건강한 성인에서 발병한 칸디다와 연관된 위궤양 1례

박지훈,이상혁,김희,이재호,박성재,지삼룡,양성연,박은택,이연재,설상영,정정명,강미선 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Fungus such as Candida albicans is a normal flora that is frequently found in the oral cavity, gastrointestinal tract, genitourinary tract, vaginal mucosa in a normal person. However, candida can cause opportunistic infection in an immune compromised host. Candidiasis has broad spectrum of disease from mucocutaneous infection to invasive or disseminated infection. But, it is rarely reported that candida is associaed with gastrointestinal tract disease in a healthy adult. The case of gastric ulcer associated with candida particularly in a health adult is reported with relevant literature.

간세포암의 고주파 열치료 후 천자침 경로를 통한 전이 1례

조영완,박석주,진한영,김준영,이재익,강명주,박정하,윤정희,박성재,지삼룡,이연재,이상혁,설상영 인제대학교 2006 仁濟醫學 Vol.27 No.-

Radiofrequency ablation(RFA), as a form of minimally invasive therapy for hepatocellular carcinoma, has become an important treatment modality. Because of limitation of surgery, RFA has become standard therapy for hepatocellular carcinoma in some situations. But there are some complications of RFA such as bleeding, infection, hematoma, adjacent organ thermal damage including intestinal perforation, needle track seeding, and so on. There are few reports in the literature that systematically evaluate the incidence of needle tract seeding and its associated risk factors. And only 2 cases of needle tract seeding of hepatocellular carcinoma after RFA were reported in Korea. We report a case of needle tract seeding of hepatocellular carcinoma after RFA.

수입각증후군에 의한 급성 복증 1례

정은욱,지삼룡,이영태,박지훈,김동기,제인수,채두근,박성재,박은택,이연재,이상혁,설상영,정정명 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Afferent loop syndrome is an uncommon complication of a gastrectomy and Billroth Ⅱ reconstruction. It may cause symtoms at any time from the first postoperative day to many years after the gastrectomy. Afferent loop syndrome is characterized by abdominal pain, vomiting and elevation of serum amylase. Thus, it is difficult to differentiate afferent loop syndrome from other cause of acute pancreatitis. However, the history of gastrectomy can be an important clue for diagnosing afferent loop syndrome. We experienced one case of chronic afferent loop syndrome with acute pancreatitis. After appropriate management, the abdominal pain disappeared and serum amylase level decreased. We report this case with a review of relevant literatures.

바터 팽대부에 생긴 유암종 1예

강명주,지삼룡,박석주,이재익,조영완,김준영,박성재,박은택,이연재,이상혁,설상영,배상균 인제대학교 2006 仁濟醫學 Vol.27 No.-

Carcinoid tumors have been reported in a wide range of organs but most commonly involve the lungs, bronchi and gastrointestinal tract. Within the gastrointestinal tract, appendix is the most common location for carcinoid, followed by the distal small intestine, the rectum, and the stomach. Among these, primary involvement of the ampulla of Vater is extremely rare. We report a case of carcinoid tumor of ampulla of Vater. A 62-year-old man presented with epigastric soreness. Gastroduodenal endoscopy showed hyperemic bulging mass on ampulla of Vater and diagnosed as carcinoid tumor by histologic finding, with immunohistochemical study. In ^(111)In-octreoscan, tumor had regional lymph node metastasis, but no evidence of distant metastasis. Pancreatoduodenectomy with lymph node dissection was performed.

신경교세포 및 RAW 264.7 세포에서 Protein kinase의 활성에 의한 유도성 Nitric oxide synthase의 발현

박상철,노삼길,배소현,박지선,이충재,허강민,석정호,이재흔 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

NO(nitric oxide) plays an important role as neurotransmitter or cytokine, and pathologic factor for some diseases by the large amount production with iNOS(inducible NO synthase) expression in macrophages or glial cells. The expression of iNOS is regulated by various cytokines, protein kinases and transcription factors. In this experiment, to investigate the roles of progein kinase and NF-kB for iNOS expression, the effects of PMA(phorbol 12-myristate 13-acetate), cAMP, and various protein kinase inhibitors on LPS(lipopolysaccharide)-induced iNOS mRNAN expression and nuclear NF-kB binding complex were examined in C6 glial cells and RAW 264.7 cells. In C6 glial cells, iNOS mRNA expression by LPS was induced from 1 hour and peak at 3 hour after treatment. In RAW 264.7 cells, the mRNA was observed from 3 hour and peak at 6 hour. PMA enhanced markedly LPS-induced iNOS mRNA expression and NF-kB binding complex in C6 glial cells, but did not much influence on LPS-induced iNOS mRNA expression in RAW 264.7 cells, in spite of increased LPS-induced NF-kB binding complex at 30 min. cAMP(dibutyryl cAMP) did not much influence on LPS-induced iNOS mRNA expression, by increased LPS-induced NF-kB binding complex in C6 glial cells. However, in RAW 264.7 cells, cAMP increased slightly LPS-induced iNOS mRNA expression without change of NF-kB binding complex. Staurosporine did not influence on LPS-induced iNOS mRNA expression and NF-kB binding complex in C6 glial cells, but in RAW 264.7 cells, decreased LPS-induced iNOS mRNA expression and NF-kB binding complex. Ro-31-8220 did not much influence on LPS-induced iNOS mRNA expression and NF-kB binding complex in C6 glial cells, but in RAW 264.7 cells, decreased significantly LPS-induced iNOS mRNA expression in spite of increased LPS-induced NF-kB binding complex for 3hours. G 6976 did not much influence on LPS-induced iNOS mRNA expression with decreased NF-kB binding complex in C6 glial cells, but in RAW 264.7 cells, decreased iNOS mRNA expression without influence on LPS-induced NF-kB binding complex. Genistein did not influence on LPS-induced iNOS mRNA expression and NF-kB binding complex in C6 glial cells, but in RAW 264.7 cells, decreased LPS-induced iNOS mRNA expression inspite of increased NF-kB binding complex. These results suggest that LPS-induced regulation of iNOS expression or NF-kB activity in C6 glial cells, might be different from RAW 264.7 cells through various protein kinases or other factors.

