급성췌장염의 조기 예후평가 - 다단계판별분석법을 이용한 예후평가 -

안신기(Shin Ki Ahn),김원호(Won Ho Kim),정준표(Jun Pyo Chung),송시영(Si Young Song),강진경(Jin Kyung Kang),박인서(In Suh Park),최흥재(Heung Jai Choi) 대한내과학회 1994 대한내과학회지 Vol.47 No.4

N/A Objectives: Early prediction of the severity in patients with acute pancreatitis is very important because severe complications usually occur in the first 48-72 hours. Many studies have been carried out to identify clinical and objective criteria which can be used to predict the outcome of the disease. Multifactor-scoring systems adopted by Ranson et al. and Irmie et al. are generally accepted. But the systems have some disadvantages: (1) too many factors and values have to be assessed, (2) full assessment of the severity takes 48 hours or longer. We, therefore, undertook this study to assess a new method of the early identification of severity which was based on the admission data. Methods: We investigated 339 patients with acute pancreatitis admitted to Severance Hospital of Yonsei Medical Center between January, 1981 and December, 1990. The patients were divided into two groups: those who had no complications or mild complications were classified as mild group (Group I) and those who had severe, systemic complications including death were classified as severe group (Group II). The clinical courses and laboratory findings were analyzed. Results: 1) One hundred two patients experienced one or more complications. Forty patients were classified as severe group (11.8%) and twenty two patients among this group expired (mortality rate, 6.5%). 2) Complications of Group II had developed earlier than those of Group I (2.9 vs. 6.4 days, p<0.05). 3) By stepwise discrimination analysis, a discrimination equation was identified which was composed of calcium, aibumin, BUN, creatinine, uric acid, base deficit, and PaO2 on the admission. Z =4.55-039×Calcium -0.53×Albumin +0.53×BUN×10-1 -0.39×Creatinine+0.14×Uric acid+0.68×Base deficit×l0-1 -0.23×PaO2×10-1 4) The mean Z scores of Group I and Group II were 1.08±0.81 and 2.25±1.34, respectively. The cutting value (Zc) of Z score was identified by chi-square test and it was 1.0. When the cases with higher Z score than cutting value (Z) were considered as severe group, the sensitivity and specificity were 88.2% and 100.0%. The total accuracy of discrimination was 96.2% (p<0.001). The Z score revealed a good correlation with mortality raie (r =0.9825, p<0.01). Conclusion: This prognosis-discriminating equation (Z score) had reliable predictive ability and significant correlation with mortality. Because Z score is a summation of different influences of each factors to prognosis, this method may be more sensitive. And early and relatively simple prediction of severity ran be possible because the parameters of this system are usually obtained on admission. Use of this system should allow early intensive treatment and diagnosis of those who need it. We think that prospective studies should be followed to verify the predictive ability of the Z score of prognosis-discriminating equation.

초고압 HVDC 용 에폭시/ 나노실리카 콤포지트의 전기적, 기계적 특성

안지후(Ahn Ji Hoo),박재형(Park Jae Hyoung),오해린(Oh Hae Rin),안동훈(An Dong Hun),신우제(Shin Woo Je),신기범(Shin Ki Bum),서세영(Seo Sae Young),박준우(Park Jun Woo),박주영(Park Joo Young),유해만(Hae Man Ryoo),박재준(Jae-jun Park) 대한전기학회 2019 대한전기학회 학술대회 논문집 Vol.2019 No.7

X-선 조사를 받은 흰쥐 망막의 색소상피세포와 기저복합층의 미세구조

고정식,신기호,안의태,양남길,박경호,김진국,Ko, Jeong-Sik,Shin, Ki-Ho,Ahn, E.Tay,Yang, Nam-Gil,Park, Kyung-Ho,Kim, Jin-Gook 한국현미경학회 1993 Applied microscopy Vol.23 No.2

