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수술적 절제술 후 간에 재발한 췌장암에서 항암화학요법과 종양절제술로 완전 관해를 보인 증례
손준혁,이재우,장동기,이상협,류지곤,김용태,Jun Hyuk Son,Jae Woo Lee,Dong Kee Jang,Sang Hyub Lee,Ji Kon Ryu,Yong-Tae Kim 대한소화기암연구학회 2015 Journal of digestive cancer reports Vol.3 No.2
Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.
상부 위장관 대량 출혈을 보인 십이지장의 Dieulafoy 병변
손준혁 ( Jun Hyuk Son ) 대한소화기학회 2024 대한소화기학회지 Vol.83 No.3
Dieulafoy’s lesion is a rare cause of gastrointestinal bleeding, accounting for approximately 1-2% of all cases of gastrointestinal bleeding. Dieulafoy’s lesion usually occurs in the lesser curvature of the stomach within six centimeters of the gastroesophageal junction. On the other hand, extragastric Dieulafoy’s lesions are uncommon. Diagnosing an extragastric Dieulafoy’s lesion by endoscopy can be challenging because of its small size and obscure location. The key elements for an accurate diagnosis include heightened awareness and a careful early endoscopic evaluation following a bleeding episode. Various endoscopic hemostatic techniques can be used for treatment. This paper presents a case of successful hemostasis using argon plasma coagulation for a life-threatening duodenal Dieulafoy’s lesion. (Korean J Gastroenterol 2024;83:119-122)
연령관련 황반변성에서 발생한 황반하출혈에 대한 조직플라스미노겐 활성제 및 가스 주입술의 효과
김종호,손준혁,장우혁,Jong Ho Kim,Jun Hyuk Son,Woo Hyok Chang 대한안과학회 2008 대한안과학회지 Vol.49 No.2
`Purpose: To study the results of intravitreal tissue plasminogen activator (tPA) and expansile gas injection for the treatment of submacular hemorrhage in age-related macular degeneration (AMD). Methods: Eleven consecutive patients (11 eyes) with submacular hemorrhage in AMD were included in this study. All patients were treated with intravitreal injections of tPA and C3F8 gas. Postoperatively, patients' follow-up period were at least 3 months. Outcome measures included early and final visual acuity, age, disc areas of hemorrhage, duration of symptoms, displacement of blood from the fovea, and final macular status. Results: The maximum diameter of the hematoma ranged from 2 to 10 disc diameters. The mean duration of submacular hemorrhage was 7.5 days. Submacular blood was completely displaced in 7 patients (64%) and partially in four (36%). Best postoperative visual acuity improved in 7 eyes; in 6 eyes (55%), the improvement was two or more lines. Final visual acuity improved in 7 eyes (64%), remained stable in 2 eyes (18%), and worsened in 2 eyes (18%). Choroidal neovascularization positioned at subfovea in 7 eyes (64%) and juxtafovea in 4 eyes (36%). No significant difference was found between postoperative visual recovery and these factors. Conclusions: Our findings suggest that intravitreal tPA and expansile gas injection are safe and of useful for displacing hemorrhages secondary to age-related macular degeneration. Final visual acuity was limited by the underlying choroidal neovascularization of AMD.`
개에 의한 안면부 교상 환자에서의 중앙이마피판을 이용한 위·아래눈꺼풀 동시 재건술의 1예
추지희,손준혁,Ji Hee Chu,Jun Hyuk Son 대한안과학회 2012 대한안과학회지 Vol.53 No.4
Purpose: While the principles of eyelid reconstruction are well established, the rapid choice of a method of upper and lower eyelid defect reconstruction is difficult. The authors present a successful case of simultaneous reconstruction of upper and lower eyelid defects with a modified paramedian forehead flap resulting from a dog bite. Case summary: The authors report a case of a 77-year-old woman with total hyphema and extensive skin defects involving the forehead, cheek, and upper and lower eyelid resulting from a dog bite. The wound on the left periorbital area was treated with microimplantation and skin grafts from the left thigh and groin. In the weeks following, sequential failure of the flap and skin graft was observed, and exposed keratitis worsened, resulting in corneal perforation. Evisceration with hydroxyapatite implantation and paramedian forehead flap was performed. After 3 weeks, division of the pedicle, transverse division of the flap, and socket reconstruction were performed. Conclusions: Reconstruction of large, full thickness defects of both upper and lower eyelids with a paramedian forehead flap is associated with a good cosmetic outcome. Paramedian forehead flap should be considered as an effective choice for simultaneous upper and lower eyelid reconstruction. J Korean Ophthalmol Soc 2012;53(4):582-587
황보성,손준혁,Bo Sung Hwang,M,D,Jun Hyuk Son,M,D 대한안과학회 2007 대한안과학회지 Vol.48 No.8
Purpose: This survey was performed to gather information about the guardians of pediatric oculoplastic patients undergoing certain medical care services in order to recommend improvements in these services. Methods: Questionnaires were distributed to guardians of pediatric oculoplastic patients who were admitted for operations to correct epiblepharon and ptosis. Completed questionnaires, which numberd 100, were then analyzed. Results: The results of this survey show that most guardians were the parents of the patient; most had a level of education higher than or equal to junior college graduation; and most were middle-class. The parents themselves had discovered their children`s disease and had a great influence on the decision to operate. Most parents took an optimistic view of the results of the operation. The higher the guardians` economic status, the more likely he or she believed that both an ophthalmic and a plastic surgeon could perform oculoplastic operations. Many guardians chose an ophthalmic clinic over a plastic surgery clinic because the likelihood of a satisfactory result is higher and because these diseases are related to visual acuity. Half of the guardians knew that there is an oculoplastic clinic at the department of ophthalmology, and many of them gathered information about oculoplastic surgery from the internet. Conclusions: Better explanations about oculoplastic diseases and more education about these diseases should be available to the guardians of patients with these diseases. Systematic publicity for the field of oculoplastic surgery is needed urgently, and the availability of accurate information and specialized medical counseling about these diseases on the internet should be increased.
