Treatment of a Total Obstructive Anastomosis Stricture Using a Transanal Laparoscopic Approach and Intraoperative Colonoscopic Balloon Dilatation

곽재영,양관모,서현일 대한대장항문학회 2020 Annals of Coloproctolgy Vol.36 No.5

An anastomosis stricture with a total obstruction is rare and treatment options are variable. We describe our experience with a combination of a single port transanal laparoscopic approach and intraoperative colonoscopic balloon dilatation. The patient was a 48-year-old man with rectal cancer. A laparoscopic single port lower anterior resection and diverting ileostomy were performed followed by a colon study and ileostomy takedown. The colon study and sigmoidoscopy revealed total obstruction of the rectum at the anastomosis level. We employed a transanal approach using a single port to correct this. We located the anastomosis stricture site and generated a lumen using a dissector and electocautery method to insert the balloon device. Colonoscopic balloon dilatation was subsequently successful. The patient was discharged with no postoperative complications. A laparoscopic single port transanal approach with an intraoperative colonoscopic balloon dilatation is a viable alternative approach to treating an anastomosis stricture of the rectum.

한방병원에서 입원치료를 시행한 중증 아토피피부염 환자의 예후지표 탐색

곽재영,김민희,강민서,박소영,최인화 대한한방안이비인후피부과학회 2018 한방안이비인후피부과학회지 Vol.31 No.4

Objectives : This study was aimed to find significant prognostic factor of inpatients with severe atopic dermatitis (AD) who treated in a Traditional Korean Medicine (TKM) hospital. Methods : A retrospective review of medical records of 39 patients with severe AD who hospitalized for more than 7days was performed. All patients were treated with acupuncture, herbal decoction and herbal wet wrap dressing. Therapeutic effect was assessed by difference of objective SCORing of Atopic Dermatitis index (ΔOSI) at admission and at discharge. Patients were divided into two groups: improvement group (ΔOSI ≤ 5) and no-improvement group (ΔOSI > 5), and clinical characteristics, severity, infectious complication, serum total IgE, eosinophil counts, adherence and concomitant treatment were investigated. Results : There were 7 cases in no-improvement group. There was no significant difference in OSI or infectious complication between the two groups. Also, there was no significant difference in total serum IgE and eosinophil counts, which are known to be related to severity of AD. However, the proportion of adherence group was significantly lower in no-improvement group than improvement group. Conclusions : This study suggest that treatment adherence is a significant prognostic factor for treatment outcome in inpatients with severe atopic dermatitis. If the adherence to treatment is improved, the therapeutic effect of hospitalization would increase in spite of severe AD or infectious complication.

Adjuvant treatment strategy of pathological down-staged patients after radical surgery of locally advanced cervical cancer with neoadjuvant chemotherapy

곽재영,이상훈,노현진,권용순 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

목적: The aim of this study is to evaluate prognosis of patients who have pathologic down-staged locally advanced cervical cancer (LACC) after neoadjuvant chemotherapy (NACT) followed by radical surgery with or without postoperative adjuvant treatment. 방법: Between June 2005 and October 2015, forty-nine patients who had locally advanced cervical cancer (LACC) IB2-IIB were eligible for radical surgery after neoadjuvant chemotherapy (NAC). Fourteen patients of the 49 patients had pathologically down-staged tumor with node-negative, margin- negative, parametria-negative which not had other pathologic risk factors for adjuvant therapy, which size was less than 2.0 cm in maximal diameter, less than a half of cervical full thickness in depth of cervical invasion. Adjuvant therapy was not performed to the nine of the eleven patients, who does not have any risk factors for adjuvant therapy and who does not meet the Sedlis criteria. The other two patient received adjuvant treatment though they had no risk factors the final pathologic report, depending on the initial high stage, before neoadjuvant therapy. Three patient received adjuvant therapy who had have parametrial invasion or LN metastasis. Consequently, total five patient were in the adjuvant group after NAC followed by radical surgery. 결과: The comparison analysis showed no significant difference between the adjuvant treatment group and the no-adjuvant treatment group in the recurrence and survival data (p value=0.23). 결론: Our study suggests that adjuvant therapy of the pathologically down-staged patients who had been performed radical surgery of locally advanced cervical cancer (LACC) followed by neoadjuvant chemotherapy (NACT) should be planned by the postoperative pathologic report not by the initial clinical staging.

