Dimethylnitrosamine 유발 급성 간 손상 흰쥐에서 ^(99m)Tc-Lactosylated Serum Albumin을 이용한 간 기능의 평가

정신영,이재태,서명랑,유정아,배진호,안병철,황재석,정재민,하정희,이규보 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.6

목적: ^(99m)Tc-lactosylated serum albumin (^(99m)Tc-LSA)은 간세포에 특이적으로 결합하는 간수용체 영상용 방사성의약품으로 새로이 합성되었다. 간섬유화를 유발하는 dimethylnitrosamine (DMN)을 투여한 간 손상 휜쥐 모델에서 ^(99m)Tc-LSa의 역동학적인 간섭취를 조사하고 간효소치의 변화와 조직학적 소견을 비교하여, LSA의 간섭취가 간기능의 변화를 반영하는지를 연구하였다. 대상 및 방법: SD계 흰쥐에 DMN를 27 mg/kg으로 복강 내 주사하여 급성 간손상을 유도하고 대조군과 비교하였다. DMN을 주사한 흰쥐를 3일(DMN-3), 8일(DMN-8), 21일(DMN-21)에 ^(99m)Tc=LSA (1,665 mg/kg) 29 MBq를 정맥 주사하여, 30분 동안 동적 영상을 획득하고 간과 신장부위에 관심영역을 설정하여 간과 심장부위의 시간방사능 곡선을 얻었다. 간기능 평가를 위해 시간방사능 곡선을 이용하여 간섭취지수와 혈중제거지수를 구하였고 곡선 최적화를 시행하였다. DMN 투여군과 대조군의 간효소치의 변화와 간조직의 광학현미경 소견을 비교하였다. 결과: 대조군에서는 ^(99m)Tc-LSA가 빠르게 간에 섭취되고 혈중에서 제거되었으나 DMN을 처리한 군에서는 간섭취가 낮았다. 간섭취지수의 비교에서 대조군에 비해 DMN 처리군에서 유의하게 간섭취지수가 낮았다(DMN-3: 0.842, DMN-8: 0.898, DMN-21: 0.91, 대조군: 0.96, p<0.05). 혈중제거지수의 비교에서도 대조군에 비해 DMN 처리군에서 혈중제거지수가 유의하게 높았다(DMN-3: 0.731, DMN-8: 0.654, DMN-21: 0.604, 대조군: 0.473, p<0.05). 비선형 회귀분석에서 R_(2) 값은 0.9이상으로 좋은 일치를 보였고, 대조군에ㅓ K값이 DMN처리군에 비해 크고(DMN-3: 0.28, DMN-8: 0.41, DMN-21: 0.46, 대조군: 0.97, p<0.05), T_(1/2)값은 작았다(DMN-3: 2.5, DMN-8: 1.7, DMN-21: 1.5, 대조군: 0.7, p<0.05). 간효소치의 변화는 DMN-3군에서는 대조군에 비해 상승하였으나 DMN-8, DMN-21군에서는 간효소치의 상승이 관찰되지 않았다. 간조직 소견의 경우 DMN-3군에서 중심정맥 주위에 괴사가 관찰되었으나 DMN-8군, DMN-21군에서는 미약한 정도의 염증세포 침윤만이 관찰되었다. 결론: ^(99m)Tc-LSA 간신티그래피의 간섭취 정도는 간손상과 반비례하였으며 간섭취의 변화는 조직학적 손상이 심한 정도와 간손상후 회복되는 과정을 반영하여 주었다. ^(99m)Tc-LSA 간신티그래피가 간손상을 평가하고 간손상후 회복되는 과정을 추적하는 간수용체 영상용 방사성 의약품으로 사용될 수 있을 것으로 생각된다. Objects: ^(99m)Tc-lactosylated human serum albumin(LSA) is a newly synthesized radiopharmaceutical that binds to asialoglycoprotein receptors, which are specifically presented on the hepatocyte membrane. Hepatic uptake and blood clearance of LSA were evaluated in rat with acute hepatic injury induced by dimethylnitrosamine(DMN) and results were compared with corresponding findings of liver enzyme profile and these of histologic changes. Materials and Methods: DMN (27 mg/kg) was injected intraperitoneally in Sprague-Dawley rat to induce acute hepatic injury. At 3(DMN-3), 8(DMN-8), and 21(DMN-21) days after injection of DMN, LSA injected intravenously, and dynamic images of the liver and heart were recorded for 30 minutes. Time-activity curves of the heart and liver were generated from regions of interest drawn over liver and heart area. Degree of hepatic uptake and blood clearance of LSA were evaluated with visual interpretation and semiquantitative analysis using parameters (receptor index : LHL3 and index of blood clearance : HH3), analysis of time-activity curve was also performed with curve fitting using Prism program. Results: Visual assessment of LSA images revealed decreased hepatic uptake in DMN treated rat, compared to control group. In semiquantitative analysis, LHL3 was significantly lower in DMN treated rat group than control rat group (DMN-3:0.842, DMN-8: 0.898, DMN-21: 0.91, Control: 0.96, p<0.05), whereas HH3 was significantly higher than control rat group (DMN-3: 0.731, DMN-8: 0.654, DMN-21: 0.604, Control: 0.473, p<0.05). AST and ALT were significantly higher in DMN-3 group than those of control group. Centrilobular necrosis and infiltration of inflammatory cells were most prominent in DMN-3 group, and were decreased over time. Conclusion: The degree of hepatic uptake of LSA was inversely correlated with liver transaminase and degree of histologic liver injury in rat with acute hepatic injury.

혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

전방 십자인대의 파열시의 자기공명영상:직접소견의 중요성

신현준,이창희,최영칠,전혜정,박정희,김동헌 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

It is Important to know the normal size, shape, and signal intensity of anterior cruciate ligament in the evaluation of knee injury Many studies have reported findings of tear or rupture as well as normal anatomy of these structure, especially with MR images. To our knowledge, there are few studies about normal structures of anterior cruciate ligament in MR images. The purpose of this study is to compare normal finding with tear of anterior cruciate ligament on MRI. Twenty-three cases with rupture of anterior cruciate ligament were evaluated on MRI, measuring the length, thickness, width of anterior cruciate ligament, and angles of anterior and posterior cruciate ligaments. Mean length, thickness, and width of anterior cruciate ligament in patients with rupture were 37.7±4.8mm, 9.0±1.2mm, 8.0±0.8mm, and mean angles of anterior cruciate ligament, and posterior cruciate ligament were 48.1±9.6˚, 118.8±13.1˚. Curvature ratio of posterior cruciate ligament was 0.25±0.09. The results showed significant differences between normal persons and patients with complete or partial rupture, and the mean angle and curvature ratio of posterior cruciate ligament which are known to related with indirect sign in tear of anterior cruciate ligament showed significant differences between ours and that of western countries. These results will be useful in the evaluation of patient wish rupture of anterior cruciate ligament, especially on MRI.

최근 5년간 피부외과술로 치료받은 환자의 분석 : 1994. 1∼1998. 12

신정현,강민정,조소연,황규광,함정희 梨花女子大學校 醫科大學 醫科學硏究所 2000 EMJ (Ewha medical journal) Vol.23 No.2

