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      • Mirizzi 증후군의 변형된 분류와 치료

        김형철,강길호,채만규,김성용,백무준,이문수,박상흠,이문호,김창호,송옥평,조무식,박희주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

        Purpose : The Mirizzi syndrome is relatively rare and preoperative diagnosis of this disease is difficult. In 1978, Morelli suggested the subclassification of the Mirizzi syndrome into acute or chronic form. We experienced 5 cases of acute form. We analysed clinical features, preoperative radiologic findings and operative findings of 18 cases including acute forms which were diagnosed as Mirizzi syndrome and should suggest the modified classification of Mirizzi syndrome for choice of appropriate treatment. Method : From January 1995 to December 1998, 18 cases, of which 8 cases were diagnosed at Soonchunhyang University Chunan Hospital, and 10 cases were reported in the Korean Journal were retrospectively analysed with regard to clinical features, preoperative radiologic findings and operative findings. According to the clinical features, whole cases were divided into type Ⅰ(acute form) and type Ⅱ(chronic form) and then each type of cases were subclassified according to preoperative radiologic findings and operative findings. Results : Of 18 cases there were 5 cases in type Ⅰ(27.8%), 13 cases in type Ⅱ(72.2%). Type Ⅱb was most common. Type Ⅰa cases were treated only with cholecystectomy. We applied cholecystectomy, T-tube choledochostomy and patch technique in type Ⅰb and thpe Ⅰc cases. Cholectystectomies including removal of gallstones and internal drainage procedures were done in type Ⅱ chronic forms. Conclusion : The acute form(Type Ⅰ) of Mirizzi syndrome was suggested by Morelli might be subclassified into typeⅠa,Ⅰb and Ⅰc following the presence of the necrotic defect in common hepatic duct. Through the modified classification of Mirizzi syndrome based on clinical feature, preoperative radiologic findings and operative findings, we can choice appropriate treatment.

      • 학생청소년의 불안성향과 문제행동 유형간의 상관분석

        김헌수,이재우,나철,김영돈,김민호,김은희,권지란,박광식,이길홍,민병근 중앙대학교 의과대학 의과학연구소 1987 中央醫大誌 Vol.12 No.4

        The purpose of the present study was to examine the relationship between their problem behavioral pattern and anxious trends among Korean student adolescent. Zung's measurement of anxiety level undergone through used of the self-rating anxiety scale. the data were collected through the questionaire survey which was conducted on Dec.1, 1983. Subjects served for this atudy consisted of 1,404 syudents in Korea, randomly sampled from Korean student population by means of census method. The data were analysed by CDC-174 computer of KAIST, using SPSS pogram. Statistical methods empoyed were χ^2 test and Eta measures. the results of this study were as follows. 1. It showed that students psychological anxious trends had greatest significant correlation with adolescent student's problem brhavioral pattern, but the cardiovascular, respiratory, gastrointestional and genitourinary anxious trends has not significantly related with student's problem behavioral pattern. 2. Students group with undersocialized aggressive, undersocialized nonaggressive,undersocialized school-norm avoidant, or socialized nonaggressive behavioral patterns were less anxious, whereas those with socialized latent aggressive, socialized sexual, or socialized modellong behavioral patterns were higher anxious.

      • KCI등재
      • 만성 경막하혈종의 단순 천공 배액술후 재발 및 두개강내 합병증 발생과 관련된 요인

        김영규,민경수,이무섭,김동호,복원길,홍석기,김호재 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.2

