Arteriohepatic Dysplasia 4예

지제근(Je Geun Chi),서정기(Jeong Kee Seo),황세희(Se Hee Hwang),박경희(Kyung Hee Park),신희영(Hee Young Shin),차한(Hann Tchah) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4

Arteriohepatic dysplasia is a disorder that is characterized by paucity of interlobular bile duct, neonatal hepatitis-like obstructve jaundice, characteristic facial profile, cardiovascular abnormalities and vertebral arch defect. We experienced 4 cases of Arteriohepatic dysplsia of a 1 year-old male, a 6 month-old female, a 3 year-old female and a 2 year 4 month-old male. L hey all showed persistent cholestasis and character- istic facies. The pulmonary artery stenosis was detected in three of them; vertebral arch defect, in one. The etiologic examnation of the liver showed pauctiy of interlobular bile ducts in all the cases.

뇌척수액내 종양세포의 원발부위 분석 및 세포학적 특징 - 총 1,438예 분석 -

김연미,전미영,지제근,Kim, Yeon-Mee,Jeon, Mi-Yeong,Chi, Je-Geun 대한세포병리학회 2000 대한세포병리학회지 Vol.11 No.2

Cytologlc evaluation of cerebrospinal fluid(CSF) is an effective mean for diagnosing many disorders involving the central nervous systems(CNS). One of the most important reasons for cytologic examination of CSF is to detect metastatic or primary neoplasms of the CNS. We did a retrospective study of 1,438 CSF specimens obtained between 1992 and 1996. A total of 1,205 adult and 233 pediatric CSF specimens from 947 patients were accessed at the Department of Pathology of Seoul National University Hospital and Children's Hospital, respectively. Among 1,438 CSF cytology specimens, 169 cases(11.8%, 77 patients) including 135 adult cases(59 patients) and 34 pediatric cases(18 patients) were positive for malignant cells. Diagnoses included 50 metastatic carcinomas(adult, 60; pediatric, 0); 46 malignant lymphomas(adult, 44; pediatric, 2); 21 leukemias(adult, 20; pediatric, 1); 4 retinoblastomas(adult, 0; pediatric 4); 2 rhabdomyosarcomas(adult, 0; pediatric, 2); 1 multiple myeloma(adult, 1; pediatric, 0), and 35 primary CNS neoplasms(adult, 10; pediatric, 25). The most commonly identified metastatic carcinomas in adults were adenocarcinoma. Their primary sites were the lung, gastrointestinal tract, and breast in order of frequency. The most common primary CNS neoplasm in children was medulloblastoma.

태아안구에서 태령에 따른 전방각 및 섬유주 조직의 형태학적 변화에 대한 연구

윤주원(Jou Weon Youn),지제근(Je Geun Chi),고명규(Myung Kyoo Ko) 대한안과학회 2001 대한안과학회지 Vol.42 No.6

배아안구 초기발육의 관찰

고명규(Myung Kyu Ko),지제근(Je Geun Chi) 대한안과학회 1986 대한안과학회지 Vol.27 No.6

구연발표 : 소아 연령에서의 만성 염증성 장질환

서정기(Jeong Kee Seo),지제근(Je Geun Chi),연경모(Kyung Mo Yeon) 대한소화기학회 1988 대한소화기학회 추계학술대회 Vol.1988 No.-

Candide species와 Cryptococcus neoformans의 전자현미경적 미세구조에 관한 비교 연구

윤철종,김성권,김수성,지제근,Yoon, Chul-Jong,Kim, Sung-Gwon,Kim, Soo-Sung,Chi, Je-Geun 한국현미경학회 1993 Applied microscopy Vol.23 No.2

