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RISS 인기검색어
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- 저자 : 박윤철(Yun Chul Park) (검색결과 12 건)
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양측 액와 유방 접근 내시경 갑상선 절제술에 대한 5년간의 분석
박윤철(Yun Chul Park),유영재(Young Jae Ryu),조진성(Jin Seong Cho),윤정한(Jung Han Yoon),박민호(Min Ho Park) 대한갑상선-내분비외과학회 2015 The Koreran journal of Endocrine Surgery Vol.15 No.2
Purpose: We investigated the efficacy and safety of endoscopic thyroidectomy using bilateral axillo-breast approach (BABA) by analyzing short term surgical outcomes. Methods: We retrospectively evaluated 355 patients who underwent BABA endoscopic thyroidectomy between August 2006 and December 2011 at Chonnam National University Hospital and Hwasun Chonnam National University Hospital. The age, sex, clinical and pathologic characteristics of tumors, extent of operation, conversion rate to open thyroidectomy, operation time, hospital stay, thyroglobulin levels after thyroidectomy, recurrence, and complications were analyzed retrospectively. Results: The mean age of the patients was 35 years. The 355 patients comprised 345 females (97.2%) and 10 males (2.8%). The benign tumor was 37 cases (10.4%) and the malignant tumor was 318 cases (89.6%). 28 patients (75.7%) of the benign tumor underwent lobectomy. In malignant tumor, 159 patients (50.0%) underwent lobectomy and 152 patients (47.8%) underwent total thyroidectomy. Mean operation time was 121.1±49.9 minutes, and mean hospital days were 3.4±1.1 days. 21 (6.0%) transient hypocalcemia and 7 (2.0%) permanent hypocalcemia were occurred. The transient voice change occurred in 5 patients (1.4%), but nobody suffered from the permanent recurrent laryngeal nerve injury. 4 patients of recurrent (1.3%) papillary thyroid carcinoma were treated by surgery. Conclusion: Compare to open thyroidectomy with long term follow up studies, BABA endoscopic thyroidectomy is a useful treatment option for both benign and malignant thyroid tumor.
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박윤철(Yun Chul Park),정재성(Jae Sung Jeong),정종길(Jong Gil Jeong),이창진(Chang Jin Lee) 한국간담췌외과학회 2011 한국간담췌외과학회지 Vol.15 No.1
Purpose: For choledocholithiasis, many doctors routinely use ERCP/EST to avoid the need for common bile duct exploration. But, ERCP/EST has some weakpoints. So it may not be a first choice for management, especially in secondary hospitals. Therefore, we investigated and reviewed results of LCBDE as a first treatment for common bile duct stones. Methods: This study was a retrospective analysis of 60 cases that could be reviewed by their medical charts and who underwent LCBDE performed by the same surgeon at the Yeosu Chonnam Hospital between March, 1996 and August, 2009. The clinical data were compared between each two groups (1996∼1999 vs 2000∼2009 years, primary closure vs T tube drainage). Results: Between groups A and B, there were no significant differences in preoperative status of the patient except for age (60.5 vs 72.6). The average operative time was decreased in group B (171.6 mins vs 143.0 mins) and the number of trocars was decreased in group B (4 vs 3.2). There were 13 postoperative complications. Among them, 11 were cases of bile leakage. All of the bile leakage cases were in group B. And there were more bile leakages in the primary repair group than in T tube drainage group (50% vs 8.9%). But, 10 cases of bile leakage were improved completely by observation and conservative treatment. Conclusion: LCBDE is a safe and useful treatment that has several advantages and can overcome problems not solved by ERCP. Fatal complications were not increased in the primary repair group compared with the T tube drainage group.
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박오현 ( Oh Hyun Park,),박윤철 ( Yun Chul Park ),이동규 ( Dong Gyu Lee ),김호현 ( Ho Hyun Kim ),박찬용 ( Chan Yong Park ),김정철 ( Jung Chul Kim ) 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.3
Purpose: Abdominal trauma rarely causes injuries involving duodenum. But, it is associated with higher rate of the complication and mortality than other abdominal injuries. There are many options for the management of duodenal injuries. Herein we are to review our experiences and find out the risk factors related to the morbidity and the mortality in traumatic duodenal injuries. Methods: The medical records of total 25 patients who managed by surgical managements and survive more than 48 hours were conducted from January 2006 to December 2012. The clinical characteristics, treatments, and outcomes are reviewed. Results: Among 25 patients, most of them (n=17, 68.0%) were managed by the pyloric exclusion and the gastrojejunostomy. The 3rd portion is the most injured site (n=15, 60.0%), and the majority exhibited grade 2 severity (n=14, 56.0%). Most of patients had blunt abdominal traumas (n=23, 92.0%) so that many of them (n=14, 56.0%) had other combined abdominal injuries. The mean ISS is 11.5±6.2. The surgery related mortality rate was 28.0%. There was no statistical significance between each factors and the mortality except leakage (p=0.012). But, we could find some trends about traumatic duodenal injuries in this study. The mortality rates of them who older than 55 years were higher than others. And, all 3 patients who delayed the operation more than 24 hours after the trauma had some complications or died. Also, the patients who had the 2nd portion injury, grade 3 injury, or combined abdominal injury were less survived. Conclusion: Duodenal injury is related to high rate of morbidity(47.8%) and mortality(28.0%). Age, portion of injury, OIS grade, ISS>15, combined intra-abdominal operation, and trauma to operation time over 24 hrs have some trend with attribution to mortality. Especially leakage of duodenal injury is related to mortality.
