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이중 봉합기 술식 후 문합부 출혈에 대한 단계별 보존적 치료 성적
김혁문,신응진,송옥평,김재준,장용석,박내경,백무준 대한대장항문학회 2005 Annals of Coloproctolgy Vol.21 No.6
Purpose: This study reviews our experience with a step- by-step management approach of increasing aggressiveness and evaluates the treatment outcome for intraluminal hemorrhage. Methods: The study group was comprised of patients who had experienced intraluminal hemorrhage after a low anterior resection with the double stapling technique from 1999 to 2003. The choice of management was selected according to our step-by-step management protocol, and the outcomes were evaluated for each step, lincluding mortality and complications. Results: Nine patients (6 males and 3 females, mean age 55 years) were identified, the mean volume of packed RBC transfusion was 2 pints, and the mean distance of the anastomotic site from the anal verge was 6 cm. The median stapler size was 31 mm. The first step was cold saline irrigation and drainage; four of 9 patients were controlled. The second step was retention enema with topical hemostatics; one of remaining 5 patients stopped bleeding. The third step was colonoscopic hypertonic saline injection around the bleeding site with direct colonoscopic electrocauterization, two of remaining 4 patients were controlled. The last step was suturing the bleeding site through the anus, the remaining 2 patients stopped bleeding. One of the 9 patients developed leakage from the anastomotic site after the last step management, three of the 9 patients had long standing ileus, and one of the 9 patients developed acute renal failure after a massive transfusion. There were no postoperative deaths. Conclusions: It is safer and easier to control bleeding with step-by-step management system of increasing aggressiveness.
김혁문,송옥평,김종민 한국유방암학회 2017 Journal of Breast Disease Vol.5 No.1
Granular cell tumor (GCT) of the breast is a rare neoplasm that is usually benign in nature. The results of physical examination and ultrasonographic findings of GCT of the breast often mimic those of other malignancies. A 46-year-old woman underwent wide excision for removal of a large mass in the left breast (about 10 cm in diameter). The pathologic finding of the excised mass was benign GCT. A year after initial surgery, recurrence of the left breast mass was found along with a newly developed mass in the contralateral right breast, which was excised. In this study, we describe the case of a newly developed GCT in the contralateral breast 1 year after excision of a larger breast GCT.
대계 추출물의 할성산소 소거능 및 Cytochrome P450 효소 저해효과
김혁,이효승,박원환,문진영,Kim, Hyuck,Yi, Hyo-Seung,Park, Won-Hwan,Moon, Jin-Young 대한본초학회 2007 大韓本草學會誌 Vol.22 No.1
Objectives: Our previous studies have clearly demonstrated that the scavenging activity of reactive oxygen species (ROS), protective effect of lipid peroxidation (LPO), and inhibition of cytochrome P450 isozymes (CYPs) from the Circium japonicum aqua-acupuncture solution (CJAS). But, Circium japonicum water extracted solution (CJWS) was weakly reported in cardiovascular diseases such as oxidative stress-mediated atherosclerosis or its value evaluated. Methods: CJWS was assessed to determine the mechanism of its scavenging activity of ROS and inhibitory effect of CYP 2E1. Results: CJWS exhibited a concentration-dependent scavenger of DPPH and superoxide anions radicals using different assay systems. In addition, CJWS showed dose-dependent free radical scavenging activity, including hydroxyl radicals, peroxynitrite, and nitric oxide. The CJWS was also found to be effective in protecting rat liver homogenate against LPO. Futhermore, the CJWS showed significant inhibition of CYP 2E1 induced by pyrazol in a rat liver microsome. Conclusion : ROS and CYPs may play a role in several diseases, such as cardiovascular disease and heart failure. Our study demonstrated that the CJWS has excellent scavenging activity of ROS. Hence, it is worthwhile to investigate the potential effectiveness of CJWS in preventing oxidative stress-mediated cardiovascular diseases.
