• 제목/요약/키워드: Retroperitoneal

검색결과 192건 처리시간 0.028초

중증 외상환자에서 mesh를 이용한 일시적 수술창 봉합의 경험 (Temporary Abdominal Coverage with Malex Mesh Prosthesis in Cases of Severely Injured Abdominal Trauma Patients)

  • 김연우;정용식;김욱환;민영기;김기운;이국종
    • Journal of Trauma and Injury
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    • 제18권1호
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    • pp.70-79
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    • 2005
  • Background: Abdominal compartment syndrome has multiple etiologies that are not only related to trauma but also any problem condition in the absence of abdominal injury. To determine whether prevention of the abdominal compartment syndrome after celiotomy for trauma victims justifies the use of temporary abdominal coverage with monofilament knitted polypropylene mesh (Malex mesh) in severely injured patients. Method: Medical records at the Ajou University Medical Center were reviewed for a 32-month period from May 1st, 2002 to December 31st, 2004. Twenty-nine consecutive patients requiring celiotomy who were survived until at the end of celiotomy received temporary abdominal coverage and staged abdominal repairs with Malex mesh. One of them was dissecting aortic aneurysm patient and the others were all trauma victims. Malex mesh prosthesis coverage was used in cases of abdominal compartment syndrome due to excessive fascial tension, severe bowel edema and retroperitoneal hemorrhage or edema followed by staged abdominal repairs. Result: Eighteen of twenty-nine patients were survived. Demographic characteristics, injury severity number of abdominal-pelvic bone injuries, mortality rate, complications, number of operations for permanent closure, required time for permanent closure showed no difference between man and women or child and adult. Except one dissecting aortic aneurysm patient, trauma cases showed $3.24{\pm}0.98$ injury sites. All cases that received temporary abdominal coverage and staged abdominal repairs did not show abdominal compartment syndrome. $10.08{\pm}5.85$ days and $2.27{\pm}0.82$ times of operation required making permanent abdominal closure after temporary abdominal coverage followed by staged abdominal repairs. Most of surviving patients have shown antibiotic-resistant organism and fungus infection. Patients who received permanent closure recovered from infectious problem completely. Conclusion: The use of Malex mesh for temporary abdominal coverage in severely injured patients undergoing celiotomy was effective treatment method.

종양색전이 우심실까지 침범한 Wilms 종양 1례 (A Case of Wilms Tumor with Thrombi which Invaded the Right Ventricule)

  • 엄지현;원성철;유철주;양창현;김병수;황의호;박영환;서창옥
    • Clinical and Experimental Pediatrics
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    • 제45권3호
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    • pp.390-394
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    • 2002
  • Wilms 종양은 소아기에 발생하는 고형중양 중 6- 7%를 차지하며 소아에서 신장에 발생하는 고형종양 중 가장 흔한 것으로 진단시 정중연령은 3-5세이고 대부분 10세 이하에서 발견된다. 무증상성 복부종괴로 발견되는 경우가 많으며 하대정맥을 침범하는 경우는 4-10%에서 발견되며 우심방까지 침범한 경우도 0.5- 3%로 발견되나 우심실까지 침범한 경우는 아직 보고된 바가 없다. 2년 7개월 된 남자 환아로 내원 2개월 전부터의 간헐적 혈뇨 및 복통을 주소로 내원 하였다. 내원 당시 이학적 검사상 심잡음이 청진 되었으며 심한 복부팽만과 늑골하 종괴가 촉지 되었다. 이에 시행한 복부 초음파, 전산화 단층촬영 및 심에코상 우측 신장에서 기시하여 하대정맥을 통해 우심방과 우심실까지 침범한 종괴가 관찰되었다. 수술 전 항암 화학요법을 시행 받았으며, 항암 화학요법 후 20일째 수술을 하여 모든 종괴를 제거 후 조직학적 소견상 Wilms 종양을 확진 받았다. 환아는 수술후 방사선 치료 및 항암 화학 요법을 진행 중이다. 저자들은 우측 신장에서 기원하여 하대정맥을 통해 우심방 및 우심실까지 종양색전을 형성한 Wilms 종양 환아 1례를 경험하였기에 보고하는 바이다.

