좌골신경손상 흰쥐의 가자미근과 내측비복근 위축에 대한 전기자극 효과

박병림,허우회,유병표,김영우,김대영 대한성형외과학회 1992 Archives of Plastic Surgery Vol.19 No.3

This experimental study includes the effect of intermittent electrical stimulation of the muscle on the atrophic response of peripherally denervated muscles. Rats(Sprague -Dawley, 240-260gm) were subjected to a severance of the sciatic nerve and mechanical properties of contraction including contraction time, half relaxation time and maximum twitch tension, maximum tetanic tension and fatigue index were observed on the slow(soleus m.) and fast(medial gastrocnemius m.) muscles 10days after serverance of the sciatic nerve. Experimental groups were divided into three groups : control group(CONT) immediately after severance of sciatic nerve, denervation group(DN) 10days after severance of sciatic nerve, and denervation plus eletrical stimulation group : (DN-ES) denervation combined with intermittent eletrical stimulation of muscles directly. Optimal frequency of electrical stimulation was 20㎐ for soleus muscle and 40㎐ for medial gastrocnemius muscle under 0.5ms of pulse width and supramaximal intensity. In DN group, muscle weight and mechanincal properties of contraction were significantly decreased compared with the control group. In DN-ES group, however, muscle weight and mechanincal properties were significantly increased compared with the denervation group. These data indicate that intermittent electrical stimulation of muscles may be useful in decreasing the muscle atrophy in peripherally denervated muscles.

국소 전기자극이 백서의 임의형 피부판 생존에 미치는 영향

유병표,김영우,허우회,박병림 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.1

Many experimental studies have demonstrated beneficial effect of electrical field application to various hard and soft tissues. The present study was undertaken to determine if application if application of exogenous electric fields could improve survival rate of random pattern skin flap in rats. 32 Spraque-Dawley rats were divided into 4 groups and caudally based random pattern flaps of 2x8cm in size were elevated in all experimental animals. Silver electrodes were implanted into the fascia to apply the electrical stimulation(-5V, 0.2ms, 20hz) to the skin flap. Electrical stimulation was applied 3 times for 1 hour daily and it was continued to the 5th day. It is concluded that exogenous electrical stimulation shows a possibility of the enhancement of flap survival rates by increasing the rates to 3.2%(P<0.01).

Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells

Young Hoe Hur,Ho Hyun Kim,Jin Shick Seoung,Kyoung Won Seo,Jin Woong Kim,Yong Yeon Jeong,Jae Hyuk Lee,Yang Seok Koh,Jung Chul Kim,Hyun Jong Kim,Chol Kyoon Cho 대한외과학회 2011 Annals of Surgical Treatment and Research(ASRT) Vol.81 No.2

Undifferentiated carcinoma with osteoclast-like giant cells is a rare neoplasm of the exocrine pancreas. Some similar cases have been reported, but the histogenesis of these tumors varies and is controversial. We report here on a case of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. A 77-year old woman presented with abdominal pain and anorexia. Abdominal computed tomography and magnetic resonance imaging showed an approximately 10 × 5 cm highly attenuated mass arising from the tail of the pancreas and invading the spleen and adjacent bowel loop. The initial impression was a malignant endocrine tumor or solid-pseudopapillary tumor of the pancreas. The patient underwent a distal pancreatectomy with splenectomy and left hemicolectomy. The histopathology and immunohistochemistry helped make the diagnosis that of an undifferentiated carcinoma with osteoclast-like giant cells of the pancreas.

Inguinal hernia repair in patients with liver cirrhosis accompanied by ascites

Young Hoe Hur,Jung Chul Kim,Dong Yi Kim,Shin Kon Kim,Chan Yong Park 대한외과학회 2011 Annals of Surgical Treatment and Research(ASRT) Vol.80 No.6

