전위된 소아 상완골 과상부 골절의 치료 : 도수정복 되지 않는 골절의 최소 절개를 통한 정복술 Open Reduction with Minimal Incision of the Manually Irreducible Fracture

한경진,어수익,박응석,강신영 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목 적 : 전위된 소아 상완골 과상부 골절의 치료에서 도수 정복 후 석고 고정술 또는 경피적 K-강선 고정술을 시행하거나 도수 정복이 되지 않은 경우 최소 피부절개를 통한 관혈적 정복 및 경피적 K-강선 고정술을 시행한 결과를 분석하고자 하였다. 대상 및 방법 : 전위된 상완골 과상부 골절(Gartland 제 Ⅱ, Ⅲ형)로 치료한 8세 이하의 환아중 1년 이상 추시가 되었던 총 74명 (74 골절) 을 대상으로 하였다. Gartland분류에 의한 제 Ⅱ형이 19차례, 제Ⅲ형이 52차례 이었고 정복의 기준은 건측의 주관절 Bauman 각으로 하였다. 안정적인Gartland 제 Ⅱ형, 6례에서 석고 고정을 시행하였고 불안정한 Gartland 제 Ⅱ형 13례와 Gartland 제Ⅲ형 52 례는 경피적 K-강선 고정술을 시행하였다. 도수 정복이 되지 않은 20례 (제 Ⅱ 형 1례, 제 Ⅲ 형 19례)의 경우, mini C-arm 영상하에 주관절 후면에 최소절개를 가하고 소절골도를 이용하여 정복하였다. 결과의 분석에는 주관절 운반각과 기능적인 운동범위의 소실 정도에 따른 Flynn의 분류를 사용하였다. 결과 : 저자들의 결과를Flynn의 분류에 따라 분석하면, 운반각의 경우 excellent는 52 례 (73.2%). good은 13례(18.3%) 로 만족할 만한 결과는 91.5% 이고 운동 범위의 경우 excellent는 49례 (69.0%), good은 20례(28.2%) 로 만족할 만한 결과는 97.2% 로서 비슷한 결과를 보였다. 도수 정복 및 경피적 K-강선 고정술이 운동 범위 요소(Functional factor)에서 더 많은 excellent, 그리고 최소 절개를 이용한 관혈적 정복 및 경피적 K-강선 고정술은 운반각 요소(Cosmetic factor)에서 더 많은 excellent를 나타내었다. 결 론 : 소아의 상완골 과상부 골절의 치료는 소아 골단의 성장판의 손상과 향후 발생할 수 있는 각변형을 고려하여 되도록 정확하고 세심한 정복과 안정적인 고정을 요한다. 또한, 도수 정복이 불가능할 경우 무리한 도수 정복 조작을 계속하지 말고 관혈적 정복을 시행하며 연부조직 손상을 줄이기 위해 가능한 최소 절개를 통한 정복 및 경피적 K-강선 고정을 하는 것이 좋은 결과를 나타내는 것으로 생각된다. Purpose : We evaluated the results of the displaced supracondylar fractures in children treated by closed reduction and cast immobilization, closed reduction and crossed K-wires fixation. Materials and Method : We retrospectively reviewed the results after 1 years of the treatment of 71 extension-type fractures (Gartland type Ⅱ-19 cases, type Ⅲ-52 cases) of supracondylar humeral fractures in children under age of 8 years. Closed reduction was impossible in 20 cases (1 type Ⅱ, 19 type Ⅲ) and we performed open reduction with minimal incision and cross percutaneous pinning. We measured Baumanns angle and range of motion of elbow and evaluated the results by Flynns criteria. Result : By Flynns criteria, 91.5 % of satisfactory (excellent, good) resuts in cosmetic factor and 97.2 % in more excellent in functional factor and that of the minimal open reduction and percutaneous pinning in cosmetic factor but over all satisfactory results were similar. Conclusion : The treatment of the displaced supracondylar humeral fractures in children need accurate and delicate reduction and firm fixation to prevent deformity and to preserve function of the elbow. Open reduction with minimal incision instead of general incision for the manually irreducible supracondylar humeral fracture would be a reliable and convenient method for the treatment of supracondylar humeral fractures in children.

