방사선 치료후 시간경과에 따른 염색체이상 빈도의 변화

송명재,하성환,이춘자,김희근,김미숙 대한방사선 방어학회 1994 방사선방어학회지 Vol.19 No.1

임파구의 염색체이상 빈도로부터 피폭자의 흡수선량을 구하는 방법은 사고로 인해 급성피폭을 받는 경우 유용하게 사용될 수 있다. 그러나 방사선 피폭 후 시간이 경과함에 따라 불안정 염색체이상을 가진 임파구는 감소하게 된다. 이에 방사선 치료후 시간 경과에 따른 불안정 염색체이상 빈도의 변화를 규명하고자 한다. 전골반에 50.4 Gy의 방사선 치료를 받은 총 20명의 자궁경부암 또는 자궁내막암 환자를 대상으로 41개의 검체를 얻었다. 채혈의 시기는 방사선 치료후 1일 3주, 6주, 12주, 24주, 52주, 104주, 156주, 208주, 520주로 하였다. 이들 말초혈액의 임파구에 대해 전혈미세배양을 실시한 후 임파구의 불안정 염색체이상을 관찰하여 Ydr, Qdr, Qdra를 얻었다. Ydr 값은 방사선 치료가 끝난 직후부터 3주까지 plateau를 보였고 이후 감소하는 경향이었다. Ydr의 평균값은 치료후 3주에 0.29에서 급격히 감소하여 2년후 0.05로 감소하였으며 이후 5년까지 서서히 감소하였다. 회귀분석을 실시한바 Ydr = 0.259×exp(-0.0429T)+0.0560×exp(-0.00106T)(time in weeks)로 나타났다. Qdr값은 치료 직후부터 24주까지 1.51 전후로 거의 변화가 없었으며 이후 감소하여 52주 이후에는 1.17 전후로 거의 일정하였다. Qdra 값은 치료 직후부터 12주까지 1.10 전후이며 이후 감소하여 52주 이후에는 0.81 전후였다. 피폭 후 시간경과에 따른 Ydr 값의 감소는 두 component exponential 모델을 잘 맞고 이 식을 이용하여 생물학적 선량측정이 가능하다. Qdr 값 및 Qdra 값은 피폭후 시간경과가 짧은 경우 피폭선량을 추정하는 지료로 사용할 수 있다. It is good method to use frequency of chromosome aberration in lymphocytes for a biological dosimetry in cases of accidental exposure to radiation. But in cases of past edposure, biological dosimetry is limited because the friquency of aberration decreases by time after exposure. To provide a basic data for estimationof past radiation exposure, the changing pattern of frequency of unstable chromosome aberration by time interbal after exposure was studied. Observation was made on peripheral lymphocytes of 41 blood samples from 20 patients treated for uterine cervical carcinoma and endometrial caricinoma. The patients received 50.4 Gy radiation to whole pelvis. Elapsed times after the completion of radiation therapy were 1 day, 3, 6, 9, 12, 24, 52, 104, 156, 208, 260 and 520 weeks. All the blood sample were microcultured. The Ydr, Qdr and Qdra were calculated form frequency of unstable aberration. Ydr did not decrease for 3 weeks after radiation therapy, and thereafter, decreased very rapidly and reached 0.05 at two years after radiation therapy and decreased very slowly until 5 years after radiation therapy. Relationship between unstable chromosome aberration and time interval after radiation therapy was described as Ydr = 0.2590.259×exp(-0.0429T)+0.0560×exp(-0.00106T)(time in weeks) Qdr remained constant at 1.51 until 24 weeks after radiation therapy and then decreased to 1.17 at 52 weeks. Therafter, it did not change. Qdra remained constant at 1.10 for 12 weeks after radiation therapy and decreased to 0.81 at 52 weeks. Thereafter, it remanined constant. Two superimposed exponential Ydr disappearance rate wuggests that it is possible to calculate the past exposure dose. When the elapsed time after exposure is short, Qdr and Qdra are useful papameters for biological dosimetry for past radiation exposure.