전치부 개교환자의 하악 운동에 관한 연구

곽재영,김광남,장익태,Koak Jai-Young,Kim Kwang-Nam,Chang Ik-Tae 대한치과보철학회 1994 대한치과보철학회지 Vol.32 No.2

It is very important for the ideal restorations of anterior openbite patients to record the mandibular movement and to harmonize mandibular movement with other organs in stomatognathic systems. This study was designed to compare the mandibular movement of anterior openbite patients with that of normal bite(Angle Class I) patients, to ascertain which components of mandibular movement have differences between two groups, and to use for occlusal treatment of mandibular movement. Saphon Visi-trainer Model 3(Tokyo Shizaisha Co. Japan) and Denar Pantronic(Denar Corp.,U.S.A.) were used to record mandibular movement. Pantronic survey was peformed by using an arbitrary hinge axis according to manufacturer's direction. Twenty-eight adult who have physiologically normal occlusion(Angle Class I) and are free of TM dysfunction were selected as a control group(Group 1). Fifteen adult who are anterior openbite patient and have not anterior guidance function and have posterior interference at protrusion were selected as a experimental group(Group 2). The results are as follows : 1. There was no statistically significant difference between the average immediate and progressive side shift of anterior openbite patients(0.54mm, $7.57^{\circ}$) and those of normal group(0.49mm, $5.96^{\circ}$). 2. The average protrusive and orbiting condylar inclination of anterior openbite patient$(30.87^{\circ},\;32.27^{\circ})$ were significantly lower than those of normal group$(36.11^{\circ},\;39.04^{\circ})$ (P<0.05). 3. In the results of Visi-trainer recordings, the mean for the maximum protrusion, the maximum laterotrusion, the angle of laterotrusion and the angle of protrusion in the horizontal trajectory between group 1 and 2 did not differ significantly. 4. The mean for the angle of protrusion, the maximum opening in the frontal trajectory, the ICP-RCP(A-P) distance and the angle of protrusion in the sagittal trajectory differ significantly(P<0.05). 5. The significant correlation was found between orbiting condylar inclination and protrusive condylar inclination.

대장 및 직장암의 임상적 고찰

곽재영,박성대,박영관 계명대학교 醫科大學 外科學敎室同門會 1990 남경 박영관 교수 정년퇴임기념 논문집 Vol.S No.-

Since early diagnosis is essential to improve the cure rate for large bowel cancer, a mass screening approach, therefore, is needed for asymptomatic patient, The only practical mass screening method available at present is testing of stoole for blood by Hemoccult slides in patients prepared by high bulk meat free diet. Those found to have occult blood positive are the subjected to diagnostic procedures. suf. ficient to rule out cancer. This paper is a clinical analysis .and review of 138 cases of colon and rectaal cancer who were admitted to Taegu Presbyterian Medical Center from June, 1968. to May, 1978. The results were as fo11ow: 1) The ratio between male and female was 1. 42 : 1 and age incidence was most prevalent in the 6th decades, comprising 32.6% of cases. 2) Location of tumor was most frequent in the rectum, sigmoid colon beingnext. 3) Most frequent sympton was bloody tarry stool, fo11owed by bowel habit change(49.3%) and abdominal pain(46.4%). 4) 44.2% of a11 patients came to hospital (within 3 months) hitory of illnes3. 5) The diagnostic accuracy of colon cancer was 18.7% by sigmoidoscopy and 99.4% by barium enema. 6) The diag-nostic accuracy of rectal cancer was 100% by sigmoidoscopy and 82.6% by barium enema. 7) The most prevalent blood type was type A(38. 6%). 8) The tumors were Dukes' classification A in 2.66%, B, 31. 9%, C, 29.2% and D, 36.3%. 9) The hemorrhoid was the most frequent associated disease in the colorectal cancer patients. 10) Miles’ operation was most frequent operation used(38.9%), and colostomy was perfo-rmed in 19.5 % of cases. 11) The most common type of cancer was adenocarcinoma(96.5%) in a11 patients. 12) Complication developed in 37.3% of cases, wound infection was the most common (I4.4%), and operative mortality was 5.3%.

콤팩트 형광램프용 Dimming형 전자식 안정기의 회로정수 결정

곽재영,송상빈,여인선 한국조명전기설비학회 1995 조명.전기설비 Vol.9 No.2

본 논문에서는 콤팩트 형광램프용 Dimming형 전자식 안정기의 설계에 있어서, 인버터 공진탱크의 커패시턴스값을 변화시킬 때 전압이득곡선을 분석하여 최적의 회로정수를 결정하는 방법을 제안하였다. 또한 하프브리지 인버터회로의 회로정수에 대한 PSpice 시뮬레이션을 행하여 램프전압과 전류값을 구하였고, 실제 전자식 안정기를 제가하고 시동특성과 조광특성을 비교분석하였다. 시동특성은 일반 전자식 안정기와 거의 동일하였으며, 조광특성은 전체 광출력의 5%까지 안정동작되어, 제안된 방법이 뛰어남을 확인하였다.

