펌프 수동정지방법 제안

왕준호,Wang, Jun-Ho 한국화재소방학회 2008 한국화재소방학회지 Vol.4 No.3

자연소실의 경과를 보인 특발성 종격동 섬유화증

왕준호 ( Joon Ho Wang ),송광선 ( Kwang Seon Song ),김현준 ( Hyun Jun Kim ),송기호 ( Ki Ho Song ),인행환 ( Haing Hwan In ),최수봉 ( Su Bong Choi ),조미연 ( Mi Yeun Joo ),성기준 ( Ki Joon Sung ),신계철 ( Kye Chul Shin ) 대한결핵 및 호흡기학회 1997 Tuberculosis and Respiratory Diseases Vol.44 No.4

Comparison of the Results of Core Decompression and Sugioka’s Transtrochanteric Rotational Osteotomy for Osteonecrosis of the Femoral Head

Jun Gyu Moon(문준규),Joon Ho Wang(왕준호),Chang Yong Hur(허창용),Won Yong Shon(손원용) 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.5

목적: 대퇴골두 괴사증 환자 중 핵심 감압술 49예와 수지오까 전자부 회전 절골 19예의 결과를 비교하여 보고하고자 한다. 대상 및 방법: 각각의 수술결과를 Ficat-Alert (F-A) 분류에 따른 골두 괴사 시기별과 Shimizu 등급에 따른 괴사의 정도에 따라 분석하였다. 핵심 감압술군의 평균 추시기간은 46개월(37-108개월), 수지오까 전자부 회전 절골술군의 경우는 52개월(36-82개월)이었다. 환자의 증상이 소실되었거나, 방사선 사진상에 진행되는 소견이 없었던 경우를 성공적인 결과로, 방사선 검사에서 괴사가 진행되거나 대퇴골두의 함몰의 소견이 관찰되거나 고관절 치환술 또는다른 대퇴 골두 구제술을 시행한 경우를 실패로 판정하였다. 결과: 49예의 핵심 감압술군 중 21예(43%)에서, 19예의 수지오까 전자부 회전 절골술군 중 14예(74%)에서 성공적인 결과를 보였다. 핵심 감압술 중 22예의 F-A I기 중 15예(68%)에서 방사선학적 성공적 결과를 보였으며 4예의 Shimizu A 등급은 전례에서, 18예의 Shimizu B와 C 등급에서는 11예(61%)에서 성공적인 결과를 보였다(p<0.01). 16예의 F-A ⅡA기 중 6예(38%)에서, 8예의 F-A ⅡB기 중 2예(25%)에서 성공적인 결과를 보였다. 반면에 수지오까 전자부 회전 절골술군 중에 FA ⅡA기13예 중 11예(85%)에서, F-A ⅡB기 4예 중 2예(50%)에서 성공적인 결과를 보였다. F-A Ⅲ기에서 핵심감압술을 시행한 전례에서 Shimizu C 등급이었으며, 3예 모두 실패의 결과를 보였으나, 2예의 수지오까 전자부 회전 절골술군은 2예 모두 성공적인 결과를 나타냈다. 결론: 핵심 감압술은 대퇴 골두 괴사 F-A I기에서만 효과적이었고, 괴사의 부위와 크기의 정도가 결과에 중요한 영향을 미쳤으며, 비스테로이드성 대퇴 골두 무혈성 괴사의 정도가 심한, 특히 50세 이하의 젊은 환자에게는 수지오까 전자부 회전 절골술이 좀 더 믿을 만한 수술방법으로 사료되었다. Purpose: This study conducted a comparative analysis on 49 hips treated with a core decompression procedure and 19 hips treated with a Sugioka’s transtrochanteric rotational osteotomy for a osteonecrosis of the femoral head (ONFH). Materials and Methods: This study evaluated the relationship between the Ficat and Arlet Stage and the extent of the necrotic lesion (using Shimizu’s Grade Classification), and the clinical outcome of each procedure. The patient’s outcomes were assessed after a mean follow-up of 46 months (range=36-82 months) after the core decompression and 53 months (range=37-108 months) after the Sugioka’s transtrochanteric rotational osteotomy. The results were considered successful if the patients were asymptomatic with no disease progression, and unsuccessful if there was radiographic (progression of the stage or collapse) or clinical failure (the need for an arthroplasty or subsequent salvage operation). Results: Twenty one out of 49 cases (43%) in the core decompression group and 14 out of 19 (74%) in the rotational osteotomy group showed successful outcomes. In the core decompression group, among the 22 F-A Stage I hips, 15 (68%) hips had survived according to radiological criteria. All four (100%) Shimizu’s Grade A hips of the F-A Stage I had successful results, which is in contrast to the 11 hips out of 18 hips (61%) of the Shimizu’s Grade B and C hips (p<0.01). Six (38%) out of 16 F-A Stage ⅡA hips and two (25%) out of eight ⅡB hips in the core decompression group had successful results, while 11 (85%) out of 13 ⅡA and two (50%) out of four stage ⅡB hips in the rotational osteotomy group had successful results. In the F-A Stage Ⅲ hips, all 2 hips in the Sugioka transtrochanteric rotational osteotomy treatment group had survived, while none of the three Shimizu’s Grade C hips in the core decompression group were successful. Conclusion: A core decompression is effective only in the earliest stages of osteonecrosis (F-A Stage I), which means that its success strongly depends on the location and extent of the femoral head necrosis. Sugioka’s transtrochanteric rotational osteotomy is a more dependable procedure than a core decompression for treating large lesions of nonsteroidal ONFH, particularly for patients under the age of 50.

