• 제목/요약/키워드: kidney surgery

검색결과 355건 처리시간 0.026초

베체트병환자의 치험례 (REPORT OF BECHET'S DISEASE)

  • 김일규;윤승환;오성섭;김형돈;최진호;오남식;김의성
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제26권2호
    • /
    • pp.219-223
    • /
    • 2000
  • Behcet's disease is a chronic, multisystemic disorder which is more frequently seen in the Mediterranean basin, Middle East, and Far East. The mean age at the first onset is third decades. In large series of patients, men predominate over women. Infectious agents, immune mechanisms, and genetic factors are implicated in the etiopathogenesis of the disease. Eyes, skin, joints, the oral cavity, blood vessels, and central nervous system are usually involved, although less frequently the heart, lung, kidney may be affected. The prognosis of the disease has been improved because of early diagnosis and suitable treatment. Local remedies and systemic administration of colchicine, corticosteoids, immunosuppressives, and other agents have been applied. Pathergy, or skin hypersensitivity to needle puncture has been reported as a diagnostic test for Behcet's disease. We have managed a Behcet's disease patient with pathergy test & corticosteroids therapy. We have obtained good result and report this case with review of literatures.

  • PDF

소아에서 발생한 복강내 염증성 근섬유모세포종의 임상적 고찰 (Abdominal Inflammatory Myofibroblastic Tumor in Children)

  • 김현영;문석배;정성은;이성철;박귀원;김우기
    • Advances in pediatric surgery
    • /
    • 제14권2호
    • /
    • pp.153-163
    • /
    • 2008
  • Inflammatory myofibroblastic tumor (IMT) is a rare reactive lesion characterized by the feature of myofibroblasts and a mixed inflammatory infiltrate that rarely undergoes malignant transformation. Extrapulmonary IMTs in children have been described involving the mesentery, omentum, retroperitoneum, abdominal soft tissues, liver, bladder, mediastinum, head and neck, extremity, appendix, and kidney. Medical records of children treated with abdominal IMT between 1985 and 2005 were reviewed retrospectively. Seven children were treated for IMT with the mean age of 3 y 2 m (range, 1 y 1 m to 14 y). Tumors were located in transverse mesocolon (n=2), omentum (n=1), porta hepatis (n=2), complex site (antrum, duodenum, common bile duct, porta hepatis) (n=2). The symptoms included abdominal mass, fever, jaundice, abdominal pain and anemia. The masses were excised totally in transverse mesocolon, omentum IMT and there is no evidence of recurrence (follow-up periods: 6 y 8 m, 8 y 9 m, 4 y 10 m). In porta hepatis IMT, liver transplantations were performed and there is no evidence of recurrence (follow period: 6 y 8 m, 8 y 7 m). In one case of complex site IMT, partial excision of mass was performed and he still survived with no change of the residual tumor during follow-up period. The other one of complex site IMT denied further treatment after the biopsy. In conclusion, complete surgical excision including liver transplantation and close follow-up are mandatory for the abdominal IMT in child.

  • PDF

암 최초 진단 후 수술 병원 결정요인: 수도권 소재 일개 종합병원을 대상으로 (Determinants of a Surgery Hospital Following a First-time Diagnosis of Cancer at a General Hospital in the Metropolitan Area)

  • 신창호;김봄결;심형섭;김태현;장석용;이상규
    • 한국병원경영학회지
    • /
    • 제26권4호
    • /
    • pp.59-66
    • /
    • 2021
  • Purposes: This study aimed to identify relevant factors that determine cancer surgery at a medium-sized general hospital where patients are diagnosed with cancer. Methodology: The study subjects were 1,530 patients diagnosed with cancer between November 2013 and October 2019 at a 400-bed general hospital located in the metropolitan area. Multiple logistic regression analysis was performed to identify the patient characteristics, cancer types, and characteristics of treatment experience of the study subjects, in addition to the determinants of cancer surgery in the hospital. Findings: Among 1,530 cases diagnosed with cancer, 353 cases (23.1%) were operated at the hospital where the cancer diagnosis was made. As determinants of surgery after a fist-time diagnosis at a general hospital, the likelihood of having surgery at the hospital, for colorectal cancer patients compared to stomach cancer patients (Odds Ratio=2.38), bladder and kidney cancer patients (Odds Ratio=1.79). According to the results of an additional survey conducted, it was found that important determinants of decisions on a hospital to receive cancer surgery were the kindness of the staff including doctors and nurses, and the trust in the medical skills and technique of the doctor. Practical Implication: The management of general hospitals should take note of the fact that it is important to establish proactive strategies for hospital management including strengthening the rapport between patients and medical institutions based on the kindness of medical staff (doctors and nurses) and staff, in addition to promoting cancer adequacy evaluation results and introducing one-stop systems.

