유방암 환자에서 종양조직내 Collagenase 활성도와 골스캔과의 비교

김창근(Chang Guhn Kim),최시성(See Sung Choi),김현정(Hyun Jeong Kim),김선구(Seon Gu Kim),임형근(Hyung Guhn Lim),노병석(Byung Suk Roh) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.3

N/A Purpose: It has been known that the activity of extracellular matrix degradative enzymes such as collagenase correlate well with the metastaic potential of various tumor cells in experimental study. This study was aimed at comparing the activities of type IV collagenase with bone scan findings in patients with breast cancer. Materials and Methods: We retrospectively correlated bone scan findings with the results of immunohistochemical staining for 92kDa, 72kDa type IV collagenase in 28, and 30 patients with metastatic breast cancer, respectively, as well as 23, and 27 patients with primary breast cancer, respectively. The immunohistochemical staining was performed with tissue specimens obtained from primary or metastatic breast tumor lesions. The amounts of the enzyme were graded from 0 to 4 and scored by multiplication metastasis was also scored from 1 to 5 with increasing probability. Results: There was a significant difference in enzyme scores between patients with and without metastasis. In patients with primary breast cancer group, the frequency of patients with enzyme score of less than 170 were 96%(26/27) and 100%(26/26) with 92kDa and 72kDa collagenase, respectively. In contrast, in patients with metastatic breast cancer group, the frequency of patients with enzyme score of more than 200 were 93%(28/30) and 87%(26/30) with 92kDa and 72kDa collagenase, respectively. All patients with each enzyme score of less than 170 show no active bony metastasis, however, there were variable bone scan findings in patients with each enzyme score of more than 200. Conclusion: Bone scan is useful to confirm, localize or follow up of bony metastasis in patients with each enzyme scores of more than 200. Acitve metastatic lesions were hardly seen on the bone scintigraphy in patients with collagenase scores of less than 170.

Iodine - 131 - Iodomethyluridine을 이용한 종양세포증식의 영상화에 관한 실험적 연구

김창근(Chang Guhn Kim),원종진(Jong Jin Won),김현정(Hyun Jeong Kim),임형근(Hyung Guhn Lim),민경윤(Kyung Yoon Min),노지영(Ji Young Rho),정선관(Seon Kwan Juhng),양경문(David J . Yang) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.3

N/A Purpose: Noninvasive imaging of tumor cell proliferation could be helpful in the evaluation of tumor growth potential and could provide an early assessment of treatment response. Radiolabeled thymidine, uridine and adenosine have been used to evaluate tumor cell proliferation. These nucleoside analogs are incorporated into DNA during proliferation. Iodine-131-Iodomethyluridine, an analog of Iodine-131-Iododeoxyuridine, is also involved in DNA/RNA synthesis. The purpose of this study was to develop Iodine-131-Iodomethyluridine and image tumor proliferation using Iodine -131-Iodomethy-luridine. Materials and Methods: Radiosynthesis of Iodine-131-5-Iodo-2'-O- methyluridine(Iodine-131-Iodomethyluridine) was prepared from 10 mg of 2'-O-methyluridine (Sigma chemical Co., St. Louis, Missouri)-and 2.1 mCi(SP. 10Ci/mg) of Iodine-131-labeled sodium iodide in 100 μl of water using iodogen reaction. Female Fischer 344 rats were inoculated in the thigh area with breast tumor cells (13765 NF, 105 cells/rat S.C.). After 14 days, the Iodine-131- Iodomethyluridine 10μCi was injected to three groups of rats(3/group). The percent of injected dose per gram of tissue weight was detennined at 0.5-hours, 2-hours, 4-hours, and 24-hours respectively. Tumor bearing rats after receiving Iodine-131-Iodomethyluridine(50μCi/rat, IV) were euthanized at 2 hours after injection. Autoradiography was done using freeze-dried 50 μ m coronal section. After injection of Iodine-131-Iodomethyluridine (100μCi/rat, IV) in three breast tumor-bearing rats, planar scintigraphy was taken at 45 minutes, 90 minutes and 24 hours. Results: Iodine-131-Iodomethyluridine was conveniently synthesized using iodogen reaction. The biodistribution showed fast blood clearance and the tumor-to-tissue uptake ratios showed that optimal imaging time was at 2 hours postinjection. Autoradiogram and planar scintigram indicated that tumor could be well visualized. Conclusion: The findings suggest that Iodine-131- Iodomethyluridine, a new radio-iodinated nucleoside, has potential use for evaluation of active regions of tumor growth.

