혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.

Dimethylnitrosamine 유발 급성 간 손상 흰쥐에서 ^(99m)Tc-Lactosylated Serum Albumin을 이용한 간 기능의 평가

정신영,이재태,서명랑,유정아,배진호,안병철,황재석,정재민,하정희,이규보 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.6

목적: ^(99m)Tc-lactosylated serum albumin (^(99m)Tc-LSA)은 간세포에 특이적으로 결합하는 간수용체 영상용 방사성의약품으로 새로이 합성되었다. 간섬유화를 유발하는 dimethylnitrosamine (DMN)을 투여한 간 손상 휜쥐 모델에서 ^(99m)Tc-LSa의 역동학적인 간섭취를 조사하고 간효소치의 변화와 조직학적 소견을 비교하여, LSA의 간섭취가 간기능의 변화를 반영하는지를 연구하였다. 대상 및 방법: SD계 흰쥐에 DMN를 27 mg/kg으로 복강 내 주사하여 급성 간손상을 유도하고 대조군과 비교하였다. DMN을 주사한 흰쥐를 3일(DMN-3), 8일(DMN-8), 21일(DMN-21)에 ^(99m)Tc=LSA (1,665 mg/kg) 29 MBq를 정맥 주사하여, 30분 동안 동적 영상을 획득하고 간과 신장부위에 관심영역을 설정하여 간과 심장부위의 시간방사능 곡선을 얻었다. 간기능 평가를 위해 시간방사능 곡선을 이용하여 간섭취지수와 혈중제거지수를 구하였고 곡선 최적화를 시행하였다. DMN 투여군과 대조군의 간효소치의 변화와 간조직의 광학현미경 소견을 비교하였다. 결과: 대조군에서는 ^(99m)Tc-LSA가 빠르게 간에 섭취되고 혈중에서 제거되었으나 DMN을 처리한 군에서는 간섭취가 낮았다. 간섭취지수의 비교에서 대조군에 비해 DMN 처리군에서 유의하게 간섭취지수가 낮았다(DMN-3: 0.842, DMN-8: 0.898, DMN-21: 0.91, 대조군: 0.96, p<0.05). 혈중제거지수의 비교에서도 대조군에 비해 DMN 처리군에서 혈중제거지수가 유의하게 높았다(DMN-3: 0.731, DMN-8: 0.654, DMN-21: 0.604, 대조군: 0.473, p<0.05). 비선형 회귀분석에서 R_(2) 값은 0.9이상으로 좋은 일치를 보였고, 대조군에ㅓ K값이 DMN처리군에 비해 크고(DMN-3: 0.28, DMN-8: 0.41, DMN-21: 0.46, 대조군: 0.97, p<0.05), T_(1/2)값은 작았다(DMN-3: 2.5, DMN-8: 1.7, DMN-21: 1.5, 대조군: 0.7, p<0.05). 간효소치의 변화는 DMN-3군에서는 대조군에 비해 상승하였으나 DMN-8, DMN-21군에서는 간효소치의 상승이 관찰되지 않았다. 간조직 소견의 경우 DMN-3군에서 중심정맥 주위에 괴사가 관찰되었으나 DMN-8군, DMN-21군에서는 미약한 정도의 염증세포 침윤만이 관찰되었다. 결론: ^(99m)Tc-LSA 간신티그래피의 간섭취 정도는 간손상과 반비례하였으며 간섭취의 변화는 조직학적 손상이 심한 정도와 간손상후 회복되는 과정을 반영하여 주었다. ^(99m)Tc-LSA 간신티그래피가 간손상을 평가하고 간손상후 회복되는 과정을 추적하는 간수용체 영상용 방사성 의약품으로 사용될 수 있을 것으로 생각된다. Objects: ^(99m)Tc-lactosylated human serum albumin(LSA) is a newly synthesized radiopharmaceutical that binds to asialoglycoprotein receptors, which are specifically presented on the hepatocyte membrane. Hepatic uptake and blood clearance of LSA were evaluated in rat with acute hepatic injury induced by dimethylnitrosamine(DMN) and results were compared with corresponding findings of liver enzyme profile and these of histologic changes. Materials and Methods: DMN (27 mg/kg) was injected intraperitoneally in Sprague-Dawley rat to induce acute hepatic injury. At 3(DMN-3), 8(DMN-8), and 21(DMN-21) days after injection of DMN, LSA injected intravenously, and dynamic images of the liver and heart were recorded for 30 minutes. Time-activity curves of the heart and liver were generated from regions of interest drawn over liver and heart area. Degree of hepatic uptake and blood clearance of LSA were evaluated with visual interpretation and semiquantitative analysis using parameters (receptor index : LHL3 and index of blood clearance : HH3), analysis of time-activity curve was also performed with curve fitting using Prism program. Results: Visual assessment of LSA images revealed decreased hepatic uptake in DMN treated rat, compared to control group. In semiquantitative analysis, LHL3 was significantly lower in DMN treated rat group than control rat group (DMN-3:0.842, DMN-8: 0.898, DMN-21: 0.91, Control: 0.96, p<0.05), whereas HH3 was significantly higher than control rat group (DMN-3: 0.731, DMN-8: 0.654, DMN-21: 0.604, Control: 0.473, p<0.05). AST and ALT were significantly higher in DMN-3 group than those of control group. Centrilobular necrosis and infiltration of inflammatory cells were most prominent in DMN-3 group, and were decreased over time. Conclusion: The degree of hepatic uptake of LSA was inversely correlated with liver transaminase and degree of histologic liver injury in rat with acute hepatic injury.

