• Title/Summary/Keyword: 간 절제술

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Changes of Specific Activity and Regulation of Nitric Oxide Synthase during Liver Regeneration after Partial Hepatectomy

  • Lee, Young-Jin;Nam, Suk-Woo;Seo, Dong-Wan;An, Sung-Whun;Ko, Young-Kwun;Sung, Dae-Seok;Han, Jung-Whan;Lee, Hyang-Woo
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1996.04a
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    • pp.185-185
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    • 1996
  • Nitric oxide synthase(NO Synthase:E.C.1.14.13.39)는 생체내에서 L-arginine을 기질로 하여 citrulline과 nitric oxide(NO)를 생성하는 효소로서, 최근 연구에 의하면 2/3 부분 간 절제술 후 prereplicative phase동안에 발현되는 것으로 알려져 있다. 한편, 생체내에서 NO Synthase에 상경적 길항제인 methylarginine에 관해서도 수년간 많은 연구가 진행되어 왔다. 이들의 생성 기전은 protein methylation에 의해 생성된 methylated protein이 생체 내에서 분해되어 생성된다고 알려져 있으나, 정확한 기전에 대해서는 아직 논란의 여지가 많다. 따라서, 본 연구에서는 In vivo 실험을 통해 부분 간 절제술 후 시간대별로 간 조직에서의 NO Synthase 활성도와 혈청에서 NO의 최종 대사물인 Nitrite/Nitrate를 측정하였으며, 또한 NO Synthase 조절에 관여하는 세포내 기질인 arginine과 억제 인자인 methylarginine함량을 간 조직 및 혈청에서 측정하고, 세포 신호 전달체계에 관여하는 cyclic GMP 함량을 측정함으로써, 부분 간 절제술 후 간 재생동안에 NO Synthase 활성도와 methylarginine 및 arginine과의 상관 관계를 규명하고, 간 재생동안, 생성된 nitric oxide의 역할을 연구하려한다.

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A Case of Pancreatic Cancer Recurred in Liver after Surgical Resection, in Complete Response after Chemotherapy and Tumorectomy (수술적 절제술 후 간에 재발한 췌장암에서 항암화학요법과 종양절제술로 완전 관해를 보인 증례)

  • Jun Hyuk Son;Jae Woo Lee;Dong Kee Jang;Sang Hyub Lee;Ji Kon Ryu;Yong-Tae Kim
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.105-107
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    • 2015
  • Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.

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Comparison of Ovariectomy and Ovariohysterectomy in Terms of Postoperative Pain Behavior and Surgical Stress in Dogs (개에서 난소자궁절제술과 난소절제술 후 나타나는 통증 행동과 스트레스 반응의 비교)

  • Lee, Scott-S.;Lee, Seung-Yong;Park, Se-Jin;Kim, Young-Ki;Seok, Seong-Hoon;Hwang, Jae-Min;Lee, Hee-Chun;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.30 no.3
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    • pp.166-171
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    • 2013
  • This study was conducted to evaluate the clinical relevance and effectiveness of ovariectomy (OVE) and ovariohysterectomy (OVH) in terms of postoperative pain behavior and surgical stress. Thirteen healthy intact mongrel purpose-bred female dogs were used in this study. OVE was performed in six dogs whereas OVH was performed in seven dogs. Prior to, 1, 2, 4, 6, 12, and 24 h after surgery, pain assessment was performed by using the Short form of Composite Measure Pain Scale (CMPS-SF) and blood analysis for the determination of glucose, creatine kinase (CK), and cortisol were done. Also, surgical time, duration of anesthesia, and incision length were compared between two groups. As a result, OVH group as opposed to OVE group showed significantly longer in surgical time, duration of anesthesia, and incision length. Also, based on the two-way ANOVA test, the CMPS-SF had significant differences (p < 0.05) between two groups, with the OVE dogs having lower values at 1, 2, 4, and 6 h postoperatively. In addition, in terms of CK, the value at 1, 2, 4, 6, and 12 h were significantly (p < 0.05) increased from the baseline value for the OVH group. However, as for CK in OVE group, the values at 4, 6, and 12 h were significantly increased from the baseline value. As for blood glucose, a significant (p < 0.05) increase from the baseline was shown at 1 h postoperatively in OVH group and no significant increase was shown in OVE group. In terms of serum cortisol level, the values at the 1 and 2 h were significantly (p < 0.05) increased from the baseline value for both groups. In conclusion, our study has shown that OVE can be considered as a superior choice in terms of sterilization technique in female dogs, considering shorter incision length, surgical time, duration of anesthesia along with lower pain and surgical stress response than OVH.

