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Polyoxyl 40 Hydrogenated Castor Oil 이 실리마린과 우루소데옥시콜린산 복합제제중 실리마린의 용해성 및 생체이용률에 미치는 영향
장우익(Woo Ik Chang),남권호(Kweon Ho Nam),조재열(Jae Youl Cho),이재휘(Jae Hwi Lee),유영효(Young Hyo Yu),박명환(Myung Hwan Park),김재환(Jae Hwan Kim) 한국응용약물학회 1997 Biomolecules & Therapeutics(구 응용약물학회지) Vol.5 No.3
The effect of nonionic surfactant(polyoxyl 40 hydrogenated castor oil, PHCO), a common solubilizer, on the solubility of silymarin in the combined preparation containing ursodeoxycholic acid(UDCA) and silymarin was investigated in vitro using HPLC. The solubility of silybin, a major component of silymarin, was enhanced by increasing the amount of PHCO. The effect of PHCO on bioavailability was also evaluated in rats. The bioavailability was calculated by silybin content in bile juice that was excreted for 24 hr after oral administration. It was found that the bioavailability of silymarin containing PHCO was significantly increased compared to that of control. These results suggest that PHCO may improve the solubility and bioavailabilty of silymarin when it is combined with UDCA and silymarin.
증례 : 폐암 환자에서 발생한 원발성 피부 Nocardia 감염증 1예
장우익 ( Woo Ik Chang ),김수진 ( Sue Jin Kim ),김영찬 ( Young Chan Kim ),권기태 ( Ki Tae Kwon ),오원섭 ( Won Sup Oh ),백경란 ( Kyong Ran Peck ),송재훈 ( Jae Hoon Song ) 대한내과학회 2007 대한내과학회지 Vol.73 No.3
Nocardia 감염증은 건강한 사람에서는 매우 드물지만 스테로이드나 면역억제제를 사용하는 경우처럼 면역기능이 저하된 환자들에서 발생하는 기회감염이 점차 증가하고 있다. 호흡기를 통해 인체에 감염되는 경우가 많으나 드물게 피부를 통하여 감염되기도 한다. 저자들은 폐암으로 방사선 치료 후 스테로이드를 투여 중이던 환자에서 발생한 족부의 원발성 피부 Nocardia 감염증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Nocardiosis is a rare opportunistic bacterial infection. The majority of nocardial infections are acquired through inhalation and smaller numbers of cutaneous nocardiosis are caused by traumatic inoculation of organisms percutaneously. We experienced a patient with lung cancer that developed a primary cutaneous nocardiosis. A 57-year-old man was admitted to the Samsung Medical Center because of a painful swelling lesion of the right foot that developed 3 weeks prior. Three months prior, the patient had been diagnosed with a non-small cell lung cancer, and then underwent palliative bronchial stent insertion, radiation therapy and corticosteroid treatment for an obstructive endobronchial lesion. Incision and drainage was performed as magnetic resonance imaging (MRI) of the foot showed an abscess cavity. Nocardia was isolated from the pus. The antibiotic therapy was changed to oral trimethoprim/sulfamethoxazole (TMP/SMX) treatment. The skin lesion was improving and the patient was discharged 20 days later. TMP/SMX was continued for a total of three months. The patient has been in good health and the skin lesion had completely healed two months after discharge.(Korean J Med 73:342-345, 2007)
간 , 담도 및 췌장 : 치료받지 않은 간암환자의 평균 생존기간 및 예후인자에 관한 고찰
장우익(Woo Ik Chang),권상옥(Sang Ok Kwon),이광훈(Kwang Hoon Lee),이흥재(Hong Jai Lee),전근재(Geun Jae Jeon),임채선(Chae Seon Lem),김남동(Nam dong Kim),심영학(Young Hak Shim),홍인수(In Soo Hong) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.2
N/A The survival period and prognostic factors of hepatocellular carcinoma were evaluated in 84 untreated patients confirmed by ultrasound-guided aspiration cytology or histopathology. The results were as follows: 1) In 82 untreated patients, the mean survival period was 16.5 weeks from diagnosis to death. 2) The survival period correlated to age, ascites and weight loss but it did not correlated to bilirubin, albumin, a-FP and the individual groups of Childs classification, 3) According to size and shape the ultrasonographic findings of hepatoma were classified, however the survival period did not correlate to them and also cytologic differentiation. 4) The revised staging system by Primark and staging system by Okuda were not significantly correlated to the survival period.