This experiment was performed to study the morphological responses of the pigment epithelial cell and the Bruch's membrane of the retina of rat following X-ray irradiation. Male rats were divided into normal and experimental groups. The heads of the rats, under sodium thiopental anesthesia, were exposed to 3,000 rads or 6,000 rads of radiation in a single dose, respectively. The source was a Mitsubishi Linear Accelerator ML-4MV. The target to skin distance was 80cm, and the. dose rate was 200 rads/min. The experimental groups were sacrificed on the 6th hour, 2nd and 6th day after X-ray irradiation. Under anesthesia, 1% glutaraldehyde-1% paraformaldehyde solution(0.1M Millonig's phosphate buffer, pH 7.3) was perfused through the left ventricle and ascending aorta. Pieces of the tissue taken from the posterior region of the retina were fixed in 2.5% glutaraldehyde-1.5% paraformaldehyde(0.1M Millonig's phosphate buffer, pH 7.3) and 1% osmium tetroxide(0.1M Millonig's phosphate buffer, pH7.3), and embedded in araldite mixture. The ultrathin sections contrasted with uranyl acetate and lead citrate were observed with JEM 100 CX-II electron microscope. The results were as follow; 1. The morphological changes of the pigment epithelial cells were not pronounced after exposure to 3,000 rads of X-ray. But on the 6th hour after exposure to 6,000 rads of X-ray, bulging nuclear membrane protruding into the cytoplasm and nuclear chromatin clumped into numerous masses along the nuclear membrane were observed. At the 2nd and 6th day post-irradiation, partial cytolysis or necrosis were seen. 2. The thickness of the Bruch's membrane of the experimental groups were increased in the time and dose range covered by this study, and splitting or diffusing basal laminae of the choriocapillary layer were observed frequently in the experimental group. Above results suggest that large amount(6,000 rads) of head irradiation induce direct hazardous effects on the pigment epitherial cells and Bruch's membrane of the retina of the rat, but pigment epithelial cells are more radioresistant than Bruch's membrane.

심실 빈맥의 임상양상 및 예후

김진배 ( Jin Bae Kim ),정보영 ( Bo Young Joung ),김종윤 ( Jong Youn Kim ),김대혁 ( Dae Huyk Kim ),안신기 ( Shin Ki Ahn ),이문형 ( Moon Hyoung Lee ),김성순 ( Sung Soon Kim ) 대한내과학회 2006 대한내과학회지 Vol.71 No.3

