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김재찬 중앙대학교 의과대학 의과학연구소 1997 中央醫大誌 Vol.22 No.3
심하게 손상된 안구 표면 질환의 치료는 임상의들이 직면하고 있는 문제로 기존적 치료방법으로는 성공적인 치료가 매우 어려운 질환으로서 치료적 정복을 위한 새로운 시도가 필요하다.
신체검사와 복강경복막외탈장수술 중 선택적 진단적 복강경 검사를 이용한 잠복성 반대측 서혜부 탈장의 발견
김재찬,설지영 대한내시경복강경외과학회 2010 Journal of Minimally Invasive Surgery Vol.13 No.2
Purpose: We determined the rate of an occult contralateral inguinal hernia by conducting only a physical examination for the unilateral inguinal hernia patients who visited our hospital. Methods: One hundred thirty nine patients were prospectively evaluated between September 2009 and October 2010. We divided the patients into 3 groups according to a physical examination of the contralateral inguinal area: Group A (no abnormality), Group B (suspicious) and Group C (definite). We defined Group B and Group C as possible occult bilateral hernia. In Group B, selective diagnostic laparoscopy was performed after the totally extraperitoneal herniorrhaphy was finishedover. We analyzed the rate of detecting a contralateral hernia, the positive predictive value and the accordance rate. Results: Of the 139 patients, the number of patients in Group A, B and C were 113 cases, 4 cases and 22 cases, respectively. The age of the patients ranged from 18~86 years (mean age:57.1), with a male to female ratio was 7:1. Twenty-six patients (18.7%) had possible occult bilateral hernia. For the left inguinal hernia patients, the incidence of contralateral hernia was 18.2% (12/66). For the right inguinal hernia patients,this was 19.2% (14/73). The detection rate of contralateral hernia by physical examination was 14.1% (19/135) and the positive predictive value was 86.4% (19/22). The accordance rate of simultaneous bilateral hernia was 57.9% for the direct hernia patients and it was 26.3% for the indirect patients. There was no recurrence or metachronous contralateral inguinal hernia occurrence. Conclusion: We can discover occult contralateral inguinal hernia by conducting a careful physical examination of the contralateral inguinal area. Conducting a proper physical examination is very important for detecting inguinal hernia.