168. 급성화농성 담낭염의 수술 시기와 방법에 관한 고찰

김대동,강구정,임태진 대한외과학회 1999 대한외과학회 학술대회 초록집 Vol.1999 No.5

수술 전 화학방사선치료에 병리학적 완전 관해를 보인 직장암 환자의 임상병리학적 특징 및 종양학적 결과

김대동,유창식,신의섭,윤상남,김진천 대한대장항문학회 2008 Annals of Coloproctolgy Vol.24 No.6

Purpose: To assess the clinico-pathologic characteristics associated with pathologic complete remission (pCR) after preoperative chemoradiotherapy (PCRT) for rectal cancer and evaluate predictive factors for pCR and prognostic impact of pCR. Methods: We analyzed 325 patients who underwent PCRT and surgical resection between September 1999 and September 2006. We have treated 319 patients with PCRT for locally advanced rectal cancer and 6 patients for sphincter-saving procedure. Chemotherapy consisted of either of bolus 5-FU (325 mg/m2/d) or capecitabine (1,650 mg/m2/d) for the duration of radiation and after surgery. Radiation therapy was delivered and surgery was performed 4∼6 weeks following the completion of PCRT. We compared pCR patients with non-pCR patients according to the clinico-pathologic characteristics and followed up with a median of 32 (range, 12∼91) months. Results: The pCR (n=41, 12.6%) and non-pCR (n=284) groups were comparable in age, sex, location of the tumor, chemotherapy regimen, pre-CRT CEA level except pre-CRT clinical stage (12.2% vs. 0.4% in stage I, P= 0.047). There was no significant difference in genetic characteristics between groups. There was no specific predictive factors for pCR except pre-CRT T category (pCR in T2 (5/8, 62.5%) vs. T3 (33/283, 11.7%) or T4 (3/33, 9.1%), P=0.001). The 3-year disease free survival (DFS) was 100% and 83.6% in the pCR and non-pCR group respectively (P=0.012). There were 5 local and 34 systemic recurrences only in non-pCR group. Conclusions: Rectal cancer patients with pCR after PCRT have an excellent prognosis and are unlikely to fail locally or systemically because of the effect of stage. However there was no specific predictive factor for pCR except preoperative T category. Purpose: To assess the clinico-pathologic characteristics associated with pathologic complete remission (pCR) after preoperative chemoradiotherapy (PCRT) for rectal cancer and evaluate predictive factors for pCR and prognostic impact of pCR. Methods: We analyzed 325 patients who underwent PCRT and surgical resection between September 1999 and September 2006. We have treated 319 patients with PCRT for locally advanced rectal cancer and 6 patients for sphincter-saving procedure. Chemotherapy consisted of either of bolus 5-FU (325 mg/m2/d) or capecitabine (1,650 mg/m2/d) for the duration of radiation and after surgery. Radiation therapy was delivered and surgery was performed 4∼6 weeks following the completion of PCRT. We compared pCR patients with non-pCR patients according to the clinico-pathologic characteristics and followed up with a median of 32 (range, 12∼91) months. Results: The pCR (n=41, 12.6%) and non-pCR (n=284) groups were comparable in age, sex, location of the tumor, chemotherapy regimen, pre-CRT CEA level except pre-CRT clinical stage (12.2% vs. 0.4% in stage I, P= 0.047). There was no significant difference in genetic characteristics between groups. There was no specific predictive factors for pCR except pre-CRT T category (pCR in T2 (5/8, 62.5%) vs. T3 (33/283, 11.7%) or T4 (3/33, 9.1%), P=0.001). The 3-year disease free survival (DFS) was 100% and 83.6% in the pCR and non-pCR group respectively (P=0.012). There were 5 local and 34 systemic recurrences only in non-pCR group. Conclusions: Rectal cancer patients with pCR after PCRT have an excellent prognosis and are unlikely to fail locally or systemically because of the effect of stage. However there was no specific predictive factor for pCR except preoperative T category.

