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하대정맥 손상후 일차봉합술로 인해 발생한 버드-키아리 증후군 환자를 혈관성형술로 치료한 증례보고
심주현 ( Joo Hyun Sim ),원제환 ( Je Hwan Won ),정경원 ( Kyoung Won Jung ),이국종 ( Cook John Lee ),김영환 ( Young Hwan Kim ) 대한외상학회 2014 大韓外傷學會誌 Vol.27 No.4
Budd-Chiari syndrome is an uncommon condition characterized by hepatic outflow obstruction. Direct suture of the injured Inferior vena cava in a patient with blunt hepatic trauma also may cause an equivalent condition. However, early diagnosis is possible with common symptoms and radiologic evaluation. Moreover, a transluminal approach with balloon angioplasty could prevent long-term complications of Budd-Chiari syndrome without repeated abdominal surgery. [ J Trauma Inj 2014; 27: 196-200 ]
증례 : 신장 ; 다낭성 신 질환 환자에서 경피적 신동맥 색전술의 효과에 대한 다섯 증례
임기현 ( Ki Hyun Lim ),김주성 ( Joo Sung Kim ),이길호 ( Gil Ho Lee ),원제환 ( Je Hwan Won ),신규태 ( Gyu Tae Shin ),김흥수 ( Heung Soo Kim ),박인휘 ( In Whee Park ) 대한내과학회 2015 대한내과학회지 Vol.88 No.4
혈액 투석을 받고 있는 상염색체 우성 다낭성 신 질환 환자에서 에탄올을 이용한 신동맥 색전술은 신장 크기 증가로 인한 복부 팽만, 복통 등의 증상 완화에 비교적 안전하고 효과적인 치료 방법으로 생각되며 이전에 시행하였던 수술적 제거술, 경화 요법, 감압법 등을 대체할 수 있는 효과적인 방법으로 생각되어 문헌고찰과 함께 5예를 보고하는 바이다. Polycystic kidney disease (PCKD) is the most common life-threatening genetic disease that causes kidney failure worldwide. Patients with autosomal dominant PCKD notice an increase in abdominal size as the kidney cysts grow and present with gastrointestinal and pulmonary symptoms. Surgical therapy, percutaneous drainage, sclerotherapy, cyst decompression, and laparoscopic fenestration have been used to treat the symptoms, but the results are often unsatisfactory. We recruited five patients with PCKD. Each patient complained of severe abdominal discomfort, and had a poor quality of life. In these patients, we performed renal artery embolization. After the procedure, all of the patients were discharged without severe complications. Follow-up abdominal computed tomography was performed 3-6 months after the procedure, and we were able to confirm a reduction in the size of both kidneys. In addition, the clinical symptoms improved in all five patients.
4 cm 이하의 단일결절 간세포암종에서 고주파열치료와 경동맥화학색전술의 효과 비교
양민재 ( Min Jae Yang ),안소연 ( So Yun An ),문은준 ( Eun Joon Moon ),이민석 ( Min Suk Lee ),황주안 ( Joo An Hwang ),정재연 ( Jae Youn Cheong ),원제환 ( Je Hwan Won ),김재근 ( Jai Keun Kim ),왕희정 ( Hee Jung Wang ),조성원 ( Sung 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.4
Carcinoma, Hepatocellular, Radiofrequency ablation, Chemoembolization, Therapeutic, 간세포암종, 고주파열치료, 경동맥화학 색전술 Background/Aims: Radiofrequency ablation (RFA) is an established curative therapeutic modality for unresectable hepatocellular carcinoma (HCC), and transarterial chemoembolization (TACE) has been used as a palliative treatment for inoperable HCC. It is still unknown whether RFA and TACE are equally effective for improving the survival of patients with unresectable HCC that is amenable to either treatment. The aim of this retrospective study was to compare the clinical impacts of two treatments, and analyze the prognostic factors for recurrence and survival. Methods: Ninety-three patients with a single HCC smaller than 4 cm who showed complete responses (complete ablation or complete lipiodol tagging) after treatment with RFA (n=43) or TACE (n=50) between January 2002 and February 2009 were investigated. Univariate and multivariate analyses were performed for 13 potential prognostic factors using the Cox proportional-hazards model. Results: The time-to-recurrence rates at 1, 2, and 3 years after treatment were 32.9%, 44.3%, and 55.4%, respectively, for the RFA group, and 42%, 68.3%, 71.7% for the TACE group. The probability of survival at 1, 2, and 3 years was 97.7%, 77.4%, and 63.1%, respectively, for the RFA group, and 95.9%, 76.1%, and 60.2% for the TACE group. The time-to-recurrence and overall survival rates did not differ significantly between the two treatment groups. A multivariate Cox proportional-hazards model revealed that a tumor size larger than 3 cm and lower serum albumin levels were independent risk factors for recurrence, and that being male, being seropositive for hepatitis B surface antigen, and having a higher serum albumin level were independent favorable prognostic factors for survival. Conclusions: TACE and RFA exhibited similar therapeutic effects in terms of recurrence and survival for patients with a single HCC smaller than 4 cm, if they could exhibited complete responses. (Korean J Hepatol 2009;15:474-485)
최상천,정지윤,이국종,원제환,조준필 대한응급의학회 2003 대한응급의학회지 Vol.14 No.1
We report a case in which traumatic epistaxis with a carotid cavernous fistula was successfully treated by using radiologic intervention. Since the inner facial bone is an anatomically weak structure and has numerous bleeding sites, traumatic epistaxis is profuse and can not be controlled well by using traditional treatments such as gauze, merocel®, and foley balloon packing. Uncontrolled epistaxis may cause unstable vital signs and threaten the patient. In the case of failure through traditional treatments, angiographic embolization can be used as a treatment of choice because angiographic embolization can be done at a high success rate with few complications. Stroke, facial palsy, visual loss, and facial pain are the most common complications. In our case, we had tried traditional treatments first, but there was no marked improvement. After the angiographic embolization had been conducted, epistaxis was successfully controlled. The patient' s vital signs were stabilized, and he was admitted to the ICU.
김호동,이광재,김진홍,조성원,이규현,진윤미,고준호,고광현,고영윤,원제환,함기백 대한소화기학회 2000 대한소화기학회지 Vol.36 No.1
Wandering spleen is a rare condition characterized by laxity or absence of the supporting splenic ligaments, in which a long pedicle allows the spleen to migrate from its normal position in the left upper quadrant. The patients are usually asymptomatic. When torsion of the pedicle occurs, a variety of clinical manifestations from mild intermittent abdominal pain to acute abdominal crisis may occur. We experienced a case of wandering spleen mimicking tumor in the left lobe of the liver in a 65-year-old female, and the spleen scan was useful for the diagnosis.