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심부정맥 혈전증의 도관유도 혈전용해술 또는 약물기계적 혈전제거술 후에 하대정맥 여과기 제거율과 임상적인 특징
노효근(Hyo Keun No),김중석(Joong Suck Kim),김장용(Jang Yong Kim),김경래(Kyung Rae Kim),신석환(Seok-Hwan Shin),안승익(Seung-Ik Ahn),조영업(Young Up Cho),김세중(Sei Joong Kim),이건영(Keon-Young Lee),허윤석(Yoon-Seok Hur),최선근(Sun Keu 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.6
Purpose: Inferior vena cava (IVC) filter is commonly practiced to prevent pulmonary embolism during endovascular therapy of deep vein thrombosis (EndoDVT). When the thrombus is trapped inside the filter during intervention, its removal is quite challenging. The purpose of this study is to determine retrieval rates of IVC filter after EndoDVT and its characteristics. Methods: Patients who underwent EndoDVT in Inha Unversity Hospital from June 2004 to May 2009 were reviewed retrospectively. Retrievable IVC filter was inserted before EndoDVT. EndoDVT was done by catheter directed thrombolysis or pharmacomechanical thrombectomy using urokinase. IVC filter retrieval was decided according to computed tomography after 2 weeks. Results: 126 patients were treated with EndoDVT. Optease (n=101) and Tulip (n=25) IVC filters were inserted. IVC filters were retrieved in 42.9% (54/126). There was no IVC filter related complication during its insertion and removal. IVC filter was not retrieved in 72 patients. Reasons for its failure include residual thrombosis in IVC filter (n=28), high risk for recurrent DVT (n=34), massive pulmonary embolism (n=8), and death (n=2). Residual thrombus inside IVC filter disappeared in 5 patients during 6-month follow up. Conclusion: IVC filters retrieval rate after EndoDVT was 42.9%. This can be improved by thorough patient follow up and extended retrievability.
급성 담낭염의 진단에 있어서 <SUP>99m</SUP>Tc-Ciprofloxacin 영상의 유용성
김광(Kwang Kim),안승익(Seung-Ik Ahn),최원식(Wonsick Choe),이건영(Keon-Young Lee),최윤미(Yun Mee Choi),조영업(Young Up Cho),최선근(Sun Keun Choi),허윤석(Yoon Seok Hur),김세중(Sei Joong Kim),홍기천(Kee-Chun Hong),신석환(Seok-Hwan Shin 대한외과학회 2006 Annals of Surgical Treatment and Research(ASRT) Vol.70 No.2
최소영(So Young Choi),김세중(Sei Joong Kim),조영업(Young Up Cho),박재영(Jae Young Park),박정미(Jeong Mi Park),주영채(Young Chae Chu),최윤미(Yun Mee Choe),최선근(Sun Keun Choi),허윤석(Yoon Seok Heo),이건영(Keon Young Lee),안승익(Seung 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.5
Purpose: Apocrine carcinoma of the breast is rare and there is confusion about the criteria of its histopathologic diagnosis. The purpose of this study is to investigate the clinical and pathologic characteristics of the disease. Methods: 9 patients diagnosed with apocrine carcinoma or apocrine carcinoma in situ and 1,009 patients diagnosed with non-apocrine carcinoma of the breast from April 1999 to March 2008 were retrospectively analyzed. Results: The mean age of the patients with apocrine carcinoma was 52.3 year. 5 patients (55.6%) among 9 patients with apocrine carcinoma were postmenopausal. There were 2,1 and 6 patients with stage 0, Ⅰ and Ⅱ disease, respectively according the TNM stage. These demographic and clinical differences between the patients with apocrine carcinoma and non-apocrine carcinoma were not significant. Only four patients (44.4%) were preoperatively diagnosed with apocrine carcinoma or apocrine carcinoma in situ. By surgical biopsy, additional 5 patients were diagnosed as apocrine carcinoma. In the immunohistochemical study, Bcl-2 was positive in one (12.5%) of 8 patients. p53 was positive in 4 (44.4%) of 9 patients. Expressions of estrogen and progesterone receptor were positive only in two patients (22.2%) with weakly positive staining. Androgen receptor was positively expressed in all cases (100%) of apocrine carcinoma. Overexpression of c-erb-B2 was detected in four patients. Conclusion: Treatment modality and prognosis of apocrine carcinoma are similar as non-apocrine carcinoma. But its preoperative diagnosis is more difficult than that of non-apocrine carcinoma and it shows different expression of hormone receptor. Further study is needed for the development of new hormonal therapy using androgen.
