관동맥 스텐트 시술후 발생하는 재협착의 형태와 미만성 재협착의 예측인자

박종선,석준호,홍그루,신동구,김영조,심봉섭 대한순환기학회 2001 Korean Circulation Journal Vol.31 No.11

Residual lesion after hysterectomy for patients with surgical margin positive after loop electroexicional procedure on cervical lesion over than carcinoma in situ

( Yh Lee ),( Go Chong ),( Dg Hong ),( Yl Cho ),( Is Park ),( Ys Lee ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

This study analyzed residual lesion after hysterectomy for patients with surgical margin positive after loop electroexicional procedure on cervical lesion over than carcinoma in situ and relations between the factors for residual lesion. We evaluated 1329 patients who underwent L.E.E.P on cervical lesion from January 2000 to June 2010.Of the 1329 patients, 314patients who underwent hysterectomy due to surgical margin positive which is over than carcinoma in situ were analyzed for the residual tumor and relations between factors. All data were compared by Pearson`s comparison test. Of the 314patients, the lesion of margin in 211 patients was carcinoma in situ, another 15 patients had adenocarcinoma in situ, the other 88patients had microinvasive lesion. In carcinoma in situ group, the residual cervix after hysterectomy had no residual lesion( 56.8%), moderate dysplasia ( 1%), carcinoma in situ(35.8%), microinvasive cancer (6%) and invasive cancer ( 0.4%). In adenocarcinoma in situ group, the residual cervix had no residual lesion ( 46.7%), adenocarcinoma in situ ( 33.3%) and microinvasive cancer ( 20%). In microinvasive cancer group, the residual cervix had no residual lesion ( 54.5%), severe dysplasia (1%), carcinoma in situ ( 21.6%), microinvasive cancer ( 21.6%) and invasive cancer (1%). The severity of residual tumor was directly porportional to age (P <0.01) and positive endocervical curettage on L.E.E.P( p<0.01), but inverse proportional to exocervical(P <0.01) or endocervical (P =0.04)margin positive. The type of instrument for L.E.E.P had no effect on the residual lesion after hysterectomy ( p=0.10). In this study, we recommend reconization or preservative treatment for patient who had margin positive on cervical lesion less than carcinoma in situ. Physiciens should consider hysterectomy for old age, endocervical curettage positive, microinvasive cancer margin positive and adenocarcinoma in situ margin positive lesion.

Practical measurement of estimated blood loss in gynecologic surgery

( Ia Hwang ),( Yh Lee ),( Go Chong ),( Dg Hong ),( Yl Cho ),( Is Park ),( Ys Lee ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

This study was designed to find practical measurement to estimate blood loss in gynecologic surgery We analysis 24 patients who underwent total vaginal hysterectomy without irrigation from January 2012 to June 2012. Real blood loss was measured, calculating the weight of suction fluid and gauzes. The relation between real blood loss and other factors which were considered to show the amount of blood loss indirectly was analyzed using statistic program. The factors were measured one day before surgery and postoperative one day. Using the factors which showed statistical significance (p<0.05), regression equation to calculate blood loss was made. Among all factors (age, weight, height, BMI, BSA, Hb change, WBC change, hematocrit change, CRP change, ESR change, potassium change), age (p=0.023), height (p=0.049), Hb change (p=0.36) and square root of WBC (p=0.024) showed statistical significance. Using multiple linear regression, regression equation was made. EBL= -2343 + (-35.8)X( age, year) + (8.6)X(height ,cm ) + (115.4 X Hb change, g/dL) + (414.8 X SQRT (WBC)). The regression equation showed p=0.05. Gynecologists should estimate real blood loss with objective methods before reporting surgical outcomes and the safety and efficiency of surgical technique. Until now there is no simple and practical measurement to estimate real blood loss. The suggested regression equation have not sufficient statistical significance, but the equation will be modified to be more accurate with more data in the future.

Postoperative drainage culture after laparoscopic incidental appendectomy in gynecologic diseases

( Bjh Hwang ),( Yh Lee ),( Go Chong ),( Dg Hong ),( Ys Lee ),( Is Park ),( Yl Cho ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

This study analyzed the drainage culture after laparoscopic incidental appendectomy in gynecologic diseases. We evaluated 477 patients who underwent laparoscopic surgery with appendectomy ( 242) and without (235) from February 2011 to June 2012. Postoperative one day drainage fluid was cultured in all patients . All data were compared by two sample t-test and Pearson`s comparison test . Bacteria grew in 98 (20.7%)patients among all patients, respectively 53(21.9%) patients in appendectomy group and 45 ( 19.1%) patients in the other group. 14 geni and 26species bacteria grew in drainage(Achromobacter, Acinetobacter, Chryseobacterium, Citrobacter, Enterobacter, Enterococcus, Escherichia, Hafnia, Streptococcus, Klebsiella, Proteus, Pseudomonas, Staphylococcous, Stenotrophomonas). The commensal organisms of human intestine ( Enterococcus n=35, Enterobacter n=12, Pseudomonas n=20 ) were most common. There were no difference in the incidence of bacteria cultured in two groups(p=0.45). But the postoperative change of WBC ( p<0.01), ANC( p<0.01), CRP ( p<0.01), fever( p=0.01), operation time(p=0.01), hospital stay( p<0.01) and postoperative complication ( p=0.04) in appendectomy were higher than those of the other group Surgical and laboratory results were worse in appendectomy group. But these outcome was not related the intraabdominal bacterial infection after incidental appendectomy. These results might be related with the nature and radicality of operation.

