http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
- 中文 을 입력하시려면 zhongwen을 입력하시고 space를누르시면됩니다.
- 北京 을 입력하시려면 beijing을 입력하시고 space를 누르시면 됩니다.
RISS 인기검색어
- 검색키워드
- 저자 : ( Won-hee La ) (검색결과 38 건)
- 무료
- 기관 내 무료
- 유료
-
Kang, Hee-Yun,Lee, Tai-Sang,Lee, Yul-Pyo,Lee, Doo-Won,La, Hyun-O,Song, Hyun-Ju,Sohn, Uy-Dong The Pharmaceutical Society of Korea 2001 Archives of Pharmacal Research Vol.24 No.6
We have previously shown that, in circular muscle cells of the lower esophageal sphincter (LES) isolated by enzymatic digestion, contraction in response to maximally effective doses of acetylcholine (ACh) or Inositol Triphosphate ($IP_3$) depends on the release of $Ca^{2+}$ from intracellular stores and activation of a $Ca6{2+}$-calmodulin (CaM)-dependent pathway. On the contrary, maintenance of LES tone, and response to low doses of ACh or $IP_3$ depend on a protein kinase C (PKC) mediated pathway. In the present investigation, we have examined requirements for $Ca6{2+}$ regulation of the interaction between CaM- and PKC-dependent pathways in LES contraction. Thapsigargin (TG) treatment for 30 min dose dependently reduced ACh-induced contraction of permeable LES cells in free $Ca6{2+}$ medium. ACh-induced contraction following the low level of reduction of $Ca6{2+}$ stores by a low dose of TG ($10^{-9}{\;}M$) was blocked by the CaM antagonist, CCS9343B but not by the PKC antagonists chelerythrine or H7, indicating that the contraction is CaM-dependent. After maximal reduction in intracellular $Ca{2+}$ from $Ca6{2+}$stores by TG ($10^{-6}{\;}M$), ACh-induced contraction was blocked by chelerythrine or H7, but not by CCS9343B, indicating that it is PKC-dependent. In normal $Ca^{2+}$medium, the contraction by ACh after TG ($10^{-9}{\;}M$) treatment was also CaM-dependent, whereas the contraction by ACh after TG ($10^{-9}{\;}M$) treatment was PKC-dependent. We examined whether PKC activation was inhibited by activated CaM. CCS 7343B Inhibited the CaM-induced contraction, but did not inhibit the DAC-induced contraction. CaM inhibited the DAC-induced contraction in the presence of CCS 9343B. This inhibition by CaM was $Ca{2+}$dependent. These data are consistent with the view that the switch from a PKC-dependent pathway to a CaM dependent pathway can occur and can be regulated by cytosolic $Ca{2+}$ in the LES.
-
S-66 Endoscopy guided da Vinci® Robotic gastric surgery for early gastric cancer
( A La Woo ),( Joo Young Cho ),( Hee Jin Hong ),( Weon Jin Ko ),( Ga Won Song ),( Yoo Min Kim ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Background: Endoscopic resection has been an optimal treatment for selected patients with early gastric cancer (EGC) based on advances in endoscopic instruments and techniques. This study aims to evaluate the result of endoscopy guided da Vinci® Robotic gastric full thickness local resection (ERGR) with sentinel lymph node dissection (SLND) under indocyanine green and infrared in cases of EGC with high risk of lymph node metastasis.?Method: This was a prospective, pilot study at a single academic center. Of 70 patients with EGC, 4 met the following criteria: 1) differentiated mucosal/submucosal cancer with an ulcer, between 3 and 5 cm by endoscopic imaging; 2) undifferentiated mucosal/submucosal cancer without an ulcer, between 2 and 3 cm by endoscopic imaging; 3) patients who had undergone previous ESD whose pathological reports recommended an additional gastrectomy due to a risk for LNM. The main outcome measure was technical success.?Results: All cases were resected en bloc with negative surgical margins. Previous forceps biopsy results revealed that all cases were undifferentiated adenocarcinoma. Three of the 4 cases were suspected submucosal cancer by endoscopic and EUS findings. The other case that had undergone previous ESD whose pathological reports recommended an additional gastrectomy due to positive vertical margin. No patient was observed lymph node metastasis. ERGR with SLND was conducted without perioperative adverse events.?Conclusions: Endoscopy guided da Vinci® Robotic gastric surgery could be a bridge between ESD and laparoscopic surgery with respect to preventing an extensive gastrectomy in patients with EGC.?