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건설공사 품질관리비용의 구성요소 및 현실화를 위한 계상방법에 대한 고찰
박형근,박윤철,Park, Kyeong-Geun,Park, Yun-Chul 한국건설관리학회 2011 한국건설관리학회 논문집 Vol.12 No.3
건설기술관리법에 의하여 발주자는 수급자에게 품질관리비용을 계상하여야 한다. 품질관리비용은 건설현장에서의 수급자가 품질확보를 위하여 수행하는 품질관리활동에 소요되는 비용을 말하며, 안전관리비, 환경보전비와 같이 별도의 항목으로 계상하도록 정하고 있다. 그러나 품질확보를 위한 업무는 수급자의 의무사항이며, 공사비에는 품질관리비용이 이미 포함되어 있으므로 중복 계상할 수 없다는 발주자의 입장과 품질시험관리인의 인건비는 간접노무비에 포함되어 있다는 회계예규의 조항 등으로 인하여 품질관리비용이 아직 현실화되지 못하고 있다. 과거 수차례에 걸쳐 조사한 결과에 의하면 총공사비의 약 0.2%가 품질관리비용으로 계상되고 있는 바, 이 비용 규모는 현실적이지 못하다는 수급자의 주장을 고려하여 품질관리비용의 정의 및 내용에 대하여 관련자료를 토대로 고찰하고 품질관리비용 현실화와 관련된 제반 문제점을 제시함으로써 품질관리비용 현실화의 토대를 제공하고자 한다. Clients ought to Appropriate the cost of quality management for contractors based on Construction Technology Management Act. The costs of safety management and environment reservation are separately estimated. and the quality management cost is added up to secure the construction quality required on sites. However, the sufficient cost for quality management was not allowed to the contractors, due to the viewpoints of the clients that the quality management should be one of the duties of contractors. In addition, an Account-related legislation enacted a provision of the labor cost of quality management as the one that should be included in the indirect labor cost. From the continuous survey the quality management cost is currently estimated by 0.2% of the total project cost and the contractors protest the portion of the quality management cost is insufficient. Thus, this paper aimed to provide the bases of estimation of the actualized quality management cost considering the viewpoint of contractors.
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김호현 ( Ho Hyun Kim ),박윤철 ( Yun Chul Park ),이동규 ( Dong Kyu Lee ),박찬용 ( Chan Yong Park ),김재훈 ( Jae Hun Kim ),김영대 ( Yeong Dae Kim ),김정철 ( Jung Chul Kim ) 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.2
A duodenal diverticulum is a frequent abnormality that is usually diagnosed incidentally. Clinical manifestations usually mimic those of highly-varied entities. Among the complications of a duodenal diverticulum, perforation is fairly rare; rupture due to blunt trauma is even rarer, and no cases have been reported in Korean literature. We report the case of a 61-year-old male patient who presented with a perforated duodenal diverticulum after a blunt trauma. We also review the existing literature.
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김호현 ( Ho Hyun Kim ),박윤철 ( Yun Chul Park ),이동규 ( Dong Kyu Lee ),박찬용 ( Chan Yong Park ),김재훈 ( Jae Hun Kim ),김영대 ( Yeong Dae Kim ),김정철 ( Jung Chul Kim ) 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.2
A cerebral fat embolism is an uncommon but serious complication of long bone fracture. It can be fatal, and early detection is not easy. Neurologic symptoms are variable, and the clinical diagnosis is difficult. The pathogenesis remains controversial, and several theories have been proposed. Magnetic resonance imaging can detect a cerebral fat embolism with a higher sensitivity than cerebral computed tomography. We report a case of a posttraumatic cerebral fat embolism without pulmonary involvement and review the existing literature.
KCI
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