요탈장 2예 보고

박성길(Sung-Gil Park),임형근(Hyung-Guhn Lim),김갑태(Kap-Tae Kim),김상현(Sang-Hyeon Kim) 대한외과학회 2001 Annals of Surgical Treatment and Research Vol.61 No.1

중재적 방사선과 전문의와 혈관외과 전문의가 함께 시술한 Tunneled Cuffed Hemodialysis Catheter의 내경정맥 삽입술

김양호 ( Yang Ho Kim ),임형근 ( Hyung Guhn Lim ),박성길 ( Sung Gil Park ),임지현 ( Ji Hyun Lim ),김용석 ( Young Seok Kim ),이진구 ( Jin Gu Lee ),최순필 ( Sun Pil Choi ),김정화 ( Jung Hwa Kim ),이광영 ( Kwang Young Lee ) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.6

배 경 : Tunneled cuffed hemodialysis catheter는 삽입 및 사용시 합병증이 적고, 비교적 장기간 사용할 수 있어, 동정맥 문합술 후 혈관이 성숙되기까지 충분히 기다릴 수 있는 시간을 마련해 주며, 반영구적인 목적으로도 사용할 수 있다. 방사선과 의사, 외과 의사, 또는 신장내과 의사 등에 의한 카데터의 삽입 시술에 관한 보고들이 발표되어, 저자들은 동일한 중재적 방사선과 전문의와 동일한 혈관 외과 전문의가 함께 시술하여 내경정맥에 삽입한 tunneled cuffed hemodialysis catheter의 사용 성적을 분석하였다. 방 법 : 1999년 12월부터 2001년 1월까지 만성 신부전 환자 31예를 대상으로 하였고 예에서 동한 중재적 방사선과 전문의와 동일한 혈관 외과 전문의가 함께 카테터를 내경정맥에 삽입하여 혈액투석 치료를 시행하였으며, 카테터 삽입 성공률, 합병증, 혈류 속도, 카테터 수명 등을 조사하였다. 결 과 : 환자의 평균연령은 51세였으며, 남자 18명, 여자 13명이었다. 카테터 사용목적은 동정맥 문합술 후 혈관 성숙을 대기하는 경우 18예(58.1%), 혈관 상태가 불량하여 동정맥 문합술을 시행하기 어려운 환자에서 혈액투석을 위한 경우 13예 (41.9%)였다. 31예 모두에서 카테터 삽입이 성공적이었으며, 기흉이나 혈흉 등의 합병증은 없었다. 후기 방병증으로 2예 (6.5%)에서 카테터의 손상, 4예 (12.9%)에서 카테터 관련 균혈증이 발생하였다. 카테터 제거의 원인은 수술한 동정맥루가 충분히 성숙하여 카테터가 필요 없어진 경우가 22예 (71.0%), 카테터 관련 균혈증 4예 (12.9%), 환자의 사망 3예 (9.7%), 카테터 손상 2예(6.5%)이었다. 카테터의 평균 수명은 1.34±96일이었으며, 카테터 삽입 후 최초 혈액투석시 혈류 속도는 230±35.5 mL/min (mean±SD), 1개월 후 혈류 속도는 248±18.6 mL/min (mean±SD)이었다. 동정맥 문합술 후 카테터를 제거하고 동정맥 문합 부위로 혈액투석을 시작한 날까지의 간격은 평균 87±17일이었으며, 전 예에서 투석시 혈류량은 250mL/min 이상이었다. 결 론 : Tunneled cuffed catheter의 내경정맥 삽입은 중한 합병증을 일으키지 않으며 장기간 사용이 가능하여, 유지 혈액투석을 필요로 하는 환자에서 일시적 또는 반영구적 혈관 접속로로 중요하며, 동일한 중재적 방사선과 전문이와 혈관외과 전문의가 함께 시술함으로써 합병증을 줄이고 혈류 속도를 개선하며 카테터의 수명을 연장시킬 수 있는 유용한 시술로 사료된다. Background : The use of daeron-cuffed tunneled double-lumen catheters for hemodialysis has become more common as patients wait for creation and maturation of a permanent access. Placement of the catheters is done by interventional radiologists, vascular surgeons or nephrologists, and the differences in success rates, complications, blood flow rates and durations of uses are reported. This study evaluated the usefulness, complications, blood flow rates and duration of use of tunneled cuffed liemodialysis catheters implanted via the internal jugular veins by an interventiunal radiologist and a vascular surgeon together. Methods : The outcomes were retrospectively analyzed of 31 hemodialysis catheters placed from December 1999 through January 2001. We investigated age, sex, indications and locations of insertion, catheter performance, complications and causes of catheter removal, All the catheters were placed via the internal jugular veins by an interventional radiologist and a vascular surgeon together. Results : Catheter placements were successful in all patients. Procedural complication was limited to clinically unimportant minor local bleeding. No instances of pneumothorax, hemothorax, vessel injury, substantial bleeding, obstruction, malposition or stenosis occurred. The blood flow rate on the first hemodialysis after placement of the catheter was 230 35.5 mL/min and that after 1 month was 248±18.6 mL/min Late complications included catheter breakage in two cases (6.5%) and bacteremia in four cases (12.9%). Catheters were removed because of catheter-related bacteremia in four cases (12.9%) and death of, patients in three cases (9.7%). In 22 cases (71.0%) the catheters were removed because the AV vascular accesses were available for hemodialysis. Mean duration of the catheter use before removal was 134±96 days. Conclusion : Tunneled cuffed catheters inserted via the internal jugular veins are safe and durable vascular accesses for hernodialysis with good blood flow rate and long duration of use, especially placed by the co-operation of an interventional radiologist and a vascular surgeon.