중엽증후군을 유발한 기관지 지방종

김현준 ( Hyun Jun Kim ),왕준호 ( Jun Ho Wang ),인행환 ( Haing Hwan In ),송기호 ( Ki Ho Song ),송종오 ( Jong Oh Song ),송광선 ( Kwang Seon Song ),용석중 ( Suk Jung Yong ),신계철 ( Kye Chul Shin ),홍순원 ( Soon Won Hong ) 대한결핵 및 호흡기학회 1997 Tuberculosis and Respiratory Diseases Vol.44 No.1

수간주사후 발병한 유기인제 중독

송기호(Ki Ho Song),송광선(Kwang Seon Song),김현준(Hyun Jun Kim),왕준호(Joon Ho Wang),인행환(Haeng Hwan In),진춘조(Choon Jo Jin),용석중(Suk Joong Yong),신계철(Kye Chul Shin) 대한내과학회 1997 대한내과학회지 Vol.53 No.5

N/A Objectives: Organophosphates make their clinical effects after absorbed through gastrointestinal tract, lungs and skin. We commonly see the gastrointestinal tract and lung as routes of organophosphates (OP) intoxication, but there have been few reports that said the skin as a route OP intoxication. We have experienced many patients that showed OP intoxication symptoms during or after the control of pine gall midge. So we analyzed the clinical characteristics of the patients and evaluated the route of OP intoxication. Methods: We analyzed retrospectively 26 cases who were diagnosed as 'OP intoxication after control of pine gall midge' from June 1 1995 to July 31 1996. Results: 1) The mean age of the cases, mean duration of work and mean initial cholinesterase level were 52 years, 11.9 days, 318.2U/L respectively. And the over all ratio of male to female was 11:15. 2) All cases were engaged in drug injection and 7 cases (32%) weared mask. Face and upper body were excluded from protective clothings. 3) The cardinal symptoms were diarrhea and dizziness followed by nausea, vomiting, headache, anorexia, paralysis in order of frequency. 4 Directly contributing factors to symptom onset were rain, excessive sweating due to hot weather and direct contact. 5) Most of cases (92%) were recovered completely. 2 cases died during hospitalization due to acute respiratory failure and sepsis. Mechanical ventilation were applied in 4 cases for mean 12 days. In 2 cases, there were neurobehavioral changes as delayed neurologic sequelae. Conclusion: We have concluded that the route of organophosporus intoxication after the control of pine gall midge was skin (transdermal absorption). Sufficient education and protective measures should be done for preventing organophosporus intoxication in the control of pine gall midge.

