절제가 불가능한 간문부담관암에서 관내 근접 방사선치료와 외부방사선 병행치료의 유용성

허찬영(Chan-Young Hur),김상원(Sang-Won Kim),김진수(Jin-Soo Kim),김광희(Kwang-Hee Kim),박정익(Jeong-Ik Park),최창수(Chang-Soo Choi),최영길(Young-Kil Choi) 한국간담췌외과학회 2008 한국간담췌외과학회지 Vol.12 No.3

Purpose: The purpose of this study was to evaluate the effect of combination intraluminal brachytherapy (ILBT) and external beam radiotherapy (EBRT) on patient survival and stent patency after metallic biliary stent placement in patients with unresectable hilar cholangiocarcinoma. Methods: We retrospectively analyzed the data of 29 patients with unresectable hilar cholangiocarcinoma who presented between January 2002 and December 2006. Fifteen patients were treated with metallic stents alone (RT (-) group), and 14 patients were treated with ILBT and EBRT after metallic stent placement (RT (+) group). ILBT was performed using a 192Ir source at a dose of 15 Gy in 3 fractions. The EBRT dose was 45 Gy in 25 fractions. Results: The 1- and 3-year patient survival rates in the RT (+) group were 51.9% and 8.7%, respectively, and those in the RT (-) group were 46.7% and 38.9%, respectively. However, there was no statistically significant difference in the survival rates between the two groups (p=0.38). The 1- and 2-year stent patency rates for the RT (+) group were numerically higher than those in the RT (-) group (74.0%, 74.0%, respectively vs. 59.9%, 39.9%, respectively), but not to a statistically significant degree (p=0.11). The median stent patency was 10 months in the RT (+) group and 8 months in the RT (-) group. All of the stents obstructed at 31 months in the RT (+) group and at 26 months in the RT (-) group. Four patients showed minor complications, including gastrointestinal discomfort and dermatitis after radiation therapy, but all of them responded well to conservative treatment. Conclusion: Although combined ILBT and EBRT for unresectable hilar cholangiocarcinoma was safely carried out after biliary stent insertion with minor complications, it did not have a significant role in improving the survival and stent patency rates.

군 조직 다면평가시스템의 개인수용도와 효과성에 미치는 영향에 관한 연구

허찬영(Hur Chan-Young),장수덕(Chang Soo-Dug),이연용(Lee Yeon-Young) 한국인적자원관리학회 2008 인적자원관리연구 Vol.15 No.S

