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김용석(Yong Seok Kim),황준영(Jun Young Hwang),안지현(Ji Hyun Ahn),김미경(Mi Kyung Kim),박준석(Jun Seok Park),최유신(Yoo Shin Choi),김범규(Beom Gyu Kim),박용검(Yong Gum Park),지경천(Kyung Chun Chi),이정효(Jung Hyo Lee),임현묵(Hyun Muc 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.6
Paragangliomas are rare tumors that arise from the extraadrenal chromaffin cells. We report here on a case of retroperitoneal paraganglioma in a 24-year-old young man. Abdomen CT and magnetic resonance imaging showed a hypervascular mass near the left ureter. He had not felt paroxysmal palpitation and his vital signs were within the normal range. An exploratory laparotomy revealed a 7.2×5.5 cm sized mass below the jejunum and near the aorta, and this mass had adhesion to the left ureter. It was histologically diagnosed with a paraganglioma after the surgical resection. Although there was an increase of blood pressure on palpation during surgery, the postoperative course was uneventful. When we consider the unusual locations and the associated operative risk, we should take care to rule out the possibility of a functional paraganglioma in the preoperative differential diagnosis of an abdominal mass.
The effect of laparoscopic versus robotic low anterior resection of rectum on postoperative pain
Hanbyul Lee(이한별),Beom Gyu Kim(김범규),Yong Gum Park(박용검),Hyun Kang(강현) 대한종양외과학회 2016 Korean Journal of Clinical Oncology Vol.12 No.2
Purpose: The aim of this study was to compare postoperative outcomes regarding pain and pain management in patients who underwent robot-assisted low anterior resection (RA-LAR) with laparoscopy-assisted low anterior resection (LA-LAR). Methods: Medical records of adult patients who underwent LA-LAR (group L) or RA-LAR (group R) using robotic system (da Vinci Surgical System, Intuitive Surgical Inc., Sunnyvale, CA, USA) were collected prospectively at Chung-Ang University Hospital between January 1, 2010 and December 31, 2015. Patients were matched at a 1 to 1 ratio from Group L and R using propensity score-matching method. Intravenous patient-controlled analgesia (IV-PCA) was applied to the patients postoperatively, and the severity of postoperative pain visual analogue scale (VAS) and nausea as the numerical rating scale (NRS) was evaluated. The incidence of vomiting, dizziness, headache, and PCA clamping was also recorded. Additional fentanyl was administered as a rescue analgesic if the VAS score was over 3, and until VAS was less than 3. Results: In the overall series, there was no significant difference between group L and group R regarding pain VAS, nausea NRS, number of vomiting episodes at day 0 and day 1. However, after propensity score analysis, pain VAS and the use of rescue analgesic at day 0 was lower in group L compared to group R (P=0.038, P=0.040). Conclusion: In regards to postoperative pain, RA-LAR did not show clear benefit over LA-LAR.
위선암종에서 p53 단백 및 CREB-결합 단백의 면역조직화학적 발현양상
노태호(Tae Ho Noh),지경천(Kyung Choun Chi),임현묵(Hyun Muk Lim),이정효(Jung Hyo Lee),박용검(Yong Gum Park),김범규(Beom Gyu Kim),김미경(Mi Kyung Kim),김진수(Jin Soo Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.6
Purpose: The wild-type p53 protein participates in suppressing cell transformations while its mutant forms has tumorigenic potential. Alterations in the structure of the p53 protein are one of the most common changes associated with human cancers. CREB-binding protein (CBP) and its homologue, p300, are transcriptional co-activators of various sequence-specific DNA-binding transcription factors and are involved in a wide range of cellular activities, such as DNA repair, cell growth, differentiation, and apoptosis. Several studies suggested that an association between p53 and p300 might account for the p53-responsible negative regulation. This study examined the relationship between p53 and CBP expression in terms of the clinicopathological factors and significance. Methods: The level of p53 protein and CBP expression was measured in 150 gastric adenocarcinoma patients, who had undergone a gastrectomy, and the relationship between p53 and CBP was examined. Immunohistochemical stain was performed on formalin-fixed paraffin-embedded sections using monoclonal anti-p53 and anti-CBP antibody. Results: 1. p53 protein was expressed in 46.3% (31/67) of early gastric cancers (EGC), 69.9% (58/83) of advanced gastric cancers (AGC)(P<0.05), 69.1% (65/94) of the intestinal type, 42.9% (24/56) of the diffuse type (P<0.05), 78.5% (55/70) of patients with a lymph node metastasis and 42.5% (34/80) of patients without a lymph node metastasis (P<0.01). 2. CBP expression was observed in 65% (61/94) of intestinal type, 51% (29/56) of the diffuse type (P>0.05), 47.8% (32/67) of EGC, 69.8% (58/83) of AGC (P<0.05), 68.6% (48/70) of patients with a lymph node metastasis and 52.5% (42/80) of patients without a lymph node metastasis (P>0.05). 3. p53 protein and CBP expression was coincidentally observed in 66.7% of gastric adenocarcinomas, and there was a significant correlation between the expression of both (P<0.05). Conclusion: That the expression of the p53 protein and CBP indirectly indicate the malignant potential of a cell, and may play an indirect role in the CBP and p53-mediated tumorigenic potential.