Cardioembolic Subcortical Infarcts : Clinical Characteristics in 46 Atrial Fibrillation Patients

Jung, Doo Kyo 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.1

We undertook this study to evaluate the prevalence, risk factors, and clinicoradiological characteristics of cardioembolic subcortical infarcts(SSI). An issue concerning cardioembolism as a cause of SSI has not been settled down. We selected 46 patients with atrial fibrillation(AF) and an isolated CT- or MRI-proven SCI in territory of the internal carotid system. The patients were divided into small(maximal diameter of lesion less than 15 mm) subcortical infarcts [SSI] group (n=27) and large (maximal diameter of lesion greater than 15 mm) subcortical infarcts [LSI] group (n=19). We investigated and compared clinical characteristics in both groups. Five (19%) patients in the [SSI] group and 15 (83%) in the [LSI] group had one or more associated neuropsychologic distrubances. In five (19%) patients in the [SSI] group and in 3 (16%) in the [LSI], the lesion was in the centrum ovale. Five (19%) cardiac embolic SSI were found in the [SSI] group (N=27). The short-term outcome for cardiac embolic SSI was better than for the remaining SSI. A higher frequency of neuropsychological disturbances and better recovery of neurologic deficits characterized cardioembolic SSI vs. SSI due to small vessel disease. Small and large centrum ovale infarcts can be caused by cardiac embolic sources. The prevalence of cardioembolic SSI in the [SSI] group was 19%.

쥐에서 Taurocholate 부하에 의한 간의 Glyoxalase I의 유도

정상호,김여희,곽춘식 계명대학교 의과학연구소 2001 계명의대학술지 Vol.20 No.1

The possible mechanisms of increased glyoxalase I (GLO-I) activity in cholestatic rat liver and serum were studied. These hepatic and serum enzyme activities were determined from the experimental rats with choledocho-caval shunt (CCS) or bile duct obstruction (BDO). The Michaelis-Menten constants in this hepatic enzyme were also measured. The activities of hepatic and serum GLO-I as well as the Vmax value of this hepatic enzyme were found to be increased significantly in both CCS plus taurocholic acid (TCA) injected group, and BDO plus TCA injected group than in each control group such as CCS alone and BDO alone. In addition, these serum and hepatic enzyme activities did not change in both the CCS plus tauroursodeoxycholic acid injected group and the BDO plus tauroursodeoxycholic acid injected group. On the other hand, the value of Km of the above hepatic enzyme did not change in any experimental group. Above results suggest that TCA induce the biosynthesis of GLO-I in the liver. The elevated activity of the serum GLO-I is believed to be caused by the increment of membrane permeabiliry of hepatocytes upon TCA mediated liver cell necrosis.

정상 체중 성인에서 혈중 지질치와 복부내장 지방량과의 상관성 연구

김승기,최승곤,서영성,김대현,이인규 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.1

This study was carried out to assess the degree of association of abdominal visceral fat amount with serum lipid levels and to determine which anthropometric measures of obesity are most closely associated with cardiovascular risk factors in normoweight adults. 60 normoweight subjects were included for this study. The data gathered by healthy adults for periodic health examination in Dongsan Medical Center, Taegu, Korea. They were normal body weight(BMI;18.5-24.9 kg/m2) and no history of hypothyroidism, corticosteroid users, and recent weight loss. Serum total cholesterol, triglycerids, HDL cholesterol, fasting blood glucose, blood pressure, waist, and waist-hip ratio were measured. Single slice CT scan was used to quantify fat deposit in visceral and subcutaneous area at the level of L4-5. Measurement for total fat amount was used to body impedance analysis method. Total body fat %, waist, and Waist-Hip ratio were significant difference on sex. Also, abdominal visceral fat area, abdominal subcutaneous fat area and abdominal visceral fat area-subcu-taneous fat area ratio(VSR) were significant difference. Independent predictor for visceral fat in male subjects was waist, and in female subjects were waist and total body fat %. Visceral fat amount seemed to play a critical role in association with cardiovascular risk factors rather than subcutaneous fat area. total body fat %, waist in normal body weight person.

고관절에 발생한 색소융모 결절성 활액막염의 진단과 치료

오두환,전시현,강창수 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.2

To investigate the clinical characteristics of pigmented villonodular synovitis of the hip and its appropriate treatment modalities. We retrospectively analyzed the clinical symptoms and signs, laboratory data, radiologic findings and methods and results of treatment of 4 patients of which the diagnosis was confirmed microscopically. The most common complaints was pain and a palpable mass was combined in one case. The limitation of joint motion was present in 3 cases and laboratory data were normal in all cases. On plain films, a classic form with large and multiple lucencies was found in 2 cases and a osteoarthritis-like form was found in 2 cases. The operative treatment was performed in all cases. In one case, there was no evidence of recurrent disease at 20 months after synovectomy alone. In 2 cases, patients were treated with total hip replacement combined with synovectomy and there were no evidence of recurrent disease at 27 months and 36 months each other. In one case, the patient had a recurrence at 7 years and 6 months after synovectomy alone and underwent total hip arthroplasty combined with synovectomy. At 4 years and 1 month after reoperation, this patient had a local recurrence and underwent curettage and bone graft. The early diagnosis and treatment of pigmented villonodular synovitis will prevent the further destruction of the hip and the thorough synovectomy will decrease the recurrent rate.

