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손경모,이인영,이윤석,계봉현,Cho Hyeon Min,장제호,김창남,이길연,이석환,김준기,The Korean Laparoscopic Colorectal Surgery Study Group 대한대장항문학회 2021 Annals of Coloproctolgy Vol.37 No.6
Colon cancer treatment is on the way to evolution over several decades. The minimally invasive surgery has improved postoperative short-term outcomes. Adjuvant chemotherapy has prolonged the survival of advanced colon cancer patients. Hohenberger proposed the noble concept of complete mesocolic excision (CME) which consists of 3 components: plane surgery, sufficient longitudinal bowel resection, and central vascular ligation (CVL). Mesocolic plane surgery shares the same surgical principle of total mesorectal excision, which is maintaining the intact mesothelial envelope. However, there remain debates about the extent of bowel resection and the level of CVL for maximizing lymph node dissection. There is no solid clinical evidence for the oncological necessity and benefit of extended radical dissection in right hemicolectomy. CME with CVL based on open surgery has been adopted in laparoscopic surgery. So, it is also necessary to look at how the CME could be transformed and successfully implanted in the laparoscopic era. Recent rapid advances in surgical technology and cancer biology are preparing for fundamental changes in cancer surgery. In this study, we reviewed the history, oncological necessity, and compatibility of CME for the right hemicolectomy in the laparoscopic era and outline the new perspectives on the evolution of cancer surgery.
Departments of Surgery,<SUP>1<.SUP>Hospital Pathology,The Catholic University of Korea,Seoul,Korea 대한갑상선-내분비외과학회 2012 The Koreran journal of Endocrine Surgery Vol.12 No.4
Purpose: The rate of malignancy in the follicular neoplasm (FN) or Hürthle cell neoplasm (HCN) of the thyroid gland is estimated as approximately 20∼30%. Fine-needle aspiration biopsy (FNAB) and frozen section examination are restricted in differentiating between benign and malignant. The aims of this study are to compare the differences of clinicopathologic features and to determine the risk factors for malignancy in patients with FN or HCN. Methods: A retrospective study was conducted of patients with FN or HCN who were diagnosed by FNAB, and underwent surgery at our institution between Jan. 2005 to Jun. 2010. We analyzed the risk factors for malignancy and the differences of clinicopathologic features in patients with FN or HCN. Results: A total of 290 patients were enrolledin this study; 160 (55.2%) patients underwent thyroidectomy, 97 (60.6%) patients had FN, and 63 (39.4%) had HCN. Forty one (25.6%) patients were diagnosed as malignancy of these, 22 (22.7%) patients were FN and 19 (30.2%) were HCN (P=0.29). Two (2.1%) patients with FN and 10 (15.9%) with HCN (P=0.002) comcomitant papillary thyroid carcinoma were indentified by FNAB. Classification of nodules according to ultrasonographic findings in both neoplasms (P<0.05) and galectin-3 in FN (P<0.05) were predictive factors for malignancy. In addition, galectin-3 was a predictive factor for malignancy in indeterminate nodules on ultrasonography (USG) (P=0.028). Conclusion: Classification of nodules according to ultrasonographic findings and galectin-3 expression is helpful in predicting carcinoma of patients with FN or HCN.
Jin Hyung Lee Department of Surgery, 순천향대학교 순천향의학연구소 2017 Journal of Soonchunhyang Medical Science Vol.23 No.1
A 39-year-old man visited Soonchunhyang University Gumi Hospital with abdominal pain. Abdominal computed tomography showed a large heterogeneously enhancing mass abutting the stomach body and a large amount of fluid collected in the peritoneal cavity. An emergency laparotomy revealed a ruptured large tumor arising from the anterior wall of the middle section of the stomach with bloody fluid in the peritoneal cavity. The patient underwent wedge resection of the tumor. The tumor was 6.5×5.5×4.0 cm in size and 49 g in weight. Immunohistochemical staining demonstrated positivity to C-kit protein, CD34, and S-100 protein. The final diagnosis was gastric gastrointestinal stromal tumor (GIST). Hemoperitoneum caused by a spontaneously ruptured GIST with cystic degeneration is extremely rare.
Dissection Manual for Open Rhinoseptoplasty in a Silicone Nose Model
Lee Ki-Il,Won Tae-Bin,Hyun Sangmin,Song Hyungmin,Jang Yong Ju,Choi Ji Yun,Hong Seung-No,Kim Hyo Yeol,Kim Ji Sun,Kim Soo Whan,The Korean Academy of Facial Plastic and Reconstructive Surgery 대한비과학회 2022 Journal of rhinology Vol.29 No.1
Open rhinoseptoplasty has been widely performed in the field of otorhinolaryngology. However, from the perspective of beginners, rhinoseptoplasty is a hard-to-learn surgery that involves a relatively steep learning curve. Therefore, practical guidance is essential to enhance the skills needed for excellent surgical outcomes. Here, we provide a step-wise dissection manual using a commercialized silicone nose model designed for rhinoseptoplasty. The contents include general approaches with regard to transcolumellar inverted V incision, flap elevation, osteotomy, septoplasty, modification of the lower lateral cartilage for tip surgery, and dorsal augmentation using silicone implants. In addition, we introduce novel techniques such as dorsal augmentation using a ready-made mold with tissue glue applied to diced cartilage and polycaprolactone mesh for rhinoseptoplasty. The present study also provides photos of individual surgical procedures using a silicone nose model for actual guidance. The authors expect that this manual will help beginning rhinoseptoplasty surgeons improve their confidence.