Purpose: We describe the clinical characteristics and assess the outcomes and stability of inguinal hernia repair under local anesthesia for patients with liver cirrhosis accompanied by ascites. Methods: We retrospectively reviewed the medical records of 22 patients with cirrhosis and ascites who underwent mesh plug hernia repair performed by a single surgeon from January 2002 to August 2009, and the clinical characteristics and outcomes of the patients were analyzed. Results: Twenty-two patients were included in the study. Fifteen (68.2%) were Child’s class B and seven (31.8%) were Child’s class C. Hernia repairs were successful without major complications or recurrence in all patients. Minor complications occurred in only three patients, consisting of two hematomas and one case of scrotal swelling. Complications were resolved spontaneously without the need for blood transfusion or reintervention. Thirteen patients died during follow-up (59.1%); eight of these patients died within 1 year after hernia repair. However, there was no 30-day postoperative mortality. Five of the eight patients who died were Child’s class B and the remaining three patients were Child’s class C. Deaths were all related to cirrhotic complications, and there was no operation-related mortality. Conclusion: Inguinal hernia repairs under local anesthesia in patients with cirrhosis accompanied by ascites were performed safely and effectively. Therefore, surgical repair is recommended even in patients with refractory ascites and poor hepatic function to prevent life-threatening complications or severe pain and improve quality of life.

Primary leiomyosarcoma of the pancreas

Young Hoe Hur,Ho Hyun Kim,Eun Kyu Park,Jin Shick Seoung,Jin Woong Kim,정용연,이재혁,고양석,김정철,김현종,조철균 대한외과학회 2011 Annals of Surgical Treatment and Research(ASRT) Vol.81 No.6

Primary sarcomas of the pancreas are extremely rare, accounting for 0.1% of malignant pancreatic (non-islet) neoplasms. Pancreatic leiomyosarcoma is a highly aggressive malignancy that spreads in a similar manner to gastric leiomyosarcoma, i.e., by adjacent organ invasion, hematogenous spread, and lymph node metastasis. These tumors are large at the time of diagnosis and are usually found at an advanced stage. We report a case of a 70-year-old female with intermittent right upper quadrant abdominal discomfort. Radiological, histopathological, and immunohistochemical studies revealed the tumor to be a primary leiomyosarcoma of the pancreas. Herein, we describe a patient with a primary leiomyosarcoma of the pancreas who presented with clinical and radiological findings indicative of a mass in the pancreatic head.

Left atrial appendage thrombi in stroke patients: detection with two-phase cardiac CT angiography versus transesophageal echocardiography.

Hur, Jin,Kim, Young Jin,Lee, Hye-Jeong,Ha, Jong-Won,Heo, Ji Hoe,Choi, Eui-Young,Shim, Chi-Young,Kim, Tae Hoon,Nam, Ji Eun,Choe, Kyu Ok,Choi, Byoung Wook Radiological Society of North America 2009 Radiology Vol.251 No.3

<P>PURPOSE: To assess the diagnostic accuracy of two-phase 64-section cardiac computed tomographic (CT) angiography for detection of left atrial appendage (LAA) thrombi and differentiation between thrombus and circulatory stasis in patients with stroke, with transesophageal echocardiography (TEE) as the reference standard. MATERIALS AND METHODS: This study was institutional review board approved, and all patients gave written informed consent. Fifty-five consecutive patients (36 men, 19 women; mean age, 61 years) who had recently experienced a stroke, had high-risk factors for thrombus formation, and underwent both two-phase 64-section cardiac CT angiography and TEE up to 5 days apart were examined. Agreement between CT and TEE for detection of thrombus was assessed with kappa statistics. For quantitative analysis, the LAA-ascending aorta attenuation ratio (LAA/AA, in Hounsfield units) was measured on early- and late-phase CT images. The significance of differences in CT attenuation measurements were assessed by using the Student t test. RESULTS: A total of 14 thrombi were detected in the 55 patients at TEE. With TEE as the reference standard, the overall sensitivity, specificity, and positive and negative predictive values of cardiac CT angiography for the detection of thrombus in the LAA were 100% (14 of 14 patients), 98% (40 of 41 patients), 93% (14 of 15 patients), and 100% (40 of 40 patients), respectively. Concordance between cardiac CT angiography and TEE for the detection of thrombus in the LAA was high (overall kappa = 0.953). Mean LAA/AA values were significantly different between thrombus (0.29 HU +/- 0.12 [standard deviation]) and circulatory stasis (0.85 HU +/- 0.12) on late-phase CT images (P < .001). CONCLUSION: Two-phase 64-section cardiac CT angiography is a noninvasive sensitive modality for detecting LAA thrombi and differentiating thrombus from circulatory stasis in stroke patients.</P>

Cystic Lymphangioma of the Pancreas

Young Hoe Hur,Ho Hyun Kim,Eun Kyu Park,Jin Shick Seoung,Yang Seok Koh,Jung Chul Kim,Chul Kyoon Cho,Hyun Jong Kim 한국간담췌외과학회 2010 한국간담췌외과학회 학술대회지 Vol.2010 No.3

