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김덕우,정승용,김대용,손대경,임석병,장희진,정경해,정준용,최효성,박재갑 대한대장항문학회 2007 Annals of Coloproctolgy Vol.23 No.4
Purpose: In Korea, colorectal cancer (CRC) is one of the most sharply-increasing malignancies, and the National Colorectal Cancer Screening Program for persons over 50 years of age began in 2004. To determine the effectiveness of the program, comparative data regarding CRCs treated prior to 2004 must be analyzed. The present study assessed CRC status at diagnosis and treatment patterns in 2003. Methods: In 2003, 503 patients were newly diagnosed with CRC and were treated at the Center for Colorectal Cancer, National Cancer Center (NCC). Clinical data were retrospectively reviewed. Results: The 503 patients included 256 colon and 247 rectal cancer patients. Of the 256 colon cancer patients, 5 (2.0%) were diagnosed during screening colonoscopies and were successfully treated using an endoscopic mucosal resection (EMR), and 17 (6.6%) received only palliative chemotherapy because of distant metastases. Forty patients (15.6%) were treated with palliative surgery and chemotherapy, and 194 (75.8%) with curative surgery with or without adjuvant chemotherapy. Of the 247 rectal cancer patients, 9 (3.6%) were treated with an EMR, 20 (8.1%) with palliative chemotherapy with or without radiotherapy, 19 (7.7%) with palliative surgery and chemoradiotherapy, and 199 (80.6%) with curative surgery with or without chemoradiotherapy. Treatment with curative intent was possible in 199 of 256 (77.7%) colon cancer patients and in 208 of 247 (84.2%) rectal cancer patients. Conclusions: Only 12.1% of colon and 8.5% of rectal cancer patients were diagnosed early and treated without adjuvant therapies at the NCC in Korea in 2003.
김덕우,김상범,한승규,김우경 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.2
Nasions are flat and located more caudally in Asian than in Caucasian. Implant insertions in rhinoplasties are apt to move nasions more cephallic, which can cause unsatisfactory results in Asian. The purpose of this study is introducing a simple technique in rhinoplasty avoiding unnatural nasion in augmentation rhinoplasty in Asian patients. Multiple radiating incisions were made at nasion level on inner side of silicone implant to fit it into the curvature around the nasion. Between October 2001 and October 2003, 27 patients underwent augmentation rhinoplasties using this technique and results were evaluated. Preoperative and postoperative photographs of patients were used to measure the levels of nasion from medial canthus. The mean nasion level from medial canthus of preopertive patients were 3.46±0.87mm and postoprative patient was 4.98±0.96 mm. The mean difference between preoperative nasion level and postoperative nasion level was 1.52mm. There was no complication such as extrusion, displacement or infection. This technique of radiating incisions on inner side of the silicon implant can minimize cephalic migration of the nasion level in augmentation rhinoplasty in Asian.
혈액은행 제조의 혈소판 농축액을 이용한 당뇨족부궤양의 치료 경험
김덕우,한승규,김우경 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.2
Many clinical trials have shown the effectiveness of the platelet releasate or the platelet gel on chronic wounds. However, the patient's own blood had to be aspirated and processed to make the platelet releasate or a platelet gel. The purpose of this study was to assess the effects of platelet concentrates from the blood bank for the treatment of diabetic foot ulcers. To obtain the basic data of the PDGF-BB content in platelet concentrates supplied from the blood bank, enzyme-linked immunosorbent assay quantification was performed. On average, 8.5pg of the PDGF-BB was released per 1 million platelets. Sixteen patients with diabetic foot ulcers ranging from 1.0 to 18.0cm2(mean, 6.1cm2) in size were treated. The platelet concentrates was centrifuged and the precipitantte was mixed with 1ml of fibrinogen. The platelets and fibrinogen mixture was dispersed on to the ulcer lesions. The liquid platelet and fibrinogen mixture was then sealed using 0.3-1.0ml of thrombin and moisture dressing was performed. The procedure was repeated every one or two weeks until wound closure. Time required for complete healing ranged from 3 to 12 weeks after treatment(mean, 7.3 weeks). Patient satisfaction was also very positive. In this study, the use of platelet concentrates from the blood bank was found to be effective in treating diabetic foot ulcers.