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손상용,이창민,안상훈,이주희,박도중,김형호 대한내시경복강경외과학회 2012 Journal of Minimally Invasive Surgery Vol.15 No.2
Purpose: The aim of this study was to compare the outcomes of robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for surgical treatment of patients with gastric cancer. Methods: Patients who underwent RG (study group) between December 2007 and December 2011 were enrolled in the study, and patients who underwent LG (control group) during the same period were matched for age, gender, and co-morbidity. Analysis of clinicopathological data, operative data, postoperative morbidity, and pathologic data was performed. Results: Twenty one RG patients (study group) and 42 LG patients (control group) were enrolled in the study. The mean age of patients in the RG group was 52.3 years, and the ratio of male to female was 14 : 7. Nineteen distal gastrectomies(90.4%), one total gastrectomy (4.8%), and one proximal gastrectomy (4.8%) were performed in the RG group. A longer mean operative time (267.2 [range, 170∼360] vs. 166.7 [range, 95∼275] min, p<0.001) and more estimated blood loss (173.2 vs. 116.6 ml, p=0.014) were observed in the RG group; however, no difference in the mean numbers of harvested lymph nodes (39.7 vs. 46.5, p=0.063), duration of hospital stay (6.4 vs. 5.9 day, p=0.508), and early complication rate (9.6% vs. 4.8%, p=0.416) was observed between the two groups. Conclusion: In our experience, RG with lymphadenectomy for treatment of early gastric cancer is technically feasible. However, compared with LG, longer operative time and more estimated blood loss was observed with RG, while no difference was observed in numbers of harvested lymph nodes and length of hospital stay.
손상용,Hai-Young Choi,이윤택,Young Suk Park,Dong Joon Shin,Aung Myint Oo,Do Hyun Jung,Sang-Hoon Ahn,Do Joong Park,Hye Seung Lee,Hyung Ho Kim 대한위암학회 2019 Journal of gastric cancer Vol.19 No.2
Purpose: Intraoperative peritoneal washing cytology (PWC) is used to determine treatment strategies for gastric cancer with suspected serosal invasion. However, a standard staining method for intraoperative PWC remains to be established. We evaluated the feasibility of a rapid and simple staining method using Shorr's stain for intraoperative PWC in advanced gastric cancer. Materials and Methods: Between November 2012 and December 2014, 77 patients with clinical T3 or higher gastric cancer were enrolled. The sensitivity, specificity, and concordance between the Shorr staining method and conventional Papanicolaou (Pap) staining with carcinoembryonic antigen (CEA) immunohistochemistry (IHC) were analyzed. Results: Intraoperative PWC was performed laparoscopically in 69 patients (89.6%). The average time of the procedure was 8.3 minutes, and the average amount of aspirated fluids was 83.3 mL. The average time for Shorr staining and pathologic review was 21.0 minutes. Of the 77 patients, 16 (20.7%) had positive cytology and 7 (9.1%) showed atypical findings; sensitivity and specificity were 73.6% and 98.2% for the Shorr method, and 78.9% and 98.2% for the Pap method with CEA IHC, respectively. Concordance of diagnosis between the 2 methods was observed in 90.9% of cases (weighted κ statistic=0.875) and most disagreements in diagnoses occurred in atypical findings (6/7). In overall survival, there was no significant difference in C-index between the 2 methods (0.459 in Shorr method vs. 0.458 in Pap with CEA IHC method, P=0.987). Conclusions: Shorr staining could be a rapid and reliable method for intraoperative PWC in advanced gastric cancer.
