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식도암의 근치적 식도 절제술 후 폐합병증의 발생에 영향을 미치는 위험인자의 임상적 분석
최필조,정상석,Choi, Phil Jo,Jeong, Sang Seok 대한기관식도과학회 2011 大韓氣管食道科學會誌 Vol.17 No.2
Purpose Pulmonary complications continue to be the major cause of morbidity and mortality after esophageal resection. The aim of this study was to compare and analyze retrospectively the factors which effect for postoperative pulmonary complications in patients who underwent curative resection for esophageal cancer. Material and Method A total of 118 patients were enrolled in the study from January 1994 to March 2009, and patients with previous neoadjuvant chemotherapy or radiotherapy were excluded. Of the total 118 patients, 27 patients developed pulmonary complications within 30 days of their operation. the factors which effect for postoperative pulmonary complications were compared and analyzed. Results There were 7 patients in-hospital deaths. 51 patients (43.2%) developed complications, and of them, the most common complication was pulmonary complication and occurred in 27 patients (22.9%). In univariate analysis, diabetes mellitus, cervical anastomosis through the retrosternal route, old age and poor lung function were risk factors contributing to postoperative pulmonary complications (p<0.05). In multivariate analysis, statistically significant factor was old age (65 years or older). Conclusion Clinical factor for the pulmonary complications after esophagectomy of esophageal cancer was significantly associated with diabetes mellitus, cervical anastomosis through the retrosternal route, old age (65 years or older) and poor lung function (FEV1<80%). Of these, old age was the most significant factor.
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Pure esophageal atresia. 2 case
정상석,최필조,박권재,방정희,조광조,우종수,정진아,Jeong, Sang-Seok,Choi, Phil-Jo,Park, Kwon-Jae,Bang, Jung-Hee,Cho, Gwang-Jo,Woo, Jong-Soo,Jung, Jin-A 대한기관식도과학회 2008 大韓氣管食道科學會誌 Vol.14 No.1
Pure esophageal atresia without tracheoesophageal fistula is a uncommon form of congenital malformation of the esophagus, which is able to be suspected by fetal ultrasonograpy before delivery and diagnosed definitely by simple chest X-ray and esophagogram immidiately after delivery. We performed delayed primary repair in 2 cases of pure esophageal atresia by using stomach for conduit in one case and colon in the other case. But there were graft failure in the latter case, so reoperation was performed by using stomach. Postoperatively, two patients showed no stenosis and leakage in anastomotic site and were discharged in good oral intake without dysphagia.
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한국인의 비소세포폐암종에서 O⁶-methylguanine-DNA methyltransferase (MGMT)의 발현도 분석
이경은(Kyung Eun Lee),홍영습(Young Seoub Hong),최필조(Phil Jo Choi),노미숙(Mee Sook Roh) 한국생명과학회 2008 생명과학회지 Vol.18 No.4
본 연구에서는 손상된 DNA를 수복하는 중요한 효소로 알려진 O?-methylguanine-DNA methyltransferase (MGMT) 발현의 의미를 비소세포폐암종에서 면역조직화학 염색법으로 알아보고자 하였다. 동아대학교 의료원에서 2001년부터 2004년까지 외과적으로 적출한 폐암종 조직 중 비소세포암 종으로 진단된 74예를 연구대상으로 하였다. 면역염색 결과, MGMT 발현은 총 74예 중 49예(66.2%)에서 양성을 보였으며, 25예(33.8%)에서 단백 소실을 보였다. 조직학적 유형에 따른 결과를 살펴보면, 편평세포암종은 8/39예(20.5%)에서 단백 소실이 보였고, 샘암종은 17/35예(48.6%)에서 단백 소실이 관찰되어 통계적으로 유의한 차이가 관찰되었다(p=0.021). 하지만 나이, 성별, 흡연유무, 종양 크기, T 병기 및 림프절 전이에 따른 유의한 차이는 관찰되지 않았다(p>0.05). MGMT 단백 발현 소실은 특히 promoter 메틸화와 연관되어 종양에서 관찰된다고 알려져 있으므로, 향후 연구에서는 비소세포폐암종의 MGMT 단백 소실에 대한 임상적 의의를 밝히기 위하여 promoter 메틸화 연구가 추가적으로 수행되어져야 될 것으로 사료된다. O?