권역 응급의료센터에 내원한 비외상성 객혈 환자에서 기관지 동맥 색전술의 장기 생존 효과

천성빈 ( Song Bin Chon ),정성구 ( Sung Koo Jung ),곽영호 ( Young Ho Kwak ),서길준 ( Gil Joon Suh ),유은영 ( Eun Young You ),신상도 ( Sang Do Shin ) 대한결핵 및 호흡기학회 2004 Tuberculosis and Respiratory Diseases Vol.57 No.2

유방암에 대한 술전항암화학요법(Neoadjuvant Chemotherapy)의 반응도에 따른 잔여종양조직의 병리학적 특성

김종완(Jong Wan Kim),정성구(Sung Ku Jung),엄태익(Taeik Eum),구본용(Bon Young Koo),강희준(Hee Joon Kang),김이수(Lee Su Kim) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.1

Purpose: There are questions about selecting the best postoperative chemotherapeutic regimen for breast cancer patients who have different response rates after neoadjuvant chemotherapy. The aim of this study was to examine the pathologic findings of residual tumors according to the response rate after neoadjuvant chemotherapy for breast cancer. Methods: We obtained specimens of residual tumors from 43 breast cancer patients who received neoadjuvant chemotherapy followed by curative operation at the Department of Breast and Endocrine Surgery, Sacred Heart Hospital, between Oct. 2002 and Oct. 2006. Four patients received 3 cycles of FAC (5-FU, Adriamycin, Cyclophosphamide) and 39 patients received 3 cycles of AT (Adriamycin, Docetaxel). We analyzed the pathologic characteristics according to the response rate. Results: The clinical response rate for neoadjuvant chemotherapy was 69.8%. There was no significant difference in the response rate for neoadjuvant chemotherapy between the AT and the FAC regimen groups. The tumors of the complete response group showed to be more ER-negative, PR-positive, p53-negative and c-erb-B2-positive and they had a lower Ki-67 staining index than the tumors of the partial response group. Moreover, the tumors of the clinical complete response group showed more triple (ER/PR/c-erb-B2) negative tumor than did the tumors of the partial response group. Conclusion: Although the tumor responded to neoadjuvant chemotherapy, the pathologic findings of the residual tumors in the clinical complete response group differed from that of the partial response group. So, this should be considered for the selection of postoperative chemotherapeutic agents.

H9c2 심근 세포주에서 외인성 nitric oxide가 허혈에 의한 세포 독성에 미치는 영향

정성구,장현용,김명천,고영관,정주호,배영미,박원서,김대중,유영민,김성수,임성빈 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Nitric oxide(NO) is known to have protective effects on an ischemic heart and to exert triggering effects on ischemic preconditioning. However, the effects of NO during the ischemic period have not been investigated. To investigate the role of exogenous nitric oxide in a model of ischemic heart cell death, we studied the effects of ischemic preconditioning and ischemia in a normal and an ischemic buffer. Methods: Rat cardiac myoblast cells(H9c2) were cultured in a normal and an ischemic buffered medium. For the ischemic culture of heart cells, the cells were cultured in a dessicator with GasPak for 5 hrs. In ischemic preconditioning, the cells were pretreated with ischemic buffer for 5 min and then perfused with normal medium for 30 min. For the measurement of the cytotoxicity, a MTT(3-4-Sdimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide) assay was performed. A DAPI(4',6-diamidino-2-phenylindole dihydrochloride) staining procedure and a flow cytometry analysis were performed to confirm apoptotic cell death by ischemia. Results: Cell viability, as determined by using a MTT assay, showed that the preconditioned group treated with NO showed more cell death than with the not-preconditioned groups in both normal and ischemic buffers. But, In normal medium and not-preconditioned groups, NO showed protective effect according to the concentrations(100,1000μM) . No treatment with NO produced the different results. In normal medium, the protective effect of ischemic preconditioning was demonstrated, but no protective effect of ischemic preconditioning could be seen in the case of the ischemic buffer. The DAPI staining and flow cytometry analysis of heart cells showed characteristic apoptotic features. Conclusion: NO added in the ischemic phase had deterious effects on heart cells. Ischemic preconditioning was more harmful than ischemia alone. The toxicity of the cells was characteristic apoptosis.