종격동 췌장 가성낭종 1예 (A Case of Mediastinal Pancreatic Pseudocyst)

  • 맹호영;정재희;이상원;박무석;정재호;김도훈;박승우;최병욱;김세규;장준;김성규;김영삼
    • Tuberculosis and Respiratory Diseases
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    • 제52권3호
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    • pp.271-277
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    • 2002
  • 저자들은 기침 및 흉통을 주소로 내원한 53세의 알코올중독 남자 환자에서 발견된 종격동 췌장 가성낭종을 내시경적 역행성췌담도배액술과 somatostatin 유사체인 octreotide acetate를 투여하여 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Retrospective Analysis of 498 Primary Soft Tissue Sarcomas in a Single Turkish Centre

  • Duman, Berna Bozkurt;Gunaldi, Meral;Ercolak, Vehbi;Afsar, Cigdem Usul;Sahin, Berksoy;Erkisi, I. Melek Koksal;Kara, Oguz;Paydas, Semra;Gonlusen, Gulfiliz;Sertdemir, Yasar
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권8호
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    • pp.4125-4128
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    • 2012
  • Background: Soft tissue sarcomas (STS) must be managed with a team involving pathologists, radiologists, surgeons, radiation therapists and medical oncologists. Treatment modalities and demographic charasteristics of Turkish STS were analysed in the current study. Material-Methods: Primary adult STS followed between 1999-2010 in Cukurova University Medical Faculty Department of Medical Oncology were analzied retrospectively Results: Of the total of 498 patients, 238 were male and 260 female. The most seen adult sarcomas were leomyosarcoma (23%). Localization of disease was upper extremity (8.8%), lower extremity (24.7%), head-neck 8.2%, thoracic 8%, retroperitoneal 5.6%, uterine 12.4%, abdominal 10%, pelvic region 3.6 and other regions 10%. Some 13.1% were early stage, 10.2% locally advanced, 8.2% metastatic and 12.2% recurrent disease. Patients were treated with neoadjuvant/adjuvant (12%) or palliative chemotherapy (7.2%) and 11.4% patients did not receive chemotherapy. Surgery was performed as radical or conservative. The most preferred regimen was MAID combination chemotherapy in the rate of 17.6%. The most common metastatic site was lung (18.1%). The overall survival was 45 months (95%CI 30-59), 36 months in men and 55 months in women, with no statistically significant difference (p=0.5). The survival rates were not different between the group of adjuvant and palliative chemotherapy (respectively 28 versus 18 months) (p=0.06), but radical surgery at 37 months was better than 22 months for conservative surgery (p=0.0001). No differences were evident for localization (p=0.152). Locally advanced group had higher overall survival rates (72 months) than other stages (p=0.0001). Conclusion: STS can be treated successfully with surgery, chemotherapy and radiotherapy. The survival rates of Turkish people were higher in locally advanced group; these results show the importance of multimodality treatment approach and radical surgery.

Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in Thailand

  • Potikul, Chalermrat;Tangjitgamol, Siriwan;Khunnarong, Jakkapan;Srijaipracharoen, Sunamchok;Thavaramara, Thaovalai;Pataradool, Kamol
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.1759-1767
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    • 2016
  • Background: Uterine sarcoma is a group of rare gynecologic tumors with various natures, and different lines of treatment. Most have a poor treatment outcome. This study targeted clinical characteristics, treatment, overall survival (OS), progression-free survival (PFS), and prognostic factors in uterine sarcoma patients in one tertiary center for cancer care. Materials and Methods: Uterine sarcoma patients who were treated at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital between January 1994 and December 2014 were identified. Clinico-pathological data were analyzed. Prognostic outcomes were examined by Kaplan-Meier curves and Cox regression analysis. Results: We identified 46 uterine sarcoma patients: 25 carcinosarcoma (CS) (54.3%), 15 leiomyosarcoma (LMS) (32.6%), and 6 undifferentiated uterine sarcoma (UUS) (13.1%) cases. Mean age was $54.0{\pm}11.9years$ (range 25-82 years). Abnormal uterine bleeding was the most common presenting symptom (63.0%). Among 33 patients (71.7%) who had pre-operative tissue collected, diagnosis of malignancy was correct in 29 (87.9%). All patients received primary surgery and retroperitoneal lymph nodes were resected in 34 (73.9%). After surgery, 5 (10.9%) had gross residual tumors. Stage I disease was most commonly found (56.5%). Adjuvant treatment was given to 27 (58.7%), most commonly chemotherapy. After a median follow-up of 16.0 months (range 0.8-187.4 months), recurrence was encountered in 22 patients (47.8%). Median time to recurrence was 5.8 months (range1.0-105.5 months). Distant metastasis was more common than local or locoregional failure. The 2-year PFS was 45.2% (95% confidence interval [CI], 30.6%-59.7%) and the 2-year OS was 48.3% (95% CI, 33.3%-60.7%). Multivariable analyses found residual disease after surgery as a significant factor only for PFS. Conclusions: Uterine sarcoma is a rare tumor entity. Even with multimodalities of treatment, the prognosis is still poor. Successful cytoreductive surgery is a key factor for a good survival outcome.