SrO·nFe₂O₃의 磁氣特性에 미치는 La₂O₃의 影響

오응철,서강수,문현욱,신용진 明知大學校 産業技術硏究所 1992 産業技術硏究所論文集 Vol.11 No.-

This paper is studies the addition effects of La₂O₃ on the magnetic properties of Sr·ferrite The calcination temperature was 1250℃ for 1hr in air, and sintering temperature has been made at the temperature of 1225℃, 1250℃, 1275℃ and 13O0℃ respectively for 0.5hr. Compositions were chosen according to the formula ?? where n was varied between 5.8∼6.1 and x was varied between 0∼3 The composition of the best value ??= 1.48MG0e was n = 6(stoichiometric composition) and x = 2 at La₂0₃ addition. This value was higher than that of ordinary isotropic strontium ferrite.

고지방식이가 운동시 흰쥐의 글리코겐 이용에 미치는 영향

민경선,장응찬,김형렬,민진아,신덕수 慶山大學校 2000 論文集 Vol.18 No.1

Carbohydrate and fat ingestion during exercise are essential nutrient, but a number of opinion is different from their contents of food. In this point of view, to study how high-fat dietary contents affects glycogen utilization, 48 female Sprague-Dawley rats were trained on the treadmill trained for 4wk with consuming two high-fat diet and one high-carbohydrate diet. All animals were fed 79%high-fat diet(n=16, 79F), 40% high-fat diet(n=16, 40F), 70% high-carbohydrate diet(n=16, 70C). After the final day of training, one-half of rats in each the three groups were run to exhaustion (E), whereas the remaining rats served as rested controls (R). All animals were trained on a motorized rodent treadmill. The animals ran for 30min/d at 28m/min(0% grade), analysis items were glycogen, body weight and %Fat were measured. All data were examined by means of one-way ANOVA and significance was set at the p<0.05. The Duncan method was used for a post hoc test. Body weight were similar among the 79F, 40F and 70C groups. %Fat was significantly greater in animals that consumed the 79F group than in those on the 70C group (P<0.05), even though similar body weight each other. Generally liver and muscle glycogen concentration had more in 79FR, on the other hand, had less in 79FE compared with the others. The mean overall glycogen utilization rate was depressed in muscle and liver after animals were on the 79% F diet. In summary, the present study has suggested that consumption of 79% F diet during endurance training can lead to an increase in exercise performance in female rats. Some of the consequences training on F diet are an increase in body fat deposition and slower utilization of glycogen during exercise. These data indicate that rats exposed to a high-fat diet are capable of prolonging exercise in spite of limited glycogen stores. This improved capacity for exercise appears to be partially the result of muscular adaptations to the diet, which apparently increase the ability to oxidize fat and concomitantly spare glycogen.