좌측 주기관지 근위부에서 발생한 무기폐를 동반한 횡문근 육종의 수술 치료 -1례 보고-
김연수,장우익,허진원,박시영,장선희,박경택,김창영,류지윤,조성준,Kim, Yeon-Soo,Chang, Woo-Ik,Huh, Jin-Won,Park, See-Young,Chang, Sun-Hee,Park, Kyung-Taek,Kim, Chang-Young,Ryoo, Ji-Yoon,Cho, Seong-Joon 대한기관식도과학회 2007 大韓氣管食道科學會誌 Vol.13 No.2
Treatment choice for primary pulmonary sarcoma is complete surgical resection. A 69 year old man developed dyspnea due to left lung atelectasis. There was endobronchial tumor completely obstructing the left main bronchus. The tumor was resected completely by main bronchial resection via a left thoracotomy incision, and diagnosed as leiomyosarcoma. Bronchoscopy and computed tomography in 6 months after operation, there was no evidence of recurrence.
심폐바이패스없이 심박동상태에서 시행한 관상동맥우회술후 중기 개통율
이철,장우익,임청,김기봉,채인호,오병희,이명묵,박영배,Lee, Cheul,Chang, Woo-Ik,Lim, Cheong,Kim, Ki-Bong,Chae, In-Ho,Oh, Byung-Hee,Lee, Myoung-Mook,Park, Young-Bae 대한흉부심장혈관외과학회 2001 Journal of Chest Surgery (J Chest Surg) Vol.34 No.8
배경: 심폐바이패스없이 심박동상태에서 시행하는 관상동맥우회술 후의 각종 도관들의 1년째 개통율을 심패바이패스하의 심정지상태에서 시행하는 통상적 관상동맥우회술 및 심폐바이패스하의 심박동상태에서 시행한 관상동맥우회술 후의 1년재 개통율과 각각 비교하고 그 차이를 알아보고자 하였다. 대상 및 방법: 심폐바이패스없이 심박동상태에서 시행한 관상동맥우회술(I군; n=122)의 결과를 심폐바이패스하의 심정지상태에서 시행하는 통상적 관상동맥우회술(II군; n=65) 및 심폐바이패스하의 심박동상태에서 시행하는 관상동맥우회술(III군; n=19)의 결과와 비교, 분석하였다. I 군에서는 수술 직후와 수술후 1년째에 관상동맥조영술이 시행되었고, II군 및 III군에서는 수술후 1년째에서 시행되었다. 도관의 개통정도는 A(excellent), B(fair), 혹은 O(occluded)의 3등급으로 평가하였다. 결과: I, II, III군에서의 평균 원위 문합수는 각각 3.1$\pm$1.1, 3.7$\pm$0.9, 3.6$\pm$0.9개 이었다. I 군에서는 92%(112/122)의 환자들에서 퇴원 전 관상동맥조영술이 시행되었는데 개통율 (A+B)은 동맥 도관이 96.4%(162/168), 복재정맥이 85.6%(160/187) 이었다. 74%(90/122)의 환자들에서 술후 1년째 관상동맥조영술이 시행되었으며, 개통율은 동맥 도관이 97.89%(132/135), 복재정맥이 67.9%(106/156) 이었다. II군에서는 65%(42/65)의 환자들에서 술후 1년째 관상동맥조영술이 시행되었다. 개통율은 동맥 도관이 93.5%(43/46), 복재정맥이 88.3%(98/111) 이었다. III군에서는 89%(17/19)DML 환자들에서 술후 1년째 관상동맥조영술이 시행되었다. TRO통율은 동맥 도관이 100%(19/19), 복재정맥이 86.8%(33/38) 이었다. 결론: 세 군간에 동맥 도관들의 1년째 개통율은 유의한 차이를 보이지 않았다. 심폐바이패스 없이 심박동상태에서 시행하는 관상동맥우회술후 복재정맥의 개통율은 수술 직후에도 동맥 도관에 비하여 유의하게 낮았으며(p<0.001), 술후 1년째 복재정맥 개통율 또한 II군(p<0.001) 및 III(p<0.01)의 수술후 1년째 복재정맥 개통율에 비하여 유의하게 낮았다. 이러한 결과는 복재정맥을 이용하여 심폐바이패스없이 시행하는 관상동맥우회술의 경우, 수술전후 항응고 요법에 특별한 주의가 필요할 것이라는 사실을 시사한다. The aim of this study was to compare one-year graft patency after coronary artery bypass grafting without cardiopulmonary bypass(OPCAB) with that of conventional CABG and that of on-pump beating CABG, and to demonstrate any differences in patency of various conduits among the three groups. Material and Method: We analyzed the results of OPCAB cases(group I; n=122) compared with those of conventional CABG cases(group II; n=65) and those of on-pump beating CABG cases(group III; n=19). In group I, coronary angiography(CAG) was performed immediately postoperatively and 1 year after surgery. In group II and III, CAG was performed 1 year after surgery. Graft patency was graded as grade A(excellent), grade B(fair), or grade O(occluded). Result: The average number of distal anastomoses in groups I, II, and II were 3.1$\pm$1.1, 3.7$\pm$0.9, and 3.6$\pm$0.9, respectively. In group I, postoperative