갑상선 질환(종양)에서 Cyclooxygenase-2의 발현에 대한 연구

이국종,박희붕,김지훈,정용식,주희재<SUP>1<,SUP>,소의영,Kug Jong Lee,M,D,Hee Boong Park,M,D,Ji Hoon Kim,M,D,Yong Sik Jeong,M,D,Hee Jae Joo,M,D,<SUP>1<,SUP> and Euy Young Soh,M,D 대한갑상선-내분비외과학회 2002 The Koreran journal of Endocrine Surgery Vol.2 No.2

Purpose: Thyroid tumor is one of the most common endocrine tumors, and yet little is known about its molecular process of development and progression. Cyclooxygenase (COX)- 2, the inducible form of the COX enzyme for prostaglandin synthesis, is up-regulated in gastrointestinal cancers and is a key mediator of epithelial cell growth. Regular intake of aspirin or other nonsteroidal antiinflammatory drugs (NSAIDs) is associated with a decreased incidence of colorectal, esophageal, gastric, and lung cancer. We sought to determine the involvement of COX-2 in human thyroid cancer. Methods: COX-2 protein was assayed in thyroid tissue of 64 which were inflammatory disease and benign tumor and malignant tumor with or without metastasis patients by using immunohistochemistry and Western Blot analysis. Results: COX-2 protein was not expressed in normal thyroid tissue. But COX-2 protein was expressed strongly in inflammatory tissue. Expression of COX-2 was very high in both benign and malignant tumor. There is no difference in pathology and malignant potential or existence of metastasis. Conclusion: There was no correlation between clinicopathological characteristics of thyroid tumor and intensity of COX-2 protein expression. In addition, there was no difference of expression of COX-2 between inflammatory thyroid disease and thyroid tumor. This study indicates that COX-2 protein over expression may contribute to an early event of gastric cancer development, and it further suggests that selective inhibition of COX-2 may provide a chemopreventive effect against thyroid cancer. (Korean J Endocrine Surg 2002;2:90-96)

술전 금식이 90% 간 절제술로 유도된 급성 간부전 백서의 생존에 미치는 영향

이국종(Kug Jong Lee),왕희정(Hee Jung Wang),김욱환(Wook Hwan Kim),김명욱(Myung Wook Kim) 한국간담췌외과학회 1999 한국간담췌외과학회지 Vol.3 No.2

외과의사 관점에서 외상전문의의 필요성과 과제

이국종 ( Kug Jong Lee ) 대한외상학회 2008 大韓外傷學會誌 Vol.21 No.1

When man first walked on this planet, injury must have been a close encounter of the first kind. The outbreak of World War I, during a period of rapid scientific growth in the basic sciences, demonstrated the need to develop better methods of care for the wounded, methods that were later applicable to the civilian population. Trauma is a multisystem disease and, as such, benefits from almost any advance in medical science. As we learn more about the physiology and the biochemistry of various organ systems, we can provide better management for trauma victims. Improved imaging techniques, better appreciation of physiologic tolerance, and increased understanding of the side effects of specific surgical procedures have combined to reduce operative intervention as a component of trauma patient care. On the other hand, because of this rapid development of medical science, only a few doctors still have the ability to treat multisystem injuries because almost doctor has his or her specialty, which means a doctor tends to see only patients with diagnoses in the doctor`s specialty. Trauma Surgeons are physicians who have completed the typical general surgery residency and who usually continue with a one to two year fellowship leading to additional board certification in Surgical Critical Care. It is important to note that trauma surgeons do not need to do all kinds of operations, such as neurosurgery and orthopedic surgery. Trauma surgeons are not only a surgeon but also general medical practitioners who are very good at critical care and coordination of patient. In order to achieve the best patient outcomes, trauma surgeons should be involved in prehospital Emergency Medical Services, the Trauma Resuscitation Room, the Operating Room, the Surgical Intensive Care and Trauma Unit, the Trauma Ward, the Rehabilitation Department, and the Trauma Outpatient Clinic. In conclusion, according to worldwide experience and research, the trauma surgeon is the key factor in the trauma care system, so the trauma surgeon should receive strong support to accomplish his or her role successfully.

중증 외상센터 설립 방안

이국종 ( Kug Jong Lee ),김재용 ( Jae Yong Kim ),이강현 ( Kang Hyun Lee ),서길준 ( Gil Joon Suh ),윤여규 ( Yeo Kyu Youn ) 대한외상학회 2005 大韓外傷學會誌 Vol.18 No.1

