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혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement
임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1
Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.
김보형,강성호,임대준 건국대학교 의과학연구소 2003 건국의과학학술지 Vol.13 No.-
Background and objectives: High-resolution endoscopes and the advent of endoscopic instruments for sinus surgery currently provide surgeons with excellent endonasal visualization and access to the medial orbital walls. The purpose of this study was to demonstrate the reduction of medial orbital wall fractures through an endonasal endoscopic approach that allows the repair of the medial orbital wall fractures without an external incision. Materials and Method : This study was a retrospective analysis of 16 patients who underwent surgical repair of medial orbital wall fractures from March of 2000 to June of 2002. The 11 male and five female patients ranged in age from 15 to 54 years (mean, 28.8 years). These patients had undergone primary reduction of medial orbital wall fractures and were observed for at least 2 months after surgery. Result: All of 16 patients showed a complete improvement of their preoperative symptoms. There were no intraoperative or postoperative complications. Conclusion: Endoscopic reduction of medial orbit wall fracture using an endonasal approach seems to produce good results and definite cosmetic advantages.
흰쥐 Kupffer 세포에 대한 Propofol의 작용
박세훈,지대림,성언기,김희선,송인환,박희영,김준수,이덕희,박대팔 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.4
Background: Propofol has an antioxidant capacity and can be used for ischemia-reperfusion injury of the liver. However, the effects of propofol on the Kupffer cells have not been establisked. Methods: Kupffer cells were isolated and cultured from male Sprague-Dawley rats. The effects of propofol on the Kupffer cells were evaluated by a phagocytosis assay, TNF-α gene expression, and superoxide anion release after administering propofol in different concentrations on the cultured Kuprrer cells. Results: The latex bead phagocytosis by the Kupffer cells was suppressed when the Kupffer cells were exposed to propofol irrespective of concentrations. Higher propofol concentrations decreased the loss of Kupffer cells after latex bead phagocytosis. Propofol induced TNF-α mRNA expression in the Kupffer cells, but the mRNA expression level after 50㎍/ml of propofol decreased. The pattern of TNF-α mRNA expression induced by propofol was different to that induced by LPS: TNF-α mRNA was expressed continuously in the propofol-treated cells until 16 hours after exposure to propofol, whereas the level of TNF-α mRNA expression induced by LPS was evident after 2 hours and was not found thereafter. TNF-α production after propofol treatment was not higher than that of the control. Formazan presipitation did not show any qualitative differences between cells untreated or treated with propofol concentrations of 0.5, 5.0, and 50 ㎍/ml. Conclusions: These results showed that propofol might inhibit Kupffer cells. This suggests that propofol and be used for patients with ischemia-reperfusion injury of the liver. (Korean J Anesthesiol 2002; 43: 475~484)
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.
성정훈,강대원,이윤수,임준우,홍영호,이덕동 경북대학교 센서기술연구소 1998 센서技術學術大會論文集 Vol.9 No.1
High selective and sensitive thick film type methane gas sensors were fabricated and their sensing characteristics for various hydrocarbon gases were investigated. Raw material, SnO_(2)/Au, prepared by coprecipitation was even grain size. SEM, TEM, BET and XRD analyses were carried out for investigation of surface morphology and crystalline structure. The thick film devices using the above materials exhibited high sensitivity to methane gas at the operating temperature of 400°C. The sensitivity of SnO_(2)/Au+Pd thick film devices to methane gas was higher than that to the other hydrocarbon gases such as iso-butane and propane. The optimal adding amounts of Au and Pd were 1wt.% and 3wt.%, respectively. The sensitivity, S, is defined as {(R_(A)-R_(G))/R_(A)}><100, which R_(A) and R_(G) are resistance in air and that in the gas ambient, respectively.
