간 허혈성괴상의 CT소견에 대한 실험적 연구 : 간실질 및 피막의 경시적 변화와 병리조직의 비교 Changes of CT Findings of Liver Parenchyama and Capsule with Time Lapse Correlated with Histopathology

김창근,김강득,최시성,정선관,노병석,원종진 圓光大學校 醫科學硏究所 1994 圓光醫科學 Vol.10 No.1-2

In order to evaluate CT findings with time and to confirm the capsular structure correlating with its histopathologic findings, we experimentally induced ischemic necrosis of liver in 20 rabbits. Incision of the abdomen was performed under anesthesia. Ligation of hepatic artery, portal vein and hepatic duct of right inferior posterior lobe of the liver after injection of macroaggregated albumin into right inferior posterior portal vein in order to prevent from developing collateral circulation as possible. Precontrast and postcontrast enhanced CT images were obtained at 1. 2. 4 days and 1, 2. 4. 6 weeks after induction of ischemic necrosis. Necrotic area in the liver showed homogeneous low density compared to normal liver, and no contrast enhancement after contrast material administration, and marked volume loss with time. CT attenuation value of necrotic area at 1 day(36.7±6.4 M±SD, Hounsfield unit) approached to two third of that of normal liver(56.3±7.3) and showed no significant change until two weeks but increased significantly after four weeks. On contrast enhanced CT images, capsular structure was obsereved as a high density rim along the liver surface of the necortic area in 8 of 15 cases. From the first day on, homogenous ischemic or coagulation necrosis was observed but rarely findings of edema, hemorrhage and cystic change were observed on histopathologic specimen. In all of the histologic samples taken from 10 cases during th 2nd to 6th week, fibrous thickening with rich vascularity was observed along the surface of the necrotic area. In conclusion, ischemic necrosis of the liver showed homogeneous low density and no contrast enhancement. CT attenuation value of necrotic area increased significantly with time associated with markedly decrease in volume. Capsular structure attributed to the hypertrophy of the liver capsule and rich vascularity within it.

복부결핵의 지연진단으로 인하여 발생한 복막농양의 경피적 배액술

김승호,오정택,김강득,위대한 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

Abdominal tuberculosis is described in two forms; tuberculous peritonitis and gastrointestinal tuberculosis. Abdominal tuberculosis is usually insidious onset with diverse symptoms and signs. The diagnosis is difficult, especially in areas where the disease is less common, as many patients do not have evidence of pulmonary tuberculosis or a positive skin test. Physicians should obtain a thorough history focusing on risk behaviors for tuberculosis. Delayed diagnosis is common, resulting in high mortality. In general, the same regimens are used to treat pulmonary and abdominal tuberculosis. Most intra-abdominal and other types of fluid collections are now successfully drained percutaneously under image guidance. The utility of percutaneous drainage(PCD) of tuberculous abscesses is less well established. A 43-years-old man, who had been diagnosed as pulmonary tuberculosis about 9 years ago, suffered from peritoneal abscess because of delayed diagnosis. The diagnosis of tuberculosis was confirmed by the PCR tests for the detection of Mycobacterium tuberculosis in the aspirates from the abscess. Drainage was done by catheter under ultrasound guidance and there were no procedural complications. The abscess was successfully and completely evacuated. We present our experience with a case of tuberculous peritoneal abscess which were successfully treated by PCD and antituberculous medication.

[지상19]Rebamipide protects against TNBS-induced colonic damage In mice

Chul Kim,Yu-Rim Kim,Kyung-Suk Kim,Sang Chul Kim,Jin Oh Kim,Jeong Re Lee,Heung Jae Lee,Deok-Hwa Choi,Jung-Taek Oh,Gang-Deuk Kim,Hye-Won Kim,Jay-Min Oh,Min-Kyu Choi,Yeun-Tai Chung 대한체질인류학회 2004 대한체질인류학회 학술대회 연제 초록 Vol.47 No.-

