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신세포암에서 하대정맥 혈전제거술 중 암색전증 예방을 위한 일시적 하대정맥 내 필터 유치
정희석 외 중앙대학교 의과대학 의과학연구소 2010 中央醫大誌 Vol.35 No.3/4
Patients with renal cell carcinoma (RCC) frequently have tumor thrombus of the renal vein and inferior vena cava (IVC) and the incidence is approximately 4-25%. In case of tumor thrombus invasion in IVC, an active management has been needed, especially radical nephrectomy with thrombectomy. Because the risk of complication such as pulmonary and tumor embolisms is high during manipulation of IVC for tumor isolation at radical nephrectomy, RCC with tumor thrombus into the IVC remains a difficult operative challenge. Placement of a suprarenal "temporary" IVC filter placed at time of radical nephrectomy to eliminate the possiblility of perioperative pulmonary embolus and avoid potential long-term sequelae of a permanent suprarenal IVC filter.
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정희석 외 중앙대학교 의과대학 의과학연구소 2010 中央醫大誌 Vol.35 No.3/4
The traditional classification system (longitudinal vs. transverse) of temporal bone fractures has limited predictability of complications. Recently, some authors reported that the otic capsule classification system (otic capsule-violated vs. -spared) was better for predicting complications of temporal bone fractures. We made a comparison between the two systems. Between January 2002 and May 2008, 43 cases of temporal bone fracture were included in this study. Using the two classification systems we evaluated the incidence of complications such as conductive hearing loss (CHL), sensorineural hearing loss (SNHL), facial nerve (FN) palsy and cerebrospinal fluid (CSF) leakage, etc. With the traditional system, fractures were classified as longitudinal 19 (44%), transverse 12 (28%), and mixed 12 (28%). With the otic capsule system, 35 (81%) were otic capsule sparing and 8 (19%) were violating. With a comparison of the two systems, patients with otic capsule-violating fractures were 1.4 times more likely to have FN palsy, 2.3 times more likely to have CSF leakage. Especially, SNHL in otic capsule-violating fractures was 5.4 times more common than in otic capsule-sparing (p <0.01). Although the traditional system failed to demonstrate clinical predictability in this study, the otic capsule system demonstrated statistically significant predictive power only for SNHL. Thus, it would be better that both traditional and otic capsule classification systems are applied for predicting the complications of the temporal bone fracture.
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