Does the Different Locations of Colon Cancer Affect the Oncologic Outcome? A Propensity-Score Matched Analysis

양관모,박인자,이종률,윤용식,김찬욱,임석병,김나영,홍신애,유창식,김진천 대한대장항문학회 2019 Annals of Coloproctolgy Vol.35 No.1

Purpose: We evaluate the prognostic value of primary tumor location for oncologic outcomes in patients with colon cancer (CC). Methods: CC patients treated with curative surgery between 2009 and 2012 were classified into 2 groups: right-sided colon cancer (RCC) and left-sided colon cancer (LCC). Recurrence-free survival (RFS) and overall survival (OS) were examined based on tumor stage. Propensity scores were created using eight variables (age, sex, T stage, N stage, histologic grade, presence of lymphovascular invasion/perineural invasion, and microsatellite instability status). Results: Overall, 2,329 patients were identified. The 5-year RFSs for RCC and LCC patients were 89.7% and 88.4% (P = 0.328), respectively, and their 5-year OSs were 90.9% and 93.4% (P = 0.062). Multivariate survival analyses were carried out by using the Cox regression proportional hazard model. In the unadjusted analysis, a marginal increase in overall mortality was seen in RCC patients (hazard ratio [HR], 1.297; 95% confidence interval [CI], 0.987–1.704, P = 0.062); however, after multivariable adjustment, similar OSs were observed in those patients (HR, 1.219; 95% CI, 0.91–1.633; P = 0.183). After propensity-score matching with a total of 1,560 patients, no significant difference was identified (P = 0.183). A slightly worse OS was seen for stage III RCC patients (HR, 1.561; 95% CI, 0.967–2.522; P = 0.068) than for stage III LCC patients. The 5-year OSs for patients with stage III RCC and stage III LCC were 85.5% and 90.5%, respectively (P = 0.133). Conclusion: Although the results are inconclusive, tumor location tended to be associated with OS in CC patients with lymph node metastasis, but it was not related to oncologic outcome.

Doxorubicin 유발 심근증 백서 모델에서 성체골수줄기세포를 이용한 심근재생 효과

양관모,박찬석,장성원,박훈준,김동빈,김범준,정해억,백상홍,승기배,최규보 대한심장학회 2008 Korean Circulation Journal Vol.38 No.2

Background and Objectives: Bone marrow cells have been shown to differentiate into various cell lineages, including cardiomyocytes, in recent studies. This study evaluates the hypothesis that intravenous injection of bone marrow mononuclear cells (BMNCs) into rats with doxorubicin-induced cardiomyopathy can induce myocardial regeneration and improve myocardial contractility. Materials and Methods: Adult male Sprague-Dawley rats were induced to develop cardiomyopathy by treatment with doxorubicin (2.5 mg/kg, 6 times, 2-week period). Stem cell enriched BMNCs were injected into the tail vein of the rats after cessation of the doxorubicin injections. One week after the injection of PKH-67-labeled BMNCs, the localization of transplanted cells was evaluated. Immunohistochemical studies and Western blots were performed two weeks after BMNCs injection. Results: Cell-treated animals showed significant improvement in left ventricular fractional shortening as compared to untreated (control) rats (cell treated group vs. control group 47.2±4.9% vs. 34.4±3.6%, p<0.01). Histological analyses showed that in the cell-treated animals there was an increase in ventricular interstitial collagen deposition and the cell-treated animals had an improved number of capillary endothelial cells as compared with the control rats. PKH-67- labeled BMNCs and cell proliferation by BrdU was noted in the cell-treated hearts. Cardiac CXCR4 protein expression increased at day 7 and 14 in the cell-treated rats, but only at day 14 in the control animals. Conclusion: These results suggest that intravenous injection of BMNCs effectively induce engraftment of BMNCs into the myocardium and attenuation of fibrosis. Intravenous injection of BMNCs also improved myocardial contractility in doxorubicininduced cardiomyopathy. Background and Objectives: Bone marrow cells have been shown to differentiate into various cell lineages, including cardiomyocytes, in recent studies. This study evaluates the hypothesis that intravenous injection of bone marrow mononuclear cells (BMNCs) into rats with doxorubicin-induced cardiomyopathy can induce myocardial regeneration and improve myocardial contractility. Materials and Methods: Adult male Sprague-Dawley rats were induced to develop cardiomyopathy by treatment with doxorubicin (2.5 mg/kg, 6 times, 2-week period). Stem cell enriched BMNCs were injected into the tail vein of the rats after cessation of the doxorubicin injections. One week after the injection of PKH-67-labeled BMNCs, the localization of transplanted cells was evaluated. Immunohistochemical studies and Western blots were performed two weeks after BMNCs injection. Results: Cell-treated animals showed significant improvement in left ventricular fractional shortening as compared to untreated (control) rats (cell treated group vs. control group 47.2±4.9% vs. 34.4±3.6%, p<0.01). Histological analyses showed that in the cell-treated animals there was an increase in ventricular interstitial collagen deposition and the cell-treated animals had an improved number of capillary endothelial cells as compared with the control rats. PKH-67- labeled BMNCs and cell proliferation by BrdU was noted in the cell-treated hearts. Cardiac CXCR4 protein expression increased at day 7 and 14 in the cell-treated rats, but only at day 14 in the control animals. Conclusion: These results suggest that intravenous injection of BMNCs effectively induce engraftment of BMNCs into the myocardium and attenuation of fibrosis. Intravenous injection of BMNCs also improved myocardial contractility in doxorubicininduced cardiomyopathy.

