백서의 복강내에 투여한 Mitomycin-C-Polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

송규상,강대영,최정목,노승무,정경수,오정연,김진향,양준목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

To evaluate the in-vivo effects of mitomycin-C-polyglycolic acid composite(MMC-PGA) the disk: shaped composite were implanted into the peritoneal cavity of the Sprague-Dawley rats. The pathologic changes were examined at various time points up to 12 weeks. Initially the soft tissue around the inserted disks showed capillary congestion at 3 days. Inflammatory infiltrates with foreign body giant cells appeared from the 2nd week and reached peak response at 6-8 weeks. These reaction diminished prominently at 12 weeks. No specific pathologic change was found in the liver, the kidneys, and the heart. The above results suggest that the MMC-PGA composite can serve as a new device for intraperitoneal chemotherapy of various types of cancers.

조혈모세포이식환자에서 조혈기능의 회복과 관련된 인자들에 관한 연구

정기주,강명수,권기두,김경하,이상철,김현정,배상병,김찬규,이남수,이규택,원종호,홍대식,박희숙 순천향대학교 의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.1

..

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

大腸癌의 東西醫學的 比較硏究

김정범,안규석 대한동의병리학회 1995 동의생리병리학회지 Vol.9 No.2

연구배경 : 飮食 및 生活上의 變化로 疾病에서도 각종 成人病과 腫瘍 疾患이 增加되고 있는데, 특히 腫瘍發生의 頻度는 최근 50년간 급격히 增加하여 癌은 國內의 경우 死亡 原因의 제 1위를 차지하고 있다. 이에 최근 들어 발생률이 날로 증가되고 있는 大腸癌에 대하여 基礎가 되는 槪念과 理論을 整理하여 한의학의 임상 활용에 도움이 되고 ,동ㆍ서 의학 협력 일환의 모형을 제시하고자 함 방법 : 歷代文獻에서의 大腸癌에 대한 認識과 最近 중국에서의 中西醫結合에 의한 腫瘍治療의 成果를 東西醫學比較의 측면에서 검토함 결과 : 大腸癌에 있어서 結腸癌은 한의학에서의 腸風下血, 腸腸癌은 臟毒, 肛門癌은 結陰에 상응하는 것으로 사려되며 分型은 東醫學에서는 證에 依據하여 濕熱蘊毒型, 脾虛蘊濕型, 脾腎陽虛型, 肝腎陰虛型, 氣血兩虛型으로 나누어지며, 西醫學에서는 解剖組織學的인 부위에 따라 듀크스 病機 혹은 結腸癌, 直腸癌, 肛門癌 등으로 나누어진다. 治法은 동의학에서는 부정배본등의 內治法과 灌注法을 활용하며 治方은 辨證에 따라 選用하여 隨症加減하고 있으며, 西醫學에서는 外料的手術을 통한 病巢除法를 우선으로 放射線療法ㆍ化學療法ㆍ 免疫療法 및 倂用療法을 使用하고 있다. 결론 : 東西兩者의 結合이 더욱 우수한 治療效果를 發揮할 수 있음을 인정할 수 있다. Through comparative study between east and west medicine on causes, symptoms, classifications, treatment, and others of the colorectal cancer, the results are obstained as follwing; 1. In the causes of colorectal cancer; we have emphasis on spirit and internal factor of our body in the east medicine, so we regard that the disease occurs because of invasion of the evil on the basis of Chi Weakness(正氣虛). On the other side they regard all sorts of carcinogen as of great importance in the west medicine. 2. In the classifications of colorectal cancer ; we classify the colorectal cancer into 5 types according to pattern(證) in the east medicine, they are ① Dampness and Heat Accumulation Type(濕熱蘊毒型), ② Dampness Accumulation according to Spleen Weakness Type (脾虛濕熱型), ③ Yang Weakness of Spleen and Kidney Type (脾腎陽虛), ④ Yin Weakness of Liver and Kidney Type(肝腎陰虛), and ⑤ Both Weakness of Chi and Blood Type (氣血兩虛), On the other side they classify colorectal cancer into Dukes' classfication or anatomical classification which are colon cancer, rectum cancer, and anus cancer in the west medicine. 3. As for treatment of colorectal cancer ; the therapies in the east medicine are inner treatment methods(內治法) which are Encourage and Strengthen Chi(扶正培本), Stimulation of Blood Circulation and Removing Extravasated Blood(活血化瘀), and Removal of Fever and Detoxification(淸熱解毒), and the other method is Rectum Irrigation. And prescription is made according to Pattern Identification(辨證). On the other side, in the west medicine, operation is the prime object and the other methods are radiotherapy, chemotherapy, immunotherapy, and combined therapy. But we can recognize that combination of East and West Medicine is more effective than one sided medicine in the treatment. 4. In the colorectal cancer, I consider that ① colon cancer in the west medicine corresponds to Intestine Wind Melena(腸風下血) in the east medicine, ② rectum eancer to Viscera Poison(臟毒), and ③ anus cancer to Accumulation of Yin (結陰).

