膀胱의 單臟器成 Shwartzman反應에 관한 超微形態學的 硏究

권민아,장세국,서인수,손태중 慶北大學校 醫科大學 1990 慶北醫大誌 Vol.31 No.4

본 연구는 감염성 방광염의 성립의 조건으로 Shwartzman반응의 기전이 참여할 것인가를 검토하고, 방광의 단장기성 Shwartzman반응에서 초기의 형태적 변화를 알아보기 위하여 시도하였다. 실험은 백색 암컷 가토를 실험동물로 하여 방광내에 내독소를 주입하고 24시간후에 정맥내로 같은 내독소를 주사하여 야기조작 15및 30분, 1, 2 및 4시간후에 방광을 적출하여 육안, 광학, 주사전자 및 투과 전자현미경으로 관찰하였던 바 그 성적을 요약하면 다음과 같다. 광학 현미경으로는 반응의 초기부터 표재세포가 호산성 덩어리로의 변성 및 괴사 탈락이 나타나고, 중간세포 및 기저세포는 야기조작 수시간 후부터 공포성 변성을 보이고, 같은 시기에 상피하 미소혈관은 울혈 및 주변 조직의 부종을 보이고, 호중구의 침윤도 관찰되었다. 주사 전자현미경으로는 표재세포 표면의 microridge의 blurring과 표면구조의 편평화 및 세포간 결합장치의 이완등을 초기에서 부터 볼 수 있었고, 수시간이 지난 후에는 군데군데에서 상피의 괴사 탈락이 관찰되었다. 투과 전자현미경으로는 포재세포의 apoptosis를 초기에서부터 볼 수 있었고, 수시간 후에는 상피층 전층의 괴사까지 관찰되었고, 기저세포에는 autophage가 증가된 것이 관찰되었다. 가장 특징적 변화는 상피직하 점막하층 미소혈관계의 변화로 반응의 초기에서부터 내피세포의 종창등의 상해성 변화를 보였고, 수시간후에는 혈소판의 응집과 호중구의 변연화 및 유주등을 관찰할 수 있었다. 이상의 성적으로 보아 방광염의 성립에 Shwartzman반응의 기전이 참여할 수 있는 것으로 생각되며, 방광의 단장기성 Shwartzman반응의 주된 반응을 하는 장소는 상피직하부의 미소혈관계인 것으로 사료된다. This study was carried out to investigate the possible role of Shwartzman reaction in the development of the cystitis and the morphologic changes in early stage of the reaction. Endotoxin extracted from E. coli was injecting same endotoxin via ear vein, 24 hours after first infection. Animals were sacrificed 15 and 30 minutes, and 1, 2 and 4 hours after the last injection. The Urinary bladders were extracted out and examined with the light, transmision electron, and scanning electron microscopes. The results obtained were summarized as follows: Ligth microscopy showed eosinophilic degradation, necrosis and detachment of the superficial cells within 1 hour after provocation treatment. Intermediate and basal cells also showed swelling after few hours. Subepithelial microvasculatures showed congestion with perivascular edema and neutrophilic infiltration from the early stages. Scanning electron microscopy dischlosed blurring of microridge structures on superficial cells with loosening of the intercellular junction from early stage. Necrosis and detachment of epithelial cells were noted in several areas after few hours, only remaining basement membranes. Transmission electron microscopy showed apoptosis of the superficial cells, with partial necrosis through total thickness of the epithelial layer after several hours. Many autophagic vacuoles were found in basal cells. Characteristic vascular change was noted in the microvasculatures on the submucosa, consisting of swelling and archade formation of the endothelial cells with platelet aggregation, and margination and emigration of neutrophils. The results suggest that Shwartzman reaction could be participated on the development of cystitis, and subepithelial small vessels were the main focus of the reaction.

Clomiphene citrate에 의한 배란유도 후의 임신율에 관한 연구

임춘근,이민용,권경익,박세출,이두룡,남동호,양숙경 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

From March 1990 to February 1993, we evaluated completely follow-uped 68 cases of amenorrhea, oligomenorrhea, infertility(anovulation). The ratio of primary to secondary is 31: 37. Ovulation rate and pregnancy rate of 68 cases which were completely treated with clomphene citrate is 72%, 71.8% respectively. Among these 23 pregnat cases, 19 cases were full term delivered, 1 case is ongoing pregnant, and 3 cases were spontaneously aborted. No one of multiple pregnancy and congenital abnormality was noted.

