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자궁내막암에서 CD44v6의 발현과 임상병리학적 예후인자와의 상관성
신병섭 ( Byung Sub Shin ),정재혁 ( Jae Heok Jeong ),정은주 ( En Ju Jeong ),조무성 ( Mu Sung Joo ),박승섭 ( Seung Seop Park ),김기형 ( Ki Hyung Kim ),윤만수 ( Man Soo Yoon ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.9
목적 : 병리조직검사로 확진된 자궁내막암 환자에서 CD44v6의 임상적 유용성을 알아보고자 본 연구를 시행하였다. 연구 방법 : 전자궁적출술과 양측 자궁부속기 절제술이 시행된 39예의 자궁내막암환자를 대상으로 의무기록지 검토와 면역조직화학 염색을 통한 후향적 연구를 하였다. 결과 : CD44v6 발현은 자궁내막암이 자궁근층 침범 없이 자궁내막에 국한된 침범을 나타낸 경우에 통계학적으로 유의한 차이로 발현되었고, CD44v6 발현된 경우 유의한 차이로 림 Objective : The purpose of this study was to evaluate the clinical usefulness of CD44v6 in patients with histologically confirmed endometrial cancer. Methods : Immunohistochemistry was used to determine the expression of CD44v6 in 39 hysterectomy specimen
치과 수술후의 통증 관리: Myprodol 대 Ibuprofen 대 Codeine
한태형(Tae Hyung Han),신병섭(Byung Seop Shin),김정 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.1
N/A Background: Myprodol, a newly introduced combination analgesics with codeine, ibuprofen and paracetamol was evaluated in the dental surgery patients for its efficacy and side effects. Methods: Total 60 ASA I or II outpatients dental surgical patients were randomly assigned into three groups(n 20 each). After various oral procedures, one of three oral analgesics, myprodol, ibuprofen or codeine, was prescribed to each patients in double blind fashion for three days. Each patient was followed carefully by daily phone calls for verbal analog pain scale, side effects and patient's satisfaction level. Results: Demographic data and duration of surgery revealed no statistical differences in all three groups. Myprodol group showed better verbal analgesic scores consistently for the study period than ibuprofen or codeine group. Adverse effects were minimal. Patients' satisfaction level was high in all three groups. Conclusion: We conclude that myprodol is an excellent oral analgesic for day-surgery based dental procedure patients. This effect appears to be synergistic among different analgesics rather than additive.
5-fluorouracil 및 mitomycin C가 생쥐 위점막 벽세포의 미세구조에 미치는 영향
고정식(Jeong-Sik Ko),신병섭(Byung-Seop Shin),안의태(E-Tay Ahn),박경호(Kyung-Ho Park),김진국(Jin-Gook Kim) 대한해부학회 2002 Anatomy & Cell Biology Vol.35 No.5
이 연구는 항암제가 위점막 벽세포의 미세구조에 미치는 영향을 알기 위하여 시행하였다. 실험동물은 체중 25 g 내외의 ICR생쥐를 이용하였으며, 정상대조군과 실험군으로 구분하였다. 실험군의 경우 5-fluorouracil (30 mg/kg) 또는mitomycin C (400 μg/kg)를 하루건너 간격으로 피부밑에 주사한 후 각각 4일과 7일 후에 동물을 희생시킨 다음 위조직을 떼어냈다. 정상대조군과 실험군에서 떼어낸 위조직은 2.5% glutaraldehyde-1.5% paraformaldehyde 혼합액에 고정한 다음, 1% osmiumtetroxide 액에 후 고정하였으며, 고정된 조직은 탈수과정을 거쳐 araldite 혼합액에 포매하였다. 포매된 조직은 1 μm 두께의 절편을 만든 후 toluidine blue로 염색하여 위점막이 세로로 잘 절단된 부위를 택하여 미세절편을 작성하였다. 절편은 uranylacetate와 lead citrate 액으로 염색한 후, JEM 100CX-II 전자현미경으로 비교 관찰하였다. 5-fluorouracil 투여군과 mitomycin C 투여군의 경우 대부분의 벽세포는 세포속모세관 속의 미세융모의 모습이 정상대조 군에 비하여 매우 불규칙하였으며 서로 밀착되어 있어서 속공간이 거의 구별되지 않았다. 대부분의 벽세포는 세관소포를 이루는 막구조가 파괴되어 전체적으로 흐트러져 보였는데, 5-fluorouracil 투여군이 더 심하게 흐트러져 보였다. 5-fluorouracil투여군의 벽세포는 mitomycin C 투여군의 것에 비하여 세포막의 돌출현상, 수초구조, 용해소체 및 뭇소포체와 세포질이 용해현상을 보이는 변성세포들이 더 자주 관찰되었다. 이상의 결과로 보아 5-fluorouracil 및 mitomycin C를 투여하면 생쥐 위점막의 벽세포는 미세구조들이 큰 손상을 받게 되어 분비기능이 매우 억제되며, 5-fluorouracil이 mitomycin C에 비하여 더 심한 영향을 준다고 생각된다. This experiment was performed to evaluate the morphological responses of 5-fluorouracil or mitomycin C on the gastric parietal cells of mouse. 