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Retroperitoneal Mucinous Cystadenoma
Gyu Yeol Kim(김규열),Dae Hwa Choi(최대화),Young Chul Lim(임영철),Byung Kyun Ko(고병균),Sang June Park(박상준),Yang Won Nah(나양원),Hong Rae Cho(조홍래),Chang Woo Nam(남창우) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.1
일차성 후복막 점액성 낭선종은 흔치 않은 종양으로 여성에게만 발생하며, 수술 전에 정확한 진단을 하기 매우 어렵다. 하지만, 이러한 낭성 종양의 낭액에서의 증가된 암태아성항원의 수치가 일차성 후복막 점액성 낭선종의 유용한 진단 지표가 될 수 도 있다. 완전 절제가 이 종양의 적절한 치료이다. 또한, 수술 중 복강 내 타 장기들을 누르거나 할 필요가 없으며, 소장 및 대장이 손상될 위험을 줄일 수 있다는 측면에서 후복막 접근이 복강 내 접근 보다 유용한 방법일 수 있다. 저자들은 후복막 접근을 통해 성공적으로 절제한 일차성 후복막 점액성 낭선종의 경험을 보고한다. We present a case of a primary retroperitoneal mucinous cystadenoma, which is a relatively rare tumor found exclusively in women. This tumor is difficult to correctly diagnose preoperatively. Although there is little published information regarding the CEA levels in the cystic fluid of cystic tumors arising in the retroperitoneum, a high CEA level in the cystic fluid is a useful diagnostic marker for a primary retroperitoneal mucinous tumor. The appropriate management of retroperitoneal mucinous cystadenomas is the total removal of the cyst. The retroperitoneal approach for retroperitoneal cystic tumors is useful, has a lower risk of traumatizing the bowel than the intra-abdominal approach, and does not require compression of the other organs. We report the successful resection of a retroperitoneal mucinous cystadenoma through the retroperitoneal approach.
Clinical implications of APEX1 and Jagged1 as chemoresistance factors in biliary tract cancer
Hong-Beum Kim,Won Jin Cho,Nam Gyu Choi,Sung-Soo Kim,Jun Hee Park,Hee-Jeong Lee,Sang Gon Park 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.92 No.1
Purpose: Biliary cancer is a highly malignant neoplasm with poor prognosis and most patients need to undergo palliative chemotherapy, however major clinical problem associated with the use of chemotherapy is chemoresistance. So far, we aimed at investigating clinical implications of apurinic/apyrimidinic endodeoxyribonuclease 1 (APEX1) and Jagged1 as chemoresistance factors in biliary tract cancer Methods: We used 5 human biliary tract cancer cell lines (SNU-245, SNU-308, SNU-478, SNU-1079, and SNU-1196), and investigated the chemosensitivity of APEX1 and Jagged1 through 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay and Western blot. Alternately, the 10 patients of advanced biliary cancer consist of 2 group according to the chemotherapy response examined by immunohistochemistry using APEX1 and Jagged1 antibody, and protein expression level was scored for staining intensity and percent positive cell. Results: The result of MTT assay after APEX1 knockdown showed that strong coexpression of APEX1 and Jagged1 cell line (SNU-245, SNU-1079, and SNU-1196) showed a greater decrease in IC50 of chemotherapeutic agent (5-fluorouracil, gemcitabine and cisplatin). The Western blot analysis of APEX1 and Jagged1 expression in biliary cancer cell lines after APEX1 knockdown definitively demonstrated decreased Jagged1 expression. The APEX1 and Jagged1expression level of immunohistochemistry represented that chemorefractory patients had higher than chemoresponsive patients. Conclusion: These results demonstrate that simultaneous high expression of APEX1 and Jagged1 is associated with chemoresistance in biliary cancer and suggest that is a potential therapeutic target for chemoresistance in advanced biliary cancer.