Efficacy of Selective Nerve Root Block as a Diagnostic Tool in Radiculopathic Patients

Kwon Sae Min,Hyoung-Joon Chun 대한말초신경학회 2018 The Nerve Vol.4 No.2

Objective Selective nerve root block (SNRB) is used for the diagnosis and treatment of different spinal disorders. However, the effectiveness of SNRB as a diagnostic tool is unclear. In this study, the efficacy of SNRB as a diagnostic tool for lumbar radiculopathy was evaluated. Methods A total of 154 patients who underwent surgery for degenerative lumbar spine disease between March 2009 and February 2016 were enrolled in the present study. Patients were divided into two groups (with or without preoperative SNRB). The postoperative outcomes were evaluated using Odom’s criteria at 30 days after surgery. Clinical and radiological findings were compared between the two groups. Results Among the 154 patients, 52 (33.8%) were included in the SNRB group. The patients in the SNRB group tended to have improved outcomes after surgery compared with those in the non-SNRB group (p=0.077). In addition, the proportion of patients with favorable outcomes was significantly greater in the SNRB group (88.5% vs. 72.5%, p=0.041). Conclusion SNRB is an excellent diagnostic tool for evaluating spinal disorders with radicular pain.

Risk Factors for Developing Large Emboli Following Carotid Artery Stenting

Kwon, Sae Min,Cheong, Jin Hwan,Lee, Sang Kook,Park, Dong Woo,Kim, Jae Min,Kim, Choong Hyun The Korean Neurosurgical Society 2013 Journal of Korean neurosurgical society Vol.53 No.3

Objective : The introduction and development of the embolic protecting device (EPD) has resulted in a decreased rate of stroke after carotid artery stenting (CAS). The authors performed a retrospective study to investigate the risk factors for developing large emboli after CAS which can lead to ischemic events. Methods : A total of 35 consecutive patients who underwent CAS between January 2009 and March 2012 were included in this study. Patients were divided into two groups including those with small emboli (group A; grade 1, 2) and those with large emboli (group B; grade 3, 4). The size and number of emboli were assigned one of four grades (1=no clots, 2=1 or 2 small clots, 3=more than 3 small clots, 4=large clots) by microscopic observation of the EPD after CAS. We compared demographic characteristics, medical history, and angiographic findings of each group. Results : Thirty-five patients underwent CAS, and technical success was achieved in all cases. Twenty-three patients were included in group A and 12 patients in group B. Our results demonstrated that advanced age [odds ratio (OR) 1.24; 95% confidence interval (CI) 1.01-1.52; p=0.044] and smoking (OR 42.06; CI 2.828-625.65, p=0.006) were independent risk factors for developing large emboli after CAS. Conclusion : In patients with carotid artery stenosis treated with CAS, advanced age and smoking increased the number and size of emboli. Although use of an EPD is controversial, it may be useful in CAS in patients with risk factors for large emboli in order to reduce the risk of ischemic events.

External Morphology and Distribution of Antennal Sensilla of Aphidius colemani (Hymenoptera: Braconidae)

Kwon Hye Ri,Kyu Sik Yoon,Min Ah Kang,Min Woo Park,Shin Hyuk Jo,Shin Hyo Seob,Sae Hee Kim,Eun Jin Kang,Mi Ja Seo,Yong Man Yu,Young Nam Youn 한국응용곤충학회 2010 한국응용곤충학회 학술대회논문집 Vol.2010 No.10

Several species of the genus Aphidius are used in biological control programs against aphid pests throughout the world and their behavior and physiology are well studied. But despite knowing the importance of sensory organs in their behavior, their antennal structure is largely unknown. In this study, the external morphology and distribution of the antennal sensilla on the antennal of both female and male adults of A. colemani were described using scanning electron microscopy (SEM). Generally, the filaform antennae of males (1,515.20±116.48 ㎛) are longer than females (1,275.06±116.42㎛). Antennae of this species is made up of scape, pedicel and flagellomeres. Male and female antennae differed in the total number of flagellomeres as 15 in males and 13 in females. Female and male antennae of A. colemani has samely seven types of sensilla. We classified sensilla placodea, Bohm bristles, 2 types of sensilla coeloconica, , 2 types of sensilla basiconica as with a tip pore and with wall pores, sensilla trichodea. In addition, the possible functions of the above sensilla types are discussed in light of previously published literature; mechanoreception(Bohm bristles, sensilla coeloconicaⅡ and sensilla trichodea) and chemoreception(sensilla coeloconicaⅠ, sensilla basiconicaⅠ,Ⅱ and sensilla placodea). Future studies on the functional morphology of the antennal sensilla of A. colemani using transmission electron microscopy (TEM) coupled with electrophysiological recordings will likely confirm the functions of the different sensilla identified in this study.