CAG was performed in 92%(112/122) of patients before discharge. The patency rate(grade A+B) was 96.4$(162/168) for arterial grafts, and 85.6%(160/187) for saphenous vein grafts(SVG). One-year follow-up CAG was performed in 74%(90/122) of patients. The patency rate was 97.8%(132/135) for arterial grafts, and 67.9%(106/156) for SVG. In group II, one-year follow-up CAG was performed in 65%(42/65) of patients. The patency rate(grade A+B) was 93.5%(43/46) for arterial grafts, and 86.8%(33/38) for SVG. Conclusion: Our results demonstrated that the patency rate of SVG after OPCAB was significantly lower than that of arterial grafts in the early postoperative CAG(p<0.001), and was also significantly lower than those of SVG of group II(p<0.001) and group III(p<0.01) in the postoperative one-year CAG, although there was no significant difference is one-year patency of arterial grafts among the three groups. Our data suggest that a specific perioperative anticoagulant therapy may be advisable in patients undergoing OPCAB with SVG.
유제화에 의한 경구용 항암제인 테가푸르의 장관 임파수송
이용복,남권호,장우익,오인준,고익배,Lee, Yong-Bok,Nam, Kweon-Ho,Chang, Woo-Ik,Oh, In-Joon,Koh, Ik-Bae 한국약제학회 1995 Journal of Pharmaceutical Investigation Vol.25 No.1
W/O and O/W emulsions of tegafur (50 mg/5 ml/kg) were orally administered to rats to compare with their mesenteric lymphatic delivery effects. And also in order to demonstrate the lymph targeting associated to the oral route, it was deemed necessary to investigate the fate of solution after oral administration as a control. Lymph and plasma samples were periodically taken from each subject of mesenteric lymphatic duct cannulated rats. Then, lymph and plasma levels of tegafur and its active metabolite, 5-FU, were simultaneously observed. Also pharmacokinetic parameters were compared with each others. On the other hand, most previous studies of lymphatic transport have not addressed the question of whether an increase in mesenteric or thoracic lymph transport by the manipulation of a suspected variable was due to a selective delivery to the intestinal lymphatics or an overall increase availability. Therefore, based on a physiologically based pharmacokinetic model which represents the characteristics of lymphatic systems, we are also going to determine the contributions of mesenteric lymph transport versus thoracic lymph transport of tegafur reported in reference(13). In comparison with tegafur solution, AUC and mean residence time of plasma tegafur were significantly increased in W/O emulsion but significantly decreased in O/W emulsion. Lymph flow rates were similar in both solution and W/O emulsion but half in O/W emulsion. AUC of tegafur in mesenteric lymph and in plasma for W/O emulsion were 3.7 times and 2.9 times more than those for O/W emulsion, respectively. And AUC of 5-FU in thoracic lymph for W/O emulsion was 3.7 times more than that for O/W emulsion. These results suggested that lymphatic delivery or tegafur by W/O emulsion was more effective than that by on emulsion due to its differences or formation ability of chylomicrons.