폐암 환자에서 Urokinase Type Plasminogen Activator 및 Plasminogen Activator Inhibitor Type 1의 임상적 의의

권순대,최원일,한승범,권건영,전영준 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.2

Cancer invasion and metastasis require the dissolution of extracellular matrix in which several proteolytic enzyme are involved. One of these enzyme the urokinase-type plasminogen activator(u-PA), and plasminogen activator inhibitor type 1(PAI-1) have a possible role in cancer invasion and metastasis by protection of cancer itself from proteolysis by u-PA. It has been reported that the level of u-PA and PAI-1 in various cancer tissues are significantly higher than those in normal tissue and significant correlation with tumor size and lymph node involvement. We measured the concentration of plasma u-PA and PAI-1 antigens in patients with lung cancer and compared the concentration of them with histologic types and staging parameters, and also compared those concentrations in pre-treatment and post-treatment. In this study we measured the concentration of plasma u-PA and PAI-1 antigens using commercial ELISA kit in 40 lung cancer patients and 22 patient with benign lung diseases. The concentration of u-PA was 1.37±0.7 ng/mL in a group of benign lung disease patients and 1.75±0.75 ng/mL in lung cancer patients. The concentration of PAI-1 was 20.86±13.2 ng/mL in benign lung disease and 20.09 ng/mL in lung cancer. The concentration of u-PA in lung cancer patients was higher than those of benign lung disease patients. The concentration of u-PA was 2.42±2.69 ng/mL in lung cancer patients who were not treated, 1.78 ng±0,79 ng/mL in patients who were treated. The concentration of PAI-1 was 19.53±11.75 ng/mL in not-treated lung cancer patients, 10.71±6.26 ng/mL in treated patient group. The concentration of PAI-1 in treated lung cancer patients was lower than those of not-treated lung cancer patients. The concentration of u-PA was 1.82 ng/mL in stage I & Ⅱ, 1.93±0.11 ng/mL in stage Ⅲ, 1.65±0.17 ng/mL in stage Ⅳ. The concentration of PAI-1 was 15.92±5.57 ng/mL in stage I & Ⅱ, 20.95±0.54 ng/mL in stage Ⅲ, 23.99±2.5 ng/mL in stage Ⅳ. The concentration of u-PA was 1.28±0.45 ng/mL in small cell carcinoma, 1.86±0.12 ng/mL in nonsmall cell carcinoma 1.76±0.0 ng/mL in squamous cell carcinoma 1.93±0.2 ng/mL in adenocarcinoma. The concentration of PAI-1 was 18.74±3.83 ng/mL in small cell carcinoma 23.13±3.95 ng/mL in nonsmall cell carcinoma 25.39±2.81 ng/mL in squamous cell carcinoma 20.96±1.62 ng/mL in adenocarcinoma. The plasma levels of u-PA in lung cancer patients were higher than those benign lung disease and plasma level of PAI- 1 in who were treated (surgery, chemotherapy and/or radiotherapy) were lower than those who were not treated. These findings suggest involvement of U-PA with local invasion of lung cancer and possible roles in predicting the prognosis and survival of lung cancer patients.

중소도시에 소재 한 일개 공업계 고교생의 건강위험행동조사

이충원 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.1

The purpose of the study were to see whether the Youth Fisk Behavior Surney(YRBS) developed by the Centers for Disease Control and Prevention(CDC) could be adapted to accomodate risk behaviors of Korean high school students as well as to see how prevalent the risk behaviors is in a Korean vocational high school students. Translation and modifications for Koreans students of the YRBS which was based on the causes of death specific for Korean teenagers were carried out February 2000 and the modified YRBS were administered to students of a male vocational high school(n=113) in a small city near Taegu February 2000. The number of students used at final analysis was 107 (response rate 94.7%). Percentage of students rarely or never used safety belts was 79.4% and that of students involved in a physical fight was low. About 41.7% of the 12 students who had ever felt sad or hopeless thought seriously about attempting suicide. Lifetime cigarette users were 72.9% and of those current users were 87.1%, frequent users 61.5% and regular users 74.3% while lifetime alcohol users were 84.1% and of those current users were 81.1%, episodic heavy drinkers 63.3%. Thirteen students(12.1%) reported to have sexual intercourse and most of them did not use condoms during last sexual intercourse. About 30% reported to attempt to lose weight and most of the students reported to eat 100% fruit juice, fruits, vegetables, or milk 1 - 3 times during last one week. More than one third of the students(37.4%) reported to participate in vigorous physical activity and 27.1% in strengthening exercises. These results suggest that the YRBS could be adapted to Korean high school students and some of risk behaviors be very prevalent in a Korean male vocational high school.