난소 및 난소 종양 염전의 초음파 소견

오연희,이현경,이원재,이성우,박수성,윤혜원,임문환,심재철,김용탁,김성숙,김정란 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Acute torsion of the ovary and ovarian mass is a recognized surgical emergency, but rarely has the diagnosis been made preoperatively on the basis of imaging studies. The sonographic findings in 14 cases of surgically proven torsion of the ovary and ovarian mass are described. Mostly cystic ovarian mass, engorged vessel, dilated uterine tube, beak-like echo(torsion site), smooth mass wall thickening an free-fluid collection in cul-de-sac are described. More significant in terms of specificity were the demonstration in 6 cases(42.9%) of the smooth mass wall thickening and in 8 cases(57.1%) of a free fluid in the cul-de-sac. We report the sonographic findings of ovary and ovarian mass torsion that may suggest the preoperative diagnosis of this condition.

해안서식 어패류 중 유해중금속 함량에 관한 연구 (Ⅰ)

유영찬,정진일,박유신,이종숙,인상환,최동기,김동우 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-

청소년에서 폭력에의 노출과 관련된 정신의학적 증상

김동기,이호분,민성길,송동호,육기환,전여숙 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

서울 시내 중학생 1345명을 대상으로 폭력에 노출되는 정도와 이와 연관된 정신의학적 증상을 알아보고자 하였다. 이를 위해 자기보고식 설문지를 사용하였는데. 설문지의 내용은 사회인구학적 자료와 집. 학교, 동네에서 폭력을 당하거나 목격했는지를 묻는 문항과 폭력에 의한 정신의학적 증상의 정도를 묻는 TSC(trauma symptom checklist)로 구성되었으며, 그 결과는 다음과 같다. 1) 전체 학생 중 45%가 폭력에 노출된 경험이 있었으며. 남자가 여자보다 많았다 (p<0.025). 집에서 구타 당한 경험은 여학생이 22.8%로 남학생보다 유의하게 높았다 (p<0.001). 학교. 동네에서 구타당한 경험은 남학생이 각각 22.1%. 10.1%로서 여학생보다 유의하게 높았다. 2) TSC를 요인 분석한 결과 불안-우울, PTSD, 해리, 분노 증상으로 나뉘었다. TSC는 폭력 경험 변인들과 상관 관계를 나타냈다. 다중 회귀분석을 실시한 결과 TSC와 연관된 폭력 노출 변인은 일생 동안의 폭력 노출(R²=0.18). 최근의 성폭력 경험(R²=7.12). 최근 집에서의 폭력 경험(R²=0.08), 최근 학교에서의 폭력 경험(R²=0.08), 최근 집에서의 폭력 목격(R²=0.07). 모든 종류의 폭력 노출(R²=0.29)로 나타났다. 3) TSC와 유의하게 연관된 사회인구학적 변인은 여성, 물질 남용의 가족력이 있는 경우, 술이나 담배 약물 남용을 하는 청소년인 것으로 나타났다. 따라서 청소년 폭력에의 희생자에 대한 정신의학적 개입에는 이러한 위험인자에 대한 고려가 필요하리라고 본다. In this research, we examined the frequency of exposure to violence in the home, school and neighborhood among middle school students as well as its related psychiatric symptoms. A total of 1,345 students from 5 middle schools in Seoul participated in this study : 670 were male,675 were female. We administered self-reported questionaires including discriptions of exposure to violence and a trauma symptom checklist(TSC)(Singer 1995). 1) The total frequency of exposure to any type of violence was 45% in our sample. The frequency of girls' being hit in home was 22.8%, which was significantly higher than it was for boys(p<0.001). The frequency of boys' exposure to violence in school and in the neighbor-hood was 22.1% and 10.1% respectively, which was higher than it was for girls(p <0.005). 2) In factor analysis of TSC, 4 factors were identified. TSC including depression-anxity, PTSD, dissociation and anger was correlated with violence exposure variables. Multiple regression analysis revealed that TSC is related with violence victimization in life(R2=0.18), sexual assault(R2= 0.12), recent victimization in the home(R2= 0.08), recent witness to violencein the home(R2=0.07), recent victimization in school(R2=0.08) and all violence exposures(R2=0.29). 3) Among the demographic variables, sex, parental alcohol problem and student alcohol-smoking-drug problems influenced the TSC(p <0.005). TSC could be result of witness to violence as well as violence victimization. And the risk factors for violence-related psychiatric symptoms were mainly seen in females, who have parents with alcohol problems or who themselves have alcohol-smoking-substance problems. So intervention programs for violence victims should be focused on the these high risk group.