        연구목적: 만성 경막하혈종은 두개골 천두술및 혈종배액으로 쉽게 치료될 수 있는 예후가 양호한 질환으로 알려져 있으나, 혈종의 재발 및 합병증이 드물지 않게 발생하기도 한다. 본 연구는 두개골 천두술 및 혈종배액으로 치료받은 102예의 만성 경막하혈종 환자들을 분석하여 혈종의 재발 및 수술후 합병증과 관련된 요인들을 분석하고자 하였다. 대상 및 방법: 만성 경막하혈종으로 진단되어 두개골 천두술 및 혈종배액술법으로 본원 신경외과에서 수술치료받은 102명의 환자를 대상으로 하였고, 입원진료기록 및 방사선소견을 후향적으로 분석하였다. 재발 및 합병증의 발생과 관련된 요인으로는 수술전 환자의 나이, 의식상태, 양측성여부, 뇌실질의 위축정도, 수술후 기뇌의 양, 전신질환여부에 대하여 분석하였다. 결과: 재발의 빈도는 9.8% 였으며 재발과 관련된 요인으로는 양측성, 고령, 수술후 뇌실질재팽창정도(뇌 실질위축, 잔여수액, 기뇌)가 관계가 있었으나 환자의 예후에는 영향이 없었다. 합병증의 종류에는 수술후 급성출혈 5예 및 경막하 농양 1예가 있었으나 이는 모두 출혈성전신질환 또는 면역결핍증이 동반된 환자에서 발생하였고 예후가 불량하였으며, 긴장성 기뇌가 1예발생 하였다. 결론: 전신질환의 동반여부가 합병증의 발생 및 환자의 예후에 가장 중요한 영향을 미쳤으며, 비록 예후에는 영향이 적으나 혈종의 재발의 빈도가 드물지 않으며 기뇌의 방지 및 배액방법의 개선으로 재발의 빈도를 줄일 수 있을 것으로 생각된다. Purpose : Most of chronic subdural hematomas(SOH) are amenable disease with simple cranoistomy drainage, but the recurrence of SDH or development of complications after surgery is not uncommon. To see the prognostic factors related to outcome the recurrence of chronic subdural hematoma and development of complication were analysed in 102 cases of chronic SDH after craniostomy drainage. Materials and Methods: We studied 102 chronic SDH patients treated with craniostomy drainage. Clinical and radiological records were reviewed retrospectively. We analysed the recurrence and complication rate, factors related to the development of recurrence and complications. Results: The rate of recurrence of chronic SDH was 9.8% and factors related to recurrence were bilaterality, old age, and postoperative intracranial environments for brain reexpansion(degree of brain atrophy, amount of residual fluid, amount of intracranial air). Intracranial complications after surgery were developed in 7 cases(6.9%), 5 postoperative bleedings, 1 tension pneumocephalus, 1 subdural empyema. Conclusion : Preoperative clinical condition and association of serious sytemic disease were of major importance in prognosis. The recurrence of chronc SDH was not uncommon, Even though the recurrence was not related to the outcome, great care should be paid on the patients with high risk group.

      • KCI등재후보

        골아세포 MC₃T₃-E₁의 증식과 기능에 Insulin Like Growth Factor Ⅰ, Ⅱ 및 부갑상선 호르몬이 미치는 영향

        윤현구,정호연,양인명,김성운,김진우,김광원,김영설,최영길,서광식 대한내과학회 1992 대한내과학회지 Vol.42 No.1

        MC₃T₃-E₁골아세포군을 이용하여 IGF-Ⅰ과 Ⅱ를 투여하고 DNA합성과 골아세포기능을 측정하기 위해 PTH에 대한 C-AMP반응정도, alkaline phosphatase 활성도를 측정하여 다음과 같은 결과를 얻었다. 1) IGF-Ⅰ과 Ⅱ는 모두 DNA합성이 어느 농도까지는 증식효과를 나타내지만 그 이후에는 억제되는 양상을 보였다. 2) PTH에 대한 골아세포의 C-AMP반응으로 증가되었지만 IGF-Ⅰ과 Ⅱ의 투여시 농도변화에 따른 의미있는 변화는 없었다. 3) 본 실험의 조건에서 alkaline phosphatase 활성도는 증가되지 않았다. 이상의 결과로 MC₃T₃-E₁ 골아세포에 IGF-Ⅰ과 Ⅱ는 세포의 증식을 자극하여 PTH는 C-AMP생성을 촉진하는 효과가 있었다. The effect of insulin-like growth factor (IGF) Ⅰ and Ⅱ on cloned MC₃T₃-E₁ cells that had osteoblastic activity was examined by [³H] thymidine incorporation into DNA, cyclic AMP responsiveness to parathyroid hormone (PTH), and alkaline phosphatase activity. IGF Ⅰ and Ⅱ stimulated the growth and proliferation of osteoblastic cells at 20ng/㎖ and 50ng/㎖, respectively. We next examined the effect of IGF-Ⅰ and Ⅱ on the expression of osteoblastic activity. Adenylate cyclase response of PTH to IGF-Ⅰ and Ⅱ-treated cells showed maximal stimulation at 10 and 50㎚PTH, respectively, but IGF Ⅰ and Ⅱ induced limited activity of osteoblastic function. In conclusion, IGF-Ⅰ and Ⅱ were potent stimulators to the growth of osteoblastic cells but did not have an immediate effect on expression of osteoblastic function in this experiment.

