절종의 악성화 예측인자를 확인하고자 하였다. 대상 및 방법 1990년 1월부터 2010년 12월까지 서울대학교어린이병원에서 수술적 절제 후 병리학적으로 갈색세포종 및 복강내 부교감신경절종으로 확진된 20명의 18세 이하 소아 환자를 대상으로 임상적 특징을 분석하였고, PASS 시스템에 따른 병리 슬라이드 판독하였다. 세포활성도를 반영한다고 알려진 유전자에 대한 항체 중 Ki-67, p53, bcl-2, mdm-2, cycline D1, p21, p27을 이용해 면역 화학검사를 한 후 결과를 확인하였다. 결과 20명의 환자 중 갈색세포종은 14명, 복강내 부교감신경절종은 6명이었다. 악성화는 각각 4명, 3명에서 관찰되었다. 혈관 침범, 주변부 지방조직 침습, 세포분열 증가가 통계적으로 유의한 악성화 예측인자였으며(각각 p=.007, .031, .031), 갈색세포종만 분석하였을 때도 통계적으로 유의하였다(각각 p=.033, .003, .019). PASS 시스템은 악성화를 예측하는데 있어 통계적으로 유의하지 않았으며, 혈관 침범, 주변부 지방조직 침습, 세포분열 증가를 항목으로 하여 새롭게 만든 병리 스코어 시스템은 악성 환자군과 양성 환자군 사이에 통계적으로 유의한 차이를 보였다(p< .001). 악성과 양성 질환 사이의 면역화학염색 결과에서 유의한 차이는 없었다. 결론 소아에서 갈색세포종 및 복강내 부교감신경절종의 악성화 예측인자로 혈관 침범, 주변부 지방조직 침습, 세포분열 증가를 이용할 수 있다. 소아에서 PASS시스템으로 악성화를 예측할 수 없었으나, 새로운 병리스코어 시스템으로 악성 환자군을 예측할 수 있었다. 면역화학검사 결과 세포 활성도를 반영하는 인자들은 악성화를 예측할 수 없었다.

LIFE CYCLE AND CHEMOTHERAPEUTIC CONTROL OF A FILARIAN WORM, PHILOMETROIDES CARASSII PARASITIC IN CARASSIUS AURATUS (붕어에 기생하는 철사충 Philometroides carassii의 생활사와 치료에 관하여)

  • OUK Dae-Han;CHUN Seh-Kyu
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.6 no.3_4
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    • pp.112-122
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    • 1973
  • Philometroides carassii (ISHII, 1931) is a parasitic nematode of Carassius auratus and gold fish. Recently a large number of parasitized fishes by this nematode have been reported by fish farmers in Korea. The present investigation was aimed to find out the life cycles of the parasites and effects of chemotherapeutic medicines on the emerged larvae from the adult parasites. Results of the study are summarized as follows : 1. Intermediate host of p. cararsii is a freshwater copepod, Cyclops sp. and the invaded lavae in the body cavity of copepod are capable for parasitizing the fish host after 3 hours of invasion. 2. The lavae eaten directly by the fish host are digested or excreted. 3. The larvae invaded in the fish intestine through the intermediate host pass into the body cavity in 1 to 10 days, and become subadult stage. After 18 to 20 months the subadults parasitic in the body cavity of the Carassius auratus, penetrate through muscle fissile into tile caudal fin where they become adults. Whereas those parasitic in the body cavity of the gold fish, 7 to 8 months the sutadults penetrate through muscle tissue into the caudal fin where they become adults. 1. Male subadults found in the body cavity of the Carassius auratus and gold fish, were larger than females, This is the first record of male subadults occurring in the fish host. 5. Among four different :drugs tested, most of all larvae died in 4 ppm of dipterex in 5 days. But no adults were harmed even in 6 ppm dipterex in 11 days.

