미숙아에서 발견된 중복장중첩증 1례

이정주 ( Jung Ju Lee ),김상원 ( Sang Won Kim ),유병훈 ( Byung Hoon Yoo ),차성재 ( Sung Jae Cha ),이종범 ( Jong Beum Lee ),권귀영 ( Gui Young Kwon ) 대한주산의학회 2010 Perinatology Vol.21 No.4

Intussusception is a common surgical disorder in infancy. Intussusception in preterm infant is very rare and about 40 cases have been reported. Furthermore, double intussusception is extremely rare in children and there seems to be no such a case reported in preterm infant. We report a case of idiopathic double intussusception in the preterm infant, who was born at 25 weeks` gestation, underwent an explolaparotomy for bowel perforation on 39 days of life, and during the operation, an ileo-ileo-colic intussusception was found without a leading point.

DCA-MOD 법에 의한 High $J_c$ YBCO 박막의 제조

김병주,김혜진,이금영,이종범,김호진,이희균,홍계원,Kim, Byeong-Joo,Kim, Hye-Jin,Yi, Keum-Young,Lee, Jong-Beum,Kim, Ho-Jin,Lee, Hee-Gyoun,Hong, Gye-Won 한국초전도학회 2006 Progress in superconductivity Vol.8 No.1

High $J_c\;YBa_2Cu_3O_x$ superconducting films were fabricated by MOD method using fluorine-free dichloroacetic acid(DCA) as chelating solvent for preparing precursor solution. Coating solutions were prepared by dissolving Y-, Ba- and Cu-acetates in DCA solvent followed by drying in rota vapor to obtain the blue gel that is diluted in methanol and 2-methoxyethanol for adjusting the cation concentration. DCA-MOD precursor solution was coated on a single crystal(001) $LaAlO_3(LAO)$ substrate by a dip coating method with a speed of 25 mm/min. Coated films were calcined at lower temperature up to $500^{\circ}C$ in flowing oxygen atmosphere with a 7.2% humidity. Conversion heat treatment was performed at various temperatures of $780{\sim}810^{\circ}C$ for 2 h in flowing Ar gas containing 1000 ppm oxygen with a humidity of 9.45%. SEM observations showed that films have very dense microstructures for the films prepared at the temperature higher than $800^{\circ}C$ regardless of diluting solvent; methanol or 2-methoxyethanol. X-ray diffraction analysis showed that YBCO grains grew with a (001) preferred orientation. A High critical current density($J_c$) of 1.28 $MA/cm^2$(@77 K and self-field) was obtained id. the YBCO film prepared using 2-methoxyethanol as a solvent.

체외충격파를 이용한 담낭결석 쇄석술 - 실험적 및 임상적 연구 -

김건상,박실무,이정효,김영구,송군식,이관세,이종범,김상준,장선택,Kim, Kun-Sang,Park, Sil-Moo,Lee, Jung-Hyo,Kim, Young-Goo,Song, Kounn-Sik,Lee, Kwan-Seh,Lee, Jong-Beum,Kim, Sang-Joon,Chang, Sun-Taik 대한영상의학회 1988 대한영상의학회지 Vol.24 No.4

Although manyalternative treatment technics have been proposed recently for gallstone to substitute cholecystectomy the extracorporeal shock wave lithotripsy (ESWL) for gallbladder stones has rarely been tried. We have carried out a series of experiments to evaluate how effective the ESWL for gallbladder stones in and how safe this procedure is. At first in vitro shock wave application was carried out to 10 gallbladder stones which were obtained from human gallbladder. Secondly gallbladder stones were implanted to canine gallbladder and treated with shock wave Lastly a total of 41 volunteers with confirmed gallbladder stones were treated with shock wave and combined oral administration of ursodeoxycholic acid. In the in vitro experiment aoo of the 10 gallstones were fragmented with variable firing rates and duration. In animal experiment the implanted stones were successfully fragmented and the organs included in the pathway of shock wave were proved to be intact histologically. in juman study complete disappearance of gallstones was noted in 78.6% of patients with single radiolucent gallbladder stones smaller than 2.5cm in the longest diameter. two patients underwent cholecystectomy after ESWL due to sudden colic attack, Onee patient had experienced and episode of mild transient obstructive jaundice. It may be concluded that the ESWL for gallbladder stones is an effective and safe method of treatment of gallbladder stones in the selected cases for example small radiolucent stones and the further study is needed to establish improved technology og the ESWL for gallbladder stones.

