쥐에서 경구 독시사이클린, 동종 혈액, 탈크의 흉막 유착에 대한 비교

강신광,원태희,김시욱,나명훈,유재현,임승평,이영,강대영 대한흉부외과학회 2003 Journal of Chest Surgery (J Chest Surg) Vol.36 No.10

배경: 흉막 유착 물질로서 정맥 주사용 테트라사이클린은 국내 생산이 중단되어 더 이상 사용할 수 없게 되었다. 본 연구 목적은 쥐에서 경구 독시사이클린의 흉막 유착 효과를 알아보고, 경구 독시사이클린과 자가 혈액과 탈크의 흉막 유착 정도를 비교하여 임상적인 효용성을 알아보고자 하였다. 대상 및 방법: 20마리의 숫쥐를 5마리씩 네 군으로 나누었다. A군은 0.9% 생리식염수 10 ml/kg를 한 쪽 흉강에 주입하였고, B군은 경구 독시사이클린 10 mg/kg, C군은 동종 혈액 2 ml/kg, D군은 탈크 70 mg/kg을 각각 주입하였다. 28일 후 모든 예를 도살하여, 육안으로 확인한 유착과 조직학적 변화를 0에서 3으로 점수화하여 관찰하고, 흉막의 두께를 비교하였다. 결과: 육안으로 관찰한 A군은 0.0점, B군 1.4±0.9점, C군 1.0±0.7점, D군은 2.2±0.8점이었고, B군과 D군은 유의한 흉막 유착을 보였다(p<0.05). 흉막 두께는 A군이 0.7±0.2 /102 mm, B군 1.2±0.4 /102 mm, C군 1.4±0.4 /102 mm, D군은 3.5±0.9/102 mm이었고, D군은 유의한 흉막 비후를 보였다(p<0.05). 조직학적으로 A군은 1.0점, B군 1.7±0.5점, C군 1.5±0.4점, D군은 2.8±0.4점이었고, B군과 D군이 유의한 조직학적 변화를 보였다(p<0.05). 결론: 본 연구에서 대조군과 비교하여 경구 독시사이클린은 육안으로, 또한 조직학적으로 유의한 흉막 변화를 일으키는 것으로 관찰되었다. 동종 혈액은 흉막 유착 물질로 적당하지 않은 것으로 관찰되었다. 탈크는 경구 독시사이클린과 동종 혈액과 비교하여 조직학적인 유착이 가장 강력한 흉막 유착 물질이었다.

심도 저체온 순환 정지를 이용한 하대정맥에 파급된 신세포암의 수술적 치료 -1례 보고-

강신광,김시욱,원태희,구관우,나명훈,유재현,임승평,이영,설종구 대한흉부외과학회 2002 Journal of Chest Surgery (J Chest Surg) Vol.35 No.10

Surgical Treatment of Renal Cell Carcinoma with IVC Tumor Extension Using Deep Hypothermic Circulatory Arrest- A Case Report - 64세 남자가 혈뇨를 주소로 입원하여 하대정맥으로 종양 혈전이 파급된 우측 신세포암으로 진단받았다. 우신 적출술 시행 후 역행성 뇌관류하면서 심도 저체온 순환정지 하에 하대정맥 혈전 제거술을 시행하였다. 종양 혈전은 우 신에서 기원하여 하대정맥으로 자라면서 좌 신정맥의 생식선정맥 유입구까지, 위로는 간정맥 유입부까지, 아래로는 신정맥 하방 3cm 까지 파급되어 있었다. 심도 저체온 순환 정지 하에서 하대정맥 손상 없이 혈전을 완전히 제거하였고 술 후 경과는 순조로웠다. 술 후 인터페론 면역 치료를 받았고 특별한 문제없이 추적관찰 중이다.7. Neves RJ, Zincke H. Surgical treatment of renal cancer with vena cava extension. Br J Urol 1987;59:390-5.8. Ngaage DL, Sharpe DA, Prescott S, Kay PH. Safe technique for removal of extensive renal cell tumors. Ann Thorac Surg 2001;71:1679-81.