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Intra-abdominal Retained Surgical Gauze in Two Dogs (개의 복강내 잔존 수술용 거즈 2예)

  • Choi, Ho-Jung;Lee, Ki-Ja;O, I-Se;Lee, Jae-Yeon;Jee, Hyun-Chul;Park, Seong-Jun;Jeong, Seong-Mok;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.238-243
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    • 2007
  • This report describes the retained surgical gauze in two dogs that had ovariohysterectomy previously. The elapsed time between surgery and diagnosis of retained surgical gauze in two dogs was 30 and 16 months, respectively. Radiographic signs included localized abdominal mass (case 1, 2) and soft tissue swelling (case 2). Retained surgical gauze was imaged by survey radiography, ultrasonography and computed tomography (CT). Ultrasonography revealed a hypoechoic mass with irregular hyperechoic center in case 1, and hypoechoic mass with oval hyperechoic center and acoustic shadowing in case 2. In CT examination of case 2, hyperdense mass with a thick peripheral rim enhancing in contrast study was shown. Cytologic examination of both cases revealed abscess and granuloma respectively. The lesions were surgically removed. The possibility of retained surgical gauze should be considered in animals with a history of previous surgery with abnormal mass.

Distal Ventriculoperitoneal Shunt Catheter Migration into the Pulmonary Vasculature and Cardiac Chamber: A Case Report (뇌실-복강 단락 원위도관의 폐동맥 및 심장 내 전위: 증례 보고)

  • Chae Bin Lee;Jongsoo Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.934-940
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    • 2023
  • Ventriculoperitoneal shunting is the most common neurosurgical procedure for treatment of hydrocephalus. Shunt-related complications are relatively common and associated with a high rate of shunt revision. However, migration of the distal ventriculoperitoneal shunt, especially into the cardiac and intravascular regions, has rarely been reported. Awareness of this rare but potentially hazardous complication is important owing to its significant morbidity, which can be prevented by prompt management. Here, we introduce a case of a 23-year-old male with migration of the distal shunt catheter through the left internal jugular vein into the cardiac chamber and both pulmonary arteries, which occurred 2 months after receiving ventriculoperitoneal shunting. Furthermore, we discuss the possible mechanisms and management of this condition.

Development of Polyclonal Antibodies to Abdominal and Subcutaneous Adipocytes for Fat-Reduced Hanwoo Beef Production (한우 체지방 감소 쇠고기 생산을 위한 복강 및 피하지방 항체 개발)

  • Choi, Chang-Weon;Kim, Yu-Hyun;Kim, Sang-Jin;Song, Man-Kang;Kwon, Eung-Gi;Oh, Young-Kyoon;Hong, Seong-Koo;Choi, Seong-Ho;Baek, Kyung-Hoon
    • Food Science of Animal Resources
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    • v.28 no.5
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    • pp.651-659
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    • 2008
  • This study aimed to develop polyclonal antibodies to regional inedible adipocytes of Korean native cattle (Hanwoo) and investigate cross-reactivity of the antibodies. Patterns in plasma membrane proteins (PMPs) from abdominal and subcutaneous adipocytes of Hanwoo isolated by collagenase digestion were investigated using SDS-PAGE. As antigens, abdominal and subcutaneous adipocyte PMPs of Hanwoo were injected to sheep 3 times at 3 wk intervals for passive immunization, and non-immunized serum and antisera were collected before and after the injections. Titers of the antisera obtained from sheep and their cross-reactivities with heart, kidney, liver, lung, muscle, and spleen of Hanwoo were determined by ELISA. Isolation and culture of abdominal and subcutaneous adipocytes of Hanwoo were performed for analysing LDH concentration. Based on the SDS-PAGE analysis, specific proteins of PMPs in abdominal and subcutaneous adipocytes appeared despite rather similar patterns between both adipocytes. At the level of 1:1,000 dilution, little antibody reactivity appeared in non-immunized serum whereas the antisera had relatively strong reactivity up to the level of 1:128,000 and 1:64,000 dilution. These findings may indicate that strong antibodies against adipocyte PMPs can be developed using an immunological approach. Extremely low reactivities of abdominal and subcutaneous adipocyte antisera were detected with PMPs of the organs. Both antisera strongly reacted with each adipocyte PMPs and showed statistically (p<0.01) higher cross-reactivities compared with non-immunized serum. In conclusion, these results may indicate that the present polyclonal antibodies against regional inedible adipocyte PMPs are well developed and have safety in cross-reactivities with body organs. Further studies on in vivo cross-reactivity and fat reduction of the antibodies against abdominal and subcutaneous adipocytes PMPs of Hanwoo should be required for inedible fat-reduced high quality beef production.