This study was done to elucidate the electron microscopic characteristics of certain pathogenic fungi. Four Candida species, (C. albicans, C. tropicalis, C. parapsilosis and C. glabrate) and Cryptococcus neoformans were cultured for 3 days at $30^{\circ}C$ in the Sabouraud dextrose medium. After incubation, they were stored at $4^{\circ}C$ for 24hours. Fine structures were analyzed by morphometry, and Tukey's HSD test was used for statistics. On scanning electron microscopy C. albicans and C. neoformans were similar in size but different in shape, showing sphero-shape or ovalo-shape in C. neoformans. Surface of C. neoformans was coarse and spiny, but Candida species examined were uniformly smooth. In size, C. glabrata was the smallest among them. Budding scar as seen on the surface of Candida species by the number ranging from 1 to 7. Cryptococcus neoformans showed one or two budding scar. On transmission electron microscopy the cytoplasm of most yeast cells showed plentiful glycogen particles, mitochondria, peroxisomes and vacuoles. However, cell walls were different among four Candida species and Cryptococcus neoformans. The cell wall of Candida species consisted of fibrous layer, that was electron dense layer and transparent layer, in contrast to Cryptococcus neoformans consisted of electron dense layer with lamellar structure. This layer was two times thicker than that of Candida species. The outer layer of cell wall was of radiating pattern.

저체온순환정지법을 이용한 개심술시 스테로이드의 뇌보호 효과 - 토끼를 이용한 심폐바이패스 실험모델에서 -

김원곤,임청,문현종,전이경,지제근,원태희,이영탁,지현근,김준우,Kim, Won-Gon,Lim, Cheong,Moon, Hyun-Jong,Chun, Eui-Kyung,Chi, Je-Geun,Won, Tae-Hee,Lee, Young-Tak,Chee, Hyun-Keun,Kim, Jun-Woo 대한흉부심장혈관외과학회 1997 Journal of Chest Surgery (J Chest Surg) Vol.30 No.5

토끼는 심폐바이패스(CPB) 실험동물로서 많은 장점을 가지고 있음에도 불구하고 토끼에서 CPB운용법의 확립은 기술적으로 대단히 어려운 것으로 알려져 있다. 한편 저체온 순환정지법은 심장수술에서 유용하게 사용되고 있으나 뇌 보호상의 문제점이 지적되고 있다. 스테로이드는 일반적으로 뇌부종 치료에 효과가 있는 것으로 알려져 있으나 순환정지시 뇌보호에 미치는 영향에 관해서는 아직 명확하게 규명되지 못하고 있다. 이런 관점에서 본 연구는 첫째 토끼에서 CPB운용법을 확립하고 둘째 이를 바탕으로 순환정지시 스테로이드에 의한 뇌보호 효과를 분석할 목적으로 시행하였다. 흰 토끼 15마리(평균 체중 3,5kg)를 3군의 실험군에 각각 5마리씩 사용하였다. 제 1실험군(대조군)은 순환 정지시 토끼를 수술대와 평행된 자세로 유지하였으며, 제 2실험군에서는 대조군과 다른 실험방법은 동일하나 순환정지시 토끼를 트렌델렌부르그 자세로 유지하였다. 제 3실험군에서는 트렌델렌부르그 자세와 함께 순환정지전 스테로이드(methylprednisolone 30 mg/kg)를 투여하였다. 실험방법은 토끼를 마취시킨후 정중흉골절 개술로 심장을 노출시키고 상행대동맥 및 \ulcorner심방부속지에 각각 3.3mm 동맥캐늘라 및 14 Fr 단일 정맥캐늘라를 삽관하였다. CPB 회로에는 롤러 펌프와 기포형 산화기를 사용하였다. 충전액은 토끼혈액 120-150cc를 포함하여 약 450cc를 사용하였다. 전체 실험시간은 70분으로 심폐바이패스 시작후 10일 동안 관류 및 표면냉각법으로 체온을 20도(직장)까지 감소시킨뒤 40분 동안 순환정지를 시켰다. 순환정지후 관류를 재개하여 20분 동안 재가온으로 체온을 정상화시키면서 심장 박동이 되돌아오는 것을 확인하였다. 관류 유속은 80~ 90mg/min 으로 시작하였고 체온 하강에 따라 유속을 조절하였다. 실험후 토끼를 희생시킨뒤 바로 부검을 시행하여 뇌, 척수, 신장, 십이지장, 폐, 심장, 간장, 비장, 췌장, 위장의 일부를 채취하여 수분함유량을 조사하였다. 각 실험군간의 수분양 비교는 Kruskal-Wallis 비모수 검정법에 의해 분석하였다. CPB 중 관류 유속 변화는 60~l00ml/kg/min 이었다. 동맥압은 대부분 35-55mmhg 사이에서 유지되었다. 재가온후 심장은 전례에서 박동을 재개하였다. 동맥혈가스분석 결과 심한 조직 허혈을 의미하는 정도의 대사 성 산증은 발견되지 않았다. 각 실험군별 조직수분양 측정 결\ulcorner 뇌를 포함한 각 장기들에서 실험군간체 유의 한 차이는 발견되지 않았다. 이러한 실험결과를 통하여 저자들은 (1) 적절한 기법하에서는 토끼에서도 정상 적인 심폐바이패스 운용이 가능하다는 것과, (2) 본 실험 범주에서는 저체온 순환정지시 트렌델렌부르그 자 세에 의한 뇌부종 발현에 대한 스테로이드의 예방효과를 검정할 수없다는 결론을 얻었다. Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