Effects of Desalinization Management on Rice Yield in Sea Water Flooded Field
Sang-Su Kim,Won-Ha Yang,Weon-Young Choi,Hong-Kyu Park,Min-Gyu Choi,Nam-Hyun Back,Si-Yong Kang,Hyun-Tak Shin,Soo-Yeon Cho,Seog-Ju Kwon,Bok-Rae Ko 韓國作物學會 1999 Korean journal of crop science Vol.44 No.1
Over 2,000 ha of rice fields in the western and southern coastal region of Korea were flooded with sea water during the spring tide, on August 19-21, 1997, and the rice plant at heading stage was injured. The field surveys were undertaken at the sea water flooded paddy fields in Chonbuk Province, to identify the injury symptoms and rice yield damage subjected to different flooding condition and desalinization methods. Five days after sea water flooding at heading stage, the flag leaves of rice plants flooded with 30 ㎝ deep sea water withered from the tip, the withering progressed to the lower leaves in deeper flooding. The spikelets were spotted black and discolored from the tip at 50 ㎝ deep flooded rice, and some panicles changed to white at 80 ㎝ deep flooded rice. Most of the rice leaves submerged completely for an hour were withered and most of panicles changed to white. The milled rice yield, percentage of ripened grain, and 1000 grain weight of flooded rice decreased with deeper flooding water, higher water salinity and longer flooding time. Even under the same flooding conditions, the damage of rice yield varied with the growth stage: heading stage>dough stage>booting stage. Rice yield damage was less in the fields on the upper riverside than those of the fields on the estuary and seaside, because of lower water salinity. In a flooded field, the rice yield damages were reduced as the distance increased from the levees where the sea water inflowed and increased as the distance increased from the fresh water irrigation gate. The desalinization treatments consisting of frequent exchange of irrigation water and spraying with fresh water soon after flooding effectively reduced the rice yield damage.
( Sung Yeon Hong ),( In-gyu Kim ),( Xu-guang Hu ),( Hee-jung Wang ),( Bong-wan Kim ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Cavernous transformation of the portal vein (CTPV) is a rare condition with various etiologies and diverse clinical presentations. We present the case of non-cirrhotic young female patient with severe portal hypertension, successfully treated with living donor liver transplantation (LDLT) and the portal inflow was obtained using one prominent collateral vein (engorged paracholedocal vein) from CTPV. Case presentation: A 23-year-old female without liver cirrhosis was admitted due to upper gastrointestinal hemorrhage at Division of Liver Transplantation and Hepatobiliary Surgery in Ajou University Medical Center. From December 2011 to October 2015, she has experienced 6 times of esophageal varix bleeding and esophageal varix ligation. At the third episode of esophageal varix bleeding, the transjugular intrahepatic portosystemic shunt (TIPS) was tried to reduce the portal pressure but it failed due to inadequate portal vein. A baseline liver biopsy was performed in January 13, 2012. Its finding revealed that fragmented hepatic parenchyma was not cirrhotic or ischemic histological evidence. In addition, there is no histological evidence to suggest vascular obstruction due to thrombosis. At that time, the patient was diagnosed as non-cirrhotic portal hypertension. In October 2015, the patient was recommended the living donor liver transplantation to solve the repeated esophageal varix bleeding from her portal hypertension. Preoperative laboratory data revealed normal liver function. Preoperative esophageogastroduodenoscopy showed esophageal varices, F2 Lm Cb RC (+) without active bleeding. Preoperative multidimensional computed tomography (MDCT) revealed massive dilated paracholedochal vein in the hepatoduodenal ligament and suprahilar area, and splenomegaly was found, too. The donor was her 3-year-older sister. The estimated graft volume of the donor’s right lobe calculated by CT volumetry was 679 ml, 63.3% of the whole liver and the estimated graft-to-recipient body weight ratio (GRWR) was 1.41%. Therefore, right lobe graft was planned to transplant on October 21, 2015. Operative finding showed an atretic main portal vein with complex network of tortuous paracholedochal vein, and we performed en bloc hilar dissection of the common bile duct and paracholedochal collateral vein. One thick paracholedochal vein of them looked like an candidate of alternative option for adequate portal inflow. We anastomosed it with donor portal vein in end-to-end fashion. Postoperatve Doppler scan and multi-detector computed tomography showed good portal vein patency to the graft. Six months after the surgery, the patient is doing well with normal liver function. Conclusions: After dissecting the hepatic artery, en bloc hilar dissection of the common bile duct and paracholedochal collateral vein was successfully performed. The thick paracholedochal vein was an alternative option for adequate portal inflow.