• Journal of Chest Surgery
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• 제47권5호
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• pp.444-450
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• 2014

Background: We aimed to evaluate the efficacy and safety of early surgical ligation (within 15 days of age) over late surgical ligation (after 15 days of age) by a comparative analysis of very low birth weight (VLBW) infants undergoing surgical correction for symptomatic patent ductus arteriosus (PDA) over the course of 6 years in our hospital. Methods: We retrospectively reviewed all the medical records in the neonatal intensive care unit at Hanyang University Seoul Hospital, from March 2007 to May 2013, to identify VLBW infants (<1,500 g) who underwent surgical PDA ligation. Results: The gestational age (GA) in the late ligation (LL) group was significantly younger than in the early ligation (EL) group (p=0.010). The other baseline characteristics and preoperative conditions did not differ significantly between the two groups. The intubation period before surgery (p<0.001) and the age at surgery (p<0.001) were significantly different. The postoperative clinical outcomes of the study patients, including major morbidity and mortality, are summarized. There were no significant differences in bronchopulmonary dysplasia, sepsis, or mortality between the EL and the LL groups. However, the LL group was significantly associated with an increased risk of necrotizing enterocolitis (p=0.037) and with a prolonged duration of the total parenteral nutrition (p=0.046) after adjusting for GA. Conclusion: Early surgical ligation for the treatment of PDA that failed to close after medical treatment or in cases contraindicated for medical treatment might be desirable to reduce the incidence of necrotizing enterocolitis and to alleviate feeding intolerance in preterm infants.

• Journal of Gastric Cancer
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• 제9권4호
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• pp.238-245
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• 2009

목적: 최근 조기위암에서 내시경하 점막절제술, 점막하층 박리술과 복강경 보조 위 절제술이 시행되고 있으나 적응 범위는 논란의 여지가 있다. 이에 조기위암으로 수술을 받은 환자들을 분석하여 내시경 치료나 축소 수술 등의 치료 방침의 기준을 보고자 하였다. 대상 및 방법: 1986년부터 2003년까지 조기위암으로 근치절제술을 받은 881명의 환자들을 후향적으로 분석하였다. 전체 환자군에서 예후 인자를 구하고 림프절 전이 및 재발에 영향을 미치는 인자를 알아보았다. 결과: 881명의 환자 중 59명이 사망하였고 21명이 재발되었다. 예후 인자는 단변량 분석상 수술 방법, 종양의 육안적 소견, 정맥관 침습여부와 림프절 병기가, 다변량 분석상 환자의 연령, 수술 방법, 종양의 육안적 소견 및 림프절 병기가 의미 있는 예후 인자였다. 림프절 전이 양성환자는 음성환자에 비해 단변량 분석상, 종양 침윤 깊이, 종양의 크기, 림프절 절제 정도, 림프관 침습여부와 정맥관 침습여부가, 다변량 분석상, 침윤 깊이, 종양 크기, 림프관 침습여부 및 정맥관 침습여부에서 유의한 차이를 보였다. 재발에 영향을 미친 인자에 대하여 다변량 분석 결과 종양의 침윤 깊이와 림프절 전이 여부가 영향을 미친 독립적인 인자로 나타났다. 결론: 조기위암에서 축소 치료 계획 시에는 림프절 전이 가능성을 고려하여 종양의 침윤 깊이와 크기 및 림프관, 정맥관 침습 여부를 확인하여야 하며, 림프절 전이 의심시에는, 위 절제술 및 광범위 림프절 곽청술을 고려해야 한다.

• Journal of Gastric Cancer
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• 제14권3호
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• pp.215-219
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• 2014

Distant metastasis from papillary thyroid carcinoma (PTC), particularly from papillary thyroid microcarcinoma, is rare. We present a case of perigastric lymph node metastasis from PTC in a patient with early gastric cancer and breast cancer. During post-surgical follow-up for breast cancer, a 56-year-old woman was diagnosed incidentally with early gastric cancer and synchronous left thyroid cancer. Therefore, laparoscopic distal gastrectomy with lymph node dissection and left thyroidectomy were performed. On the basis of the pathologic findings of the surgical specimens, the patient was diagnosed to have papillary thyroid microcarcinoma with perigastric lymph node metastasis and early gastric cancer with mucosal invasion. Finally, on the basis of immunohistochemical staining with galectin-3, the diagnosis of perigastric lymph node metastasis from PTC was made. When a patient has multiple primary malignancies with lymph node metastasis, careful pathologic examination of the surgical specimen is necessary; immunohistochemical staining may be helpful in determining the primary origin of lymph node metastasis.

