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국소적으로 진행된 상장간막동맥 박리에 스텐트 그라프트 삽입
변승재(Seung Jae Byun) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.78 No.2
Focal aneurysmal change after spontaneous superior mesenteric artery (SMA) dissection has been reported rarely. A stent graft implantation can exclude false lumen and possibly make major abdominal operation avoidable. A 52-year-old male patient was admitted due to abdominal pain for 10 days. A CT scan showed severe narrowing of the true lumen of SMA, approximately a 7 ㎝ segment from the origin, due to compression by the thrombosed false lumen. Five days after admission, abdominal pain aggravated progressively. The follow-up CT revealed focal aneurysmal dilatation of the dissected SMA segment. I report here an endovascular treatment with stent graft implantation for a focal aneurysmal change after SMA dissection.
자석 기어를 활용한 적응형 그리퍼의 2 링크 손가락 설계
변승재(Seung Jae Byun),황면중(Myun Joong Hwang) 대한기계학회 2021 대한기계학회 춘추학술대회 Vol.2021 No.11
This paper proposes a design of two-link finger of an adaptive gripper to stably grasp an object by adapting the characteristics of magnetic gear. Since magnetic gears transmit power in a non-contact manner, even if some driven shafts cannot move due to mechanical limit, when a torque greater than the allowable torque of the magnetic gear is applied, the other drive shafts can rotate. The finger design of an adaptive gripper is proposed to move two links under the driving of a single motor by these characteristics. The mechanism is configured to move the second link only when the object contacts the interior of the first link to adaptively grasp various shaped objects. The proposed design is experimentally evaluated for adaptive grasping on a single-finger model fabricated by 3-D printing.
넙다리-무릎위오금동맥 우회로술에서의 PTFE Graft의 유용성
소병준(Byung Jun So),변승재(Seung Jae Byun) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.6
Purpose: Which graft material is appropriate for the above-knee femoropopliteal (AK fem-pop) bypass has been a controversy. We were to evaluate the usefulness of PTFE graft in AK fem-pop bypass by comparing the results of autogenous vein graft in below-knee femoropopliteal bypass. Methods: This was a retrospective study of data for Fem-Pop bypass from August 1999 to August 2008. The median follow-up was 59.9±27.3 months. The demographic data, patency rate, secondary procedures, and amputation rate were compared, and statistical comparison was performed by Kaplan-Meier method, Log-rank test, and Chi-square test. Results: Seventy-three bypasses were performed in 63 patients: PTFE graft in 48 cases (Group A), autogenous vein in 25 cases (Group B). Sixty-one patients (96.81%) were men. The mean age was 67.3±8.0 years. The indication for surgery was intermittent claudication in 27 cases (37.0%), critical limb in 46 cases (63.0%). The 6-yr primary patency rates were 28.1%; 60.3%, the 6-yr secondary patency rates were 37.2±8.4%, 67.0±14.7% in Group A and Group B, respectively (P<0.05). The number of secondary procedures was 31 and 3, respectively (P<0.05). Major amputation at later periods was not needed in Group B, but there were 9 cases in group A (P<0.05). Conclusion: PTFE graft for above-knee femoropopliteal bypass shows poor long-term patency with a large number of secondary procedures and a higher amputation rate than vein graft in BK Fem-Pop bypass. PTFE graft should be limited to patients with high operative risk, or poor venous graft.
김근영(Keun Young Kim),김승호(Seung Ho Kim),변승재(Seung Jae Byun),권정남(Jung Nam Kwon),소병준(Byung Jun So) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.3
Purpose: Prompt operative management of patients with peripheral artery embolism remains the treatment of choice for this malady. The clinical status of the limb, rather than the elapsed time from the onset of occlusion, was recently determined to be the best predictor of limb salvage. We investigated the clinical features, therapeutic modalities and treatment results of popliteal artery embolism compared with that of ilio-femoral artery embolism. Methods: A retrospective review was carried out for 21 cases that were treated for lower extremity arterial embolism, from March 2000 to June 2006. The patients were classified into two groups; Group A (ilio-femoral artery embolism, n=11) and Group B (popliteal artery embolism, n=10). We analyzed the interval time from the onset of symptoms to starting treatment (the interval time), the degree of limb ischemia, the therapeutic modalities and the treatment results. Results: The average interval time was 16.2±16.9 hours in the total 21 cases; the average interval time for Group A was 7.7±2.9 hours and that for Group B was 25.5±20.9 hours (P<0.05), and the incidence of severe limb ischemia (class IIb according to the SVS/ISCVS reporting standard) was 72.7% vs 20.0%, respectively (P<0.05). For the therapeutic modalities, surgical thromboembolectomy was performed in all cases of Group A and for 3 cases of Group B. Seven cases of Group B received radiologic intervention (3 cases percutaneous aspiration embolectomy only, and 4 cases of additional thrombolytic therapy). Conclusion: This study shows that the interval time for popliteal artery embolism is longer than that for ilio-femoral artery embolism. In other words, it is suggested that the symptomatic progression of popliteal artery embolism is slower than that of ilio-femoral artery embolism. Therefore, we can have more chances for variable therapeutic options such as surgical thromboembolectomy, percutaneous aspiration embolectomy and/or thrombolytic therapy in patients suffering with popliteal artery embolism.