내시경을 이용한 비출혈의 치료

안병훈 계명대학교 의과학연구소 2001 계명의대학술지 Vol.20 No.1

Otolaryngologist encounters epistaxis as one of the most common disease in the emergent situation or postnasal surgery. Management of epistaxis is often namely simple but sometimes cause serious situations which require hospitalization and surgical intervention. Nasal endoscopy is the essential tool for modern sinus surgery and also imperative for identifying bleeding point when nasal bleeding occurs. During recent 6 years, author employed the nasal endoscopy to manage nasal bleeding which require hospital admission and surgical intervention. Precise localization of the nasal bleeding was possible in 38/43 cases (88.4%). Mean days of hospital stay were 4 and there was no complication noted during routine follow up periods. The advantages of endoscopic management of epistaxis are shorter hospital stay, less morbidity, no external wound, and useful modality that can be retried when initial therapeutic attempt fails.

터어키안 주위병변 수술을 위한 작은 전두안와 개두술

우윤구,김일만,손은익 계명대학교 의과학연구소 2001 계명의대학술지 Vol.20 No.1

To minimize brain injury from exposure and retraction and to achieve better cosmesis, in subfrontal approach for skull base lesions, a smaller and more basal opening is required. The technique and result of the frontoorbital minicraniotomy are presented. A frontoorbital minicraniotomy through a curvilinear frontotemporal skin incision was performed by removing parts of frontal bone, orbital roof, and orbital rim as a single piece. Extensive and deep lesions were handled via combined subfrontal and pterional routes during the same operation. This technique has been applied to seven patients who were operated on for different pathologies in the parasellar region. Subtotal removal of lesion was achieved in one patient with large craniopharyngioma. The lesions of other patients (two Rathke's cleft cysts, two meningiomas, one neurocysticercosis, one craniopharyngioma) were removed completely. There were no approach-related complications. The major advantages of this approach are a short surgical route, a basal view with only minimal brain trauma, and a minimized amount of bone resection with excellent cosmetic results.

기관내삽관 후 발생한 후두육아종

배정인 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.1

Post-intubation granuloma of the larynx is a rare complication. Post-intubation granuloma are associated with direct mechanical irritation of laryngeal mucosa from trauma, prolonged period of endotracheal intubation, multiple intubation, endotracheal movement. This study was performed retrospectively to evaluate symptom, location of lesion. treatment and prevention of the intubation granuloma. The patients aged from 26 to 64 years old. The male to female ratio was 3:12 in favor of female, predominantly female. The location of lesion was bilateral(4 cases) and unilateral(left side 2 cases, right side 9 cases). The clinical symptom was hoarseness and dyspnea. The peak duration between endotracheal intubation and symptom development was 4∼5 weeks. Duration of endotracheal intubation was 1 hour in 2 cases, 1∼3 hours in 9 cases, 3∼6 hours in 1 case, 6∼9 hours in 1 case, more than 3 days in 2 cases. 2 cases were recurred. To remove post-intubation granuloma of the larynx, all patients were administered triflupro-mazine(VeprinR). nalbuphine hydrochloride and glycopyrrolate intramuscular before anesthe-sia-induction 1 hour for premedication. Induction was established with pentothal sodium and succinylcholine after preoxygenation. N2O/O2(2: 1), enflurane and vecuronium chloride were administered for maintenance. ECG, pulse oximeter and ETCO2 were monitored. To remove the post-intubation granuloma of the larynx, laryngeal irritation and duration of intubation must be minimized.

피부 각질화세포에서 자외선 B 조사로 발현이 유도된 유전자의 검출

노진석,이인환,추영애,정수경,최인장,김홍태 계명대학교 의과학연구소 2001 계명의대학술지 Vol.20 No.1

Ultraviolet light is the most important environmental insult to skin. Even single exposure to UVB irradiation can result in inflammation and may also lead to DNA damage and apoptosis in the acute response of the cutaneous tissue. To elucidate the complex alterations of gene expression in human keratinocytes underlying these UVB responses, ordered differential display polymerase chain reaction (ODD-PCR) technology was performed in one human keratinocyte cell line. Several genes were induced and down-regulated during 12 hours after UVB irradiation in a time-dependent manner. Five UVB-induced cDNA clones were isolated, including cDNAs for karyo-pherin alpha 2, human mRNA for TI-227H, ribosomal protein L13a and keratin 19. Differential expression of these genes after UVB irradiation has not been reported. Authors identified a new sequence that is negatively regulated by UVB irradiation. In general our results showed that ODD-PCR is a useful tool in the analysis of quantitative changes of mRNA levels in human keratinocytes after UVB irradiation. The identification of new UVB-modulated genes offters the opportunity to identify unrecognized molecular mechanism in response of human cells to UV irradiation