안와를 침범한 상악동 악성종양에서 안구 보존을 위한 내시경의 역할

조규섭,노환중 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.24

Background and Objectives: The periorbita has been regarded as the crucial structure in decision of orbital exenteration in the patients with paranasal malignancies. The mass beyond the thickened periorbita on T2-weighted images was considered to be a positive finding of orbital invasion. The purpose of this study is to evaluate the oncological safety of endoscopic removal of infiltrated tumor onto the periorbita but not transgress into orbital fat. Patients and Methods: Five patients of advanced maxillary cancer, showing bony orbital wall destruction and infiltration onto the periorbita but not transgress into orbital fat, underwent partial or total maxillectomy. Preoperative Cl and MRI were performed in all cases and compared with intraoperative findings. The successful dissection between tumors and periorbita using bipolar nasal coagulation forceps and tumor forcep was performed under endoscopy. Results: The mean age was 54.4 (41-74) years. All tumors of five patients originated from maxillary sinus and extended to involve multiple different subsites according to AJCC (2002, 6^(th) ed.) Histopathology included four squamous cell carcinomas and one adenoid cystic carcinoma. Follow-up ranged from 30 to 121 months (mean 53.6 months). All cases showed no local recurrence on the periobita after endoscopic removal. One patient had local recurrence in the pterygopalatine fossa and the other had in the neck. Conclusion: Endoscopic removal of infiltrated tumor onto the periorbita using microdebrider, bipolar nasal coagulation forceps and tumor forceps can be oncologically safe technique in advanced maxillary cancer infiltrated onto the periorbita but not invaded into orbital fat.

화학공정 안전성평가 기법에 관한 비교 연구

변윤섭,안대명,황규석 한국안전학회 2003 한국안전학회지 Vol.18 No.2

A new reliability assessment methodology is presented and the new method is compared with fault tree analysis. The system is modeled by directed graph at a new methodology, which is composed of nodes and arcs. The directed graph corresponds to the layout of chemical process and is easy to construct. Therefore, the directed graph analysis is applicable to the chemical process that has complex sequence. The example of fault tree analysis and directed graph analysis is given. The directed graph analysis has proved to be a valuable and useful method for the reliability assessment of chemical process.

실험적 구루병에서 백서 치아조직 및 하악골의 무기질함량에 관한 연구

박규섭,조재오 대한구강생물학회 1988 International Journal of Oral Biology Vol.12 No.1

Richets is not the deposit of mineral in the skeletal tissue and is the retardation of skeletal growth in growing animals. In the skeletal disease such as rickets, vitamin D was known the most effective element. The purpose of this study was to investigate mineral changes induced by rachitogenic diet No. 2, which was high in calcium but low in phosphorus and deficient in vitamin D upon the dental structures and mandibular bone of rats. For this study, 48 albino rats were used and divided into two groups. While 24 rats of experimental group were maintained rachitogenic diet, 24 rats of control group were maintained normal diet for experimental period. For observation, animals were killed at 7 days intervals during the 42 days period and obtained specimen of teeth and mandibular bone. After both materials were powdered, Ca content determined by atomic absorption spectrophotometer (Shimadju Co, Flame Emission Spectrophotometer : AA-640-18) and P content determined by UV-spectrophotometer (Bausch and Lomb, Spectrophotometer 21) The results were as follows : 1. The Ca content in incisor of control group rose from 19.0% of dry weight in 7 days to 19.8% in 42 days while that of experimental group fell from 18.6% in 7 days to 17.8% in 42 days. 2. The P content in incisor of control group rose from 9.8% dry weight in 7 days to 10.7% in 42 days while that of experimental group fell from 9.6% in 7 days to 8.8% in 42 days. 3. The Ca content in molar of control group rose from 19.0% of dry weight in 7 days to 19.8% in 42 days while that of experimental group fell from 18.8% in 7 days to 18.3% in 42 days. 4. The P content in molar of control group rose from 10.0% dry weight in 7 days to 10.7% in 42 days while that of experimental group fell from 9.9% in 7 days to 9.4% in 42 days. 5. The Ca content in mandibular bone of control group rose from 14.2% of dry weight in 7 days to 15.0% in 42 days while that of experimental group fell from 14.0% in 7 days to 11.5% in 42 days. 6. The P content in mandibular bone of control group rose from 7.5% of dry weight in 7 days to 8.7% in 42 days while that of experimental group 7.4% in 7 days to 6.2% in 42 days.