수영 운동이 난소절제 후 비만 쥐의 지방조직에서 염증에 미치는 억제 효과 (The inhibitory effect of swimming exercise on inflammation in adipose tissue of obese mice after ovariectomy)

  • 정선효
    • 한국응용과학기술학회지
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    • 제37권5호
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    • pp.1125-1137
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    • 2020
  • 본 연구는 암컷 쥐의 난소절제 후 고지방식이로 비만이 유도된 비만 쥐에서 수영운동이 지방조직에서 염증반응을 억제하는지를 조사하였다. 실험군과 대조군은 모의수술군(Sham), 난소절제 수술군(OVX) 및 수영운동을 실시한 난소절제 수술군(OVX/Ex)으로 구분되어 8주 동안 고지방식이(45% fat) 사료를 섭취하면서 사육되었다. 생식기 주변 지방조직, 복막 신장주변 지방조직, 및 장간막 지방조직을 포함한 내장지방조직의 무게는 Sham에 비해 OVX에서 증가하였으나, OVX에 비해 OVX/Ex에서는 감소하였다. Sham에 비해 OVX는 지방조직에서의 IκBα의 유전자 발현이 감소하였고 염증성 사이토카인(IL-6, MCP-1, TNF-α 및 leptin)의 유전자 발현은 증가하였다. OVX에 비해 OVX/Ex는 지방조직에서의 IκBα이 증가하였고 염증성 사이토카인의 유전자 발현은 감소하였다. 결론적으로 본 연구는 난소절제 후 고지방식이로 비만이 유도된 비만 쥐에서 수영 운동은 지방조직에서 염증반응을 억제함으로써 비만의 예방과 치료에 효과적이다는 것을 제시하였다.

강황 발효액이 고지방 섭취 흰쥐의 비만에 미치는 효과 (Effects of Fermented Turmeric Extracts on the Obesity in Rats Fed a High-Fat Diet)

  • 양철영;조미진;이치호
    • Journal of Animal Science and Technology
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    • 제53권1호
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    • pp.75-81
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    • 2011
  • 본 실험에서는 발효 강황 발효액의 급여가 내장지방과 혈청지질에 미치는 효과를 살펴보고자 수행하였다. 강황과 흑설탕을 동일비율로 혼합하여 12개월간 숙성 발효하였다. 발효액은 HPLC를 이용해 발효 후 유리당의 함량을 분석하였다. 동물실험은 총 3군으로 일반 대조군에는 고지방사료와 흑설탕 7.2% (HFD), 처리군에는 고지방 사료에 흑설탕 7.2%와 강황 12.8% (TP), 고지방 사료에 분말화한 발효 강황 20% (FTP)을 첨가한 배합사료를 4주간 급여 하였다. 혈청지질에서 총 콜레스테롤과 LDL-콜레스테롤은 HFD군에 비하여 모두 감소하는 경향이었다. 혈청 중 아디포넥틴과 렙틴은 HFD군에 비해서 FTP군이 유의적으로 낮았으며(P<0.05), TNF-$\alpha$은 HFD군에 비해서 FTP군이 감소하였다. 또한 간 손상 지표인 혈청의 AST는 HFD군에 비해서 FTP군이 감소하였다. 이를 통해 발효 강황 발효액은 발효 전보다 발효 후에 고지방식이를 투여한 흰쥐에 있어서 비만을 억제할 수 있는 가능성이 있는 것으로 사료되었다.

조영제 혈관 외 유출이 관찰된 복부 둔상 환자의 유출부위에 따른 예후 (Prognosis for Blunt Abdominal Trauma Patients with Contrast Extravasation on the Abdominopelvic CT Scan)

  • 신형진;이강현;곽영수;김선휴;김현;황성오
    • Journal of Trauma and Injury
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    • 제22권1호
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    • pp.57-64
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    • 2009
  • Purpose: Computed tomography (CT) is an accurate test for evaluating hemodynamically stable patients with blunt abdominal trauma. Until now, there have been few studies concentrating on the diagnostic and prognostic significance of the intravenous contrast extravasation (CE) site. We investigated the site of CE on abdominopelvic CT (APCT) and its effect on treating trauma patients and predicting the clinical outcome. Methods: The 50 patients admitted to our emergency department with blunt abdominal trauma showing CE on APCT from January 2004 to September 2006 were included in this study. Patients were prospectively collected, and medical records were reviewed and analyzed. The patients'clinical and lab findings, Focused Assessment with Sonography for Trauma (FAST) findings, CT findings were analyzed. CE sites were classified as intraperitoneal, retroperitoneal, and pelvic cavity and were correlated with post-treatment complications, mortality, and morbidity. Results: Of the 50 patients (mean age : $45{\pm}18years$, 29 males, 21 females) included in our study, 33 patients died (66%). There was no correlation between CE site and ICU or total hospitalization duration (p=0.553, p=0.523). During the first 24 hours of resuscitation, the pelvic cavity group required a mean of 20 units more of packed red blood cell (pRBC) transfusion compared to other groups (p=0.003). In the intraperitoneal group, more patients received operative invasive intervention - either laparotomy or embolization (p=0.025). The intraperitoneal group had the highest mortality, with 13 deaths (11/33, 39%), and the highest early mortality rate (10/13, 76%) in the first 24 hours (p=0.001). Conclusion: Intraperitoneal CE on the CT scan in cases of blunt abdominal trauma is regarded as an indication of a need for invasive intervention (either angiography or laparotomy) and of a higher mortality rate in the first 24 hours. A pelvic cavity CE rquires more aggressive transfusion with pRBC. However, the CT findings themselves showed no significant correlation with overall mortality, morbidity, or hospitalization.

