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복강경 담낭 절제술 2,523예 시행 중 개복술로 전환한 111예에 대한 임상적 고찰
방지성(Ji Sung Bang),최유신(Yu Sin Choi),김범규(Beom Gyu Kim),차성재(Sung Jae Cha),지경천(Kyung Choun Chi),이정효(Jung Hyo Lee),장인택(In Taik Chang) 한국간담췌외과학회 2008 한국간담췌외과학회지 Vol.12 No.3
Purpose: While laparoscopic cholecystectomy can be successfully performed in the majority of patients, conversion to open procedure is still necessary in certain cases. The purpose of this study was to identify the discerning factors that helped to predict the need for conversion to open cholecystectomy. Methods: A retrospective review was conducted on the data for 2,523 laparoscopic cholecystectomies performed at Chung-Ang University Hospital between January 2002 and July 2007. Patient sex, age, height, weight, body mass index (BMI), duration of preoperative hospital stay, preoperative physical examination, laboratory data, radiologic findings, and reasons for conversion to open procedure were evaluated. Results: Adhesion was perceived to be the most critical factor for conversion in 56 of 111 total cases (50.5%). Bleeding (22.5%), bile duct injury (11.7%), inflammation (9.0%), and uncertain anatomy (6.3%) followed sequentially in incidence. Factors found to significantly increase the risk of conversion on univariate analysis were patient age >70 years, male sex, previous abdominal operation, preoperative common bile duct stone, tenderness in the right upper quadrant, distended shape of the gallbladder, and pericholecystic fluid collection. On multivariate analysis, the following factors were found to be associated with a higher risk: patient age >70 years (p=0.002), male sex (p=0.012), previous abdominal operation (p<0.0001), and preoperative common bile duct stone (p=0.041). Conclusion: In the case of operations with such discerning factors, surgeons should be more cautious and delicate in all procedures throughout the operative period. Furthermore, to reduce the risk of additional severe complications, surgeons need to decide early on if they will perform a conversion.
결장직장암에서 Nuclear Factor-κB p65와 Nuclear Factor-κB p50 단백 발현과 임상병리학 인자와의 연관성
강기창(Gi Chang Kang),김범규(Beom Gyu Kim),박준석(Jun Suk Park),최유신(Yu Sin Choi),차성재(Sung Jae Cha),박성준(Sung Jun Park),장인택(In Taik Chang),박성일(Sung il Park),이태진(Tae Jin Lee),최영철(Young Cheol Choi) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.2
Purpose: Nuclear Factor-κB p65 (NF-κB p65) and nuclear Factor-κB1 p50 (NF-κB p65) have been shown to play roles in cell proliferation, apoptosis, cytokine production and oncogenesis. This study was designed to investigate the expressions of NF-κB p65 and NF-κB p50 proteins in premalignant lesions and colorectal adenocarcinoma. Methods: Paraffin sections of 20 normal mucosa specimens, 20 low grade tubular adenoma specimens, 20 high grade tubular adenoma specimens and 64 adenocarcinoma specimens were analyzed immunohistochemically for the expressions of NF-κB p65 and NF-κB p50 proteins. Results: The expressions of NF-κB p65 and NF-κB p50 proteins were significantly higher in the adenocarcinoma tissue compared with that in the normal mucosa, the low grade tubular adenoma and the high grade tubular adenoma tissues. The frequency of a NF-κB p50 expression was higher in the poorly differentiated histologic grade specimens, in the presence of nodal metastasis and in the high stage specimens. There were significant correlations between the NF-κB p65 and NF-κB p50 proteins. Conclusion: The expressions of NF-κB p65 and NF-κB p50 proteins may play a role in the pathogenesis of colorectal carcinoma.