Vivekanand Sabanna Kattimani,Krishna Prasad Lingamaneni Department of Oral and Maxillofacial Surgery,Sibar Institute of Dental Sciences,Guntur 대한구강악안면외과학회 2019 대한구강악안면외과학회지 Vol.45 No.1
Objectives: Various bone graft substitute materials are used to enhance bone regeneration in the maxillofacial skeleton. In the recent past, synthetic graft materials have been produced using various synthetic and natural calcium precursors. Very recently, eggshell-derived hydroxyapatite (EHA) has been evaluated as a synthetic bone graft substitute. To assess bone regeneration using EHA in cystic and/or apicectomy defects of the jaws through clinical and radiographic evaluations. Materials and Methods: A total of 20 patients were enrolled in the study protocol (CTRI/2014/12/005340) and were followed up at 4, 8, 12, and 24 weeks to assess the amount of osseous fill through digital radiographs/cone-beam computed tomography along with clinical parameters and complications. Wilcoxon matched pairs test, means, percentages and standard deviations were used for the statistical analysis. Results: The sizes of the lesions in the study ranged from 1 to 4 cm and involved one to four teeth. The study showed significant changes in the formation of bone, the merging of material and the surgical site margins from the first week to the first month in all patients (age range, 15-50 years) irrespective of the size of the lesions and the number of teeth involved. Bone formation was statistically significant from the fourth to the eighth week, and the trabecular pattern was observed by the end of 12 weeks with uneventful wound healing. Conclusion: EHA showed enhancement of bone regeneration, and healing was complete by the end of 12 weeks with a trabecular pattern in all patients irrespective of the size of the lesion involved. The study showed enhancement of bone regeneration in the early bone formative stage within 12 weeks after grafting. EHA is cost effective and production is environment friendly with no disease transfer risks. Thus, natural bioceramics will play an important role in the reduction of costs involved in grafting and reconstruction.
( Kwang-woong Lee ),( Suk-won Suh ),( Jaehong Jeong ),( Hyeyoung Kim ),( Nam-joon Yi ),( Kyung-suk Suh Surgery ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: In spite of expansion of indication for advanced hepatocellular carcinoma (HCC), the portal vein tumor thrombosis (PVTT) has been accepted as an absolute contraindication for liver transplantation. However, we experienced unexpectedly good prognosis in selected cases with pre-transplant PVTT. In this study, we tried to identify the prognostic factors after living donor liver transplantation (LDLT) for HCC with major PVTT. Methods: Between January 2009 and December 2013, 282 patients underwent living donor LT (LDLT) for HCC at our institution. Among them, 11 patients (3.9%) with major PVTT diagnosed before transplantation were retrospectively reviewed. Results: The duration of follow-up was more than 2 years in all patients. HCC recurrence occurred in 6 patients (54.5%) after LDLT. One-year, 3-year, and 5-year recurrence-free survival was 63.6%, 42.4%, and 42.4%, respectively. One-year, 3-year, and 5-year overall survival was 72.7%, 63.6%, and 63.6%, respectively. Main PV invasion, high value of multiplication of AFP and PIVKA-II (AP score, ≥ 20,000), large original tumor (> 7cm) were significant risk factors for HCC recurrence after LDLT in pre-transplant major PVTT. There was no recurrence in 5 patients with low AP score (< 2,000). Conclusions: If pre-transplant PVTT is not to exceed main PV and AP score is less than 20,000, we can consider LDLT as a curative treatment option. [figure1]
( Masaru Murata ),( Toshiyuki Akazawa ),( Junichi Hino ),( Junichi Tazaki ),( Katsutoshi Ito ),( Makoto Arisue ),( Maxillofacial Surgery ) 조선대학교 치의학연구원 2011 Oral Biology Research (Oral Biol Res) Vol.35 No.1
The aim of this study was to evaluate the hard tissue-inductive capability by human decalcified dentin matrix (DDM) with or without recombinant human bone morphogenetic protein-2 (BMP-2). Human teeth were crushed, completely decalcified and freeze-dried. We named the material DDM. The shape of DDM was a particle type and its size varied from 0.4 to 0.8 mm. The hard tissue induction by 70 mg of DDM was estimated histologically in the nude mice subcutaneous tissue at 4 weeks after implantation. The DDM alone induced bone and cartilage, independently, in the back skin. In addition, the time-course of bone induction by BMP-2 (5.0 μg)/DDM (70 mg) was analyzed in the rat subcutaneous tissues. Histological findings showed that the BMP-2/DDM induced bone and marrow between the DDM particles. Calcium content in the BMP-2/DDMinduced tissue was compatible to the histological findings. The morphometric analysis demonstrated that the BMP-2/DDM showed 66.9%, 79.0% in the volume of bone and marrow, and 32.4%, 21.0% in that of DDM at 8, 32 weeks, respectively. These results indicate that human DDM particles are osteo-chondroinductive and absorbable matrics. Human DDM are effective biomaterials of BMP-2 delivering for bone engineering.