The comparative study of arthroscopic meniscectomy with or without high tibial osteotomy in patients with degenerative medial meniscus posterior horn tear (내반 변형을 지닌 내측 반월상 연골판 후방 골 기시부 퇴행성 파열 환자에서 반월상 연골판 절제술 단독과 근위 경골 절골술 동반 수술의 결과 비교)

  • Moon, Jae-Young;Seon, Jong-Keun;Song, Eun-Kyoo;Kim, Hyung-Soon;Yim, Ji-Hyeon;Cho, Hyun-Jong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.30-36
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    • 2012
  • Purpose: We compared the clinical and radiological results of meniscectomy with HTO or without HTO for degenerative medial meniscus posterior horn with varus deformity. Materials and Methods: Forty-two patients who had medial meniscus degenerative root tear with varus deformity more than 3 degrees were included for this study. Among them, 30 patients were performed meniscectomy combined with open wedge HTO and 12 patients were performed only meniscectomy without HTO. The mean follow-up period was 52.5 months. The clinical results were evaluated based on symptom improvement, patients' subjective satisfaction for surgery and HSS score. We also compared the osteoarthritic progression between the group on preoperative and at the final follow up radiographs. Results: Symptom improvement was achieved in 83.3% (25 cases) with HTO group and 66.7% (8 cases) without HTO group at final follow up with a significant difference. Patients' satisfaction was achieved in 83.3% (25 cases) with HTO group and 58.3% (7 cases) without HTO group which has a significant difference. The HSS score was improved in both group (90.8: with HTO group, 89.0: without HTO group) at the final follow up without significant difference. WOMAC score was improved in both groups at the final follow up without significant difference. There were no significant differences in the osteoarthritic progression between two groups. Conclusion: The good clinical result for treatment of patient who have medial meniscus degenerative root tear with varus deformity, proximal high tibial osteotomy is considered absolutely necessary. However, the progression of degenerative arthritis, its effect on long term follow up will be needed.

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Long-Term Result of Surgical Treatment for Esophageal Cancer -500 cases- (식도암에서 외과적 요법의 장기성적에 대한 임상적 고찰 -500예 보고-)

  • 임수빈;박종호;백희종;심영목;조재일
    • Journal of Chest Surgery
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    • v.34 no.2
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    • pp.148-155
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    • 2001
  • 배경: 본 연구는 1987년부터 1997년까지 원자력병원에서 수술을 시행한 500명의 식도암환자를 대상으로 하여 휴향적 방법을 통해 조기 및 장기성적, 재발양상, 예후인자 등을 보고하고자 한다. 대상 및 방법: 대상환자 중에서 발병암이 있는 경우, 인두식도 경계부위나 위식도 경계부위 암, 고식적 우회술 또는 인공식도 삽입예 그리고 시험적 개흉술이나 개복술 만을 시행한 경우는 제외 시켰다. 식도 절제는 대부분 우측 개흉술을 이용한 Ivor Lewis 술식을 사용하였고 대부분의 문합은 stapler를 사용하였다. Extended lymph node dissection은 1994년 8월부터 시행하였고 그 이전에는 standard lymph node dissection을 하였다. 96.8%에서 위를 식도 대체장기로 사용하였고 경부에서 절제 및 재건술을 시행한 경우를 제외한 모든 식도재건은 후종격동을 통해 시행하였다. 결과: 474예(94.8%)가 편평상피 세포암이었고 대부분(58.2%)은 중부식도에 위치하였다. 술후병기는 47.4%가 stage III이었고 25%가 stage IIA이었다. 392예에서 근치적 절제가 가능하였고 74예는 고식적 절제를 시행하였으며, 식도열공을 통한 식도절제술과 경부에서의 유리공장 이식술을 시행한 34예는 위분류에서 제외하였다. 술후 유병율은 38.4%이었고 수술 사망률은 5.8%로 호흡기 감염, 문합부 유출이 주요 원인이었다. 대상환자의 99.8%에서 추적은 가능하였고 수술사망 예를 포함한 전체환자의 1, 2, 5년 생존율은 각각 63.5%, 38.9%, 19.4% 이었다. Standard lymph node dissection 그룹에서의 1, 2, 5년 생존율이 60.7%, 35.9%, 16.9%이었으나 extended lymph node dissection그룹에서는 1, 2, 4년 생존율이 70.2%, 46.5%, 30.9%이었다. 근치적 절제의 경우는 1, 2, 5년 생존률이 69.4%, 43.9%, 21.9%이었고, 고식적 절제의 경우는 37.8%, 17.6%, 7.3%이었다. 수술사망을 제외한 근치적 절제술과 extended lymph node dissection을 함께 시행한 경우의 4년 생존율은 35.6%이었다. 수술후 재발은 226예에서 발견되었고 주로 국소임파절(69%; 경부, 종격동, 복부)이었으며, 전신재발은 간, 폐, 뼈, 뇌 등의 순이었다. 결론: 저자들은 적절한 술후 환자관리가 선행되어야 하지만 근치적 절제와 광범위한 임파절 절제가 장기성적의 향상에 필수적 요소이고, 진행된 식도암에 있어서는 보다 효과적인 보강적 복합치료가 연구되어야 할 것으로 생각된다.