성인에서 Haemophilus influenzae 감염증의 임상양상과 미생물학적 특성

이종섭,황병연,정희진,김우주,박승철,이도현,이창규,신종희,황규잠,이영희 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.2

목적 : H. influenzae는 성인에서 흔히 호흡기 감염을 일으키는 균주로, 최근 ampicillin 내성 β-lactamase 생성 균주들이 지속적인 증가를 보이고 있어, 이에 국내 성인에서 H. influenzae에 의한 감염의 임상양상과 분리된 균주들의 미생물학적 특성을 조사하고자 하였다. 방법 : 1998년 3월부터 1999년 9월까지 고려대 구로병원에 내원한 환자중에서 H. influenzae가 분리된 68명을 대상으로 임상양상을 조사하고 항균제 감수성 검사를 시행하였다. 분리된 33주에 대해서 혈청형, 생물형, 세포외막 단백분석을 시행하였고, β-lactamase 생성여부에 따른 감염 환자군간 임상상 및 예후의 차이를 비교하였다. 결과 : 환자의 평균연령은 68세였고, 지역사회 획득감염이 전체의 85%를 차지하였다. 폐렴과 기관지염과 같은 하기도 감염이 전체환자의 75%를 차지하였고 분리 검체 역시 객담이 84%로 가장 많았다. 환자의 71%가 기저질환을 가지고 있었으며, 그 중에 만성 폐쇄성 폐질환, 심혈관 질환, 악성종양, 당뇨병이 대부분이었다. 혈청형으로는 nontypeable 형이 68%로 가장 많았고 b형은 한 예도 없었다. β-lactamase 생성율은 63.2%였고, β-lactamase 양성균주의 항균제 내성율이 음성균주에 비하여 높았으나 β-lactamase 생성 여부에 관계없이 cefotaxime, azithromycin, ciprofloxacin에 대하여 100%의 감수성을 나타내었고 cefaclor, cefuroxime에 대해서는 10% 이하의 낮은 내성율을 보여 이들 항균제들이 치료에 효과적일 것으로 사료된다. 세포외막 단백분석에서는 C형과 D형이 전체의 64%로 가장 많았으며, 혈청형과의 유의한 연관성은 보이지 않았다. 결론 : 성인에서 H. influenzae는 주로 만성 기저질환자에서 급성 호흡기감염 또는 만성 폐쇄성 폐질환의 급성 악화를 유발한다. 기존의 보고에 비해 β-lactamase 양성율이 증가하였고, 이에 따른 항균제 내성율도 증가하여 항균제의 선택에 유의하여야 할 것으로 생각된다. 세포외막 단백분석상 특정한 유형의 균주에 의해 감염이 집중적으로 발생하고 있어 향후 역학 조사의 도구로 이용할 수 있겠다. Purpose : H. influenzae is one of the common causative microorganisms of respiratory tract infections in adults. Recently. β-lactamase producing, ampicillin-resistant H. infiuenzae has become worldwide problem as well as in Korea. We studied to investigate the clinical features and microbiologic characteristics of H. infiuenzae infections in adults. Materials & Methods : From March 1998 to September 1999, 68 patients were enrolled in this study. Clinical features of H. infiuenzae infections were investigated, 68 isolates were subjected to the β-lactamase test, and 33 isolates were used for serotyping. biotyping, antibiotic susceptibility and outer membrane protein (OMP) analysis. Results : Mean age of study patients was 68 years-old and the acquisition rate in community was 85%. Pneumonia and bronchitis were the most common type of infection such as 80%, sputum was the most common clinical specimen for H. mQuenzae isolation. 70% of patients had chronic underlying diseases. Non-typeable strains were 68% and β-lactamase producing rate was 63%. There was no difference in the clinical features and prognosis of H. influenzae infection between the β-lactamase positivie and -negative groups. The susceptibility of cefotaxime, azithromycin, and ciprofloxacin was 100% and that of cefaclor, cefuroxime was under 10% in spite of β-lactamase positivity. In OMP analysis, C and D types were dominant (64%). Conclusion : H. influenzae caused acute respiratory infections in adults with chronic underlying disorders. This study shows higher β-lactamase producing rate and antibiotic-resistance rate than that were reported previously. OMP analysis shows that two major types of strains cause clinical infections intensively.

