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안민성(Min-Sung An),김상효(Sang-Hyo Kim),윤혜경(Hye-Kyoung Yoon),김운원(Woon-Won Kim) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.6
Purpose: Cox-2 expression in breast carcinoma has been reported to be related to angiogenesis, lymph node metastasis and Her-2 expression. The aim of this study is to evaluate the clinicopathologic significance of Cox-2 expression in the invasive ductal carcinomas (IDC) and intraductal carcinomas (DCIS) of the breast. Methods: The materials were 353 IDC cases and 82 DCIS cases. Immunohistochemical stain for Cox-2 was interpreted as 1+ (weak & focal) and 2+ (diffuse), and the relationships between Cox-2 and ER, PR, Her-2, p53, Ki-67 and bcl-2 expressions were analyzed. Results: There was no significant difference of Cox-2 expression between IDC (148/353, 41.9%) and DCIS (38/82, 46.3%). Cox-2 (2+) expression was more frequent in low grade than intermediate and high grade IDC, but the difference was not significant statistically (P=0.0833), and there were no significant differences of Cox-2 expression according to age, tumor size, nuclear grade, lymph node metastasis in IDC and DCIS cases. In IDC cases, Cox-2 (1+ and 2+) expression showed positive relationships with p53 (+) and more than 10% of Ki-67 labeling index (P=0.0029, P=0.0015), and revealed tendencies of positive relationships with ER (+) and bcl-2 (+) (P=0.0750, P=0.0776). However, no significant relationship between Cox-2 and Her-2 expressions was recognized. In DCIS cases, Cox-2 (2+) expression rate was increased in cases showing negative for Her-2 (P=0.0092) and positive for bcl-2 (P=0.0486). Conclusion: Cox-2 expression seems to be involved in the development of breast carcinomas, but not related to the invasiveness. Cox-2 expression, especially 2+, in the DCIS cases suggest a possibility of less aggressive biological behavior.
장중첩증을 동반한 Peutz-Jeghers Syndrome
안민성(Min Sung An),김운원(Woon Won Kim),오상훈(Sang Hoon Oh),이난주(Nan Joo Lee) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.5
Peutz-Jeghers syndrome (PJS) is a rare hereditary disease where the clinical manifestations are multiple harmatomatous gastrointestinal polyps and pigmentations of the skin. A harmatomatous polyp can develop at any part of the gastrointestinal tract, and the proximal small bowel is frequently involved. Intestinal obstruction, bleeding and intussusception, caused by GI polyps have been reported, which often require repeated surgery. A female patient presented with suffering of abdominal pain for two days duration. The patient was diagnosed with intussusception, and a resection and anastomosis of the small bowel was performed. The patient was treated for 15 days, and was discharged from the hospital without any particular complications. We report this case with a review of the literature.
Se Hui Oh(오세휘),Nak Jun Choi(최낙준),Sang Hyuk Seo(서상혁),Min Sung An(안민성),Kwang Hee Kim(김광희),Ki Beom Bae(배기범),Jin Won Hwang(황진원),Sang Heon Lee(이상헌),Ji Hyun Kim(김지현),Sam Ryong Jee(지삼룡),Mi Seon Kang(강미선),Kwa 대한종양외과학회 2016 Korean Journal of Clinical Oncology Vol.12 No.1
Purpose: Colorectal obstruction develops most frequently by carcinoma, and 7%–30% of these colorectal carcinomas are acute cases. The oncologic safety of self-expanding metal stent (SEMS) insertion as a bridge to surgery has not yet been established. Thus, we investigated the oncologic safety of SEMS insertion as a bridge to surgery in patients with obstructive colorectal cancer. Methods: This retrospective had 56 patients enrolled requiring emergency management for obstructive colorectal cancer at stage II or III, who had undergone curative surgery between July 2008 and June 2011. These subjects were divided into two groups: patients who had undergone emergency surgery without SEMS insertion (non-stent group) and those who had undergone elective surgery after preoperative decompression with SEMS insertion (stent group). The two groups were compared for clinicopathologic characteristics, postoperative complications, and survival rate. Results: Enterostomy was performed in 25 patients (100.0%) in the non-stent group and 1 patient (3.2%) in the stent group; laparoscopic surgery was carried out in 7 patients (28.0%) in the non-stent group and 19 patients (61.29%) in the stent group, each showing statistically significant differences. There was no statistically significant difference in postoperative complications and 5-year disease-free survival rate (72% vs. 74.19%, P=0.87, respectively). Conclusion: In treatment of malignant colorectal obstruction, elective operation after stent insertion had similar oncologic outcomes compared with emergency operation. Preoperative stent insertion not only lowers the incidence of enterostomy but also makes laparoscopic surgery possible, thereby enhancing patients’ quality of life. Therefore, preoperative stent insertion is a useful method that may replace emergency surgery in treatment of malignant colorectal obstruction.
