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김두상,김경환,안혁,김용진,Kim, Doo-Sang,Kim, Kyung-Hwan,Ahn, Hyuk,Kim, Yong-Jin 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.12
일반적으로 개심술에는 많은 양의 실현이 따르게 마련이고 그 결과로 많은 수혈을 하게 되는데, 응혈 이상증, 과민반응, 급성호흡곤란증 등의 수혈부작용과 간염 및 후천성면역결핍증 등의 질병 감염의 위험성, 그리고 종교적인 이유 등으로 최근들어 동종수혈을 줄이고자 하는 노력이 계속되고 있다. 개심술시 동종수혈에 따른 부작용을 피하기 위해, 동종수혈 없이 자가수혈만으로도 성인개심술이 가능한지 연구하였다. 서울대학교 의과대학 흉부외과학 교실에서는 1996년 1월부터 12월까지 1년 간 자가수혈만으로 개심술을 시행한 실험군 126명과 동종수혈을 시행한 대조군 45명을 대상으로 양군을 비교하였다. 양군 간에 환자의 성별, 대동맥 질환을 제외한 기타 질환, 대동맥수술과정을 제외한 단순 및 복잡수술과정, 평균 대동맥 겸자시간, 수술전 및 수술후 1일째와 7일째 혈색소수치 및 적혈구용적, 수술 전후의 protein 수치와 수술후 albumin 수치, 자가수혈량과 혈장증량제 사용량 등에서는 유의한 차이가 없었으나, 연령, 대동맥질환 및 대동맥수술과정, 평균체외순환시간, 수술 후 회수된 피의 양, 수술직후의 혈색소수치와 적혈구용적, 수술 전 albumin 수치, 그리고 3일간 흉관으로 배액된 양에 있어 차이가 있었다. 본 연구를 통해 동종수혈 없이 자가수혈만으로도 큰 차이없이 여러 종류의 성인 개심술을 성공적으로 할 수 있음을 보고한다.
김두상 순천향대학교 순천향의학연구소 2012 Journal of Soonchunhyang Medical Science Vol.18 No.2
We present a case of urinary tract fistula between ureter and intervertebral space that developed spontaneously. A 73-year-old woman with left flank pain and fever was referred to the Soonchunhyang University Cheonan Hospital. Abdominal computed tomography and retrograde pyelography revealed the presence of fistula between left upper ureter and L4-5 intervertebral space after spontaneous ureteral rupture. We performed percutaneous nephrostomy and antegrade a Double-J ureteral stent insertion. Three months later, after removal of the stent, repeat retrograde pyelography showed healed ureter. To our knowledge, we report the first case of fistula between ureter and intervertebral space after spontaneous ureteral rupture, as well as the description of endourologic management, instead of open surgery.
복강경을 이용한 정계정맥류절제술의 유용성, 안전성 및 효과에 관한 연구: 2개 Trocar와 3개 Trocar의 비교
김두상,이창호,전윤수,이남규 순천향대학교 순천향의학연구소 2011 Journal of Soonchunhyang Medical Science Vol.17 No.1
Objective: Varicocelectomy can be accomplished using a variety of approaches, including retroperitoneal, transinguinal, subinguinal or scrotal approach and there are advantage and disadvatage, respectively. The goal of this study is to evaluate the efficacy, safety and effect of the laparoscopic varicocelectomy and compare 2 trocars laparoscopic technique with 3 trocars. Methods: Between March 2003 and December 2007, 46 patients with varicocele were treated using 3 trocars (group A) or 2 trocars (group B) laparoscopic varicocelectomy. Data regarding operative time, time of vein ligation, hospital stay, recurrence rate and complications of each procedure were retrospectively evaluated. Results: Of the 46 patients 39 with left side varicocele constituted the population of the present study; the others, with bilateral varicocele,were excluded. No significant differences were found in terms of mean operative time, mean time of vein ligation, mean hospital stay and morbidity between group A and B. Conclusion: Laparoscopic varicocelectomy is feasible, safety and effective surgical technique. Compared with 3 trocars, 2 trocars laparoscopic varicocelctomy results in similar operative and postoperative outcomes. In addition, it is cost-effective and cosmetic.
김두상,경윤수,우승효,장영섭,김형지 대한배뇨장애요실금학회 2011 International Neurourology Journal Vol.15 No.3
Purpose: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) exhibits variable lower urinary tract symptoms (LUTS). The aim of this study was to evaluate the incidence of LUTS and the efficacy of an anticholinergic agent in young and middle-aged CP/CPPS patients. Methods: Ninety-six men with CP/CPPS were randomly assigned in a single-blind fashion and received either ciprofloxacin (group 1, 49 patients) or ciprofloxacin and solifenacin (5 mg/day; group 2, 47 patients) for 8 weeks. The National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), the International Prostate Symptom Score (IPSS), and the International Index of Erectile Function-5 (IIEF-5) were used to grade the patients’ symptoms and the quality of life impact at the start of the study, and at 4 and 8 weeks from the initiation of the study. Results: There was no significant difference between groups 1 and 2 with respect to age, duration of disease, or sub-domains of the IPSS, NIH-CPSI, or IIEF-5 at baseline. Of these patients, 67.4% had LUTS. Statistically significant differences were determined via the NIH-CPSI for total score and the pain and urinary domain scores. Statistically significant differences were determined via the IPSS for total score and the storage domain score. The total score of the IIEF-5 increased, but the change was not significant. There was no statistically significant difference in residual urine. Conclusions: Many CP/CPPS patients had LUTS. Solifenacin in CP/CPPS demonstrated improvements in the NIH-CPSI and the IPSS total score and storage score. Storage factors significantly improved via the NIH-CPSI and IPSS assessments in the solifenacin treatment group.
김두상,안혁,Kim, Doo-Sang,Ahn, Hyuk 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery (J Chest Surg) Vol.31 No.2
28세 여자환자가 임신중 발생한 급성 A 형 대동맥 박리증으로 응급제왕 절개술을 시행하여 아이를 분만하고 곧바로 응급 상행 및 전대동맥궁 치환술을 시행받아 별 문제없이 퇴원하였다가 수술후 1년 6개월 뒤에 만성 대동맥 박리증에 의한 하행 대동맥 및 복부 대동맥류가 재발하여 하행 대동맥으로부터 복부 대동맥을 거쳐 양쪽 총장골동맥까지 치환하는 수술을 시행하여 결국 대동맥 전장을 치환하여 이를 문헌 고찰과 함께 보고한다. A 28 years old pregnant woman(Gestational age 35 weeks) had been operated emergency Cesarian section for delivery and emergency graft replacement of ascending aorta and total arch for acute type A aortic dissection. 1 year and 6 months later, she underwent aortic graft replacement from descending thoracic aorta to both common iliac arteries because of further progression of aortic dissection. So far she has a complete artificial graft aorta.