http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
김흥대 ( Hung Dai Kim ) 대한임상종양학회 2008 Korean Journal of Clinical Oncology Vol.4 No.2
우리나라의 암 발생양상이 점차 서구화되어 2005년도 대장암의 발생률이 위암에 이어 2위를 차지하였다. 그런데 대장암 환자의 1/3 이상에서 진단 당시 이미 림프절전이가 존재하며 근치적 절제술을 받은 환자들 중 절반이상이 재발로 인하여 사망한다. 그러므로 잔류 암세포를 공격하여 재발율을 낮추기 위해 보조항암약물요법을 시행한다. 현재 건강보험심사평가원의 항암제사용지침에 따르면 5-Fu 이외에 oxaliplatin, capecitabine 등이 결장암 3기 및 위험인자를 동반한 2기 환자의 보조항암약물요법에 사용이 허가되었다. 이들 약제 중 oxaliplatin based chemotherapy (FOLFOX)가 결장암에서 보조항암약물요법의 표준으로 자리잡을 수 있었던 MOSAIC trial의 6년 추적결과에 따르면 대조군에 비해 사망위험도가 20% 감소하였다고 보고하였다. 2기 결장암의 경우 보조항암약물요법의 필요성에 대해 논란이 많으나 2007년에 발표된 QUASAR study에서는 보조항암약물요법을 시행한 군이 대조군에 비해 생존율이 3.6% 향상되었다고 보고하였다. 그러므로 위험인자가 있는 결장암 2기 환자에게는 적극적인 항암약물요법이 권장되고 있다. 진행성 대장암에 사용되고 있는 targeting agent는 다기관 임상연구가 아직 진행 중이어서 보조항암약물요법에 사용하기 위해서는 연구결과가 발표될 2010년까지는 기다려야 하겠다. 결장암에 비해 직장암의 경우 oxaliplatin이나 capecitabine의 임상성적에 대한 가치있는 연구결과가 없어 아직은 5-Fu+Radiation이 치료의 표준이다. 향후 진행 중인 임상연구의 결과가 발표되면 보다 다양하고 효과적인 regimen을 얻을 수 있을 것으로 기대한다.
비전이성 진행 췌장암에서 Gemcitabine 단독 항암 화학요법을 통한 장기 생존 1예
김형욱 ( Hyung Ook Kim ),김흥대 ( Hung Dai Kim ),신준호 ( Jun Ho Shin ) 대한임상종양학회 2009 Korean Journal of Clinical Oncology Vol.5 No.1
복부 전산화 단층 촬영 및 조직병리 검사상 비전이성 진행 췌장암 진단 하에 개복술을 통한 고식적 총담관공장문합술을 시행 받고, 수술 후 gemcitabine 단독 항암 화학요법으로 종양의 진행이나 수술 및 항암 화학요법에 따른 특별한 합병증 없이 30개월 이상 장기 생존하고 있는 69세 남자 환자를 문헌 고찰과 함께 보고한다. We report a 69-year-old male patient with non-metastatic advanced pancreatic cancer confirmed by abdominal computed tomography and intraoperative biopsy. He presented with long-term survival more than 30 months without disease progression or complication following palliative surgery and chemotherapy, after palliative choledochojejunostomy and postoperative gemcitabine alone chemotherapy.