뇌출혈이 합병된 감염성 심내막염 1례

박동건,이재욱,권삼,이동철,강승완 동국대학교 경주대학 1997 東國論集 Vol.16 No.2

감염성심내막염에 의한 신경계 합병증은 색전성 뇌경색, 색전성 뇌출혈, 두개내 패혈성 동맥류, 뇌농양, 뇌막염등 다양한데 항생제 요법의 발달과 판막치환술에도 불구하고 그 빈도는 감소되지 않고 있다. 이 중 두개내 패혈성 동맥류의 파열에 의한 뇌출혈은 사망률이 80%로 치명적일 수 있어 조기 발견 및 적절한 치료가 필요하다. 저자들은 두통, 열감, 근육통 등의 증상으로 내원하여 감염성 심내막염으로 진단받고, 항생제 치료로 임상증세의 호전중에 심한 두통과 전신적 발작이 있은 후 갑자기 발생한 두개내 뇌출혈을 심장초음파 및 뇌 컴퓨터 단층촬영을 통하여 진단, 경험하였기에 문헌고찰과 함께 보고하는 바이다. The complications of infective endocarditis may involve any organ system ie, cardia, neurologic, vascular, dermatologic, and kidney. Extracardiac complications are usually caused by either embolization of vegetations or deposition of immune complexes. Neurologic complications remain a significant problem in bacterial endocarditis and have been reported to occur in up to 20% to 40% of cases of infective endocarditis. The various types of central nervous system disease seen in patients with infective endocarditis are cerebral embolism (with infarction or with intracerebral hemorrhage), intracranial mycotic aneurysm, seizures, brain abscess, meningitis, mental change, psychiatric disorder. Mycotic aneurysms are uncommon but not rare and are an important cause of local or systemic sepsis and acute hemorrhage following aneurysmal rupture. Cerebral mycotic aneurysms have been noted in 2∼10% of cases of bacterial endocarditis and account for 2.5∼6.2% of all intracerebral aneurysms. We have experienced a case of neurologic complication due to infective endocarditis in a 23 year-old female patient, who admitted to our hospital because of fever, chill, headache, myalgia. This case was diagnosed by echocardiography, brain computed tomography. The patient died of sudden intracerebral hemorrhage in the 53th hospital day despite intensive medical treatment. We report one case of intracerebral hemorrhage complicated with infective endocarditis.

동일한 국제예후지표(International Prognostic Index)를 나타내는 미만성 대형 B-세포 림프종에서 Bcl-2와 p16의 임상적 중요성

박상은,박수진,곽승근,박남숙,천재민,윤환중,조덕연,김삼용,김진만 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