Hepatic CT Enhancement: Comparison between Dimeric and Monomeric Nonionic Contrast Agents in Rabbits

김기현,곽병국,심형진,김교남,유위강,유승훈,김양수,이종범,김건상,Kim, Gi-Hyeon,Kwak, Byung-Kook,Shim, Hyung-Jin,Kim, Kyo-Nam,Liu, Wei Chiang,Ryu, Seung-Hoon,Kim, Yang-Soo,Lee, Jong-Beum,Kim, Kun-Sang The Korean Radiological Society 2003 대한영상의학회지 Vol.48 No.6

목적: 정상 가토에서 비이온성 이중체(dimer)인 iodixanol과 단량체(monomer)인 ioversol간의 간과 대동맥에서의 조영증강 정도를 비교하고자 하였다. 대상과 방법: 나선식 CT를 이용하여 가토 7마리에서 일주일 간격을 두고 iodixanol(Visipaque 320, Nycomed, Oslo, Norway)과 ioversol(Optiray 320, Mallincrodt medical, Quebec, Canada)로 각각 3초간격으로 120초 동안 간의 한부위에서 역동적 CT를 시행하였다. 각 가토 체중에 따라 동일량의 조영제를 사용하였으며 2(ml/kg), 조영 증강치와 최고 조영 증강치에 도달하는 평균 시간을 산출한 후 조영증강 곡선을 구하였고, 두 조영제간의 차이를 통계학적으로 비교하였다. 결과: 간실질의 평균 조영 증강치는 후기 동맥기에서 조기 문맥기(18-39초)에 이르는 동안 ivorsol을 사용한 예에서 더 높게 관찰 되었으며 통계학적으로 의의가 있었다(P<0.05). 또한 간실질, 문맥, 대동맥에서의 평균 최고 조영 증강치 역시 ioversol을 사용한 예에서 더 높게 관찰되었다. 그러나, 최고 조영 증강치에 도달하는 평균시간은 두 조영제 사이에 유의한 차이가 관찰되지 않았다. 결론: Ioversol은 후기 동맥기에서 조기 문맥기에 이르는 동안 간실질의 조영증강에 있어 iodixanol보다 통계적으로 유의한 효과를 보였다. Purpose: To determine the hepatic and vascular enhancement profiles with nonionic dimeric, iodixanol, contrast agent in the rabbit and to compare them with nonionic monomeric, ioversol, contrast agent. Materials and Methods: Seven rabbits initially underwent hepatic dynamic CT scan with either iodixanol or ioversol, followed by repeated CT scan with other unused contrast agent with one week interval between scans. Pre and post contrast attenuation values of hepatic parenchyma, aorta and portal vein were measured sequentially. The mean enhancement of the hepatic parenchyma, aorta and portal vein were compared between two agents. The mean peak enhancement and peak enhancement time of the liver, aorta, and portal vein were also compared. Results: The attenuation values of ioversol showed a greater mean hepatic enhancement than iodixanol from 18 seconds to 39 seconds after injection (from late arterial phase to early portal venous phase) with a statistical significance (p<0.05). The mean peak enhancement of hepatic parenchyma, aorta and portal vein was also greater using ioversol than iodixanol, but the mean peak enhancement times of ioversol and iodixanol were nearly identical. Conclusion: Ioversol may have the greater effects than iodixanol on hepatic tumor conspicuity, especially from late arterial phase to early portal veneous phase.

체외충격파로 분쇄된 담석의 주사전자현미경적 연구

김영구(Young Goo Kim),박중원(Joong won Park),김건상(Kun Sang Kim),이종범(Jong Beum Lee),심형진(Hyung Jin Shim),이용철(Yong Chul Lee),김수련(Soo Ryun Kim) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.4

N/A Background/Aims: To evaluate the effects of extracorporeal shock-wave lithotripsy(ESWL) on diverse composition-types of gallstones, we conducted an analysis of the characteristics of scanning electron microscopic features of gallstones fragmented by extracorporeal shock waves. Methods: Fifteen gallstones from 1S cholecystectomized patients were fragmented by extracorporeal shock waves in vitro. The fragmented gallstones were studied by gross examination, simple X-ray, microscopic examination, and the scanning electron microscope(SEM). The composition of gallstones was classified by infrared spectrophotometric analysis as cholesterol stone, calcium carbonate stone, and pigment stone. Results; Fifteen gallstones were classified into five groups: three pure cholesterol stones, seven cholesterol stones, two calcium carbonate stones, two hlack pigment stones, and one brown stone. Scanning electron microscopic examination showed that radially oriented clusters of cholesterol crystals and the plane of fracture are parallel to the long axis of the crystals in pure cholesterol stones, intermeshed cholesterol crystals with rounded-border in mixed stones, broken egg-shell-like thin structures in calcium carbonate stones, and irregular bordered and amorphous structures in pigment stones, either black or brown ones. Conclusions: The surface of the gallstone fragments by ESWL showed different SEM patterns according to the type of gallstones, depending on their unique structure and composition. (Korean J Gastroenterol 1995;27:441 - 449)

