http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
송종훈(Jong Hoon Song),김도헌(Do Hern Kim),허준(Jun Hur),전욱(Wook Chun),김종현(Jong Hyun Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.1
Purpose: The most common cause of death in massive burn patients is burn wound sepsis. Therefore we have been using allograft skin for preventing burn wound sepsis. Methods: Included in this study were 71 subjects who had sustained extensive burns from December 2003 through February 2006. 1. Early selective Escharectomy was performed for full thickness burn areas. 2. Allograft skins were grafted on excision area. 3. An autograft was performed for areas with a formation of granulation tissue after the allograft skin had come away. 4. A modified sandwich grafting technique (1:4∼6 meshed autograft with Cultured Epithelial Autografts) was performed in large sized burns. 5. Acellular dermal substitute was concurrently used to prevent burn scar contraction on joint areas. Results: Seventy one subjects were included (Fresh allograft: 9 cases, Cryo-preserved allograft: 42 cases, Glycerol preserved allograft: 20 cases). The average burn area was 41.8 (20∼92) %TBSA (Total Body Surface Area). The mean area of the allograft skin used was 26.9 (8∼70) %TBSA. The grafted allograft skins usually came away 3 weeks later. Four cases of initial take failure were occurred. All of these cases were pediatric patients using cadaver skin. Nine patients were dead from heart failure, severe inhalation, respiratory failure, pneumonia in old age, renal failure etc. There was no definite wound sepsis. Cultured Epithelial Autografts (CEAs) were used in fourteen cases. In twentyfive cases, acellular dermal substitute was simultaneously used. Conclusion: Early selective escharectomy, allograft skin coverage, acellular dermal substitutes and wide meshed autograft with CEA application would be immensely helpful techniques in patients with extensive burns.
우시욱 ( Si Uk Woo ),최규성 ( Gyu Sung Choi ),김도헌 ( Do Hern Kim ),허준 ( Jun Hur ),전욱 ( Wook Chun ),이재정 ( Jae Jung Lee ) 대한외상학회 2003 大韓外傷學會誌 Vol.16 No.2
Background: During the past several decades, advances in burn treatment, including the improvement in fluid ressusitation, the evolvement of antibiotics, and the early excision of the wound, have increased the survival rate of burn patients. How ever sepsis and organ dysfunction are major causes of death after burn trauma. This study focused on finding the demography of burn mortality and the cause of death and on characterizing the time course of severe burn injury. Method: From January 1, 2002, to December 31, 2002, 543 patients were treated at the Burn Unit of General Surgery, Han Gang Sacred Heart Hospital after burn trauma. Among them, 112 patients expired. We reviewed their medical records and analyzed their demography, the cause of death, and the survival period, retrospectively. Results: Among the 112 patient, the cases of death are most common in the male patients aged 40 to 49. The most common cause of burn was flame (94.6%). They expired from sepsis (63.39%), pulmonary complication (13.39%), burn shock (13.39%) and acute renal failure (6.25%). Unill 72 hours after the burn injury, burn shock was the most common cause of death, between the 3rd day and the 7th day, pulmonary complications were the most common cause and after the 7th day, sepsis was. Conclusions: Even nowadays, many burn patients expire from burn shock and sepsis. Rapid transportation to a specialized burn center, judicious fluid ressusitation, wound care for wound healing, and prophylaxis of secondary infection can save more massive-burn victims.
중증 화상 환자의 CRRT 시행 시 임상양상과 적절한 적용기준
변광(Kwang Byun),송종훈(Jong Hoon Song),최규성(Gyu-seong Choi),김도헌(Do Hern Kim),허준(Jun Hur),전욱(Wook Chun),김종현(Jong Hyun Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.1
Purpose: Acute renal failure is not a rare event in severe burns and the prognosis of a burn patient becomes remarkably unfavorable with the onset of renal insufficiency. Several studies have reported that the incidence of ARF in severe burns is 0.5∼30% and the mortality rate is 73∼90%. This study analyzed the clinical features of severe burns requiring continuous renal replacement therapy (CRRT) to determine the adequate indication for CRRT. Methods: Thirty-nine patients requiring CRRT out of 492 burned patients who were admitted to the burn intensive care unit in the Burn center, Hangang Sacred Heart Hospital from January 2003 to December 2004, were reviewed. CRRT was indicated when azotemia, fluid overload, acidosis, or hyperkalemia were observed. The APACHE Ⅱ score, BUN, creatinine, creatine kinase, bicarbonate and base excess were analyzed at admission and at the initiation of CRRT for the survival group and non-survival group. Results: The incidence of ARF requiring CRRT in severely burned patients was 7.9%. The average of burn area was 51.1%. The mean delay in initiating CRRT was 16.6 days and the mean duration of CRRT was 7.0 days. There was no difference between the survival group and the nonsurvival group in the data obtained upon admission, but there was a significant difference in the BUN level at the initiation CRRT. Therefore, the BUN level at the initiation CRRT has corelation with the mortality. Conclusion: CRRT is helpful for treating severely burned patients who have ARF, particularly those with accompanying with hemodynamic instability. This study showed that the BUN level at the initiation of CRRT associated with mortality. Therefore, the BUN level is an important criterion for initiating CRRT in these patients. However, a prospective randomized control study will be needed to accurately define BUN level.
결장 및 직장암에서 Ki- 67 Index의 임상적인 의의
양형태(Hyeong Tae Yang),윤대근(Dae Kun Yoon),장우영(Woo-Young Jang),최규성(Gyu-Seong Choi),강희준(Hee Jun Kang),전성은(Seong Eun Cheon),박성길(Sung Gil Park),김종현(Jong Hyun Kim),전욱(Wook Chun),허준(Jun Hun),김도헌(Do Hern Kim),이 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.4
Purpose: Monoclonal antibody Ki-67 has been employed to evaluate the growth fraction of various tumors. The purpose of this study is to determin the prognostic value of the Ki-67 index for colorectal cancer. Methods: The Ki-67 index was investigated by counting the immunohistochemically stained cells. We described this as the permillage. We reviewed the test results of 36 colorectal cancer patients and we compared the Ki-67 index with other clinical factors. Results: There was no correlation between the Ki-67 index and the other established risk factors, and only the number of invaded lymph nodes and their degree of differentiation were related with the Ki-67 index. Conclusion: The Ki-67 index is an important marker of the growth fraction of tumor. The pattern of tumor growth is determined not only by the growth fraction, so the discovery of other parameters that can reflect tumor growth and the Ki-67 index can help the patients with respect to their prognosis & treatment.