• Journal of Gastric Cancer
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• 제12권4호
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• pp.232-236
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• 2012

Purpose: With an increase in life expectancy, more elderly patients are presenting with gastric cancer. As a result it is yet be resolved whether laparoscopy assisted distal gastrectomy is a suitable treatment for elderly patients with early gastric cancer. This study retrospectively compared surgical outcomes of laparoscopy assisted distal gastrectomy between elderly and nonelderly patients with gastric cancer. Materials and Methods: The study group was comprised of 316 patients who underwent laparoscopy assisted distal gastrectomy between April 2005 and December 2010. Of these patients, 93 patients whose ages were 65 years or more were compared with 223 patients who were younger. Results: There were no differences in the short term outcome or minor complication rate between the elderly patients and the nonelderly patients. The hospital stay was significantly longer and the major complication rate was significantly higher for the elderly patients compared with nonelderly patients. Conclusions: Laparoscopy assisted distal gastrectomy for early gastric cancer in the elderly patients had comparable operation time and blood loss with the nonelderly group. However, the safety and advantage of laparoscopy assisted distal gastrectomy in the elderly patients need to be further studied in higher volume trials.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3747-3750
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• 2013

Purpose: To evaluate the efficacy of conservative surgery plus chemo-, radio-therapy in treating patients with early stage breast cancer. Patients and Methods: Eligible patients were treated by postoperative chemotherapy as well as whole-breast irradiation with tumor bed boost. Postoperative radiotherapy consisted of 6 MV whole breast linear accelerator irradiation with two tangential half fields to a total dose of 45~50 Gy, followed by $10{\sim}15MeV{\beta}$ boost irradiation to tumor bed for 10~20Gy, total dose 56~66Gy. Results: Fifty-two patients were enrolled. Overall 1-, 2- and 3 year survival rates were 98.1%, 92.3%, and 90.4%, respectively, with a local recurrence rate of 5.77%. Cosmetic results were evaluated as good by doctors in 90.4% of patients. Conclusions: Breast conservative surgery combined with chemo- radio-therapy could be a treatment option for Chinese patients with early stage breast cancer.

• Archives of Reconstructive Microsurgery
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• 제12권1호
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• pp.13-18
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• 2003

Fournier's gangrene is a synergistic necrotizing fasciitis of the perineal, perirectal and urogenital area and can be fatal unless treated in early stage. Perianal and urogenital infections are common causes of the disease but it can occur after artificial procedure on perineal area using by surgical instruments. It is mixed aerobic and anaerobic infection and E. coli is the most common causative bacteria. Untill now many investigators have focused on early diagnosis, preserving hemodynamic stability, broad-spectrum systemic antibiotics and treatment of underlying disease in management of Fournier's gangrene. The authors have experienced five patients of chronic liver disease whose necrotizing perineal infections developed spontaneously and treated them aggressively as described above and reconstructed perineal soft tissue defects using by various surgical methods, then we got good results both functionary and cosmetically. From now on, we would better reconstruct soft tissue defect of perineum with skin graft or pedicled flap in early stage when treat Fournier's gangrene, thereafter we can get an ultimate increase in patient's life quality.