5-fluorouracil (30 mg/kg) or mitomycin C (400 μg/kg) were injected subcutaneously every other day, and the animals were sacrificed at 4th day and 7th day following the first injection. Pieces of the tissue were taken from the stomach, prefixed with 2.5% glutaraldehyde-1.5% paraformaldehyde, followed by post-fixation with 1% osmium tetroxide. The ultrathin sections were stained with uranyl acetate and lead citrate. In both of the 5-fluorouracil or the mitomycin C treated groups, most parietal cells showed severely reduced luminal spaces of the intracellular canaliculi, since microvilli of intracellular canaliculi were very irregular shaped and nearly contacted with each other, and the cytoplasmic tubulovesicular membranes were disintegrated and indistinct. The changes in the 5-fluorouracil treated group were more indistinct than in those of the mitomycin C treated group. In the 5-fluorouracil treated group, balooning of the cytoplasm, focal cytolysis, myelin figures, lysosomes and multivesicular bodies in the parietal cells were observed more frequently than in those of the mitomycin C treated group. Above results suggest that the 5-fluorouracil or mitomycin C treated animals might suffer from reduced acid secretion of the parietal cell, since the collapsed lumen of the intracellular canaliculi, the disintegration of the tubulovesicular membranes, and the reduction of cell organelles in the parietal cells are occurred within a few days following injections. 5-fluorouracil was proved more harmful on the parietal cell than mitomycin C does.
실험연구 : 잡견에서 Bupivacaine의 주입에 의한 심장 독성 발생 시 시행한 심폐소생술에서 인슐린 부가 효과의 연구
함태수 ( Tae Soo Hahm ),신병섭 ( Byung Seop Shin ),김정수 ( Chung Su Kim ),이상민 ( Sang Min Lee ),여진석 ( Jin Seok Yeo ),황희윤 ( Hee Youn Hwang ),이국현 ( Kook Hyun Lee ),조현성 ( Hyun Sung Cho ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.5
Background: Because of the difficulty of resuscitation caused by bupivacaine-induced cardiotoxicity, the choice of resuscitation medication is still unclear. We investigated whether insulin can improve outcomes of resuscitation by epinephrine from bupivacaine-induced cardiovascular collapse. Methods: Twenty-four mongrel dogs were randomly allocated to one of the two groups: an EPI group (n = 12), and an EPI + RI group (n = 12). Sixty minutes after induction of general anesthesia, baseline measurement of hemodynamic parameters and arterial blood gas tension was performed. Bupivacaine infusion was started at a rate of 0.5 mg/kg/min and kept until mean arterial blood pressure fell below 40 mmHg and heart rate 40 beats per minute. At this point, bupivacaine infusion was stopped and resuscitation was started, with epinephrine in EPI group and epinephrine combined with regular insulin in EPI + RI group. Results: Bupivacaine infusion caused significant decreases in mean arterial blood pressure, heart rate, cardiac output, and systemic vascular resistance and increases in mean pulmonary blood pressure, pulmonary capillary wedge pressure, pulmonary vascular resistance, and central venous pressure. The recovery rate of EPI + RI group (8/12) was higher than that of EPI group (2/12). Conclusions: Combined administration of epinephrine and regular insulin improves outcomes of resuscitation of bupivacaine-induced cardiovascular collapse. Therefore, we believe that prompt administration of insulin should be strongly considered in case of bupivacaine-induced cardiotoxicity. (Korean J Anesthesiol 2006; 50: 579~84)
임상연구 : 마취 중 H1-수용체 길항제 투여에 의한 혈역학적 변화에 대한 고찰
