1.Experience with a Retroperitoneoscopic Adrenalectomy: Results of 41 cases .
Suk Kyung HONG ; Sung Kwan HONG ; Suk Joon HONG
Journal of the Korean Surgical Society 2000;59(2):200-205
PURPOSE: A retroperitoneoscopic adrenalectomy is theoretically the ideal procedure for an adrenalectomy. However, it is not popular due to its technical difficulty. Herein, we report our experience with retroperitoneoscopic adrenalectomies and describe the difficulties encountered during the operations. METHODS: From November 1996 to October 1999, a total of 41 retroperitoneoscopic adrenalectomies were performed. Forty (40) patients had a unilateral adrenal tumor (size: 1-6 cm): 21 aldosteronomas, 12 Cushing adenomas, 3 neurogenic tumors, 2 nonfunctioning adenomas, 1 vascular cyst, and 1 angiomyolipoma of the kidney. One (1) had bilateral hyperplasia. The operations were carried out in prone position in all cases with 3 trochars. RESULTS: Thirty five (35) operations were completed endoscopically. Five were converted to open procedures, and one was converted to a transperitoneal laparoscopic approach. The causes of conversion were 1 severe subcutaneous emphysema, 2 technical difficulties, 1 bleeding, 1 partial nephrectomy, and 1 missing tumor. The average operating time for the complete endoscopic adrenalectomies was 183 minutes in the first 14 cases and 142 minutes in the next 21 cases. There was no operative morbidity or mortality. The average hospital stay was 4.3 days in the first 14 cases and 2.8 days in the next 21cases. CONCLUSION: A retroperitoneoscopic adrenalectomy is a less invasive procedure than any other adrenalectomy procedure, and its only disadvantage is technical difficulty. However, the technical difficulty can be overcome with increasing experience.
Adenoma
;
Adrenalectomy*
;
Angiomyolipoma
;
Hemorrhage
;
Humans
;
Hyperplasia
;
Kidney
;
Length of Stay
;
Mortality
;
Nephrectomy
;
Prone Position
;
Subcutaneous Emphysema
2.Aortic Dissection in a Survivor after Cardiopulmonary Resuscitation.
Jeong Sun LEE ; Suk Kyung HONG
Korean Journal of Critical Care Medicine 2017;32(2):218-222
We describe a case of traumatic aortic dissection associated with cardiac compression in a patient with anaphylactic cardiac arrest who underwent cardiopulmonary resuscitation (CPR). A 54-year-old man who was scheduled to undergo surgery for gastric cancer went into cardiac arrest caused by an anaphylactic reaction to prophylactic antibiotics in the operating room. Veno-arterial extracorporeal membrane oxygenation (ECMO) was performed. CPR, including chest compressions, was performed for 35 minutes, and the patient was transferred to the intensive care unit (ICU) after spontaneous circulation returned. The patient received ECMO for 9 hours until confirmation of normal cardiac function on transthoracic echocardiography. Twenty days after cardiac arrest, an aortic dissection and fractures in the left fourth and fifth ribs due to chest compression were detected by abdominal computed tomography. The DeBakey type III aortic dissection extended from the distal arch of the thoracic aorta to the proximal level of the renal artery, involving the celiac trunk. It was considered an uncomplicated type B aortic dissection with no sign of malperfusion of the major vessels. This case demonstrates the potential traumatic injuries that can occur after CPR and encourages proper management of mechanical complications in cardiac arrest survivors.
Anaphylaxis
;
Anti-Bacterial Agents
;
Aorta, Thoracic
;
Cardiopulmonary Resuscitation*
;
Echocardiography
;
Extracorporeal Membrane Oxygenation
;
Heart Arrest
;
Humans
;
Intensive Care Units
;
Middle Aged
;
Operating Rooms
;
Renal Artery
;
Ribs
;
Stomach Neoplasms
;
Survivors*
;
Thorax
;
Tomography, Spiral Computed
3.Experience with a Retroperitoneoscopic Adrenalectomy: Results of 41 Cases.
Suk Kyung HONG ; Sung Kwan HONG ; Suk Joon HONG
Korean Journal of Endocrine Surgery 2003;3(2):178-182
PURPOSE: A retroperitoneoscopic adrenalectomy is theoretically the ideal procedure for an adrenalectomy. However, it is not popular due to its technical difficulty. Herein, we report our experience with retroperitoneoscopic adrenalectomies and describe the difficulties encountered during the operations. METHODS: From November 1996 to October 1999, a total of 41 retroperitoneoscopic adrenalectomies were performed. Forty (40) patients had a unilateral adrenal tumor (size: 1?? cm): 21 aldosteronomas, 12 Cushing adenomas, 3 neurogenic tumors, 2 nonfunctioning adenomas, 1 vascular cyst, and 1 angiomyolipoma of the kidney. One (1) had bilateral hyperplasia. The operations were carried out in prone position in all cases with 3 trochars. RESULTS: Thirty five (35) operations were completed endoscopically. Five were converted to open procedures, and one was converted to a transperitoneal laparoscopic approach. The causes of conversion were 1 severe subcutaneous emphysema, 2 technical difficulties, 1 bleeding, 1 partial nephrectomy, and 1 missing tumor. The average operating time for the complete endoscopic adrenalectomies was 183 minutes in the first 14 cases and 142 minutes in the next 21 cases. There was no operative morbidity or mortality. The average hospital stay was 4.3 days in the first 14 cases and 2.8 days in the next 21 cases. CONCLUSION: A retroperitoneoscopic adrenalectomy is a less invasive procedure than any other adrenalectomy procedure, and its only disadvantage is technical difficulty. However, the technical difficulty can be overcome with increasing experience.