In Korea, malignant lymphoma is a common cancer, comprising about 2.7% of all malignant neoplasm. Diffuse large B cell lymphoma is the most common lymphoma, representing about 50% of all Non-Hodgkin's lymphoma. Diffuse large B-cell lymphoma is usually considered as heterogeneous group of neoplasms rather than a single clinicopathological entity. Clinical prognostic systems, including the International Prognostic Index (IPI), although useful to assess overall prognosis, embrace patients with heterogeneous prognoses. But International Prognostic Index scoring system is not sufficiently predict the prognosis. It is likely that the prognostic assessment of patients with diffuse large B-cell lymphomamight be improved by using biological features. Bcl-2 protein and p16 protein expression is recognized as useful biologic markers predicting the prognosis of patients with diffuse large B-cell lymphoma. To determine the clinical significance and prognostic value of bcl-2 and p16 proteins expression patterns, we studied 18 patients with de novo DLBL, whose archival pathology specimen were available for immunohistochemistry studies, atChungnam National University Hospital from September 1992 to December 2000. Archival specimens from each patient were immunostained with respective antibodies for bcl-2, p16. The results are as follows; 1) The median age was 54(rage : 37-69). There were 12 male patients(66.7%) and 6 female patients(33.3%) The 'B' symptom was abscentin all patients. The stages were as follows : Ⅰ, 2 patient(11.1%), Ⅱ, 10 patient(55.6%), Ⅲ, 4patient(22.2%) and Ⅳ, 2patient(11.1%). 3 patients(16.8%) had the elevated LDH level, 14 patients(77.8%) had the normal LDH level and 1 patients(5.6%) was not identified the LDH level. 2 patients(11.1%) had the bulky disease and 16 patients(88.7%) had no bulky diease. The distribution of ECOG status were O, 2 patients(11.1%c), 1, 14patients(77.8%) and 2, 2patients(11.1%). 2) Theimmunohistochemistry results are as follows bcl-2:+,10 patients(55.6%), bcl-2:-, 8patinets(44.4%), p16:+,3 patients(16.7%), p16:-, 15patients(83.3%) 3) After a median follow UP durations of 67 months, the median survival time was 57 months with a rage of 7-100+ months. 5-years overall survival rates was 44% by Kaplan-Meier method. 4) Reduced overall survival was demonstrated in the patients who expressed bcl-2 protein(P=0.0174). 5-year overall survivial rate was 12%(bcl-2 expression) versus 88%(no bcl-2 expression) 5) Among diffuse large B-cell lymphoma patients with IPI score 0-1, reduced overall survival was demonstrated with bcl-2 expression(P=0.023). 5-year overall survival rate was 18%(bcl-2 expression group) versus 100%(no bcl-2 expressiongroup) 6) Median survival durtation of diffuse large B-cell lymphoma patients negative for p16 expression was 57 months whereas p16 postive patients' median survival duration was not reached(P=0.4478). In diffuse large B-cell lymphoma patients with identical IPI scores, bcl-2 expression had additional prognostic value.

Brevibacterium albidum중의 제한효소 Bal I의 정제 및 특성에 관한 연구

박정수,배광묵,박재윤,고광삼 朝鮮大學校 附設 醫學硏究所 1987 The Medical Journal of Chosun University Vol.12 No.1

In this report, Bal I endonuclease from brevibacterium albium (ATCC 15831) strain was purified characterized. Bal I endonuclease was purified by the following procedures; ammonium sulfate fractionation, DEAE-cellulose column chromatography, phosphocellulose column chromatography. Bal I endonuclease has a specific site for type II enzyme in that has been proven by the facts that PBR322 DNA cleaved by Bal I endonuclease. All sited cleaved by Bal I are also cut by the speficif endonuclease Hae III from haemephilus aegyptiu. The recognition sequence of Bal I are. ◁수식 삽입▷ (원문을 참조하세요)

췌십이지장절제술 후 발생한 지속적인 구토증과 Wernicke 뇌병증

박우영,김성완,이삼연,신일선,김재민,박기형,양수진,윤진상 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.3

Wernicke encephalopathy is an acute neurologic disorder attributable to thiamine (vitamin B1) deficiency. We report the case of a 61-year-old female patient who presented Wernicke encephalopathy after surgery for pancreatic head cancer. From the ninth postoperative day, she had suffered from nausea and vomiting and had difficulties ingesting food, she was given total parenteral nutrition (TPN), but lacked adequate vitamin (thiamine) supplementation. After 28 days, she developed ataxia, ophthalmoplegia, and mental confusion. The magnetic resonance image showed pathologic changes in the medial thalamus,periaqueductal gray matter, medulla and mamillary bodies. The blood level of thiamine was very low. After intravenous and oral supplementation of thiamine (200 mg/day), consciousness was soon normalized and neurologic symptoms have gradually been improving. Nausea and vomiting disappeared after administration of a low dose of mirtazapine (7.5 mg/day). We emphasize the importance of thiamine supplementation to the patients who suffer from vomiting which hinders them from taking food and who require prolonged TPN.

Transthyretin의 Glutathione 자동산화 촉진작용

박종근,정신,김재휴,김수한,강삼석,이제혁,안봉환 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.8

When reduced glutathione(GSH) was incubated at neutral pH and at 37°, its concentration decreased slowly with formation of oxidized glutathione(GSSG). Autooxidation of GSH was accelerated by Cu^(2+) and Hg^(2+), but not by other common mono-, di-, and tri-valent cations. Transthyretin was found to stimulate autooxidation of GSH in the presence or absence of Cu^(2+) and Hg^(2+). EDTA inhibited perfectly the autooxidation of GSH regardless of the presence of transthyretin. The stimulating activity of transthyretin was maximal at pH 7.0, declining progressively with increase or decrease of pH from 7.0. Sulfhydryl-blocking agents such as p-hydroxymercuribenzoic acid and Nethylmaleimide markedly inhibited the stimulating activity of transthyretin. Transthyretin stimulated autooxidation of other sulfhydryl compounds such as clithiothreitol and cysteine. However, it did not show a significant effect on autooxidation of sulfhydryl group of egg albumin and eye lens proteins. And transthyretin did not cause any oxidative change to thyroxine(T₄), 3, 5, 3Ltri iodo thyronine(T₃) and 3, 3: 5~triiodothpnine(rT₃) bound to it in the presence of GSH and Cu^(2+). The above results suggest that transthyretin may play a role in regulation of oxidized status of sulfhydryl groups in blood plasma and cerebrospinal fluid