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흉부자상에 의한 심실중격결손 및 승모판 부전증 치험 1예
김범식,조순걸,곽영태,조규석,박주철,유세영 慶熙大學校 1985 論文集 Vol.14 No.-
A 34-year-old man was stabbed with knife in the left fourth intercostal space. He was admitted to Kyung Hee University Hospital Emergency room with Cardiac tamponade state. Through a left anterior thoracotomy, a tense hemopercardium was released. A 2㎝ wound of right ventricle was sutured with 3-0 prolein. Seven month after the injury he was readmitted for cardiac catheterization. Cardiac catheterization confirmed the presence of an interventricular septal defect in the membranous septum with left ventricle to right ventricle shunt. A laceration of the septal leflet of mitral valve was also demonstrated. The pulmonary blood flow as 1.22 times the systemic flow. A longitudinal incision was made on the right atrium on the cardiopulmonary bypass. An 1×0.5㎝ interventricular septal defect was found in the membranous septum. In order to achieve and adequate repair interventricular spetal defect and mitral insufficency. The ventricular septal defect was repaired 3-0 prolein plegeted suture with interrupted. Artifical atrial septal defect was made and the septal leflet defect(1.5㎝) was reattached with 3-0 prolein plegeted suture interrupted. The partient had and uneventful post operative recovery and was discharged the Hospital on the 24day post operative day.
Cho, Bum-Joo,Bang, Chang Seok,Park, Se Woo,Yang, Young Joo,Seo, Seung In,Lim, Hyun,Shin, Woon Geon,Hong, Ji Taek,Yoo, Yong Tak,Hong, Seok Hwan,Choi, Jae Ho,Lee, Jae Jun,Baik, Gwang Ho Georg Thieme Verlag KG 2019 Endoscopy Vol.51 No.12
<B>Abstract</B><P> Background Visual inspection, lesion detection, and differentiation between malignant and benign features are key aspects of an endoscopist’s role. The use of machine learning for the recognition and differentiation of images has been increasingly adopted in clinical practice. This study aimed to establish convolutional neural network (CNN) models to automatically classify gastric neoplasms based on endoscopic images.</P><P> Methods Endoscopic white-light images of pathologically confirmed gastric lesions were collected and classified into five categories: advanced gastric cancer, early gastric cancer, high grade dysplasia, low grade dysplasia, and non-neoplasm. Three pretrained CNN models were fine-tuned using a training dataset. The classifying performance of the models was evaluated using a test dataset and a prospective validation dataset.</P><P> Results A total of 5017 images were collected from 1269 patients, among which 812 images from 212 patients were used as the test dataset. An additional 200 images from 200 patients were collected and used for prospective validation. For the five-category classification, the weighted average accuracy of the Inception-Resnet-v2 model reached 84.6 %. The mean area under the curve (AUC) of the model for differentiating gastric cancer and neoplasm was 0.877 and 0.927, respectively. In prospective validation, the Inception-Resnet-v2 model showed lower performance compared with the endoscopist with the best performance (five-category accuracy 76.4 % vs. 87.6 %; cancer 76.0 % vs. 97.5 %; neoplasm 73.5 % vs. 96.5 %; P < 0.001). However, there was no statistical difference between the Inception-Resnet-v2 model and the endoscopist with the worst performance in the differentiation of gastric cancer (accuracy 76.0 % vs. 82.0 %) and neoplasm (AUC 0.776 vs. 0.865).</P><P> Conclusion The evaluated deep-learning models have the potential for clinical application in classifying gastric cancer or neoplasm on endoscopic white-light images.</P>
( Hyun Bum Park ),( Hyung Chul Park ),( Cho Yun Chung ),( Jong Sun Kim ),( Dae Sung Myung ),( Sung Bum Cho ),( Wan Sik Lee ),( Young Eun Joo ) 대한장연구학회 2014 Intestinal Research Vol.12 No.1
Solitary rectal ulcer syndrome (SRUS) is an uncommon benign disease that is misdiagnosed as malignancy or inflammatory bowel disease because of similarities in clinical and endoscopic manifestations. Furthermore, SRUS with ulcerative colitis (UC) is extremely rare. To date, two cases have been reported in the medical literature. We report an additional case of SRUS with UC that was misdiagnosed as rectal cancer. A 61-year-old man was admitted to our hospital with rectal bleeding. Colonoscopy showed a well-demarcated, shallow, ulcerative lesion with polypoidal growth involving the entire circumference of the rectal lumen. Findings from imaging studies, including abdominal computed tomography (CT) and positron emission tomography (PET)/CT resembled those of rectal cancer. Surgical resection was performed because clinical symptoms persisted despite medical treatment and because occult rectal cancer could not be ruled out. Histopathological examination of the resected specimen revealed fibromuscular obliteration of the lamina propria and crypt abscesses, characteristics compatible with SRUS and UC. (Intest Res 2014;12:70-73)
( Sung Bum Cho ),( Yen Joo Kim ),( Won Hyung Choi ),( Chung Hwan Cheon ),( Ki Hoon Lee ),( Nam Kyu Zang ),( Jin Woong Kim ),( Young Eun Joo ),( Sung Kyu Cho ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-
Background: Liver abscess was very rare but serious complication lead to liver failure and fatal outcomes after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). This study was evaluated to clinical features of TACE related liver abscess and predicting risk factors among HCC patients who developed postembolization syndrome after TACE. Methods: From January 2008 to December 2010, 13 patients of liver abscess which was undergone percutanous drainage developed in 2582 sessions of TACE. There was retrospectively analyzed to clinical features and predicting risk factors of liver abscess compared with control group who was selected 181 patients with fever after TACE. Results: The incidence of liver abscess was 0.5%. The etiologic types were necrosis related abscess (7 cases, 54%), biloma related abscess (4 cases, 31%), indirect abscess (2 cases, 15%). The mean interval time between percutanous drainage and TACE was 51±38 days. The positive culture rate was 69 % (9 cases) and organisms were enterococcus (4), Klebsiella pnemumoniae (2), Escherichia coli (1), Citrobacter (1) and Clostridium difficile (1). Abscess group was more higher peak AST level, peak bilirubin level, single nodular type HCC, Choledocholithiasis, air forming tumoral necrosis than control group. Independent predicting risk factors to abscess was only large air forming tumoral necrosis. The overall mortality rate of abscess was 61%. 6 patients were died caused by directly related to abscess. Conclusions: TACE related liver abscess was fatal infectious complication related to extensive air forming tumoral necrosis. The clinician should be considered to possibility of developing abscess in HCC patient with high risk factors after TACE.