      • 색과 향의 첨가에 따른 콩나물의 기호도 조사

        김학윤,박영호,허상선,이인중,신동현,김길웅 경북대학교 농업과학기술연구소 2000 慶北大農學誌 Vol.18 No.-

        Preferences on the change of color and aroma of soybean sprout was surveyed. Negative response of 'bad' or 'very bad' on pink (72%), red (60%), and green (44%) coloring was obtained. However, yellow coloring showed about 55% of positive response of 'good' or 'very good'. Thus yellow is the only color which received highly positive response among altered-color soybean sprouts. Significantly different result was observed when various aroma was added to soybean sprout. 80% of peanut scent-added soybean sprout and 76% of melon scent-added soybean sprout received positive response of 'good' or 'very good' while only 20% of the reponse was negative. In conclusion, altering color to yellow and addition of peanut scent or melon scent could increase the general preference of soybean sprout.

      • U.unicinctus 웅성(雄性) 배아세포(胚芽細胞)의 체세포적 기원과 Diffuse 정자 완성과정

        김호진,김완종,신길상 순천향대학교 기초과학연구소 2001 순천향자연과학연구 논문집 Vol.7 No.1

        The cellular components of U. unicinctus coelomic fluid are prepared to study seasonal differentiation of the cells and examined on electron microscope. Under various types of cells, coelomic sperm ball(CSB) have been observed. CSBs are composed of a somatic cell and innumerable spermatids along the somatic cell membrane. The somatic cell membranes are enlarged to form membranous structures which are resemble with exocytotic vesicles. In the vesicle, spermatids nucleus, acrosome, proximal and distal centrioles and not yet fully elongated flagellum have been identified. It seems likely that the spermatids are produced from the somatic cell which secretes the vesicular contents through a process exactly resemble with exocytosis of a secretory cell. It was observed that the organelles as well as the germ nucleus are also supplied from the somaic cell of CSB, which mean the unit of male germ cell production is the somatic cell. There are numerous CSBs floating in the coelomic fluid of U. unicinctus, and it was a conclusion in this work that U. unicinctus performs a diffuse spermatogenesis. The observed origin of male germ cell in U. unicinctus can be compared with the theories on the origin of germ cells, somatic cell origin vs germ plasm origin. In U. unicinctus, spermatic are arises from the somatic cell. The somatic cell engaged itself to produce many male germ cells, and can not be differentiated itself into a male germ cell. Thus, on the origin of germ cell, the conceptual and structural differences between the previous theory of somatic origin of germ cell and CSBs are reported and discussed in consideration of origin of male germ cells in U. unicinctus. Key words: Germ cell, Somatic origin, Sperm ball, Exocytosis, Diffuse spermatogenesis

