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잡종유아견에서의 복벽근육조작에 의한 복강용적 증대효과에 대한 연구
안우섭 東國大學校 1993 東國論叢 Vol.32 No.-
Primary reduction of the eviscerated visceral bulk present in gastroschisis and large omphalocele can cause elevation of the diaphragm, compression of the vena cava, and pressure on the viscera due to the significant disproportion between extra-abdominal bulk and capacity of the abdominal cavity. A similar discrepancy also exist between the amount of viscera reduced and the space available to accomodate such within the peritoneal cavity following repair of the major diaphragmatic hernia. Many techniques have been suggested as a means of circumventing this loss of intra-abdominal domain for protruding viscera. But none has proved to be the foolproof. The ideal repair is complete primary closure without compressing and compromising the respiratory state, venous return, or intestinal blood supply. I, the author, have applied a new procedure to the abdominal muscles of five puppies with various weights, and measured before and after this proecdure, inferior vena cava pressure and intra-gastric pressure versus air volume of the balloon in the abdominal cavity before and after application of this procedure, respectively. The result is that the capacity of abdominal cavity can be increased by this procedure. So I'd like to introduce this procedure as one method of primary closure of gastroschisis and omphalocele.
안우섭 東國大學校醫學硏究所 2004 東國醫學 Vol.11 No.1
충수 게실염은 1893년에 처음 보고피었다. 병변의 크기가 작아서 주로 육안적 소견 보다는 조직학적으로 진단되며 충수 절제술의 조직 검사에서 약 2%정도로 보고 되고 있다. 명확한 원인은 밝혀져 있지 않으나, 충수 개구부의 폐쇄로 인해 내강 내부의 압력이 증가되어 게실이 발생하는 것으로 알려져 있다. 증상 발생시 염증이 동반되어 충수염과 감별이 어려워 술 후에 조직학적으로 진단된다. 치료는 충수 절제술 외에 다른 치료는 필요하지 않다. 동국 대학 병원에서 충수 게실염이 진단된 42세 여자환자를 치험하여 문헌 고찰과 함께 보고한다. Appendiceal diverticular disease was first described in 1893. It was diagnosed by pathologic fingng rather than gross finding bacause of small size of lesion. It's incidence is about 2% of appendectomy specimen. The definite etiology is not, but after obstruction of opening of appendix, intraluminal pressure is increased and diverticulum is developed. Inflammation is developed in diverticulum. It is difficult to differentiate between appendicitis and appendiceal diverticulitis preoperatively. The treatment is appendectomy and further procedure is not needed.
복벽근조작술에 의한 제탈장과 위벽파열의 치료 : A NEW APPROACH
안우섭 동국대학교 경주대학 1993 東國論集 Vol.12 No.-
The disproportion between extra-abdominal visceral bulk and concomitant expensile capacity of the intra-abdominal volume is the most immediate threat to survival in infants with either a sizable gastroschisis or the large forms of omphalocele. Under these circumstances, the forceful return of eviscerated visceral bulk to their abdominal cavity invites disaster. The extreme increase in intra-abdominal pressure that results not only thrusts the diaphragm upward and, thereby, severely limits ventilatory exchange but also prevents, through compression of the inferior vena cava, free return of venous blood to the heart. Recently auther have a case of a large omphalocele and three cases of gastroschis closed primarily using a procedure increasing the size of the abdominal cavity by the seperation of skin flap, external-and internal-oblique muscles, and transversal muscles with peritoneum, respectively. This procedure was obtained after five small puppy(Mean age ; 5 days, mean weight ; 2.0kg) were used for the animal experiment. I belive that this proceure can accomplish the primary closure of the gastroschisis, omphalocele or major disphragmatic hernia ; with disolving the some degree of disproportion between the size of the eviscerated visceral bulk and the size of the abdominal cavity ; with rare necessary for ventilatory support and elimination of infectious or other complications those can be occurred by other procedures.
Interleukin-2를 이용한 진행성 위장관암의 비장을 경유한 자가 LAK Cell의 면역학적 반응
안우섭,강중신,김인호,전석길,손수상 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3
To elucidate the anticancer effect by observing the effect of LAK cells after infusion of IL-2 through splenic artery for the advanced gastrointestinal cancer, randomized study was performed for the 8 patients who had liver metastasis from gastic and rectal cancer. 4 patients were performed subtotal gastrectomy for stomach cancer and the others were done abdominoperineal resections for rectal cancer. The liver metastasis were noted all of the cases after surgery between October 1989 and December 1992 at the Department of Surgery, Keimyung University School of Medicine. After confirmation of the hepatic metastasis from gastorintestinal cancer, we performed selective splenic arterial infusin of IL-2 with the dosage of 20,000 units/kg B.W. We checked the immune function pre-and post-IL2 infusion therapy, such as total lymphocyte count, T-cell percentage and CMI multitest with blood count and hepatorenal function. There was no difference between the pre-and post IL-2 infusion in the hemoglobin, serum protein, albumin, BUN and creatinin. The total lymphocyte counts of pre-and post IL-2 infusion were 1641.2 and 1727.4, respectively. The T cell percentage of pre-and infusion were 62.51% and 64.27%, respectively and had the tendency to increase in comparison with pre-IL-2 infusion, but there were not stastical differences. The results of CML muiltitest of pre-and post IL-2 infusion were not definite differences. From the above results, it could be suggested that LAK cell after infusion of IL-2 via selective splenc artery had the slightly positive effect of the immune function of advanced gastrointestinal cancer patient, with hepatic metastasis.