An ideal trauma care system would include all the components identified with optimal trauma care, such as prevention, access, acute hospital care, rehabilitation, and research activities. Central to an ideal system is a large resource-rich trauma center. The need for resources is primarily based on the concept of being able to provide immediate medical care for unlimited numbers of injured patients at any time. Optimal resources at such a trauma center would include inhouse board-certified emergency medicine physicians, general surgeons, anesthesiologists, neurosurgeons, and orthopedic surgeons. Other board-certified specialists would be available, within a short time frame, to all patients who require their expertise. This center would require a certain volume of injured patients to be admitted each year, and these patients would include the most severely injured patients within the system. Additionally, certain injuries that are infrequently seen would be concentrated in this special center to ensure that these patients could be properly treated and studied, providing the opportunity to improve the care of these patients. These research activities are necessary to enhance our knowledge of the care of the injured. Basic science research in areas such as shock, brain edema, organ failure, and rehabilitation would also be present in the ideal center. This trauma center would have an integrated concurrent performance improvement program to ensure optimal care and continuous improvement in care. This center would not only be responsible for assessing care delivered within its trauma program, but for helping to organize the assessment of care within the entire trauma system. This ideal trauma center would serve as a total resource for all organizations dealing with the injured patient in the regional area.

수술 전 문맥지결찰이 간절제술 후 잔존간의 재생에 미치는 영향

이국종(Kug-Jong Lee),왕희정(Hee-Jung Wang),김욱환(Wook-Hwan Kim),김명욱(Myung-Wook Kim) 대한외과학회 2005 Annals of Surgical Treatment and Research(ASRT) Vol.69 No.1

복부 둔상으로 인한 지연성 소장 파열 1례

박현수 ( Hyeon Soo Park ),허재민 ( Jae Min Hur ),정용식 ( Yong Sik Jung ),이국종 ( Kug Jong Lee ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.2

Due to recent industrialization and increasing population, there has been increase in number of accident, which has subsequently led to increase in trauma patients. Blunt abdominal trauma is a supreme challenge to the emergency specialist`s clinical acumen. Historical data may be incomplete, absent, or presumptive. The symptoms and signs can be unreliable and obfuscated by head injury, alcohol, or depressed mental status(1). Although abdominal trauma is common, diagnosis and treatment has always been difficult due to the complex structure of abdomen, despite advance in diagnostic technique. If the patient show peritoneal irritation sign or hemodynamic instability immediately after abdominal trauma, there is need for open surgery to diagnose and to treat peritonitis and hemoperitoneum. However, it is known that patient may show no symptom or sign immediately but may result in delayed bowel perforation which could be fatal for the patient. Therefore we reported a case of peritonitis due to delayed bowel perforation 7 days after abdominal trauma.

교통사고로 인한 중증손상 환자에 대한 분석

정지윤 ( Ji Yoon Jung ),백경원 ( Kyung Won Paek ),이국종 ( Kug Jong Lee ),조준필 ( Joon Pil Cho ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.2

Background: To provide information about serious traffic accident injuries in Suwon, Korea, during the year of 2000, we conducted an epidemiologic study of injured patients. Methods: The data were obtained by reviewing medical records of patients requiring hospital admission due to traffic injury. A retrospective study, the selection of patients was made according to ICD-10 code. Results: A total of 1389 patients were surveyed. With respect to the causes of injury, traffic accidents accounted for the highest percentage (40.2%). More men than women were injured in all age groups. The highest frequency of traffic injuries was noted in patients ranging in age from 20 to 39 years. The occurrences of accidents were distributed evenly throughout the year, with little seasonal correlation. As for the time of day, the accidents occurred more often in the afternoon and evening. Most of patients were admitted to general ward. The mean ISS of all traffic accident patients was 9.41±7.81. Factors associated with injury severity were sex, age, road user, time of day, and results of ED treatment. Conclusion: This is the first study of serious traffic accident injuries in Suwon for the year 2000. As such, our findings constitute the seminal information for future research, including collection of further data, analyses, and extensions to other cities.

국내 하지손상의 발생현황에 대한 분석

김창선 ( Chang Sun Kim ),최혁중 ( Hyuk Joong Choi ),김재용 ( Jai Yong Kim ),신상도 ( Sang Do Shin ),고상백 ( Sang Baek Koh ),이국종 ( Kug Jong Lee ),임태호 ( Tai Ho Im ) 대한외상학회 2008 大韓外傷學會誌 Vol.21 No.1

Purpose: We conducted this retrospective epidemiological study to assess the incidence and severity of lower extremity injuries in Korea Methods: For this study, we retrospectively reviewed nationwide lower-extremity injury data compiled from 2001 to 2003 based on the National Injury Database, what included National Health Insurance Corporation (NHIC), Car Insurance, and Industry Insurance data. Data were standardized in terms of demographic characteristics, region, and socioeconomic status by using NHIC data. To assess the degree of the injuries, we used the Modified Abbreviated Injury Scale (MoAIS), what has been changed from the International Classification of Disease-10 (ICD-10) code. By using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS), we classified the degree of severity into four categories: mild, moderate, severe and critical. Results: From 2001 to 2003, lower extremity injuries increased slightly, with a yearly average of 2,437,335. Insurance data should that lower-extremity injuries were the most common, followed by upper-extremity injuries. Significant difference were seen in the numbers of lower extremity injuries based on gender and age. As for provinces, Seoul and Gyeongi provinces had the highest numbers of cases. Junlabukdo had the highest rate of 55,282 cases per 1 million people for standardized gender and population. The annual incidence of the insured patients with lower extrimity injuries was higher than the employer`s medical insurance contributions to the medical insurance program. Daily cases occur most often in May and June, with the lowest occurrences being in January and February. Conclusion: The result of this study shows that lower extremity injuries comprised common cause of all injuries. In addition, differences associated with gender, location and socioeconomic status were observed. Further studies are needed to find reasons and then this knowledge will allow strategies to prevent the lower extremity injuries.