조직학적으로 확진된 복강내 악성병변에 대한 세침흡입 세포학적 검사의 진단적 가치
김남동(Nam Dong Kim),장우익(Woo Ik Chang),권상옥(Sang Ok Kwon),이광훈(Kwang Hoon Lee),배선우(Seon Woo Bae),김태승(Tae Seung Kim) 대한내과학회 1987 대한내과학회지 Vol.33 No.2
N/A An ultrasound-guided percutaneous aspiration cytology was performed with a 22 G Chiba needle in 65 patients with intraabdominal malignancy confirmed by histologic diagnosis and the results were as follows: 1) Malignancy was confirmed by an exploratory laparotomy in 22 patients and by an aspiration biopsy in 43 patients. 2) The diagnostic accuracy of fine needle aspiration cytology was demonstrated in 89.1% of the patients. 3) The aspiration biopsy was diagnostic in 2 patients, even when the aspiration cytology was non-diagnostic. 4) There were no serious complications of the fine needle aspiration. In conclusion, the fine needle aspiration cytology with ultrasound guidance is safe, simple and accurate diagnostic method in the evaluation of space-occupying intra-abdominal malignancy. Histologic examination of tissue fragment obtained from the aspirated material appear to increase the yield of malignancy on aspiration cytology.
김연수,박경택,류지윤,김창영,장우익,장선희,Kim, Yeon-Soo,Park, Kyoung-Taek,Ryoo, Ji-Yoon,Kim, Chang-Young,Chang, Woo-Ik,Chang, Sun-Hee The Korean Bronchoesophagological Society 2008 大韓氣管食道科學會誌 Vol.14 No.2
Nerogenic tumor of various histologic types may arise in the posterior mediastinum. Mediastinal schwannoma is a frequent paraspinal neurogenic tumor, but malignant mediastinal schwannoma is rare tumor which is derived from Schwann cells. Although there are some reports dealing with approach for screening patients with symptoms suggesting malignancy and the imaging criteria for distinguishing malignant from benign schwannoma but the results are not clearly defined. We present a case of hugh mediastinal schwannoma which was taken for malignancy in imaging studies because of its invasiveness.
기관지 내시경으로 초기에 제거할 수 없었던 기도 이물 : 2례 보고
김연수,남승연,곽병곤,장우익,박경택,김창영,류지윤,Kim, Yeon-Soo,Nam, Seung-Yeon,Kwak, Byeong-Gon,Chang, Woo-Ik,Park, Kyung-Taek,Kim, Chang-Young,Ryoo, Ji-Yoon 대한기관식도과학회 2007 大韓氣管食道科學會誌 Vol.13 No.2
Foreign body aspiration is a cause of the accidental death at home. Therefore, early intervention and proper management is important. A bronchoscopy is indicated whenever there is a suggestive history and medical opinion. Occasionally, foreign body removal with bronchoscopy may be fail. But, on the situation, there is no definite recommended standard management. We experienced two cases of bronchial foreign body could not be removed with bronchoscopy at first intervention. The one was diagnosed too late. Endobronchial granulation tissue and edema made it impossible to find the foreign body at first bronchoscopy. After steroid and antibiotic therapy, foreign body could be removed with secondary bronchoscopy. Another was bronchial foreign body jammed tightly bronchus intermedius. Even after medical therapy, patient got aggravated. So foreign body was removed with bronchotomy.