면역화학분석법을 이용한 뇌종양의 증식능력 측정 : A Kinteics Study with Bromodeoxyuridine and Proliferating Cell Nuclear Antigen

이규성,이규창,정상섭,최중언,서정호,김태승,양우익 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.12

Bromodeoxyuridine(BUdR) labeling study provides valuable cell kinetic information for individual tumors and could suggest the prognosis of each patient with the tumor. Recently, a monoclonal antibody against the proliferating cell nuclear antigen(PCNA or cyclin), a nuclear protein expressed in proliferating cells, was developed. One of the main purpose of this study was to correlate the histological grade of brain tumor with the BUdR labeling study and the PCNA method in the same patient. The relationship between labeling indices of BUdR incorporated into S-phase and behavior of the tumor was studied in 96 patients. In 31 among those patients. PCNA expressed by cycling cells was also investigated. Both of the LIs showed good correlation with histological grade of the tumor. When both LIs were studied in the same patient, the values of the PCNA LI were parallel but higher than those of the BUdR LI, and the relation PCNA LI=2.2×BUdR LI+0.8(r²=0.86) was obtained. The results of this study show that PCNA could replace the BUdR method for identifying the proliferating cells, and the major advantage of PCNA method is that it could be done without any pretreatment and avoid injection of the teratogenic agent for diagnostic purpose.

유리 광배근피판을 이용한 하지의 재건

이규윤,김용배,이영만,양순재,박종섭 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.1

Significant soft-tissue defects in the lower extremity including the tibia and the foot are best managed with free skin-muscle of skin-grafted free muscle transfers. While free flap donor sites useful for lower exremity reconstruction include the latissimus dorsi, the rectus abdominis, the gracilis, and the scapular flaps, the latissimus dorsi seems ideal. This muscle has a reliably long vascular pedicle of wide diameter, making microsurgical anastomosis of the thoracodorsal vessels straightforward. Because it is so large, it can cover virtually and size defect. Furthermore, its flat configuration makes it especially easy to fold on itself to that it can be used to closure wounds with complex three-dimensional geometry and dead space. Although the gracilis and rectus abdominis muscles have their roles, in most cases the latissimus dorsi should serve well. We described technical considerations in each case and the advantages of free latissimus dorsi myocutaneous flap on the reconstruction of the soft tissue defect in the lower extremity.

TMCP 강재를 사용한 용접 H형강 보-기둥의 특성에 관한 연구

문태섭,김규석,김동규,김덕재 서울市立大學校 1993 論文集 Vol.27 No.-

This paper is the experimental study on the behavior of welded H-shape beam-column using TMCP steel. The purpose of this paper is to evaluate the elasto-plastic behavior of TMCP steel as it applies beam-column members. In the test, H-188 ×188 ×30 ×30 shape beam-column was loaded monotonic and cyclic by parameter "e"(eccentricity). The structural behavior of specimen under the eccentric loading have been evaluated by moment-curvature relationship and load-deflection relationship. Their load carrying capacities from the result of the test are compared with the theoretical load capacities based on P-M interaction curve.

