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김기한,김민찬,최석렬,정갑중,김형호,Kim, Ki-Han,Kim, Min-Chan,Choi, Seok-Reyol,Jung, Ghap-Joong,Kim, Hyung-Ho 대한위암학회 2003 대한위암학회지 Vol.3 No.4
Purpose: Preoperative staging of gastric cancer is crucial because the treatment modality and the prognosis depend upon the stage of gastric cancer. Current treatment modalities for early gastric cancer have focused on the quality of life. Endoscopic ultrasonography (EUS) and abdominal computed tomography (CT) are commonly used diagnostic tools to evaluate the invasiveness (T stage) of the primary tumor. The purpose of this paper is to evaluate the sensitivity and the specificity of preoperative EUS and CT in comparison with postoperative pathology. Materials and Methods: From October 2001 to October 2002, EUS and abdominal CT were performed simultaneously on 75 patients who underwent radical gastric surgery for the treatment of gastric cancer. Through analyzing the clinical T stage and the pathologic T stage, We evaluated the diagnostic sensitivities and specificities of endoscopic ultrasonography and abdominal computed tomography. Results: The male-to-female sex ratio was 1 : 0.6 (males: 47, females: 28). The mean age was 55.4 years in males (range: $28\~81$) and 54.4 years in females (range: $23\∼77$). The clinical T stage based on EUS included 22 T1mm, 7 T1sm, 22 T2, and 24 T3. The clinical T stage based on CT included 20 Tx, 23 T2, and 32 T3. The permanent pathologic report confirmed 23 T1mm, 10 T1sm, 17 T2, 24 T3, and 1 T4. The sensitivity and specificity of EUS were $84.2\%\;and\;94.7\%$, respectively. However, the sensitivity and specificity of abdominal CT were $53.3\%\;and\;77.0\%$, respectively. Conclusion: Our data suggest that EUS is a very useful diagnostic tool for evaluating the T stage of gastric cancer because EUS has higher specificity than abdominal CT. Therefore, EUS may have a significant role as a preoperative diagnostic modality in patients undergoing minimally invasive surgery.
Plummer-Vinson Syndrome과 동반된 진행성 위암 1예
이성근,이태무,권육,김기한,김민찬,정갑중,Lee Sung-Gun,Lee Tae-Mu,Kwon Yuk,Kim Ki-Han,Kim Min-Chan,Jung Ghap-Joong 대한위암학회 2004 대한위암학회지 Vol.4 No.2
Plummer-Vinson syndrome (sideropenic dysphagia) is characterized by dysphagia due to an upper esophageal or a hypopharyngeal web in a patient with chronic iron deficiency anemia. The main cause of dysphagia is the web of the cervical esophagus, and an abnormal motility of the pharynx or the esophagus is found to play a significant role in the above cause. Patients with this syndrome are thought to be precancerous because squamous cell carcinomas of the hypopharynx, oral cavity, or esophagus take place in $10\%$ of those patients. However, for Plummer-Vinson syndrome to be combined with gastric cancer is most unusual. We report the case of a 43-year-old woman who was first found to have stomach cancer under a diagnosis of Plummer-Vinson syndrome and who recovered after surgery.
이종훈,최석렬,한상영,황태호,김민찬,정갑중,노미숙,정진숙,Lee Jong Hoon,Choi Seok Ryeol,Han Sang Young,Hwang Tae Ho,Kim Min Chan,Jung Ghap Joong,Roh Mee Sook,Jeong Jin Sook 대한위암학회 2002 대한위암학회지 Vol.2 No.4
Purpose: The cDNA microarray provides a powerful alternative with an unprecedented view in monitoring geneexpression levels and leads to discoveries of regulatory pathways involved in complicated biological processes. Our aim is to explore the different gene-expression patterns in gastric adenocarcinomas. Materials and Methods: By using a cDNA microarray representing 4,600 cDNA clusters, we studied the expression profiling in 10 paired gastric adenocarcinoma samples and in adjacent noncancerous gastric tissues from the same patients. Alterations in the gene-expression levels were confirmed by Vsing Northern blots and reverse-transcription PCR (RT-PCR) in all of 4 randomly selected genes. Results: Genes those were expressed differently in cancer ous and noncancerous tissues were identified. 44 (of which 26 were known) and 92 (of which 43 were known) genes or cDNA were up- and down-regulated, respectively, in more than $80\%$ of the gastric adenocarcinoma samples. In cancer ous tissues, genes related to gene/protein expression, cellcycle regulation, and metabolism were mostly up-regulated whereas genes related to the oncogene/tumor suppressor gene, cell structure/motility, and immunology were mostly down-regulated. The semi-quantitative RT-PCR results for the four genes we tested were consistent with the array findings. Conclusions: These results provide not only a new molecular basis for understanding the biological properties of gastric adenocarcinomas but also a useful resource for future development of therapeutic targets and diagnostic markers for gastric adenocarcinomas.
단일기관에서 시행한 2,000예 이상의 복강경 담낭 절제술에 대한 임상적 분석
안영주(Young Joo An),김영훈(Young Hoon Kim),정갑중(Ghap Joong Jung),김성흔(Sung Heun Kim),노영훈(Young Hoon Roh) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.6
Purpose: Laparoscopic cholecystectomy has become the standard modality of acute and chronic gallbladder disease. This study was performed to evaluate a change in the indication for laparoscopic cholecystectomy according to period by analyzing our experiences. Methods: We retrospectively analyzed 2,096 cases of laparoscopic cholecystectomy that were treated at the Department of Surgery, Dong-A University. They were divided into 3 groups from October 1992 to December 1996 (Group 1), from January 1997 to December 2001 (Group 2) and from January 2002 to March 2007 (Group 3). Results: The mean age was 50.14±13.89 years and the male-to-female ratio was 1:1.23. Previous abdominal surgery was noted in 12.24% from Group 1, 14.96% from Group 2 and 21.48% from Group 3. Chronic cholecystitis was the most common pathologic diagnosis in all cases. However, while the incidence of acute cholecystitis and gallbladder empyema in Group 1 was 3.36% and 0%, that of Group 2 was 12.52% and 3.88% and that of Group 3 was 31.79% and 7.59%, which was increased. The mean operation time of each group was 101.00±51.00, 69.86±40.55, 78.01±45.55 minutes (P<0.05). The conversion rate of each group was nine cases (6.04%), 21 cases (3.02%), and 51 cases (4.07%). The surgical complication rate was 7.38%, 3.88% and 4.71%, respectively. The length of hospital stay was 6.08±3.65, 3.16±2.99 and 2.91±3.34 days, which was significantly decreased (P<0.05). Conclusion: As surgical experience increased and laparoscopic surgical skills developed, the indication for laparoscopic cholecystectomy changed. The results of this study showed that laparoscopic cholecystectomy was feasible for the treatment of complicated gallbladder lesion.