인공 승모판막에 생긴 혈전의 혈전용해 치료 -1례 보고-

강신광,김시욱,원태희,구관루,나명훈,유재현,임승평,이영,정진옥 대한흉부외과학회 2002 Journal of Chest Surgery (J Chest Surg) Vol.35 No.11

Thrombolytic Therapy for Thrombosis of Prosthetic Mitral Valve ­A Case Report­ 하행 괴사성 종격동염은 치원성 및 구강인두 감염증의 합병증으로 발병되며 높은 사망률을 보이는 질환이다. 자연성 인두천공이 원인이 되어 발생한 급성 하행 괴사성 종격동염은 국내에서 보고된 바 없으며 영어로 발표된 문헌들을 조사해서도 한 증례만 검색할 수 있었다. 본 증례의 치료과정 중 종격동내의 배농관이 정확하게 위치되어서 효과적인 배농술이 이루어져야 환자의 생존률을 높이는데 도움이 되리라고 생각되었다.가톨릭 대학교 의과대학 흉부외과학 교실에서는 자연성 하인두 천공에 의해 발생한 급성 하행 괴사성 종격동염의 증례를 치험하였기에 보고하는 바이다.

뇌농양으로 발견된 폐동정맥루 - 1례 보고 -

강신광,김시욱,원태희,구관우,박상순,유재현,나명훈,임승평,이영,Kang, Shin-Kwang,Kim, Si-wook,Won, Tae-Hee,Ku, Kwan-Woo,Park, Sang-Soon,Yu, Jae-Hyun,Na, Myung-Hoon,Lim, Seung-Pyung,Lee, Young 대한흉부심장혈관외과학회 2001 Journal of Chest Surgery (J Chest Surg) Vol.34 No.12

폐동정맥루는 비교적 흔하지 않은 질환이다. 뇌농양은 폐동정맥루의 드물고, 가장 심각한 합병증이며, 폐동정맥루는 신경학적 증상으로 처음 발현되는 수도 있다. 저자들은 뇌농양으로 발견된 폐동정맥루를 치험하였기에 보고하는 바이다. Pulmonary arteriovenous malformations(PAVM) are uncommon diseases. Brain abscesse could be a rare and devastating comlplication of PAVM. Central nervous complaints may be the first manifestations of PAVM. We report a case of PAVM presented by brain abscess which was treated by craniotomy.

In Vivo Neuroprotective Effect of Histidine-Tryptophan-Ketoglutarate Solution in an Ischemia/Reperfusion Spinal Cord Injury Animal Model

강신광,강민웅,이연주,김국성,전병화,한성준,조현진,나명훈,유재현 대한흉부외과학회 2016 Journal of Chest Surgery (J Chest Surg) Vol.49 No.4

Background: Paraplegia is a devastating complication following operations on the thoracoabdominal aorta. We investigated whether histidine-tryptophan-ketoglutarate (HTK) solution could reduce the extent of ischemia/reperfusion (IR) spinal cord injuries in a rat model using a direct delivery method. Methods: Twenty-four Sprague-Dawley male rats were randomly divided into four groups. The sham group (n=6) underwent a sham operation, the IR group (n=6) underwent only an aortic occlusion, the saline infusion group (saline group, n=6) underwent an aortic occlusion and direct infusion of cold saline into the occluded aortic segment, and the HTK infusion group (HTK group, n=6) underwent an aortic occlusion and direct infusion of cold HTK solution into the occluded aortic segment. An IR spinal cord injury was induced by transabdominal clamping of the aorta distally to the left renal artery and proximally to the aortic bifurcation for 60 minutes. A neurological evaluation of locomotor function was performed using the modified Tarlov score after 48 hours of reperfusion. The spinal cord was harvested for histopathological and immunohistochemical examinations. Results: The spinal cord IR model using direct drug delivery in rats was highly reproducible. The Tarlov score was 4.0 in the sham group, 1.17±0.75 in the IR group, 1.33±1.03 in the saline group, and 2.67±0.81 in the HTK group (p=0.04). The histopathological analysis of the HTK group showed reduced neuronal cell death. Conclusion: Direct infusion of cold HTK solution

분화도가 높은 간세포암종의 세침흡인 세포학적 소견 - 비종양성 병변과의 감별 -

강신광,이승숙,조경자,하화정,Khang, Shin-Kwang,Lee, Seung-Sook,Cho, Kyung-Ja,Ha, Hwa-Jeong 대한세포병리학회 1997 대한세포병리학회지 Vol.8 No.1