노인 여성에서 유방동맥 석회화와 만성질환의 관련성

남미영(Mee-Young Nam),박종욱(Jong-Wook Park),임형근(Hyung-Guhn Lim),임방은(Bang-Eun Lim),박종헌(Jong-Heon Park),이신석(Shin-Seok Lee),마성권(Seong-Kwon Ma),김수완(Soo-Wan Kim),김남호(Nam-Ho Kim),최기철( Ki-Chul Choi) 대한임상노인의학회 2005 대한임상노인의학회지 Vol.6 No.2

Background: The purposes of this study are to assess the incidence of mammographically detected breast arterial calcifications, and to evaluate the association between breast arterial calcifications and chronic medical diseases such as hypertension, diabetes mellitus, hyperlipidemia, obesity, osteoporosis in elderly Korean women. Methods: The records of total 303 women who underwent mammography at a health care center from January 2004 to January 2005 were retrospectively reviewed. Their mammography, body mass index, blood pressure, plasma glucose, lipid profile, serum total calcium, and bone mineral density were precisely reviewed. Bone mineral density was examined by dual energy X-ray absorptiometry. Especially, we focused on the 82 women who aged more than 60 years, and their data were analyzed according to the presence (calcification group) or absence (control group) of breast arterial calcifications. Results: The incidence of breast arterial calcifications in the 303 subjects was 17.2%. The incidence of breast arterial calcifications showed statistically significant difference according to the age, with a higer incidence in older women (P<0.05). Half of women who aged more than 60 years showed breast arterial calcifications. There was no significant association between the prevalences of hypertension, diabetes mellitus, hyperlipidemia, obesity, and breast arterial calcifications. However, we found that the prevalence of osteoporosis in the calcification group (51.2%) was significantly higher than the control group (26.8%) (P<0.05). Conclusion: Breast arterial calcifications on mammogram in Korean women aged more than 60 years are a reliable indicator of osteoporosis, and not associated with hypertension, diabetes mellitus, hyperlipidemia, obesity. 연구배경: 유방촬영 시에 종종 볼 수 있는 유방동맥 석회화에 관한 우리나라 노인 여성에서의 발생 빈도를 조사하고, 고혈압, 당뇨병, 고지혈증, 비만, 골다공증 등의 내과적 만성질환들과의 연관성을 조사해 보고자 연구하였다. 방법: 2004년 1월부터 2005년 1월까지 유방촬영 및 건강검진 프로그램을 받기 위해 검진센터를 방문한 총 303명의 여성을 대상으로 하였다. 대상 여성들에게 키, 체중, 체질량 지수, 혈압, 골밀도검사 및 혈액검사를 시행하였으며, 60세 이상의 노인 여성 82명을 최종 연구대상자로 선정하여 유방동맥 석회화가 있는 군(석회화군)과 없는 군(대조군)으로 나누어 내과적 만성질환들과의 연관성을 조사하였다. 모든 결과들은 후향적으로 분석하고 평가하였다. 결과: 총 303명의 대상 여성 중에서 유방동맥 석회화가 있는 여성은 52명(17.2%)이었고, 60세 이상의 여성 82명 중에서는 41명(50.0%)이었다. 유방동맥 석회화 현상은 나이의 증가에 따라서 통계학적으로 의의있게 많아짐을 보였다(P<0.05). 60세 이상 노인 여성 중의 석회화군 41명과 대조군 41명간에 있어서 고혈압, 당뇨병, 고지혈증, 비만의 유병률은 서로 유의한 차이는 없었으며, 골다공증 유병률만 석회화군에서 51.2%로 대조군의 26.8%보다 의의있게 높았다(P<0.05). 결론: 60세 이상 노인 여성에서의 유방동맥 석회화는 상당히 흔하였으며, 골다공증과 유의한 연관성이 있었다.

Wegener 씨 육아종 증례보고 1예 : A Case Report

정선관,임형근,정은택,노병석,김창근,원종진 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.2

Wegener's granulomatosis is characterized by necrotizing and granulomatous disease which involves upper, lower respiratory tract and kidney. The basic pathophysiologic mechanism of Wegener's granulomatosis is still unknown. We report a case of Wegener's granulomatosis which involved lung and pleura and was diagnosed by clinical symptoms, radiologic findings and anti-neutrophilic cytoplasmic autoantibodies.

초음파 유도하 터널식 혈액투석용 도관 삽입술

이병용,김철승,임형근 대한혈관외과학회 2004 Vascular Specialist International Vol.20 No.1