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최건무(Kun Moo Choi),박기영(Ki Young Park),엄대운(Dae Woon Eom) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.6
Traditionally, it has been emphasized that hemolytic disease was the primary cause of gallstones (cholelithiasis) in most young patients. In recent years, gallstones and common bile duct calculi have been increasingly diagnosed in infants and children, unrelated to hemolytic diseases. On the matter, the World Health Organization (WHO) classified intraepithelial neoplasia (dysplasia) of gall bladder as one of the precursor lesions of invasive cancer. The following article describes the case of a 2-year-old girl who had a laparoscopic cholecystectomy due to cholelithiasis and the pathologic diagnosis was chronic cholecystitis with diffuse, mild mucosal dysplasia.
위암에서 새롭게 개정된 제7판 UICC/AJCC N병기에 대한 제6판 N병기와의 비교평가
김지훈(Ji Hoon Kim),김찬욱(Chan Wook Kim),최남규(Nam Kyu Choi),곽진호(Jin Ho Kwak),최건무(Kun Moo Choi),장혁재(Hyuk Jae Jang),한명식(Myung Sik Han),이상진(Sang Jin Lee),오호석(Ho Suk Oh),최종수(Jong Soo Choi) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.3
Purpose: The 7th edition UICC/AJCC TNM classification for gastric cancer has several changes from the previous edition. Especially, the classification of the number of lymph node metastases (LNM) is reorganized. According to the new TNM system, N stage was categorized to N0 (no LNM), N1 (1∼2 LNM), N2 (3∼6 LNM), N3 (7 or more LNM). The aim of our study was to compare the prognostic significance of the new (7th) UICC/AJCC N stage with the old (6th). Methods: From 2000 to 2005 a total of 425 patients who underwent curative resections with D2 and with 15 or more lymph nodes retrieved were studied retrospectively. Results: According to the 7th UICC/AJCC N stage, the 5-year cumulative survival rates (5YSR) of N0, N1, N2, N3 were 96.0%, 79.2%, 58.5% and 24.3%, respectively (P<0.001). Using univariate analysis, the N stage of 7th and 6th UICC/AJCC TNM classification, 7th UICC/AJCC T stage, differentiation of tumor, type of gastrectomy (subtotal and total gastrectomy), size of primary tumor (≤5, 5<≤10, 10<) were associated with 5YSR. However, Cox regression multivariate analysis showed the 7th UICC/AJCC N stage to bean independent factor for predicting the 5YSR instead of the 6th UICC/AJCC N stage (P<0.001, hazard ratio (HR) 1.859, 95% confidence interval (CI) 1.576∼2.194), including depth of tumor invasion (P<0.001, HR 1.673, 95% CI 1.351∼2.073). Conclusion: The new (7th) UICC/AJCC N stage is a more reliable prognostic factor of gastric cancer than the old (6th) N stage.
양성간외담도협착증에서 중재적 방사선치료와 고식적 외과치료의 비교고찰
이종남(Jong Nam Lee),이승규(Sung Gyu Lee),권태원(Tae Won Kwon),최건무(Kun Moo Choi),성규보(Kyu Bo Seong),김명환(Myeong Hwan Kim),이성구(Sung Koo Lee),민병철(Pyung Chul Min) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.4
N/A Benign biliary stricture represents a significant clinical problem, despite of the technological development that has facilitated diagnosis and management. Without proper treatment, it could cause recurrent cholangitis, biliary cirrhosis, liver failure, and death. There are several e- tiologic factors in benign biliary strictures but almost all cases are related to biliary operation, especially cholecystectomy. At Asan Medical Center, from July 1989 through June 1993, nineteen patients were man- aged for post-operative biliary strictures with surgery and radiologic intervention. Nine pa- tients were treated with surgical repair (Roux-en-Y choledocho- or hepaticojejunostomy); ten patients were treated with radiologic and endoscopic intervention (9 endoscopic or tran- shepatic balloon dilatation with stent placement and 1 balloon dilatation only). All patients had the history of previous biliary scrgery, 15 cholecystectomy or CBD explo- ration, 2 choledochoenterostomy, and 2 endoscopic papillostomy. There was no motality after any proce- dure and mean period of follow-up was 10.2 months (3 36 months) for both groups. In sur- gery group, 8 patients (89%) showed successful outcome but in radiologic intervention group, only 4 patients (40%) showed successful outcome. Minor complications after procedure were 4 cases in surgery group and 3 cases in radiologic intervention group but there was no major complication in both groups. Mean period of hospital stay was 6 days (1 16 days) in radiolog- ic intervention group and 23.1 days (19&5 days) in surgery group. Five patients required retreatment because of recurrent strictures after endobiliary stenting. In these patients, 3 Roux-en-Y hepaticojejunostomy was performed, 1 pancreaticduodenectomy was done because of a possibility of malignancy and 1 PTBD was done because the patient refused the surgery. In conclusion, Radiologic intervention for benign biliary strictures provides temporary relief of symptom and might be an alternative treatment, especially in poor risk patients. However, open surgery (mucosa-to-mucosa anastomosis) is superior to radiologic intervention for definite treatrnent of postoperative biliary strictures because of fewer problems that require fur- ther therapy and excellent outcome. (Korean J Gastroenterol 1994; 26: 697 705)
증례 : 신장; 혈액 투석 환자에서 발생한 경화성 피막성 복막염 1예
송윤아 ( Yun A Song ),김은정 ( Eun Jung Kim ),권준성 ( Jun Sung Kwon ),김수희 ( Su Hee Kim ),최건무 ( Kun Moo Choi ),엄대운 ( Dae Woon Eom ),송경일 ( Kyung Il Song ) 대한내과학회 2013 대한내과학회지 Vol.85 No.6
저자들은 B형 간염에 의한 간경화가 있는 혈액투석 환자에서 반복적인 복수 및 복막염의 증상이 발생하여 경화성복막염 의심하에 개복술로 이를 확진하였고 이후 스테로이드 치료로 호전된 경화성 피막성 복막염을 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Encapsulating peritoneal fibrosis (EPF) is a serious, uncommon complication of chronic peritoneal dialysis. However, it is rare in hemodialysis patients. EPF is characterized by peritoneal membrane inflammation followed by peritoneal membrane fibrosis and encapsulation. The etiology is unclear, but inflammation of the deteriorated peritoneum causes peritoneal fibrosis. We present a case of EPF that occurred in a 29-year-old man with hepatitis B-associated liver cirrhosis with ascites that was treated solely with hemodialysis. We managed this patient surgically and then medically with prednisolone. To our knowledge, this is the first such case in Korea, so we report this case with a literature review. (Korean J Med 2013;85:629-633)