급성 허혈성 뇌졸중에 대한 동맥내 혈전 용해술 후 발생한 혈복증 1예

정성구,김명천,고영관 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Although thrombolytic therapy is one of the most effective therapeutic option for acute ischemic stroke, hemorrhagic complication still remains major concern about its application. A patient with hemoperitoneum, who previously underwent thrombolytic therapy(intraarterial urokinase infusion, IAUK) for acute ischemic stroke was treated successfully with emergency transarterial embolization for rupture of hepatocellular carcinoma. We present a rare case of rupture of hepatocellular carcinoma after intraarterial urokinase infusion for acute ischemic stroke with brief review of the literature.

패혈증과 피부 감염증 의증으로 오진된 스티븐스 존슨 증후군 1예

정성구,김명천,고영관 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Stevens-Johnson syndrome(SJS) is a rare, life-threatening, drug-induced cutaneous reaction which presents dramatic, unforgettable manifestations. While the characteristic features of the disease are well known universally, many physicians have not seen a case of SJS which may result in delay in recognition and treatment. We report a rare case of SJS, which was initially misiagnosed as sepsis with skin infection and atypical pneumonia on emergency department presentation, and we give a brief review of the literature.

허혈-재관류성 뇌 손상 저빌 모델에서 중등도 저체온증이 뇌 부위별 신경 전달 물질의 함량에 미치는 영향

정성구,김인병,김창현 대한응급의학회 2002 대한응급의학회지 Vol.13 No.4

Purpose: Hypothermia induces tolerance to ischemic brain injury and has protective effects. The role of catecholamine and indole amine in ischemic brain injury has not been well documented. To investigate the relationships between hypothermia and catecholamines in ischemia-induced brain damage, we performed a quantitative measurements of the catecholamines in each brain region after a periods of ischemia and ischemia reperfusion. Methods: By using the Gerbil global ischemic reperfusion model, we divided the experimental group into control, ischemia (10 minute), ischemia with hypothermia, ischemia reperfusion, and ischemia reperfusion with hypothermia groups. After periods of ischemia and ischemia reperfusion with or without hypothermia, the amine concentrations in five brain regions were measured using high performance liquid chromatography (HPLC). Results: The norepinephrine (NE) content in the hippocampus was increased in the ischemia group and the ischemia reperfusion with hypothermia group, but diminished in the ischemia with hypothermia group and the ischemia reperfusion group (p<0.05). The dopamine content was decreased in the hippocampus in the ischemia with hypothermia group and was increased in the ischemia reperfusion with hypothermia group. However, the striatal dopamine content was increased in the ischemia with hypothermia. The contents of both 5-HT and 5-HIAA in the striatum of both referfusion roups were changed significantly. The contents of the other neurotansmitters were changed markedly, but the changes had no statistical significance. Conclusion: This study indicates that ischemia and hypothermia have great influences on amine contents of the brains, and suggests that much researches is required to elucidate the effects of hypothermia on the neurotransmitter content in ischemic-reperfusion brain injury.

인터넷을 이용한 One-Click 호출 시스템

안효용,정성구,김명천,고영관 대한응급의학회 2000 대한응급의학회지 Vol.11 No.2

Background: The time lag and the difficulty associated with calling clinicians of other departments are major concern in the emergency department(ED). We tried to design a new paging system which was faster, easier, and more accurate. Method: We made a web page comprised of paging numbers and then connected a personal computer in the ED to the internet through a dial-up moderm, via a web-paging service, and could page persons wearing public pagers. Results: We found that using the internet for paging was faster and more accurate than the hand-operated way. Calls were placed via the internet with only one click of the mouse. Conclusion: The One-click paging system is useful for hospital telecommunication. In this way, the internet can be applied to the entire emergency medical service system.

