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최상용,한호용,박신희,김진승,신용원,송병주 대한외상학회 1997 大韓外傷學會誌 Vol.10 No.2
We have reviewed 73 acute traumatic death patients who visited from January 1994 to June 1996 to evaluate the quality of inhospital care. Deaths that occurred within 48 hours of admission were classified as acute stage. The age of the patients ranged from 15 to 97 years(mean age 48.1). Male was 56 and female was 17 in number with a ratio of 3.3:1. Motor vehicle trauma was the most common cause of injury leading to death(72.6%). Central nervous system injuries were the most common cause of death(53.4%). Overall motality was 8.1%. Injury Severity Score(lSS) ranged from 9 to 50(mean ISS 28.9). Not all the victims had severe anatomic injuries, however;19.2% had an ISS of 25 or less, suggesting that futher improvements in care could reduce motality. All body systems were equally represented. Most patients had more than two system involved(67.1%). Ten patients(13.6%) had pre-existing disease. Possibly preventable deaths occurred in 8 cases(11.0%): 3 case in surgical delay, 3 case in delayed diagnosis and 2 case in no surgery. These data reinforce the continuing need for physician trainning in proper management and careful, through diagnostic evaluation of critically injured patients.
이향주,신용원,한호용,박신희,전하영,장석,권학중,신경철 대한소화기학회 1998 대한소화기학회지 Vol.31 No.5
Biliary cystadenomas and cystadenocarcinomas are rare tumors of biliary origin and constitute less than 5% of the total intrahepatic cysts of bile duct origin. They occur most commonly in middle age females. Clinical manifestations are non-specific, so these tumors are incidentally found during autopsy or surgery. The ultrasonogram, abdominal CT scan, angiography and aspiration cytology are valuable diagnostic methods. The typical sonographic appearance of these tumors is a large intrahepatic globular or ovoid thick-walled cystic mass which often contains multiple septations or papillary infoldings. The characteristic CT appearance of these tumors is similar to that of a low-density intrahepatic mass which may cantain mural nodule or internal septation. However, regardless of the diagnostic modalities, pre-operative diagnosis as well as intra-operative one is difficult. Since biliary cystadenocarcinomas are believed to arise from benign cystadenornas, complete surgical resections, if possible, is a warranted method to avoid malignant change of these tumor. We report one of biliary cystadenocarcinoma canfirmed by the operation with review of the literatures.
김동환,강동수,송병주,한호용,박신희,김진승 대한외상학회 1996 大韓外傷學會誌 Vol.9 No.2
Unneccessary abdominal explorations in injured patients can be reduced by employing emergent or urgent laparoscopy in abdominal trauma. Twenty-seven hemodynamically stable trauma patients were evaluated retrospectively by laparoscopy before planned laparotomy. Laparoscopy was performed using a forward viewing laparoscope connected to two high-resolution video monitors. The mechanism of injury was blunt trauma in nine, stab wound in 17, and colonoscopic injury in one. All patients had the procedures performed in the operating room. Only one patient had the procedure under the local anesthesia, and the others had the procedure under general anesthesia. Laparoscopy correctly identified the presence of an intraperitoneal injury in 17 patients and 8 of these patients underwent laparotomy. The ten other patients had no demonstrable injury and did not undergo laparotomy. There was no missed injury. In 10 patients, the laparoscopic findings were negative. Laparoscopy was performed easily in all patients, and there were no complications associated with its use.