Acriflavine-Guanosine 복합제 (AG60)의 조직내 분포에 대한 형광현미경적 연구

고정식,임수재,안의태,김진국,김상건,이경영,강종구,홍은경,정영신,유보림,한영복 대한해부학회 1999 Anatomy & Cell Biology Vol.32 No.1

알코올 금단 발작 환자에서 진전 섬망 예방에 대한 Nimodipine과 Chlordiazepoxide의 효과 비교

정두신,양광익,이보람,방차옥,이태경,성기범,안무영,박형국 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Background & objectives : An increase of calcium influx during alcohol withdrawal state may contribute to neuronal hyperexitability, which cause delirium tremens(DT). Some investigators have found calcium channel blockers effects in prevention of DT in experimental animals. Therefore we evaluated the preventive effects of calcium channel blocker(nimodipine) and benzodiazepine(chlordiazepoxide) on the development of DT in alcohol withdrawal seizure(AWS) patients. Method : A total 59 patients with AWS were divided into three groups according to the management nimodipine-treated, chlordiazepoxide-treated, and control(no specific medication) groups. We compared the incidence rates of DT in the three groups. Results : Total incidence rate of DT was 30.5%(18 of 59 patients). There were 6 DTs of 18 patients(33.5%) in nimodipine-treated group, 4 of 21 patients(22.5%) in chlordiazpoxide-treated group, and 8 of 20 patients(44.0%) in control. Conclusion : The control group(44.0%) showed the highest incidence rate of DT. And nimodipine-treated(33.5%) and chlordiazepoxide-treated group(22.5%) were followed. However, this result failed to demonstrated statistically significant differences due to small numbers size.

