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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.
김준우,안철우,남주영,김똘미,김영균,추적금,박종숙,박진아,조승현,김동연,김도연,윤수지,이경열,차봉수,김경래,임승길,이현철,허갑범 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.2
본 저자들은 인위적인 인슐린 투여로 인한 인간성 저혈당증 1예에서 보존적인 치료로 의식기능은 회복하였으나, 현저한 인지능력 저하를 하였기에 문헌고찰과 함께 보고하는 바이다. Factitious hypoglycemia is a covert attempt to lower the blood glucose concentration with insulin or a sulfonylurea agent. This attempt is mainly performed by the patients themselves. In a large series of diabetics who had overdosed on drug, less than 5% had used insulin for suicidal or homicidal purposes. Additionally, 4 of 204 hypoglycemic episodes were due to a suicide attempt with insulin. The onset of insulin action, its peak level, and duration, and the degree of hypoglycemia, are determined by insulin's pharmacokinetics. However, the final outcomes are not associated with the amount of insulin used. The complications related to insulin overdose are cerebral damage and hypokalemia. Other complications include, pulmonary edema attributed to congestive heart failure and hypertensive crisis, as well as respiratory insufficiency. We report this case with a review of the literature.
Postweaning Multisystemic Wasting Syndrome (PMWS)에 이환된 자돈에 대해 Porcine circovirus 2 Rep 유전자 검출에 관한 연구
이용훈,김지영,楚佳奇,서상희,장경수,김명철,박창식,전무형 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-
Postweaning multisystemic wasting syndrome (PMWS) is a new emerging disease in swine herds world wide, and porcine circovirus type 2 (PCV2) is known as a major cause of PMWS. In this study, the prevalence of PCV2 Rep gene was examined for the serum, nasal swabs and feces collected from 30 heads of piglets affected with PMWS and 10 heads of normal healthy piglets using polymerase chain reaction (PCR). The diagnostic efficiency of the PCR was evaluated for different types of samples. Rep gene of the isolate (PCV2 S1) was then sequenced. In the group of PMWS-affected piglets, the prevalence of PCR-positive were 70.0% in sera, 33.3% in nasal swabs and 0% in feces. In the normal healthy group, the PCR-positive rates of sera, nasal swabs and feces were 30%, 20% and 0%, respectively. Seven piglets (17.5%) out of 40 showed the simultaneously positive results in both of sera and nasal swabs. The nucleotide sequence homology of Rep gene of PCV2 S1 as compared with the reference strain of PCV2 (GenBank accesson no.AF027217) was 99.3%.
소모성 질환에 이환된 이유자돈에 대해 Porcine cytomegalovirus DNA Polymerase 유전자 검출과 분석
김지언,김지영,楚佳奇,채미경,장경수,김명철,박창식,전무형 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-
Porcine cytomegalovirus (PCMV) causes piglet deaths, runting, inclusion body rhinitis, respiratory and reproductive disorders in swine herd, resulting in the significant economic losses in the swine industry. Recently, in the field of pig-to-human xenotransplantation, PCMV has been indicated as a potential xenogeneic pathogen with the risk for infection transmitted from the xenograft donor to the recipient. In this study, PCMV DNA polymerase gene was detected in the sera and nasal swabs from 30 heads of the weaned piglets affected with various wasting diseases and 10 heads of normal healthy piglets using polymerase chain reaction (PCR), and the diagnostic efficacy of PCR was evaluated. The prevalence of the PCR-positive by specimens from the diseased piglets were 83.3% in sera and 33.3% in nasal swabs. In the normal healthy group, the PCR-positive rates of sera and nasal swabs were 40% and 30%, respectively. Ten piglets (25.0%) out of 40 showed the simultaneously positive results in both of sera and nasal swabs. According to this result, it was found that the serum specimen was the most appropriate sample for detection of PCMV by PCR. The nucleotide sequence homology of DNA polymerase gene of PCMV KS1 as compared with the reference strain of PCMV (GenBank accesson no.AF027217) was 99.0%.