목적: 심실 빈맥의 원인 질환으로 허혈성 심질환이 가장 흔하다고 보고되고 있으나 우리나라의 경우 허혈성 심질환에 의한 심실 빈맥의 빈도나 임상양상 및 예후에 대하여 국내 보고가 미흡한 상태였다. 따라서 본 연구를 통해 우리나라에서 발생한 심실 빈맥의 임상적 특징과 예후에 대해 알아보고자 하였다. 방법: 1999년 1월부터 2002년 12월까지 본원에서 심실 빈맥으로 진단된 환자 136명을 대상으로 하였으며 내원 당시 ECG의 특징과 임상적 특징, 추적 결과을 분석하여 예후을 조사하였다. 결과: 남자는 100명(73.5%), 여자는 36명(26.5%)으로 남녀 비는 2.76:1였다. 환자의 발작 시 증상 중 가장 많이 호소하였던 것은 심계 항진(50.8%)이었으며 흉통(17.6%), 졸도가 15예(11.0%), 호흡곤란 7예(5.1%), 심장 돌연사 7예(5.1%)였으며 무증상인 경우가 2예(1.5%), 기타 다른 증상이 4예(2.9%)였다. 심실 빈맥의 발생에 특별한 유발 인자가 없었던 경우가 제일 많았으며(58.1%), 물리적인 활동(33.1%), 감정적인 스트레스(7.4%)가 유발인자로 관찰되었다. 심전도상의 특징을 살펴보면 기저 심박수는 74.8±17.5회, QRS폭은 101.1±18.5 ms였으며 전기축은 정상축이 가장 많았으며 V1 유도의 QRS 모양으로 분류해 보면 우각 차단형이 54예(39.7%), 좌각 차단형이 44예 (32.4%), 다형 심실 빈맥이 15예(11.0%)였으며 V1유도가 기록되지 않았던 경우가 23예(16.9%)있었다. 심실 빈맥의 원인 질환으로는 특발성 심실 빈맥이 74예(54.4%)로 가장 많았으며 허혈성 심질환이 29예(21.3%)로 그 다음이었다. 특발성 심근병증이 16예(11.8%)였으며 심판막증이 6예(4.4%)있었고, 그 밖에도 선천성 심질환(3예), Long QT 증후군(4예), Brugada 증후군(4예)있었다. 추적관찰되었던 119예 중에서 재발되었던 환자는 31예(22.8%)였으며 사망한 환자는 12예(10.1%)였다. 추적 관찰에서 재발 및 사망 여부가 확인되지 않은 환자는 17명(13.9%)였다. 재발하기까지의 기간이나 사망률로 환자의 예후를 판별하였는데, 여타 질환에 비해 특발성 심실 빈맥의 경우가 통계적으로 유의하게 좋은 예후를 보여 주었으며 허혈성 심질환인 경우가 가장 좋치 못한 결과를 보여 주었다(p<0.05). 특발성 심실 빈맥의 치료법 중 전극 도자 절제술가 가장 좋은 예후를 보여 주었으며 득발성 심실 빈맥의 경우 사망 환자는 없었다(p<0.05). 결론: 국내 심실 빈맥의 환자는 서구와는 달리 특발성인 경우가 가장 많았고 특발성 심실 빈맥의 경우가 다른 심실 빈맥에 비하여 예후가 가장 좋았으며 특발성 심실 빈맥의 치료 방법 중 전극 도자 절제술의 효과가 가장 좋았다. Background: Although the determination of etiology is crucial for the management of ventricular tachycardia (VT), there have been few studies on the epidemiology and clinical characteristics of patients with ventricular tachycardia in Korea. Previous studies on Western populations have shown that ischemic VT is the most common type arrhythmia; however, the incidence of ischemic heart disease in Korea is lower than in Western culture. The purpose of this study was to determine the clinical characteristics and prognosis of Korean patients with VT. Methods: From January 1999 to December 2002 patients who were diagnosed with VT by ECG or confirmed by electrophysiological studies were enrolled. Hospital records were reviewed for the clinical characteristics which included: demographic features, underlying disease, clinical presentation, ECG features and prognosis in 136 patients who visited our emergency room or out patient clinic. Results: There were 100 men and 36 women (mean age 51.517.6). The most common presenting symptom was palpitation (56.6%), which was followed by chest pain and syncope. The most common type of VT was idiopathic VT (54.4%); ischemic VT was found in 29 cases (21.3%) and dilated or hypertrophic cardiomyopathy in 16 cases (11.8%). For all types of VT, the idiopathic VT showed the best prognosis and cardiac function (p<0.05). RFCA (Radiofrequency catheter ablation) was the best treatment option for treatment of idiopathic VT (p<0.05). Conclusions: These findings suggest that idiopathic VT may be the most common type of VT in Korean patients; it usually originates form either the right ventricular outflow tract (RVOT) or the LV. The response to treatment and prognosis was poor in VT patients who had underlying heart disease; however, the prognosis was excellent for those with idiopathic VT.(Korean J Med 71:276-284, 2006)

위장관 ( 胃腸管 ) : 위암 환자에 있어서 말초혈액 단핵구 및 국소 림프절 단핵구의 NK 및 LAK 활성도에 관한 연구

강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),김원호(Won Ho Kim),노성훈(Sung Hoon Noh),함기백(Ki Baik Hahm),김태수(Tae Soo Kim),안신기(Shin Ki Ahn),윤정구(Jung Koo Youn) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2