Clinical Outcomes of Arteriovenous Grafts Using the Superficial Vein versus Venae Comitantes as Venous Outflow

  • Yo Seb Lee;Song Am Lee;Jae Joon Hwang;Jun Seok Kim;Hyun Keun Chee
    • Journal of Chest Surgery
    • /
    • 제57권2호
    • /
    • pp.178-183
    • /
    • 2024
  • Background: The superficial veins are commonly used in conventional autogenous arteriovenous fistulas and the placement of prosthetic grafts. When they are unsuitable, however, the use of the deep veins (venae comitantes) is generally considered to be a reasonable alternative. This study conducted a comparative analysis of clinical outcomes for arteriovenous grafts between 2 groups based on the type of venous outflow: superficial veins or venae comitantes. Methods: In total, 151 patients who underwent arteriovenous grafts from November 2005 to March 2022 were retrospectively analyzed. The patients were divided into 2 groups: group A (superficial veins, n=89) and group B (venae comitantes, n=62). The primary, secondary patency, and complication rates were analyzed in each group. A propensity score-matched analysis was performed. Results: In total, 55 well-balanced pairs were matched. Kaplan-Meier analysis revealed no significant differences in the primary patency rate between the 2 groups at 1-year, 3-year and 5-year intervals (group A, 54.7%, 35.9%, 25.4% vs. group B, 47.9%, 16.8%, 12.6%; p=0.14), but there was a difference in the secondary patency rate (group A, 98.2%, 95.3%, 86.5% vs. group B, 87.3%, 76.8%, 67.6%; p=0.0095). The rates of complications, simple percutaneous transluminal angioplasty, and stent insertion were comparable between the groups. Conclusion: Although this study demonstrated not particularly favorable secondary patency rates in the venae comitantes group, the venae comitantes may still be a viable option for patients with unsuitable superficial veins because there were no significant differences in the primary patency and complication rates between the 2 groups.

치아 기관배양시 골형성단백의 역할에 관한 연구 (THE ROLE OF BONE MORPHOGENETIC PROTEIN IN THE TOOTH CULTURE)

  • 정일혁;정종훈;정필훈
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제30권5호
    • /
    • pp.438-443
    • /
    • 2004
  • Objectives : The proper development of the facial structures relies upon a sequence of tightly regulated signaling interactions between the ectoderm and mesoderm involving the participation of several families of signaling molecules. Among these, bone morphogenetic proteins (BMPs) have been suggested to be a key signal that regulates the development of the mandible and the initiation and morphogenesis of the teeth. The aim of this study was to examine the artificial development of the mandibular structures and to examine the role of BMPs on tooth morphogenesis and differentiation using an organ culture system. Materials and Methods : The tooth germs from Ed 11.5, 13.5 mice were dissected, and transplanted into the diastema of the mandible primordia. The mandibles containing the transplanted tooth germs were cultured in vitro. During this period, beads soaked with BMP4 were implanted around the transplanted tooth germs. In addition, a diastema block containing the transplanted tooth germ was dissected, then transferred to an adult mouse kidney. After the organ culture, the developing mandibular explant was removed from the kidney and prepared for the tissue specimens. Odontogeneis of the transplanted tooth germs was examined after Hematoxylin-eosin, Masson-trichrome staining. Results : Proliferation and differentiation of the tooth germs cultured in the diastema was observed. In the BMP4-treated tooth germs, the formation of the first and second molars was noted. The crown of the developing tooth showed the formation of a mature cusp with the deposition of enamel and dentin matrix. In conclusion, it was confirmed that BMP4 is involved in the formation of a dental crown and the differentiation of ameloblasts and odontoblasts of the molar tooth during the development of the transplanted tooth germs.