송영진 ( Young Jin Song ),최정식 ( Jung Sik Choi ),박수영 ( Su Young Park ),박영진 ( Young Jin Park ),안민성 ( Min Sung An ),배기범 ( Ki Beom Bae ),홍관희 ( Kwan Hee Hong ) 대한내과학회 2014 대한내과학회지 Vol.86 No.1
급성 췌장염 환자에게 대장 천공이 생기는 경우는 매우 드물지만 사망률이 50% 이상인 치명적인 합병증이므로 중 증 급성 췌장염 환자를 치료할 때는 대장 관련 합병증도 고려하여야 한다. 본 증례에서는 급성 췌장염으로 입원한 50세 남자 환자를 치료하던 중 진단 후 22일째에 대장의 천공을 발견하였다. 췌장 효소가 풍부한 염증 삼출물의 직접적인 작용으로 대장의 괴사와 천공이 발생한 것이다. 장 절제술과 괴사 조직 절제 및 배액 치료를 하여 환자를 살려낼 수 있었다. 우리나라에서 급성 췌장염에 의해서 간 굽이나 우측 대장 이 천공되어 즉시 수술한 보고가 없다. 이에 저자들은 급성 췌장염 후에 발생한 대장 천공의 예를 문헌고찰과 함께 보 고하고자 한다. Colonic perforation after acute necrotizing pancreatitis is a very rare but critical complication. The mortality rate is greater than 50%. Therefore, a high index of suspicion is needed for early detection of the complication. We present a case of a 50-year-old man diagnosed as colonic perforation after acute necrotizing pancreatitis. During the treatment course, fecal material was drained via a pleural drainage tube. Colonic perforation was confirmed on CT scan. The pathogenesis of colonic perforation in this case involved direct spread of pancreatic enzymes and inflammatory exudate. He was treated successfully with colectomy, ileostomy, debridement of necrotic tissue, and drainage. (Korean J Med 2014;86:59-64)
직장암에서 복강경 수술과 개복 수술 후 단기간의 종양학적 결과에 대한 비교
최낙준(Nak Jun Choi),유종한(Jong Han Yoo),이홍태(Hong Tae Lee),신재호(Jae Ho Shin),박하경(Ha Kyoung Park),안민성(Min Sung An),하태권(Tae Kwun Ha),김광희(Kwang Hee Kim),배기범(Ki Beom Bae),김태현(Tae Hyun Kim),최창수(Chang Soo Choi),오 대한종양외과학회 2013 Korean Journal of Clinical Oncology Vol.9 No.1
Purpose: The aim of this study was to assess the impact of laparoscopic vs. conventional open surgery for rectal cancer on clinical and oncologic outcome in a multi-modal setting. Methods: In total, 940 patients who underwent conventional open surgery between February 1995 and October 2007, and 311 patients who underwent laparoscopic surgery between December 2006 and May 2011 were enrolled retrospectively. Oncologic outcomes included 3-year overall survival (OS) and disease free survival, factors affecting them, and risk factors for local and systemic recurrence. Results: No difference was found between laparoscopic surgery and conventional open surgery in terms of OS, disease free survival rate at stages I and II, but the 3-year OS for stage III was different between the groups (70.26% for conventional open surgery vs. 90.14% for laparoscopic surgery; P=0.0002). The 3-year disease free survival rate for stage III was 56.59% for conventional open surgery vs. 56.65% for laparoscopic surgery (P=0.6578). The local recurrence rates were 6.81% vs. 8.47% (conventional open surgery vs. laparoscopic surgery; P=0.4960). The systemic recurrence rates were 15.64% vs. 15.71% (conventional open surgery vs. laparoscopic surgery; P=0.9713). Conclusion: Laparoscopic surgery for rectal cancer showed a similar short-term oncologic outcome to conventional open surgery. This suggests that laparoscopic surgery is an acceptable alternative to conventional open surgery for selected patients with rectal cancer.