Expression of Anion Exchanger and CFTR in the Hepatocyte and Cholangiocytes in Bile Duct-Ligated Rat

Jae Dong Lee(이재동),Joon Ho Wang(왕준호),Seung Seog Ki(기승석),Won Hyeok Choe(최원혁),Jae Seung Park(박재승),Won Kyoo Cho(조원규),Jung-Jun Park(박정준),Hong Su Kim(김홍수) 한국생명과학회 2011 생명과학회지 Vol.21 No.12

본 연구는 흰쥐의 담관 세포와 간세포에서 CFTR과 AE1 AE2 AE3 유전자들의 발현 유무를 조사하고 흰쥐에서 담관 결찰 후 AE2 유전자의 발현의 변화를 관찰하고자 하였다. 200-250 g의 Sprague Dawley 계 흰쥐 24마리의 총담관을 결찰한 후 4 주 동안 1 주일에 6마리씩 희생하여 간세포와 담관 세포를 분리하였다. 6마리는 대조군으로 사용하여 간세포와 담관 세포에서 CFTR 유전자와 AE1 AE2 와 AE3 유전자 발현을 조사하고 담관 결찰 후 1 2 3 4주 간격으로 AE2 유전자 발현을 조사하였다. AE1 AE2 와 AE3는 간세포와 담관 세포에서 발현되었고 CFTR은 담관 세포에서만 발현되었다. 담관 결찰 담관세포군에서 AE2 유전자의 발현은 대조군인 정상 담관세포군에 비해서 낮았다. 결찰 담관세포군에서 AE2 유전자의 발현은 결찰 기간에 따라 차이가 없었다. 담관 결찰 간세포군에서 AE2 유전자의 발현은 대조군인 정상 간세포군에 비해서 경계적 유의성을 보이며 증가하는 경향이 있었다. 결찰 간세포군에서 AE2 유전자의 발현은 결찰 기간에 따라 차이는 없었다. 따라서 CFTR AE1 AE2 그리고AE3 는 간세포와 담관 세포에서 중탄산염이온과 수액을 매개하는 주된 이온 전달체라는 사실을 고려할 때 담도 담즙정체 간질환에서CFTR과 AE2 발현의 변화는 병리학적 기전에 중요한 역할을 할 수 있으리라고 생각된다. Cystic fibrosis transmembrane conductance regulator (CFTR) gene and sodium-independent Cl?/HCO₃? anion exchanger (AE) genes are expressed in a wide variety of mammalian tissues including cholangiocytes. They play an important role in the regulation of intracellular pH (pHi) as well as in transepithelial acid/base transport necessary for biliary bicarbonate secretion. The aim of this study was to examine the expression level of CFTR gene and AE genes (AE1, AE2 and AE3) in the cholangiocytes and the hepatocytes, and also measure AE2 gene expression level after bile duct ligation (BDL). As we previously described, isolated hepatocytes and cholangiocytes from the liver of normal and BDL rats were prepared and gene expression levels were measured by using RT-PCR. We found that AE1, AE2, and AE3 genes were expressed in both hepatocytes and cholangiocytes, but CFTR was only in cholangiocytes. AE2 gene expression level was higher in the BDL hepatocytes than normal hepatocytes, which was significantly different between two groups. AE2 gene expression level was lower in the BDL cholangiocytes than normal cholangiocytes. However, AE2 gene expression level in both hepatocytes and cholangiocytes were not changed with a longer duration of BDL. These results suggest that CFTR and AE2 may play an important role in the pathogenetic mechanism of biliary cholestatic liver disease.