본 논문은 군 조직에 있어서 다면평가시스템의 특성이 개인의 수용도에 미치는 영향을 살펴보고 이에 대한 반응변수로서 다면평가시스템의 효과성을 검증하기 위해 실시되었다. 그리고 연구결과를 바탕으로 엄격한 상·하관계를 이루고 있는 군 조직에서 다면평가시스템에 대한 인식을 살펴봄으로써 장교근무평정 제도에 대한 발전방안을 도출하고자 시도되었다. 이론적 연구를 통해 주요 변수는 다면평가시스템의 특성, 개인의 수용도, 효과성, 유용성 인식도로 구분했다. 다면평가시스템의 특성이 수용도에 미치는 영향을 분석해 보고 수용도가 실제로 효과성에 미치는 매개효과를 분석하였다. 아울러 다면평가시스템의 특성에 따른 수용도가 다면평가시스템의 유용성의 인식도에 따라 달라질 수 있으므로 다면평가시스템의 유용성인식도가 미치는 조절효과를 중심으로 연구모형과 가설을 도출하였다. 연구의 목적을 달성하고 가설을 검증하기 위해 군 조직 영관장교로부터 장군까지 753명을 대상으로 하여 설문조사를 실시하였으며, 실증분석에는 빈도분석, 상관관계분석, 회귀분석 등의 분석기법이 사용되었다. 그 결과 다면평가시스템의 특성은 수용도에 각기 다른 영향력을 미치는 것으로 나타났다. 다면평가시스템에 대한 수용도가 효과성에 미치는 영향을 살펴본 결과 다면평가시스템의 수용도가 높을수록 효과성이 증가하는 것으로 분석되었다. 다면평가시스템의 특성과 효과성의 관계에 수용도는 부분매개역할을 하였으며, 다면평가시스템의 특성과 수용도의 관계에 있어서는 유용성의 인식도는 조절효과를 나타내지 못했다. 이러한 결과는 군 조직은 다면평가시스템의 효과성을 높이기 위해서는 수용도를 증진시키기 위한 노력이 필요하다는 것을 시사하는 것이라 할 수 있다. The purpose of this study is to analyze how the characteristics of the 360 degree appraisal system have an effect on the personal acceptability and to verify its effectiveness in the military organizations. Also the study was drawn up to present the developing device of the military officer evaluation reporting system through the correct understanding of the 360 degree appraisal system in the military organizations, so called the strict up-down relationship. The main variable of this study was classified as characteristics of the 360 degree appraisal system, personal acceptability, effectiveness, and availability perception by theoretical studies. the characteristics of the 360 degree appraisal system impacting the acceptability and its mediating effects impacting the effectiveness of the 360 degree appraisal system were measured. And the research model and the hypothesis were used based on the moderated effects by an availability perception in the 360 degree appraisal system, for the acceptability related to the characteristics of the 360 degree appraisal system was variable according to its availability perception. And then his study were divided into two areas ; researching those answers from the military field grades to general officers" level, and using frequency analysis, correlation analysis and regression analysis in the context of the positive analysis in order to verify its hypothesis and to achieve its purpose. The result showed that the characteristics of the 360 degree appraisal system has differently influenced the availability. And it turned out that the acceptability plays a role of partial mediating in the mutual relation with the characteristics of the 360 degree appraisal system and the effectiveness as an analysis on the impact of its acceptability on the 360 degree appraisal system and it didn"t showed that the availability perception appealed the moderated effect on in the mutual relation with the characteristics of the 360 degree appraisal system and the effectiveness. These results of the study suggest that the extra efforts be required for promoting the acceptability to raise the effectiveness of the 360 degree appraisal system in military system.

복강경 담낭 절제술 후 유실 담석의 경피적 제거술

박정익(Jeong-Ik Park),허찬영(Chan-Young Hur),김진수(Jin-Soo Kim),김기훈(Ki-Hun Kim),김광희(Kwang-Hee Kim),박오환(Oh-Hwan Park),최창수(Chang-Soo Choi),최영길(Young-Kil Choi) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.78 No.1

Gallbladder perforation during laparoscopic cholecystectomy (LC) with spillage of bile and gallstones occurs frequently, but clinical sequelae caused by dropped gallstones are uncommon. We present a case of subhepatic and right-back abscess formation due to spilled gallstones occurring two years after LC, which were successfully removed using a percutaneous method as a minimally invasive technique. The patient firstly visited a primary care physician with right-back mass that was increasing in size and becoming symptomatic, then underwent incision and drainage. He was referred to our hospital and the subhepatic and right-back inflammatory mass containing spilled gallstones was revealed by computed tomography. Under fluoroscopic control, a percutaneous drainage catheter was placed within the abscess and pus was aspirated. The spilled gallstones were successfully retrieved with basket forceps, thereafter. The patient was discharged without significant complications on the 9th day after the percutaneous stone removal.

Signet-ring 세포형 위암의 유방과 난소 전이

변경도 ( Kyung Do Byun ),허찬영 ( Chang Young Hur ),김기훈 ( Ki Hoon Kim ),박정익 ( Jeong Ik Park ),김광희 ( Kwang Hee Kim ),김태현 ( Tae Hyun Kim ),최창수 ( Chang Soo Choi ),최영길 ( Young Kil Choi ) 대한임상종양학회 2009 Korean Journal of Clinical Oncology Vol.5 No.1

