Mirizzi 증후군의 변형된 분류와 치료

김형철,강길호,채만규,김성용,백무준,이문수,박상흠,이문호,김창호,송옥평,조무식,박희주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Purpose : The Mirizzi syndrome is relatively rare and preoperative diagnosis of this disease is difficult. In 1978, Morelli suggested the subclassification of the Mirizzi syndrome into acute or chronic form. We experienced 5 cases of acute form. We analysed clinical features, preoperative radiologic findings and operative findings of 18 cases including acute forms which were diagnosed as Mirizzi syndrome and should suggest the modified classification of Mirizzi syndrome for choice of appropriate treatment. Method : From January 1995 to December 1998, 18 cases, of which 8 cases were diagnosed at Soonchunhyang University Chunan Hospital, and 10 cases were reported in the Korean Journal were retrospectively analysed with regard to clinical features, preoperative radiologic findings and operative findings. According to the clinical features, whole cases were divided into type Ⅰ(acute form) and type Ⅱ(chronic form) and then each type of cases were subclassified according to preoperative radiologic findings and operative findings. Results : Of 18 cases there were 5 cases in type Ⅰ(27.8%), 13 cases in type Ⅱ(72.2%). Type Ⅱb was most common. Type Ⅰa cases were treated only with cholecystectomy. We applied cholecystectomy, T-tube choledochostomy and patch technique in type Ⅰb and thpe Ⅰc cases. Cholectystectomies including removal of gallstones and internal drainage procedures were done in type Ⅱ chronic forms. Conclusion : The acute form(Type Ⅰ) of Mirizzi syndrome was suggested by Morelli might be subclassified into typeⅠa,Ⅰb and Ⅰc following the presence of the necrotic defect in common hepatic duct. Through the modified classification of Mirizzi syndrome based on clinical feature, preoperative radiologic findings and operative findings, we can choice appropriate treatment.

간 세포암에서 VEGF, TGF-β1, b-FGF 발현의 의의

김성용,남충현,주종우,채만규,백무준,이문수,김형철,안현철,김홍수,김창진,김창호 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: Angiogenesis is important for the proliferation and the metastasis of solid tumors. The growth of a solid tumor is widely recognized to depend on the process of neovascularrozation. Without angiogenesis, tumors cease to grow beyond even a few milimeters in diameter. It has been shown that tumor vascular density is an independent prognostic marker in several types of human tumors and is known to correlate with poor prognosis. To date, many angiogenic factors have been identified, such as transforming growth factor-α(TGF-α), transforming growth factor-β(TGF-β), fibroblast growth factor family(FGF), vascular endothelial growth factor(VEGF), platelet derived endothelial cell growth factor(PD-ECGF), tumor necrosis factor-α(TNF-α), and angiogenin. Hepatocellular carcinoma(HCC) is the second most common tumor in Korean males and is known as a typical hypervascular tumor with frequent portal vein invastion. The authors identified the expreesion of VEGF, TGF-β1, and b-FGF in HCC specimens and evaluated the relationship between these growth factors and the clinicopathologic characteristics of HCC. Method: We reviewed the medical records of 30 patients who were diagnosed as hepatocellular carinoma treated with hepatic resection between January 1994 and December 1998 in Soonchunhyang University Chunan Hospital. The selection of the cases was decided according to the condition of paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum α-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus(HBV) infection, and Edmonson-Steiner(E-S) grade were investigated. Relationship between the prognostic factors and the immunopathologic expression of the TGF-β1, b-FGF, and VEGF was examined. Result: Thirty patients (24 males, 6 females) were included in the current study. The patient's mean age was 50.6 years and the age ranged from 36 to 65 years. The mean size of the tumor was found to be 5.2cm. All the patients were follewed up for 7 to 63 months. Child's classification A patients were 23(76.7%)cases, B patients were 7(23.3%)cases, and C was none. Immunohistochemical staining of HCC tumor mass in VEGF expression patients were 17(56.7%), b-FGF expression patients were 10(33.3%), and TGF-β1 expression patients were 10(33.3%). VEGF expression or more than one positive expression among the three factors correlated with tumor size and the stage of HCC but did not correlated with other clinicopathological characteristics. TGF-β1 and b-FGF did not correlate with any clinicopathological characteristics. Conclusion: The results suggest that the expression of VEGF or more than one positive expression among the three factors in HCC cells may be a significant prognostic factor of HCC.