우리나라 위식도역류질환의 임상상

이성희(Seong Hee Lee),최명규(Myung Gyu Choi),추교영(Kyo Young Choo),왕준호(Jun Ho Wang),문성배(Sung Bae Moon),최황(Hwang Choi),방춘상,김재광(Jae Kwang Kim),최규용(Kyu Yong Choi),정규원(Kyu Won Chung),선희식(Hee Sik Sun),박수헌(Soo Heon 대한소화기기능성질환·운동학회 2000 Journal of Neurogastroenterology and Motility (JNM Vol.6 No.1

N/A Baekground/Aim: Heartburn, which was the most common symptom of reflux disease, was unreliably interpreted by Korean patients. Our aim was to evaluate the clinical spectrum of gastroesophageal reflux disease(GERD) in Korea. Methods: Patients who were diagnosed by an endosopy or ambulatory pH monitoring at a tertiary medical facility were given a validated questionnaire and the clinical spectrums were prospectively investigated. Results: Seventy one patients were included, Heartburn was occurring m 39 patients and the frequency of heartburn on two or more days a week were found in only 12 patients. Negative impact of reflux symptoms on health related well being were found in 16 patients. The reflux related atypical symptoms were hoarseness(55%), globus sensation(45%), cough(25%), and chest pain(20%). Twenty two patients complained of epigastric pain or discomfort more than 6 times a year, with 13 patients listing abdominal pain as the most bothersome one. The clinical spectrums were not different between endoscopy negative patients and those with esophagitis. Conclusions: Typical reflux symptoms are absent in a substantial proportion of Korean patients with GERD. True dyspepsia could result from gastroesophageal reflux, GERD needs to be clarified in patients with chronic laryngeal symptoms, cough or chest pain. (Korean Journal of Gastrointestinal Motility 2000;6:1-10)

창자 가로절단-재문합 실험모델에서 창자신경계통의 형태계측학적 변화

오수연(Soo-Youn Oh),박웅채(Ung-Chae Park),김경래(Kyung-Rae Kim),왕준호(Jun-Ho Wang),이재동(Jae-Dong Lee),김순제(Soon-Je Kim),송우철(Wu-Chul Song),박승화(Seung-Hwa Park) 대한체질인류학회 2007 해부·생물인류학 (Anat Biol Anthropol) Vol.20 No.1

