Predicting Difficulties on Delayed Laparoscopic Cholecystectomy in Symptomatic Cholelithiasis with Preoperative Sonographic Evaluation

Kim, Heekyung Graduate School, Eulji University 2017 국내석사

Purpose : The aim of this study was to evaluate the role of preoperative sonography in predicting potential technical difficulties that can be encountered in delayed laparoscopic cholecystectomy in patients with symptomatic cholelithiasis. Material and Methods : We retrospectively reviewed the records of 239 patients who underwent laparoscopic cholecystectomy between January 2014 and May 2014 in a single hospital of university. Total of 181 patients meeting the inclusion criteria were finally consisted as the final study group. Preoperative abdominal sonography was performed by an abdominal radiologist with 19 years of experience and the patient group was devided as emergency sonography group and elective sonography group, according to the time when the sonographic evaluation was done. The following eight sonographic parameters were assessed : the thickness of the GB wall, The number of the gallstones, the maximum diameter of the gallstones, presence of the sludge in the GB, presence of the fluid at the GB fossa, the maximum diameter of extrahepatic duct (EHD), presence of CBD stone, presence of GB polyp and maximum size. The following ten parameters in surgical fields were assessed : the duration of operation, the grade of GB inflammation, the grade of adhesion to peritoneal cavity, the thickness of GB wall, The number of the gallstones, the maximum diameter of the gallstones, presence of the fluid at the GB fossa, the maximum diameter of extrahepatic duct (EHD), presence of GB polyp and maximum size, and the presence of conversion to open cholecystectomy. The timing of the operation and difficulty score were also noted. Results : emergency group (n=141) shows higher age distribution as 58.55 compared with elective group (n=40) as 51.4. GB wall thickness, EHD dilatation, presence of EHD stone, and the presence of pericholecystic fluid show significantly high in the emergency sonography group. (p<0.05) GB stone number shows significantly high in the elective sonography group. (p<0.05) The operation time and the operation difficulty score are significantly higher in the emergency sonography group. In the statistical analysis does not distinguish between groups, the clinical and sonographic parameter that shows the significant difference of the operation time is the age. The clinical and sonographic parameters that show the significant difference of the operation difficulty score are sex, previous operation history, GB wall thickness, and EHD dilatation. In the statistical analysis of the elective sonography group of 141 patients, there is no parameter which shows statistically significant difference of the operation time. The operation difficulty score show difference in the parameters of sex, previous operation history, GB wall thickness, and the number of GB stones. In the statistical analysis of the emergency sonography group of 40 patients, the parameters which show statistically significant difference of the operation time are the maximum size of GB stone and pericholecystic fluid. The operation difficulty score is significantly higher in the patients over sixty years of age group. (mean 6.65, p<0.05) Conclusion : GB wall thickness 3mm or more, dilatation of the EHD to 7mm or more on preoperative sonography, presence of previous operation history, male gender have been identified as predictive factors for the determination of potential intraoperative technical difficulties especially when the elective sonography was done. If the emergency sonography was done and interval cholecystectomy is in scheduled, maximum GB stone size and pericholecystic fluid collection should be considered to predict operative difficulties.

The relationship between serum vitamin D levels and clinical characteristics in chronic urticaria : 만성 두드러기 환자에서의 혈청 비타민 D 수치와 임상적 특징과의 연관성