-
자궁경부암 환자의 근치적 방사선치료 시 VEGF 발현의 임상적 의의
박원(Won Park),최윤라(Yoon-La Choi),허승재(Seung Jae Huh),윤상민(Sang Min Yoon),박영제(Young Je Park),남희림(Hee Rim Nam),안용찬(Yong Chan Ahn),임도훈(Do Hoon Lim),박희철(Hee Chul Park) 대한방사선종양학회 2006 Radiation Oncology Journal Vol.24 No.1
Purpose: We wanted to determine the clinical characteristics and prognosis according to the VEGF expression in stage II cervical carcinoma patients treated with definitive radiotherapy. Materials and Methods: We enrolled 31 patients who were diagnosed with cervical cancer from 1995 to 2003 at Samsung Medical Center and their paraffin block tissue samples were available for study. The median age of the patients was 65 years. The mean tumor size was 4.1 cm (range: 1.2∼8.2 cm). Seven patients (22.6%) were suspected of having pelvic lymph node metastasis. An external beam irradiation dose of 45-56.4 Gy was administered to the whole pelvis with a 15 MV linear accelerator, and an additional 24 Gy was given to point A by HDR intracavitary brachytherapy. VEGF staining was defined as positive when more than 10% of the tumor cells were stained. The median follow-up duration was 58 months. Results: A positive VEGF expression was observed in 21 patients (67.7%). There was no significant correlation between the VEGF expression and pelvic lymph node metastasis, tumor size and the response of radiotherapy. During follow-up, 7 patients had recurrence. The complete response rate was not significant between the VEGF (-) and VEGF (+) tumors. However, the VEGF (+) tumors showed a significantly higher recurrence rate in comparison with the VEGF (-) tumors (p=0.040). The three year disease-free survival rates were 100% and 66.7%, respectively, for patients with VEGF (-) or VEGF (+) tumor (p=0.047). Conclusion: The VEGF expression was a significant factor for recurrence and disease-free survival. However, the significance of the VEGF expression is still controversial because of the various definitions of VEGF expression and the mismatches of the clinical data in the previous studies. 목 적: 종양 내 VEGF의 발현이 방사선저항성과 관련이 있고, 자궁경부암에서 VEGF 발현이 예후와 관련된다는 보고들이 있다. 본 연구에서는 자궁경부암 환자에서 근치적 방사선치료를 시행받은 환자를 대상으로 후향적으로 VEGF 발현에 따른 임상적 특성 및 환자 예후와 연관 관계를 알아보고자 하였다. 대상 및 방법: 1995년 9월부터 2003년 4월까지 삼성서울병원에서 자궁경부의 편평상피세포암 FIGO 병기 II로 진단받고 근치적 방사선치료가 시행된 환자 중 면역조직학 검사를 위한 파라핀 블록이 유용한 31명 환자를 대상으로 하였다. 대상환자들의 연령 분포는 38∼83세(중간값 65세)였다. 종양의 크기는 1.2∼8.2 cm (평균 4.1 cm)였고, 골반내 림프절 전이는 7예(22.6%)에서 있었다. 방사선치료는 15 MV 광자선으로 매일 1.8 Gy씩 주 5회, 전골반 내 조사가 시행되었는데 외부방사선치료 선량은 45∼56.4 Gy (중간값 50.4 Gy)였고, 강내치료는 point A에 1회 4 Gy씩 주2회, 총 24 Gy 조사되었다. 방사선치료 기간은 48∼67일(중간값 53일)이었다. VEGF 면역조직학 검사상 양성은 종양세포 중 VEGF 분포가 10% 이상인 경우로 정하였다. 대상환자들의 추적관찰기간은 12∼119개월(중간값 58개월)이었다. 결 과: VEGF 양성인 경우는 21예(67.7%)였다. VEGF 발현에 따른 골반 내 림프절 전이 유무, 종양 크기와 방사선 치료에 따른 관해 정도의 유의한 차이는 없었다. 