위 전암성 병변에 대한 내시경적 추적 관찰

김규종,박선자,남지현,임현정,김지연,박무인,구자영 고신대학교 의학부 2005 高神大學校 醫學部 論文集 Vol.20 No.1

Background: The aims of this study were to investigate the endoscopic findings of precancerous lesions of stomach and to see whether or not these lesions could progress to the carcinoma. Method: May 2000 to February 2001, consecutive patients diagnosed as having chronic active gastrits (CAG), intestinal metaplasia (IM), dysplasia, adenoma by endoscopic biopsy were enrolled. A total of 359 patients were included in this study and endoscopically followed-up to Autust 2001. Results; Among all 33 patients (26 dysplasia, 7 dysplasia with adenoma) diagnosed as dysplasia by endoscopic biopsy, there were 6 chronic erosive gastritis (CEG), 6 chronic erosion, 17 adenoma, 4 R/O cancer. On follow-up endoscopic biopsy (17 patients), there were 3 IM, 4 dysplasia, 5 adenoma, 5 carcinoma. Among all 107 patients (53 IM, 38 IM with CAG, 14 IM with CEG, 1 IM with adenoma, 1 IM with dysplasia) diagnosed as IM by endoscopic biopsy, there were 52 CEG, 33 chronic erosion, 6 local lesion, 5 adenoma, 5 R/O cancer, 3 gastric polyp, 3 atrophy with IM> On follow-up endoscopic biopsy (25 patients), there were 2 chronic gastritis, 1 CEG, 3 CAG, 14 IM 3 dysplasia, 2 adenoma, 1 carcinoma. Among all 185 patients (147 CAG, 37 CAG with IM, 1 CAG with adenoma) diagnosed as CAG by endoscopic biopsy, there were 86 CEG, 62 chronic erosion, 4 local lesion, 10 adenoma, 16 R/O cancer, 4 gastric polyp, 2 IM, 1 chronic gastritis. On follow-up endoscopic biopsy (35 patients), there were 8 chronic gastritis, 3 CEG, 14 CAG, 5 IM, 2 dysplasia, 1 adenoma, 2 arcinoma. Among All 34 patiets (22 adenoma, 8 adenoma with low grade dysplasia, 2 adenoma with moderate grade dysplasia, 2 adenoma with high grade dysplasia) diagnosed as gastric adenoma by endoscopic biospy, there were 1 local lesion, 24 adenoma, 2 R/O cancer, 7 gastric polyp. On follow-up endoscopic biopsy (17 patients), there were 2 CEG, 2 low grade dysplasia, 1 high grade dysplasia, 4 adenoma 1 adenoma with dysplasia, 4 adenoma with low grade dysplasia, 2 adenoma with high grade dysplasia, I cancerous change. Conclusions: Althought it was short period, there were some of cancerous change in precancerous lesions at follow-up endoscopy. This study suggests that screening for precancerous lesions, is one method of improving the prognosis of gastric carcinoma and when the precancerous lesions are diagnosed on endoscopy, serial endoscopic follow-up should be done to find early gastric cancer.