A rare tumor : gastrointestinal stromal tumor in the rectovaginal septum

( Ey Hur ),( Yh Lee ),( Go Chong ),( Dg Hong ),( Yl Cho ),( Is Park ),( Ys Lee ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

Objective: To describe a case of gastrointestinal stromal tumor (GIST) outside gastrointestinal tract and arising in the recovaginal septum. Case A 54-year-old woman presented protruding large vaginal mass. The mass adhered with posterior vaginal wall but did not invade rectum. Total abdominal hysterectomy, bilateral salpingooophorectomy and lower anterior resection of rectum with end to end anastomosis were performed. Pathologically the tumor consisted of spindle cells of high cellular density and focal necrosis with the mitotic count being 4-5 mitoses per 50 high-power fields. On immunohistochemical evaluation, the tumor cell express strong and diffuse staining for c-kit, P53, S-100 and P16, and the tumor cells showed no staining with SMA. After surgery, the patient received imatinib (Glivec). Conclusions Until now, only 11 cases of GIST arising in rectovaginal septum have been research in Pubmed. Complete excision with free margin and use of imatinib are treatment of choice. With literature review late recurrences occurred. Long term follow up is necessary. Gynecologist should be consider GIST in the evaluation of a mass arising in the rectovaginal septum.

Definitive concurrent chemoradiotherapy in locally advanced pancreatic cancer

Kwak YK,Lee JH,Lee MA,Chun HG,Kim DG,You YK,Hong TH,Jang HS. 대한방사선종양학회 2014 Radiation Oncology Journal Vol.32 No.2

Purpose Survival outcome of locally advanced pancreatic cancer has been poor and little is known about prognostic factors of the disease, especially in locally advanced cases treated with concurrent chemoradiation. This study was to analyze overall survival and prognostic factors of patients treated with concurrent chemoradiotherapy (CCRT) in locally advanced pancreatic cancer. Materials and Methods Medical records of 34 patients diagnosed with unresectable pancreatic cancer and treated with definitive CCRT, from December 2003 to December 2012, were reviewed. Median prescribed radiation dose was 50.4 Gy (range, 41.4 to 55.8 Gy), once daily, five times per week, 1.8 to 3 Gy per fraction. Results With a mean follow-up of 10 months (range, 0 to 49 months), median overall survival was 9 months. The 1- and 2-year survival rates were 40% and 10%, respectively. Median and mean time to progression were 5 and 7 months, respectively. Prognostic parameters related to overall survival were post-CCRT CA19-9 (p = 0.02), the Eastern Cooperative Oncology Group (ECOG) status (p < 0.01), and radiation dose (p = 0.04) according to univariate analysis. In multivariate analysis, post-CCRT CA19-9 value below 180 U/mL and ECOG status 0 or 1 were statistically significant independent prognostic factors associated with improved overall survival (p < 0.01 and p = 0.02, respectively). Conclusion Overall treatment results in locally advanced pancreatic cancer are relatively poor and few improvements have been accomplished in the past decades. Post-treatment CA19-9 below 180 U/mL and ECOG performance status 0 and 1 were significantly associated with an improved overall survival.

관동맥 시술 환자에서 안지오실�의 효과와 합병증

석준호,박용호,김민경,이상희,김웅,홍그루,박종선,신동구,김영조,심봉섭 대한순환기학회 2003 Korean Circulation Journal Vol.33 No.7

이차성 고혈압으로 발현된 복부 대동맥 단절 1례

박병은,김현승,권혁문,김동수,홍범기,심대근,김기중,황학진,조윤형,유영훈 대한순환기학회 2001 Korean Circulation Journal Vol.31 No.12

한국형 軍 외상 시스템에 대한 硏究 - 외상 환자의 항공 의무 후송 시간 비교를 중심으로 -

최병섭 ( Bs. Choi ),황일웅 ( Iu. Hwang ),정신 ( S. Jeong ),오대근 ( Dg. Oh ),홍진선 ( Js. Hong ) 국군의무사령부 2016 대한군진의학학술지 Vol.47 No.1

Objectives ; Rapid evacuation and proper initial treatment is well known to be crucial for trauma casualties. The purpose of this study is to evaluate the effect of air evacuation by helicopter after highly recommending it since 2013 and to propose a more appropriate trauma system in military, through the retrospective study of trauma casualties occurred in ROK military between 2012 and 2013. Materials & Methods ; The subjects of this study were 45 military trauma patients evacuated by helicopter from January 2012 to December 2013. All trauma casualties were transported to the definitive MTF(Medical Treatment Facility) by air ambulance helicopter. Casualties were divided 2 groups. 2012 CY(Calendar Year) group is 23 casualties who were injured from January to December 2012. 2013 CY group is 22 casualties who were injured from January to December 2013. The data about casualties were reviewed based on the injury severity, evacuation time, regions, types and mechanisms of injuries. Results ; In the case of 2012 CY group, the average evacuation time was 3 hours 29 minutes, most of the injuries were caused by gunshot(43.5%) and explosion(13.0%), the most common injury site was head & neck(37.9%) and then extremities(31.0%). In the case of 2013 CY group, the average evacuation time was 3 hours 33 minutes, most of incidents took place during drill and duty, explosion(27.3%) was the most common cause and then gunshot injury(22.7%) was the next and the most common injury site was extremity(27.8%). Although helicopter evacuation for military trauma patients was strongly recommended in 2013, there was no meaningful difference in mean evacuation time between 2012 and 2013. Although there were more casualties who had ISS(Injury Severity Score) over 16 in 2013, the evacuation phase and mortality was decreased in 2013 compared to 2012. Conclusions ; Military trauma system should be developed on the premise that every soldier injured on the battlefield or the site of their work has the optimal chance for survival and maximal potential for recovery. For this, we should focus our efforts on making integrated military trauma system as well as establishment of military trauma center and faster medical evacuation system.