牙山人工湖의 理化學的水質調査

沈英燮,羅圭煥,洪思澳 成均館大學校 1978 論文集 Vol.25 No.-

The surface and bottom of the water quality in the Asan artificial reservoir have investigated in 6 sites according to the geographycal view points during 3 seasons, summer, autumn and winter. As compared the water quality of two areas near the dike with upper area at 4km distance from dike, it was not found any difference. Vertical variation of water quality was not found certainly difference between the surface and the bottom. Because the depth of this reservoir was no more than 3m, the water temperature was 1℃ high in the surface than bottom in summer, the conductivity increase 7.5μ? high in surface but in autumn and winter the conductivity increase in the bottom especially 12μ? and 13.2μ?. The another items of water quality didn't found any difference. According to the seasonal variation of water quality, the water temperature was 25.6℃ in summer, 17.4℃ in autumn and 4℃ in winter. The concentration of Cl^- was 26.6ppm in summer and gradually increase in autumn and winter especially 103.6ppm and 267.9ppm. The total hardness exhibit much the same tendency with Cl^- and most high in winter as 134.9 ppm. The content of K and Na was lower in summer but most high in winter especially 10.0 ppm and 159.3 ppm. The water quality of the Jin wi river which is one of the water source in this reservoir was severely polluted with industrial waste water. The content of total hardness 152ppm, conductivity 565μ?, the content of COD 6.7ppm, the content of Na 550ppm and the content of Fe 1.4ppm.

Prednisolone 에 의한 장티푸스 抗菌治療의 지연

鄭喜泳,鄭圭源,金在亨,徐廷和,宋貞燮 대한감염학회 1976 감염 Vol.8 No.1

For the purpose of shortening of febrile period of typhoid fever, prednisolone was administered with bacteriocidal antibiotics though corticosteroid had not been used routinely for its possible side effects on typhoid fever. The authors suspected beneficial effects of corticosteroid because the action of bacteriocidal antibiotics was different from the action of bacteriostatic effects of chloramphenicol which was used in the last 30 years. The result was quite different from expectation and the febrile period of the patients was prolonged in all of the cases as shown in figures. Corticosteroid must not be used in typhoid fever so far as it is possible because delay of antibiotic effect than other known side effect. The possible mechanism of the longer intracellular parasitism of Salmonella typhi due to corticosteroid for the prolongation of fever was discussed.

포도상구균 초항원과 연관된 만성 비·부비동염의 병인에서 감마 인터페론 생산 T세포의 역할

김창수,조규섭,이현순,박희영,노환중 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.24

Background and Objectives: The etiology and pathogenesis of chronic rhinosinusitis (CRS) is multifactorial and the role of infectious agents in CRS is not clear. S. aureus is the most frequent cultured pathogen in CRS and it expresses toxin, SEA, SEB and TSST-l, with superantigen (SAG) activity. Recently an importnat role of these staphylococcal toxins in CRS with nasal polyposis (CRSwNP) has been suggested. CRSwNP is a severe chronic inflammation characterized by massive infiltration of lymphocytes and eosinophils in the sinonasal mucosa and nasal polyp. However, there has been no further studies evaluating the properties of infiltrating T lymphocytes in CRSwNP and the cytokine profiles in activated T-Iymphocyte relating with SAGs. The aims of this study was to know what kind of T lymphocytes infiltrates in nasal mucosa and polyp tissue of CRSwNP, to analyze the cytokine profiles in infiltrating T cells, and to determine whether infiltrating T lymphocytes are specific for SAGs. Patients and Methods: Ethmoid sinus mucosa and polyp tissue samples were collected from 13 patients with CRSwNP and control sinus mucosa were obtained from 10 patient without CRS. Tissue infiltrating cells and T cells were isolated from tissue samples and flow cytometry, enzyme-linked immunosorbent assay, reverse transcriptase-polymerase chain reaction, in vitro T lymphocyte stimulation with S. aureus toxin were performed. Results: The mean total CD3+ T cell count was significantly higher in the mucosa and polyp tissue of patients with CRSwNP compared with control mucosa. Most infiltrating T cells in mucosa and polyp tissue were activated type, expressing CD45RO. CD8+ T cells were significantly increased in mucosa and polyp tissue of patients with CRSwNP compared with CD4+ cells IFN-γ was highly expressed in infiltrating T cells in both mucosa and polyp tissue, whereas IL-10 was expressed a small amount and IL-4 was not expressed. IFN-γ levels were significantly higher than IL-4 and IL-10 when isolated T cells were stimulated with SAGs in vitro. Conclusion: CD8+ T-cytotoxic and IFN-γ producing Th1 cells could paly an important role in the CRSwNP if sinonasal chronic inflammation is induced by SAGs.