[지상18]The protective roles of gliotoxin on TNBS-induced colitis in mice

Yu-Rim Kim,Chul Kim,Kyung-Suk Kim,Sang Chul Kim,Jin Oh Kim,Jeong Re Lee,Heung Jae Lee,Deok-Hwa Choi,Jung-Taek Oh,Gang-Deuk Kim,Hye-Won Kim,Yeun-Tai Chung,Min-Kyu Choi,Jay-Min Oh 대한체질인류학회 2004 대한체질인류학회 학술대회 연제 초록 Vol.47 No.-

자궁경부암 세포에 시스플라틴이 소포체 스트레스에 미치는 영향

김훈영 ( Hun Young Kim ),김병륜 ( Byoung Ryun Kim ),김강득 ( Gang Deuk Kim ),김형진 ( Hyung Jin Kim ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.4

목적: 항암제 시스플라틴의 세포독성 기전은 활성산소종과 lipid peroxydation의 증가와 DNA adduct의 형성 등이 알려져 있다. 이 연구에서는 시스플라틴이 자궁경부암 세포인 Hela 세포에서 과량의 NO와 세포 내 칼슘 이온의 농도 증가를 통해 소포체 스트레스 관련 단백질들의 발현을 증가시킴을 확인하고자 하였다. 연구방법: Hela세포는 시스플라틴으로 처리하였고 다음으로 소포체 스트레스 반응은 western blot, Flow cytometry, fluorescence 분석을 이용하여 측정하였다. 결과: 시스플라틴에 의해 유도되어지는 세포자멸사 현상은 유도성 NO 합성효소의 특이적 억제제인 1400 W와 세포 내 칼슘이온 소거제인 1, 2-bis-(o-aminophenoxy)ethane-N,N,N`,N`-tetraacetic acid tetra-(acetoxymethyl) ester에 의해 감소되었다. 이러한 약물들은 또한 미토콘드리아의 막전위를 회복시킴으로써 미토콘드리아에 의한 세포자멸사 신호전달은 억제하였다. 결론: 시스플라틴에 의한 세포자멸사 현상은 초기 시간대의 칼슘이온 농도의 증가와 그에 따른 미토콘드리아에 의한 세포자멸사 신호전달체계에 의해 유도되며, 이때 소포체가 중요하게 관여되어 있음을 확인할 수 있었다. Objective: Cis-diamminedichloroplatinum (cisplatin) is a widely used chemotherapeutic agent. A number of evidences in cytotoxic mechanism of cisplatin, including perturbation of redox status, increase in lipid peroxydation, formation of DNA adduct, have been suggested. The author hypothesized that cisplatin would mediate apoptosis via endoplasmic reticulum (ER) stress in human cervical cancer cell. Methods: Human cervical cancer cell line (Hela cells) were treated with cisplatin and then ER stress-related response were performed using western blot, Flow cytometry and fl uorescence analysis. Results: After addition of cisplatin to Hela cells, the author observed an expression of ER stress response genes through a gradual increase of nitric oxide and cytosolic Ca2+ concentration. Cisplatin-induced apoptosis can be inhibited by the inducible nitric oxide synthase inhibitor, 1400 W, and intracellular Ca2+ chelator, 1, 2-bis-(o-aminophenoxy)ethane-N,N,N`,N`-tetraacetic acid tetra-(acetoxymethyl) ester (BAPTA-AM). These inhibitors also reduced mitochondrial apoptotic signals, such as mitochondrion membrane potential disruption, cytochrome c release and eventually reduced the death of Hela cells. Conclusion Taken together, ER would seem to contribute to cisplatin-induced apoptosis via both the early release of Ca2+ and the late amplifi cation of mitochondria-mediated apoptotic signals.