상품화된 성장인자 제품이 다공성 안와충전물의 섬유혈관화에 미치는 영향
구원모,최준혁,손준혁,Won Mo Gu,Joon Hyuk Choi,Jun Hyuk Son 대한안과학회 2014 대한안과학회지 Vol.55 No.9
Purpose: To investigate the effects of commodified growth factor products used clinically on fibrovascular ingrowth into porous polyethylene orbital implants. Methods: Porous polyethylene orbital implant sheets (Medpor<SUP><FONT size=2>Ⓡ</FONT>) soaked with Nepidermin (Easyef<SUP><FONT size=2>Ⓡ</FONT>), Trafermin (Fiblast<SUP><FONT size=2>Ⓡ</FONT>), and normal saline were implanted into the backs of 18 Sprague-Dawley rats. The degree of fibrovascular ingrowth as observed using a light microscope was compared 1 and 2 weeks after implantation and was calculated as a percentage of the fibrovascular ingrowth length. Results: One week after implantation, the percentage of fibrovascular ingrowth length was 25.33 ± 5.43%, 22.56 ± 5.30%, and 21.78 ± 4.66% in the Easyef<SUP><FONT size=2>Ⓡ</FONT>-, Fiblast<SUP><FONT size=2>Ⓡ</FONT>- and normal saline-soaked groups. The degree of fibrovascularization was higher in the Easyef<SUP><FONT size=2>Ⓡ</FONT>-soaked group than in the other groups (<EM>p</EM> = 0.020, 0.012). Two weeks after implantation, the degree of fibrovascularization was 98.33 ± 5.00%, 100.00 ± 0.00%, and 95.89 ± 4.57%, which was significantly higher in the Easyef<SUP><FONT size=2>Ⓡ</FONT>-, and Fiblast<SUP><FONT size=2>Ⓡ</FONT>-soaked groups than in normal saline-soaked group (<EM>p </EM>= 0.019, <0.001). Conclusions: Commodified growth factor products used in other areas selectively enhanced fibrovascular ingrowth to a greater degree and earlier in ophthalmic plastic and reconstructive surgery. J Korean Ophthalmol Soc 2014;55(9):1366-1371
구병영,김원제,손준혁,Byoung Young Gu,Won Jae Kim,Jun Hyuk Son 대한안과학회 2011 대한안과학회지 Vol.52 No.5
Purpose: To determine the learning curve of dacryocystorhinostomy (DCR) performed by a single oculoplastic surgeon after one year of fellowship training. Methods: This retrospective review study comprised nasolacrimal duct obstruction patients that underwent endonasal DCR at our hospital between February 2006 and February 2008. The patients that completed at least six months of follow-up were included in the analysis. Exclusion criteria were patients less than 20 years of age and NLD obstructions due to malignancy or canalicular obstructions. Success was defined as duct patency on syringing at the final follow-up and no complaints of epiphora. Results: Out of 161 eyes, the overall surgical success rate was 83.2% (134/161 eyes) and the mean postoperative follow-up period was 6.5 months (6-18 months). Success rates gradually increased as follows: 71.2% (37/52 eyes) for the first group, 88.7% (47/53 eyes) for the second group, and 89.3% (50/56 eyes) for the third group (second and third group compared to first group, p = 0.025, p = 0.017, respectively). Conclusions: To ensure high DCR success rates, the novice surgeon should perform at least 50 surgeries. J Korean Ophthalmol Soc 2011;52(5):519-523