원저 : 비디오 흉강경을 이용한 흉부수술 31예

성숙환 ( Sook Whan Sung ),김관민 ( Kwhan Mien Kim ),김주현 ( Joo Hyun Kim ) 대한결핵 및 호흡기학회 1993 Tuberculosis and Respiratory Diseases Vol.40 No.5

Pretreatment Prognostic Factors in Carcinoma of the Uterine Cervix

하성환(Sung Whan Ha),오도훈(Do Hoon Oh),김미숙(Mi Sook Kim),신경환(Kyung Hwan Shin),김재성(Jae Sung Kim),이무송(Moo Song Lee),유근영 (Keun Young Yoo) 대한방사선종양학회 1993 Radiation Oncology Journal Vol.11 No.2

자궁경부암에 있어서의 예후인자를 알아보기 위해 1979년 3월부터 1986년 12월까지 서울대학교 병원에서 근치적방사선치료를 시행받은 510명의 환자를 대상으로 후향적분석을 시행하였다. FiGO 병기 IB, IIA, IIB, IIIA, IIIB, IVA의 환자 수는 각각 35, 89, 232, 8, 134, 12명 이 었고 병기에 따른 5년 국소치유율은 각각 79%, 78%, 70%, 58%, 51% and 27%이었으며 5년 무병생존율은 각각 76%, 67%, 60,57%, 40%, and 25%, 5년 생존율은 각각 82%, 72%, 67%, 67%, 51%, and 33%이었다. 단변수분석에 의하면 병기, 연령, 혈색소치, 병리조직학적 소견, 원발병소의 크기와 전산화단층촬영상 골반림프절 비대, 대동맥림프절 비대, 자궁방조직 침윤의 정도, 방광의 침윤 및 직장의 침윤소견이 국소치유율에 영향을 미치는 인자이었고 상기 인자와 혈중요소질소나 혈중 크레아티닌의 증가가 무병 생존율에 영향을 미치는 인자이었으며 생존율에 영향을 미치는 인자는 병기, 혈색소치, 혈중요소질소나 혈중크레아티닌의 증가, 병리조직학적 소견, 원발병소의 크기와 전산화단층촬영상 골반림프절비대, 대동맥림프절비대, 자궁방조직 침윤의 정도, 방광의 침윤 및 직장의 침윤 소견이었다. 전산화 단층촬영 소견을 포함하지 않은 다변량분석에 의하면 IVA병기, 병리조직학적 소견, 원발병소의 크기가 국소치유율 및 무병생존율에 영향을 미치는 인자이었고 생존율에 영향을 미치는 인자는 IVA 병기와 원발병소의 크기이었다. 전산화단층촬영 소견을 포함한 다변량분석에 의하면 병리조직학적 소견, 원발병소의 크기, 전산화단층촬영상 골반림프절 비대가 국소치유율, 무병생존율, 생존율에 영향을 미치는 인자이었고 이들 세가지 인자와 전산화단층촬영상의 대동맥림프절 비대가 생존율에 영향을 미치는 인자이었다. To identify pretreatment prognostic factors in carcinoma of the uterine cervix, a retrospective analysis was undertaken of 510 patients treated with curative radiation therapy in Seoul National University Hospital during the 7 year period, from March 1979 through December 1986. According to FIGO classification,35 patients were stage I B,89 were stage IIA, 232 were stage IIB,8 were stage IIIA, 134 were IIIB, and 12 were stage IVA. Five year locoregional control (LRC) rates in stage I B, II A, II B, IIIA, IIIB, and IVA were 79%, 78%, 70%, 58%, 51% and 27%, respectively. Five year disease free survival (DFS) rates were 76%, 67%, 60, 57%, 40%, and 25%, respectively. Overall survival (OS) rates at five years were 82%, 72%, 67%, 67%, 51%, and 33%, respectively. In univariate analyses, stage, age, initial hemoglobin level, type of histology, tumor size, and several CT findings including pelvic lymph node (LN) status, paraaortic lymph node (PAN) status, extent of parametrial invasion, bladder invasion, and rectal invasion were significant factors in terms of LRC. All these factors and elevation of BUN or creatinine were associated with DFS. In terms of overall survival, stage, initial hemoglobin level, type of histology, tumor size, elevation of BUN or creatinine, and five CT findings associated with LRC were prognostically significant. In multivariate analysis excluding CT findings, stage IV disease, non-squamous histology, and tumor size ge4 cm were associated with poor LRC and DFS. Stage IV disease and tumor size significantly affected OS. in multivariate analysis including CT findings, histology, tumor size, and pelvic LN status on CT were uniformly significant in terms of LRC, DFS, and 05, PAN status on CT affected overall survival only.