외상성 대량 간 손상 환자에서 수술 후 간 동맥 색전술의 유용성

차수현 ( Soo Hyun Cha ),정용식 ( Yong Sik Jung ),원제환 ( Jae Hwan Won ),김욱환 ( Wook Whan Kim ),왕희정 ( Hee Jung Wang ),김명욱 ( Myung Wook Kim ),이국종 ( Kug Jong Lee ) 대한외상학회 2006 大韓外傷學會誌 Vol.19 No.1

Purpose: Acute liver failure after massive partial hepatectomy is critical condition with high mortality. To prevent postoperative liver failure from being induced by a massive partial hepatectomy, many doctors do a minimal resection on the single lobe of the liver that might cause postoperative bleeding from the remaining ruptured parenchyma. The objective of this study was to assess clinical experience with postoperative hepatic arterial embolization to control bleeding from the remaining ruptured liver during the postoperative period. Methods: This retrospective 4-year study was conducted from May 2002 to April 2006 and included consecutive patients who had sustained massive hepatic injuries and who had undergone a laparotomy, followed by postoperative hepatic arterial angiographic embolization to control bleeding. Data on the injury characteristics, the operative treatment and embolization, and the amount of transfused packed red cells (PRBC) were gathered and analyzed. In addition, data on the overall complications and survival rate were collected and analyzed. Results: Every case showed severe liver injury, higher liver injury scaling grade IV. Only ten cases involved a ruptured bilateral liver lobe. A lobectomy was done in 6 cases, a left lobectomy was done in 3 cases, and a primary suture closure of the liver was done in 2 cases. Suture closure was also done on the remaining ruptured liver parenchyma in cases of lobectomies. The postoperative hepatic arterial embolizations were done by using the super-selection technique. There were some cases of arterio-venous malformations and anomalous vessel branches. The average amount of transfused PRBC during 24 hours after embolization was 2.36±1.75, which statistically significantly lower than that before embolization. Among the 11 cases, 9 patients survived, and 2 died. There was no specific complications induced by the embolization. Conclusion: In cases of postoperative bleeding in severe hepatic injury, if there is still a large amount of bleeding, postoperative hepatic arterial embolization might be a good therapeutic option. (K Korean Soc Traumatol 2006;19:59-66)

대학병원 응급의료센터로 전원되는 중증 외상환자의 현황 및 문제점

한상수 ( Sang Soo Han ),정경원 ( Kyoung Won Jung ),권준식 ( Jun Sik Kwon ),김지영 ( Hu Young Kim ),최상천 ( Sang Cheon Choi ),이국종 ( Kug Jong Lee ) 대한외상학회 2011 大韓外傷學會誌 Vol.24 No.2

Purpose: The incidence of multiple trauma is increasing nowadays and is the leading cause of death among young adults, Initial treatment is well known to be crucial in multiple trauma victims. However, many indiscriminate transfers occur due to the lack of a well-organized trauma system in Korea. The objective of this study is to demonstrate the current serious state in which major trauma patients are transferred to the Emergency Medical Center of a university hospital from another medical center. Methods: From November 2009 to October 2010, we performed a retrospective study to analyze the characteristics of patients who visited the Ajou University Medical Center located in Gyeonggi-do. We evaluated the ISS (injury severity score), and a score over 15 point was identified as major trauma. The major trauma patients were separated into two groups according to the visit route, and the characteristics of each group were analyzed. Results: Among the 88,862 patients who visited to the Emergency Medical Center, trauma patients accounted for 19,950, and 343 of them were evaluated as major trauma patients. Among the 343 patients, 170 patients had been transferred from other medical centers. The proportion of males to females was 3.3:1, and the mean ISS was 22.7. The leading cause of trauma was motor vehicle accidents. Of the total 170 patients, 77.6% were admitted to the Intensive care unit and 36.3% underwent surgery. The 170 patients that had been transferred to our medical center, 78.8% were transferred from Gyeonggi-do, 15.3% were transferred from other regions, and 5.9% were miscellaneous, Conclusion: Almost half of the major trauma victims treat at our medical center had been transferred from other medical centers, Establishing a traumatic system, supported by well-organized trauma centers and emergency medical services, that can reduce inappropriate transfers among medical facilities is essential.