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- 저자 : 장수근(Su Kurn Chang) (검색결과 3 건)
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황윤진(Yoon Jin Hwang),김종열(Jong Yeol Kim),장수근(Su Kurn Chang),김상걸(Sang Geol Kim),김양일(Yang Il Kim),황정현(Jeong Hyun Hwang) 한국간담췌외과학회 2008 한국간담췌외과학회지 Vol.12 No.1
Purpose: Acute fulminant hepatic failure (FHF) is associated with high mortality. Recent studies have shown that a liver support system based on viable hepatocytes can prolong life in animal models of FHF and also in some FHF patients who were successfully bridged to liver transplantation. To be applied in humans, the bioartificial liver (BAL) system should have sufficient liver cell mass to provide adequate bioactive support. The most widely investigated bioreactor at present is based on hollow fiber membrane. However, it is difficult to build a scaledup module of this model. We devised a fluidized-bed bioreactor that is packed with isolated porcine hepatocytes, and these hepatcytes are immobilized in Ca-alginate hydrogel. Methods: We isolated fresh porcine hepatocytes using a 2-step collagenase perfusion method, and they were suspended in 1.5% alginate solution. Through a drop-generator, this mixture was gelled in 135mM Cacl2. The resulting spherical beads (mean size: 500 m) were embedded in a module. An average of 2x1010 hepatocytes were present in the module. The efficacy of our design was tested in pigs that had undergone total hepatic devascularization and portocaval shunt. Results: The BAL-treated group showed a significantly lower ammonium build-up rate compared to the control group (598.6±344.2 g/dl vs 1937.6±744.1 g/dl, respectively, at 8 hours after connecting to BAL). In addition, the intracranial pressure was well controlled in the BAL-treated group, whereas the control group showed a progressive increase of the intracranial pressure (16.9±1mmH2O vs 21.9±2.6mmH2O, respectively, at 8 hours after connecting to BAL). Conclusion: Our bioartificial liver system is a fluidized-bed bioreactor packed with immobilized porcine hepatocytes, and it seems to be a more effective scaled-up module.
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조자윤(Ja Yun Cho),김종열(Jong Yeol Kim),장수근(Su Kurn Chang),김상걸(Sang Geol Kim),황윤진(Yoon Jin Hwang),윤영국(Young Kook Yun) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.4
Purpose: Biliary tract disease is one of the most common causes of acute abdominal pain in elderly patients, but there is still some debate over treatment. The aim of this study is to determine the safety and surgical outcomes of laparoscopic cholecystectomy (LC) for benign gallbladder disease in octogenarian patients. Methods: We selected 42 patients of 80 years or older who underwent LC or open-converted cholecystectomy(OC) from February 1992 to November 2006. We evaluated clinicopathological features, treatment modalities, and surgical outcomes retrospectively. Results: The patients included 17 males and 25 females. The mean age of the patients was 83.3 and 83.7, respectively. Right upper quadrant pain was the most common symptom, present in 85.7% of the patients. Gallstones were present in 85.7%. ASA class Ⅱ and Ⅲ comprised 92.9% of the patients. Comorbidities included hypertension, cardiac disease, pulmonary disease, and diabetes mellitus. Preoperatively biliary drainage was performed in 12 cases (endoscopic drainage in 8, percutaneous drainage in 4 cases). Preoperative cholecystostomy was performed in 5 cases. Emergency operations were more frequent than elective surgery (25 vs. 17). Mean hospital stay of LC patients was 5 days, whereas that of OC patients was 13 days. Open conversion rate was 16.7%. No surgical mortality was present and postoperative morbidity included acute myocardial infarction in one patient and wound infection in one patient. Conclusion: LC in octogenarian patients was safe. However, since the incidence of comorbidities is high in these patients, great care should be taken to evaluate and manage the comorbidities before surgery.
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