속발성 난소암을 동반한 대장암의 병태 생리학적 특징 및 생존율 분석

김대동,홍동현,정상훈,최평화,박인자,김희철,유창식,김진천 대한소화기학회 2006 대한소화기학회 추계학술대회 Vol.2006 No.-

국내에서 소비되는 육류의 부위별 비타민 K 함량 분석 및 비교

김대동,이서경,강유리,신재홍,박진주,김현정 한국식품과학회 2022 한국식품과학회지 Vol.54 No.1

Vitamin K is a group of fat-soluble vitamins that naturally exist in phylloquinone (vitamin K1) and menaquinone (vitamin K2). In this study, the vitamin K content in different meats commonly consumed in Korea was analyzed using HPLC, and the analytical method was validated. Vitamin K1 was not detected in any of the meat samples. Vitamin K2 contents in different cuts of beef ranged from 0.00 to 5.87 μg/100 g, whereas the corresponding value in different parts of chicken ranged from 16.59 to 46.64 μg/100 g. In the case of pork, vitamin K2 contents varied from 4.33 to 22.90 μg/100 g. Among the different types of meat, the highest vitamin K2 content was found in boiled chicken meat and skin (46.64 μg/100 g). The analytical method was found to be reliable and had high accuracy. These results provide accurate nutritional information and contribute a food composition database for meat consumption.

장루 복원술의 합병증

김대동,김은정,이혜옥,박인자,김희철,유창식,김진천 대한대장항문학회 2008 Annals of Coloproctolgy Vol.24 No.2

The study aimed to investigate the complications accompanying stoma take-down and to elucidate the significant factors associated with complications. Methods: We recruited 341 patients who underwent stoma take-down in our hospital between January 2000 and December 2005. Data on various complications during this procedure, i.e., wound infection, prolonged ileus, and anastomotic leakage, were collected with respect to patient- and operation-associated parameters. Results: Complications of stoma take-down developed in 72 (21.1%) patients: 53 (20.3%) patients in a loop ileosotmy, 10 (21.3%) patients in a loop colostomy, and 9 (27.3%) patients in a Hartmann colostomy, The overall complication rate was significantly associated with the urgency of the primary operation (elective vs. emergent, 17.8% vs. 29%, P=0.017), and with the operation time (≤80 min vs. >80 min, 16.5% vs. 29.3%, P=0.005). Among the complications, ileus developed in 46 (13.5%) patients, wound infection in 17 (5.0%) patients, and anastomotic leakage in 5 (1.5%) patients. Wound infection was related to the type of stoma between a loop ileostomy and a Hartmann colostomy (3.5% vs. 12.1%; P=0.014), but no other factors were associated with other complications. Conclusions: There were significant differences in overall complications in relation to urgency of the primary operation and the operation time, but there was no statistical difference in complications between a loop ileostomy and a loop colostomy take- down groups. The significance of these factors appears to be reduced with accurate surgical technique and patient care.

유방암의 치료에 있어서 유방보존술과 변형근치유방절제술의 비교

김대동,손창용,김진희,김유사 啓明大學校 醫科大學 2002 계명의대학술지 Vol.21 No.1

유방암의 치료에 따른 생존율과 재발율의 차이를 알기 위해 1987년 8월부터 2000년 8월까지 계명대학교 동산의료원 외과에서 유방보존술을 시행한 환자 134명을 임상적, 병리학적 유형이 유사한 조건에서 변형근치유방절제술을 시행받은 134명과 비교하여 생존율, 무병생존율, 재발율을 조사 분석하였다. 조사 결과 두 군 사이에서 5년 생존율과 5년 무병생존율 및 재발율에 차이가 없었으며 국소 재발에 관여하는 인자들을 충분히 고려하여 치료방법을 결정해야 할 것으로 생각된다. Modern prospective studies have demonstrated that breast conservation procedure (BCP) and modified radical mastectomy (MRM) produce comparable actuarial survival rates. This study was designed to evaluate the merit of BCP in the treatment of breast cancer. 134 patients underwent BCP during the period of Aug. 1987 to Aug. 2000 (BCP group), and they were compared with patients who underwent MRM during the same period (MRM group). Tumor size, lymph node status and age were similar between the two groups. The clinicopathologic features, locoregional recurrence, distant metastasis, actuarial overall survival rate and disease-free survival rate were analyzed. The mean age of the BCP group was 44.6 yrs. and that of the MRM group was 44.8 yrs. The mean size of tumor was 1.89 ㎝ in the BCP group and 1.92 ㎝ in the MRM group. Among the 134 patients in the BCP group, no lymph node metastasis was observed in 92 (68.7%), 1-3 lymph node(s) in 26 (19.4%), and more than 4 lymph nodes in 16 (11.9%). In the MRM group, the numbers were the same. In the BCP group, the actuarial 5-yr overall survival rate was 88.20% and the 5-yr disease-free survival rate was 84.2%. For the MRM group, the actuarial 5-yr overall survival rate was 85.7% and 5-yr disease-free survival rate was 80.4%, showing no significant difference between two groups. Thirteen in the 134 BCP group and five in the 134 MRM group had locoregional recurrences and five in the 134 BCP group and 17 in the 134 MRM group had distant metastases. The above results suggest that BCP can be a standard surgical treatment modality for most patients with early stage breast cancer.