작은창자의 손상 후 시간경과에 따른 재생과정에서 근육층신경얼기와 제1형 카할사이질세포가 각각 어떻게 변화하는지를 살펴보고자 돌창자 가로절단-재문합 실험모델을 제작하여 형태계측학적 방법으로 비교분석 하였다. 형태계측학적 분석을 하기위해 Sprague Dawley계 성숙흰쥐의 돌창자를 가로절단한 후 재문합시킨 실험군과 가로절단을 하지 않고 개복 후 봉합수술만을 시행한 대조군에서 수술 후 3일, 7일, 15일, 30일군의 근육층신경얼기와 제1형 카할사이질세포의 변화를 영상분석기를 이용하여 계수하고 통계처리 하였다. 작은창자의 가로절단으로 인한 손상효과는 근육층신경얼기와 제1형 카할사이질세포에서 동시에 일어났으며 손상부위를 중심으로 앞쪽과 뒤쪽(구강쪽과 항문쪽) 양 방향으로 고르게 나타났다. 손상효과는 수술 후 3일군과 7일군에서 가장 심하게 나타나 근육층신경얼기의 경우 신경세포의 형태적 변성과 아울러 세포수가 약 40% 감소하였다. 제1형 카할사이질세포는 세포수가 20~37% 감소하였으며 대부분 세포의 세포질에는 많은 공포가 형성되어 있었다. 수술 후 15일 이후부터는 재생이 일어나기 시작하여 근육층신경얼기에서 신경세포의 감소정도는 20~25%로 줄어들었으며 세포의 염색정도나 형태가 정상으로 회복되는 양상을 보였다. 제1형 카할사이질세포 수의 감소정도도 13~20%로 줄어들었으며 세포질 내 공포가 형성된 세포의 수도 감소하였다. 수술 후 30일군에서 근육층신경얼기를 이루는 신경세포의 형태는 대조군과 유사하였으며 신경세포의 수는 수술 면을 기준으로 구강쪽과 항문쪽에서 각각 12.3%, 15.6% 씩 감소하여 (p<0.01) 정상으로의 완전한 회복은 이루어지지 않았다. 제1형 카할사이질세포 수는 구강쪽과 항문쪽에서 각각 7.5%, 4.2%씩 감소하였으나 유의한 차이는 없었으며(p>0.01) 세포 형태도 정상이었다. 이로서 작은창자의 가로절단으로 인한 손상효과는 근육층신경얼기에서 좀 더 심하게 나타나며 정상으로의 회복도 제1형 카할사이질세포에 비해 더디게 나타남을 알 수 있었다. This study was performed to investigate the morphometric changes of myenteric plexus and type 1 interstitial cells of Cajal (ICC-I) in regeneration process of small intestine transection. Sprague Dawley rats (200~250 g) were anesthetized with ether; then the full thickness of ileal wall were semitransected; and subsequent end-to-end anastomosis were performed by using 6-0 silk suture thread. Sham-operated rats, which only underwent the laparotomy, were used for control group. Experimental animals were sacrificed at 3 days, 7 days, 15 days, and 30 days after the operation. In each group myenteric plexus and ICC-Is were prepared by histochemical method (NADH-TR stain for myenteric plexus, ZIO stain for ICC-Is) and cell numbers were counted by image analyzer (Image plus pro-5.0, Media Cybermedics, USA). Degeneration of myenteric neurons and ICC-Is occurred simultaneously and it was similar in oral and anal to the site of transection. Degeneration effects were most prominent at 3 days and 7 days after intestinal transection. In myenteric plexus, many neurons had degenerated appearances and about 40% of them were lost. Most of ICC-Is had cytoplasmic vacuoles and 20~37% of the cells were lost. At 15 days after transection, there were no more degeneration in myenteric neurons (20~25% cell loss) and ICC-Is (20~13% cell loss). At 30 days after transection, numbers of myenteric neurons were not recovered as that of the control group. However numbers of ICC-Is were as similar as that of the control group. In conclusion, we confirmed that degeneration effects of intestinal transection are more severe in myenteric plexus than in ICC-Is, and recovery of cell loss occurs more slowly in myenteric plexus.

심폐소생술과 제세동 후에 발생한 횡문근융해증 환자에서 지속적 신대체요법 중 발생한 고칼슘혈증의 성공적인 치료

박지민 ( Jee Min Park ),전규락 ( Gyu Rak Chon ),왕준호 ( Jun Ho Wang ),이태의 ( Tae Ui Lee ),이우성 ( Woo Sung Lee ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.5

Rhabdomyolysis is a common clinical and laboratory syndrome resulting from reversible skeletal muscle injury, with release of muscle cell contents into the plasma. Cardioversion, and cardiopulmonary resuscitation may produce rhabdomyolysis and myoglobinuria. We report a 5-year-old boy surviving after cardiopulmonary resuscitation and repeated 5 times of cardioversion. He showed elevated serum BUN and creatinine levels, requiring hemodialysis treatment. We had tried 5 times of intermittent hemodialysis, but oliguria was continued and there was no change of serum BUN and creatinine. His urine output was less than 100 cc per day and he showed severe edema and weight gain of 7 kg, and so we started the continuous renal replacement therapy (Prismaflex(R), gambro). After 12 days of continuous venovenous hemodiafiltration (CVVHDF), his urine output recovered and his BUN, creatinine, liver enzyme, creatine kinase, and lactate dehydrogenase levels returned to normal. During the treatment of CVVHDF, he had shown persistent hypercalcemia, and so we changed dialysate and replacement solution from hemosol B0 to calcium free solution. The hypercalcemia was controlled successfully using this calcium free pharmacy-made bicarbonate solution.

