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박상환(Sang-Hwan Park),윤성수(Sung-Su Yun),이동식(Dong-Shik Lee),김홍진(Hong-Jin Kim),최준혁(Joon-Hyuk Choi),김종연(Jong-Yeon Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.1
Purpose: Liver cell damage after ischemia and reperfusion injury has been a major cause of death after liver surgery. Yet there have been no exact and practical guidelines for assessing liver cell damage after ischemia and reperfusion injury. The aim of this study was to estimate the liver cell viability after ischemia and reperfusion injury. Methods: A 70% partial liver occlusion model with employing Spraque Dawley Rats was used. The ATP content of the liver tissue, the palmitic acid metabolic rate and the histologic change (H/E, TUNEL stain) were all measured at 30 minute intervals to assess liver cell viability during 120 minutes of ischemia. At 24 hours reperfusion after 30, 60 and 120 minutes ischemia, the same parameters and the AST/ALT level in the blood were measured. Results: The ATP content was decreased below 20% compared to normal liver after ischemia, but there were no significant changes in the histology and the palmitic acid metabolic rate during 120 minutes ischemia. At 24 hours reperfusion after 30, 60 and 120 minutes ischemia, the ATP content was decreased to around 50% in all the groups and the palmitic acid metabolic rate was decreased 90.9±2.4%, 80.0±5.3% and 79.1±7.7%, respectively, compared to the control liver. But histologic change was not as great as the change in the ATP content and the palmitic acid metabolic rate. Conclusion: Judging by these results, liver has relatively good tolerance during ischemia, but after reperfusion, the liver showed damage depending on the duration of ischemia. This study might be very helpful as a guide line of liver damage after ischemia and reperfusion in both clinical practice and basic research.
허영수,강수환,윤성수,Huh, Young-Soo,Kang, Su-Hwan,Yun, Sung-Su 대한소아외과학회 1999 소아외과 Vol.5 No.2
Splenic cysts are uncommon and classified as either primary(true) or secondary(pseudo-) depending on the presence or absence of a true epithelial lining. True cysts (epidermoid cyst) of the spleen are very rare. Three cases of splenic cysts in childhood were treated at the Yeungnam University Hospital in the last eleven years(1989-1999). Two of patients were girls. The ages at diagnosis were 7, 12 and 15 years. Abdominal ultrasonography and computerized tomography were utilized for the diagnosis. Radionuclide scanning was performed in one patient. Surgical resection(one partial splenectomy and two total splenectomies) was performed. The sizes of cysts were 4, 6.5 and gem in maximum demension.
밀란기준 내 속하며 간기능이 보존된 간세포암에서 첫 치료로 시행된 간절제술의 성적 분석
이동식(Dong-Shik Lee),윤성수(Sung-Su Yun),김홍진(Hong-Jin Kim) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.4
Purpose: Hepatic resection and liver transplantation are surgical therapeutic options for small-sized HCC. But, the therapeutic option for patients meeting the Milan criteria with preserved liver function is facing a dilemma. In this study, we examined the outcomes of surgical resection for HCC patients meeting the Milan criteria with preserved liver function and rationale of hepatic resection as the first treatment for HCC meeting the Milan Criteria. Methods: Between 1991 and 2006, 248 patients with HCC underwent hepatectomy in 158 primary HCC patients meeting Milan criteria (Group M) and in 90 patients beyond Milan criteria (Group N). Median age was 54.5 years in group M and 52.4 years in group N. Results: The tumor size, mean survival months, E-S grade and vascular invasion rate were significantly different between the two groups. 67 patients in group M and 22 patients in group N had intrahepatic recurrence after primary hepatectomy. The cumulative 1, 3, and 5-year survival rates were 91.9%, 74.5%, and 60.5% in intrahepatic recurrence group M after primary hepatectomy and 100%, 96.0%, and 90.5% in repeated hepatic resection for recurrent treatment in group M, respectively. Conclusion: Because of the high survival rate and long-term survival after adequate treatment of recurrence, primary hepatectomy is considered a reasonable option as first-line treatment for HCC meeting Milan criteria with preserved liver function.