Postweaning Multisystemic Wasting Syndrome (PMWS)에 이환된 자돈에 대해 Porcine circovirus 2 Rep 유전자 검출에 관한 연구
이용훈,김지영,楚佳奇,서상희,장경수,김명철,박창식,전무형 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10
Postweaning multisystemic wasting syndrome (PMWS) is a new emerging disease in swine herds world wide, and porcine circovirus type 2 (PCV2) is known as a major cause of PMWS. In this study, the prevalence of PCV2 Rep gene was examined for the serum, nasal swabs and feces collected from 30 heads of piglets affected with PMWS and 10 heads of normal healthy piglets using polymerase chain reaction (PCR). The diagnostic efficiency of the PCR was evaluated for different types of samples. Rep gene of the isolate (PCV2 S1) was then sequenced. In the group of PMWS-affected piglets, the prevalence of PCR-positive were 70.0% in sera, 33.3% in nasal swabs and 0% in feces. In the normal healthy group, the PCR-positive rates of sera, nasal swabs and feces were 30%, 20% and 0%, respectively. Seven piglets (17.5%) out of 40 showed the simultaneously positive results in both of sera and nasal swabs. The nucleotide sequence homology of Rep gene of PCV2 S1 as compared with the reference strain of PCV2 (GenBank accesson no.AF027217) was 99.3%.
동서연 ( Seo Yun Tong ),김여홍 ( Yeo Hong Kim ),최영준 ( Young Jun Choi ),김소라 ( So Ra Kim ),이보연 ( Bo Yon Lee ),이선경 ( Seon Kyung Lee ),허주엽 ( Chu Yeop Huh ),김승보 ( Seong Bo Kim ) 대한주산의학회 2003 Perinatology Vol.14 No.4
목적: 선행제왕절개 후 질식분만을 시도한 산모들 중 성공군과 실패군을 비교하여 성공을 예측할 수 있는 인자를 알아보고자 하였다. 방법: 1997년 3월부터 2003년 2월까지 경희대학교 의과대학 산부인과에서 선행제왕절개 후 질식분만을 위하여 내원한 환자중 질식분만의 금기가 아닌 경우 위험요소 등에 대하여 충분히 상의한 후 분만을 시도한 382명의 환자를 대상으로 하였다. 대상군의 의무기록을 통하여 분만당시 산모의 나이, 분만력, 제태연령, 신생아 몸무게, 입원시 자궁경부 상태 및 Bishop score, 분만의 진행과정, 결과 및 합병증을 조사하여 성공군과 실패군의 차이를 비교분석 하였다. 결과: 292(76.5%)명이 질식분만에 성공하였다. 여러 인자 중 태아의 몸무게(odds ratio, 0.2 ; 95% confidence interval (CI), 0.1-0.4), 입원시 Bishop score(odds ratio, 1.8 ; 95% CI, 1.5-2.1), 질식분만의 과거력(odds ratio, 3.6 ; 95% CI, 1.1-11.6)이 VBAC의 성공과 관련이 있었다. 또한 선행제왕절개시 적응증이 태위이상인 경우에 성공률이 높은 것으로 나타났다(odds ratio, 3.2 ; 95% CI, 1.2~8.6). 입원시 Bishop score로 VBAC의 성공을 예측할 수 있는 지 알아보기 위하여 receiver-operating characteristic curve 분석을 시행하였고, 5점을 cut-off로 하였을 때 47.4%의 민감도와 87.6%의 특이도를 보였다(AUC, 0.765 ; p<0.05). 결론: 출생체중, 질식분만의 과거력, 입원시 Bishop score가 선행제왕절개 후 질식분만을 고려하는 경우 성공의 예측인자로서 유용하게 사용되어 질 수 있을 것이다. Objective: The purpose of this report is to determine the predictable factors for successful vaginal birth after cesarean (VBAC). Methods: In this study, 382 women who attempted VBAC at Kyung-Hee university hospital were included. The medical records of them were reviewed retrospectively. Informations was collected about demographics, medical history, obstetric history, neonatal birth weight, complications, treatment, and outcome of the index pregnancy. Results: The overall success rate was 76.5% (292 cases). Among variables, neonatal birth weight (odds ratio, 0.2; 95% confidence interval, 0.1-0.4), Bishop score at admission (odds ratio, 1.8; 95% confidence interval, 1.5-2.1 ; p<0.05), and history of vaginal delivery (odds ratio, 3.6 ; 95% confidence interval, 1.1-11.6 ; p<0.05) were significant. The Bishop score showed most significant relationship with successful VBAC. The Bishop score 5 at admission had a sensitivity of 47.4% and a specificity of 87.6% in the prediction of successful VBAC. Malpresentation as indications of previous cesarean delivery showed more tendency to succeed than others. Conclusion: Several factors such as birth weight, Bishop score at admission, and history of vaginal delivery may be used to predict the success of VBAC.