함태수 ( Tae Soo Hahm ),김정수 ( Chung Soo Kim ),구명신 ( Myong Shin Koo ),신병섭 ( Byung Seop Shin ),황희윤 ( Hee Youn Hwang ),이상민 ( Sang Min Lee ),조현성 ( Hyun Sung Cho ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.4
Background: Antihistamine agents are one of the most common drugs used during perioperative periods. As histamine can cause various hemodynamic reactions, administration of antihistamine can also result in unexpected responses. Therefore, we investigated what kind of hemodynamic changes might occur after the administration of antihistamine. Methods: We prospectively performed this study on 12 patients who underwent lung surgery. After induction of anesthesia, Swan-Ganz catheter was introduced and continuous arterial blood pressure was checked via radial arterial catheterization. Initial hemodynamic parameters were checked. Based on these parameters, we calculated systemic vascular resistance (SVR), pulmonary vascular resistance (PVR). After administration of chlorpheniramine maleate 8 mg, hemodynamic parameters were checked and calculated at 2, 4, 6, 8, 10, 12, and 15 minute. Then, we made comparisons of these values with initial values. It is commonly recommended to maintain hemodynamic values within 20% of baseline for safe use of a drug. Results: SVR and PVR failed to show statistically significant changes. Heart rates were increased only at 2 minute after administration of chlorpheniramine maleate. Blood pressures were increased but returned to basal level within 4 minutes. Cardiac output showed statistically significant increase until 8 minutes. However, the changes of hemodynamic values were maintained within 20% of basal levels. Conclusions: Chlorpheniramine maleate is observed to cause statistically significant hemodynamic change after intravenous administration during anesthesia. But the changes were within 20% of basal levels, and we can safely use chlorpheniramine maleate 8 mg IV in the view of hemodynamic changes. (Korean J Anesthesiol 2006; 51: 395~9)
27G 척추침의 사전 경막천자가 제왕절개술을 위한 경막와 마취에 미치는 영향
최덕환,신병섭,김지애 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.1
Background : If started with segmental block epidural anesthesia appears to have an inadequate sacral block in the early part of cesarean deliveries. A dural puncture using the combined spinal-epidural technique making an early sacral blookade might be a solution. Methods : A propective, randomized, double-blinded study was performed on forty patients who were divided into two groups (C, DP; n = 20, each). An epidural infusion of 25 ml of 2% lidocaine with epinephrine was given to the group C. A dural puncture with a 27G Whitacre needle was done before the epidural infusion in the group DP. Two-way sensory levels were checked for 15 min, just before the operation. The side effects and recovery variables were also compared between the groups. Results: Initial wider cephalic block (P = 0.038, 0 min) followed by more caudal block (P=-0.023, 0.013; 5, 10 min after the completion of the epidural infusion respectively) occurred in the DP group. After 10 min, there were no differences in both block levels. The number of dermatomes blocked was bigger in the DP group at 10 min after. Fewer patients in the DP group had nausea and/or vomiting (P = 0.044). Conclusions : Early spread of the sensory blockade, initial cephalic and then caudal, was due to the dural punoture by a 27G needle. This fast onset could make the parturients more comfortable in the early part of cesarean sections. (Korean J Anesthesiol 2000: 38: 63∼68)