N/A Several lymphocytic subpopulations, such as natural killer (NK) cells and lymphokine-activated killer (LAK) cells, are involved in immunosurveillance against tumors. Whereas the biological significance of the regional lymph node as a tumoral barrier remains unclear, the clinical prognostic relevance of the neoplastic infiltration of these nodes is accepted. Although there is general agreement that the NK and LAK activities of peripheral blood mononuclear cells (PBMC) decreases in patients with various solid and leukemic tumors, this decrease remains unclear with regard to the NK and LAK activities of their regional lymph node mononuclear cells (LNMC). We measured NK and LAK activities of PBMC and LNMC in 10 patients with resectable gastric cancer by 4 hour Cr-release assay using K562, Raji cell and allogenous gastric cancer cell as a target cell. The results obtained are as follows: l) Recombinant interleukin-2 induced strong cytotoxic activities against various target cells in PBMC and LNMC. 2) In patients with gastric cancer, NK and LAK activities of LNMC against K56Z and Raji cell were lower than those of PBMC. 3) However, NK ad LAK activities against the allogenous gastric cancer cell did not differ between LNMC and PBMC. 4) NK and LAK activities of PBMC and LNMC against K562 and Raji cell were not different betveen in patient with early gastric cancer and in patients with advanced gastric cancer. 5) However, NK and LAK activities of PBMC ad LNMC against the allogenous gastric cancer cell were lower in patients with advanced gastric cancer than in patients with early gastric cancer.