응급센터에서 기관내 삽관을 시행하지 않은 호흡곤란 환자의 동맥혈 이산화탄소분압과 호기말 이산화탄소분압의 연관성분석

김형국,박승현,오동렬,박규남,이원재,황두영,최승필,이운정,정시경,김세경 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background: The end-tidal carbon dioxide tension(ETCO₂) is defined as a partial pressure of carbon dioxide at the end of an exhaled breath. The purpose of this study is to determine the correlation between ETCO₂and arterial carbon dioxide tension(PaO₂) in nonintubated patients with respiratory distress in emergency department(ED). Methods: A prospective non-blind study was performed in ED of our university hospitals. Participants included all nonintubated adult patients with respiratory distress requiring arterial blood gas analysis. ETCO₂was measured with a capnography monitor during tidal volume breathing. ETCO₂were recoreded at the time of arterial blood gas sampling. The correlation between ETCO₂and PaCO₂was analyzed in all patients and in subgroups by simple linear regression. Results: Sixty patients were enrolled. In all patients, ETCO₂was 5.72mmHg lower than PaCO₂and correlated well with PaCO₂(r²=0.716). ETCO₂correlated best with PaCO₂in patients who were either acidotic or non-smoking. Conclusion: ETCO₂correlate well with PaCO₂in nonintubated patients with respiratory distress in ED. ETCO₂may be sufficient to reflect PaCO₂in selected patients and obviate the need for repeat arterial blood gas determination.

백반증의 PUVA치료반응에 관한 연구(제1보)

박장규,성열훈,성범진,김영호,이증훈 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

The authors evaluated response to PUVA therapy in 44 vitiligo petients who did'nt show the spontaneous re-pigmentation. In the responded group to PUVA therapy after systemic administration of 8-methoxy psoralen, average MPD of female patients was 3.4 times higher than males, interestingly. Number of irradiation of UVA was similar between male and female, but total doses of female patients group were about 2 times than males till the first re-pigmented spots were noted. The response to PUVA therapy was quite different according to duration of disease and site of lesion. Therefore, we suppose that it is necessary to consider sex of patient, duration of disease, location of vitiligo before making a plan of PUVA therapy.

여드름양 발진에서의 말라쎄지아 포자 검출 빈도에 관한 연구

박장규,이웅재,김연수,서영준,김경호,이증훈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

Steroid acne and pityrosporum folliculitis have similar clinical manifestations. So it was not casy to do differential diagnosis of these two diseases. We have tried to find out the different points between these diseases in clinical characteristics, positive rate of the malassezia spores, and their response to antifungal agents. We studied 21 patients with acneiform eruptions which were distinct from acne vulgaris. Patients were divided into two groups by steroid treatment history. Among 21 patients, 6 were administered steroid just before eruption and 15 were free from steroid within 6 months. We have examined malassezia spores with 10% KOH/Parker blue black ink mount from papules, pustules and comedones according to the patients skin lesions. The malassezia spores detected in 5 paticnts(83.3%) in the former and 9 patients(60%) in the latter. In malassezia folliculitis, the frequency of which showed above the (3+) score of malassezia spore under microscopy was higher than in steroid acne. Mean duration of the disease was 70.4 weeks in latter group, which was longer than 5.2 weeks of the former group. And there were some differences between two groups in the distribution of the lesions. Mean treatment duration was same in two groups (4 wks, 3.5 wks). Steroid acne patients would be treated better with antifungal agents than with acne regimens.

월남전 당시 살포된 고엽제에 의해 발생한 것으로 생각되는 피부 질환

이증훈,김윤동,서기범,박장규 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

Although many dermatologists need adequate information about Agent Orange-related skin lesions, there have been few researches about them. We observed various skin manisfestations from 266 Korean Vietnam veterans who visited Department of Dermatology, Chungnam National University Hospital, inculding seborrheic dermatitis(46%), xerotic eczema(45%), chloracne(30%), generalized pruritus (10%), dermographism (5%), chronic urticaria (4%), photosensitive dermatitis (3%), etc. Among them chloracne is well known as a disease which results from exposure to Agent Orange which was used for a defoliating agent during Vietnam war. It is a refractory acneiform eruption due to halogenated polyaromatic compounds(eg. dioxin, dibenzofurane, polychlorinated biphenyls, etc.). 2,3,7,8-tetrachlorodibenzo-p-dioxin, a kind of dioxin isomer, contained in the Agent Orange which was used for a defoliating agent during Vietnam war. It is characterized by recalcitrant comedones and cysts predominantly in the malar and postauricular area. We concluded that the various skin lesions in Vietnam veterans resulted from probably the chemicals in defoliant and further researches would be required to find out subjective guidelines for the evaluation of the skin lesions.