Adenoma
;
Adrenalectomy*
;
Angiomyolipoma
;
Hemorrhage
;
Humans
;
Hyperplasia
;
Kidney
;
Length of Stay
;
Mortality
;
Nephrectomy
;
Prone Position
;
Subcutaneous Emphysema
4.Experience with a Retroperitoneoscopic Adrenalectomy: Results of 41 Cases.
Suk Kyung HONG ; Sung Kwan HONG ; Suk Joon HONG
Korean Journal of Endocrine Surgery 2003;3(2):178-182
PURPOSE: A retroperitoneoscopic adrenalectomy is theoretically the ideal procedure for an adrenalectomy. However, it is not popular due to its technical difficulty. Herein, we report our experience with retroperitoneoscopic adrenalectomies and describe the difficulties encountered during the operations. METHODS: From November 1996 to October 1999, a total of 41 retroperitoneoscopic adrenalectomies were performed. Forty (40) patients had a unilateral adrenal tumor (size: 1?? cm): 21 aldosteronomas, 12 Cushing adenomas, 3 neurogenic tumors, 2 nonfunctioning adenomas, 1 vascular cyst, and 1 angiomyolipoma of the kidney. One (1) had bilateral hyperplasia. The operations were carried out in prone position in all cases with 3 trochars. RESULTS: Thirty five (35) operations were completed endoscopically. Five were converted to open procedures, and one was converted to a transperitoneal laparoscopic approach. The causes of conversion were 1 severe subcutaneous emphysema, 2 technical difficulties, 1 bleeding, 1 partial nephrectomy, and 1 missing tumor. The average operating time for the complete endoscopic adrenalectomies was 183 minutes in the first 14 cases and 142 minutes in the next 21 cases. There was no operative morbidity or mortality. The average hospital stay was 4.3 days in the first 14 cases and 2.8 days in the next 21 cases. CONCLUSION: A retroperitoneoscopic adrenalectomy is a less invasive procedure than any other adrenalectomy procedure, and its only disadvantage is technical difficulty. However, the technical difficulty can be overcome with increasing experience.
Adenoma
;
Adrenalectomy*
;
Angiomyolipoma
;
Hemorrhage
;
Humans
;
Hyperplasia
;
Kidney
;
Length of Stay
;
Mortality
;
Nephrectomy
;
Prone Position
;
Subcutaneous Emphysema
5.Correlative study of systolic and diastolic blood pressure with body mass index and age.
Ae Kyung CHO ; Jong Suk PARK ; Kyung Hwan CHO ; Myung Ho HONG ; Sun Duk KIM
Journal of the Korean Academy of Family Medicine 1993;14(3):156-166
No abstract available.
Blood Pressure*
;
Body Mass Index*
7.Silent Aortic Regurgitation.
Jae Kyung ROH ; Sung Soon KIM ; Suk Ho CHUNG ; Hong Do CHA
Korean Circulation Journal 1977;7(1):39-45
Aortic regurgitation is a common valvular heart disease, usually the result of rheumatic fever, or syphilis, and rarely of congenital origin. It is frequently associated with other valvular heart disease, especially mitral valve disease. It can be diagnosed by the presence of pulse pressure widening, a Corrigan pulse, and an early decreascendo diastolic murmur at the left sternal border between the second and third intercostal spaces. After the clinical application of cineaortography in the diagnosis of valvular disease, Segal et al (1964) first reported rheumatic aortic regurgitation without an audible murmur in patients having mitral valve disease. The importance of discovering aortic reguritation in patients with predominent mitral disease has begun to be appreciated recently, especially as commisurotomies for the relief of mitral stenosis are performed more frequently. Nowadays eventhough the severity of aortic regurgitation is often not evident preoperatively, aortic regurgitation can become very evident when mitral stenosis is relieved. This study was comprised of seventeen patients with silent aortic regurgitation which was confirmed by cineaortography at Severance Hospital from January, 1970 to August, 1976. 1. Of the seventeen patients, 12 patients were associated with mitral stenosis, 4 with mitral steno-insufficiency, and 1 with mitral insufficiency. 2. Silent aortic regurgitation was suggested from the accompanying clinical features such as chest pain, apical heaving, and left ventficular hypertrophy pattern on both roentgenogram of the chest and electrocardiogram. 3. The severity of the aortic regurgitation was mild to moderate; 7 of the 17 patients being grade I, and 10 patients being grade II on cineaortogram.