Newcastle Disease Virus의 Fusion 단백 유전자의 제한효소분절형태(RELP)의 특이성

장경수,김지영,김석,김태용,송영환,허지연,김현수,송희종,전무형 충남대학교 수의과대학 동물의과학연구소 2001 動物醫科學硏究誌 Vol.9 No.-

To evaluate the specificity of restriction fragment length polymorphism (RFLP) of Newcastle disease virus (NDV) fusion (F) protein gene for various NDV strains. F protein genes of NDV CBP-1 isolate, LaSota, B1 and Kyojungwon (KJW) were amplified by reverse transcriptase-polymerase chain reaction (RT-PCR) and RFLP were examined. In RT-PCR using F primer sets for 1.7 kb F gene, the amplified products were observed in CBP-1, LaSota and B1 except KJW. However, F2 primer set for 521 bp yielded the amplified bands with all strains. The amplified F genes (1.7 kbp) were treatd with 15 different restriction enzymes to analyze RFLP and the cleavage patterns. CBP-1 showed various cleavage patterns with 8 enzymes, LaSota, with 11 enzymes and B1, with 11 enzymes. According to the cleavage patterns, the physical maps were constructed, and it was found that CBP-1, LaSota and B1 strains had specific cleavage sites with HinfI, XbaI and XhoI. These findings suggest that RFLP are worth applying in the diagnosis and molecular epidemiological studies of Newcastle disease.

Brucella abortus 국내 분리주의 36kDa 외막단백을 암호하는 omp2b 유전자의 염기 분석

허지연,김지영,송근호,김명철,박창식,김태용,김정화,전무형 충남대학교 형질전환복제돼지연구센터 2004 논문집 Vol. No.8

B. abortus 국내 분리주의 분자유전학적 성상을 규명하고 분자역학적 연구에 필요한 기초자료를 얻기 위해 36kDa OMP를 암호하는 omp2b 유전자를 PCR법으로 확인하고,그리고 omp2b 유전자의 핵염기 서열과 아미노산 서열을 결정하고 이 결과를 Brucella 표준균주 및 여러 동물에서 분리된 Brucella 분리주와 상호 비교 분석하였던 바 다음과 같은 결과를 얻었다. 1. B. abortus 분리 주 (7주)에 대해 omp2b primers를 이용하여 PCR을 수행한 바 공시한 참조균주와 분 리균주 모두에서 1,251bp의 특이한 DNA 절편이 각각 증폭되었다. 2. omp2b 유전자의 1,089bp에 대한 염기서열과 이에 대한 362개의 아미노산 서열을 결정하였다. 분리 균주의 omp2b 유전자의 염기서열을 참조균주와 비교 분석한 결과 B. abortus 2308 (biovar 1) 및 B abortus B3196 (biovar 5)과는 99.6%∼100% 및 99.5%∼99.9%의 매우 높은 상동성을 나타내었고,B. abortus 45/20 (biovar 1)과는 97.1%~97.4%의 상동성을 나타내었다. 또한 362개의 아미노산 서열에 대해 분석하였던 바,분리균주들은 B.abortustus 2308 (biovar 1) 및 B. abortus B3196 (biovar 5)과는 99.2%∼100%의 매우 높은 상동성을 보였으며,B. abortus 45/20 (biovar 1)과는 96.4%∼ 97.2%의 상동성을 보였다. 3. 본 시험에 공사된 브루셈라균주의 omp2b 유전자 서열과 여러 동물에서 분리된 브루셀라 분리주의 자료를 바탕으로 phylogenetic tree를 작성 한 바,국내 분리주는 B. abortus 2308 (biovar 1),B. abortus B3196 (biovar 5),B. abortus 45/20 (biovar 1),B. suis 1330 (biovar 1),B. melitensis 16M (biovar 1),B. canis NCTC 01854,B. neotomae 5K33과 97.3% 이상의 높은 근연성을 보이며 동일한 cluster에 소속되었으며,omp2b 유전자는 매우 잘 보존됨을 알 수 있었다. omp2b gene of Brucella abortus isolates encoding 36kDa outer membrane protein (OMP) was amplified by polymerase chain reaction (PCR) and the sequences of nucleotide and amino acid were determined and analyzed to obtain the basic data for molecular epidemiological features of brucellosis in Korea. In PCR using omp2b primers for the gene of 36kDa aMP, the specific signals at 1,251bp were demonstrated, The nucleotide sequences of omp2b gene of 1,089bp were sequenced by dye terminator cycle sequencing method, and 362 amino acid sequences were predicted. As compared the nucleotide sequences with those of B. abortus reference strains, the isolates showed the very high homology to the reference strains ranging 97.1%∼100%. The similar results were also obtained in the analysis of the amino acid sequences. In the phylogenetic tree, the isolates clustered with the reference strains and the majority of strains originated from pig, dog, wood rat and cattle.