경피경간담배액술 (經皮經肝膽排液術) 193예에 관한 분석

최병인(Byung Ihn Choi),박재형(Jae Hyung Park),임덕(Duk Lim),한만청(Man Chung Han),한준구(Jun Koo Han),이종범(Jong Beum Lee),김주완(Chu Wan Kim) 대한소화기학회 1984 대한소화기학회지 Vol.16 No.2

N/A Percutaneous transhepatic biliary drainage has played a major role in treatment of patients with biliary tract disease, especially obstruction by malignant disease. Percutaneous transhepatic biliary drainage was perfor med 193 times in 152 patients of obstructive jaundice for recent 3 years from July, 1981 to September, 1984 at department of radiology, Seoul National University Hospital. The results were as follows: 1) The male to female ratio was 2:3:1 and the 7 th decade was the most common. 2) The causes of obstructive jaundice included 135 malignant diseases and 17 benign diseases. Malignant diseases were 61 cases of bile duct cancer, 36 cases of metastasis, 26 cases of pancreatic cancer, 6 cases of gallbladder cancer, 4 cases of ampulla Vater cancer, 1 case of duodenal cancer, and 1 case of hepatoma. Benign diseases were 10 cases of common bile duct stone, 1 case of intrahepatic stones, 4 cases of benign stricture and 2 cases of cholangitis. 3) The most common indication was palliative drainage of obstruction secondary to malignant tumor in 113 cases. 4) The overall success rate was 95%. Internal drainage was achieved in 45(24%) cases and external drainage was accomplished in 139 (76%) cases. 5) Decline in serum bilirubin level was found in 144 patients (95%) with the most rapid decline within 1 week after the procedure. 6) Acute major complication occurred in 17 cases (9%) Percutaneous transhepatic biliary drainage is a proven technique for non-operative biliary decompression and established alternative to surgery.

토끼 콩팥에 대한 키토산 미세구의 색전 효과

이종익,곽병국,심형진,이종범,이용철,유재형,한상문 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.1

The aim of the study was to evaluate the possibility of therapeutic use of chitosan microspheres as a new embolic material. Twenty four New Zealand white rabbits were divided into four groups. Polyvinyl alhocol (PVA) particles (150-250 ㎛ ) was used in group 1. Chitosan microspheres were used in group 2 (150-250 ㎛ ), group 3 (250-355 ㎛) and group 4 (355-500 ㎛) respectively. Arteriography of right kidney was performed using 4 F cobra catheter. Embolization was continued until complete occlusion of the right renal artery was achieved. Catheters were tested whether the lumen is obstructed by embolic materials during and after embolization. One animal was sacrificed in each group on the 1st and 3rd day, 1st, 2nd, 4th, and 8th week respectively. Basic hematologic and blood chemisty were analyzed, and gross and microscopic pathologic findings were observed. Chitosan microspheres were round to oval shape, and had smooth surface and even size under the light microscope. Successful embolizations were achieved in all twenty four rabbits. On gross pathologic examination, all chitosan microsphere groups showed no differences from PVA particle group in renal contraction and discoloration. Histologically chitosan microsphere groups had a higher incidence of vasculitis. but did not show any recanalization in comparison with PVA particle group. Hematologic and blood chemisty showed no significant abnormal change in all groups. In conclusion, effective, technically easy and safe embolizations were achieved with chitosan microspheres in rabbit kidney. Chitosan microspheres might be a good embolic material.

양성 유방질환의 절제생검후 유방촬영 소견의 변화

김양수,이종범,심형진,송인섭,최영희,이용철,김건상,박성준,지경천,박용검 중앙대학교 의과대학 의과학연구소 1997 中央醫大誌 Vol.22 No.1

We retospectively analyzed mammographic changes after excision biopsy in patients with benign breast diseases. We evaluated follow-up mammograms of 30 cases in 22 patients who confirmed as benign breast disease, pathologically. The age distribution of the patients was 29 years in the youngest and 71 years old in the oldest(mean: 45.3). The intervals between pre-biopsy mammography and post-biopsy follow up study was 20 days to 31 months(mean: 286 days). The pathologic diagnosis of the cases were 11 fibrocystic disease patient(50%), 4 adenosis (18.2%), 3 atypical intraductal papillomatosis (8.2%) and I case of atypical ductal hyperplasia, atypical lobular hyperplasia, atrophic breast tissue, fibroadipose tissue and fibrosis. On follow-up mammographies, 15 cases(68.2%) shouled parenchymal changes such as focally increased density, architectural distorsoin, parenchymal retraction, spiculated density 10 cases(45.5%), skin changes such as retraction or thickening but 4 cases did not show any discernible abnormality. Among cases showing parenchymal changes, 6 cases showed different configuration on different projection, which suggesting benign lesion rather than breast cancer. It was suggested that the mammographic findings after excision biopsy in benign diseases be considerably variable, and to know these findings and history of biopsy seem to be mandatory in interpretation of post-biopsy mammograms.