한국산 수종 갯지렁이의 산란기 및 생식주기

양관모 부산수산대학 학도호국단 1978 白鯨論集 Vol.3 No.-

스퍼드형 가스버너의 연소특성에 관한 실험적 연구 ( An Experiment Study on combustion Characteristics of the Spud Type Gas Burner )

양관모,천무환,선칠형,장인갑,장길홍 대한기계학회 2000 대한기계학회 춘추학술대회 Vol.- No.-

유기용제 흡입중독후 의식소실로 발생한 중증의 저체온증 치유 1례

양관모 ( Kwan Mo Yang ),권태욱 ( Tae Wook Kwon ),김형국 ( Hyung Kook Kim ),박규남 ( Kyu Nam Park ),김세경 ( Se Kyeung Kim ) 대한응급의학회 1997 대한응급의학회지 Vol.8 No.2

A 19-year-old man had a good neurologic recovery from a severe hypothermia(19C) and a prolonged coma following active intemal rewarming. From inhaling hydrocarbons, he was left unconscious on the cold floor for 24 hours. As soon as the patient was brought into the emergency medical center, he was early evaluated and treated aggressively. 'ECG showed Osborn(J) wave on all leads. The temperature of patient was increased by 2-3C per hour through active external rewarming (by heating blankets and warm bag) and active intemal rewarming (by airway rewarming, warmed IV fluids, gastrointestinal tract irrigation, and bladder irrigation). The temperature reached 36C after 6 hours. Active internal rewarming provides rapid core rewarming with the additional benefit of circulatory support during the period of cardiac instability.

데페록사민 전처치가 토끼 심근경색 크기의 감소에 미치는 효과

양관모,오동렬,박승현,박규남,이원재,김형국,황두영,최승필,채장성 대한응급의학회 1998 대한응급의학회지 Vol.9 No.4

Background: Reperfusion of ischemic myocardium has been postulated to result in a specific oxygen radical mediated tissue injury. Iron may liberate during ischemia and we hypothesized that administration of the iron chelator, deferoxamine during ischemia would result in improved recovery after postischemic reperfusion. Purpose: To test whether iron-catalyzed processes contribute to myocardial necrosis during ischemia and reperfusion, deferoxamine was administered to block iron catalyzed hydroxyl radical formation in rabbits. Methods: Eleven rabbits were divided into two groups : control group (n=5) and deferoxamine pretreatment group (n=6). The left circumflex coronay artery was ligated for 30 minutes and reperfused for 180 minutes. Area at risk (AR) was measured by non-stained area with methylene blue injection into left atrium after left circumflex coronary artery ligation. Infarct size was measured by weighing after triphenyltetrazolium chloride staining. Heart rate was measured using electrocardiographic recording and systemic blood pressure was monitored by pressure transducer connected to the catheter in the left ventricle. Results: 1. There was no significant difference of heart rate and blood pressure in deferoxamine pretreatment group compared with control group. 2. There was significant decrease of serum iron concentration after continuous infusion of deferoxamine compared with serum iron concentration before ligation of coronary artery(P<0.05). 3. There was no significant difference of area at risk between control and deferoxamine pretreatment group. 4. Area at necrosis to area at risk was significantly reduced in deferoxamine pretreatment group compared with control group(P<0.05). The results suggest that deferoxamine infusion prior to coronary artery occlusion has a significant benefit in reducing infarct size in this model.