남성 동성애자에서 발생한 직장의 성병림프육아종 1예

김대동 대한대장항문학회 2010 Annals of Coloproctolgy Vol.26 No.2

We present the case of a 41-yr-old homosexual man who was managed for suspected rectal cancer before lymphogranuloma venereum was clinically diagnosed. At first, he presented with constipation and tenesmus for several days. Upon rectal examination, the mass was palpated at 3 cm from the anal verge. Colonoscopy revealed a tumor of lower rectum, but multiple endoscopic biopsies were unable to reveal the nature of the tumor, so the pathologist just gave the diagnosis of a rectal pseudo-tumor. Positive chlamydial serology was found, and the final diagnosis was made. He was treated for Chlamydia trachomatis with Doxycycline, 100 mg twice daily for 21 days.

유방암 환자의 세침흡입 세포검사상 위음성에 영향을 주는 임상병리학적 특성

김대동,김종흥,최경우 대한외과학회 2002 대한외과학회 학술대회 초록집 Vol.2002 No.5

가족성 용종증에서 유건종의 발생양상

김대동,유창식,홍동현,정상훈,최평화,박인자,김희철,김진천 대한대장항문학회 2008 Annals of Coloproctolgy Vol.24 No.1

This research was conducted to assess the incidence, clinical characteristics, and treatment outcomes for desmoid tumors in patients with familial adenomatous polyposis (FAP). Methods: At Medical Center, we recruited 47 patients who had been diagnosed as having intraabdominal or abdominal wall desmoid tumor between Aug. 1995 and Dec. 2005. We compared FAP- associated desmoid tumors with non-FAP-associated desmoid tumors according to clinical characteristics and treatment outcomes. Results: Desmoid tumors developed 12/46 (26.1%) in FAP, 1/14 (7.1%) in attenuated FAP and 34 in non-FAP associated. Unlike non-FAP- associated desmoid tumors, the occurrence of FAP- associated desmoid tumors in tended to be higher in the earlier age groups (≤40 yrs, 92.3% vs 67.6%, P=0.082) and no sexual predominancy was observed (male:female ratio of 1.2:1 vs a tumor ratio 1:3.9, P=0.033). Intraabdominal-type desmoid tumors associated for the majority of FAP-associated desmoid tumors (92.3% vs 38.2%, P=0.002), and 70% of the desmoid tumors occurred within 3 years after total proctocolectomy. In the treatment of FAP-associated intraabdominal desmoid tumors, surgery was performed in 7 cases (58.3%), and complete resections were done in only 3 cases (25%), with one recurrence. In non-FAP-associated desmoid tumors, complete resection was possible in 10 cases (76.9%), and there was no recurrence (P=0.036). The medical treatment for unresectable or incompletely resectable cases in cases of non-FAP-associated desmoid tumor was good, but for FAP-associated desmoid tumors, the effectiveness was not good, and further investigation was needed. Conclusions: Intraabdominal desmoid tumors in FAP patients occurred frequently in the early (≤3 yrs) postoperative period, and the treatment, outcome including surgery and medication, outcome was not good in patients with FAP-associated desmoid tumors.

소화관운동 : 직장암 환자에서 J-결장낭 형성술이 배변기능에 미치는 영향

김대동,김희철,신의섭,윤상남,박인자,유창식,김진천 대한소화기학회 2007 대한소화기학회 추계학술대회 Vol.2007 No.-