Segmental Prevalence and Extraction Rate of Retained Intrahepatic Stone

Kwak, Byung Kook,Lee, Jong Beum,Joo, Sang Shin,Lee, Hwa Yeon,Shim, Hyung Jin,Kim, Kun Sang,Lee, Yong Chul 중앙대학교 의과대학 의과학연구소 1996 中央醫大誌 Vol.21 No.2

간내 잔류담석의 간 구역별 빈도와 제거율과 실패원일을 알고자 한다. 담석증으로 수술을 받고 T자관을 통하여 잔류담석 제거술을 시행 받은 환자중 간내담도에 잔류담석이 있던 126명을 후향적으로 담도조영사진을 분석하였다. 간내담도별 잔류 단석의 빈도와 제거율은 좌외측(left lateral)이 각각 54.0%, 91.1% ; 우후(right posterior)가 38.1%, 81.2% ; 우전(right anterion)이 26.2%, 93.8% ; 좌 내측(left medial)이 14.3%, 77.7%를 보였다. 전체 제거율은 85.6%이었다. 미상엽은 모든 예에서 간내 담석이 없었다. 제거 실패의 주된 원인은 담도 협착과 매복된 담석이었다. 우후와 좌내측 간내담도에서는 고유한 담도의 굴곡이 또 하나의 실패의 주된 원인이었다. 결론적으로 좌외측 간내담도가 담석의 빈도가 가장 높고 우후, 우전, 좌내측 간내담도의 순서로 높았다. 우후와 좌내측 간내담도의 담석제거율이 우전, 좌외측 보다 낮았으며, 이것은 고유한 굴곡 대문으로 설명된다. To evaluate the hepatic segmental prevalence and the extraction rate of the retained intrahepatic stones on cholangiogram and the cause of failure of percutaneous stone removal through a T-tube tract. One hundred and twenty-six patients who had undergone the extraction of the retained intrahepatic stones were evaluated. Selective segmental cholangiogrmas were obtained for each segmental prevalence by using a pre-shaped 10F catheter. The results of the segmental extraction rate and the cause of failure were also evaluated after completing the stone removal session. The segmental prevalence and the extraction rate were 54.0% and 91.1% in the left lateral(LL), 38.1% and 81.2% in the right posterior(RP), 26.2% and 93.8% in the right anterior(RA), 14.3% and 77.7% in the left medial(LM) segmental duct, respectively. The total extraction rate was 85.6%. The caudate lobe had no stone in all cases. The main causes of extraction failure were stricture and stone impaction. In the RP and the LM segmental duct, duct angulation was another amin cause of failure. The prevalence of retained stones is highest in the LL segmental duct, the RP, the RA and the LM segmental duct, in descending order. There was no stone in the caudate lobe. The extraction in the RP and LM segmental ducts is more difficult than in the RA and LL segmental ducts. This result can be explained by the natural anatomical angulation of these ducts.

동맥성 발기부전증 환자의 진단에서 선택적 혈관조영술의 역할의 재평가

정세열,심형진,이종범,송인섭,류대식,김영구,김양수,이용철 중앙대학교 의과대학 의과학연구소 1993 中央醫大誌 Vol.18 No.4

For the evaluation of role of internal pudendal arteriogram in arteriogenic impotence, 70 selective arteriograms of 35 suspected postraumatic impotence patients were analyzed and compared to results of penile bracial index(PBI), duples ultrasonograms of cavernosal artery and cavernosal artery systolic occlusion pressure(CASOP). The results of selective internal pudendal arteriography(SIPA) were classified as 44 cases with normal vascular findings and 26 with abnormal findings. Between two groups, ther was no significant difference in peak velocity and diameter of cavernosal artery in duples ultrasonograms, in pressure difference between systolic pressure of brachial artery and CASOP, and in PBI. These results are also true even in cases with nonvisualization of cavernosal artery casued by complete occlusion of internal pudendal artery. In conclusion, selective pudendal arteriogram is the only one reliable study for the evaluation of arteriogenic impotence, although further study is needed to define the role of other noninvasive approaches.