소아 갑상선 결절의 수술적 치료

오흥권,김현영,박귀원,정성은,이성철,김우기 대한외과학회 2005 대한외과학회 학술대회 초록집 Vol.2005 No.10

Results of Surgical Treatment on Benign Anal Diseases in Korean HIV-Positive Patients

오흥권,문상희,유승범,최은경,박규주 대한의학회 2014 Journal of Korean medical science Vol.29 No.9

Perianal diseases are the most common reasons for surgery in HIV-positive patients. Thisstudy aimed to evaluate the outcomes of these surgical procedures in Korean patients,focusing on wound healing and postoperative complications. Retrospective analysis wasperformed on 72 HIV-positive patients who underwent surgery by a single surgeon forbenign anal disease between 1998 and 2011. Of these, 68.1% (49/72) of patients receivedsurgery for condyloma acuminata, 19.4% (14/72) for anal fistulas, 6.9% (5/72) forhemorrhoids, and 5.6% (4/72) for perianal abscesses. Patients with condyloma acuminatareceived surgical excision with electrical coagulation, and all wounds healed completelywithin 3 months, though 16.3% (8/49) of these patients experienced recurrence. Twelveof the 49 patients (24.5%) who were treated for condyloma acuminata underwentsimultaneous operations for concomitant anal fistulas (n = 6), hemorrhoids (n = 4), andperianal abscesses (n = 2). Overall, 3 postoperative complications developed following atotal of 94 procedures, and there was no significant increase in complication rate for patientswith a low CD4+ T-cell count ( < 200/μL) compared to those with a higher count. The resultsdemonstrate favorable results following perianal surgery in HIV-positive Korean patients.

소아 갑상선 결절의 수술

오흥권,김현영,박귀원,정성은,김우기,Oh, Heung-Kwon,Kim, Hyun-Young,Park, Kwi-Won,Jung, Sung-Eun,Kim, Woo-Ki 대한소아외과학회 2006 소아외과 Vol.12 No.2

Thyroid nodules are less common in children than in adults and their management is still controversial. The clinical presentations, operations, complications, histopathologic findings, and postoperative progressions of 34 pediatric patients that underwent thyroidectomy for palpable thyroid nodule at the Department of Surgery, Seoul National University Children Hospital between 1986 and 2003 were studied retrospectively by reviewing medical records and telephone interviews. The mean age of the patients was 11.8 years old. There were 23 females (67.6 %) and 11 males (32.4 %). Surgical indications were clinical need of histological confirmation (n=15), unresponsiveness to thyroxin replacement therapy (n=10), suggestion of the carcinoma on fine needle aspiration cytology (n=5), cosmetic purpose-a huge benign nodule (n=2), completion thyroidectomy for medullary thyroid carcinoma (n=1), and prophylactic thyroidectomy in a MENIIpatient (n=1). Unilateral Lobectomy was performed in 20 patients (57.1 %), subtotal thyroidectomy in 8 (22.9 %), total thyroidectomy in 5 (14.7 %), and completion thyroidectomy in 1 (2.9 %). Lymph node dissection was performed in 9 cases. Benign tumor was found in 23 patients (67.6 %), adenomatous goiter (n=18) and follicular adenoma (n=5). Malignant tumor was found in 11 children (32.4 %), 9 papillary carcinomas (26.5 %), and 2 medullary carcinomas (5.9 %). Of the 9 papillary carcinomas, 7 cases (77.8 %) had lymph node metastasis. No lymph node metastasis was found in 2 medullary carcinomas. Complications developed in 5 cases - transient hypocalcaemia (n=2), and temporary hoarseness (n=3). There was no mortality. Median follow-up period was 7.4 years (0.5-18 years). One patient showed recurrence in cervical lymph nodes 10 years after surgery and modified radical neck dissection was performed. Because of the high incidence of malignancy and advanced stage at initial presentation, more meticulous diagnostic work up is necessary for children with thyroid nodule, and more radical surgical treatment should be performed when malignant nodule is suggested.