손상용,이남준,홍근,김혜영,박민수,최영록,서경석,김덕우,정승용,박규주,박재갑,이근옥 한국간담췌외과학회 2011 한국간담췌외과학회지 Vol.15 No.4
Backgrounds/Aims: Hepatic resection has only guaranteed long-term survival in patients with colorectal liver metastasis (CRLM) even in the era of effective chemotherapy. The definite role of neoadjuvant chemotherapy (NCT) is to improve outcomes of unresectable CRLMs, but it its role has not been defined for initially resectable CRLMs (IR-CRLMs). Methods: We reviewed the medical records of 226 patients, who had been diagnosed and treated for IR-CRLM between 2003 and 2008; the patients had the following pathologies: 10% had more than 4 nodules, 11% had tumors larger than 5 cm, and 61% had synchronous CRMLs. Among these patients, 20 patients (Group Y) were treated with NCT, and 206 (Group N) did not receive NCT according to their physician's preference. The median follow-up time was 34.1 months. Results: The initial surgical plans were changed after NCT to further resection in 20% and to limited resection in 10% of 20 patients. Complication rates of Groups Y (30%) were indifferent from Group N (23%) (p=0.233), but intraoperative transfusions were more frequent in Group N (15%) than in Group Y (5%) (p=0.006). There was one case of hospital mortality (0.44%). Disease-free survival rates in Groups Y and N were 23% and 39%, respectively, and patient survival rates were 42% and 66% (p>0.05). By multivariate analysis, old age (≥60 years), differentiation of primary tumor (poorly/mucinous), resection margin involvement, and no adjuvant chemotherapy were associated with poor patient survival; the number of CRLMs (≥4) was associated with poor disease-free survival. Conclusions: NCT had neither a positive impact nor a negative impact on survival, even with intraoperative transfusion, as observed on operative outcomes for patients with IR-CRLM. Further study is required to elucidate the role of NCT for treatment of patient with IR-CRLMs. (Korean J Hepatobiliary Pancreat Surg 2011;15:206-217)
Incomplete Removal of Totally Implantable Venous Devices : Report of 2 Cases
손상용,이한별,김수홍,박태진,정규환,김현영,김웅한,정성은,Son, Sang-Yong,Lee, Han-Byoel,Kim, Soo-Hong,Park, Taejin,Jung, Kyuhwan,Kim, Hyun-Young,Kim, Woong-Han,Jung, Sung-Eun Korean Association of Pediatric Surgeons 2012 소아외과 Vol.18 No.1
Totally implantable venous devices (TIVD)는 장기간 항암 화학 요법이나 총 정맥 영양, 수액치료가 필요한 환자에서 많이 사용된다. TIVD는 매우 유용하고 안전한 장치이지만, 이와 관련된 다양한 합병증이 보고 되어 왔다. 저자들은 카테터의 혈관 내 유착에 의해 TIVD의 제거가 불완전하게 된 2예를 경험하였기에 보고하는 바이다.
한국 유권자들은 정말 핵무장을 원하는가? 실험 설문을 이용한 핵무장 여론 분석
손상용,박종희 한국정치학회 2020 한국정치학회보 Vol.54 No.2
Public opinion poll on nuclear development in South Korea has consistently showed that more than a majority of respondents support nuclear armament of South Korea. Does this result mean that South Korean voters really desire nuclear armament? In this paper, we seek to answer this question by forcing South Korea voters into an experimental set-up in which respondents are exposed to expert information conflicting with respondents’ predispositions on nuclear armament. Specifically, we randomly assign respondents into different treatment groups in which respondents receive expert information on the cost/benefit, infeasibility/necessity, and the chance and type of international sanctions. The results of this experiment show that the proportion of respondents who changed their positions is larger within the pro-armament group than within the anti-armament group. Interestingly, the most effective attitude changing expert information was economic sanctions for the pro-armament group and the weakening US security guarantee for the anti-armament group. The findings of the study show that opinion survey has a serious limitation in revealing voters’ true preferences on a sensitive and complex issue such as nuclear armament. 한국 핵무장에 대한 여론조사는 일관되게 절반 이상의 응답자들이 핵무장에 찬성하는 것으로 나타난다. 이러한 여론조사 결과가 한국 유권자의 핵무장에 대한 선호를 대변하는가? 본 논문은 이에 대한 답을 찾기 위해 응답자들에게 핵무장과 관련된 입장에 반대되는 전문가 정보를 제공한 후, 응답자들의 반응을 조사하는 실험 설문을 진행했다. 핵무장에 찬성하는 응답자들에게는 핵무장의 비용, 현실성, 그리고 국제사회의 제재 등에 대한 전문가 정보를 제공하고, 핵무장에 반대하는 응답자들에게는 핵무장의 필요성, 가능성, 그리고 국제사회의 반응에 대한 전문가 정보를 제공하였다. 그 결과 응답자들의 핵무장에 대한 입장은 전문가 정보에 따라 크게 변화한다는 점을 확인하였다. 특히 핵무장에 찬성하는 응답자들의 태도 변화가 반대하는 응답자들의 태도 변화보다 컸다. 만약 유권자들이 핵무장에 대한 전문가 수준의 정보와 지식을 제공받는다면, 핵무장 찬성 여론은 여론조사에서 드러난 61%에서 38% 수준으로 낮아질 것으로 본 실험은 예측하였다. 본 실험 결과를 통해서 볼 때, 응답자들의 핵무장 반대 태도 변화를 유도하는 가장 효과가 높은 정보는 국제사회의 경제제재였으며 핵무장 찬성 태도 변화에서는 미국에 의한 안전보장의 약화가 가장 효과가 높았다. 이러한 실험 결과는 설문조사를 통한 여론조사는 민감하고 복잡한 정치적 이슈에 대한 유권자들의 선호를 파악하는 데에 한계가 있다는 점을 시사한다.
손상용,노철규,허훈,한상욱 대한내시경복강경외과학회 2021 Journal of Minimally Invasive Surgery Vol.24 No.1
Laparoscopic surgery is rapidly evolving with technological advances, but there are several drawbacks. An articulating device, with freedom of a perfect 360°, is attractive as a solution to overcome the restriction of instrument movement caused by straight tools. Its usefulness or efficacy should be supported by relevant scientific evidence. However, it is sometimes difficult to prove it because the factors influencing the surgical outcomes are complex and closely related to each other.