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        복부 둔상 후 발견된 복강동맥 박리 1례

        서윤석 ( Yun Suhk Suh ),김성춘 ( Seong Chun Kim ),라환도 ( Hwan Do Ra ),한호성 ( Ho Seong Han ) 대한외상학회 2006 大韓外傷學會誌 Vol.19 No.2

        We report a case of celiac artery dissection after abdominal blunt trauma. A 29-year-old man visited the emergency room for acute left periumbilical pain after abdominal blunt trauma from his child. Computed tomography showed a wedge-shaped splenic infarction with splenic artery thrombus. He was hospitalized for careful observation, and after two days, follow-up computed tomographic angiography showed a progressed celiac artery dissection that involved common hepatic artery and an increased extent of splenic infarction. He underwent conventional angiography, and a self-expandable stent was placed between the celiac axis and the common hepatic artery. After two days, follow-up computed tomographic angiography showed good hepatic arterial blood flow via the stent and no progression of splenic infarction. After ten days, he was discharged without complications. (J Korean Soc Traumatol 2006;19:196-200)

      • KCI등재

        림프절 전이로 오인된 이물 육아종의 복강경을 이용한 진단

        서윤석(Yun Suhk Suh),박도중(Do Joong Park),김형호(Hyung Ho Kim),한호성(Ho Seong Han),이혁준(Hyuk Joon Lee),양한광(Han Kwang Yang),이건욱(Kuhn Uk Lee) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.3

        We report the case of a postoperative foreign body granuloma, which was misdiagnosed as a metastatic lymph node, but confirmed by laparoscopic removal. A-68-year old man was admitted for the management of a suspected metastatic lymph node. He had undergone a laparoscopy-assisted distal gastrectomy, with simultaneous D2 lymph node dissection and a left adrenalectomy for T1N0M0 early gastric cancer and an adrenal adenoma 8 months previously. Preoperative computed tomography and whole body PET showed a 1.6 ㎝ sized suspected metastatic lymph node between the efferent jejunal loop and pancreas tail. A diagnostic laparoscopy was performed for pathological confirmation. After laparoscopic adhesiolysis, the lesion was localized using laparoscopic ultrasonography, with the mass also removed laparoscopically. Permanent pathology revealed the mass to be a foreign body granuloma, but without malignancy. In cases of suspected local recurrence or lymph node metastasis following radical surgery, a diagnostic laparoscopic procedure could play a role in confirming the recurrence.

      • 국내 대형병원에서 경장 또는 정맥영양 공급을 받은 환자의 임상적 특성 및 임상 경과

        설은미 ( Eunmi Seol ),서윤석 ( Yun-suhk Suh ),주달래 ( Dal Lae Ju ),배혜정 ( Hye Jung Bae ),이혁준 ( Hyuk-joon Lee ) 한국정맥경장영양학회 2016 한국정맥경장영양학회지 Vol.8 No.2

        Purpose: The purposes of this study are to evaluate clinical characteristics of malnourished patients who received nutritional therapy and to compare their clinical courses according to nutritional support team (NST) consultation in tertiary referral hospital in Korea. Methods: From June 2014 to May 2015, 43,954 admitted patients who were more than 18 years old were retrospectively investigated. Characteristics of patients who received enteral nutrition (EN) or parenteral nutrition (PN) for more than 3 days (nutritional therapy group) were compared to the patients without nutritional therapy (control group). In addition, clinical courses according to NST consultation (NST group and non-NST group) were compared through propensity score matching (PSM). Results: EN or PN was applied in 4,599 patients for more than 3 days (nutritional therapy group: 10.5%). For characteristics, there were significant differences between two groups (nutritional therapy group vs. control group) with age, male proportion, body weight, body mass index. All laboratory data at admission were significantly worse in nutritional therapy group. And for clinical courses, there were significant differences in length of stay (LOS), rate of intensive care unit (ICU) admission, LOS in ICU, Acute Physiology and Chronic Health Enquiry (APACHE Ⅱ) score, days of nutritional therapy, mortality rate. NST consultation was made in 39% of nutritional therapy group. Among departments, Thoracic Surgery showed the highest rate of NST consultation (68.5%) otherwise Neurosurgery showed the lowest rate (18.7%). When PSM between NST group vs. non-NST group were made, significant differences was shown only in the rate of ICU admission, EN or PN support days, cholesterol at discharge. Conclusion: In tertiary referral hospital in Korea, more than 10% of patients still needed active nutritional therapy. NST consultation rate varies among departments. We failed to find significant differences between NST group and non-NST group.

      • 위암 수술 후 발생한 문합부 누출에 대한 경장 및 정맥 혼합 영양 지원의 효과

        이경구 ( Kyung Goo Lee ),이혁준 ( Hyuk Joon Lee ),양준영 ( Jun Young Yang ),오승영 ( Seung Young Oh ),서윤석 ( Yun Suhk Suh ),공성호 ( Seong Ho Kong ),양한광 ( Han Kwang Yang ) 한국정맥경장영양학회 2014 한국정맥경장영양학회지 Vol.6 No.3

        Purpose: The effectiveness of enteral nutrition for patients with anastomotic leakage after gastric cancer surgery is controversial. The purpose of this study is to compare effectiveness between combined enteral nutrition with parenteral nutrition (EPN) and total parenteral nutrition (TPN). Methods: Patients who underwent gastric cancer surgery for primary gastric cancer from April 2010 to August 2012 were reviewed. Clinicopathologic characteristics, complication, laboratory tests, and body weight (Bwt) were compared between EPN and PN. Results: Among patients with postoperative leakage within postoperative 1 month (n=43), 13 patients were supported by EPN and 23 patients by TPN. Clinicopathologic characteristics, including preoperative Bwt, body mass index, nutritional status, other complications, and TNM stage were similar. Preoperative serum albumin and Bwt were similar between EPN and TPN. However, after 1 week of nutritional support, albumin at EPN was significantly higher than that of PN (3.52±0.3 and 3.25±0.3; P=0.010). Adjusted by preoperative Bwt, preoperative nutritional status, and difference in Bwt between preoperative and pre-nutritional support period, decrease of Bwt between pre-nutritional support and discharge was significantly less at EPN than at TPN (.4.5±5.4% and .6.3±4.1%; P=0.001). Conclusion: In terms of the maintenance of serum albumin and Bwt during nutritional support, EPN may be a better supportive option than TPN for patients with anastomotic leakage after gastric cancer surgery.

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