머리부분에 방사선조사를 받은 흰쥐 샘뇌하수체의 변화에 대한 면역전자현미경적 연구

신기호,박경호,안의태,양남길,고정식 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

본 실험은 과다한 X-선에 머리부분이 노출되었을 때, 샘뇌하수체의 변화를 알아보기 위하여 시행하였다. 체중 200-250g의 Sprague Dawley계 숫흰쥐를 실험동물로 사용하였으며, 정상군과 방사선조사군으로 나누었다, 방사선조사군은 조사량에 따라 3,000 rad 조사군과 6,000 rad조사군으로 나누어, 방사선 조사후 6시간, 2일 및 6일 후에 도살하여 조직을 절취하였다. 방사선조사는 흰쥐를 sodium thiopental로 마취한 후 방사선선형가속기(Mitsubishi Linear Accelerator ML-4MV)를 사용하여 머리부위를 조사하였다. 조사조건은 조사거리 80 cm, 조사구역 30 cm X 30 cm, 조사깊이 1.2 cm(100% skin dose)였으며, 분당 200 rad씩 조사하였다. 샘뇌하수체는 1% glutaraldehyde- 1% paraformaldehyde액으로 일차 고정한후, 2% osmium tetroxide액에 이차고정하였으며, 고정이 끝난 조직은 alcohol과 acetone으로 탈수한 후 araldite혼합액에 포매하였다. 포매된 조직은 , LKB-V ultratome으로 60-70nm두께의 절편을 작성하여 300 mesh nickel grid에 붙인 다음 젖샘자극호르몬과 성장자극호르몬에 대한 단독면역염색 및 이중면역염색을 시행하였다. 면역염색이 끝난 절편은 uranyl acetate와 lead citrate로 염색한후, JEM 100CX-Ⅱ 전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. 1. 젖샘자극호르몬분비세포는 불규칙한 모양을 한 큰 분비과립(300-700 nm)을 가진 성숙세포, 크기가 다양한 둥근 분비과립(150-200 nm)을 가진 중간 세포와 크기가 작은 둥근 분비과립(100-150 nm)을 가진 미성숙세포로 나눌 수 있었다. 2. 성장자극호르몬분비세포는 크고 둥근 분비과립(200-500 nm)을 가진 제 1 형 세포와 상대적으로 작고 둥근 분비과립 (150-200 nm)을 가진 제 Ⅱ형 세포로 나눌 수 있었다. 3. 방사선 조사후 6 시간군에서 3,000 rad에서는 큰 변화가 없었고, 6,000 rad에서는 사립체와 과립형질내세망의 수조 확장이 관찰되었다. 방사선 조사후 2일군에서는 큰 변화가 없었으며, 6일군에서는 핵막구조의 확장이 관찰되었다. 4. 세포의 종류도 젖샘자극호르몬분비세포는 3,000 rad 조사군과 6,000 rad 조사군 모두 2일군에서는 성숙형이 감소하고 중간형과 미성숙형이 자주 관찰되었으며, 6일군에서는 정상군과 같은 분포양상을 보였으나 분비과립의 금입자표지가 감소한 것을 관찰할 수 있었다. 성장자극호르몬분비세포에서는 뚜렷한 세포형이 분포변화는 관찰할 수 없었으나 금입자표지의 감소는 나타났다. 5. 방사선조사후 6시간군에서 부터 mammosomatography가 나타났는데, 한 세포 내에 젖샘자극호르몬과 성장자극호르몬을 지닌 분비과립이 함께 존재하였으며, 세포의 모양은 다핵세포의 형태를 하고 있는 것과 불규칙한 모양을 한 것이 있었는데, 이와같은 결과는 방사선조사 후 샘뇌하수체의 기능저하에 따른 보상작용으로 나타난 현상이라 생각된다. 이상의 결과로 보아 방사선 조사를 받은 초기에는 분비과립의 방출이 과다하게 일어나며, 방사선 조사의 영향으로 세포질소기관의 기능이 약화되어 6일이 지나면 샘뇌하수체의 호르몬분비능력이 저하되는 것 같다. This experiment was performed to study the morphological changes of the adenohypophysis of rat following X-ray irradiation. Male rats were divided into normal and X-ray irradiation groups. The heads of rat were exposed to 3,000 rads or 6,000 rads of radiation in a single dose. X-ray source was a Mitsubishi Linear Accelerator ML-4MV. Only the heads of animals were exposed at the distance of 80 cm, within the area of 30 X 30 cm, in the depth of 1 cm, with the speed of 200 rad/min. Animals of X-ray irradiation group were sacrificed on 6 hours, 2 days and 6 days after the irradiation. Tissue blocks of adenohypophysis were fixed in the 1% glutaraldehyde - 1% paraformaldehyde solution, followed by refixation in the 2% osmium tetroxide solution. Dehydradted blocks were embedded in araldite mixture. The sections were cut on a LKB V ultrotome, and ultrathin sections were places on bare nickel grid(200 mesh). The section-bearing grids were floated upside down on the solutions in a moisture chamber at room temperature. Sections were single immunostained or double immunostained for prolactin and/or growth hormone. And the sections were jet washed with distilled water. The immunostained sections were contrasted with uranyl acetate and lead citrate, and observed with JEM 100CX II electron microscope. The results were as follows: 1. Three types of the prolactin cells according to their size and shape of secretory granules were found; mature type cells contained large pleomorphic secretory granules(above 500 nm). intermediate type cells contained round granules of varying size(200-250 nm), and immature type cells contained small round granules(100 nm). 2. Two types of the growth hormone cells according to their size of secretory granules were found: type I cells contained large round secretory granules(200-300 nm) and type II cells contained small granules(100-200 nm). 3. Six hours after the irradiation, adenohypophysis showed swollen cisternae of granular endoplasmic reticulum and alterations of mitochondrial cristae, but only in doses of 6.000 rads. 4. Adenohypopysis showed decrease in number of mature type prolactin cells on 2 days after irradiatin, and recovered number of mature typer prolactin cell. but their immunoreactiveity were gradually decreased following the irradiation, as compared with that in normal adenohypophysis. 5. Six hours after the irradiation, mammosomatotrophs were found to contain prolactin and growth hormone within different granules each other. Some cells were multinucleated, and some cells exhibited irregular cytoplasmic processes. Summarizing the above results, adenohypophysis rapidly released the secretory granules after the irradiation, and cell organelles of prolactin cells and growth hormone cells were altered or degenerated. It means that adenohypophysis decreased its hormone producing activity on 6 days after irradiation.

부정맥의 항응고 치료

안신기 약업신문사 2000 의약정보 Vol.2000 No.5

심방빈맥의 고주파 전극도자 절제술

안신기,이문형,편욱범,김성순 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.2

Wolff-Parkinson-White증후군의 임상상 및 전기생리학적 소견

안신기,이문형,장양수,오동진,최인석,하종원,임세중,김병옥,정남식,심원흠,조승연,김성순 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.9

심방세동 환자에서 항부정맥제 Ic drug인 Propafenone과 Flecainide의 drug Efficacy

김동수,고충원,조홍근,김태용,안신기,이문형,김성순 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.9