금 합금 보철물의 교합면 삭제로 인한 임플란트-골 계면으로의 열전달에 관한 연구

조재영,강선녀,정창모,윤미정,허중보,전영찬 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.1

연구 목적: 임플란트-골 계면에서 발생하는 과도한 열은 골유착을 저해하여 임플란트의 실패를 유발한다. 이에 이번 연구에서는 임플란트 금 합금 보철물의 교합면 삭제시 임플란트-골 계면으로의 열전달 양상과 냉각 방식의 효율성을 알아 보고자 하였다. 연구 재료 및 방법: 온도 감지 장치 제작을 위하여 Internal cone 연결형태의 임플란트에 16개의K형 열전대를 부착하여 아크릴릭 레진에 포매하였다. 치과용 금 합금과 주조용 abutment를 사용하여 교합면에 3개의 요철을 가지는 시편을 10개 제작하였고, 연결 나사를 이용하여 임플란트와 연결한 뒤 온도 감지 장치를 37℃로 유지되는 수조에 위치시켰다. 저속 핸드피스와 green stone bur를 이용하여 30초 동안 보철물의 요철을 삭제하였는데, 무냉각군, 공기 냉각 군, 물 분사 냉각 군으로 나누어 요철을 삭제하였다. 보철물이 삭제 되는 동안 임플란트의 부위별로 온도가 0.05초 간격으로 기록되었고, 삭제를 멈춘 뒤에도 무 냉각 군의 경우 임계 온도인 47℃ 이하로 온도가 하강할 때까지, 공기 냉각군과 물 분사 냉각군의 경우 삭제 중단 후 30초 동안 추가로 온도를 기록하였다. 냉각 방식에 따른 임플란트-골 계면의 온도를 알아보고, 임플란트의 부위별 온도변화의 유의차를 알아보기 위하여 one-way ANOVA를 실시하였고, Turkey HSD 이용하여 95% 유의수준에서 사후 검증하였다. 결과: 무 냉각 군은 임플란트-골 계면의 온도가 47℃ 이상으로 상승하였으며, 임플란트의 경부에서 유의하게 높은 열이 측정되었다(P>.05). 공기냉각군과 물분사 냉각군은 임플란트-골 계면의 온도가 47℃ 이하로 유지되었다. 무 냉각 군에서 임플란트 경부의 온도가 47℃에 도달되는 데는 약 10.8 ± 1.5초가 소요되었다. 공기 냉각 군과 물 분사 냉각 군 사이에서는 임플란트-골 계면 온도의 유의차가 없었다(P>.05) 결론: 이상의 결과로부터 임플란트 금 합금 보철물의 교합면 삭제 시, 임플란트 주위 조직에 위해를 가할 수 있는 임계 온도 이상의 열이 발생했음을 알 수 있었으며, 냉각방식은 공기 냉각과 물 분사 냉각 모두 효과적이라고 생각된다. PURPOSE. The purpose of this study was to analyze temperature change along the implant-bone interface induced by grinding the occlusal surface of implant gold prosthesis and to compare the temperature generated by grinding of prosthesis with different cooling methods. MATERIALS AND METHODS. The experimental gold prostheses were fabricated with dental gold alloy and castable abutment. The prostheses had 3 cylindrical protrusions on the occlusal surface with 1mm in height. Temperature was measured using 16 thermocouple wires attached to the implant fixture surface and the fixture was embedded in an acrylic resin block inside the 37℃ water bath. Cylinders were grinded for a period of 30 second with a low-speed handpiece with green stone point. One cylindrical protrusion was grinded without cooling, the second one was grinded with air blow, and the third one was grinded with water-spray. RESULTS. The mean maximum temperature was measured more than 47℃ of the implant and the maximum temperature was measured at the cervical portion of the implant in the group without cooling. There was statistically significant difference between the group without cooling and the groups with cooling (P<.05). However, there was no significant difference at all portion of implant in the groups with cooling (P>.05). CONCLUSION. The results of this study support that the grinding of implant gold prosthesis without cooling may damage the peri-implant tissue. The continuous use of air blow and water-spray adjacent to prosthesis during the grinding of implant gold prosthesis may prove to be beneficial for cooling of the implant.

Continuous Wave of Condensation Technique으로 근관충전시 치근면 온도상승 분석

김영주,황윤찬,김선호,황인남,최보영,정영진,정우남,오원만 전남대학교 치의학연구소 2003 구강과학 Vol.15 No.4

This study was conducted to evaluate safety to the supporting tissues of the root while the root canal is obturated using continuous wave of condensation technique. A extracted maxillary central incisor was prepared for repeated canal obturation. After conventional access opening, working length was then established to the point 1㎜ from anatomical root apex. The root canal was prepared with GT rotary Ni-Ti file (Dentsply Maillefer, Switzerland). Five thermocouples (Onega Engineering Inc., USA) were placed at 2㎜ increments on one side beginning 1㎜ from the anatomical root apex and the other five thermocouples at 2㎜ increments on the other side beginning 2㎜ from it. For obturation, a nonstandardized medium size gutta-percha cone and a ML Buchanan plugger (Analytic technologies, USA) were selected. After drying of root canal, AH 26 root canal sealer (Dentsply Detrey, Germany) was applied on the wall of the root canal. Baseline temperature was measured on the root surface. The ML size plugger was preheated for 2seconds and then the real temperature of it was recorded before insertion into the root canal. The root canal was obturated with continuous wave of condensation technique as described by Buchanan. The root surface temperature was recorded during obturation and it was performed ten times at each of the following temperature settings: 150℃, 200℃, 250℃ and 300℃. After completion of the temperature recording, the dentinal-cementum thickness at each sites where thermocouples were attached was measured. The data were analyzed using one-way ANOVA followed by Scheffe's test and linear regression test. The results were as follows. 1. When the temperature was set at 150℃, 200℃, 250℃ and 300℃ on the digital display of System B HeatSource, the real temperature of the plugger at the 1㎜ point from the tip revealed 130.82±2.96℃, 158.00±5.26℃, 215.92±6.91℃ and 249.88±3.65℃ respectively. 2. The position of 8 ㎜ from the anatomical apex showed the highest temperature increase at each temperature settings and it was significantly higher than those of other positions (p<0.01). The temperature rise was constantly increased toward coronal portion from apex of the root. 3. The maximum temperature increase on the root surface was 2.37±0.09℃ at 150℃ setting, 3.11±0.12℃ at 200℃ setting, 3.93± 0.09℃ at 250℃ setting and 5.69± 0.15℃ at 300℃ setting. These results suggest that it be relatively kind to the supporting tissues of the root that the root canal is obturated using continuous wave of condensation technique at 150℃, 200℃, 250℃ and 300℃ temperature settings on digital display of System B HeatSource.

