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      • KCI등재

        담낭암에서 Fascin 발현에 대한 연구

        나국영(Kuk Young Na),김용호(Yong Ho Kim),김윤화(Youn Wha Kim),홍성화(Sung Wha Hong) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.2

        Purpose: Gallbladder carcinoma is the most common malignancy of the biliary tract in Koreans. However the exact histopathological characteristics and its carcinogenesis are not well understood. Fascin is an actin bundling protein, and it induces membrane protrusions and increased cell motility in various transformed cells. The expression of fascin is known to be greatly increased in various human neoplasms, but its expression in gallbladder carcinoma is unknown. Methods: A total 110 cases of gallbladder carcinoma, six cases of carcinoma in situ and 10 cases of chronic cholecystitis were immunohistochemically studied to evaluate the expression of fascin in the light of its relationship with various prognostic factors. Results: Seventy eight gallbladder carcinomas (70.9%) showed positive staining for fascin, but none of the chronic cholecystitis and carcinoma in situ was positive. Fascin was strongly stained in the cytoplasm of the cancer cells. The adjacent normal mucosa was negative for fascin staining. There was a significant correlation between lymph node metastasis (P=0.039) and the presence of residual tumor (P=0.016) but there was no significant correlation between age, gender, tumor invasion, histologic difference, neural invasion, lymphatic invasion, stage and recurrence. The 5-year overall survival rate of the fascin positive and negative groups were 48.5% and 53.8%, respectively (P=0.236). On the multivariate analysis, a fascin expression was not significant. Conclusion: Our results suggest that a fascin expression is strongly associated with neoplastic progression in gallbladder carcinomas and fascin positive gallbladder carcinomas show more aggressive behavior.

      • KCI등재

        위암 환자에서 수술 전 혈청 CEA, CA19-9, AFP의 예후 인자로서의 의의

        나국영(Kuk-Young Na),장연수(Yeon Soo Chang),김용호(Yong Ho Kim),주선형(Sun Hyung Joo),이석환(Suk-Hwan Lee) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.5

        Purpose: No tumor-specific markers for gastric cancer are currently known, although various tumor markers have been utilized. CEA, CA19-9 and AFP are the most commonly used tumor markers for gastric cancer. The aim of this study is to evaluate the prognostic significance of the preoperative CEA, CA19-9 and AFP levels in patients with gastric cancer. Methods: A total of 366 patients who underwent curative surgery for gastric cancer were analyzed. The clinicopathologic characteristics and disease-free survival rate of the patients were compared between the positive and negative CEA, CA19-9 and AFP groups of patients, respectively. Also, the prognostic significance of each tumor marker was assessed by multivariate analysis. Results: The CEA, CA19-9 and AFP levels were elevated in 14.2%, 7.9% and 19.1% of the patients, respectively. Serosal invasion and advanced cancer were more frequently found in the groups of patients who were positive for CEA and CA19-9 (P<0.05). More lymph node metastasis and an advanced tumor stage were found in the group of patients who were positive for CA19-9 (P<0.05). On univariate analysis, the disease-free survival rate was significantly lower in the CA19-9 positive group (P<0.05). Serosal invasion and lymph node metastasis were the only significant prognostic factors on multivariate analysis. Conclusion: CEA, CA19-9 and AFP have proved unhelpful for the early detection of gastric cancer due to the low positive rate. CEA and AFP have no prognostic significance and only CA19-9 can be useful for estimating the severity of gastric cancer and as a limited prognostic factor for gastric cancer patients.

      • KCI등재후보

        무기하 액와 접근법을 이용한 로봇 갑상선 절제술: 단일 술자에 의한 최초 1년간의 경험

        노재형,이정훈,나국영,이잔디,정웅윤<SUP>1<.SUP>,소의영,Jae Hyung Noh,Jeong Hun Lee,Kuk Young Na,Jandee Lee,Ph.D.,Woong Youn Chung Ph.D.<SUP>1 <.SUP>and Euy Young Soh,Ph.D. 대한갑상선-내분비외과학회 2010 The Koreran journal of Endocrine Surgery Vol.10 No.3

        Purpose: Various endoscopic thyroidectomy procedures have been designed to minimize visible cervical scarring. However, endoscopic thyroidectomy is a technically challenging procedure that is performed by a limited surgeon. Robotic systems aida surgeon in performing minimally invasive head and neck surgery by offering superior visualization and dexterity. This study reports the initial experience of one surgeon with robotic thyroidectomy to assess the technical feasibility and safety of the approach. Methods: One hundred four thyroid cancer patients (97 females, 7 males; mean age of 39.8±8.1 years) underwent robotic thyroidectomy using gasless transaxillary approach between November 2008 and October 2009 in Ajou University Hospital. All the procedures were completed successfully using the da Vinci surgical system without open conversion. Patient characteristics, postoperative clinical results, complications, and pathologic details were assessed. Results: Total thyroidectomy was performed in 25 (24.0%) patients, subtotal thyroidectomy in 13 (12.5%) patients, and unilateral lobectomy in 66 (63.5%) patients. All patients underwent ipsilateral central compartment neck dissection, and two patients underwent selective lymph node (LN) dissection. The mean operation time was 134.5±47.2 min (range 61∼310 min), in which the actual time for the thyroidectomy with lymphadenectomy (console time) was 56.4 min. (range 31∼270). The mean number of LN resected was 3.9 (range 0∼28). There were no serious complications. The mean hospital stay was 2.9±0.9 days (range 2∼7). Conclusion: Robotic thyroidectomy is a feasible, safe, and cosmetically excellent procedure. The application of robotic technology for thyroid surgeries could be an alternative to endoscopic or conventional open thyroidectomy. (Korean J Endocrine Surg 2010;10:157-162)

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