Correlation between the Korean Version of Asthma Control Test and Health-Related Quality of Life in Adult Asthmatics

Kwon, Hyouk-Soo,Lee, So-Hee,Yang, Min-Suk,Lee, Sang-Min,Kim, Sae-Hoon,Kim, Deok-In,Sohn, Seong-Wook,Park, Chang-Han,Park, Heung-Woo,Kim, Sun-Sin,Cho, Sang-Heon,Min, Kyung-Up,Kim, You-Young,Chang, Yoon The Korean Academy of Medical Sciences 2008 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.23 No.4

<P>The Asthma Control Test (ACT) is a patient-completed questionnaire developed to assess asthma control. Health-related quality of life (HRQL) in asthmatics has shown relatively low correlations with parameters of asthma control and the relationship between the ACT and HRQL in asthmatics is yet unclear. Because revalidations of translated versions of questionnaires are critical for its utilization, we first sought to validate the Korean version of ACT and then to evaluate the relationship between the ACT and HRQL. Patients (n=117) completed the ACT and asthma-related quality of life questionnaire (AQLQ) at 3 physician visits. Pulmonary function was measured and an asthma specialist rated asthma control. The Korean version of ACT was found to be reliable, valid, and responsive to changes in asthma control over time up to three consecutive visits. ACT scores correlated significantly (<I>p</I>=0.001) with symptoms domain (r=0.72), activity domain (r=0.65), emotional domain (r=0.69), and environmental domain (r=0.67) of AQLQ. In conclusion, the Korean version of the ACT was found to be a reliable and valid tool for measuring asthma control, and to correlate well with AQLQ scores. Moreover, the ACT was responsive to changes in AQLQ scores over time.</P>

Reperfusion Injury after Autologous Cranioplasty in a Patient with Sinking Skin Flap Syndrome

Kwon, Sae-Min,Cheong, Jin-Hwan,Kim, Jae-Min,Kim, Choong-Hyun The Korean Neurosurgical Society 2012 Journal of Korean neurosurgical society Vol.51 No.2

The sinking skin flap syndrome is a rare complication after a large craniectomy. It consists of a sunken skin above the bone defect with neurological symptoms such as severe headache, mental changes, focal deficits, or seizures. In patient with sinking skin flap syndrome, cerebral blood flow and cerebral metabolism are decreased by sinking skin flap syndrome, and it may cause the deterioration of autoregulation of brain. We report a case of a patient with sinking skin flap syndrome who suffered from reperfusion injury after cranioplasty with review of pertinent literature.

Clinical Implications of the Mitotic Index as a Predictive Factor for Malignant Transformation of Atypical Meningiomas

Sae Min Kwon,Jeong Hoon Kim,Young-Hoon Kim,Seok Ho Hong,Young Hyun Cho,Chang Jin Kim,Soo Jeong Nam 대한신경외과학회 2022 Journal of Korean neurosurgical society Vol.65 No.2

Objective : Intracranial atypical meningiomas have a poor prognosis and high rates of recurrence. Moreover, up to one-third of the recurrences undergo high-grade transformation into malignant meningiomas. We aimed to investigate the clinical factors that can predict the propensity of malignant transformation from atypical to anaplastic meningiomas. Methods : Between 2001 and 2018, all patients with atypical meningioma, in whom the tumors had undergone malignant transformation to anaplastic meningioma, were included. The patients’ medical records documenting the diagnosis of atypical meningioma prior to malignant transformation were reviewed to identify the predictors of transformation. The control group comprised 56 patients with atypical meningiomas who were first diagnosed between January 2017 and December 2018 and had no malignant transformation. Results : Nine patients in whom the atypical meningiomas underwent malignant transformation were included. The median time interval from diagnosis of atypical meningioma to malignant transformation was 19 months (range, 7–78). The study group showed a significant difference in heterogeneous enhancement (77.8% vs. 33.9%), bone invasion (55.6% vs. 12.5%), mitotic index (MI; 14.8±4.9 vs. 3.5±3.9), and Ki-67 index (20.7±13.9 vs. 9.5±7.1) compared with the control group. In multivariate analysis, increased MI (odds ratio, 1.436; 95% confidence interval, 1.127–1.900; p=0.004) was the only significant factor for predicting malignant transformation. Conclusion : An increased MI within atypical meningiomas might be used as a predictor of malignant transformation. Tumors at high risk for malignant transformation might require more attentive surveillance and management than other atypical meningiomas.