국내 조혈모세포이식 환자에서 Human Cytomegalovirus gB 유전형의 분포와 질환과의 연관성 : 예비 보고

최수미,김진희,이동건,박선희,최정현,유진홍,박철민,이종욱,민우성,황응수,신완식,김춘추 대한감염학회 2007 감염과 화학요법 Vol.39 No.2

목적 : 사람 거대세포바이러스(Human cytomegalovirus, 이하 HCMV) glycoprotein B (gB)는 UL55 유전자에 의해 부호화되는 당단백으로, UL55 유전자의 염기서열변화에 따라 4가지 유전형으로 나뉜다. 본 연구에서는 국내 조혈모세포이식 환자들에서 HCMV gB 유전형의 분포와 그 특성을 알아보고, gB 유전형에 따라 특정 HCMV 질환 발생과 연관이 있는지 그 임상적 의미를 분석해 보고자 하였다. 재료 및 방법 : 동종 조혈모세포이식 환자 52명의 혈액검체 94개에 대해, Chou 등이 제시한 방법에 따라, 먼저 UL55 유전자 부위를 nested PCR로 증폭한 후, RsaI과HinfI으로 Restriction fragment length polymorphism(RFLP) 분석을 시행하였다. 결과 : gB type 1은 73.1% (38/52), gB type 2는 13.5%(7/52), gB type 3는 1.9% (1/52), gB type 1과 type 2에 의한 혼합감염은 9.6% (5/52)로 나타났다. gB type 4는 관찰되지 않았다. 1명(1.9%)에서 gB 유전형을 결정할 수 없었는데, RFLP 패턴으로 보아 Trincado 등이 제시한 gB type 7에 해당하는 것으로 생각되었고, 이 새로운 아형에 대해서는 현재 염기서열 분석 중이다. 52명 중 5명(9.6%)에서 HCMV 질환이 발생하였고, 3명에서 HCMV 폐렴, 1명에서 망막염과 위장관염, 나머지 1명에서 망막염이 발생하였다. 5명 중 HCMV 질환과 관련하여 사망한 예는 없었고, 감염된 HCMV는 모두 gB type 1이었다. HCMV gB유전형과 HCMV 질환 발생 사이에 유의한 연관성은 없었고, 단일 주에 의한 감염과 혼합감염에 따른 HCMV 질환발생 사이에도 유의한 연관성은 관찰되지 않았다. 자료 분석 중 gB type 2에 감염되어 있던 환자에서 gB type 1에 재감염 되면서 발열, 간효소 수치 상승 및 pp65 HCMV 항원혈증이 나타난 예가 있었다. 결론 : 연구결과 gB type 1이 아주 우세하고, gB type 4는 검출되지 않았으며, 혼합감염의 빈도가 비교적 낮은 분포를 보였다. 이는 외국의 보고와는 다른 국내 조혈모세포이식 환자에서의 독톡한 감염 양상으로 추정된다. 본 연구에서 HCMV gB 유전형과 질환 발생과의 연관성을 밝힐 수는 없었으나, HCMV 유전형에 대한 연구는 바이러스 감염의 발병기전이나 전파 경로 및 양식과 같은 역학적 연구에 중요한 자료가 될 것이다. 현재 더 많은 수의 조혈모세포이식 환자를 대상으로 연구가 진행 중에 있으며, 앞으로 다른 질환군의 환자나 건강한 잠복 감염자에서의 추가 연구가 필요할 것으로 생각된다. Background : Human cytomegalovirus (HCMV) glycoprotein B (gB) is the major envelope glycoprotein, encoded by the UL55 gene. Based on sequence variation in the UL55 gene, HCMV can be classified into four gB genotypes. Previous studies have suggested an association between HCMV gB genotypes and clinical outcome in the immunocompromised hosts. The goal of this study was to determine the distribution of HCMV gB genotypes and the effect of gB genotype in the developement of HCMV diseases in hematopoietic stem cell transplant (HSCT) recipients in Korea. Materials and Methods : DNA was extracted from 94 blood specimen of 52 allogeneic HSCT recipients with HCMV infection. HCMV gB genotype was determined using polymerase chain reaction to amplify a region of UL55, followed by restriction fragment length polymorphism (RFLP) analysis based on RsaI and HinfI digestion. Results : The distribution of gB types were as follows: gB1, 73.1% (38/52) of patients; gB2, 13.5% (7/52); gB3, 1.9% (1/52) and mixed infection (gB1 and gB2), 9.6% (5/52). While gB4 was not detected, a new genotype (described as gB7 by Trincado et al, 2000) was identified on the basis of their RFLP pattern. During average 708 days’ follow up period, HCMV diseases developed in 5 patients. All of them had gB1 genotype. There was no statistically significant association between the incidence of HCMV diseases and the gB genotypes. Re-infection with gB1 strain was detected in one patient who had been previously infected with gB2. This episode was associated with fever, elevated liver enzyme and positive antigenemia. Conclusion : HCMV gB1 was the dominant genotype and no gB4 was detected in allogeneic HSCT recipients in Korea, which is an unique pattern compared with the previous reports. Although we can not find significant association between the HCMV diseases and the gB genotypes, genotyping of HCMV will serve in the study of pathogenesis and transmission of this virus in transplant patients. Further study is underway with large study population.

다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.

직장암 수술 후 국소재발과 예후

김태윤,백무준,김성용,신응진,박내경,이문수,김창호,송옥평 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Locally recurrent rectal cancer is a difficult clinical problem. Local recurrence following treatment for rectal cancer is a major cause of morbidity and mortality. The reported range of local recurrence rates following surgical treatment for rectal cancer has varied from 4% to 50%. We retrospectively reviewed the charts of 142 rectal cancer patients from January 1991 to December 1999. Analysis of patients factors included age, gender, type of surgery, and adjuvant therapy. Tumors were assessed for level, stage, and grade. Local recurrence and distant metastases were also documented. Variables influencing local recurrence in this group were identified and disease-free survival is determined. Of the 142 patients(74 males, 68 females; mean age 62.6 years), 137 consecutive patients operated on for rectal cancer and followed up to December 2000 (range 23-118months) were analyzed. Local recurrence rate was 18.3%. Age and sex of patients, type of surgery, location of tumor in the rectum, size, morphology and grading of the tumor were all unrelated to the event under investigation. At Cox regression, the Dukes stage and the postoperative radiotherapy were the only independent prognostic factors for local recurrence, and Dukes stage (Hazard ratio=2.89, p<0.001) and local recurrence (Hazard ratio=3.31, p<0.01) were the only independent factors associated with improved survival.