Brucella abortus 국내 분리주의 36kDa 외막단백을 암호하는 omp2b 유전자의 염기 분석

허지연,김지영,송근호,김명철,박창식,김태용,김정화,전무형 한국수의공중보건학회 2003 예방수의학회지 Vol.27 No.1

B. abortus 국내 분리주의 분자유전학적 성상을 규명하고 분자역학적 연구에 필요한 기초자료를 얻기위해 36kDa OMP를 암호하는 omp2b 유전자를 PCR법으로 확인하고, 그리고 omp2b 유전자의 핵염기 서열과 아미노산 서열을 결정하고 이 결과를 Brucella 표준균주 및 여러 동물에서 분리된 Brucella 분리주와 상호 비교 분석하였던 바 다음과 같은 결과를 얻었다 1. B. abortus 분리주 (7주)에 대해 omp2b primers를 이용하여 PCR을 수행 한 바 공시한 참조균주와 분리균주 모두에서 1,251bp의 특이한 DNA 절편이 각각 증폭되었다 2. omp2b 유전자의 1,089bp에 대한 염기서열과 이에 대한 362개의 아미노산 서열을 결정하였다. 분리균주의 omp2b 유전자의 염기서열을 참조균주와 비교 분석한 결과 B. abortus 2308 (biovar 1) 및 B. abortus B3196 (biovar 5)과는 99.6%~l00% 및99.5%~99.9%의 매우 높은 상품성을 나타내었고, B. abortus 45/20 (biovar 1)과는 97.1%~97.4%의 상품성을 나타내었다. 또한 362개의 아미노산 서열에 대해 분석하였던 바, 분리균주들은 B. abortustus 2308 (biovar 1) 및 B. abortus B3196 (biovar 5)과는 99.2%~l00%의 매우 높은 상품성을 보였으며, B. abortus 45/20 (biovar 1)과는 96.4%~97.2%의 상품성을 보였다. 3. 본 시험에 공시된 브루셀라균주의 omp2b 유전자서열과 여러 동물에서 분리된 브루셀라 분리주의자료를 바탕으로 phylogenetic tree를 작성 한 바, 국내 분리주는 B. abortus 2308 (biovar 1), B. abortus B3196 (blovar 5), B. abortus 45/20 (biovar 1), B. suis 1330 (biovar 1), B. melitensis 16M (biovar 1), B. canis NCTC 01854, B. neotomae 5k33과 97.3%이상의 높은 근연성을 보이며 동일한 cluster에 소속되었으며, omp2b 유전자는 매우 잘 보존됨을 알 수 있었다. omp2b gene of Brucella abortus isolates encoding 36kDa outer membrane protein (OW) was amplified by polymerase chain reaction (PCR) and the sequences of nucleotide and amino acid were determined and analyzed to obtain the basic data for molecular epidemiological features of brucellosis in Korea. In PCR using omp2b primers for the gene of 36kDa OMP, the specific signals at 1,251bp were demonstrated, The nucleotide sequences of omp2b gene of 1,089bp were sequenced by dye terminator cycle sequencing method, and 362 amino acid sequences were predicted. As compared the nucleotide sequences with those of B. abortus reference strains, the isolates showed the very high homology to the reference strains ranging 97.1%-100%. The similar results were also obtained in the analysis of the amino acid sequences. In the phylogenetic tree, the isolates clustered with the reference strains and the majority of strains originated from pig, dog, wood rat and cattle.