      • KCI등재후보

        성장기 여아에서 첫째 및 셋째 수지 지절 변화와 초경시기

        김경호,최광철,정길용 대한치과교정학회 2002 대한치과교정학회지 Vol.32 No.4

        성장기 환자의 발육 상태를 나타내는 여러 지표 중 수완부 골성숙도와 초경시기가 유용하게 사용될 수 있으며 수완부 골성숙도에서는 첫째와 셋째 수지의 변화가 비교적 중요한 의미를 가지고 있다. 이에 본 연구에서는 첫째 수지 및 셋째 수지의 지절 변화와 초경 및 부정교합과의 연관성을 조사하기 우해, 성장기여아 중 Ⅰ급 부정교합자 29명, Ⅱ급 부정교합자 27명, Ⅲ급 부정교합자 27명을 대상으로 약 6개월 간격으로 모지척측종자골 출현 전부터 수지 지절의 융합이 거의 이루어지는 시기까지 누년적으로 촬영한 수완부골 방사선 사진과 초경시기를 평가하여 다음과 같은 결론을 얻었다. 1. 부정교합에 따른 골성숙도의 차이는 없었다. 2. 부정교합에 따른 초경연령의 차이는 없었으며, 초경의 평균 연령은 12.30±0.98세였다. 3. 모지척측 종자골 출현은 10.35±1.01세, 첫째 수지의 원심부 지절에서 capping단계는 11.26±1.04세, 융합시기는 13.12±1.06세이고 셋째 수지의 중간 지절의 capping은 11.57±1.02세 융합은 13.72±1.01세에 일어났다. 4. 초경은 첫째 수지 원심부 지절의 융합이 진행되는 시기와(p<0.001, r=0.82), 세째 수지 중간 지절의 융합이 시작되는 시기와(p<0.001, r=0.78) 비슷한 시기에 나타났다. 이상의 결과로 첫째 또는 셋째 수지 지절 변화만으로 성장기 여아에서의 발육상태를 평가할 때 도움을 줄 수 있음을 알 수 있었다. Among many maturation indicators of growing patients, menarche and skeletal maturity are useful to assess growth and development, and the changes of the first and third finger are relatively important in hand-wrist X-rays. The objective of this study was to evaluate the relation between menarcha and the changes of the phalanx of the first and third finger and compare skeletal maturation among different malocclusion types. The sample used in this study was 29 Class Ⅰ, 27 Class Ⅱ and 27 Class Ⅲ females whose hand-wrist X-rays had been taken with 6 month interval before the appearance of ulnar sesamoid ossification till the phalanges of the fingers were almost fused. The results were as follows. 1. There was no skeletal maturity difference among malocclusion types. 2. There was no difference in the mean chronologic age of menarche among different malocclusion type and that was 12.30±0.98 years. 3. The ulnar sesamoid was observed at 10.35±1.01 years, and distal phalanx of the first finger, epiphyseal capping appeared at 11.26±1.04 years and fusion at 13.12±1.06 years. The epiphyseal capping on middle phalanx of the third finger was observed at 11.57±1.02 years and fusion at 13.27±1.04 years. 4. The timing of menarche occurred around the same time as the fusion process of distal phalanx of the first finger(p<0.001, r=0.82) and the initiation of fusion of middle phalanx of the third finger(p<0.001, r=0.78). Therefore, we can give the aid when we evaluate the growth and development of growing females seeing the changes at phalanx of the first and third finger.

      • 토끼 정세포의 Manchette α-Tubulin과 항 생쥐 IgG-금 입자(10mm)의 면역 반응

        김호진,김완종,신길상 순천향대학교 기초과학연구소 1999 순천향자연과학연구 논문집 Vol.5 No.1

        The spermatids of rabbit are investigated to identify α-tubulin of axoneme microtubules using mouse monoclonal anti-α-tubulin as the first antibody(Ab) and gold(10nm) conjugated goat anti-mouse IgG as the Ad marker. The Ag-Ab reaction analyzed the localization of α-tubulin and the gold particles incorporated with the proximal and distal centrioles, manchette microtubules and flagellum. However, much more gold particles are incorporated with the spermatid nucleus rather than flagellum and centrioles, especially at the near of vacuoles or ring of spermatid nucleus. This was unexpected because it is already well known that the α-tubulin is one of quantitative dimeric substance of flagellum. The results reveal immunologically the α-tubulin is one of composition of manchette microtubules, which are involved in nuclear morphogenesis in rabbit spermatid. The spermatids at the stage are at a final morphogenic stage with a long conical form of nucleus(500×5000nm). The relation of length to width of nuclear proximal base is about 10 : 1 and acrosome is already formed. The less incorporation of gold particles in number to the flagellum is char-acteristic and discussed.

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