전체 환자 중 7예에서 재발이 있었는데 국소재발, 원격전이, 국소 재발과 원격전이가 동반된 경우가 각각 3예, 3예, 1예였다. VEGF 음성과 양성인 경우에 방사선치료 후 완전관해율이 각각 90%와 81%로 의의있는 차이는 없었지만, 재발은 모두 VEGF 양성인 환자에서 발생하여 통계적으로 의의 있는 차이를 보였다(p=0.040). 3년 무병생존율은 77.4%였는데, VEGF 음성과 양성인 경우 각각 100%와 66.7%로 차이가 있었다(p=0.047). 결 론: 자궁경부암 FIGO 병기 2기 환자의 근치적 방사선치료 시 종양 내 VEGF 발현 유무는 재발률과 무병생존율에 영향을 주는 인자였다. 그러나 VEGF 과발현에 대한 각 문헌마다 정의가 다르고, 문헌에 보고되는 환자수가 많지 않아 향후 VEGF 발현이 자궁경부암 환자의 예후인자로 결정되기 위해서는 대규모 연구가 필요하겠다
-
-
-
이희숙 ( Hee Suk Lee ),김주명 ( Joo Myung Kim ),유지희 ( Ji Hee Yoo ),육지형 ( Ji Hyung Yook ),김미라 ( Mi La Kim ),윤재범 ( Jae Bum Yoon ),주관영 ( Kwan Young Joo ),전종영 ( Jong Young Jun ),한호원 ( Ho Won Han ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.5
목적: 배란유도제 사용 또는 보조생식술 후 병합임신이 된 환자에서 보존적 치료 후의 임신의 결과에 대해 알아보고자 하였다. 연구 방법: 2000년 1월 1일부터 2008년 4월 30일까지 병합임신으로 진단된 24명의 환자를 대상으로 후향적 연구를 시행하였다. 환자의 보조생식술 방법, 자궁외임신 부위 및 진단당시의 자궁내임신 상태, 보존적 치료 후의 임신의 결과에 대해 알아보았다. 결과: 총 24명의 환자가 있었고, 모두 불임치료 후 발생한 경우로 자연임신 후 발생한 경우는 없었다. 환자의 평균 나이는 31.5세 였으며, 진단당시 주수는 약 8주였다. 불임의 원인인자로 가장 흔한 것은 난관의 문제로 54.2%의 환자가 이에 해당하였다. 과배란유도 방법을 사용한 환자는 4명, 시험관아기를 한 경우가 18명이었으며, 2명의 환자는 타원에서 보조생식술을 시행 받아 정확한 시술방법은 모르는 상태였다. 자궁외임신 부위는 난관이 75%, 난소가 4.2%, 자궁각이 20.8%였으며, 50%가 자궁외임신 부위가 파열된 상태에서 진단되었다. 진단 이전 계류유산으로 소파술 시행 후 자궁외임신이 진단된 환자가 3명, 계류유산과 자궁외임신이 동시에 진단된 환자가 4명이었으며, 정상 자궁내임신과 자궁외임신이 동시에 진단된 환자는 17명이었다. 24명 중 3명에서만 출혈이나 유착 등으로 인해 개복수술을 시행하였으며, 21명은 복강경수술을 시행받았고, 정상 자궁내임신이었던 17명에서 모두 자궁내임신이 유지되었으며, 단태아 12명, 쌍태아 2쌍을 분만하였고, 3명은 각각 임신 12주, 23주 5일, 27주 6일에 타원으로 전원되어 정확한 임신의 결과를 알 수 없었다. 결론: 임신 초기에 시행한 초음파상 정상 자궁내임신이 확인된 경우라도 산모가 하복통이나 질출혈의 증상이 있는 경우, 불임치료 등의 위험요인을 가진 환자에서는 반드시 병합임신의 가능성을 염두에 두고 조기에 진단 및 적절한 치료를 시행해야 할 것이다. Objective: The purpose of this study was to evaluate the pregnancy outcomes of heterotopic pregnancy. Methods: Retrospective analysis was done in 24 patients who were diagnosed as heterotopic pregnancy between January 2000 and April 2008. Patients` characteristics, risk factors, treatment methods and pregnancy outcomes were evaluated. Results: A total of 24 patients were diagnosed as heterotopic pregnancy, all of these had undergone assisted reproductive technique. The mean age was 31.5 years and the mean gestational age at diagnosis was about 8 weeks. The most common etiology of infertility was tubal factor (54.2%). Four (16.7%) of the women had undergone ovulation induction, eighteen (75%) had undergone in vitro fertilization, but 2 patients (8.3%) had undergone assisted reproductive technique at other hospital and we didn`t know the exact method. The most common of ectopic site was tube (75%), and 50% of ectopic sites were ruptured status at diagnosis. Three (12.5%) of 24 patients were diagnosed ectopic pregnancy after dilatation and evacuation due to missed abortion, 