• Archives of Plastic Surgery
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• 제34권4호
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• pp.520-523
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• 2007

Purpose: Verrucous carcinoma is a rare, low-grade and well-differentiated squamous cell carcinoma, representing as a warty tumor. Estimation of the incidence for cutaneous lesions is not available because they are rare. We describe a case of verrucous carcinoma, a rare type, complication of a chronic pressure ulcer of duration more than 15 years. Methods: A 17-year-old boy presented with a large lesion involving the sacral area, which had been neglected for about 15 years. He had a history of surgical extirpation 2 years ago, but not cured. Examination revealed a cauliflower-like mass arising from an irregularly oval-shaped tumor which was $6.0{\times}4.5cm$ in size with signs of infection and ulcer. The lesion involved the sacrococcygeal area, spreading to both medial gluteal regions. The perianal skin did not appear to be directly affected. Results: A preoperative punch biopsy revealed a extremely well differentiated verrucous carcinoma. There were positive results in immunohistochemistry in the items of p53, p63, Ki-67. An 'en-bloc' excision of the tumor with the clinically normal surrounding tissue was carried out. Reconstruction was achieved by local regional flap. Histopathological findings of the excised area fully confirmed the preoperative biopsy report. It remained free of recurrence for a period of about 8 months. Conclusion: We believe that in patients with buttock involvement, regardless of the extent of such tumors, surgical therapy should be considered as the first-choice of treatment as reconstruction can be performed without excessive impairment for the patient.

• 한국융합학회논문지
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• 제12권12호
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• pp.563-572
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• 2021

본 연구의 목적은 네트워크 메타분석 방법을 활용하여 중환자실 환자들의 욕창예방 중재의 비교효과와 순위를 평가하기 위하여 수행하였다. 네트워크 메타 분석은 R software의 "netmeta": 패키지를 이용한 빈도주의 방법을 이용하였다. 최종적으로 10편의 논문이 선정되었으며. 네트워크 메타 분석에 결과에 따른 욕창예방의 프로그램의 중재 간 비교우위는 욕창 표준중재와 비교하여 순위는 피부보호 용품 사용이(P-Score 85.3.%: OR=0.12, 95% CI: 0.03, 0.49) 가장 효과적일 확률이 높았으며 두 번째는 실리콘 폼 드레싱(P-Score 84.5%: OR=0.14, 95% CI: 0.05, 0.38)으로 나타났다. 그 다음으로는 통합중재 (P-Score 60.0%: OR=0.29, 95% CI: 0.07, 1.25), 체위변경 (P-Score 32.3%: OR=0.66, 95% CI: 0.21, 2.09) 그리고 마찰을 감소시킬 수 있는 직물의 사용(P-Score 23.8%: OR=0.85, 95% CI: 0.20, 3.65) 순이었다. 본 연구의 결과는 중환자실 욕창예방 프로그램의 효과적인 적용을 위한 정보를 제공 할 수 있을 것으로 생각된다.

• 가정∙방문간호학회지
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• 제26권3호
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• pp.329-340
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• 2019

Purpose: This study aimed to provide basic data necessary to develop education programs and educational services for home care by investigating the degree of patient and family education among home health care nurses. Methods: Data collection was carried out with 145 people from 47 institutions that agreed to participate in the research. A total of 128 questionnaires were received, of which 122 were analyzed. Data were analyzed using SPSS 12.0. Results: The item on which education was most frequently delivered was intravenous injection speed control (66.4%), whereas the item requiring the longest teaching period was pressure ulcer care. The average degree of impediment perceived by home care nurses was 2.82 out of 5. Conclusion: Medical institutions should develop educational materials and programs that reflect the characteristics and degree of home health care needed. Repeated research, including that by medical institutions, on the degree and impeding factors related to patient and family education performance of home health care nurses should be conducted. Moreover, medical institutions should investigate the nursing and educational needs of patients and families who received home health care service.