Insular Component가 공존한 고분화 갑상선암 (Well Differentiated Thyroid Carcinoma with Insular Component)

  • 정웅윤;심정연;박정수
    • 대한두경부종양학회지
    • /
    • 제13권1호
    • /
    • pp.74-80
    • /
    • 1997
  • We have experienced 5 cases of unusual well differentiated thyroid carcinoma with insular component during the past 5 years. 4 cases were presented with cervical masses but I case (patient 2.) was initiallty with lung and brain metastasis. The tumors from 4 cases showed invasive growths but that of 1 cases(patient 1.) showed intrathyroidal. Total thyroidectomy and cervical lymphnode dissection(CCND or RND) was performed in 4 cases but only RND was performed in spite of mediastinal metastasis of the tumor in patient 5 under the patient's choice. During the follow-up period, we also performed radical nephrectomy and metastatectomy for the kidney and iliac bone metastasis respectively, in patint 2. Microcsopically, the tumors showed the insular growth patterns, focally(less than 50%) in 3 cases and predominantly(more than 75%) in 2 cases. And the insular componentas were combined with papillary carcinoma in 2 cases and follicular carcinoma in 3 cases. Cervical lymphnode metastases were confirmed in 4 cases. Patient 2 died of disease with metastases to lung, brain, bone and kidney, 52 months after initial therapy. Patient 1, 3 and 4 are alive and have no recurrence and distant metastasis. Patient 5 is also alive with the mediastinal metastasis. In our experience, the well differentiated thyroid carcinomas with insular component showed characteristic histologic features, aggressive behavior in initial presentation and unfavorable prognosis regardless of the percentage of the insular component.

  • PDF

A Rare Case of Canine Huge Renal Cell Carcinoma with Ovarian Metastasis

  • Koo, Jiyoung;Song, Woo-Jin;Jo, Heesoo;Ahn, Hyerin;Choi, Solji;Jeong, Hyohoon;Cheong, Jongtae;Park, Hyun-Jung;Yun, Youngmin
    • 한국임상수의학회지
    • /
    • 제39권4호
    • /
    • pp.168-172
    • /
    • 2022
  • A 10-year-old female Pomeranian weighing 2.25 kg with a history of gradual weight loss and an intraabdominal mass confirmed with ultrasonography at a local hospital was referred to the Veterinary Medical Teaching Hospital, Jeju National University. Physical examination revealed abdominal distention. Blood analysis revealed hypoglycemia (57 mg/dL; reference range, 60-110 mg/dL). On abdominal ultrasonography, a heterogeneously hyperechoic mass measuring 7.51 × 10.6 cm was found at the level of the left kidney. Computed tomographic findings showed a unilateral left kidney mass with a 10-cm diameter and vessel contrast enhancement in the corticomedullary phase. Unilateral nephrectomy and ovariohysterectomy were performed because left ovary enlargement was observed during surgery. The renal mass was adjacent to the aorta and vena cava and attached to a portion of the small intestine, greater omentum, and left ovary. The mass was huge (12.5 × 10 × 7 cm) and was 16.5% of the body weight. Histopathological examination revealed renal cell carcinoma (RCC) and ovarian metastasis. After surgery, clinical signs improved remarkably, and serum glucose level returned to normal. As RCC is resistant to radiation and chemotherapy, the owner decided not to proceed with postoperative adjunctive therapies. To the best of our knowledge, this is the first case report of ovarian metastasis with huge RCC in a dog.

Exocrine pancreatic cancer as a second primary malignancy: A population-based study

  • Mee Joo Kang;Jiwon Lim;Sung-Sik Han;Hyeong Min Park;Sung Chun Cho;Sang-Jae Park;Sun-Whe Kim;Young-Joo Won
    • 한국간담췌외과학회지
    • /
    • 제27권4호
    • /
    • pp.415-422
    • /
    • 2023
  • Backgrounds/Aims: Although cancer survivors are at higher risk of developing second primary malignancies, cancer surveillance strategies for them have not yet been established. This study aimed to identify first primary cancers that had high risks of developing second primary exocrine pancreatic cancer (EPC). Methods: Data on individuals diagnosed with primary cancers between 1993 and 2017 were obtained from the Korea Central Cancer Registry. The standardized incidence ratios (SIRs) of second primary EPCs were analyzed according to the primary tumor sites and follow-up periods. Results: Among the 3,205,840 eligible individuals, 4,836 (0.15%) had second primary EPCs, which accounted for 5.8% of the total EPC patients in Korea. Between 1 and 5 years after the diagnosis of first primary cancers, SIRs of second primary EPCs were increased in patients whose first primary cancers were in the bile duct (males 2.99; females 5.03) in both sexes, and in the small intestine (3.43), gallbladder (3.21), and breast (1.26) in females. Among those who survived 5 or more years after the diagnosis of first primary cancers, SIRs of second primary EPCs were elevated in patients whose first primary cancers were in the bile duct (males 2.61; females 2.33), gallbladder (males 2.29; females 2.22), and kidney (males 1.39; females 1.73) in both sexes, and ovary (1.66) and breast (1.38) in females. Conclusions: Survivors of first primary bile duct, gallbladder, kidney, ovary, and female breast cancer should be closely monitored for the occurrence of second primary EPCs, even after 5 years of follow-up.

