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RISS 인기검색어
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- 저자 : 우병완(Byung Wan Woo) (검색결과 5 건)
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이인영 ( In Young Lee ),우병완 ( Byung Wan Woo ) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5
N/A The surgical management of intrahepatic stones is problematic because of difficulty not only in finding and removing of all stones, but in relieving of accompanying biliary strictures. This study was performed to evalute the prognostic significance of various operation methods, especially that of the stone basket removal. From Jan. 1987 through Dec. 1991, 68 cases with intrahepatic stones had underwent operation were reviewed. Percutaneous stone removal procedure was done in 26 cases. The result. were as follows, Of all 244 choledochotomy cases, the incidence of intrahepatic stones was 27.8%, it was most frequent occured 4th to 7th decade and female was more commonly affected by the ratio 1:1.8. The accuracies of each diagnostic methods were 71%(USG), 80%(T), 82.3%(ERCP), and 100%(PTC/PTBD). L-type was most common (57.3%) and LR type(23.5%), R type(19.2%) were followed in decreasing order of frequency. I, IE, IE and IE type were occupied in 75%., 14.7%, 7.3%, 3.0%. respectively. Operation methods used were performed by the one of the followings; drainage procedures (with or without hepatic resection), choledochotomy and T-tube drainage (with or without hepatic resection). we preferred the methods of choledochotomy and T-tube drainage without hepatic resection. Overall operative mortality rate was 4.4%, three were died of sepsis, cardiac arrythmia, and lung cancer, respectively. Since 1990, percutaneous extractions of residual biliary tract stones through T-tube tract were performed in 26 cases. Success rate was 88.5%. The prognosis was more favorable in 1990-91 operation group (good and fair 76.1%, poor 12%) than in 1987-89 operation group (good and fair 62. 2%, poor 6.7%) Conclusively, the above results proved the effect of percutaneous extraction of residual biliary tract stones.
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원형섭,김상은,배성만,박철완,이 근,조상훈,김상일,우병완 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1
Extremity vascular trauma is common in most emergency centers, and controversy remains about the optimal management of arterial injuries. Retrospectively we reviewed the records of 23 patients who had upper or lower extremity arterial trauma from July 1994 to December 1995. The purpose of this study was to evaluate our department`s management policy to major arterial injuries. The leading cause of major arterial injuries was penetrating trauma. We found that there were clinical findings such as absence of or decreased strength of pulsation(82.6%), cool ischemic extremity(69.6%), large expanding hematoma(43.5%), major bleeding(17.4%) and bruit or thill(8.7%). We gave the priority to management of life-threatening injuries and applied the pressure dressing to wounds as early as possible. There were 18 men(78.3%) and 5 women(21.7%); the mean age was 35(range 20-56 years old) years. There were 12 arterial injuries(52.2%) in the upper extremity and 11 arterial injuries(47.8%) in the lower exteremity. The most commonly injured artery was the brachial artery in the upper(34.8%) and the femoral artery in the lower(30.4%) extremity. The etiology included knife stabbing in 10 patients(43.5%), motor vehicle accidents in 6(26.1%), industrial accidents in 4(17.4%), falls in 2(8.7%) and a farm equipment accident in 1 patient(4.3%). The associated injuries were muscle injuries(78.3%), fracture(56.5%), nerve injuries(52.2%), vein injuries(43.5%), shock(17.4%) and dislocation(13.0%). All patients with arterial injuries were given a preoperative prophylactic antibiotic and TIG(tetanus immunoglobulin). We used Doppler technique as a means of detecting the blood flow. Fourteen patients(60.9%) underwent preoperative arteriography in the radiology department. We performed surgical exploration as soon as major arterial injuries were suspected. The most common methods of treating major arterial injuries were interposition vein graft(69.6%) and end to end anastomosis(21.7%). Systemic or locally infused heparin was used for all vascular repairs. In many of our patients(56.5%), fasciotomy was performed before the vascular repair, as a part of the exploration of the distal arteries. There were 2 amputations(8.7%) but no death. The reason for secondary amputation were wound infection in one and failure to achieve sufficient arterial flow to the involved extremity with resulting gangrene in the other. As the time factor is vitally important in the management of arterial injuries, we advocate prompt and early surgical treatment within 6 hours of the trauma. In conclusion, we believe that the crucial factorsin successful management of major arterial injuries of the extremities are early diagnosis, prompt treatment, complete debridement, fasciotomy when indicated, and simultaneous treatment of concomitant injuries.
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한인수,이홍규,박혜영,강문호,김종호,김종유,신언수,장환준,박흠례,우병완 대한내과학회 1995 대한내과학회지 Vol.48 No.1
Cavernous hemangiomas of the adrenal gland are rare, and no cases of them seem to have been reported in Korea. We report a case of adrenal hemangioma which was incidentally found in a patient with rectal cancer. The clinical presentation, rediographic characteristic, and management are also reviewed. Although rare, a hemangima should be considered in the differential diagnosis of a adrenal neoplasm.
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