-methylguanine-DNA methyltransferase (MGMT) is a DNA repair protein that protects cells against the carcinogenic effects of alkylating agents. The loss of MGMT expression was commonly known due to hypermethylation of CpG islands in its promoter region. We evaluated the expression of MGMT by immunohistochemistry in order to examine the relationship between loss of MGMT expression and clinicopathological characteristics in 74 Korean patients with non-small cell lung cancers. Loss of MGMT was detected in 25 (33.8%) of 74 cases. The loss of MGMT expression was frequently seen in the adenocarcinoma than in the squamous cell carcinoma (p=0.021). However, there was no significant differences between loss of MGMT expression and other clinicopathological characteristics, including age, gender, smoking status, tumor size, tumor T stage, and lymph node metastasis (p>0.05). In conclusion, loss of MGMT expression was related with the histologic type of lung cancer. Further methylation study of MGMT promoter is needed to evaluate the relationships with immunohistochemical expression of MGMT and to clarify the role of MGMT in lung cancer.
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손유정 ( You Jeong Sohn ),박수경 ( Soo Kyung Park ),김슬기 ( Seul Ki Kim ),김기남 ( Ki Nam Kim ),양두경 ( Doo Kyung Yang ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ),노미숙 ( Mee Sook Roh ),최필조 ( Phil Jo Choi ),방정희 ( J 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.1
Background: Eosinophilic lung disease (ELD) or eosinophilic pneumonia is recognized as a heterogeneous group of disorders characterized by varying degrees of pulmonary parenchymal or blood eosinophilia. The spectrum of diseases that can be primarily or secondarily associated with pulmonary eosinophilia is diverse. We evaluated the clinical features of ELD in 25 patients. Method: Twenty-five patients diagnosed as ELD were evaluated. Data were obtained prospectively using the standard form of evaluation to find the cause of ELD. Result: The most common cause of ELD was a parasitic infection (n=7,28%) and the others were idiopathic hypereosinophilic syndrome (n=6,24%), Churg-Strauss syndrome (n=4,16%), simple pulmonary eosinophilia (n=4,16%), drug (n=2,8%), and mycoplasma infection (n=2,8%). At radiographic presentation, the ground-glass opacity was 45% (n=11), consolidation was 32% (n=8), and nodule was 24% (n=6). Mean peripheral blood cosinophil counts were 4,104.6 ± 867.6/μL. The mean serum total IgE levels measured by CAP were 3,309.0±688.9 kU/L in the parasite infection group. However, peripheral blood eosinophil counts or serum total IgE levels were not significantly different among the disease groups classified by causes of ELD. Organs with eosinophilic infiltration other than the lungs were the stomach (n=3), liver (n=3), skin (n=2), heart (n=1), and nerve (n=1). Conclusion: Further and careful examinations are required to evaluate the causes of ELD. Moreover, we would like to stress the evaluation of curable causes, especially infectious disease such as parasite. (Korean J Asthma Allergy Clin Immunol 2006;26:46-51)
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정찬종,박헌수,이종한,최필조 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.34 No.1
Complications of tracheal intubation are well documented. However, iatrogenic aspiration of a broken metallic stylet following tracheal intubation has been infrequently reported. A 60-year-old woman, 10 days after shoulder arthroscopic surgery under endotracheal general anesthesia, was admitted to our hospital because of right chest pain. Chest radiographs showed a 8 cm length of metallic foreign body in the lower lobe of the right lung. Attempts at retrieval, including thoracoscopy, were unsuccessful. Open thoracostomy was performed. The removed foreign body was a part of metallic stylet. We report a case of iatrogenic aspiration of a broken metallic stylet. (Korean J Anesthesiol 1998; 34: 182∼186)
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