Woo, Yu Ri Graduate School, Eulji University 2015 국내석사

Background: Chronic urticaria is defined as the development of daily repeated episodes of itchy wheal and flare lasting for 6 weeks or longer. Owing to its chronic nature and intractable course, it impairs the patients’ quality of life and causes a high burden. However, the exact etiology of chronic urticaria still remains unclear. Nowadays a matter of great interest is on the role of vitamin D in various chronic diseases such as malignancies, infectious diseases, cardiovascular diseases and utoimmune diseases and allergic disease such as atopic dermatitis and asthma. However, limited data is available on the vitamin D status in patients with chronic urticaria. Objective: The goal of the present study was to investigate the relationship between vitamin D status and clinical characteristics of chronic urticaria. Methods: The clinical records from December 2013 to October 2014 were reviewed retrospectively. 72 patients of chronic urticaria, 72 healthy controls, 26 patients of acute rticaria and 26 patients of atopic dermatitis who visited the outpatient clinic of the Department of Dermatology and Familiy Medicine, Eulji University Hospital were included in this study. I analyzed the serum serum 25-(OH)D3 status with various clinical parameters for chronic urticaria; result of autologous serum skin test(ASST), disease duration, urticaria activity score, age, sex and season. Results: The serum 25-(OH)D3 level was significantly reduced in patients with chronic urticaria compared with acute urticaria (p = 0.024), atopic dermatitis (p = 0.008) and healthy controls (p < 0.001). In particular, the prevalence of vitamin D critically low level (< 10 ng/ml) was significantly higher in patients with chronic urticaria than that observed in acute urticaria (26%) (p < 0.002), atopic dermatitis (28%) (p < 0.004) and healthy controls (8%) (p < 0.001). The ASST positive patients had the lower vitamin D level than the ASST negative patients (p = 0.034). In chronic urticaria patient, the serum vitamin D levels showed the significant negative associations with urticaria acitivity score (UAS) (p < 0.001). Also, the serum vitamin D levels showed the significant negative associations with disease duration (p < 0.001). Conclusion: I found that, in chronic urticaria patient, the serum vitamin D levels were critically low (< 10 ng/ml). Also, serum vitamin D status was inversely related to the disease severity and disease duration of the chronic urticaria patient. Therefore, it might be possible that vitamin D is supposed to be involved in the pathogenesis of chronic urticaria, and these findings may open up the possibility of clinical use of vitamin D as a predictive marker for the disease activity in chronic urticaria.

Mutational analysis of extranodal NK/T-cell lymphoma using targeted sequencing with comprehensive cancer panel

최승규 Eulji University 2016 국내박사

Study on pathogenesis of allergy induced by house dust mite and a novel allergen binding to TLR4

이나래 Eulji University 2018 국내박사

GABA from reactive astrocytes deteriorates anxiety and aggression in adolescence period in mouse by early life stress

Anjana Silwal Adhikari Eulji University 2022 국내박사

Astrocyte reactivity can be stimulated by variety of sources in response to plenty of central nervous system pathologies like trauma, stroke or various neurodegenerative diseases. Normal astrocyte reactivity can protect neural tissue, maintain tissue homeostasis, and preserve neurological functions. Dysfunction of reactive astrocytes can impart to disorder of central nervous system (CNS) either through loss of normal functions or through gain of abnormal functions. The latest research show that reactive astrocytes excessively produce the inhibitory gliotransmitter gamma-aminobutyric acid (GABA) by monoamine oxidase-B (MAOB) and abnormally release GABA through the bestrophin 1 (Best1) channel. This research focuses on the properties of the GABA from glial cells and their expression in paraventricular nucleus (PVN), basolateral amygdala (BLA), central nucleus of amygdala (CeA) and dentate gyrus (DG) of ventral hippocampus that relates early life stress in maternal separation (MS) model of mouse. Many studies had been done with relation to different animal model to understand the role of GABA, its synthesis and release in the glial cells. However, there had not been much investigation in astrocytic reactivity of GABA and its expression specially on emotion disorder in the model of early life stress (ELS). Thus, this research integrated about the ELS and focus mostly on anxiety and aggression as an animal model of MS, to show how ELS affects glial cell function specially astrocytes. Specially, this study focuses on the immunoreactivity expression of GABA, MAOB and Best1 channel in three major regions of brain. Importantly, the finding also emphasizes the roles GABA in reactive astrocytes and be a potential intervention target for anxiety and aggression in ELS model in future.

Proteomic approach for drug response in prostate cancer using cell lines

박아름 Eulji University 2015 국내석사

Gland attenuation, a novel morphological feature of colorectal cancer : evidence for epithelial-mesenchymal transition

백태화 Eulji University 2016 국내박사

(The) effects PKCε activation on neural damage induced by amyloid β

양종윤 Eulji University 2014 국내박사

Effect of simultaneous native nephrectomy on the outcome of kidney transplant recipients with autosomal dominant polycystic kidney disease

김정호 Eulji University 2015 국내석사

Effects of high-glucose induced epithelial to mesenchymal transition by Sulforaphan in human renal tubule cells

신종호 Eulji University 2016 국내박사