후방골절단술과 Skeletal anchorage system를 이용한 사악구치부압하 : 증례보고 CASES REPORT

임광수,풍무걸,김기형,이희철,김우형,김동우 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

The severe extrusion of the maxillary [post.teeth after the early loss of the mandibular post.teeth makes the fabrication of the mandibular prothesis difficult, and without proper planning.the treatment results are often unsatisfactoy. Several treatment modalitys have been introducted to correct the interarch space deficency.:Reduction the occlusal surfaces,Crown lengthening,Endodontics & restorative approach,Extraction, Orthodontic intrusion and segmental osteotomy. Because of many advantages,conservative method is widely used if it has no particular limits of treatment adjustment, but the cases of surgical correction indication are found in clinical experience. In our clinic,we corrected severe extruded maxillary post.teeth by performance of a unilateral posterior osteotomy with superior repositioning of the segment and orthodontic intrusion using Skeletal anchorage system,so here we reported the cases with a study of documents.

Roxythromycin-tylosin-furaltadone 합제의 닭 유래 세균에 대한 시험관내 항균효과

김지영,채미경,윤효인,서상희,박배근,김현수,전무형 충남대학교 수의과대학 동물의과학연구소 2003 動物醫科學硏究誌 Vol.11 No.-

In vitro antimicrobial susceptibility of roxythromycin (Rx), tylosin (Tyl), erythromycin (EM) and furaltadone (Fur) was studied, either by the single type or the combinated type of Rx-Tyl-Fur (RTF) against E. co1i (30 strains), Staph. aureus (20 strains) and Mycoplasma gallisepticum (5 strains) that are the major pathogens in poultry farm. The paper disk diffusion and MIC tests were applied. In screening test by paper disk diffusion method, the single types of antibiotics showed the sensitivity against 55 strains of bacteria in order of Fur, EM, Rx and Tyl. The combinated RTF showed the higher rate of sensitivity (80∼83.3% at 64㎍/disk, 60-75% at 32㎍/disk) and wider range of growth inhibiting zone (19.6±3.7-24.8±4.7mm) than those of the single drugs. In MIC test, the sensitivity against the 55 strains appeared in order of Fur. EM, Rx and Tyl as similar to those of paper disk diffusion method. The MIC ranges of RTF were 0.125∼16㎍/ml for E. coli, 0.25∼16㎍/ml for Staph. aureus and 1-8㎍/ml for Myco. gallisepticum, showing evidently lower than those of the single types. The MIC_(50) and MIC_(90) of RTF were estimated l∼4㎍/ml and 8∼16㎍/ml, respectively, and remarkably lower than those of the single drugs.

노견에 발생한 신종양의 외과수술 1례

김명철,박창식,전무형 충남대학교 수의과대학 동물의과학연구소 2003 動物醫科學硏究誌 Vol.11 No.-

Neoplasm of the left kidney was diagnosed in a 11 years old Jindo dog. The clinical signs were loss weight, depression, anorexia and vomition after a meal. Large mass was palpated on the left abdomen. Abdominal radiography revealed a large mass in the region of the left kidney. Left kidney with neoplasm was removed by nephrectomy. The size of removed kidney was 16 by 12 by 10 cm. The dog was given postoperative penicillin and streptomycin to prevent secondary infection for 5 days. The dog lived 1 years after surgical removal of the affected kidney.

노견에 발생한 신종양의 외과수술 1례

김명철,박창식,전무형 충남대학교 형질전환복제돼지연구센터 2004 논문집 Vol. No.8

Neoplasm of the left kidney was diagnosed in a 11 years old Jindo dog. The clinical signs were loss of weight. depression, anorexia and vomition after a meal. Large mass was palpated on the left abdomen. Abdominal radiography revealed a large mass in the region of the left kidney. Left kidney with neoplasm was removed by nephrectomy. The size of removed kidney was 16 by 12 by 10 cm. The dog was given postoperative penicillin and streptomycin to prevent secondary infection for 5 days. The dog lived 1 years after surgical removal of the affected kidney.

매쉬-심 용접 판재의 성형 한계

김형목,허영무,양대호,서대교 기계기술연구소 1999 성균관대학교 논문집 기계기술편 Vol.1 No.1

This paper describes experimental investigation on the forming limit for mash-seam welded sheets. The uniaxial tensile test was conducted to evaluate the mechanical properties of weld bead. Experimental forming limit diagrams were investigated for the different thicknesses and properties of welded sheets.