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김운원 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5
Posterolateral vertebral fusion has had injury of back muscles, spinal cord, dura, nerve roots and post operative adhesion that caused persistent back pain. Traditional anterior approach was designed but has septic complication, intestinal complication, wound infection and high morbidity. Recently minimally invasive anterior approach of vertebral interbody fusion has less morbidity. This minimally invasive anterior approach of vertebral interbody fusion has not only disadvantage- vascular, nerve, urinary, intestinal injury but also advantage- rapid recovery, short hospital day, high fusion rate, less morbidity. More study of operative instruments, techniques, and skills for less mobidity and safety give comfort to the patients.
김운원(Woon Won Kim),김상효(Sang Hyo Kim) 대한두경부종양학회 2003 대한두경부 종양학회지 Vol.19 No.2
Introduction: A routine superficial parotidectomy with facial nerve dissection in parotid tumor surgery often results in facial dysfunction, Frey syndrome and defect in operation site. Formal facial nerve dissection has been a recommended procedure, because pleomorphic adenoma is a commonly recurrent tumor in case of inadequate surgical management, however it can not be always reasonable in aspect of postoperative sequelae. Patients and Methods: Through retrospective review of 245 cases parotidectomies and follow up for more than three years, clinicophathologic factors influencing to the selection of surgical procedure were considered to be age, sex, and preoperative pathology confirmed by preoperative MRI and FNA. Results: Five categories were established as follow for surgical decision in parotid tumor surgery. Category 1. Superficial lobe adenoma -- Superficial parotidectomy -- 124 Category 2. Deep lobe adenoma -- Deep parotidectomy -- 39 Category 3. Non pleomorphic adenoma -- Tumorectomy 1.5cm adenoma in young female -- Tumorectomy -- 25 Category 4. Recurrent multicentric tumor -- Parotidectomy+RT -- 9 Category 5. Parotid cancer; Parotidectomy + UND (RND) + RT -- 48 ; CORE (Composite Regional Ear Resection) -- 2 Conclusion: Surgical morbidity and recurrence rate could be minimized by individualizing the surgical procedure according to the category principle based on the clincopathologic features.
결직장 암종에서 핵 내 β-catenin 발현이 cyclin D1 발현에 미치는 영향
박경선,김운원,오상훈,김상효,양영일 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5
Objectives : β-Catenin plays dual roles, a structural role in cell-cell juction for signal transduction and a regulatory role in the nucleus for gene expression. β-Catenin can translocate into the nucleus, where it forms a complex with transcription factor of the lymphoid enhancing factor (Lef-1), and activates the expression of mostly unknown genes. β-catenin mediated signal depends on its accumulation and subsequent translocation into the nucleus. Elevated β-catenin level in colorectal cancers is caused b y mutations in β-catenin itself or adenomatous polyposis coli(APC). Recent studies described that up-regulation of β-catenin might promote neoplastic conversion in colorectal cancers by triggering cyclin D1 expression. We investigated to determine whether the nuclear translocation of β-catenin can influence to in vivo expression of cyclin-D1, and growth pattern at the invasive front in sporadic colorectal cancers. 37 cases of sporadic colorectal carcinomas were retrospectively reclassified and investigated the expression patterns and degrees of β-catenin, cyclin-D1, and p53 by immuno-histochemical method, and also reanalyzed clinical and pathological parameters. In the majority of carcinoma cells in the superficial areas, expression patterns of β-catenin were mostly membramous pattern, and cytoplasmic or mixed pattern of membranous and cytoplasmic were occasionally observed. But nuclear expression of β-catenin were more frequently observed at the invasive border(22/37, 59.5%). High level expression(more than 40% of carcinoma cell) of cyclin-D1 was detected in 7 cases(7/37, 18.9%) of colorectal carcinomas, and the expressed location of cyclin-D1 was significantly related nuclear expression of β-catenin(p=0.0012). However, nuclear expression of β-catenin was not relationship with p53 expression and other clinicopathologic parameters(p>0.05). Conclusions : Conclusively, nuclear expression of β-catenin could promote cyclin-D1 expression, subsequently influences upon the cell cycle, and may be play an important role in tumor progression of sporadic colorectal carcinomas