심근보호에 칼슘길항제 Verapamil의 효과

성숙환 ( Sook Whan Sung ) 국군의무사령부 1986 대한군진의학학술지 Vol.17 No.1

Mechanism of Glutamate-induced [Ca<SUP>2⁢</SUP>]<SUB>i</SUB> Increase in Substantia Gelatinosa Neurons of Juvenile Rats

Sung Jun Jung,Jeong Sook Choi,Jiyeon Kwak,Jun Kim,Jong Whan Kim,Sang Jeong Kim 대한생리학회-대한약리학회 2003 The Korean Journal of Physiology & Pharmacology Vol.7 No.2

The glutamate receptors (GluRs) are key receptors for modulatory synaptic events in the central nervous system. It has been reported that glutamate increases the intracellular Ca<SUP>2⁢</SUP> concentration ([Ca<SUP>2⁢</SUP>]<SUB>i</SUB>) and induces cytotoxicity. In the present study, we investigated whether the glutamate-induced [Ca<SUP>2⁢</SUP>]<SUB>i</SUB> increase was associated with the activation of ionotropic (iGluR) and metabotropic GluRs (mGluR) in substantia gelatinosa neurons, using spinal cord slice of juvenile rats (10∼21 day). [Ca<SUP>2⁢</SUP>]<SUB>i</SUB> was measured using conventional imaging techniques, which was combined with whole-cell patch clamp recording by incorporating fura-2 in the patch pipette. At physiological concentration of extracellular Ca<SUP>2⁢</SUP>, the inward current and [Ca<SUP>2⁢</SUP>]<SUB>i</SUB> increase were induced by membrane depolarization and application of glutamate. Dose-response relationship with glutamate was observed in both Ca<SUP>2⁢</SUP> signal and inward current. The glutamate-induced [Ca<SUP>2⁢</SUP>]<SUB>i</SUB> increase at holding potential of ⁣70 mV was blocked by CNQX, an AMPA receptor blocker, but not by AP-5, a NMDA receptor blocker. The glutamate-induced [Ca<SUP>2⁢</SUP>]<SUB>i</SUB> increase in Ca<SUP>2⁢</SUP> free condition was not affected by iGluR blockers. A selective mGluR (group I) agonist, RS-3,5-dihydroxyphenylglycine (DHPG), induced [Ca<SUP>2⁢</SUP>]<SUB>i</SUB> increase at holding potential of ⁣70 mV in SG neurons. These findings suggest that the glutamate-induced [Ca<SUP>2⁢</SUP>]<SUB>i</SUB> increase is associated with AMPA-sensitive iGluR and group I mGluR in SG neurons of rats.

A Case of Recurrent Solid Pseudopapillary Tumor of the Pancreas with Involvement of the Spleen and K idney

Sang Eun Park,Nam Sook Park,Jae Min Chun,Nam Whan Park,Young Joon Yang,Gak Won Yun,이효진,Hwan Jung Yun,Deog Yeon Jo,Kyu Sang Song,Samyong Kim 대한암학회 2006 Cancer Research and Treatment Vol.38 No.2

Solid pseudopapillary tumor of the pancreas (SPTP) isa rare primary pancreatic tumor of an unknown etiologythat is usually diagnosed in adolescent girls and youngwomen. Most SPTPs are considered to be benign andonly rarely metastasize. We report here on a 27-year oldwoman with recurrent SPTP with involvement of both thespleen and left kidney at the time of the initial diagnosis,and with aggressive behavior. In July 1995, she wasadmitted with abdominal discomfort and mass. Sheunderwent exploratory laparotomy with distal pancreatectomy, left nephrectomy and splenectomy, and wasdiagnosed with SPTP with invasion to both the spleenand left kidney. In June 2001, she again presented withabdominal pain and was diagnosed as having recurrenceof the tumor. She underwent mass excision and omentectomy.Then she was lost to follow-up. In November2005, she presented once again with an abdominal massand was diagnosed with recurred SPTP, which formed ahuge intraperitoneal mass with peritoneal seeding and thetumor showed multiple metastases in the liver. She iscurrently being treated conservatively. (Cancer Res Treat.2006;38:118-120)

폐이식

成?煥 대한의사협회 1996 대한의사협회지 Vol.39 No.1