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장재율,장서혁,송다운,송노준,한새로아름,오승준,윤의정,안지인,이석찬,구진모,박계원 한국식품영양과학회 2021 Journal of medicinal food Vol.24 No.12
Butea monosperma (Lam.) Taub. has been applied to treat inflammatory, metabolic, and infectious diseases. However, the antiobesity effects of B. monosperma (Lam.) Taub. flower (BMF) and the underlying mechanisms have not been determined. In this study, we analyzed the various extraction procedures, investigated the antiobesity effects, and identified the main chemical constituents of BMF. The BMF was subjected to acid hydrolysis in 5% H2SO4 in methanol at 50°C for 48 h and partitioned with ethyl acetate. The acid-hydrolyzed BMF ethyl acetate extracts (BMFE) strongly induced the expression of uncoupling protein 1 (Ucp1) and other thermogenic genes in C3H10T1/2 adipocytes. Daily oral administration of 70 mg/kg BMFE (BMFE70) to mice with diet-induced obesity resulted in less body weight gain, increased glucose tolerance, higher rectal temperature, and increased oxygen consumption. Qualitative and quantitative analyses along with treatments in Akt1 knockout mouse embryonic fibroblasts indicate that butein is a major active ingredient of BMFE, which stimulates Ucp1 gene expression. These data show the effects of butein-containing B. monosperma flower extract on thermogenesis and energy expenditure, further suggesting the potential role of BMFE as a functional ingredient in obesity and related metabolic diseases.
장재율(Jae Yool Jang),안영준(Young Joon Ahn),정중기(Jung Kee Chung),정인목(In Mok Jung),허승철(Seung Chul Heo),황기태(Ki-Tae Hwang),안혜성(Hye Seong Ahn),신은(Eun Shin),서자희(Ja Hee Seo) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.78 No.5
Adenosquamous carcinoma arising in congenital choledochal cyst is very rare and herein we report a case thereof. A 37-year-old woman was referred for further evaluation of pancreas head mass and a hepatic nodule on CT. She had been diagnosed with congenital choledochal cyst at 22-years-old and received Roux-en-Y choledochojejunostomy at that time. Endoscopic ultrasonography-guided biopsy proved the pancreas head mass as a squamous cell carcinoma and liver biopsy also proved the liver mass as a metastatic squamous cell carcinoma. We performed pancreaticoduodenectomy and tumorectomy of metastatic liver nodule. Grossly, the primary lesion was located at intrapancreatic portion of choledochal cyst. Histologically, the primary lesion and hepatic nodule was metastatic adenosquamous carcinoma. So far, there have been only three cases of adenosquamous carcinoma arising in congenital choledochal cyst reported in English-language literature. This is another case and the first case reported in Korea.
Laparoscopic Approach for Pancreatic Leiomyosarcoma with Metachronous Liver Metastasis
이우형,장재율,홍순찬,정치영 대한내시경복강경외과학회 2017 Journal of Minimally Invasive Surgery Vol.20 No.2
Although pancreatic leiomyosarcoma (PLM) is a rare malignant pancreatic cancer, it usually shows aggressive biological features such as invasion to an adjacent organ or distant metastasis at the time of diagnosis. Radical resection is the best treatment modality but effective chemotherapies have not been identified. A 58-year-old female was referred to us complaining of intermittent left upper quadrant abdominal discomfort. Imaging studies revealed a 10-cm mass in the pancreatic tail. The patient underwent laparoscopic distal pancreatectomy with splenectomy, and the pathological findings were consistent with PLM. Imaging studies 14 months after surgery revealed multiple liver metastases. Because the patient was young with a sufficient remnant liver, we performed laparoscopic metastatectomy without any postoperative complications. Patients with PLM need frequent checkups, even after curative resection. The role of laparoscopic resection should be confirmed in the future.
Laparoscopic Repair of Diastasis Recti: A Case Report and Literature Review
이우형,정치영,장재율,홍순찬,조진규 대한내시경복강경외과학회 2019 Journal of Minimally Invasive Surgery Vol.22 No.3
Diastasis recti is a state with separated aponeurosis between two recti caused by weakening of the intercrossing fibers in the linea alba and it causes abdominal protrusion. Common causes comprised of increased intraabdominal pressure, or congenital weakening of myoaponeurotic layer. We describe a patient who underwent laparoscopic repair of diastasis recti. A 30-year-old woman was referred to our outpatient department for an abdominal mass that had appeared 1 year earlier. Physical examination revealed an abdominal wall defect along the midline and computed tomography showed thinning and stretching of the linea alba. The patient underwent laparoscopic repair for diastasis recti. The stretched linea alba was approximated using interrupted sutures from the epigastrium to the suprapubic area. A dual mesh was applied below the peritoneum to prevent recurrence. The patient was discharged without complications, and was followed up for 1 year without recurrence. Laparoscopic repair could be a considerable is a treatment modality for diastasis recti.