증례 : 박리성 간질성폐염의 1 예

한용철 ( Yong Chol Han ),지제근 ( Je Geun Chi ),강홍모 ( Hong Mo Kang ),함의근 ( Eui Keun Ham ),정준기 ( Jun Key Chung ),김건열 ( Keon Youl Kim ) 대한내과학회 1981 대한내과학회지 Vol.24 No.3

Tannic acid를 이용한 전자현미경 (TEM) 염색효과

윤철종,한정연,김철우,지제근,Yoon, Chul-Jong,Han, Joung-Yeon,Kim, Chul-Woo,Chi, Je-Geun 한국현미경학회 1994 Applied microscopy Vol.24 No.2

Using mouse tissue, we studied electron opacity effect of tannic acid for transmission electron microscopic staining. Tannic acid-glutaraldehyde in 0.1M phosphate buffer was used as a fixative. To compare with this we have tested another method consisting of heavy metal staining after treatment of tannic acid in sodium tetraborate (borax) on glutaraldehyde-fixed sections. We have achieved equally consistent electron opacity in both methods. The elastin, collagen, basal lamina of skin and gap junctions of the epithelial cells gave excellent results, while it was good for glycogen, cilia, and plasma. Also fat cells and lipid droplets gave good preservation when tannic acid was added in the fixative. However, prolonged fixation in tannic acid-added fixative was hazardous for further processing, i.e., sectioning problem and deep electron opacity background.

담도 폐쇄증 환아에서 우연히 발견된 간엽 과오종 1례

최경단,서정기,신언우,고재성,김우선,박영수,강경훈,지제근,Choi, Kyung-Dan,Seo, Jeong-Kee,Shin, Eon-Woo,Ko, Jae-Sung,Kim, Woo-Sun,Park, Young-Su,Kang, Kyung-Hoon,Chi, Je-Geun 대한소아소화기영양학회 2001 Pediatric gastroenterology, hepatology & nutrition Vol.4 No.1

소아에서 간의 간엽 과오종은 주로 복부팽만을 주소로 내원하여 대부분 2세 이내에 발견되며, 비교적 크기가 큰 낭종의 소견을 보이는 것으로 알려져 있다. 저자들은 담도 폐쇄증으로 Kasai 수술받은 8개월 여아에서 복부 초음파 검사상 작은 기질성 종괴를 우연히 발견하여 병리학적으로 확진된 간엽과오종 1례를 보고하는 바이다. Mesenchymal hamartoma is an uncommon benign tumor usually found in childhood, especially during the first two years of life. The tumor consists of a solid component and multiple cyst. Without treatment, these lesions can grow to an enormous size. We experienced a case of mesenchymal hamartoma which was found incidentally, in a 8 month old girl who had ascending cholangitis after Kasai operation due to biliary atresia. On abdominal ultrasonography and CT, there was a well-defined homogeneous small echogenic mass in the right lobe of the liver with cirrhosis. Five months later, she underwent liver transplantation. Gross picture of the resected liver showed a dark greenish pigmented solid mass in the right lobe of the cirrhotic liver. Microscopic findings showed reactive mesenchyma and epithelial overgrowth.