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Vitamin C Promoted Liver Regeneration Following Partial Hepatectomy-induced Hepatic Injury in Senescence Marker Protein-30-deficient Mice (비타민 C 투여는 간 부분절제술에 의한 간 재생을 촉진 시킴)

  • Han, Seon Young;Hwang, Meeyul;Kim, Ah-Young;Lee, Eun-Mi;Lee, Eun-Joo;Lee, Myeong-Mi;Sung, Soo-Eun;Kim, Sang-Hyeob;Jeong, Kyu-Shik
    • Journal of Life Science
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    • v.25 no.3
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    • pp.336-344
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    • 2015
  • The capacity for liver regeneration involves a variety of nutritional factors. Vitamin C has multiple metabolic and antioxidant functions. In this study, we investigated the role of vitamin C in liver regeneration following hepatectomy in senescence marker protein (SMP)-30 knockout (KO) mice. Partial hepatectomy was performed by resecting the median and left lateral lobes of mice. Vitamin C accelerated liver recovery in SMP30 KO mice treated with vitamin C (KV). The livers of the KV mice exhibited lower levels of aspartate aminotransferase and lower injury than those of the KO mice. Increased type II transforming growth factor-β receptor (TGF-βRII)-mediated regeneration signaling was accompanied by HGF and cMet in the KV but not the KO mice. Consistent with this, the expression of cell cycle regulatory proteins, including cyclin D1 and proliferating cell nuclear antigen (PCNA), increased rapidly in the KV mice. Enhanced activation of ERK and GSK-3β proteins and a significantly increased number of binuclear hepatocytes were also detected in the livers of the KV mice. Moreover, the KV mice synthesized the highest levels of albumin. These data suggest that treating SMP30 knockout mice with vitamin C resulted in earlier recovery and liver regeneration by activation of the regeneration system.

Arthroscopic Distal Clavicle Resection for Chronic Stage 2 Acromioclavicular Dislocation - Preliminary Report of 6 Cases Study - (관절경하 원위 쇄골 절제술을 이용한 만성 제 2형 견봉쇄골 손상의 치료 - 6례에 대한 예비 연구 -)

  • Yoo Yeun-Sik;Yoon Young-Gon;Nam Il-Hyun;Moon Gi-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.171-176
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    • 2002
  • Purpose : To evaluate effectiveness of arthroscopic distal clavicle resection for chronic stage 2 acromioclavicular dislocation. Material: 6 patients who had failed to respond to physical therapy were evaluate more than 6 months prospectively, which were treated with arthroscopic distal clavicular resection from february 1998 to January 2001. Result : The median preoperative Constant score changed from 32 of 100 to 37 of 100 at 3 to 6 weeks, to 49 of 100 at 3 months and to 69 of 100 at 6months. Improvement was achived at mean follow up more than 6 months after surgery. Overal $83\%$ of patient were satisfied with this procedure. but the remained case was unsatisfied because symptom was not improved more than 6 months Conclusion : Arthroscopic distal clavicle resection is useful method to treatment for chronic stage 2 acromioclavicular dislocation.