Single Incision Laparoscopic Cholecystectomy without a Camera Operator
최영록,한호성,윤유석,조재영,장재율,최한림,장재성,권성욱,김성호,최장규 대한내시경복강경외과학회 2017 Journal of Minimally Invasive Surgery Vol.20 No.2
Purpose: This study aimed to evaluate the implementation of solo surgery using a laparoscopic scope holder for single incision laparoscopic cholecystectomy (SILC). Methods: With a glove port and a flexible high-definition scope, SILC was performed through a single trans-umbilical incisional site with CO2 pneumoperitoneum at a pressure of 12 mmHg. Fiftyeight patients who underwent solo SILC using a scope holder (Solo-SILC) were compared to 15 patients who underwent camera operator-assisted SILC (Ca-SILC) in terms of intraoperative and postoperative outcomes. Results: The mean BMI and operation time were 23.0±3.6 kg/m2 and 64.4±16.6 min in Ca-SILC and 25.0±3.8 kg/m2 and 58.2±27.1 min in Solo-SILC, respectively (p=0.067 and p=0.410). Estimated blood loss was negligible and an additional assistant port was not required in either groups. A case of gallbladder perforation and bile leak was noted in the Ca-SILC group, and 13 cases of bile leak in the Solo-SILC group, with no significant differences (p=0.167) during the surgery. Postoperative outcomes including surgical complications, diet restriction, diarrhea and hospital stay were not significantly different except for shoulder pain (p<0.001). Conclusion: Even with the limitations of a small number of patients, Solo-SILC proved to be a feasible technique. To confirm the safety of solo-SILC, further studies with a larger sample size are required.
김대환(Daehwan Kim),한호성(Ho-Seong Han),윤유석(Yoo-Seok Yoon),조재영(Jai Young Cho),최영록(Youngrok Choi),장재율(Jae Yool Jang),최한림(Hanlim Choi) 대한종양외과학회 2015 Korean Journal of Clinical Oncology Vol.11 No.2
Purpose: Pancreatic surgery is challenging and associated with high morbidity. Therefore, it is important to detect it early before it becomes clinically apparent. The white blood cell (WBC) count useful as a predictive marker of postoperative pancreatic fistula. The aim of this study was to evaluate the diagnostic accuracy of WBC in predicting pancreatic fistula. Methods: Between September 2003 and December 2013, 405 patients underwent elective pancreaticoduodenectomy or pylorus preserving pancreaticoduodenectomy for periampullary malignancy. Among them, 372 patients with no preoperative leukocytosis were enrolled in this study. The serum WBC count was monitored daily until postoperative day 8. The clinic and pathological data of these patients were analyzed by reviewing medical records retrospectively. Results: Thirty patients (8%) developed pancreatic fistula grade B and C. The WBC count, measured every other day, was significantly higher every other day during the first 7 postoperative days in patients who developed pancreatic fistula grade B and C, compared with those patients who did not develop pancreatic fistula. The WBC count cutoff value of 13.07x10<SUP>9</SUP>/L, 10.37 x10<SUP>9</SUP>/L on postoperative day 1,7 yielded a sensitivity of 57%, 70%, specificity of 53%, 67% for the detection of pancreatic fistula. Conclusion: Patients with postoperative fistula grades B and C showed WBC counts that did not decrease on subsequent measurements during the early postoperative period. The measurement of WBC counts after pancreaticoduodenectomy can play a clinically important role in the early detection of pancreatic fistula development even from postoperative one day.
Primary hepatic choriocarcinoma in a female patient
Makhmud Malikov,Eun Shin(신은),Jai Young Cho(조재영),Ho-Seong Han(한호성),You-Seok Yoon(윤유석),Young Rok Choi(최영록),Jae Yool Jang(장재율),Hanlim Choi(최한림),Jae Seong Jang(장재성),Seong Uk Kwon(권성욱),Haeryoung Kim(김혜령) 대한종양외과학회 2015 Korean Journal of Clinical Oncology Vol.11 No.1
Choriocarcinoma is a germ cell tumor belonging to the spectrum of gestational trophoblastic diseases, and occurs most commonly in the gonads. Primary hepatic choriocarcinoma is very rare, especially in females. A 59-year-old woman was referred to our clinic with a history of upper right quadrant pain lasting 1 month. Computed tomography and magnetic resonance imaging revealed a large hypervascular mass in the right liver, characteristic of angiosarcoma. The patient underwent right hemihepatectomy without unexpected events. Histopathology revealed the tumor as a choriocarcinoma, with numerous syncytiotrophoblasts. Immunohistochemistry was positive for β-human chorionic gonadotropin and CK-19, with a Ki-67 labeling index of 90%. The tumor showed focal positivity for CD31 and human placental lactogen. The patient started chemotherapy (vincristine and cyclophosphamide) on postoperative day 16. The patient’s clinical condition improved and she was discharged on postoperative day 17. Primary hepatic choriocarcinoma in female adults is a rare aggressive tumor, and further studies are needed to improve its diagnosis and treatment.