4 (16.7%) were diagnosed ectopic pregnancy and missed abortion, and 17 (70.8%) were diagnosed ectopic pregnancy and living intrauterine pregnancy at the time of diagnosis. Laparotomy was done in 3 patients (12.5%) and laparoscopy was done in 21 patients (87.5%). Among 17 patients who had normal intrauterine pregnancy, 12 (70.6%) delivered singletones, 2 (11.8%) delivered twins, but 3 (17.6%) patients were lost follow up. Conclusion: Heterotopic pregnancy should be considered in pregnant woman with abdominal pain or vaginal bleeding, although confirmed normal intrauterine pregnancy using ultrasonography at early gestational age, especially if the woman have treatment history for infertility. And early diagnosis and proper management are important.
-
자궁근종으로 진단된 환자의 치료 선호도 및 치료방법에 관한 고찰
조수희 ( Soo Hee Jo ),김주명 ( Joo Myung Kim ),유원식 ( Won Sik Yoo ),김경연 ( Kyung Yeon Kim ),김미라 ( Mi La Kim ),최규홍 ( Kyu Hong Choi ),전종영 ( Jong Young Jun ),한호원 ( Ho Won Han ),주관영 ( Kwan Young Joo ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.11
목적: 외래 내원 환자 중 자궁근종을 가진 환자의 치료 방법에 대한 선호도를 확인하고, 진단 이후의 치료방법에 대해 알아보고자 하였다. 방법: 2006년 1월 1일부터 12월 31일까지 외래를 내원한 환자 중 초음파상 자궁근종으로 진단된 577명의 환자를 대상으로, 진단 후 치료방법에 대해 후향적으로 의무기록을 확인하였다. 또한, 외래 초진시 근종으로 진단받은 환자 100명에서의 치료 방법에 대한 설문지 선호도 조사 자료를 분석하였다. 결과: 자궁근종을 가진 환자에서 가장 흔하게 나타나는 증상은 통증으로 58.6%에서, 출혈과 관련된 증상은 51.3%, 압박증상은 30.2%에서 보였다. 특별한 약물치료 없이 정기적 추적관찰은 31.7%의 환자에서 시행되었으며, NSAID와 같은 비호르몬제 약물은 27.1%에서, 미레나를 포함한 호르몬제는 41.9%에서 사용되었다. 수술을 시행받은 환자는 총 182명으로 31.5%에서 시행되었으며, 그 중 104명은 자궁근종절제술을 시행받았으며, 아전자궁적출술은 36명, 전자궁적출술은 42명에서 시행되었다. 출혈관련 증상을 가진 환자의 42.6%, 통증관련은 34.6%, 압박증상 관련은 50.6%에서 수술을 시행하였다. 근종으로 진단된 초진 환자 100명을 대상으로 한 설문지 조사에서는 우선적으로 약물치료를 원하는 환자가 78명, 수술적 치료를 원하는 환자가 22명이었다. 수술을 시행받아야 한다면 우선적으로 근종절제술을 시행받기를 원한 환자가 94명, 자궁적출술을 받기를 원한 환자는 6명이었다. 결론: 출혈이나 통증과 관련된 증상을 가진 자궁근종 환자에서는 일차적으로 약물치료가 효과적이며, 환자의 선호도 역시 비침습적인 약물치료를 우선 시행받는 것을 원하는 것으로 나타났다. Objective: The purpose of this study was to describe the clinical features of myoma, treatment options, patient preference and to identify the clinical features which affect the management of myoma. Methods: We retrospectively analyzed medical records of 577 patients who were diagnosed as uterine myoma on ultrasound exam between January 2006 and December 2006. Patients` characteristics, treatment methods and questionnaires for patient preference were evaluated. Results: The mean age was 42.3 years and 90.8% of the patients were premenopausal status. Common symptoms were pain (58.6%), bleeding (51.3%) and compression symptom (30.2%). In our study, 183 of 577 patients (31.7%) planned to have regular follow-up without treatment. Non-hormonal medical treatment was used in 27.1% and hormonal treatment was used in 41.9% of the patients. One hundred eighty-two