마이크로 컨트롤러를 이용한 가변출력형 전자식 안정기의 설계 및 제어

곽재영,여인선 한국조명전기설비학회 1997 조명.전기설비 Vol.11 No.4

이 논문에서는 형광램프용 가변출력형의 전자식 안정기의 설계방법 및 제어방법을 제안하였다. 마이크로 컨트롤러를 이용한 인버터회로의 주파수제어의 의하여 여러 가지 출력의 형광램프를 점등시킬 수 있는 시제품을 제작하였다. 이 가변출력형 전자식 안정기는 정류회로, 인버터회로, 그리고 여러 가지 출력의 램프에 이용되는 최적의 주파수를 결정하는 주파수 제어회로로 구성되어 있다. 제안된 설계방법의 적합성을 증명하기 의해 11[W], 15[W] 콤팩트 형광램프와 20[W] 형광램프에 적용하여 가변출력형 전자식 안정기의 시제품을 제작하였다. 램프의 전압과 전류를 관찰한 결과, PSpice 시뮬레이션 결과와 거의 일치하였다. 또한 발광효율은 다른 전자식 안정기와 거의 동일하였다. 그러므로 제안된 가변출력형 전자식 안정기의 설계 및 제어방법이 타당함을 입증하였다. This paper proposes a new approach for the design of a multi-output electronic ballast for fluorescent lamps of different outputs and control method. At first, a standard-output electronic ballast is constructed and then fluorescent lamps with different outputs are lighted by the frequency control of inverter circuit using MeV. This multi-output electronic ballast consists of a rectifier circuit, an inverter circuit, and a frequency control circuit to determine the optimal frequency for the lamps of different output. In order to verify the proposed design method, a prototype of a multi-output electronic ballast for 11 [WJ. 15[WJ compact fluorescent lamps and 20W fluorescent lamp is constructed. Results of observing the voltage and current characteristics of lamps are in accord with those of PSpice simulation. Also its efficacy is nearly the same as the other electronic ballasts. From the result, therefore, validity of the proposed design method of a multi-output electronic ballast for fluorescent lamps is verified.

telescope형 및 Clasp형 유지장치를 이용한 국소의치 지지조직의 응력분포에 관한 삼차원 유한요소법적 연구

곽재영,김광남,장익태,허성주,Koak, Jai-Young,Kim, Kwang-Nam,Chang, Ik-Tae,Heo, Seong-Joo 대한치과보철학회 1999 대한치과보철학회지 Vol.37 No.1

The purpose of this study was to compare and evaluate the stress distribution and displacement developed in the abutment teeth and residual ridge area by madibular unilateral distal extension removable partial denture with 2 different retainer designs. The retainers on right and left canine and right 2nd molar were Alters clasp in one model and telescopic crown in the other model. The stress distribution of abutment teeth and residual ridge area on two model were compared and analyzed with 3-dimensional finite element method. 150N and 400N forces were applied vertically, 30 degree and horizontally on the central fossa area of left 1st molar of the removable partial denture, and then stress distribution patterns were analyzed and compared. The results were as follows 1. As the magnitude and angulation of applied force were increased, the magnitude of stress on the right and central residual ridge area and the right canine of the telescopic type increased and comparing to those of the Alters clasp type. 2. As the magnitude and angulation of applied force were increased, the mesial direction of displacement on the right residual ridge area and the right tooth of the telescopic type increased and the distal direction of displacement on left residual ridge area and the left canine increased comparing to those of Akers clasp type. 3. As the vertical force was applied, the distal direction of the displacement of the right tooth were greater and that of the left canine was smaller and the upward displacement of the right canine was greater in telescopic partial denture than those of Akers clasp type. 4. As the 30 degree force was applied, the mesial direction of the displacement of the right tooth were greater and the distal direction of the displacement of the left canine was smaller and the upward displacement of the right canine was greater in telescopic partial denture than those of Akers clasp type. In the horizontal force the results were same in right area tooth but the distal direction of displacement was greater in left canine. 5. In both removable partial dentures, as the magnitude and degree of force were increased, the stress and displacement were increased. The compressive force was dominative than the ten sile force. 6. In both removable partial dentures, the magnitude of stress was greater on mucosal tissue area than that of the alveolar bone area on distal extension residual ridge area but the result was reversed on anterior residual ridge area. The displacement was always greater on mucosal tissue area than that of alveolar bone area.