투석을 받고 있으며 신장 이식 수술 전 구강내 평가를 위해 의뢰된 말기 신장 질환 자의 치주 상태 (Periodontal status of end-stage renal disease patients undergoing dialysis and referred for intraoral evaluation prior to kidney transplant surgery)

  • 최윤경;전혜미;주지영;김현주;권은영
    • 구강회복응용과학지
    • /
    • 제40권2호
    • /
    • pp.46-54
    • /
    • 2024
  • 목적: 투석을 받고 있으며 신장 이식 수술 전 구내 평가를 위해 의뢰된 말기 신장 질환자의 치주 상태를 신장 기능이 정상인 대상자들과 비교 평가하고자 함이다. 연구 재료 및 방법: 말기 신장 질환으로 투석을 받고 있으면서 신장 이식 수술 전 구강내 평가를 위해 대학병원 신장 내과에서 치과진료센터로 의뢰된 환자들을 대상으로 하였다. 치주 상태의 비교를 위해 신장 기능에 이상이 없으면서, 나이와 성별이 부합하는 대상자를 추출하여 건강한 대조군으로 선정하였다. 신장내과 진료 기록을 통해 환자의 연령, 성별, 동반질병, 받고 있는 투석의 종류, 투석 기간을 조사하였으며, 치주과 진료 기록을 통해 치주 상태에 대한 자료를 분석하였다. 결과: 투석을 받는 환자 51명 및 건강한 대조군에 속한 51명을 합하여 모두 102명이 본 연구에 포함되었다. 신장 이식 수술을 받기 전까지 투석을 받은 말기 신장 질환자들에서 건강한 대상자들에 비해 치주낭 깊이, 임상적 부착수준, 치주낭 깊이가 5 mm 이상 되는 부위의 백분율, 임상적 부착수준이 4 mm 이상 되는 부위의 백분율, 탐침시 출혈이 일어나는 치아의 백분율, 상실치 수 등이 유의하게 크게 나타났다. 또한 투석을 받는 환자 그룹에서 중등도에서 중도 치주염을 지닌 비율이 건강한 대조군에 비해 더 높은 것으로 나타났다. 결론: 본 연구에서 투석을 받고 있으며 신장 이식 수술 전 구강내 평가를 위해 의뢰된 말기 신장 질환자의 치주 상태는 연령과 성별이 유사한 건강한 대조군에 속한 대상자들에 비해 악화된 상태였다.

구강 및 악골에 생긴 전이 암종 (METASTATIC CARCINOMA OF ORAL CAVITY)

  • 김창수;이정훈;안희용;정상철;최홍식
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제12권1호
    • /
    • pp.142-147
    • /
    • 1990
  • 구강내에 발생하는 암종은 원발성으로 나타나는 것이 보통이지만 신체내 다른 부위의 원발성 암종에 의해 이차적으로 전이되기도 한다. Clausen 과 Poulsen에 의하면 원발성 암종중에서 breast, lung, kidney, thyroid의 순으로 구강내 전이암종을 많이 나타내는 것으로 알려져 있다. 문헌에 의하면 구강 및 악골에 발생한 전이암종 중에서 약 70%가 adenocarcinoma 이며 주로 혈행적(hematogenous) 전이를 하는 것으로 알려져 있다. 이때 전이는 일차적으로 악골내에, 이차적으로 연조직에 전이되며, 이로인해 발생한 악성 전이 암종은 구강내에 발생하는 악성종양의 약 1%에 해당한다. 그러나, 실제로 이의 발견이 어려운 것은 악골에 대한 일상의 검사가 이루어지지 않으며 환자 자신이 특별한 증상을 호소하지 않기 때문이다. 본 교실에서는 문헌상 빈도수가 적은 gall bladder cancer 와 pancreatic tumor 에서 전이된 암종이 특이하게 악골내에서는 나타나지 않고 연조직에만 발생하였기에 이에 보고하는 바이다.

  • PDF