절개창탈장의 교정 방법에 따른 재발률 비교

송인호,오흥권,김지선,신루미,최은경,유승범,정승용,박규주 대한외과학회 2010 대한외과학회 학술대회 초록집 Vol.2010 No.11

Surgical Treatment of a Parastomal Hernia

허승철,오흥권,송윤숙,서미선,최은경,유승범,박규주 대한대장항문학회 2011 Annals of Coloproctolgy Vol.27 No.4

Purpose: Parastomal hernia is a major complication of an intestinal stoma. This study was performed to compare the re- sults of various operative methods to treat parastomal hernias. Methods: Results of surgical treatment for parastomal hernias (postoperative recurrence, complications and postoperative hospital stays) were surveyed in 39 patients over an 11-year period. The patients enrolled in this study underwent surgery by a single surgeon to exclude surgeon bias. Results: Seventeen patients were male, and twenty-two patients were female. The mean age was 65.9 years (range, 36 to 86 years). The stomas were 35 sigmoid-end-colostomies (90%), 2 loop-colostomies (5%), and 2 double-barrel-colostomies. Over half of the hernias developed within two years after initial formation. Stoma relocation was performed in 8 patients, suture repair in 14 patients and mesh repair in 17 patients. Seven patients had recurrence of the hernia, and ten patients suffered from complications. Postoperative complications and recurrence were more frequent in stoma relocation than in suture repair and mesh repair. Emergency operations were performed in four patients (10.3%) with higher incidence of complications but not with increased risk of recurrence. Excluding emergency operations, complications of relocations were not higher than those of mesh repairs. Postoperative hospital stays were shortest in mesh repair patients. Conclusion: In this study, mesh repair showed low recurrence and a low complication rate with shorter hospital stay than relocation methods, though these differences were not statistically significant. Further studies, including randomized tri- als, are necessary if more reliable data on the surgical treatment of parastomal hernias are to be obtained. Purpose: Parastomal hernia is a major complication of an intestinal stoma. This study was performed to compare the re- sults of various operative methods to treat parastomal hernias. Methods: Results of surgical treatment for parastomal hernias (postoperative recurrence, complications and postoperative hospital stays) were surveyed in 39 patients over an 11-year period. The patients enrolled in this study underwent surgery by a single surgeon to exclude surgeon bias. Results: Seventeen patients were male, and twenty-two patients were female. The mean age was 65.9 years (range, 36 to 86 years). The stomas were 35 sigmoid-end-colostomies (90%), 2 loop-colostomies (5%), and 2 double-barrel-colostomies. Over half of the hernias developed within two years after initial formation. Stoma relocation was performed in 8 patients, suture repair in 14 patients and mesh repair in 17 patients. Seven patients had recurrence of the hernia, and ten patients suffered from complications. Postoperative complications and recurrence were more frequent in stoma relocation than in suture repair and mesh repair. Emergency operations were performed in four patients (10.3%) with higher incidence of complications but not with increased risk of recurrence. Excluding emergency operations, complications of relocations were not higher than those of mesh repairs. Postoperative hospital stays were shortest in mesh repair patients. Conclusion: In this study, mesh repair showed low recurrence and a low complication rate with shorter hospital stay than relocation methods, though these differences were not statistically significant. Further studies, including randomized tri- als, are necessary if more reliable data on the surgical treatment of parastomal hernias are to be obtained.

중증감염의 치료

박규주,오흥권 대한외과학회 2011 대한외과학회 학술대회 초록집 Vol.2011 No.5

Electrophysiological and Mechanical Characteristics in Human Ileal Motility: Recordings of Slow Waves Conductions and Contractions, In vitro

유승범,오흥권,문상희,최은경,유성아,박성혜,박규주 대한약리학회 2015 The Korean Journal of Physiology & Pharmacology Vol.19 No.6

Little human tissue data are available for slow waves and migrating motor complexes, which are the main components of small bowel motility. We investigated the electrophysiological and mechanical characteristics of human ileal motility, in vitro. Ileum was obtained from patients undergoing bowel resection. Electrophysiological microelectrode recordings for membrane potential changes and mechanical tension recordings for contraction from smooth muscle strips and ileal segments were performed. Drugs affecting the enteric nervous system were applied to measure the changes in activity. Slow waves were detected with a frequency of 9∼10/min. There were no cross-sectional differences in resting membrane potential (RMP), amplitude or frequency between outer and inner circular muscle (CM), suggesting that electrical activities could be effectively transmitted from outer to inner CM. The presence of the interstitial cell of Cajal (ICC) at the linia septa was verified by immunohistochemistry. Contractions of strips and segments occurred at a frequency of 3∼ 4/min and 1∼ 2/min, respectively. The frequency, amplitude and area under the curve were similar between CM and LM. In segments, contractions of CM were associated with LM, but propagation varied with antegrade and retrograde directions. Atropine, NW-oxide-L-arginine, and sodium nitroprusside exhibited different effects on RMP and contractions. There were no cross-sectional differences with regard to the characteristics of slow waves in CM. The frequency of contractions in smooth muscle strips and ileal segments was lower than slow waves. The directions of propagation were diverse, indicating both mixing and transport functions of the ileum.