脂肪組織에 있어서 Glucose-〔U〕-^14C의 脂質에의 編入에 대한 人蔘成分의 影響

郭再濚,曺準承 慶北大學校 醫科大學 1980 慶北醫大誌 Vol.21 No.2

攝食 및 絶食狀態에서 또는 여기에 人蔘을 投與함으로써 脂肪組織에 있어서 glucose의 脂質生合成에의 利用이 어떻게 變動하는 가를 觀察하기 위하여 白蓼根의 methanol 抽出成分을 分離 乾燥하고 이것을 體重 100g當 5㎎ 을 生理的食監水 0.5㎖에 녹여서 쥐에게 4日間 注入하고 對照群에는 같은 量의 食監水만 投與해서 다시 이것들을 正常 攝食群과 24時間 絶食群으로 各各 나누어서 人蓼抽出物 또는 生理的食監水를 마지막 投與한 한 時間 뒤에 體重 100g當 glucose-(U)-^14C 4μC와 carrier로써 D-glucose 100㎎를 法入하고 3時間後에 腹腔內의 脂肪組織을 摘出하여 이의 脂質量과 이에 編入된 glucose의 放射性 炭素量을 測定하였다. 脂肪組織中의 脂質含量은 人蓼投與로써 攝食時에는 뚜렷한 增減이 없었으나 絶食時에 있어서 그 減少를 적게 하였다. 投與한 放射性 glucose는 脂肪組中의 脂質에 활발히 編入되었으며 또한 이것은 絶食狀態나 人蓼投與로써 變動하였다. 卽 放財性 glucose의 脂質에의 編入率은 攝食群에 비하여 絶食群에서 約 1.9倍로 높았으며, 여기에 人蓼을 投與한 攝食群에는 多少 增加의는 傾向이었으나 絶食群에서는 約 1.3倍로 若干 높았었다. 그러나 人蓼을 投與한 編入率은 人蓼을 投興하지 않는 絶食群의 그것에 比하여 約 3分의 1이나 낮은 값이었다. 脂肪組織에서의 이러한 현상들은 血淸脂質에 대해서도 유사한 경향을 나타내었다. To investigate effects of ginseng extract on the incorpcration of glucose-(U)-^14C into lipid of adipose tissue in rats, a methanol extract of the roots of dried ginseng was prepared. The extract was injected into the peritoneal cavity of rats in single daily dose of 5㎎ in 0.5㎖ of saline solution per body weight of 100gm for 4 days, and the control group was injected with 0.5㎖ of saline. The two groups were divided into the feeding and the fasting (24 hours). After one hour following the final administration of ginseng extract and saline respectively, all rats were injected with 4μCi of glucose-(U)-^14C mixed with 100gm of glucose, per body weight of 100gm. Three hours later, the amount of lipid content was checked, and the radioactivity of lipid ^14C was measure with gas flow counter. The lipid content of adipose tissue was not so notable increasing effect in the normal feeding with ginseng. However, under the fasting group, the decreasing rate of lipid content was minimized with ginseng administration. The utilization rate of glucose-(U)-^14C into lipid of adipose tissue showed a slight increase under a normal feeding with ginseng. However, it decreased under fasting with ginseng administration. These effects of ginseng administration in the adipose tissue appeared almost same effects in the rat serum.

아토피피부염 환자에서 중증도 변화에 따른 SCORAD index와 혈청 총 IgE 및 호산구 수의 상관관계

곽재영,김민희,강민서,최인화 대한한방안이비인후피부과학회 2018 한방안이비인후피부과학회지 Vol.31 No.1

Objectives : This study was aimed to evaluate the correlation between changes in disease severity and serum total IgE or eosinophil count in individual patients of atopic dermatitis depending on the change of severity. Methods : We performed a retrospective chart review of 8 cases of atopic dermatitis who underwent blood tests more than five times. Disease severity was assessed by objective SCORing of Atopic Dermatitis index (OSI). Blood tests include serum total IgE, eosinophil counts, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN) and serum creatinine (SCr). In each subject, on the day that the blood test was performed, OSI was also assesed by a same physician. Correlation between OSI and total IgE or eosinophil count was analysed by nonparametric correlation analysis. Results : There was a statistically significant positive correlation between OSI and total IgE in three cases and a positive correlation between OSI and eosinophil count in two cases. In other three cases, there were no significant correlation. There were no cases that OSI correlated with total IgE and eosinophil count at the same time. In all cases, AST, ALT, BUN and SCr were stable. Conclusions : We suggest that total IgE and eosinophil count may reflect the severity of atopic dermatitis differently in individual patients. We also suggest that total IgE and eosinophil counts may be used as biomarkers to predict the severity of atopic dermatitis in some patients depending on the underlying pathology.