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.

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.

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.

수요함수 관점에서 해석한 수요반응의 사회적 후생 분석

이광호,양관모,Lee, Kwang-Ho,Yang, Kwan-mo 대한전기학회 2017 전기학회논문지 Vol.66 No.1

Social Welfare is useful concept for evaluating the effectiveness of an economic policy in micro economics. This paper focuses on Social Welfare(SW) of electricity market incorporating demand response(DR). Competition between DR and generation company is modeled as a simple bid function. DR function can be considered as an negative generation(called Negawatt) and as an element of modified demand function. These two approaches result in the same demand reduction, generation power, and the market price. However, SW in the modified demand function approach is not identical to SW in the Negawatt approach. It makes the numerical index of DR effectiveness less persuasive. This paper proposes modified definition of SW in the demand function approach. The proposed definition of SW leads the DR effectiveness index to be identical to that in the Negawatt approach.

수요함수 관점에서 해석한 수요반응의 사회적 후생 분석

이광호(Kwang-Ho Lee),양관모(Kwan-mo Yang) 대한전기학회 2017 전기학회논문지 Vol.66 No.2

Social Welfare is useful concept for evaluating the effectiveness of an economic policy in micro economics. This paper focuses on Social Welfare(SW) of electricity market incorporating demand response(DR). Competition between DR and generation company is modeled as a simple bid function. DR function can be considered as an negative generation(called Negawatt) and as an element of modified demand function. These two approaches result in the same demand reduction, generation power, and the market price. However, SW in the modified demand function approach is not identical to SW in the Negawatt approach. It makes the numerical index of DR effectiveness less persuasive. This paper proposes modified definition of SW in the demand function approach. The proposed definition of SW leads the DR effectiveness index to be identical to that in the Negawatt approach.

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.

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.

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.

대규모의 종교집회에서 요구되는 응급의료의 수준

권태욱,황두영,양관모,이환,황주일,김세경 대한응급의학회 1997 대한응급의학회지 Vol.8 No.2

STUDY OBJECTIVE To determine the level of medical care required for mass gatherings and describe the types of medical problems encountered in a religious mass gathered ceremony. DESIGN: Standard charts and a four-tiered triage system(minor, moderate, urgent, and emergent) were developed before the event. The triage system was applied to each chart retrospectively by a single emergency physician. SETTING: Medical staff(10 physicians, 13 nurses, 1 pharmacist, and 54 first-aid attendants) were based in 8 advanced life support(ALS) clinics. INTERVENTIONS: First-aid attendants referred patients to the clinics, where nurses conducted initial assessments and referred patients to physicians at the venue. Three ambulances were stationed at the venues. RESULT: 22 trauma patients were developed and 183 medical complaints were encountered. Only 7 urgent medical problems were encountered.

급성신부전증에 합병된 에틸렌 글라이콜 중독의 성공적인 치험1례

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

Ethylene glycol is a sweet-tasting liquid with industrial use a solvent or as a starting reagent in chemical processes. Physicians are familiar with ethylene glycol because it is the major component of many antifreeze solutions and is taken in suicide attempts or, more often inadvertency. its metabolites may cause severe intoxication. Unfortunately, its administration and enhancement of elimination. The most commonly used elimination technique is hemodialysis We describe an 21-year-old man with acute renal failure dye to ingestion of antifreeze that contained ethylene glycol. He was transferred to our patient with severe ethylene glycol intoxication illustrates that aggressive and early treatment can prevent mortality and morbidity