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Myoglobin에 의한 급성 신부전에서 Oxygen Free Radical의 역할
김주섭 ( Joo Seop Kim ),정대윤 ( Dae Yune Jung ),김장만 ( Jang Man Kim ),조홍래 ( Hong Rae Cho ),배수동 ( Soo Tong Pai ),강구 ( Gu Kang ),신형식 ( Hyung Sik Shin ) 대한외상학회 1991 大韓外傷學會誌 Vol.4 No.2
Highly reactive oxygen metabolites have been known to have a role in several models of acute renal failure. Especially hydroxyl radicals have been proved to be important mediators by some previous authors. This study was aimed to determine the role of superoxide radical as well as hydroxyl radical and to compare the protective effects of both scavengers in myoglobinuric renal failure. Acute renal failure was induced by intramuscular injection of hypertonic glycerol (6mg/kg, half-dose in each hindlimb muscles) in rats. Rats treated with glycerol and hydroxyl radical scavenger, dimethylsulfoxide (DMSO), showed lower serum blood urea nitrogen (BUN) and creatinine level than rats with glycerol alone. And also significant protection was noticed histologically. Superoxide radical scavenger, superoxide dismutase (SOD), had a similar protective effects. In contrast, allopurinol, an inhibitor of xanthine oxidase, was not protective at all. The present study may suggest that both superoxide and hydoxyl radical playa role of tissue injury in myoglobin-induced renal failure. Beside xanthine oxidase, other souces of oxygen free radical may exist.
김미희 ( Mi Hee Kim ),김은정 ( Eun Jung Kim ),강진구 ( Jin Gu Kang ),이지운 ( Ji Un Lee ),양보경 ( Bo Kyung Yang ),김형수 ( Hyoung Su Kim ),이진헌 ( Jin Heon Lee ),김주섭 ( Joo Seop Kim ) 대한췌담도학회 2013 대한췌담도학회지 Vol.18 No.4
총수담관 담석에 의한 폐쇄성 황달 발생시 일반적으로 담즙정체형 간기능 이상을 보이나 일부 환자에서는 아미노전이효소가 1,000 IU/L 이상 증가되는 간세포손상형의 간기능 이상을 보여 급성 간염으로 오인되는 경우가 있다. 이에 저자 등은 아미노전이효소가 1,000 IU/L 이상 상승하였고 혈청 ALP 검사치는 정상이며 영상검사에서 담관계 질환이 관찰되지 않아 급성 간염으로 진단 후 치료 중 급성 담관염으로 재진단된 1 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Choledocholithiasis usually reveals cholestatic features in liver function test. Alkaline phosphatase(ALP) and gamma glutamyl transferase(γ-GTP) level usually elevates out of portion to aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in bile duct obstruction. However, marked elevation of AST and ALT levels over 1,000 IU/L with normal range of ALP has been rarely reported in patients with choledocholithiasis. This could be confused initially, as acute hepatitis due to viral, toxic or ischemic origins. We report a case of 48-year-old man with choledocholithiasis, misdiagnosed as acute hepatitis due to initial result of unusual liver function test.
내장 역위증(Situs Inversus)을 동반한 말기 간경변 환자에게 시행된 뇌사자 전간이식
주선형(Sun Hyung Joo),박상훈(Sang Hoon Park),장명국(Myung Kook Jang),김한준(Han Jun Kim),김인규(In Kyu Kim),전장용(Jang Yeong Jeon),전성은(Sung Eun Jeon),이삼열(Samuel Lee),김주섭(Joo Seop Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.5
Situs inversus refers to a mirror image of the viscera, while situs solitus is defined as the normal anatomical situation. Several cases of successful liver transplantation for situs inversus recipients have been reported, and modifications of the standard surgical techniques were used. We report here on a case of cadaveric liver transplantation in an end-stage liver disease patient with situs inversus. The donor liver was rotated clockwise 90 degrees to the left with the right lobe lying in the left upper quadrant and the left lobe pointing down into the left iliac fossa. The donor’s suprahepatic vena cava was oversewn and the infrahepatic vena cava anastomosed end to side to the recipient’s inferior vena cava. The postoperative course was good until the postoperative 26th day, when rupture of a hepatic artery pseudoaneurysm occurred. An emergency laparotomy was done and the hepatic artery was ligated. Despite the hepatic artery ligation, the liver function recovered quite well. But sudden intracranial hemorrhage developed on the postoperative 28th day and sadly, the patient expired on the postoperative 30th day. Complete preoperative evaluation of the recipient is essential for the operative planning, and careful donor selection should be attempted to obtain a smaller graft to allow maximum flexibility for placing the donor liver. The use of a reduced-sized graft should be considered in the case for which a smaller graft is not available. In conclusion, adult situs inversus is no longer a contraindication for a liver transplant, although technical difficulties do exist for this procedure.