Patterns of recurrence after radiation therapy for high-risk neuroblastoma

  • Jo, Ji Hwan;Ahn, Seung Do;Koh, Minji;Kim, Jong Hoon;Lee, Sang-wook;Song, Si Yeol;Yoon, Sang Min;Kim, Young Seok;Kim, Su Ssan;Park, Jin-hong;Jung, Jinhong;Choi, Eun Kyung
    • Radiation Oncology Journal
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    • 제37권3호
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    • pp.224-231
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    • 2019
  • Purpose: To investigate the patterns of recurrence in patients with neuroblastoma treated with radiation therapy to the primary tumor site. Materials and Methods: We retrospectively analyzed patients with high-risk neuroblastoma managed with definitive treatment with radiation therapy to the primary tumor site between January 2003 and June 2017. These patients underwent three-dimensional conformal radiation therapy or intensity-modulated radiation therapy. A total of 14-36 Gy was delivered to the planning target volume, which included the primary tumor bed and the selected metastatic site. The disease stage was determined according to the International Neuroblastoma Staging System (INSS). We evaluated the recurrence pattern (i.e., local or systemic), progression-free survival, and overall survival. Results: A total of 40 patients with high-risk neuroblastoma were included in this study. The median patient age was 4 years (range, 1 to 11 years). Thirty patients (75%) had INSS stage 4 neuroblastoma. At the median follow-up of 58 months, there were 6 cases of local recurrence and 10 cases of systemic recurrence. Among the 6 local failure cases, 4 relapsed adjacent to the radiation field. The other 2 relapsed in the radiation field (i.e., para-aortic and retroperitoneal areas). The main sites of distant metastasis were the bone, lymph nodes, and bone marrow. The 5-year progression-free survival was 70.9% and the 5-year overall survival was 74.3%. Conclusion: Radiation therapy directed at the primary tumor site provides good local control. It seems to be adequate for disease control in patients with high-risk neuroblastoma after chemotherapy and surgical resection.

식이성 고지혈 및 비만에 대한 산마늘 추출물의 효과 (Effect of Allium Victorialis Var. platyphyllum Leaves on Triton WR-1339-Induced and Poloxamer-407-Induced Hyperlipidemic Rats and on Diet-Induced Obesity Rats)

  • 최종원;이경태;김원배;박광균;정원윤;이진하;임상철;정현주;박희준
    • 생약학회지
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    • 제36권2호통권141호
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    • pp.109-115
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    • 2005
  • The herb of Allium victorialis var. platyphyllum (Liliaceae) has been used as an edible wild herb and to treat heart failure and gastritis. We have already reported antihyperlipidemic anti-tumor effects of this plant. To enlarge the commercial availability of this food, it was investigated whether the extracts of A. victorialis var. platyphyllum reduce hyperlipidemia and obesity or not. The plants tested in this experiment were collected from two eco-types of Is. Ullung and Mt. Odae cultivated at Pyongchang. Extracts were prepared by extracting the fresh leaves and those dried at $36^{\circ}C$ and $90^{\circ}C$, respectively. Pretreatment with the ethanolic extracts for two weeks(p.o.) reduced serum triglyceride-, total cholesterol- and LDL-cholesterol contents in rats induced by Triton WR-1339, respectively. Furthermore, oral administration of the extracts also inhibited the hyperlipidemia induced with oral diet of 30% corn oil. In the other attempt to find to alleviate the obesity, the model rats with obesity were induced by the high fat-diet for six weeks. Post-treatment with the extracts for two weeks significantly reduced the hyperlipidemia. Retroperitoneal-, epidymal- and total abdominal fat pad weights were considerably reduced at 100 mg/kg oral administration of the extracts. Increased feces lipid contents were also found in the rat treated with the extracts. The extract may lead to the higher activity in treatment of hyperlipidemia and obesity than of the dried one.