The fine needle aspiration biopsy(FNAB) has become a popular method to diagnose mass lesions of the liver. Although many reports have listed FNAB criteria to be used to diagnose hepatocellular carcinoma(HCC), a diagnostic dilemma still exists at the extreme ends of the spectrum, particularly for well differentiated HCC. The authors reviewed a series of FNAB specimens of the liver to distinguish well differentiated HCC from nonneoplastic liver. Fifteen cytologic features were examined in this study: high cellularity, large sheet formation, trabecular pattern, acinar pattern, dispersed pattern, irregular arrangement, increased nuclear/cytoplasmic ratio, naked nuclei, irregular chromatin, irregular nuclear contour, multinucleation, uniform macronucleoli, multiple nuclei, uniform small cytoplasm and monotony of atypia. These features were examined in a series of 76 FNAB specimens. Fifty two specimens were from patients with HCC and 24 specimens were from patients with nonneoplastic lesion or tumors other than HCC containg adequate amount of nonneoplastic hepatocytes in smear. All specimens were coded as to the presence or absence of the above cytologic features. With the use of step-wise logistic regression analysis, three features were identified as the key cytologic features predictive of HCC: irregular chromatin, monotony of atypia and absence of large sheet formation. When these criteria were used, the sensitivity diagnosing HCC by FNAB was 94.2%, specificity 100%, positive predictive value 100% and negative predictive value was 88.9%.

Clinical Features of Deep Neck Infections and Predisposing Factors for Mediastinal Extension

강신광,이석기,오현공,강민웅,나명훈,유재현,구본석,임승평 대한흉부외과학회 2012 Journal of Chest Surgery (J Chest Surg) Vol.45 No.3

Background: Deep neck infections (DNI) can originate from infection in the potential spaces and fascial planes of the neck. DNI can be managed without surgery, but there are cases that need surgical treatment, especially in the case of mediastinal involvement. The aim of this study is to identify clinical features of DNI and analyze the predisposing factors for mediastinal extension. Materials and Methods: We reviewed medical records of 56 patients suffering from DNI who underwent cervical drainage only (CD group) and those who underwent cervical drainage combined with mediastinal drainage for descending necrotizing mediastinitis (MD group) from August 2003 to May 2009 and compared the clinical features of each group and the predisposing factors for mediastinal extension. Results: Forty-four out of the 56 patients underwent cervical drainage only (79%) and 12 patients needed both cervical and mediastinal drainage (21%). There were no differences between the two groups in gender (p=0.28),but the MD group was older than the CD group (CD group, 44.2±23.2 years; MD group, 55.6±12.1 years; p=0.03). The MD group had a higher rate of co-morbidity than the CD group (p=0.04). The CD group involved more than two spaces in 14 cases (32%) and retropharyngeal involvement in 12 cases (27%). The MD group involved more than two spaces in 11 cases (92%) and retropharyngeal involvement in 12 cases (100%). Organism identification took place in 28 cases (64%) of the CD group and 3 cases of (25%) the MD group (p=0.02). The mean hospital stay of the CD group was 21.5±15.9 days and that of the MD group was 41.4±29.4 days (p=0.04). Conclusion: The predisposing factors of mediastinal extension in DNI were older age, involvement of two or more spaces, especially including the retropharyngeal space, and more comorbidities. The MD group had a longer hospital stay, higher mortality, and more failure to identify causative organisms of causative organisms than the CD group.

갑상선 흡입세포 검사시 핵구의 진단적 의의

강신광,강구 인제대학교 1992 仁濟醫學 Vol.13 No.1

갑상선 흡입세포검사에서 다수의 핵구출현은 유두상암의 진단에 중요한 소견이며 고배율로 핵막의 주름 및 함몰을 확인함이 필요하다. In order to assess the dialgnostic significance of nuclear grooves in cytologic smears, the pesence of this feature was evaluated in needle aspiration from 14 papillary carcinomas, 9 follicular adenomas, 1 follicular carcinoma, 11 adenomatous goiters and 3 cases of Hashimoto's thyroiditis, all of which were histologically confirmed. Nuclear grooves were observed in 13 out of 14 papillary carcinomas(93%), 6 out of 9 follicular adenomas(67%), and 1 out of 11 adenomatous goiters(9%) They were not observed in cases of follicular carcinoma and thyroiditis. Grooves, however, in follicular adenomas and adenomatous goiters were fewer in number and not as distince as those in papillary carcinomas. Since artifacts such as linearly aligned nuclear chromatin, different stainability in a single nucleus, folding over of nuclear membrane and overlapped nuclei may be indistinguishable from true grooves, grooves should be interpreted cautiously and used in conjunction with other criteria in the diagnosis of papillary carcinoma Observation of nuclear infoldings in oil immersion level would be important in the diagnosis of papillary carcinoma.

자궁경부의 상피내 신생물과 콘딜로마의 병리조직학적 비교

강신광,신형식,박영의 한림대학교의료원 1987 人間科學 Vol.11 No.1

연조직(軟組織)에 발생된 연골종(軟骨腫) -1증례 보고

강신광,함의근,송계용,이춘택 대한병리학회 1980 Journal of Pathology and Translational Medicine Vol.14 No.4