연구 목적 : 1990년대 이후 국외 및 국내에서 피부외과의 영역이 넓어지고 있으나 현재 국내에서 시행되고 있는 피부외과적 수술에 대한 통계는 아직 보고되지 않아 그 현황이 잘 파악되지 않고 있다. 이에 저자들은 본교실 미용피부외과 클리닉에 내원하여 수술을 받은 환자 1,075명을 대상으로 통계적 분석을 시행하여 피부외과 환자의 분포, 경향을 파악하여 향후 발전의 토대로 삼고자 한다. 방법: 1994년 1월부터 1998년 12월까지 5년간 이화여자대학교 의과대학 부속 동대문병원 피부과 미용피부외과 클리닉에 내원하여 수술을 받은 환자 1,075명을 대상으로 성별, 연령별, 주거지역별 분포와 진단명 및 수술의 종류에 대하여 통계적 분석하였다. 결과: 1) 남녀비는 1 : 2.4였고, 연령은 10개월부터 87세까지로 다양하였으나 20, 30대가 66.0%로 가장 많고 평균연령은 남자 30.6세, 여자 30.2세였다. 환자의 주거지역별 분포는 서울시가 75%로 가장 많았고 서울시내 지역구별의 차이는 크지 않았다. 2) 환자 1명이 두 가지 이상의 질환을 가질 때 각 질환을 개개로 간주하여 총 1.354예의 질환을 수술하였으며 반흔(39.8%), 색소성 질환(30.8%), 악성/양성종양(21.2%), 기타질환(8.2%) 순이었다. 3) 수술은 총 2,334회 시행되었고 그 종류별 빈도는 화학박피수술 가장 많아 846예(36.2%)이었고 다음으로 냉동외과술 650예(27.8%), CO_2 레이저 255예(10.9%), 기계박피술 209예(8.9%), 외과적 절제술 113예(4.8%), Mohs 미세도식수술 61예(2.6%), 혈관응고술 50예(2.1%), 피판재건술 48예(2.0%)이었으며 그 외 모발이식 15예, 표피이식 13예, 자가지방이식 2예 등이 있었다. 4) 각 반흔의 종류에 따라 분류하면, 여드름반흔은 화학박피술(72.7%), CO_2 레이저(11.9%) 및 기계박피술(9.7%)로, 위축성반흔은 기계박피술(37.3%). CO_2 레이저(27.8%) 및 펀치상향술(11.9%)로, 비후성반흔은 냉동외과술(28.2%), 기계박피술(24.2%) 및 CO_2 레이저(22.7%)로 치료하였다. 5) 악성종양 및 일부 양성종양에 Mohs 미세도식수술을 시행하였으며 재건술로 총 61예 중 피판재건술을 시행한 예가 가장 많아 45.9%이었고, 단순봉합이 36.1%, 복합봉합은 18.0% 이었다. 결론: 피부외과적 수술환자는 여자가 남자보다 2.4배 많았으나 남자의 비율이 증가추세에 있고 남녀 모두 평균 연령은 30대였다. 수술질환은 반흔과 색소성 질환이 가장 많아 미용적인 관심이 매우 높음을 알 수 있었고 연도별 유의한 차이는 없었다 총 2,334회 수술 중 화학박피술, 냉동외과술이 50% 이상을 차지하였고 반흔의 종류에 따라 선호되는 수술이 달랐다. 악성종양은 모두 Mohs 미세도식 수술하였으며 주로 국소 피판술로 재건하였다. 이상의 분석으로 피부외과적 수술환자의 분포, 대상질환, 수술방법 등을 빈도별로 파악할 수 있었으며, 향후 각 질환별 혹은 수술별로 세분하여 수술성과 및 만족도 조사를 시행함으로써 피부외과 분야 및 본 크리닉의 발전 방향을 설정하는 가늠자 역할을 할 것으로 기대한다. Background : The field of dermatologic surgery has seen trementdous developments in the past few years. Objective : Our purpose was to discuss current statistical data on the dermatologic patients treated by surgical methods at our institute. Methods : We analyzed 2,334 cases of surgeries performed on 1,075 patients at the Department of Dermatology of Ewha Womans University Tongdaemun Hospital during a period of 5 years (1994. 1 - 1998. 12). Results & Conclusion : The results are summarized as folows: 1) Of the 2,334 cases of surgeries, 846 cases(36.2%) were chemical peelings, 650 cases(27.8%) cryosurgeries, 255 cases(10.9%) CO_2, lasers, 209 cases(8.9%) dermabrasions, 113 cases(4.8%) scalpel surgeries, 61 cases(2.6%) Mohs micrographic surgeries, 50 cases(21.1%) sclerotherapy, 48 cases(2.0%) flap repair surgeries, 35 cases(1.5%) punch elevations, 15 cases(0.6%) hair transplantations, 13 cases(0.5%) epidermal grafts, and 2 cases(0.1%) autologous fat/collagen transplantations. 2) The ratio of male to female was 1 : 2.4 and the mean age of patients was 30.3 years. 3) A total of 1,354 cases of diseases were managed surgically : among them, the most frequent disease was scar(39.8%), followed by pigmentary disorders(30.8%), and benign or malignant tumors(21.2%). 4) With respect to the types of scars, acne scar was treated most frequently by chemical peeling (72.7% of 580 cases), atrophic scar by dermabrasion(37.3% of 126 cases), and hypertrophic scar (including burn scars) by cryosurgery(35.3% of 85 cases).