• 디지털융복합연구
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• 제19권12호
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• pp.567-575
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• 2021

본 연구는 중요도-수행도 분석을 통해 복부수술 환자의 조기운동에 대한 외과병동 간호사의 중요도 인식 및 수행 정도를 확인하기 위함이다. 연구대상은 외과병동에서 근무하는 간호사 162명을 대상으로 자가보고 설문지를 이용하여 2021년 3월 8일부터 22일까지 자료를 수집하였다. 수집된 자료는 SPSS/WIN 25.0를 이용하여 기술통계, independent t-test, paired t-test, one-way ANOVA로 분석하였으며 중요도와 수행도는 IPA분석 기법을 사용하였다. 조기운동은 폐합병증 예방운동과 조기이상으로 구분하였다. 연구결과, 집중이 필요한 영역은 흡인위험성 확인, 개선이 필요한 영역은 구강간호, 호흡음 청진, 진동/타진, 필요시 흡인, 강화운동 영역이었다. 따라서 임상에서 조기운동의 중요도 및 수행도의 격차를 줄일 수 있는 방안을 마련하여야 하겠다.

• Journal of Gastric Cancer
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• 제15권3호
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• pp.183-190
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• 2015

Purpose: The Lauren classification system is a very commonly used pathological classification system of gastric adenocarcinoma. A recent study proposed that the Lauren classification should be modified to include the anatomical location of the tumor. The resulting three types were found to differ significantly in terms of genomic expression profiles. This retrospective cohort study aimed to evaluate the clinical significance of the modified Lauren classification (MLC). Materials and Methods: A total of 677 consecutive patients who underwent curative gastrectomy from January 2005 to December 2007 for histologically confirmed gastric cancer were included. The patients were divided according to the MLC into proximal non-diffuse (PND), diffuse (D), and distal non-diffuse (DND) type. The groups were compared in terms of clinical features and overall survival. Multivariate analysis served to assess the association between MLC and prognosis. Results: Of the 677 patients, 48, 358, and 271 had PND, D, and DND, respectively. Their 5-year overall survival rates were 77.1%, 77.7%, and 90.4%. Compared to D and PND, DND was associated with significantly better overall survival (both P<0.01). Multivariate analysis showed that age, differentiation, lympho-vascular invasion, T and N stage, but not MLC, were independent prognostic factors for overall survival. Multivariate analysis of early gastric cancer patients showed that MLC was an independent prognostic factor for overall survival (odds ratio, 5.946; 95% confidence intervals, 1.524~23.197; P=0.010). Conclusions: MLC is prognostic for survival in patients with gastric adenocarcinoma, in early gastric cancer. DND was associated with an improved prognosis compared to PND or D.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.49-52
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• 2020

The specialized structure of the upper eyelid ensures complete closure of the eye and eyeball sealing. An upper eyelid injury can cause various symptoms associated with eyeball trauma, not just scar formation or eyelid deformity. In this report, we describe a case of lagophthalmos observed after wound repair in a patient with a crushing injury caused by a grinder. Several surgical techniques are used to treat lagophthalmos or scar contracture. In most cases, a releasing procedure is performed after 6 months of initial repair. However, if the patient has severe symptoms that are not relieved by conservative care, early revision is inevitable. We describe a case of early lagophthalmos successfully resolved with pentagonal wedge resection, fat redistribution, and full-thickness skin grafting. After the revisional surgery, we observed that the patient regained the ability to completely close the injured eyelid, with restoration of function and favorable cosmetic outcomes. Pentagonal wedge resection to release a retracted structure, fat redistribution to prevent readhesion, and full-thickness skin grafting for enough amount of skin to regain upper eyelid function is useful for scar release and lagophthalmos following crushing injuries of the upper eyelid.

• Journal of Chest Surgery
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• 제41권4호
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• pp.480-483
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• 2008

질환에 따라서 많은 논란이 있으나, 최근 선천성 심기형의 수술적 교정시 조기의 일단계 완전 교정술을 시행하는 쪽이 장점이 부각되고 있다. 저체중(low birth weight) 미숙아에서 체외순환을 통한 개심술은 여러 가지 이유로 수술이 쉽지 않아 환자의 체중 및 장기 기능이 발달할 때까지 단계적으로 수술을 시행하는 경우가 대부분이다. 본 증례에서는 심실 중격 결손을 동반한 대동맥축착증을 가진 태내주수 29주, 출생체중 1,280 g, 수술 당시 체중 1,250 g의 미숙아의 성공적인 일단계 완전 교정술을 보고하고자 한다.