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Segmentation of Liver on MDCT Image (MDCT 영상에서 간의 추출)

  • Seo Jeongjoo;Ryu Gangmin;Fei Yang;Park Jongwon
    • Proceedings of the Korean Information Science Society Conference
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    • 2005.07b
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    • pp.802-804
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    • 2005
  • 제안된 연구에서는 기존의 일반 CT(Computerized tomography) 영상이 아닌 MDCT(Multi Detector CT) 영상을 이용하여 장기 추출에 관한 연구를 진행하였다. 조영제를 이용한 복부 MDCT 영상으로부터 모폴로지(morphology) 기법을 통해 간에 근접한 노이즈를 제거하고, 기존의 Otsu threshold를 개선하여 간의 명암값 분포를 구분할 수 있는 임계치를 구하였다. 찾아진 임계치를 이용하여 영상을 이진화하고, 최종적으로 위치정보를 이용하여 간에 해당하는 부분들을 추출하였다. 이러한 방식은 명암값과 위치정보를 이용하여 간을 추출한 후 다시 노이즈 문제를 해결하는 기존의 알고리즘과 비교했을 때, 처리 방식이 단순해지고 속도가 향상되었다. 추출된 간은 간 이식술이나 절제술에 필요한 간 내부의 혈관 인식과 간의 부분체적 계산 연구에 중요한 정보로 사용될 수 있을 것이다.

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Portal Placement for Thoracoscopic Right Middle Lung Lobectomy with One-Lung Ventilation in Beagle Dogs (비글견에서 편측성 분리폐 환기를 이용한 흉강경 우중폐엽 절제술을 위한 포트 위치)

  • Park, Ji Young;Lee, Hae-Beom;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.9-15
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    • 2015
  • Purpose of this study is to determine the reasonable portal approach for thoracoscopic right middle lung lobectomy in small sized dogs under 10 kg. Ten healthy beagle dogs weighing $8.67{\pm}0.49kg$ were included. Under general anesthesia, one-lung ventilation (1LV) was achieved using endobronchial blocker with guidance of fiber-optic bronchoscope. Two portal approaches were used; 8-6-10 intercostal space (ICS) and 8-6-5 ICS approach. Thoracoscopic right middle lung lobectomy was performed using endoscopic linear self-cutting stapler and specimen retrieval bag. Each approach was evaluated by scoring 0; bad, 1; endurable, 2; good, 3; excellent in following five category, 1) visualization, 2) triangulation; instrumental sword fighting in the thoracic cavity, 3) approach to hilar pedicle; application of stapler, 4) any obstacles in applicating Lap Bag, and 5) the operator's convenience. Favorable working space was secured by 1LV and thoracoscopic right middle lung lobectomy was successfully completed in all dogs. There was no need to change the portal location and iatrogenic complication. Most of scores were good to excellent in both approaches. Consequently, both approaches are feasible methods for thoracoscopic right middle lung lobectomy with one lung ventilation using endoscopic linear self-cutting stapler in dogs weighing less than 10 kg.

The Comparison of Efficacy and Safety between Radiofrequency Ablation Alone and Ethanol Ablation Followed by Radiofrequency Ablation in the Treatment of Mixed Cystic and Solid Thyroid Nodule (낭성 및 고형성 혼합 갑상선 결절 치료에서 고주파 절제술 단독요법과 에탄올 절제 후 고주파 절제술 요법의 유효성 및 안전성 비교)

  • Min Gang Jo;Min Kyoung Lee;Jae Ho Shin;Min Guk Seo;So Lyung Jung
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.618-630
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    • 2024
  • Purpose To compare the efficacy and safety of radiofrequency ablation (RFA) and ethanol ablation (EA) followed by RFA in treating mixed cystic and solid thyroid nodules. Materials and Methods We included 243 nodules from 243 patients who underwent RFA for mixed cystic and solid benign nodules. The nodules were divided into two groups (RFA alone and EA + RFA). We evaluated volume reduction rate (VRR), therapeutic success rate, improvement in symptomatic and cosmetic issues, complications, and adverse effects. Results The RFA group included 204 patients, and the EA + RFA group included 39 patients. The long-term success rates in the RFA only and EA + RFA groups were 90.2% and 97.4%, respectively. The mean VRR at the last follow-up in the RFA and EA + RFA groups were 81.6% and 87.2%, respectively. Therapeutic results were similar in both groups at the last followup. Cosmetic and symptomatic problems markedly improved in both groups. No major complications were observed. Conclusion Both RFA alone and EA + RA are safe and effective methods for treating mixed cystic and solid thyroid nodules, although EA + RFA is slightly more effective.