콘크리트용 잔골재로서 고막 패각의 활용성에 관한 연구

신용석,이설,김판선,조철희,김정섭 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1(구조계)

1) As a result of compressive strength experiment, rupture compressive strength showed more increases in specimens of 15% and 20% of Cockle shells in those of non-mixture. Comparing compressive strength between no-mixed Specimens and Specimens of containing Cockle shells, Specimens containing Cockle shells showed higher strength in 60 days of age, and as ark Cockle is contained and age is elapsed, compressive strength is also increased. 2) To sum up the above experimental results, it is found that using splitted Cockle shells as aggregate for concrete by 10% - 20% showed the same or higher compressive strength and shear strength as concretes using general aggregate and it can be used as substitute aggregate of concrete. It is considered that for future use of splitted Cockle shells as substitute concrete aggregate, continuous researches of its durability, applicability and economy are needed.

감마선 조사 랫트의 고환에서 fibronectin의 발현

정진우,김희철,김정태,안미정,이지영,신태균 제주대학교 방사능이용연구소 2005 방사선응용과학연구소논문집 Vol.19 No.-

Periotron을 이용한 소아 치은 상태의 평가

신정근,백병주,김재곤,양연미,김성희 대한소아치과학회 2006 大韓小兒齒科學會誌 Vol.33 No.3

간외담관 폐쇄에서의 초음파소견 : 담관벽 경계소실의 중요성 Significance of Decreased Echotexture of Bile Duct Wall-Interface

신현준,손은주,이창희,최영칠,전혜정,박정희,이태의 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-

Ultrasound is very useful in evaluation of obstructive jaundice. We retrospectively evaluated the useful findings of ultrasonography in differentiating benign extrahepatic duct obstruction from malignant diseases. Among the 36 patients, 25 patients were benign extrahepatic obstruction and 11 patients were malignant obstruction. The shapes of extrahepatic dilatation were classified into fustiform, meniscus, and abrupt cut off by bowel gas. The diameter, length, and bile duct wall-interface were compared between benign and malignant groups and serum bilirubin and alkaline phosphatase were also compared between two groups retrospectively. The results were as follows. The most common form of extrahepatic dilatation was meniscus(10 of 26 patients, 38%) in benign obstruction, and fusiform(8 of 11 patients, 73%) in malignant obstruction. No significant difference was noted in diameter, length, serum bilirubin, and alkaline phosphatase between benign and malignant groups. Only one case showed decreased bile duct wall-interface in benign obstruction, but loss or decrease of bile duct wall-interface were 8 patients in malignant obstruction. The combined findings of fusiform dilatation and loss of bile duct wall-interface in ultrasonography will be helpful in differential diagnosis of malignant extrahepatic bile obstruction from benign conditions.

전기진단검사로 확인된 한랭 예민성 양성 국소성 근위축증-증례 보고-

서정환,신용일,김연희 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.6

의약분업 전후의 의약정보서비스의 질의응답과 질의자의 만족도 분석

신정인,김미애,허경희,김미정,신현택,오정미 한국병원약사회 2003 병원약사회지 Vol.20 No.2

Drug Information Centers(DICs) are responsible for providing updated and relevant drug information on the efficacy, safety and quality of drugs to health-care practitioners and finally to patients. After the establishment of new prescription law(Bunup)' on August 2000, the future direction for DICs is strongly needed to provide specified, appropriate and rapid information to health-card practitioners and patients. This project was undertaken to provide a future direction of DICs via comparing differences of Q&A before and after Bunup, based on the analysis of Q&A worksheets that were conducted from August 1999 to July 2001 at Drug Information Research Institute(DIRI) of Sookmyung Women's University. In addition, feedback sheets were collected from the users of DIRI from April 2001 to August 2001, to evaluate the satisfaction scores by '5-point Likert scale' on the response. The number of inquiries responded by DIRI was increase from 201 to 574 and the most frequently asked inquirers were pharmacists, specifically community pharmacists. The mean time to respond before and after Bunup was 5.35 and 4.68 hours, respectively. The method of inquiry utilized the most was electronic mailing system followed by telephone both before and after Bunup(66.2% vs. 65.7% via e-mail, from 32.8% vs. 32.4% via telephone). The most frequently asked category of question was on the 'clinical drug' category both before and after Bunup (79% vs. 73.6%). The tertiary literature was the most frequently used reference to answer the inquiries. Mean feedback result via questionnaires was good. That included accuracy, quality of information, time to respond, attitude of provider, accessibility, etc. The most increased inquirer after Bunup was general person, compared with before. Therefore DICs should provide separate responds according to inquirers, develop the systemic program to improve the response for each request, have systemic Q&A worksheet, and develop the educational program for drug information providers. DICs should continuously provide more appropriate and rapid information to health-care practitioners and patients.