Sodium bromate 음독후 비가역적 급성 신부전 및 청력소실과 시력소실이 발생한 1례

양관모,이원재,권태욱,박규남,나병호,유은영,최승필,김세경 대한응급의학회 1997 대한응급의학회지 Vol.8 No.4

A 39-year-old hairdresser developed sodium bromate poisoning after drinking a cup of hair neutralizer in a suicide attempt. This is the first case of visual loss afteringestion of sodlum bromate. Only few cases are as a cause of acute renal failure reported in medical literature. She presented I day later with anuria, required hemodialysis. Sensorineural hearing loss, often a characteristic finding, was developed.

절제 불가능한 전이가 동반된 4기 대장암 환자의 고식적 복강경 대장절제

양관모(Kwan Mo Yang),임석병(Seok-Byung Lim),윤용식(Yong Sik Yoon),김찬욱(Chan Wook Kim),박인자(In Ja Park),유창식(Chang Sik Yu),김진천(Jin Cheon Kim) 대한종양외과학회 2013 Korean Journal of Clinical Oncology Vol.9 No.2

Purpose: This study aimed to evaluate role of palliative laparoscopic colorectal resection for patients with stage IV colorectal cancer with unresectable metastasis. Methods: We reviewed 248 patients with stage IV colorectal cancer who underwent palliative bowel resection of the primary tumor during the period from January 2008 to December 2010 at Asan Medical Center. The short-term and oncologic outcomes of those with laparoscopic resection were reviewed and comparison was made between patients with laparoscopic and open resection. Results: A total of 248 patients were identified and of these patients, 50 underwent laparoscopic resection and conversion was required in six patients (12.0%). There was no differences in the gender, age, the location of primary tumor. But in the open group, peritoneal seeding was more (31.8% vs. 14.3%) and lung metastasis was less (28.3% vs. 48.0%; P=0.023) than laparoscopic group. The length of postoperative hospital stay in the laparoscopic group was significantly shorter than that in the open group (10.4 days vs. 6.7 days; P=0.048), and the postoperative complications were no significant difference in the both groups (13.1% vs. 8.0%; P=0.466) The overall survivals were similar in the both groups (mean survival, 758 days vs. 851 days; P=0.278). Conclusion: Considering of the patient’s general condition and distant metastasis, laparoscopic palliative bowel resection for stage IV colorectal cancer with unresectable metastasis is effective and safe.

자발적인 식도파열(Boerhaave 증후군) 2례

양관모,박재길,최승필,박규남,김영민,나병호,이원재,김세경 대한응급의학회 1997 대한응급의학회지 Vol.8 No.4

We experienced two cases of Boerhaave syndrome (spontaneous esophageal rupture). The first patient was a 62-year-old male who presented epigastric pain after several violent vomitings associated with alcohol ingestion. Diagnosis was done early and promptly in our emergency center and then definitive treatment was done only after 12hrs from onset of his symptom and he was discharged in relatively good condition 25days after his admission. The second patient was a 44-year-old male who was transfered to our emergency center with chest pain, dyspnea and fever after vomitings associated with autobicycle accident. Diagnosis was delayed due to initial trauma oriented evaluation and incidious development of typical clinical findings and then he was managed conservatively but he died of multiple organ failure due to sepsis. We report these cases with literature review.

Role of Palliative Laparoscopic Bowel Resection in Stage Ⅳ Colorectal Cancer Patients with Unresectable Metastasis

Kwan Mo Yang(양관모),Seok-Byung Lim,Yong Sik Yoon,Chan Wook Kim,In Ja Park,Chang Sik Yu,Jin Cheon Kim 대한종양외과학회 2013 대한임상종양학회 학술대회지 Vol.2013 No.3

Purpose: This study aimed to evaluate short-term and oncologic outcomes of palliative laparoscopic colorectal resection for patients with colorectal cancer with unresectable metastasis compared with open resection.<br/> Methods: From the database for patients who underwent surgery for colorectal cancer in our institution. those with colorectal cancer who underwent palliative bowel resection of tumor during the period from January 2008 to December 2010were included. The outcomes of those with laparoscopic resection were reviewed and was made between patients with laparoscopic and resection.<br/> Results: A total of 248 patients (133 men) were included, and 50 underwent laparoscopic resection. Conversion was required in six patients (12.0%) and the reasons for conversion were fix or bulky tumors. There was no 30-day postoperative mortality in the laparoscopic group. The complication rate after laparoscopic surgery (8.0%) was similar to that after open surgery (13.1%) (p=0.466) The length of postoperative hospital stay in the laparoscopic group was significantly shorter than that in the open group. (6.7 vs 10.3 days; P=0.048). The overall survivals were similar in the two groups.<br/> Conclusions: Compared with open surgery, laparoscopic primary bowel resection for stage Ⅳ colorectal cancer with unresectable metastasis has advantages in the operative outcomes in terms of hospital stay and comparable in the long term oncologic outcomes.