RAPD법을 이용한 양파품종(Allium cepa L.)간의 유전변이와 유연관계분석

양보경,김도훈,이영병,남재성,정순재 동아대학교 농업생명과학연구소 2001 農業生命資援硏究 Vol.10 No.1

This study was carried out to investigate genetic variation and relationships among onion varieties, Allium cepa L., by RAPD-PCR analysis. In the test of 120 primers with 58 onion varieties collected from local and abroad, eight primers turned out to be useful for further analysis. These primers eventually provided a total of 71 bands, consisting of 68 polymorphic and three monomorphic ones. The polymorphic bands were subjected to phylogenetic analysis using NTSYS and PAUP computer programs. In the NTSYS analysis, similarity coefficient of the 58 onion varieties ranged from 0 to 0.9179 and that of 27 varieties with obvious origin ranged from 0.0306 to 0.9032, The dendrogram of 58 varieties obtained by NTSYS analysis resulted in 15 groups, but overall groupings were not consistent with bulb phenotypes (e.g., color, weight, and shape) or origin of the varieties either In the PAUP analysis, genetic divergence of the 58 onion varieties ranged from 0.042 to 0.532 and that of 27 varieties with obvious origin ranged from 0.042 to 0.394. Phylogenetic analysis using PAUP revealed 13 group with 58 varieties and nine group with 27 varieties, but these were not consistent with any bulb phenotypes or origin either, as seen in the NTSYS analysis.

CT flouroscopy를 이용한 중재적 시술의 유용성

전혜정,박정희,서보경,박상우,신현준,최영철,한혜승,이창희 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

Conventional CT-guided needle localization has been reported many times, but a few reports of interventional procedures by using multidetector CT scan with CT-fluoroscopy have been described. We presented 36 cases of CT-fluoroscopy guided interventional procedures focusing on the puncture technique. Two cases of small pneumothorax and one case of pulmonary hemorrhage out of 2lcases after lung biopsy, were not needed any treatments We can easily and accurately access to the lesion by using CT-fluoroscopy and unique our marker system.

제2형 당뇨병 환자에서 우연히 발견된 기종성 방광염 1례

박보민,김윤정,이영태,노정현,권수경,김동준,고경수,이병두,임경호,이순희,박정현 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Emphysematous cystitis is an uncommon disease in which bacterias produce gas within the bladder wall and surrounding tissue. Patients with diabetes, neurogenic bladder and chronic urinary tract infection are predisposed to the disease. It is usually caused by E.coli and Klebsiella. Severity of illness ranges from an asymtomatic condition to life threatening cystitis. Succesful management depends on early diagnosis with correction of underlying causes, administration of appropriate antibiotics, establishment of adequate bladder drainage and surgical excision of involved tissue when required. We report a case of 52-year-old woman who did not compain of symtoms of cystitis but epigastric pain, nausea, and vomitting. Emphysematous cystitis was revealed on the abdominal X-ray series incidentally. CT scans of the pelvis showed mottled gas bubble within the bladder. After treatment, the symtoms subsided and plain abdominal film showed no evidence of gas shadow in the pelvic cavity.

저압 나노여과 공정에서의 유해성 유기물질의 거동

오정익,이석헌,이보영 대한상하수도학회 2004 상하수도학회지 Vol.18 No.2

Behavior of hazardous organic compounds including bisphenol A, phtalic acid, and phosphoric acid in low pressure nanofltration process were investigated. In the case of NTR729HF, rejection of all target organic compounds except 2-H-Benzothiazol and 2-isopropyl phenol was more than 90%. The lowest rejection for 2-H-Benzothiazol was observed in another membranes. The UTC60 and UTC20 showed similar rejection characteristics of hazardous organic compounds. Although the rejection of Bisphenol A, n-buthyl benzenesulfoneamide, N-ethyl-p-toluensulfonamide, 2-H-benzothiazol, p-t-butylphenol and 2-isopropyl phenol was less than 30%, the rejection of tribuiyl phosphate, triethyl phosphate, camphor, 2,2,4 trimethyl 1,3 pentandiol and diphenyl amine was more than 90% in the case of UTC60 and UTC20. The rejection characteristics of various hazardous organic compounds were converted into one parameter Ks, which was proposed in the diffusion-convection model. The Ks of hazardous organic compounds were discussed by comparing with their solute size represented by Stokes radius. The diffusion convection model considering Ks was successful to interpret rejection characteristics of hazardous organic compounds by low-pressure nanofiltration membranes.