• Journal of Gastric Cancer
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• 제13권1호
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• pp.65-68
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• 2013

Gastric carcinoma rarely presents as a perforation, but when it does, is perceived as advanced disease. The majority of such perforations are Stage III/IV disease. A T1 gastric carcinoma has never been reported to perforate spontaneously in English literature. We present a 56 year-old Chinese male who presented with a perforated gastric ulcer. Intra-operatively, there was no suspicion of malignancy. At operation, an open omental patch repair was performed. Post-operative endoscopy revealed a macroscopic Type 0~III tumour and from the ulcer edge biopsy was reported as adenocarcinoma. Subsequently, the patient underwent open subtotal gastrectomy and formal D2 lymphadenectomy. The final histopathology report confirms T1b N0 disease. The occurrence of a perforated early gastric cancer reemphasises the need for vigilance, including intra-operative frozen section and/or biopsy, as well as routine post-operative endoscopy for all patients.

• 대한소아치과학회지
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• 제26권1호
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• pp.139-145
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• 1999

본 병원에 동통을 느끼지 못하는 것으로 인한 혀나 손가락 깨물기 등의 자가 손상, 무한증, 반복적 발열등의 임상증상을 보이며 유전성이 없이 CIPA로 내원한 환아에서 보호자에게 세심한 보호와 우발사고 방지에 대한 교육이 무엇보다도 중요하며, 치면세마, 불소도포, 소와열구전색등의 예방적인 처치와 주기적으로 내원시켜 치과적인 문제를 조기에 해결하는 것이 필요하다고 사료된다.

• 대한간호
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• 제12권5호통권67호
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• pp.83-92
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• 1973

1972년 1월부터 1972년 12월말까지 충남대학교 의과대학 부속병원에서 위 수술을 받은 환자 66명을 대상으로 여러 가지 통계 결과 1. 성별 분포에선 남자가 51명 여자가 15명으로 약 3.4:1의 비율을 나타냈다. 2. 연령별 분포에선 $69.7\%$가 40세 이상에서 나타났다. 3. Chief complain은 Indigestion이었다. 4. 증상의 평균 연한은 1년 전후의 Chronic symptom을 경험했다. 5. Vital sign의 변화는 대부분이 별로 나타나지 않았다. 6. 수술 전 수혈은 1000cc 이내로 환자의 $78\%$에 필요했었다. 7. 수술 전의 Hb은 정상보다 낮은 율은 $45.4\%$였고 정상은 $54.6\%$였다. 8. 수술 전의 W.B.C는 정상보다 낮은 율은 $10.6\%$, 정상이 $42.4\%$, 정상보다 높은 율이 $47\%$였다. 9. 수술 전의 Ht치는 정상보다 낮은 율은 $60.6\%$, 정상은 $36.4\%$ 정상보다 높은 율은 $3\%$였다. 10. 수술 전 위액검사 결과는 Cancer인 경우는 Free acid와 Total acid가 모두 거의 정상보다 낮았고 Ulcer인 경우 대부분 높았다. 11. Liver function test에서는 표에서 나타난 대로 많은 변화는 없었다. 12. 병소 부위는 Cancer의 경우 $51.8\%$에서 Pylorus부위에 왔었고 Ulcer의 경우 $62.4\%$에서 Lesser curvature (ciratricial region포함)에 왔었다. 13. 수술방법은 $77.7\%$가 Subtotal gastrectomy였었다. 14. 위 수술을 위한 입원 일자는 $60\%$ 이상에서 $11\~15$일간의 평균을 보였었다.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.79-82
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• 2010

Purpose: Carcinosarcomas are rare neoplasms in which both malignant epithelial and mesenchymal elements are identified. We have found only twenty one cases of primary cutaneous carcinosarcoma in the English language literature. Therefore it has been difficult to diagnosis because its unclear etiology and low frequency. Methods: A 31-year-old young man with a protruding mass on his ankle dorsum was examined. The tumor was $7{\times}6{\times}3\;cm$ sized and arose from a burn scar. The mass was wide excised and applied split thickness skin graft. Characteristic pathologic finding was a mixture of squamous cell carcinoma and malignant fibrous histiocytoma. Results: Three months after the operation, the patient died of multiple metastasis to the liver, lung and finally of sepsis despite adjuvant chemotherapy and adjuvant radiotherapy. Conclusion: If a metastatic cutaneous carcinosarcoma is diagnosed, wide excision is required. There should be more aggressive management to minimize the risk of recurrence. Further research into the etiology and pathophysiology of the disease and a more careful differential diagnosis may allow improvement in treatment.