Evaluation of Stent Apposition in the LVIS Blue Stent-Assisted Coiling of Distal Internal Carotid Artery Aneurysms : Correlation with Clinical and Angiographic Outcomes

Kwon, Min-Yong,Ko, Young San,Kwon, Sae Min,Kim, Chang-Hyun,Lee, Chang-Young The Korean Neurosurgical Society 2022 Journal of Korean neurosurgical society Vol.65 No.6

Objective : To evaluate the stent apposition of a low-profile visualized intraluminal support (LVIS) device in distal internal carotid artery (ICA) aneurysms, examine its correlation with clinical and angiographic outcomes, and determine the predictive factors of ischemic adverse events (IAEs) related to stent-assisted coiling. Methods : We retrospectively analyzed a prospectively maintained database of 183 patients between January 2017 and February 2020. The carotid siphon from the cavernous ICA to the ICA terminus was divided into posterior, anterior, and superior bends. The anterior bends were categorized into angled (V) and non-angled (C, U, and S) types depending on the morphology and measured angles. Complete stent apposition (CSA) and incomplete stent apposition (ISA) were evaluated using unsubtracted angiography and flat-panel detector computed tomography. Dual antiplatelet therapy with aspirin 200 mg and clopidogrel 75 mg was administered. Clopidogrel resistance was defined as fewer responders (≥10%, <40%) and non-responders (<10%) based on the percent inhibition (%INH) of the VerifyNow system. These were counteracted by a dose escalation to 150 mg for fewer responders or substitution with cilostazol 200 mg for non-responders. IAEs included intraoperative in-stent thrombosis, transient ischemic attack, cerebral infarction, and delayed in-stent stenosis. A multivariate logistic regression analysis was used to determine the predictive factors for ISA and IAEs. Results : There were 33 ISAs (18.0%) and 27 IAEs (14.8%). The anterior bend angle was narrower in ISA (-4.16°±25.18°) than in CSA (23.52°±23.13°) (p<0.001). The V- and S-types were independently correlated with the ISA (p<0.001). However, treatment outcomes, including IAEs (15.3% vs. 12.1%), aneurysmal complete occlusion (91.3% vs. 88.6%), and recanalization (none of them), did not differ between CSA and ISA (p>0.05). The %INH of 27 IAEs (13.78%±14.78%) was significantly lower than that of 156 non-IAEs (26.82%±20.23%) (p<0.001). Non-responders to clopidogrel were the only significant predictive factor for IAEs (p=0.001). Conclusion : The angled and tortuous anatomical peculiarity of the carotid siphon caused ISA of the LVIS device; however, it did not affect clinical and angiographic outcomes, while the non-responders to clopidogrel affected the IAEs related to stent-assisted coiling.

The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Recommendation Using the Delphi Method (Version 2023.1)

( Min-sung Kim ),( Se-il Go ),( Chan Woo Wee ),( Min Ho Lee ),( Seok-gu Kang ),( Kyeong-o Go ),( Sae Min Kwon ),( Woohyun Kim ),( Yun-sik Dho ),( Sung-hye Park ),( Youngbeom Seo ),( Sang Woo Song ),( 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2023 Brain Tumor Research and Treatment Vol.11 No.2

Background During the coronavirus disease 2019 (COVID-19) pandemic, the need for appropriate treatment guidelines for patients with brain tumors was indispensable due to the lack and limitations of medical resources. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, has undertaken efforts to develop a guideline that is tailored to the domestic situation and that can be used in similar crisis situations in the future. Methods The KSNO Guideline Working Group was composed of 22 multidisciplinary experts on neuro-oncology in Korea. In order to reach consensus among the experts, the Delphi method was used to build up the final recommendations. Results All participating experts completed the series of surveys, and the results of final survey were used to draft the current consensus recommendations. Priority levels of surgery and radiotherapy during crises were proposed using appropriate time window-based criteria for management outcome. The highest priority for surgery is assigned to patients who are life-threatening or have a risk of significant impact on a patient’s prognosis unless immediate intervention is given within 24-48 hours. As for the radiotherapy, patients who are at risk of compromising their overall survival or neurological status within 4-6 weeks are assigned to the highest priority. Curative-intent chemotherapy has the highest priority, followed by neoadjuvant/adjuvant and palliative chemotherapy during a crisis period. Telemedicine should be actively considered as a management tool for brain tumor patients during the mass infection crises such as the COVID-19 pandemic. Conclusion It is crucial that adequate medical care for patients with brain tumors is maintained and provided, even during times of crisis. This guideline will serve as a valuable resource, assisting in the delivery of treatment to brain tumor patients in the event of any future crisis.