이관호 ( Kwan Ho Lee ),김형욱 ( Hyung Ook Kim ),류창학 ( Chang Hak Yoo ),손병호 ( Byung Ho Son ),박용래 ( Yong Lai Park ),조용균 ( Yong Kyun Cho ),김흥대 ( Hung Dai Kim ),한원곤 ( Won Kon Han ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.3
Background/Aims: Radiofrequency ablation (RFA) has been mostly used as a therapeutic alternative to hepatic resection for treating liver metastasis of colorectal cancer. The purpose of the present study was to determine whether there were differences in outcome between RFA and surgical resection in the treatment of colorectal cancer with liver metastases. Methods: We performed a retrospective analysis of 53 patients who underwent only hepatic resection or only RFA for colorectal liver metastases. Twenty-five patients who underwent hepatic resection were compared with 28 patients who underwent RFA for synchronous or metachronous liver metastases. Results: The median CEA level at the time of diagnosis of liver metastases was significantly higher in the resection group (14.2ng/mL vs. 2.8ng/mL, p=0.002). The median size of main liver metastases was significantly larger in the resection group (4.0 cm vs. 2.05 cm, p=0.002). There was no difference in the percentage of patients experiencing major complication (one patient in each group). The marginal recurrence rate was significantly higher in the RFA group (p=0.004). Disease-free and overall survival were longer in the resection group (p=0.008 and 0.017, respectively). In multivariate analysis, only the type of treatment was a factor associated with disease-free and overall survival (p=0.004 and 0.007, respectively). Conclusions: Because of the high marginal recurrence rate, RFA shows an inferior outcome in comparison with surgical resection. Therefore, RFA should be considered for only selected patients with unresectable (by any means) disease or with high operative risk.
내시경하 갑상선절제술에 있어 CO₂ 가스주입은 안전한가?
최원범(Won Beom Choi),박용래(Yong Lai Park),최준호(Jun Ho Choe),김흥대(Hung Dai Kim),배원길(Won Gil Bae) 대한외과학회 2007 Annals of Surgical Treatment and Research Vol.73 No.4
Purpose: Endoscopic thyroidectomy has recently been widely used in clinical practice. The operative method can be classified into CO₂gas insufflation and the gasless technique. This study assessed the safety of low pressure CO₂gas insufflation (up to 6 mmHg) by performing continuous measurement of the end-tidal CO₂ (ETCO₂) pressure. Methods: From March 2003 to October 2006, 95 patients (90 hemithyroidectomies and 5 total thyroidectomies) underwent endoscopic thyroidectomy. The low pressure CO₂gas insufflation technique was applied in all cases. The ETCO₂ pressure of the patients was measured by capnometry at the time of a pre-CO₂gas insufflation status (0 minutes) and at the time of post-CO₂gas insufflation (30 minutes) and then it was measured every 30 minutes with also performing capnograms. We analyzed the ETCO₂ pressure at the time of the pre-CO₂gas insufflation status (0 min) and we compared this with that of each status by using paired T-test. Results: For all 95 cases, the mean patient age was 36.2±9.1 (range: 21∼57 years), the mean tumor size was 1.7±1.1 (range: 0.1∼4.5 ㎝) and the mean operative time was 135.0±46.1 (range: 50∼340 min). The mean ETCO₂ pressure (mmHg) was 33.0±3.9 at the time of pre-CO₂gas insufflation status (0 min); the mean ETCO₂ pressure was 31.1±3.7 at 30 min (n=95), 33.5±3.7 at 60 min (n=95), 35.2±3.6 at 90 min (n=95), 34.9±3.7 at 120 min (n=90), 34.6±3.8 at 150 min (n=70), 34.1±3.4 at 180 min (n=40), 34.3±5.2 at 210 min (n=15) and 34.0±4.2 at 240 min (n=9). There was a significant difference the early post-CO₂gas insufflation status (P<0.05 at 30 min, 90 min, 120 min), but there was no significant difference in the late post-CO₂gas insufflation status (P>0.05; at 60 min, 150 min, 180 min, 210 min, 240 min). At each time point, the ETCO₂ pressures were all within the normal range. Conclusion: We successfully performed endoscopic thyroidectomy with using the low pressure CO₂gas insufflation technique and there were no significant complications. We think that performing endoscopic thyroidectomy with using the low pressure CO₂gas insufflation technique is a safe procedure.
복부수술 전 젖소초유의 경구투여가 내독소혈증과 TNF-α에 미치는 영향
서현일(Hyun Il Seo),전우규(Woo Kyu Jeon),강진호(Jin Ho Kang),임시영(Si Young Lim),이승세(Seung Sei Lee),손병호(Byung Ho Sohn),류창학(Chang Hak Ryu),신준호(Jun Ho Shin),김흥대(Hung Dai Kim),한원곤(Won Kon Han),오태윤(Tae Yun Oh),우희연(H 대한외과학회 2006 Annals of Surgical Treatment and Research(ASRT) Vol.70 No.6