응급의료센터로 내원한 급성 A형 간염 환자의 임상적 고찰

곽영호,신중호,정성구,이중의,서길준,윤여규,이창현 대한응급의학회 2002 대한응급의학회지 Vol.13 No.3

Purpose: We conducted this study to evaluate the clinical manifestations of acute hepatities A in an emergency center. Methods: All hepatitis A patients who visited the emergency center of Seoul National University Hospital from October 1999 to March 2002 were analyzed using a retrospective medical record review. Variables included in the data analysis were age, sex, clinical symptoms and signs, and laboratory findings on initial presentation and their peak values. Results: A total of 31 patients showed positive for the anti-HAV lgM antibody, and 29 patients had apparent hepatitis A. The number of hepatitis A cases per month in 1999, 2000, 2001, and 2002 were 1.33, 0.25, 0.92, and 4.3, respectively. Among the 29 patients, 15 were brought to the emergency center and constituted the study group. The mean age were 22.3 years old. The most common symptoms were nausea and vomiting (100%), followed by fever (86.7%), anorexia (66.7%). Common signs were jaundice (53.3%) and hepatomegaly (46.7%). Seven patients admitted via the outpatient department were older and had a longer duration of symptoms from onset to diagnosis than the study group. The mean values of the initial laboratory tests were serum aspartate aminotransferase (AST) of 3,044 IU/L, alanine aminotransferase (ALT) of 3,521 IU/L, and a total bilirubin of 4.15 mg/dL. The peak mean values of those variables were 4,067 IU/L, 4,662 IU/L, and 7.35 mg/dL, respectively. All patients recovered without complications. Conclusion: Patients with hepatitis A showed benign clinical features. This study revealed a trend of increasing incidence of hepatitis A in adults and suggested the possibility of an outbreak. Further effort to prevent the propagation of the disease is warranted.

硫黃細菌에 의한 金屬 製鐵 및 加黃고무의 脫黃 再生에 관한 硏究

李培咸,全英淵,丁聖九 건국대학교 1970 學術誌 Vol.11 No.1

In this paper the important results obtained on properties of culture condition for iron-oxidizing to sulfide ores and discharge sulfur in Rubber treated by Ferrobacillus ferrooxi-dans-28 and Thiobacillus thiooxidans-4 which isolated soil are as follows : ① F. ferrooxidans-28 is completly oxidized to Fe2+ for incubates at 25℃, three days in K-medium ② The optimum temperature for iron-oxidizing and growth rate of F. ferrooxidans -28 is range 20-30℃ and optimal pH, the range 1.5-3.0. ③ Bacterial action are most effected in K-medium contaning 400-600ppm Nitrogen. ④ T. thiooxidans-4 is prominently discharged sulfur in Rubber. ⑤ Bacterial sulfur dicharge rate attained 24% for 4-days, 30℃ incubation. ⑥ And it seems to belike that the smaller rubber particle size, the easier to dicharged sulfur become.

서울지역 대기오염과 급성관상동맥증후군 환자의 흉통 발생의 관계에 대한 연구

조익준,신중호,정성구,서길준,이중의,정연권,이창현,윤여규 대한응급의학회 2002 대한응급의학회지 Vol.13 No.3

Purpose: There have been some studies on the hazardous effects of air pollution for patients with cardiovascular diseases. This study was designed to evaluate the possible relationship between air pollution and development of chest pain in acute coronary syndrome patients. Methods: The medical records of 109 acute coronary syndrome patients, who visited two university hospital emergency rooms in the Seoul area between January 1999 and July 2001, were reviewed. Hourly concentrations of particulate mass< 10 μm and of four gaseous air pollutants were measured at 19 different points in the Seoul area. The data were analyzed using a case-crossover approach. Results: The analysis of the data showed no definite relationship between chest pain development and either the concentrations of particulate mass<10 μm(PM_10) or of four gaseous air pollutants; namely, carbon monoxide (CO), nitrogen dioxide(NO₂), ozone (O₃), and sulfur dioxide (SO₂). However, increases in the concentrations of particulate matter, gaseous NO₂and gaseous O₃showed a positive correlation, but without statistical significance. Conclusion: This study shows no relationship between the concentrations of PM10 and other air pollutants with the development of chest pain in acute coronary syndrome patients. However, for particulate mass<2.5μm, which is currently not measured in the Seoul area, the possibility of a relationship between development of chest pain in acute coronary syndrome patients and particulate air pollutants still exists.