연령증가에 따른 혈압요소들의 좌심실비대 및 관동맥질환과의 관련성

박재석,박창규,박미영,박재형,김용현,나진오,신성희,서순용,홍순준,박성미,임홍의,김응주,서홍석,오동주,노영무 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

Epigenetic inactivation of RUNX3 in colorectal cancer

Eung Jin Shin,Han Jo Kim,Myoung Won Son,Tae Sung Ahn,Hyun Yong Lee,Dae Ro Lim,Sang Byung Bae,Seob Jeon,Hyungjoo Kim,Dongjun Jeong,Moon Soo Lee,Dong-Sun Kim,Jeong Se Noh,Moo-Jun Baek 대한외과학회 2018 Annals of Surgical Treatment and Research Vol.94 No.3

The Impact of Discrepancy between Measured versus Stated Weight on Hemorrhagic Transformation and Clinical Outcomes after Intravenous Alteplase Thrombolysis

Shin, Dong Hoon,Kang, Min-Ju,Kim, Jin Wook,Shin, Dong-Jin,Park, Hyeon-Mi,Sung, Young Hee,Kim, Eung Yeop S. Karger AG 2017 Cerebrovascular diseases Vol.44 No.5

<P><B><I>Background:</I></B> An accurate measurement of patient weight is important in determining the dosage for intravenous alteplase thrombolysis. In most emergency rooms, however, weight is not measured. We investigated the difference between stated and measured weight and its effect on hemorrhagic transformation and clinical outcomes. <B><I>Methods:</I></B> We enrolled 128 consecutive patients who had hyperacute stroke and were treated by alteplase. Alteplase dose was calculated using the weight provided by patient or guardian/caregiver, and the actual weight was measured after administration. Patients were classified into 2 groups: overused group (stated weight >measured weight) and underused group (measured weight ≥stated weight). The prevalence of hemorrhagic transformation on follow-up, determined by gradient-recalled echo MRI or non-enhanced CT, was compared between the 2 groups. The predictors for hemorrhage with progression, defined as an increase in the National Institutes of Health Stroke Scale (NIHSS) by a value of 4 or more accompanied by hemorrhage, were determined using multivariable logistic regression analysis and included the overused or underused alteplase and baseline clinical and laboratory findings. <B><I>Results:</I></B> Sixty-six (51.6%) of 128 patients were in the underused group and 62 patients (48.4%) in the overused group. The median difference between the stated and measured weights was 1.5 (interquartile range 0.56-3.81) kg, with the largest difference being 25.6 kg. Although there were no significant difference in baseline clinical and laboratory findings between the 2 groups, the overused group showed a significantly higher prevalence of hemorrhagic transformation (<I>p</I> = 0.012) and hemorrhage with progression (<I>p</I> = 0.025). The multivariable logistic regression analysis demonstrated that overused alteplase (OR 7.26; 95% CI 1.24-42.45; <I>p</I> = 0.028), baseline glucose (>144 mg/dL; OR 5.03; 95% CI 1.00-25.26; <I>p</I> = 0.050), and initial NIHSS (OR 1.13 per 1-point NIHSS increase; 95% CI 1.00-1.27; <I>p</I> = 0.047) in model 1 that use alteplase overdose as a categorical variable and overused alteplase (OR 1.67 1-mg increase; 95% CI 1.05-2.66; <I>p</I> = 0.027) in model 2 that use an overused alteplase dose as numerical variable were significant predictors for hemorrhage with progression. <B><I>Conclusion:</I></B> More alteplase usage than actual weight led to higher hemorrhagic transformation. As one of the predictors for clinical deterioration, it is important to administrate alteplase based on an accurately measured weight.</P>

CORRIGENDUM: Correction of funding statement in ACKNOWLEDGEMENTS section: Epigenetic inactivation of <i>RUNX3</i> in colorectal cancer

Shin, Eung Jin,Kim, Han Jo,Son, Myoung Won,Ahn, Tae Sung,Lee, Hyun Yong,Lim, Dae Ro,Bae, Sang Byung,Jeon, Seob,Kim, Hyungjoo,Jeong, Dongjun,Lee, Moon Soo,Kim, Dong-Sun,Noh, Jeong Se,Baek, Moo-Jun The Korean Surgical Society 2018 Annals of Surgical Treatment and Research(ASRT) Vol.94 No.3