Rebamipide Protects Colonic Damage Induced by Trinitrobenzene Sulfonic Acid (TNBS) via Down-Regulation of TNF-α, IL-1β‚ and ICAM-1

김연하(Yeun-Ha Kim),김성중(Sung-Jung Kim),황호근(Ho-Geun Hwang),최석채(Suk-Chei Choi),김유림(Yu-Rim Kim),김경숙(Kyung-Suk Kim),김철(Chul Kim),최덕화(Deok-Hwa Choi),오정택(Jung-Taek Oh),김강득(Gang-Deuk Kim),김혜원(Hye-Won Kim),전창덕(C 대한해부학회 2004 Anatomy & Cell Biology Vol.37 No.2

염증성 장 질환의 병리기전에는 tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) 및 intracellular adhesion molecule-1 (ICAM-1)의 발현 등 수많은 염증반응의 매개 물질들이 관여하고 있다. Rebamipide는 위염과 위궤양 치료제로 개발된 약제로 아직까지 염증성 장 질환의 치료효과를 검증한 연구는 거의 없다. 따라서 본 연구에서는 Rebamipide의 염증성 장 질환에 대한 치료효과를 검증하고 그 기전을 분석하고자 Rebamipide의 TNF-α와 IL-1β, 그리고 세포의 부착에 중요한 역할을 하는 ICAM-1의 발현의 조절에 대한 효과를 조사하였다. 5%의 2, 4, 6-trinitrobenzenesulfonic acid (TNBS)를 실험 첫째날과 7일째에 직장 내로 넣어줌으로써 염증성 장질환의 동물모델을 제작하였고 2mM의 Rebamipide를 실험 0일, 3일, 6일째에 역시 직장 내로 투여하여 염증 억제 효과를 분석하였다. Rebamipide는 TNBS에 의하여 유도되는 체중감소를 현저히 억제하였으며 대장의 충혈과 부종역시 억제하였다. 조직소견에서도 Rebamipide 는 TNBS에 의해 유도되는 염증세포의 침착을 현저히 억제하였다. 또한 Rebamipide에 의해 TNF-α, IL-1β 및 ICAM-1의 발현 역시 현저히 억제되는 것을 면역 조직 화학 염색법을 통하여 확인하였다. 결론적으로 Rebamipide는 TNF-α, IL-1β와, ICAM-1의 발현을 조절함으로써 TNBS에 의해 유도되는 대장의 손상을 억제하리라고 생각되며 염증성 장 질환의 치료에도 좋은 효과가 있을 것으로 생각한다. During inflammation of the colon, cells of the gut mucosa produce or express numerous inflammatory mediators, such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and intercellular adhesion molecule 1 (ICAM-1). These mediators have been implicated as contributory factors to the inflammatory process, which results in colitis during inflammatory bowel disease (IBD). Rebamipide is an anti-gastric ulcer drug with anti-inflammatory properties in vivo and in vitro. The effects of Rebamipide on IBD have not been largely evaluated. Therefore, this study investigated the potential of Rebamipide to regulate the production of inflammatory mediators such as TNF-α, IL-1β, and ICAM-1. Mice with trinitrobenzene sulfonic acid (TNBS)-induced colitis (IBD animal model), were treated intrarectally with 2 mM Rebamipide. Body weight, macro- and micro-histological scores, and activity were evaluated. As an index of tissue edema, the thickness of the colonic wall was measured between the serosal surface and the luminal surface of the mucosa. TNF-α, IL-1β, and ICAM-1 were detected by immunohistochemical staining. Rebamipide treatment of mice exhibiting TNBS-induced colitis dramatically improved the clinical and histopathological findings of inflammation. In addition, Rebamipide suppressed TNF-α, IL-1β, and ICAM-1 expression in TNBS-treated animals. Taken together, these findings suggest that Rebamipide is a potential therapeutic agent for treating patients with IBD.

골프채 파악에 의한 제3 구역 내 심 수지 굴곡건 폐쇄성 파열

김영진 ( Yeung Jin Kim ),김태균 ( Tae Kyun Kim ),양환덕 ( Hwan Deok Yang ),김형준 ( Hyoung Jun Kim ),채수욱 ( Soo Uk Chae ),김강득 ( Gang Deuk Kim ),이지완 ( Ji Wan Lee ) 대한스포츠의학회 2009 대한스포츠의학회지 Vol.27 No.1

Closed rupture of flexor tendons without an associated pathologic condition in the hand is rare. Authors report a patients who sustained a rupture of flexor digitorum profundus in Zone III on his left little finger as a result of an repeated inappropriate strong grip of a golf club. The patient had the good range of motion with excellent clinical results after direct repair by modified Kessler method.