박재영(Jae-Young Park),김세중(Sei Joong Kim),조영업(Young Up Cho) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.78 No.2
Thyroid hemiagenesis of one lobe of the thyroid is a rare congenital anomaly in which one lobe of the thyroid gland fails to develop. It is more frequently found in women than in men, and absence of the left lobe is more common. The variations of prevalence of the anomaly have been reported to be around 0.05∼0.2%. Patients with thyroid hemiagenesis are usually asymptomatic and discovered incidentally with other pathologic condition such as a benign adenoma, multinodular goiter, hyperthyroidism or carcinomas. We report a 29-year-old woman with an incidentally discovered hemiagenesis of the right thyroid.
악성 종양의 추적 관찰 중 PET-CT에서 발견된 갑상선의 우연종
김중석,최소영,노효근,김세중,김윤정<SUP>1<,SUP>,현인영<SUP>2<,SUP>,김영모<SUP>3<,SUP>,조영업,Joong Suck Kim,M,D,So-young Choi,M,D,Ph,D,Hyo Keun No,M,D,Sei Joong Kim,M,D,Ph,D,Youn Jeong Kim,M,D,Ph,D,<SUP>1<,SUP>,In Young Hyun 대한갑상선-내분비외과학회 2010 The Koreran journal of Endocrine Surgery Vol.10 No.4
Purpose: The incidence of thyroid cancer is increasing in Korea, partially owing to the development of diagnostic tools. Positron emission tomography (PET)-computed tomography (CT), in particular, has generally been used for evaluation of metastasis and follow-up of malignancy. Methods: We retrospectively investigated 2,833 patients with PET-CT for metastasis work-up or cancer follow-up, which was performed between January 1998 and May 2008 at Inha University Hospital. Of them, abnormal thyroid findings were discovered in 181 patients and we studied the result of further evaluation or follow-up PET-CT. Results: Thyroid cancer was diagnosed in 26 patients, including metastatic cancer in 3 patients, and non-operated primary cancer in 2 patients. Other 21 patients received operation, which in all histopathologically revealed papillary carcinoma. The mean age of the 21 patients was 55.4 years. Nine patients had a history of radiotherapy. The site of malignant nodule was discordant between PET-CT and histopathologic result in 6 patients. The mean size of malignant nodules was 9.45 mm (0.1∼23 mm) with microcarcinoma in 10 patients (47.6%). The mean interval between diagnoses was 15.8 months, and in 4 patients operations for two malignancies were performed in a same day. The incidence of thyroid cancer was significantly high in female patients, but the differences of incidence among different cancer groups were not significant for female patients. Conclusion: Early diagnosis of synchronous or secondary thyroid cancer by PET-CT in cancer patients can make early treatment and better strategies for multiple malignancies possible. (Korean J Endocrine Surg 2010;10:249-255)
체질량지수 25 ㎏/㎡ 미만의 2형 당뇨 환자에서 십이지장 공장 우회술의 효과
홍인기(In Ki Hong),김장용(Jang Young Kim),이연지(Yeon Ji Lee),최윤미(Yun-Mee Choe),최선근(Sun Keun Choi),이건영(Keon Young Lee),김세중(Sei-Joong Kim),조영업(Young Up Cho),안승익(Seung Ik Ahn),홍기천(Kee Chun Hong),신석환(Seok Hwan Sh 대한외과학회 2011 Annals of Surgical Treatment and Research(ASRT) Vol.80 No.2
Purpose: Diabetes mellitus refers to one of several risk factors for cardiovascular diseases, renal failure and so on. Medical treatments of T2DM cannot suggest a perfect cure. But gastric bypass resulting in the exclusion of the duodenum and proximal jejunum has been shown to improve or resolve T2DM. The goal of this study is to evaluate the effect of duodenojejunal bypass for T2DM patients below BMI 25 ㎏/㎡ in early postoperative period. Methods: Duodenojejunal bypass was performed on 25 patients at Inha University Hospital from July 2009 to April 2010. We compared 75 g OGTT, insulin, C peptide to those 7 days postoperative. The definitions for improvement are serum glucose level below 200 ㎎/㎗ of 75 g OGTT at 120 min or below 200 ㎎/㎗ at every other time in spite of over 200 ㎎/㎗ at 120 min. Results: A total of 25 patients (15 men and 10 women) were included. Median value BMI was 23.17 ㎏/㎡ and the mean duration of T2DM was 8.3 years. There was a significant decrease of postoperative 75 g OGTT levels from 176, 268, 345, 373, 371 ㎎/㎗ to 125, 170, 200, 225 and 241 ㎎/㎗, respectively (P<0.001). Only patients’ age was an independent factor resolution of T2DM based on this study. Conclusion: Duodenojejunal bypass could be one viable treatment modality for improving or resolving of T2DM although these are early results. This study has preliminary meanings only and the results of longer follow-up and a larger number of patients are necessary, by which we should be able to determine the effect and indications for surgical treatment of T2DM.