Aortic Valve Insufficiency*
;
Blood Pressure
;
Chest Pain
;
Diagnosis
;
Electrocardiography
;
Heart Murmurs
;
Heart Valve Diseases
;
Humans
;
Hypertrophy
;
Mitral Valve
;
Mitral Valve Insufficiency
;
Mitral Valve Stenosis
;
Rheumatic Fever
;
Syphilis
;
Thorax
8.Nutrition therapy in the intensive care unit.
Journal of the Korean Medical Association 2014;57(6):496-499
Nutrition therapy is challenging in critically ill patients. Critical illness is associated with a state of catabolic stress, in which stress hormones and inflammatory mediators are activated, resulting in proteolysis. The aim of nutrition therapy in critically ill patients is to preserve lean body mass, to preserve immune function, and to avoid metabolic complications. Enteral nutrition is preferred over parenteral nutrition. Enteral nutrition should be initiated within 24 to48 hours of intensive care unit admission. However, enteral nutrition should be withheld until the patient is fully resuscitated. If enteral nutrition is not feasible within several days, supplementary parenteral nutrition is necessary. In the acute phase, energy requirements should not be over 20 to 25 kcal/kg/d, and protein should be supplemented in the range of 1.2 to 2.0 g/kg/day. Monitoring tolerance is very important in critically ill patients with artificial nutrition to avoid complications. Immunonutrition such as glutamine and omega-3 fatty acid is helpful to modulate effects on the immune system in critically ill patients. Implementation of a feeding protocol and the involvement of a nutrition support team can systemize nutrition therapy. Together, these steps will hopefully enable the integration of evidence-based guidelines into practice, leading to improvements in nutrition performance so that patients' chances of a good outcome are optimized.
Critical Illness
;
Enteral Nutrition
;
Glutamine
;
Humans
;
Immune System
;
Intensive Care Units*
;
Nutrition Therapy*
;
Parenteral Nutrition
;
Protein-Energy Malnutrition
;
Proteolysis
9.Histopathological Studies on Carcinomas of the Stomach in the Taegu Area.
Suk Jae HONG ; Tae Sook LEE ; Won Hee CHOI ; Kyung Chul LEE
Yeungnam University Journal of Medicine 1985;2(1):65-69
For evaluation on the histopathologic studies, and age and sex distribution of the gatric carcinomas in the Taegu Area, the gastrectomized and gastroscopic biopsy materials were collected at the Department of Pathology, College of Medicine, Yeungnam University, and the analyzed results were as follows: 1. In total of 350 cases of gastroscopic biopsy materials adenocarcinomas are 344 cases (98.3%), squamous cell carcinomas and undifferentiated carcinomas are only 6 cases (1.7%). In adenocarcinomas the most of all are tubular type, 215 cases (61.4%). In age distribution the highest is the 50th age group, and 120 cases (34.3%), the next 60th, 81 cases (23.1%), 40th, 76 cases (21.7%), respectively. 2. In total of 130 cases of gastrectomized materials adenocarcinomas are 127 cases (97.7%), and are the highest incidence, the next, carcinomas originated from chronic peptic ulcer of the stomach, and are 3 cases (2.3%). In adenocarcinomas the highest are tubular type, 86 cases (66.2%), the next, signet ring cell type, 20 cases (15.4%). The highest age incidence of the age group is 50th, and the next, 60th, 40th, 30th, 70th and 10th age group, respectively.
Adenocarcinoma
;
Age Distribution
;
Biopsy
;
Carcinoma
;
Carcinoma, Squamous Cell
;
Daegu*
;
Humans
;
Incidence
;
Pathology
;
Peptic Ulcer
;
Sex Distribution
;
Stomach*
10.Exceptionally Good Lymphocytic Infiltration with Histiocytes and Multinucleated Giant Cells of Stomach Cancer: A case report.
Dongsoo SUK ; Sook Hee HONG ; Hye Kyung YOON ; Hyung Gin KANG
Korean Journal of Pathology 1986;20(1):112-115
Stomach of 34 year old man showed an early stage of the cancer with slight involvement of the superficial part of the inner muscle layer and accompanied with one metastatic lymph node. The cancer is that of medium differentiated adenocarcinoma. There is an heavy infiltration of lymphocytes mixed with histiocytic mononuclear cells and multinucleated giant cells. Some giant cells appear as Langhans' type suggesting phagocytic cells of their origin containing PAS positive materials in the cytoplasma. In other places, they appear as atrophic cancer nests suggesting that these tumor nests were arrested and undergone to regressive cellular process because of the over-whelming immunological pressure by the host.
Male
;
Humans
;
Neoplasm Metastasis
;
Stomach Neoplasms