혼합 간세포-담관암 환자에서 담관암에 의한 전이성 소장 천공
강동백(Dong Baek Kang),김승호(Seung Ho Kim),변승재(Seung Jae Byun),오정택(Jung Taek Oh),박원철(Won Cheol Park),김강득(Kang Deuk Kim),조향정(Hyang Jeong Jo),이정균(Jeong Kyun Lee) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.2
Advances in chemotherapy and radiation therapies for malignant tumors have resulted in the identifications of various novel features of intestinal metastasis. The common causes of small bowel metastasis are malignant melanoma and lung cancer, and this has also been rarely reported to uterine cervical cancer, malignant lymphoma of the larynx, malignant lymphoma of soft palate, and hepatocellular carcinoma (HCC). The Combined HCC cholangiocarcinoma (HCC-CC) is a rare primary liver malignancy, and is composed of cells with the histopathological features of both HCC and CC, but metastatic small bowel perforation by CC in a patient with combined HCC-CC has not been reported previously. The authors describe the case of a 51-year-old man with a metastatic small bowel perforation caused by an intrahepatic CC in combined HCC-CC with a review of the literature.
증례 : 신장 ; 신증후군 환자에서 발생한 뇌정맥혈전증 1예
김현정 ( Hyun Jung Kim ),정덕은 ( Duk Eun Jung ),변승재 ( Seung Jae Byun ),이유민 ( Yu Min Lee ),이지은 ( Ji Eun Lee ),안선호 ( Seon Ho Ahn ),송주흥 ( Ju Hung Song ) 대한내과학회 2009 대한내과학회지 Vol.77 No.4
저자들은 두통을 주소로 내원한 미세변화 신증후군 환자에서는 드물게 발생하는 뇌정맥혈전증을 진단하고 항응고 요법을 통해 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 본 환자의 경우 혈전 재발을 예방하기 위하여, 급성기 치료가 종결된 이후에도 단백뇨 감소 및 혈청알부민이 유지될 때까지 항응고제의 지속적 투여가 필요하다. 또한 비만 및 흡연 등의 혈전의 고식적인 위험요소 조절도 동반되어야 할 것이다. 결론적으로 신증후군 환자에서 신경학적 이상을 동반하지 않더라도 두통 및 오심, 구토 등 증세가 발생하는 경우 뇌 혈전증을 고려하여 조기 검사 및 치료가 필요할 것으로 생각된다. Nephrotic syndrome is associated with proteinuria, hypoalbuminemia, edema, hyperlipidemia, and thromboembolic complications. Thromboembolic complications of nephrotic syndrome are common, especially in the renal vein, while cerebral venous thrombosis is a less frequent complication of minimal change nephrotic syndrome. The pathophysiology remains unclear, but various changes in coagulant and anticoagulant factors may be responsible. We report a case of cerebral venous thrombosis associated with nephrotic syndrome. A 19-year-old man was admitted with a headache and nausea. Cerebral thrombosis was diagnosed on brain computed tomography and magnetic resonance imaging. He recovered gradually after treatment with anticoagulants and achieved control of the nephrotic syndrome. A discussion of this case, coupled with a review of the literature, emphasizes that an early diagnosis is essential for anticoagulation therapy and a successful outcome. (Korean J Med 77:517-521, 2009)
임병훈 ( Byung-hun Lim ),이송이 ( Song-i Lee ),임재홍 ( Jae-hong Lim ),오수진 ( Su-jin Oh ),주민수 ( Min-su Chu ),안선호 ( Seon-ho Ahn ),변승재 ( Seung-jae Byun ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.1
Primary dissection of the renal artery is rare. Spontaneous renal artery dissection can be associated with diseases such as medial degeneration, neurofibromatosis, syphilitic arteritis, tuberculosis, polyarteritis nodosa, Marfan syndrome, fibromuscular dysplasia, or Ehlers-Danlos syndrome (EDS). Among these causes, EDS related renal artery dissection is very rare worldwide and has not been previously reported in Korea. EDS are a group of heritable connective tissue disorders characterized by fragility of the skin and hypermobility of the joints. We describe the case history of a young man who presented with left side flank pain, hypermobility of the hand joints and showed left renal artery dissection on computed tomography and angiography that turned out to be the first complication of vascular type EDS.