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강중신,조원현,양한홍 대한혈관외과학회 1991 Vascular Specialist International Vol.7 No.1
From January 1979 to December 1989, a total of 451 arteriovenous fistulas were performed for permanent hemodialysis in patients with chronic renal failure. Among them, 359 cases in 286 patients were followed up until the end of October 1990 and were analysed their early and late complications and patency rate. The average age of all patients was 41.3 years and man to female ratio was 164 to 122. Primarily, the radial artery and the cephalic vein were anastomsed in end-to-side fashion to reduce the venous hypertention and steal syndrome. Fifty one patients needed more than two operations of the fistula due to early or late occlusion. Early failure of arteriovenous fistula was defined as poor function of the fistula by occlusion or insufficient blood flow in the fistula within one month after fistula creation and its rate of our cases was 10.0%. The late complications were developed in 146 cases in 85 patients. The most common late complication, which were developed in 44 cases, was fistula obstruction caused by stenosis or thrombosis. Other complications we experienced were aneurysm at fistula site or repeated venipuncture site in 43 cases, venous hypertention in 18 cases, cellulitis and lymphocele in l4 cases and arterial steal syndrome in 7 cases. Also, the sensory change at hand of fistula site and bleedings and infections in wound were observed. The patency rates of arteriovenous fistulas performed between radial artery and cephalic vein were 83.2% in one year, 77.8% in two years and 68.3% in five years.
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강중신,손수상,박해한 대한소화기학회 1992 대한소화기학회지 Vol.24 No.5
The clinical records of surgical geriatric patients over 70 years of age who were admitted to the surgical department of Keimyung University Hospital (Doing San Medical Center) from january 1981 to December 1990 were reviewed and the following results of statistical analysis was obtained. 1) Surgery was performed in 992' patients over 70 years of age. 2) The sex distribution was 212 males and 180 female, ratio was 1.18:1 (1:0.85). 3) The most common age distribution was 70 to 74 years of age which was 65.05% of the total patients. 4) Benign disease was 72.19% of all patients of which acute appendicitis was the most frequent benign disease Malignant disease was 27.81% of all ad stomach cancer was the most frequent malignant disease. 5) 120 cases (30.61%) had combined diseases, pulmonary disease (35%) was the most frequent combined disease, and the next was cardiovascular disease (30%). 6) General anesthesia was used during surgery on 93.11% of all patients and the most common duration was 1 to 2 hours (41.64?0. 7) Postoperative complications occurred in 92 cases (23.47%). Wound complications (59.78%) were the most common complications and the next was pulmanary (15.22%) and voiding difficulty (15.22%). 8) There were 8 eases of postoperative deaths and the mortality was 2.2%. 9) The length of admission for patients over 70 years off age was most commonly 8 to 14 days and the average length of stay was 20.3 dyas. The results of the clinical studies of aged patients as shown above indicates that age itself is not a contraindication for surgery because of the newly developed medical services. An increase in life span and quality, early diagnosis, arid better and more effective treatment of pre and post operative care and anesthesia produces the same morbidity and mortality as patients in general and makes it possible for us to treat all patients alike.
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An Exprimental Study of Postoperative Intraabdominal Adhesions
이봉우,최봉락,양동휘,김인호,손수상,강중신 啓明大學校 醫科大學 1986 계명의대학술지 Vol.5 No.2
수술후 나타나는 장유착은 적지 않은 빈도를 나타내며 보편화된 개복 수술후 증가된 유착성 장폐색증은 외과영역에서 중요한 문제의 하나로 많은 연구보고가 되고 있으며 유착의 형성은 기계적, 세균학적 및 화학적 외상 즉 복강내 외상이나 손상후의 치유과정의 한단계로 유착이 나타난다고 한다. 장유착의 원인과 이차적인 병태생리학적인 변화에 대한 충분한 이해를 갖고 조기에 적절한 치료를 하면 이병율과 사망율을 감소시킬 수 있는 질환이다. 저자들은 한국산 성숙된 가토를 이용하여 실시한 실험적 연구로써 도끼 60마리를 각 20마리씩 3군으로 나누어 관찰하였다. 즉 모든 토끼는 ether로 open drip마취를 하고 정중선 복별절개로 개복한 후 5.0+ 5.0cm정도의 전벽복막을 점상 출혈이 나타날 때 까지 찰과상을 형성시켜 그 결과를 관찰하였다. 제1군의 20마리는 단지 scratching method만 시행한 control group으로 하고 제2군의 20마리에서는 scratchiing method 후 복강내 polyethylene feeding tube를 넣고 매일 50ㅊㅊ의 생리식염수를 중비하였으며 제3군 20마리에서는 복강투석액인 peritosol solution으로 생리식염수 대신에 매일 50cc씩 복강내에 주입하여 관찰 비교하였다. 모든 토끼들은 개복술 10일후 재 개복하여 복막의 유착과 소장간의 유착정도를 관찰비교하여 다음과 같은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다. Control group에서는 20예중 유착정도가 15예에서 나타나 75%를 나타내었고 생리식염수 투여군에서는 20예중 13예에서 나타나 65%의 유착을 나타내었으며 peritosol군에서는 20예중 9예로서 45%로 감소된 유착양상을 나타내었다. 본 실험에서는 peritosol투여군이 control group이나 생리식염수 투여군보다 실험적 유착상태가 적은 것에 유의를 하였으며 아직 인체에 peritosol세척 시도는 못해 보았지만, 본실험과 같은 효과가 있다면 술후 장유착 예방에 의의가 있을 것으로 사료되어 보고 드리는 바이다.
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장가중,손수상,강중신 啓明大學校 醫科大學 1982 계명의대학술지 Vol.1 No.1
A clinical and statistical study was made on 73 cases of anorectal cancer patients admitted to the Department of surgery. Dong-San Medical Center, Keimyung University from January 1978 to October, 1982. The results were as follows; 1) In anorectal cancer, the ratio between male and female was 1:1.1 and age incidence was most prevalent in the 5th decade, comprising 30.1% of cases. 2) The duration of symtoms prior to admission was 6 months in 61.1%. 3) The frequent symtoms and signs were bloody stool, abdominal pain, tenesmus and weight loss in decreasing order. 4) Location of tumor was most frequent at the midrectum area in 46.5%. 5) Diagnostic procedure was made by rectal examination, sigmidoscopy, barium enema and colonofiberscopy. 6) The treatments prior to this admission were mainly for the benign diseases in 19.2% and hemorroids were the most frequent diagnosis. 7) Rescetability was 86.5% in rectal cancers and 66.6% in anal cancers. 8) The most common histological type of rectal cancer was adenocarcinoma(96.1%) and squamous cell ca. in all the anal lesions. 9) The distant metastsis were found in 27.4% and pelvic organs were the most common sites. 10) Postoperative complications developed in 41.4% of cases and dysuria was the most common (15.7%) and operative mortality was 1.4%.
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