유방외 종양으로부터 유방으로의 전이는 매우 드문 것으로 되어 있다. 난소 및 유방으로의 동시 다발성전이는 더욱 드물다. 45세 여자가 5년 전 위암으로 근치적 위아전절제술 및 위십이지장문합술을 시행하였고 문합부 폐쇄, 좌측 요도 폐쇄와 크루켄베르크종양으로 내원하였다. 문합부 폐쇄는 스텐트 삽입으로, 좌측 요도 폐쇄는 Double J catheter 삽입으로, 크루켄베르크종양은 FOLFOX 항암치료를 시행하였다. 10차 항암치료 후 크루켄베르크종양의 크기 증가로 전자궁적출술 및 양측 난소 난관 절제술을 시행하였고 전이성 signet ring형 암이었다. 한달 후 양측 유방종괴가 만져져 시행한 초음파에서 양측 유방의 염증성 침윤이 관찰되었다. 3차례의 Paclitaxel 항암치료 후 양측 변형 근치 유방절제술을 시행하였고 전이성 signet ring형 암을 보였다. Estrogen 수용체 및 Progesterone 수용체, c-erbB-2 음성이었다. 환자는 현재 생존중이며 추가 항암요법을 고려중에 있다. Metastatic deposits to the breast from extramammarian tumors are rare. Both ovary and breast metastasis are more rare. A 45-year-old woman who had underwent radical subtotal gastrectomy and gastroduodenal anastomosis 5 years ago visited our hospital due to the obstruction of anastomotic site, the obstruction of left ureter and Krukenberg`s tumor. She underwent stent insertion on anastomotic obstruction, Double J catheter insertion on the obstruction of left ureter and FOLFOX chemotherapy on Krukenberg`s tumor. After 10 cycles chemotherapy, she underwent total hysterectomy and bilateral salphingooophorectomy because of the enlarged size of Krukenberg`s and the pathologic report was metastatic signet ring cell carcinoma. Since palpable masses were felt in both breast after one month she was examined breast ultrasonography so she was reported inflammatory infiltration of both breast. After 3 cycles of Paclitaxel chemotherapy she underwent both modified radical mastectomy so she was pathologically reported metastatic signet ring cell carcinoma. Estrogen and progesterone receptors and c-erbB-2 were negative. Now She is alive and is under consideration additional chemotherapy.

세포내형 동결보존액을 이용한 사람 간세포의 동결보존 개선

장원희 ( Won Hee Jang ),김형인 ( Hyeong In Kim ),이우정 ( Woo Jeong Lee ),서지연 ( Ji Yeon Seo ),최창수 ( Chang Soo Choi ),최영길 ( Young Kil Choi ),허찬영 ( Chan Young Hur ),김기훈 ( Ki Hoon Kim ),박정익 ( Jeong Ik Park ),김광희 한국조직공학·재생의학회 2009 조직공학과 재생의학 Vol.6 No.4

Primary human hepatocytes are used for cell transplantation and bioartificial liver system for supporting patients with intractable liver diseases. Efficient cryopreservation of human hepatocytes is of great interest. To improve the cryopreservation outcome of human hepatocytes, effects of intracellular-type cryopreservation solutions and apoptosis inhibitor were investigated. Hepatocytes were isolated from the resected livers from 10 patients with intrahepatic stones or tumors. Isolated hepatocytes were cryopreserved usingeither culture media with 10% DMSO, CryoStor CS5, or University of Wisconsin(UW) solution with 10% DMSO. CryoStor CS5 significantly improved the post-thaw cell viability assessed by MTT test, the recovery of viable cells, and the plating efficiency compared to the culture media-based solution. UW solution also showed some beneficial effects on the cryopreservation outcome, but the effects were not statistically significant except the improved 24 hours post-thaw viability. On the other hand, inhibition of apoptosis by a pan-caspase inhibitor Z-VAD-fmk showed no effects on the cryopreservation outcome. These results demonstrate the usefulness of the intracellular-type cryopreservation solutions and CryoStor CS5 is superior to UW solution for the cryopreservation of human hepatocytes.