소적정원산(消積正元算)으로 호전된 적증(積證)환자 1례 보고
허진일,조동희,김동우,임희용,오중한,김대준,변준석,최빈혜,Hur, Jin-Il,Cho, Dong-Hee,Kim, Dong-Woo,Lim, Hee-Yong,Oh, Jung-Han,Kim, Dae-Jun,Byun, Joon-Seok,Choi, Bin-Hye 대한한방내과학회 2005 大韓韓方內科學會誌 Vol.26 No.2
This study was designed to evaluate the effects of the oriental medicine(Sojeockjeongwonsan) on a Jeock-Jeung patient. The clinical data was analyzed on a patient with Jeock-Jeung, deemed due to Gangiulgyul(肝氣鬱結) and Junggiheoyak(正氣虛弱). The patient’s main symptoms were abdominal pain and abdominal mass. The patient was admitted to Dae-Gu Hanny University Dae-Gu Oriental Medicine Hospital. Clinical symptoms, including abdominal pain, abdominal mass and general condition, improved after treatment. This study suggests that Sojeockjeongwonsan is significantly effective in treatment of a Jeock-Jeung.
( Dae Hyun Lim ),( Jai Hoon Yoon ),( Dae Won Jun ),( Oh Young Lee ),( Byung Chul Yoon ),( Hang Rak Lee ),( Kyung Soo Kim ),( Ho Soon Choi ) 대한간암학회 2020 대한간암학회지 Vol.20 No.1
Tyrosine kinase inhibitors are widely used as targeted treatments for various malignancies. Sorafenib is an orally active tyrosine kinase inhibitor that blocks the signaling pathways of several growth factors. Its use is approved for various malignancies such as unresectable hepatocellular carcinoma, renal cell carcinoma, and gastrointestinal stromal tumors. Several adverse effects have been reported in the literature; however, cardiotoxicity is rare. We present a case of recurrent coronary vasospasm caused by short-term administration (5 days) of sorafenib. Since it caused refractory ischemia after re-administration, we had no choice but to stop the treatment. (J Liver Cancer 2020;20:67-71)
( Dae Hyun Lim ),( Mimi Kim ),( Dae Won Jun ),( Min Jung Kwak ),( Jai Hoon Yoon ),( Kang Nyeong Lee ),( Hang Lak Lee ),( Oh Young Lee ),( Byung Chul Yoon ),( Ho Soon Choi ),( Bo Kyeong Kang ) 대한소화기학회 2021 Gut and Liver Vol.15 No.1
Background/Aims: To date, studies on various noninvasive techniques have been suggested to evaluate the degree of liver fibrosis. We aimed to investigate the diagnostic performance of serum asialo α1-acid glycoprotein (AsAGP) in the diagnosis of liver cirrhosis compared with chronic hepatitis for clinically useful result. Methods: We conducted a case-control study of 96 patients with chronic liver disease. Chronic hepatitis was defined as the presence of chronic liver disease on ultrasonography, with a liver stiffness of less than 5.0 kPa as shown on magnetic resonance elastography (MRE). Liver cirrhosis was defined as liver stiffness of more than 5.0 kPa on MRE. The serum AsAGP concentration was compared between the two groups. Results: Serum AsAGP levels were significantly higher in patients with cirrhosis than in those with chronic hepatitis (1.83 μg/mL vs 1.42 μg/mL, p<0.001). Additionally, when comparing patients in each cirrhotic group (Child-Pugh grades A, B, and C) to those with chronic hepatitis, AsAGP levels were significantly higher in all the cirrhotic groups (p<0.05, p<0.01, p<0.001, respectively). The sensitivity and specificity of AsAGP for detecting cirrhosis were 79.2% and 64.6%, respectively, and the area under the curve value was 0.733. The best diagnostic cutoff to predict cirrhosis was 1.4 μg/mL. AsAGP and bilirubin were found to be independent risk factors for the prediction of cirrhosis in the logistic regression analysis. Conclusions: Serum AsAGP showed an acceptable diagnostic performance in predicting liver cirrhosis. (Gut Liver 2021;15:109-116)