patients underwent surgical treatment, including myomectomy (57.1%), subtotal hysterectomy (19.8%) and total hysterectomy (23.1%). Among the patients who underwent surgery, 50.6% of patients (88/174) had surgery due to compression symptom, 42.6% (126/296) due to bleeding, and 34.6% (117/338) due to pain. According to the 100 patients who answered the questionnaires, 78 patients preferred medical therapy initially, but 22 patients chose surgical treatment. When the patient was asked to choose between myomectomy and hysterectomy, 94 patients wanted myomectomy, but only 6 patients chose hysterectomy. Conclusions: Many patients diagnosed as myoma prefer medical treatment initially. Medical treatment for myoma may be considered as the first line treatment for pain and bleeding symptoms before proceeding to surgical treatment.
-
출혈성 소화성 궤양 환자에서 재출혈의 위험인자 및 재출혈률
서승원(Seung Won Seo),김연수(Yeon Soo Kim),문희석(Hee Seok Mun),박기오(Ki Ho Park),이엄석(Eom Seok Lee),김선문(Seon Mun Kim),양현웅(Hyeon Woong Yang),나병규(Byung Kyu La),성재규(Jae Kyu Seong),이병석(Byung Seok Lee),정현용(Hyun Yong 대한소화기학회 2002 대한소화기학회지 Vol.39 No.2
Background/Aims: Bleeding from peptic ulcer is a common and serious complication. Endoscopic therapy is effective in hemostasis of active bleeding. However, rebleeding occurs in 10-30% of patients with bleeding peptic ulcer, and is an important factor associated with mortality. In this study, we analyzed risk factors and rate of rebleeding in patients with bleeding peptic ulcer. Methods: We analyzed 194 patients with peptic ulcer bleeding between June 1995 and May 1998. We retrospectively analyzed the rebleeding risk factors by reviewing medical records and telephone interviews. Results: Rebleeding of peptic ulcer occurred in 43 patients (22.2%). Cumulative rebleeding rate was 12.1% after 1 month, 15.2% after 6 months. The cumulative rebleeding rates at 1, 2, and 3 years were 16.2%, 19.4% and 20.9%, respectively. On the basis of an univariate analysis of clinical and endoscopic findings, significant predictive factors for rebleeding were history of peptic ulcer bleeding (p=0.002), use of NSAIDs (p=0.08), endoscopic stigmata of recent hemorrhage (p=0.000), and presence of shock (p=0.002). In multivariate analysis, history of peptic ulcer bleeding (odds ratio, OR=9.12), use of NSAIDs (OR=7.91), endoscopic stigmata of recent hemorrhage (OR=0.37), and presence of shock (OR=3.83) were independent risk factors of rebleeding. Conclusions: Rebleeding rate of peptic ulcer is 20.6% during 3 years of follow-up and important risk factors of rebleeding are history of peptic ulcer bleeding, use of NSAIDs, endoscopic stigmata of recent hemorrhage, and presence of shock. (Korean J Gastroenterol 2002;39:101-107)
-
-
연관 검색어 추천
이 검색어로 많이 본 자료
활용도 높은 자료