Operative Treatment with a Laparotomy for Anorectal Problems Arising from a Self-Inserted Foreign Body

유승범,오흥권,Heon-Kyun Ha,Eun Kyung Choe,문상희,박규주 대한대장항문학회 2012 Annals of Coloproctolgy Vol.28 No.1

An anorectal foreign body can cause serious complications such as incontinence, rectal perforation, peritonitis, or pelvic abscess, so it should be managed immediately. We experienced two cases of operative treatment for a self-inserted anorectal foreign body. In one, the foreign body could not be removed as it was completely impacted in the anal canal. We failed to remove it through the anus. A laparotomy and removal of the foreign body was performed by using an incision on the rectum. Primary colsure and a sigmoid loop colostomy were done. A colostomy take-down was done after three months. The other was a rectal perforation from anal masturbation with a plastic device. We performed primary repair of the perforated rectosigmoid colon, and we didea sigmoid loop colostom. A colostomy take-down was done three months later. Immediate and proper treatment for a self-inserted anorectal foreign body is important to prevent severe complications,and we report successful surgical treatments for problems caused by anorectal foreign bodies.

Transmissibility of the Campaign for Colorectal Cancer Awareness in Korea Among Twitter Users

이근철,오흥권,박기범,박소현,서봉원,배우경,김진원,윤혁,김명조,강성일,손일태,김덕우,강성범 대한대장항문학회 2016 Annals of Coloproctolgy Vol.32 No.5

Purpose: The Korean Society of Coloproctology holds its annual colorectal awareness month every September. This study analyzed the users and the contents of Korean tweets regarding colorectal cancer and estimated the transmissibility of the awareness campaign among Twitter users. Methods: Prospective data collection was employed to accumulate Korean tweets containing the keywords “colorectal cancer,” “colorectal cancer awareness campaign,” “gold ribbon,” and/or “love handle,” from August 1 to September 30, 2014. Twitter users and contents were analyzed, and the credibility of information-sharing tweets throughout the study period was evaluated. Results: In total, 10,387 tweets shared by 1,452 unique users were analyzed. As for users, 57.8% were individuals whereas 5.8% were organizations/communities; spambots accounted for a considerable percentage (36.4%). As for content, most tweets were spam (n = 8,736, 84.1%), repetitively advertising unverified commercial folk remedies, followed by tweets that shared information (n = 1,304, 12.6%) and non-information (n = 347, 3.3%). In the credibility assessment, only 80.6% of the information-sharing tweets were medically correct. After spam tweets had been excluded, a significant increase was seen in the percentage of information-sharing tweets (77.1% to 81.1%, P = 0.045) during the awareness campaign month. Conclusion: Most Korean tweets regarding colorectal cancer during the study months were commercial spam tweets; informative public tweets accounted for an extremely small percentage. The transmissibility of the awareness campaign among Twitter users was questionable at best. To expand the reach of credible medical information on colorectal cancer, public health institutions and organizations must pay greater attention to social media.

부분 장폐색이 생쥐 소장의 이동성 위장관 복합운동에 미치는 영향

문상희,오흥권,유승범,최은경,문정선,박규주 대한대장항문학회 2010 Annals of Coloproctolgy Vol.26 No.3

Purpose: Partial obstruction of the small bowel causes hypertrophy of smooth muscle cells and enteric neurons. After small bowel obstruction, slow waves have also been reported to disappear or to be greatly reduced at the oral site of the obstruction in the murine ileum. The purpose of this research was to study the changes in migrating motor complexes (MMCs) after partial obstruction in order to compensate for the attenuated function of slow waves. Methods: A ring of film (6 mm in length, 4 mm in internal diameter) was placed over the small intestine 5-6 cm oral to the ileocecal valve in 8-10 wk old female ICR mice. These rings resulted in a partial obstruction of the intestine after 2 wk. The mechanical activities of the small intestine were recorded and the amplitude, interval, and half-duration of the MMCs were analyzed. Results: The MMCs from a partially obstructed ileum occurred every 1.58±1.06 min and had a half-duration of 6.90±5.54sec. The interval and the half-duration of the control MMCs were 3.60±1.11 min and 31.5±11.4 sec, respectively. The difference in interval and the half-duration of the MMCs reached statistical significance (P=0.03; P=0.00). The amplitude and the area under the curve (AUC) of the MMCs of the obstructed ileum were much higher than those of the control (31.3±8.86 vs. 6.05±1.92 mN; 161.18±44.09 vs. 72.95±2.45 mN sec/MMC wave; P=0.00, 0.02). Conclusion: The MMCs with higher amplitude and AUC, with shorter interval, and with shorter half-duration, compared with those of the control, were recorded from the partially obstructed murine ileum, reflecting efforts to overcome the effect of obstruction by increasing the power of contractions.