골격근 허혈-재관류 손상 시 세포외 Superoxide Dismutase의 역할

박종웅(Jong Woong Park),김성곤(Sung Kon Kim),박정호(Jung Ho Park),홍준석(Jun Seok Hong),왕준호(Joon Ho Wang),송준엽(Joon Yeop Song) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.3

목적: 본 연구는 중요한 항산화 효소중의 하나인 세포외 superoxide dismutase (EC-SOD)가 골격근의 허혈-재관류 손상에 미치는 역할을 알아 보고자 하였다. 대상 및 방법: EC-SOD knockout (EC-SOD-/-) 생쥐, 세포내 항산화 효소인 CuZn-SOD knockout (CuZn-SOD+/-) 생쥐 및 wild-type (WT) 생쥐의 거고근 유경피판을 거상한 후 혈관을 결찰하여 4.5시간의 허혈을 유도하였다. 이후 90분간의 재관류 동안 피판의 혈관내경의 변화, 혈류량 등을 측정하였으며, 조직검사를 병행하였다. 재관류 손상에 따른 각 superoxide dismutase의 mRNA, protein 발현 양상을 quantitative real-time PCR 과 westem blot으로 측정하였다. 결과: EC-SOD-/- 생쥐는 다른 두 군의 생쥐 보다 확연히 느리고, 불완전한 혈관내경 및 혈류량 회복을 보여주었다. EC-SOD mRNA는 재관류 후 CuZn-SOD+/- 생쥐 및 WT 생쥐 모두에서 증가하였으나, CuZn-SOD와 Mn-SOD mRNA는 3군 모두에서 감소하였다. EC-SOD protein은 CuZn-SOD+/- 생쥐 및 WT 생쥐에서 모두 감소하였다. 조직검사 상 전반적인 부종 및 염증세포의 침윤이 관찰되었으며, 급성 염증반응은 EC-SOD-/- 생쥐가 가장 심하였다. 결론: 본 연구 결과는 세포외 superoxide dismutase가 허혈-재관류 손상 시 다량으로 발생하는 반응성 산소기에 의한 골격근 손상을 방어하는데 중요한 역할을 담당함을 시사한다. Purpose: This study investigated the role of extracellular superoxide dismutase (EC-SOD), which is a major extracellular antioxidant enzyme in skeletal muscle ischemia and reperfusion (I/R) injury. Materials and Methods: The pedicled cremaster muscle flaps from homozygous EC-SOD knockout (EC-SOD-/-), heterozygous CuZn-SOD knockout (CuZn-SOD+/-) and wild-type (WT) mice were subjected to 4.5 hour ischemia followed by 90 min reperfusion. The pedicled cremaster muscle flaps were examined by functional analysis during the reperfusion. The mRNA and protein expressions of each SOD after I/R were evaluated using quantitative real-time PCR and western blot. Results: The results showed that the EC-SOD-/- mice had a more profound I/R injury than the CuZn-SOD+/- or WT mice. In particular, there was a delayed and incomplete recovery of the arterial diameter and blood flow during reperfusion and as well as there being more severe inflammation. After 90 min reperfusion, the EC-SOD mRNA levels increased more in the CuZn-SOD+/- mice than in the WT mice. However, the CuZn-SOD and Mn-SOD mRNA levels decreased similarly in all 3 groups. The CuZn-SOD protein levels decreased in all groups. The EC-SOD protein levels decreased in the CuZn-SOD+/- and WT mice, but the Mn-SOD protein levels were unchanged or slightly increased in all groups. The histological results showed diffuse edema and inflammatory cell infiltration around the muscle fibers and these changes were more severe in the EC-SOD-/- mice. Conclusion: EC-SOD plays an important role in protecting the skeletal muscle from I/R injury caused by the excessive generation of reactive oxygen species.