Cardiac Computed Tomographic Angiography for Detection of Cardiac Sources of Embolism in Stroke Patients

Hur, Jin,Kim, Young Jin,Lee, Hye-Jeong,Ha, Jong-Won,Heo, Ji Hoe,Choi, Eui-Young,Shim, Chi-Young,Kim, Tae Hoon,Nam, Ji Eun,Choe, Kyu Ok,Choi, Byoung Wook Ovid Technologies Wolters Kluwer -American Heart A 2009 Stroke Vol.40 No.6

<P>BACKGROUND AND PURPOSE: We assessed the diagnostic performance of 2-phase 64-slice cardiac computed tomographic angiography (CCTA) for the detection of a cardiac source of embolism in stroke patients using transesophageal echocardiography (TEE) as the reference standard. METHODS: We selected 137 patients who had experienced a recent episode of stroke and had undergone both 2-phase 64-slice CCTA and TEE within a period of 5 days. A potential cardiac source of embolism detected at both CCTA and TEE was recorded, and echocardiographic findings were categorized into high- and medium-risk sources based on the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification. RESULTS: Of 137 patients, 100 abnormal findings in 91 patients were found on TEE, and 46 patients had no abnormal finding on TEE. The overall sensitivity, specificity, positive predictive value, and negative predictive value of the 64-slice CCTA for detecting cardiac sources of embolism were 89% (95% CI, 82%, 95%), 100% (95% CI, 90%, 100%), 100% (95% CI, 95%, 100%), and 81% (95% CI, 70%, 92%), respectively. TEE detected a total of 47 high-risk sources of embolism, whereas CT detected 44 lesions. For medium-risk sources of cardiac embolic stroke, TEE detected a total of 53 abnormal findings, whereas CT detected 44 abnormal findings. Of 53 lesions, there were 8 false-negative results on CT (5 patent foramen ovale and 3 atrial septal aneurysm). CONCLUSIONS: Two-phase 64-slice CCTA is a noninvasive and useful modality for detecting high-risk cardiac sources of embolism in stroke patients.</P>

Undifferentiated Carcinoma with Osteoclast-like Giant Cells of the Pancreas

Young Hoe Hur,Ho Hyun Kim,Eun Kyu Park,Jin Shick Seoung,Yang Seok Koh,Jung Chul Kim,Chol Kyoon Cho,Hyun Jong Kim 한국간담췌외과학회 2010 한국간담췌외과학회 학술대회지 Vol.2010 No.3

Patent foramen ovale: diagnosis with multidetector CT--comparison with transesophageal echocardiography.

Kim, Young Jin,Hur, Jin,Shim, Chi-Young,Lee, Hye-Jeong,Ha, Jong-Won,Choe, Kyu Ok,Heo, Ji Hoe,Choi, Eui-Young,Choi, Byoung Wook Radiological Society of North America 2009 Radiology Vol.250 No.1

<P>PURPOSE: To evaluate the clinical feasibility and accuracy of 64-section multidetector computed tomography (CT) compared with transesophageal echocardiography (TEE) for diagnosis of a patent foramen ovale (PFO). MATERIALS AND METHODS: Institutional review board approval was obtained for this retrospective study. The study included 152 consecutive stroke patients (mean age, 61.7 years; 98 men, 54 women) who underwent both cardiac multidetector CT and TEE. Electrocardiographically gated cardiac CT was performed with a 64-section CT scanner by using a saline-chaser contrast agent injection technique. A contrast agent jet from the contrast agent-filled left atrium (LA) to the saline-filled right atrium (RA) and channel-like appearance of the interatrial septum (IAS) were evaluated on axial and oblique sagittal CT images. Two-dimensional and Doppler TEE were performed to detect PFO. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT were obtained with TEE as the reference standard. RESULTS: A PFO was present in 26 patients at TEE. On CT images, a left-to-right contrast agent jet toward the inferior vena cava was noted in 21 patients (sensitivity, 73.1%; specificity, 98.4%; PPV, 90.5%; NPV, 94.7%). Channel-like appearance of the IAS was detected in 38 patients (sensitivity, 76.9%; specificity, 85.7%; PPV, 52.6%; NPV, 94.7%). Channel-like appearance of the IAS was noted in all patients who had a contrast agent jet. CONCLUSION: A contrast agent jet from LA to RA toward the inferior vena cava with channel-like appearance of the IAS on CT images confirms the presence of a PFO.</P>