피부의 평활근육종 : 1예 보고

김강득,김혜원,오정택 圓光大學校 醫科學硏究所 2003 圓光醫科學 Vol.18 No.1

16채널 다중검출 CT를 이용한 말초 폐동맥의 평가

김강득,오정택 圓光大學校 醫科學硏究所 2004 圓光醫科學 Vol.19 No.2

외상성 척추 압박골절 : 자기공명영상 신호강도와 골절시기 Usefulness of MRI to Predict the Time of Fracture Onset

김강득 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.2

배경 : 인구의 노령화로 인한 골다공증 환자의 증가와 빈발하는 자동차 사고로 척추 압박골절은 흔한 병이 되었으며 임상적으로 급성 및 만성 골절의 감별은 많은 논란을 야기하고 있다. 자기공명영상으로 외상성 척추 압박 골절의 신호강도 변화를 통해 골절 시기를 예측할 수 있는지 알아보고자 하였다. 방법 : 척추 자기공명영상을 시행한 환자 중 양성압박골절을 보이는 환자 33명(남:여=13:20, 나이; 20-79)의 67개 척추체(흉추 17개, 요추 50개)를 대상으로 하였고 이중 12명의 환자는 1회 내지 3회 추적조사를 하였으며, 척추체의 형태 및 신호강도를 정상 척추체와 비교하여 5가지 형태로 분류하여 후향적 및 전향적으로 관찰하였다. 결과 : 자기공명영상에서 모든 골절부위는 골수 신호강도의 이상이 관찰되었으며 12주이내에 시행한 자기공명영상 37예중 35예의 골절부위에서 T1강조영상에서 저신호강도, T2강조영상에서는 불균질한 고신호강도를 보였고(type Ⅰ) 이러한 소견은 13주 이후에는 보이지 않았다. 13주 이후에 시행한 30예 모두 병변의 범위 및 추체높이 감소가 있었으며 T1 및 T2강조영상에서 저신호강도를 보이는 경우(type Ⅲ and Ⅳ)는 25예, 고신호강도를 보이는 경우(type Ⅱ)는 3예, 동등신호강도를 보이는 경우(type Ⅴ)는 2예에서 보였다. 결론 : 외상성 척추 압박골절에서 신호강도의 변화와 골절기간과는 밀접한 상관관계가 있었으며 자기공명영상의 신호강도 변화를 통해 척추압박골절의 시기를 예측할 수 있을 것으로 사료된다. Background : The vertebral compression fracture is common, and distinction between the acute and chronic vertebral compression fractures pose a common clinical problem. So we evaluated the usefulness of MRI to predict the time of fracture onset in patients with traumatic vertebral compression fractures. Materials and Methods : We retrospectively and prospectively studied MR images of 67 cases (17 thoracic, 50 lumbar spines) of vertebral compression fracture in 33 patients (13 men, 20 women; range, 20-79 years), and 12 patients underwent follow up MR imaging for 1 to 3 times following initial examination. MR images were evaluated for the signal intensity pattern and shape of the vertebral compression fracture comparing with those of normal vertebrae. Results : The signal intensity in 35 of 37 fractures less than 12 weeks was low SI pattern on Tl-weighted images and inhomogeneous high on T2WI (type Ⅰ), and type Ⅰ was not seen after 13 weeks on MR images. All 30 fractures more than 13 weeks had been decreased in the area of low signal intensity and also in height of the compressed vertebral bodies. Twenty-five cases had low signal intensities (type Ⅲ and Ⅳ), 3 cases had high signal intensities (type Ⅱ) and 2 cases had iso signal intensities (type Ⅴ) on all pulse sequences. Conclusion : There are good correlation between the signal intensity change and fracture age of traumatic vertebral compression fracture. So sequential change of signal intensity can predict the time of fracture onset of vertebral compression fracture on MRI.