大? 藥鍼液의 지질과산화 및 CYP 억제에 미치는 影響
이정주,김혁,문진영,박원환,이효승 경락경혈학회 2006 Korean Journal of Acupuncture Vol.23 No.4
목적 : 藥鍼液의 지질과산화 예방 및 cytochrome P450과의 상호 작용에 있어서 大의 역할은 과거 연구가 거의 없었다. 따라서 본 실험에서는 大 藥鍼液이 지질과산화를 예방하고, 심혈관계질환 유발에 밀접한 연관이 있는 cytochrome P450의 직접적인 저해 효과를 검토 하고자 한다.방법 : 大 藥鍼液이 지질과산화를 억제하는 정도를 평가하기 위하여 세포막을 구성하는 불포화지방산의 일종인 linoleic acid를 대상으로 지질과산화 진행 시간과 大 藥鍼液의 농도에 의존적인 저해 효과를 실험 하였다. 또한 실험쥐의 간조직을 이용하여, 강제적인 과산화를 유도한 후 이를 방어하는 효능을 검토하였다. 그리고 cytochrome P450을 구성하는 그룹의 1A1, 1A2 및 2E1의 활성을 각각 EROD, MROD, p-nitrophenol, aniline 방법으로 측정하였다. 결과 및 결론 : 大 藥鍼液은 세포막 구성의 불포화 지방산인 linoleic acid의 산화를 시간 및 처리 농도에 의존적으로 억제하였고, 실험쥐의 조직 과산화를 유의성 있게 저해하였다. 또한 aryl hydrocarbon receptor (AHR)을 활성화 시켜 polycyclic aromatic hydrocarbons (PAHs)에 의한 심혈관계 질환 유발 인자로 알려진 cytochrome P450 1A1 및 1A2의 발현을 일부 저해 하였으며, 특히 체내에 흡수된 알콜 대사에 관여하는 P450 2E1을 강하게 억제 시켰다.
한국 유방암 환자에서 TAC 보조항암화학요법의 독성 및 내성에 대한 연구
우희두,김형수,이지현,김혁문,한선욱,김성용,임철완,이민혁 한국유방암학회 2011 Journal of breast cancer Vol.14 No.-
Purpose: Recent randomized phase III trial by the Breast Cancer International Research Group (BCIRG 001) showed that docetaxel plus doxorubicin and cyclophosphamide (TAC) is superior to fluorouracil plus doxorubicin and cyclophosphamide (FAC) as adjuvant chemotherapy for node-positive operable breast cancer. Unfortunately, TAC was clearly more toxic than FAC not only with respect to neutropenic fever events, but also with respect to many extrahematological side effects. The aim of this study was to evaluate the toxicity and tolerability of Korean patients with breast cancer treated with TAC. Methods: This study was conducted on 80 patients with breast cancer who underwent primary surgery at the Department of Surgery in Soonchunhyang University (4 affiliated hospitals) from October 2005 to October 2008. The patients received 480 courses consisting of TAC (75/50/500 mg/㎡, every 3 weeks for 6 cycles) without prophylactic granulocyte colony-stimulating factor (G-CSF). Toxicity was graded according to the National Cancer Institute Common Toxicity Criteria version 3.0. Results: The main toxicities were hematologic (neutropenia grade 3/4 in 98.8% of patients and 92.3% of cycles; febrile neutropenia in 42.5% of patients and 16.0% of cycles). No cases of septic death occurred. The peak time of occurrence for febrile neutropenia was 7-10 days after receiving chemotherapy (mean duration, 2.05 days). Severe nonhematologic adverse events were as follows: myalgia (30.0%), neurotoxicity (17.5%), fatigue (16.3%), stomatitis (12.5%), and nausea (11.3%). Conclusion: An adjuvant TAC regimen without prophylactic G-CSF was tolerable in Korean patients with breast cancer. Although most of the patients developed neutropenia, the nonhematologic toxicities (cardiac toxicity) were tolerable. Further studies on prophylactic G-CSF use to assess the contribution to reduced hematologic toxicities are required in Korean patients with breast cancer.
포도근 약침액이 LPO, RNS 및 Cytochrome P450에 미치는 효과
임성철 ( Seong Cheorl Lim ),김혁 ( Hyuck Kim ),이효승 ( Hyo Seung Yi ),박원환 ( Won Hwan Park ),문진영 ( Jin Young Moon ) 대한경락경혈학회 2007 Korean Journal of Acupuncture Vol.24 No.1
Objectives: In this study, we determinated protective effects of Vitis labrusca Root herbal-acupuncture solution (VLHA) against atherosclerosis and cardiovascular disease induced by oxidative damage and cytochrome P450 (CYP) induction. Methods: Antioxidant capacity of VLHA were evaluated by the β-carotene/linoleic acid emulsion system and FeCl2-ascorbic acid stimulated lipid peroxidation in rat liver homogenate, respectively. Scavenging effects of VLHA on ONOO- and NO were measured by DHR 123, DAF-2 assay. Furthermore, we measured inhibitory activity of VLHA on CYP 2E1 in rat liver microsome using by Aniline assay. Results: VLHA exhibited potent inhibition rate(74%) on FeCl2-ascorbic acid induced lipid peroxidation, and revealed a strong scavenging effects on ONOO- and NO. In addition, VLHA showed inhibitory effect on CYP 2E1. Conclusions: The present study concludes that our results suggest that VLHA could be used as a good source in the prevention of atherosclerosis and alcoholic liver injury.