• Vascular Specialist International
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• 제34권4호
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• pp.117-120
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• 2018

The endovascular recanalization of the iliocaval system has replaced venous surgical reconstructions as the primary treatment option in severe post-thrombotic syndrome (PTS). We herein present a 51-year-old female with previous deep venous thrombosis, complicated with PTS with a large and complex circumferential calf ulcer measuring 25 cm of length in the left lower extremity. Venogram revealed a complete and extensive occlusion in the left iliofemoral system. A surgical bypass from the left common femoral vein to the right common iliac vein was performed. Patient recovered well and after 12 months postoperation her large wound is healing favorably with a clean and well granulated bed. Iliofemoral venous bypass is a feasible treatment for non-healing ulcer of lower extremity.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.112-118
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• 2005

Background: N-Butyl Cyanoacrylate (NBCA) is a liquid embolic material that can be useful for transcatheter arterial embolization (TAE) of acute bleeding especially in patients with coagulopathy, because it does not depend on coagulation for its therapeutic effect. The aims of this study were to evaluate the clinical efficacy and safety of TAE with NBCA in acute bleeding patients. Methods: Between August 2003 and September 2004, TAE using NBCA for acute bleeding was performed in 23 patients (16 men, 7 women; mean age, 56.5years). The causes of bleeding were gastric ulcer (n=5), postoperative bleeding (n=4), post-biopsy bleeding (n=3), postpartum bleeding (n=3), duodenal ulcer (n=2), angiodysplasia (n=2), gastric lymphoma (n=1), iatrogenic injury (n=1), CMV gastritis (n=1), stab injury of the liver (n=1). TAE was performed using 1:3 mixtures of NBCA and iodized oil. The angiographic and clinical success rate, recurrent bleeding rate, procedure-related complication and clinical outcomes were evaluated. Results: The angiographic and clinical success rate was 100% and 91.3% (21/23), respectively. There was no serious ischemic complication. Recurrent bleeding occurred in 2 patients (8.7%) and they were managed with successful second TAE (n=1) and endoscopic treatment (n=1). Nine patients (39.1%) had coagulopathy at the time of TAE and clinical success rate in this group of patients was 88.9% (8/9). Conclusions: TAE with NBCA is highly effective and safe treatment modality for acute bleeding patients, especially when the patient has a coagulopathy.

• 대한한방내과학회지
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• 제36권3호
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• pp.276-283
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• 2015

Objectives: The purpose of this study is to report bowel sound patterns recorded in 3 diseases associated with structural deformity of the pylorus-duodenum. Methods: : Bowel sound recording is a useful non-invasive tool for the evaluation of gastrointestinal motility. However, the difficulty in manual attachment of the electronic stethoscope on the abdominal wall and noise production against bowel sound signals have prohibited its widespread use. Therefore, I developed a new apparatus that eliminates the noise; it contains a sound absorbing device and a holder for the head of stethoscope. Using the new bowel sound recording system, bowel sounds of the patients were recorded repeatedly. The endoscopic and abdominal computed tomography findings were obtained from other hospitals' medical record, and all patients were confirmed to have structural deformity in the pylorus-duodenum. The records of each patient were compared and assessed. Results: : Patients had either duodenal ulcer scar, pyloric stricture, or far advanced malignant stomach cancer, as diagnosed by the gastroscopy. Their dominant frequency of bowel sound obtained from the new system was checked more than 2 times at regular intervals. All 8 recordings in the 2 patients with duodenal ulcer scar (5 times) or pyloric stricture (3 times) showed a decrease in postprandial than fasting dominant frequency. One patient with stomach cancer showed no significant change between postprandial and fasting states at 2 recordings. Conclusions: The analysis of dominant frequency in bowel sounds can indicate the existence of pyloric obstruction that could delay gastric emptying.